scholarly journals TYPE III TYMPANOPLASTY: A COMPARATIVE STUDY BETWEEN AUTOLOGOUS INCUS AND TRAGAL CARTILAGE AS OSSICULOPLASTY MATERIAL – OUR EXPERIENCE

2020 ◽  
pp. 1-3
Author(s):  
Arjun S Doshad ◽  
Ravindra Singh Bisht ◽  
Nitin Sharma ◽  
Amit Shah
Keyword(s):  
Middle Ear ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Type Iii ◽  
Hearing Gain ◽  
Medical College ◽  
Middle Ear Prosthesis ◽  
Additional Role ◽  
Middle Ear Cleft

Background: Type III tympanoplasty involves complete disease clearance from middle ear cleft and retaining or improving the serviceable hearing by ossiculoplasty. Various auto and allografts have been used with variable outcomes. The objective of the study was to evaluate hearing improvement in patients who underwent type III tympanoplasty using autologous incus and tragal cartilage as ossiculoplasty material. Method: A retrospective chart review of 30 patients who underwent type III tympanoplasty at medical college Srinagar Pauri Garhwal from January 2019 to December 2019 was done. In 10 patients autologous incus and in 20 tragal cartilage was used for ossiculoplasty. Those patients who required wall down were excluded from the study and only patient with limited atticotomy and complete mastoidectomy requiring type III tympanoplasty were included in the study. Pure tone audiograms done after 3 months were compared with the pre operative audiogram. Result: 10 patients who underwent type three tympanoplsty with use of autologous incus for ossiculoplasty had a mean hearing gain of 17.08dB and 20 pateint underwent type three tympanoplasty with use of tragal cartilage for ossiculoplasty had mean hearing gain of 18.26 dB at 3 months after surgery. Hearing gain was similar in both groups irrespective of the material used. The tragal cartilage was used as strut extending from stapes head to the anteroinferior part of annulus supporting the graft throughout and additionally helping in maintaining the middle ear space. Conclusion: The post-operative hearing gain with autologous incus and tragal cartilage as middle ear prosthesis are similar but the additional role of cartilage supporting the graft and maintaining the middle ear space overrule the use of tragal cartilage for ossiculoplasty in type three tympanoplasty. So by this study we recommend the use of tragal cartilage as ossiculoplasty material for type III tympanoplasty over other material.

scholarly journals Outcomes of type III tympanoplasty: our experience

2020 ◽  
Vol 6 (2) ◽  
pp. 287
Author(s):  
Ravishankar C. ◽  
Ramya Bandadka
Keyword(s):  
Middle Ear ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Canal Wall ◽  
Type Iii ◽  
Hearing Gain ◽  
Middle Ear Prosthesis ◽  
Canal Wall Down ◽  
Middle Ear Cleft ◽  
Canal Wall Up

<p class="abstract"><strong>Background:</strong> Type III tympanoplasty involves complete disease clearance from middle ear cleft and retaining or improving the serviceable hearing by ossiculoplasty. Various auto and allografts have been used with variable outcomes. The objective of the study was to evaluate hearing improvement and healing of cavity in patients who underwent type III tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> A retrospective chart review of 21 patients who underwent type III tympanoplasty at Bowring and Lady Curzon Hospital from January 2018 to December 2018 was done. In 7 patients autologous incus, 6 tragal cartilage and 8 teflon prosthesis was used for ossiculoplasty. Intra and postoperative events were assessed. Pure tone audiograms done after 3 and 6 months were compared.  </p><p class="abstract"><strong>Results:</strong> 15 patients who underwent canal wall down procedure (CWDP) had a mean hearing gain of 20.33 dB and 26.67 dB while in 5 patients of canal wall up procedure (CWUP) group mean hearing gain was 22.5 dB and 27.5 dB at 3 and 6 months after surgery respectively. Hearing gain was similar in both groups irrespective of the prosthesis used. Autologous materials were used in most of the CWUP with intact stapes and teflon prosthesis was used in majority of CWDP where only mobile stapes foot plate was present. Prosthesis extrusion was not encountered in any of our cases so far in this series.</p><p class="abstract"><strong>Conclusions:</strong> The post-operative hearing gain with autologous incus, tragal cartilage and teflon middle ear prosthesis are similar. Teflon prosthesis is an effective material for ossiculoplasty, especially useful when incus and stapes are absent while autologous incus or tragal cartilage are preferred in cases with intact stapes head.</p>

