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1.
Berat Demir Murat Sarı Adem Binnetoglu Ali Cemal Yumusakhuylu Deniz Filinte İshak Özel Tekin Tekin Bağlam Abdullah Çağlar Batman 《Auris, nasus, larynx》2018,45(2):301-305
Objective
The present study aimed to compare the effects of bacterial cellulose used for closure of pharyngocutaneous fistulae, a complication of total laryngectomy, with those of primary sutures in a rat model.Methods
Thirty female Sprague-Dawley underwent experimental pharyngoesophagotomy and were grouped depending on the material used for pharyngocutaneous fistula closure: group I, which received primary sutures alone, group II, which received bacterial cellulose alone; and group III, which received both. After 7 days, the rats were sacrificed. Pharyngocutaneous fistula development was assessed, the gross wound was inspected, and histological examination was conducted.Results
Pharyngocutaneous fistulae developed in 12 rats (41%) in all: 6 from group I (21%), 4 from group II (14%) and 2 from group III (7%).Conclusion
Fibroblast density and inflammatory cell infiltration were significantly greater in group III than group I. We concluded that bacterial cellulose may be useful for pharyngocutaneous fistula closure. 相似文献2.
Patrik Pipkorn Parul Sinha Joseph Zenga Evan Graboyes Bruce H. Haughey 《American journal of otolaryngology》2017,38(3):329-332
Purpose
Pharyngocutaneous fistula (PCF) after laryngectomy continues to be a serious complication, especially after radiation. Recruitment of non-radiated tissue into the surgical defect may decrease the risk of fistula. These techniques however have significant morbidity and increases operative time. We hypothesized that using acellular dermal graft to reinforce the pharyngeal closure could decrease the risk of fistula, without the added morbidity of a vascularized flap.Methods
We performed a retrospective chart review of all patients that underwent a laryngectomy between 2005 and 2015 at an acedemic tertiary referral center. Patients who underwent primary pharyngeal closure with Alloderm® reinforcement without any other flap reconstruction were identified. Basic demographics, previous treatment, operative technique and fistula were extracted from the medical records. The primary outcome was PCF rate. The time to closure, margin status and disease recurrence was also evaluated.Results
Among 16 patients with AlloDerm® augmentation, eight had primary laryngectomy and eight had salvage laryngectomy. A total of three in the salvage laryngectomy with prior history of radiation developed PCF. The fistula closed in all three cases with conservative treatment. There was no PCF in the primary laryngectomy group without prior history of radiation.Conclusion
The rate of PCF among the salvage laryngectomy group with previous radiation did not differ from historical data. AlloDerm® can however, provide a simple alternative for repair in radiation patients where flap cannot be performed for pharyngeal reconstruction. In non-radiated patients, AlloDerm® augmentation may have a protective effect on fistula formation. 相似文献3.
Eric J. Formeister A. Sean Alemi Ivan El-Sayed Jonathan R. George Patrick Ha P. Daniel Knott William R. Ryan Rahul Seth Matthew L. Tamplen Chase M. Heaton 《American journal of otolaryngology》2018,39(5):548-552
Purpose
To evaluate how the interval between radiation and salvage surgery for advanced laryngeal cancer with free tissue transfer reconstruction influences complication rates.Materials and methods
This is a retrospective series of 26 patients who underwent salvage laryngectomy or laryngopharyngectomy with vascularized free tissue reconstruction (anterolateral thigh or radial forearm) following radiation or chemoradiation between 2012 and 2017 at a single academic center. The primary outcome was incidence of postoperative complications, including pharyngocutaneous fistula. Secondary outcomes included the need for a second procedure, time to resumption of oral feeding, feeding tube dependence, and hospital length of stay.Results
Salvage surgery was performed for persistence (7/26, 27%), recurrence/new primary (12/26, 46%), and dysfunctional larynges (7/26, 27%). Twenty-two (85%) defects were reconstructed with an anterolateral thigh free flap and 4/26 with a radial forearm free flap (15%). There were no flap failures. There were significantly more complications in patients undergoing surgery within 12?months of completion of radiation therapy (7/12, 58%) versus those undergoing surgery after 12?months (1/14, 7%; p?=?.02). Patients experiencing complications more often required a second procedure (4/7 vs. 0/1; p?=?.02), experienced a longer delay to initiation of oral diet (61 vs. 21?days; p?=?.04), and stayed in the hospital longer (28 vs. 9?days; p?=?.01).Conclusions
Shorter intervals between definitive radiation and salvage laryngopharyngeal surgery with free tissue reconstruction increases postoperative complications, hospital length of stay, and the likelihood of feeding tube dependence. Reconstructive surgeons can use these findings to help guide preoperative patient counseling and assess postoperative risk. 相似文献4.
