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

Biography:

Devendra Kumar Soni has completed his Masters in Otolaryngology in year 2005 from Mahatma Gandhi Memorial Medical Collage, Devi Ahilya University, India. He worked as an Assistant Professor in ENT in MMMC, Ambala. He has publications in international and national journals. He has been assigned work of case reviewer in international journal. Presently, he is working as specialist ENT in Prime Healthcare, Dubai

Abstract:

Allergic rhino sinusitis is common condition seen in day to day ENT practice. Especially in urban area, people are facing significant nasal symptoms, may be due to more exposure to pollutants and chemicals. Although allergic reaction is hyper immune response of our body to any particular allergen/s and well controlled by medical treatment in form of anti-allergic and steroidal nasal spray with or without oral antihistamines and mast cell stabilizers but there is stage where even use of these medicines do not give significant improvement in patient symptoms of persistent nasal obstruction, decrease or loss of sense of smell. Then the role of surgery comes in scene. Studies done in past found that there is up to 61% reduction of medicine requirement for nasal allergy and asthma postoperatively. Although allergic rhino sinusitis is well controlled by medicine but in chronic allergic rhino-sinusitis and its complication, surgery has a significant role.

Biography:

U Ayfer Yukselen has completed her Medical Education at Cukurova University Faculty of Medicine in 1990 and Education of Child Health and Diseases at Hacettepe University Faculty of Medicine in 1995 and education about Pediatric Allergy and Immunology at Cukurova University Faculty of Medicine in 2010. She is currently working in Gaziantep Children Hospital Clinic of Pediatric Allergy as an Associate Professor. She has published more than 25 papers in reputed journals.

Abstract:

Allergic rhinitis represents a major cause of morbidity that includes interference with usual daily activities and impairment of sleep quality. The majority of patients respond adequately to pharmacotherapy, provided that it is taken properly and regularly. Nevertheless, a substantial proportion of patients report inadequate relief of symptoms despite treatment with intranasal corticosteroids and oral or topical antihistamines. Immunotherapy, both subcutaneous and sublingual, is an effective treatment for adults and children with severe allergic rhinitis that does not respond to conventional pharmacotherapy and allergen avoidance measures. It is also reasonable to offer allergen immunotherapy to those unable to tolerate pharmacotherapy. Selection of patients for immunotherapy requires accurate identification of an underlying allergic trigger through a combination of clinical history and skin and/or blood tests for allergen specific IgE. The efficacy of immunotherapy depends on correct patient selection, the type of allergen and the product chosen for treatment. The benefit of immunotherapy for AR triggered by perennial allergens, particularly HDM, is less well established than with seasonal allergens. The available data also suggests that immunotherapy may offer long-term benefits after its discontinuation, particularly where treatment has been continuously administered for several years.

Biography:

Aysser Tawfik Bassaly has obtained his Otolaryngology degree from Banha University in Egypt in 1994. Later, he obtained the European Board of Snoring and Sleeping Disorders from Forli, Italy in 2014. He is an Otolaryngology Consultant and the Head of the Otolaryngology Section at the Arab Academy for Science, Technology and Maritime Transport (League of Arab States) in AboKir, Alexandria Governorate, Egypt. He is a Rhinology and Sinoscopy Specialist and a Qualified Expert in Otolaryngology in Sleep Disordered Breathing Surgery. He is a founding member in the Pan Arab Rhinology Society (PARS). He is an instructor for aspiring otolaryngology physicians in the area of Nasal Sinoscopy Surgery, Snoring, Sleeping and Breathing Disorders.

Abstract:

Respiratory disorders are a big issue that affects around 60% of the population all over the world. It varies from simple snoring up to severe stridor which appears mainly during sleep. The cause of all respiratory disorders depends on obstruction, vibration or both. We can also find respiratory disorders in some rare cases like Obesity Hypoventilation Syndrome or Multisystem Disease. The respiratory events start with simple snoring without symptoms of dyspnea or hypopnea. It may extend to arousals due to respiratory efforts (RERAs Syndrome). With more and more distress, the hypopnea (decrease in Oxygen) appears till complete apnea occurs with awakened stridor. The most common sequence of events in sleep respiratory disorders can be summarized into the following; simple snoring which leads to the increase in upper airway resistance and finally ending in a group of syndromes like OSAS (Apnea, Hypopnea, RERAs).In another sequence, snoring leads to Uvular Oedema which feels like morning Obstructive Sleep Hypopnea Apnea Syndrome (Ob-SHAS). This leads to increase in Arterial Hypertension which causes daytime sleepiness. There are a lot of complications in OSAS which may be local complications in mouse, nose and chest or CVS complications like Erythema or Hypertension or psychological problems like dizziness or loss of consciousness or daytime sleepiness. One of the most common problems is how to exactly detect the size and site of the obstruction of air flow. There are several methods like full history of the patient and the partner, full clinical examination, full radiological examination or fiber-optic endoscopic examination. The treatment is either medical or surgical according to the case.

Biography:

Colonel M. Kemal Irmak MD, PhD is a Professor of Histology and Embryology in School of Medicine at Gulhane Military Medical Academy (Ankara, Turkey) where he became a medical doctor in 1987. He specialized in Histology and Embryology at Hacettepe University (Ankara) in 1992 and then received a PhD on Biochemistry at Inonu University (Malatya) in 2001. His research is focused on biological adaptation through epigenetic inheritance system and on Merkel cells as electromagnetic receptor cells. He is the author of over 80 papers with over 1300 citations and 16 h index

Abstract:

Brain is protected from thermal damage by a so-called radiator system: brain cooling system. As brain gets hotter, the veins of this radiator system bring in cool blood from the evaporating surfaces of skin and craniofacial cavities. Nasal cavity, paranasal sinuses, tympanic cavity and certain parts of head skin are the major components of this system. The cooling occurs through evaporation of mucus or sweat, and the transfer of the cool venous blood to the brain. Therefore washing or wetting these surfaces of the head (face, mouth, nose, scalp, nape and ears) a number of times helps the brain to remain cool throughout the day. In hot climates as in Africa, craniofacial features such as thick everted lips, broader nasal cavity and bigger paranasal sinuses provide more evaporating surfaces for an effective brain cooling. These geographic variations are due to direct environmental effects which, over many generations, became inherited. Epigenetic inheritance system is a genetic regulatory mechanism that allows humans to maintain extraordinarily stable patterns of gene expression over many generations. It enables organisms to acquire and transmit different phenotypes to the next generation. In this system, heritable changes occur in gene expression that are not encoded in the DNA sequence itself in the germ cells (oocytes). Epigenetic modifications of DNA include covalent modifications of bases in the DNA and of amino acid residues in the histones. But inheritance of adaptive changes is limited to embryonic neural crest derivatives such as craniofacial tissues and melanocytes, and species-to-species evolution seems unlikely.

Biography:

Julien Wen Hsieh graduated from University of Geneva Medical School (CH) where he worked on human olfaction following nasal surgery and the control of genome expression in yeast cells. He carried out an Ear, Nose and Throat (ENT) residency at Luxembourg Hospital Center in Luxembourg. In 2014, he won the "Junior Scientific Excellence Prize" for the development of a Smell and Taste Clinic in Luxembourg to treat chemosensory disorders and promote research in this field. He joined the Vosshall Lab at The Rockefeller University in January 2014 as an Instructor in Clinical Investigation. He is working with Andreas Keller in designing novel smell tests that will be useful to diagnose olfactory dysfunction in clinical settings around the world.

Abstract:

Background: Smell dysfunction severely affects human health. Olfactory tests are available; however, they have two shortcomings: (a) the testing scores depend on familiarity with the odors used in the test, and (b) they rely on the detection of a single type of molecules and people are frequently insensitive to single types of molecules, due to differences in genetic background, which are unrelated to health. This leads to misdiagnosis. To address these issues, we developed a set of olfactory tests designed to be useful in all genetic and cultural populations: The General Olfactory Threshold (GOT) and the Olfactory Resolution (OR) tests.<br>
Objectives: To investigate whether (a) the GOT test is reliable and can discriminate between subjects with low sensitivity to phenyl ethyl alcohol and anosmic subjects, and whether (b) the OR test is reproducible and measures a different aspects of olfactory perception than GOT test.<br>
Methods: The design was a test-retest reliability study. The primary outcome measure was the testing score of a butanol threshold, phenyl ethyl alcohol threshold, GOT 1, GOT 2, OR 1, and OR 2 tests. Results: A total of 75 subjects were recruited (mean age: 44.06 ± 16.77; range: 21 to 72). Regarding the GOT tests, we found that the single measure of intra class correlation coefficient was 0.43 and 0.63 for GOT 1 and GOT 2, respectively. The inter-individual variability of the GOT score was reduced compared to the olfactory threshold test (Olfactory threshold versus GOT 1: F (74, 74) = 2,982 P<0.0001; Olfactory threshold versus GOT 2: F(74,73)=2,579 P<0.0001 ). The only anosmic subject could be detected with the GOT test, but not with the olfactory threshold test. The Intra-class Correlation Coefficient of OR 1 and OR 2 was 0.74 and 0.65, respectively. We showed that the Pearson’s correlation between threshold and resolution tests is small (r=0.164-0.365), whereas the correlation between tests of the same kind is greater, especially if they were the novel smell tests (GOT 1 vs. GOT 2: r=0.62; OR 1 vs. OR 2: r=0.58).<>
Conclusion: We developed a reliable method to quantify the resolution and the general threshold of the olfactory system. We showed that this method is able to distinguish between healthy subjects with low sensitivity to phenyl-ethyl alcohol and subjects with a reduced general olfactory sensitivity. Both tests measured different aspects of the olfactory system.

Biography:

Muhammad Sami Jabbr has completed his Bachelor of Medicine from Damascus University and Master degree in Otolaryngology from Ministry of Health in Syria, then two university Diploma from Paris XI University. He got the Arab Board certificate in otolaryngology, Head and Neck surgery in 2015. He is ENT Specialist Senior registrar at Dubai Hospital.

Abstract:

Introduction: Internal nasal valve collapse is a troublesome that the Otolaryngology doctors faces in many patients suffering from inadequate nasal breathing. There are two main suggested reasons for inadequate nasal breathing at the internal nasal valve region; collapsing alar cartilage and narrow nasal angle. While most of the new literature emphasizes the spreader graft technique, I believe that flaring technique still plays an important role in management this challenging quest.
Aim: The aim of the present study is to re-evaluate the role of combining alar flare technique to spreader graft in management of internal nasal valve collapse.
Patients & Methods: 56 patients were included in the present study that underwent different surgical techniques for management of internal nasal valve collapse. None of the patients had undergone any nasal surgical repair procedure to his or her condition before. Spreader graft technique have been used alone in 10 patients, while combined alar flare with spreader graft technique was used in 46 patients through an open rhinoplasty approach. The time of surgical procedure, post-operative healing time, subjective scoring of nasal airway breathing before and after surgery and the degree of nasal dryness were recorded and compared between the two surgical groups. The post-operative evaluation period ranged from 3 to 5 years.
Results: In the first group of patients who underwent spreader graft technique alone all patients have reported an initial improvement in nasal airway breathing but only 80% of them have sustained these results after 4 years. In the second group of patients who underwent a combined alar flare with spreader graft technique, 95.7% of patients have sustained these satisfactory results after 5 years of surgical procedure.
Conclusion: The combined alar flare with spreader graft technique still provides better results than any of the two surgical techniques alone.

Biography:

Sara Safar Alshehri is a 6th year medical student from King Faisal University. She is working on 5 ongoing researches.

Abstract:

Aim: Our study aimed to determine the effect of marriage and sexual activity as risk factors on allergic rhinitis and to figure out degree of impact of consanguinity in the Saudi population on allergic rhinitis.
Methods: The study design was a cross-sectional study. The study was conducted at the outpatient ENT clinic of King Faisal University polyclinic centre at the period from October 2015 to February 2016. A random of 60 patients of age group 20-55 years old including both sexes. The inclusive criteria were patients experienced symptoms related to out- door, indoor allergic rhinitis in the past 12 months. All of them were married and subjected to a questionnaire. It included 21 questions assessing symptoms of allergic rhinitis to verify the diagnosis, and its frequency and severity. It also included the marital details and patterns of consanguinity. The result was 7 female patients (out of 24=29%) and 4 male ones (out of 25=16%) admitted experience of post coital exacerbation of allergic rhinitis attacks. In discussion the two previous studies could not find any association between AR prevalence and marriage. Marriage exerted a protective effect on AR in another study. In contrast, unhappy marriage or dissatisfied marriage can put people under stress and health problems.
Results: Human seminal plasma allergy, in women, is usually caused by sensitization to proteins present in the seminal fluid, leading to immediate hypersensitivity manifestations during or soon after coitus. Four patients had experienced post-coital exacerbation of asthma and allergic rhinitis in a case report. Sexual intercourse can precipitate sexercise-induced asthma or honeymoon rhinitis due to emotional excitement or autonomic over activity.
Conclusion: Marriage and sexual activity are risk factors for allergic rhinitis as 18% of our study experienced post coital exacerbation of allergic rhinitis attacks.

Biography:

Mario Tavolaro Giuseppe is performing the duties of Medical Director of 1st level C/O INAIL Lecce office since 1996. He also performs the assignment of Leadership Medical Major Thickness (B1) carried out at the headquarters of INAIL Jerseys since April, 2008. Dr. Giuseppe is the appointed contact person for the Regional Prevention (Puglia) and he has taken responsibilities in various high ranks in the field. He completed his degree of Medicine & Surgery from the University of Bari in 1985 and specialization in Occupational Medicine from the University of Messina in 1992. He has done extensive work in the field and his work with other authors and co-authors were published in various national and international reputed journals.

