Objectives: An Otolaryngology—Head and Neck Surgery clinic is an integral part of any modern tertiary center outpatient department. The objective of this article is to present our experience in developing a local ele...Objectives: An Otolaryngology—Head and Neck Surgery clinic is an integral part of any modern tertiary center outpatient department. The objective of this article is to present our experience in developing a local electronic Makkah Otolaryngology—Head and Neck DATABASE (MO-HND) and provide a roadmap for the development of Otolaryngology—Head and Neck Surgery clinics in other tertiary centers. Methods: This is a prospective audit of all patients attending our clinic over 3 months period (July to September 2014). The data were recorded using our MO-HND. Results: A total of 1178 patients were included. The mean age was 27.7 ± 6.7 years. Participants included 586 males (49.7%) and 592 females (50.3%). There were 1139 (96.6%) Saudi and 39 (3.4%) non-Saudi patients. The specialist clinic undertook most of the workload (66%). The majority of surgery bookings (94%) were carried out through a consultant clinic. Of all participants, 80% were diagnosed with general ENT conditions, 21% underwent a procedure in the clinic, and 29% required further investigations. The surgical conversion rate was 16.3%. Conclusion: Electronic DATABASES have become important tools for improving medical services. Primary and secondary level medical centers and hospitals should increase their role in alleviating pressure from tertiary and quaternary level hospitals. In turn, a model concentrated on subspecialty clinics and services should be developed.展开更多
Head and neck cancers are frequently associated with dysphagia. Both pre-treatment and post-treatment etiologies have been described in the literature. The result of dysphagia has been well-documented as causing reduc...Head and neck cancers are frequently associated with dysphagia. Both pre-treatment and post-treatment etiologies have been described in the literature. The result of dysphagia has been well-documented as causing reductions in both quality-of-life and physical well-being. The goal of this review is to consolidate the current understanding of the relationship between head and neck cancers and dysphagia.展开更多
Background: Thyroid diseases are among the leading endocrine disorders affecting a large proportion of people worldwide and show geographical variation in incidence and histopathological pattern related to age, sex, d...Background: Thyroid diseases are among the leading endocrine disorders affecting a large proportion of people worldwide and show geographical variation in incidence and histopathological pattern related to age, sex, dietary and environmental factors. Histopathological patterns of surgically treated thyroid diseases play an important role in early diagnosis and management of these diseases. There is, however, limited published data regarding histopathological reports on thyroid disease in our local setting. This study aimed to determine the histopathological patterns and highlight early postoperative complications among patients with surgically treated thyroid diseases at Bugando Medical Centre (BMC). Methods: This was a longitudinal study involving all patients with surgically treated thyroid diseases seen at BMC over a period of 6 months from October 2019 to March 2020. Results: A total of 84 patients were studied. Females outnumbered males by a female to male ratio of 11:1. The median age of patients was 44 [IQR, 35 - 54] years old, the youngest was 14 years old and the oldest was 76 years old. Colloid goiter was the most common non-neoplastic lesion accounting for 34 (44.7%) patients. Among the neoplastic lesions, follicular adenoma was the most commonly encountered benign pathologies (n = 16;21.1%), while papillary carcinoma was the most commonly encountered malignancy (n = 4;50%). Following thyroidectomy, 12 (14.3%) patients developed early complications, of which hemorrhage sometimes requiring blood transfusion was the leading intra/postoperative complications accounting for 4 (33.3%) patients. Other complications include temporary recurrent laryngeal nerve palsy 2 (16.7%), surgical site infection 2 (16.7%) and tracheomalacia, bronchospasm, thyroid abscess and respiratory obstruction in 1 (8.3%) patient each, respectively. In this study, malignant thyroid lesion (p Conclusion: This study demonstrated that colloid goiter was the most common non-neoplastic lesion, and on the neoplastic category, follicular adenoma was the most common benign lesion, while papillary carcinoma was the most frequent malignant lesion.展开更多
Aims: To assess the hearing outcome in patients who have undergone stapes surgery using polytetrafluoroethylene (PTFE) and Titanium prosthesis at 1 and 3 months post operatively. Material & Methods: Research desig...Aims: To assess the hearing outcome in patients who have undergone stapes surgery using polytetrafluoroethylene (PTFE) and Titanium prosthesis at 1 and 3 months post operatively. Material & Methods: Research design: Prospective study. Setting: ENT department, Pushpagiri Medical College. Study population: All age groups with clinical diagnosis of otosclerosis and air-bone gap more than 15 dB irrespective of sex difference. Patients with Meniere’s disease are excluded. Method: A prospective study was conducted for a period of one and a half years from January 2014 to July 2015 to find out the hearing outcome of stapes surgery in patients with otosclerosis using polytetrafluoroethylene (PTFE) and Titanium prostheses, attending our outpatient department. Results: In this study, 84.21% of ears with polytetrafluoroethylene (PTFE) and 81.81% of ears with titanium were able to achieve good results in terms of Air-Bone gap (ABG) closure (ABG Conclusion: Stapes surgery is the surgical procedure of choice for otosclerosis. In our study, a significant hearing improvement was seen in majority of cases. None of the factors considered relevant for the success of stapes surgery like age, sex, type of prosthesis appeared to affect the post-operative hearing significantly. Hence stapes surgery can be effectively used to improve hearing in otosclerosis.展开更多
