Head Department Research Articles

Hearing and speech outcomes in children with cochlear nerve hypoplasia who underwent cochlear implantation

Background: Data on hearing and speech outcomes following cochlear implantation in prelingual sensorineural hearing loss (SNHL) children with cochlear nerve hypoplasia, especially in Indonesia, is still limited. Purpose: To evaluate the hearing and speech function of prelingual SNHL children who had undergone cochlear implantation. Method: A retrospective cross-sectional study was conducted on 28 children who had undergone cochlear implantation procedures at the Department of Otorhinolaryngology and Head and Neck Surgery, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, for more than 12 months. The hearing and speech function of the subjects were assessed using the modified Categories of Auditory Performance (CAP-II) and the speech intelligibility rating (SIR) scores. Result: Children with cochlear nerve hypoplasia showed an increase in CAP-II and SIR scores after using cochlear implants for more than 12 months (versus pre-surgery, high CAP score [≥5]: 89.3% [25/28 children] vs 3.6% [1/28 children] and high SIR score [≥3]: 82.1% [23/28 children] vs 7.1% [2/28 children]; both p<0.001). Post-operative CAP-II and post-operative SIR scores were highly positively correlated (r=0.705, p<0.001). Type of cochlear nerve hypoplasia (unilateral vs bilateral) were not significantly associated with post-operative CAP-II and SIR scores (p=0.382 and p=0.459, respectively). Conclusion: Prelingual SNHL children with cochlear nerve hypoplasia may still get the benefit from cochlear implantation, as shown by a remarkable improvement in hearing and speech function as assessed with the CAP-II and SIR scores.
 Keywords: auditory perception, cochlear implants, cochlear nerve hypoplasia, prelingual sensorineural hearing loss, speech intelligibility

Risk Factors for Adenoid Hypertrophy in Patients Twelve Year and Older

Background: The adenoids are part of Waldeyer’s ring of lymphoid tissue and when hypertrophied they cause many symptoms, e.g., snoring. They hypertrophy physiologically in children between the ages of 6 and 10 years, and then atrophy by the age of 16 years.
 Objectives: The aim of this study was to reveal the risk factors and clinical patterns associated with adenoid hypertrophy in patients aged over 12 years.
 Methods: We studied 130 patients aged over 12 who had undergone an adenoidectomy between January 2016 to January 2021. Patients were evaluated in the Department of Otorhinolaryngology and Head and Neck Surgery at Jordan University Hospital, Amman, Jordan. Some patients were accessed using medical records and their data were collected by telephone.
 Results: Of the 130 patients, 81 were male and 49 were female, with a mean age of 19.68 years. Snoring was the most common presenting symptom (81.5%), followed by nasal obstruction (75.4%) and mouth breathing (71.5%). The most common associated risk factor was septal deviation (44.6%), and then passive smoking (40.8 %), allergic rhinitis (38.5%), and pollution (38.5%).
 Conclusion: There are multiple suspected risk factors for adenoid hypertrophy in patients aged over 12 years. In our study, septal deviation was the most common associated factor, followed by passive smoking, allergic rhinitis and pollution. Snoring was the most common presenting symptom, followed by nasal obstruction.

Prevalance of unsafe ear in patients presenting with chronic ear discharge

Objective: The purpose of this study was to determine the frequency of atticoantral/unsafe chronic suppurative otitis media in patients with chronic ear discharge. Materials and Methods: This Cross-sectional study was conducted in the department of ENT and Head and Neck Surgery, Hayatabad Medical Complex and Department of ENT, Naseerullah Khan Babar memorial Hospital, Peshawar from August 2018 to February 2019. In this study 199 patients were enrolled with consecutive sampling. Detailed demographic data like history and physical examination were taken from patients. All patients were subjected to detailed otoscopic examination and pure tone audiometery by a consultant. A detailed performa was designed in which all information of the patients like name, age, gender, duration of symptoms and CSOM were recorded by SPSS analysis. Results: With a standard deviation of ± 10.334, the average age of participants in this study was 29 years. There were more males than women among the patients present, with 60% of them being men. Twelve percent of patients with chronic discharge developed CSOM, compared to 90% of those who didn't have the condition at all. Conclusion: Our study shows that individuals who come with persistent ear drainage frequently have hazardous ears.

