3^rd International Conference and Exhibition on Rhinology & Otology April 25-27, 2016 - The Oberoi: Dubai, UAE

Biography:

Shayan Ansari is a Consultant Head & Neck / ENT Surgeon in University Hospital Crosshouse, NHS Ayrshire & Arran, UK and also an Honorary Clinical Senior Lecturer in The University of Glasgow, UK. Bulk of his practice includes management of benign and malignant head and neck diseases including sinonasal, thyroid & parathyroid, laryngeal and pharyngeal pathologies. He also enjoys dealing with general ENT conditions. He completed his Head & Neck / ENT training in Scotland, UK. His interest has always been in Head & Neck surgical oncology especially organ preservation and salvage strategies. To achieve his ambition, he spent some time working in a busy head and neck unit in Groote Schuur Hospital, Cape Town, South Africa. His other interests include teaching and training of medical students, dental students, speech and language therapists, teachers and post-graduate doctors in various ENT disorders. He not only teaches in various courses for this purpose but also is an organizer and tutor in various Royal College of Surgeons of Edinburgh endorsed courses. He has various academic publications on ENT and head and neck surgical topics especially patient reported outcomes measures. He is director and trustee for two UK charities (Postgraduate Education Group Scotland and Rawalians’ Association for Healthcare Improvement and Innovation) that work for improvement of health care and education in UK and developing countries. He is also a founding member of Scottish Head And Neck Research Collaboration (SHANREC). His special interest in information technology and health informatics helps him in handling and maintaining online / standalone databases and networks. He is in a process of launching first dedicated Health Resource Portal for ENT / Head & Neck surgeons.

Abstract:

Objective: To determine voice outcomes in endo-laryngeal surgery.
Methods: Prospective assessment of patients undergoing endo-laryngeal surgery in one Head & Neck team in North Glasgow from 2007 to 2014. Each patient completed a VoiSS questionnaire at pre-assessment and post-endo-laryngeal surgery. Per-operatively the aim of the procedure was recorded from a choice of seven options in addition to the clinical conditions and the procedure.
Results: 1066 patient episodes were recorded. 32 had incomplete data at pre-assessment and were excluded. Of the remainder, 703(68%) had complete paired data sets. “To improve voice” (n=169.24%) and ‘to achieve a biopsy with no deterioration in voice’ (n=185.26%) categories had statistically significant outcomes in keeping with the operative aims.
Conclusion: This study demonstrated it is possible to assess patient reported voice outcomes in universal heterogeneous endolaryngeal surgery cohort over a prolonged period. The voice outcomes were in keeping with the stated aims of the endo-laryngeal surgical procedures.

Biography:

Kathryn E Roth is an Assistant Professor with Schulich School of Medicine, Western University, Canada. She has completed OTO-HNS Residency at Western University and Head and Neck Reconstructive Surgery Fellowship from the Sydney Head & Neck Cancer Institute and Sydney Melanoma Unit, Australia in 2010. She is currently pursuing a Masters in Health Professions Education, University of Illinois at Chicago with a research interest in skill retention. She was named Deputy Chair, Cutaneous Oncology; London Regional Cancer Program in 2014 and Co-developed a Canadian National Melanoma database. Her clinical and research focus is in cutaneous oncology with facial reconstruction, melanoma (including sentinel node), thyroid and salivary gland pathology

Abstract:

This session will provide an examination of the current surgical challenges in melanoma of the head and neck including margin status in cosmetically or functionally sensitive regions and reconstructive options in the head and neck to permit ongoing oncologic surveillance. Controversy regarding the efficacy of sentinel lymph node biopsy (SLNB) continues despite the publication of the final results of the multicenter MSLT-1 trial. SLNB is minimally invasive and numerous large studies establish accuracy in identification of nodal metastases. OTO-HNS has a lower adoption rate of sentinel node biopsy relative to other surgical specialties. Controversy exists regarding the validity, reproducibility and utility of this procedure. Proponents list the value of prognostic information to patients, early completion lymphadenectomy, eligibility for interferon and novel clinical trials. Disadvantages include the false negative rate, complexity of H&N lymphoscintigraphy and risks associated with the procedure and with stage migration. Pitfalls and pearls to improve sensitivity in SLNB particular to the head and neck will be emphasized. Study results from the new, comprehensive melanoma database developed by the Canadian Melanoma Research Network (CMRN) will be highlighted. 171 cutaneous head & neck melanoma cases were analyzed with a mean age of 71.6 years and average length of follow-up 3.6 years. 56% of the patients were male. AJCC Stage I (38%) or II (42%); 93% were M0 and 77% were N0 at time of presentation. Sentinel node biopsy was completed in 22% of T2 and 18% of T3 tumors with a positive nodal rate of 14% and 33% respectively.

Biography:

Claudia Regina Furquim de Andrade is a Speech, Language and Hearing Therapist. She has completed her under graduation course at the Catholic University of São Paulo, Brazil in 1979. She has earned a PhD in Linguistics from the University of São Paulo (1994). She is a Full Professor at the School of Medicine, University of São Paulo, Brazil, since 2001. She has published 127 papers in indexed journals and 285 abstracts in conference proceedings. She has published 48 book chapters and 22 books and received 46 awards. She is the Director of Speech-Language and Hearing Science.

Abstract:

SpeechEasy is an eletronic device used to treat stuttering, similar in appearance to a hearing aid. However, rather than amplifying sound, SpeechEasy device alters the way its users perceive their own speech, so that they hear their voice at a slight time delay and at a different pitch. This effect is called altered auditory feedback (AAF), i.e., the use of a digital signal processor to produce a second altered signal using one’s own speech. The alteration to the auditory feedback creates the illusion of a second speaker producing similar linguistic material, emulating choral speech. Previous studies, besides their largely different purposes and methodology, appear to agree that AAF can decrease the number of stuttering events without changing naturalness characteristics of speech production. However, substantial variability is found across studies regarding degree and pattern of benefit. The present study is a randomized clinical trial, undertaken to verify the effectiveness of SpeechEasy device on stuttering treatment in comparison to behavioral techniques. Two groups participated: Group 1 consisted of 11 people who stutter including 10 males and 1 female aged 21-42 years (M=30.0). Group 2 consisted of seven people who stutter including six males and one female, aged 20-50 years (M=35.6). Participants in Group 1 were fit with a SpeechEasy and were not given any additional training (i.e., supplementary fluency enhancing techniques). Participants used the device daily for six months. Participants in Group 2 received treatment in the form of a 12-week fluency promotion protocol with techniques based on both fluency shaping and stuttering modification. There were no statistically significant differences (p>0.05) between groups in participants’ stuttered syllables following treatment. That is both therapeutic protocols achieved approximately 40% reduction in number of stuttered syllables with no significant relapse after three or six months post-treatment. The results suggest that the SpeechEasy device can be a viable option for the treatment of stuttering.

Biography:

Argiro Kipreou graduated from 6th Lyceum of Piraeus and got her medical degree from Athens Medical School in 1995. She made rural service in the General Hospital of Sparta, General Surgery Department. She worked as an ENT specialist at the Naval Hospital of Athens from 1997 to 2002 where she majored in wider field Rhinoplasty, rhinoplasty including 3,000 cases. She further did her training in Facial Plastic Surgery at UIC University, Chicago, USA and on particular section of total reformation of the nose with costal cartilage graft. She is member of the European Society of Plastic Surgery Face (EAFPS), The Greek Society of Functional Rhinoplasty and General medical council of Pireaus. She performs more than 200 reconstructive and cosmetic rhinoplasties per year. Since 2008 she is working as a Director, ENT and facial plastic surgery in Metropolitan Hospital.

Abstract:

Rhinoplasty is the most common of all the plastic surgeries done in the world. It has the aim to reshape the nose and also make it functional. We have to be familiar with the anatomy of the nose, the types of incisions and the surgical approaches we use for rhinoplasty. The basic principles of each rhinoplasty are to make a new nose according to the aesthetic analysis of the face so that it will be appealing and natural. We must not forget our goal during the whole operation and we have got to have all the deep knowledge and also a variety of techniques to help us reach a beautiful final result. Modern rhinoplasty is mainly a structural rhinoplasty. We do not make movements we will regret for; we do not remove but 1-2 mm of the cartilages, so we strictly avoid over resections of bone or cartilage. We want to shape the new nose using suitable sutures and thin grafts so that the new structure will be stable forever. We will analyze how we shape the nasal tip with transdomal sutures, overlay technique and lower lateral strut grafts. We will also discuss the indications for each technique. It is also very important to preserve the anterior cartilaginous septum and also to use grafts to extend it when it is necessary for the stability of the nasal tip.