Managing cut throat injuries are a challenge as it may involve the three anatomical components of the neck namely vascular component, which involves carotid arteries, jugular veins, subclavian vessels and the vertebra...Managing cut throat injuries are a challenge as it may involve the three anatomical components of the neck namely vascular component, which involves carotid arteries, jugular veins, subclavian vessels and the vertebral arteries;respiratory component, which involves larynx and trachea and digestive component, which involves pharynx and esophagus. Injury to one or more of the components may lead to profuse hemorrhage from injured major blood vessels, air embolism and airway obstruction. Managing electrical cut throat injuries to neck are particularly challenging because of the damage that occurs at cellular level. We hereby report a case of electrical cut throat injury to neck.展开更多
Objective: To identify the facial nerve trunk (FNT) very easily. quickly and accurately considering the styloid process as the robust anatomically consistent landmark during parotid surgery. Patients and Methods: This...Objective: To identify the facial nerve trunk (FNT) very easily. quickly and accurately considering the styloid process as the robust anatomically consistent landmark during parotid surgery. Patients and Methods: This prospective study was conducted between January 2010 to December 2022 at a Tertiary care hospital. It included 130 patients: 84 (65%) males and 46 (35%) females with a mean age of 43.52 ± 15.63 years. Patients presented with pleomorphic adenoma (90), chronic sialectasis (05), parotid cyst (03), parotid sinus (01), mucoepidermoid carcinoma (28), adenoid cystic carcinoma (02) and squamous cell carcinoma (01) were subjected to superficial parotidectomy and total parotidectomy. The outcome was evaluated regarding the clinical success of facial nerve function that considered the location of the styloid process in the triangle technique for identification of the FNT during parotid surgery. Results: All 130 patients underwent superficial and total parotidectomy. The facial nerve trunk was successfully identified as the location of the styloid process in the triangle technique in all the patients with no intra-operative complications. Operative time ranged from 50 to 180 minutes with a mean time 90.70 ± 15.68 minutes. Dysfunction of the angle of the mouth due to the deficit of the marginal mandibular nerve (MMN) was noted in 5 patients (3.8%), 02 had difficulty in eye closure (1.5%). No patient reported surgical site infection, skin flap necrosis and hematoma in this series. Conclusion: Styloid process is the prominent robust landmark in the triangle technique for the identification of facial nerve trunk with relative ease, safety and accuracy in the parotid surgical procedure. This can be a very useful method to locate the FNT and minimize facial nerve injury during parotid surgery.展开更多
Introduction: Laryngeal carcinoma accounts for 13.9% of head and neck tumors, and squamous cell carcinoma is the main pathological type. At present, the treatment of laryngeal cancer is mainly surgical treatment or po...Introduction: Laryngeal carcinoma accounts for 13.9% of head and neck tumors, and squamous cell carcinoma is the main pathological type. At present, the treatment of laryngeal cancer is mainly surgical treatment or postoperative radiotherapy. The surgery is delicate, complex, time-consuming and traumatic. Postoperative patients are prone to dysphagia, leading to an increase in the incidence of malnutrition. Malnutrition can cause a series of negative effects, including weight loss, increased incidence of infection, reduced tolerance of anti-tumor treatment, and extended length of hospital stay. Therefore, how to effectively improve the nutritional status of laryngeal cancer patients through nursing intervention has become an important topic of nursing research. Objective: Investigate the effect of individualized nutrition intervention care combined with swallowing training on postoperative nutritional status in patients with laryngeal cancer. Methods: A total of 120 consecutive patients who underwent laryngeal surgery at our hospital for the first time between May 2018 and May 2021 were selected for the study and equally divided into the control group and the study group by the random number table method, with 60 patients in each group. Patients in the control group were given swallowing function training and health counseling, and the study group adopted individualized nutrition intervention care based on the control group. The nutritional status, swallowing function, and quality of life (QOL) of the patients were assessed using the Patient-generated Subjective Global Assessment (PG-SGA), MD Anderson Dysphagia Inventory (MDADI), and Quality of Life Questionnaire-Core30 (QLQ-C30) before the intervention and three months after the intervention. Results: Before the intervention, the scores of MDADI, PG-SGA, and QLQ-C30 were not significantly different between the two groups (P > 0.05), and three months after the intervention, the scores of MDADI and QLQ-C30 increased and the score of PG-SGA decreased in the study group, with significant differences (P 0.05). At three months after the intervention, patients in the study group had higher scores on MDADI, QLQ-C30 and lower scores on PG-SGA than the control group, with significant differences (P Conclusion: Combining individualized nutrition intervention care with swallowing training improves the postoperative nutritional status, swallowing function, and QOL of patients with laryngeal cancer.展开更多