Risk and Protective Factors Affecting Children in Foster Care: A Pilot Study of the Role of Siblings*

1992 ◽  
Vol 37 (9) ◽  
pp. 616-622 ◽  
Author(s):  
M.B. Thorpe ◽  
G.T. Swart
Keyword(s):  
Foster Care ◽  
Protective Factors ◽  
School Performance ◽  
Extracurricular Activities ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Factors Affecting ◽  
Children In Foster Care ◽  
High Risk Children

A retrospective chart review of 115 siblings (from 48 families) simultaneously taken into the care of a Children's Aid Society was conducted. These children were a very neglected group at great risk of developing mental illness. There was a significant correlation between the number of symptoms the child had while in the receiving home and the time spent in foster care. Protective factors correlated with fewer symptoms at home but not while the child was in care. Being in care resulted in better performance at school, fewer symptoms and involvement in more extracurricular activities. High risk children made up their losses. While in foster care, 53% were eventually separated from their siblings. Children were more likely to be separated from their siblings if they were older, their father was physically ill or their parents were separated. Children who were separated from their siblings had more risk factors and placements while in care. However, they had fewer symptoms and better school performance while they were in foster care and fewer symptoms at discharge than the siblings who stayed together.

Abstract 3235: Low LDL is Associated with Hematoma Expansion in Chronic Daily Alcohol Users with Intracranial Hemorrhage

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Gayle R Pletsch ◽  
Christopher Burns ◽  
Karen C Albright ◽  
Amelia K Boehme ◽  
T. M Beasley ◽  
...  
Keyword(s):  
Chart Review ◽  
Ldl Cholesterol ◽  
Independent Predictor ◽  
Retrospective Chart Review ◽  
Platelet Inhibition ◽  
Demographic Variables ◽  
Hematoma Expansion ◽  
Chi Square ◽  
Alcohol Users

Background: Prior studies have reported elevated blood pressure, platelet inhibition, and low LDL cholesterol in chronic daily alcohol users (CDA). Each of these has been shown to be associated with intracerebral hemorrhage (ICH) growth. We hypothesized that CDA patients with ICH and low LDL were at higher risk for ICH growth than CDA users with high LDL. Methods: Retrospective chart review was performed on patients who presented to Tulane University from 7/1/08-12/31/10 with a spontaneous ICH. Patients who underwent hematoma evacuation were excluded. Clinical and demographic variables were abstracted. Hemorrhages volumes were calculated based on ABC/2 method. LDL was dichotomized into low (<100mg/dl) and high (≥100mg/dl) values. Comparisons were made using t-tests, Chi-square and non-parametric equivalents where appropriate. ICH growth in 24 hours and CDA use were evaluated using linear regression. Results: Of the 99 patients with spontaneous ICH, 25.3% were CDA users. No significant differences were observed when comparing baseline demographics of CDA users with LDL<100 and CDA users with LDL>=100 ( Table 1). Patients with low LDL had larger baseline ICH volumes (21.4 vs. 7.5, p=.03) and were more likely to experience ICH growth (87.5% vs. 57.1%, p=0.0002). Initial LDL was an independent predictor for 24 hour ICH growth. Every 10 points the initial LDL was below 100 predicted 1 cc of growth. LDL did not predict ICH growth in non-CDA users (p=0.9430). Discussion: Our data suggest that initial LDL level in chronic daily alcohol users can be used to predict ICH growth. The role of LDL in the importance of vessel fragility and clot stabilization needs to be further explored as this appears be important in patients who are chronic daily alcohol users.

scholarly journals 4225 Evaluation of Neurotransmitters in Channelopathy-Related Epilepsy