To the 125th Anniversary of the Birth of Professor Zalkind Emil Moiseevich

The article is devoted to the 125th anniversary of Zalkind Emil Moiseevich — doctor of medical sciences, professor of the Department of Psychiatry and head of the psychiatric clinic of the Perm Medical Institute. In 1922 he graduated from the Medical Faculty of Don University, and later entered as a resident of the neuropsychiatric clinic of the North Caucasian Medical Institute in Rostov-on-Don, where he served until 1932. He is the author of more than 100 scientific papers devoted to the problem of mental disorders in diseases of the brain. Initiator of the creation of the Ural Research Psychoneurological Institute. He was awarded the Order of the Badge of Honor. In addition to medicine, he was fond of music, graduated from the Saratov Philharmonic with a piano class from the composer Glier, having received a higher musical education. For his great achievements in the field of medicine, Zalkind was awarded the title of Honored Scientist of the Russian Soviet Federative Socialist Republic.

Analysis of rehabilitation effects of cochlear implantation in elderly patients with prelingual deafness

Objective:The auditory and speech rehabilitation effects were assessed by the Categories of Auditory Performance（CAP） and the speech intelligibility rating scale（SIR） after cochlear implantation（CI） in prelingually elderly patients by telephone follow-up or face-to-face conversation. Methods:The clinical data of the prelingually deaf patients who underwent unilateral CI in the Department of Otorhinolaryngology and Head and Neck Surgery, Shanxi People's Hospital, from December 2016 to December 2021 were collected. Thirty-eight patients were divided into Group A（SIR 1, 17 cases）, Group B（SIR 2, 10 cases） and Group C（SIR 3, 11 cases） according to the preoperative SIR Score. Nineteen patients with post-lingual hearing impairment were selected as the control group（Group D, 19 cases）. The effects of hearing and speech rehabilitation were evaluated using CAP and SIR Scores before surgery, 6 months after startup, and 1 year after startup. Results:There were no significant differences in CAP scores among the three groups of patients with prelingually deaf patients at 6 months and 1 year after startup（P>0.05）, but there were significant differences between group A and group D at 6 months and 1 year after startup（P<0.05）; the SIR Score of group A had statistical difference before surgery and 6 months after startup（P<0.05）, group B had statistical difference before surgery and 1 year after startup（P<0.05）, and group C and D had no statistical difference before surgery and 6 months and 1 year after startup, respectively（P>0.05）. Conclusion:For the prelingually deaf elderly patients, hearing will develop rapidly 6 months after startup, and the effect of postoperative auditory rehabilitation was positively correlated with the preoperative speech ability. In the aspect of speech, the prelingually dear elderly patients who have poor preoperative speech ability could benefit more from CI early after surgery. CI is not contraindicated in prelingually deaf elderly patients, even those with poor preoperative speech function.

Management of radial forearm free flap failure in head and neck reconstruction due to COVID-19 infection

Free flap surgery is a largely diffuse technique that allow to reconstruct various complex tissue defects. In head and neck surgery, they allowed reconstruction of an important variety of defects such extensive resection in treatment of malignant and benign tumors, defects as trauma consequence, congenital defects, and others. We present the case of 69-year-old Caucasian male admitted to the Department of Head and Neck for a cT2 N2b M0 squamous cell carcinoma of oral cave extended to the oral pharynx and treated with extended resection and radial forearm free flap reconstruction. No early postsurgery complication was detected. After 10 days from surgery, patient resulted positive for SARS-CoV-2. In the days after positivization, free flap started to show signs of ischemia, which lead to necrosis flap itself. A second surgery with palatal rotation flap and Bichat fat pad flap was necessary. Failure of free flap reconstruction is associated to vascular failure. In particular, venous thrombosis is the most common cause of vascular failure. Anterolateral thigh free flap was the one associated with the highest incidence of complications. Clinical comorbidity, smoking, age, and surgeon experience have been described as the mean risk factors. Actual knowledge as confirmed an increased risk of venous and arterial thromboembolic events in patients with SARS-CoV-2 infections. Nowadays there is no evidence of a correlation between SARS-CoV-2 diseases and free flap failure. Our case, about the patient with a tardive vascular free flap failure consequent to SARS-CoV-2 infection, suggests how COVID-19 could be a new risk factor for reconstructive surgery that surgeon community must keep in mind.

