Journal Reviews » ENT and Audiology News. Select Category: Audiology Vestibular Disorders. Laryngology Voice Swallow. Mouth. Otology Neuro- otology. Nose Sinuses Cosmetic. Head & Neck. Paediatrics. Maxillo Plastics. Go > | View all< Home. AMERICAN JOURNAL OF OTOLARYNGOLOGYComplication rates for grommet insertion in H& N cancer patients. Reviewed by: Rohit Verma. Vol 2. 5 No 5. Otitis Media (OM) can be the direct result of H& N malignancy itself or secondary to treatment of malignancy. Both surgery and radiotherapy can cause lasting changes to the physiologic function of the ET, middle ear, tympanic membrane and ear canal. Common treatment options for OM include observation, myringotomy alone and myringotomy with tympanostomy tube insertion (MTT). This US retrospective study identified 7. OM. Among these 7. OM was identified in 9. MTT, five (5%) treated with myringotomy alone and six (7%) observed. Of the 8. 2 ears treated with grommet insertion, 5. OM resolution without complication and 2. · Summary. A substantial minority of high-risk children has long-term medical, developmental and psychological adverse outcomes and will consume extensive. Even more » Account Options. Sign in; Search settings. AUDIOLOGY AND NEUROTOLOGY. OTO-104 in noise-induced and cisplatin-induced hearing loss Reviewed by: Stephen James Broomfield Vol 25 No 5. These two animal studies. · CDE Catalog. The CDE Catalog is a directory of the available NINDS CDEs. Users can search the Catalog to isolate a subset of the CDEs.Of the five ears treated with myringotomy alone, three (6. OM resolution, one (2. Of the six ears that were observed, four (6. OM resolution and two (3. The presence of Eustachian tube dysfunction prior to treatment for cancer was associated with a significantly higher complication rate. This study highlights that complication rates following grommet insertion are higher in H& N cancer patients than the general population, with about 1. The authors suggest that their data does not support the use of myringotomy alone over grommets as a treatment for OM in this population. The complication rates of OM treatment in nasopharyngeal or sinonasal cancer patients, regardless of whether the intervention occurred before or after radiotherapy, does not differ significantly. Reference. Complications of tympanostomy tubes in head and neck cancer patients. Shah Jo, Herrera SJ, Roberts DB et al. AMERICAN JOURNAL OF OTOLARYNGOLOGY- HEAD AND NECK MEDICINE AND SURGERY2. AUDIOLOGY AND NEUROTOLOGYCochlear implant electrode insertion technique. Reviewed by: Stephen James Broomfield. Vol 2. 5 No 5. Atraumatic cochlear implant insertion techniques (so- called ‘soft surgery’) are now standard practice in most centres for all cases (no longer just for attempted hearing preservation cases). This has led to several studies examining cochlear trauma and electrode insertion force. In this study, the authors used a microsensor attached to a model cochlea to compare intracochlear pressure changes (recording maximum amplitude change and peak frequency deviation) between a number of insertion techniques. All cases were with an Advanced Bionics 1. J electrode using the insertion tool via a 1. The conditions tested were: freehand (no support to hand or elbow); one- point support (left hand used to support the right); two- point support (left hand supporting right and elbow resting on table); semi- automated insertion (insertion tool held but electrode advanced with a linear actuator) with one- point support; semi- automated insertion with two- point support; and fully automated insertion (insertion tool fixed to a retractor and linear actuator used to advance the electrode). Unsurprisingly, the two- point support minimised amplitude changes and frequency deviations compared to other manual techniques; this is an important conclusion that can be applied more widely to other otological procedures. Interestingly, the freehand two- point technique out- performed the semi- automated two- point technique. However, the fully automated technique scored best in all conditions. While the exact clinical effects of intra- cochlear pressure changes remain unknown, fully automated insertions may one day be routine clinical practice. Reference. Effects of different insertion techniques of a cochlear implant electrode on the intracochlear pressure. Todt I, Ernst A, Mittmann P. AUDIOLOGY AND NEUROTOLOGY2. AUDIOLOGY AND NEUROTOLOGYOTO- 1. Reviewed by: Stephen James Broomfield. Vol 2. 