Oshri Wasserzug Gad Fishman Anat Wengier Yael Oestreicher-Kedem Ophir Handzel Dan M. Fliss Nevo Margalit Ahmad Safadi Ari DeRowe 《American journal of otolaryngology》2018,39(5):628-630
Background
Direct laryngoscopy and rigid bronchoscopy are currently performed using 2-dimensional endoscopic systems. Our objective was to determine whether a 3-dimensional endoscopic system can enhance visualization of the surgical field in pediatric direct laryngoscopy and rigid bronchoscopy.Methods
A prospective cohort study was conducted. Thirty three children who underwent direct laryngoscopies in a tertiary referral children's hospital were enrolled. Direct laryngoscopy was performed using both 2- and 3-dimensional endoscopic systems, after which the surgeons scored the quality of the images obtained with each system on a scale from 1 (low) to 5 (high). Comparison of the scores obtained with the 2 endoscopic systems was performed.Results
The 33 study children (mean age 2.3?years, M:F ratio 1:1.6) underwent 47 direct laryngoscopies. The mean score for visualization of the glottis was 4.8 for the three-dimensional system compared to 4.0 for the two-dimensional system (P?=?.025), 4.7 vs. 3.8, respectively, (P?=?.019) for the subglottis, and 4.6 vs. 3.9, respectively (P?=?.031) for visualization of the proximal trachea. The mean score for visualization of the distal trachea was 3.0 vs. 3.7, respectively (P?=?.020). In a child with recurrent type 3 laryngotracheal cleft a residual tracheo-esophageal fistula could not be detected using the 2D system, but was immediately detected using the 3D system.Conclusions
Visualization of the glottis, subglottis and proximal trachea during direct laryngoscopy using a 3-dimensional endoscopic system was rated by the surgeons as being superior to the conventional 2-dimensional technique. Further outcome studies that will demonstrate the clinical advantage of the 3D technology are highly required.Level of evidence: 2b. 相似文献5.
Kayvon F. Sharif Fred M. Baik Lauren E. Yue Muhammad Qazi Margaret Brandwein-Weber Azita S. Khorsandi Mark L. Urken 《American journal of otolaryngology》2019,40(2):314-318
Background
Osteoradionecrosis (ORN) is a well-known complication following irradiation of head and neck malignancies. ORN commonly occurs in the mandible but is rarely reported in the hyoid bone.Case presentation
A 76-year-old female with a history of oropharyngeal squamous cell carcinoma presented with pharyngocutaneous fistula 14?years after primary chemoradiation. Imaging showed necrosis of the hyoid bone. She underwent excision of the hyoid to rule out malignancy. Pathology was negative for carcinoma, but did show extensive fragmentation and bony necrosis consistent with ORN. The patient's clinical course, surgical treatment, and management considerations are discussed here.Conclusions
Hyoid ORN should remain in the differential during diagnostic workup of previously irradiated head and neck cancer patients. The presentation of a pharyngocutaneous fistula should prompt workup to rule out malignancy before assigning a diagnosis of ORN. 相似文献6.
Nicholas B. Abt Priya Srikanth Sidharth V. Puram Daniel G. Deschler 《American journal of otolaryngology》2017,38(2):254-256
Introduction
PCF is the most common major complication after salvage total laryngectomy (TL), especially for previously irradiated patients with laryngeal or hypopharyngeal cancer.Methods/results
A 65-year-old woman presented with recurrent bilateral supraglottic SCC requiring salvage TL 5.5 years after initial T1N0M0 epiglottic SCC resection. Her post-operative course was complicated by PCF development one month post-operatively and surgical fistula closure was delayed for adjuvant chemoradiotherapy. The fistula persisted despite local wound therapy, several primary closures, pectoralis flap reconstruction with multiple revisions, and extensive hyperbaric oxygen treatments. Given her prior history, she underwent a staged right temporoparietal fascial flap reconstruction for persistent complex fistula, with second-stage flap takedown and complete inset of the TPFF skin island into the PCF.Conclusion
This case demonstrates the utility of staged TPFF in complex PCF repair, with minimal morbidity, especially in a patient with prior irradiation and flap use that complicates tissue availability. 相似文献7.