Role of Serum Lipid Profile; Indicator of Early Changes in Head and Neck Cancer Cells

Objective: The objective of this study was to investigate the role of serum lipid profile as an indicator of early changes in head and neck cancer cells and to assess the potential value of these changes in detecting neoplastic cell alterations at an early stage. Methodology: The Hospital-based case-control study was carried out on 48 patients with newly diagnosed Head &amp; Neck malignancies, attending the Department of Otorhinolaryngology and Head and Neck Surgery Pakistan Institute of Medical Sciences Islamabad between July 2020 and December 2020. Forty-eight Age and sex-matched who did not have any renal, hepatic or cardiac dysfunction were taken as controls. Fasting blood samples were drawn and analyzed for lipid profile as recommended in the literature. Results: A significant change in plasma lipid profile with P values of Total Cholesterol (0.000), Triglyceride (0.004), and HDL (0.009) of &lt;0.05 indicates that there is a statistically significant reduction of mean serum Total Cholesterol, Triglyceride, and HDL in subjects with head and neck cancer compared to the control group. Conclusion: The altered plasma lipid status observed in this study suggests its potential as a valuable signal for early alterations in neoplastic cells associated with head and neck malignancies. Furthermore, a comprehensive review focusing on cholesterol-carrying lipoprotein transportation and the efficacy of receptor systems may contribute to a better understanding of the underlying mechanisms controlling plasma cholesterol concentration in the context of cancer.

Extra-Parotid Pleomorphic Adenoma and Low-Grade Salivary Malignancy in the Head and Neck Region.

Background and objective Pleomorphic adenoma is the most common major salivary gland neoplasm. Around 80% of them arise in the parotid glands, whereas 10% originate in the minor salivary glands. The pleomorphic adenoma of the extra-parotid site is defined by its location outside the primary salivary gland. The minor salivary gland adenomas occur at the hard and soft palate, lips, tongue, lacrimal glands, pharynx, larynx, paranasal sinus, and nasal cavity. Pleomorphic adenoma in parapharyngeal space may occur de novo or as an extension of the deep lobe of the parotid tumors. Our objective in this study wasto assess the location and presentations of extra-parotid pleomorphic adenomaand frequency of low-grade salivary gland malignancy diagnosed as pleomorphic adenomavia fine-needle aspiration cytology (FNAC)in the head and neck region andthe treatment outcomes after the resection of the tumors. Materials and methods This was a retrospective observational study. All patients with FNAC-diagnosedpleomorphic adenoma of extra-parotid locations of the head and neck region who underwent curative surgery in the Department of Otorhinolaryngology and Head and Neck Surgery at a rural tertiary care center between August 1997 and August 2022 were included in the study. Data on the symptoms, FNAC report, surgical techniques, pathological results, adjuvant therapy, andany recurrence were documented. Data were entered into a Microsoft Excelsheet and analyzed using IBM SPSS Statistics version22 software (IBM Corp., Armonk, NY). Results Our study included 23 patients, of which 14 were females and nine were males. The various sites of involvementwere as follows: parapharyngeal space (four), larynx (one), nasal septum (two), hard palate (five), soft palate (four), hard and soft palate (three), and submandibular salivary gland (four). Of note, 17.3% of the patients had local recurrence withan average time frame of three years post-surgery: 20% in patients with low-grade malignancy and 16.6% in patients with pleomorphic adenoma. Conclusion Extra-parotid pleomorphic adenomas are common and have a high malignant potential. The preferred choice of treatment for extra-parotid salivary tumors is complete resection with adequate clearance. Malignant pleomorphic adenomas may require stagingneck dissection and adjuvant treatment for a better prognosis.

