To Compare the Graft Uptake in Permeatal versus Postaural Approaches in Myringoplasty

2021 ◽  
Vol 15 (12) ◽  
pp. 3450-3451
Author(s):  
Wajih-ud-Din Shinwari ◽  
Amjad Ali ◽  
Sadaf Raffat Mustafa ◽  
Uzair Mushahid ◽  
Muhammad Jamil ◽  
...  

Objective: To compare the graft uptake in permeatal versus postaural approaches in myringoplasty. Study design: Cross sectional comparative Place and Duration of Study: Department of ENT, Head and Neck Surgery, Pakistan Institute of Medical Sciences/Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad Pakistan from 1st March 2018 to 31st December 2018. Methodology: Seventy two patients were classified into two equal groups. Thirty six patients underwent myringoplasty by permeatal approach and thirty six patients underwent postaural approach. Those patients were included who had mucosal type moderate central perforation with inactive disease with age 15-42 years and those patients were excluded who had small, subtotal, total, squamosal type atticoantral tympanic membrane perforation, with comorbidities and pregnancy. Results: Thirty seven were (51.4 %) males and 35 (48.6%) were females. In both the groups the success of graft uptake was 52 (72.2%) patients and graft rejection in 20 (27.8%) patients. In each group there were 36 patients. The graft uptake in permeatal approach was 30 patients (83.3%), while the graft uptake in postaural approach was 22 (61.1%) patients. The overall graft uptake in permeatal approach is more as compared to postaural approach (p=0.035). Conclusion: The permeatal approach is better than the postaural approach in terms of graft uptake in medium sized central perforations in myringoplasty. Key words: Myringoplasty, Tympanoplasty, Permeatal, Postauricular

Author(s):  
Magis Mandapathil ◽  
Jens E. Meyer

Abstract Purpose Since its introduction over a decade ago, the use of robotic surgery (RS) in head and neck surgery has widely spread around the globe, with very differential adoption of this novel surgical technique in different parts of the world. In this study, we analyze the acceptance and adoption of robotic surgery in the head and neck in Germany. Materials and methods A cross-sectional analysis using a questionnaire evaluating the acceptance and adoption of RS was performed. Questionnaires were distributed to all chairmen /-women of Otorhinolaryngology, Head and Neck Surgery Departments in Germany. Results A total of 107 respondents completed the questionnaire (65.2%). At university hospitals, 71.4% of the respondents indicated that a robotic system was available, and 21.4% responded that robotic surgery was performed at their institution; 22.7% and 0.04%, respectively, at non-university hospitals. The overall adoption rate was 0.8%. The most common cases performed were TORS resection in the oropharynx. Main reasons for not adopting this technique were costs, lack of interest and available co-operations. Conclusion This study provides evidence of the extent of adoption of TORS in Germany; main perceived barriers to adoption are costs with lack of cost-covering reimbursement and insufficient co-operations with other disciplines as well as hospital administration resulting in a very low adoption rate of this technique over the past decade. Results from this study may assist in decision-making processes on adopting this technique in the future.


2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Christiana Maria Ribeiro Salles Vanni ◽  
Leandro Luongo de Matos ◽  
Mário Paulo Faro Junior ◽  
Jossi Ledo Kanda ◽  
Cláudio Roberto Cernea ◽  
...  

Introduction. The reconstruction of complex cervicofacial defects arising from surgical treatment for cancer is a real challenge for head and neck surgeons, especially in salvage reconstruction surgery and/or failed previous reconstruction. The pectoralis major myocutaneous flap (PMMF) has been widely used in these specific situations due to its reliability and low rate of failure or complications.Objectives. Identify factors that determine complications and influence the final outcome of the reconstructions with PMMF in salvage cancer surgery or in salvage reconstruction.Methods. A cross-sectional study design was used to evaluate a sample including 17 surgical patients treated over a period of ten years that met the inclusion criteria.Results. Reconstruction was successful in 13 cases (76.5%), with two cases of partial flap loss and no case of total loss. Complications occurred in 13 cases (76.5%) and were specifically related to the flap in nine instances (52.9%). An association was identified between the development of major complications and reconstruction of the hypopharynx () as well as in patients submitted to surgery in association with radiation therapy as a previous cancer treatment (). The former condition is also associated with major reconstruction failure (). An even lower incidence of major complications was noted in patients under the age of 53 ().Conclusion. Older patients, with hypopharyngeal defects and submitted to previous surgery plus radiation therapy, presented a higher risk of complications and reconstruction failure with PMMF.


