No abstract

No abstract

Objective To determine whether double gloving would negatively affect participants' ability to perform a simulated microsurgical task. Study Design Randomized single-blinded controlled crossover trial. Setting Temporal bone laboratory of an academic otolaryngology department. Subjects and Methods This study involved the simulated insertion of a stapes prosthesis into a model of the ossicular chain under microscopy. Forty-one participants were recruited from our medical and dental school and randomized into 2 groups. All groups began by performing the task without gloves, acting as their own control arm. The first group (A) then performed the task with a single pair of gloves while the second group (B) next performed the task with 2 pairs of gloves. The groups then switched gloving methods. The total time taken to perform the task was recorded for each participant and the results subjected to a series of statistical measures. Results This study found a statistically significant difference in the average time taken to complete the task between the "no-glove" arm of the study and both experimental groups but no difference between the 2 experimental groups. Likewise, no significant difference was found between the 2 experimental groups when comparing the rate at which they improved at performing the task. Conclusion These data suggest that wearing 2 pairs of surgical gloves does not negatively affect the speed at which a microsurgical procedure may be performed, lending support to the practice of double gloving, even in the setting of microsurgical fine motor tasks.

After the investigators controlled for luminal circumference and multiple measurements, submucosal collagen area was increased in group 2 (burn) compared with group 1 (sham) (P = .012). Submucosal collagen area was decreased in group 3 (DEDE stent) compared with group 2 (P = .042). No statistically significant difference in submucosal collagen area was observed between animals in group 1 and group 3 (P = .800). CONCLUSIONS;Topical application of mithramycin-A via a DEDE stent modulates collagen deposition after acute thermal injury in the rat esophagus.

Poster Presentations P191outcomes of management of trachea-esophageal fistulae with t-tube placement.Methods: A retrospective case series with chart review was conducted at an academic practice in a regional referral center. Two patients with tracheo-esophageal fistulae who either were not candidates for open surgical repair or refused open surgical repair were successfully managed with a Montgomery T-tube to stent the fistula. Outcome measures included resumption of oral diet, need for further procedures, and fistula size.Results: Both patients had t-tubes that were sized to stent the fistula and maintain an airway without esophageal stent or tracheostomy. There were no cases of migration or enlargement of fistula. No patients required revision procedures. Fistulae were successfully controlled in all patients, with full resumption of oral intake and maintenance of voice. No patients had closure of fistula.Conclusions: Montgomery T-tube stenting is a safe and minimally invasive way to manage trachea-esophageal fistulae in patients who are not candidates for open surgical repair. This technique minimizes soilage of the airway with maintenance of voice that is often difficult in management with cuffed tracheotomy tubes. Neither migration nor enlargement of fistula was noted.

No abstract