Pub Date : 2019-10-31DOI: 10.1017/S0022215119002032
F. Hassannia, P. Douglas-Jones, J. Rutka
BACKGROUND Transmastoid occlusion of the posterior or superior semicircular canal is an effective and safe management option in patients with refractory benign paroxysmal positional vertigo or symptomatic superior semicircular canal dehiscence. A method of quantifying successful canal occlusion surgery is described. METHODS This paper presents representative patients with intractable benign paroxysmal positional vertigo or symptomatic superior semicircular canal dehiscence, who underwent transmastoid occlusion of the posterior or superior semicircular canal respectively. Vestibular function was assessed pre- and post-operatively. The video head impulse test was included as a measure of semicircular canal and vestibulo-ocular reflex functions. RESULTS Post-operative video head impulse testing showed reduced vestibulo-ocular reflex gain in occluded canals. Gain remained normal in the non-operated canals. Post-operative audiometry demonstrated no change in hearing in the benign paroxysmal positional vertigo patient and slight hearing improvement in the superior semicircular canal dehiscence syndrome patient. CONCLUSION Transmastoid occlusion of the posterior or superior semicircular canal is effective and safe for treating troublesome benign paroxysmal positional vertigo or symptomatic superior semicircular canal dehiscence. Post-operative video head impulse testing demonstrating a reduction in vestibulo-ocular reflex gain can reliably confirm successful occlusion of the canal and is a useful adjunct in post-operative evaluation.
{"title":"Gauging the effectiveness of canal occlusion surgery: how I do it.","authors":"F. Hassannia, P. Douglas-Jones, J. Rutka","doi":"10.1017/S0022215119002032","DOIUrl":"https://doi.org/10.1017/S0022215119002032","url":null,"abstract":"BACKGROUND\u0000Transmastoid occlusion of the posterior or superior semicircular canal is an effective and safe management option in patients with refractory benign paroxysmal positional vertigo or symptomatic superior semicircular canal dehiscence. A method of quantifying successful canal occlusion surgery is described.\u0000\u0000\u0000METHODS\u0000This paper presents representative patients with intractable benign paroxysmal positional vertigo or symptomatic superior semicircular canal dehiscence, who underwent transmastoid occlusion of the posterior or superior semicircular canal respectively. Vestibular function was assessed pre- and post-operatively. The video head impulse test was included as a measure of semicircular canal and vestibulo-ocular reflex functions.\u0000\u0000\u0000RESULTS\u0000Post-operative video head impulse testing showed reduced vestibulo-ocular reflex gain in occluded canals. Gain remained normal in the non-operated canals. Post-operative audiometry demonstrated no change in hearing in the benign paroxysmal positional vertigo patient and slight hearing improvement in the superior semicircular canal dehiscence syndrome patient.\u0000\u0000\u0000CONCLUSION\u0000Transmastoid occlusion of the posterior or superior semicircular canal is effective and safe for treating troublesome benign paroxysmal positional vertigo or symptomatic superior semicircular canal dehiscence. Post-operative video head impulse testing demonstrating a reduction in vestibulo-ocular reflex gain can reliably confirm successful occlusion of the canal and is a useful adjunct in post-operative evaluation.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"19 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89796642","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 : 2019-10-22DOI: 10.1017/S0022215119001981
B. Mettias, M. Lyons
OBJECTIVE Vestibular schwannoma is the most common neoplasm in the cerebellopontine angle, and fast spin-echo T2-weighted magnetic resonance imaging is the most sensitive test for diagnosing it. This study evaluated the financial and time costs of unnecessary magnetic resonance imaging referrals before and after the application of a magnetic resonance imaging protocol. METHOD A full audit cycle was used for the assessment. The first cycle in January 2012 was retrospective and evaluated the financial impact of current selection criteria for magnetic resonance imaging referral against standard guidelines. The second cycle in January 2014 was prospective after implementation of the protocol. RESULTS There were 46 and 112 patients who had magnetic resonance imaging during first and second cycle, respectively. Of the referrals for magnetic resonance imaging, 65 per cent versus 81 per cent of the referrals were appropriate in the first and second cycles, respectively. The relative risk was reduced from 0.5 to 0.2. The waiting times for magnetic resonance imaging scans improved. CONCLUSION Selection criteria for magnetic resonance imaging referral are important in reducing waiting times for scans, patient anxiety and conserving trust resources.