Biography:

Ansari Shayan currently working as a Consultant Head & Neck Surgeon in University Hospital Crosshouse, NHS Ayrshire & Arran, UK. Bulk of my practice includes management of benign and malignant head and neck diseases including sinonasal, thyroid, parathyroid, laryngeal and pharyngeal pathologies but I also enjoy management of general ENT conditions. I completed my Head & Neck / ENT training in West of Scotland. My interest has always been in Head & Neck surgical oncology and to achieve my specialist interest I spent some time working with Prof Fagan in Groote Schuur Hospital, Cape Town, South Africa to learn surgical management of advance head and neck pathologies. I have also experience of working in Plastic Surgery, Vascular Surgery and Neurosurgery. My other interests include teaching and training of medical students, dental students, speech and language therapists, teachers and post-graduate doctors in various ENT disorders. I not only teach in various courses for this purpose but also organize various Royal College of Surgeons of Edinburgh endorsed courses. I have various academic publications on ENT and head and neck surgical topics especially patient reported outcomes measures. I am director and trustee for two UK charities (Postgraduate Education Group Scotland and Rawalians’ Association for Healthcare Improvement and Innovation) that work for improvement of health care and education in UK and developing countries. I have a special interest in information technology and health informatics. I am quite proficient in handling and maintaining online / standalone databases and networks. This helps me collect evidence for future research and management. I am also in a process of launching first dedicated Health Resource Portal for ENT / Head & Neck surgeons

Abstract:

Introduction: Surgical intervention in patients with Reinke’s oedema can be a contentious issue. There is compelling evidence suggesting it is rare to have pre-malignant / malignant association. Similarly improvement in voice has been reported with specialized techniques in specialist centres. The aim of this study is to determine if improvement of voice in patients with Reinke’s Oedema is an indication for surgery in the routine clinical setting. Methods: Prospective audit of patients with Reinke’s Oedema undergoing trans-oral micro-laryngeal surgery from 2007 to 2014. The procedures were performed by a consultant and registrars under direct supervision, in a single head & neck unit in North Glasgow, using standard cold surgical techniques. Voice outcomes were recorded using Voice Symptom Scale (VoiSS) pre- and post-operatively. Results: 56 patients underwent trans-oral microsurgery (cold steel) for Reinke’s oedema with an aim ‘to improve voice’. 53(95%) patients were female and all 56(100%) patients were smokers. 51 patients (91%) had a single procedure for Reinke’s Oedema. 33 patients (59%) had complete pre and post op paired data. There was a significant improvement in VoiSS scores (p=0.008). Conclusion: Our practice has shown an improvement in-voice in patients undergoing standard cold surgical techniques in the routine clinical setting. Given the very low incidence of malignancy in this condition we conclude that this is the principle reason for surgical intervention in patients with Reinke’s Oedema.

Biography:

Kathryn E Roth is an Assistant Professor with Schulich School of Medicine, Western University, Canada. She has completed OTO-HNS Residency at Western University and Head and Neck Reconstructive Surgery Fellowship from the Sydney Head & Neck Cancer Institute and Sydney Melanoma Unit, Australia in 2010. She is currently pursuing a Masters in Health Professions Education, University of Illinois at Chicago with a research interest in skill retention. She was named Deputy Chair, Cutaneous Oncology; London Regional Cancer Program in 2014 and Co-developed a Canadian National Melanoma database. Her clinical and research focus is in cutaneous oncology with facial reconstruction, melanoma (including sentinel node), thyroid and salivary gland pathology

Abstract:

This symposium will offer a practical, case-based approach to the management options available for advanced basal cell carcinoma (BCC) skin lesions of the head and neck region. Discussion will include margin status and reconstructive options. Tumor size, poorly defined margins, the presence of perineural or vascular invasion and failed prior treatments are factors associated with poorer prognosis and a more aggressive phenotype. Increasing rates of immunosuppressive therapies and solid organ transplants confer higher risk of recurrent skin carcinoma. Aggressive or neglected tumour growth is seen in rare but unfortunate patients who may have medical contraindications for surgery or where resection may result in significant morbidity or deformity. Vismodegib is a novel, targeted systemic therapy indicated for advanced, unresectable BCC. An update regarding the hedge-hog signalling inhibition mechanism of action and the efficacy of vismodegib will be provided. Results from the SHH477g and STEVIE trials with vismodegib highlight the tolerable side effect profile and clinical utility for patients with basal cell nevus (Gorlin’s) syndrome. Future areas of study in the use of non-surgical options for patients with advanced BCC will be examined.

Biography:

Ryoji Tokashiki graduated from Tokyo Medical University in 1990. He is a Professor of Tokyo Medical University since 2008. In 2010, he opened his own practice “Shinjyuku Voice Clinic” focusing on voice disorders. He performs over 200 voice surgeries for vocal fold paralysis (UVFP), spasmodic dysphonia and achieving promising outcome. He also performs over 500 office surgeries annually for vocal fold lesions such as polyp, nodule, cysts and injection laryngoplasty. His practice also treats a lot of functional voice disorder patients including stuttering. At present, he is interested in analyzing brain activity when phonation using functional MRI.

Abstract:

Introduction: This time I will introduce novel procedure of office based injection laryngoplasty. This technique is very simple and safe with almost 100% complete rate.
Material & Methods: This procedure is performed under laryngeal endoscopic view under topical anesthesia. The 23G 60mm needle bended at the two points, about 1-1.5cm and 2-3cm from the tip, is inserted to the larynx through about 5mm above the superior thyroid notch. The needle can reach every part of the vocal fold from anterior to posterior in all directions. Because the needle length is only 60mm, the loss of injection material is slight. Additionally this procedure is useful not only for injection but for incision to vocal fold lesions such as polyp, nodule and cyst.
Results: We performed this procedure over 1000 cases for unilateral vocal fold paralysis or botulinum toxin injection for adductor spasmodic dysphonia and removal for vocal fold polyps, nodule and cyst since January 2012. There was no severe complication and accomplish rate was nearly 100%.
Conclusions: This method is very simple and useful without technical or medical failure.

Biography:

Carlos Edgar Perez Bolde Villarreal has completed his MD at the La Salle University in Mexico City and later on completed his Otolaryngology Training at the Ignacio Zaragoza, ISSTE Hospital. He has an outcomes Research Diploma by Harvard University, a Rhinology and Facial Surgery Diploma by the National University in Mexico (UNAM) and a Business Development and Management Diploma by the Technologic Institute in Mexico (ITAM). In 2008, he has started his private practice and in 2009, he has started working with Schering Plough as Medical Manager for the respiratory area. He is currently an Asociate Medical Director In Charge of Outcomes Research at Merck Mexico and he still combines his private practice with reseach

Abstract:

The body dysmorphic disorder also known as dysmorphic syndorme or dismophophobia is a mental disorder categorized in the obsessive compulsive spectrum and is characterized by an obsessive worry of a perceived defect in one’s own appearance. Usually patients imagine the flaw or if it actually exists, the magnitude of it is exaggerated. This patients often search for surgery to correct the problem and in the case that the surgeon does not detect this disorder prior to surgery, it may affect the surgeon’s reputation and become a real problem. Having the right rhinoplasty patient is not just avoiding conflicting patients as the ones with body dismorphic disorder, but to perform the right analysis and surgical plan based on the physical and anatomical characteristics of each patient. Multiple facial analysis have been described to evaluate symmetry and beauty characteristics and test for detecting body dysmophic disorder but there is no evidence that they are used rutinarely to evaluate patients searching for aesthetic surgery in Mexico. We conduct a survey to determine how otolaryngologist and plastic surgeons in Mexico approach patients willing to have aesthetic nose surgery.

Biography:

Ahmad A. Mirza has completed his MBBS at the age of 25 years from Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia. Recently, he has been appointed as demonstrator (Teaching Assistant) in Departmetn of Surgery, Taif University. He has published 2 papers in reputed journals and currently, he is working on 7 ongoing researches. He has been attended and presented in many national and international conferences.