2020 ◽  
Vol 3 (2) ◽  
pp. 52-56
Author(s):  
Mojtaba Meybodian ◽  
◽  
Mohsen Abouii ◽  
Mohammadhossein Dadgarnia ◽  
Mohammadhossein Baradaranfar ◽  
...  

Objective: The purpose of this study was to compare the effect of intratympanic injection of dexamethasone and triamcinolone on sudden sensorineural hearing loss (SSNHL). Methods: In this study 60 patients with SSNHL were divided into two groups of Dexamethasone 8 mg and Triamcinolone 40 mg. Patients in both groups underwent five injections. Hearing status of the two groups was recorded one day before each injection as well as one week and one month after the last injection at different frequencies. Any possible complications following the injection, such as infection and tympanic membrane perforation was evaluated and recorded. Results: The results showed that after the first and second injection, there was no significant difference between the two groups regarding hearing frequency and speech discrimination score (SDS). Significant differences were observed between the two groups in the third and fourth injections at a frequency of 500 Hz and also in the fifth injection at frequencies of 500, 1000, and 2000 Hz. Tympanic membrane perforation was observed in three patients in the dexamethasone group (P.value>0.05). Conclusion: In our study, the effect of triamcinolone was found to be significantly better than dexamethasone in the treatment of SSHNL at lower frequencies. The SDS was also higher in the triamcinolone group than dexamethasone. Based on our results, intratympanic injection of both triamcinolone and dexamethasone are safe and effective treatments for the treatment of SSNHL, but given its desirable medicinal properties, intratympanic injection of triamcinolone can be a safe and effective alternative for SSNHL treatment.


Author(s):  
Raana Jafarizadeh ◽  
Somayeh Zeynizadeh-Jeddi ◽  
Akbar Pirzadeh ◽  
Mahzad Yousefian ◽  
Firouz Amani

Introduction: Quality of life (QOL) is an important index in society that need for evaluation in all age groups people especially in medical university students as a people that their physical and mental health is related with community health. This study aims to investigate the quality of life (QOL) of Ardabil University of Medical Sciences. Methods: This is a cross-sectional study that has been conducted on 200 students who selected by random sampling method from Ardabil medical university students. The QOL was measured by WHOQOL-BREF which its validity and Reliability were investigated and approved. This questionnaire include 26 questions in four dimensions (physical, mental, social and environmental health). Collected data we analyzed by statistical test such as t-test for compare the mean of QOL score among demographic data. Results: Of all students, 57% were male and 91.5% were single. Of all students, 56% had desired quality of life. The relationships between QOL and variables such as gender, educational level, marital status and age of students wasn’t significant. The mean difference of four dimension scores among two sexes was statistically significant. The mean of Physical health dimension score was 11.6±2.1, Psychological was 12.3±2.4, Social relationships was 13.1±3.4 and environment was 12.7±3.2. The mean of total score of QOL in all students was 12.4±2.3. Conclusion: Results showed that the QOL of all students were in high level and in four dimension of QOL the female students had significant higher score than male students.


2021 ◽  
pp. 019459982110332
Author(s):  
Joo Hyun Kim ◽  
Elysia Grose ◽  
Justine Philteos ◽  
David Forner ◽  
Christopher W. Noel ◽  
...  