Introduction: Bell’s palsy is an uncommon adverse effect of the COVID-19 vaccine that has been reported in clinical trials. Even though a few studies have linked the vaccination to Bell’s palsy, the actual mechanism...Introduction: Bell’s palsy is an uncommon adverse effect of the COVID-19 vaccine that has been reported in clinical trials. Even though a few studies have linked the vaccination to Bell’s palsy, the actual mechanism is uncertain. Objectives: To describe the demographic data and COVID-19 vaccines-related data with Bell’s palsy in a tertiary centre of Malaysia, Hospital Kuala Lumpur. Methods: A retrospective cross-sectional study was observed among vaccinated recipients who developed Bell’s palsy within 60 days and sought treatment in the Otorhinolaryngology Department Hospital Kuala Lumpur, Malaysia between 1<sup>st</sup> May 2021 and 30<sup>th</sup> November 2021. The demographic data, clinical history, and vaccination history were collected from clinical records. The facial paralysis was graded according to the House-Brackmann grading system. Results: A total of 26 patients with a mean age was 38.5 years;higher incidence in younger age, below 60 years old (n = 24), specifically 18 - 30 years old (n = 11). We observed an equal number in relation to gender and onset (after the first or second dose) of facial palsy. Predominantly were Malay (n = 21) and only 6 patients had comorbidities. We found there was no difference in regard to the type of vaccine among Bell’s palsy patients;Pfizer (n = 9), followed by Sinovac (n = 9) and AstraZeneca (n = 8). Conclusion: Bell’s palsy was found to be a possible adverse event of the COVID-19 vaccine. Younger groups were noted as susceptible to this rare adverse effect. However, the benefits of vaccination outweigh the risk of Bell’s palsy, which has a good prognosis. More research with larger samples is needed to determine the true relationship between vaccination and Bell’s palsy.展开更多
In this case report, we discuss a patient who presented with Tullio’s phenomenon, who also experienced bone-conduction induced seizures on two occasions. Tullio’s phenomenon refers to sound induced vestibular sympto...In this case report, we discuss a patient who presented with Tullio’s phenomenon, who also experienced bone-conduction induced seizures on two occasions. Tullio’s phenomenon refers to sound induced vestibular symptoms, including disequilibrium oscillopsia, and vertical nystagmus. We were ultimately able to rule out some of the more common pathologies associated with Tullio’s phenomenon for this patient based on imaging findings. However, given the specific nature of her chronic symptoms, as well as her seizure like activity in clinic, we performed a literature search to investigate other less common pathologies associated with Tullio’s phenomenon. Given her past medical history of mixed psychogenic non-epileptic seizures (PNES), there is likely a somatic component to her presentation. However, given the specific and unexpected nature of these events, we propose that her symptoms may also be related to a unique inner ear pathology. Specifically, we feel that she may have exhibited symptoms of vestibular atelectasis, a relatively new otologic diagnosis characterizing the pathologic collapse of the ampulla and utricle, such that the membranous labyrinth contacts the stapes. In this way, loud sounds or changes in pressure may induce vestibular symptoms. Dizzy patients can be a difficult demographic to diagnose and manage, especially when their presentation is complicated by other functional neurologic disorders. Ultimately, we believe that this case report offers helpful insights into a new disease process associated with Tullio’s phenomenon.展开更多
Kimura’s disease is a rare chronic affection of unknown etiology, endemic in the far east with a net male predominance. We present the case of a 37-year-old female patient who developed a tumor process in the left pa...Kimura’s disease is a rare chronic affection of unknown etiology, endemic in the far east with a net male predominance. We present the case of a 37-year-old female patient who developed a tumor process in the left parotid region over a period of 3 years. A total left parotidectomy was performed with simple postoperative course. The anatomopathological study of the surgical specimen was in favor of Kimura’s disease. Through this case and a review of the literature, we present the main clinical, anatomopathological, therapeutic and evolutionary characteristics of this rare disease.展开更多
Otitis media with effusion(OME)is a frequent paediatric disorder.The condition is often asymptomatic,and so can easily be missed.However,OME can lead to hearing loss that impairs the child's language and behaviour...Otitis media with effusion(OME)is a frequent paediatric disorder.The condition is often asymptomatic,and so can easily be missed.However,OME can lead to hearing loss that impairs the child's language and behavioural development.The diagnosis is essentially clinical,and is based on otoscopy and(in some cases)tympanometry.Nasal endoscopy is only indicated in cases of unilateral OME or when obstructive adenoid hypertrophy is suspected.Otitis media with effusion is defined as the observation of middle-ear effusion at consultations three months apart.Hearing must be evaluated(using an age-appropriate audiometry technique)before and after treatment,so as not to miss another underlying cause of deafness(e.g.perception deafness).Craniofacial dysmorphism,respiratory allergy and gastro-oesophageal reflux all favour the development of OME.Although a certain number of medications(antibiotics,corticoids,antihistamines,mucokinetic agents,and nasal decongestants)can be used to treat OME,they are not reliably effective and rarely provide long-term relief.The benchmark treatment for OME is placement of tympanostomy tubes(TTs)and(in some cases)adjunct adenoidectomy.The TTs rapidly normalize hearing and effectively prevent the development of cholesteatoma in the middle ear.In contrast,TTs do not prevent progression towards tympanic atrophy or a retraction pocket.Adenoidectomy enhances the effectiveness of TTs.In children with adenoid hypertrophy,adenoidectomy is indicated before the age of 4 but can be performed later when OME is identified by nasal endoscopy.Children must be followed up until OME has disappeared completely,so that any complications are not missed.展开更多
