Pub Date : 2022-01-01DOI: 10.21608/ejentas.2022.118244.1465
Amr Elemam, Hazem Dewidar, A. Shawky, Mahmoud S. Elfouly, M. Sabaa
Background: Preservation of the middle nasal vault has become a main concern in primary rhinoplasty surgery. This research elucidates the outcome of the hump re-insertion technique as a method to reconstruct the mid-vault in primary rhinoplasty after dorsal hump resection in comparison to the hump resection with no dorsal grafting technique. Patients and Methods: This study was a randomized controlled trial, conducted on forty patients, divided into 2 groups: Group (A) included 20 patients underwent dorsal hump remodeling and reinsertion, while group (B) involved 20 patients subjected to hump resection with no dorsal grafting. Patients were assessed by the Nasal Obstruction Symptom Evaluation (NOSE) score, the active anterior rhinomanometry, Visual Analogue Scale (VAS) scale and photography. Results: Both groups showed significant improvement in NOSE scores postoperatively. there was a superiority in group A with mean score 23 compared to group B with score 27.5 ( P =0.005 ). 65% of group (A) patients showed improvement to VAS 4 compared to 20% for group B ( P =0.004 ). Postoperative mean nasal airway resistance comparison was statistically insignificant ( P=0.2 ). There was more effective narrowing in dorsal width of nasal bones in group A. Conclusion: Hump remodeling and re-insertion technique is more superior in the aesthetic outcome with more natural looking dorsum and narrowing of the dorsal nasal width. Additionally, it decreases in the need for osteotomies and avoids their consequences. Hump reinsertion is useful as a rescue procedure in case of excessive dorsal resection. Dorsal reconstruction, Hump re-insertion, Primary rhinoplasty.
{"title":"Outcome after Dorsal Hump Resection versus Hump Remodeling and Re-insertion: A Randomized Controlled Trial","authors":"Amr Elemam, Hazem Dewidar, A. Shawky, Mahmoud S. Elfouly, M. Sabaa","doi":"10.21608/ejentas.2022.118244.1465","DOIUrl":"https://doi.org/10.21608/ejentas.2022.118244.1465","url":null,"abstract":"Background: Preservation of the middle nasal vault has become a main concern in primary rhinoplasty surgery. This research elucidates the outcome of the hump re-insertion technique as a method to reconstruct the mid-vault in primary rhinoplasty after dorsal hump resection in comparison to the hump resection with no dorsal grafting technique. Patients and Methods: This study was a randomized controlled trial, conducted on forty patients, divided into 2 groups: Group (A) included 20 patients underwent dorsal hump remodeling and reinsertion, while group (B) involved 20 patients subjected to hump resection with no dorsal grafting. Patients were assessed by the Nasal Obstruction Symptom Evaluation (NOSE) score, the active anterior rhinomanometry, Visual Analogue Scale (VAS) scale and photography. Results: Both groups showed significant improvement in NOSE scores postoperatively. there was a superiority in group A with mean score 23 compared to group B with score 27.5 ( P =0.005 ). 65% of group (A) patients showed improvement to VAS 4 compared to 20% for group B ( P =0.004 ). Postoperative mean nasal airway resistance comparison was statistically insignificant ( P=0.2 ). There was more effective narrowing in dorsal width of nasal bones in group A. Conclusion: Hump remodeling and re-insertion technique is more superior in the aesthetic outcome with more natural looking dorsum and narrowing of the dorsal nasal width. Additionally, it decreases in the need for osteotomies and avoids their consequences. Hump reinsertion is useful as a rescue procedure in case of excessive dorsal resection. Dorsal reconstruction, Hump re-insertion, Primary rhinoplasty.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76834709","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 : 2022-01-01DOI: 10.21608/ejentas.2022.129609.1488
Widia Sujana, Iriana Maharani
Introduction: Chronic Rhinosinusitis (CRS) produce economic strain to patients and health system. The Sinonasal Outcome Test 22-item (SNOT-22) measured the subjective symptoms of CRS. This questionnaire was beneficial for clinical practice to understand the amplitude of patient’s symptoms. While the objective measurement from CT-Scan was developed to evaluate the disease severity such as the Lund-Mackay Score (LMS) and the Harvard staging system. Objective: To examine the correlation between the SNOT-22 and the CT-Scan scoring system of Lund-Mackay Score and Harvard staging system in patients diagnosed with CRS. Material and Methods: This was a retrospective cross-sectional study using medical records between 1 January 2019 and 30 September 2021 in Otorhinolaryngology Head and Neck Surgery Department. A total of 29 patients were included in this study. The SNOT-22 score and CT-Scan were obtained as part of routine preparations before surgery and recorded in the medical records. Result: The correlation coefficient between the total score of SNOT-22 and LMS was 0.77 ( p-value <0.05). There was a significant correlation between the total score of SNOT-22 and the Harvard staging ( p-value <0.05). A significant correlation between SNOT-22 domain of rhinologic, sleep dysfunction, and psychological dysfunction domain with the Harvard staging system were found with the correlation coefficient of 0.57 ( p-value <0.05), 0.44 ( p-value = 0.02), 0.47 ( p-value 0.01), respectively. Conclusions: In specific domains of SNOT-22, both CT-Scan scoring were correlated with the nasal domain. While only the Harvard staging system showing additional correlation with the sleep and psychological domains.
