Day 2 :
Alexandria University, Egypt
Keynote: Comparison of scalar location and insertion depth of cochlear implant electrode implanted through the round window versus cochleostomy approach
Time : 10:00-10:35
Ahmed Mehanna is Lecturer of ENT at Alexandria University in Egypt. He has received his MBBCH degree in September 1999 and Master degree of Otorhinolaryngology and Head and Neck Surgery in 2004. He has received his Doctorate degree of Otolaryngology in 2009 from Alexandria University. He has served as House officer (Intern)rnat Alexandria University Hospital (2000-2001). He has worked as a Clinical and Research ENT Fellow in The Royal Prince Alfred Hospital, Westmead Children Hospitalrnand Sydney Cochlear Implant Centre. He has also worked in The Matter Hospital with Prof. Gibson in his private operative work. He has attended several internationalrnconferences and has 4 publications. His research interests include otology and cochlear implant surgery, pediatric otolaryngology and airway management.
Objective: Compare the insertion depth and scalar location of cochlear implant (CI) electrode implanted through round window membrane (RWM) versus cochleostomy approach using multislice computed tomography (CT).
Materials & Methods: The study was conducted on twenty fresh human temporal bones. Ten were implanted through RWM approach and the other ten through cochleostomy using standard dummy CI electrode (MED-EL, Innsbruck, Austria). The CI electrodes were advanced till the point of first resistance then assessed using multislice CT.
Results: The study showed no significant differences in insertion depths whether angular or linear in the two study groups. However the RWM approach was associated with statistically significant higher incidence of scala tympani (ST) placement compared to scala vestibuli (SV) placement. Also ST placements were associated with statistically significant lower insertion depth compared to SV placement.
Conclusion: The present study suggests that, for hearing preservation cochlear implantation, advancing the CI electrode through the RWM till the point of first resistance is the recommended first choice whenever the anatomical orientation of the RWM allows.rn
- Track 1: Head & Neck Cancer
Track 6: Audiology
Alexandria University, Egypt
Phani Kumar Kuchimanchi
Dr. Phani’s Dental Clinics, India
Navy General Hospital, China
Title: Hyperbaric oxygen treatments attenuate the neutrophil-to-lymphocyte ratio in patients with idiopathic sudden sensorineural hearing loss
Time : 11:45-12:10
Shuyi Pan is currently working in Hyperbaric Oxygen Center of Chinese People’s Liberation Army, Department of Hyperbaric Oxygen, Navy General Hospital of Chinese People’s Liberation Army, and Beijing, China. His research interests are his research interest are Hyperbaric Oxygen, Traumatic Brain Injury, Hyperbaric Oxygen Chamber, Craniocerebral Injury, and Installation.
Kim ENT Clinic, Republic of Korea
Title: Reciprocal causal relationship between laryngopharyngeal reflux and Eustachian tube obstruction
Time : 12:10-12:35
Hee-Young Kim has completed his MD from Chung-Ang University in Seoul, Republic of Korea and PhD from Chung-Ang University School of Medicine. He is the Director of Kim ENT Clinic in Seoul, Republic of Korea. He has published papers in reputed journals.
My own experience in the medical treatment of a lot of patients for 20 years has proved that many cases have both laryngopharyngeal reflux (LPR) and Eustachian tube obstruction (ETO) at the same time. In these cases, ETO can be a cause of LPR or conversely, LPR can be a cause of ETO and hence it is natural that a concept of a ‘reciprocal causal relationship between LPR and ETO’ emerges from it. A combination like ‘hearing loss’ or and ‘ear fullness’ or and ‘dizziness (vertigo) or and ‘tinnitus’ or and ‘headache (migraine)’ due to ETO, is regarded as consisting of major symptoms originating from ETO. In addition to nausea, vomiting and perspiration as the common symptoms accompanied by vertigo, any other multiple complaints from LPR or gastro esophageal reflux disease (GERD) also may be clinical manifestations originating from ETO. Reversely, the fact that LPR can be a cause of ETO also has been proved by recent researches. In conclusion, treating patients regardless in an emergency room or outpatient department, a wide and diverse variety of symptoms and diseases originating from both LPR or GERD and ETO has to be considered with the mutual connection observantly. And they should be subjected to the therapeutic test of inflation of the tubes as a first step in a thorough clinical investigation. Ideally normal middle ear cavity pressure with perfectly equal balance between both ears is the core prerequisite before diagnosis and treatment for any symptoms and diseases.
