Endonasal Free Flap Reconstruction Combined With Draf Frontal Sinusotomy for Complex Cerebrospinal Fluid Leak: A Technical Report & Case Series

xlomafota13 shared this article with you from Inoreader Endonasal Free Flap Reconstruction Combined With Draf Frontal Sinusotomy for Complex Cerebrospinal Fluid Leak: A Technical Report & Case Series Via leak of cerebrospinal fluid Oper Neurosurg (Hagerstown). 2021 Aug 23:opab309. doi: 10.1093/ons/opab309. Online ahead of print. ABSTRACT BACKGROUND: Frontal sinus cranialization with closure via bifrontal pericranial flaps is the gold standard for separating the nasofrontal recess from the intracranial cavity for posterior table defects. Despite the high success rate, cerebrospinal fluid (CSF) leak may persist and is particularly challenging when vascularized reconstructive options from the bicoronal incision are exhausted. OBJECTIVE: To assess a novel endonasal technique using an adipofascial radial forearm free flap delivered to the frontal recess through a Draf sinusotomy to repair complex CSF leaks from the frontal sinus. METHODS: A retrospective review of 3 patients (all male; ages 42, 43, and 69 yr) with persistent CSF leak despite frontal sinus cranialization and repair with bifrontal pericranium was performed. Etiology of injury was traumatic in 2 pat ients and iatrogenic in 1 patient after anaplastic meningioma treatment. To create space for the flap and repair the nasofrontal ducts, endoscopic Draf III (Case 1, 3) or Draf IIb left frontal sinusotomy (Case 2) was performed. The forearm flap was harvested, passed through a Caldwell-Luc exposure, and placed within the Draf frontal sinustomy. The flap vessels were tunneled to the left neck and anastomosed to the facial vessels by the mandibular notch. RESULTS: Intraoperatively, the flaps were well-seated and provided a watertight seal. Postoperative hospital courses were uncomplicated. There were no new CSF leaks or flap necrosis at 12, 14, and 16 mo. CONCLUSION: Endoscopic endonasal free flap reconstruction through a Draf procedure is a novel viable option for persistent CSF leak after failed frontal sinus cranialization. PMID:34423844 | DOI:10.1093/ons/opab309 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcome of Eustachian Tube Balloon Dilation in Children: A Systematic Review

xlomafota13 shared this article with you from Inoreader Outcome of Eustachian Tube Balloon Dilation in Children: A Systematic Review Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Aug 22:34894211041340. doi: 10.1177/00034894211041340. Online ahead of print. ABSTRACT OBJECTIVE: Eustachian tube dysfunction (ETD) is a chronic entity that has been historically managed with adenoidectomy and ventilation tube insertion. Recently, balloon dilation of the eustachian tube has shown promising results in recalcitrant eustachian tube dysfunction. We reviewed the literature to determine the outcome of eustachian tube balloon dilation in children. METHODS: A literature search was conducted for the period from 1990 to 2020 by searching several databases over a 1-month period (January 2021) according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews for Interventions. Primary outcome was defined as the success of the intervention determined by the resolution of symptoms, and secondary outcome was determined by revisions surgery and presence of complications. RESULTS: Only 7 articles were identified based on our objectives and selection criteria. All studies included are retrospective cohort case series (Level IV) and 1 cohort of matched controls (Level III). A total of 284 patients were included in this review, with a mean age of 7.8 years. A total of 463 balloon dilation were performed either bilaterally or unilaterally. The most common finding of ETD is middle ear effusion in 5 studies. Balloon dilation of eustachian tube was second-line treatment in 6 studies and first-line treatment in 1 study. Improvement of symptoms was identified in all studies through various assessments performed. Revision surgery was performed in 1 study with no major complications reported. CONCLUSIONS: Balloon dilation of the eustachian tube may be considered as an alternative procedure following failed standard treatment in children. The quality of evidence is inadequate to recommend widespread use of the technique until a better-quality study has been completed. Future randomized controlled studies with a large sample size are warranted to determine the efficacy of this procedure amongst children. PMID:34423675 | DOI:10.1177/00034894211041340 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Use of 532 nm Potassium Titanyl Phosphate Laser on Vocal Fold Scars Under Topical Anesthesia: A Pilot Study