Neonatal Hearing Screening Programme And Challenges Faced By The Developing Country: A Tertiary Care Hospital Experience.

To screen new-borns to diagnose any hearing impairment early. The prospective, cross-sectionalstudy was conducted at the Department of Otorhinolaryngology, Head and Neck Surgery Liaquat National Hospital, Karachi, from November 1, 2020, to April 30, 2021, and new- borns of either gender aged >12h born via spontaneous vaginal delivery, induced labour, and Caesarean section. A predesigned questionnaire was used to collect detailed case history, including gestational age, duration of labour, and other prenatal, natal, and postnatal risk factors. Otoacoustic emission test was performed, and infants referred twice were scheduled for complete diagnostic evaluation and brainstem evoked response audiometry. Data was analysed using SPSS 23. Of the 267 neonates, 249(93.3%) passed the first screening. Of the remaining 18(6.7%) neonates, 8(44.4%) passed the second screening, while 10(55.5%) were asked to come for a follow-up after three weeks. Of them, 3(30%) returned for check-up, while 7(70%) did not show up. Neonatal risk factors associated with hearing loss need to be identified, and a comprehensive hearing screening programme is required for neonates.

Gasless Endoscopic Submandibular Gland Excision Through Hairline Approach.

The aim of this study was to evaluate the therapeutic effect of gasless endoscopic submandibular gland excision through hairline approach and the safety, feasibility and practicability of this technique. Twenty-five patients with submandibular gland lesions who underwent gasless endoscopic submandibular gland excision through hairline approach at the Department of Head and Neck Oncology of the West China Hospital of Stomatology from May 1 st 2021 to May 31 st 2022 were included in this prospective study. The variables were analyzed statistically with SPSS software version 23.0 (IBM Corp, Armonk, New York, USA). There was a female predominance (72%), female to male ratio was 2.6. The mean age was 30.6±10.2 years (range: 11 to 52year). All 25 cases of endoscopic submandibular gland excision through hairline approach were done without conversion to conventional approach. This approach was indicated in 14 cases (56%) for pleomorphic adenoma, 8 cases (32%) for chronic sialadenitis, 2 cases (8%) for adenoid cystic carcinoma, and 1 case (4%) for lymphadenitis. The incision length mean was 4.8±0.4mm (range: 4 to 5mm); the operation duration mean was 100.6±39.7min (range: 51 to 197min); the intraoperative bleeding mean was 13.2±5.7ml (range: 5 to 20ml); the hospital length of stay mean was 4.5±0.8 days (range: 3 to 6days). The follow-up mean was 10±3.4 months (range: 5 to 16months). The patients were very satisfied with postoperative cosmetic result (score mean: 9.2±1). No recurrence of disease and complications such as postoperative bleeding, hematoma, nerve damage, skin necrosis, infection, and hair loss occurred. Gasless endoscopic submandibular gland excision through hairline approach is safe, feasible and practicable, resulting in a very satisfied cosmetic result without significant complications; the intraoperative bleeding is less, the operative field is clear, the operation duration decreases with accumulation of experience.

