1) The document discusses several studies on chronic otitis media (COM) and related complications in children and adults.
2) One study finds that in addition to conductive hearing loss, COM can cause clinically significant sensorineural hearing loss (SNHL) in children. Risk factors for more severe SNHL include older age, presence of cholesteatoma, and longer duration of disease.
3) Another study evaluates using a hydroxyapatite/chitosan patch for mastoid obliteration surgery and finds it induces more bone growth and is better for filling the mastoid cavity than other materials tested.
4) Other studies discuss facial paralysis as a rare complication of COM with cholesteat
Role of CT Mastoids in the Diagnosis and Management of Chronic Inflammatory E...Dr.Juveria Majeed
This study emphasises the role of CT Temporal bone in the diagnosis and management of chronic inflammatory ear disease...published in the Indian Journal of Otolaryngology Head and Neck surgery.
Deviated Nasal Septum Correction by Septoplasty with Turbinoplasty and Intran...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Role of CT Mastoids in the Diagnosis and Management of Chronic Inflammatory E...Dr.Juveria Majeed
This study emphasises the role of CT Temporal bone in the diagnosis and management of chronic inflammatory ear disease...published in the Indian Journal of Otolaryngology Head and Neck surgery.
Deviated Nasal Septum Correction by Septoplasty with Turbinoplasty and Intran...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The Mastoid Compartment of Middle Ear Cleft-A Clinic Pathological Study in Patients with Chronic Otitis Media-Mucosal Type by George MV in Experiments in Rhinology & Otolaryngology
https://crimsonpublishers.com/ero/fulltext/ERO.000525.php
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 31st publication IJAR 1st name
The First Active Transcutaneous Bone Conduction Implant in Romania-Case Repor...CrimsonpublishersTTEH
Since the introduction of bone conduction hearing implants in 1977, quality of life of the implantees have improved substantially. The first available option were bone-anchored hearing devices, which improved sound quality, but had the major disadvantage of post-operative skin and wound infections. Therefore, new technologies seeking intact skin solution have emerged lately. The BONEBRIDGE system (MED-EL, Medical Electronics, Innsbruck, Austria) incorporates the first active bone conduction device, which especially aims to resolve abutment issues and still offers excellent audiological benefit. The successful implantation of this system in the first Romanian patient suffering from congenital lip and hard palate cleft with recurrent suppurative otitis media is presented. The authors report their experience with implantation, in terms of indications, selection assessment as well as functional results with a critical review of advantages and disadvantages in comparison with classical methods.
Objectives: To determine the potential of“Black Bone” MRI as an alternative to CT in the maturation parameters of the palatine suture and identify the optimal time to perform orthodontic palatal expansion. Methods: two patients from 10.3 and 25.9 years underwent “Black Bone” MRI “, T1 and T2 weighted spin echo imaging were obtained in the axial plane in addition to routine cranial RMI. “Black Bone” datasets weresubsequently compared to T2 wheighted RMI for the visualisation medial palatine sutures by using a similarbased method to evaluate suture fusion stages. Results: Patient palatine sutures were consistently identified on “Black Bone” MRI as áreas with different signal intensity according to the maturation stage, from complete separation of the halves to total fusion, as also found in the T2 weighted protocol.“Black Bone” MRI can be considered as an alternative o CTBC to assess the maturation of medial palatine suture for orthodontic purposes. Conclusions “Black Bone” MRI has considerable clinical potential as a nonionising alternative to CT in the assessement of the medial palatine suture.
Otosclerosis or otospongiosis is a bone degeneration that occurs in the otic capsule, the bone structure that surrounds the cochlea and labyrinth. Is an aberrant process of bone resorption of the labyrinthine capsule followed by reparative deposition of new, immature sclerotic bone (Abdurehim, 2016) [1]. This disease most often starts at the base of the stapes, which is the smallest bone in the human body, receiving the name of fenestral otosclerosis. Over time, it can progress to the cochlea and even reach the internal auditory meatus. Therefore, it is far from being a simple “calcification” of a small ear bone, requiring correct diagnosis, long-term follow-up, and personalized treatment.