Abstract:

We tend to consider taste to be a minor sense, although gustatory perception is highly refined. Its physiology is poorly understood and the little is known about the symptoms of pathological conditions affecting taste. Taste is essentially an oral sense, and it is now widely accepted that we can perceive seven different basic tastes: sweet, salty, bitter, sour, umami, astringent and metallic. Taste is also linked to olfaction (the sense of smell) and salivation. Patients experiencing taste problems should undergo a detailed interview with their doctor, with the aim of identifying the cause of the problem. Buccal, ear-nose-and throat and neurological examinations should be carried out and chemical or electrical stimulation tests can also be very useful. Taste problems may have many different causes. They affect quality of life, reduce appetite and constitute a risk factor for under-nutrition. These conditions are difficult to treat, requiring elimination of the cause, the use of flavor enhancers or a change in diet according to the advice of a dietician. Any associated under-nutrition must be dealt with. This article focuses on post-traumatic dysguesia and its management in affected workers.

Biography:

Vipan Gupta has completed his MBBS from Govt. Medical College, Patiala, Punjab and MS ENT from the same university. He is the Professor and Head of ENT Department at MMMC&H. He has published several papers in reputed journals and has been a reviewer of ENT book of repute.

Abstract:

Background: The intranasal steroids remain the most effective treatment as all major symptoms of allergic rhinitis are effectively attenuated. However, addition of decongestant increases the response obtained along with intranasal steroids. The data on effect of addition of Oxymetazoline to fluticasone is limited. Hence, this study was done to compare the efficacy of fluticasone combined with oxymetazoline and fluticasone alone for a 4-week treatment course of allergic rhinitis.
Methodology: In this randomized, open, parallel study, out of 123 patients randomly assigned to receive fluticasone with oxymetazoline (Group 1) or fluticasone alone (Group 2), 91 patients completed the entire 4 weeks of study. The primary outcome measure was mean change of the daytime nasal symptom score (PDTS) and secondary outcome measure was mean change of nighttime nasal symptom score (PNTS) and composite symptom score (PCS).
Results: The change in total daytime nasal symptom, composite symptom, night time nasal symptom score was significantly (p<0.05) greater in Group 1 as compared to Group 2. Sub-group analysis showed a significantly (p<0.05) greater improvement in congestion score from 2nd week onwards in Group 1.
Conclusion: Oxymetazoline combined with fluticasone was effective in reducing daytime, night time, and composite symptom score as compared to fluticasone alone.

Biography:

Giannicola Iannella graduated in Medicine from Sapienza University of Rome in 2012, with a score of 110/110 with distinction. Currently he is registered to the graduate school in Otorhinolaryngology and Cervico-Facial Pathology to the Policlinico Umberto I “Sapienza” University of Rome since July 2013. He is also the author of more than 40 publications in otolaryngology head and neck surgery.

Abstract:

Recently, a new acoustic device, the so-called Sophono Alpha system (SAS), has been introduced into clinical practice. This is a boneconduction system, implanted transcutaneously, devised for restoring conductive or mixed hearing loss with bone conduction thresholds better than or equal to 45dB. It consists of a behind-the-ear external digital audio processor and a subcutaneous magnetic implant, screwed to the skull. To our knowledge, no investigation has been reported regarding its use in patients submitted to subtotal petrosectomy (SP). This surgical technique induces a postoperative conductive hearing loss up to 50 or 60 dB. SAS may be an optimal alternative to conventional bone conductive hearing aids, in order to restore adequate hearing. The aim of this study was to assess SAS hearing aids in 10 patients suffering from recurrent chronic middle ear disease who underwent subtotal petrosectomy. Presence of mixed hearing loss with bone conduction thresholds better than or equal to 45dB was present in each patient. Audiometric tests were performed before and after Sophono implantation and using a conventional bone conduction hearing aid (hearing glasses). Speech audiometry data (speech recognition threshold and word recognition score) were also performed. Speech recognition threshold in dB and percentage of word recognition score at 65dB were subsequently calculated. After implantation and activation of the Sophono Alpha system audiological data showed an average air conduction value of 42.1 dB. By comparing this data with the values of air conduction following subtotal petrosectomy, an average acoustic improvement of 29.7 dB could be calculated. Results in terms of hearing have been compared with those obtained using conventional hearing aids. The hearing results showed significant better outcomes of Sophono Alpha system vs. conventional bone conduction aid. Information about general, social and physical patient benefits after SAS implantation was carefully investigated using the validated Glasgow Benefit Inventory.

Biography:

Mohammed Alshahrani has completed his MBBS at the age of 24 years from King Saud University and currently an Otolaryngology resident in Saudi Arabia. He has published 2 papers and has many ongoing researches focusing on Otolaryngology.

Abstract:

Introduction: Supraomohyoid neck dissection considered as a part of the management in oral cavity cancer mainly, by dissecting the lymph node in level I-III including the submandibular gland. This will let the patient to have xerostomia post-operatively and it will be worse if the patient received radiotherapy post-operatively. For this reason, we conducted this study to find out the incidence and pattern of metastasis to submandibular gland in oral cavity cancer. This will answer our question if is it safe to preserve it intraoperatively to minimize the risk to have xerostomia later on.
Methodology: Multicenteric retrospective review for all the patients who diagnosed with early stage oral cavity SCC and underwent surgical resection of the primary tumor with neck dissection involving the submandibular gland in King Fahad Medical City-Riyadh- KSA and King Abdul-Aziz Medical City-Jeddah-KSA between 2008 and 2016.
Result: 41 patients were included in our study and 68% of them diagnosed with moderately differentiate SCC. None of our patient reported to have metastasis to the submandibular gland.
Conclusion: Metastases to the submandibular gland itself are extremely rare. Removal of the lymph nodes in sublevel IB seems to be feasible without removal of the submandibular gland itself. This will prevent the patient to have xerostomia.

Biography:

Abstract:

Rhinitis is one of the most common occupational diseases. Since it causes little disability, it is often neglected by affected individuals. However, it is often the preliminary manifestation of a respiratory disorder that could lead to physical complications and socio-economic disability. The potential causative agents of rhinitis are both numerous and diverse. Respiratory disorders that initially manifest as rhinitis may progress to asthma with continued exposure. Prevention of occupational rhinitis depends upon reducing exposure to allergens and irritants. When rhinitis becomes apparent, removal of the causative agent is essential to stop progression to asthma.

Biography:

Andrew Imogu is a chief consultant Ear, Nose and Throat/ Head and Neck Surgeon at the National Hospital, Abuja, Nigeria. He is also the Chief Medical Director of Hi-Fi Hospital Abuja - a high end specialist hospital with emphasis on head and neck medicine and surgery. He had his undergraduate medical training at the prestigious University of Ibadan, Nigeria before proceeding for postgraduate training in the field of Otorhinolaryngology at the Lagos University Teaching Hospital, Lagos, Nigeria. He is a fellow, faculty board member and examiner of the West African College of Surgeons. He is the immediate past president of the Otolaryngological Society of Nigeria. He is an established researcher with special interest in sinus and sleep surgery. He is currently the deputy editor-in-chief of the Nigerian Journal of Otolaryngology and associate editor of the West African Journal of Otolaryngology.

Abstract:

Introduction: Head and neck trauma is a fairly common occurrence in ORL practice in sub-Saharan Africa. Assault from unconventional weapons is increasing following a rise in terrorist activities in some countries including Nigeria.
Methodology / Results: 2 cases of penetrating laryngeal injury following assault with an unusual weapon are presented.Retrograde exploratory Laryngorrhaphy in management of stem-spiked arrow embedded in larynx is described as an innovative technique for the management of unusual penetrating injury to the larynx.
Discussion: The challenges and future perspective of this technique are discussed.

Biography:

G Dave Singh was born, educated and trained in England, UK. He holds three Doctorates including a Degree in Dental Surgery; PhD in Craniofacial Development and DDSc in Orthodontics. At the Center for Craniofacial Disorders, USA, he led a NIH-funded program of craniofacial research. He is currently a Member of the World Association of Sleep Medicine and American Academy of Dental Sleep Medicine and Fellow of the World Federation of Orthodontists and International Association for Orthodontics. He has published numerous articles in the medical, dental and orthodontic literature and has lectured in North America, Asia, Europe and Australia

Abstract:

In this study, we investigated changes in nasal cavity morphology to test the hypothesis that nasal cavity morphology can be improved in patients with sleep disordered breathing. After obtaining informed consent, we undertook 3D cone-beam CBCT scans of 11 consecutive patients prior to and after biomimetic oral appliance therapy (BOAT). The mean treatment time was 18.4 months±2.5. Volumetric 3D reconstruction of the nasal cavity was undertaken and the nasal volume was calculated in all cases. The findings were subjected to statistical analysis using paired t-tests. The results showed that the mean nasal cavity volume was 41.9 cm3±12.0 prior to treatment. After BOAT, the mean volume increased to 44.0 cm3±12.7 (p=0.022). Next, we applied the same protocol to a patient with a history of chronic rhinitis as well as sleep disordered breathing. In this case, treatment was completed over a period of 24 months. During this time, the patient showed less rhinorrhea, improved nasal breathing and regression of adenoidal hypertrophy. In addition, the patient’s head posture, facial appearance and dental occlusion improved along with better sleep. We conclude that biomimetic oral appliance therapy may be beneficial in patients with sleep disordered breathing including chronic rhinitis.

Biography:

Arman Afrashi has completed his MD from Ege University and Post-doctoral studies from Ege University School of Medicine, ENT department. He is a Member of European Sleep Research Society ESRS. He has published 2 papers describing original new methods in positional therapy and surgical therapy for treatment of obstructive sleep apnea in scientific medical journals and has been serving as an Editorial Board Member of Journal of Sleep Medicine and Management and Reviewer of Journal of Sleep Disorders and Therapy.

Abstract:

Obstructive sleep apnea is a disease consisting of episodes of partial or complete closure of the upper airway that occur during sleep and lead to breathing cessation defined as a period of apnea more than 10 s. Symptom include restlessness, snoring, recurrent awakening, morning headache and excessive day time sleepiness. Diagnosis of obstructive sleep apnea is based on sleep history and polysomnography. Today the major treatment methods are continuous positive airway pressure, weight loss, positional therapy, oral appliances and different surgical procedures. In all surgical procedures except maxillomandibular advancement, the main problem is failure of preventing the collapse of lateral pharyngeal wall. In this designed new technique pharyngolateral ferromagnetic prosthesis will prevent the collapse of lateral pharyngeal wall during sleep. Pharyngolateral ferromagnetic prosthesis contains two parts for each side of the pharyngeal part of the neck. 1. Internal part of prosthesis contains a fragmented thin part of a ferromagnetic material such as Iron (Fe), coated with biocompatible Silicone or another biocompatible material 2. External part of prosthesis contains a natural magnet with power more than 10,000 Gauss. The external part of pharyngolateral ferromagnetic prosthesis will use only during sleep in external part of the neck. Surgical technique: patient should be in supine position and under general anesthesia during surgery. After inserting Davis-Boyle mouth gag, surgeon should make a 3-cm long incision vertically in lateral wall of pharynx at the level of base of the tongue. Then surgeon should make dissection under mucosal and submucosal layers toward hypopharynx. After that he/she should insert the internal part of prosthesis and at the end close the incision . Then surgeon could perform the same procedure to the opposite side of the neck or perform unilaterally. A few days after surgery patient should use the external part of the prosthesis in both sides of the neck during sleep. The magnetic power of external part of prosthesis will pull the internal part of prosthesis and lateral hypopharyngeal wall together and this will prevent the collapse of lateral pharyngeal wall and obstructive attacks.

Biography:

Mohamed Ahmed Eladl has completed his Master and PhD in Anatomy and Embryology since 2006 from Mansoura University, Egypt. He has completed his Postdoctoral studies in Medical College of Georgia, USA. He had a Diploma in Quality Management from American University in Cairo and Master of Leadership in Medical Education from Royal College of Surgeons in Ireland. He is an Assistant Professor in the Basic Medical Sciences Department, College of Medicine at University of Sharjah. His areas of research interest are Anatomy, embryology and Medical Education.

Abstract:

Paranasal sinuses are four paired air-filled hollow sacs that surround the nasal cavity. Coronal plane computerized tomographic (CT) scanning has greatly enhanced paranasal sinuses imaging anatomy and increasingly, delicate bony anatomic variations and mucosal abnormalities of this region are being detected. In addition, anatomy has been modified significantly after endoscopes were started to be used commonly. Although the clinical significance of studies of paranasal sinuses development is limited, it is important for the otolaryngologist and radiologist to understand the details of the variation seen in the development of the paranasal sinuses in a clinically relevant manner. Knowledge of the development and pneumatization of sinuses and proper understanding of the highly complex paranasal sinuses anatomy and their anatomical variations is important for understanding sinusitis pathogenesis and its complications. It also helps for proper planning for surgical and endoscopic interventions and reduces complications following endoscopic sinus surgery. The paranasal sinuses develop as early as 8th week of intrauterine life from ridges and furrows in the lateral nasal wall. The maxillary sinuses pneumatize at birth and demonstrate an increasing growth pattern until 15 years of age. The frontal sinuses begin to pneumatize at 2 years of age and exhibit a faster growth pattern between 6 and 19 years of age. The sphenoid sinuses display a growth surge between 6 and 10 years of age and completed by 15 years of age. The ethmoid sinuses exhibit a faster initial tendency to increase until 7 years of age and completed by 15-16 years of age.