{"title":"The Correlation Between the CT-Scan Scoring System and the SNOT-22 Score in Adult Chronic Rhinosinusitis","authors":"Widia Sujana, Iriana Maharani","doi":"10.21608/ejentas.2022.129609.1488","DOIUrl":"https://doi.org/10.21608/ejentas.2022.129609.1488","url":null,"abstract":"Introduction: Chronic Rhinosinusitis (CRS) produce economic strain to patients and health system. The Sinonasal Outcome Test 22-item (SNOT-22) measured the subjective symptoms of CRS. This questionnaire was beneficial for clinical practice to understand the amplitude of patient’s symptoms. While the objective measurement from CT-Scan was developed to evaluate the disease severity such as the Lund-Mackay Score (LMS) and the Harvard staging system. Objective: To examine the correlation between the SNOT-22 and the CT-Scan scoring system of Lund-Mackay Score and Harvard staging system in patients diagnosed with CRS. Material and Methods: This was a retrospective cross-sectional study using medical records between 1 January 2019 and 30 September 2021 in Otorhinolaryngology Head and Neck Surgery Department. A total of 29 patients were included in this study. The SNOT-22 score and CT-Scan were obtained as part of routine preparations before surgery and recorded in the medical records. Result: The correlation coefficient between the total score of SNOT-22 and LMS was 0.77 ( p-value <0.05). There was a significant correlation between the total score of SNOT-22 and the Harvard staging ( p-value <0.05). A significant correlation between SNOT-22 domain of rhinologic, sleep dysfunction, and psychological dysfunction domain with the Harvard staging system were found with the correlation coefficient of 0.57 ( p-value <0.05), 0.44 ( p-value = 0.02), 0.47 ( p-value 0.01), respectively. Conclusions: In specific domains of SNOT-22, both CT-Scan scoring were correlated with the nasal domain. While only the Harvard staging system showing additional correlation with the sleep and psychological domains.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91182910","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 : 2022-01-01DOI: 10.21608/ejentas.2022.121392.1473
A. Rabie, M. Elbegermy, M. Yassin, M. Aleem
Background: Nasal skin edema is a common result of soft and bony tissue trauma during rhinoplasty. In a cosmetic surgery like rhinoplasty, skin edema can fade the cosmetic results and can lead to dissatisfaction for both the surgeon and the patient. Local saline /adrenaline injection is claimed to reduce the nasal skin edema intraoperative. Objective: To assess effect of injection of saline adrenaline (1/100000) 15ml versus 5ml on the skin oedema and thickness during rhinoplasty through thesis study. Patients and Methods: In this study 60 cases of rhinoplasty will be operated, 30 cases will be injected by saline adrenaline (1/100000) of 5ml and the others 30 cases will be injected by saline adrenaline (1/100000) of 15 ml, then measuring the skin oedema after 10 minutes of saline adrenaline (1/100000) injection, after 30 minutes and after 60 minutes of the injection at three sites; the dorsum, supratip and the tip of the nose by Seal Gouge Caliper (surgical caliber). Results: The intraoperative skin edema was significantly decreased with local injection of large amount (15ml) of saline / adrenaline 1/100000 than the usual injected amount (5ml) saline /adrenaline 1/100000 specially at the tip and the supratip of the nose and specially at 30 min and 60 min after injection, but statistically significance difference only at 60min at the dorsum. Conclusion: That the skin oedema much less with injection of 15ml of saline adrenaline (1/100000) in comparison to injection of 5ml of saline adrenaline (1/100000).