Abstract:

BACKGROUND: Nasal deformity is an abnormality in the appearance of the nose due to either congenital defect or trauma. In the traumatic cases, the patients often present with combined functional and cosmetic complaints of the nose. Wherefore, otolaryngologists take into account both breathing and aesthetic nasal issues. The purpose of this prospective investigation was to evaluate the changes of the nasal dorsum and base as well as to compare breathing and aesthetic satisfaction scores following two types of lateral nasal osteotomy defined as low-to-low and low-to-high osteotomy.

MATERIALS/METHODS: This non-randomized interventional prospective study was conducted in King Abdullah Medical City among all patients received hump reduction rhinoplasty from 2013 till 2015. Twenty-eight patients underwent low-to-low osteotomy while 18 patients received low-to-high type of osteotomy consecutively. Preoperative and postoperative photographs were captured from each candidate to measure the differences in dorsal (DW/IP) and ventral (VW/IP) widths over the inter-pupillary distance (30mm). Satisfaction scores of both cosmetic and breathing function were obtained in the postoperative evaluation using a 5-point likert scale.

RESULTS: In both techniques, there was a significant decrease from preoperative to postoperative ratios of VW/IP distance and DW/IP distance. However, differences in DW/IP ratio and VW/IP ratio (pre versus post-op) were significantly high in the group with low-to-low class. All the patients showed breathing satisfaction post operatively regardless of the operative techniques used for them. Moreover, all the patients who were below satisfaction level of aesthetic sensibility, i.e., neutral and dissatisfied were belonged to low-to-high osteotomy.

CONCLUSIONS: Both types of osteotomy showed a satisfactory outcome either in the objective and subjective measures. However, low-to-low osteotomy is superior in the differences of DW/IP and VW/IP.
 

Biography:

Charles P Sia is the Chairman of the Department of Oral and Maxillofacial Surgery at Gullas Medical Center – University of the Visayas and a Consultant in Oral and Maxillofacial Surgery at St. Luke’s Medical Center – Global City, University of the East Ramon Magsaysay Memorial Medical Center, University of Cebu Medical Center, Chong Hua Hospital Group and Cancer Center, and the Craniofacial Foundation of the Philippines. Currently, he holds the position as Vice President of the Philippine Association of Oral and Maxillofacial Surgeons and is a Clinical Assistant Professor of the Department of Oral Surgery and Oral Medicine at Cebu Doctors’ University. He was appointed as the International Relations Officer for the Philippines of the Young Oral and Maxillofacial Surgeon Group of Hong Kong. He obtained his Bachelor’s Degree from Cebu Doctors’ University, Postgraduate Diploma in Oral Surgery and Master’s Degree in Oral and Maxillofacial Surgery at the University of Hong Kong. He is a Fellow of the International Association of Oral and Maxillofacial Surgery and a member of the Asian Association of OMS, International College of Maxillofacial Surgery, International Cleft Lip and Palate Foundation and International Congress of Oral Implantologists.

Abstract:

In retrospect, it is well understood and proven in clinical studies that Ameloblastoma is well renowned due to its high recurrence rates on enucleation alone while it has also been well documented with certain treatment options mostly concentrating to wide resections resulting in mandibular defects. Although at this moment, the pinnacle of jaw reconstruction has been well established and continually improving with the advent of vascularized flaps and growth factors, most regions require further development with regards to team protocols, equipment, healthcare coverage, and most importantly experience of microvascular surgeons. Ideal mandibular reconstruction requires complete bone restoration with contour and an emphasis on facial esthetics and future occlusal function restored by endosteal implants. This presentation will share our experience with combined surgical and medical treatment protocol applied for all types of Ameloblastoma cases treated in our centers highlighting the preservation of the mandible particularly on large tumors ideally treated by mandibulectomy.

Biography:

Maie St John is an academic head & neck surgeon with a passion for education. She holds the Pearlman endowed Chair in Otolaryngology/Head and Neck Surgery and is the Co-Director of the UCLA Head and Neck Cancer Program. The focus of her clinical work is the treatment of head and neck tumors. As chair of the Curriculum Committee in the Department of Head and Neck Surgery at UCLA, she developed a critical and comprehensive education program that prepares our graduates for board certification. She has also been awarded the Samuel and Della Pearlman Chair in Head & Neck Surgery as a result of her teaching evaluations and contributions to the Department. Recently, she also received the UCLA Health System Humanism Award, as one of the top 10 most humanistic physicians at UCLA. She is an active member of several professional societies, including the American Academy of Otolaryngology-Head and Neck Surgery, the American Head and Neck Society, the Los Angeles Biomedical Research Institute, the Triological Society and the American Association for Cancer Research.

Abstract:

Oral and Head and neck squamous cell carcinoma (OSCC) is the sixth most common cancer in the world. The primary management of OSCC relies on complete surgical resection of the tumor. Positive margin status is associated with significantly decreased survival. This project focuses on the development of a novel biocompatible modular polymer platform, which will improve the outcome for patients with advanced or recurrent Oral and Head & Neck Squamous Cell Carcinoma (HNSCC). The management of these HNSCC patients poses a considerable challenge to the surgeon and the radiation oncologist. The surgical demand in such a setting is for wider resection or, in some instances when the tumor is fixed to the underlying vital structures, to debulk as much of a large tumor as possible and leave behind the unresectable portions. Unfortunately, local failure in these cases is at least 40% or greater. The ability to decrease mortality, and improve survival for these patients has been a longstanding goal for cancer researchers. We have developed a polymer wrap that has the characteristics such as biocompatibility, is slowly degradable and can serve as a platform to deliver immunomodulators and chemotherapeutic agents so as to most effectively kill tumor cells in the proximity of the polymer application. This polymer wrap is designed to be applied intraoperatively to the surgical bed after removing or debulking the tumor, thus allowing for enhanced post-operative radiation treatment, and also functioning as a platform for the delivery of immunomodulators. Besides its clinically relevant features, the modular nature of this polymer platform provides an elegant approach to future investigations, allowing us to seek out specific molecular targets. This will enable us to dissect underlying mechanisms of immune activation and expansion, which will in turn help us design additional strategies to block the inactivation and death of the cytotoxic effectors in patients with aggressive HNSCC. We are able to build polymers that specifically target each patient’s tumor as we can profile the tumors and then target them selectively on the polymer platform. As more combinations of the polymer platform are developed, direct polymer therapy may play an important role in the armamentarium against oral and head and neck SCCA, as well as many other cancers and human diseases.

Biography:

Dhafer Ali AlGerrah started otolaryngology, head and neck surgery residency program from 1990-1994. My training was based at the medical city teaching hospital in Baghdad, which is the largest teaching hospital in Iraq. During the year 1993, I was granted DLO (Diploma) in otolaryngology and in 1994 I got the Iraqi board in otolaryngology, head and neck surgery. In 1999, I became a Fellow of the Royal College of Surgeons, Glasgow-UK. In addition, I worked as an ENT consultant & head of department at Al-Noor Private Hospital and was a member of the scientific committee. Some of the research work I did was about tonsillotomy versus tonsillectomy, tongue base reduction by coblator and the use of chemoprophylaxis in total laryngectomy. I continue to be passionate about ENT with a great interest in rhinoplasty and facial aesthetic medicine.

Abstract:

Background: Rhinoplasty is always associated with bruising nasal swelling nasal block and periorbital edema in the short postoperative period affecting quality of life of the patient badly. Platelets rich plasma (PRP) is claimed to fasten healing process reducing postoperative edema and bleeding.
Objective: To determine the effect of injecting PRP in the surgical site and under the eye on periorbital edema, bruising, wound healing, nasal swelling and nasal patency. A prospective study between 2 groups of patients with and without PRP was undertaken to assess the above parameters.
Result: A part from the cost, PRP is a safe nontoxic procedure and easy to perform.
Conclusion: PRP is promising in improving all studied parameters in post rhinoplasty cases and is improving quality of life of PRP patients compared with non PRP patients. We highly recommend use of PRP in Rhinoplasty provided patient can afford its cost as it is yet not covered by insurance

Biography:

Nawaf Hassan Fatani is a senior medical student at Umm-Alqura University in Makkah, KSA. He has participated in different research activities and is a co-author in a cross sectional study of Awareness of Pilgrims about Middle East Respiratory Syndrome-Corona Virus during 2015 Hajj Season under the supervision of Dr. Islam R Herzallah, Dr. Osama A. Marglani, ENT Department, King Abdullah Medical City, Makkah, KSA, 2015

Abstract:

