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  • ISSN: 2379-948X
    Volume 3, Issue 4
    Short Communication
    Carson T Williams* and David A Sherris
    Septal deviations are common causes of disordered nasal breathing. The caudal septum is of special interest as it contributes to shape and support for nasal breathing and aesthetics. Caudal end septoplasty involves correction of deviation while maintaining adequate support and tip projection. Here, the caudal septum's contribution to the internal nasal valve area is highlighted and an explanation is given why this critical area is corrected to improve nasal breathing. In this report, we share our experience with a modification of the caudal end transplant using autologous posterior bony-cartilaginous septum in which the resection of the donor septum occurs posterocephalic to the internal valve area and a specific suture technique is employed to secure the transplanted septum to the dorsal strut and nasal spine.
    Satyawati Mohindra*, Neha Chauhan, Amanjit Bal and Nalini Gupta
    Objective: To report a short series of tuberculous dacryocystits managed successfully by endoscopic dacryocystorhinostome (endo-Dcr) and antitubercular drugs.
    Design: A Short Series of Three Patients.
    Participant: Three female patients with age ranging from 23- 50 years.
    Testing/Intervention: The authors describe the clinical findings, radiologic study, and histopathologic study and important nasal endoscopic findings of all the patients.
    Main Outcome Measures: Relief of symptoms, return of normal endoscopic picture and restoration of patency of the endo-Dcr.
    Results: All the three patients had a successful outcome after antitubercular treatment and endo-Dcr.
    Conclusion: Tuberculosis of the lacrimal sac is very rare and can be suspected during endo-Dcr and successfully treated by antitubercular drugs. Fnac can also be helpful in providing a diagnosis. The present study highlights the importance of keeping in mind the subtle findings in suspecting something different from usual and saving the patient from unnecessary morbidity.
    Deborah Ann Hall*, Robert Henryk Pierzycki, Holly Thomas and Derek James Hoare
    Study results for an early-phase trial evaluating a novel sound therapy for tinnitus (the T30 neurostimulator) were made publicly available in May 2015 via the Clinical Trials.gov Identifier: NCT01541969. There was no evidence for a clinically meaningful difference between active intervention and placebo groups enrolled, but this null finding still leaves open the question of clinical efficacy. Here we share our experience and discuss four specific learning experiences relating to the design and conduct of future clinical trials of this type: i) The device fitting procedure should follow manufacturer documentation for normal conditions of clinical use and may even need to be more fully documented (EU Directive 93/42/EEC); ii) Acceptable tolerance limits should be clearly established for deciding when and how any device recalibration may be required; iii) A monitoring plan and documented monitoring of progress of the clinical investigation at all sites are essential (ISO14155). Monitoring includes competence in device fitting and compliance with the study-specific device fitting procedure; and iv) Choice of comparator is important, and the challenge in selecting an appropriate medical device placebo must be carefully considered.
    Robert T. Standring*, Robert Guglielmo, Alvin B. Ko, Glendon Gardner, Ilaaf Darrat, Lamont Jones, Ed Peterson, Michael D. Seidman and Kathleen Yaremchuk
    Objective: The goal of this study was to examine the efficacy of two separate pain regimens for patients post-tonsillectomy.
    Study Design: This prospective randomized cohort study at our tertiary referral hospital compared the efficacy of ibuprofen and acetaminophen/hydrocodone or acetaminophen/codeine for postoperative tonsillectomy pain control.
    Methods: Patients of any age undergoing tonsillectomy from June 2011 to August 2013 were randomized into one of two postoperative pain regimen groups. All tonsillectomy procedures were performed using the same technique. Patients/families completed postoperative questionaires to document the level of pain and duration of time to return to normal diet, school/work, and baseline activity. Levels of pain were measured using a validated visual pain scale. Data were compared using Student's t-tests, analysis of variance, and chi-squared tests.
    Results: Of 91 patients enrolled, 25 patients completed the study packet (12 patients from the ibuprofen arm and 13 patients from the acetaminophen/hydrocodone/codeine arm). No significant differences were found in time to return to regular diet (p=0.685), baseline activity (p=0.919), or work/school (p=0.893). No difference was found in the rate of complications between the groups (p=0.550). Mean ages of the groups were not found to impact results.