{"title":"The Effect of Injection of Saline Adrenaline (1/100000) 15ml versus 5ml on the Intraoperative Skin Edema and Thickness during Rhinoplasty","authors":"A. Rabie, M. Elbegermy, M. Yassin, M. Aleem","doi":"10.21608/ejentas.2022.121392.1473","DOIUrl":"https://doi.org/10.21608/ejentas.2022.121392.1473","url":null,"abstract":"Background: Nasal skin edema is a common result of soft and bony tissue trauma during rhinoplasty. In a cosmetic surgery like rhinoplasty, skin edema can fade the cosmetic results and can lead to dissatisfaction for both the surgeon and the patient. Local saline /adrenaline injection is claimed to reduce the nasal skin edema intraoperative. Objective: To assess effect of injection of saline adrenaline (1/100000) 15ml versus 5ml on the skin oedema and thickness during rhinoplasty through thesis study. Patients and Methods: In this study 60 cases of rhinoplasty will be operated, 30 cases will be injected by saline adrenaline (1/100000) of 5ml and the others 30 cases will be injected by saline adrenaline (1/100000) of 15 ml, then measuring the skin oedema after 10 minutes of saline adrenaline (1/100000) injection, after 30 minutes and after 60 minutes of the injection at three sites; the dorsum, supratip and the tip of the nose by Seal Gouge Caliper (surgical caliber). Results: The intraoperative skin edema was significantly decreased with local injection of large amount (15ml) of saline / adrenaline 1/100000 than the usual injected amount (5ml) saline /adrenaline 1/100000 specially at the tip and the supratip of the nose and specially at 30 min and 60 min after injection, but statistically significance difference only at 60min at the dorsum. Conclusion: That the skin oedema much less with injection of 15ml of saline adrenaline (1/100000) in comparison to injection of 5ml of saline adrenaline (1/100000).","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81621861","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 : 2022-01-01DOI: 10.21608/ejentas.2021.67861.1331
Islam A. Amer
Background: The most commonly observed emergency, contributing to high morbidity and mortality is pediatric trauma. The purpose of this research is to analysis the incidence and pattern of maxillofacial trauma in children in Upper Egypt and to assess its management regarding to the successful healing with the least complications. Patients and Methods: This prospective research was performed at the Maxillofacial / Head and Neck Surgery Unit of General Surgery Department of Sohag University Hospitals. All children with maxillofacial trauma during the period from January 2016 to May 2020 and from all governor around sohag that include Qena, Luxor, Aswan and the Red Sea were enrolled . The study included 232 pediatric patients with a total of 298 fractures. Results: The male: female ratio was 3.3:1. The age group 6 to <12 years was the most common group to be injured by 95 patients (40.9%) and the age group <3 years was the least group to be injured by 8 patients (3.4%). The most common cause of maxillofacial trauma was falling from hight (FFH) with 144 (62.1%) patients, followed by motor car accident (MCA) affecting 67 (28.9%) patients. Mandibular fractures had the highest incidence with 152 (51.0%) followed by Midface fractures with 73 (24.5%). Associated soft tissue injuries were present in 22% of all cases. All the included fractures healed successfully. Conclusion: FFH was the essential cause for maxillofacial injuries. Males and parasymhesial fractures showed the highest predominance. International guidelines should be followed for the determination of the treatment of choice either conservatively or surgically and the treatment of choice is dependent on fracture morphology, patient characteristics and surgeon experience and skill. The post traumatic follow up helps to avoid harmful draw backs.