Objective: Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is becoming a global health concern and with higher risk of transmission during Hajj. The purpose of this study is to assess awareness of pilgrims about this disease and to determine important aspects for future pilgrims’ education plans.
Methods: During Hajj 2015, a questionnaire on MERS-CoV was prepared in 7 languages (Arabic, English, French, Urdu, Malayalam, Indonesian and Turkish). Questionnaires were distributed inside Makkah to 2350 pilgrims from 33 different countries with the help of 56 medical students. Exclusion criteria were illiterate pilgrims and those speaking non-included languages. Pilgrims’ demographics and responses to different questions about MERS-CoV were tabulated and analyzed.
Results: A total of 2302 pilgrims (97.9%) have responded to the questionnaire, only 1156 (50.2%) reported they have heard about MERS-CoV. Out of these, 75.5% did not know about diarrhea as a presenting symptom, 33% believed the disease has a vaccine, (43.9%) is the percentage of pilgrims who thought they are not following the appropriate measures and did not know about these measures to avoid the infection, and 40.5% did not know what to do after exposure to a patient. TV was a valuable source of information for 62.8% of pilgrims, Internet 38.3% and teaching flyers for only 19.5% of them.
Conclusion: There is significant need for pilgrims’ education about MERS-CoV. The lack of appropriate orientation of pilgrims about the disease highlights the importance of awareness campaigns and teaching materials about MERS-CoV as well as other Hajj related health problems and catastrophes.

Biography:

Abstract:

A 66 years old patient consults for a progressive dysphonia. The fibroscopic examination reveals a partial immobility of the left arytenoid without mucosal lesion. The direct laryngoscopy under total anesthesia shows a sub-mucosal deformation of the left pyriform sinus and the deep biopsy under the hypopharyngeal mucosa shows a grade II chondrosarcoma whose origin – cricoid or thyroid cartilage – could not be specified neither by the CT scan nor by MRI. After a negative Pet scan, a total laryngectomy was proposed to this patient which decide to ask for a second opinion. After examination of the patient and the different images, we proposed a partial laryngectomy with immediate reconstruction in case of safe resection margins. The surgical procedure begins with a left functional neck dissection preserving the vascularization of the sub-hyoid muscles. After a tracheotomy the hyoid attaches of the sub-hyoid muscles are released and a fronto-lateral laryngeal approach is performed in order to conserve the anterior commissure and the vocal folds. Then the progressive sub-mucosal dissection of the thyroid ala demonstrates its healthiness and the presence of a left hemi-cricoid tumor. The section of the inferior crico-thyroid joint allows developing a sub-hyoid myo-cartilaginous flap including the left thyroid ala. And the anterior and posterior vertical mucosal and cartilaginous sections allow resecting the left hemicricoid including the crico-aryténoid joint but saving the left vocal cord. After checking the resection margins, the reconstruction is realized using the pediculed subhyoid myo-cartilagenous flap. The internal side of the thyroid ala is slotted to fold and create an angle imitating the shape of a closer hemilarynx. This remodeled structure is fixed to the front and rear margins of the cricoid, and the left vocal cord and surrounding tissues are sutured to this flap. Definitive histological analyses confirm a grade II chondrosarcoma with safe resection margins and no regional lymph node invasion. Postoperative period begins with an ethyl withdrawal requiring keeping the patient asleep to the 13th day. After intra-operative antibiotic, an episode of pyrexia necessitated its recovery during one week. Because of the innovative nature of this technique, postoperative rehabilitation has been slow and cautious. Rehabilitation of swallowing could begin on the 21st day. The complete oral diet was possible from the 23rd day and the feeding tube was finally removed on day 35. Because of a glottic gap, this patient has a breathy voice. The 27th postoperative day, by direct laryngoscopy, we failed to fullfill the glottic leaks with a hypopharyngeal mucosal flap. Finally, the patient was discharged from hospital on the 36th day with an obturated tracheal cannula. He continues his vocal réhabilitation ambulatory and his voice quality is improving but the tracheotomy weaning was postponed because a laryngeal lipofilling has been organized aiming to reduce the glottic leak.

Biography:

Abstract:

Lateral pharyngeal wall collapse and splinting possibilities is still unsolved problem in OSA surgery. The commonly used techniques are expansion sphincter pharyngoplasty and relocation pharyngoplasty. I proposed a new technique which is a combination of expansion and relocation called extensive lateral wall enhancement. A study was conducted on 30 cases of isolated lateral wall collapse during DISE. 10 cases managed by expansion sphincter pharyngoplasty and 10 cases were managed by relocation pharyngoplasty, 10 cases by our technique of extensive lateral wall enhancement, maximal AHI reduction occurred with our technique with no wound dehiscence.

Biography:

Maie St John is an academic head & neck surgeon with a passion for education. She holds the Pearlman endowed Chair in Otolaryngology/Head and Neck Surgery, and is the Co-Director of the UCLA Head and Neck Cancer Program. The focus of her clinical work is the treatment of head and neck tumors. As chair of the Curriculum Committee in the Department of Head and Neck Surgery at UCLA, she developed a critical and comprehensive education program that prepares our graduates for board certification. She has also been awarded the Samuel and Della Pearlman Chair in Head & Neck Surgery as a result of her teaching evaluations and contributions to the Department. Recently, she also received the UCLA Health System Humanism Award, as one of the top 10 most humanistic physicians at UCLA. She is an active member of several professional societies, including: the American Academy of Otolaryngology-Head and Neck Surgery, the American Head and Neck Society, the Los Angeles Biomedical Research Institute, the Triological Society and the American Association for Cancer Research.

Abstract:

Oral and Head and neck squamous cell carcinoma (OSCC) is the sixth most common cancer in the world. The primary management of OSCC relies on complete surgical resection of the tumor. Positive margin status is associated with significantly decreased survival. This project focuses on the development of a novel biocompatible modular polymer platform, which will improve the outcome for patients with advanced or recurrent Oral and Head & Neck Squamous Cell Carcinoma (HNSCC). The management of these HNSCC patients poses a considerable challenge to the surgeon and the radiation oncologist. The surgical demand in such a setting is for wider resection or, in some instances when the tumor is fixed to the underlying vital structures, to debulk as much of a large tumor as possible and leave behind the unresectable portions. Unfortunately, local failure in these cases is at least 40% or greater. The ability to decrease mortality, and improve survival for these patients has been a longstanding goal for cancer researchers. We have developed a polymer wrap that has the characteristics such as biocompatibility, is slowly degradable and can serve as a platform to deliver immunomodulators and chemotherapeutic agents so as to most effectively kill tumor cells in the proximity of the polymer application. This polymer wrap is designed to be applied intraoperatively to the surgical bed after removing or debulking the tumor, thus allowing for enhanced post-operative radiation treatment, and also functioning as a platform for the delivery of immunomodulators. Besides its clinically relevant features, the modular nature of this polymer platform provides an elegant approach to future investigations, allowing us to seek out specific molecular targets. This will enable us to dissect underlying mechanisms of immune activation and expansion, which will in turn help us design additional strategies to block the inactivation and death of the cytotoxic effectors in patients with aggressive HNSCC. We are able to build polymers that specifically target each patient’s tumor as we can profile the tumors and then target them selectively on the polymer platform. As more combinations of the polymer platform are developed, direct polymer therapy may play an important role in the armamentarium against oral and head and neck SCCA, as well as many other cancers and human diseases.

Biography:

Simple Patadia completed her MBBS (2010) and MS ENT (2013) from the reputed BJ Medical College, Ahmedabad (registered under Dr. Rajesh Vishwakarma). She joined her senior residency in Neuro-otology in the department of Neuro-surgery at Sanjay Gandhi Post Graduate Institute of Medical Sciences in Jan 2014. She has special interest in Neuro-otology and Endoscopic Skull Base Surgery and has presented many papers in national conferences.