    Conclusion: Ibuprofen and acetaminophen/hydrocodone/codeine are adequate regimens following tonsillectomy for pain control and for return to baseline activity. Due to the variable metabolism and potential mortality associated with acetaminophen/hydrocodone/codeine in children, we recommend that ibuprofen be an option for pain control after tonsillectomy.
    Research Article
    Derek J Handzo, Virginia S Ramachandran, Brad Stach, Ed Peterson and Kathleen L Yaremchuk*
    Objective: To determine if glycemic control corresponded to the degree of hearing loss found in diabetic patients and if hearing loss was greater in diabetic patients compared to age-matched gender-matched non-diabetic patients.
    Study Design: Retrospective chart review.
    Methods: Using an institutional database, patients were identified that had Hemoglobin A1c results and hearing evaluations performed between 2000 and 2008. Subjects were classified by gender and three age tertiles (<60, 60-75, >75). Diabetes severity was classified as well- or poorly-controlled or non-diabetic. A three-way analysis of variance (ANOVA) was used to examine the relationship of pure tone average (PTA), speech frequency PTA, high frequency PTA, and word recognition scoring (WRS) to age and diabetic control levels.
    Results: The study analyzed 990 patients. Statistically significant differences in hearing were found for females that were non-diabetic (average PTA 14.8±6.9 for <60 years old, 23.6±8.9 for 60-75 years), well-controlled diabetic (PTA 20.0±10.7 for <60, 27.0±11.6 for 60-75), and poorly-controlled diabetic (22.1±14.2 for <60, 29.6±13.2 for 60-75) categories. P-values were < 0.01 for both age groups comparing non-diabetics to poorly-controlled diabetics and <0.05 for non-diabetics versus well-controlled diabetics for the younger females. This difference was not seen in the male patients.
    Conclusion: Glycemic control in diabetes appears to be directly correlated with the degree of hearing loss in females. Hearing loss in the male population was significantly worse in all age categories compared to females but did not demonstrate a difference between well-controlled or poorly-controlled diabetics.
    Case Report
    Ilze Dobele* and GintsKragis
    Objectives: The purpose of this case report was to describe the intra orbital complication of maxillary sinusitis caused by tooth 2.6.periapical abscess. Cone beam tomography (CBCT) has diagnostic value and interdisciplinary collaboration of dentists and otolaryngologist is crucial in the effective treatment of odontogenic sinusitis.
    Aim and Introduction: Recent publications highlight that 40% cases of inflammation in unsuccessfully treated maxillary sinuses are caused by odontogenic infections, this proportion being significantly higher than historic data with only 10-12% cases [1-6]. Identification of odontogenic infections as a cause of maxillary sinusitis is difficult if evaluation is performed by intraoral radiograph and dental evaluation, whereas CBCT provides more detailed picture of the association of maxillary posterior teeth pathology and maxillary sinusitis [7-10].
    Leire Garcia-Iza*, AneUgarte, Izaskun Thomas, Joaquin Estefano, Eduardo Perez and XabierAltuna
    Mucormycosis is a rare, aggressive opportunistic infection from a fungus of the order of mucorales. This infection is usually seen in patients with underlying conditions such as diabetes mellitus and haematological malignancies. This infection could be presented in various clinical forms, but Rhino-Orbital-Cerebral Mucormycosis (ROCM) is the most common. In this article we report a case of a middle age man suffered from poorly controlled diabetes and Leukaemia. He started with an atypical clinical form of ROCM, attending to the Emergency room with a progressive right eye acute orbital apex syndrome (OAS) which quickly evolves to a bilateral affection. After clinical and endoscopic exhaustive examination and radiologic imaging were done, a high suspect of ROCM was established. An aggressive surgical debridement of necrotic tissue and reservoir were done, bilateral orbital exenteration and an aggressive antifungal intravenous and local treatment were done. The man is successfully free of infection at this moment.
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