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1.
J Int Adv Otol ; 19(2): 105-111, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36975082

ABSTRACT

BACKGROUND: In the surgical development of cholesteatoma, in order to reduce the recurrence of cholesteatoma, 2 kinds of surgeries were carried out: removal of Cog and Korner's septum to ventilate supratubal recess (supratubal recess opened) and obliteration of the mastoid and attic space (bony obliteration tympanoplasty) were invented, respectively. Their purpose is the same but the theoretical basis is different, and the comparison of these 2 methods is not reported in the current literature. This study aims to evaluate the rates of recurrent and residual cholesteatoma with the simple canal wall up and canal wall up-supratubal recess opened and canal wall up-bony obliteration tympanoplasty mastoidectomy in a large cohort of patients. The secondary objectives were to assess the 3 techniques' infection rates and hearing outcomes. METHODS: Overall, 352 patients with middle ear cholesteatoma preoperatively underwent temporal bone ultrahigh-resolution computed tomography scan. The shape of the Eustachian tube and the supratubal recess were analyzed, and superior and posterior tympanic recesses, including the supratubal recess, were opened in different surgical groups. RESULTS: After 5 years of follow-up, the results show that the lowest recurrence rate was 6.6% (7/106) for canal wall up-supratubal recess opened, 10.9% (12/101) for canal wall up-bony obliteration tympanoplasty, and canal wall up had the highest recurrence rate of 19.31% (28/145). The postoperative infection rate was 5.7% in the canal wall up-supratubal recess opened group, 10.89% in the canal wall up-bony obliteration tympanoplasty group, and 7.59% in the simple canal wall up group. The postoperative median air conduction was increased 8 dB in the canal wall up-supratubal recess opened group, 1 dB in the canal wall up-bony obliteration tympanoplasty, and 6 dB in the simple canal wall up group. CONCLUSION: Opening the supratubal recess to ensure the patency of the attic facilitates the gas exchange between the mastoid process and the middle ear and reduces the possibility of cholesteatoma recurrence.


Subject(s)
Cholesteatoma, Middle Ear , Tympanoplasty , Humans , Tympanoplasty/methods , Retrospective Studies , Ear, Middle/surgery , Tympanic Membrane/surgery , Cholesteatoma, Middle Ear/surgery , Mastoid/surgery , Ear Canal/surgery , Treatment Outcome
2.
Acta Otolaryngol ; 143(2): 176-184, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36803162

ABSTRACT

BACKGROUND: A painless and effective treatment of childhood epistaxis is needed. OBJECTIVE: To observe the effectiveness of low-intensity diode (Lid) laser in treating epistaxis complicated with allergic rhinitis in children. METHODS: Our study is a prospective, randomized, controlled, registry trial (NO. 202001201) involving 44 recurrent epistaxis children (<14 years old) with or without Allergic Rhinitis (AR) in our hospital. They were divided randomly into the Laser and Control groups. The Laser group was treated with Lid laser (wavelength 635 nm, power 15mW) for 10 min after nasal mucosa was moistened with normal saline (NS). The Control group moistened their nasal cavities with NS only. Children in two groups complicated with AR were given nasal glucocorticoids for 2 weeks. The effectiveness of Lid laser in treating epistaxis and AR were compared between the two groups after treatment. RESULTS: After treatment, the effective rate of the Laser group in epistaxis (23/24, 95.8%) was higher than the Control group (16/20, 80%) (p < .05). The VAS scores of the children complicated with AR in the two groups both improved after treatment, however, the variation of VAS score (3.02 ± 1.50) in the Laser group was greater than the Control group (1.83 ± 1.56) (p < .05). CONCLUSION: As a safe and efficient method, Lid laser treatment can effectively alleviate epistaxis and inhibit symptoms of AR in children.


Subject(s)
Glucocorticoids , Rhinitis, Allergic , Humans , Child , Adolescent , Glucocorticoids/therapeutic use , Epistaxis/etiology , Epistaxis/therapy , Prospective Studies , Lasers, Semiconductor/therapeutic use , Treatment Outcome
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