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Elzayat S, Lasheen H, Gehad I, El-Deeb ME, Soltan I, Aouf MM, Elgendy A. The Efficacy of Budesonide as Intrapolyp Injection Agent in the Management of Type 2 CRSwNP. Laryngoscope 2024; 134:2085-2092. [PMID: 37916779 DOI: 10.1002/lary.31137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/18/2023] [Accepted: 10/10/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVES To assess the efficacy and safety of budesonide as an intrapolyp injection in chronic rhinosinusitis with nasal polyps (CRSwNP) in comparison to control and systemic steroids. METHOD In a prospective double-blinded controlled randomized clinical trial, 150 patients with CRSwNP were divided into 3 groups in a ratio 1:1:1 where group (A) was given oral prednisolone 1 mg/kg tapered daily for 2 weeks, group (B) was given budesonide intrapolyp injection weekly for 5 consecutive weeks, and group (C) was given intrapolyp injection with saline as the control group. Patients were assessed upon Sinonasal Outcome Test (SNOT-22) score, Total Nasal Polyp score (TNPS), Serum IgE, absolute eosinophilic count, and morning cortisol level before treatment, 1 week and 6 months after completing their treatment protocol. RESULTS SNOT 22 score improved significantly in all groups compared to those at baseline. Reduction in the oral and injection groups was much greater than the control group (P2 < 0.001), (P3 < 0.001), and the same trend concerning TNPS score (P2 < 0.001), (P3 < 0.001) but with no significant change in the control group. CONCLUSION Intrapolyp steroid injection is considered a safe and effective method in nasal polyposis with limited side effects in comparison to systemic steroids. Using Budesonide as an agent for intrapolyp injection appears to be promising. It's advisable in patients with multiple relapses or high-risk patients to avoid repeated courses of oral steroids. LEVEL OF EVIDENCE 2 Laryngoscope, 134:2085-2092, 2024.
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Affiliation(s)
- Saad Elzayat
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafr El-Shaikh, Egypt
| | - Hesham Lasheen
- Otorhinolaryngology Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Ibrahim Gehad
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafr El-Shaikh, Egypt
| | - Mohamed E El-Deeb
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafr El-Shaikh, Egypt
| | - Islam Soltan
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafr El-Shaikh, Egypt
| | - Mohammad M Aouf
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafr El-Shaikh, Egypt
| | - Ahmed Elgendy
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafr El-Shaikh, Egypt
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Elgendy A, Khafagy Y, Elzayat S, Gamal A. The role of using the submucosal conchoplasty technique for the management of concha bullosa in decreasing the postoperative middle meatus synechia formation after endoscopic sinus surgery: A randomised controlled trial. J Laryngol Otol 2024:1-27. [PMID: 38682681 DOI: 10.1017/s002221512400063x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Affiliation(s)
- Ahmed Elgendy
- Otorhinolaryngology, Faculty of medicine- Kafrelsheikh University, Egypt
| | - Yasser Khafagy
- Otorhinolaryngology, Faculty of Medicine- Mansoura University, Egypt
| | - Saad Elzayat
- Otorhinolaryngology, Faculty of medicine- Kafrelsheikh University, Egypt
| | - Ali Gamal
- Otorhinolaryngology, Faculty of medicine- Kafrelsheikh University, Egypt
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Elzayat S, Elgendy A, Lasheen H, El-Deeb ME, Aouf MM, Gehad I. The role of budesonide intrapolyp injection in the management of type 2 chronic rhinosinusitis with nasal polyps: a randomised clinical trial. J Laryngol Otol 2024; 138:416-424. [PMID: 37781760 DOI: 10.1017/s0022215123001688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
PROBLEM To assess the efficacy of budesonide intrapolyp injection in chronic rhinosinusitis with nasal polyps. METHOD Ninety patients were divided into three groups; group A was given oral prednisolone, group B was given budesonide intrapolyp injection weekly for five consecutive weeks and group C was given budesonide as nasal irrigation for one month. Patients were assessed using Sino-Nasal Outcome Test 22 score, total nasal polyp score, serum immunoglobulin E, absolute eosinophilic count, and morning cortisol level before treatment, one week and three months after completing their treatment. RESULTS Total nasal polyp score decreased significantly in all groups compared to those at baseline. Reduction in the oral and injection groups was greater than the wash group (p2 = 0.004), (p3 < 0.001), and the same trend concerning Sino-Nasal Outcome Test 22 score (p2 < 0.001), (p3 < 0.001). CONCLUSION Budesonide is an effective agent used in intrapolyp injection with no documented systemic or visual side effects that has comparable results with oral steroids.
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Affiliation(s)
- Saad Elzayat
- Otorhinolaryngology Department, Faculty of Medicine - Kafrelsheikh University, Kafr ElSheikh, Egypt
| | - Ahmed Elgendy
- Otorhinolaryngology Department, Faculty of Medicine - Kafrelsheikh University, Kafr ElSheikh, Egypt
| | - Hesham Lasheen
- Otorhinolaryngology Department, Faculty of Medicine - Cairo University, Cairo, Egypt
| | - Mohamed E El-Deeb
- Otorhinolaryngology Department, Faculty of Medicine - Kafrelsheikh University, Kafr ElSheikh, Egypt
| | - Mohammad Mahmoud Aouf
- Otorhinolaryngology Department, Faculty of Medicine - Kafrelsheikh University, Kafr ElSheikh, Egypt
| | - Ibrahim Gehad
- Otorhinolaryngology Department, Faculty of Medicine - Kafrelsheikh University, Kafr ElSheikh, Egypt
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Barbara M, Margani V, Covelli E, Romano A, Bozzao A, Lotfy R, Mandour M, Swaid A, Soltan I, Elzayat S, Elfarargy HH. Radioclinical Assessment of Posterior Tympanotomy Difficulties during Ordinary Cochlear Implantation: A Prospective Case-Series Study. Otol Neurotol 2024; 45:e162-e169. [PMID: 38361294 DOI: 10.1097/mao.0000000000004116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVES This study proposes a preoperative radiologic scoring system for predicting posterior tympanotomy (PT) and mastoidectomy-associated difficulties during cochlear implantation (CI). STUDY DESIGN It was a prospective case-series study. SETTINGS The included CI surgeries were performed at tertiary referral institutions from October 2022 to April 2023. SUBJECTS We included 73 CI candidates performed via the PT approach. INTERVENTION The proposed radiologic score, composed of 13 items, was fulfilled and evaluated before each CI surgery. MAIN OUTCOME MEASURE We correlated this score with the intraoperative difficulty and surgical duration. RESULTS The operation was straightforward in 42 patients with a score of 3.87 ± 1.72 and challenging in 31 patients with a score of 10.66 ± 1.73. The radiologic score was strongly correlated with the surgical difficulty and duration (p < 0.0001). CONCLUSIONS Our proposed radiologic score was a valid, reliable, and precise tool to predict intraoperative difficulty during cochlear implantation. Chorda-facial angle was the strongest predictor, significantly affecting the difficulty, surgical duration, and preoperative radiologic score. A score equal to or more than 7.5 was expected to be associated with surgical difficulty.