Biography:

Curriculum Vitae Personal Data Name Dr. Moustafa Mohamed Abdelnaby Date and Place of Birth 25/09/1980 Alexandria, Egypt Nationality Egyptian Marital Status Married and has 2 sibs Mailing Address 49 khalil el masry st, kafrabdo, Alexandria, Egypt Telephone Contact 002 - 01156777686 E-Mail mostafanaby@hotmail.com Qualification / Education Higher Education: Physicians Credentials Registry of Canada registered  Doctor degree processing :finished the credit hours of PHD 2013, ALEXANDRIA University.  Master Degree of OTORHINOLARYNGOLOGY Head and Neck Surgery ( Ear-Nose-Throat) (ENT)surgery Nov 2009 Faculty of Medicine, Alexandria University, EGYPT.  Bachelor Degree of medicine and surgery Sep 2003. Faculty of Medicine, Alexandria University, EGYPT. High School Degree, moubarak School of Alexandria , EGYPT Sep 1997 Professional work Experience From April 2010: Assistant Lecturer in Otorhinolaryngology Head and Neck Surgery Department . From April 2009 : Demonestrator in Otorhinolaryngology Head and Neck Surgery Department . Alexandria Faculty of Medinine, Egypt. Main duties: • Teaching the residents in the department operative and clinical skills. • Teaching the 4th year students ear, nose and throat surgery(ENT) both academic teaching and clinical teaching. • Ear,nose, throat outpatient clinic three days a week in the main university hospital (ENT) department this includes new cases and follow up cases and post operative cases. • Operations and practising surgery three days a week in the main university hospital , (ENT) department : what I do exactly is:  Ear surgery : grommet (myringotomy), myringoplasty, tympanoplasty, mastoid surgery either canal up or down, canaloplasty, preauricular sinuses, assisting in microtia cases and bat ear and glomus tumors and ear tumors.  Head and Neck: tracheostomy, thyroidectomy, thyroglossal cysts excision, laryngectomy either partial or total, microlaryngosurgery(MLS), direct laryngoscopy, oesaphegoscopy, bronchoscopy, assisting in salivary glands surgery and glomus jugulare surgery and tracheoplasty and total maxillectomy with or without orbital excentration .  Nose: endoscopic sinus surgery, septoplasty, turbinoplasty, caldwell luc operation, lynch external frontoethmoidectomy, orbital cellulitis management, dacrocystorhinostomy, dentigerous cysts surgery, assisting in CSF rhinorrhea repair, septorhinoplasty, pituitary transsphenoidal transnasal endoscopic surgery.  General: tonsillectomy and adenoidectomy, tie tongue repair, epistaxis management . • Acadmic hours for helping 4th year student for related subject and how to make a presentation and how to search about and collect data for any research. Additional work: Nov 2009 till now : ENT surgery and clinics at the SIDIGABER hospital, OKBA BIN NAFEE HOSPITAL , ROYAL Hospital , GERMAN hospital Alexandria. Jul 2005 – July 2008 Resident doctor in Otorhinolaryngology department Alexandria Main University Hospitals(EL MERY Hospital).  Training in ENT clinics  Training in operation theaters ENT on the same operations like above  Research work for the master degree in ENT (bacteriological study on the sinuses ; endoscopic work)  Practicing surgery and examination on ENT patients under supervision. Feb 2004- Feb 2005 House officer in Alexandria Main University Hospitals  2 months general surgery training  2 month internal medicine training  2 months obstetrics and gynacology training  2 months pediatric medicine training  2 months emergency  2 anaethesia and orhtopaedic surgery Feb 2004- June 2005 part time(evening or night shifts) work in El Ahly Hospital, Alexandria the work was in the emergency room also assisting many surgeon in different specialities mostly orthopaedic surgery and traumatology. Additional Skills _______________________________________________________________________ Languages spoken : Arabic (Mother Tongue) English (excellent) Reading , writing, speaking and reading as well . British council (IELTS) French (good reading and writing, moderate speaking and listening ). Deutch( limited) gates eins in gouta instituten. Computer Knowledge: ICDL Activities Otorhinolaryngology department, OTTAWA University, Canada training and observership oct 2013-may 2014 Mount Sinai University, Newyork : training in Otorhinolaryngology Department Jan 2011, 2012 for one month each. Heinch Heine Dusseldorf University, germany Aug 2008 training in haut clinic(dermatology unit). Septorhinoplasty course : organising and attende under supervision Prof. dr. Hossam M.T. foda MD held in Alexandria on: Apr 2007 Apr 2008 Apr 2009. Apr 2010. Apr 2011. Interactive endoscopic sinonasal surgery course Attende under supervision Prof. dr. M. Hassab MD Oct 2007, 2008,2009,2010,2011 Alexandria. Alexandria international combined orl congress Under supervision Prof. Dr. samy Elwany MD, Prof. Hisham Abdelfatah 2007 2008 2009 2010 2012 2013 Egyptian society of skull base surgery Under supervision Prof.Dr . M.Badreldeen MD nov 2008 Alexandria. Rhinoalex Attende under supervision Prof. dr. M. Hassab MD oct 2009, 2010, 2011,2013 Egyptian ORL society( member ) Since 2009feb Cairo. Cairo university rhinology conference 2008,2009,2010,2011. Ballon sinoplasty course sharm el sheikh Einshams University conference, march 2010 Cardiopulmonary Resuscitation Course from European Resuscitation Council feb 2012 Refrences Prof.DR.gehad shebib MD Ottawa Hospital 001613 -721 5757 Prof.DR.Hisham Abdelfatah 002-01222169896 Prof. Dr. Samy Elwany ex-Head of the Department 002-01222166222 Prof dr.fathy Abdel baky ex- Head of the Department 002-01222172076 Prof. dr. Hossam M.T. foda MD 002-01222158695

Abstract:

Background: Chronic polypoidal rhinosinusitis (CPRS) is characterized by mucosal inflammation affecting the nasal cavity and paranasal sinuses. Its pathogenesis is not completely established and potentially overlapping. The possible explanations are: Immune deficiencies, genetics, aeroallergens, fungal sinusitis, osteitis and biofilms. Multivariate causality makes the diagnosis of CPRS and selection of treatment complex. Surgical ventilation with mechanical disruption of biofilms and osteitis is a potential therapeutic choice. Purpose: To study the role of osteitis and biofilms in patients with CPRS and outcomes of functional endoscopic sinus surgery (FESS) in its management. Patients & Methods: Fifty patients (22 males, mean age of 30.6 years) undergoing FESS for CPRS. Multislice CT scan on nose and paranasal sinuses were examined and scored by Lund-Mackay (LM) staging protocol, determination of the severity of Osteitis using a new Global Osteitis Scoring Scale (GOSS). Samples of tissue and bone biopsy were taken from diseased sinuses to be analyzed histopathologically for detection of osteitis/biofilm and with scanning electron microscopy (EM) to evidence biofilms. From another ten patients scheduled for septoplasty with no evidence of sinusitis or polyposis, tissue specimens were obtained 1 cm behind the anterior end of inferior turbinate and processed in the same manner as a control group. Study design: A prospective cross-sectional cohort study Results: In 70% (35/50) of the CPRS patients, histopathology was positive for osteitis and biofilms were detected by EM in 39 (78%). Two of controls (20%) were positive for biofilm but none with osteitis. The mean LM staging was 19.08 and mean GOSS was 18.68. There was a significant correlation between LM staging and GOSS and between both and histopathologically proven osteitis, biofilms and postoperative endoscopic healing where increase soft tissue disease is associated with bad healing and vice versa. Conclusion: Osteitis and biofilms underlie the pathogenesis in the majority of Egyptian patients with CPRS. Scanning EM is a good method for visualization of biofilms that evidenced its presence in CPRS cases. FESS with surgical ventilation, mechanical disruption of biofilms and osteitis is a mandatory therapeutic choice.

Biography:

Mohd Mujtaba Khan has completed his Masters in Otolaryngology from Osmania Medical College, India. He is a Consultant at MAA ENT Hospital, Hyderabad. He is a Member of the prestigious American Head and Neck Society (AHNS). He has given several presentations in national and international conferences and published papers in various journals

Abstract:

Paranasal sinus neoplasms, both benign and malignant are relatively rare in the head and neck. Malignant neoplasms of the paranasal sinuses account for approximately 3.0% of head and neck cancers. In general, these tumors are identified and treated at advanced stages as their symptoms mimic benign inflammatory conditions. Benign lesions tend to slowly enlarge and therefore remodel bone rather than destroy it. Malignant processes are more likely to show frank bone erosion and destruction. The most common malignant neoplasm of the nose and paranasal sinuses is squamous cell carcinoma. The presenting symptoms in patients with paranasal sinus neoplasms are nasal obstruction, rhinorrhea and sinus congestion. However, as the masses grow, paranasal sinus neoplasms lead to facial pain and epistaxis. Imaging is critical to identify the extent of both benign and malignant disease. Treatment includes surgical resection, radiation and rarely chemotherapy. Benign tumors present in a similar manner and typically necessitate surgical resection and close postoperative follow-up. The following presentation is a retrospective study of 40 sinonasal tumors over a period of 2 years at a tertiary referral centre in India. A detailed description of etiology, diagnosis and managment of sinonasal tumors is presented.

Biography:

I am Dr.Uzma Tanveer, Resident doctor at Otorhinolaryngology-Head & Neck Surgery Department, Liaquat National Hospitali have, Karachi.I completed my MBBS in 2009 and then passed fcps part 1 in 2011,I joined as resident doctor at Liaquat National Hospital in 2013. I have publications in journals. Recently I Participated and presented paper on ROLE OF NECK DISSECTION IN N0 DISEASE at 25TH International Conference of PSOL.

Abstract:

ABSTRACT: Introduction: Nasal polyps are grape like structures that originate in the mucous membranes lining the nasal passages or paranasal sinus. Treatment included Functional Endoscopic sinus surgery and post operative steroid therapy. The duration of steroid use is still debatable.
Objective: To assess the frequency and recurrence of patients presenting with nasal polyposis who underwent Functional Endoscopic Sinus surgery and was given topical steroids for twenty four months. Material and method: Total 90 patients diagnosed with nasal pathology were enrolled; various sign & symptoms were tabulated. Clinical and histopathological reports were analyzed. Post operative steroid dose and recurrence rate was noted . Frequency and percentage were calculated of qualitative variables, chi-square test and Fisher’s exact test was applied to see the recurrence.
Results: Total 90 patients of either gender aged between 12 to 63 years fulfilled the inclusion criteria and were enrolled in the study. The results showed that among all study patients, 53(58.9%) were male and 37(41.1%) were female. Common presenting symptoms include nasal obstruction (97%), nasal discharge (90%) and headache followed by diplopia and proptosis. From 90 cases, 73(81.2%) had Allergic sinusitis without fungus & 17(18.9%) cases had Allergic Fungal Sinusitis (Aspergillus). Postoperatively patients were given topical steroids &recurrence was seen in twelve (17.8%) patients, 9(12%) with Allergic sinusitis without fungus and 3(17%) with AFRS.
Conculsion: The incidence of AFRS is (17)18.9% of CRS which is slightly higher as reported in previous literature. Patients presented with nasal polyposis should receive steroids to prevent recurrence.

Biography:

Kul Bhushan Bali completed his Masters degree from King George Medical University in 1989. He has advanced training in ear and nasal surgeries from Scotland, Germany, Austria and Canada. He is working at Al Ain Hospital since 2007.

Abstract:

Myringoplasty is the procedure for restoring the integrity of the tympanic membrane. Success rates for myringoplasty vary widely in the literature from 65-100%, with many authors advocating specific techniques to improve outcomes. We discuss our eight years’ experience of doing various types of Myringoplasties at Al Ain Hospital and its success rate.

Biography:

Lebogang Ramma completed his Doctor of Audiology (AuD) degree from the University of Florida, Gainesville, USA and Master of Public Health degree (MPH) from the University of Witwatersrand, Johannesburg, South Africa. He is the current Head of Division, Division of Communication Sciences & Disorders at the University of Cape Town. He has published over 20 papers in reputed journals. He also chaired a Health Professions Council of South Africa’s task team that developed guidelines for monitoring ototoxicity in patients who are on treatment that involves ototoxic medications.

Abstract:

Ototoxicity, defined as a functional impairment and cellular degeneration of the tissues of the inner ear caused by therapeutic agents, is a common adverse event reported following treatment with various compounds such as aminoglycosides and platinum derivatives. Ototoxicity often leads to permanent damage to cochlear and vestibular end organs and may lead to permanent hearing loss. Several criteria have been developed over the years to document ototoxicity-induced hearing loss following treatment with ototoxic medication. However, most of existing criteria have limitations that preclude their use across different contexts; lack of a ‘common language’ used to grade ototoxicity, do not strongly relate to functional outcomes and do not appreciate the effect of ultrahigh frequency hearing loss. We therefore developed an alternative and more clinically relevant grading system (UCT ototoxicity grading scale) for ototoxicity in adults that could be used across patient populations and institutions. In this study, we assessed the feasibility of using this alternative ototoxicity grading criteria as well as compared it to existing ototoxicity grading criteria for adults. The findings of our study showed that the new criteria was easy to use (good interrater reliability, Kappa = 0.87) and showed good agreement with existing ototoxicity grading criteria for adults (UCT versus CTCAEv4, 73.4%; UCT versus TUNE, 78.2%). Given that the UCT ototoxicity grading scale was developed from universally used hearing loss classification systems and it is easy to use, we recommend it for use across different contexts and population groups.