{"title":"Magnetic resonance imaging for vestibular schwannoma: cost-effective protocol for referrals.","authors":"B. Mettias, M. Lyons","doi":"10.1017/S0022215119001981","DOIUrl":"https://doi.org/10.1017/S0022215119001981","url":null,"abstract":"OBJECTIVE\u0000Vestibular schwannoma is the most common neoplasm in the cerebellopontine angle, and fast spin-echo T2-weighted magnetic resonance imaging is the most sensitive test for diagnosing it. This study evaluated the financial and time costs of unnecessary magnetic resonance imaging referrals before and after the application of a magnetic resonance imaging protocol.\u0000\u0000\u0000METHOD\u0000A full audit cycle was used for the assessment. The first cycle in January 2012 was retrospective and evaluated the financial impact of current selection criteria for magnetic resonance imaging referral against standard guidelines. The second cycle in January 2014 was prospective after implementation of the protocol.\u0000\u0000\u0000RESULTS\u0000There were 46 and 112 patients who had magnetic resonance imaging during first and second cycle, respectively. Of the referrals for magnetic resonance imaging, 65 per cent versus 81 per cent of the referrals were appropriate in the first and second cycles, respectively. The relative risk was reduced from 0.5 to 0.2. The waiting times for magnetic resonance imaging scans improved.\u0000\u0000\u0000CONCLUSION\u0000Selection criteria for magnetic resonance imaging referral are important in reducing waiting times for scans, patient anxiety and conserving trust resources.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"27 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2019-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73173545","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 : 2019-10-21DOI: 10.1017/S002221511900197X
D. Murphy
BACKGROUND ENT disease prevalence, risk factors and treatment vary between developed and developing countries. Health provision, particularly disease prevention strategies and surgery, in developing countries is poor, manifesting as a high frequency of common and preventable diseases. Healthcare systems in developing countries are unsustainable, and the technological advances that provide ENT surgery with novel diagnostic and treatment opportunities are inaccessible. CONCLUSION A multifaceted approach is essential to improve the care of patients with ENT diseases in developing countries. Public health efforts must focus on educating the local community, reducing high-risk behaviours and decreasing the frequency of preventable diseases. Governments must be pressured to prioritise the funding of long-term, sustainable efforts with effective disease prevention strategies. Providing local healthcare professionals with high-quality ENT training so that self-sustaining and low-cost care can be delivered, mainly in a primary care setting, is key.
{"title":"A comprehensive review of otorhinolaryngological global health concerns.","authors":"D. Murphy","doi":"10.1017/S002221511900197X","DOIUrl":"https://doi.org/10.1017/S002221511900197X","url":null,"abstract":"BACKGROUND\u0000ENT disease prevalence, risk factors and treatment vary between developed and developing countries. Health provision, particularly disease prevention strategies and surgery, in developing countries is poor, manifesting as a high frequency of common and preventable diseases. Healthcare systems in developing countries are unsustainable, and the technological advances that provide ENT surgery with novel diagnostic and treatment opportunities are inaccessible.\u0000\u0000\u0000CONCLUSION\u0000A multifaceted approach is essential to improve the care of patients with ENT diseases in developing countries. Public health efforts must focus on educating the local community, reducing high-risk behaviours and decreasing the frequency of preventable diseases. Governments must be pressured to prioritise the funding of long-term, sustainable efforts with effective disease prevention strategies. Providing local healthcare professionals with high-quality ENT training so that self-sustaining and low-cost care can be delivered, mainly in a primary care setting, is key.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"11 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2019-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89257677","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 : 2019-10-21DOI: 10.1017/S002221511900210X
H. Ding, H. Xie, F. Qiao, T. Wang, X. Huang, Q. Ning
OBJECTIVE This study aimed to classify the pre-auricular sinus before performing radical dissection, so as to achieve optimal aesthetic results. METHODS The recent five-year clinical data of 53 patients with a congenital pre-auricular sinus and infection treated in the hospital were reviewed. According to the sinus course, pre-auricular and post-auricular types were defined, and regional dissection was performed using the modified supra-auricular or post-auricular approach. RESULTS All patients achieved primary intention healing of the incision, and were followed up for six months to five years. No recurrence was found, and the incision scar was completely concealed. CONCLUSION Surgical approaches for regional dissection might be adopted based on the different types of pre-auricular sinuses, and further radical dissection might be performed to achieve optimal aesthetic results.
