Availability and impact of great auricular nerve preservation during superficial parotidectomy on auricular sensation and patients quality of life

The present study aimed to evaluate the feasibility and impact of great auricular nerve [GAN] preservation after superficial parotidectomy on its functional outcome; namely auricular sensation and patients' quality of life [QOL]. The study included 17 patients; 12 males and 5 females with mean age of 51.2 +/- 11.4: range: 30-62 years. All patients presented by unilateral swelling in the parotid region and underwent superficial parotidectomy with preservation of GAN. Postoperative touch sensation of the pinna and QOL after parotidectomy were evaluated and represented on 100-point visual analogue scale [VAS] at 2-weeks. 1, 2, 3 and 6-months after surgery. All surgeries were completed with no intraoperative complications. Posterior branches of GAN could be preserved in 12 cases [70.6%] while the nerve was thin and could not be preserved in 2 cases and was adherent and could be dissected in another 3 cases, thus GAN was excised in 5 cases [29.4%]- Touch sensation of the pinna showed progressive time-course improvement in all patients whether the GAN was preserved or excised and the mean sensation VAS score showed a significant [P<0.05] increase at each time of examination compared to the previous records irrespective of nerve preservation or excision with significantly higher [P<0.05] in patients with preserved GAN compared to those with excised GAN. Also, mean QOL scores showed progressive time- course improvement In all patients with significantly [P<0.05] higher QOL scores in patients with preserved GAN compared to those with excised GAN. It could be concluded that preservation of posterior branch of GAN Is feasible and Improves the outcome of parotidectomy with significant preservation of sensation of pinna and improved quality of life

Assessment of Semont repositioning maneuver for treatment of benign paroxysmal positional vertigo

This study was designed to assess the efficacy of Semont repositioning maneuver for treatment of benign paroxysmal positional vertigo [BPPV] with or without nystagmus and included 60 patients complaining of vertigo. Patients were categorized into two groups: patients who were observed to have nystagmus with vertigo [Objective group] and those who experienced only vertigo without nystagmus [Subjective group]. All patients underwent physical treatment using Semont liberatory maneuver and were re-evaluated in clinic at 3 weeks' time till stability of the result. Treatment was graded as complete [no subjective complaint of vertigo], partial [significant improvement but persistent vertigo of nonpositional nature] or failure. In objective BPPV group, 27 patients had complete resolution of vertigo after one session of treatment, while 8 patients required 2 sessions and 3 of them had complete resolution while 5 had marked improvement, with an overall response of 87.5%, whereas 12 patients with subjective BPPV had complete resolution after one session of treatment, while 4 patients developed marked improvement 3 patients after one session and one patients after two seasons of treatment, with an overall response of 80%. There was a non-significant difference both between the number of seasons required to achieve result. [X[2]= 2.05, P>0.05] and between the obtained results. [X[2]= 1.25, P>0.05] between both categories of vertigo. There were 7 patients reported recurrence of vertigo, 4 in objective and 3 in subjective group. Pre-treatment duration of vertigo showed a negative significant correlation with result obtained, [r=-0.67. P<0.05], while showed a positive significant correlation with the number of sessions of treatment required to achieve result, [r=0.64. P<0.05]. Also, there was a negative significant correlation between the number of treatment sessions and the obtained result, [r=-0.89. P<0.05]. Thus, we can conclude that repositioning treatment using Semont liberatory maneuver is a safe, simple treatment strategy that yields a rapid relief of benign paroxysmal positional vertigo whether accompanied with nystagmus or not

Observation on the content of serum and effusion superoxide dismutase in otitis media with effusion patients

This study was designed to estimate both plasma and middle ear effusion [MEE] superoxide dismutase [SOD] levels and to evaluate the relationship between clinical data, and macro and microscopic characters of MEE and SOD levels. The study comprised 60 patients [36 males and 24 females] aged 4-16 years. After clinical examination, diagnosis of otitis media with effusion [OME] was made by otomicroscopic findings and tympanometry; there were 15 patients with bilateral and 45 patients with unilateral OME. Blood sample was taken and MEE was collected by aspiration [with a Juhn-Tym-Tap] after myringotomy under general anesthesia. On the basis of polymorphnuclear leucocytes [PNL] content of MEEs, samples were classified into 4 grades. There were 29 mucoid; 36 serous and 10 purulent effusions. Effusion SOD levels showed a significant [P<0.05] increase compared to its levels in plasma, but with a nonsignificant correlation. Mucoid effusions showed the highest SOD levels, followed by serous, than purulent effusion. There was a significant [P<0.05] increase of SOD levels in mucoid effusion compared to its level in other types of effusions and to plasma levels, and in serous effusion compared both to purulent effusion and plasma levels, moreover, mean SOD level in purulent effusion showed a significant [P<0.05] increase compared to plasma levels. According to PNL content, grade I [7 samples], grade II [23 samples]; grade III [22 samples] and grade IV [15 samples]. SOD levels of MEE showed a significant [P<0.05] increase in grade IV compared to the other grades, and in grades III and II samples compared to grade I samples. There was a negative significant correlation between MEE levels of SOD and its PNL content, [r=0.565, P<0.001], however, there was a positive significant correlation between SOD levels and PNL content of MEE in grade III [r=0.521, P=0.013] and grade IV, [r=0.596, P=0.019]. We can conclude the prooxidant/antloxidant disequilibrium plays a major role in pathogenesis and persistence of middle ear otitis media with effusion, and that SOD levels were found to increase in MEEs independently of the plasma level, and in serous and mucoid MEEs than in purulent MEEs