Pub Date : 2017-02-01DOI: 10.1017/S0022215116009920
L. Flood
{"title":"SCARY CASES IN OTOLARYNGOLOGY M P Platt, K M Grundfast Plural Publishing, 2017 ISBN 978 1 59756 654 4 pp 230 Price US$99.95","authors":"L. Flood","doi":"10.1017/S0022215116009920","DOIUrl":"https://doi.org/10.1017/S0022215116009920","url":null,"abstract":"","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"15 1","pages":"185 - 185"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88041121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-26DOI: 10.1017/S0022215117000032
N. Venkatesan, C. Johnson, M. T. Siddiqui, D. Cates, M. Kuhn, G. Postma, P. Belafsky
Abstract Objectives: To validate the ovine model of profound oropharyngeal dysphagia and compare swallowing outcomes of laryngotracheal separation with those of total laryngectomy. Methods: Under real-time fluoroscopy, swallowing trials were conducted using the head and neck of two Dorper cross ewes and one human cadaver, secured in lateral fluoroscopic orientation. Barium trials were administered at baseline, pre- and post-laryngohyoid suspension, following laryngotracheal separation, and following laryngectomy in the ovine model. Results: Mean pre-intervention Penetration Aspiration Scale and National Institutes of Health Swallow Safety Scale scores were 8 ± 0 and 6 ± 0 respectively in sheep and human cadavers, with 100 per cent intra- and inter-species reproducibility. These scores improved to 1 ± 0 and 2 ± 0 post-laryngohyoid suspension (p < 0.01). Aerodigestive tract residue was 18.6 ± 2.4 ml at baseline, 15.4 ± 3.8 ml after laryngotracheal separation and 3.0 ± 0.7 ml after total laryngectomy (p < 0.001). Conclusion: The ovine model displayed perfect intra- and inter- species reliability for the Penetration Aspiration Scale and Swallow Safety Scale. Less aerodigestive tract residue after narrow-field laryngectomy suggests that swallowing outcomes after total laryngectomy are superior to those after laryngotracheal separation.
摘要目的:验证羊重度口咽吞咽困难模型，比较喉气管分离与全喉切除术的吞咽效果。方法:在实时透视下，以2只杜珀杂交母羊和1具人尸的头颈部进行吞咽试验，并在侧位透视下固定。在羊模型中，分别在基线、喉舌骨悬吊前后、喉气管分离后和喉切除术后进行钡试验。结果:干预前渗透吸入量表和美国国立卫生研究院吞咽安全量表在羊和人尸体中的平均得分分别为8±0和6±0，种内和种间的重复性为100%。喉舌骨悬吊后得分分别为1±0分和2±0分(p < 0.01)。气道残留基线时为18.6±2.4 ml，喉气管分离后为15.4±3.8 ml，全喉切除术后为3.0±0.7 ml (p < 0.001)。结论:该模型对渗透吸入量表和吞咽安全量表具有良好的种内和种间可靠性。窄场喉切除术后气管消化道残留较少，说明全喉切除术后吞咽效果优于喉气管分离术。
{"title":"Comparison of swallowing outcomes of laryngotracheal separation versus total laryngectomy in a validated ovine model of profound oropharyngeal dysphagia","authors":"N. Venkatesan, C. Johnson, M. T. Siddiqui, D. Cates, M. Kuhn, G. Postma, P. Belafsky","doi":"10.1017/S0022215117000032","DOIUrl":"https://doi.org/10.1017/S0022215117000032","url":null,"abstract":"Abstract Objectives: To validate the ovine model of profound oropharyngeal dysphagia and compare swallowing outcomes of laryngotracheal separation with those of total laryngectomy. Methods: Under real-time fluoroscopy, swallowing trials were conducted using the head and neck of two Dorper cross ewes and one human cadaver, secured in lateral fluoroscopic orientation. Barium trials were administered at baseline, pre- and post-laryngohyoid suspension, following laryngotracheal separation, and following laryngectomy in the ovine model. Results: Mean pre-intervention Penetration Aspiration Scale and National Institutes of Health Swallow Safety Scale scores were 8 ± 0 and 6 ± 0 respectively in sheep and human cadavers, with 100 per cent intra- and inter-species reproducibility. These scores improved to 1 ± 0 and 2 ± 0 post-laryngohyoid suspension (p < 0.01). Aerodigestive tract residue was 18.6 ± 2.4 ml at baseline, 15.4 ± 3.8 ml after laryngotracheal separation and 3.0 ± 0.7 ml after total laryngectomy (p < 0.001). Conclusion: The ovine model displayed perfect intra- and inter- species reliability for the Penetration Aspiration Scale and Swallow Safety Scale. Less aerodigestive tract residue after narrow-field laryngectomy suggests that swallowing outcomes after total laryngectomy are superior to those after laryngotracheal separation.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"1 1","pages":"350 - 356"},"PeriodicalIF":0.0,"publicationDate":"2017-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78093506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-26DOI: 10.1017/S0022215116009956
