A new extraoral closed reduction technique for temporomandibular joint dislocation: A preliminary case series

Objective@#This study aims to describe a new extraoral technique for reducing bilateral temporomandibular joint (TMJ) dislocations.@*Methods@# Design: Retrospective Preliminary Case Series Setting: Tertiary Government Training Hospital Participants: Ten (10) adults with bilateral TMJ dislocation@*Results@#Ten patients, 7 males and 3 females with median age of 35.50 (IQR:21.25 [23.50, 44.75]) years old were included in our series. Seven had more than one previous episode of TMJ dislocation, and the dislocation spontaneously occurred while yawning or eating in six patients. Our new technique resulted in complete bilateral reduction in three patients who had first-episode TMJ dislocations but only in four out of seven with previous dislocation. The three others (two partial, unilateral failure of reduction and one complete failure of reduction) needed conventional extraoral reduction (Hippocratic technique). @*Conclusion@#This new extraoral technique may show promising preliminary results in the management of temporomandibular joint dislocation, but a larger trial in comparison with other techniques is needed.

Hearing and clinical otologic profile of Filipinos living in Southern Tagalog Region IV-A (CALABARZON), Philippines: The Southern Tagalog ENT Hearing Specialists (STENTS) Survey 2012-2017

@#<p><strong>Objective:</strong> To determine the prevalence of hearing loss and otologic diseases among Filipinos living in the Southern Tagalog Region IV-A: CALABARZON (Cavite, Laguna, Batangas, Rizal and Quezon), Philippines.</p><p><strong>Methods:</strong></p><p><strong>               Design:</strong> Retrospective Review of Community Survey Data</p><p><strong>               Setting:</strong> Communities in Region IV-A provinces, Philippines</p><p><strong>               Participants:</strong> 3267 residents of the five provinces aged 0 months and above</p><p> <strong>Results:</strong> About 71.29% and 74.60% had at least mild hearing loss, in right and left ears, respectively. For disabling hearing impairment, overall prevalence was 26.33%, distributed into 11.87% among 4 to 18-year-olds; 8.97% for 19 to 64-year-olds; and 3.17% for 65-year-olds and above. Absence of prevalent and hearing loss-associated diseases: serous otitis media [OR 0.362, 95% CI 0.167 to 0.782, p = .010], CSOM [OR 0.407, 95% CI 0.236 to 0.703, p = .001] COM [OR 0.229, 95% CI 0.106 to 0.494, p < .001] can decrease the risk for hearing loss development in the region. Prevention of noise-induced hearing loss or delay in the manifestation of presbycusis can reduce the risk of having hearing loss by as much as 75% [OR 0.253, 95% CI (0.180 to 0.355), p < .001]. All pure tone audiometry measurements were obtained with surrounding median ambient noise of 55dB (IQR 46 to 60dB).</p><p><strong>Conclusion:</strong> The prevalence of hearing loss among surveyed residents of the Southern Tagalog Region IV-A provinces was high compared to the previous nationwide study but low compared to other low- and middle-income countries. The top otologic conditions of this population (ear occlusion with ear wax, chronic suppurative otitis media, chronic otitis media, presbycusis, noise-induced hearing loss) were associated with hearing loss and their absence decreased the risks for hearing impairment.</p>

Emergent reconstruction of laryngeal penetrating neck injury: A case report

@#<p><strong>OBJECTIVE:</strong> This paper aims to describe an unconventional surgical procedure performed in a case of penetrating neck injury involving the larynx.</p><p><strong>METHODS:</strong></p><p><strong>Design:</strong> Case Report</p><p><strong>Setting:</strong> Tertiary Government Hospital</p><p><strong>Population:</strong>          One</p><p><strong>RESULTS:</strong> A 38-year-old man sustained a hacking laceration to the anterior neck that extended into the hypopharyngeal area, transecting the thyroid cartilage. After pre-emptive tracheostomy, the patient was referred to otorhinolaryngology - head and neck surgery due to the extensive hypopharyngeal injury. Neck exploration performed to control bleeders confirmed a Schaefer-Fuhrman Classification Group 3 penetrating neck injury. Anastomotic reconstruction of the hypopharynx, transected thyroid cartilage and strap muscles was attempted using absorbable sutures with post-operative re-establishment of structural continuity and documentation of full bilateral vocal fold mobility. The patient was about to be discharged home with a tracheotomy and nasogastric tube when he suddenly deteriorated and expired on the eighth post-operative day.</p><p><strong>CONCLUSION:</strong>  Our technique might be utilized in cases where urgent reconstruction of laryngeal structures is considered despite serious damage to the laryngeal skeleton, and may provide a temporary surgical option for similar cases in an emergent setting. However, we cannot recommend it as a routine standard on the basis of one case.</p><p><strong>KEYWORDS: </strong> larynx; penetrating neck injury; vocal cord; reconstruction, neck exploration</p>