The Wheel-Shaped Composite Cartilage Graft for Type 1 Tympanoplasty: Comparison with Palisade and Island Cartilage Graft

xlomafota13 shared this article with you from Inoreader The Wheel-Shaped Composite Cartilage Graft for Type 1 Tympanoplasty: Comparison with Palisade and Island Cartilage Graft Via Otolaryngology Indian Abstract This study aims to compare the graft success and hearing results of the palisade and island cartilage graft, with wheel-shaped composite cartilage graft (WsCCG) for type 1 tympanoplasty. The study was designed retrospectively. Only patients with conductive hearing loss and simple pars tensa perforation of the tympanic membrane were included in the study. Pure tone average (PTA), air–bone gap gain (ABG), word recognition score (WRS), ABG closure and grafts success were compared between the graft groups. Records of 111 patients were analyzed. The graft success rate was 89.7% for palisade cartilage graft (PCG, n = 39), 86.1% for island cartilage graft (ICG, n = 36), and 97.2% for wheel-shaped composite cartilage graft (WsCCG, n = 36) (p = 0.244). Average postoperative PTA and ABG values were significantly affected by the cartilage graft type, but WRS was not affected. (p = 0.005, 0.019, 0.306, respectively, One Way-Anova te st). Post-Hoc LSD test showed a statistically significant decrease in PTA and ABG averages for WsCCG group compared to the ICG group (p = 0.004; CI%95 = 15.1–2.2 dB and p = 0.023; CI%95 = 8.2–0.4 dB, respectively). Postoperative PTA and ABG averages for WsCCG and PCG groups were similar (p = 0.069 and p = 0.053, respectively). In addition, while there were 2 (5.1%) retractions in the PCG group and 1 (2.7%)in the ICG group, there was no retraction in the WsCCG group. The WsCCG provided comparable results with classical reliable graft techniques (PCG and ICG) and may recommend as a more suitable graft due to hearing results and resistance against retraction. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcome of Universal Neonatal Hearing Screening Programme at a Tertiary Care Centre: A Prospective Study

xlomafota13 shared this article with you from Inoreader Outcome of Universal Neonatal Hearing Screening Programme at a Tertiary Care Centre: A Prospective Study Via Otolaryngology Indian Abstract Hearing is an important sense organ for human beings essential for speech, language and overall development. Universal neonatal hearing screening programmes are mandatory in many developed countries. In India out of 1000 neonates approximately 5–6 infants are diagnosed with hearing impairment but still universal neonatal hearing screening programme is in its infancy. To screen all neonates delivered at our centre in three years, with secondary objective of determining the significance of risk factors with neonatal hearing loss and to provide appropriate intervention following the detection of a permanent hearing impairment. It is a non-randomised prospective cohort study conducted at a tertiary care centre to screen all neonates born between Jan 2017 and Dec 2019 with 2 stage protocol using distortion product otoacoustic emission and auditory brainstem response. The study population was also divided into two groups, ''at risk'' and ''no risk'' g roups to determine the significance of risk factors on neonatal hearing loss. Total 2676 neonates were screened, OAE referral rate was 1.53%. There was a 94.12% follow up. The incidence of hearing impairment was found to be 7 per 1000(In the "no risk" group, 2.9 per 1000 and in the "at risk" group, 41.38 per 1000). Statistically, a significant difference was found in the incidence of hearing impairment between the two groups (p < 0.05, chi-square Test). Hospital based universal hearing screening of new born before discharge is feasible at a tertiary care centre. A high incidence of 0.7% congenital hearing impairment warrants universal newborn hearing screening programme. Considering the limitations and infrastructure in India, we should at least employ screening for all high risk neonates. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Salvaging Cochlear Implant After Suspected Biofilm Infection: Our Experience

xlomafota13 shared this article with you from Inoreader Salvaging Cochlear Implant After Suspected Biofilm Infection: Our Experience Via Otolaryngology Indian Abstract We describe a novel procedure using betaine surfactant and polyhexanide for biofilm in cochlear implants. Early intervention along with wound debridement, double layer vascularized flap and rifampicin helps in salvaging the implant. Leaving the array in cochlea avoids fibrosis and can be considered for cochlear implantation at a later stage. This novel procedure significantly limits morbidity and repeated surgeries. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correlating Nasal Patency with Obstructive Sleep Apnea in Obese Versus Non-Obese Patients: An Acoustic Rhinometry Study