Moderní terapeutické možnosti syndromu Freyové – analýza pěti případů

Introduction: Frey‘s syndrome (SF), auriculotemporal syndrome, is an often neglected complication occurring in 6–96% of patients after parotid gland surgery according to recent studies. It arises on the basis of aberrant ingrowth of parasympathetic fi bers into the sheaths of denervated sweat glands after auriculotemporal nerve damage. The syndrome is characterized by a triad of symptoms: sweating, redness and burning or even pain in connection with food intake. Diagnosing these problems is not a time-consuming process and there are a number of therapeutic options. However, the vast majority of approaches, whether surgical or non-surgical, have only a short-term effect and carry a number of complications. The application of botulinum toxin A (BTXA) represents a relatively simple, effective and safe treatment option consisting of intradermal application of the solution according to a predetermined Frey syndrome activation map. Objectives: Presentation and evaluation of pilot results of therapeutic application of BTXA in patients dia gnosed with Frey‘s syndrome. Material and methods: Retrospective analysis of a group of 5 patients who underwent parotid gland surgery of various extents at the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital at St. Anny in Brno between 2006 and 2019, in whom there was a signifi cant manifestation of SF symptoms on the basis of which BTXA was therapeutically applied. Results: Evaluating the subjective manifestations of SF in all patients in our cohort, after the application of BTXA, showed that the problems signifi cantly decreased from “annoying and reducing their quality of life” to “never” or “almost never” occurring. Objective results of the Minor test interpreted by SketchAndCalc showed a decrease in SF activation of 91.6% on average. Only two patients required re-administration of BTXA at 6 and 19 months intervals. No adverse reactions to BTXA were reported or observed with any of the patients. Conclusion: BTXA is an eff ective and safe way to treat patients with Frey‘s syndrome. Keywords: parotidectomy – Frey syndrome – auriculotemporal syndrome – gustatory sweating – botulinum A toxin

Laryngectomy: Phonation Alternatives and Their Impact on the Quality of Life.

Background The decision to consent to surgery is a life-changing moment. This study addresses the impact of total laryngectomy (TL) on phonation and its effect on the quality of life (QoL) of patients. The primary objective of this cohort study is to compare the alternatives in phonation rehabilitation, and the secondary objective is to identify concurrent predictors of vocal outcomes. Methodology To perform a comprehensive analysis, we reviewed data from patients who underwent TL with bilateral radical neck dissection in the Department of Otolaryngology, Head and Neck Surgery at Centro Hospitalar Universitário de Santo António between January 2010 and October 2022.Adult patients who consented to participate in the study and underwent subjective evaluation were included in this study. Data regarding clinical history was primarily collected. Statistical analysis was performed using SPSS version 26 (IBM Corp., Armonk, NY, USA). Different types of vocal rehabilitation formed the subgroups to be compared. An additional analysis was performed for baseline variables collected in the clinical records, and vocal outcomes were measured using the Self-Evaluation of Communication Experiences After Laryngectomy (SECEL) questionnaire. Furthermore, linear models taking SECEL scores as the outcome were developed. Results The first search identified a total of 124 patients operated during the study period. In total, 63 patients were alive at the time of the current follow-up, with 61 deaths (49%). Overall, 26 of the 63 alive patients completed the SECEL questionnaire. All patients were male. The mean age at diagnosis was 62.2 ± 10.6 years. The mean age at the time of subjective vocal assessment with the SECEL questionnaire was 66.3 ± 10.4 years. The mean time of follow-up after the initial diagnosis was 4 ± 3.8 years. A statistically significant difference was observed in esophageal speech (ES), which was inferior to other modalities (mean SECEL total score for ES: 46.6 ± 12.2 vs. mean SECEL total score for all other modalities: 33 ± 15.1; p = 0.03). The follow-up time correlated significantly with vocal function, as measured by the SECEL questionnaire (p = 0.013). Conclusions The SECEL questionnaire can be a valuable tool to evaluate QoL in laryngectomy patients, given its usefulness in assessing the psychological impact derived from vocal functionality in this group. ES appears inferior to other modalities regarding voice-related QoL.

