Cartilage tympanoplasty: an evaluation of the results

Objective: This paper aims at evaluating the success rate and hearing outcome of cartilage tympanoplasty

Methods: All cases that underwent type I cartilage tympanoplasty in Hai Al Jamea Hospital, between the years 2001-2005 were included in this study. There were 104 cases. A semi-lunar canchal cartilage was placed anterior under the annulus residue. The graft was next placed over this cartilage and under the annulus. It was placed either under the handle of malleus in 72 cases or over the handle after dissecting the drum from the malleus in 32 cases

Results: One hundred cases had complete closure of the perforation whereas four cases showed residual perforation. The graft take rate was 96.2%. The mean pre0perative air bone gap [ABG] was 24.2] [13, whereas the mean postoperative audiogram was 5.21 dB. Closure of ABG to 0-10 dB group was achieved in 90.4% of cases

infratemporal fossa approach for the management of difficult lateral skull base lesions

Management of infratemporal fossa lesions poses certain difficulties. The presentation of these cases is variable, their location is deep and they may be related to important neurovascular structures. The aim of the present report is to present our experience in the management of extensive lesions involving the lateral skull base using a variety of infratemporal fossa approaches. The clinical picture, indications, technique, complications and outcome are discussed. This is a retrospective study in which all patients managed surgically for infratemporal fossa lesions at the ENT Department, Faculty of Medicine, Alexandria University and Hai Al Jamea Hospital, Jeddah, Saudi Arabia in a 2-year period were included. Nine patients were included, of whom four were recurrent juvenile nasopharyngeal angiofibromas, two nasopharyngeal carcinomas, one recurrent chondrosarcoma, one trigeminal neurinoma and one meningioma. The approaches used were the infratemporal fossa type C in two cases, the preauricular infratemporal fossa approach in six patients with [3 cases] or without [3 cases] orbitozygomatic osteotomy and a combined modified transcochlear and infratemporal fossa type B approach in the remaining case. Total removal could be accomplished in eight cases. No mortality was recorded The infratemporal fossa approaches provide a viable alternative for the management of difficult to treat lateral skull base lesions

Surgical strategy in the management of jugular foramen tumors

The deep location of the jugular foramen and the close relation to vital neurovascular structures are some of the difficulties encountered in the management of tumors involving this area. In addition, the rarity of cases, the diversity of tumor behavior and the possibility of extension not only in the temporal bone but also in the posterior fossa and the neck have imposed unique problems that need to be addressed in the management of these cases. The aim of the present work is to present our strategy in the management of jugular foramen tumors based on our experience in the treatment of 15 tumors in 14 cases in the Otolaryngology department, Alexandria University and Hai Al-Jamea Hospital Jeddah. There were six cases of glomus jugulare tumors, five cases of meningioma, two cases of lower cranial nerve schwannoma, one case of chordoma and one cases of glomus vagale tumor. In eight cases, the infratemporal fossa approach with [7 cases] or without [1 case] anterior rerouting of the facial nerve was utilized. The petro-occipital transsigmoid [POTS] approach was used in four cases. The transcochlear transcervial, translabyrinthine and transmastoid transcervical approaches were used in the remaining three cases. Total removal was achieved in 10 cases whereas subtotal removal was achieved in another four. The remainder was a malignant meningioma and only debulking was performed. One case died after initial good recovery due to cerebrovascular accident. Postoperative cranial nerve deficits constituted the major postoperative morbidity. CSF leak occurred in four cases. The results show the difficulties encountered in the management of these challenging lesions and the need for an individualized approach for each particular case

Serum levels of total testosterone and the severity of erectile dysfunction

The aim of this study was to correlate the severity of erectile dysfunction [ED] with the total testosterone serum levels [TT], 208 men aged 40 to 80 years, were asked to answer the questionnaire of the Simplified International Index of Erectile Function [IIEF-5] as a method to diagnose and classify ED. The IIEF-5 scores ranged from 1 to 25 and the ED was classified into five groups according to the score: severe [1-7], moderate [8-11], mild - moderate [12-16], mild [17-21], and no ED [22-25]. Also, all subjects had their TT serum levels determined based on the blood sample obtained between 08:00 and 10:00. The analysis of the relationship between the different degrees of ED and TT levels were then studied. The prevalence of all degrees of ED was 49.0 percent. The degree of ED was mild in 15.38 percent, mild to moderate in 13.46 percent, moderate in 6.25 percent and severe in 13.94 percent. The variation of TT serum concentrations was similar [P > 0.05] in the different age groups. Furthermore, the TT serum levels were not different for individuals with and without ED [P > 0.05] and similar concentrations of TT was observed in different severity degrees of ED [P > 0.05]. ED presented a clear association with the subjects' aging, but neither correlation between TT levels and ED, nor with its severity, could be demonstrated in the present study