2020 ◽  
Vol 4 (s1) ◽  
pp. 95-95
Author(s):  
Sunita N Misra ◽  
Theresa M. Czech ◽  
Jennifer A. Kearney
Keyword(s):  
Mouse Model ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Brain Regions ◽  
Autism Spectrum ◽  
Wild Type ◽  
Voltage Gated Sodium Channels ◽  
Study Population ◽  
Genotype A

OBJECTIVES/GOALS: Variants in voltage-gated sodium channels (VGSC) are a common cause of severe early onset epilepsy. Changes in CSF neurotransmitters (NT) were identified in 2 cases of VGSC-related epilepsy. Here we investigate NT changes in patients and a novel mouse model of VGSC-related epilepsy. METHODS/STUDY POPULATION: We conducted a single site IRB approved retrospective chart review of patients with VGSC-related epilepsy who underwent CSF NT testing for diagnostic purposes. In parallel, we examined NT levels from the brains of wild-type (WT) and a novel VGSC-related epilepsy mouse model after obtaining IACUC approval. We rapidly isolated forebrain, cortex, striatum, and brainstem from 5-6 animals per sex and genotype. A combination of HPLC with electrochemical detection and mass spectrometry were used to quantify NT levels from brain samples. RESULTS/ANTICIPATED RESULTS: We identified 10 patients with VGSC-related epilepsy who received CSF NT testing. Two of these patients had abnormal NT results including changes to dopamine (DA) or serotonin (5-HT) metabolites. We analyzed NT levels from four brain regions from male and female WT and VGSC-related epilepsy mice. We anticipate that most of the NT levels will be similar to WT, however subtle changes in the DA or 5-HT metabolites may be seen in VGSC-related epilepsy. DISCUSSION/SIGNIFICANCE OF IMPACT: Patients with VGSC-related epilepsy often have autism spectrum disorder, sleep, and movement disorders. Understanding the role of aberrant NT levels in VGSC-related epilepsy may provide additional therapeutic targets that address common neuropsychological comorbidities as well as seizures.

Combined Phacoemulsification and Pars Plana Vitrectomy for the Treatment of Cataract in Patients With Noninfectious Uveitis

2020 ◽  
Vol 4 (5) ◽  
pp. 393-400
Author(s):  
Christopher D. Conrady ◽  
Akbar Shakoor ◽  
Rachel Patel ◽  
Marissa Larochelle ◽  
Majid Moshirfar ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Inflammatory Disease ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Visual Rehabilitation ◽  
Disease Remission ◽  
Pars Plana ◽  
Vitrectomy Surgery

Purpose: This work evaluates the role of combined phacoemulsification and vitrectomy surgery in the management of cataract associated with noninfectious uveitis. Methods: A retrospective chart review was conducted of all patients aged 7 years or older who underwent a combined surgical approach from 2005 to 2018. Results: Eighty-five eyes of 67 patients were included in the study; 10.7% of eyes had a best-corrected visual acuity (BCVA) of 20/40 or better at time of surgery. At 1-year follow-up, 63.4% of eyes had a BCVA 20/40 or better and 7.6% had a BCVA of 20/200 or worse. There was an overall decrease in cystoid macular edema after surgery compared with preoperatively (47.6% vs 34.5% presurgery and postsurgery, respectively). Complete inflammatory disease remission off immunomodulatory therapy and systemic steroids was achieved in 21.1% of patients. Conclusions: A combined surgical approach is effective in visual rehabilitation in patients with uveitic cataracts and may promote inflammatory disease remission specifically in intermediate uveitis.

scholarly journals Assessment of Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycobacterium tuberculosis infections in women undergoing laparoscopy: the role of peritoneal fluid sampling

2016 ◽  
Vol 31 (4) ◽  
Author(s):  
Miroslav Dragic ◽  
Patrizia Posteraro ◽  
Carla Marani ◽  
Maria Emanuela Natale ◽  
Alessia Vecchioni ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Chlamydia Trachomatis ◽  
Peritoneal Fluid ◽  
Bacterial Infections ◽  
Chart Review ◽  
Molecular Detection ◽  
Retrospective Chart Review ◽  
Potential Link ◽  
Fluid Sampling

