Meatoplasty in Canal wall down Surgery: Our Experience and Literature Review.

INTRODUCTION: Meatoplasty is the final and essential step in performing effective canal wall down surgery for chronic otitis media. In this article we review some previous techniques and discuss our preferred method. MATERIALS AND METHODS: In this observational case series study, we used this technique in 53 patients (28 male and 25 female) between January 2005 and January 2008. Our survey was completed in 31 patients. RESULTS: Twenty-six patients (83.9%) said their ear appeared normal after the procedure, but five patients (16.1%) complained of some minor change in the shape of their ear. Twenty-nine patients (93.5%) had a completely wide ear canal. The ear canal had some degree of stenosis in two patients (6.5%) post-operatively. CONCLUSION: This technique offers good functional and cosmetic results with minimal manipulation and minimal anatomic disruption.

Short- and long-term survival of esophageal cancer patients treated at the Cancer Institute of Iran.

INTRODUCTION: Little data is available on the prognosis of esophageal cancer (EC) in Iran. We studied the short- and long-term survival of EC patients treated at the Cancer Institute of Iran. METHODS: 619 patients were followed who had been operated in the years 1997-2006. The 1-month to 5-year survival rates of EC and hazard ratios (HR) for different prognostic factors were estimated. RESULTS: Median survival was 11.5 months and 5-year survival was 10%. Patients at the advanced stage had a 2.1-fold higher risk of mortality compared to the early stage (95% CI 1.2-3.4). One-month mortality decreased from 12.2 in 1997-1999 to 9.1% in 2003-2006. In the first month, patients who were diagnosed in 2003-2006 had a significantly (60%) lower HR compared to 1997-1999 (HR = 0.4, 95% CI 0.1-0.9). In addition, patients with cardiopulmonary complications had an 11.7-fold higher HR compared to patients without complications (95% CI 4.7-29.3). CONCLUSIONS: The 5-year survival rate for operated EC patients was considerably low in Iran. Cardiopulmonary complications were the strong prognostic factors for first-month mortality. We suggest improving the pre- and postoperative care of EC to control these complications. Regular monitoring of patient survival is recommended to evaluate the effect of this intervention.

The butterfly procedure: a new technique and review of the literature for treating anterior laryngeal webs.

Congenital laryngeal webs, subglottic stenosis, and laryngeal atresia result from various degrees of failure of airway recanalization as a spectrum. The symptoms also range from asymptomatic to dysphonia and severe airway obstruction. There are a number of methods for management of symptomatic patients. In this article, we discuss a new procedure that was used in the management of two anterior laryngeal web patients with relatively acceptable results.