{"title":"Pediatric Maxillofacial Injuries; A single institutional experience","authors":"Islam A. Amer","doi":"10.21608/ejentas.2021.67861.1331","DOIUrl":"https://doi.org/10.21608/ejentas.2021.67861.1331","url":null,"abstract":"Background: The most commonly observed emergency, contributing to high morbidity and mortality is pediatric trauma. The purpose of this research is to analysis the incidence and pattern of maxillofacial trauma in children in Upper Egypt and to assess its management regarding to the successful healing with the least complications. Patients and Methods: This prospective research was performed at the Maxillofacial / Head and Neck Surgery Unit of General Surgery Department of Sohag University Hospitals. All children with maxillofacial trauma during the period from January 2016 to May 2020 and from all governor around sohag that include Qena, Luxor, Aswan and the Red Sea were enrolled . The study included 232 pediatric patients with a total of 298 fractures. Results: The male: female ratio was 3.3:1. The age group 6 to <12 years was the most common group to be injured by 95 patients (40.9%) and the age group <3 years was the least group to be injured by 8 patients (3.4%). The most common cause of maxillofacial trauma was falling from hight (FFH) with 144 (62.1%) patients, followed by motor car accident (MCA) affecting 67 (28.9%) patients. Mandibular fractures had the highest incidence with 152 (51.0%) followed by Midface fractures with 73 (24.5%). Associated soft tissue injuries were present in 22% of all cases. All the included fractures healed successfully. Conclusion: FFH was the essential cause for maxillofacial injuries. Males and parasymhesial fractures showed the highest predominance. International guidelines should be followed for the determination of the treatment of choice either conservatively or surgically and the treatment of choice is dependent on fracture morphology, patient characteristics and surgeon experience and skill. The post traumatic follow up helps to avoid harmful draw backs.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88926798","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 : 2022-01-01DOI: 10.21608/ejentas.2022.108514.1442
S. Abdelhay, Ahmed Abdelgoad, M. Elawady, Dina M. Khaled
Objective: This study aimed to translate the original Voice-Related Quality of Life (V-RQOL) version into Arabic language version and to evaluate the validity and reliability of the translated Arabic version of the V-RQOL in order to be used as a valuable test to assess any voice problems influencing the everyday routine duties of the Arabic speaking patients with voice disorders. Patients and Methods: The V-RQOL questionnaire is made up of 10 items. The questionnaire was translated from English to Arabic by two doctors both were native Arabic speakers and fluent in English as well. Then the translated copy was revised by another two native Arabic speaking physicians and fluent in English as well. The questionnaire was applied on 50 controls healthy participants and 100 patients with voice disorders who were recruited from the Phoniatric outpatient clinic of Benha University Hospital, between the period from May 2020 till June 2021.The V-RQOL questionnaire translated version was completed twice by 30 participants with 2 weeks apart to analyze the test-retest reliability. The person completed the questionnaire by him/herself or if he/she is illiterate, it was done by the help of the physician. Additional to the V-RQOL questionnaire, the participants underwent full history taking and Full laryngeal assessment and completed the Voice Handicap Index (Arabic version) as well. Results: The V-RQOL questionnaire is as valid & reliable tool as the VHI for patients with voice disorders. It was shown in the Cronbach's alpha coefficient for all 10 questions of V-RQOL and the thirty questions of VHI were 0.879 & 0.94 respectively, which indicates a very good level of reliability of both questionnaires. Conclusion: The V-RQOL questionnaire clearly measures the socio-emotional aspects and the physical-functional aspects of voice disorder patients in a simple, rapid, easy way to apply and not time-consuming tool which is suitable for the countries with high population density like Egypt.
{"title":"The Validation of the Voice-Related Quality of Life (V-RQOL): Arabic version","authors":"S. Abdelhay, Ahmed Abdelgoad, M. Elawady, Dina M. Khaled","doi":"10.21608/ejentas.2022.108514.1442","DOIUrl":"https://doi.org/10.21608/ejentas.2022.108514.1442","url":null,"abstract":"Objective: This study aimed to translate the original Voice-Related Quality of Life (V-RQOL) version into Arabic language version and to evaluate the validity and reliability of the translated Arabic version of the V-RQOL in order to be used as a valuable test to assess any voice problems influencing the everyday routine duties of the Arabic speaking patients with voice disorders. Patients and Methods: The V-RQOL questionnaire is made up of 10 items. The questionnaire was translated from English to Arabic by two doctors both were native Arabic speakers and fluent in English as well. Then the translated copy was revised by another two native Arabic speaking physicians and fluent in English as well. The questionnaire was applied on 50 controls healthy participants and 100 patients with voice disorders who were recruited from the Phoniatric outpatient clinic of Benha University Hospital, between the period from May 2020 till June 2021.The V-RQOL questionnaire translated version was completed twice by 30 participants with 2 weeks apart to analyze the test-retest reliability. The person completed the questionnaire by him/herself or if he/she is illiterate, it was done by the help of the physician. Additional to the V-RQOL questionnaire, the participants underwent full history taking and Full laryngeal assessment and completed the Voice Handicap Index (Arabic version) as well. Results: The V-RQOL questionnaire is as valid & reliable tool as the VHI for patients with voice disorders. It was shown in the Cronbach's alpha coefficient for all 10 questions of V-RQOL and the thirty questions of VHI were 0.879 & 0.94 respectively, which indicates a very good level of reliability of both questionnaires. Conclusion: The V-RQOL questionnaire clearly measures the socio-emotional aspects and the physical-functional aspects of voice disorder patients in a simple, rapid, easy way to apply and not time-consuming tool which is suitable for the countries with high population density like Egypt.