Giuseppe Spriano Giuseppe Mercante Giovanni Cristalli Raul Pellini Fabio Ferreli 《American journal of otolaryngology》2017,38(5):598-602
Introduction
The supracricoid partial laryngectomy has been described for the treatment of T3 laryngeal glottic and supraglottic tumors as well as upfront and salvage surgery. Good oncological and functional outcomes are expected, while the post-operative rehabilitation can be quite difficult for the patient. Early and late complications can occur especially in salvage surgery. Neck dissection according to the T stage is often associated with the resection of the primary tumor.Objective
To verify the feasibility of a minimally invasive procedure for supracricoid partial laryngectomy by adopting the lateral cervical approach.Methods/results
A 61-year old man affected by a cT3N0 glottic cancer already treated 10 years prior with radiotherapy for oropharyngeal cancer underwent supracricoid laryngectomy using the lateral approach. The key point of the procedure was a subfascial dissection with the harvesting of anterior cervical flap including skin, fat, platysma, fascia superficialis, anterior jugular veins, homo- and sterno-hyoid muscles.Conclusion
Supracricoid laryngectomy by a lateral approach is feasible and safe; it allows to perform a simultaneous neck dissection and the removal of the entire laryngeal specimen preserving ample healthy tissue compared to the classic anterior approach. 相似文献8.
N.K. Prenzler B. Schwab D.M. Kaplan S. El-Saied 《American journal of otolaryngology》2018,39(1):46-49
Purpose
The purpose of this study was to describe the role of explorative tympanotomy in patients with Profound Sudden Sensorineural Hearing Loss (SSNHL) without clinical evidence of perilymphatic or labyrinthine fistula and to compare intraoperative findings with the postoperative hearing outcome.Study design
Retrospective study of all patients diagnosed with SSNHL who underwent explorative tympanotomy between 2002 and 2005.Settings
Tertiary care university-affiliated hospital.Subjects and methods
Eighty-two patients were diagnosed with unilateral profound SSNHL and underwent tympanotomy with sealing of the round and oval windows. Values of pure tone audiograms and percentage hearing loss of patients with and without intraoperative diagnosed perilymphatic fistula (PLF) were compared and analyzed.Results
PLF was diagnosed in 28% cases intraoperatively. In most cases, hearing improved significantly after surgery. Interestingly, patients with PLF had a 2.4 times greater decrease of percentage hearing loss compared to patients without PLF.Conclusions
Explorative tympanotomy seems to be useful in patients with profound SSNHL. Patients with PLF benefit more from the surgical procedure and have better outcome than patients without PLF. 相似文献9.
Sarah M. Kidwai Arjun K. Parasher Abib Agbetoba Alfred M. Iloreta Peter Som Satish Govindaraj Brett A. Miles 《American journal of otolaryngology》2018,39(5):507-510
Background
Chronic rhinosinusitis (CRS) is a disease of widespread prevalence and high morbidity. Many suggest that the introduction of toxins and allergens via nasal airflow plays a significant role in the development of CRS. In patients who have undergone total laryngectomy, nasal airflow is disrupted, providing an opportunity to examine the role of nasal airflow in sinonasal pathology.Methods
All patients who received a total laryngectomy between 2002 and 2012 with preoperative and postoperative computed tomography (CT) scans were retrospectively reviewed. The Lund-Mackay (LM) score for each sinus was recorded for both scans. The assessment of differences in pre-operative and post-operative LM scores was analyzed utilizing paired t-tests.Results
56 patients underwent total laryngectomy and had both preoperative and postoperative CT scans. There were no significant differences in the LM scores between pre-operative and post-operative scans within each sinus (frontal sinus, p?=?1.0; anterior ethmoid sinus, p?=?0.77; posterior ethmoid sinus, p?=?0.45; maxillary sinus, p?=?0.90; sphenoid sinus, p?=?0.63; ostiomeatal complex, p?=?0.78) or in the total LM scores (p?=?0.97). Furthermore, patients with pre-operative sinonasal mucosal thickening (total LM score?>?0) showed no significant change in their total LM score post-operatively (p?=?0.13).Conclusion
In total laryngectomy patients, studies demonstrate that a disruption in nasal airflow is correlated to altered sinonasal physiology and decreased subjective symptoms. However, our study shows that the disruption of nasal airflow results in no significant change in radiographic evidence of sinonasal mucosal thickening. 相似文献10.
