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  • ISSN: 2379-948X
    Volume 2, Issue 1
    Case Report
    Xiaoyu Jiang1, Qiujian Chen2, Yubin Chen3, Yu Si1, Yi Liu2 and Zhigang Zhang1*
    Abstract: Ectopically erupted tooth is a rare disease, indicating that a tooth erupts into regions other than the oral cavity. We present a case of an ectopic maxillary third molar tooth in the external acoustic meatus, and discuss the diagnosis and treatment of this entity.
    Research Article
    Abdul-latif Hamdan1, Georges Ziade1, Maher M. Kasti2, Jad Jabbour1, Jihad Nassar3, Iyad El-Dahouk1 and Sami Azar4*
    Abstract: The aim of the study is to describe the vocal characteristics of a group of female patients with goiter. For this purpose, a total of 43 female patients with goiter presenting to the endocrinology clinic and another age-matched group of controls were recruited. Patients underwent acoustic analysis and perceptual evaluation of their voice using the GRABS classification. Zero was considered normal, and 1, 2 and 3 as mild, moderate, severe deviation from normal, respectively. The mean score of each parameter was computed and the distribution of severity of each perceptual parameter was listed. The results of the study showed no significant difference in any of the acoustic variables between patients and controls. There was also no significant difference in the mean score of any of the perceptual evaluation parameters between the two groups except for straining. Goiterous patients had a significantly higher straining score comparing to controls, 0.48±0.59 vs. 0.13 ±0.35, with a p value of 0.039. The means of all the perceptual parameters were less than 1 indicating a relatively mild or minimal deviation from normal. Therefore, female patients with goiter seen in a clinical set up have more vocal straining compared to controls, however, the amount of straining is minimal. Acoustic analysis failed to reveal any significant difference compared to controls.
    Adel Denewer1*, Ashraf Khater1, Osama Hussein1, Fayez Shahhto1, Sameh Roshdy1, Mohammed Hafez1, Khaled Abdel Wahab1, Adel Fathi1, Fathy Denewer2 and Emad Hamed1
    Abstract: Hypo pharyngeal carcinoma is relatively uncommon. No single surgical technique is superior in achieving the best oncologic and functional results.Reconstruction of the digestive tract to restore postpharyngectomy continuity is challenging. Free jejunum transfer remains the most reliable option. Micro vascular techniques minimize partial flap necrosis and the subsequent salivary fistula and are superior to pedicled flaps. Improving the results of free jejunum pharyngeal substitute is thus of utmost importance to the success of treatment of patients with hypo pharyngeal carcinoma.
    Refinement plan: Considerations for organ preservation determine the choice of therapy in the majority of cases. Most patients present with stage III or resectable stage IV tumors. Combined surgery and chemo-irradiation is essential for these patients. A few of our patients present as early cancers (stage I, II).
    Surgical ablative phase: the majority of patients need formal total laryngectomy, pharyngectomy, thyroidectomy and bilateral modified block dissection (i.e. neck emptying).
    Reconstructive phase
    The jejunal loop is harvested through an abdominal midline incision. Careful dissection of the mesentery exposes the primary branches of the superior mesenteric artery (SMA). The free flap is based on the second and third branches of SMA. Refinement in the technique includes
    The distal jujeno-esophageal anastomosis is performed with a circular (EEA) stapler.
    Double vascular pedicle is used in the irradiated neck.
    A jejunal window is always used in the irradiated neck.
    Results: In total, mortality rate was 8.3% (4 patients). The most common causes of operative death were pulmonary embolism and sepsis syndrome. Hospital stay ranged from 10-22 days. Three flaps were lost out of 28 traditional flaps and the remaining 25 flaps were evaluated for technique-related morbidity. One flap was lost after 20 modified procedures and 19 patients were evaluated for technique-related morbidity.
    Conclusion: Free jejunal transfer remains the most effective method of reconstruction of the hypopharynx. Several modifications have been recently introduced to refine the technique and maximize the chance of rapid recovery and improved function of these debilitated patients.
    Rivka Bendrihem1, Christian Vacher2* and Jacques Patrick Barbet3
    Objective: Prominent ears are generally considered as primary cartilage deformities, but some authors consider that posterior auricular muscles malposition could play a role in the genesis of this malformation.
    Study design: Auricle dissections of 30 cadavers and histologic sections of 2 fetuses' ears.
    Methods: Posterior area of the auricle has been dissected in 24 cadavers preserved with zinc chlorure and 6 fresh cadavers in order to describe the posterior muscles and fascias of the auricle. Posterior auricle muscles from 5 fresh adult cadavers have been performed and two fetal auricles (12 and 22 weeks of amenorhea) have been semi-serially sectioned in horizontal plans. Five µm-thick sections were processed for routine histology (H&E) or for immuno histochemistry using antibodies specific for the slow-twitch and fast-twich myosin heavy chains in order to determine which was the nature of these muscles.
    Results: The posterior auricular and the transversus auriculae muscles looked in most cases like skeletal muscles and they were made of 75% of slow muscular fibres. The histologic sections of the auricle in the fetus suggest that the transversus auriculae plays a role in the constitution of the antihelical fold. The obliquus auriculae muscle was rather a fascia than a muscle in adult dissections and in fetuses auricle sections. Conclusion: Some cases of prominent ears are related to anomalies of the posterior muscles of the auricle.
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