Abstract:

Introduction: Para-pharyngeal space (PPS) is one of potential confined fascial planes of head and neck that may be involved by various pathological processes. Being rare, they represent an ominous challenge in its clinical assessment and appropriate surgical intervention.
Material & Methods: A study of 14 Cases of para-pharyngeal space tumors (PPST) which presented to our tertiary care Institute from January 2013 to January 2015, were included in this study. All cases were studied by their clinical examination, fine needle aspiration cytology, radiology (computerized tomography and magnetic resonance imaging), extent of excision, postoperative complications and definitive biopsy. All patients underwent surgery by trans-cervical approach. All patients were followed up for a minimum period of 6 months.
Results: The most common tumor of the para-pharyngeal space was pleomorphic adenoma (n=8), followed by schwannomas (n=5), and carotid body tumor (paraganglioma). Twelve patients were operated via extra-capsular dissection (ECD), while two patients with intra-capsular dissection (ICD). Post-operative complications were vocal cord palsy in two cases, marginal mandibular weakness in one case, Horner syndrome in one case and hypoglossal palsy in one case.
Conclusion: The trans-cervical approach is a versatile approach for complete excision of tumors with excellent exposure and minimum morbidity. It can also be combined with excision of sub-mandibular gland in order to improve exposure. In cases of large schwannomas, ICD is recommended to favor a complete excision.

Biography:

Róbert Késmárszky is currently involved in tropical ENT and Head and Neck surgical projects besides effecting neuro-mechanical research at the University of Technology and Economics in Budapest, Hungary. He is passionate about the facial nerve and reconstructive surgery. He is the author of several presentations and reviewer in the field.

Abstract:

Aim: To analyze the anatomical characteristics of the inferior division of the extra-temporal facial nerve with its impact on neck dissections.
Sources & Methods: Having the approval of the ethical committee over a hundred extra-temporal facial nerves were dissected in the department of pathology. Intra-dissective observations, macroscopic and stereomicroscopic observations were analyzed.
Results: The course, diameter, branching patterns of the examined nerves present an important difference. Their rapport with other anatomical structures is not constant. The side, sex and age of the patients were analyzed related to the differences. Though the dissective conditions were constant, unpredictable, anatomical and pathological; bleeding related difficulties occurred.
Conclusion: Malignancies of the nose and paranasal sinuses may require neck dissection with the risk of damage to the facial nerve’s inferior branches. The lesion of the marginal mandibular branch provokes serious clinical symptoms, its anatomy is inconstant. To protect its integrity, profound knowledge of the anatomy and meticulous surgery are needed.

Biography:

Cyrus Kerawala graduated with an honours degrees both dentistry (1985) and medicine (1992) from the University of London. During training he was awarded 17 undergraduate prizes. After experience in general surgery and neurosurgery he spent five years of specialist head and neck training in the North East of England. Cyrus passed the Intercollegiate Examination in Maxillofacial Surgery in September 1998 and has been on the Specialist Register of the General Medical Council since August 1999. After eight years as a Consultant at the Royal Surrey County Hospital (Guildford) and North Hampshire Hospital (Basingstoke) he moved to join the Head and Neck Unit at the Royal Marsden Hospital where his practice is exclusively oncology. The Unit acts as a secondary and tertiary referral service for complex head and neck oncological problems from both the United Kingdom and abroad. Cyrus is author of a book on Maxillofacial Surgery and has written numerous chapters in other books. He has also authored some 80 peer-reviewed publications. He devotes a significant amount of time to teaching, professional training and continuing medical education. He has presented over 100 papers at international and national meetings and has been invited to lecture throughout Europe, America, the Middle East, Asia and Australia. Cyrus is at the forefront of head and neck cancer surgery and in 2011 carried out the first trans-oral robotic resection of a tumour in the UK. In the same year he was featured in The Times newspaper as one of Britain’s 50 top surgeons. He is the Clinical Lead for the NICE guidelines on upper aerodigestive tract cancers which are due to be published in February 2016 and Honorary Treasurer of the British Association of Head and Neck Oncologists.

Abstract:

The treatment of patients with early stage, clinically node-negative oral squamous cell carcinoma remains a contentious issue. The majority of patients treated with curative intent undergo surgical excision of the primary tumour. The neck is either electively treated at the time of ablation or subjected to watchful-waiting with therapeutic neck dissection for nodal relapse. Proponents of the elective approach site decreased relapse and better survival rates. Data from prospective trials provides conflicting advice. The watchful-waiting approach has the potential advantage of avoiding surgery in up to 70% of patients who are eventually found to be pathologically node-negative. In addition, neck dissection is associated with cost, be it morbidity to the patient or financial to the health system. Proponents of a watchful-waiting approach put forward an argument that metastases can be detected at an early stage during a proactive follow-up protocol and as such a patient’s outcome is ultimately not compromised. These conflicting opinions have led to variability in management throughout the world. This presentation aims to inform the audience regarding these controversies and delineate an approach to the clinically node-negative neck in early oral squamous cell carcinoma on the basis of evidence and health economics.

Biography:

Feras Alkholaiwi is a demonstrator at Faculty of Medicine, Imam University, Riyadh, Saudi Arabia. He is also Resident in Saudi Board Program , Otorhinoloaryngology, Head and Neck Surgery. He is a graduate of King Saud Bin Abdulaziz University for Health Science. He has many research papers, with previous presentation in international otorhinolaryngology conference.

Abstract:

Voice disorders are described as effortful or difficulties in phonation and deviant voice qualities are very often associated with physical discomfort and disability. In the study we reviewed the medical records of all patients who attended the speech and language clinic at King Abdulaziz Medical City , Riyadh ,Saudi Arabia from the period of 2007 till 2013. A retrospective, cross sectional study . 998 charts in our data analysis, we excluded patient based on repeated files, incomplete data and out of the intended study period i.e. 2007 - 2013 Data was extracted from medical charts from the quadramed medical system and reviewed for key variables such as (age, gender, occupation, smoking history and history of known related diseases). Gender was almost evenly distributed in the sample. The majority of the sample were non-smokers. The three top diagnoses were ( Gastro-esophageal reflux disease 43.49%, Vocal fold cyst 11.824%, Vocal fold paralysis 10.32%.) The overall prevalence of voice disorder accounted for 37.37%. The prevalence of Voice disorder showed significant difference between genders (P-value= 0.0007) and between different age groups (P-value= < 0.0001).

Biography:

Heike Penner is a Speech Language Therapist (SLT) with 27 years of work experience in Neurologic and Geriatric Clinics. She has completed her MSc and PhD at the University of Newcastle upon Tyne and has participated in several research projects on Dysarthria in Parkinson’s Disease and Dysphagia in Geriatric Patients. She has published 12 papers and book chapters in the area of Dysarthria and Dysphagia and has given talks and presented posters at German and international conferences. She is a Member of the dBL (German Association of SLTs) and the AEM (German Academy of Ethics in Medicine).

Abstract:

Dysphagia is a symptom observed in about half of the patients admitted to an acute clinic of geriatric medicine. Dysphagia can be caused by a multitude of illnesses and its consequences such as malnutrition, cachexia, dehydration and aspiration pneumonia are noted in a high percentage of geriatric in-patients. The male patient (80 years old) presented in this case study was admitted to our geriatric clinic because of a persistent cough and severe weight loss. He had had a 16 months long history of consultations at several hospitals and medical specialists: A bronchoscopy, an X-ray of the lungs and a laryngeal examination including stroboscopy at an ENT clinic had been conducted. Finally the patient had been diagnosed with a beginning fibrosis of the lungs and compulsive throat clearing. The latter was treated to little effect by a speech and language therapist. Bedside evaluation of the patient’s swallowing performance including the Daniels Test suggested severe dysphagia which was confirmed by a video endoscopic evaluation of swallowing. The endoscopy revealed great amounts of pharyngeal residues with a high risk of post deglutitive aspiration of pudding and silent aspiration of fluids. Further medical diagnostic procedure comprised a neurologic examination, an MRT of the brain stem and blood tests which suggested scleroderma as the underlying pathology. This was later confirmed by a clinic for entorology. Severe dysphagia caused by reduced opening of the upper esophagus sphincter and beginning fibrosis of the lungs were the first symptoms of scleroderma in this patient. In general, an examination of persistent cough should include screening for dysphagia and scleroderma shoud be considered as differential diagnosis

Biography:

Kavin Andi is a Consultant Maxillo-Facial Surgeon, Clinical Research Lead and Honorary Senior Clinical Lecturer specializing in Microvascular Facial Plastic & Reconstructive Surgery at St George’s University Hospitals NHS Foundation Trust and St George’s Medical School, University of London. After completing Medical and Dental degrees at Bart’s and The London Schools of Medicine and Dentistry he undertook his basic Surgical Training in South East London before returning to the London Deanery Higher Surgical Training program in Oral & Maxillo-Facial Surgery at The Royal London Hospital; St Bartholomew’s Hospital; The Luton & Dunstable Hospital; University College London and Guy’s, King’s and St Thomas’ Hospitals. Following the award of Fellowship of the Royal College of Surgeons he was subsequently ranked 1st in the United Kingdom by the Joint Committee for Higher Surgical Training for the Advanced Head & Neck Surgery Fellowship Training Program which he successfully completed at Guy’s Hospital, London in conjunction with the award of Fellowship of The Higher Education Academy. His research interests include augmented reality, surgical robotics and 3D surgical planning for which he was awarded the prestigious 2012 Norman Rowe Clinical Prize by the British Association of Oral & Maxillo-Facial Surgeons.