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Affiliation(s)
- Maurizio Barbara
- Department of Neuroscience, Mental Health and Sensory Organs (NEMOS), Sant Andrea University Hospital, Sapienza University, Italy
| | - Valerio Margani
- Department of Neuroscience, Mental Health and Sensory Organs (NEMOS), Sant Andrea University Hospital, Sapienza University, Italy
| | - Edoardo Covelli
- Department of Neuroscience, Mental Health and Sensory Organs (NEMOS), Sant Andrea University Hospital, Sapienza University, Italy
| | - Andrea Romano
- Radiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Alessandro Bozzao
- Radiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Rasha Lotfy
- Radiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mahmoud Mandour
- Otorhinolaryngology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ali Swaid
- Otorhinolaryngology Department, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Islam Soltan
- Otorhinolaryngology Department, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Saad Elzayat
- Otorhinolaryngology Department, Kafrelsheikh University, Kafrelsheikh, Egypt
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Elzayat S, El-Deeb ME, El-Shirbeny HA, El-Shirbiny H, Abdel-Maboud M, Nasr K. The Prevalence and Association of Biofilms With Otitis Media With Effusion: A Systematic Review and Meta-Analysis. Ann Otol Rhinol Laryngol 2024; 133:229-238. [PMID: 37553806 DOI: 10.1177/00034894231188855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
PURPOSE We aimed to identify the role of bacterial biofilms in the chronicity of otitis media with effusion and its resistance to antibiotics. We illustrated this role by reviewing, analyzing, and correlating the findings with the results of the included studies to reach clear evidence. METHODS A comprehensive search of electronic databases (Scopus, PubMed, Web of Science, Cochrane, and GHL databases) was performed for all studies using the following strategy till April 2021 with the search terms: Biofilm and Middle ear effusion. We found 935 references, 421 were duplicates, and 514 were needed for further screening, and it was as follows: PubMed 215, Scopus 18, Cochrane 130, Web of Science 136, and GHL 15. RESULTS The pooled prevalence of culture-positive effusions was estimated to be 40% (95% CI [28%, 53%]) of the total OME population. Overall, the prevalence of PCR-positive effusions was estimated to be 97% (95% CI [95%, 99%]) of the total OME population. The pooled prevalence of EM-positive effusions was estimated to be 82% (95% CI [69%, 95%]) of the total OME population. CONCLUSION The data presented in this study coincide with the significant role of bacterial biofilms in the pathogenesis of chronic otitis media with effusion. The involvement of bacterial biofilm as a component of the OME pathogenic process can help us to explain why antimicrobial therapy is not always effective in the eradication of the disease process and, also explain the recurrence of middle ear effusion after treatment with tympanostomy tubes either with or without adenoidectomy.
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Affiliation(s)
- Saad Elzayat
- Department of Otorhinolaryngology, Faculty of Medicine-Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Mohamed E El-Deeb
- Department of Otorhinolaryngology, Faculty of Medicine-Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Hussein A El-Shirbeny
- Department of Otorhinolaryngology, Faculty of Medicine-Kafrelsheikh University, Kafrelsheikh, Egypt
| | | | | | - Khaled Nasr
- Department of Otorhinolaryngology, Faculty of Medicine-Kafrelsheikh University, Kafrelsheikh, Egypt
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Mandour M, Amer M, Elzayat S, Covelli E, Barbara M, Lotfy R, Elfarargy HH, Tomoum MO. Localization of the Vertical Part of the Facial Nerve in the High-Resolution Computed Tomography During Pediatric Cochlear Implantation. J Int Adv Otol 2024; 20:8-13. [PMID: 38454282 PMCID: PMC10895885 DOI: 10.5152/iao.2024.231212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/15/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND This study proposed a classification of the vertical portion of the facial nerve (VPFN) location, incorporating the previous classifications regarding the posterior-to-anterior and medial-to-lateral dimensions. We also evaluated the implication of this proposed classification on the round window visibility during pediatric cochlear implantation (CI). METHODS It was a retrospective multicenter observational cohort study. This study included 334 cases that underwent CI between 2015 and 2022 at multiple referral institutes. Two physicians evaluated the preoperative computed tomography images of 334 patients and determined the radiological type of the VPFN. These types were matched with intraoperative round window accessibility. RESULTS The Spearman's correlation coefficient showed a strong correlation between the proposed VPFN type and the intraoperative round window visibility, as the P-value was <.001. CONCLUSION This classification could provide the surgeon preoperatively with the precise location of the VPFN in the lateral-to-medial and posterior-to-anterior dimensions. Furthermore, this location classification of the VPFN was significantly correlated with intraoperative round window accessibility, with an accuracy of 90.42%. Therefore, types C and D were expected to have difficult accessibility into the round window, and more surgical interventions were needed to modify the posterior tympanotomy or use other approaches.
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Affiliation(s)
- Mahmoud Mandour
- Department of Otorhinolaryngology, Tanta University, Faculty of Medicine, Tanta, Egypt
| | - Mohamed Amer
- Department of Otorhinolaryngology, Tanta University, Faculty of Medicine, Tanta, Egypt
| | - Saad Elzayat
- Department of Otorhinolaryngology, Kafrelsheikh University, Faculty of Medicine, Kafrelsheikh, Egypt
| | - Edoardo Covelli
- Department of Neuroscience, Mental Health and Sensory Organs, Sant’ Andrea University Hospital, Sapienza University, Faculty of Medicine and Psychology, Rome, Italy
| | - Maurizio Barbara
- Department of Neuroscience, Mental Health and Sensory Organs, Sant’ Andrea University Hospital, Sapienza University, Faculty of Medicine and Psychology, Rome, Italy
| | - Rasha Lotfy
- Department of Radiology, Tanta University, Faculty of Medicine, Tanta, Egypt
| | - Haitham H. Elfarargy
- Department of Otorhinolaryngology, Kafrelsheikh University, Faculty of Medicine, Kafrelsheikh, Egypt
| | - Mohamed Osama Tomoum
- Department of Otorhinolaryngology, Tanta University, Faculty of Medicine, Tanta, Egypt
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El-Sobki A, Ae Ibrahim R, Elzayat S, El-Deeb ME, Ashraf B, Hashish MI, Alsobky MEI, Salamah A. Evaluation of swallowing in children with higher grades glottic web. Eur Arch Otorhinolaryngol 2023; 280:4987-4994. [PMID: 37500784 PMCID: PMC10562259 DOI: 10.1007/s00405-023-08127-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE to evaluate the swallowing function in children with higher grades of glottic web and to detect the impact of surgical division of the glottic web on the swallowing parameters. We also performed a voice analysis as a secondary objective in this study. METHODS This prospective case series study included 12 children with higher grades of the glottic web; grades 3 and 4. Evaluation of the swallowing function was done by clinical swallowing evaluation including symptoms and signs of swallowing dysfunction during feeding, such as vomiting, coughing, choking, or cyanosis, and bedside swallowing assessment using the 3-oz water swallow test. Instrumental evaluation of swallowing function was performed using flexible endoscopic evaluation of swallowing (FEES). The evaluation was performed both preoperatively and postoperatively. RESULTS The number of children suffering from swallowing difficulties significantly increased during the postoperative evaluation where 6 (50%) children demonstrated choking during feeding after the surgical division of the web in comparison to only 3 (25%) preoperatively. Also, coughing and choking during the 3-oz water swallow test significantly increased following the division of the web with P < 0.001. CONCLUSION Swallowing assessment is mandatory as children with higher grades of the glottic web, requiring reconstructive surgeries, are at risk of swallowing deficit which can be aggravated postoperatively. With improvement in the airway and surgery-specific outcomes, swallowing function is an important secondary outcome that has a significant impact on the lives of these kids and their families.
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Affiliation(s)
- Ahmed El-Sobki
- Otorhinolaryngology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Reham Ae Ibrahim
- Phoniatrics Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Saad Elzayat
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Mohamed E El-Deeb
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
| | - Bassem Ashraf
- Otorhinolaryngology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | | | - Abeer Salamah
- Pediatrics Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
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Barbara M, Elzayat S, El-Shirbeny HA, Salem MA, Ebeed AI, Covelli E, Volpini L, Margani V, Elfarargy HH. Assessment of the ability of the radiological incudo-stapedial angle to predict the stapedotomy technique type: a prospective case-series study. Eur Arch Otorhinolaryngol 2023; 280:4879-4884. [PMID: 37198302 DOI: 10.1007/s00405-023-08008-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/08/2023] [Indexed: 05/19/2023]
Abstract
PURPOSE This study aimed to propose a radiological classification of the incudo-stapedial angle by preoperative high-resolution computed tomography (HRCT) images and to highlight its importance for predicting the use of reversal-steps stapedotomy (RSS) rather than the traditional non-reversal technique. METHODS We included 83 candidates for stapedotomy operation. Two physicians measured the radiological incudo-stapedial joint angle in the preoperative HRCT. According to this measurement, the radiological incudo-stapedial joint was classified into three types: obtuse, right, and acute. In addition, this radiological classification was correlated with the intraoperative use of the stapedotomy technique, either reversal or non-reversal. RESULTS The RSS technique was used in forty-two (97.7%) cases with an obtuse angle and twenty-six (89.7%) with a right angle. At the same time, the traditional non-reversal technique was used in all patients with an acute angle. The three groups differed significantly regarding the method used for stapedotomy (P value < 0.001). Moreover, Spearman's correlation coefficient revealed a significant correlation between the used technique and the radiological type of the incudo-stapedial angle (P value < 0.001). CONCLUSIONS This prospective study proposed a preoperative radiological classification of the incudo-stapedial angle. This classification was significantly correlated with the type of stapedotomy technique. The RSS technique was feasible in most cases with an obtuse and right radiological incudo-stapedial angle. In contrast, the non-reversal method was used in all patients with an acute radiological incudo-stapedial angle. This radiological classification could predict the choice for the stapedotomy technique with an accuracy of 95.18%, a sensitivity of 73.33%, and a specificity of 100%.
