Middle Ear Packing and External Ear Packing with Fibrin Glue Enhances the Success of Fat Myringoplasty without Hyaluronic Acid Disc

Significant Difference ◽

Background: To date, FM using middle ear packing has rarely reported. In this study, we hypothesized that middle ear packing with dexamethasone soaked gelfoam and fibrin glue over the fat graft could promote the success rate of TMP closure regardless of perforation size. Methods: Between January 2005 and July 2020, a total of 209 patients who underwent fat myringoplasty due to chronic TMP at tertiary referral center were encountered and analyzed. The success rate and audiologic outcome was analyzed. Results: The mean successful TM closure rate was 88.0 %. The success rate by different age generation was not significant difference. The size of the perforation grade showed no significant difference. The perforation site by anterior or posterior was not significant. The preoperative mean threshold of AC, BC and ABG were 55.71, 12.98 and 42.73 dB respectively. The postoperative mean threshold of AC, BC and ABG were 23.67, 12.98 and 10.69 dB. The change of preoperative and postoperative hearing showed statistically significant. Conclusion: From our results, the simple trimming of the perforation edge and middle ear packing with external ear canal packing using fibrin glue induced the stable adhesion between the remnant TM and the fat graft.

The Long-Term Stability of Fat-Graft Myringoplasty in the Closure of Tympanic Membrane Perforations and Hearing Restoration

ORL ◽

10.1159/000512084 ◽

2020 ◽

pp. 1-8

Author(s):

Jae Sang Han ◽

Jung Ju Han ◽

Jung Mee Park ◽

Jae-Hyun Seo ◽

Kyoung Ho Park

Keyword(s):

Tympanic Membrane ◽

Fat Graft ◽

Closure Rate ◽

Term Stability ◽

Long Term Stability ◽

Tympanic Membrane Perforations ◽

Background/Aims: This study was conducted to evaluate the long-term stability of fat-graft myringoplasty (FGM) for chronic tympanic membrane perforations, analyzing the perforation closure rate and re-gained hearing outcome with respect to the size and location of the perforations. Methods: Between August 2007 and June 2018, a total of 193 patients who underwent FGM due to chronic tympanic membrane perforation at a tertiary referral center were enrolled and analyzed. Results: The mean follow-up was 14.6 months (range 6–39). The complete perforation closure rate after FGM was 89.6%, with no statistical difference among the perforation size groups. The mean postoperative air-bone gap (ABG) was 11.0 dB and mean ABG improvement was 4.9 dB. Conclusion: Our FGM technique had a favorable tympanic closure rate for small to large perforations, and yielded relatively good hearing improvement in the mid-size perforation cases over long-term follow-up periods. According to the topographic evaluation of FGM, this procedure resulted in a reliable perforation closure rate and audiological results regardless of the perforation site.

Frequency reallocation based on cochlear place frequencies in cochlear implants: a pilot study

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-021-07245-y ◽

2022 ◽

Author(s):

Flavia Di Maro ◽

Marco Carner ◽

Andrea Sacchetto ◽

Davide Soloperto ◽

Daniele Marchioni

Keyword(s):

Cochlear Implants ◽

University Hospital ◽

Speech Discrimination ◽

Tertiary Referral ◽

Mean Values ◽

Significant Difference ◽

Before And After ◽

Cochlear Duct Length ◽

Abstract Purpose The aim of this study is to evaluate speech perception outcomes after a frequency reallocation performed through the creation of an anatomically based map obtained with Otoplan®, a tablet-based software that allows the cochlear duct length to be calculated starting from CT images. Methods Ten postlingually deafened patients who underwent cochlear implantation with MED-EL company devices from 2015 to 2019 in the Tertiary referral center University Hospital of Verona have been included in a retrospective study. The postoperative CT scans were evaluated with Otoplan®; the position of the intracochlear electrodes was obtained, an anatomical mapping was carried out and then it was submitted to the patients. All patients underwent pure tonal and speech audiometry before and after the reallocation and the audiological results were processed considering the Speech Recognition Threshold (SRT), the Speech Awareness Threshold (SAT) and the Pure Tone Average (PTA). The differences in the PTA, SAT and SRT values before and after the reallocation were determined. The results were statistically processed using the software Stata with a significance value of α < 0.05. Results The mean values of SRT (61.25 dB versus 51.25 dB) and SAT (49 dB versus 41 dB) were significantly lower (p: 0.02 and p: 0.04, respectively) after the reallocation. No significant difference was found between PTA values (41.5 dB versus 39.25 dB; p: 0.18). Conclusions Our preliminary results demonstrate better speech discrimination and rapid adaptation in implanted postlingually deaf patients after anatomic mapping and subsequent frequency reallocation.

