Acta Oto Laryngologica 2021-10-20

Endoscopic transtympanic cartilage push-through myringoplasty without tympanomeatal flap elevation for tympanic membrane perforation

Fengming Gu

Publication date 24-08-2021


The elevation of the tympanomeatal flap in endoscopic myringoplasty will cause considerable tissue damage. To analyze anatomic and audiological results of tympanic membrane perforation underwent endoscopic transtympanic cartilage push-through myringoplasty without tympanomeatal flap elevation (EPM) and their relationship with the size of perforation. A clinical retrospective study was performed on 75 cases of tympanic membrane perforation that underwent EPM from January 2019 to March 2021. Graft success and hearing outcomes were evaluated 3 months after surgery. The overall graft success rate for EPM was 94.7% (71/75). The total rate of hearing success, postoperative ABG ≤ 20 dB was achieved in 96.0% (72/75). The overall mean AC threshold of 35.1 ± 5.6 dB was lowered to 25.0 ± 4.8 dB postoperatively ( It is revealed that EPM is an effective method to repair perforation of tympanic membrane. The size of the tympanic membrane perforation may be a risk factor for perforation healing and hearing recovery, although EPM is available for large perforations.

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Vestibular nerve deficiency and vestibular function in children with unilateral hearing loss caused by cochlear nerve deficiency

Keita Tsukada,Shin-ichi Usami

Publication date 19-08-2021


High-resolution MR imaging enables the visualization of individual nerves in the internal auditory canal (IAC). Cochlear nerve deficiency (CND) is recognized as one of the major causes of sensory neural hearing loss (SNHL), especially in cases of unilateral hearing loss in childhood. Some patients with CND are thought to have accompanying vestibular nerve deficiency (VND). However, there have been few reports focusing on VND and vestibular function in these children. The aim of this study was to evaluate the frequency of VND and vestibular dysfunction in children with unilateral SNHL caused by CND. Thirty-eight children with unilateral SNHL, who were diagnosed with CND by 3 T-MRI, were evaluated for VND and underwent caloric testing and cervical vestibular evoked potential (cVEMP). Fourteen of 38 patients (37%) had VND, and eleven (29%) of the patients [ten of the patients (71%) with VND] had at least one vestibular dysfunction. The patients with VND had significantly worse hearing and an IAC of smaller diameter than did patients without VND. We should pay attention to VND as well as vestibular dysfunction in hearing loss patients with CND.

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A nationwide epidemiologic, clinical, genetic study of Usher syndrome in Japan

Hidekane Yoshimura,Shin-ya Nishio,Yuichi Isaka,Toru Kurokawa,Shin-ichi Usami

Publication date 29-08-2021


Usher syndrome (USH) typically leads to deaf-blindness, requiring the provision of extensive education and rehabilitation services. Therefore, investigating the prevalence is crucial to requests for proper government support for USH patients. The aim was to perform a nationwide epidemiologic survey of USH in Japan to estimate the prevalence of USH and reveal the relative frequency and characteristics of the three USH subtypes. To estimate the number of USH patients visiting hospitals over a 1-year period, 1,628 hospitals were randomly selected from all Departments of Otorhinolaryngology and Ophthalmology in Japan. Subsequently, we collected data regarding the clinical characteristics of each patient treated and the results of genetic testing, if performed. We found that the prevalence of USH was at least 0.4 per 100,000 population. The frequency of clinical subtypes and causal genes for USH were consistent with previous reports. Also, we demonstrated the feasibility of genetic counseling for USH patients based on the results of genetic testing. USH is a rare disease, but requires social support due to the severity of symptoms. To minimize these issues, understanding the clinical characteristics and performing comprehensive genetic testing could allow early and accurate diagnosis as well as medical intervention.