L. Park, N. Lilic, B. Addison, R. Patel
Abstract Objective: Osteoradionecrosis is a significant complication of head and neck cancer treatment, and its most severe form (grade III) necessitates radical surgery. This study aimed to compare the cost of free-flap reconstructive surgery for grade III osteoradionecrosis and similar non-osteoradionecrosis cases in order to assess the cost burden of osteoradionecrosis treatment. Methods: All patients who underwent free-flap reconstructive surgery for osteoradionecrosis between July 2004 and July 2010 at Auckland City Hospital (19 patients) were identified, and relevant data were collected retrospectively. These patients were matched in terms of age and sex with patients who underwent free-flap reconstructive surgery. Results: The treatment cost was 44 per cent higher in osteoradionecrosis patients when compared to non-osteoradionecrosis patients. Conclusion: The significant financial burden on the health system, and the growing evidence for the effectiveness of pentoxifylline, tocopherol and clodronate, should prompt us to explore this alternative treatment further.
{"title":"Cost analysis of osteoradionecrosis","authors":"L. Park, N. Lilic, B. Addison, R. Patel","doi":"10.1017/S0022215116009956","DOIUrl":"https://doi.org/10.1017/S0022215116009956","url":null,"abstract":"Abstract Objective: Osteoradionecrosis is a significant complication of head and neck cancer treatment, and its most severe form (grade III) necessitates radical surgery. This study aimed to compare the cost of free-flap reconstructive surgery for grade III osteoradionecrosis and similar non-osteoradionecrosis cases in order to assess the cost burden of osteoradionecrosis treatment. Methods: All patients who underwent free-flap reconstructive surgery for osteoradionecrosis between July 2004 and July 2010 at Auckland City Hospital (19 patients) were identified, and relevant data were collected retrospectively. These patients were matched in terms of age and sex with patients who underwent free-flap reconstructive surgery. Results: The treatment cost was 44 per cent higher in osteoradionecrosis patients when compared to non-osteoradionecrosis patients. Conclusion: The significant financial burden on the health system, and the growing evidence for the effectiveness of pentoxifylline, tocopherol and clodronate, should prompt us to explore this alternative treatment further.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"106 1","pages":"303 - 308"},"PeriodicalIF":0.0,"publicationDate":"2017-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72753007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-23DOI: 10.1017/S0022215117000068
P. Doyle, I. Beegun, H. Saleh
Abstract Objectives: When performing septoplasty or septorhinoplasty, we have observed that patients blink on injection of local anaesthetic (lidocaine 1 per cent with adrenaline 1:80 000) into the nasal mucosa of the anterior septum or vestibular skin, despite appropriate general anaesthesia. This study sought to quantify this phenomenon by conducting a prospective audit of all patients undergoing septoplasty or septorhinoplasty. Methods: Patients were observed for a blink reflex at the time of local anaesthetic infiltration into the nasal vestibule. Also measured at this point were propofol target-controlled infusion levels, remifentanil rate, bispectral index, blood pressure, heart rate, pupil size and position, and patient movement. Results: There were 15 blink reflexes in the 30 patients observed. The average bispectral index value was 32.75 (range, 22–50) in the blink group and 26.77 (range, 18–49) in the non-blink group. No patients moved on local anaesthetic injection. Conclusion: The blink reflex appears to occur in 50 per cent of patients, despite a deep level of anaesthesia. Without an understanding and appreciation of the blink reflex, this event may result in a request to deepen anaesthesia, but this is not necessary and surgery can proceed safely.