Cameron C. Wick Rod P. Rezaee Tammy Wang Andrea M. Garcia-Jarchow Chad A. Zender Michael Gibson Min Yao Pierre Lavertu 《American journal of otolaryngology》2017,38(1):72-76
Hypothesis
Patients with advanced laryngeal cancer sometimes desire organ preservation protocols even if it portends a worse outcome.Background
To assess outcomes of patients with T4 laryngeal cancer treated with chemoradiation therapy.Methods
Case series with chart review at a tertiary university hospital. Twenty-four patients with T4 laryngeal cancer all declined total laryngectomy with adjuvant radiation as the primary treatment modality and alternatively received concurrent chemoradiation therapy. The primary outcome was overall survival. Secondary outcomes were rates of tracheotomy dependence, gastric tube dependence, and need for salvage laryngectomy.Results
All patients had T4 laryngeal disease, 71% had cartilage invasion and 59% had regional metastasis to the neck. Kaplan–Meier analysis determined 2-year and 5-year overall survival to be 64% and 59% respectively. The locoregional recurrence rate was 25%. The distant metastasis rate was 21%. The rate of salvage laryngectomy was 17%, which occurred at a mean of 56.5 months after the original diagnosis. The rate of tracheotomy dependence was 33% while gastric tube dependence was 25%.Conclusion
Advanced T4 laryngeal cancer, particularly with cartilage invasion, remains a surgical disease best treated with total laryngectomy and adjuvant radiation. This data may help guide patients and practitioners considering concurrent chemoradiation therapy for definitive treatment of advanced laryngeal cancer. 相似文献11.
Mejd Jumaily Joel Franco James A. Gallogly Joshua L. Hentzelman Dary J. Costa Alan P.K. Wild Anthony A. Mikulec 《American journal of otolaryngology》2018,39(4):396-400
Purpose
In 1998, Dr. Eavey described the trans-canal inlay butterfly cartilage tympanoplasty technique, also known as cartilage button tympanoplasty. Many retrospective studies have since demonstrated its efficacy and decreased operative time when compared to underlay and overlay tympanoplasty techniques. The butterfly cartilage tympanoplasty approach uses only a cartilage graft to repair tympanic membrane perforations. The aim of this study was to review the literature for studies that examined butterfly cartilage tympanoplasty success rates and outcomes and compare them to outcomes from our cohort.Materials and methods
Butterfly cartilage tympanoplasties were performed in 23 pediatric patients and 7 adult patients. We evaluated the tympanic membrane perforation closure rate and hearing results measured by closure of the air-bone gap.Results
The reviewed studies evaluating butterfly cartilage tympanoplasties demonstrated perforation closure rates between 71%–100%. The hearing outcomes in the reviewed literature varied, although the majority reported improved hearing. In our cohort, 21 of the 32 repaired tympanic membrane perforations demonstrated complete perforation closure. The mean follow-up length was 13.4?months. The mean air-bone gap decreased from 13.4?dB to 6.9?dB.Conclusions
The butterfly cartilage/cartilage button technique is effective in closing tympanic membrane perforations and decreasing the air-bone gap in both adults and children. 相似文献12.
Richard Chan Woo Park Amishav Y. Bresler Amy P. Bansal Soly Baredes 《American journal of otolaryngology》2018,39(5):522-526
Background
Resident duty hour restrictions can limit the frequency of resident flap checks at smaller institutions with “home” call. Institutions are compensating with adjuvant nursing flap checks as well as incorporating technology; however, this management remains controversial.Methods
A prospective cohort of 122 free flaps for reconstruction of the head and neck by a single surgeon. Demographic information, operative details, postoperative care, and flap outcomes were recorded.Results
Over 42?months, 122 free flaps were performed on 115 patients. The overall flap success rate was 96%. The flap success rate at 72?h was 98% and 96% at the time of discharge with reexploration rates of 11.6%. The intraoperative and postoperative salvage rates were 71% and 64.3% respectively.Conclusion
Limited resident flap checks combined hourly nurse flap checks and an implantable Doppler is an effective monitoring protocol for academic programs in the setting of residency duty hour restrictions. 相似文献13.
Does long-term success from endoscopic DCR correlate with early post-operative reduction in tearing?
