Stapes surgery: comparison between microdrill and footplate perforator

The study goal was to compare the effect of using footplate perforator and the microdrill on the postoperative hearing results and complications rate during stapes surgery. 70 ears with otosclerosis have been operated upon using microdrill to perforate the footplate in 34 ears and microperforator in 36 ears. All operations were operated upon at the Department of Otolaryngology, Mansoura University Hospitals from 2005 to 2007. The audiological results and complications rate of both groups were compared. There were statistically significant decrease of postoperative air and bone conduction in both groups. There was significant decrease in the mean post operative bone conduction in the microdrill group as compared to the perforator group. The mean postoperative air bone gap [500-4000Hz] was 7.8 dB and 9.3 dB for the microdrill group and the perforator group, respectively, which was statistically insignificant there was no significant SNHL in the microdrill group, while there was one ear [2.7%] had it in the perforator group. Stapedotomy using microdrill or footplate perforator provides good results, however, the use of microdrill may be useful as it is easy, safe and less traumatizing to the inner ear

Comparative study of the efficacy of local ciprofloxacin versus Aluminum acetate 3.5% in the management of active chronic suppurative otitis media [CSOM]

The management of active mucosal chronic otitis media can be both time consuming and difficult. Treatment options include aural toilette, local insufflations of anti-septic powders, an array of topical otic drops and sprays, systemic antibiotics and surgery. to determine the clinical and bacteriological efficacy of local Ciprofloxacin versus Aluminum acetate 3.5% in cases of active chronic supp.o.media. Design: Randomized double-blind study with clinical, bacteriological and audiological assessment pre and post management. Patients: A total of 30 patients with bilateral Ch.O.S.M aged 8-17 years, were enrolled, if they has persistent otorrhea. Intervention: All Rt. ears, received ototopical ciprofloxacin hydrochloride 0.3% drops and all left ears received Aluminum acetate 3.5% solution for 14 days in both ears. Patients were examined for clinical improvement on days7 and 14. Bone conduction audiometry was performed at baseline, on day 14 and one month after the end of the course therapy. Our results showed that Rt.ears had the same cure rate of the Left ears so, long as the duration of otorrhea was less than 2 months.Rt.ears otorrhea had more successful improvement rate 94%, than Left ears 82%, if the duration was more than 2 months. Pure tone average improvement was 10.6 dB in RI ears compared with 9.3 dB in Left ears. We concluded that both ciprofloxacin 0.3% and aluminum acetate 3.5% drops were effective in the treatment of active CSOM, with no adverse effects were noted especially on hearing. There was no statistically significant difference in the efficacy of both drops with a better clinical improvement with ciprofloxacin, if otorrhea is more than 2 months. Aluminum acetate solution 3.5% fulfills the criteria for a cheap, yet effective alternative to more expensive antibiotic preparation

Stapes surgery in children and young patients

Thirty two stapes procedures in children and young patients were reviewed. There were 18 males and 14 females. The mean age at the time of surgery was 16 years with a range from 8 to 20 years. Stapedectomy was performed in 12 cases and stapedotomy in 20 cases. Follow up period ranged from 6 monthes to 12 years with an average of 3 years. Our results showed an average postoperative air-bone gap of 9.8 dB and an average hearing improvement of 19.5 dB. The best results were obtained when the small fenestra technique was used. According to our results, we conclude that stapedectomy in children is satisfactory and the results are comparable to the other published results

Chlamydia IgA in acute ENT infections

Detection of Chlamydia IgA was done in 106 patients with acute infections in ear, nose and throat sites. The patients were divided into 3 diagnostic groups [pharyngitis, otitis media and sinusitis groups]. Acute phase serum antibodies were measured by using ELISA diagnostic kit Chlamydia IgA [eurogenetics]. The antibodies were detected in 8.8% [6/68] of those patients with pharyngitis, 30.7% [8/26] of those with otitis media and 8.3% [1/12] of those with sinusitis, whereas no one of the control group had acute antibodies. The overall incidence of acute antibodies was 14.2% [15/106]. This put Chlamydia species as an important etiologic pathogen in acute ENT infections