{"title":"The Doyle–Saleh blink reflex","authors":"P. Doyle, I. Beegun, H. Saleh","doi":"10.1017/S0022215117000068","DOIUrl":"https://doi.org/10.1017/S0022215117000068","url":null,"abstract":"Abstract Objectives: When performing septoplasty or septorhinoplasty, we have observed that patients blink on injection of local anaesthetic (lidocaine 1 per cent with adrenaline 1:80 000) into the nasal mucosa of the anterior septum or vestibular skin, despite appropriate general anaesthesia. This study sought to quantify this phenomenon by conducting a prospective audit of all patients undergoing septoplasty or septorhinoplasty. Methods: Patients were observed for a blink reflex at the time of local anaesthetic infiltration into the nasal vestibule. Also measured at this point were propofol target-controlled infusion levels, remifentanil rate, bispectral index, blood pressure, heart rate, pupil size and position, and patient movement. Results: There were 15 blink reflexes in the 30 patients observed. The average bispectral index value was 32.75 (range, 22–50) in the blink group and 26.77 (range, 18–49) in the non-blink group. No patients moved on local anaesthetic injection. Conclusion: The blink reflex appears to occur in 50 per cent of patients, despite a deep level of anaesthesia. Without an understanding and appreciation of the blink reflex, this event may result in a request to deepen anaesthesia, but this is not necessary and surgery can proceed safely.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"21 1","pages":"347 - 349"},"PeriodicalIF":0.0,"publicationDate":"2017-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85503408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-11DOI: 10.1017/S0022215116009944
Tiia Kujala, Alho Op, A. Kristo, Matti Uhari, M. Renko, T. Pokka, Peppi Koivunen
Abstract Objective: Acute otitis media causes discomfort to children and inconvenience to their parents. This study evaluated the quality of life in children with recurrent acute otitis media aged less than 24 months. Methods: Quality of life was evaluated in 149 children aged 10 to 24 months who were referred to the Oulu University Hospital on account of recurrent acute otitis media. The children were treated with or without surgery. Age-matched controls were selected randomly from the general child population. Parents completed the Child Health Questionnaire. Results: The children with recurrent acute otitis media had a significantly poorer quality of life than control children. The control children with a history of a few acute otitis media episodes had a significantly poorer quality of life than those without any such history. The quality of life of the children with recurrent acute otitis media improved during the one-year follow up, regardless of the treatment, but did not reach the same level as healthy children. Conclusion: Acute otitis media detracted from quality of life when a generic measure was used. The mode of treatment used to prevent further recurrences of acute otitis media did not influence quality of life improvement.
{"title":"Recurrent acute otitis media detracts from health-related quality of life","authors":"Tiia Kujala, Alho Op, A. Kristo, Matti Uhari, M. Renko, T. Pokka, Peppi Koivunen","doi":"10.1017/S0022215116009944","DOIUrl":"https://doi.org/10.1017/S0022215116009944","url":null,"abstract":"Abstract Objective: Acute otitis media causes discomfort to children and inconvenience to their parents. This study evaluated the quality of life in children with recurrent acute otitis media aged less than 24 months. Methods: Quality of life was evaluated in 149 children aged 10 to 24 months who were referred to the Oulu University Hospital on account of recurrent acute otitis media. The children were treated with or without surgery. Age-matched controls were selected randomly from the general child population. Parents completed the Child Health Questionnaire. Results: The children with recurrent acute otitis media had a significantly poorer quality of life than control children. The control children with a history of a few acute otitis media episodes had a significantly poorer quality of life than those without any such history. The quality of life of the children with recurrent acute otitis media improved during the one-year follow up, regardless of the treatment, but did not reach the same level as healthy children. Conclusion: Acute otitis media detracted from quality of life when a generic measure was used. The mode of treatment used to prevent further recurrences of acute otitis media did not influence quality of life improvement.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"16 1","pages":"128 - 137"},"PeriodicalIF":0.0,"publicationDate":"2017-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78611289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-10DOI: 10.1017/S002221511600997X
S. Geerse, F. Ebbens, M. D. de Wolf, E. van Spronsen
Abstract Objective: This study aimed to evaluate the results of revision radical cavity surgery with mastoid obliteration using a standardised grading scheme. Methods: A retrospective study was performed of 121 patients (122 ears) with chronically draining ears who underwent revision radical cavity surgery with mastoid obliteration between 2007 and 2013. Surgical indications, patient characteristics, pre- and post-operative Merchant grade, and surgical outcomes were recorded. The main outcome measures were presence of a dry ear, time for complete re-epithelialisation, presence of residual or recurrent disease, and need for revision surgery. Results: In the 5-year follow-up group (n = 31), dry ears were found in 97 per cent after 6 minor revisions and cholesteatoma-free ears were found in 97 per cent. In the total cohort, dry ears were found in 93 per cent after nine revisions and cholesteatoma-free ears were found in 98 per cent. The median time for complete re-epithelialisation was eight weeks. There were no major complications. Conclusion: In terms of the dry ear rate, residual cholesteatoma and time to complete epithelialisation, revision radical cavity surgery with mastoid obliteration produces very good results in concordance with published results, despite most patients suffering from very troublesome cavities prior to surgery.
