How to teach otologic surgery to the next generation?

This was a descriptive ecological study that used publicly accessible data from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales in Wales for the period April 1999 to April 2020 to investigate the trends of hospital admissions due to diseases of the ear and mastoid process. All diagnosis codes for diseases of the ear and mastoid process (H60–H95) were utilized in this study. Hospital admissions rate for ear and mastoid process diseases decreased by 17.2% (from 189.18 [95% confidence interval [CI]: 188.00–190.36] in 1999 to 156.60 [95% CI: 155.60–157.60] in 2020 per 100,000 persons, P ≤ .05). The most common diseases of the ear and mastoid process hospital admissions causes were diseases of the middle ear and mastoid, diseases of the external ear, diseases of the inner ear, and other disorders of the ear, which accounted for 63.7%, 12.1%, 11.7%, and 11.4%, respectively. In England and Wales, the rate of admission for ear and mastoid process diseases has dropped during the last 2 decades. Education campaigns should be maintained to raise knowledge of this category of disorders among parents and the general public, which will eventually lead to a reduction in its associated admission rates.

IntroductionThis study is aimed at determining the pattern of ear, nose and throat diseases and their relationship with socio-demographic factors with auditing intent in a tertiary hospital in South-western Nigeria.MethodsMedical records of patients managed at the Department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria from 2006 to 2010 were reviewed for all essential clinical data.ResultsThere were 2641 (52.8%) males and 2360 (47.2%) females. Two thousand and fifty (41%) patients had age ≤15years old. Sixty three percent of the patients were Christians, 37% were Muslims and less than 1% had other religions. There were more patients in lower occupational classes than those in the upper classes. The average number of patients with ear, nose and throat diseases managed per month was eighty three. Patients with ear diseases were 3136 (62.7%), the nose diseases were 1153 (23.0%), the throat diseases were 479 (9.6%) and head/neck diseases were 233 (4.7%).ConclusionThis study showed that otitis media, obstructive adenoid, foreign bodies in the ear and throat infections were the common ear, nose, throat disorders seen in patients aged ≤15years whereas, hearing loss, rhinosinusitis and tumors were the common disorders of ear, nose and throat seen in patients aged 16 years and above. Although these disorders are not yet considered to be of public health importance, they contribute significantly to the existing burden of health problems in our environment. Therefore, there is a need for improved public awareness on ear, nose and throat diseases.

That the nose, throat and ears are closely related anatomically, physiologically and pathologically is a fact that needs no demonstration at my hands. But, that most of the non-suppurative inflammations of the middle ear originate in the diseases of the nasal and post-nasal region is as trite a fact, but not as generally recognized by most practitioners. And even many aurists have yet to learn that the way to most successfully treat many of these non-suppurative diseases of the middle ear and the resulting loss of hearing, is by a thorough, skilful treatment of the diseases of the nose and throat. I know of few other conditions, in this line of practice, in which the results of surgical interference and treatment are more apparent and gratifying to both physician and patient, notwithstanding the fact that a well-known author, in a recent work on diseases of the ear, says that the

To assess whether day-case major otologic ear surgery is a safe and feasible alternative to inpatient surgery, while maintaining equal complication rates, and to identify causes of admission after day-case surgery. PubMed, Embase, and Cochrane. A systematic search was conducted. Studies reporting original data on the effect of day-case ear surgery on admission rate, patient satisfaction, and/or postoperative complications were included. Risk of bias of the selected articles was assessed using criteria based on the Cochrane Collaboration's tool for assessing risk of bias. A total of 1,734 unique studies were retrieved of which 35 articles discussing 34 studies were eligible for data extraction. The admission rates ranged from 0% to 88% following day-case endaural surgery, 0% to 13% following day-case stapes surgery, 0% to 82% following day-case mastoid surgery, and 0% to 15% following day-case cochlear implant surgery. Patient and parent satisfaction regarding day-case surgery ranged from 67% to 99%. Five studies comparing day-case and inpatient otologic surgery showed no difference in hearing outcome, postoperative complications, or patient satisfaction. The highest pooled admission rate was seen following day-case mastoid surgery. Studies comparing day-case and inpatient care suggest hearing results and postoperative complication rates in day-case otologic surgery are similar to inpatient otologic surgery in both children and adults. Therefore, day-case major otologic surgery seems to be a safe and feasible alternative to inpatient surgery for both children and adults.

Pros and Cons of the Exoscope for Otologic Surgery.

