ORL 2020-12-18

The Long-Term Stability of Fat-Graft Myringoplasty in the Closure of Tympanic Membrane Perforations and Hearing Restoration

Publication date 18-12-2020

Background/Aims: This study was conducted to evaluate the long-term stability of fat-graft myringoplasty (FGM) for chronic tympanic membrane perforations, analyzing the perforation closure rate and re-gained hearing outcome with respect to the size and location of the perforations.
Methods: Between August 2007 and June 2018, a total of 193 patients who underwent FGM due to chronic tympanic membrane perforation at a tertiary referral center were enrolled and analyzed.
Results: The mean follow-up was 14.6 months (range 6–39). The complete perforation closure rate after FGM was 89.6%, with no statistical difference among the perforation size groups. The mean postoperative air-bone gap (ABG) was 11.0 dB and mean ABG improvement was 4.9 dB.
Conclusion: Our FGM technique had a favorable tympanic closure rate for small to large perforations, and yielded relatively good hearing improvement in the mid-size perforation cases over long-term follow-up periods. According to the topographic evaluation of FGM, this procedure resulted in a reliable perforation closure rate and audiological results regardless of the perforation site. ORL

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Office-Based Sinus Surgery for Cystic Fibrosis Chronic Rhinosinusitis

DB Spielman,DA Gudis

Publication date 17-12-2020

Objective: Chronic rhinosinusitis (CRS) is nearly ubiquitous in the cystic fibrosis (CF) population, and many patients require multiple endoscopic sinus surgeries throughout their lifetime. Recent studies have demonstrated the profound pulmonary and systemic health benefits of comprehensive CRS treatment. Both endotracheal intubation with mechanical ventilation and inpatient hospital care represent significant risks for CF patients. The goal of this study is to evaluate the safety and feasibility of performing revision endoscopic sinus surgery for CF patients in the outpatient office setting using only local anesthesia to decrease the need for mechanical ventilation and inpatient hospitalization.
Methods: This is a prospective cohort study conducted at a tertiary care academic medical center with a CF Foundation-accredited care center. Patients with CF and refractory CRS despite prior surgery and medical therapy were eligible for inclusion. Comprehensive revision ESS was performed in the office using only local anesthesia.
Results: Five patients were enrolled and underwent revision endoscopic sinus surgery without complication. The average preoperative Sinonasal-Outcome Test-22 score was 52.0 ± 12.1 and the average preoperative Lund-Mackay score was 15.2 ± 3.8. No patients requested aborting the procedure early due to pain, discomfort, or any other reason. No subjects required prolonged observation or postoperative hospital admission.
Conclusion: This prospective pilot study is the first to demonstrate the safety and feasibility of performing comprehensive revision endoscopic sinus surgery for CF patients in the outpatient office setting using only local anesthesia. ORL

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A Rare Case of Temporal Bone Pneumocephalus Tracking through the Internal Auditory Canal

W Watson,E Mulry,A Kaufman,SJ Eliades

Publication date 15-12-2020

A 39-year-old male with chronic hydrocephalus requiring biventricular shunts presented with progressive pneumocephalus over several years. He showed no improvement following ventriculoperitoneal (VP) shunt revision and anterior skull base repair for a sphenoid dehiscence. Imaging continued to show worsening pneumocephalus with air tracking along the right facial nerve from the geniculate ganglion to the internal auditory canal (IAC). The patient then underwent tympanomastoidectomy and skull base reconstruction. Based on a search of published literature, this appears to be the first reported case of temporal bone pneumocephalus coursing through the IAC, unlike most cases associated with tegmen defects and middle fossa pneumocephalus. ORL

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Iatrogenic Tracheal Injuries: Case Series and Review of the Literature

A Frost,N Ruszkay,TB Steinberg,J Atkins,N Mirza

Publication date 09-12-2020

Iatrogenic tracheal injuries are an uncommon but serious complication of endotracheal tube intubation. We present two cases that illustrate iatrogenic tracheal injuries presenting hours after the time of their injury. This report addresses the critical diagnostic evaluation and management of iatrogenic tracheal injuries resulting from endotracheal intubation. ORL

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Decrease and Recovery of Olfactory and Gustatory Function in a Case of SARS-CoV-2 Infection

DT Liu,B Prem,G Besser,CA Mueller,B Renner

Publication date 02-12-2020

Self-reported chemosensory dysfunction in severe acute respiratory syndrome coronavirus 2 patients is common. We present a case of reversible smell loss in a young patient with mild coronavirus disease 2019 infection assessed with established testing methods over a period of 8 weeks. ORL

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"Publishers Note"

Publication date 30-11-2020


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Content Vol. 82, 2020

Publication date 27-11-2020

ORL 2020;82:I–VI

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Acknowlegement to Reviewers

Publication date 27-11-2020

ORL 2020;82:351–352

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Apparently Minor Head Trauma Can Lead to Anosmia: A Case Report

Y Zang,A Hähner,S Negoias,T Lakner,T Hummel

Publication date 11-11-2020

We report the case of a 49-year-old female patient who suffered from anosmia following an apparently mild head trauma when bumping into a door at her home. She reported no other accompanying symptoms after the injury that day. Olfactory function was completely lost, which was noted the day after the trauma. Gustatory function remained normal. Magnetic resonance imaging indicated lesions/bleeding in the right frontal lobe and in the area of the olfactory sulcus/bulb. The present case indicates that in case of apparently mild head trauma with anosmia, an MRI scan of the head should be performed because of suspect brain damage. This case also points to the deeper question how to gauge severity of head trauma. ORL 2021;83:2–6

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Transoral Laser Surgery for Early Glottic Carcinoma: A Single Surgeon Experience of 101 Consecutive Cases

K Ozturk,G Turhal

Publication date 10-11-2020

Purpose: Investigate the clinical and oncological results of early-stage glottic laryngeal carcinoma patients performed by a single surgeon.
Methods: This study was carried out at a tertiary academic center. A total of 101 patients were included (92 males 91.1%, 9 females 8.9%). Mean age was 62.98 ± 10.2 years (range 33–87). Recurrence, disease-free survival, overall survival, laryngeal preservation rates were analyzed.
Results: Tumor stage was Tis (carcinoma in situ) in 11 patients (10.9%), T1a in 66 patients (65.3%), T1b in 12 patients (11.9%), and T2 in 12 patients (11.9%). Postoperative pathology was squamous cell carcinoma in 69 patients (68.3%), carcinoma in situ in 26 patients (25.7%), and high-grade dysplasia in 6 patients (5.9%). Five patients (5.0%) underwent type 1, 7 (6.9%) type 2, 45 (44.6%) type 3, 24 (23.8%) type 4, 6 (5.9%) type 5a, 8 (7.9%) type 5c, 4 (4.0%) type 5d, and 2 (2.0%) type 6 cordectomy. Median follow-up time was 30 months (range 14–66). There were 5 recurrences (5.0%). Three-year disease-free survival was 94.4%. Three-year disease-free survival for stage I and II patients was 94.9 and 91.7%, respectively. Overall survival was 93.8%. Only 1 patient died related to cardiovascular disease. Disease-specific survival was 100%.
Conclusions: In conclusion, this is a large case series with good oncological outcomes presented with the perspective of a single surgeon. The data of the study is in accordance with the previous reports. ORL 2021;83:41–46

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