{"title":"Successful obliteration of troublesome and chronically draining cavities","authors":"S. Geerse, F. Ebbens, M. D. de Wolf, E. van Spronsen","doi":"10.1017/S002221511600997X","DOIUrl":"https://doi.org/10.1017/S002221511600997X","url":null,"abstract":"Abstract Objective: This study aimed to evaluate the results of revision radical cavity surgery with mastoid obliteration using a standardised grading scheme. Methods: A retrospective study was performed of 121 patients (122 ears) with chronically draining ears who underwent revision radical cavity surgery with mastoid obliteration between 2007 and 2013. Surgical indications, patient characteristics, pre- and post-operative Merchant grade, and surgical outcomes were recorded. The main outcome measures were presence of a dry ear, time for complete re-epithelialisation, presence of residual or recurrent disease, and need for revision surgery. Results: In the 5-year follow-up group (n = 31), dry ears were found in 97 per cent after 6 minor revisions and cholesteatoma-free ears were found in 97 per cent. In the total cohort, dry ears were found in 93 per cent after nine revisions and cholesteatoma-free ears were found in 98 per cent. The median time for complete re-epithelialisation was eight weeks. There were no major complications. Conclusion: In terms of the dry ear rate, residual cholesteatoma and time to complete epithelialisation, revision radical cavity surgery with mastoid obliteration produces very good results in concordance with published results, despite most patients suffering from very troublesome cavities prior to surgery.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"60 1","pages":"138 - 143"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88514284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-10DOI: 10.1017/S0022215116010021
K. Stephenson, J. Fagan
Abstract Background: The optimal management of glottic carcinoma involving the anterior commissure is controversial. Method: A retrospective analysis was conducted of 76 patients with glottic squamous cell carcinoma treated by transoral carbon dioxide laser resection by a single surgeon. Results: Sixty-three patients (with tumour stage Tis–T3) were eligible for inclusion. Thirty patients had involvement of the anterior commissure; these patients were significantly more likely to have either uncertain or positive margins (63.3 vs 30.3 per cent, p = 0.012), and were also more likely to receive adjuvant radiotherapy (40 vs 3.2 per cent, p = 0.0005). The overall laryngeal preservation rate was 96.8 per cent; there was no statistically significant difference between those with and without anterior commissure involvement (96.7 and 96.9 per cent respectively). Conclusion: Transoral laser resection with the use of adjuvant radiotherapy in a minority of patients with adverse pathological findings can be recommended for the primary treatment of anterior commissure glottic cancer from an oncological perspective; excellent local control and laryngeal preservation rates can be achieved.