Biography:

Ahmad Nasrat Al-Juboori has received his PhD in Iraqi Commission for Medical Specialization, Al-Nahrine University during the period of 1994-1997. Currently, he is working as Professor in Otorhinolaryngology in Ibn Sina College of Medicine, Al-Iraqia University. He has successfully completed his administrative responsibilities as Consultant Otorhinolaryngologist. His research has included 18 published articles in ear, nose, throat and neck surgical fields. Based on this research and fellowship training he has received several awards and honors, such as: Award from ministry of Iraqi higher education and scientific research, award from Iraqi ministry of health and membership of American Association for Science and Technology (AASCIT). He is serving as an Editorial Board Member of several reputed journals like General Medicine: open access in OMICS group, as well as to International Journal of Clinical Medical Research (USA) & expert Reviewers for journals like International Journal of Clinical Medical Research. He has authored 18 research articles. He is a member of Iraqi Medical Association, Iraqi Society of Otolaryngology, head and neck surgery, as well as American Association for Science and Technology.

Abstract:

Keratosis obturans is a rare condition characterized by the accumulation of desquamated keratin material in the bony portion of the external auditory canal (EAC). It is thought that keratosis obturans is due to abnormal epithelial migration of ear canal skin. Classically, it is reported to present with severe otalgia, conductive deafness and global widening of the canal. The frequency of keratosis obturans has been estimated as 4-5 in 1000 new otological cases. Extensive erosion of the bony meatus, with exposure of the facial nerve, has been previously reported as one of the complications on Medline the 1st published such complication in 2006. The purpose of this case report was to present a rare and probably the first reported keratosis obturans in Iraq that caused facial palsy.

Biography:

Amany Ahmed Shalaby, MD is the Professor of Audiology in Ain Shams University since 1994. She is the Member of International Auditory Physician Association (IAPA), Egyptian Otorhino-laryngology Society, Egyptian Audio-Vestibular Medical Society and Board Member in the Egyptian Audio-vestibular Medicine Association (EAVMA). She is a Certified Trainer of KAMPS method of Auditory Integration Training (AIT). She is a Reviewer in the ENT Committee for promotion of Professors and Assistant Professors and Reviewer of EJENTAS Journal and EJO Journal. She is specialized in diagnosis & management of hearing & balance disorders, main domain evaluation & management of children with learning disabilities, central auditory processing disorders (CAPD), Attention Deficit Hyperactive Disorder (ADHD), Autistic spectrum disorder.

Abstract:

Background & Aims: The purpose of this study was to investigate whether children with ADHD may have a co-existing auditory attention disorder which may be a potential underlying cause for their impaired recognition in background noise and therefore their educational problems.
Methods: A prospective study, in which sixty children diagnosed as having ADHD were examined. They were classified according to DSM-IV or its Arabic translation (ADHD-SC4) into three subgroups: 20 children were ADHD-HI, 20 children were ADHD-IA and 20 children were ADHD-C. The control group comprised twenty children, ranging in age from 5-12 years with normal hearing sensitivity, normal middle ear function, normal intelligence and good scholastic achievement. All children were subjected to history taking, basic audiological evaluation, ACPT test to measure sustained auditory attention, SPIN test and TEOAE suppression test to measure selective auditory attention.
Results: ACPT test showed moderate sensitivity in diagnosing ADHD disorder, though it was efficient in ADHD sub-typing. Children with ADHD have poor selective auditory attention ability as shown by reduction in SPIN test scores in the three subgroups. ADHD children showed limited overall TEOAEs suppression which suggested medial OCB involvement.
Conclusion: Management plan for ADHD should include strategies for selective as well as sustained auditory attentional abilities. And rehabilitation of ADHD children should be directed to enhance their auditory abilities rather than to depend on their visual perception which is more commonly affected.

Biography:

Debora Maria Befi-Lopes 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 PhD in Linguistics from the University of São Paulo (1997). She is an Associate Professor at the School of Medicine, University of São Paulo, Brazil, since 2002. She has published 98 papers in indexed journals and 284 abstracts in conference proceedings. She has published book chapters and books and received 39 awards and honors.

Abstract:

To evaluate neural mechanisms encoding speech sounds through Speech-ABR in APD and SLI children. Specifically, literature describes temporal processing abnormalities in SLI, so we hypothesized that SLI and APD would demonstrate greater perceptual deficits in neural encoding of speech sounds in subcortical auditory pathways in response to rapidly speech. Speech-ABR was tested in 57 children, 6-12 years old (three groups), TD (n=18; mean 109, 83 months), APD (n=18; mean 110, 00 months) and SLI (n=21; mean 96, 00 months). All children presented normal peripheral hearing bilaterally. Speech-ABRs were elicited using fiveformant syllable/da/(BioMARK). Based on these characteristics of Speech-ABR response, 3 dimensions were defined for analysis: Timing, harmonics and pitch. ANOVA test was applied (significance level 0.05). Timing of onset response to /da/ showed statistical differences between groups with APD and SLI, showing greater latency of “A” peak than TD (p=0.009 and p=0.002, respectively). For C, E, F and O peaks, only SLI group showed a statistically significantly increase in latency when compared to TD [E, O=p<0.05; C, F=p<0.01]. Furthermore, we observed discrete latency increase for SLI when compared to APD group with difference for E and F peaks [p<0.05]. For pitch and harmonic encoding, there were no group differences in amplitude of spectral component F0 and F1. In contrast, there was difference in encoding of HF among the response to TD and SLI (p=0.01) as well as APD and SLI (p=0.05). TD and APD exhibited greater amplitudes when compared with SLI. We concluded abnormal encoding for specific acoustic features that are characteristic of speech for children with APD and SLI. The hypothesize that abnormal speech-ABR should manifest itself in difficulties in speech perception was confirmed. However, SLI exhibited worst results when compared with APD and TD suggesting worst representation of crucial components of speech sounds could contribute to difficulties.

Biography:

Mohammad Hossein Khosravi is a young investigator and medical student and has dedicated most of his research favor to otorhinolaryngology. He has already published two papers in this field in journals like International Forum of Allergy and Rhinology and also has one in press in British Journal of Oral and Maxillofacial Surgery. He is working on several Otolaryngology projects especially “new treatments for tinnitus” as his thesis. Recently he participated in 6th THC and 1st ICNU as a member of students' scientific committee. At present, he is in charge for deputy of research and head of otorhinolaryngology research group at BMSU students' research committee.

Abstract:

Tinnitus is the perception of a sound in the absence of an apparent acoustic stimulus. After otorrhea and hearing loss, tinnitus is the most common symptom in the patient with chronic otitis media (COM). We aimed to evaluate the improvement of tinnitus in COM patients after tympanoplasty and tympanomastoidectomy surgeries. This prospective study was conducted on 50 COM patients suffering from tinnitus who were referred to Otolaryngology clinic of Baqiyatallah Hospital and underwent tympanoplasty or tympanomastoidectomy surgery. After confirmation of COM, Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) questionnaires were filled before and two months after surgery by patients and considered subjects were compared with each other. Also an audiometry test was taken from each patient before and two months after surgery and results as well as Air-Bone gap were measured and evaluated prior and after surgery. Eventually 26 male and 24 female patients with a mean age of 38.62±11.88 years underwent analysis. Air conduction at all frequencies was significantly improved after surgery (P<0.001). Severity of tinnitus was significantly decreased after surgery based on both TIH (P<0.001) and VAS (P<0.001) evaluations. Tinnitus severity reduction was significantly associated with the improvement of hearing loss and decrement of Air-Bone gap (P<0.001). Tinnitus symptoms such as loudness, annoyance, impact on life and perception of tinnitus significantly reduced after surgery. Also tympanomastoidectomy was more effective on improvement of tinnitus in comparison with tympanoplasty (P=0.019). So, both tympanomastoidectomy and tympanoplasty surgeries are effective on improvement of tinnitus in patients with COM; however tympanomastoidectomy seems to be more effective.

Biography:

Rezvan Dashti has completed her MSc in Rehabilitation administration at the age of 28 years from Ahvaz jundishapur University of medical science.She has published more than 4 papers in reputed journals.

Abstract:

Background & Objectives: Hearing loss is one of the most disabling impairments that its consequences affect hearing impaired people in all aspects. Using hearing aid in order to resolve hearing problem, positively affects this peoples’ quality of life. This research aimed to assess satisfaction with hearing aids based on type and degree of hearing loss.
Subjects & Methods: This descriptive-analytic and cross-sectional research was conducted on 187 subjects with hearing loss who were using hearing aid. The subjects were over 18 years old and they have been using hearing aid at least for 6 months. Persian version of Satisfaction with Amplification in Daily Life (SADL) questionnaire was the instrument which was used for assessing satisfaction with hearing aid. It was assessing four dimensions: services and costs, users’ self-image, negative features and positive effects.
Results: A significant difference was observed among mean satisfaction scores between people with different degree of hearing loss in cost and services subscale (P=0.04); subjects with moderate hearing loss estimated more satisfied. Mean satisfaction in persons who had mixed hearing loss estimated more than people who had sensorineural hearing loss in all subscales (P<0.021).
Conclusion: Global mean score of satisfaction showed a relatively high satisfaction of subjects with heir hearing aids. Increasing knowledge and educating audiologists for more proper and better hearing aid fitting as well as using self-reporting questionnaires like SADL for estimating social condition can essentially change patients’ disability condition and countervail their hearing loss. Audiologists can decrease negative effects in moderate as well as moderate to severe hearing loss persons by deliberate consulting about limitation and abilities of amplifier.

Biography:

Amaia Méndez Zorrilla holds a BSc in Telecommunication Engineering and a PhD in Computer Science from the University of Deusto. She is currently a lecturer at the University of Deusto, where she teaches at the Bilbao campus. She teaches BSc courses in Industrial Technology Engineering. Specifically, she teaches the following subjects: Networks I, TV and Video Digital Systems and Multimedia Networks. Her publications mainly focus on biomedical engineering and new technologies applied to society. During the past few years she has carried out research on the design and development of digital image-processing algorithms and on projects to improve the quality of life of people with special needs. She is part of the DeustoTech Life research team.

Abstract:

Hypothesis: Personalizing the material used for the tests based on the physiological characteristics of each patient can reduce patient discomfort during endoscopies.
Background: It is common to use similar probes in terms of diameter and length regardless of the characteristics of the patient. This can cause discomfort during execution of the tests and can lead to results of worse quality than expected.
Methods: A low-cost app installed on an iPad which from a photo of the patient performed at a set distance can extract the necessary measurements for the probe could optimize endoscopies. The application includes an algorithm that automatically calculates distances including bends that the fiber optic probe/strobe would go, so the doctor can prepare material for use with a personalized size for each patient.
Results: We have performed simulations in the University of Deusto Evida Laboratory of patients with varied characteristics of age, race and skin tone. Tests have also included patients with different aesthetic characteristics such as beards, glasses or fringes. In 80% of cases the results are satisfactory in the first iteration. In 12.3% of cases the application does not detect the important points for calculations in the first iteration and needs a second, obtaining the expected results in the second attempt. Only in 7.7% of cases the app does not work properly at all, although the authors have found that the capture stage did not meet the 100% ideal lighting conditions and distance to the camera.
Conclusions: ICTs are a great support to medical personnel and can improve the user experience during the clinical trials.

Biography:

Enaas Kolkaila has finished Medical School in 1983 from Tanta University and completed her Master's in 1987 from Ain Shams University in Cairo. She lived the following years in USA and returned in 1991 when she continued studies and finished MD in 1997 from Ain Shams University. She is a Professor of Audiology in Tanta University which is the 4th largest university in Egypt. She had supervised 22 theses both Masters and MD. She has published more than 30 papers and has been serving as a reviewer in EJENTA.

Abstract:

Background: Tinnitus is a sound perception in one or in both ears, as well as in one's head which is not related to any external source of stimulation or noise. It is now evident that tinnitus may be initiated by abnormal activity from the peripheral auditory system. However, its progress is due to involvement of the central nervous system.
Objectives: This study was designed to evaluate cortical auditory evoked potentials (CAEPs) in tinnitus patients with normal hearing. Subjects & Method: This study included two groups: Group I (control group); consisted of 20 normal hearing adults and group II (study group) consisted of 20 normal hearing subjects with bilateral tinnitus. CAEPs were recorded using tone stimuli in frequencies of 500, 1000, 2000 and 4000Hz at 50dB & 70dB sensation levels.
Results: The tinnitus group showed no significant difference among the four frequencies in latencies at 70dBSL. Also, there was more saturation of 4000Hz latency response to increased intensity and the shorter latencies than control group in the four tested frequencies at both intensities used.
Conclusion: Tinnitus patients with normal hearing showed alterations of CAEPs response which confirm the central auditory structures changes in those patients.

Biography:

Somia Tawfik has been graduated from medical college on 1978 & had Doctorate degree of audiological medicine on 1986 from Ainshams University. She is a senior professor of audio-vestibular medicine at Ainshams University. She is a member of International Association of Physicians in Audiology (IAPA), International Association of Logopedics and Phoniatrics (IALP), the Egyptian Audio-Vestibular Medicine Association (EAVMA) and the Egyptian Society of Oto-rhino-laryngology. She has published more than 30 papers in reputed journals particularly in the auditory processing area. She is a member of the team who developed the Arabic test materials for diagnosis of central auditory processing disorders in adults & children and shared in the development of the Arabic computer-based program for remediation of children with central auditory processing disorders. She is a reviewer at the EJENTAS & the AAA journals. She has been invited to speak in many regional & international audio-vestibular and ENT conferences.