{"title":"Supra-auricular and post-auricular resection of pre-auricular and post-auricular sinuses.","authors":"H. Ding, H. Xie, F. Qiao, T. Wang, X. Huang, Q. Ning","doi":"10.1017/S002221511900210X","DOIUrl":"https://doi.org/10.1017/S002221511900210X","url":null,"abstract":"OBJECTIVE\u0000This study aimed to classify the pre-auricular sinus before performing radical dissection, so as to achieve optimal aesthetic results.\u0000\u0000\u0000METHODS\u0000The recent five-year clinical data of 53 patients with a congenital pre-auricular sinus and infection treated in the hospital were reviewed. According to the sinus course, pre-auricular and post-auricular types were defined, and regional dissection was performed using the modified supra-auricular or post-auricular approach.\u0000\u0000\u0000RESULTS\u0000All patients achieved primary intention healing of the incision, and were followed up for six months to five years. No recurrence was found, and the incision scar was completely concealed.\u0000\u0000\u0000CONCLUSION\u0000Surgical approaches for regional dissection might be adopted based on the different types of pre-auricular sinuses, and further radical dissection might be performed to achieve optimal aesthetic results.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"9 4","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2019-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S002221511900210X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72475692","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 : 2019-10-21DOI: 10.1017/S0022215119002123
S. I. Kirubaharane, S. Palani, A. Alexander, A. Sreenivasan
BACKGROUND Detection and valid measurements of distortion product otoacoustic emissions are not influenced by cochlear status alone, but also by middle-ear status. There is a need to understand the use of ultra-high frequency distortion product otoacoustic emissions in cases of abnormal distortion product otoacoustic emission findings for conventional frequencies related to the middle-ear condition. METHOD The present study investigated distortion product otoacoustic emission input-output functions in conventional and ultra-high frequencies in: 37 adults with chronic suppurative otitis media (clinical group) and 37 adults with normal hearing sensitivity (control group). RESULTS There were significant reductions in distortion product otoacoustic emission amplitude and mean signal-to-noise ratio in the clinical group compared to the control group, especially for conventional frequencies. CONCLUSION There was a significant reduction in the rate of ears with measurable distortion product otoacoustic emissions in the clinical group, especially for conventional frequencies. The effect of chronic suppurative otitis media was more pronounced in the conventional frequency range compared to the smaller effect seen in the ultra-high frequency range.
{"title":"Effect of chronic suppurative otitis media on distortion product otoacoustic emission input-output functions in conventional and ultra-high frequencies.","authors":"S. I. Kirubaharane, S. Palani, A. Alexander, A. Sreenivasan","doi":"10.1017/S0022215119002123","DOIUrl":"https://doi.org/10.1017/S0022215119002123","url":null,"abstract":"BACKGROUND\u0000Detection and valid measurements of distortion product otoacoustic emissions are not influenced by cochlear status alone, but also by middle-ear status. There is a need to understand the use of ultra-high frequency distortion product otoacoustic emissions in cases of abnormal distortion product otoacoustic emission findings for conventional frequencies related to the middle-ear condition.\u0000\u0000\u0000METHOD\u0000The present study investigated distortion product otoacoustic emission input-output functions in conventional and ultra-high frequencies in: 37 adults with chronic suppurative otitis media (clinical group) and 37 adults with normal hearing sensitivity (control group).\u0000\u0000\u0000RESULTS\u0000There were significant reductions in distortion product otoacoustic emission amplitude and mean signal-to-noise ratio in the clinical group compared to the control group, especially for conventional frequencies.\u0000\u0000\u0000CONCLUSION\u0000There was a significant reduction in the rate of ears with measurable distortion product otoacoustic emissions in the clinical group, especially for conventional frequencies. The effect of chronic suppurative otitis media was more pronounced in the conventional frequency range compared to the smaller effect seen in the ultra-high frequency range.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"39 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2019-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90200557","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 : 2019-10-18DOI: 10.1017/S0022215119002160
A. Saibene, A. Bulfamante, P. Lozza, L. De Pasquale
BACKGROUND Narrow-band imaging uses selective haemoglobin light absorption to emphasise vascular visualisation and capillary networks. OBJECTIVE This study aimed to evaluate the application of this technique to parathyroid surgery. METHOD This preliminary evaluation was carried out on five consecutive patients with single parathyroid adenoma being considered for minimally invasive video-assisted parathyroidectomy. The adenomas were checked for narrow-band imaging vascular patterns. Minimally invasive video-assisted parathyroidectomy was then carried out in accordance with our standard protocol. RESULTS In four out of the five cases, narrow-band imaging integrated the white endoscopic light and direct vision, but in one case narrow-band imaging allowed distinction between the hidden neoplastic tissue and the surrounding structures thanks to the different vascular patterns. CONCLUSION Narrow-band imaging was helpful in properly identifying adenoma. It is suggested that this technique be considered as a means for surgeons to improve their confidence in selected surgical treatments and to improve treatment quality.