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Feasibility of an inexperienced examiner using trans-cervical ultrasound in the diagnosis of peritonsillar abscesses

Mathias von Beckerath,Joacim Svensson,Fredrik Landström

Publication date 17-08-2021


A peritonsillar abscess (PTA) is a common complication to acute tonsillitis. Needle aspiration (NA) is the gold standard for diagnosis of PTA. NA is usually painful and not risk-free. Ultrasound (US) is a noninvasive, portable radiological modality that could potentially be used in the diagnosis of PTA and selection of patients for NA. The reliability of US is dependent on the experience of the examiner which limits is usefulness. To evaluate the reliability of US in the diagnosis of PTA by an inexperienced examiner. Thirty patients with suspected PTA were included. They were first examined with trans-cervical US by a medical student then clinically examined by a physician that performed a NA if clinically motivated. They were then followed for at least two days. Three patients were excluded from analysis because no NA was performed. In these patients, US correctly classified them as negative for PTA. In the remaining 27 patients, the sensitivity and negative predictive value was 100%. The specificity was 64.3% and the positive-predictive value was 72.2%. US can be very useful in the diagnosis of PTA and the selection for NA even with an inexperienced examiner. The results highlight the usefulness of ultrasound in otolaryngology.

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Surgical treatment of T2-3 posterior hypopharyngeal carcinoma with preservation of laryngeal function

Ling Chen,Yu Si,Peiliang Lin,Zhong Guan,Wenying Zhu,Haifeng Liang,Qian Cai

Publication date 31-08-2021


Posterior hypopharyngeal carcinoma indicates a poor prognosis. Previous treatments predicted negative influence to the pronunciation and swallowing function. The present study focuses on improving survival rate while improving quality of life. To investigate on the surgical techniques of the preservation of laryngeal function of posterior hypopharyngeal carcinoma. Eighteen patients with posterior hypopharyngeal carcinoma of T2-T3 were studied. All primary lesions were removed and the defects were repaired with the radial forearm free flap (RFFF). The 3-year overall survival rate was 51.9%. All patients could maintain daily caloric intake by feeding orally, and remove the gastric tube 28-61 days after operation. Assessed swallowing function by Fiberoptic endoscopic evaluations of swallowing. When eating solid food, 66.67% patients had food residue; no food entered airway, and all patients had Penetration-Aspiration Scale of level 1. As for liquid, 11.11% patients had level 5, 16.67% level 4, 27.78% level 2 and 44.44% level 1. By preserving the integrity of larynx and superior laryngeal nerve with repairing the defects of posterior wall of hypopharynx with RFFF, patients with T2 and T3 stage posterior hypopharyngeal carcinoma could live a better quality of life.

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Impact of tonsillectomy on COVID–19 pandemic: an observational study of the incidence and prognosis

Ahmet Kara,Halil Elden,Engin Okur,Mahmut Sinan Yilmaz,Fuldem Mutlu,Mehmet Guven,Deniz Demir

Publication date 07-09-2021


Due to many different reasons such as possible coronavirus colonization in tonsillar tissue, decreased enzymatic antiviral activity, decreased cytokine activity from palatine tonsil tissue and reduced humoral and cellular immune response, tonsillectomy may alter the incidence of Covid-19. To reveal the frequency of Covid-19 in patients who underwent tonsillectomy and to analyze the effect of tonsillectomy on the severity of the disease. Patients aged between 15 and 65 and had a history of tonsillectomy were compared with control group in terms of incidence and severity of Covid-19 disease. A 4% Covid rRT-PCR test positivity rate was detected in patients with tonsillectomy whereas; it was 6.8% in the control group with a statistically significant difference. However, in terms of disease severity there was no difference between the two groups. It has been proven that tonsillectomy surgery does not pose an additional risk in terms of COVID 19 disease severity. The positive effect of tonsillectomy in terms of disease frequency has been even demonstrated for the first time in the literature.

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Risk factors for local recurrence of early bilateral vocal cord carcinoma treated with transoral CO2 laser microsurgery

Chen Tan,Jugao Fang,Ru Wang,Qi Zhong,Lizhen Hou,Hongzhi Ma,Ling Feng,Shizhi He,Meng Lian,Yifan Yang

Publication date 28-09-2021


The incidence of local recurrence after transoral CO To investigate risk factors for local recurrence after CO We retrospectively studied patients undergoing CO All 85 patients (83 male; age, 63.33 ± 10.59 years; 36 T1b and 49 T2 lesions; 28 cases with and 57 without anterior commissure (AC) involvement) survived; 15 exhibited postoperative local recurrence.
Recurrence rates differed between the following groups: patients without (6/57) versus patients with AC involvement (9/28) ( Patients with stage T1b and T2 glottic carcinoma with AC involvement, positive resection margins, and p53 expression should be followed up at shorter intervals. This article provided valid clinical data for risk factors for local recurrence after CO