Abstract:

Background: Tinnitus is a sound perception in one or in both ears, as well as in one's head which is not related to any external source of stimulation or noise. It is now evident that tinnitus may be initiated by abnormal activity from the peripheral auditory system. However, its progress is due to involvement of the central nervous system.
Objectives: This study was designed to evaluate cortical auditory evoked potentials (CAEPs) in tinnitus patients with normal hearing. Subjects & Method: This study included two groups: Group I (control group); consisted of 20 normal hearing adults and group II (study group) consisted of 20 normal hearing subjects with bilateral tinnitus. CAEPs were recorded using tone stimuli in frequencies of 500, 1000, 2000 and 4000Hz at 50dB & 70dB sensation levels.
Results: The tinnitus group showed no significant difference among the four frequencies in latencies at 70dBSL. Also, there was more saturation of 4000Hz latency response to increased intensity and the shorter latencies than control group in the four tested frequencies at both intensities used.
Conclusion: Tinnitus patients with normal hearing showed alterations of CAEPs response which confirm the central auditory structures changes in those patients.

Biography:

Amany Ahmed Shalaby, MD is the Professor of Audiology in Ain Shams University since 1994. She is the Member of International Auditory Physician Association (IAPA), Egyptian Otorhino-laryngology Society, Egyptian Audio-Vestibular Medical Society and Board Member in the Egyptian Audio-vestibular Medicine Association (EAVMA). She is a Certified Trainer of KAMPS method of Auditory Integration Training (AIT). She is a Reviewer in the ENT Committee for promotion of Professors and Assistant Professors and Reviewer of EJENTAS Journal and EJO Journal. She is specialized in diagnosis & management of hearing & balance disorders, main domain evaluation & management of children with learning disabilities, central auditory processing disorders (CAPD), Attention Deficit Hyperactive Disorder (ADHD), Autistic spectrum disorder.

Abstract:

Objectives: To study temporal auditory processing abilities in SNHL children using behavioural [Auditory fusion test (AFT); Duration pattern test (DPT); Pitch pattern sequence test (PPST); time compressed sentence test (TCST)] and electrophysiological measure [Mismatch negativity (MMN)]. And to study whether there is a correlation, if any, between results of behavioural tests and MMN in assessment of temporal auditory processing.
Methods: This study included 2 groups: A study group of 60 children with mild to moderate sensorineural hearing loss (SNHL); and a control group of 30 normal hearing children. The children's age ranged from 6-12 years.
Results: The SNHL subgroups showed statistically significant lower scores in AFT, TCST, DPT and PPST as well as longer MMN latency than their controls. Age had significant effect on temporal auditory processing tests results and on MMN parameters but gender and aetiology of SNHL had no effect. There was no statistically significant correlation between results of behavioural tests and MMN in normal as well as SNHL children.
Conclusion: Sensorineural hearing loss affects temporal auditory processing abilities reflected on both behavioural & electrophysiological test results. Age showed maturational effect on behavioural tests in all subjects, but this effect was not reflected on the MMN results of the controls, despite of the significant effect of SNHL on MMN parameters. There was no correlation between behavioural & electrophysiological test results.

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: Cochlear implants are one of the most successful implants in the world. However, any implantation surgery is prone to considerable risk of failure (4-8% in literature). Our experience in dealing failure of cochlear implant devices is shared in this paper.
Materials & Methods: A retrospective study of 250 patients (201 children, 41 adults), with normal cochlea, at a tertiary care center, from June 2004 to June 2014, was done. All cases were implanted multichannel devices via Veria technique of cochlear implant surgery. Preoperative assessment, surgical considerations and postoperative audio-logical outcomes were analyzed. Preoperative and postoperative audio-logical outcomes were analyzed using Category of Auditory Perception (CAP) Score and Speech Intelligibility Rating (SIR) Score
Results: Rate of re-implantation was 2.8%. The causes of revision cochlear implant surgery were hard device failure (n=3), surgical complications (n=2), magnet displacement (n=2), soft failure (n=1), electrode extrusion (n=1). In one patient, recurrent cutaneous infection on the implanted site ultimately resulted in re-implantation in the opposite ear, after multiple surgical interventions on the same side. The preoperative and postoperative CAP and SIR score showed significant improvement in postoperative period with p<0.05 as compared with paired t test.
Conclusions: Preoperative counseling for device failure should always be emphasized. There is a high surgical success rate in RCI with preservation or improvement in preoperative auditory performance.

Biography:

Rezvan Dashti has completed her MSc in Rehabilitation administration from Ahvaz Jundishapur University of Medical Science. She has published more than 4 papers in reputed journals

Abstract:

Objectives: WHO (2005) estimated 278 billion of people suffer from hearing loss that about 2/3 of them live in developing countries. The practical step in aural rehabilitation process for majority of persons who have hearing loss is hearing aid.
Methods: 187 patients with hearing loss fitted with different hearing aids were included. Scale “Satisfaction with Amplification in Daily Life" (SADL) was applied used to assess the benefits yielded by the hearing aids.
Results: In evaluation of satisfaction with hearing aid, the positive effects showed the highest mean score among SADL subscales and negative features has the least mean score that shows relative dissatisfaction of elderly users. Significant difference was observed between mean satisfaction score and hearing aid model too. In evaluating satisfaction with hearing aid and style of that only was observed in cost and services subscale (P=0.005).
Conclusion: Subjects with different style of hearing aid were estimated relatively satisfied. Whereas prevalence of hearing loss is flourish, specify need to rehabilitation was developing and think for fund supply to secure that.

Biography:

Manal El-Banna has completed her MD in 2005 from Alexandria University and became Assistant Professor in Phoniatrics in 2011. She is a member of IALP since 1998. She is consultant at the Clinical Genomic center since 2010. She has published 13 papers at national and international journals.

Abstract:

Introduction: Cochlear implant recipients vary in their performance with their implants. One of the reasons of difference in performance might be the number of surviving spiral ganglion cells. Potentials evoked by electrical stimulation of the auditory nerve depend on the degree of synchrony of neural firing. Thus it is expected that cochlear implant recipients who show electrically evoked potentials at different levels of the auditory nervous system might perform better than those who do not.
The aim of this study: To record EABR and EMLR from cochlear implant users, investigate consistency over time, investigate the relationship between electrophysiology and MAP psychophysics and correlate the recordings with speech perception scores. Subjects: Twenty four cochlear implanted subjects were recruited from Audiology clinic; Otolaryngology Department, Faculty of Medicine, University of Alexandria, Egypt The inclusion criteria were to have a functioning implant that possessed a bidirectional telemetry feature.
Methodology: All subjects underwent the following, (1) detailed history taking medical and surgical, (2) aided free field testing with their implants, (3) electrically evoked potentials recordings, (4) Speech perception testing was performed at the phonetic level using the speech pattern contrast test that tested the ability of cochlear implant users to differentiate between contrasts related to vowels and consonants.
Results: Most of the subjects showed responses at one or more electrically evoked potential. Electrophysiological thresholds of EABR were within patients’ dynamic ranges and were detected form the first recording time and were generally consistent over time. EMLR was absent in many children before 1 year of implant use. All subjects were able to detect vowels and consonants, however, performance in the discrimination task varied. Comparing different speech perception scores with electrophysiological parameters revealed that the slope of EABR amplitude growth function showed significant correlation with fricative discrimination. Also, EABR latency decreased whereas amplitude increased with increased performance. There was no relationship between the numbers of the electrophysiological levels showing performance and speech perception scores.
Conclusion: EABR might serve as a predictor of speech performance at the phonetic level; however, increasing the sample size is required for generalization.

Biography:

Harun-Ar-Rashid Talukder graduated from Mymensingh Medical College and completed his Post-Graduation (FCPS) in Otolaryngology from Bangladesh College of Physicians and Surgeons, Dhaka. His research and medical interest lies in Otology. He has attended many ENT and Head-Neck Surgery conferences, both in Bangladesh and abroad. He is presently working as Consultant and Resident Surgeon (ENT & Head-Neck Surgery) in Shaheed Suhrawardi Medical College Hospital, 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:

Nancy Tye-Murray specializes in Aural Rehabilitation Research. Her research projects concern auditory training, speech reading and audiovisual integrations and speech recognition assessment. She is the former Director of Research at Central Institute for the Deaf and is currently the Hearing Editor of Journal of Speech-Language-Hearing Research. Her books include the introductory textbook, Foundations of Aural Rehabilitation: Children, Adults and Their Family Members (4th Edition).

Abstract:

Many exciting developments are happening in the realm of auditory training. This presentation will present an overview of these developments and will also highlight what may happen in the near future. The purpose of auditory training is to maximize a patient’s ability to utilize residual hearing, especially when background noise is present. New developments include an emphasis on transfer-appropriate-processing (TAP) and learning, training with frequent communication partners, game-like instructional designs and web-based platforms. We will consider auditory training for both adults who have hearing loss as well as children. The presentation will be comprehensive and will cover assessment issues, training protocols and recent research about efficacy. The research concerns two studies recently completed in our laboratory. The first study provided TAP training to a group of adults and found that training led to better speech recognition. The second study showed that patients can benefit from training with speech spoken by their frequent communication partners

Biography:

Peter Rhys Evans has been a Consultant Otolaryngologist/Head, Neck & Thyroid Surgeon within the NHS since 1981 and has been Chief ENT/Head and Neck Surgeon at the Royal Marsden Hospital in London since 1986, specialising in multidisciplinary management of benign and malignant tumours of the head and neck. He also treats private patients at the Royal Marsden Hospital. Peter also has private practice consulting sessions at the Cromwell Hospital and Lister Hospital where he has a wide practice in general ENT problems and he is on the Consultant staff of King Edward VII Hospital. His secretarial office is based at The Lister Hospital, London

Abstract:

For well over a century, otolaryngologists have been aware of a curious otological condition, now known colloquially as ‘Surfer’s Ear’, in which bony growths appear in the deep part of the external ear canal. The unusual aspect of these bony protrusions lies in the fact that they are only seen in surfers or rather are associated with frequent swimming and water immersion of the auditory canal.
Much has been written about the possible pathogenesis of these bony tumours, called exostoses, but several aspects still remain unclear. The fact that the condition is always bilateral is fairly obvious since both ears are immersed in water, but Why do they only grow in swimmers?; Why do exostoses only grow in the deep bony meatus and not elsewhere in the ear canal?; Why do they always grow at 2 or 3 constant sites; and, from an evolutionary point of view; What is or was the purpose and function of these rather incongruous protrusions. In recent decades, paleo-anthropological evidence has modified our ideas about early hominid evolution, inspired by Sir Alister Hardy's visionary article (1960) and Elaine Morgan's Aquatic Ape Theory (1982, 1990). At a time several million years ago following the late Miocene drought when quadruped pre-hominid apes desperately sought new sources of food, the traditionally held “Savannah Theory” (Dart, 1924) suggests that pre-hominid ape man developed a new habitat on the savannah where he stood upright “to see further” and started running after gizelle and other game. Critics suggest that if it was so advantageous for one branch of the family, why didn’t all apes evolve in this way and why does man have so many different anatomical and physiological characteristics which are unique amongst terrestrial mammals, but commonplace among aquatic and semi-aquatic mammals. A much more plausible scenario suggested by Hardy was that early pre-hominid man began to explore the rich quantity of marine food that was readily available around the shores, estuaries and rivers in that area of East Africa.
In the context of this suggested littoral influence during evolution, the senior author explored various enigmatic anatomical features relating to the upper aero-digestive tract, unique in man, that were not seen in other higher primates nor other terrestrial mammals and suggested that these were much more logically explained by an historical period of aquatic adaptation during early hominid evolution (Rhys Evans, 1992).
One of these anatomical features was the question of exostoses, which the author suggested were evolved for the purpose of protection of the delicate tympanic membrane during swimming and diving, to narrow the ear canal in a similar fashion to protective mechanisms seen in other semi-aquatic species. He suggested that if exostoses were identified in early hominid fossil skulls, this would provide good evidence to support the aquatic theory that suggests that early hominid man spent significant periods of time submerged in the water. In contrast to modern man, early hominids would not have been surfing or swimming for social reasons, but their frequent immersion in water would have been in search of food, hunting for their survival. We believe that recent fossil evidence of exostoses of the external ear canal in early hominid skulls has now established confirmation of this aquatic theory. This paper reviews the current literature regarding external auditory canal exostoses with reference to contemporary and ancient populations. We also describe the developmental embryology of the external auditory canal and suggest a hypothesis to explain the specific growth sites of the exostoses which correspond to the 3 epiphyseal growth plates of the external ear canal. We suggest that external auditory canal exostoses provide the only hard (fossil) evidence of man’s aquatic past.. We also explore other unique characteristics of the human upper aero-digestive tract that support this aquatic evolutionary theory.

Biography:

Ricardo L. Marengo graduated from medical school at the Salvador University of Buenos Aires City in 1994. He did his specialization in otolaryngology with guidance skull base surgery as a medical resident at the Higher Institute of Otolaryngology of the City of Buenos Aires, where he was later chief of residents and surgical instructor. He earned the degree of specialist in otolaryngology at the University of Buenos Aires. He was head of Otolaryngology and Communication Disorders of FLENI , between 1997 and 2008 , were today is external consultant in ENT and skull base surgery. From 2009 to present, he is Head of ENT and audiology department of CEMIC surgery department. He is Professor of otolaryngology at the University Institute of CEMIC and Professor in Audiology Clinic UMSA. He is a former president of the Association of Otolaryngology of the City of Buenos Aires, member of numerous academic national and international associations. Director of numerous national and international courses. He is a founding member and currently President Solidarity Initiative Foundation of CIAC Group.