Surgical results and factors affecting outcome in patients with fat-graft myringoplasty

Ear Nose & Throat Journal ◽

10.1177/01455613211063243 ◽

2021 ◽

pp. 014556132110632

Author(s):

Hong Chan Kim ◽

Kyeong Suk Park ◽

Hyung Chae Yang ◽

Chul Ho Jang

Keyword(s):

Success Rate ◽

Tympanic Membrane ◽

Surgical Outcomes ◽

Underlying Disease ◽

Tertiary Hospital ◽

Tympanic Membrane Perforation ◽

Fat Graft ◽

Ear Surgery ◽

Closure Rate ◽

Diabetes Status

Objectives: We evaluated the closure rate after fat-graft myringoplasty (FGM) of perforations differing in size and location. We explored whether patient’s factors and the FGM surgical technique influenced surgical outcomes. Methods: We retrospectively studied patients with tympanic membrane perforations who underwent FGM from March 2015 to March 2019. All procedures were performed by a single senior surgeon at our tertiary hospital. The patients who followed-up for at least 6 months after surgery were enrolled. We recorded hypertension and diabetes status, age, any prior ear surgery, any calcific plaques adjacent to the perforation, and perforation size and location. Results: A total of 150 patients were enrolled. Our success rate of FGM was 90%. Hypertension, diabetes, prior ear surgery history, and eardrum calcific plaques did not affect the surgical outcomes. There was no statistical difference in the surgical success rate according to the size (< 50%) or location of perforation. The closure rate was 97.2% in patients aged 1660 and 87.5% in patients aged > 60, respectively. However, FGM was successful in only two of six children (33.3%) aged ≤ 15 years, thus significantly less than in the other groups. Conclusion: FGM is a fast, safe, and efficient method for repairing tympanic membrane perforation. The surgical outcome is not significantly affected by underlying disease, perforation size or location, or by the condition of the tympanic membrane or older age. However, it may be poor in children with dysfunctional Eustachian tube.

Is Allergic Rhinitis a Factor That Affects Success of Tympanoplasty?

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2016.48 ◽

2016 ◽

Vol 59 (1) ◽

pp. 10-13

Author(s):

Elif Ersoy Callioglu ◽

A. Sami Bercin ◽

Hayati Kale ◽

Togay Muderris ◽

Sule Demirci ◽

...

Keyword(s):

Allergic Rhinitis ◽

Success Rate ◽

Middle Ear ◽

Success Rates ◽

Type 1 Tympanoplasty ◽

Significant Difference ◽

Patient Groups ◽

The Difference ◽

Graft Success

Objective: The aim of the present study was to investigate the effect of allergic rhinitis on the success of the operation in chronic otitis surgery by using score for allergic rhinitis (SFAR). Materials and Methods: In the present study; 121 patients, who underwent type 1 tympanoplasty were examined retrospectively. SFAR of all patients were recorded. The graft success rates of 26 patients with allergic rhinitis (AR) and 95 patients with no allergic rhinitis group (NAR) were compared. Results: While the graft success rate in NAR group was 89.5%, this rate was 80.8% in the AR group. However, the difference between groups was not statistically significant (p = 0.311). Conclusion: These findings suggest that allergic rhinitis decreases the graft success rate of the pathologies occurring in eustachian tube, middle ear and mastoid although statistically significant difference wasn’t found. Prospective studies with larger patient groups are required in order to evaluate this pathology.