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The prognostic value of thyroid gland invasion in locally advanced laryngeal cancers

Mustafa Aslıer,Bahar Ezgi Uçurum,Hilmi Cem Kaya,Hakan Coskun

Publication date 19-08-2021


Locally advanced laryngeal cancers can spread to the thyroid gland by direct invasion of cricothyroid membrane. The prevalence of thyroid gland invasion (TGI) and the predictive factors of TGI were well described in literature. However, the association of TGI with survival was undetermined yet. The aim of this study is to analyze the effects of TGI on survival rates in patients with locally advanced laryngeal cancer. Medical records of 91 patients who underwent total laryngectomy with thyroidectomy were retrospectively reviewed. Demographical, clinical, and histopathological characteristics of the patients were noted. Kaplan-Meier test was used for survival analysis. Histopathology reports revealed the prevalence of TGI as 14.3% (13/91). Survival analyses showed that TGI did not affect recurrence free ( Thyroid gland invasion is one of the characteristic features of locally aggressive laryngeal tumors. In this study, TGI is not a statistically significant prognostic factor that has impact on survival of the patients with locally advanced laryngeal cancer.

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Starplasty contributes to reduce tracheostomal granulation in pediatric tracheostomy

Keisuke Enomoto,Tatsuya Shiga,Masamitsu Kono,Hideki Sakatani,Mai Miyamoto,Saori Takeda,Shunji Tamagawa,Muneki Hotomi

Publication date 15-09-2021


Starplasty tracheostomy for pediatric patients has been suggested to reduce complications, including accidental decannulation and granulation. This study, based in a single hospital, aims to evaluate whether starplasty tracheostomy decreases the incidence of postoperative granulation of tracheostoma. A retrospective review was performed of patients that underwent tracheostomy under the age of 10 years in a single center between January 2001 and August 2020. Of the 46 patients reviewed, 18 were males and 28 were females, and the median age at the initial operation was 6 months. Methods of tracheostomy were starplasty in 16 patients, vertical in 15 patients, horizontal H-shaped in 10 patients, fenestration in 3 patients, and trap door/inverted U-shaped in two patients. During observation, tracheostoma granulation was found in 25 patients and bleeding from tracheostoma occurred in one patient. No other major complications were observed. The incidence of postoperative tracheostoma granulation was significantly lower in patients that underwent starplasty tracheostomy compared with patients that underwent other types of tracheostomy ( Starplasty tracheostomy was shown to decrease the incidence of tracheostoma granulation compared with other types of tracheostomy.

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Circulating fatty acids in patients with head and neck cancer after treatment: an explorative study with a one-year perspective

Constantina Nadia Christou,Ylva Tiblom Ehrsson,Erik Lampa,Ulf Risérus,Göran Laurell

Publication date 17-08-2021


Unintended weight loss and nutritional problems are often seen in patients with head and neck cancer, but changes in lipid metabolism are poorly studied. The present study aimed to explore the longitudinal changes in circulating fatty acid (FA) composition in patients with head and neck cancer. This study included 27 patients with head and neck cancer. Treatment consisted of single modality or combined modality treatments. The patients were assessed by repeated blood sampling and body weight assessments before treatment started and on three occasions after the start of treatment. FA profiling included gas chromatography analysis of unsaturated FAs and saturated FAs in serum. The values of three fatty acids - FA 14:0, FA 18:3n3, and FA 20:3n6 - changed in a specific pattern over the course of the study and the change in FA 14:0 correlated with weight changes. This study showed altered profiles of both saturated and unsaturated FAs. An improved understanding of the metabolic pathways in patients with head and neck cancer supports the development of better nutritional surveillance and nutritional treatments.