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Affiliation(s)
- Maurizio Barbara
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Saad Elzayat
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh University Hospital, El-Geish Street, Kafrelsheikh, 33155, Egypt
| | - Hussein A El-Shirbeny
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh University Hospital, El-Geish Street, Kafrelsheikh, 33155, Egypt.
| | | | - Ahmed I Ebeed
- Radiology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Edoardo Covelli
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Luigi Volpini
- Otolaryngology Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Valerio Margani
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Haitham H Elfarargy
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh University Hospital, El-Geish Street, Kafrelsheikh, 33155, Egypt
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El-Sobki A, Elzayat S, El-Deeb ME, Ibrahim RAE, Gehad I, Negm A, Alsobky MEI, Elgendy A. Surgical Management of Bilateral Abductor Paralysis: Diode Laser Versus Coblation; A Prospective Study. J Voice 2023:S0892-1997(23)00318-1. [PMID: 37923654 DOI: 10.1016/j.jvoice.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES We aimed to compare the results of both diode laser and coblation in the treatment of bilateral vocal fold immobility (BVFI). MATERIALS AND METHODS This prospective clinical study was performed on 80 non-tracheostomised patients with bilateral vocal fold paralysis divided into two groups; Group A: diode laser, Group B: coblation. Medical Research Council "mMRC" Dyspnea scale, maximal phonatory time (MPT), Voice handicap index (VHI), and functional outcome swallowing scale (FOSS) were assessed preoperatively and postoperatively. Also, the VAS pain scale and operative time of both groups are recorded. RESULTS Within each group, there was a statistically significant decrease in the mMRC dyspnea scale and maximum phonation time and a significant increase in VHI (P < 0.001). There was a statistically significant difference between the studied groups postoperative and regarding the percent change of the MPT ( more decrease in the coblation group). Concerning the operative time and the VAS pain score, there was a statistically significant difference between the studied groups regarding operating time and the VAS pain scale (significantly lower in the coblation group) (P < 0.001). CONCLUSION Both Coblation and diode laser are effective tools in the treatment of BVFI with similar minimal voice quality affection. The maximum phonation time decreased more in the coblation group, while the voice handicap index did not significantly differ between both groups. However, Coblation may be superior to diode laser in terms of less operative pain and shorter intraoperative time. Coblation may be more favorable for patients at risk of prolonged general anesthesia duration.
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Affiliation(s)
- Ahmed El-Sobki
- Otorhinolaryngology Department, Faculty of Medicine-Mansoura University, Egypt
| | - Saad Elzayat
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Egypt
| | - Mohamed E El-Deeb
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Egypt.
| | - Reham A E Ibrahim
- Phoniatrics Department, Faculty of Medicine, Assiut University, Egypt
| | - Ibrahim Gehad
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Egypt
| | - Ahmed Negm
- Otorhinolaryngology Department, Faculty of Medicine, Misr University for science and technology, Egypt
| | | | - Ahmed Elgendy
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Egypt
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Fayed A, El-Deeb ME, Magnan J, Meller R, Deveze A, Elzayat S. Lower Four Cranial Nerves in the Management of Glomus Jugulare: Anatomical Study. Int Arch Otorhinolaryngol 2023; 27:e511-e517. [PMID: 37564483 PMCID: PMC10411147 DOI: 10.1055/s-0042-1755308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/28/2022] [Indexed: 08/12/2023] Open
Abstract
Introduction The surgical management that achieves minimal morbidity and mortality for patients with glomus and non-glomus tumors involving the jugular foramen (JF) region requires a comprehensive understanding of the complex anatomy, anatomic variability, and pathological anatomy of this region. Objective The aim of this study is to propose a rational guideline to expose and preserve the lower cranial nerves (CNs) in the lateral approach of the JF. Methods The technique utilized is the gross and microdissection of 4 fixed cadaveric heads to revise the JF's surgical anatomy and high part of the carotid sheath compared with surgical cases to understand and preserve the integrity of lower CNs. The method involves radical mastoidectomy, microdissection of the JF, facial nerve, and high neck just below the carotid canal and the JF. The CNs IX, X, XI, and XII are microscopically dissected and kept in sight up to the JF. Results This study realized well the surgical and applied anatomy of the lower CNs with relation to the facial nerve and JF. Conclusions The JF anatomy is complicated, and the key to safely operate on it and preserving the lower CNs is to find the posterior belly of the digastric muscle, to skeletonize the facial nerve, to remove the mastoid tip preserving the stylomastoid foramen, to skeletonize the sigmoid sinus and posterior fossa dura not only anterior but also posteroinferior to reach and drill the jugular tubercle.
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Affiliation(s)
- Ashraf Fayed
- Otolaryngology Department, El Galaa Military Hospital, Cairo, Egypt
| | - Mohamed E. El-Deeb
- Otolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Jacques Magnan
- Otolaryngology Department, Hospital Nord, Mediterranean University, Marseille, France
| | - Renaud Meller
- Otolaryngology Department, Hospital Nord, Mediterranean University, Marseille, France
| | - Arnaud Deveze
- Otolaryngology Department, Hospital Nord, Mediterranean University, Marseille, France
| | - Saad Elzayat
- Otolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
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Mandour MF, Elsheikh MN, Amer M, Elzayat S, Barbara M, Covelli E, Elfarargy HH, Tomoum M. The impact of adding platelet-rich plasma during fat graft myringoplasty for managing medium-sized tympanic membrane perforations: A prospective randomized case-control study. Am J Otolaryngol 2023; 44:103755. [PMID: 36580741 DOI: 10.1016/j.amjoto.2022.103755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 12/15/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aimed to evaluate the effect of adding platelet-rich plasma (PRP) during FGM to close medium-sized TM perforations. METHODS This prospective randomized case-control study was conducted from February 2017 to March 2022. We included 320 patients with a medium-sized TM perforation with inactive mucosal otitis media. Transcanal FGM managed all patients under general or local anesthesia according to the patient preference. According to PRP, patients were divided into two groups: the first with PRP (170 patients) and the other without PRP (150 patients). We evaluated the closure rate of both groups one month, six months, and one year after the surgery. Also, we assessed the audiological performance before and one year after the operation for the patients with a successful closure. RESULTS The closure rate was 87.6 % in the first group and 72.7 % in the second group, with a statistically significant difference between both groups as the P-value, was 0.001. Successful closure of the ABG to <10 dB occurred in 95.3 % of group A and 90.8 % of group B without a statistically significant difference between both groups (P-value = 0.163). CONCLUSIONS This prospective comparative study on a relatively large number of patients revealed that FGM effectively closed medium-sized TM perforations. It also significantly improved postoperative audiological performance in both groups. Adding PRP during the FGM enhanced the closure success and the healing process without recorded complications. We recommend using the PRP in the routine FGM for closing medium-sized TM perforations.
