Canal wall dwon mastoidectomy for pediatric cholesteatoma [single-stage approach] the impact of surgery on hearing status

The management of pediatric cholestetoma is still controversial. We report our experience with one-stage procedure canal wall down technique in children who had acquired cholesteatoma with evaluation of the hearing status pre and post operatively. Single-stage CWD mastoidectomy approach has a good hearing result with low rate recidivism [7.5%,] and minimal cavity problem. Hearing was preserved in [32%], improved [40%] and became worse [28%] of cases postoperatively. Single-stage approach has low rate of recidivism during follow-up period and overcome the social problems of multi-stage procedure in children

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