xlomafota13 shared this article with you from Inoreader Use of 532 nm Potassium Titanyl Phosphate Laser on Vocal Fold Scars Under Topical Anesthesia: A Pilot Study Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Aug 23:34894211041819. doi: 10.1177/00034894211041819. Online ahead of print. ABSTRACT OBJECTIVE: This pilot study aims to evaluate the efficacy of 532 nm potassium titanyl phosphate (KTP) laser under topical anesthesia in patients with vocal fold scars. METHODS: A series of 18 patients with vocal fold scars of varying degrees were treated. The KTP laser was used under local anesthesia in the outpatient clinic. It was set to deliver 6 W o f power using a continuous output mode. Close-to-contact mode was used for laser irradiation, and contact mode was used for ablation and excision of the lesions. Some of the patients received laser scar ablation on both vocal folds; the scarred vocal fold on one side and the hypertrophic vocal fold on the other. Parameters include glottic closure, amplitude, and mucosal wave pattern were measured using laryngeal stroboscopic examination. Aerodynamic and voice evaluations were carried out using maximum phonation time (MPT), jitter, shimmer, Voice Handicap Index questionnaire (VHI-30), and GRBAS scale. RESULTS: In total, 21 surgeries were performed on 18 patients. Glottic closure, amplitude, and mucosal wave pattern showed improvement 2 months postoperatively (P < .05). There was significant improvement in the postoperative scores for VHI-30, VHI-emotional sub-scale, VHI-physical sub-scale, and GRBAS (P < .05). There was no significant difference in the MPT a nd VHI-functional sub-scale before and after the operation (P > .05). Re-adhesion of the anterior commissure was observed in 2 patients with Type III scars. CONCLUSION: The 532 nm KTP laser is an effective tool for the treatment of vocal fold scars. Further research is required to determine if serial laser applications could improve outcomes for this challenging condition. LEVEL OF EVIDENCE: Level IV. PMID:34423674 | DOI:10.1177/00034894211041819 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of Acoustic Reflex Thresholds in COVID-19 Patients With Taste Disorders

xlomafota13 shared this article with you from Inoreader Evaluation of Acoustic Reflex Thresholds in COVID-19 Patients With Taste Disorders Via ear nose throat Ear Nose Throat J. 2021 Aug 23:1455613211039808. doi: 10.1177/01455613211039808. Online ahead of print. ABSTRACT OBJECTIVE: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, can result in persistent loss of taste and smell. This study was performed to assess acoustic reflex threshold (ART) in patients with taste disorders caused by SARS-CoV-2. MATERIAL AND METHODS: This retrospective study enrolled 11 patients (9 men, 2 women; average age = 22.3 years) with a history of COVID-19 and had complaints of taste disorder and sensitivity to loud sounds. The control group consisted of 13 healthy participants (10 men, 3 women; average age = 23.4 years). Anamnesis, neuro-otological, ear, nose and throat, and eye examinations, as well as a taste test, pure tone audiometry, speech discrimination test, and impedance audiometry were performed in all participants. RESULTS: All participants in the study group had a negative taste test result. In addition, ART values were significantly higher in the study group than the control group at all frequencies. CONCLUSIONS: SARS-CoV-2 could be a neurotropic virus that can cause facial nerve neuropathy. PMID:34420420 | DOI:10.1177/01455613211039808 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Skull Base Osteomyelitis After Nasopharyngeal Cyst Excision

xlomafota13 shared this article with you from Inoreader Skull Base Osteomyelitis After Nasopharyngeal Cyst Excision Via ear nose throat Ear Nose Throat J. 2021 Aug 23:1455613211039044. doi: 10.1177/01455613211039044. Online ahead of print. ABSTRACT We present a case of an 80-year-old male who developed skull base osteomyelitis after nasopharyngeal cyst removal. A review of the literature regarding complications after nasopharyngeal cyst removal was performed. We describe the difficulty of diagnosing an osteomyelitis infection and the best approach to recognizing osteomyelitis before complications worsen. PMID:34420423 | DOI:10.1177/01455613211039044 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Granular Cell Tumor in Auditory Meatus: A Case Report

xlomafota13 shared this article with you from Inoreader Granular Cell Tumor in Auditory Meatus: A Case Report Via ear nose throat Ear Nose Throat J. 2021 Aug 23:1455613211038234. doi: 10.1177/01455613211038234. Online ahead of print. ABSTRACT Granular cell tumor (GCT) is a rare benign soft tissue neoplasm that develops primarily in the skin and subcutaneous tissue of the head and neck, frequently in the tongue, but has not been observed in the auditory meatus. These tumors generally present as slow-growing nodules with few unique clinical or radiological features, and so must be confirmed by pathologic al examination. Here, we present the case of a 62-year-old female with right hearing loss and benign GCT in the right auditory meatus initially misdiagnosed as cholesteatoma. PMID:34420421 | DOI:10.1177/01455613211038234 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reimplantation of an Extruding Cochlear Implant

xlomafota13 shared this article with you from Inoreader Reimplantation of an Extruding Cochlear Implant Via ear nose throat Ear Nose Throat J. 2021 Aug 23:1455613211039042. doi: 10.1177/01455613211039042. Online ahead of print. ABSTRACT Cochlear implants have successfully improved hearing in severe and profoundly deaf patients in addition to improving their quality of life. Implant extrusion and wound infection of a cochlear implant are one of the most common postoperative complications, although it does not occur frequently (1.5%-5% of cases).1,2 We present a case of an extruding coch lear implant with dehiscence that was successfully reimplanted, a procedure of which there have been few previous reports in the literature. PMID:34420408 | DOI:10.1177/01455613211039042 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.