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Affiliation(s)
- Mahmoud F Mandour
- Otorhinolaryngology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohamed N Elsheikh
- Otorhinolaryngology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohamed Amer
- Otorhinolaryngology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Saad Elzayat
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Maurizio Barbara
- Department of Neuroscience, Mental Health and Sensory Organs, Sant Andrea University Hospital, Faculty of Medicine and Psychology, Sapienza University, Italy
| | - Edoardo Covelli
- Department of Neuroscience, Mental Health and Sensory Organs, Sant Andrea University Hospital, Faculty of Medicine and Psychology, Sapienza University, Italy
| | - Haitham H Elfarargy
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
| | - Mohamed Tomoum
- Otorhinolaryngology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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12
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Abdelhamid AS, Elzayat S, Amer MA, Elsherif HS, Lekakis G, Most SP. Arabic translation, cultural adaptation, and validation of the BDDQ-AS for rhinoplasty patients. J Otolaryngol Head Neck Surg 2023; 52:11. [PMID: 36759927 PMCID: PMC9912650 DOI: 10.1186/s40463-022-00613-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/07/2022] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Body Dysmorphic Disorder (BDD) is a significant aspect that compromises patient satisfaction after rhinoplasty. BDDQ-AS (Body Dysmorphic Disorder Questionnaire-Aesthetic Surgery) is a validated, simple, reliable patient-reported outcome measure. It is a screening tool to detect body dysmorphic disorder in rhinoplasty patients. This study aimed to translate, culturally adapt, and validate BDDQ-AS to Arabic as a novel tool for screening and detecting BDD in Arabic rhinoplasty individuals. METHODS BDDQ-AS was translated from English to Arabic following the international consensus guidelines. We tested the translation on ten Arabic-speaking rhinoplasty patients to ensure that the final version was understandable and acceptable. The proposed Arabic version was then completed by 112 patients whose average age was 28.79 ± 9.32 years. The screening is assumed positive if the patients expressed bother and preoccupation about their appearance (questions 1 and 2 "yes"), as well as a moderately disrupted everyday life (question 7 "yes" or questions 3, 4, 5, or 6 are equal to or greater than "3''). The internal consistency, test-retest reliability, and item-response theory (IRT) were used to evaluate psychometric validations. RESULTS The Arabic BDDQ had a high level of internal consistency, as measured by Cronbach's alpha 0.995. The A-BDDQ-AS was deemed reliable with an Intraclass Correlation Coefficient (ICC) of 0.989. A-BDDQ had good discrimination scores (above 2.0) with adequate difficulty parameters. The overall scale content validity average was 0.83, affirming that all items were relevant, clear, and straightforward. CONCLUSION The Arabic version of the BDDQ-AS is reliable, culturally adapted, and psychometrically validated to be readily used and incorporated into clinical practice. It is a beneficial tool that can guide the screening of Arabic rhinoplasty patients suffering from body dysmorphic disorder and be utilized in further studies to optimize patient outcomes.
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Affiliation(s)
- Ahmed S. Abdelhamid
- grid.411978.20000 0004 0578 3577Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Kafrelsheikh University, El-Geish Street, Kafrelsheikh, 33155 Egypt
| | - Saad Elzayat
- grid.411978.20000 0004 0578 3577Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Kafrelsheikh University, El-Geish Street, Kafrelsheikh, 33155 Egypt
| | - Mohamed A. Amer
- grid.412258.80000 0000 9477 7793Department of Otorhinolaryngology, Faculty of Medicine, Tanta University, El-Gesih St., Tanta, Egypt
| | - Hossam S. Elsherif
- grid.412258.80000 0000 9477 7793Department of Otorhinolaryngology, Faculty of Medicine, Tanta University, El-Gesih St., Tanta, Egypt
| | - Garyfalia Lekakis
- Department of Otorhinolaryngology, Head and Neck Surgery, Moliere Longchamp Hospital, Rue Marconi 142, 1190 Brussels, Belgium
| | - Sam P. Most
- grid.168010.e0000000419368956Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road Palo Alto, Stanford, CA 94304 USA
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13
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Abdelhamid AS, Elzayat S, Essa AA, Elsherief H, Amer M. Pleomorphic adenoma of the cheek: a case presentation. Egypt J Otolaryngol 2022. [DOI: 10.1186/s43163-022-00352-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Background
Pleomorphic adenoma, also known as a benign mixed tumor, is the most common salivary gland tumor. The parotid gland accounts for 90% of the total, with the minor salivary glands accounting for 10%. Buccal minor salivary glands pleomorphic adenoma is extremely rare. It manifests as a painless, firm, slow-growing mass in most cases.
Case presentation
A pleomorphic adenoma in the buccal minor salivary glands was discovered in an adult 43-year-old female patient treated with wide surgical resection. A literature review of the PA of the cheek is stated.
Conclusion
In the differential diagnosis of cheek masses, pleomorphic adenoma should be scrutinized. The remedy of choice is wide local excision with at least a 5-year follow-up.
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Sabino L, Cavalcanti L, Marcaccio C, Elzayat S, Procaccini A, Elfarargy HH, Barbara M. The novel traction-suturing technique in correction of caudal end deviation of the nasal septum. Eur Arch Otorhinolaryngol 2022; 280:2293-2298. [PMID: 36416972 DOI: 10.1007/s00405-022-07753-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/14/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Caudal end correction is one of the main challenges during septoplasty that needs extra steps and skills. This complex area affects the shape of the nose. Moreover, the caudal end represents the medial boundary of the internal nasal valve. Thus, any deviation may disturb this critical area causing nasal obstruction. This study aimed to evaluate the novel traction-suture technique to correct septal caudal end deviation and its postoperative impact. STUDY DESIGN This prospective case-series study. SETTINGS It was held in a tertiary referral university institute between January 2019 to February 2022. METHODS We included 95 cases who suffered from nasal obstruction and a cosmetic problem because of mild or moderate caudal end deviation. Under general anesthesia, the caudal end was corrected by the novel traction-suturing technique (TST). To evaluate the surgical outcomes and patients' related quality of life, we used two validated questionnaires; the Nasal Obstruction Symptom Evaluation and the Rhinoplasty Outcome Evaluation before the surgery and 1 year after the surgery. RESULTS NOSE and ROE questionnaires showed statistically significant improvements after the surgery (P value was < 0.001). Complications occurred in seven patients (7.3%), all of which were minor complications. CONCLUSIONS Traction-suturing technique (TST) improved nasal breathing and patients' satisfaction with their nasal configuration. Traction-suturing is a simple short maneuver that junior doctors can easily learn without distinct complications or recurrence.
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Affiliation(s)
- Luigi Sabino
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Luca Cavalcanti
- Department of Otorhinolaryngology, Policlinico University Hospital, Sapienza University, Rome, Italy
| | | | - Saad Elzayat
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, El-Geish Street, Kafr Elsheikh, 33155, Egypt
| | | | - Haitham H Elfarargy
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, El-Geish Street, Kafr Elsheikh, 33155, Egypt.
| | - Maurizio Barbara
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
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Barbara M, Elzayat S, Lotfy A, Sabino L, Bandiera G, Elsherif HS, Youssef M, Fouad A, Nasr K, Volpini L, Elfarargy HH. Invasive fungal rhinosinusitis associated with COVID-19: Course changes and prognosis predictors. Acta Otorrinolaringologica (English Edition) 2022:S2173-5735(22)00124-7. [DOI: 10.1016/j.otoeng.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 09/21/2022] [Accepted: 09/24/2022] [Indexed: 12/02/2022]
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16
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Elzayat S, Elfarargy HH, Mandour M, Mahrous A, El-Deeb ME, Barbara M, Elsherief H. The Impact of COVID-19 on the Daily Life and Medical Practice of Otolaryngology Physicians. Int Arch Otorhinolaryngol 2022; 26:e478-e486. [PMID: 35846808 PMCID: PMC9282957 DOI: 10.1055/s-0042-1745854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 03/01/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction
The coronavirus disease 2019 (COVID-19) has made otolaryngologists more susceptible than their counterparts to its effect.
Objective
This study aimed to find if COVID-19 had a different impact on ear, nose, and throat (ENT) physicians' of various categories (residents, registrars, and consultants ) regarding many aspects of the quality of life (protection, training, financial, and psychological aspects).
Methods
We included 375 ENT physicians, of different categories (residents, registrars, and consultants), from 33 general hospitals and 26 university hospitals in Egypt. The study was conducted using a 20-item questionnaire with a response scale consisting of three categories: yes, no, and not sure. It covered infection control and personal protective equipment (PPE) usage; medical practice and safety; online consultation and telemedicine,; webinars and online lectures; COVID-19 psychological, financial, and quarantine period effects; and future expectations.