Alexandria University, Egypt
Ahmed Mehanna is Lecturer of ENT at Alexandria University in Egypt. He has received his MBBCH degree in September 1999 and Master degree of Otorhinolaryngology and Head and Neck Surgery in 2004. He has received his Doctorate degree of Otolaryngology in 2009 from Alexandria University. He has served as House officer (Intern) at Alexandria University Hospital (2000-2001). He has worked as a Clinical and Research ENT Fellow in The Royal Prince Alfred Hospital, Westmead Children Hospital and Sydney Cochlear Implant Centre. He has also worked in The Matter Hospital with Prof. Gibson in his private operative work. He has attended several international conferences and has 4 publications. His research interests include otology and cochlear implant surgery, pediatric otolaryngology and airway management.
Objectives: The aim of this study was to assess the incidence of CSF gusher during cochlear implantation in children with and without congenital inner-ear malformation and to establish a simple stepwise algorithm for managing CSF gusher at the time of cochleostomy.
Materials & Methods: A total of 54 congenitally deaf children were included in a retrospective study between January 2012 and December 2013. All cases underwent classical cochlear implantation surgeries via mastoidectomy and posterior tympanostomy approach.
Results: Nine patients developed gusher at the time of the cochleostomy. Among the nine cases, only one child did not show any preoperative radiologic evidence of any bony cochleovestibular malformation, whereas the remaining eight cases had different congenital inner-ear malformations with known risk for intraoperative gusher during surgery.
Conclusion: We concluded that the CSF gusher is a surgical difficulty or an intraoperative challenge rather than a bad prognostic determinate for the postoperative audiologic performance and in cases of congenital cochleovestibular malformation that develop gusher, a high degree of congenital anomaly of the cochlea and not the degree or the amount of gusher is correlated to the poor patient performance. Finally, we were able to achieve a simple stepwise algorithm for the management of gusher during cochlear implantation.
Beijing Tongren Hospital, China
Time : 10:35-11:00
Xiaohong Chen is MD and a Professor. In 2005, he has obtained his ENT Doctor degree and he has worked as Post-doctor in UCLA from 2009-2010. He is the Vice-Director of Otolaryngology, Head and Neck Surgery Department in Beijing Tongren Hospital, Capital Medical University, China. He is a Member of the Committee of Beijing Anticancer Association and the Commission of Chinese Anti-Cancer Association and Melanoma Committee. He is an expert in diagnosis and treatment on rare diseases of head and neck, operation design for maintaining function of important organs and cosmetic result of incision design in head and neck tumor surgery, retention function of eye of the patients with the malignant nasal cavity and paranasal sinus tumor, salvage or radical surgery for advanced tumor of head and neck and familial hereditary tumor.
Background & Purpose: A series of head and neck skin flaps were harvested to maximize the function of the donor area and minimize the complications of the recipient area.
Material & Methods: With the help of by digital subtraction angiography (DSA) of the responsible vessel in the perforator for surface markers or preoperative vascular ultrasound positioning has completed in 45 cases of island pectoralis major myocutaneous flap, 11 cases of mammary perforator island flap, 3 cases of lower trapezius island flap, 2 cases in sternocleidomastoid myocutaneous island flap, 3 cases of transverse cervical vessels of superficial flap and 3 cases of thoracoacromial artery perforator flap. In addition, such conventional island flap is modified including 16 cases of submental flap, 8 cases of frontal flap island flap. The diseases in the recipient site included primary or recurrent pharyngeal and laryngeal cancer and tonsil carcinoma, soft palate tumor, tongue reconstruction of total glossectomy, maxillary sinus carcinomaases, recurrent ethmoid maxillary sinus carcinoma, gingival carcinoma, cervicahypopharyngeal and cervical esophageal stenosis, base of tongue cancer, external nose neoplasm postoperative defect anterior cervical skin defect, tracheoesophageal fistula, post burn scar hypopharyngeal stenosis, cervical vertebra trauma pharyngeal fistula Behcet's disease, anterior wall defect, the fistula recurrence carcinoma.
Results: Eight cases presented postoperative pharyngeal fistula and were cured after local dressing. Two cases were failed, including 1 case with the vascular pedicle damaged when isolated, 1 case with broken vascular pedicle when transferring the flap to the maxillary defect. Two cases presented partial flap necrosis 1 cm*2 cm necrosis of skin and recovered after local dressing. The retention of shoulder joint was good and the upper arm function was normal and the figure of upper part of the chest was better in all the island PMMF patients.
Conclusion: The island flap is minimally invasive design, not only less injury combined better figure in the donor site but also less complications and a further transfer distance in the recipient site, but it needs a high surgical technique.