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  • ISSN: 2379-948X
    Volume 1, Issue 3
    Case Report
    Thomas M. Kaffenberger1*, Ryan M. Stephenson2, Danielle Columbe1 and Jonas T. Johnson1
    Objective: Among patients who undergo tracheoesophageal puncture (TEP) after total laryngectomy (TL) a subset develop leakage around their voice prosthesis (VP). This can be difficult to manage and leads to surgical closure of TEP in some cases due to aspiration risk. TEP-injection (TEP-I) is a practical method of resolving low volume leaks. Our study reviewed the outcomes of 22 patients at our institution who underwent TEP-I.
    Study Design: Case series of 22 patients.
    Methods: Chart review of 22 patients who underwent TEP-I with calcium Hydroxyapatite after leakage around the VP due to an enlarged TEP. Data was gathered regarding demographics, leakage resolution, tumor stage, and radiotherapy history.
    Results: 22 patients had undergone TEP-I procedures and 8 of these had multiple injections. TEP-I provided durable (>90 days) leakage resolution in 20 (91%) patients and the mean duration of leakage resolution in these successful patients was 462 days. When leakage resolution was controlled for the length of therapy, patients on average spent 81% of the time in durable resolution.19patients had a history of radiotherapy. No complications were experienced due to TEP-I.
    Conclusion: This study found that TEP-I is an effective and safe intervention for patients who experience low volume leakage around the VP. It is important to develop management strategies, including TEP-I, for these difficult to manage cases.
    Kiminori Sato*, Shun-Ichi Chitose and Hirohito Umeno
    Objectives: This report concerns office-based esophageal foreign body extraction using transnasal video endoscopy and advantages of this intervention.
    Methods: A video endoscope with a working channel for irrigation, air insufflation and forceps was used. The diameter of the video endoscope tip was 5.3 mm. Transoral esophageal foreign body extraction using transnasal esophagoscopy was performed under surface anesthesia.
    Case Report: A seventy-one-year old male complained of having a sore throat after taking medicine. An X-ray examination showed the esophageal foreign body (PTP: Press through package medicine). Transnasal esophagoscopy was performed in a sitting position on a procedure chair at the outpatient clinic without sedation. In this case, the foreign body was too large to extract through the nasal cavity. Therefore, after extracting the foreign body as far as the oropharynx, the PTP was extracted transorally.
    Results: The patient could be treated in a sitting position on a procedure chair at the otolaryngology outpatient clinic, which obviates the need for sedation or general anesthesia. The videoendoscope diameter is relatively small and results in less discomfort to the patient.
    Conclusions: Transoral esophageal foreign body extraction using transnasal videoendoscopy is one of the options that have widened the indications for office-based foreign body extraction.
    Pedram Kordrostami1* and Amit Parmar2
    Para nasal sinus infection is common in paediatric patients; however isolated infection of the sphenoid sinus is rare and can result in life threatening complications. Diagnosing Sphenoiditis on the basis of history and examination can be troublesome as the clinical picture is often non-specific and patients seldom complain of nasal symptoms. We report a case of sphenoid sinusitis in a 12-year-old boy who presented with unilateral VIth nerve palsy and visual disturbance. This case highlights the diagnostic challenge of sphenoid sinusitis and the importance of early collaboration between paediatric, ophthalmology and ENT specialists to achieve the best outcomes.
    Phakdee Sannikorn1*, Puangmali Praweswararat2, Sakchai Jitpakdee1 and Ruthairat Suphareokthaweechai1
    Schwannomas (also known as Neurilemmomas) are benign nerve sheath tumor which can arise from any myelinated nerve. Base of tongue schwannomas are rare and manifest with vague symptoms resulting in delayed diagnosis and treatment. Histologic identification of Antoni A and B areas with strong and diffuse S-100 staining, confirm the pathological diagnosis of schwannoma.
    Review Article
    Huaili Jiang and Zhigang Zhang*
    Objective: to investigate whether cartilage or temporalis fascia is more ideal for tympanoplasty under the circumstance of Eustachian tube (ET) dysfunction.
    Material and methods: Firstly, we summarized some biological comparisons among tympanic membrane, cartilage and temporalis fascia. Secondly, we conducted a meta-analysis that involved three randomized controlled trials (RCT) to compare their difference in improving hearing level and morphological success rate.
    Results: in terms of biological properties, cartilage was stiffer than temporalis fascia. But cartilage can be cut into different thickness to balance the ability of acoustic sensitivity and resistance to negative pressure induced by ET dysfunction, which was impossible for temporalis fascia. When it came to clinical properties, there was no statistical significance between cartilage and temporalis fascia in postoperative air-bone gap≤ 20dB (p=0.61) and 20dB (p=0.25) in 24 months. However, cartilage showed better morphological success in 12 months with p=0.04.
    Conclusions: Cartilage should be cut as thin as possible if ET function was normal. However, under the circumstance of ET dysfunction, cartilage with more than 500um thickness was supposed to be the first choice for tympanoplasty.
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