RCT on Base tie in laparoscopic appendecomy (Journal Club).pptxadnanhabib31
This is ppt made on a study based on Randomised controlled trial on the tie of appendix base in laparoscopic appendectomy by hem-o-lok,endoloop or stapler.This study showed that hem-o-lok clips are better and cheaper as compared to others.
5th publication -Dr Rahul VC Tiwari - Department of ral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Takkellapadu,Guntur, Andhra Pradesh - 522509.
Emergency management of patients with facial traumaAhmed Adawy
Emergency management of patients with facial trauma
Dr. Ahmed M. Adawy Professor Emeritus, Dept. Oral & Maxillofacial Surg. Former Dean, Faculty of Dental Medicine
Al-Azhar University.
Maxillofacial trauma is without doubt a most challenging area within the specialty of oral and maxillofacial surgery. As with all traumas, basic Advanced Trauma Life Support principles (ATLS) should be applied to the initial assessment of the casualty. The primary survey is given by the letters ABCDE.
• Airway maintenance with cervical spine protection.
• Breathing and ventilation.
• Circulation with hemorrhage control.
• Disability: neurological status.
• Exposure/environmental control - undress the patient but prevent hypothermia.
Each was explored and discussed.
Unlocking the Benefits of Cognitive Behavioural Therapy (CBT) with Renewed Edgerenewed edge
Discover the transformative potential of Cognitive Behavioural Therapy (CBT) with Renewed Edge. This presentation covers the core principles of CBT, its development, practical applications, benefits, and how to get started with this evidence-based approach to improving mental well-being.
The Mastoid Compartment of Middle Ear Cleft-A Clinic Pathological Study in Patients with Chronic Otitis Media-Mucosal Type by George MV in Experiments in Rhinology & Otolaryngology
https://crimsonpublishers.com/ero/fulltext/ERO.000525.php
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 31st publication IJAR 1st name
The First Active Transcutaneous Bone Conduction Implant in Romania-Case Repor...CrimsonpublishersTTEH
Since the introduction of bone conduction hearing implants in 1977, quality of life of the implantees have improved substantially. The first available option were bone-anchored hearing devices, which improved sound quality, but had the major disadvantage of post-operative skin and wound infections. Therefore, new technologies seeking intact skin solution have emerged lately. The BONEBRIDGE system (MED-EL, Medical Electronics, Innsbruck, Austria) incorporates the first active bone conduction device, which especially aims to resolve abutment issues and still offers excellent audiological benefit. The successful implantation of this system in the first Romanian patient suffering from congenital lip and hard palate cleft with recurrent suppurative otitis media is presented. The authors report their experience with implantation, in terms of indications, selection assessment as well as functional results with a critical review of advantages and disadvantages in comparison with classical methods.
Objectives: To determine the potential of“Black Bone” MRI as an alternative to CT in the maturation parameters of the palatine suture and identify the optimal time to perform orthodontic palatal expansion. Methods: two patients from 10.3 and 25.9 years underwent “Black Bone” MRI “, T1 and T2 weighted spin echo imaging were obtained in the axial plane in addition to routine cranial RMI. “Black Bone” datasets weresubsequently compared to T2 wheighted RMI for the visualisation medial palatine sutures by using a similarbased method to evaluate suture fusion stages. Results: Patient palatine sutures were consistently identified on “Black Bone” MRI as áreas with different signal intensity according to the maturation stage, from complete separation of the halves to total fusion, as also found in the T2 weighted protocol.“Black Bone” MRI can be considered as an alternative o CTBC to assess the maturation of medial palatine suture for orthodontic purposes. Conclusions “Black Bone” MRI has considerable clinical potential as a nonionising alternative to CT in the assessement of the medial palatine suture.
Otosclerosis or otospongiosis is a bone degeneration that occurs in the otic capsule, the bone structure that surrounds the cochlea and labyrinth. Is an aberrant process of bone resorption of the labyrinthine capsule followed by reparative deposition of new, immature sclerotic bone (Abdurehim, 2016) [1]. This disease most often starts at the base of the stapes, which is the smallest bone in the human body, receiving the name of fenestral otosclerosis. Over time, it can progress to the cochlea and even reach the internal auditory meatus. Therefore, it is far from being a simple “calcification” of a small ear bone, requiring correct diagnosis, long-term follow-up, and personalized treatment.