{"title":"The role of narrow-band imaging in parathyroid surgery: a preliminary evaluation in five parathyroid adenoma cases.","authors":"A. Saibene, A. Bulfamante, P. Lozza, L. De Pasquale","doi":"10.1017/S0022215119002160","DOIUrl":"https://doi.org/10.1017/S0022215119002160","url":null,"abstract":"BACKGROUND\u0000Narrow-band imaging uses selective haemoglobin light absorption to emphasise vascular visualisation and capillary networks.\u0000\u0000\u0000OBJECTIVE\u0000This study aimed to evaluate the application of this technique to parathyroid surgery.\u0000\u0000\u0000METHOD\u0000This preliminary evaluation was carried out on five consecutive patients with single parathyroid adenoma being considered for minimally invasive video-assisted parathyroidectomy. The adenomas were checked for narrow-band imaging vascular patterns. Minimally invasive video-assisted parathyroidectomy was then carried out in accordance with our standard protocol.\u0000\u0000\u0000RESULTS\u0000In four out of the five cases, narrow-band imaging integrated the white endoscopic light and direct vision, but in one case narrow-band imaging allowed distinction between the hidden neoplastic tissue and the surrounding structures thanks to the different vascular patterns.\u0000\u0000\u0000CONCLUSION\u0000Narrow-band imaging was helpful in properly identifying adenoma. It is suggested that this technique be considered as a means for surgeons to improve their confidence in selected surgical treatments and to improve treatment quality.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"68 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2019-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91369332","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 : 2019-10-16DOI: 10.1017/s0022215119002135
S. Okhovat, T. Milner, Arunachalam Iyer
OBJECTIVE Comparing the feasibility of ovine and synthetic temporal bones for simulating endoscopic ear surgery against the 'gold standard' of human cadaveric tissue. METHODS A total of 10 candidates (5 trainees and 5 experts) performed endoscopic tympanoplasty on 3 models: Pettigrew temporal bones, ovine temporal bones and cadaveric temporal bones. Candidates completed a questionnaire assessing the face validity, global content validity and task-specific content validity of each model. RESULTS Regarding ovine temporal bone validity, the median values were 4 (interquartile range = 4-4) for face validity, 4 (interquartile range = 4-4) for global content validity and 4 (interquartile range = 4-4) for task-specific content validity. For the Pettigrew temporal bone, the median values were 3.5 (interquartile range = 2.25-4) for face validity, 3 (interquartile range = 2.75-3) for global content validity and 3 (interquartile range = 2.5-3) for task-specific content validity. The ovine temporal bone was considered significantly superior to the Pettigrew temporal bone for the majority of validity categories assessed. CONCLUSION Tympanoplasty is feasible in both the ovine temporal bone and the Pettigrew temporal bone. However, the ovine model was a significantly more realistic simulation tool.