Results
The results of the questionnaire showed that COVID-19 had a statistically significant impact on the daily life of the responders. There were statistically significant differences among the three involved categories, based on their answers.
Conclusion
This study showed a statistically significant difference regarding the impact of COVID-19 on many aspects of the quality of life (protection, training, financial, and psychological aspects) of ENT physicians of various categories (residents, registrars, and consultants), and these effects may persist for a long time.
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Affiliation(s)
- Saad Elzayat
- Faculty of Medicine, Department of Otorhinolaryngology, Kafrelsheikh University, Egypt
| | - Haitham H Elfarargy
- Faculty of Medicine, Department of Otorhinolaryngology, Kafrelsheikh University, Egypt
| | - Mahmoud Mandour
- Faculty of Medicine, Department of Otolaryngology, Tanta University, Egypt
| | - Ali Mahrous
- Faculty of Medicine, Department of Otorhinolaryngology, Al-Azhar University, Egypt
| | - Mohamed E El-Deeb
- Faculty of Medicine, Department of Otorhinolaryngology, Kafrelsheikh University, Egypt
| | - Maurizio Barbara
- Faculty of Medicine, Department of Otolaryngology, Sapienza Roma University, Italy
| | - Hossam Elsherief
- Faculty of Medicine, Department of Otolaryngology, Tanta University, Egypt
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Barbara M, Margani V, Covelli E, Filippi C, Volpini L, El-Borady OM, El-Kemary M, Elzayat S, Elfarargy HH. The Use of Nanoparticles in Otoprotection. Front Neurol 2022; 13:912647. [PMID: 35968304 PMCID: PMC9364836 DOI: 10.3389/fneur.2022.912647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/31/2022] [Indexed: 11/24/2022] Open
Abstract
The inner ear can be insulted by various noxious stimuli, including drugs (cisplatin and aminoglycosides) and over-acoustic stimulation. These stimuli damage the hair cells giving rise to progressive hearing loss. Systemic drugs have attempted protection from ototoxicity. Most of these drugs poorly reach the inner ear with consequent ineffective action on hearing. The reason for these failures resides in the poor inner ear blood supply, the presence of the blood-labyrinthine barrier, and the low permeability of the round window membrane (RWM). This article presents a review of the use of nanoparticles (NPs) in otoprotection. NPs were recently used in many fields of medicine because of their ability to deliver drugs to the target organs or cells. The studies included in the review regarded the biocompatibility of the used NPs by in vitro and in vivo experiments. In most studies, NPs proved safe without a significant decrease in cell viability or signs of ototoxicity. Many nano-techniques were used to improve the drugs' kinetics and efficiency. These techniques included encapsulation, polymerization, surface functionalization, and enhanced drug release. In such a way, it improved drug transmission through the RWM with increased and prolonged intra-cochlear drug concentrations. In all studies, the fabricated drug-NPs effectively preserved the hair cells and the functioning hearing from exposure to different ototoxic stimuli, simulating the actual clinical circumstances. Most of these studies regarded cisplatin ototoxicity due to the wide use of this drug in clinical oncology. Dexamethasone (DEX) and antioxidants represent the most used drugs in most studies. These drugs effectively prevented apoptosis and reactive oxygen species (ROS) production caused by ototoxic stimuli. These various successful experiments confirmed the biocompatibility of different NPs and made it successfully to human clinical trials.
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Affiliation(s)
- Maurizio Barbara
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Valerio Margani
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Edoardo Covelli
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Chiara Filippi
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Luigi Volpini
- Otolaryngology Department, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Ola M. El-Borady
- Institute of Nanoscience and Nanotechnology, Kafrelsheikh University, Kafr El-Shaikh, Egypt
| | - Maged El-Kemary
- Institute of Nanoscience and Nanotechnology, Kafrelsheikh University, Kafr El-Shaikh, Egypt
| | - Saad Elzayat
- Otolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafr El-Shaikh, Egypt
| | - Haitham H. Elfarargy
- Otolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafr El-Shaikh, Egypt
- *Correspondence: Haitham H. Elfarargy ;
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Elzayat S, Elfarargy HH, Lotfy R, Soltan I, Lasheen HN, Margani V, Covelli E, Barbara M, Mandour M. Validation of the radiological detection of the chorda-facial angle: impact on the round window accessibility during pediatric cochlear implantation. Eur Radiol 2022; 33:144-151. [PMID: 35732930 DOI: 10.1007/s00330-022-08953-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The facial recess, an essential landmark for the posterior tympanotomy approach, is limited by the facial nerve and the chorda tympani, with a complicated relationship. This study tried to find the most appropriate radiological method to evaluate the chorda-facial angle (CFA). We also checked the effect of this angle on the round window accessibility during cochlear implantation. METHODS It was a retrospective study that included cochlear implant surgeries of 237 pediatric patients, from September 2016 to April 2021. Two physicians evaluated the CFA in the para-sagittal cut of the preoperative HRCT. The round window accessibility was assessed in the unedited surgery videos. RESULTS The CFA ranged from 21° to 35° with a mean of 27.14 ± 3.5°. It was detected in all cases with a high agreement between the two CT reviewers' measurements. The CFA differed significantly between the accessible group and the group with difficult accessibility (p value < 0.001). Spearman's correlation coefficient revealed a strong correlation between the CFA and the intraoperative round accessibility. 25.5° was the best cutoff point; below this angle, difficult accessibility into the RW was expected, with high sensitivity, specificity, and accuracy CONCLUSIONS: Our study on a relatively large number of cases provided a precise, valid, reliable, and applicable method to evaluate the CFA in the HRCT scan. We found a significant-close relation between the CFA and the round window accessibility; the difficulty increased with a need for posterior tympanotomy modification when the angle decreased. KEY POINTS • Radiological detection of the chorda-facial angle was always problematic, without a previous straightforward method in the literature. • We used the para-sagittal cut of the high-resolution CT scans to evaluate the CFA. This cut was beneficial to seeing the chorda tympani nerve in every examined case. There was a high agreement between the two CT reviewers' measurements. • Preoperative evaluation of the CFA in the HRCT accurately predicted the round window accessibility. Patients with CFA less than 25.5° were expected to have difficult accessibility into the round window during cochlear implantation.
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Affiliation(s)
- Saad Elzayat
- Otolaryngology Department, Kafrelsheikh University, Kafr el-Sheikh, Egypt
| | | | - Rasha Lotfy
- Radiology Department, Tanta University, Tanta, Egypt
| | - Islam Soltan
- Otolaryngology Department, Kafrelsheikh University, Kafr el-Sheikh, Egypt
| | | | - Valerio Margani
- Otolaryngology Department, Sapienza University of Rome, Rome, Italy
| | - Edoardo Covelli
- Otolaryngology Department, Sapienza University of Rome, Rome, Italy
| | - Maurizio Barbara
- Otolaryngology Department, Sapienza University of Rome, Rome, Italy
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19
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Elzayat S, Elfarargy HH, Soltan I, Aouf M, Elsherif H, Margani V, Covelli E, Volpini L, Lasheen HN, Barbara M. What is the most appropriate hemostatic material during pediatric adenoidectomy? A prospective comparative randomized double-blinded controlled study. Int J Pediatr Otorhinolaryngol 2022; 156:111095. [PMID: 35259633 DOI: 10.1016/j.ijporl.2022.111095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 02/20/2022] [Accepted: 03/01/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To evaluate the effect of different hemostatic materials used in adenoidectomy operations to improve the quality of life with the most negligible hazardous impact on pediatric health. STUDY DESIGN a prospective, case-series, randomized, controlled, double-blinded study. SETTING All adenoidectomy surgeries were performed between September 2016 to December 2019 at tertiary referral institutions. PATIENTS AND METHODS 519 patients were included in five groups. Adenoidectomy was performed under general anesthesia, with the following hemostatic procedures: adrenaline, tranexamic acid, hydrogen peroxide, xylometazoline, and saline (as a control group). The five groups were compared regarding the intraoperative blood loss, surgery duration, need for more hemostatic steps, postoperative reactionary and secondary bleedings, postoperative pain and halitosis, and one-year outcome. RESULTS The four procedures were effective in reducing the blood loss by 19.86%, 11.7%, 30.95%, and 18.91%, respectively, in comparison to the control group. The surgical duration was reduced by 27.65%, 17.86%, 48.11%, and 23.88%, respectively. The need for other hemostatic steps was the least in the hydrogen peroxide group. There was no significant difference between the five groups regarding reactionary bleeding, secondary bleeding, one-week pain, one-month pain, one-month halitosis, and one-year complications. On the other side, hydrogen peroxide had the least one-week halitosis and first-day pain among the five groups. Also, it had the least intraoperative blood loss and surgery duration. CONCLUSIONS Hydrogen peroxide showed to be the best choice to control hemostasis during an adenoidectomy. It can decrease blood loss and surgery duration with less need for other hemostatic steps. It can improve the patient's quality of life without significant postoperative complications. Xylometazoline was studied for the first time as a hemostatic material during adenoidectomy with good satisfying results.