RADIOLOGICAL EVALUATION OF PEDIATRIC SENSORINEURAL HEARING LOSS AT A TERTIARY CARE CENTER IN CENTRAL INDIA

Objective: Hearing dysfunction is the most common sensory deficit in children. If hearing is lost, especially in children's, it may have a huge impact on life, interfering with the acquisition of spoken language and social development. It is therefore important to detect any abnormalities at an early age. Patients with complaint of inability to hear since birth attending ENT OPD, M.Y.H Hospital, Indore and patients referred to M.Y.H hospital from district hospitals with inability to hear since birth were evaluated clinically and audiometry was done. Patients with SNHL fulfilling the inclusion criteria were considered and their radiological evaluation was done. High resolution computed tomography scan (HRCT) of temporal bone were used in radiological evaluation of patients with congenital sensorineural. SUBJECTS AND METHODS: The study was conducted at a tertiary care centre Maharaja Yashwantrao Holkar (MYH) hospital and Mahatma Gandhi Memorial Medical College (MGMMC), Indore in the Department of otorhinolaryngology and head &amp; neck surgery. Cases with hearing loss from 1 to 16 years of age were selected. A detailed medical history with primary focus on inability to hear was obtained with emphasis on previous hospital stays, developmental delay, maternal history, family history. Complete ENT examination was done. Our study included a total 30 children. All chil Results: dren were between 1-16 years of age with sensorineural hearing loss. Majority 11(36.67%) of the participated in the study were between 5-8 years of age. Cochlear anomaly was found in 03(10%) patients. Cochlea was found normal in 27(90%) on both the ears, 03(10%) child had hypoplastic cochlea bilaterally, none were with aplastic cochlea. Vestibular anomaly was seen normal in 28(93.33%) patients on bilateral side. 02(6.67%) patients were present with dysplastic vestibule. SSC was found dysplastic/malformed in 04(13.33%) patients who had dysplastic/malformed semicircular canal. Conclusion: The selection of candidates for hearing aid trials and cochlear implantation requires consideration of a variety of clinical, audiological and radiological factors. Imaging is a fundamental part of the preoperative workup, it provides the surgeon with details which will lead him to a successful cochlear implantation with no or minimal complications. HRCT temporal bone provided us the information about the presence of various inner ear malformations including cochlea, vestibule, SCC, IAC. Mastoid, pneumatization, variations in vascular anatomy which included forward lying sigmoid sinus and high riding jugular bulb. All these findings are important for a detection of cause of SNHL in patients.

Clinical features and management analysis of 11 cases of laryngocele

Objective: To summarize clinical features and our experience of the diagnosis and treatment of laryngocele. Methods: Clinical data of 11 laryngocele patients in department of Otorhinolaryngology Head and Neck Surgery of the Second Affiliated Hospital of Shanxi Medical University from January 2012 to December 2021 were retrospectively reviewed, including 9 men and 2 women, aged from 12 to 75 years, with median age of 56 years. Electronic laryngoscope was performed in 10 of all patients, laryngeal CT in 10 and cervical color ultrasound in 5 before operation.All the operations were performed under general anesthesia, and the external cervical approach was used for external and combined laryngocele. The internal laryngocele was resected by low temperature plasma through transoral endoscopy. Patients were followed up regularly after operation to evaluate the effect. Clinical feature, types of lesions, imaging findings, surgical approaches and follow-up results were analyzed through descriptive statistical method. Results: Eleven laryngocele patients were divided into mixed type (n=6), internal type (n=4) and external type (n=1).Nine patients presented with hoarseness or dysphonia, 7 with cervical mass and 1 with airway obstruction. Surgical resections were done through external cervical approach (n=7)or transoral endoscopic approach (n=4). All the operations were successful and no complication occurred. All cases were followed up from 17 to 110 months. No recurrence was encountered. Conclusions: Laryngocele is a rare lesion with atypical clinical presentation. Preoperative imaging including CT scan and electronic laryngoscope is essential to evaluate the location, and extent of the lesion, and to make the surgical plan.Complete surgical excision is required. Surgical resection is the only effective method for the treatment of laryngocele.

Editorial introductions.