{"title":"Feasibility of ovine and synthetic temporal bone models for simulation training in endoscopic ear surgery.","authors":"S. Okhovat, T. Milner, Arunachalam Iyer","doi":"10.1017/s0022215119002135","DOIUrl":"https://doi.org/10.1017/s0022215119002135","url":null,"abstract":"OBJECTIVE\u0000Comparing the feasibility of ovine and synthetic temporal bones for simulating endoscopic ear surgery against the 'gold standard' of human cadaveric tissue.\u0000\u0000\u0000METHODS\u0000A total of 10 candidates (5 trainees and 5 experts) performed endoscopic tympanoplasty on 3 models: Pettigrew temporal bones, ovine temporal bones and cadaveric temporal bones. Candidates completed a questionnaire assessing the face validity, global content validity and task-specific content validity of each model.\u0000\u0000\u0000RESULTS\u0000Regarding ovine temporal bone validity, the median values were 4 (interquartile range = 4-4) for face validity, 4 (interquartile range = 4-4) for global content validity and 4 (interquartile range = 4-4) for task-specific content validity. For the Pettigrew temporal bone, the median values were 3.5 (interquartile range = 2.25-4) for face validity, 3 (interquartile range = 2.75-3) for global content validity and 3 (interquartile range = 2.5-3) for task-specific content validity. The ovine temporal bone was considered significantly superior to the Pettigrew temporal bone for the majority of validity categories assessed.\u0000\u0000\u0000CONCLUSION\u0000Tympanoplasty is feasible in both the ovine temporal bone and the Pettigrew temporal bone. However, the ovine model was a significantly more realistic simulation tool.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"12 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85203194","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 : 2019-10-14DOI: 10.1017/S0022215119001993
B. Zakaria, J. Muzaffar, L. Orr, C. Coulson, N. Sharma
BACKGROUND Blunt neck trauma can cause serious morbidity and mortality rates of up to 40 per cent, but there is a paucity of literature on the topic. METHOD A retrospective case note review was performed for all blunt neck trauma cases managed at the Queen Elizabeth Hospital Birmingham between 1st January 2011 and 31st December 2017. RESULTS Seventeen cases were managed, with no mortality and limited morbidity. Most patients were male (70.6 per cent) and road traffic accidents were the most common cause of injury (41.2 per cent). The median age of patients was 40.6 years (range, 21.5-70.3 years). Multidetector computed tomography angiography of the neck was performed in 9 patients (52.9 per cent) with 'hot' reports made by on-duty radiology staff matching consultant reports in all but 1 case. Six patients underwent operative exploration yielding a negative exploration rate of 33.3 per cent. Imaging reports matched operative findings in 3 cases (60 per cent). CONCLUSION Blunt neck trauma is uncommon but usually presents in polytrauma. Imaging has inaccuracies when compared with operative findings, regardless of radiological experience.
{"title":"Blunt neck trauma at a level I trauma centre: six-year retrospective case note review.","authors":"B. Zakaria, J. Muzaffar, L. Orr, C. Coulson, N. Sharma","doi":"10.1017/S0022215119001993","DOIUrl":"https://doi.org/10.1017/S0022215119001993","url":null,"abstract":"BACKGROUND\u0000Blunt neck trauma can cause serious morbidity and mortality rates of up to 40 per cent, but there is a paucity of literature on the topic.\u0000\u0000\u0000METHOD\u0000A retrospective case note review was performed for all blunt neck trauma cases managed at the Queen Elizabeth Hospital Birmingham between 1st January 2011 and 31st December 2017.\u0000\u0000\u0000RESULTS\u0000Seventeen cases were managed, with no mortality and limited morbidity. Most patients were male (70.6 per cent) and road traffic accidents were the most common cause of injury (41.2 per cent). The median age of patients was 40.6 years (range, 21.5-70.3 years). Multidetector computed tomography angiography of the neck was performed in 9 patients (52.9 per cent) with 'hot' reports made by on-duty radiology staff matching consultant reports in all but 1 case. Six patients underwent operative exploration yielding a negative exploration rate of 33.3 per cent. Imaging reports matched operative findings in 3 cases (60 per cent).\u0000\u0000\u0000CONCLUSION\u0000Blunt neck trauma is uncommon but usually presents in polytrauma. Imaging has inaccuracies when compared with operative findings, regardless of radiological experience.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"212 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2019-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90830922","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 : 2019-10-07DOI: 10.1017/S0022215119002093
B. Mettias, G. Dow, D. Srinivasan, Y. Ramakrishnan
BACKGROUND Pott's puffy tumour is a rare complication of sinusitis. This osteomyelitis can affect the outer and inner tables of the frontal sinus. The treatment of Pott's puffy tumour combines medical and surgical approaches. Surgical approaches have traditionally been open, but endoscopic techniques have been adopted recently in select cases. The bony defect from debridement can be left alone, or closed with autografts or allografts. OBJECTIVE To describe a technique for the reconstruction of a large skull vault after the debridement of extensive osteomyelitis of the anterior cranial vault. METHODS Modified distraction osteogenesis is used in the cranial vault, to induce new bone formation. This is customarily used to lengthen long bones. The advantages of this technique include avoiding autologous grafts or alloplastic cranioplasty in the infected surgical bed, and allowing primary closure. RESULTS Early post-operative imaging results have been encouraging, with no reported complications. CONCLUSION Modified distraction osteogenesis is a novel technique in the primary reconstruction of calvarial bone.
