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  • ISSN: 2379-948X
    Volume 2, Issue 11
    Research Article
    Shi Nee Tan* and Aminuddin Bin Saim
    Abstract:
    Vocal cord palsy presented with hoarseness due to cardiovascular pathology, is an extremely rare entity, better known as Ortner's syndrome or cardiovocal syndrome. The common underlying pathology is described as compression of the recurrent laryngeal nerve by the pulmonary artery or enlargement of the left atrium. We reported a case of undiagnosed congenital heart disease in a young woman presented to the ENT clinic for hoarseness and discuss the approach to the diagnosis. Even though hoarseness is often encountered in the ENT outpatient department, cardiovascular related hoarseness is indeed a rare findings. Partial and complete resolution of voice have been reported after treatment of the underlying cardiac pathology.
    Peter Catalano*, Mary G. Ashmead and David Carlson
    Abstract:
    Introduction: Anatomic etiologies of nasal obstruction (NO) include septal deviation, turbinate hypertrophy, and nasal valve collapse. We have also noted that nasal septal swell bodies (NSB) are extremely common and can produce a significant effect on nasal resistance. The aim of our study was to explore changes in validated outcome metrics after surgical reduction of NSB.
    Methods: 60 consecutive patients (38 M: 22 F) were enrolled after persistent nasal obstruction following septoplasty, turbinate reduction and internal nasal valve repair. Clinical history and nasal endoscopy confirmed prominent NSB. Evaluation of treatment effect was determined by changes in the NOSE scale and a newly developed NSB grading scale before, and six months after swell body ablation in the office-setting using radiofrequency. NSB grades were based on endoscopic visualization of the middle turbinate (MT): 1= > 50% MT visualized; 2 = < 50% MT visualized; 3 = no MT visualized. Patient data was scored and transferred for analysis using Prism6 Graph Pad software.
    Results: The 60 patients in our study had a mean age of 48 years (range 19-71) and were followed for 3 and 6 months. The mean pre-operative NOSE score was 41.6 and mean NSB grade was 2.5. At 3 months, the mean post-operative NOSE score was 17 with NSB grade of 1. At 6 months, the NOSE score was 21 and the NSB grade was 1.2 (p<.05). Thus, statistically significant improvement in NOSE scores and standardized NSB grading was noted at 3 and 6 months post coblation of NSB tissue. There was one asymptomatic small septal perforation noted, and 5 patients needed retreatment at 6 months.
    Conclusions: Coblation reduction of NSB is a safe and very effective new office-based treatment option for the correction of refractory nasal obstruction.
    Case Report
    Eduardo Boaventura Oliveira, Marco Antônio Ferraz de Barros Baptista*, Alcebíades Alves de Liz and Danilo Augusto Nery dos Passos Martins
    Abstract:
    Introduction: The Kearns-Sayre syndrome (KSS) belongs to the group of mitochondrial diseases. Cells that require more energy intake, such as muscle, nerve, retinal and cochlear, are most commonly affected.
    The established diagnostic criteria are: 1) the age of onset before 20 years old (100%), 2) progressive external ophthalmoplegia (100%), 3) pigmentary retinopathy (100%), and 4) at least one of the following: heart block, cerebellar ataxia (84%) and protein> 100 mg/dL in the cerebrospinal fluid. Additional features are the presence of bilateral sensorineural hearing loss and myopathy.
    Genetic testing of mitochondrial DNA can confirm the diagnosis. The aspect of muscle biopsy is typical, showing ragged red fibers (RRF).
    Objectives: Present a literature review and report the cochlear implantation in a patient with KSS.
    Case Report: ACVF, female, was born in 1989 from a gemelar pregnancy. At the age of ten years, the patient began manifesting hypoacusia associated with a continuous and bilateral tinnitus. In 2000, the patient was evaluated by a medical geneticist because of palpebral ptosis, progressive ophthalmoplegia, reduction in muscle mass, facies myopathica, an alteration in the index-nose test and slight restriction of ocular motricity. A muscular biopsy revealed RRF. The genetic test performed showed deletion of mitochondrial DNA compatible with a diagnosis of KSS. Her twin sister also had the diagnosis of the syndrome based on the same tests.
    The patient showed a deterioration of hypoacusia even after the adaptation of the hearing aid. During the tone audiometric exam, it was seen that the patient had evolved towards a bilateral and profound deafness. The results of the complete audiological evaluation enabled the realization of Cochlear Implantation.
    Daniele Borsetto*, Chiara Faccioli, Elisabetta Zanoletti and Alessandro Martini
    Abstract:
    Introduction: Congenital cholesteatoma of the petrous bone, though originating in childhood, has often a delayed diagnosis due to its poor symptoms and can grow achieving great extension. When asymptomatic or pauci-symptomatic, the diagnosis is incidental and purely radiological. Leaving the lesion untreated implies an inexorable progression leading to extensive erosion of the petrous bone and cranial nerves involvement. First choice treatment is radical surgical excision. An aggressive treatment is recommended, a combination of approaches to the petrous bone and skull base may be used to obtain complete removal. Surgical morbidity is a balance between the choice of the approach and the goal of radical excision. Prevention of relapse is essential not to expose the patient to further morbidity some years later. Long term follow-up is essential.
    Short Communication
    Sim Choroomi* and Andrew Frankel
    Abstract:
    Background: The "Pixie ear" earlobe deformity is a condition where the ear lobe is unnaturally pulled in a straight line towards the angle of the mandible. It is often due to excess tension on closure of the face-lift flap at its attachment to the earlobe.
    Method: We describe a simple and effective technique for surgical correction of this deformity, based on a skin-preserving V-Y plasty.
    Results: We have performed this technique on 22 patients over a 10 year period, with no recurrences or revisions required. The technique we describe can be used in an isolated manner or in conjunction with revision face-lift surgery.
    Conclusion: We provide a simple, safe and reproducible skin-preserving technique for correction of a deformity with highly satisfactory post-operative results.
    Level of Evidence: IV
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