In this experiment,97 patients with obstructive sleep apnea hypopnea syndrome were divided into three groups(mild,moderate,severe) according to minimum oxygen saturation,and 35 healthy subjects were examined as contro...In this experiment,97 patients with obstructive sleep apnea hypopnea syndrome were divided into three groups(mild,moderate,severe) according to minimum oxygen saturation,and 35 healthy subjects were examined as controls.Cognitive function was determined using the mismatch negativity paradigm and the Montreal Cognitive Assessment.The results revealed that as the disease worsened,the mismatch negativity latency was gradually extended,and the amplitude gradually declined in patients with obstructive sleep apnea hypopnea syndrome.Importantly,mismatch negativity latency in severe patients with a persistent time of minimum oxygen saturation < 60 seconds was significantly shorter than that with a persistent time of minimum oxygen saturation > 60 seconds.Correlation analysis revealed a negative correlation between minimum oxygen saturation latency and Montreal Cognitive Assessment scores.These findings indicate that intermittent night-time hypoxemia affects mismatch negativity waveforms and Montreal Cognitive Assessment scores.As indicators for detecting the cognitive functional status of obstructive sleep apnea hypopnea syndrome patients,the sensitivity of mismatch negativity is 82.93%,the specificity is 73.33%,the accuracy rate is 81.52%,the positive predictive value is 85.00%,the negative predictive value is 70.21%,the positive likelihood ratio is 3,and the negative likelihood ratio is 0.23.These results indicate that mismatch negativity can be used as an effective tool for diagnosis of cognitive dysfunction in obstructive sleep apnea hypopnea syndrome patients.展开更多
Objective:To investigate surgical indications,operative techniques,complications and auditory and speech rehabilitation for cochlear implant(CI) in children with otitis media with effusion(OME).Materia! and methods:Th...Objective:To investigate surgical indications,operative techniques,complications and auditory and speech rehabilitation for cochlear implant(CI) in children with otitis media with effusion(OME).Materia! and methods:This is a retrospective review of records of 24 children with bilateral profound sensorineural hearing loss and OME who were implanted during January 2011 to November 2014 in the Department of Otorhinolaryngology and Head and Neck Surgery at the PLA Hospital,using one-stage implantation via the facial recess approach and round window insertion.The incus was removed in 8 cases during the implantation procedure.Local infiltration of dexamethasone and adrenaline in the middle ear was also performed.Postoperative complications were examined.Preoperative and postoperative questionnaires including Categories of Auditory Performance(CAP).Speech Intelligibility Rating(SIR),and the Meaningful Auditory Integration Scale(MAIS) were collected.Results:All electrodes were implanted successfully without any immediate or delayed complications.Inllammatory changes of middle ear mucosa with effusion were noted in all implanted ears.The scores of post-implant CAP and SIR increased signilicantly in all 24 cases(t =-25.95 and-14.09.respectively for CAP and SIR.p < 0.05).Conclusions:One-stage CI via the facial recess approach with round window insertion is safe and effective in cochlear implant candidates with OME,as seen in the 24 children in our study who achieved improved auditory performance and speech intelligibility after CI.展开更多
There are several challenges to inner ear drug delivery and imaging due to the existence of tight biological barriers to the target structure and the dense bone surrounding it. Advances in imaging and nanomedicine may...There are several challenges to inner ear drug delivery and imaging due to the existence of tight biological barriers to the target structure and the dense bone surrounding it. Advances in imaging and nanomedicine may provide knowledge for overcoming the existing limitations to both the diagnosis and treatment of inner ear diseases. Novel techniques have improved the efficacy of drug delivery and targeting to the inner ear, as well as the quality and accuracy of imaging this structure. In this review, we will describe the pathways and biological barriers of the inner ear regarding drug delivery, the beneficial applications and limitations of the imaging techniques available for inner ear research, the behavior of engineered nanomaterials in inner ear applications, and future perspectives for nanomedicine-based inner ear imaging.展开更多
Nanoparticles(NPs) with easily modified surfaces have been playing an important role in biomedicine.As cancer is one of the major causes of death,tremendous efforts have been devoted to advance the methods of cancer d...Nanoparticles(NPs) with easily modified surfaces have been playing an important role in biomedicine.As cancer is one of the major causes of death,tremendous efforts have been devoted to advance the methods of cancer diagnosis and therapy.Recently,magnetic nanoparticles(MNPs) that are responsive to a magnetic field have shown great promise in cancer therapy.Compared with traditional cancer therapy,magnetic field triggered therapeutic approaches can treat cancer in an unconventional but more effective and safer way.In this review,we will discuss the recent progress in cancer therapies based on MNPs,mainly including magnetic hyperthermia,magnetic specific targeting,magnetically controlled drug delivery,magnetofection,and magnetic switches for controlling cell fate.Some recently developed strategies such as magnetic resonance imaging(MRI) monitoring cancer therapy and magnetic tissue engineering are also addressed.展开更多
Ototoxic drugs can be used to produce a loss of cochlear hair cells to create animal models of deafness. However, to the best of our knowledge, there is no report on the establishment of a rat deafness model through t...Ototoxic drugs can be used to produce a loss of cochlear hair cells to create animal models of deafness. However, to the best of our knowledge, there is no report on the establishment of a rat deafness model through the combined application of aminoglycosides and loop diuretics. The aim of this study was to use single or combined administration of furosemide and kanamycin sulfate to establish rat models of deafness. The rats received intravenous injections of different doses of furosemide and/or intramuscular injections of kanamycin sulfate. The auditory brainstem response was measured to determine the hearing threshold after drug application. Immunocytochemistry and confocal microscopy were performed to evaluate inner ear morphology. In the group receiving combined administration of furosemide and kanamycin, the auditory brainstem response threshold showed significant elevation 3 days after administration, higher than that produced by furosemide or kanamycin alone. The hair cells showed varying degrees of injury, from the apical turn to the basal turn of the cochlea and from the outer hair cells to the inner hair cells. The spiral ganglion cells maintained a normal morphology during the first week after the hair cells completely disappeared, and then gradually degenerated. After 2 months, the majority of spiral ganglion cells disappeared, but a few remained. These findings demonstrate that the combined administration of furosemide and kanamycin has a synergistic ototoxic effect, and that these drugs can produce hair cell loss and hearing loss in rats. These findings suggest that even in patients with severe deafness, electronic cochlear implants may partially restore hearing.展开更多