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Relative contributions of radiation and cisplatin-based chemotherapy to sensorineural hearing loss in head-and-neck cancer patients

Nidhin Das,Darwin Kaushal,Sourabha Kumar Patro,Puneet Pareek,Abhinav Dixit,Kapil Soni,Nithin Prakasan Nair,Bikram Choudhury,Amit Goyal

Publication date 07-09-2021


One of the debilitating complications of head and neck cancer radiotherapy is hearing loss. To quantify the magnitude of sensory neural hearing loss (SNHL) in the head and neck cancer patients undergoing chemoradiation therapy. This is a prospective study. Eighty patients with head and neck cancers and undergoing volumetric arc therapy were taken up for the study. Regular audiological evaluation was done. The changes in audiological parameters from baseline are correlated with cochlear dose. Cochlea received maximum doses of up to 28.52 Gy without causing SNHL in the absence of chemotherapy. But in concurrent chemoradiotherapy, hearing loss was found at least dose of 9 Gy at frequency range of 4 KHz-8 KHz. The risk of SNHL is independent of cumulative doses of Cisplatin. In 106 ears receiving concurrent chemoradiation, 82.1% and 74.5% ears had sensorineural hearing loss at 4 KHz and 8 KHz respectively, following the completion of treatment. Otoacoustic emissions in the chemoradiation group showed a significant change at the completion of treatment. Volumetric arc therapy have facilitated sparing of cochlea (< 40 Gy). This has resulted in better clinical outcome in terms of SNHL. The inclusion of concurrent cisplatin chemotherapy is a significant risk factor for the development of SNHL at higher frequencies.

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Radiological classification of the mastoid portion of the facial nerve: impact on the surgical accessibility of the round window in cochlear implantation

Mahmoud Mandour,Saad Elzayat,Haitham H. Elfarargy,Rasha Lotfy,Ahmed ELnaggar

Publication date 24-08-2021


Mastoid portion of the facial nerve plays an important role in the round window approach of cochlear implantation. This study aimed to predict the anterior displacement of the mastoid portion of the facial nerve in the preoperative HRCT coronal cuts. We also aimed to detect the implication of anterior displacement of MPFN on the R.
W. accessibility through the posterior tympanotomy during cochlear implantation. It was a retrospective observational cohort study in tertiary referral hospitals. We included 246 pediatric patients who underwent cochlear implantation due to bilateral severe to profound SNHL through a posterior tympanotomy approach. Type I MPFN was present in 84 cases, type II MPFN was present in 149 patients, and type III MPFN was present in 13 cases. R.
W. was inaccessible in 3 cases with MPFN type II and in 11 subjects with MPFN type III. There was a statistically significant difference regarding the R.
W. accessibility between the three types of MPFN ( Mandour radiological classification of the mastoid portion of the facial nerve in the preoperative HRCT coronal offers an easily applicable method to detect the anterior displacement of the facial nerve by using easy and well-known landmarks. This classification can also predict R.
W. accessibility through posterior tympanotomy during cochlear implantation with 97.97% accuracy.

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Combination of a negative pressure suction device and endoscope can accurately locate the bleeding site of refractory epistaxis

Xinghong Yin,Xinhai Zhang,Bo Wang,Keliang Li,Maoli Duan

Publication date 12-10-2021


Selective endoscopic coagulation of a nasal bleeding vessel is an effective means of treating epistaxis. Precisely locating the bleeding site(s) is critical. To investigate the utility of combining a negative pressure suction device and endoscope in locating bleeding sites of refractory epistaxis. A total of 116 patients with refractory epistaxis, who underwent systematic endoscopic exploration under local anesthesia in the absence of identifiable sites of bleeding were randomizely divided into two groups Compared with the CG, there were statistically significant differences in length of hospital stay, rebleeding, and postoperative pain and complications (all Combining a negative pressure suction device and endoscope was a safe and effective technique for accurately locating bleeding sites in patients with refractory epistaxis.

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Whether cochlea involvement on CT in otosclerosis patients impacts the effect of stapedotomy

Yanqing Fang,Yu Zhao,Wei Pan,Matthew Silverman,Yilai Shu,Bing Chen

Publication date 12-10-2021


The success rate of stapedotomy in otosclerosis patients with cochlea involvement was unknown. To determine the difference of surgical outcomes and symptomatology in otosclerosis patients with or without cochlea involvement on CT. 79 otosclerosis patients were included and grouped by HRCT, including cochlear-involved otosclerosis (C-group) or non-cochlear-involved otosclerosis (NC-group, control group). Patients were defined as NC-group in the presence of normal or solely fenestral involvement, or C-group if the hypodensities involve other parts of the labyrinthine bone Patients in the control group were collected at a 2:1 ratio to the C-group with similar follow-up times. Detailed complaints and surgical outcomes were compared between these groups. Chief complaints were similar in the C-group and NC-group. Although postoperative AC, BC, and ABG decreased significantly in both groups, the success rate was significantly higher in C-group regarding the postoperative ABG ≤10 dB. Furthermore, diffuse lesions may indicate a more severe disease and a poorer prognosis. Stapedotomy was effective for clinical otosclerosis. The surgical outcome was inferior favorable for cochlea involvement patients, especially for cases with widely involvement. There was no difference in chief complaints among patients with different CT degree of otosclerosis.

