The Role of Multi-slice CT in Preoperative Assessment of Temporal bone in patients prepared to cochlear implantation

Background MDCT plays a critical role in evaluation and management of different causes of hearing loss which require many therapeutic techniques including cochlear implantation. In general, most causes of hearing impairment are best diagnosed using computed tomography scan of the temporal bone using bone algorithm and windowing techniques. Patients and Methods The study included a total of 20 patients referred to the Radiodiagnosis department from the E.N.T department in EL-Galaa Military Hospital. CT was done for assessment of the cochlear state prior to the cochlear implantation operation. The CT was used to delineate the different cochlear and middle ear anatomy and to orient and modify the surgical strategy. Results Only 18 patients from 20 patients underwent cochlear implantation, the other two cases were diagnosed as Otosclerosis & Bilateral longitudinal fractures. Patients with multiple other congenital anomalies in the external or internal ear had the cochlear implantation in the other ear (To raise the % of success). Conclusion MDCT is the technique of choice in preoperative assessment of patient of SNHL.

Hearing and Mortality Outcomes following Temporal Bone Fractures

The aim of this article is to determine hearing and mortality outcomes following temporal bone fractures. Retrospective chart review was performed of 152 patients diagnosed with a temporal bone fracture presenting to the emergency room at a tertiary care referral center over a 10-year period. Utilizing Patients’ previously obtained temporal bone computed tomographic scans and audiograms, fractures were classified based on several classification schemes. Correlations between fracture patterns, mortality, and hearing outcomes were analyzed using χ2 tests. Ossicular chain disruption was seen in 11.8% of patients, and otic capsule violation was seen in 5.9%; 22.7% of patients presented for audiologic follow-up. Seventeen patients with conductive hearing loss had air–bone gaps of 26 ± 7.5 dB (500 Hz), 27 ± 6.8 dB (1,000 Hz), 18 ± 6.2 dB (2,000 Hz), and 32 ± 7.7 dB (4,000 Hz). Two cases of profound sensorineural hearing loss were associated with otic capsule violation. No fracture classification scheme was predictive of hearing loss, although longitudinal fractures were statistically associated with ossicular chain disruption ( p < 0.01). Temporal bone fractures in patients older than 60 years carried a relative risk of death of 3.15 compared with those younger than 60 years. The average magnitude of conductive hearing loss resulting from temporal bone fracture ranged from 18 to 32 dB in this cohort. Classification of fracture type was not predictive of hearing loss, despite the statistical association between ossicular chain disruption and longitudinal fractures. This finding may be due to the low follow-up rates of this patient population. Physicians should make a concerted effort to ensure that audiological monitoring is executed to prevent and manage long-term hearing impairment.

Arthroscopic treatement of patella fractures in children

Introduction. The frequency of patellar fractures is approximately 0.5% to 1.5% of all skeletal injuries. The following types of fractures can be distinguished: avulsive, transverse, longitudinal, and comminuted. In cases of displacement of more than 2–3 mm and quadriceps tendon injuries open reduction and internal fixation with the restoration of the articular surface is more preferable. In cases of longitudinal fractures, arthroscopy is regarded as a highly effective method of surgical treatment. Materials and methods. Using arthroscopy, we have operated on 4 patients with longitudinal fracture of the patella. The average age of the injured persons was 15.4 years (14–17). These were 3 males and 1 female. All patients had sport-related injuries. Because of the longitudinal fracture of the patella, the lateral knee extensor mechanism remained intact, and arthrosopy-assisted surgical intervention with closed reposition of fragments and transcutaneous wire fixation was performed without wire suturing. Results and discussion. Minimal invasiveness, the possibility of visual control over the recovery quality of patellar surface, the reliability of fragment fixation, and a significant reduction in the subsequent rehabilitation make arthroscopy a highly effective method of surgical treatment for patellar fractures.

Splinting of Longitudinal Fracture: An Innovative Approach

Trauma may result in craze lines on the enamel surface, one or more fractured cusps of posterior teeth, cracked tooth syndrome, splitting of posterior teeth, and vertical fracture of root. Out of these, management of some fractures is of great challenge and such teeth are generally recommended for extraction. Literature search reveals attempts to manage such fractures by full cast crown, orthodontic wires, and so forth, in which consideration was given to extracoronal splinting only. However, due to advancement in materials and technologies, intracoronal splinting can be achieved as well. In this case report, longitudinal fractures in tooth #27, tooth #37, and tooth #46 had occurred. In #27, fracture line was running mesiodistally involving the pulpal floor resulting in a split tooth. In teeth 37 and 46, fractures of the mesiobuccal cusp and mesiolingual cusp were observed, respectively. They were restored with cast gold inlay and full cast crown, respectively. Longitudinal fracture of 27 was treated with an innovative approach using intracanal reinforced composite with Ribbond, external reinforcement with an orthodontic band, and full cast metal crown to splint the split tooth.

FRACTURE MODELING IN OIL AND GAS RESERVOIRS USING IMAGE LOGS DATA AND PETREL SOFTWARE

The purpose of modelling the fractures is to create simulation properties with the power to predict the reservoir behaviour. Petrel software is one of the best softwares in the market that can do this task very well, but there is no available educational paper for every researcher. Therefore, in this work, a fracture modelling job was done in one of the most important Iranian fields using Petrel software and image log data. The purpose of this work was to determine the new information of the fractures in Gachsaran field and also to prepare a valuable educational paper for other researchers who are interested to learn about the fracture modelling. This work revealed that in this field, the longitudinal fractures had been parallel to minimum stress (Zagros trend), fracture intensity was the nearest to the major fault and northern flank, fracture porosity was 0-7%, fracture permeability was 0-6000 MD, and more valuable information is provided in this paper.

Electron microscopy study of a vascular prosthesis destructed in vivo reveals fractures in Dacron fibers

The genuine destruction of a synthetic prosthesis wall, as a late complication of vascular surgery, is extremely rare. We report a case of a 64-year-old male who had his 12-year-old femoropopliteal synthetic graft explanted due to two large pseudoaneurysms in the middle section of the graft. Microscopic evaluation demonstrated the areas of focal thinning along the entire prosthesis wall, with “foreign body” type reaction in the adjacent connective tissue. Transmission electron microscopy showed longitudinal fractures of Dacron fibers interposed with cellular structures, suggesting that destruction must have taken place significantly earlier. The problems of limited graft durability and graft surveillance are discussed.