Ureteric Stent Use - Part of the Solution and Part of the Problem

Current Urology ◽

10.1159/000447206 ◽

2017 ◽

Vol 11 (3) ◽

pp. 126-130 ◽

Cited By ~ 4

Author(s):

Victor G. Ilie ◽

Vlad I. Ilie

Keyword(s):

Infectious Complications ◽

Diabetic Patients ◽

Tertiary Referral ◽

Chronic Renal Impairment ◽

Institutional Practice ◽

Ureteric Stent ◽

Significant Difference ◽

Period Data ◽

Stent Complications

Background: The aim of the study is to comprehensively report on a single tertiary referral center experience with the use of ureteric stents, assess complication burden and determine risk factors to further inform institutional practice. Materials and Methods: The retrospectively analyzed cohorts includes 529 patients treated over a 12 months period. Data regarding details of the index pathology, stent characteristics and complications were collected retrospectively. Results: Most stents (58.9%) were used in the context of stone surgery. Stent encrustation occurred in 14.5% of patients and sepsis in 4.3%. There was a statistically significant difference between the complications of the stents removed after 90 days and the rest of the cohort. Infectious complications were more frequent in diabetic patients and in patients with chronic renal impairment. At our institution, we managed to avoid forgotten stents and catastrophic complications. Conclusion: Stent complications are the complex outcome of interplay between the foreign body and the collecting system environment, influenced by the nature and timing of surgery. Longer stent dwelling times are associated with increased complications rates, especially in patients with significant comorbidities.

Amniotic Band Syndrome: A Single-Institutional Experience

Fetal Diagnosis and Therapy ◽

10.1159/000358301 ◽

2014 ◽

Vol 37 (1) ◽

pp. 1-5 ◽

Cited By ~ 9

Author(s):

Corey W. Iqbal ◽

S. Christopher Derderian ◽

Yvonne Cheng ◽

Hanmin Lee ◽

Shinjiro Hirose

Keyword(s):

Body Wall ◽

Membrane Disruption ◽

Common Site ◽

Tertiary Referral ◽

Fetal Intervention ◽

Amniotic Band ◽

Amniotic Band Syndrome ◽

Institutional Experience ◽

Introduction: Amniotic band syndrome (ABS) is uncommon. We review our single-institutional experience to define its natural history and outcomes. Materials andMethods: We conducted a retrospective analysis from a single, tertiary referral center of patients evaluated for and confirmed to have ABS from 1997 to 2012. Results: Twenty-eight patients had confirmed ABS. The mean ± SD maternal age was 27.9 ± 5.9 years, and the mean gestational age at diagnosis was 20.7 ± 3.8 months. Oligohydramnios was reported in 4 patients. Eleven patients had membrane disruption, of whom 4 had undergone a prior percutaneous intervention. Extremities were the most common site affected (n = 20), followed by the umbilical cord (n = 7), abdomen (n = 5), limb-body wall complex (n = 5), head (n = 1), and chest (n = 1). Nine patients were felt to be candidates for fetal intervention; 5 underwent fetoscopic amniotic band lysis with 4 survivors. Overall survival, excluding 3 terminations, was 74%. There were 5 fetal demises and one neonatal death. Cord involvement was higher in nonsurvivors (67%) compared to survivors (19%, p = 0.05). Discussion: ABS most commonly involves the extremities. Membrane disruption is not always present. Fetoscopic lysis is appropriate for select patients, and special consideration should be given for cord involvement, which is associated with a worse outcome.

Laparoendoscopic Two-Site Myomectomy (LETS-M) Using Conventional Laparoscopic Instruments and The Glove-Port Technique

10.21203/rs.3.rs-129591/v1 ◽

2021 ◽

Author(s):

Pei-Chi Wu ◽

Bor-Ching Sheu ◽

Kuan-Ju Huang ◽

Su-Cheng Huang ◽

Wen-Chun Chang

Keyword(s):

