Medialization thyroplasty using medpor [R] implant material under superficial cervical plexus blocks

Medialization thyroplasty has rapidly gained popularity as the treatment of choice for unilateral vocal fold immobility over other methods applied for treatment of glottic insufficiency. The reasons for this are the physiologic aspect of medialization thyroplasty and ability of monitoring during surgery. In this study medialization thyroplasty type I was performed according to Isshiki Technique using Medpor as an implant material in 12 patients with unilateral vocal fold paralysis under bilateral superficial cervical plexus blocks with minimal sedation. Pre-and post-operative phoniatric assessment included auditory perceptual assessment, acoustic analysis of voice and videolaryngostroboscopy. All the patients showed improvement in the assessment parameters with no detected complications

Double aneuploidy in three Egyptian patients: Down- Turner and Down- Klinefelter syndromes

The co-occurrence of two numerical chromosomal abnormalities in same individual [double aneuploidy] is relatively rare and its clinical presentations are variable depending on the predominating aneuploidy or a combination effect of both. Furthermore, double aneuploidy involving both autosomal and sex chromosomes is seldom described. In this study, we described three patients with double aneuploidy involving chromosome 21 and sex chromosomes. They all had the classical non disjunction trisomy 21; that was associated with monosomy X in two of them and double X in the other. Clinically, they had most of the phenotypic features of Down syndrome as well as variable features Characteristic of Turner or Klinefeiter syndrome. Cytogenetic studies and fluorescence in situ hybridization [FISH] analysis were carried out for all patients and their parents. The first patient was a male, mosaic with 2 cell lines [45, X / 47, XY, +21] by regular banding techniques and had an affected sib with Down syndrome [47, XY, +21]. The second was a female mosaic [46, X, +21 / 47, XX, +21] where monosomy X was detected only by FISH in 15% of cells, nevertheless, stigmata of Turner syndrome was more obvious in this patient. The third patient had non mosaic double trisomy, Down-Klinefelter [48, XXY, +21] presented with Down syndrome phenotype. Parental karyotypes and FISH studies for these patients were normal with no evidence of mosaicism. In this report, we reviewed variable clinical presentations among the few reported cases with the same aneuploidy in relation to ours. Also, the proposed mechanisms of double aneuploidy and the occurrence of non-disjunction in more than one family member were discussed. This study emphasizes the importance of molecular cytogenetics techniques for detection of mosaicism, furthermore, we recommend studying of more than one tissue in cases with atypical features of characteristic chromosomal aberration syndromes

Correction of velopharyngeal incompetence by the use of the spuperiorly based lined pharyngeal flap with lateral ports

In this study the superiorly based lined pharyngeal flap with lateral ports was used to correct modaerate to severe velopharyngeal incompetence [VPI] due to sevseral causes after failure of speech therapy in 20 patients. All the patients were diagnosed and documented preoperatively using the assessment protocol for VPI cases in the Phoniatric Unit. They were referred again one month after surgery in the ENT department for postoperative documentation and speech therapy. All the patients showed marked subjective and objective improvement of the degree of hypernasality and complete closure of the velopharyngeal gap endoscopically. The overall speech intelligibility showed continuous improvement with postoperative speech therapy. Although all the patients snored postoperatively, none of them suffered from obstructive sleep apnea