RCT on Base tie in laparoscopic appendecomy (Journal Club).pptxadnanhabib31
This is ppt made on a study based on Randomised controlled trial on the tie of appendix base in laparoscopic appendectomy by hem-o-lok,endoloop or stapler.This study showed that hem-o-lok clips are better and cheaper as compared to others.
5th publication -Dr Rahul VC Tiwari - Department of ral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Takkellapadu,Guntur, Andhra Pradesh - 522509.
Emergency management of patients with facial traumaAhmed Adawy
Emergency management of patients with facial trauma
Dr. Ahmed M. Adawy Professor Emeritus, Dept. Oral & Maxillofacial Surg. Former Dean, Faculty of Dental Medicine
Al-Azhar University.
Maxillofacial trauma is without doubt a most challenging area within the specialty of oral and maxillofacial surgery. As with all traumas, basic Advanced Trauma Life Support principles (ATLS) should be applied to the initial assessment of the casualty. The primary survey is given by the letters ABCDE.
• Airway maintenance with cervical spine protection.
• Breathing and ventilation.
• Circulation with hemorrhage control.
• Disability: neurological status.
• Exposure/environmental control - undress the patient but prevent hypothermia.
Each was explored and discussed.
Unlocking the Benefits of Cognitive Behavioural Therapy (CBT) with Renewed Edgerenewed edge
Discover the transformative potential of Cognitive Behavioural Therapy (CBT) with Renewed Edge. This presentation covers the core principles of CBT, its development, practical applications, benefits, and how to get started with this evidence-based approach to improving mental well-being.
ASSISTING WITH THE USE OF BED PAN BY ANUSHRI SRIVASTAVA.pptxAnushriSrivastav
When a patient uses a bedpan, promote comfort and normalcy and respect the patient’s privacy as much as possible. Be sure to maintain a professional manner. In addition, provide skin care and perineal hygiene after bedpan use
Regular bedpans have a rounded, smooth upper end and a tapered, open lower end. The upper end fits under the patient’s buttocks toward the sacrum, with the open end toward the foot of the bed
. A special bedpan called a fracture bedpan is frequently used for patients with fractures of the femur or lower spine
Fracture bedpan - used for patients with fractures of the femur or lower spine. The fracture pan has a shallow, narrow upper end with a flat wide rim, and a deeper, open lower end. The upper end fits under the patient’s buttocks toward the sacrum, with the deeper, open lower end toward the foot of the bed.
Ordinary Bedpan
EQUIPMENTS
Bedpan (regular or fracture)
Toilet tissue
Disposable clean gloves
Additional PPE, as indicated
Cover for bedpan or urinal (disposable waterproof pad or cover)
ASSESSMENT
Assess the patient’s normal elimination habits.
Determine why the patient needs to use a bedpan (e.g., a medical order for strict bed rest or immobilization).
Assess the patient’s degree of limitation and ability to help with activity.
Assess for activity limitations, such as hip surgery or spinal injury, which would contraindicate certain actions by the patient.
Check for the presence of drains, dressings, intravenous fluid infusion sites/equipment, traction, or any other devices that could interfere with the patient’s ability to help with the procedure or that could become dislodged.
Assess the characteristics of the urine and the patient’s skin
Assisting With Use of a Bedpan When the Patient Has Limited Movement
Patients who are unable to lift themselves onto the bedpan or who have activity limitations that prohibit the required actions can be assisted onto the bedpan in an alternate manner using these actions
Psoriasis is an inflammatory skin disease that is associated with multiple comorbidities and substantially diminishes patients' quality of life. Topical therapies remain the cornerstone for treating mild psoriasis. Therapeutic advancements for moderate to severe plaque psoriasis include biologics that inhibit TNF-α, p40IL-12/23, IL-17, and p19IL-23, as well as an oral phosphodiesterase 4 inhibitor.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
What can we really do to give meaning and momentum to equality, diversity and...Rick Body
A copy of the slides for my talk on how we can meaningfully improve diversity and inclusion in emergency care research, at the Royal College of Emergency Medicine Research Engagement Day in May 2024.