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Affiliation(s)
- Saad Elzayat
- Otolaryngology Department, Kafrelsheikh University, Egypt
| | | | - Islam Soltan
- Otolaryngology Department, Kafrelsheikh University, Egypt
| | - Mohammed Aouf
- Otolaryngology Department, Kafrelsheikh University, Egypt
| | | | - Valerio Margani
- Otolaryngology Department, Sapienza University of Rome, Italy
| | - Edoardo Covelli
- Otolaryngology Department, Sapienza University of Rome, Italy
| | - Luigi Volpini
- Otolaryngology Department, Liverpool University Hospitals NHS Foundation Trust, UK
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Mandour M, Elfarargy HH, Lotfy R, Elsheikh MN, Barbara M, Elzayat S. A novel radiological method to evaluate the posterior tympanotomy depth for cochlear implantation: our experience in 257 patients. Eur Arch Otorhinolaryngol 2022; 279:4893-4898. [PMID: 35344073 PMCID: PMC9474370 DOI: 10.1007/s00405-022-07334-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 02/28/2022] [Indexed: 12/20/2022]
Abstract
PURPOSE This study aimed to validate our novel proposed radiological evaluation of the posterior tympanotomy (PT) depth. This dimension represents the bone of the facial recess needed to be drilled to get access into the middle ear during cochlear implantation. METHODS It was a retrospective observational study that included 257 patients who underwent cochlear implantation from July 2018 to April 2021 in tertiary referral institutions. Two physicians evaluated the preoperative HRCT to measure the PT depth in the oblique para-sagittal cut. On the other hand, two other physicians evaluated the unedited surgical videos to judge the PT depth and classified it into an ordinary PT or deep PT. Then, the preoperative radiological measurements were correlated with the intraoperative findings. RESULTS The radiological PT depth ranged from 2.5 to 5.4 mm with a mean of 3.91 ± 0.886. Sixty-six patients had ordinary PT, and 191 patients had deep PT. Spearman's correlation coefficient revealed a strong correlation between the preoperative radiological PT depth measurements and the intraoperative PT depth judgments (p value < 0.0001). CONCLUSIONS We created a novel radiological method to measure the posterior tympanotomy depth. This method was valid, reproducible, and reliable in the preoperative radiological evaluation of the PT depth with high sensitivity (91.71%), specificity (90.62%), and accuracy (91.44%). We also found a significant impact of the PT depth on the PT difficulty during cochlear implantation.
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Affiliation(s)
| | - Haitham H Elfarargy
- Otolaryngology Department, Kafrelsheikh University, Elgeeish Street, Kafrelsheikh, 33511, Egypt.
| | - Rasha Lotfy
- Radiology Department, Tanta University, Tanta, Egypt
| | | | - Maurizio Barbara
- Otolaryngology Department, Sapienza University of Rome, Rome, Italy
| | - Saad Elzayat
- Otolaryngology Department, Kafrelsheikh University, Elgeeish Street, Kafrelsheikh, 33511, Egypt
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Elzayat S, Mandour M, Elfarargy HH, Lotfy R, Soltan I, Lotfy A, Margani V, Covelli E, Monini S, Barbara M. Radiological Analysis of the Facial Recess: Impact on Posterior Tympanotomy Difficulty During Pediatric Cochlear Implantation. Otolaryngol Head Neck Surg 2022; 167:769-776. [PMID: 35133920 DOI: 10.1177/01945998221076998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We analyzed several radiological features of the facial recess to correlate them with the intraoperative findings to highlight the most reliable predictors of posterior tympanotomy difficulty. STUDY DESIGN Retrospective observational cohort study. SETTING Multicenter study at tertiary referral institutions. METHODS We included 184 pediatric patients who underwent cochlear implantation through the posterior tympanotomy approach. The correlation was attempted between 8 radiological features in the preoperative high-resolution computed tomography scan and intraoperative surgical difficulty. RESULTS Posterior tympanotomy was straightforward in 136 (73.9%) patients. In contrast, it was challenging in 48 (26.1%) patients. The facial recess was aerated in 74.5% of patients. The mean (SD) posterior tympanotomy depth was 3.98 (0.867) mm. The mean (SD) chorda-facial angle was 27.67° (3.406°). The mean (SD) chorda-facial to stylomastoid length was 3.898 (0.6304) mm. The mean (SD) facial nerve second genu angle was 94.54° (6.631)°. Deep-unaerated facial recess wall was associated with the most difficulty. There was a statistically significant difference in the unchallenging and challenging posterior tympanotomy groups regarding the surgical duration (P < .0001). CONCLUSIONS According to this analytic study, the chorda-facial angle, the facial recess aeration, and the chorda-facial to stylomastoid length were respectively the strongest preoperative radiological predictors of the surgical difficulty of posterior tympanotomy during cochlear implantation. Chorda-facial angle <25.5° was associated with difficult posterior tympanotomy. The oblique parasagittal cut was essential for the radiological analysis of the facial recess.
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Affiliation(s)
- Saad Elzayat
- Otolaryngology Department, Tanta University, Egypt
| | | | | | - Rasha Lotfy
- Radiology Department, Tanta University, Tanta, Egypt
| | - Islam Soltan
- Otolaryngology Department, Tanta University, Egypt
| | - Ashraf Lotfy
- Otolaryngology Department, El-Glaa Military Hospital, Cairo, Egypt
| | - Valerio Margani
- Otolaryngology Department, Sapienza University of Rome, Rome, Italy
| | - Edoardo Covelli
- Otolaryngology Department, Sapienza University of Rome, Rome, Italy
| | - Simonetta Monini
- Otolaryngology Department, Sapienza University of Rome, Rome, Italy
| | - Maurizio Barbara
- Otolaryngology Department, Sapienza University of Rome, Rome, Italy
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Khafagy Y, Ghonim M, Elzayat S, Elgendy A. Comparison between the endoscopic scores of bolgerization versus partial resection of the middle turbinate for management of the postoperative lateralization in the early follow-up period after endoscopic frontal sinusotomy: A randomized controlled study. Am J Otolaryngol 2021; 42:102998. [PMID: 33780901 DOI: 10.1016/j.amjoto.2021.102998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Frontal sinusotomy is a challenging procedure that needs meticulous handling due to its unique anatomical position. Postoperative middle turbinate lateralization is critical comorbidity for the success rate, and many techniques are adopted to prevent it. The study aimed to compare the effect of middle turbinate bolgerization and partial resection on the postoperative endoscopic scores and assess their impact on the middle meatus and the frontal recess outcome. PATIENT AND METHODS This prospective study was conducted on forty-one patients undergoing bilateral frontal sinusotomy for chronic frontal sinusitis. Nasal cavities were randomized so that partial middle turbinate resection technique was done alternately with bolgerization approach in every patient. Each participant acted as their control. Both sides were compared using Lund Kennedy Endoscopic Score (LKES) and Perioperative Sinus Endoscopy Score (POSE) at the baseline, 1st, 3rd, and 12th-month intervals postoperatively. Also, middle turbinate status was assessed at the end of the 12th-month interval using POSE score. RESULTS The total frontal sinus patency rate was 82.9% (63/76 operated sinus). Baseline scores, LKES (3.79 ± 0.777 vs 4.05 ± 0.769, p = 0.142, for the side of resection and the side for bolgerization respectively) and POSE (1.79 ± 0.413 vs 1.82 ± 0.393, p = 0.777, for the side of resection and the side for bolgerization respectively). Regarding LKES, the differences between both operated sides were fluctuating with p values: 0.001*, 0.171, and 0.044* for the 1st, 3rd, and 12th months follow-up intervals, respectively. Regarding the POSE score of the frontal sinus, the difference between both groups was steadily increasing with p values: 0.318, 0.119, and 0.017* for the 1st, 3rd, and 12th months follow-up intervals. The middle turbinate's POSE score at the 12th month was significantly higher in the side allocated for bolgerization (p-value = 0.008*). CONCLUSION Partial middle turbinate resection showed favorable endoscopic outcomes than bolgerization at the 12th month follow up period in patients undergoing primary ESS for chronic frontal sinusitis.
