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.