Blood Loss ◽

Operation Time ◽

Intraoperative Blood Loss ◽

Experienced Surgeon ◽

Minimally Invasive Surgical ◽

Postoperative Hematoma ◽

Significant Difference ◽

The Mean ◽

Glove Port

Abstract We aim to evaluate the surgical outcome of laparoendoscopic two-site myomectomy (LETS-M). The medical records of 204 women receiving LETS-M in a tertiary referral center, including 183 surgeries performed by the experienced surgeon and 21 surgeries performed by 3 well-supervised trainees were retrospectively reviewed. The age of the participants was 39.3±6.4 years. The mean diameter of the largest myoma was 8.5±2.2 cm. The mean weight of the myomas was 281.1±183.1 g. The operation time was 97.6±40.2 min, and the intraoperative blood loss was 99.3±115.2 mL. There were 3 (1%) cases of excessive blood loss (more than 500 mL) and 2 (1%) of postoperative hematoma. The only significant difference between the experienced surgeon and trainees was the operation time (92.3±32.2 min vs. 141.2±54 min, p<.001), while the myoma number, myoma diameter, myoma weight, and intraoperative blood loss were not significantly different. The operation time did not differ among different myoma locations. In multivariate analysis, virginity, myoma number, more than 2 large myomas, and myoma size were independent variables for longer operation times. No patient experienced any major complications. The result revealed that LETS-M is a minimally invasive surgical method that is safe, effective, and easy to learn for managing uterine myoma.

Preoperative and Postoperative PROMIS and FFI Scores Based on Region of Foot Pathology and Surgery

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00389 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0038

Author(s):

Charles C. Pitts ◽

Bradley Alexander ◽

Elise M. Greco ◽

Benjamin B. Cage ◽

Spaulding F. Solar ◽

...

Keyword(s):

Physical Function ◽

Surgical Intervention ◽

Activity Limitation ◽

Foot And Ankle ◽

Pain Disability ◽

Ankle Surgery ◽

Significant Difference ◽

Patient Reported ◽

Category: Other; Ankle; Ankle Arthritis; Bunion; Hindfoot; Lesser Toes; Midfoot/Forefoot Introduction/Purpose: The Patient-Reported Outcomes Measurement Instrumentation System (PROMIS) has become increasingly utilized in orthopaedic foot and ankle surgery to assess outcomes and better understand patient function, pain, and disability. Similarly, the Foot Function Index (FFI) is used to assess pain, disability, and activity limitation. PROMIS scores have been shown to predict, preoperatively, which patients will benefit most from foot and ankle surgery from a general perspective. It is currently unknown, with regard to chronic foot pathology, which region of the foot has the greatest effect on PROMIS and FFI scores and which region is affected the most by surgical intervention. Methods: PROMIS physical function, pain index, and depression scores along with FFI scoring subsets of pain, disability, and activity limitation were retrospectively reviewed for patients at a tertiary referral center with chronic pathology in either the hindfoot, midfoot, or forefoot that underwent surgery. Scores were obtained preoperatively and at 6 weeks postoperatively, and a preoperative to postoperative difference was calculated. Once the mean of each subcategory was obtained, an analysis of variance (ANOVA) was conducted in order to compare the means and identify statistically significant differences. Significance was set at p < 0.05 and p < 0.10. Results: There was no statistically significant difference between the mean preoperative PROMIS or FFI scores in the forefoot, midfoot, or hindfoot regions. There was also no statistically significant difference between means of PROMIS or FFI categories at 6 weeks postoperatively. However, the mean pre- to postoperative differences between PROMIS physical function scores of the forefoot, midfoot, and hindfoot were statistically significantly different at 9.12, 8.16, and 2.88, respectively (p=0.037). There was no statistically significant difference between the remaining scoring categories. Conclusion: Physical function, pain, depression, disability, and activity limitation are not affected disparately by the location of chronic pathology within the foot. Surgical intervention for problems in the forefoot, midfoot, and hindfoot does not provide differences in outcomes with regard to pain, disability, depression, or activity limitation based on region. Patients who have undergone surgical intervention for forefoot or midfoot pathology may experience greater improvements in physical function postoperatively when compared to patients who have undergone hindfoot surgery. [Table: see text]

Taste and Smell Impairment in COVID-19: An AAO-HNS Anosmia Reporting Tool-Based Comparative Study

Otolaryngology ◽

10.1177/0194599820931820 ◽

2020 ◽

Vol 163 (3) ◽

pp. 473-479 ◽

Cited By ~ 17

Author(s):