Shani Golan Yuefan Chen Benjamin Levine Aaron N. Pearlman Joshua I. Levinger Abtin Tabaee Ashutosh Kacker Gary J. Lelli 《American journal of otolaryngology》2018,39(5):592-593
Purpose
The purpose of the study was to determine the association between early post-operative improvement in tearing and the long-term success rate of endoscopic dacryocystorhinostomy (eDCR).Methods
A retrospective review of consecutive patients who underwent eDCR and were followed up for at least 6?months at our institution from January 2010 to December 2017 was performed.Results
47 cases(39 patients) of eDCR met the inclusion and exclusion criteria during this time period.Mean follow up after the surgery was 12.5?±?8?months. In 45 out of 47 (96%) cases post-operative improvement in epiphora within 2?weeks of surgery, or lack thereof, correlated with long-term success or failure of the procedure.There were only 2 cases in which the patients felt improvement in tearing at the initial post-operative visit and the tearing recurred in the late post-operative period (>6?months).Conclusions
There is a strong association between the early initial post-operative assessment of tearing resolution and the long-term result of eDCR. 相似文献14.
Roxana Fu Nicholas Moore Taha Z. Shipchandler Jonathan Y. Ting Travis Tollefson Cyrus Rabbani Meena Moorthy William R. Nunery H.B. Harold Lee 《American journal of otolaryngology》2018,39(5):472-475
Purpose
To present the results of treating combined lower eyelid laxity, retraction and midface descent secondary to facial nerve weakness with a hybrid surgical procedure.Materials and methods
A retrospective analysis of patients from January 2015 to January 2017 who underwent a hybrid surgical technique for the treatment of corneal exposure secondary to facial nerve paresis with a single surgeon was performed. Age, gender, and presence of exposure symptoms were recorded pre-operatively. Outcomes assessed included improvement of lower eyelid laxity and position, operative complications, and post-operative symptomatic relief.Results
A total of 11 patients underwent unilateral eyelid surgery. All patients had symptomatic relief and good functional outcomes defined as improvement in eyelid laxity, lower eyelid position, and objective corneal exposure. No cases required reoperation during an average follow up of 174.5?days.Conclusions
Combining portions of a tarsorrhaphy and lateral wedge resection technique is a simple and effective procedure to improve lower eyelid position and limit corneal exposure secondary to facial nerve paresis. 相似文献15.
Jia Hui Jang Hiang Khoon Tan N. Gopalakrishna Iyer Khee Chee Soo Ngian Chye Tan 《American journal of otolaryngology》2017,38(1):82-86
Background
Nasopharyngectomy for excision of nasopharyngeal tumors is challenging, as access to the nasopharynx is difficult. Recently our institution embarked on two new approaches – robotic nasopharyngectomy and open nasopharyngectomy with operating microscope (NOM) via maxillary swing approach. This article proposes that the novel approach of NOM via maxillary swing aids visualization for resection of locally invasive nasopharyngeal tumors.Methods
Over a thirteen-month period, eight patients required nasopharyngectomy in our single Asian institution. Four underwent robotic nasopharyngectomy and four underwent NOM via maxillary swing approach. The latter four were retrospectively reviewed, and their clinical characteristics and surgical outcomes reported. Tips and pearls for operative setup and patient selection were also discussed.Results
All four patients who underwent NOM had negative intraoperative frozen sections with subsequent negative paraffin sections. All patients remained disease free post-salvage surgery.Conclusion
NOM via maxillary swing allows better visualization and aids in augmentation of open nasopharyngectomy. This enables achievement of adequate resection margins and fewer surgical complications in locally invasive nasopharyngeal tumors. 相似文献16.
Kylie H. Kang William Grubb Komal Sawlani Michael K. Gibson Christopher J. Hoimes Lisa R. Rogers Pierre Lavertu Min Yao 《American journal of otolaryngology》2018,39(5):642-645
Background
We present a case of myositis and possible overlapping neuromuscular junction disorder following treatment with nivolumab for recurrent/metastatic head and neck squamous cell carcinoma (HNSCC).Methods
We report a 75-year-old man with recurrent stage IVA, T1N2cM0 oral cavity HNSCC treated with weight-dosed nivolumab who presented three weeks later with severe fatigue, generalized weakness, and bilateral ptosis. Evaluation demonstrated elevated creatine kinase and myopathic motor units on electromyography, supporting a diagnosis of an underlying muscle disease. Elevated serum acetylcholine receptor binding antibodies raised the possibility of concurrent myasthenia gravis.Results
He received corticosteroids and plasmapheresis without improvement in muscle weakness. His course was complicated by bacteremia, cardiac arrest, and concerns for recurrent malignancy. Following a two-month hospital stay, he was made comfort care and died.Conclusions
With increasing usage of checkpoint inhibitors in HNSCC, clinicians must be aware of and vigilant for associated rare but serious adverse events. 相似文献17.