文摘Objectives: An Otolaryngology—Head and Neck Surgery clinic is an integral part of any modern tertiary center outpatient department. The objective of this article is to present our experience in developing a local electronic Makkah Otolaryngology—Head and Neck DATABASE (MO-HND) and provide a roadmap for the development of Otolaryngology—Head and Neck Surgery clinics in other tertiary centers. Methods: This is a prospective audit of all patients attending our clinic over 3 months period (July to September 2014). The data were recorded using our MO-HND. Results: A total of 1178 patients were included. The mean age was 27.7 ± 6.7 years. Participants included 586 males (49.7%) and 592 females (50.3%). There were 1139 (96.6%) Saudi and 39 (3.4%) non-Saudi patients. The specialist clinic undertook most of the workload (66%). The majority of surgery bookings (94%) were carried out through a consultant clinic. Of all participants, 80% were diagnosed with general ENT conditions, 21% underwent a procedure in the clinic, and 29% required further investigations. The surgical conversion rate was 16.3%. Conclusion: Electronic DATABASES have become important tools for improving medical services. Primary and secondary level medical centers and hospitals should increase their role in alleviating pressure from tertiary and quaternary level hospitals. In turn, a model concentrated on subspecialty clinics and services should be developed.
文摘Head and neck cancers are frequently associated with dysphagia. Both pre-treatment and post-treatment etiologies have been described in the literature. The result of dysphagia has been well-documented as causing reductions in both quality-of-life and physical well-being. The goal of this review is to consolidate the current understanding of the relationship between head and neck cancers and dysphagia.
文摘Background: Thyroid diseases are among the leading endocrine disorders affecting a large proportion of people worldwide and show geographical variation in incidence and histopathological pattern related to age, sex, dietary and environmental factors. Histopathological patterns of surgically treated thyroid diseases play an important role in early diagnosis and management of these diseases. There is, however, limited published data regarding histopathological reports on thyroid disease in our local setting. This study aimed to determine the histopathological patterns and highlight early postoperative complications among patients with surgically treated thyroid diseases at Bugando Medical Centre (BMC). Methods: This was a longitudinal study involving all patients with surgically treated thyroid diseases seen at BMC over a period of 6 months from October 2019 to March 2020. Results: A total of 84 patients were studied. Females outnumbered males by a female to male ratio of 11:1. The median age of patients was 44 [IQR, 35 - 54] years old, the youngest was 14 years old and the oldest was 76 years old. Colloid goiter was the most common non-neoplastic lesion accounting for 34 (44.7%) patients. Among the neoplastic lesions, follicular adenoma was the most commonly encountered benign pathologies (n = 16;21.1%), while papillary carcinoma was the most commonly encountered malignancy (n = 4;50%). Following thyroidectomy, 12 (14.3%) patients developed early complications, of which hemorrhage sometimes requiring blood transfusion was the leading intra/postoperative complications accounting for 4 (33.3%) patients. Other complications include temporary recurrent laryngeal nerve palsy 2 (16.7%), surgical site infection 2 (16.7%) and tracheomalacia, bronchospasm, thyroid abscess and respiratory obstruction in 1 (8.3%) patient each, respectively. In this study, malignant thyroid lesion (p Conclusion: This study demonstrated that colloid goiter was the most common non-neoplastic lesion, and on the neoplastic category, follicular adenoma was the most common benign lesion, while papillary carcinoma was the most frequent malignant lesion.
文摘Aims: To assess the hearing outcome in patients who have undergone stapes surgery using polytetrafluoroethylene (PTFE) and Titanium prosthesis at 1 and 3 months post operatively. Material & Methods: Research design: Prospective study. Setting: ENT department, Pushpagiri Medical College. Study population: All age groups with clinical diagnosis of otosclerosis and air-bone gap more than 15 dB irrespective of sex difference. Patients with Meniere’s disease are excluded. Method: A prospective study was conducted for a period of one and a half years from January 2014 to July 2015 to find out the hearing outcome of stapes surgery in patients with otosclerosis using polytetrafluoroethylene (PTFE) and Titanium prostheses, attending our outpatient department. Results: In this study, 84.21% of ears with polytetrafluoroethylene (PTFE) and 81.81% of ears with titanium were able to achieve good results in terms of Air-Bone gap (ABG) closure (ABG Conclusion: Stapes surgery is the surgical procedure of choice for otosclerosis. In our study, a significant hearing improvement was seen in majority of cases. None of the factors considered relevant for the success of stapes surgery like age, sex, type of prosthesis appeared to affect the post-operative hearing significantly. Hence stapes surgery can be effectively used to improve hearing in otosclerosis.