{"title":"[Pott's puffy tumour: innovative technique in calvarial reconstruction].","authors":"B. Mettias, G. Dow, D. Srinivasan, Y. Ramakrishnan","doi":"10.1017/S0022215119002093","DOIUrl":"https://doi.org/10.1017/S0022215119002093","url":null,"abstract":"BACKGROUND\u0000Pott's puffy tumour is a rare complication of sinusitis. This osteomyelitis can affect the outer and inner tables of the frontal sinus. The treatment of Pott's puffy tumour combines medical and surgical approaches. Surgical approaches have traditionally been open, but endoscopic techniques have been adopted recently in select cases. The bony defect from debridement can be left alone, or closed with autografts or allografts.\u0000\u0000\u0000OBJECTIVE\u0000To describe a technique for the reconstruction of a large skull vault after the debridement of extensive osteomyelitis of the anterior cranial vault.\u0000\u0000\u0000METHODS\u0000Modified distraction osteogenesis is used in the cranial vault, to induce new bone formation. This is customarily used to lengthen long bones. The advantages of this technique include avoiding autologous grafts or alloplastic cranioplasty in the infected surgical bed, and allowing primary closure.\u0000\u0000\u0000RESULTS\u0000Early post-operative imaging results have been encouraging, with no reported complications.\u0000\u0000\u0000CONCLUSION\u0000Modified distraction osteogenesis is a novel technique in the primary reconstruction of calvarial bone.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"226 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77105539","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 : 2019-10-07DOI: 10.1017/S0022215119002081
K. Matsushima, Hidehito Matsui, Shinya Ohira, K. Matsuura
OBJECTIVE This study investigated the position of adduction thread attachment, pulling direction and fixation position in revision arytenoid adduction surgery performed in two patients with left vocal fold palsy in whom satisfactory speech improvement had not been obtained by arytenoid adduction and type 1 thyroplasty. METHODS Revision arytenoid adduction surgery was performed with the vocal fold in the midline position in both cases. A type 1 thyroplasty procedure was subsequently added in one case because of worsened quality of speech following arytenoid adduction. RESULTS AND CONCLUSION Although the arytenoid adduction procedure is conceptually well established, there is still room for debate concerning the actual surgical procedures used. The technique described in this report is effective, suggesting that it is worthy of recognition as an index procedure.
{"title":"Outcomes in two patients with vocal fold palsy who underwent revision arytenoid adduction surgery.","authors":"K. Matsushima, Hidehito Matsui, Shinya Ohira, K. Matsuura","doi":"10.1017/S0022215119002081","DOIUrl":"https://doi.org/10.1017/S0022215119002081","url":null,"abstract":"OBJECTIVE\u0000This study investigated the position of adduction thread attachment, pulling direction and fixation position in revision arytenoid adduction surgery performed in two patients with left vocal fold palsy in whom satisfactory speech improvement had not been obtained by arytenoid adduction and type 1 thyroplasty.\u0000\u0000\u0000METHODS\u0000Revision arytenoid adduction surgery was performed with the vocal fold in the midline position in both cases. A type 1 thyroplasty procedure was subsequently added in one case because of worsened quality of speech following arytenoid adduction.\u0000\u0000\u0000RESULTS AND CONCLUSION\u0000Although the arytenoid adduction procedure is conceptually well established, there is still room for debate concerning the actual surgical procedures used. The technique described in this report is effective, suggesting that it is worthy of recognition as an index procedure.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"36 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2019-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82100811","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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