Sami P. Moubayed Rosalie Machado Marcela Osorio Azita Khorsandi Juan Hernandez-Prera Mark L. Urken 《American journal of otolaryngology》2017,38(6):720-723
Background
Metastasis of squamous cell carcinoma (SCC) to the superior cervical ganglion (SCG) has never been reported. Its anatomic location may easily be mistaken for a retropharyngeal lymph node. We present the first case of SCC metastasis to the SCG.Methods
We report a case of a 69 year-old never smoking male, who presented with right retropharyngeal PETCT-avid disease following chemoradiation for squamous cell carcinoma of the tonsil. He was brought to the operating room for resection, intraoperative radiation and reconstruction.Results
Intraoperatively, visualization and frozen section confirmed squamous cell carcinoma located in the superior cervical ganglion. The ganglion was resected, intraoperative radiation was given and the patient was reconstructed with a radial forearm free flap. Postoperatively, the patient displayed features of a Horner's syndrome.Conclusions
The superior cervical ganglion may be mistaken for a retropharyngeal lymph node. Although extremely rare, these entities may be differentiated on the basis of radiological studies. 相似文献18.
Objectives
The utility of topical mitomycin C (MMC) as an adjuvant treatment in the management of laryngeal and tracheal stenosis has been studied; however, the ideal timing of MMC application has not been fully elucidated. There is a paucity of studies evaluating the timing of MMC application after surgical airway intervention for stenosis. The purpose of this study is to describe a novel technique for MMC application that allows for delayed application in the unsedated, office-based setting, approximately one week following endoscopic airway dilation.Methods
A technique for retrograde transtracheal application of MMC was developed and utilized in 3 tracheostomy-dependent patients with subglottic stenosis and glottic stenosis with bilateral vocal fold immobility. After administration of topical anesthesia, a MMC (0.4?mg/ml) coated pledget was advanced via a transtracheal approach and directed to the area of stenosis in retrograde fashion using endoscopic frontal sinus instruments. Appropriate positioning of the pledget was confirmed via transnasal flexible fiberoptic laryngoscopy.Results
All 3 patients underwent successful in-office retrograde application of MMC onto the area of laryngeal stenosis 7–9?days after their preceding surgery. There were no complications. Two patients achieved decannulation while the third patient's management was interrupted due to cancer treatment.Conclusions
We present a novel and well tolerated technique for delayed in-office application of MMC in tracheostomy-dependent patients with laryngeal stenosis. This approach can facilitate the study of the ideal timing of topical MMC use in airway stenosis. 相似文献19.
Samir Sorour Sorour Nasser Nagieb Mohamed Magdy M. Abdel Fattah Mohammad El-Sayed Abd Elbary Mohammad Waheed El-Anwar 《American journal of otolaryngology》2018,39(3):282-285
Background
Canal wall down (CWD) mastoidectomy has many drawbacks including chronic otorrhea, granulations, dizziness on exposure to cold or hot water and tendency of debris accumulation in the mastoid cavity demanding periodic cleaning. Many of these problems can be solved by reconstruction of the posterior meatal wall (PMW).Objectives
To assess the results of PMW reconstruction after CWD mastoidectomy for cholesteatoma using bioactive glass (BAG) that is fabricated and built up intraoperatively.Patients and methods
This study was applied on 20 patients had atticoantral chronic suppurative otitis media. All cases were subjected to CWD mastoid surgery with complete elimination of the disease and reconstruction of the PMW by BAG that was prepared and built up intraoperatively. All patients were exposed to full preoperative evaluation and full postoperative assessment of complications, appearance of the external auditory canal contour, and the hearing gain expressed by the change of the air bone gap postoperatively.Results
During a follow up of 12 to 36?months, postoperative appearance of external auditory canal contour was found smooth without hidden pouches, irregularities nor stenosis in all cases. No registered granulation, foreign body reaction, nor extrusion and/or displacement of the BAG material. No reported facial palsy or recurrent cholesteatoma. Significant hearing improvement was statistically reported (p?=?0.0006).Conclusion
Surgical reconstruction of the PMW using BAG that operatively fashioned immediately after CWD mastoidectomy appears to be reliable without considerable complications giving smooth appearance of the PMW and improving the hearing. 相似文献20.
Clare Richardson Prashanth Thalanayar Muthukrishnan Chelsea Hamill Vidya Krishnan Freedom Johnson 《American journal of otolaryngology》2018,39(6):785-787