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"2693 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86594791","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 : 2022-01-01DOI: 10.21608/ejentas.2021.77335.1371
Hossam Sanyelbhaa, Nashwa Refaat, A. Zein-Elabedein
Purpose: This study aimed to evaluate vestibulo-ocular reflex (VOR) in subjects with Meniere’s disease using caloric test and video head impulse test (vHIT). Patients and Methods: A case control study included 120 subjects: 60 normal subjects (control group) and 60 subjects diagnosed as Meniere’s disease (MD) according to (AAO-HNS) 2015 criteria with hearing loss (study group). All subjects enrolled in this study underwent: Detailed clinical history, audiological and vestibular evaluation. vHIT and bithermal caloric test were done to evaluate the vestibulo-ocular reflex. Results: The entire control group had normal vHIT, and VNG (bithermal caloric test) results. In the MD group: vHIT reveals (37%) abnormality: (28% for low gain & 8% for saccades). But in bithermal caloric test; unilateral canal paresis was detected in (40%), and bilateral canal paresis in (15%). Thirty three percent had abnormality in both caloric and vHIT. Conclusion: Caloric test is more sensitive in detection of VOR abnormalities in Meniere’s disease. Results of caloric test and, vHIT show discrepancy but complementary to each other. Adding vHIT to the VNG is recommended for diagnosis of vestibular disorders.
{"title":"Sensitivity of caloric test versus video head impulse test for detection of vestibulo-ocular reflex abnormalities in Meniere's disease","authors":"Hossam Sanyelbhaa, Nashwa Refaat, A. Zein-Elabedein","doi":"10.21608/ejentas.2021.77335.1371","DOIUrl":"https://doi.org/10.21608/ejentas.2021.77335.1371","url":null,"abstract":"Purpose: This study aimed to evaluate vestibulo-ocular reflex (VOR) in subjects with Meniere’s disease using caloric test and video head impulse test (vHIT). Patients and Methods: A case control study included 120 subjects: 60 normal subjects (control group) and 60 subjects diagnosed as Meniere’s disease (MD) according to (AAO-HNS) 2015 criteria with hearing loss (study group). All subjects enrolled in this study underwent: Detailed clinical history, audiological and vestibular evaluation. vHIT and bithermal caloric test were done to evaluate the vestibulo-ocular reflex. Results: The entire control group had normal vHIT, and VNG (bithermal caloric test) results. In the MD group: vHIT reveals (37%) abnormality: (28% for low gain & 8% for saccades). But in bithermal caloric test; unilateral canal paresis was detected in (40%), and bilateral canal paresis in (15%). Thirty three percent had abnormality in both caloric and vHIT. Conclusion: Caloric test is more sensitive in detection of VOR abnormalities in Meniere’s disease. Results of caloric test and, vHIT show discrepancy but complementary to each other. Adding vHIT to the VNG is recommended for diagnosis of vestibular disorders.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72725470","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 : 2022-01-01DOI: 10.21608/ejentas.2020.49735.1281
Ibrahim Abdel-Shafy, A. Hamdan
Objective: Assessment of endoscopic transcanal simple myringoplasty using a push-through technique with cartilage ring graft versus temporalis fascia graft. Patients and Methods: A prospective comparative study was conducted on 60 patients distributed randomly and equally into two groups. Both groups were subjected to endoscopic transcanal simple myringoplasty using a push-through technique with cartilage ring graft used in group I and temporalis fascia graft used in group II. The degree of improvement of postoperative air-bone gap (ABG) was assessed in both groups. Both groups were compared regarding healing, hearing success, and ABG gain. The correlation between the healing success and size and site of the perforation was assessed. Results: The present study showed a highly significant ABG improvement in both groups (p< 0.00001 for both). There was a non-significant difference between the two groups regarding healing success (83.3% and 80% respectively), hearing success, and ABG gain (p = 0.739, 0.417, and 0.757 respectively). There was a non-significant correlation between the healing success in both groups and the perforation size (p = 0.6221 and 0.3598, respectively). There was a non-significant correlation between the healing success of the operation in both groups and the perforation site (p = 0.704 and 0.516, respectively). Conclusion: Both cartilage ring and temporalis fascia grafts resulted in a highly significant postoperative improvement of ABG with comparable results regarding healing and hearing success and ABG gain. Both graft types showed a nonsignificant correlation between success and site and size of the perforation.
