• McCoy Krogh posted an update 6 months, 1 week ago

    5 ± 32.4% and 44.9 ± 17.8%, respectively) were significantly lower than in the EAC skin (83.4 ± 17.5% and 55.7 ± 7.1%, respectively) (p < 0.001 and p < 0.01). In contrast, the positive rate of p53 expression in the cholesteatoma (8.5 ± 11.4%) was significantly higher than in the EAC skin (0.5 ± 0.7%) (p < 0.001).

    The decreases in Notch1 and HES1 protein expression might play an important role in the hyperproliferative character of the keratinizing squamous epithelium in cholesteatoma. An increase in p53 might reflect the reaction to cellular hyperproliferation.

    The decreases in Notch1 and HES1 protein expression might play an important role in the hyperproliferative character of the keratinizing squamous epithelium in cholesteatoma. An increase in p53 might reflect the reaction to cellular hyperproliferation.

    To analyze the outcomes of the underwater endoscopic ear surgery (UWEES) technique for closure of cholesteatomatous labyrinthine fistula (LF) with preservation of auditory function.

    Retrospective case review study.

    Tertiary referral center.

    A total of 12 patients with cholesteatomatous LF.

    Surgical method of closure using UWEES for cholesteatomatous LF to minimize inner ear damage. Artificial cerebrospinal fluid (CSF) was used as the perfusate, except for earlier cases when saline was employed.

    Comparison of bone conductance hearing level (BCHL) before and after surgery. Selleckchem AG-1024 A change of BCHL less than 10 dB was defined as successful preservation of bone conductance hearing.

    All cases of LF were treated successfully by closure using the UWEES technique. Seven cases were type I, one was type IIa, and four were type III according to the Milewski and Dornhoffer classification of LF. The average LF size was 3.1 mm (1-7 mm). Eleven patients were evaluated and their bone conductance hearing was well preserved in all of them (11/11). One patient was too young for preoperative evaluation of BCHL, but hearing preservation was verified 2 years later at the age of 6 years. Remarkably, none of the patients complained of vertigo, except for only a slight manifestation on postoperative day 1.

    The UWEES technique was effective for closure of cholesteatomatous LF with preservation of auditory function.

    The UWEES technique was effective for closure of cholesteatomatous LF with preservation of auditory function.

    To compare hearing outcomes between traditional microsurgical transmastoid repairs and underwater, endoscopic transmastoid repairs of superior semicircular canal dehiscence syndrome (SCDS).

    A retrospective review of 14 patients undergoing transmastoid repair of SCDS between 2013 and 2017. Preoperative, immediate (7-10 d) postoperative, and long-term (>6 wk) postoperative speech discrimination scores, pure-tone averages, as well as pure-tone air conduction and bone conduction thresholds were obtained at 250 Hz, 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz, and 8000 Hz. Hearing threshold changes were all calculated as preoperative thresholds subtracted from postoperative threshold at each frequency. Wilcoxon rank-sum tests were conducted to assess changes in postoperative hearing thresholds at both the immediate and long-term postoperative period between those undergoing the traditional transmastoid technique and the underwater, endoscopic transmastoid technique.

    Our results demonstrate patients who underwent underwater transmastoid repairs had significantly less increase in their high-frequency bone conduction thresholds at both time periods, indicating less sensorineural hearing loss, compared to the traditional microscopic repair (p = 0.02 , p = 0.006 ). At long-term follow-up, there was also significantly improved pure-tone averages in the patients in the underwater repair cohort compared to the traditional group (p = 0.004 ). There were no differences in air-bone gaps at any frequency or any time period between the two cohorts.

    Preliminary findings show that the underwater endoscopic technique may prevent sensorineural hearing loss during transmastoid repair of SCDS.

    Preliminary findings show that the underwater endoscopic technique may prevent sensorineural hearing loss during transmastoid repair of SCDS.

    Topical ciprofloxacin and dexamethasone have both been shown to disrupt healing of tympanic membrane perforations in animal models. There have been no clinical studies evaluating the effect of ciprofloxacin-dexamethasone (CD) ear drops on success of tympanoplasty. We compare perforation closure rates in pediatric endoscopic tympanoplasty with and without use of postoperative CD.

    Retrospective comparative cohort study.

    Tertiary referral centre.

    One hundred sixty-two totally endoscopic tympanoplasties with porcine-derived collagen graft in children, mean age 12.0 years (range 2.3-17.9 yrs).

    Prescription of CD versus no ear drops in the immediate postoperative period.

    Perforation closure rate 2 months after totally endoscopic tympanoplasty.

    Postoperative CD was given to 65 (40%) ears and no drops given to the remainder. Overall, successful closure of tympanic membrane perforation was achieved in 140 (86%) of ears. The closure rate was not significantly different in those ears given CD postoperative this finding but a randomized prospective study could be justified for more reliable evidence.

    This study compares post-operative hearing outcomes and morbidity after pediatric total ossicular replacement prosthesis (TORP) ossiculoplasty with transcanal totally endoscopic ear surgery (TEES) versus a post-auricular microscope-guided (PAM) approach.

    Forty-four children who underwent ossiculoplasty with titanium TORP after previous cholesteatoma surgery.

    Ossiculoplasty using TEES or PAM approach.

    Hearing outcome after ossiculoplasty was determined by post-operative air-bone gap (ABG) on audiogram nearest to 1 year after surgery. Post-operative morbidity was measured by total number of opiate doses the child received during hospital stay, along with the highest documented post-operative pain score. Comparisons were made with Mann-Whitney U test.

    Hearing data were available for 41 patients 21 had undergone TEES (median preoperative ABG 39 dB) and 20 had PAM surgery (median preoperative ABG 39 dB). Post-operatively at 1 year, ABG closed significantly in each group (TEES 21 dB, p = 0.003; PAM 23 dB, p = 0.

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