Abstract:

Introduction: The hybrid cochlear implant was designed for patients suffering from severe-to-profound hearing loss in higher frequencies with good Residual hearing in lower frequencies as they do not benefit with the use of a hearing aid , especially in situations of background noise, the combination of both technologies allows stimulation of the entire frequency range. Audiological candidates are frequently found in population over 65 years old and are not usually considered.

Objectives: To evaluate the hearing gain and use of electroacustic stimulation in two patients over 65 years.

Materials and Methods: Two patients who received cochlear implant Hybrid L at ages of 76 and 71 years. Evaluation of hearing gain made without equipment, with hearing aids and electro acustic stimulation. Performance in situations of silence and background noise were compared. Results were also compared with population in the same hearing conditions and stimulation but with less chronological age.

Results: The pre -surgical hearing level and pos-surgical pre activation were evaluated. Later, pos activation at three and six months and finally annually for up to five years. None of the patients had intra nor pos surgical neurosensorial hearing loss. Auditory performance was evaluated with and without background noise in different situations, showing increased discrimination from 0 and 30 % up to 70 and 90 % in noise. The hearing gain was similar to that of younger cases. The use of bimodal stimulation was permanent in both cases, referring great recovery comfort and quality of auditory life.

Conclusion: No differences were observed in auditory gain neither in time of use with younger population with the same technology. Both patients use bimodal stimulation permanently.

Biography:

Ricardo L. Marengo graduated from medical school at the Salvador University of Buenos Aires City in 1994. He did his specialization in otolaryngology with guidance skull base surgery as a medical resident at the Higher Institute of Otolaryngology of the City of Buenos Aires, where he was later chief of residents and surgical instructor. He earned the degree of specialist in otolaryngology at the University of Buenos Aires. He was head of Otolaryngology and Communication Disorders of FLENI , between 1997 and 2008 , were today is external consultant in ENT and skull base surgery. From 2009 to present, he is Head of ENT and audiology department of CEMIC surgery department. He is Professor of otolaryngology at the University Institute of CEMIC and Professor in Audiology Clinic UMSA. He is a former president of the Association of Otolaryngology of the City of Buenos Aires, member of numerous academic national and international associations. Director of numerous national and international courses. He is a founding member and currently President Solidarity Initiative Foundation of CIAC Group.

Abstract:

Introduction: The hybrid cochlear implant, was designed for patients suffering from severe-to-profound hearing loss in higher frequencies with good residual hearing in lower frequencies as they do not benefit with the use of hearing aids, especially in situations of background noise, the combination of both technologies allows stimulation of the entire frequency range. Same doubts appear about the possible negative effect over the remanents cochlear structures and functions with a foreign body in the cochlea and because of effect of continuum ear electrical stimulations during years.

Objectives: In this study, the evaluation of residual hearing is made in postoperative for up of five years.

Material and Methods: Three patients with bimodal stimulation have a time of up to five years of residual hearing follow up. Both, bone and air conduction hearing were evaluated pre and post surgical for up to five years. Residual audition were compared with contralateral hearing (non-implanted and with similar pre operatively function) from the same subjects. Results. In all three cases, small bone - air gap between 12 and 17.5 dB for frequencies average 256-4096 were evidenced. No significant progression in hearing loss from the contralateral were evidenced.

Conclusion. In all three cases with hybrid cochlear implant permanent use and follow up to five years, no sensorineural hearing loss were attributable to the effect of foreign body or electrical stimulation was evident. In all cases the benefit was highly significant with the electroacustic stimulation both silence and noise.

Biography:

Ricardo L. Marengo graduated from medical school at the Salvador University of Buenos Aires City in 1994. He did his specialization in otolaryngology with guidance skull base surgery as a medical resident at the Higher Institute of Otolaryngology of the City of Buenos Aires, where he was later chief of residents and surgical instructor. He earned the degree of specialist in otolaryngology at the University of Buenos Aires. He was head of Otolaryngology and Communication Disorders of FLENI , between 1997 and 2008 , were today is external consultant in ENT and skull base surgery. From 2009 to present, he is Head of ENT and audiology department of CEMIC surgery department. He is Professor of otolaryngology at the University Institute of CEMIC and Professor in Audiology Clinic UMSA. He is a former president of the Association of Otolaryngology of the City of Buenos Aires, member of numerous academic national and international associations. Director of numerous national and international courses. He is a founding member and currently President Solidarity Initiative Foundation of CIAC Group.

Abstract:

Introduction: The hybrid cochlear implant, was designed for patients suffering from severe-to-profound hearing loss in higher frequencies with good residual hearing in lower frequencies as they do not benefit with the use of hearing aids, especially in situations of background noise, the combination of both technologies allows stimulation of the entire frequency range. Same doubts appear about the possible negative effect over the remanents cochlear structures and functions with a foreign body in the cochlea and because of effect of continuum ear electrical stimulations during years.

Objectives: In this study, the evaluation of residual hearing is made in postoperative for up of five years.

Material and Methods: Three patients with bimodal stimulation have a time of up to five years of residual hearing follow up. Both, bone and air conduction hearing were evaluated pre and post surgical for up to five years. Residual audition were compared with contralateral hearing (non-implanted and with similar pre operatively function) from the same subjects. Results. In all three cases, small bone - air gap between 12 and 17.5 dB for frequencies average 256-4096 were evidenced. No significant progression in hearing loss from the contralateral were evidenced.

Conclusion. In all three cases with hybrid cochlear implant permanent use and follow up to five years, no sensorineural hearing loss were attributable to the effect of foreign body or electrical stimulation was evident. In all cases the benefit was highly significant with the electroacustic stimulation both silence and noise.

Biography:

Ricardo L. Marengo graduated from medical school at the Salvador University of Buenos Aires City in 1994. He did his specialization in otolaryngology with guidance skull base surgery as a medical resident at the Higher Institute of Otolaryngology of the City of Buenos Aires, where he was later chief of residents and surgical instructor. He earned the degree of specialist in otolaryngology at the University of Buenos Aires. He was head of Otolaryngology and Communication Disorders of FLENI , between 1997 and 2008 , were today is external consultant in ENT and skull base surgery. From 2009 to present, he is Head of ENT and audiology department of CEMIC surgery department. He is Professor of otolaryngology at the University Institute of CEMIC and Professor in Audiology Clinic UMSA. He is a former president of the Association of Otolaryngology of the City of Buenos Aires, member of numerous academic national and international associations. Director of numerous national and international courses. He is a founding member and currently President Solidarity Initiative Foundation of CIAC Group.

Abstract:

Introduction: The hybrid cochlear implant, was designed for patients suffering from severe-to-profound hearing loss in higher frequencies with good residual hearing in lower frequencies as they do not benefit with the use of hearing aids, especially in situations of background noise, the combination of both technologies allows stimulation of the entire frequency range. Same doubts appear about the possible negative effect over the remanents cochlear structures and functions with a foreign body in the cochlea and because of effect of continuum ear electrical stimulations during years.

Objectives: In this study, the evaluation of residual hearing is made in postoperative for up of five years.

Material and Methods: Three patients with bimodal stimulation have a time of up to five years of residual hearing follow up. Both, bone and air conduction hearing were evaluated pre and post surgical for up to five years. Residual audition were compared with contralateral hearing (non-implanted and with similar pre operatively function) from the same subjects. Results. In all three cases, small bone - air gap between 12 and 17.5 dB for frequencies average 256-4096 were evidenced. No significant progression in hearing loss from the contralateral were evidenced.

Conclusion. In all three cases with hybrid cochlear implant permanent use and follow up to five years, no sensorineural hearing loss were attributable to the effect of foreign body or electrical stimulation was evident. In all cases the benefit was highly significant with the electroacustic stimulation both silence and noise.

Biography:

Ricardo L. Marengo graduated from medical school at the Salvador University of Buenos Aires City in 1994. He did his specialization in otolaryngology with guidance skull base surgery as a medical resident at the Higher Institute of Otolaryngology of the City of Buenos Aires, where he was later chief of residents and surgical instructor. He earned the degree of specialist in otolaryngology at the University of Buenos Aires. He was head of Otolaryngology and Communication Disorders of FLENI , between 1997 and 2008 , were today is external consultant in ENT and skull base surgery. From 2009 to present, he is Head of ENT and audiology department of CEMIC surgery department. He is Professor of otolaryngology at the University Institute of CEMIC and Professor in Audiology Clinic UMSA. He is a former president of the Association of Otolaryngology of the City of Buenos Aires, member of numerous academic national and international associations. Director of numerous national and international courses. He is a founding member and currently President Solidarity Initiative Foundation of CIAC Group.

Abstract:

Introduction: The hybrid cochlear implant, was designed for patients suffering from severe-to-profound hearing loss in higher frequencies with good residual hearing in lower frequencies as they do not benefit with the use of hearing aids, especially in situations of background noise, the combination of both technologies allows stimulation of the entire frequency range. Same doubts appear about the possible negative effect over the remanents cochlear structures and functions with a foreign body in the cochlea and because of effect of continuum ear electrical stimulations during years.

Objectives: In this study, the evaluation of residual hearing is made in postoperative for up of five years.

Material and Methods: Three patients with bimodal stimulation have a time of up to five years of residual hearing follow up. Both, bone and air conduction hearing were evaluated pre and post surgical for up to five years. Residual audition were compared with contralateral hearing (non-implanted and with similar pre operatively function) from the same subjects. Results. In all three cases, small bone - air gap between 12 and 17.5 dB for frequencies average 256-4096 were evidenced. No significant progression in hearing loss from the contralateral were evidenced.

Conclusion. In all three cases with hybrid cochlear implant permanent use and follow up to five years, no sensorineural hearing loss were attributable to the effect of foreign body or electrical stimulation was evident. In all cases the benefit was highly significant with the electroacustic stimulation both silence and noise.

Biography:

Ricardo L. Marengo graduated from medical school at the Salvador University of Buenos Aires City in 1994. He did his specialization in otolaryngology with guidance skull base surgery as a medical resident at the Higher Institute of Otolaryngology of the City of Buenos Aires, where he was later chief of residents and surgical instructor. He earned the degree of specialist in otolaryngology at the University of Buenos Aires. He was head of Otolaryngology and Communication Disorders of FLENI , between 1997 and 2008 , were today is external consultant in ENT and skull base surgery. From 2009 to present, he is Head of ENT and audiology department of CEMIC surgery department. He is Professor of otolaryngology at the University Institute of CEMIC and Professor in Audiology Clinic UMSA. He is a former president of the Association of Otolaryngology of the City of Buenos Aires, member of numerous academic national and international associations. Director of numerous national and international courses. He is a founding member and currently President Solidarity Initiative Foundation of CIAC Group.

Abstract:

Introduction: The hybrid cochlear implant, was designed for patients suffering from severe-to-profound hearing loss in higher frequencies with good residual hearing in lower frequencies as they do not benefit with the use of hearing aids, especially in situations of background noise, the combination of both technologies allows stimulation of the entire frequency range. Same doubts appear about the possible negative effect over the remanents cochlear structures and functions with a foreign body in the cochlea and because of effect of continuum ear electrical stimulations during years.

Objectives: In this study, the evaluation of residual hearing is made in postoperative for up of five years.

Material and Methods: Three patients with bimodal stimulation have a time of up to five years of residual hearing follow up. Both, bone and air conduction hearing were evaluated pre and post surgical for up to five years. Residual audition were compared with contralateral hearing (non-implanted and with similar pre operatively function) from the same subjects. Results. In all three cases, small bone - air gap between 12 and 17.5 dB for frequencies average 256-4096 were evidenced. No significant progression in hearing loss from the contralateral were evidenced.

Conclusion. In all three cases with hybrid cochlear implant permanent use and follow up to five years, no sensorineural hearing loss were attributable to the effect of foreign body or electrical stimulation was evident. In all cases the benefit was highly significant with the electroacustic stimulation both silence and noise.

Biography:

Ricardo L. Marengo graduated from medical school at the Salvador University of Buenos Aires City in 1994. He did his specialization in otolaryngology with guidance skull base surgery as a medical resident at the Higher Institute of Otolaryngology of the City of Buenos Aires, where he was later chief of residents and surgical instructor. He earned the degree of specialist in otolaryngology at the University of Buenos Aires. He was head of Otolaryngology and Communication Disorders of FLENI , between 1997 and 2008 , were today is external consultant in ENT and skull base surgery. From 2009 to present, he is Head of ENT and audiology department of CEMIC surgery department. He is Professor of otolaryngology at the University Institute of CEMIC and Professor in Audiology Clinic UMSA. He is a former president of the Association of Otolaryngology of the City of Buenos Aires, member of numerous academic national and international associations. Director of numerous national and international courses. He is a founding member and currently President Solidarity Initiative Foundation of CIAC Group.

Abstract:

Introduction: The hybrid cochlear implant, was designed for patients suffering from severe-to-profound hearing loss in higher frequencies with good residual hearing in lower frequencies as they do not benefit with the use of hearing aids, especially in situations of background noise, the combination of both technologies allows stimulation of the entire frequency range. Same doubts appear about the possible negative effect over the remanents cochlear structures and functions with a foreign body in the cochlea and because of effect of continuum ear electrical stimulations during years.

Objectives: In this study, the evaluation of residual hearing is made in postoperative for up of five years.

Material and Methods: Three patients with bimodal stimulation have a time of up to five years of residual hearing follow up. Both, bone and air conduction hearing were evaluated pre and post surgical for up to five years. Residual audition were compared with contralateral hearing (non-implanted and with similar pre operatively function) from the same subjects. Results. In all three cases, small bone - air gap between 12 and 17.5 dB for frequencies average 256-4096 were evidenced. No significant progression in hearing loss from the contralateral were evidenced.