5 No 5. These two animal studies report on potential new applications for intra- tympanic OTO- 1. Europe- wide randomised trial for Ménière’s disease. In the first paper, guinea pigs were given a single bilateral dose of OTO- 1. In the control and lowest dose OTO- 1. OTO- 1. 04 group in whom hearing was preserved. The protective effect was still seen when the OTO- 1. In the second of the papers, a single dose of OTO- 1. The cisplatin doses were calculated to be equivalent to those used in human clinical practice. In both conditions, the OTO- 1. The higher dose (6%) appeared to offer a greater protective effect than lower doses. In both studies, standard aqueous dexamethasone was not seen to have any therapeutic effect. In addition, co- administration of OTO- 1. OTO- 1. 04 is on classical nuclear receptor pathways. Caution must be used in interpreting the results of these early studies in small numbers of animals. However, the results are interesting and will undoubtedly prompt further studies in humans. Reference. The sustained- exposure dexamethasone formulation OTO- 1. Harrop- Jones A, Wang X, Fernandez R, et al. AUDIOLOGY AND NEUROTOLOGY2. B- ENTLaser for active mucosal chronic otitis media. Reviewed by: Sunil Sharma. Vol 2. 5 No 5. Active mucosal chronic otitis media (COM) is a condition characterised by otorrhoea secondary to chronic inflammation of the middle ear and mastoid mucosa associated with granulations and a tympanic membrane perforation. Surgical intervention is often required, but concurrent mastoidectomy with tympanoplasty remains a controversial treatment option for mucosal COM. The use of laser is well established for squamous disease, but it has never been reported for mucosal disease. In this study the authors have performed a retrospective review of 7. The patients who were included were those with active mucosal COM and intra- operative observation of granulation tissue. All patients underwent complete cortical mastoidectomy and tympanoplasty. A hand- held fibre 9. The mean follow- up was 2. The reported success rate of 9. They also reported a mean post- operative air- bone gap of < 2. B in 7. 4. 3% of patients, and complications of transient vertigo (n=2), wound infection (n=2), and temporary facial nerve palsy (n=1). Interestingly, the authors report that there were no complications relating to thermal damage from the laser. They acknowledge that all the patients included in this study underwent mastoidectomy as well as tympanoplasty, which may have led to such high success rates, but a recent systematic review has suggested no benefit of concurrent mastoidectomy versus simple tympanoplasty in the management of mucosal COM. The authors surmise that the concurrent use of laser during surgery is what has led to the high success rate. There are limitations within the study such as the retrospective nature and the lack of a comparison group. Nonetheless, this is a novel pilot study, and larger prospective studies would be useful. Reference. Laser- assisted tympanomastoidectomy for active mucosal chronic otitis media. Wilkie MD, Tahery J. B- ENT2. 01. 6; 1. B- ENTSubannular T- tubes for adhesive otitis. Reviewed by: Sunil Sharma. Vol 2. 5 No 5. This Italian study looked at the success rates of a novel method to manage adhesive otitis media (chronic otitis media with adhesion of the tympanic membrane to the promontory). The authors looked at 2. All these patients underwent insertion of a silastic disk (6mm in diameter with a T- tube inserted in the centre) in the posterior inferior tympanic membrane between the annulus and bony wall of the middle ear. The mean improvement in air- bone gap at two years was 1. B, with 8. 1. 8% of patients achieving a satisfactory auditory outcome at two years (as defined by an improvement in the air- bone gap of > 1. B). Only one patient had extrusion of the T- tube with residual perforation at two years. There are limited numbers in this study, and there is no comparison with other methods used to treat adhesive otitis media such as cartilage tympanoplasty. Nonetheless, this provides an interesting pilot study as to the effective of subannular T- tubes with silastic for the treatment of adhesive otitis media. Reference. Subannular T- tubes for the treatment of adhesive otitis: how we do it? Galletti B, Galletti F. B- ENT 2. 01. 6; 1. BMC EAR, NOSE AND THROAT DISORDERSA review of endoscopic sinus surgery outcomes. Reviewed by: Gauri Mankekar.
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