{"title":"Transoral laser resection of glottic carcinoma: what is the significance of anterior commissure involvement?","authors":"K. Stephenson, J. Fagan","doi":"10.1017/S0022215116010021","DOIUrl":"https://doi.org/10.1017/S0022215116010021","url":null,"abstract":"Abstract Background: The optimal management of glottic carcinoma involving the anterior commissure is controversial. Method: A retrospective analysis was conducted of 76 patients with glottic squamous cell carcinoma treated by transoral carbon dioxide laser resection by a single surgeon. Results: Sixty-three patients (with tumour stage Tis–T3) were eligible for inclusion. Thirty patients had involvement of the anterior commissure; these patients were significantly more likely to have either uncertain or positive margins (63.3 vs 30.3 per cent, p = 0.012), and were also more likely to receive adjuvant radiotherapy (40 vs 3.2 per cent, p = 0.0005). The overall laryngeal preservation rate was 96.8 per cent; there was no statistically significant difference between those with and without anterior commissure involvement (96.7 and 96.9 per cent respectively). Conclusion: Transoral laser resection with the use of adjuvant radiotherapy in a minority of patients with adverse pathological findings can be recommended for the primary treatment of anterior commissure glottic cancer from an oncological perspective; excellent local control and laryngeal preservation rates can be achieved.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"71 1","pages":"168 - 172"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86397789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-10DOI: 10.1017/S002221511601001X
Chloe Swords, Matthew E. Smith, J. Wasson, Asad Qayyum, J. Tysome
Abstract Background: First-on-call ENT cover is often provided by junior doctors with limited ENT experience; yet, they may have to manage life-threatening emergencies. An intensive 1-day simulation course was developed to teach required skills to junior doctors. Methods: A prospective, single-blinded design was used. Thirty-seven participants rated their confidence before the course, immediately following the course and after a two-month interval. Blinded assessors scored participant performance in two video-recorded simulated scenarios before and after the course. Results: Participant self-rated confidence was increased in the end-of-course survey (score of 27.5 vs 53.0; p < 0.0001), and this was maintained two to four months after the course (score of 50.5; p < 0.0001). Patient assessment and management in video-recorded emergency scenarios was significantly improved following course completion (score of 9.75 vs 18.75; p = 0.0093). Conclusion: This course represents an effective method of teaching ENT emergency management to junior doctors. ENT induction programmes benefit from the incorporation of a simulation component.
背景:耳鼻喉科急诊通常由经验有限的初级医生提供;然而，他们可能不得不处理危及生命的紧急情况。开发了为期1天的强化模拟课程，向初级医生教授所需技能。方法:采用前瞻性单盲设计。37名参与者在课程开始前、课程结束后和间隔两个月后对自己的信心进行了评分。盲法评估人员对参与者在课程前后的两个模拟视频场景中的表现进行评分。结果:在课程结束调查中，参与者的自评信心有所增加(得分27.5 vs 53.0;P < 0.0001)，并且在课程结束后2至4个月保持这种情况(得分为50.5;P < 0.0001)。在课程结束后，视频记录的紧急情况下的患者评估和管理显著改善(得分9.75 vs 18.75;P = 0.0093)。结论:本课程是对初级医师进行耳鼻喉科急诊管理教学的有效方法。耳鼻喉科入门课程受益于模拟部分的纳入。
{"title":"Validation of a new ENT emergencies course for first-on-call doctors","authors":"Chloe Swords, Matthew E. Smith, J. Wasson, Asad Qayyum, J. Tysome","doi":"10.1017/S002221511601001X","DOIUrl":"https://doi.org/10.1017/S002221511601001X","url":null,"abstract":"Abstract Background: First-on-call ENT cover is often provided by junior doctors with limited ENT experience; yet, they may have to manage life-threatening emergencies. An intensive 1-day simulation course was developed to teach required skills to junior doctors. Methods: A prospective, single-blinded design was used. Thirty-seven participants rated their confidence before the course, immediately following the course and after a two-month interval. Blinded assessors scored participant performance in two video-recorded simulated scenarios before and after the course. Results: Participant self-rated confidence was increased in the end-of-course survey (score of 27.5 vs 53.0; p < 0.0001), and this was maintained two to four months after the course (score of 50.5; p < 0.0001). Patient assessment and management in video-recorded emergency scenarios was significantly improved following course completion (score of 9.75 vs 18.75; p = 0.0093). Conclusion: This course represents an effective method of teaching ENT emergency management to junior doctors. ENT induction programmes benefit from the incorporation of a simulation component.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"26 1","pages":"106 - 112"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80679191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-10DOI: 10.1017/S0022215116009993
G. Singh, S. Ranjan, R. Arora, S. Kumar
Abstract Objective: This study aimed to evaluate the surgical success of a modified inlay tympanoplasty technique, known as circumferential subannular tympanoplasty, for anterior and subtotal perforations. Methods: This prospective study was performed in a tertiary care teaching hospital between October 2013 and April 2016. A total of 58 adult patients of both sexes with anterior or subtotal perforations underwent circumferential subannular tympanoplasty under local anaesthesia. In this technique, after tympanomeatal flap elevation, the temporalis fascia graft is placed directly onto the annulus instead of being tucked underneath the tympanic membrane remnant. Outcome data were graft uptake and hearing improvement. Results: This technique had a surgical success rate of 97 per cent and led to significant hearing improvement. Conclusion: Circumferential subannular tympanoplasty has a definitive role in managing anterior and subtotal perforations.