Current Opinion in Oncology was launched in 1989. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of psychiatry is divided into 15 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Joel GuigayJoel GuigayJoël Guigay is Professor of Medicine, Past Director of Cancer Center Antoine-Lacassagne in Nice, France, and Past President of the Head & Neck-Unicancer group. Prior to this, he was Head Physician in the Department of Head & Neck and Thoracic Medical Oncology at Gustave Roussy in Villejuif, France. Professor Guigay received his Medical Degree from Lyon University of Medicine, France, in 1984 and subsequently undertook extensive postgraduate training in Pneumology, Cancerology, Oncogenesis, and Thoracic Endoscopy. In 2001, he was appointed Professor of Medicine at the Hôpital d’Instruction des Armées Val-de-Grâce in Paris, France. He currently serves as Head of partnerships and clinical development - Early assets for the Groupe Oncologie Radiothérapie Tête et Cou (GORTEC), and as deputy director of the Hospital University Federative OncoAge. In addition, he is an active member of many national and international societies, including the American Society of Clinical Oncology (ASCO), the European Society for Medical Oncology (ESMO) as a Faculty member for Head and Neck cancers and as a member of the OncologyPro WG, as Co-Chair of the scientific committee of the Head and Neck Cancer International Group (HNCIG). His main fields of interest are head and neck and lung oncology with a focus on rare tumors, salivary gland tumors, nasopharyngeal cancers and neuroendocrine tumors. His areas of research include clinical studies with new drugs and translational research with a focus on immunotherapy. Professor Guigay coordinates several clinical trials including phase I to large randomized trials in recurrent or metastatic HNSCC such as TPExtreme trial. He currently leads also a large research program for elderly head and neck cancer patients (ELAN study). Arif HussainArif HussainArif Hussain, MD, is Professor of Medicine with Tenure in the Department of Medicine, School of Medicine, at the University of Maryland in Baltimore, USA, where he is also Professor of Biochemistry in the Department of Biological Chemistry and Professor of Pathology in the Department of Pathology. He serves as Co-Leader of the Hormone Related Cancers Program at the University of Maryland Greenebaum Comprehensive Cancer Center. Dr Hussain's clinical interest is in genitourinary cancers, and he serves as Principal Investigator on several clinical trials that focus on therapies for high risk, recurrent and metastatic prostate cancer, as well as renal cell cancer. In addition, he has a research laboratory with a translational focus, studying drug resistance and adaptive intracellular signaling pathways in treatment-sensitive and treatment-resistant prostate cancer.

ENDOSCOPIC TYMPANOMASTOIDECTOMY IN ATTICO-ANTRAL CHRONIC SUPPURATIVE OTITIS MEDIA - AN OBSERVATIONAL STUDY

An Observational Study was undertaken at Department of Otorhinolaryngology and Head and Neck Surgery, AIMSR from Jan 2019 - August 2020. The aim of this study was to observe the outcome of endoscopic tympanomastoidectomy for attico-antral type of CSOM. All the patients attending ENT OPD at AIMSR within the age group of 11-60 yrs, irrespective of sex with Attico-Antral CSOM either unilateral or bilateral were included in this study. However, revision mastoidectomies, patients with intracranial complications of CSOM or actively discharging ear, or patients with external and middle ear abnormalities either congenital or acquired, medically and surgically unfit patients and Patients unwilling to take part in study were not included. In our study of 50 patients, 40 patients had graft uptake after disease clearance and 8 had failure of graft uptake without chronic otorrhoea and 2 had failure with chronic otorrhoea. Through this study we concluded that Endoscopic Tympano-mastoidectomy for attico-antral type of CSOM is an excellent technique for complete removal of cholesteatoma especially from inaccessible areas of middle ear cleft.

What Approach Minimizes Hearing Loss in Superior Semicircular Canal Dehiscence Repair?