Objective Patient education materials across 3 national English otolaryngology–head and neck surgery (OHNS) societies: the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS), the Canadian Society of Otolaryngology–Head and Neck Surgery (CSOHNS), and Ear, Nose, and Throat United Kingdom (ENT UK) were examined to determine whether they are written at a level suitable for patient comprehension. Study Design Cross-sectional study. Setting Online patient materials presented through OHNS national societies. Methods Readability was calculated using the Flesch-Kincaid Grade Level, Flesch-Kincaid Reading Ease Score, and Simple Measure of Gobbledygook Index. All public patient education materials available through the CSOHNS, AAO-HNS, and ENT UK websites were assessed. Patient education materials were grouped into categories by subspecialty. Results In total, 128 patient materials from the 3 societies were included in the study. All 3 societies required a minimum grade 9 reading comprehension level to understand their online materials. According to Flesch-Kincaid Grade Level, the CSOHNS required a significantly higher reading grade level to comprehend the materials presented when compared to AAO-HNS (11.3 vs 9.9; 95% CI, 0.5-2.4; P < .01) and ENT UK (11.3 vs 9.4; 95% CI, 0.9-2.9; P < .01). Patient education materials related to rhinology were the least readable among all 3 societies. Conclusion This study suggests that the reading level of the current patient materials presented through 3 national OHNS societies are written at a level that exceeds current recommendations. Promisingly, it highlights an improvement for the readability of patient materials presented through the AAO-HNS.


2017 ◽  
Vol 21 (04) ◽  
pp. 336-342 ◽  
Author(s):  
Mohammed Dawood

Introduction Tympanic membrane perforation is a relatively common problem that predisposes patients to varying degrees of conductive hearing loss. Objective The objective of this study is to evaluate and analyze the frequency dependence hearing loss in tympanic membrane perforation based on the size and the site of perforation. Methods For the study, I selected 71 patients' (89) ears for the cross-sectional study with tympanic membrane perforations; I examined the size and the site of perforations under the microscope and classified them into small, moderate, large, and subtotal perforations, and into anterior central, posterior central, malleolor central, and big central perforations. I measured mean level of speech frequencies hearing loss, and its relation with the site and the size of the perforation analyzed. Results The mean hearing loss at different sizes of the perforation at all speech frequencies was 37.4 dB, with ABG of 26.6 dB, and its maximum loss was detected in subtotal perforation of 42.3 dB, with ABG of 33.7 dB, at 500 Hz frequency, while in relation to the sites, it was 38.2 dB, with ABG of 26.8 dB, and its maximum loss was detected in big central site perforation of 42.1 dB, with ABG of 33.6 dB, at 500 Hz frequency. Conclusions The hearing loss was proportionally related with the sizes of the perforations, and the posterior site had greater impact on the hearing than anterior site perforations. This was also applied to the frequency dependence hearing level, as was detected to be worse at lower frequencies as 500 Hz, than those of 1000–2000 Hz.


2019 ◽  
Vol 24 (2) ◽  
pp. 131-136
Author(s):  
Md Abdur Razzak ◽  
KM Mamun Murshed ◽  
AKMA Sobhan ◽  
Md Rakib Hossain ◽  
SM Nafeez Imtiaz

Background: Myringoplasty is one of the surgical techniques for the management of chronic supportive otitis media with permanent perforation of tympanic membrane. It is defined as simple surgical repair of tympanic membrane perforation without doing ossicular reconstruction. Objective: To determine the success rate of myringoplasty and to examine whether the hearing improvement is a potential indication for surgery. Methods: This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, Shaheed Suhrawardy Medical College Hospital from January 2017 to December 2017 and 100 patients who underwent myringoplasty in this period were analyzed. About 100 patients with dry central tympanic membrane perforations of various size were included in this study Results: Myringoplasty was performed in 100 patients. Male were (45%) and females were (55%).Twenty one (7%) of them belonged to age group of 10-20 years, 31 (31%) were in the age range of 21-33 years, 38(38%) were the age range 31-40 years while 24 (24%) aged between 41-50 years with mean age of 26.32 ±S.D 9.59 years. Overall success rate of graft uptake was noted in 88 (88%) out of 100 cases Conclusion: Myringoplasty is a safe surgical procedure in achieving intact tympanic membrane and to improve the hearing loss. Therefore, underlay technique being technically simple should be preferred, but the ultimate decision about the technique to be employed depends on the surgeons preference and the site of perforation  Bangladesh J of Otorhinolaryngology; October 2018; 24(2): 131-136