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OnabotulinumtoxinA injection towards the SPG for treating symptoms of refractory chronic rhinosinusitis with nasal polyposis: a pilot study

Kent Are Jamtøy,Erling Tronvik,Daniel Fossum Bratbak,Joan Crespi,Lars Jacob Stovner,Irina Aschehoug,Wenche Moe Thorstensen

Publication date 12-10-2021


The main objective of this prospective, open, uncontrolled pilot study was to investigate the safety of administering onabotulinumtoxinA (BTA) towards the sphenopalatine ganglion (SPG) in 10 patients with refractory chronic rhinosinusitis with nasal polyposis (CRSwNP) using a novel injection tool, the Multi Guide A one-month baseline period was followed by bilateral injections of 25 U BTA in the SPG and a follow-up of 12 weeks. The primary outcome was adverse events (AE), and the main efficacy outcome was a 50% reduction in visual analogue scale (VAS) symptoms for nasal obstruction and rhinorrhea in months 2 and 3 post-treatment compared to baseline. We registered 13 AEs, none of which were serious, however, one patient experienced diplopia which moderately affected his daily activities. The symptoms slowly improved and resolved 4 weeks after injection. Five patients were treatment responders with at least 50% median reduction in the nasal obstruction, and four were treatment responders concerning rhinorrhea. Injection of BTA toward the SPG using the Multi Guide

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Role of laryngopharyngeal reflux (LPR) in complications after tonsillectomy in adult patients

Jie Tan,Xueshi Li,Yixin Zhao,Yuguang Wang,Jinxia Shen,Lihong Zhang,Lin Han,Lisheng Yu

Publication date 12-10-2021


Tonsillectomy and tonsillectomy with adenoidectomy are among the most common surgical procedures in otolaryngology practice, but the complications, especially the postoperative bleeding, are seriously troubling surgeons. Some authors had identified that gastroesophageal reflux and LPR are both risk factors for complications in tonsillectomy of children patients. Therefore, we designed this prospective study to assess the role of LPR in the development of complications following tonsillectomy in adult patients. We want to provide a basis for future clinical practice. We recruited a totally of 150 adult patients (18-60 years old) who had an indication of tonsillectomy because of recurrent tonsillitis and divided them into two groups, the laryngopharyngeal reflux (LPR) group and the control group identified by the results of Reflux Symptom Index (RSI) and Reflux Finding Score (RFS). The complications that were observed and evaluated were pain, hemorrhage, fever, infection, and pulmonary problems. All the patients complained of pain after surgery. The duration of the pain in the LPR group was much longer than that of the control group. In the LPR group, patients had a similar pain level on the first day after surgery. However, on the 7th day and 14th day after surgery, the pain level was obviously higher than that of the control group. We found that the body temperature mildly rose on the 1st day after surgery and gradually fell to normal level in both groups. No cases had bleeding within 24 h after surgery. There were nine cases of bleeding in the LPR group, while only one case of bleeding occurred in the control group. There were no cases of infection or pulmonary complications in either group. LPR is closely related to the complications followed by tonsillectomy and we also suggest that high dosages of proton pump inhibitors (PPI), alkaline water, and alginates should be proscribed to the patients with LPR during the perioperative period.