Conclusion. In all three cases with hybrid cochlear implant permanent use and follow up to five years, no sensorineural hearing loss were attributable to the effect of foreign body or electrical stimulation was evident. In all cases the benefit was highly significant with the electroacustic stimulation both silence and noise.

Biography:

Ricardo L. Marengo graduated from medical school at the Salvador University of Buenos Aires City in 1994. He did his specialization in otolaryngology with guidance skull base surgery as a medical resident at the Higher Institute of Otolaryngology of the City of Buenos Aires, where he was later chief of residents and surgical instructor. He earned the degree of specialist in otolaryngology at the University of Buenos Aires. He was head of Otolaryngology and Communication Disorders of FLENI , between 1997 and 2008 , were today is external consultant in ENT and skull base surgery. From 2009 to present, he is Head of ENT and audiology department of CEMIC surgery department. He is Professor of otolaryngology at the University Institute of CEMIC and Professor in Audiology Clinic UMSA. He is a former president of the Association of Otolaryngology of the City of Buenos Aires, member of numerous academic national and international associations. Director of numerous national and international courses. He is a founding member and currently President Solidarity Initiative Foundation of CIAC Group.

Abstract:

Introduction: The hybrid cochlear implant, was designed for patients suffering from severe-to-profound hearing loss in higher frequencies with good residual hearing in lower frequencies as they do not benefit with the use of hearing aids, especially in situations of background noise, the combination of both technologies allows stimulation of the entire frequency range. Same doubts appear about the possible negative effect over the remanents cochlear structures and functions with a foreign body in the cochlea and because of effect of continuum ear electrical stimulations during years.

Objectives: In this study, the evaluation of residual hearing is made in postoperative for up of five years.

Material and Methods: Three patients with bimodal stimulation have a time of up to five years of residual hearing follow up. Both, bone and air conduction hearing were evaluated pre and post surgical for up to five years. Residual audition were compared with contralateral hearing (non-implanted and with similar pre operatively function) from the same subjects. Results. In all three cases, small bone - air gap between 12 and 17.5 dB for frequencies average 256-4096 were evidenced. No significant progression in hearing loss from the contralateral were evidenced.

Conclusion. In all three cases with hybrid cochlear implant permanent use and follow up to five years, no sensorineural hearing loss were attributable to the effect of foreign body or electrical stimulation was evident. In all cases the benefit was highly significant with the electroacustic stimulation both silence and noise.

Biography:

Rich was trained as a clinical audiologist at The University of Western Ontario and then completed a Ph.D. in Psychoacoustics and The University of Iowa. He worked initially at the Institute of Hearing Research in the United Kingdom and is currently a Professor in both the Department of Otolaryngology - Head & Neck Surgery and in the Department of Communication Sciences and Disorders at the University of Iowa. His scientific work includes the quantification of tinnitus, as well as the investigation of different treatments. Dr. Tyler sees tinnitus patients weekly, and hosts an annual Tinnitus Treatment Workshop. He has edited The Tinnitus Handbook (2000), Tinnitus Treatments: Clinical Protocols Tyler, R.S. (Ed.). (2006), and The Consumer Handbook on Tinnitus (2008). He has also been involved with cochlear implants from the early years, providing independent evaluations in realistic listening situations, proposed selection strategies among different hearing aid and implant combinations, and developed the first spatial hearing training program. He edited the second book in the area; Cochlear Implants: Audiological Foundations: 1993. Rich has served on committees for the World Health Organization, the American Academy of Otolaryngology, the Veterans Administration, and the National Academy of Science

Abstract:

Electricity presented to the cochlea likely has one of the best opportunities for treating tinnitus. First, we review early laboratory trials demonstrating the range of analog and pulsatile stimuli that can be effective. We include observations on different depths of electrodes. Second, we review data from patients with a hearing implant but who also have tinnitus, including studies with unilateral deaf patients. Third, we highlight important observations from recent laboratory trials comparing the effectiveness of different stimuli. Finally, we discuss options and share data for field trials with stimuli specific for tinnitus. We conclude that there will soon be a range of cochlear implants to treat tinnitus. This will include strategies interleaved with electrodes to code speech, tinnitus stimuli running in the background of speech-coded stimuli, and a short basal electrode.
Support from the Action on Hearing Loss, Tinnitus Research Initiative, and Cochlear Corporation

Biography:

Douglas Denys has completed his Medical School at the University of Utah School of Medicine and Post-graduate Training in Otolaryngology-Head and Neck Surgery at the University of Tennessee Health Science Center. He is Founder of Utah Ear, Nose and Throat in Utah and he has been in private practice for fourteen years as an Attending Surgeon at Intermountain Health Care Hospitals.

Abstract:

Introduction: Tympanic membrane perforations are common conditions that may require surgical closure. The least invasive technique is favored to reduce cost and possible complications. Repair of select small defects may be accomplished using local anesthesia; larger defects often require general anesthesia, elevation of a tympanomeatal flap and entry into the middle ear space. A new technique is described for closure of favorable perforations using local anesthesia that does not require elevation of a tympanomeatal flap thus potentially reducing the risk of surgical complications and the cost of treatment. Design: Five patients with chronic tympanic membrane perforations were selected. The perforations were measured and two disks of Gelfilm sterile absorbable gelatin film (Pfizer) were moistened with saline and cut to a size that 3-5 mm larger than the defect and a 6.0 polydiaxanone suture was placed through one implant. Phenol was used to treat the perforation edge. The implant was inserted through the perforation and set into position on the medial side of the tympanic membrane by applying traction with the suture. The second Gelfilm disk was threaded on the suture and applied to the lateral tympanic membrane such that the perforation was closed. The suture was glued and trimmed. Results: Successful closure of each perforation using the Gelfilm sandwich technique was accomplished at 2, 4 and 10 weeks. Conclusions: Use of the Gelfilm sandwich technique maybe an option for closure of select tympanic membrane perforations that fail to heal spontaneously

Biography:

Ricardo L. Marengo graduated from medical school at the Salvador University of Buenos Aires City in 1994. He did his specialization in otolaryngology with guidance skull base surgery as a medical resident at the Higher Institute of Otolaryngology of the City of Buenos Aires, where he was later chief of residents and surgical instructor. He earned the degree of specialist in otolaryngology at the University of Buenos Aires. He was head of Otolaryngology and Communication Disorders of FLENI , between 1997 and 2008 , were today is external consultant in ENT and skull base surgery. From 2009 to present, he is Head of ENT and audiology department of CEMIC surgery department. He is Professor of otolaryngology at the University Institute of CEMIC and Professor in Audiology Clinic UMSA. He is a former president of the Association of Otolaryngology of the City of Buenos Aires, member of numerous academic national and international associations. Director of numerous national and international courses. He is a founding member and currently President Solidarity Initiative Foundation of CIAC Group.

Abstract:

Introduction: The hybrid cochlear implant, was designed for patients suffering from severe-to-profound hearing loss in higher frequencies with good residual hearing in lower frequencies as they do not benefit with the use of hearing aids, especially in situations of background noise, the combination of both technologies allows stimulation of the entire frequency range. Same doubts appear about the possible negative effect over the remanents cochlear structures and functions with a foreign body in the cochlea and because of effect of continuum ear electrical stimulations during years.

Objectives: In this study, the evaluation of residual hearing is made in postoperative for up of five years.

Material and Methods: Three patients with bimodal stimulation have a time of up to five years of residual hearing follow up. Both, bone and air conduction hearing were evaluated pre and post surgical for up to five years. Residual audition were compared with contralateral hearing (non-implanted and with similar pre operatively function) from the same subjects. Results. In all three cases, small bone - air gap between 12 and 17.5 dB for frequencies average 256-4096 were evidenced. No significant progression in hearing loss from the contralateral were evidenced.

Conclusion. In all three cases with hybrid cochlear implant permanent use and follow up to five years, no sensorineural hearing loss were attributable to the effect of foreign body or electrical stimulation was evident. In all cases the benefit was highly significant with the electroacustic stimulation both silence and noise.

Biography:

Rudolf Hagen has graduated in 1976, he has studied Medicine at the University of Würzburg, Germany and completed his MD in 1984. This was followed by a Training in ORL under Professor Walter Kley and Professor Jan Helms, Würzburg. In 1991, he has completed his Post-doctorate and became first Assistant Professor and in 1998, Extraordinary Professor. From 1998 to 2005, he has Headed the ENT-Clinic at the Katharinen Hospital in Stuttgart. He took over the chair of ORL at the University Clinic of Würzburg in 2005. He has received several scientific prizes (e.g., Anton-von Tröltsch-Prize 1995) and published 169 papers in reputed journals.

Abstract:

Severly hearing impaired people have intense problems especially when arriving in a public medical center, which must be considered with great prudence. Besides a propper arrangement of spatial arrays and organisational processes, there is a wide spectrum of interdisciplinary diagnostics, therapeutic approaches, rehabilitation offers and long term after care, which has to be included within a comprehensive center. The Wuerburg CHC was established in 2009 and gradually linked to all necessary partners including physicians, audiologists, psychologists, genetisists, radiologists as well as care attendants, medical engineers and health care professionals. Now the CHC offers the complete spectrum starting with newborn hearing screening, early hearing aid fitting and genetic counselling, including all kind of otosurgical procedures like classical middle ear surgery, cochlea and other hearing implants or acoustic neurinoma surgery and finally the necessary rehabilitation programs. Regular board meetings for difficult cases, new technological developments as well the integration of research programs enable a continuous adjustment to the rapidly developing field of hearing restoration. Patients feed back demonstrated, that the decoupling of the center from the general duty of a large university ENT clinic, succeeded in a better quality of patient care for hearing impaired people.

Biography:

Abstract:

Internal nasal valve collapse is a troublesome that the Otolaryngology doctors faces in many patients suffering from inadequate nasal breathing. There are two main suggested reasons for inadequate nasal breathing at the internal nasal valve region; collapsing alar cartilage and narrow nasal angle. While most of the new literature emphasize the spreader graft technique, I believe that flaring technique still plays an important role in management this challenging quest.
Aim: The aim of the present study is to re-evaluate the role of combining alar flare technique to spreader graft in management of internal nasal valve collapse.
Patients and Methods: 56 patients were included in the present study who underwent different surgical techniques for management of internal nasal valve collapse. None of the patients had undergone any nasal surgical repair procedure to his or her condition before. Spreader graft technique have been used alone in 10 patients, while combined alar flare with spreader graft technique was used in 46 patients through an open rhinoplasty approach.
The time of surgical procedure, post-operative healing time, subjective scoring of nasal airway breathing before and after surgery and the degree of nasal dryness were recorded and compared between the two surgical groups. The post-operative evaluation period ranged from 3 to 5 years.
Results: In the first group of patients who underwent spreader graft technique alone all patients have reported an initial improvement in nasal airway breathing but only 80% of them have sustained these results after 4 years. In the second group of patients who underwent a combined alar flare with spreader graft technique, 95.7% of patients have sustained these satisfactory results after 5 years of surgical procedure.
Conclusion: The combined alar flare with spreader graft technique still provides a better results than any of the two surgical techniques alone.

Biography:

Razan Al Fakir has more than 15 years of Clinical Experience in Clinical Otolaryngology and Audiologic Rehabilitation. She is a PhD candidate at the Department of Speech Language and Hearing Science-University of Florida. Her research is geared toward optimization of audiologic rehabilitation programs. She has received two awards for her Outstanding Achievement in Academic, University and Community Service from the International Center University of Florida Alec Courtelis Award in 2014 and the Graduate Students Council Award in 2015. She has published two papers in reputed journals and highly involved in teaching, mentoring and community education. Her career plans are to continue her research in audiologic rehabilitation to make a difference in the lives of persons both domestically in the US and globally. She eventually plans to return to the Middle East as either a consultant or as a permanently and bring a new prospective to hearing heath care to the region.

Abstract:

Maintaining optimal functioning for the aging population with chronic disorders including hearing disorder is becoming a contemporary therapy in medicine, public health and health professions. Functioning is the integration of all body functions and the individual’s ability to participate in everyday life activities. Functioning refers to the causes of human’s behavior, which are highly influenced by the complex interaction between individual and environment. Understanding the link between functioning and behavior requires a multi-componential approach creating a comprehensive profile of factors that influences behavior. Longitudinal studies showed that aging is accompanied by decline in several domains of functions including sensory, cognition, emotional and social within six years. These findings raised important questions in audiologic rehabilitation: How do older adults with hearing impairment socially interact and function if hearing loss is associated with such deficits? What are the environmental and personal factors that permit elders with hearing loss to continue to interact and function effectively in social life? What changes in audiologic rehabilitation programs are needed to meet these challenges? Obviously, being able to answer these questions require a revolutionary concept analysis and integrative understanding of the comprehensive profile of an individual instead of focusing only on the auditory system. I propose that the use of the WHO-International Classification of Functioning, Disability and Health (WHO-ICF, 2001) framework and the ICF brief core set for hearing loss will help to investigate the complex relationship between hearing disability and socio-emotional isolation which is a major and prevalent health problem among aging population.

Biography:

Alessandro Bucci is a Reserve Medical Officer of the Italian Navy. He has experienced Fellowship in Otolaryngology (University Hospital, Cadiz, Spain). He was a Consultant in Otolaryngology from 2002. He has obtained PhD in 2006. He is Fellowship trained in Facial Plastic Surgery (AMC) and OSAS (Sint Lucas Andreas Hospital), Amsterdam, The Netherlands and in facial plastic surgery (C. Garcia University Hospital, Cuba). He is a dedicated ENT Specialist Surgeon with 13 years experience providing the highest standard of treatment. Reserch focused on Rhinology/Rhinoallergology, OSAS and dysphagia. He is an invited speaker for different conferences in Italy and abroad.