{"title":"Role of circumferential subannular tympanoplasty in anterior and subtotal perforations","authors":"G. Singh, S. Ranjan, R. Arora, S. Kumar","doi":"10.1017/S0022215116009993","DOIUrl":"https://doi.org/10.1017/S0022215116009993","url":null,"abstract":"Abstract Objective: This study aimed to evaluate the surgical success of a modified inlay tympanoplasty technique, known as circumferential subannular tympanoplasty, for anterior and subtotal perforations. Methods: This prospective study was performed in a tertiary care teaching hospital between October 2013 and April 2016. A total of 58 adult patients of both sexes with anterior or subtotal perforations underwent circumferential subannular tympanoplasty under local anaesthesia. In this technique, after tympanomeatal flap elevation, the temporalis fascia graft is placed directly onto the annulus instead of being tucked underneath the tympanic membrane remnant. Outcome data were graft uptake and hearing improvement. Results: This technique had a surgical success rate of 97 per cent and led to significant hearing improvement. Conclusion: Circumferential subannular tympanoplasty has a definitive role in managing anterior and subtotal perforations.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"18 1","pages":"123 - 127"},"PeriodicalIF":0.0,"publicationDate":"2017-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86012507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-09DOI: 10.1017/S0022215116009816
M. Taube, G. M. Potter, S. Lloyd, S. Freeman
Abstract Background: A pneumocele occurs when an aerated cranial cavity pathologically expands; a pneumatocele occurs when air extends from an aerated cavity into adjacent soft tissues forming a secondary cavity. Both pathologies are extremely rare with relation to the mastoid. This paper describes a case of a mastoid pneumocele that caused hypoglossal nerve palsy and an intracranial pneumatocele. Case report: A 46-year-old man presented, following minor head trauma, with hypoglossal nerve palsy secondary to a fracture through the hypoglossal canal. The fracture occurred as a result of a diffuse temporal bone pneumocele involving bone on both sides of the hypoglossal canal. Further slow expansion of the mastoid pneumocele led to a secondary middle fossa pneumatocele. The patient refused treatment and so has been managed conservatively for more than five years, and he remains well. Conclusion: While most patients with otogenic pneumatoceles have presented acutely in extremis secondary to tension pneumocephalus, our patient has remained largely asymptomatic. Aetiology, clinical features and management options of temporal bone pneumoceles and otogenic pneumatoceles are reviewed.
{"title":"Successful conservative treatment of an intracranial pneumatocele with post-traumatic hypoglossal nerve palsy secondary to diffuse temporal bone pneumocele: case report and review of the literature","authors":"M. Taube, G. M. Potter, S. Lloyd, S. Freeman","doi":"10.1017/S0022215116009816","DOIUrl":"https://doi.org/10.1017/S0022215116009816","url":null,"abstract":"Abstract Background: A pneumocele occurs when an aerated cranial cavity pathologically expands; a pneumatocele occurs when air extends from an aerated cavity into adjacent soft tissues forming a secondary cavity. Both pathologies are extremely rare with relation to the mastoid. This paper describes a case of a mastoid pneumocele that caused hypoglossal nerve palsy and an intracranial pneumatocele. Case report: A 46-year-old man presented, following minor head trauma, with hypoglossal nerve palsy secondary to a fracture through the hypoglossal canal. The fracture occurred as a result of a diffuse temporal bone pneumocele involving bone on both sides of the hypoglossal canal. Further slow expansion of the mastoid pneumocele led to a secondary middle fossa pneumatocele. The patient refused treatment and so has been managed conservatively for more than five years, and he remains well. Conclusion: While most patients with otogenic pneumatoceles have presented acutely in extremis secondary to tension pneumocephalus, our patient has remained largely asymptomatic. Aetiology, clinical features and management options of temporal bone pneumoceles and otogenic pneumatoceles are reviewed.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"35 7 1","pages":"181 - 184"},"PeriodicalIF":0.0,"publicationDate":"2017-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81161140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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