文摘Managing cut throat injuries are a challenge as it may involve the three anatomical components of the neck namely vascular component, which involves carotid arteries, jugular veins, subclavian vessels and the vertebral arteries;respiratory component, which involves larynx and trachea and digestive component, which involves pharynx and esophagus. Injury to one or more of the components may lead to profuse hemorrhage from injured major blood vessels, air embolism and airway obstruction. Managing electrical cut throat injuries to neck are particularly challenging because of the damage that occurs at cellular level. We hereby report a case of electrical cut throat injury to neck.
文摘Objective: To identify the facial nerve trunk (FNT) very easily. quickly and accurately considering the styloid process as the robust anatomically consistent landmark during parotid surgery. Patients and Methods: This prospective study was conducted between January 2010 to December 2022 at a Tertiary care hospital. It included 130 patients: 84 (65%) males and 46 (35%) females with a mean age of 43.52 ± 15.63 years. Patients presented with pleomorphic adenoma (90), chronic sialectasis (05), parotid cyst (03), parotid sinus (01), mucoepidermoid carcinoma (28), adenoid cystic carcinoma (02) and squamous cell carcinoma (01) were subjected to superficial parotidectomy and total parotidectomy. The outcome was evaluated regarding the clinical success of facial nerve function that considered the location of the styloid process in the triangle technique for identification of the FNT during parotid surgery. Results: All 130 patients underwent superficial and total parotidectomy. The facial nerve trunk was successfully identified as the location of the styloid process in the triangle technique in all the patients with no intra-operative complications. Operative time ranged from 50 to 180 minutes with a mean time 90.70 ± 15.68 minutes. Dysfunction of the angle of the mouth due to the deficit of the marginal mandibular nerve (MMN) was noted in 5 patients (3.8%), 02 had difficulty in eye closure (1.5%). No patient reported surgical site infection, skin flap necrosis and hematoma in this series. Conclusion: Styloid process is the prominent robust landmark in the triangle technique for the identification of facial nerve trunk with relative ease, safety and accuracy in the parotid surgical procedure. This can be a very useful method to locate the FNT and minimize facial nerve injury during parotid surgery.
文摘Introduction: Laryngeal carcinoma accounts for 13.9% of head and neck tumors, and squamous cell carcinoma is the main pathological type. At present, the treatment of laryngeal cancer is mainly surgical treatment or postoperative radiotherapy. The surgery is delicate, complex, time-consuming and traumatic. Postoperative patients are prone to dysphagia, leading to an increase in the incidence of malnutrition. Malnutrition can cause a series of negative effects, including weight loss, increased incidence of infection, reduced tolerance of anti-tumor treatment, and extended length of hospital stay. Therefore, how to effectively improve the nutritional status of laryngeal cancer patients through nursing intervention has become an important topic of nursing research. Objective: Investigate the effect of individualized nutrition intervention care combined with swallowing training on postoperative nutritional status in patients with laryngeal cancer. Methods: A total of 120 consecutive patients who underwent laryngeal surgery at our hospital for the first time between May 2018 and May 2021 were selected for the study and equally divided into the control group and the study group by the random number table method, with 60 patients in each group. Patients in the control group were given swallowing function training and health counseling, and the study group adopted individualized nutrition intervention care based on the control group. The nutritional status, swallowing function, and quality of life (QOL) of the patients were assessed using the Patient-generated Subjective Global Assessment (PG-SGA), MD Anderson Dysphagia Inventory (MDADI), and Quality of Life Questionnaire-Core30 (QLQ-C30) before the intervention and three months after the intervention. Results: Before the intervention, the scores of MDADI, PG-SGA, and QLQ-C30 were not significantly different between the two groups (P > 0.05), and three months after the intervention, the scores of MDADI and QLQ-C30 increased and the score of PG-SGA decreased in the study group, with significant differences (P 0.05). At three months after the intervention, patients in the study group had higher scores on MDADI, QLQ-C30 and lower scores on PG-SGA than the control group, with significant differences (P Conclusion: Combining individualized nutrition intervention care with swallowing training improves the postoperative nutritional status, swallowing function, and QOL of patients with laryngeal cancer.
