Background and aim: Complete disruption of the ossicular chain can result in up to 60 dB hearing loss. Hearing restoration surgery comprises ear drum repair and ossicular chain reconstruction in ears housing defective ossicles. The aim of this study was to assess cartilage strip and bone cement in ossiculoplasty. Patients and methods: This is a prospective, cross sectional study and was carried out on 36 patients (27 females and 9 males) with chronic suppurative otitis media, their age ranged from 12 to 38 years. Patient were subjected to complete history taking, complete ENT examination, preoperative audiological evaluation, high resolution computed tomography "HRCT" and complete laboratory investigations. All patients were operated by tympanomastoidectomy for eradication of middle ear pathology (21 cases underwent canal wall up technique while 15 cases underwent canal wall down technique), Then reconstruction of the ossicular chain was done by cartilage strip and bone cement (30cases between malleus to stapes while 6 cases between incus to stapes). Postoperative assessment done by pure tone audiometry & tympanometry 3 & 6 months postoperatively. Results: Regarding improvement in hearing 83.3% of our patient were improved while the remaining 16.7% were not. The result of pure tone audiometry & typanometry were significantly improved (p=0.0008). Graft taken occur in 83.3% of cases. Conclusions: The usage of bone cement with a cartilage strip is a simple and effective method for ossicular reconstruction and associated with significant improvement in conductive hearing loss.
Background: Concha bullosa (CB) is the most prevalent anatomical variant in the osteo-meatal complex. Middle Easterners have a disproportionately high incidence of nasal septal deviation (NSD). Objectives: To determine if concha bullosa increases the risk of developing rhinosinusitis and NSD. Subjects and Methods: Thirty people who were diagnosed with chronic rhinosinusitis at the ENT Outpatient Clinic at Zagazig University Hospitals participated in this prospective study. All subjects undergone full clinical evaluation as well as Computerized tomography study on the nose and paranasal sinuses. Results: None of the groups differed significantly in terms of the quantity or location of NSD, and between 88% and 12% of the patients with CB, the air channel was either intact or completely obliterated. About 96% of the patients with NSD had preserved air channel and 4% of them had obliterated air channel. Conclusion: CT-imaged concha bullosa, regardless of its size or shape, does not increase the likelihood of sinusitis or NSD.
Background: Rapid Rhino® nasal pack was used to minimize bleeding and to relieve postoperative pain after endoscopic sinus procedures (ESS), while different nasal packs have been employed in various sinonasal surgeries throughout the last decades. The aim of the study was to compare the effectiveness of Rapid Rhino® Pack and Gloved Nasal Pack as Middle Meatal Spacers after ESS for reducing postoperative adhesion in-patient undergoing ESS and reducing the pain during pack removal. Patients and Methods: We conducted a prospective, randomized controlled clinical trial, at ENT Department, Faculty of Medicine, at Zagazig University Hospitals on 44 cases. Patients were randomized to receive Rapid Rhino® pack the in one middle meatus (right or left), and the Gloved Nasal pack in the contra-lateral middle meatus intra-operatively. Results: Sino-nasal Outcome Test (SNOT-22) chart significantly decreased from a pre-operative mean of 52.59 (SD13.17) to 34.18 (SD 8.79) at 3 months post-operatively. Visual Analogue Scale (VAS) for pain significantly decreased in the Rapid Rhino pack groups compared with gloved nasal pack. Bleeding was more in gloved nasal pack side with statistically significant difference among both groups (p=0.007). Endoscopic evaluation of our cases revealed no significant difference between both groups regarding edema, discharge and both groups were significantly improved while significant differences were found regarding while scarring and crusting. Conclusion:We concluded that whether packs are always necessary following endoscopic sinus surgery. Rapid Rhino® Pack fulfils their primary purpose of hemostasis and is well tolerated. It has also been shown to cause little pain on removal and may prevent adhesion formation.
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