xlomafota13 shared this article with you from Inoreader Correlating Nasal Patency with Obstructive Sleep Apnea in Obese Versus Non-Obese Patients: An Acoustic Rhinometry Study Via Otolaryngology Indian Abstract The aim of this study was to correlate nasal patency with Obstructive Sleep Apnea (OSA) in obese versus non-obese patients using Acoustic Rhinometry (AR). Eccovision® Acoustic Rhinometer equipment was used to compare nasal cross-sectional areas (CSA1,2 & 3 corresponding to nasal valve region, anterior portion of middle & inferior turbinate and posterior portion of middle & inferior turbinate respectively) and volume in age and gender matched sample divided into three groups: Group 1: Non-obese patients without OSA (25 patients, 13 males and 12 females); Group 2: Non-obese patients with OSA (25 patients, 14 males and 11 females); Group 3: Obese patients with OSA (25 patients, 13 males and 12 females). The mean nasal cross-sectional areas and volume were lower in Group 2 compared to Group 1 but statistically non-significant (P value > 0.05 for all). The mean nasal cross-sectional areas and volume were significantly lower in Group 3 as compared to Groups 1 and 2 (P value < 0.05 for all). BMI showed a statistically significant positive (direct) correlation with AHI in Groups 2 and 3 (P value < 0.05 for both). The nasal cross-sectional areas and volume showed a statistically significant negative (inverse) correlation with AHI in Groups 2 and 3 (P value < 0.05 for both). OSA diagnosed cases with high BMI may not present with an obvious nasal obstruction; the nasal patency may still be compromised due to reduced nasal lumen secondary to obesity. AR, being cost-effective and non-invasive modality; is advocated to evaluate pre-treatment nasal patency, as well as follow up evaluation to ascertain improvement after the intervention. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Maxillofacial Infections in Covid-19 Era—Actuality or the Unforeseen: 2 Case Reports

xlomafota13 shared this article with you from Inoreader Maxillofacial Infections in Covid-19 Era—Actuality or the Unforeseen: 2 Case Reports Via Otolaryngology Indian Abstract In this era of the COVID-19 pandemic, patients with diabetes mellitus are at an increased risk of secondary infections and systemic complications. Here we are reporting 2 cases in post-covid-19 patients, who were uncontrolled type 2 diabetics and diagnosed with fungal osteomyelitis and mucormycosis respectively. Both patients were treated surgically immediately. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic endonasal surgery during COVID-19 pandemic: management guideline

xlomafota13 shared this article with you from Inoreader Endoscopic endonasal surgery during COVID-19 pandemic: management guideline Via Sociedad Luso-Española de Neurocirugía Neurocirugia (Astur). 2021 Apr 20. doi: 10.1016/j.neucir.2021.03.007. Online ahead of print. ABSTRACT Current SARS-CoV-2 coronavirus pandemic is challenging medical and surgical activities. Specifically, within neurosurgery, endoscopic endonasal approaches pose a high risk of contagion for healthcare personnel involved in it. Initially, the recommendation was to avoid such surgeries. However, the pandemic has dragged on and new solutions must be proposed to continue carrying out these approaches safely. Given the lack of established protocols, we propose the following one, which concisely establishes the measures to be taken in both urgent and scheduled surgery. In addition, a new protection-aspiration device (Maskpirator) is described. PMID:33994775 | PMC:PMC8057759 | DOI:10.1016/j.neucir.2021.03.007 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Persistent sciatic artery: A case report and literature review

xlomafota13 shared this article with you from Inoreader Persistent sciatic artery: A case report and literature review Via Sociedad Luso-Española de Neurocirugía Neurocirugia (Astur). 2021 May 13:S1130-1473(21)00048-8. doi: 10.1016/j.neucir.2021.03.006. Online ahead of print. ABSTRACT The persistent sciatic artery is an uncommon disease, considered an axial congenital vascular malformation due to the lack of involution of the sciatic artery during embryonic development. It may be associated with abnormalities in the development of the iliac, common femoral and superficial femoral arteries. Patients may be asymptomatic, or they could present chronic pain, such as sciatic neuralgia, caused by nerve damage, since it is close to the abnormal persistent vessel, or due to ischemic pain, as a result of a thrombosis or embolism of an aneurysm, which could compromise the viability of the limb. PMID:33994283 | DOI:10.1016/j.neucir.2021.03.006 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intramedullary pancreatic adenocarcinoma metastasis: The first case in literature

xlomafota13 shared this article with you from Inoreader Intramedullary pancreatic adenocarcinoma metastasis: The first case in literature Via Sociedad Luso-Española de Neurocirugía Neurocirugia (Astur). 2021 May 13:S1130-1473(21)00046-4. doi: 10.1016/j.neucir.2021.03.005. Online ahead of print. ABSTRACT BACKGROUND: Pancreatic cancer is a common gastrointestinal malignancy, and is often associated with a poor prognosis. Although liver is generally seen as a distant metastasis point, it has been shown that it can metastasize to any organ, especially the gastrointestinal tract, and approximately 0.3% of metastases are observed in spinal cord. CASE DESCRIPTION: We report a 36-year-old woman with a prior history of pancreatic adenocarcinoma who presented to us with a thoracic intramedullary lesion and recent onset of neurological deficits. She underwent surgery with histological confirmation of a diagnosis of metastatic adenocarcinoma. CONCLUSION: To our knowledge there is no prior report of pure intramedullary spinal cord metastasis from a pancreatic adenocarcinoma in the literature. We report the present patien t in view of the rarity of intramedullary spinal cord metastasis and its clinical significance. Although intramedullary metastases are rare, they should be investigated in every patient with malignancy and progressive neurological deficit. While its general prognosis is poor regardless of the type of treatment, early diagnosis and treatment is important in terms of quality of life and survival. PMID:33994284 | DOI:10.1016/j.neucir.2021.03.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Perigeniculate arachnoid cysts and CSF fistulae of the fallopian canal: Histopathologic correlates of a rare clinical entity