PT MANAGEMENT OF URINARY INCONTINENCE.pptxdrtabassum4
A home-based pelvic floor muscle training and bladder training in women with urinary incontinence showed that combined pelvic floor muscle training and bladder training decreased the symptoms and improved the quality of life
To strengthen your pelvic floor muscles, squeeze the muscles up to 10 times while standing, sitting or lying down.
Do not hold your breath or tighten stomach, bottom or thigh muscles at the same time.
When you get used to doing pelvic floor exercises, you can try holding each squeeze for one second
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Transforming Healthcare: The Rise of AI in Telemedicine24HrDOC
Explore the transformative impact of AI in telemedicine with 24HrDOC. Our AI-powered telehealth platform offers 24/7 access to certified doctors for affordable, personalized medical consultations. Revolutionize your healthcare experience today!
ASSISTING WITH THE USE OF URINAL BY ANUSHRI SRIVASTAVA.pptxAnushriSrivastav
Male patients confined to bed usually prefer to use the urinal for voiding.
The use of a urinal in the standing position facilitates emptying of the bladder
If the patient is unable to stand, the urinal may be used in bed. Patients may also use a urinal in the bathroom to facilitate measurement of urinary output.
Provide skin care and perineal hygiene after urinal use and maintain a professional manner
EQUIPMENT
Urinal with end cover (usually attached)
Toilet tissue
Clean gloves
Additional PPE, as indicated
ASSESSMENT
Assess the patient’s normal elimination habits.
Determine why the patient needs to use a urinal, such as a physician’s order for strict bed rest or immobilization.
Assess the patient’s degree of limitation and ability to help with activity
Assess for activity limitations, such as hip surgery or spinal injury, which would contraindicate certain actions by the patient.
Check for the presence of drains, dressings, intravenous fluid infusion sites/equipment, traction, or any other devices that could interfere with the patient’s ability to help with the procedure or that could become dislodged.
Assess the characteristics of the urine and the patient’s skin.
Document the patient’s tolerance of the activity. Record the amount of urine voided on the intake and output record, if appropriate. Document any other assessments, such as unusual urine characteristics or alterations in the patient’s skin.
SPECIAL CONSIDERATION
Urinal should not be left in place for extended periods because pressure and irritation to the patient’s skin can result. If patient is unable to use alone or with assistance, consider other interventions, such as commode or external condom catheter.
It may be necessary to assist patients who have difficulty holding the urinal in place, such as those with limited upper extremity movement or alteration in mentation, to prevent spillage of urine.
The urinal may also be used standing or sitting at the bedside or in the patient’s bathroom, if patient is able to do so.
ASSISTING WITH THE USE OF URINAL BY ANUSHRI SRIVASTAVA.pptx
Facial Paralysis in Chronic Otitis Media with Cholesteatoma.pdf
1. doi:10.1017/S0022215116007349
ID: IP238
Clinical Significance of Sensorineural
Hearing Loss in Pediatric Chronic Otitis
Media
Presenting Author: Noam Yehudai
Noam Yehudai, Michal Luntz
Bnai Zion Medical Center, Technion – The
Bruce Rappaport Faculty of Medicine, Haifa,
Israel
Learning Objectives: to promote awareness to the long term
effects of chronic OM in terms of SNHL.
Introduction: Hearing loss is considered a common compli-
cation and sequela of chronic otitis media (COM). The loss is
usually conductive, but sensorineural involvement also
occurs. Clinically significant sensorineural hearing loss
(SNHL) has been reported in adults with COM; however
its significance in children is still unclear. The aim of the
study is to assess the severity of SNHL in single sided
COM, in a group of children, using the contra-lateral
healthy ear as a control and to define risk factors for the
development of SNHL in COM. Characterizing these risk
factors will assist in better defining treatment indications
for COM and thus reduce the occurrence of SNHL.
Methods: The study cohort included 124 children with uni-
lateral COM operated between 1997 and 2010. Mean age
at surgery was 13.3 ± 3.2 years (range, 7–18 years), and
mean duration of disease was 88.4 ± 45.0 months (range, 6
-192 months). Bone conduction (BC) pure tone average
(PTA) of the two ears was calculated as the average of BC
thresholds at 500, 1000, 2000 and 4000 Hz. The parameters
evaluated included: demographics (age, sex, and side), dur-
ation of disease, presence and location of cholesteatoma, pre-
vious otologic history and previous ear surgery.