Despite the large number of people needing ear surgery on the African continent, otologic (ear) surgeries are few. However, safe and effective otologic surgeries are attainable via rural Ethiopian otologic surgical camps which also provide training to Ethiopian surgeons: Operations and operative results: A total of 137 otologic surgeries were performed during 4 weeklong surgical camps at a rural hospital in Butajira, Ethiopia. Most patients had large, central perforations, 94% of the operations were under local anesthesia, 26 patients from the first week’s camp returned for follow-up testing. There were no complications of surgery, 83% of perforations closed completely, and 69% patients had improved hearing measured by pure tone air and bone audiometry. Trainees’ experience: A total of 9 Ethiopian ENT surgeons who had previously lacked operative experience as the primary surgeon performed these operations. Three were already in practice, and 6 were recent graduates. All 3 senior Ethiopian doctors returned to their local sites and now perform otologic surgery there. Keywords: Ear, Developing Countries, Hospitals, rural

Introduction: Ear diseases have been found to be important health problems among children. Nearly one third of Otorhinolaryngology outdoor attendance in the hospital comprised of paediatric age group. The problem is compounded by the fact that the children are economically dependent on their parents who are largely poor. However, the cause of hearing loss in children is more varied, including the etiologies. Objective: To find out ear diseases in children presenting at Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh. Materials and Methods: This hospital-based prospective study was carried at Department of ENT & Head-Neck Surgery, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh from January to December 2021. 985 patients below sixteen years of age presented to the ENT OPD during the study period. Of them, 450 had ear disease. All patients aged 16 years or younger presenting with ear diseases to the ENT clinic of the hospital and seen by ENT surgeons were enrolled into the study. The diagnoses were made on the basis of history and clinical examination. Results were expressed in numbers and percentages. Results: Out of 985 patients below sixteen years of age presented to the ENT OPD during the study period. Of them, 450 had ear disease. Five hundred and sixty one (64.4%) were males. The male to female sex ratio was 1.8:1. Table 2 the various types of ear disease were as CSOM (Chronic Suppurative Ottitis Media), ASOM (Acute Suppurative Ottitis Media) and OME (Ottitis Media with Effusion). Wax (33.6%) followed by CSOM (18.7%) and ASOM (13.8%) were the most common ear diseases in paediatric patients in tertiary care centre. Ear diseases commonly found in this study were in the age group of 6-10 years and most ear diseases were more common in boys. It was found that wax (33.6%) was the most common diagnosed ear disease. Conclusion: Ear diseases are most common condition in ENT OPD among paediatric age group. Wax, CSOM and ASOM were the three most common ear diseases. Improvement of health care facilities and awareness amongst health care providers would definitely be helpful in reducing the prevalence of ear diseases in developing countries.

Making Audiology Work During COVID-19 and Beyond

A multicenter study to investigate the positive rate of SARS-CoV-2 in middle ear and mastoid specimens from otologic surgery patients

Piezosurgery in otologic surgery: Four years of experience

To discuss effects of smoking on otologic surgery in an era of electronic (e-) cigarettes and proposals for legalization of marijuana. Physiologic mechanisms and clinical outcomes are presented. Tobacco smoke can cause a variety of tissue effects that may adversely impact otologic surgery outcomes. Results in tympanoplasty using temporalis fascia are inferior in smokers compared with nonsmokers. More recent data show that in cartilage tympanoplasty, graft incorporation rates in smokers may approach those of nonsmokers. However, these results may not be as durable long-term in smokers. Evidence from nonotologic studies suggests that smoking cessation and nicotine replacement therapy may reduce perioperative morbidity. No data are available on electronic cigarettes and otologic outcomes; however, based on the pathophysiologic mechanisms of tobacco smoking, electronic cigarettes are likely a safer alternative. Marijuana smoke also needs to be considered as more states consider legalization. Cigarette smoking negatively influences otologic surgery results, mostly because of tobacco combustion byproducts. Counseling and, if needed, pharmacologic measures to reduce smoking are recommended. E-cigarettes that deliver nicotine in water vapor may be safer than tobacco smoking. Our review contributes to the discussion of how the trends of e-cigarette use and marijuana legalization will unfold in the future to affect our patients' outcomes.

Automated diagnosis of ear disease using ensemble deep learning with a big otoendoscopy image database.