xlomafota13 shared this article with you from Inoreader Perigeniculate arachnoid cysts and CSF fistulae of the fallopian canal: Histopathologic correlates of a rare clinical entity Via leak of cerebrospinal fluid World J Otorhinolaryngol Head Neck Surg. 2021 Jan 24;7(2):71-81. doi: 10.1016/j.wjorl.2020.12.005. eCollection 2021 Apr. ABSTRACT Cerebrospinal fluid (CSF) fistulae originating from the fallopian canal of the facial nerve is hypothesized to arise due to atypical patterns of subarachnoid space extension into the geniculate ganglion or more distal regions along the intratemporal course of the facial nerve, but its pathogenesis remains poorly understood. Although a rare etiology of CSF fistulae of the temporal bone, there are significant clinical ramifications due to the risk of recurrent meningitis, difficulty in identifying the anatomic location of the CSF leak, and technical challenges associated with surgical repair. We present three clinical cases of arachnoid cysts within the geniculate fossa with or without CSF fistulization and provide histopathologic correlates of this rare clinical phenomenon from a human temporal bone collection. The pediatric and adult patients presented suggest differential pathophysiologic mechanisms associated with CSF fistulae. Temporal bone histology reveals atypical patterns of subarachnoid space extension in the fallopian canal that may underlie arachnoid cyst formation and overt CSF leak from the geniculate region. PMID:33997715 | PMC:PMC8103539 | DOI:10.1016/j.wjorl.2020.12.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa

xlomafota13 shared this article with you from Inoreader Reducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa Via leak of cerebrospinal fluid World J Otorhinolaryngol Head Neck Surg. 2021 Mar 6;7(2):82-87. doi: 10.1016/j.wjorl.2021.01.003. eCollection 2021 Apr. ABSTRACT OBJECTIVE: To describe the procedure and results of an adapted closure and reconstruction technique for translabyrinthine surgery that focuses on identifying and managing potential pathways for CSF egress to the middle ear and Eustachian tube. METHODS: Retrospective review of a cohort of translabyrinthine acoustic neuroma cases that were reconstructed using this technique. RESULTS: In addition to meticulous packing of potential conduits using soft tissue, hydroxyapatite cement is used to seal opened air cell tracts prior to obliteration of the mastoid defect using adipose tissue. Early results of a small patient cohort using this technique are encouraging and there were no wound infections. There was a single case of CSF rhinorrhea associated with incomplete sealing of opened petrous apex cells, with no recurrence after appropriate implementation of the described protocol during revision surgery. CONCLUSION: Proactive management of potential conduits of CSF egress including opened air cell tracts has a high likelihood of reducing rates of rhinorrhea and need for revision surgery after the translabyrinthine approach to the posterior fossa. PMID:33997716 | PMC:PMC8103534 | DOI:10.1016/j.wjorl.2021.01.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

'She's sprung a leak': Significant cerebrospinal fluid leak in an infant post-lumbar puncture

xlomafota13 shared this article with you from Inoreader 'She's sprung a leak': Significant cerebrospinal fluid leak in an infant post-lumbar puncture Via leak of cerebrospinal fluid J Paediatr Child Health. 2021 May 17. doi: 10.1111/jpc.15547. Online ahead of print. NO ABSTRACT PMID:33998724 | DOI:10.1111/jpc.15547 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lessons Learned from A Case of Functional Total Laryngeal Obstruction Under Anaesthesia by Vocal Cord Polyp Managed by Vortex Approach

xlomafota13 shared this article with you from Inoreader Lessons Learned from A Case of Functional Total Laryngeal Obstruction Under Anaesthesia by Vocal Cord Polyp Managed by Vortex Approach Via Polyps Turk J Anaesthesiol Reanim. 2021 Apr;49(2):175-177. doi: 10.5152/TJAR.2021.64. Epub 2021 Apr 1. ABSTRACT Dynamic airway obstruction is a terrifying situation. Most of the time, the obstruction is intermittent. The situation becomes horrifying and panicky when this intermittent dynamic airway obstruction turns into a total laryngeal obstruction under anaesthesia. Herein, we present a case of a 56-year-old male with vocal cord polyp, who was posted for excision. The difficult airway was anticipated in view of a thick neck. He was also hypertensive and a suggestive case of obstructive sleep apnoea. The patient went to the cannot ventilate, cannot intubate, cannot oxygenate situation because of the polyp taking position between the vocal cords and completely obstructing the central airway gateway. The case was successfully managed by emergency cricothyroidotomy by following the Vortex approach but taught us a few lessons. The case shows us the re levance of clinical findings and the importance of vocal polyp as a cause of inducible laryngeal obstruction and highlights the consequences of intuition and minor lacuna in airway management. PMID:33997850 | PMC:PMC8098741 | DOI:10.5152/TJAR.2021.64 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.