Role of botulinum toxin type a in management of vocal fold contact granuloma meta-analysis study

Background: granulomas of the vocal process of the larynx are benign lesions of the posterior glottis generally centered over the tips of the cartilaginous vocal processes. Clinically they are associated with odynophagia, throat clearing, globus, and otalgia

Aim of the Work: this meta-analysis study aimed to know the role of botulinum toxin type A in management of vocal fold contact granuloma

Materials and Methods: this study strictly followed the recommendation of referred reporting items for systematic reviews and meta-analyses [PRISMA] statement. It was done in the following steps: target determination, identification the location of articles, screening and evaluation, data collection, data analysis and finally reporting and interpretation

Results: there was acceptable complete response rate of contact granuloma to botulinum toxin injection with event rate of 85.422% while rate of improvement among selected cases was 92.962%. Concerning to complications the most common complication was hoarsness of voice with rate of 52.737% while dysphagia was 21.125% among cases

Conclusion: botulinum toxin is a safe and effective therapy in resolving vocal process granulomas. Complete response and partial response are significant in our study also decreased Valsalva effort, failure rate and relapse rate are all significant outcomes. While temporary post injection hoarsness of voice, dysphagia, local pain at injection sites and fluid aspiration considered non significant outcomes

Comparison of nested RT- PCR with conventional viral culture and immunofluorescence techniques for diagnosis of respiratory syncytial virus infection in middle ear effusion

A rapid method for detection of respiratory syncytial virus [RSV] in middle ear effusion [MEE] samples, involving a combination of reverse transcription and polymerase chain reaction amplification [RT-PCR], has been used. The RT-PCR assay employs oligonucleotide primers specific for the region of the RSV genome which encodes the Fl subunit of the fusion [F] glycoprotein. The RT-PCR assay was tested on 30 samples collected at time of tympanostomy with or/without adenoidectomy from 30 children with otitis media with effusion [OME] and the results from RT-PCR were compared with those obtained from virus culture and direct immunofluorescence [DIF]. 13[43.3%] out of 30 samples were positive by RT-PCR and viral culture, as well as 12 [40.0%] of 30 samples which were positive by direct immunofluorescence [DIF]. Sensitivity and specificity of RT-PCR and DIF in comparison to the results of tissue culture of the studied patients were, 92.3%, 100% and 84.6%, 88.2% respectively with the accuracy 96.7% for RT-PCR. Results of RT-PCR assay suggest that this technique could be useful for diagnosis of RSV in clinical samples as an immediate procedure and in facilities lacking a comprehensive virology laboratory