İbrahim Sayin ◽

Kadriye Kart Yaşar ◽

Zahide Mine Yazici

Keyword(s):

Comparative Study ◽

Neck Surgery ◽

Negative Group ◽

Positive Group ◽

Significant Difference ◽

The Mean ◽

Polymerase Chain ◽

Reporting Tool ◽

Taste And Smell

Objective To identify the taste and smell impairment in coronavirus disease 2019 (COVID-19)–positive subjects and compare the findings with COVID-19–negative subjects using the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) Anosmia Reporting Tool. Setting Tertiary referral center/COVID-19 pandemic hospital. Study Design Comparative study. Subjects and Methods After power analysis, 128 subjects were divided into 2 groups according to real-time polymerase chain reaction (RT-PCR) COVID-19 testing results. Subjects were called via telephone, and the AAO-HNS Anosmia Reporting Tool was used to collect responses. Results The mean age of the study group was 38.63 ± 10.08 years. At the time of sampling, rhinorrhea was significantly high in the COVID-19–negative group, whereas those complaints described as “other” were significantly high in the COVID-19–positive group. There was a significant difference in the smell/taste impairment rates of the groups (n = 46% [71.9%] for the COVID-19–positive group vs n = 17 [26.6%] for the COVID-19–negative group, P = .001). For subjects with a smell impairment, anosmia rates did not differ between the groups. The rates of hyposmia and parosmia were significantly high in the COVID-19–positive group. For the subjects with taste impairment, ageusia rates did not differ between groups. The rate of hypogeusia and dysgeusia was significantly high in the COVID-19–positive group. Logistic regression analysis indicates that smell/taste impairment in COVID-19–positive subjects increases the odds ratio by 6.956 (95% CI, 3.16-15.29) times. Conclusion COVID-19–positive subjects are strongly associated with smell/taste impairment.

The effect of migraine and motion sickness on symptoms evoked by the caloric vestibular test

Journal of Vestibular Research ◽

10.3233/ves-210046 ◽

2021 ◽

pp. 1-10

Author(s):

Ozlem Gedik Soyuyuce ◽

Pinar Yalinay Dikmen ◽

Nazim Korkut

Keyword(s):

Data Analysis ◽

Motion Sickness ◽

Retrospective Data ◽

Tertiary Referral ◽

Sensory Stimuli ◽

Retrospective Data Analysis ◽

Increased Risk ◽

Vestibular Symptoms ◽

BACKGROUND: The caloric vestibular test (CVT) may evoke headache and vestibular symptoms in susceptible people. Patients with migraines have higher susceptibility to motion sickness. In migraines, impaired habituation to repetitive stimuli is a well-known interictal abnormality. OBJECTIVE: This study is aimed at evaluating CVT-evoked headache, nausea, vomiting, and imbalance in patients with and without migraine and/or motion sickness. METHODS: A retrospective data analysis was performed on 554 patients with a complaint of dizziness who underwent bithermal CVT at a tertiary referral center. The occurrences of CVT-evoked headache, nausea, vomiting, and imbalance were observed in four groups: patients with only migraine (MG; n = 94), those with only motion sickness (MSG; n = 89), those with migraine and motion sickness (MMSG; n = 122), and those without migraine and motion sickness (non-MMSG; n = 146). The differences between the groups were assessed. RESULTS: The mean ages of groups were similar (p = 0.534). The proportions of females were higher in the MG, MSG, and MMSG (p = 0.001). The severity of nausea and headache for each gender was higher in the MG, MSG, and MMSG (p < 0.001). Vomiting was more common in MMSG among males (p = 0.003), while there was no difference between groups among females (p = 0.099). Imbalance was more common in MMSG among females (p < 0.001). A relationship was detected between age and imbalance (p < 0.001), where an increased risk for imbalance was evident with greater age. Three patients in the MMSG needed hospitalization after CVT. CONCLUSIONS: Special caution is needed when performing caloric testing for patients with migraines or MS since CVT-evoked symptoms may occur with higher incidence and intensity, which might be related to a lack of habituation in neuronal information processing after robust sensory stimuli like CVT.