Journal of Laryngology and Otology最新文献

Background: The adipofascial anterolateral thigh (AF-ALT) free flap represents a versatile technique in head and neck reconstructions, with its applications increasingly broadening. The objective was to detail the novel utilization of the AF-ALT flap in orbital and skull base reconstruction, along with salvage laryngectomy onlay in our case series.

Method: We conducted a retrospective analysis at Roswell Park Comprehensive Cancer Center, spanning from July 2019 to June 2023, focusing on patient demographics and reconstructive parameters data.

Results: The AF-ALT flap was successfully employed in eight patients (average age 59, body mass index [BMI] 32.0) to repair various defects. Noteworthy outcomes were observed in skull base reconstructions, with no flap failures or major complications over an average 12-month follow-up. Donor sites typically healed well with minimal interventions.

Conclusion: Our series is the first to report the AF-ALT flap's efficacy in anterior skull base and orbital reconstructions, demonstrating an additional innovation in complex head and neck surgeries.

Objective: This study evaluates the safety and utility of Eustachian tube balloon dilatation in treating Eustachian tube dysfunction symptoms in adults without middle-ear disease.

Methods: A prospective cohort study was performed. Adults with dilatory Eustachian tube dysfunction symptoms and no middle-ear disease underwent Eustachian tube balloon dilatation. A clinical assessment including tympanometry, pure tone audiometry, otoscopy, ability to Valsalva, and Eustachian Tube Dysfunction Questionnaire-7 was performed pre-operatively and repeated during a 12-month follow-up period.

Results: Fifteen participants were enrolled. The mean pre-operative Eustachian Tube Dysfunction Questionnaire-7 score of 4.6 reduced to 2.5 at six weeks (P < 0.01), 3.0 at six months (P = 0.02) and 2.6 at 12 months (P < 0.01) post-operatively. All patients without evidence of negative middle-ear pressure had Eustachian Tube Dysfunction Questionnaire-7 score improvements. There were no post-operative complications.

Conclusion: Eustachian tube balloon dilatation is safe and effective at treating Eustachian tube dysfunction in patients with no middle-ear disease or evidence of negative middle-ear pressure.

Objectives: This study aimed to compare the graft success rate, hearing outcomes, operation time and complications between myringoplasty with raising of a mucosal flap (RMF) and raising of a tympanomeatal flap (RTF) for the repair of subtotal perforations.

Methods: Subtotal perforations were recruited and randomly allocated to either the RMF group or the RTF group. The graft success rate, hearing outcomes and complications were evaluated at 6 months post-operatively.

Results: The mean operation time was 31.4 ± 2.8 minutes (range: 26-47) in the RMF group and 57.6 ± 0.9 minutes in the RTF group (p < 0.01). The graft success rate was 96.0 per cent in the RMF group and 88.9 per cent in the RTF group (p = 0.659).

Conclusion: Endoscopic myringoplasty with the RMF achieved similar graft success and hearing gain compared to the tympanomeatal flap technique for repairing subtotal perforations, but with significantly shorter operation time and minimal temporary hypogeusia.

Objective: This study aimed to assess the impact of the scutum on oval window accessibility during stapedotomy surgery. Radio-clinical correlation was applied to determine the impact.

Methods: This was a prospective observational case-series study that included 127 candidates for stapedotomy surgery. The oval fossa was classified into two types according to the accessibility of the stapes footplate.

Results: Both study groups showed a statistically significant difference in pre-operative radiological length as the p value was less than 0.001. The Spearman correlation coefficient revealed that the intra-operative oval window fossa was only significantly related to the radiological scutum length because the p value was less than 0.001.

Conclusion: Our results revealed that the pre-operative radiological length can predict the intra-operative oval fossa type with high sensitivity and specificity. Patients with a pre-operative scutum length of less than 2.35 mm were predicted to have an easily accessible oval window without requiring intra-operative scutum curettage.

Objectives: This study aimed to investigate the impact of vitamin D deficiency on vestibular function and recurrence in patients with benign paroxysmal positional vertigo.

Methods: This study enrolled 138 patients diagnosed with benign paroxysmal positional vertigo. Vestibular function was evaluated, including ocular vestibular evoked myogenic potentials, cervical vestibular evoked myogenic potentials and caloric tests. Vitamin D levels were recorded.

Results: There was a significant difference in mean vitamin D levels between the normal and abnormal groups of the caloric test, cervical vestibular evoked myogenic potentials, and ocular vestibular evoked myogenic potentials. The likelihood of abnormal vestibular function was lower in patients with normal vitamin D levels than those with deficient levels (< 10 ng/ml). Vitamin D levels were the only predictive factor for recurrence among patients with benign paroxysmal positional vertigo.

Conclusion: A deficiency in vitamin D is more likely to result in abnormalities in the caloric test, cervical vestibular evoked myogenic potentials, and ocular vestibular evoked myogenic potentials in benign paroxysmal positional vertigo patients. The interaction among these factors may contribute to the recurrence.