Effect of chronic hypoxia and hypercapnea on the nervous system: visual and auditory brainstem evoked potentials in patients with chronic obstructive pulmonary disease

We aimed at studying the effect of the pathophysiological changes associated with chronic obstructive pulmonary disease [COPD] on the nervous system and its aetiopathogenesis using the pattern shift visual evoked potentials [PSVEPs] and the brainstem auditory evoked potentials [BAEPs]. There are still great controversies between different studies that assessed cranial nerves and central nervous system functions in COPD patients using different neurophysiological techniques. In addition, those who reported abnormalities did not find any correlation between their findings and the pulmonary functions and arterial blood gas measurements. Design and methods: Participants consisted of 35 COPD male patients. Sixteen patients diagnosed as stable at risk or mild COPD and 19 patients diagnosed as stable moderate or severe COPD were included in the study as group I and II respectively. In addition, 20 age- and sex- matched healthy individuals were included in this study as a control group [group III]. We performed pulmonary function tests, arterial blood gas analysis, audiogram, auditory brainstem evoked responses [ABR] and visual evoked potentials [VEP] for all patients and controls. All patients in group I had normal BAEPs. Conversely, all patients in group II had abnormal BAEPs studies. All of them had significantly delayed wave I, III and V absolute latencies. However, 11 [58%] patients had significantly delayed IPLs III-V and I-V. There were significant negative correlations between PaO2 and wave I peak latency [p< 0.05]. There were also significant positive correlations between PaCO2 and wave V peak latency, I-V and III-V interpeak latencies [P< 0.01]. Lastly, there was a significant correlation between the Forced Expiratory Flow [FEF25-75%] and all BAEPs abnormalities. VEP study showed that the P100 was mildly but insignificantly delayed in group II. The function of the eighth nerve and the brainstem were highly abnormal in moderate and severe COPD. We also found that the impairment of the eighth nerve is mostly due to hypoxia and the impairment of the brainstem is mostly due to hypercapnea. Finally, our results have shown that the nervous system function could also be impaired in COPD through other mechanisms rather than hypoxia and hypercapnea

Cisplatin combined chemotherapy in advanced ovarian cancer

For the past decade the treatment of advanced ovarian cancer has generally comprised maximal debulking surgery followed by combination -chemotherapy. Cisplatin has been the most active single agent. At a dose of 100 mg/m2 cisplatin every 3 or 4 weeks, the clinical complete and partial response rates exceed 50% and the pathological complete remission rate is around 30% in patients who have received no prior chemotherapy or radiotherapy. Many clinicians judge the most effective treatment for the majority of patients to be a combination chemotherapy regimen using cisplatin at the maximally tolerated dose, usually 100 mg/m2 [Ozols, 1985]. a large randomized Italian study has shown a higher response rate for combination chemotherapy with cisplatin. Adriamycin and cyclophosphamide compared with cisplatin alone, although no survival differences were observed, perhaps because of cross-over between the treatment arms [GICOG, 1987]

Studies on food borne fungi on carcass surface and air in Zagazig abattoir

358 mould genera were isolated from 150 swab specimens obtained from the surface of cattle carcasses after their evisceration [50 each of thigh, innerside of the thorax and outerside of the thorax] as well as 25 air samples collected from different locations of the slaughter halls of Zagazig abattoir. The total mould count/cm[2] of the thigh, innerside of the thorax and outerside of the thorax ranged from 1x10[2] to 3x10[2] 1x10[2] to 1x10[4] and 1x10[2], to 1x10[3] with mean values of 2x10[2], 2x10[3] and 4x10[2] respectively. The isolated moulds were Aspergillus niger, penicillium, Alternaria, Mucor, Cladosporium, A.fumigatus, Geotrichum, Fusarium, A.flavus and Rhizopus. The public health importance of such excistence was also discussed