Review of endoscopic myringoplasty success: comparisons of intra-operative graft material and post-operative packing in terms of graft failure rate.

BACKGROUND: Myringoplasty success rate is estimated to be between 60 and 90 per cent. Factors predicting success include the choice of graft and use of auditory canal packing. This study aimed to determine the intra-operative factors associated with endoscopic myringoplasty success. METHODS: A retrospective review of all endoscopic myringoplasty cases between January 2017 and January 2020 was undertaken. Data were collected on: patient demographics, tympanic membrane perforation size, intra-operative details, audiology and post-operative outcomes. RESULTS: There was no significant difference in graft success rates between cases using bismuth iodoform paraffin paste and Spongostan packing (86.7 per cent vs 84.9 per cent, respectively). Conchal cartilage graft had a higher success rate (100.0 per cent) compared with Biodesign grafting biomaterial (66.7 per cent), but was not superior to tragal cartilage (84.6 per cent) or temporalis fat or fascia (80.0 per cent). CONCLUSION: Spongostan packing is equivalent to bismuth iodoform paraffin paste in terms of endoscopic myringoplasty success rate. Although conchal cartilage graft had higher success rates, it was not statistically significantly different from tragal cartilage.

Three-dimensional versus two-dimensional endoscopes in anatomical orientation of the middle ear and in simulated surgical tasks.

BACKGROUND: Three-dimensional endoscopes provide a stereoscopic view of the operating field, facilitating depth perception compared to two-dimensional systems, but are not yet widely accepted. Existing research addresses performance and preference, but there are no studies that quantify anatomical orientation in endoscopic ear surgery. METHODS: Participants (n = 70) were randomised in starting with either the two-dimensional or three-dimensional endoscope system to perform one of two tasks: anatomical orientation using a labelled three-dimensional printed silicone model of the middle ear, or simulated endoscopic skills. Scores and time to task completion were recorded, as well as self-reported difficulty, confidence and preference. RESULTS: Novice surgeons scored significantly higher in a test of anatomical orientation using three-dimensional compared to two-dimensional endoscopy (p < 0.001), with no significant difference in the speed of simulated endoscopic skills task completion. For both tasks, there was lower self-reported difficulty and increased confidence when using the three-dimensional endoscope. Participants preferred three-dimensional over two-dimensional endoscopy for both tasks. CONCLUSION: The findings demonstrate the superiority of three-dimensional endoscopy in anatomical orientation, specific to endoscopic ear surgery, with statistically indistinguishable performance in a skills task using a simulated trainer.

Everything Matters: The ReproNim Perspective on Reproducible Neuroimaging.

There has been a recent major upsurge in the concerns about reproducibility in many areas of science. Within the neuroimaging domain, one approach is to promote reproducibility is to target the re-executability of the publication. The information supporting such re-executability can enable the detailed examination of how an initial finding generalizes across changes in the processing approach, and sampled population, in a controlled scientific fashion. ReproNim: A Center for Reproducible Neuroimaging Computation is a recently funded initiative that seeks to facilitate the "last mile" implementations of core re-executability tools in order to reduce the accessibility barrier and increase adoption of standards and best practices at the neuroimaging research laboratory level. In this report, we summarize the overall approach and tools we have developed in this domain.

Postnasal drip syndrome. Two hundred years of controversy between UK and USA.

This review discusses the trans-Atlantic controversy concerning Post Nasal Drip Syndrome (PNDS). PNDS was described as a common condition in the UK in the nineteenth century and was so extraordinarily prevalent in the USA that it was called 'American catarrh'. American chest physicians adopted PNDS as the most common cause of chronic cough. A relationship between PNDS and chronic cough was not accepted by UK chest physicians, who preferred to use the term 'rhinosinusitis' instead of PNDS. In the USA the diagnosis of PNDS was linked to a response to therapy with a sedating antihistamine and decongestant, but UK physicians doubted if this was a specific therapy and did not accept the therapy as diagnostic for PNDS. In 2006 the American College of Chest Physicians replaced the term PNDS with upper airway cough syndrome and some UK otolaryngologists proposed that PNDS should be replaced with rhinosinusitis. PNDS is now being replaced with more general descriptions of upper airway disease and a causal link with chronic cough is now disputed. PNDS may be caused by a mucus hypersecretory phenotype that develops following chronic exposure of the respiratory tract to particulate matter, allergens, irritants and pathogens. Current research on treating excessive airway mucus in the lower airways may be applicable to PNDS.

The effects of a hot drink on nasal airflow and symptoms of common cold and flu.

Hot drinks are a common treatment for common cold and flu but there are no studies reported in the scientific and clinical literature on this mode of treatment. This study investigated the effects of a hot fruit drink on objective and subjective measures of nasal airflow, and on subjective scores for common cold/flu symptoms in 30 subjects suffering from common cold/flu. The results demonstrate that the hot drink had no effect on objective measurement of nasal airflow but it did cause a significant improvement in subjective measures of nasal airflow. The hot drink provided immediate and sustained relief from symptoms of runny nose, cough, sneezing, sore throat, chilliness and tiredness, whereas the same drink at room temperature only provided relief from symptoms of runny nose, cough and sneezing. The effects of the drinks are discussed in terms of a placebo effect and physiological effects on salivation and airway secretions. In conclusion the results support the folklore that a hot tasty drink is a beneficial treatment for relief of most symptoms of common cold and flu.

Management of chondrodermatitis nodularis chronica helicis using a 'doughnut pillow'.

UNLABELLED: Chondrodermatitis nodularis chronica helicis is a well-recognised painful condition of the pinna. There have been several modes of treatment described for this condition. Although the most common mode of treatment is surgery,1,2 several conservative approaches have also been tried. OBJECTIVES: To determine if chondrodermatitis nodularis chronica helicis can be treated conservatively using a doughnut-shaped pillow. DESIGN AND SETTING: Prospective study in Wrexham Maelor Hospital, which is a district general hospital. PARTICIPANTS: All the patients clinically diagnosed with chondrodermatitis nodularis chronica helicis between September 2003 and September 2004. All such patients were seen by an ENT consultant with a special interest in facial lesions. Patients who could not be clinically diagnosed with chondrodermatitis nodularis chronica helicis were excluded from the study. MAIN OUTCOME MEASURE: Pain relief following the use of a doughnut pillow was used as the main outcome measure. RESULTS: Twenty-three (14 female and 9 male) patients were treated with a special doughnut-shaped pillow designed to relieve the pressure on the affected ear. Of the 23 lesions treated 13 remained pain free after a follow-up period of one year. CONCLUSION: Conservative treatment of chondrodermatitis nodularis chronica helicis using a doughnut pillow is very cost effective.

Pre-vertebral surgical emphysema following functional endoscopic sinus surgery.

Functional endoscopic sinus surgery (FESS) is a widely practiced technique in the UK. This procedure has variable complication rates and can have some serious consequences. We present a case of surgical emphysema of the neck, face and the pre-vertebral space following FESS. Emphysema of the face and neck has been previously reported. However, to our knowledge, emphysema of the pre-vertebral space following FESS has not been documented. Pre-vertebral emphysema following FESS is an unusual and potentially serious complication.