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Mandour M, Elzayat S, Elfarargy HH, Lotfy R, ELnaggar A. Radiological classification of the mastoid portion of the facial nerve: impact on the surgical accessibility of the round window in cochlear implantation. Acta Otolaryngol 2021; 141:894-897. [PMID: 34424819 DOI: 10.1080/00016489.2021.1963473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Mastoid portion of the facial nerve plays an important role in the round window approach of cochlear implantation. OBJECTIVES This study aimed to predict the anterior displacement of the mastoid portion of the facial nerve in the preoperative HRCT coronal cuts. We also aimed to detect the implication of anterior displacement of MPFN on the R.W. accessibility through the posterior tympanotomy during cochlear implantation. MATERIALS AND METHODS It was a retrospective observational cohort study in tertiary referral hospitals. We included 246 pediatric patients who underwent cochlear implantation due to bilateral severe to profound SNHL through a posterior tympanotomy approach. RESULTS Type I MPFN was present in 84 cases, type II MPFN was present in 149 patients, and type III MPFN was present in 13 cases. R.W. was inaccessible in 3 cases with MPFN type II and in 11 subjects with MPFN type III. There was a statistically significant difference regarding the R.W. accessibility between the three types of MPFN (p-value <.05). There was a strong statistically significant correlation between R.W. accessibility and the radiological type of the MPFN. CONCLUSION Mandour radiological classification of the mastoid portion of the facial nerve in the preoperative HRCT coronal offers an easily applicable method to detect the anterior displacement of the facial nerve by using easy and well-known landmarks. This classification can also predict R.W. accessibility through posterior tympanotomy during cochlear implantation with 97.97% accuracy.
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Affiliation(s)
| | - Saad Elzayat
- Otolaryngology Department, Kafrelsheikh University, Kafrelsheikh, Egypt
| | | | - Rasha Lotfy
- Radiology Department, Tanta University, Tanta, Egypt
| | - Ahmed ELnaggar
- Otolaryngology Department, Tanta University, Tanta, Egypt
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Elzayat S, Elfarargy HH, Soltan I, Abdel-Kareem MA, Barbara M, Fayed A, Baki F. Morphological classification of crista fenestra of round window corridor during pediatric cochlear implantation. Int J Pediatr Otorhinolaryngol 2021; 148:110816. [PMID: 34198228 DOI: 10.1016/j.ijporl.2021.110816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/19/2021] [Accepted: 06/24/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study aimed to document the observation of the Crista Fenestra's morphological types (CF) of the round window and to detect its impact during cochlear implant operation. STUDY DESIGN A prospective descriptive cohort study. SETTINGS We conducted this study at tertiary referral institutions in Egypt. PATIENTS This study included 140 children who underwent cochlear implantation. INTERVENTION We observed the CF's morphological type during the operation according to (Baki-Elzayat) novel classification of CF anatomy, and the need for drilling in each CI operation. MAIN OUTCOME MEASURES CF has two main types. Type A, in which CF was present at the same level of round window membrane and attached to it. Type B, in which CF was medial to the Round window membrane. RESULTS Type (A) CF was detected in 125 cases (89.28%), while 25 cases (10.71%) showed type (B) CF. Drilling was needed in 10 cases (7.14%), including CF types A.3 and B2. Drilling was not needed in 130 cases (92.85%), including CF type A.1, A.2, and B.1. There was a statistically significant difference in the need for drilling (P-value <0.001). CONCLUSIONS According to this prospective study, CF had complicated anatomy. Baki-Elzayat classified the CF into two main types. In type A, CF was at the same level of RWM and attached to it. In type B, CF was medial to RWM. We recommended drilling for partial removal of massive CF types (A.3 and B.2) for atraumatic safe insertion of the electrode without deflection. This classification can offer an easy language system for CI surgeons to describe and register CF during their operations and in the surgical files.
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Affiliation(s)
- Saad Elzayat
- Otolaryngology, Otolaryngology Department, Kafrelsheikh University, Egypt
| | - Hitham H Elfarargy
- Otolaryngology, Otolaryngology Department, Kafrelsheikh University, Egypt.
| | - Islam Soltan
- Otolaryngology, Otolaryngology Department, Kafrelsheikh University, Egypt
| | | | - Maurizio Barbara
- Otolaryngology, Otolaryngology Department, Sapienza University of Rome, Italy
| | - Ashraf Fayed
- Otolaryngology, Otolaryngology Department, El-Glaa Military Hospital, Egypt
| | - Fathi Baki
- Otolaryngology, Otolaryngology Department, Alexandria University, Egypt
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Elsherief H, Amer M, Abdel-Hamid AS, El-Deeb ME, Negm A, Elzayat S. The Pattern of Anosmia in Non-hospitalized Patients in the COVID-19 Pandemic: A Cross-sectional Study. Int Arch Otorhinolaryngol 2021; 25:e334-e338. [PMID: 34377164 PMCID: PMC8321629 DOI: 10.1055/s-0041-1730303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/07/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction It is now evident that the loss of smell and/or taste may be consistent accompanying symptoms of the SARS-CoV-2 infection. Objective To estimate the social behavior of recent anosmic non-hospitalized patients in the COVID-19 pandemic and to try to obtain the natural pattern in society in a cross-sectional study. Methods A cross-sectional study conducted on 4,860 patients with anosmia complaints during the COVID-19 pandemic. Patients who needed a consultation for an anosmia complaint confirmed that they had completed the survey regarding age, gender, history of general diseases, history of nasal disease, associated COVID-19 symptoms, smoking, blood group, and risk factors. Results A total of 4,860 patients with a mean age of 34.26 ± 11.91 years completed the study. There was a predominance of female patients: 3,150 (58.9%). Most patients (4,083 patients; 83%) developed sudden anosmia. In 85% (4131 patients) of the patients, a previous history of contact with anosmic patients was present. The most prevalent blood group was O (39%). In total, 67.4% of the patients underwent medical treatment. A history of unusual influenza attacks in December 2020 was reported by by 27% (1312 patients) of the patients. Conclusion Despite large diversity of behaviors among anosmic patients in the COVID-19 pandemic, we can observe a great similarity in the pattern of anosmia in non-hospitalized patients, especially in the way it spreads, the predisposing factors, and the individual recovery.