目的:评价经鼻内镜下单纯鼓膜成形术中软骨环移植与颞肌筋膜移植的应用价值。患者与方法:将60例患者随机平均分为两组，进行前瞻性比较研究。两组均行内镜下经扫描单纯鼓膜成形术，采用推通技术，ⅰ组采用软骨环移植物，ⅱ组采用颞筋膜移植物。评估两组患者术后气骨间隙(ABG)改善程度。两组在治疗、听力成功和ABG增加方面进行比较。评估愈合成功与穿孔的大小和位置之间的相关性。结果:本研究显示两组ABG均有显著改善(p< 0.00001)。两组在愈合成功率(分别为83.3%和80%)、听力成功率和ABG增益方面差异无统计学意义(p分别为0.739、0.417和0.757)。两组愈合成功率与穿孔大小无显著相关(p = 0.6221, p = 0.3598)。两组手术愈合成功率与穿孔部位无显著相关性(p分别为0.704和0.516)。结论:软骨环和颞筋膜移植术后ABG的改善非常显著，在愈合、听力成功和ABG增加方面的结果相当。两种移植类型的成功率与穿孔的位置和大小没有显著的相关性。
{"title":"Endoscopic Transcanal Simple Myringoplasty Using Push Through Technique with Cartilage Ring Graft Versus Temporalis Fascia Graft","authors":"Ibrahim Abdel-Shafy, A. Hamdan","doi":"10.21608/ejentas.2020.49735.1281","DOIUrl":"https://doi.org/10.21608/ejentas.2020.49735.1281","url":null,"abstract":"Objective: Assessment of endoscopic transcanal simple myringoplasty using a push-through technique with cartilage ring graft versus temporalis fascia graft. Patients and Methods: A prospective comparative study was conducted on 60 patients distributed randomly and equally into two groups. Both groups were subjected to endoscopic transcanal simple myringoplasty using a push-through technique with cartilage ring graft used in group I and temporalis fascia graft used in group II. The degree of improvement of postoperative air-bone gap (ABG) was assessed in both groups. Both groups were compared regarding healing, hearing success, and ABG gain. The correlation between the healing success and size and site of the perforation was assessed. Results: The present study showed a highly significant ABG improvement in both groups (p< 0.00001 for both). There was a non-significant difference between the two groups regarding healing success (83.3% and 80% respectively), hearing success, and ABG gain (p = 0.739, 0.417, and 0.757 respectively). There was a non-significant correlation between the healing success in both groups and the perforation size (p = 0.6221 and 0.3598, respectively). There was a non-significant correlation between the healing success of the operation in both groups and the perforation site (p = 0.704 and 0.516, respectively). Conclusion: Both cartilage ring and temporalis fascia grafts resulted in a highly significant postoperative improvement of ABG with comparable results regarding healing and hearing success and ABG gain. Both graft types showed a nonsignificant correlation between success and site and size of the perforation.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"262 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79145086","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 : 2022-01-01DOI: 10.21608/ejentas.2021.89110.1406
Adel El-Antably, U. Mohamed, Mahmoud Abbas, A. Megahed
Background: The decision between the partial resection and preservation of the middle turbinate has raised considerable debate. Patients and Methods: This prospective study included thirty randomly selected patients with chronic rhinosiusitis with polyps who underwent surgery. A total 60 sides of nasal cavity were divided into two groups with 30 sides each. Group I comprised 30 sides underwent FESS with partial middle turbinate resection and group II comprised the opposite 30 sides underwent FESS without MTR and each patient acts as his own control. Both groups were compared objectively and subjectively postoperatively at the 1 st , 3 rd and 6 th month postoperatively. Results : The results showed endoscopic grade 0 mucosa was found more in group I (100%; n = 30) than group II (73.3% n = 22) and the recurrence of nasal polyps was 0.00% (n = 0) in group I compared to recurrence 26.6% (n = 8) in group II. Nasal obstruction was grade 0 in 100% (n =30) sides of group I and grade 0 in 73.3% (n = 22) sides of groupII. Hyposmia improved to normal in group I in 100% n=30 compared to hyposmia in 26.66% n=8 in group II. The 30 (100%) resected sides of group I showed central middle turbinate stump not obscuring frontal recess area with 100% patency of frontal sinus ostia compared to 5 cases 16.7% in group II showing frontal sinus ostium closure . Maxillary sinus antrostomy patency was found patent in 100.00% (n = 30) sides and in group II it was 73.33% (n = 22).