Abstract:

Advances in imaging science, rapid prototyping and software manipulation of radiological datasets have given surgeons the ability to see structures inside the body with more clarity and precision than ever before. Tracking, registration and 3D technology co-exist in many hospitals but the convergence into a single augmented reality patient focused system has not yet been formally established. From pre-operative planning, surgical simulation to intra-operative delivery, I will outline how 3D technologies such volumetric reconstruction, advanced segmentation and predictive tools for vascular analysis in isolation are useful to surgeons and why as a combined vision assisted solution they will become essential to healthcare practitioners in all specialties

Biography:

oral and maxilofacial surgeon University CES Medellín Colombia -distraction osteogenesis Santa Rosa Maxillofacial Surgery center Caracas Venezuela Dr cesar guerrero -irector departament of oral and Maxillofacial Surgery Hospital Ses Hospital santa Sofía Hospital infantil Manizales Colombia -departament of oral and Maxillofacial Surgery Consultant profesor, university CES -departament of orthodontic University autónoma of manizales

Abstract:

The technique of distraction osteogenesis was used for reconstruction of long bone defects since the early 1900; Dr Illizaron demonstrated both the scientific basis and clinical efficacy of distraction that the technique gained widespread use. The mandibular reconstruction using distraction osteogenesis intraoral and bone transport technique, it will be possible to provide better treatment result for patients with significant bony defect. The advantages of this technique include the use of a minor surgical procedure without the need for blood transfusions, bone grafts, microsurgical grafts, donor site morbidity, prolonged hospital stays and may also provide superior results in patients with previously irradiated bone

Biography:

Natasha Mirza is the first woman to be appointed as Professor in the Department of Otolaryngology at the University of Pennsylvania. She has completed her Residency at the University of California, Irvine. She is the Director of the Penn Voice and Swallowing Center and Chief of Otolaryngology at the Philadelphia VA Medical Center. She has a busy clinical and surgical practice. She teaches the residents and students and has won numerous awards and she has published extensively and she is active in translational research studying subglottic stenosis and interventions to treat the condition

Abstract:

Purpose: Using a functional model of airway granulation tissue in subglottic stenosis, we investigated changes in histopathology and inflammatory markers within granulation tissue in response to intraperitoneal IL-1 Receptor Antagonist (IL1RA) injections. Changes in inflammatory markers will allow us to further delineate the immune response to wound healing and to potentially identify treatment markers. Methods: Laryngotracheal complexes (LTCs) of donor mice underwent direct airway injury. LTCs were transplanted into subcutaneous tissue pockets in the backs of recipient mice in two groups: IL1RA-treated and untreated. The IL1RA-treated arm received daily intraperitoneal injection of IL1RA for three weeks. LTCs were then harvested. Granulation formation was measured. The mRNA expression of TGF-beta and IL-1 was quantified using RT-PCR with SYBR Green Assay. Results: At 3 weeks post-transplantation, there were statistically significant differences in observable lamina propria thickness between the treated and untreated mice. There were no statistically significant changes in mRNA expression of TGF-β and IL-1β within the IL-1 Receptor Antagonist treated arm as compared to the untreated arm. Conclusions: Using a previously described murine model, we begin to delineate inflammatory markers that can be targeted for potential therapy. While the lamina propria thickness shows that the effect of IL-1 has been inhibited, the levels of inflammatory markers do not change. This verifies that early use of the IL1RA will inhibit the efficacy of IL-1 in the inflammatory cascade and can prevent early granulation formation but does not affect the levels of inflammatory markers expressed in tissue

Biography:

Prof Milan Stankovic is a: Full time Professor of Otolaryngology, Head of Otolaryngology at Medical Faculty University of Nis Serbia, Vice Director of ORL Clinic Nis, Serbia, Instuctor of European Academy of Otology and Otoneurology, Ambassador to American Academy of Otolaryngology, Visiting Professor at Ahepa University Hospital Thessaloniki Greece, International Elector at Ahepa University Hospital Thessaloniki and Larisa University of Thessaly Greece, Honorary Member of Italian Rhinologic Society, Honorary Member of ENT Society of Northern Greece, Contributor to Encyclopedia of ORL Springer New York, Editor in World Articles of Otolaryngology, Member of Editorial Board for International Advanced Otology, Balkan Jounal of Medicine, Journal of Hearing Science.

Abstract:

Purpose: In this retrospective study we analysed patients with advanced squamous cell carcinoma of the larynx and hypopharynx treated with primary total laryngectomy (PTL) between 1990 and 2007.
Methods: The patients were treated by classical PTL, radiotherapy 60-70 Gy, concomitant radio and chemotherapy (cisplatin and 5-fluorouracil) or salvage total laryngectomy (STL). They were followed up for 5 years and complications, survival, residual/recurrent disease and metastases were registered.
Results: STL after previous radiotherapy (STL-pRT), and after chemoradiotherapy (STL-pCTRT) caused more frequent local complications than PTL. Five-year disease-free survival (DFS) rate was significantly influenced by TNM stage and localization of the primary laryngeal tumor. For laryngeal cancer it was: 61.3% for PTL, 54.1% for STL-pC-TRT, and 47.6% for STL-pRT. Incomplete responders to initial treatment had low survival rate. PTL for hypopharyngeal carcinoma and particularly salvage laryngectomy after chemoradiotherapy were associated with more frequent local complications. The 5-year DFS for hypopharyngeal cancer was lower than for laryngeal cancer.
Conclusion: PTL still offers the best survival rate with low complications for advanced laryngeal and hypopharyngeal squamous cell carcinoma. STL causes more frequent local complications, especially after chemoradiotherapy. Addition of chemotherapy to radiotherapy increases the survival. Five-year DFS rate depends on TNM stage and localization of the primary tumor.

Biography:

Heike Penner is a Speech Language Therapist (SLT) with 27 years of work experience in Neurologic and Geriatric Clinics. She has completed her MSc and PhD at the University of Newcastle upon Tyne and has participated in several research projects on Dysarthria in Parkinson’s Disease and Dysphagia in Geriatric Patients. She has published 12 papers and book chapters in the area of Dysarthria and Dysphagia and has given talks and presented posters at German and international conferences. She is a Member of the dBL (German Association of SLTs) and the AEM (German Academy of Ethics in Medicine

Abstract:

Lodging of tablets or capsules in the pharynx or their aspiration may result in reduced absorption, mucosal ulcerations, aspiration pneumonia or even suffocation. To facilitate swallowing, tablets are frequently split or crushed and capsules are opened which can impair efficacy and safety of drug treatment. Although it can be expected that swallowing solid medication is especially difficult for patients suffering from dysphagia, this issue has not been investigated thoroughly before. Therefore we investigated the prevalence of difficulties swallowing solid dosage forms in patients with stroke-induced dysphagia, whether the risk of aspiration for the accompanying bolus increases during oral intake of solid medication, whether routinely performed assessment tests help identify patients at risk and the prevalence of inappropriate manipulation of solid dosage forms. Using video endoscopy, we evaluated how 52 patients swallowed four placebos of different shapes with texture-modified water (TMW, pudding consistency) and milk. Lodging of placebos was observed and swallowing performance was rated according to the Penetration Aspiration Scale (PAS). Additionally, the Daniels Test, the Bogenhausener Dysphagie score, the Scandinavian Stroke Scale, the Barthel Index and Tinetti’s Mobility Test were conducted. Finally, the patients’ medication was checked for inappropriate modification. A substantial proportion of the patients (>40%) experienced severe difficulties swallowing solid oral dosage forms. Compared to the administration of TMW/milk alone, the placebos increased the PAS values for the accompanying bolus in the majority of the patients (p 0.0001) and residue values were significantly higher (p 0.05) as well. There was no correlation to any of the routinely performed bedside tests. Of the drugs that were modified before video-endoscopic evaluation 20.8% were crushed inappropriatly. As a consequence we suggest that safety and effectiveness of swallowing tablets and capsules should be evaluated routinely in video-endoscopic examinations.