文摘Introduction: Bell’s palsy is an uncommon adverse effect of the COVID-19 vaccine that has been reported in clinical trials. Even though a few studies have linked the vaccination to Bell’s palsy, the actual mechanism is uncertain. Objectives: To describe the demographic data and COVID-19 vaccines-related data with Bell’s palsy in a tertiary centre of Malaysia, Hospital Kuala Lumpur. Methods: A retrospective cross-sectional study was observed among vaccinated recipients who developed Bell’s palsy within 60 days and sought treatment in the Otorhinolaryngology Department Hospital Kuala Lumpur, Malaysia between 1<sup>st</sup> May 2021 and 30<sup>th</sup> November 2021. The demographic data, clinical history, and vaccination history were collected from clinical records. The facial paralysis was graded according to the House-Brackmann grading system. Results: A total of 26 patients with a mean age was 38.5 years;higher incidence in younger age, below 60 years old (n = 24), specifically 18 - 30 years old (n = 11). We observed an equal number in relation to gender and onset (after the first or second dose) of facial palsy. Predominantly were Malay (n = 21) and only 6 patients had comorbidities. We found there was no difference in regard to the type of vaccine among Bell’s palsy patients;Pfizer (n = 9), followed by Sinovac (n = 9) and AstraZeneca (n = 8). Conclusion: Bell’s palsy was found to be a possible adverse event of the COVID-19 vaccine. Younger groups were noted as susceptible to this rare adverse effect. However, the benefits of vaccination outweigh the risk of Bell’s palsy, which has a good prognosis. More research with larger samples is needed to determine the true relationship between vaccination and Bell’s palsy.
文摘In this case report, we discuss a patient who presented with Tullio’s phenomenon, who also experienced bone-conduction induced seizures on two occasions. Tullio’s phenomenon refers to sound induced vestibular symptoms, including disequilibrium oscillopsia, and vertical nystagmus. We were ultimately able to rule out some of the more common pathologies associated with Tullio’s phenomenon for this patient based on imaging findings. However, given the specific nature of her chronic symptoms, as well as her seizure like activity in clinic, we performed a literature search to investigate other less common pathologies associated with Tullio’s phenomenon. Given her past medical history of mixed psychogenic non-epileptic seizures (PNES), there is likely a somatic component to her presentation. However, given the specific and unexpected nature of these events, we propose that her symptoms may also be related to a unique inner ear pathology. Specifically, we feel that she may have exhibited symptoms of vestibular atelectasis, a relatively new otologic diagnosis characterizing the pathologic collapse of the ampulla and utricle, such that the membranous labyrinth contacts the stapes. In this way, loud sounds or changes in pressure may induce vestibular symptoms. Dizzy patients can be a difficult demographic to diagnose and manage, especially when their presentation is complicated by other functional neurologic disorders. Ultimately, we believe that this case report offers helpful insights into a new disease process associated with Tullio’s phenomenon.
文摘Kimura’s disease is a rare chronic affection of unknown etiology, endemic in the far east with a net male predominance. We present the case of a 37-year-old female patient who developed a tumor process in the left parotid region over a period of 3 years. A total left parotidectomy was performed with simple postoperative course. The anatomopathological study of the surgical specimen was in favor of Kimura’s disease. Through this case and a review of the literature, we present the main clinical, anatomopathological, therapeutic and evolutionary characteristics of this rare disease.
文摘Otitis media with effusion(OME)is a frequent paediatric disorder.The condition is often asymptomatic,and so can easily be missed.However,OME can lead to hearing loss that impairs the child's language and behavioural development.The diagnosis is essentially clinical,and is based on otoscopy and(in some cases)tympanometry.Nasal endoscopy is only indicated in cases of unilateral OME or when obstructive adenoid hypertrophy is suspected.Otitis media with effusion is defined as the observation of middle-ear effusion at consultations three months apart.Hearing must be evaluated(using an age-appropriate audiometry technique)before and after treatment,so as not to miss another underlying cause of deafness(e.g.perception deafness).Craniofacial dysmorphism,respiratory allergy and gastro-oesophageal reflux all favour the development of OME.Although a certain number of medications(antibiotics,corticoids,antihistamines,mucokinetic agents,and nasal decongestants)can be used to treat OME,they are not reliably effective and rarely provide long-term relief.The benchmark treatment for OME is placement of tympanostomy tubes(TTs)and(in some cases)adjunct adenoidectomy.The TTs rapidly normalize hearing and effectively prevent the development of cholesteatoma in the middle ear.In contrast,TTs do not prevent progression towards tympanic atrophy or a retraction pocket.Adenoidectomy enhances the effectiveness of TTs.In children with adenoid hypertrophy,adenoidectomy is indicated before the age of 4 but can be performed later when OME is identified by nasal endoscopy.Children must be followed up until OME has disappeared completely,so that any complications are not missed.
基金supported by the National Natural Science Foundation of China,No. 30973309
文摘In this experiment,97 patients with obstructive sleep apnea hypopnea syndrome were divided into three groups(mild,moderate,severe) according to minimum oxygen saturation,and 35 healthy subjects were examined as controls.Cognitive function was determined using the mismatch negativity paradigm and the Montreal Cognitive Assessment.The results revealed that as the disease worsened,the mismatch negativity latency was gradually extended,and the amplitude gradually declined in patients with obstructive sleep apnea hypopnea syndrome.Importantly,mismatch negativity latency in severe patients with a persistent time of minimum oxygen saturation < 60 seconds was significantly shorter than that with a persistent time of minimum oxygen saturation > 60 seconds.Correlation analysis revealed a negative correlation between minimum oxygen saturation latency and Montreal Cognitive Assessment scores.These findings indicate that intermittent night-time hypoxemia affects mismatch negativity waveforms and Montreal Cognitive Assessment scores.As indicators for detecting the cognitive functional status of obstructive sleep apnea hypopnea syndrome patients,the sensitivity of mismatch negativity is 82.93%,the specificity is 73.33%,the accuracy rate is 81.52%,the positive predictive value is 85.00%,the negative predictive value is 70.21%,the positive likelihood ratio is 3,and the negative likelihood ratio is 0.23.These results indicate that mismatch negativity can be used as an effective tool for diagnosis of cognitive dysfunction in obstructive sleep apnea hypopnea syndrome patients.