The LaryngoscopeEarly View Triological Society Best Practice What Approach Minimizes Hearing Loss in Superior Semicircular Canal Dehiscence Repair? Hunter L. Elms MD, Hunter L. Elms MD orcid.org/0000-0003-1509-8971 Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USASearch for more papers by this authorJulia E. Canick AB, Julia E. Canick AB orcid.org/0000-0002-8353-4838 Duke University School of Medicine, Durham, North Carolina, USASearch for more papers by this authorDavid M. Kaylie MD, MS, Corresponding Author David M. Kaylie MD, MS [email protected] Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA Send correspondence to David M. Kaylie, 40 Duke Medicine Cir, Durham, NC 27710-4000, USA. Email: [email protected]Search for more papers by this author Hunter L. Elms MD, Hunter L. Elms MD orcid.org/0000-0003-1509-8971 Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USASearch for more papers by this authorJulia E. Canick AB, Julia E. Canick AB orcid.org/0000-0002-8353-4838 Duke University School of Medicine, Durham, North Carolina, USASearch for more papers by this authorDavid M. Kaylie MD, MS, Corresponding Author David M. Kaylie MD, MS [email protected] Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA Send correspondence to David M. Kaylie, 40 Duke Medicine Cir, Durham, NC 27710-4000, USA. Email: [email protected]Search for more papers by this author First published: 18 April 2023 https://doi.org/10.1002/lary.30705 Editor's Note: This Manuscript was accepted for publication on March 27, 2023. The authors have no funding, financial relationships, or conflicts of interest to disclose. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

The Variations in Deviation of Nasal Septum and their Impact on Maxillary Sinus Volume and Occurrence of Sinusitis.

To study the effect of variations in deviation of the nasal septum and their impact on maxillary sinus volume and occurrence of sinusitis. This prospective observational study was conducted in the department of ENT, Head &Neck surgery GMC Jammu from August 2021 to November 2022. 130 patients (90 males, 40 females), with age range of 18-47years with DNS were included in the study. Grade of DNS was classified according to Mladina's classification and volume of maxillary sinus was calculated using geometric formula by performing 256 slice CT Scan. In our study mean age of the males was 32.8 ± 6.99years and females was 33.7 ± 7.26years with Male: Female ratio of 9:4.Patients with grade 1 DNS had mean maxillary sinus volume of 9.9 ± 1.97cumm while patients with grade 7 DNS had mean maxillary sinus volume of 3.8 ± 1.47cumm. Thus, with the increasing grade of DNS, the OMC blockage increased towards the side of DNS and so the occurrence of maxillary sinusitis. The study showed that with high grade DNS, the maxillary sinus volume decreases on the side of septum deviation and there is association of blocked OMC with increasing grade of DNS. The incidence of maxillary sinusitis findings on the side of septum deviation was significantly increased.

Effect of Corporate Governance Practice on Private Banking in Iraq: Empirical research in private banking in Iraq

The research will examine if private banks in Iraq practice principles of corporate governance which were suggested and confirmed by the Basel Committee on Banking Supervision (2000). The aims of the research are identify the role of BOD and CEO in corporate governance practice, role and experience of board directors in corporate governance practice, and the role of compliance policy in corporate governance practice. The research collected data by distributing 120 questionnaires randomly to high-level bank employees involved in corporate governance. The target population comprises credit risk managers, head departments, CEO, and board members. The researcher designed a questionnaire that include 92 closed questions. The research shows that private banks in Iraq, in general, are effective in applying the principles of corporate governance from the point of view of the respondents in general. The research finds also that the internal audit function assists effective manner senior management and the board of directors in the efficient and effective discharge of their responsibilities.

Unusual Foreign Bodies in the Head &amp; Neck Region

Introduction: Injuries in the Head Neck region due to impacted or penetrating foreign bodies are not uncommon in ENT ER or OPD. These injuries carry the risk of retained foreign bodies with dramatic consequences if remain untreated. Therefore, it is mandatory to detect any foreign body during clinical workup. The objective of our study is to evaluate the location of foreign bodies and to plan concerned surgical approach. Method: A Case Series of 9 patients, presenting with foreign body injury in the Head and Neck region in the Outpatient Department or Emergency of Department of Otorhinolaryngology and Head and Neck Surgery of a tertiary care hospital in Kolkata in a span of 3years, has been presented. Result: All the foreign objects were retrieved successfully without any surgical complication. Conclusion: History taking and Clinical examinations are the crucial steps in Investigation. Imaging studies can significantly increase the chance of detecting a foreign body.