Biography:

Vural Fidan has received his MD and PhD in Hacettepe University. He is the Deputy Director of ENT Department. He is an Otorhinolaryngologist at Yunus Emre Government Hospital. He has worked as a Visiting Scientist at Yale University ENT and Allergy Departments. He has more than 20 SCI indexed articles to his credit. His research interests are pulmonary hypertension, allergy, otology, rhinology and sleep medicine.

Abstract:

Objectives: Obstructive Sleep Apnea Syndrome (OSAS) is associated with severe complications. Uvulopalatopharyngoplasty (UPPP) is one of several treatment modalities suggested for OSAS. The purpose of this study is to evaluate the effect of UPPP on Nasal Continuous Positive Airway Pressure (CPAP) levels in patients with OSAS. Methods: 20 patients who had been diagnosed with OSAS before UPPP were retrospectively evaluated. All patients had demonstrated compliance on home CPAP therapy, were minimally 6 months post-surgery and had follow-up reports that their CPAP was less effective. We collected data on age, sex, weight, BMI and apnea/hypopnea index (AHI). Optimal CPAP pressure was determined initially through attended in laboratory complex polysomnography. Follow-up CPAP pressure was obtained using an auto-titrating PAP device at home. These data were used to appreciate the pressure alterations that accompanied surgery. Results: The starting CPAP pressures averaged 12±3.5 cm H2O with a range of 8-18 cm H2O. Follow-up CPAP pressures averaged 9.5±2.9 cm H2O with a range of 4-12 cm H2O, representing an overall reduction of 22%. Conclusion: CPAP pressure requirements shift considerably in patients undergoing UPPP. Auto-titrating PAP devices have commit for facilitating the management of CPAP therapy during this time. Consideration should also be given to the use of auto titrating PAP units as the treatment of choice in these subjects.

Biography:

Kathryn E Roth is an Assistant Professor with Schulich School of Medicine, Western University, Canada. She has completed OTO-HNS Residency at Western University and Head and Neck Reconstructive Surgery Fellowship from the Sydney Head & Neck Cancer Institute and Sydney Melanoma Unit, Australia in 2010. She is currently pursuing a Masters in Health Professions Education, University of Illinois at Chicago with a research interest in skill retention. She was named Deputy Chair, Cutaneous Oncology; London Regional Cancer Program in 2014 and Co-developed a Canadian National Melanoma database. Her clinical and research focus is in cutaneous oncology with facial reconstruction, melanoma (including sentinel node), thyroid and salivary gland pathology

Abstract:

In-office ultrasound has become more common in Otolaryngology-Head and Neck Surgery practice. This affords an opportunity to examine thyroid nodules, lymph nodes in oncologic surveillance, abscesses, and pathological salivary glands in real-time. Basics of ultrasound technology and techniques specific to the head and neck region will be discussed. There is an emerging role for ultrasound in managing thyroid nodules, determining surgical candidacy for thyroidectomy, and for revision surgery in thyroid cancer, melanoma and SCC of the head and neck. The utility of ultrasound-guided fine needle biopsy (FNAB) will be highlighted, in conjunction with the 2015 American Thyroid Association guidelines for management of thyroid nodules and well-differentiated thyroid cancer. By the end of this session, the participant will be able to: 1. List the ultrasound technical requirements for thyroid examination 2. List the indications for thyroid FNAB 3. Describe the procedure for performing a thyroid FNAB 4. Demonstrate an endocrine sonographic examination of the neck 5. Recognize normal anatomical structures surrounding the thyroid on ultrasound 6. Recognize the sonographic features of concern (dimensions, echogenicity, peripheral vascularity, micro calcifications) in a thyroid nodule

Biography:

Dr. Md. Harun Ar Rashid Talukder • Fathers name: Late Abdul Motaleb Talukder • Date of Birth: 5th February 1971 • Graduated (MBBS) from: Mymensingh Medical College, Bangladesh • Completed Post Graduation (FCPS) in Otolaryngology from: Bangladesh College of Physicians and Surgeons, Dhaka • Special interest in Otology • Attended in different “ENT and Head-Neck Surgery conferences” in both home and abroad • Presently working as Consultant and Resident Surgeon ( ENT & Head-Neck Surgery) in Shaheed Suhrawardi Medical College Hospital, Dhaka, Bangladesh

Abstract:

Objectives: To observe the way of presentation of extracranial complication and to find out the relationship between socio-economic factors & extracranial complication of CSOM. Methods: This is a cross-sectional study carried out in the Department of Otolaryngology and Head-Neck Surgery, Sir Salimullah Medical College & Mitford Hospital and Dhaka Medical College Hospital, Bangladesh from 1st July 2009 to 30th June 2010. 100 patients of CSOM were included in this study. Diagnosis was established by detailed history, clinical examination and investigations. Collected data was analyzed by using SPSS. Results: In this study it was found that illiterate (24%) & less educated (41%) male patients (59%) of lower socio-economic group (57%) aged 11-20 years (51%) living in rural areas (66%) who bath in the ponds and rivers (66%) were more sufferers. Cholesteatoma was found in 78% of patients. Post auricular abscess (47%), Postauricular discharging sinus (26%), facial nerve paralysis (11%), Bezold’s abscess (07%) and Zygomatic abscess (06%), labyrinthitis (3%) was the extracranial complications revealed in this study. Conclusion: The frequency of CSOM with extracranial complications is still high in the young age of lower socio-economic class in rural areas. Findings of this study will help create awareness among all level of medical practitioners about the extracranial complications of CSOM and its association with certain socio-demographic factors to enhance prompt diagnosis and treatment.

Biography:

Zivorad Nikolic has graduated both from Medical and Dental Schools at the University of Belgrade, Serbia, Yugoslavia. He has finished his Post graduate Surgical Specialty Training and Master of Science in 1993 at the Department for Maxillofacial Surgery, Faculty of Dental Medicine; University of Belgrade. During his education, he had Specialty Training with emphasis on Plastic and Reconstructive surgery of Head and Neck as well as Craniofacial Surgery at Oxfords Radcliffe Infirmary, Great Britain. During the years 2000-2002, he spent 18 months working at Newcastle General Hospital and London’s Central Middlesex Hospital working as a part of the team for Head and Neck Surgery performing various types of microsurgical reconstructions after tumor removal, which he continued to perform back at Department for Maxillofacial Surgery in Belgrade till now. After he received his PhD title in 2006 he was appointed as Associate Professor at the Faculty of Dental Medicine, University of Belgrade.

Abstract:

Contemporary facial plastic surgery is based on achieving best possible results not only in correction of facial deformities but also in reconstruction of defects after tumor resection. It is not always an easy goal and sometimes it is necessary to perform multi stage surgical procedures to satisfy high aesthetic criteria of modern society. In corrective surgery of primary and secondary facial deformities, the most difficult task is to obtain natural look which will be socially accepted and will afford the patient normal life. Almost same criteria are in use when reconstructive surgery is in question. Doing this, at all times we have in our minds function, which should be unimpaired if not improved and aesthetic that will dominate in outside look and not interfere with function. These two main principles should be our ultimate goals in facial plastic and reconstructive surgery.