Results: A statistically significant difference in BC-PTA
was found between the diseased ear (12.74 ± 8.75 dB)
and the healthy ear (9.36 ± 6.33 dB) (p < 0.01).
Statistically significant correlation was found between the
level of SNHL in the diseased ear, age and the presence
of cholesteatoma.
Conclusions: One of the complications of chronic COM is
the development of SNHL in addition to conductive
hearing loss. It is imperative to actively treat COM patients
in order to prevent the expected development of SNHL.
An insistent approach to patients presenting with these
factors is mandatory since they are prone to develop a
more severe form of SNHL.
doi:10.1017/S0022215116007350
ID: IP239
Rat Mastoid Bullae Obliteration Using
Hydroxyapatite/Chitosan Patch
Presenting Author: Keun-Ik Yi
Keun-Ik Yi
Pusan National University Hospital
Learning Objectives:
Purpose: Canal wall down mastoidectomy is often per-
formed to prevent recurrence and complete removal of
lesion in the treatment of otitis media with cholesteatoma.
In this case, however, several problems can be caused to
the mastoid cavity. Therefore to improve the long term sta-
bility of the mastoid cavity and to eliminate the cavity
related problems significant modifications were introduced
such as the mastoid obliteration technique using various
methods including bone, cartilage, fat, flaps and others.
This study evaluated the effectiveness of hydroxyapatite/
chitosan patch(HAp/Chi patch) known as the new materials
to promote osteogenesis for mastoid obliteration in animal
model.
Materials and Methods: Sprague-Dawley rats underwent
mastoid obliteration using hydroxyapitie powder(Mimix®
),
cartilage and HAp/Chi patch in each five ear. CT (computed
tomography) and mastoid tissue sampling was done after
twelve weeks. And we evaluated the degree of osteogenesis
and inflammation of tissue.
Results: The mastoid cavity in HAp/Chi patch group was
best filled in CT findings. In the histopathological aspects
of the osteogenesis and inflammation, it exhibited 7.5%/
20%, 28%/3% and 25%/50% in the group of cartilage,
hydroxyapitie powder and HAp/Chi patch group,
respectively.
Conclusions: Hap/Chi patch is less absorbent, better to fill
the mastoid cavity and more induce osteogenesis than the
other obliteration material. But the degree of inflammation
in Hap/Chi patch group is highest. It may be necessary to
secure the stability of the mastoid obliteration material
through additional experiments.
doi:10.1017/S0022215116007362
ID: IP240
Facial Paralysis in Chronic Otitis Media
with Cholesteatoma
Presenting Author: Nadir Yildirim
Nadir Yildirim1
, Sinan Aksoy2
, Sermin Tok3
1
Dumlupinar Universitesi Medical Faculty,
2
DPU Medical Faculty Department of ORL-
HNS, 3
Mersin University Department of
Radiology
Learning Objectives:
Objective: Facial paralysis is a rare and drastic complication
of chronic otitis media and middle ear cholesteatoma. The
predisposing factors that lead to facial nerve paralysis in
ABSTRACTS
S250
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2. choesteatomatous ears are still obscure. Herewith, we aimed
to investigate the possible etio-pathogenesis of facial paraly-
isi in our cholesteatoma cases.
Material and Methods: We retrospectively reviewed the
charts of 5 facial nerve paralysis cases that were con-
nected to co-existing chronic otitis media with cholestea-
toma and compare our findings with reported case series
in literature. The duration and degree of facial paralysis,
temporal bone CT findings including the size of the mas-
toids, dehiscence of the fallopian canal and other accom-
panying radiological abnormalities such as semicircular
canal dehiscence, and intraoperative findings were noted.
