CONCLUSION:The occipital fasciocutaneous rotation-advancement flap is a relatively simple means of obtaining local, vascularized, hair-bearing tissue for repair of wound breakdown following cochlear implantation. AOM Thomas Walker, MD (presenter); Simon Angeli, MD OBJECTIVE: Bacteria living in biofilms are extremely resistant to antibiotic therapy. Recurrent acute otitis media appears to be a disease process related to biofilm formation. The goal of this study is to determine if middle ear irrigations with saline or baby shampoo could significantly reduce or eradicate mucosal biofilms in an animal model of acute otitis media. METHOD: After an ABR was performed to assess baseline hearing, the middle ears of ten adult chinchillas were inoculated with 10 5 colony forming units of biofilm-forming H. influenzae. Five days after inoculation, the right middle ear was irrigated with 1% baby shampoo and the left ear with normal saline as a control. Two days following irrigations, a final ABR was obtained to assess post-intervention hearing. The animals were then euthanized and middle ear mucosa of each animal harvested. All specimens were analyzed by a blinded microscopist using scanning electron microscopy (SEM). RESULTS: Biofilm densities of middle ear mucosa are similar after 1% baby shampoo or saline irrigations. The hearing thresholds on auditory brainstem responses at frequencies 16 kHz, four kHz, one kHz and 500 Hz are unchanged two days after baby shampoo irrigations when compared to the baseline ABR. CONCLUSION: 1) Preliminary results indicate that middle ear irrigations with 1% baby shampoo in normal saline do not lead to significant decrease in biofilm density when compared to normal saline alone. 2) Baby shampoo is non-ototoxic and can be safely used in middle ears. 3) More chinchillas will be examined for a total of 28 animals to reach statistical significance.
Middle Ear Irrigations on Biofilm in Chinchillas with
MRI in Evaluation of Clinical Treatment of OtospongiosisAndy Vicente, MD, PhD (presenter); Helio Yamashita, MD; Oswaldo Laercio Cruz, MD, PhD; Norma Penido, MD, PhD OBJECTIVE: To evaluate the applicability of magnetic resonance imaging (MRI) as a method for monitoring the activity of otospongiotic lesions before and after clinical treatment. METHOD: A prospective, randomized, controlled, doubleblind study involving 31 patients with clinical, audiometric, and tomographic diagnosis of otosclerosis. As computed tomography (CT) demonstrated active lesions, consistently at the region anterior to the oval window, these patients underwent MRI in order to confirm the spongiotic foci activity (areas of gadolinium enhancement). The patients were then divided into three groups (A, B and C), receiving treatment with placebo, alendronate sodium, and sodium fluoride, respectively, for 6 months. After this period they were submitted to new clinical and audiometric evaluations along with a second MRI study. All MRI images were evaluated by a neuroradiologist and an otolaryngologist in a subjective (visual) and ob...