Biography:

Abstract:

Background: Changes of the hemomicrocirculatory bed play important role in diagnosis, assessment of severity and character of pathological processes. Few data exist concerning changes of the hemomicrocirculatory system in congenital heart anomalies and the problem remains unsettled. Objectives: The aim of this research was to investigate pathomorphological changes of the hemomicrocirculatory bed of the heart in newborns dying within the first 7 days of postnatal life from congenital heart disease. Methods: The hemomicrocirculatory bed of the hearts of corpses of 48 newborns who died of congenital heart anomalies has been studied. As a control group, hearts of corpses of 20 newborns that died of other diseases has been studied. The hemomicrocirculatory bed has been examined by means of Ca2+ ATP method (Chilingaryan A. M.) and modified method of Gomory (Sisakyan C. A.). Results: It was revealed that the hemomicrocirculatory system of newborn’s heart that was died not of congenital heart anomalies but because of other diseases during the first 7 days of postnatal life, sufficiently differentiated, but at the same time, in the terminal part of the hemomcirculatory system non integrated vascular loops connecting and main capillaries were found. In newborns that died of congenital heart disease in the early postnatal period pathologic alterations in the hemomicrocirculatory bed of the heart were revealed. Activity of growth and making anastomosis of the vascular buds were decreased. Inhibition of integration processes of vascular loops. The growth portion of these loops underwent pathological atrophy and finally disappeared, venous knee of these loops became tortuous. Major part of the connecting and main capillaries contained short and long vascular protrusions with signs of pathological atrophy and the tip of the dome of these protrusions was expanded. Many of connecting and main capillaries were devoid of buds of growth or there were a few of them. Inhibition of processes of formation of true capillaries in microcirculatory system was revealed. More common changes in congenital heart anomalies characterized by collapses, sclerosis and reduction of micro vessels, mostly true capillaries, they became tortuous. Configuration of loops also has changed: They lost their architecture, arterial and venous knees were located far from each other. As a result of the suppression of growth and progressive reduction of the true capillaries capillarotrophic failure of the microcirculation developed, leading to appearance of dystrophic, atrophic and sclerotic lesions. Conclusion: Pathology of development of microcirculatory system is determined not only by reducing the activity and then blocking formation of new portion of terminal part of vascular system but also by collapse, progressive reduction and sclerosis of already developed micro vessels. As a result, micro vascular remodeling is revealed. The main manifestation of this is the true capillary deficiency in the hemomicrocirculatory system that results in centralization of tissue circulation and reduction of its metabolic efficiency.

Biography:

Dr Farzin Sarkarat Board certified Oral and Maxillofacial Surgeon. Head of the O.M.F.S department, Azad medical university, Tehran, Iran. Chief of O.M.F.S ward, Buali Hospital, Azad medical university, Tehran, Iran. Head of CranioMaxilloFacial Research center, IAU, Tehran, Iran. CEO and Founder of PERIS craniomaxillofacial cosmetic and reconstructive surgery center, Tehran, Iran Consultant Maxillofacial Surgeon, DDC clinic, Dubai, U.A.E. National and International lecturer of oral and Maxillofacial surgery with more than 100 topics. More than 20 publications in O.M.F.S journals.

Abstract:

Three-dimensional virtual surgical planning using computer-aided design and manufacturing (CAD/CAM) has gained popularity in planning cosmetic surgery because of its ability to guide complex geometric planning in tree-dimensional space and save time in the operating room. The purpose of our study was to review a new concept using CAD/CAM in facial cosmetic surgery. Recent advances in the fields include facial analysis and planning in facial surface and bone graft or implant volume analysis in cosmetic surgery. In recent years, the patients who are candidate for facial cosmetic surgery want to have an image of the post-surgical face form. Furthermore, the symmetry of areas like cheeks is also of great importance for both patient and surgeon. In the present article, we applied a new method using CAD/CAM for primary scanning of soft and hard tissues in patients and their processing through computer in order to analyze the current and the ideal post-surgical face forms. Thereafter, the required molds for the operation of various facial areas were made using PLA. These molds are so designed that using them, all phases of the surgical procedure can ideally be proceeded according to analysis and this will lead ultimately to the facial symmetry and satisfaction of patient and surgeon. The CAD/CAM planning lasted one session preoperative. Positioning guides were used, translating to significant precision as well as the final position. Qualitatively, the positioning guides were easy to use and improved operating room efficiency. To conclude, CAD/CAM virtual surgical planning is effective in the performance of cosmetic surgery. More work is needed to more clearly define surgical indications for this new technology. Further out come studies are still needed to show the superiority of these methods to contemporary techniques.

Biography:

Abstract:

Management of difficult airway is one of the most challenging tasks for anesthesiologists and failure of securing it could have fatal consequences. A difficult airway is defined as the clinical situation in which a conventionally trained anesthesiologist experiences difficulty with face mask ventilation and or difficulty with tracheal intubation. Difficult mask ventilation is defined as the inability of a trained anesthesiologist to maintain oxygen saturation >90% using a face mask, 100% oxygen and positive pressure ventilation. Difficult intubation is defined as the need for more than three attempts for intubation of the trachea or more than 10 minutes to achieve it. The incidence of difficult mask ventilation is estimated to be 0.9%-5% and the incidence of difficult intubation is 0.13%-13%. The major complications associated with the difficult airway include death, hypoxic brain injury, cardiopulmonary arrest, unnecessary tracheotomy, airway trauma including aspiration of gastric contents and damage of soft tissues and teeth. In order to avoid this fatal outcome, several societies have developed guidelines for management of the difficult airway. Anesthesiologists must be prepared to deal with problems in management of difficult airway at any time. Medical history and physical examination are important tools in prediction of the difficult airway. An airway physical examination should be performed prior to the initiation of anesthetic care in all patients. Focused medical history (previous anesthesia record or anesthesia document) may detect medical, surgical and anesthetic factors that may indicate the presence of a difficult airway. Difficult intubation can either be anticipated or unanticipated. An anesthesiologist must be aware of the possibility of both situations to arise and preparations must be taken to deal with such cases and improve the safety of our patients. Practice guidelines are systematically developed recommendations that help anesthesiologists in the management of difficult airway.

Biography:

Arturo Mario Poletti is a Specialist in Otorhinolaryngology and Audiology at University of Pavia. He has worked in Otorhinolaryngology, Skull Base Surgery Bergamo Hospital directed by Dr. A. Mazzoni. He is currently the Director of Otorhinolaryngology, Department of Humanitas Clinical and Research Hospital, Italy. He was the Vice President of Italian Skull Base Society and a Member of American Academy Otolaryngology Head and Neck Surgery, Società Italiana Otorinolaringoiatria.

Abstract:

The tumors that arise in the parapharingeal space can be primary, metastatic and secondary to extension from contiguous structures. Up to 50% of all primary PPS lesions are of salivary origin, while 20% are neurogenic and 30% are of varied histology. Surgery is the treatment of choice and many approaches are proposed. We have analyzed our cases operated in the last 11 years. The role of the cervical and lateral skull base approaches will be summarized and discussed. Trans-parotid and trans-cervical approaches were adequate in most benign tumors. Combined trans-parotid-trans-cervical, trans-cervical-trans-mandibular, infratemporal fossa and petro-occipital trans-sigmoid approaches were needed for bigger tumors, malignant tumors, tumors with skull base involvement and trans-cranial extension

Biography:

Sanjay Helale is a Consultant of ENT and Head and Neck Surgeon with 18 years of experience in the field. He is currently the Head of Department of ENT at Kohinoor Hospital and Fauzia Hospital, Mumbai. His key areas include Neuro-Otology, Phono-surgery, Laser Surgery, Endoscopic Sinus Surgery and Head & Neck Surgery. In 2014, he has conferred Clinical Fellowship in Lateral Skull Base Surgery and Cochlear Implant Surgery from University of Cheiti, Italy, Fellowship Program in Rhinology and Skull Base Surgery from University of Insubria, Italy and Trans-Oral Robotic Surgery from University of Pavia, Italy. He has conferred Clinical Visiting Fellowship in Transnasal Endoscopic Skull Base Surgery Attended State of the Art Endoscopic Skull Base Surgery: A Hands on Course at The Ohio State University Wexner Medical Center and Trans-Oral Robotic Surgery from University of Pennysylvania, USA. He has published in Bombay Hospital Journal, National Journal of Otorhinolaryngology and Head and Neck Surgery Journal and Journal of Otolaryngology-ENT Research, USA and International Journal Of Advances In Case Reports.

Abstract:

1. Unusual presentation of Parapharyngeal Space Tumor , removedvia Transoral endoscopic approach 2. Unusual presentation of Kimura’s Disease 3. Rare presentation of Infected Epidermoid Cyst of Parotid , treatedpreviously for 7 years as a case of MDR Koch’s 4. HemangioendotheliomaParanasal sinuses 5. Adult onset Cystic Hygroma with axillary extension removed by Retroclavicular approach 6. Medullary Carcinoma Thyroid engulfing the carotid and extending to mediastinum, removed by transclavicular approach 7. Submandibular salivary gland malignancy presented with right sided ankyloglossia , with surgical treatment( Tracheostomy+ Feeding Gastrostomy+ Mandibulotomy+ 2/3 Glossectomy + RND + Free Flap Reconstruction) We have been following up a large no of patients over the years and have developed a substantial amount of data for the same. We have also developed case reports and case series not only about such diseases and our methods but also about their long term outcomes. As such there is a paucity of literature about some of these diseases and hence we have published these cases in scientific literature