Results: In the years of 2014–2015 we admitted 156
primary of recurring cases of middle ear cholesteatoma in
our clinic, 5 (3.2%) of which also had associated facial
paralysis. This percentage was comparable to those of
reported series. Of those patients, 2 of whom had already
been operated with canal wall-down (CWD) technique
years ago for cholesteatoma that recurred. According to
House-Brackmann (H-B) classification, one patient had
grade 5, one patient grade 4, two patients grade 3 and
one patient grade 2 paralyses. All three previously unoper-
ated cases had relatively smaller mastoids and lateral semi-
circular canal (LSSC) dehiscence, detected either on CT
and/or perioperatively. Fallopian canal dehiscences were
in tympanic segment in 3 and in mastoid segment in 2
of the patients. All patients were operated with CWD tech-
nique as to include facial canal decompression. All but one
paralyses were regressed to either HB-1 (3 cases) or HB-0
(1 case) grades postoperatively.
Discussion and Conclusion: It appears that previously exist-
ing facial canal dehiscence and small mastoids predisposes
both facial canal and LSSC erosion in untreated chronic
otitis media with cholesteatoma as to result in facial nerve
palsy.
doi:10.1017/S0022215116007374
ID: IP241
Randomized clinical trial for partial canal
wall preserved mastoitympanoplasty
Presenting Author: Xin Ying
Xin Ying, Song Weiming
Peking University
Learning Objectives:
Objective: To study and evaluate the outcome of partial
canal wall preserved mastoitympanoplasty (PCM) for
chronic otitis media with cholesteatoma and/or granulation
tissue.
Methods: Thirty-nine patients were randomly divided into
two groups. 20 patients underwent PCM, 19 patients under-
went canal wall down mastoitympanoplasty(CWD). All of
the patients had a follow-up period of 5 years.
Results: All the patients in the two groups underwent the
operation successfully and no intraoperative or post-
operative complications were found. The mean time of
drying of cavity was 6 weeks (4–8weeks) in the PCM
group, while it was 8 weeks (6–10weeks) in the CWD
group. The cavity in the PCM group were near normal
or slightly larger than the external auditory canal, and
the tympanal flaccid part slightly wider than normal,
patients could able to wear traditional hearing aids. The
patients need cavity cleaning less than 1 times a year in
the PCM group and 3–4 times a year in the CWD
group. The surgery cavity volume was 1.4 + 0.2 ml in
the PCM group and 2.6 + 1.1 ml in the CWD group
(P < 0.05), the difference was statistically significant.
There were 8 patients (40%) improved hearing level (thresh-
old improved > 10 dB) 5 years after operation in the PCM
group and 6 patients (32%) in the CWD group, no statistic-
ally significant difference. 1 patient (5%) developed a recur-
renct cholesteatoma which was located in the attic and 4
patients (20%) developed retraction pockets in the attic in
the PCM group, while 3 patients (15.8%) developed
cavity problem that the epithelial accumulation were not
easy to clean in the CWD group, no statistically significant
difference.
Conclusion: With PCM technique, cholesteatoma could be
completely and safely removed from the middle ear, and
patients had near normal postoperative external auditory
canal. Therefore, PCM was a reasonable choice for the
surgery of otitis media with cholesteatoma and/or granula-
tion tissue.
doi:10.1017/S0022215116007386
ID: IP242
Ossicular Anomaly and Endolymphatic
Hydrops as Risk Factors for
Complications after Ossiculoplasty
Presenting Author: Tadao Yoshida
Tadao Yoshida1
, Satofumi Sugimoto2
, Michihiko Sone2
1
Nagoya University Graduate School of
Medicine, 2
Department of
Otorhinolaryngology, Nagoya University
Graduate School of Medicine
Learning Objectives:
We report a case of endolymphatic hydrops with an ossicular
anomaly, in which a hearing test showed fluctuating mixed
hearing loss. A 42-year-old man with hearing impairment
had experienced varying ear symptoms on his right side
since elementary school. Evaluation by computed tomog-
raphy showed an ossicular anomaly, and magnetic resonance
imaging revealed endolymphatic hydrops in the symptomatic
ear. Ossiculoplasty or stapes surgery is considered in patients
with conductive hearing loss; however, the existence of
endolymphatic hydrops is a risk factor for surgical complica-
tions. Preoperative magnetic resonance imaging examination
may be beneficial when evaluating inner ear conditions such
as ossicular anomalies, especially in cases accompanied by
fluctuating hearing loss.
ABSTRACTS S251
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