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Supporting the use of adjuvant radiotherapy in recurrent pleomorphic adenoma of the parotid

Justin M. Hintze,Fergal O’Duffy,Ailbhe White-Gibson,Paul O’Neill,John Kinsella,Conrad Timon,Paul Lennon

Publication date 09-10-2021


The use of adjuvant radiotherapy remains controversial in the treatment of recurrent pleomorphic adenomas. The aim of this study was to provide the highest level of evidence possible by performing a systematic review and meta-analysis of the literature. We searched the English-language literature between 1985 and 2019.
Inclusion criteria included any study on the treatment and outcome of recurrent pleomorphic adenomas. Exclusion criteria included the use of radiotherapy for residual tumors, case reports, and pleomorphic adenomas not arising from the parotid. A total of 522 abstracts were studied, data analyzed from 14 studies, on a total of 697 patients. When the data werepooled, the overall risk of further recurrence was 21%. In studies where surgery alone was undertaken this increased to 26% and decreased to 10% in those receiving adjuvant radiotherapy ( These data support the use of radiotherapy to decrease the risk of re-recurrence in recurrent pleomorphic adenoma. This study is the highest level of evidence currently available in guiding management of recurrent pleomorphic adenoma.

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Vestibular evoked myogenic potentials in chronic renal disease

Shibi Varghese,Kaushlendra Kumar,Mohan Kumar Kalaiah,Usha Shastri,Anupriya Ebenezer,Mayoor Vasant Prabhu

Publication date 09-10-2021


There is limited evidence to provide an insight on the VEMP characteristics to explain the association between chronic renal disease (CRD) and its effect on otolith structures. To compare the otolithic function of individuals with CRD and individuals with no known CRD. To investigate the relationship between disease duration and VEMP and creatine level and VEMP among individuals with CRD. A cross-sectional study design using convenient sampling method was adapted for the present study. A total of 50 adults aged between 40 and 60 years participated in the study. Group 1 included 25 individuals with CRD undergoing hemodialysis and Group 2 included 25 individuals with no known CRD. cVEMP and oVEMP were recorded from participants in both groups. cVEMP and oVEMP was absent in 28% and 44% of individuals with CRD respectively, while, both VEMPs were present among all participants in group 2. Further, peak-to-peak amplitude of VEMP was reduced in individuals with CRD suggesting abnormal otolith function. In addition, a negative correlation was found between disease duration and the peak-to-peak amplitude of VEMP. The abnormal VEMP findings in individuals with CRD shows presence of otolithic dysfunction along with amplitude is found to decrease with an increase in the disease duration.

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A novel puncture needle designed for endoscopic keel placement to treat anterior glottic webs

Jian Chen,Haitao Wu,Peijie He

Publication date 09-10-2021


Endoscopic keel placement is difficult for patients with poor laryngeal exposures. To introduce a novel extra-endo laryngeal puncture technique for endoscopic keel placement to manage anterior glottic webs. Patients with anterior glottic webs and difficult laryngeal exposure in our hospital during 2018 to 2020 were recruited in this study. After the incision of the web, a novel puncture needle modified from a maxillary sinus puncture needle was inserted into endolarynx, and could pull the suture passing along a keel from inside out. The suture was then fixated on the neck, and the keel was placed for 4 weeks. Patients were followed up for at least 1 year. Eight patients including three men and five women were included in this study. All the patients tolerated the silicone keel well, and 7 of 8 (87.5%) patients did not have web relapses and reached remarkable voice improvements during follow-up. None of the cases needed a tracheotomy due to the dyspnea postoperatively. The novel puncture technique is an easy and effective approach to facilitate endoscopic keel placement for the treatment of anterior glottic webs and other surgical procedures requiring endolaryngeal suturing.

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Navigation system for percutaneous tracheotomy

Johan Ullman,Jonas Karling,Rusana Bark,David Nelson,Michael Wanecek,Gregori Margolin

Publication date 28-09-2021


Percutaneous dilatational tracheotomy (PDT) is a well-established method. The prerequisite is to identify anatomical landmarks of the neck. We introduce a three-dimensional navigation system - Safe Trach. We present an alternative technique using internal landmarks that can be used in patients with difficult anatomy. The device is a forceps-like instrument with an outer and an inner shank. The later serves as a ventilation lumen and stabilizes the orotracheal tube in the midline of trachea. The outer shank acts as a three-dimensional guide for the puncturing needle. Out of 48 patients we have determined the level of puncture in 20 patients by using intraoperative measurements. The distance from the vocal cords to the puncture site was about 50 mm for men and 40 mm for women. In 13 of the patients who had had CT scans, we studied the distance between the vocal cords and the optimal puncture site and found the median distance for men 45 mm and for women 42 mm. With the studied navigation system one may use external or internal landmarks to indicate the puncture level in PDT. The device may minimize the risk of injuring the posterior tracheal wall.