Author(s):  
Jitendra Pratap Singh Chauhan ◽  
Bhartendu Bharti ◽  
Sunil Singh Bhadouriya ◽  
Abhay Kumar ◽  
Prem Narain ◽  
...  

<p class="abstract"><strong>Background:</strong> The larynx serves protective, respiratory and phonatory functions in humans. Cancer of the larynx is common cancer of head and neck region. This study was done to determine the predisposing factors, clinical aspects and histopathological pattern of the laryngeal malignancies. Patients were studied with particular significance given to the mode of presentation, risk factors, topography and histopathology of the tumour.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted at Department of Otorhinolaryngology Head and Neck Surgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah. All 65 cases of laryngeal cancer presented from July 2016 to July 2017were included in this study.  </p><p class="abstract"><strong>Results:</strong> Most of cases belonged to age group 51-60 years. Tobacco intake in the form of smoking was the major risk factor and present in 80% of cases. Commonest presenting symptom was the dysphagia followed by hoarseness of voice. Supraglottic area was the commonest site (69.23%) for laryngeal cancer in this study. Squamous cell carcinoma was found in 98.46% of patients. Moderately differentiated category seen in 49.23% of patients. Most of the patients presented in the stage III and IV (30.77% and 44.62%). 37 (56.92%) cases out of 65 cases had cervical lymph node metastasis at the time of presentation.</p><strong>Conclusions:</strong>Diagnosis is based on proper history, clinical examination, direct visualization of the larynx, CT scan and established by histopathological examination. This study has been done to improve comprehension and care of patients with laryngeal carcinoma.<p> </p>


2020 ◽  
Vol 163 (2) ◽  
pp. 335-343 ◽  
Author(s):  
Zaid Al-Qurayshi ◽  
Christopher Blake Sullivan ◽  
Adam Schwalje ◽  
Jarrett Walsh ◽  
Rodrigo Bayon ◽  
...  

Objectives To examine clinical profile and outcomes of elderly patients (65-90 years) undergoing head and neck surgeries in the United States. Study Design A retrospective cross-sectional analysis. Setting The Nationwide Readmissions Database, 2010 to 2015. Subjects and Methods Adult (≥18 years) patients who underwent head and neck surgeries. Analysis included χ2 test and logistic analysis. Results A total of 113,602 and 32,580 patients <65 and ≥65 years old, respectively, were included. Patients ≥65 years old were more likely to have multiple comorbidities (62.8% vs 32.6%, P < .001) and to present with head and neck cancer (19.8% vs 11.4%, P < .001). The most common comorbidity was diabetes (21.0%). The most common cancer types by site were mouth (29.12%), thyroid (28.08%), and nonmelanoma skin cancer (13.22%). The percentage of geriatric patients who underwent head and neck surgeries increased from 21.8% in 2010 to 25.0% in 2015 ( P < .001). A total of 5450 (16.85%) patients developed postoperative complications, and the most common complications were pulmonary related (10.55%), bleeding (6.96%), acute renal failure (6.01%), and infection (3.97%). Blood transfusion was required in 3.53% of the patients. Readmission prevalence was 0.32%, and mortality risk was twice as likely (odds ratio, 2.05; 95% confidence interval, 1.77-2.38; P < .001). Independent risk factors of mortality were older age, multiple comorbidities, type of surgery, blood transfusion, and tracheostomy ( P < .05, each). Conclusion Elderly patients currently represent 25% of patients admitted for head and neck surgery. This population should be provided with a different level of care due to a higher risk of complications and mortality.


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