基金supported by grants from the National Basic Research Program of China(973 Program)(#2012CB9679002011CBA01000)+1 种基金the National Natural Science Foundation of China(NSFC #81271082)the grants of the National Key Basic Research Program of China(973 Program),No.2014CB943003
文摘Objective:To investigate surgical indications,operative techniques,complications and auditory and speech rehabilitation for cochlear implant(CI) in children with otitis media with effusion(OME).Materia! and methods:This is a retrospective review of records of 24 children with bilateral profound sensorineural hearing loss and OME who were implanted during January 2011 to November 2014 in the Department of Otorhinolaryngology and Head and Neck Surgery at the PLA Hospital,using one-stage implantation via the facial recess approach and round window insertion.The incus was removed in 8 cases during the implantation procedure.Local infiltration of dexamethasone and adrenaline in the middle ear was also performed.Postoperative complications were examined.Preoperative and postoperative questionnaires including Categories of Auditory Performance(CAP).Speech Intelligibility Rating(SIR),and the Meaningful Auditory Integration Scale(MAIS) were collected.Results:All electrodes were implanted successfully without any immediate or delayed complications.Inllammatory changes of middle ear mucosa with effusion were noted in all implanted ears.The scores of post-implant CAP and SIR increased signilicantly in all 24 cases(t =-25.95 and-14.09.respectively for CAP and SIR.p < 0.05).Conclusions:One-stage CI via the facial recess approach with round window insertion is safe and effective in cochlear implant candidates with OME,as seen in the 24 children in our study who achieved improved auditory performance and speech intelligibility after CI.
基金supported by the National Natural Science Foundation of China(grant number:81170914/H1304)
文摘There are several challenges to inner ear drug delivery and imaging due to the existence of tight biological barriers to the target structure and the dense bone surrounding it. Advances in imaging and nanomedicine may provide knowledge for overcoming the existing limitations to both the diagnosis and treatment of inner ear diseases. Novel techniques have improved the efficacy of drug delivery and targeting to the inner ear, as well as the quality and accuracy of imaging this structure. In this review, we will describe the pathways and biological barriers of the inner ear regarding drug delivery, the beneficial applications and limitations of the imaging techniques available for inner ear research, the behavior of engineered nanomaterials in inner ear applications, and future perspectives for nanomedicine-based inner ear imaging.
基金Project supported by the National Natural Science Foundation of China (Grant Nos. 51125001,51172005,and 90922033)the Research Fellowship for International Young Scientists of the National Natural Science Foundation of China (Grant No. 51250110078)+1 种基金the Doctoral Program of the Education Ministry of China (Grant No. 20120001110078)PKU COE-Health Science Center Seed Fund
文摘Nanoparticles(NPs) with easily modified surfaces have been playing an important role in biomedicine.As cancer is one of the major causes of death,tremendous efforts have been devoted to advance the methods of cancer diagnosis and therapy.Recently,magnetic nanoparticles(MNPs) that are responsive to a magnetic field have shown great promise in cancer therapy.Compared with traditional cancer therapy,magnetic field triggered therapeutic approaches can treat cancer in an unconventional but more effective and safer way.In this review,we will discuss the recent progress in cancer therapies based on MNPs,mainly including magnetic hyperthermia,magnetic specific targeting,magnetically controlled drug delivery,magnetofection,and magnetic switches for controlling cell fate.Some recently developed strategies such as magnetic resonance imaging(MRI) monitoring cancer therapy and magnetic tissue engineering are also addressed.
基金supported by grants from the National Program on Key Basic Research Project of China(973 Program),No.2011CBA01000,2012CB967900
文摘Ototoxic drugs can be used to produce a loss of cochlear hair cells to create animal models of deafness. However, to the best of our knowledge, there is no report on the establishment of a rat deafness model through the combined application of aminoglycosides and loop diuretics. The aim of this study was to use single or combined administration of furosemide and kanamycin sulfate to establish rat models of deafness. The rats received intravenous injections of different doses of furosemide and/or intramuscular injections of kanamycin sulfate. The auditory brainstem response was measured to determine the hearing threshold after drug application. Immunocytochemistry and confocal microscopy were performed to evaluate inner ear morphology. In the group receiving combined administration of furosemide and kanamycin, the auditory brainstem response threshold showed significant elevation 3 days after administration, higher than that produced by furosemide or kanamycin alone. The hair cells showed varying degrees of injury, from the apical turn to the basal turn of the cochlea and from the outer hair cells to the inner hair cells. The spiral ganglion cells maintained a normal morphology during the first week after the hair cells completely disappeared, and then gradually degenerated. After 2 months, the majority of spiral ganglion cells disappeared, but a few remained. These findings demonstrate that the combined administration of furosemide and kanamycin has a synergistic ototoxic effect, and that these drugs can produce hair cell loss and hearing loss in rats. These findings suggest that even in patients with severe deafness, electronic cochlear implants may partially restore hearing.