<em>Background</em>. Aim of this study was to assess the role of peritoneal fluid sampling for detection of bacterial infections due to <em>Chlamydia trachomatis </em>(CT), <em>Neisseria</em> <em>gonorrhoeae</em> (NG), and <em>Mycobacterium</em> <em>tuberculosis</em> (MT) in women undergoing laparoscopic investigation. The potential link between microbiological positive result(s) and types of gynecological pathology was also evaluated. <em><br />Materials</em> <em>and</em> <em>Methods</em>. A large sample of women (n=1377) with their peritoneal fluids taken laparoscopically was studied. Data of microbiological and clinical/histopathological findings were entered into a database from a retrospective chart review. Culture and/or microscopy were used to detect NG or MT infection, whereas CT infection was detected using a PCR-based test. <em><br />Results and Conclusions</em>. Of all the patients (14 to 50 years aged), 463 (33.6%) had endometriosis, 1179 (85.6%) had a pathology/condition other than endometriosis, and 71 (5.2%) had no pathology as histologically documented. None of the patients had peritoneal fluid samples positive for NG or MT. In contrast, 30 (2.2%) of 1377 patients had peritoneal fluid samples positive for CT. Except for 3 women with no histopathological alteration, all the CT positive patients had either endometriosis (n=12) or non-endometriosis (n=13) pathology. Two remaining patients were diagnosed with both the pathologies. Accordingly, no significant association (OR) was found between CT positivity and pathology [only endometriosis, 1.13 (95%CI, 0.30-4.20)]; [only non-endometriosis, 0.53 (95%CI, 0.15-1.87)]. While confirming the low positivity rate for the CT molecular detection, the present data indicate the need for prospective studies to firmly establish the clinical usefulness of peritoneal fluid diagnostic in gynecological settings.

A Comparison of Sexual Arousal in Men Exposed to Visual Stimuli With and Without Facial Blurring

Sexual Abuse ◽  
2019 ◽  
Vol 32 (6) ◽  
pp. 619-633 ◽  
Author(s):  
Leah Rosetti ◽  
Susan Curry ◽  
Lisa Murphy ◽  
John B. Bradford ◽  
J. Paul Fedoroff
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Effect Sizes ◽  
Modest Effect Size ◽  
Legal Challenges ◽  
And Gender ◽  
Gender Categories ◽  
Facial Images ◽  
Modest Effect

The role of the facial images in arousal and attraction has been examined before but never via penile plethysmography (PPG). This retrospective chart review aimed to determine the significance and magnitude of differences in arousal measured by PPG in 1,000 men exposed to slide stimuli with or without facial blurring in subjects of various ages. Arousal in response to blurred stimuli was significantly higher than nonanonymized stimuli with modest effect sizes for slides across age and gender categories. Facial blurring increased differences in arousal between adults and adolescents with a modest effect size. Our findings support the use of facial blurring to further protect the anonymity of models and limit the ethical and legal challenges of using slide stimuli with child models.

scholarly journals OSSICULAR STATUS IN CHOLESTEATOMA : A DEPARTMENTAL EXPERIENCE IN A STATE MEDICAL COLLEGE OF WESTBENGAL.

2015 ◽  
Vol 23 (3) ◽  
pp. 116-119
Author(s):  
Somesh Mozumder ◽  
Arunabha Sengupta ◽  
Alok Ranjan Mondal ◽  
Soumik Basu
Keyword(s):  
Otitis Media ◽  
Clinical Examination ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Radiological Evaluation ◽  
Super Structure ◽  
Medical College ◽  
Middle Ear Cleft ◽  
Age And Sex

Introduction: Chronic otitis media is a long standing infection of part or whole of middle ear cleft. Its active squamosal variant (cholesteatoma) is most dangerous due to its bone eroding property. Aims & Objective: Background knowledge of ossicular status in cholesteatoma  will help us in determining the type  of reconstruction needed during the surgery. Material & methods: 60 cases of cholesteama, irrespective of age and sex [diagnosed on the basis of clinical examination , audiological and radiological evaluation] were selected during the study period of two years and their ossicular status were recorded intra-operatively. Results &  analysis: Ossicles and their parts getting involved in cholesteatoma cases , in decreasing order are : Lenticular process (in total 50 cases)>Long process of incus (in total 49 cases) > stapes super-structure(in total 29 cases) > body of incus(in total 26 cases)> head of malleus(in total 23 cases)> handle of malleus(in total 10 cases). Ossicular chain  defeact in decreasing order are : M-I-S- > M+I-S- > M-I-S+ > M+I-S+. Conclusion: In our study it was found that incus is the most vulnerable ossicle to get involved in cases of active squamosal variety of chronic otitis media where as malleus appeared to be the least susceptible one.