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Higher incidence of Ménière’s disease during COVID-19 pandemic: a preliminary report

Andrea Lovato,Andrea Frosolini,Gino Marioni,Cosimo de Filippis

Publication date 16-09-2021


Coronavirus disease 2019 (COVID-19) pandemic represented a stressful event. The incidence of newly diagnosed Ménière's disease (MD) patients before and during COVID-19 at our Institution was calculated. The period 2018-2020 was considered. Incidence was calculated as number of annual first MD diagnoses divided by the number of annual first audiological evaluations. One hundred and eighty-three patients were considered. Annual incidence of MD at our institution was 1.3% in 2018, 1.2% in 2019, and 3.2% in 2020, resulting in a significant increase during COVID-19 pandemic (2018 A higher incidence of MD first diagnosis was calculated during COVID-19 pandemic; furthermore, MD patients presented with more vertigo attacks and higher DHI values. These could be associated with the higher state anxiety during COVID-19 pandemic.

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Effects of transtympanic intermittent pressure therapy using a new tympanic membrane massage device for intractable Meniere’s disease and delayed endolymphatic hydrops: a prospective study

Hideo Shojaku,Mitsuhiro Aoki,Hiromasa Takakura,Michiro Fujisaka,Masatsugu Asai,Masahito Tsubota,Yatsuji Ito,Yukio Watanabe

Publication date 15-09-2021


The retrospective study showed that the effect of the middle ear pressure treatment by the tramstympanic membrane massage (TMM) device was similar to that of the Meniett device. The new TMM device named EFET device was prospectively evaluated in patients with Meniere's disease (MD) and delayed endolymphatic hydrops (DEH) and we compared the effects to the Meniett device. 23 ears of 19 patients were treated with an EFET device, and 17 ears of 15 patients were treated with the Meniett device. All patients suffering from intractable MD and DEH were treated for 4 months. The insertion of a transtympanic ventilation tube was necessary for the Meniett device, but not the EFET device. In patients treated by the EFET and Meniett devices, the frequency of vertigo significantly improved after treatment. The distribution of vertigo outcomes at 4 months after treatment did not differ between patients treated with the both devices. Middle ear pressure treatment by the EFET device is effective and provides minimally invasive options for intractable MD and DEH like the Meniett device.

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Magnetic resonance imaging with intravenous gadoteridol injection based on 3D-real IR sequence of the inner ear in Meniere’s disease patient: feasibility in 3.5-h time interval

Wei Chen,Yue Geng,Naier Lin,Sihui Yu,Yan Sha

Publication date 15-09-2021


Intravenous gadoteridol injection can be applied to visualize endolymphatic hydrops (EH). To explore whether 3.5-h time interval was feasible for clinical practice. We collected 70 unilateral Meniere's disease (MD) patients who were divided into two groups randomly (group A: 3.5-h time interval; group B: 4-h time interval). Among the two groups, the signal intensity (SI) in perilymphatic area of the basal turn of cochlea, the results of visual evaluations in the vestibule, cochlea and semicircular canal and the detection results of EH were compared. Regarding the SI, no difference was found between A-affected ears and B-affected ears ( In the clinical application of gadoteridol for the inner ear, 3.5-h delayed MR imaging is feasible.

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The impact of surgical masks on the nasal function in the COVID-19 era

Simonetta Monini,Piero Giuseppe Meliante,Gerardo Salerno,Chiara Filippi,Valerio Margani,Edoardo Covelli,Maurizio Barbara

Publication date 15-09-2021


The Covid-19 pandemics has obliged to using different types of personal protective devices (PPD) for a prolonged time of the day, especially in the Health Centers, with preference of surgical masks (SM) during the first pandemic waves. This study was designed to assess the eventual changes of the nasal respiratory condition during continuous SM wearing. Fourteen healthcare professionals filled a visual analogue scale (VAS) questionnaire for the detection of eventual nasal breathing impairment or symptoms. Nasal resistance and flow values were obtained The increase of inspiratory resistance was significantly correlated to the reduction of the maximum flux, when comparing SM parameters to the basal ones ( The SMs do not induce evident physiological variations of the nasal function due to a compensatory respiratory mechanism that, despite a progressive increase of nasal resistances, is not inducing significant changes of the nasal fluxes.

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