Inlay cartilage myringoplasty has gained consensus by many surgeons for the repair of tympanic membrane erforations through a transcanal approach. 4 It provides several practical advantages, for example, no support through external auditory canal packing or middle ear is required as the graft has good stability. Postoperatively patient comfort is enhanced, and the operation has less expenditure because of contracted operative and recovery time. 5 Periosteum of the mastoid cortex has been described in the literature as a suitable grafting material for tympanic membrane repair, with several advantages. 6 However, there are few clinical trials comparing both types of grafts. Material and methods This study was retrospective controlled trial, comparing two different techniques performed by two university hospitals, in the period from 2014 to 2016. One hundred fourty nine patients were involved in this study. Patients were classified into two groups: Group A Included 88 patients underwent underlay periosteal TM grafting performed in a university hospital. Group B Included 61 patients subjected to inlay cartilage tympanoplasty in another university hospital. All patients had dry central TM perforation for at least 2 months before surgery. Cases with granulations, discharge, myringitis, active infection, otomycosis, mixed hearing loss, previous failed myringoplasty, and cases which required cortical mastoidectomy, middle ear exploration were excluded. Preoperative history taking and audiological assessment were done by calculating Air Bone Gap (ABG) as the average hearing level at 500, 1000, 2000 and 4000 Hz frequencies. Intraoperatively the time consumed during the operation was recorded in minutes. Postoperative evaluation was done 6 months post surgery included: graft take and mean ABG. Statistical methods Data were coded and entered using the statistical package Statistical Package for the Social Sciences (SPSS) version 25. Data was

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Background Study the incidence of thyroid gland invasion by laryngeal carcinoma and the risk factors that may predispose to this condition. Aiding surgeons develop an evidence-based plan for the management of the thyroid gland during total laryngectomy. Results Retrospective analysis of the available medical records for patients who had total laryngectomy together with total thyroidectomy or hemithyroidectomy in the same procedure. Associated pathological features were also investigated. Patients who had laryngeal carcinoma managed by total laryngectomy with total thyroidectomy or hemithyroidectomy between January 1, 2011, and December 31, 2017. Three hundred seventy-seven records were retrieved. The incidence of thyroid gland invasion by the laryngeal carcinoma was 24 (6.4%). Three patients showed microscopic extension (3/356; 0.8%). Six patients had malignant pathology other than squamous cell carcinoma (SCC). Two over six had invasion of the thyroid gland; OR (95% CI): 7.9 (1.4-45.4). Patients who had primary tumor stage of T4a were 244. 23/244 had thyroid gland invasion, 13.7 (1.8-102.9). Poorly differentiated tumors had significant incidence of thyroid gland invasion (4/15), 6.2 (1.8-21.3). Patients who had subglottic extension by the primary tumor were 177 with 20 patients having thyroid gland invasion (20/177), 6.2 (2.1-18.6). Conclusion Several risk factors are associated with higher incidence of invasion of the thyroid gland by laryngeal carcinoma. Identification of these factors can help surgeons develop a surgical strategy for the management of the thyroid gland during total laryngectomy.

Background Bipolar electrocautery tonsillectomy has been the preferred technique for many otolaryngologists, yet coblation tonsillectomy is gaining popularity in the current practice. This study aims at comparing both techniques in terms of pain, bleeding, and healing. Results A total of 120 patients were randomly divided into two equal groups. Overall mean pain score associated with coblation tonsillectomy was statistically less than that caused by bipolar electrocautery throughout the follow-up period (p < 0.001). The difference in pain duration was statistically longer for the bipolar group. The incidence of postoperative hemorrhage—both reactionary and secondary—was statistically higher in the bipolar group. Coblation tonsillectomy showed statistically shorter duration of healing (p < 0.001). Conclusions Coblation tonsillectomy is associated with less pain severity and shorter pain duration, fewer bleeding incidents, and more prompt healing.

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