{"title":"Partial Resection versus Preservation of Middle Turbinate in Surgery for Chronic Rhinosinusitis With - Without Nasal Polyposis","authors":"Adel El-Antably, U. Mohamed, Mahmoud Abbas, A. Megahed","doi":"10.21608/ejentas.2021.89110.1406","DOIUrl":"https://doi.org/10.21608/ejentas.2021.89110.1406","url":null,"abstract":"Background: The decision between the partial resection and preservation of the middle turbinate has raised considerable debate. Patients and Methods: This prospective study included thirty randomly selected patients with chronic rhinosiusitis with polyps who underwent surgery. A total 60 sides of nasal cavity were divided into two groups with 30 sides each. Group I comprised 30 sides underwent FESS with partial middle turbinate resection and group II comprised the opposite 30 sides underwent FESS without MTR and each patient acts as his own control. Both groups were compared objectively and subjectively postoperatively at the 1 st , 3 rd and 6 th month postoperatively. Results : The results showed endoscopic grade 0 mucosa was found more in group I (100%; n = 30) than group II (73.3% n = 22) and the recurrence of nasal polyps was 0.00% (n = 0) in group I compared to recurrence 26.6% (n = 8) in group II. Nasal obstruction was grade 0 in 100% (n =30) sides of group I and grade 0 in 73.3% (n = 22) sides of groupII. Hyposmia improved to normal in group I in 100% n=30 compared to hyposmia in 26.66% n=8 in group II. The 30 (100%) resected sides of group I showed central middle turbinate stump not obscuring frontal recess area with 100% patency of frontal sinus ostia compared to 5 cases 16.7% in group II showing frontal sinus ostium closure . Maxillary sinus antrostomy patency was found patent in 100.00% (n = 30) sides and in group II it was 73.33% (n = 22).","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79571660","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 : 2022-01-01DOI: 10.21608/ejentas.2022.141176.1519
mohamed El awady
Introduction: Different approaches were used for myringoplasty mainly the post-auricular, the endaural and trans-canal using either the endoscopic or the microscopic. This study aims to compare endoscopic myringoplasty with microscopic myringoplasty through end aural approach using temporalis fascia graft regarding operative technique, success rate and postoperative hearing improvement. Patients and Methods: The work was performed at the ENT Department, Al-azhar University hospitals. The work involved 40 cases diagnosed to have chronic suppurative otitis media of tubotympanic type submitted to myringoplasty operation. They were classified into Class A: endoscopic myringoplasty and Class B: microscopic myringoplasty through endaural approach. Results: The graft was taken after 3 months in 18 cases (90%) in class A and in 17 cases (85%) in class B. The mean of Preoperative airbone gab (ABG) was 22.85±10.34db in group A and the mean postoperative ABG was 5.5 ±2.15 db while the mean Preoperative ABG was 25.75±5.90 db in class B and the mean postoperative ABG was 7 ±3.25 db with statistically significant difference between Preoperative and postoperative ABG ( p value <0.05), also in class A, the perforation circumference was definitely visible in whole cases (100%) without the necessity for external auditory canal drilling or curettage, whereas in class B, it was only partially visible in 7 cases (35%). Conclusion: Regardless of the perforation's width, the external auditory canal's narrowness, or its protrusion, an endoscopic myringoplasty can be done. The best hope for ear surgery in the future is the endoscope.