<p class="abstract"><strong>Background:</strong> Ear, nose and throat (ENT) diseases are very common in general population. Internal living environment can act an important risk factor for these diseases. In rural areas, patients do not consult ENT experts. So, free health camps can bring treatment facilities at their doorsteps. The objective of this study was to determine the pattern and prevalence of ENT diseases in rural areas of Sasaram, Rohats district, Bihar and to find out the effect of living environment on these diseases.</p><p class="abstract"><strong>Methods:</strong> The study<strong> </strong>was conducted using camp approach in rural areas of Sasaram, Rohtas, Bihar. ENT and Community Medicine experts, interns along with audiologists, medico social workers, nurses and paramedical staff were voluntarily involved.<strong> </strong>The patients were screened and referred to ENT experts. A logistic regression analysis was conducted to determine the internal environment factors associated with ENT diseases. </p><p class="abstract"><strong>Results:</strong> Out of 832 patients, 61.9% were suffering from ENT disorders. Most common age group affected was of 31-40 years. 54.8% of patients were suffering from ear diseases while nasal and throat problem was seen in 14.9% and 30.3% respectively.<strong> </strong>Multiple logistic regression analysis of living environment conditions propounds that non-availability of cross ventilation in houses and overcrowding are most important factor influencing ENT diseases.</p><p class="abstract"><strong>Conclusions:</strong> Free health camps conducted by medical experts act as an opportunity to screen people with various diseases of ENT in a community. Bad internal environment can act as a vital determinant for these diseases.</p><p class="abstract"> </p>

Aim. To analyze the characteristics of primary childhood disability due to diseases of the ear and mastoid process in St. Petersburg from 2001 to 2018.
 Methods. It was analyzed the indicators of primary childhood disability due to diseases of the ear and mastoid process in St. Petersburg over 18 years (20012018) since the beginning of the pediatric medical and social examination service appeared in the city: number, rate and structure. For the calculation we used the statistical data of the St. Petersburg Health Committee (reporting forms No. 12 and No. 30), the Federal Treasury Institution The Main Bureau of Medical and Social Expertise across St. Petersburg form 7-D (social security), and data of a single automated vertically integrated information and analytical system for conducting. Statistical methods for studying disability were used: continuous observation (indicators of the number and rate of primary disability), nesting (serial) sampling to study the structure of disability (910 children recognized as disabled by the citys Bureau of Medico-social Examination from the moment of their occurrence).
 Results. The rate of primary disability of children due to pathology of the ear and mastoid process for 18 years ranged from 0.34 to 1.4 per 10 thousand children , the average over the entire period of 0.77 per 10 thousand. In the structure of primary disability due to diseases of the ear and mastoid process in children, was 54.8% boys and 45.2% girls. It was recorded, that increase of the number of children recognized as disabled for the first time due to this pathology was related with an increase in the share of coverage of newborns with hearing screening, as well as an increase in the average annual number of children in St. Petersburg. Also, indicators of primary childhood disability depend on indicators of the primary incidence of ear diseases and mastoid process.
 Conclusion. Indicators of the number and rate of disability of the children who were first recognized as disabled due to ear and mastoid diseases in St. Petersburg increased from 2001 to 2018, which is associated with an increase in birth rates, primary morbidity and primary detection of ear and mastoid diseases in children.

This era has opened up lot of opportunity for a wide range of image analysis. Imaging techniques especially in the field of medicine have improved many folds. Providing solutions through image analysis has always been challenging. Ear disease identification using image analysis is a field where many algorithms have yet to identified. Ear and mastoid disease can easily be treated by early detection and appropriate medical care. Ear infections are painful because of the inflammation and buildup of excess fluid that increase pressure on the eardrum. There is a short of specialists, and relatively low diagnostic accuracy calls for a new way of diagnostic strategy, in which deep learning may play a significant role. In this communication, three major ear disease identifications have been focused, namely normal, myringosclerosis, earwax plug, and chronic otitis media. In this paper, VGG-19 architecture which has 14 convolutional layers, 5 max pooling layer, and 3 fully connected layer, and results in 143 M parameters are used to classify the ear images. Four major middle ear diseases which can be cured if detected early is the main focus of this work. The images are mainly classified as four groups, namely myringosclerosis, earwax plug, chronic otitis media, and normal ear. The dataset consists of 1880 RGB images among which each category consists of 470 images. These architectural results are compared with some of exciting algorithms like AlexNet, VGG Net, Inception, and ResNet, and an accuracy of 97% is obtained with other algorithms. This architecture produces better results with less amount of data.KeywordsMyringosclerosisEarwax plugChronic otitis mediaCNNEar disease