Prevention of middle ear barotrauma with oxymetazoline/fluticasone treatment

2021 ◽  
Vol 03 (01) ◽  
pp. 149-152
Author(s):  
Susan B. Millan ◽  
◽  
Catherine A. Hontz-Geisinger ◽  
Benjamin J. Rooks ◽  
Derek B. Covington ◽  
...  
Keyword(s):  
Treatment Group ◽  
Middle Ear ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Common Complication ◽  
Membrane Rupture ◽  
Significant Difference ◽  
Male Sex ◽  
Treatment Pressure ◽  
Hbo2 Therapy

Prevention of middle ear barotrauma with oxymetazoline/fluticasone treatment Middle ear barotrauma (MEB) is a common complication of hyperbaric oxygen (HBO2) therapy. It has been reported in more than 40% of HBO2 treatments and can interrupt the sequence of HBO2. MEB may lead to pain, tympanic membrane rupture, and even hearing loss.The aim of this study was to determine if pretreatment with intranasal fluticasone and oxymetazoline affected the incidence of MEB. We conducted a retrospective chart review of subjects undergoing HBO2 at our institution between February 1, 2014, and May 31, 2019. Subjects in the fluticasone/oxymetazoline (FOT) treatment group used intranasal fluticasone 50 mcg two times per day and oxymetazoline 0.05% one spray two times per day beginning 48 hours prior to initial HBO2. Oxymetazoline was discontinued after four days. Fluticasone was continued for the duration of HBO2 therapy. A total of 154 unique subjects underwent 5,683 HBO2 treatments: 39 unique subjects in the FOT group underwent 1,501 HBO2; 115 unique subjects in the nFOT (no oxymetazoline or fluticasone treatment) group underwent 4,182 HBO2 treatments. The incidence of MEB was 15.4% in the FOT group and 16.2% in the nFOT group. This was not a statistically significant difference (OR = 0.77; p = 0.636). Treatment pressure, age over 65 years, male sex, and BMI were not associated with a difference in MEB incidence. In summary, pretreatment with intranasal oxymetazoline and fluticasone in patients undergoing HBO2 did not significantly reduce MEB. More investigation with larger numbers of participants and prospective studies could further clarify this issue.

Immune checkpoint inhibitors for treatment of periorbital squamous cell carcinoma

2021 ◽  
pp. bjophthalmol-2021-319417
Author(s):  
Jeremy Allan Goldfarb ◽  
Renata Ferrarotto ◽  
Neil Gross ◽  
Ryan Goepfert ◽  
James Matthew Debnam ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Chart Review ◽  
Checkpoint Inhibitors ◽  
Locally Advanced ◽  
Retrospective Chart Review ◽  
Cutaneous Squamous Cell Carcinoma ◽  
Therapeutic Outcomes

PurposeTo report on the outcomes of immunotherapy in patients with locally advanced periorbital squamous cell carcinoma.MethodsWe performed a retrospective chart review of seven consecutive patients with locally advanced periorbital cutaneous squamous cell carcinoma treated with anti-PD-1 immunotherapy. Treatments and therapeutic outcomes were reviewed.ResultsOf the seven patients, six were treated with cemiplimab, and one was treated with pembrolizumab. Five patients were treated with immunotherapy as neoadjuvant therapy before planned surgical resection; two patients received immunotherapy for treatment of advanced recurrent lesions deemed unresectable following multiple previous excisions and radiation therapy. In all seven patients, measurable clinical and/or radiologic response was observed.ConclusionsOur findings support the emerging role of anti-PD-1 immunotherapy in the management of locally advanced periorbital cutaneous squamous cell carcinoma.

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