Abstract:

OSA (Obstructive Sleep Apnea) in children has been recognized as a significant disorder warranting evaluation and management. The prevalence of OSAS in pediatric population is 1–4% and is linked to a number of health-related issues and behavioral problems such as daytime sleepiness, cardiovascular problems, poor growth, hyperactivity, enuresis, academic difficulties and attention issues. Even those no universally accepted criteria have been developed for its diagnosis and treatment. Adenotonsillar hypertrophy is the primary cause of OSA in children but tonsillectomy and adenoidectomy (T&A) are not always resolutive. Studies have shown that 15–20% of children will have persistent OSA due to sites of obstruction in the airway other than the tonsils and adenoids. Identifying these areas in the past has been problematic and therefore, therapy for OSA in children who have failed adenotonsillectomy has often been unsatisfactory. DISE was performed on all children with persistent OSA after T&A. Multilevel upper-airway obstruction was identified and described (sites, pattern and degree of airway obstruction) in the majority of patients, most commonly related to tongue base obstruction, adenoid regrowth, septal deviation and/or inferior turbinate hypertrophy. Findings from DISE suggest that multiple factors contribute to airway obstruction in persistent OSA after T&A. DISE is a dynamic and safe procedure, easily practicable, valid and reliable. It provides clinical information not available by routine clinical inspection alone. DISE permits to visualize the anatomical sites of snoring or apneas and guides the design of a tailor-made treatment plan in individual cases.

Biography:

Isabelle Nibelle has completed her PhD in France at the University of Strasbourg and Post-doctoral studies in Paris. She is Head of the ENT department in Al Ain Hospital, UAE and is teaching as Adjunct Assistant Professor at the UEA College of Medicine and Health Sciences.

Abstract:

Introduction: Salivary fistula is a common complication in oncology neck surgery. However, this is an unusual outcome after neurosurgical procedure with cervical approach. We report a case of late onset salivary fistula occurring after cervical spinal fixation following a fracture C5C6. We analyze the risk factors. We discuss the diagnostic and therapeutic choices. Finally, we insist on preventing this complication.
Material & Method: A 21 year old patient was admitted with quadriplegia after a neck trauma. The injury was a fracture dislocation-C6 / C7 with narrowing of the posterior wall. A neurosurgical surgery is performed in emergency by right anterior cervical approach: decompression of the posterior wall, vertebral fixation with screws C5 to C7, bone graft, laminectomy at C6 and partial facetectomy.A tracheostomy is performed in the same surgical time. Postoperative feeding is provided by nasogastric tube. The patient developed day 43 postoperative a cervical collection, which is simply drained by general surgeons. Collection reccures, associated with clear right paratracheal discharge. Clinical examination is in favor of a salivary fistula. A hydrosoluble hypo pharyngeal transit confirms the continuity between the pharynx and the cervical skin. Direct laryngoscopy confirms the fistula with hypopharyngeal mucosa breach, at the retro-cricoid area with exposure of cervical fixation material. Esophagus is intact. Percutaneous gastrostomy is performed at the same time. Local care with compressive dressing cannot dry the fistula. Surgical closure is performed at day 79 from the initial surgery: The exposure of the previous ostheosyntesis materiel reveals that two screws are loose. The anterior fixation material is removed. Visualization of the salivary fistula at the level of the retro-cricoid area; Hypo pharyngeal mucosa is closed with intermittent stiches with Vicryl 3.0. Coverage performs with local sternocleidomastoid muscle flap with upper and lower attachment. No postoperative event; no recurrence of the fistula.
Discussion: Late onset salivary fistula in neck surgery is an unusual complication after neurosurgical approach. In this case, several risk factors have been identified: The presence of tracheotomy, as a factor of compression, nutrition by nasogastric tube as a factor of compression, denutrition as a general condition and the presence of mobile screws, as a friction factor which resulted in the damage of the hypo pharyngeal mucosa. The diagnosis of a salivary fistula is based on: Clinical arguments, biological level of amylase on the discharge, hypo pharyngeal transit with hydrololules: communication between hypopharynx and skin and direct laryngoscopy: visualization of the fistula. Treatment is based on: Local care: twice a day dressing with washing, swallowing diluted betadine and compression bandages, Surgery if failure of the dressing to repair mucosa and coverage flap. Local: sternocleidomastoid muscle or platysmamuscle flap. Regional: pectoralis major and latissimus dorsi flap and free: antebrachial flap
Conclusion: Late onset salivary fistulas are rare in non-neoplastic pathologies but may complicate neurosurgical cervical spine surgery with cervical approach. Diagnostic has to be done in front of cervical collection associated with chronic cervical discharge. The treatment begins with twice-daily dressing and, in case of failure, surgery. Prevention is based on reducing risk factors: avoid prolonged nasogastric nutrition, promote high-calorie, high protein nutrition in vulnerable subjects, ensure adequate fixation.

Biography:

Laila M Telmesani graduated from King Faisal University in 1986 and received the King Faisal Fellowship in ORL in 1990, FRCS ed. in 1993. She started as Demonstrator and assigned as Professor in 2010, obtained a fellowship in otology neuro-otology from Bern University Hospital 2010. She was assigned as the Head of ENT department in KFUH from 2006 to April 2014, then as the head of CI unit in April 2014, established the CI program in the eastern province, KFUH, UOD, April 2009. She was also assigned as Director of Saudi board training program for ENT head & neck surgery (eastern province) since 2007 to date. He is the member of the scientific committee Saudi commission for health specialties since 2002.

Abstract:

From April 2009 to date, in the cochlear implant unit at King Fahd University Hospital, University of Dammam, we operated on more than 100 cases of cochlear implantations, 8% adult and more than 90% of the cases were children pre-operative. CT scan showed that 29% of them have abnormal inner ears, intra-operative difficulties increase when operating on abnormal bony inner ears. Aberrant facial nerve may force the surgeon to change his approach, unfavorable presentation of round window niche and membrane may make the surgeon modify the soft surgery to bony cochleaostomy, in addition to CSF leak in the form of oozing or gusher. It is a retrospective review of all the cases in respect to the location of the vertical segment of the facial nerve, the unfavorable orientation of the round window niche and the incidence of CSF leak, the author will talk about alternative approaches, is there a way to predict these difficulties radiologically preoperative? Is there a difference between children and adults? All can take place in patients with normal inner ears; review of the literature; what are the recommendations in respect to patients’ counseling, proper CT findings and surgery.

Biography:

School in 1996 and was treained in ENT Head and Neck Surgery at this same University. He completed his Ph.D Level at the University of Minesota USA in 2001 where he dedicated to the study of deafness at the Otopathology Laboratory under Dr MM Paparella isntructions. Now he is the chairmen of the Otolaryngology Department at the University Hospital. He is Author and Co-author of many book chapenters, free prasantatiton, and original artical publishied under André Sampaio name. He is the coordinator of cochlear implantation and auditory implants center at the University of Brasília, Brazil.

Abstract:

Objective: To correlate the annoyance of tinnitus assessed by the Tinnitus Handicap Inventory and on a visual analogue scale with the evoked otoacoustic emission test result in tinnitus patients with normal hearing. Study design: Case-control study. Setting: Public tertiary hospital. Subjects & Methods: The sample was initially based on a population of 80 subjects with tinnitus; 20 of them had normal hearing and normal evoked otoacoustic emission test results and comprised the study group. For the purpose of comparison, a control group was formed, which consisted of 17 subjects with no hearing complaints and normal hearing. The participants were submitted to hearing tests, immittance testing and tests for the evaluation of acoustic reflexes, distortion product otoacoustic emissions, transient evoked otoacoustic emissions (TEOAEs) and suppression of TEOAEs. The tests were performed in a sound-treated booth using a linear contralateral noise of 60 dB. The presence of suppression effects was defined when the response amplitude was 0.5 dB or higher. Results: Abnormal evoked otoacoustic emission suppression test results were observed in 52.9% of tinnitus patients and in 32.4% of control subjects (p=0.086). Suppression effects of TEOAEs were absent in 38.5% of subjects with minimal or mild discomfort and in 61.9% of subjects with moderate or severe discomfort (p=0.183). Conclusion: It was not possible to associate the annoyance caused by tinnitus with the TEOAE suppression test results, although suppression effects were found to decrease with increasing annoyance.

Biography:

Swati Agrawal has completed her MS from PGIMER & Dr. Ram Manohar Lohia Hospital, New Delhi, India. She is currently pursuing her Senior Residency from the same institute.

Abstract:

Background: Sudden SNHL is a common otologic emergency, presenting mostly as an abrupt onset unilateral deafness. By definition, the etiology of sudden SNHL is unknown. Because of the multifactorial etiopathology, a number of different regimens have been used as therapy, Hyperbaric Oxygen Therapy being a novel one. Objectives: To ascertain whether the addition of HBOT to the conventional medical treatment improves the hearing outcome in patients with Sudden Sensorineural Hearing loss, to assess the impact of patient-related and audio vestibular parameters on the prognosis of sudden hearing loss and to document any adverse effects of HBOT. Methods: Forty patients with Sudden SNHL, 18-60 years were enrolled in this randomized controlled study. Twenty patients (Group A) received steroids, plasma expander dextran, gingko biloba extract, nicotinic acid, beta histine and antiviral acyclovir. A second group (Group B) of 20 patients received the same with the addition of 10 sessions of HBOT. Audiological assessments were performed with pure tone audiometry on day 5, 10 and at the end of each month for next 3 months. The following parameters were noted: Demographics (age, gender); presence of tinnitus; vestibular symptoms; time elapsed between onset of hearing loss and initiation of treatment; severity of hearing loss at presentation. Hearing outcomes were evaluated by four indices: Cure rate, marked recovery rate, recovery rate and hearing gain. Results: Mean hearing gain was 31.5±20.0 dB in Group B, which was significantly higher than that in Group A, 16.8±17.5 dB (p=0.018). The marked recovery rate was significantly higher in Group B than in Group A (50% vs. 20%; p=0.047). The patients who were treated within the first seven days of onset of hearing loss showed significantly higher hearing gains and better marked recovery rates. The cure rate was significantly higher in patients without vertigo than in those with vertigo (19% vs. 0%; p=0.045). 20% of the patients suffered from adverse effects of HBOT, the most common of which was otitis media. No other complications were reported. Conclusions: The addition of HBOT to the conventional treatment significantly improves the outcome of sudden deafness and its use should be encouraged as an adjunctive therapy along with conventional medical treatment. Also, age, gender, tinnitus and severity of hearing loss were not found to affect the outcome of sudden hearing loss. However, the following were found to be poor prognostic factors: The presence of vertigo and initiation of treatment more than seven days after onset of deafness. HBOT was found to be a relatively benign intervention.

Biography:

Mubarak Muhamed Khan has graduated from Government Medical College, Maharashtra in 1995. He stood 1st at Shivaji University in DLO examination in 1999 and passed DNB successfully in 2002. He has started working as an Assistant Professor in Department of otorhinolaryngolgy, MIMER Medical College, India since 2002. Currently he is working as an Associate Professor since 2007. He has completed his Training in “Cochlear Implant and Advanced Middle Ear Surgery” at Wurzburg University, Germany. He has also completed Training in Rhinoplasty under the world famous Rhinoplasty Surgeon, Prof. Yong Ju Jang; Seoul in October 2011. His keen interest is in Endoscopic OtoRhinoLaringolgical surgeries and creating innovations for the same and he is pioneer in India. He has authored two books, “Endoscopic Color Atlas of Ear Diseases” and “Endoscopic Color Atlas of Larynx &Pharynx” as an innovator he has developed many instruments and Endoscope holders for endoscopic rhinological and otological procedures. He has applied for two patents for “Khan’s Endoscope Holder” and “Justtach” (attachment to microscope for holding endoscope). He holds 10 publications to his credit. His other interest is Philosophy, he has just published book “An Odyssey through Philosophy of Mind”

Abstract:

Introduction: Endoscopic ear surgeries provide minimally invasive approach to the middle ear. The disadvantage of endoscopic ear surgeries is that it is one-handed surgical technique as the non-dominant left hand of the surgeon is utilized for holding and manipulating the endoscope. This necessitated the need for development of the endoscope holder which would allow both hands of the surgeon to be free for surgical manipulation and also to imitate more or less same actions of the left hand. Aim: To report the preliminary utility of our designed and developed Endoscope Holder for two handed technique of endoscopic cartilage tympanoplasty. Methods & Materials: It is a prospective non randomized clinical study. Our endoscope holder was designed and developed to aid in endoscopic ear surgery and to overcome the disadvantage of single handed endoscopic surgery. It was tested clinically for endoscopic ear surgeries. The design of the Endoscope holder is described in detail along with its manipulation and maneuvering. A total of 179 endo holder assisted endoscopic cartilage tympanoplasties were operated to evaluate its feasibility for the two handed technique and also simultaneously to evaluate the results of endoscopic cartilage tympanoplasty. Results: In our early follow up period ranging from 6 to 20 months in 179 ears operated, the graft uptake was seen in 174 patient’s ears with one residual perforation and 4 recurrent perforations giving a success rate of 97.206 percent. Our endoscope holder is a good option for two handed technique in endoscopic ear surgery. Conclusion: The study reports the successful application and use of the endo holder in two handed technique of endoscopic tympanoplasty.

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