{"title":"Endoscopic Versus Microscopic Myringoplasty Through Endaural Approach","authors":"mohamed El awady","doi":"10.21608/ejentas.2022.141176.1519","DOIUrl":"https://doi.org/10.21608/ejentas.2022.141176.1519","url":null,"abstract":"Introduction: Different approaches were used for myringoplasty mainly the post-auricular, the endaural and trans-canal using either the endoscopic or the microscopic. This study aims to compare endoscopic myringoplasty with microscopic myringoplasty through end aural approach using temporalis fascia graft regarding operative technique, success rate and postoperative hearing improvement. Patients and Methods: The work was performed at the ENT Department, Al-azhar University hospitals. The work involved 40 cases diagnosed to have chronic suppurative otitis media of tubotympanic type submitted to myringoplasty operation. They were classified into Class A: endoscopic myringoplasty and Class B: microscopic myringoplasty through endaural approach. Results: The graft was taken after 3 months in 18 cases (90%) in class A and in 17 cases (85%) in class B. The mean of Preoperative airbone gab (ABG) was 22.85±10.34db in group A and the mean postoperative ABG was 5.5 ±2.15 db while the mean Preoperative ABG was 25.75±5.90 db in class B and the mean postoperative ABG was 7 ±3.25 db with statistically significant difference between Preoperative and postoperative ABG ( p value <0.05), also in class A, the perforation circumference was definitely visible in whole cases (100%) without the necessity for external auditory canal drilling or curettage, whereas in class B, it was only partially visible in 7 cases (35%). Conclusion: Regardless of the perforation's width, the external auditory canal's narrowness, or its protrusion, an endoscopic myringoplasty can be done. The best hope for ear surgery in the future is the endoscope.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"202 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77015630","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 : 2022-01-01DOI: 10.21608/ejentas.2022.46414.1427
M. Aleem, Abdel Hamid Nashar, W. Ezzat, Mohammed Al-Shahat
Background: Fungal rhinosinusitis (FRS) includes a spectrum of disease processes that vary in clinical presentation, histologic appearances, and treatment options. Objective: This systematic review was done to reach the effective and safe method in management of FRS. Patients and Methods: Meta-analysis was performed in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). This study used the published articles (from Jan1985 to Jan2018) in treatment of FRS via search in several databases. Results: Finally, forty-five studies were included in this study. Fifteen of them assessed the treatment of fungal ball (FB) using mainly the functional endoscopic sinus surgery (FESS) the success rate was 98.1%. Twenty included studies have evaluated the management of allergic fungal sinusitis (AFS) via FESS, Systemic steroids, Antifungals and immunotherapy. The results showed that FESS represents the first-line, followed by aggressive medical therapies, the recurrence rate after postoperative steroids was 20.6%, postoperative antifungals was 40% and after immunotherapy was 9.1%. Ten included studies considered the Invasive Fungal sinusitis. The results showed that the combination of systematic antifungal therapy and aggressive surgical debridement was the treatment of the choice. Conclusion: FESS is the treatment of choice for FB. AFS treatment consists of surgical extirpation of the allergic mucin and followed by anti-fungal therapy, Immunotherapy, and corticosteroids. Treatment of invasive fungal sinusitis includes surgical resection of necrotic tissues, systemic antifungal therapy and reversal of immune dysfunction.
{"title":"Efficacy of Different Modalities in Treatment of Different Types of Fungal Sinusitis","authors":"M. Aleem, Abdel Hamid Nashar, W. Ezzat, Mohammed Al-Shahat","doi":"10.21608/ejentas.2022.46414.1427","DOIUrl":"https://doi.org/10.21608/ejentas.2022.46414.1427","url":null,"abstract":"Background: Fungal rhinosinusitis (FRS) includes a spectrum of disease processes that vary in clinical presentation, histologic appearances, and treatment options. Objective: This systematic review was done to reach the effective and safe method in management of FRS. Patients and Methods: Meta-analysis was performed in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). This study used the published articles (from Jan1985 to Jan2018) in treatment of FRS via search in several databases. Results: Finally, forty-five studies were included in this study. Fifteen of them assessed the treatment of fungal ball (FB) using mainly the functional endoscopic sinus surgery (FESS) the success rate was 98.1%. Twenty included studies have evaluated the management of allergic fungal sinusitis (AFS) via FESS, Systemic steroids, Antifungals and immunotherapy. The results showed that FESS represents the first-line, followed by aggressive medical therapies, the recurrence rate after postoperative steroids was 20.6%, postoperative antifungals was 40% and after immunotherapy was 9.1%. Ten included studies considered the Invasive Fungal sinusitis. The results showed that the combination of systematic antifungal therapy and aggressive surgical debridement was the treatment of the choice. Conclusion: FESS is the treatment of choice for FB. AFS treatment consists of surgical extirpation of the allergic mucin and followed by anti-fungal therapy, Immunotherapy, and corticosteroids. Treatment of invasive fungal sinusitis includes surgical resection of necrotic tissues, systemic antifungal therapy and reversal of immune dysfunction.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90927319","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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