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Affiliation(s)
- Hossam Elsherief
- Department of Otorhinolaryngology, Faculty of Medicine, Tanta University, Egypt
| | - Mohmed Amer
- Department of Otorhinolaryngology, Faculty of Medicine, Tanta University, Egypt
| | - Ahmed S Abdel-Hamid
- Department of Otorhinolaryngology, Faculty of Medicine, Kafrelsheikh University, Egypt
| | - Mohamed E El-Deeb
- Department of Otorhinolaryngology, Faculty of Medicine, Kafrelsheikh University, Egypt
| | - Ahmed Negm
- Department of Otorhinolaryngology, Faculty of Medicine, Misr University for Science and Technology, Egypt
| | - Saad Elzayat
- Department of Otorhinolaryngology, Faculty of Medicine, Kafrelsheikh University, Egypt
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Elzayat S, Mandour M, Elfarargy H, Lotfy R, Soltan I, Mahrous A. Correlation of Preoperative Computerized Tomography Scoring System and the Surgical Encounters in Cochlear Implantation. J Int Adv Otol 2021; 17:200-206. [PMID: 34100743 PMCID: PMC9449888 DOI: 10.5152/iao.2021.9138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective: To propose a numerical radiological scoring system of the pre-operative high-resolution computed tomography scan aiming to predict the surgical difficulty during cochlear implantation. Methods: This was a retrospective study of 272 pediatric patients who underwent cochlear implantation in 3 tertiary referral centers from April 2017 to August 2019. The correlation was attempted between our proposed scoring system (consisting of 8 radiological features) and the intraoperative surgical difficulty both objectively and subjectively. Results: our proposed scoring system showed a statistically significant correlation with surgical difficulty and also the duration of surgery. Scoring 5 or more predicted the surgical difficulty with a sensitivity of 80.85% and a specificity of 92.13%. The absence of air cells around the facial recess was the most independent predictor of difficulty (P value = .002). Conclusion: This proposed radiological scoring system is a simple reliable method to predict the difficulty which we may encounter during CI surgery. Scoring of 5 or more would predict intraoperative difficulty as opposed to less scoring which would predict a straightforward surgery.
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Affiliation(s)
- Saad Elzayat
- Department of ENT, Kafrelsheikh University, Egypt
| | | | | | - Rasha Lotfy
- Department of Radiology, Tanta University, Egypt
| | - Islam Soltan
- Department of ENT, Kafrelsheikh University, Egypt
| | - Ali Mahrous
- Department of ENT, Al-Azhar University, Egypt
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Elsobki A, Moussa HH, Eldeeb ME, Fayed A, Elzayat S. Efficacy, predictors of success and failure of an updated lateral pharyngoplasty approach as an independent procedure in treating obstructive sleep apnea with CPAP failures. Eur Arch Otorhinolaryngol 2021; 279:945-953. [PMID: 33885973 DOI: 10.1007/s00405-021-06825-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/13/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE To assess predictors of success and failure of an updated lateral pharyngoplasty as an independent procedure in treating obstructive sleep apnea with CPAP failures. METHODS Forty-six patients with known OSAS who were resistant to CPAP or failures were included. BMI, Stop-Bang score, and sleep study data were recorded before and after the updated Cahali pharyngoplasty procedure. Pre-operative DISE was done for all cases; however, postoperative DISE was done only for non-responders. RESULTS Successful operation outcomes achieved in 69.6% (32 cases) and 30.4% (14 cases) were failure rates. Postoperative snoring index, Stop Bang score, and AHI were significantly decreased compared to pre-operative data (p value < 0.001). There is statistically a significant increase in minimal and baseline SpO2 postoperatively (p value < 0.001). Patients with no laryngeal collapse (L0) predict operation success. However, patients with high pre-operative snoring index, collapse at lateral wall hypopharynx, high tongue collapse, laryngeal collapse, tongue palate interaction, and low grades tonsils (1, 2) predict the failure of the surgery (p value = 0.006*,0.024*,0.047*, respectively). CONCLUSION Updated Cahali lateral pharyngoplasty could not be used as an independent procedure in all OSA patients. The lack of laryngeal collapse (L0) is a considerable success predictor for the procedure. However, the pre-operative low-grade tonsils (1, 2) and high snoring index predict operation failure.
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Affiliation(s)
- Ahmed Elsobki
- Otorhinolaryngology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Hany H Moussa
- Chest Diseases Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Mohamed E Eldeeb
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
| | - Ashraf Fayed
- Otorhinolaryngology Department, El Galaa Military Hospital, Cairo, Egypt
| | - Saad Elzayat
- Otorhinolaryngology Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
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Khafagy Y, Ghonim M, Elgendy A, Elzayat S. The prognostic variables affecting the frontal sinusotomy patency outcome and how to manage: A prospective study. Clin Otolaryngol 2021; 46:969-975. [PMID: 33745238 DOI: 10.1111/coa.13761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/03/2021] [Accepted: 03/14/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The study aimed to assess the factors affecting the frontal sinus patency after endoscopic frontal sinusotomy. DESIGN A prospective cohort study. SETTING Tertiary centre hospital. MAIN OUTCOME MEASURES Fifty patients with refractory chronic frontal sinusitis (83 operated frontal sinuses) had frontal sinusotomy and followed up for six months. Multiple operative factors were included the type of the procedure, intraoperative sinus findings, degree of mucosal preservation and middle turbinate stability. Other factors were also assessed, including smoking, the presence of allergic rhinitis, asthma, gastroesophageal reflux and other associated medical comorbidities. RESULTS The sinus patency success rate was 75.9%. There was a significant difference regarding the intraoperative anteroposterior sinus ostium diameter (5.36 ± 1.45 mm vs 8.88 ± 2.38 mm, P-value: .001* in the failed group and the success group, respectively). There was a significant association between the patency outcome and the presence of associated medical comorbidities (P-value: .001*), the presence of allergic rhinitis (P-value: .001*), the degree of sinus mucosal preservation (P-value: .012*) and the degree of middle turbinate stability (P-value: .001*). The multivariate analysis showed that the intraoperative anteroposterior diameter of the sinus ostium, middle turbinate stability and presence of allergic rhinitis were significant predictors (P-value: .012*, .042* and .013*, respectively). CONCLUSION Sinuses with anteroposterior ostium diameters less than 5.36 mm are more susceptible to restenosis. The flail middle turbinate increases the risk of postoperative middle meatus synechia and frontal sinus patency failure. The presence of allergic rhinitis has a negative impact on the patency outcome.
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Affiliation(s)
- Yasser Khafagy
- Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed Ghonim
- Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed Elgendy
- Department of Otorhinolaryngology, Faculty of Medicine, Kafrelsheikh University, Kafr el-Sheikh, Egypt
| | - Saad Elzayat
- Department of Otorhinolaryngology, Faculty of Medicine, Kafrelsheikh University, Kafr el-Sheikh, Egypt
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Khafagy Y, Ghonim M, Elgendy A, Elzayat S. The impact of bolgerization versus partial resection of the middle turbinate on frontal sinusotomy patency outcome: A randomised controlled study. Clin Otolaryngol 2021; 46:954-960. [PMID: 33730409 DOI: 10.1111/coa.13758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 02/09/2021] [Accepted: 03/07/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aimed to compare the effects of middle turbinate resection vs bolgerization on the incidence of middle meatus synechia and their prognostic value on the patency outcomes after frontal sinusotomy. DESIGN A randomised controlled study. SETTING Tertiary centre hospital. MAIN OUTCOME MEASURES Thirty-eight patients undergoing bilateral frontal sinusotomy for chronic frontal sinusitis were included. Partial middle turbinate resection was alternated with bolgerization in both nasal cavities of every patient. The Lund-Kennedy endoscopic scores (LKESs) for both sides were compared at the first, third and sixth months postoperatively. Middle meatus synechia was assessed using the visual analogue score (VAS). Sinus patency was assessed at the end of the sixth month using a 70° nasal endoscope. RESULTS The sinus patency outcome was significantly higher in the resected group (34\38) than the bolgerized group (26\38), (P = .047*). The VAS scores suggested that the middle turbinate bolgerization group showed a significantly higher incidence of middle meatal synechia than the partial middle turbinate resection group (4.47 ± 2.617 vs 3.29 ± 2.301; P = .040*). CONCLUSION Middle turbinate resection showed more favourable results than bolgerization concerning the sinus patency outcome after frontal sinusotomy. It also showed a lower incidence of middle meatus synechia postoperatively.
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Affiliation(s)
- Yasser Khafagy
- Otorhinolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed Ghonim
- Otorhinolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed Elgendy
- Otorhinolaryngology, Faculty of medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Saad Elzayat
- Otorhinolaryngology, Faculty of medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
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Khafagy Y, Ghonim M, Elgendy A, Elzayat S. The preoperative radiological findings associated with failure of frontal sinusotomy: A prospective study. Clin Otolaryngol 2021; 46:834-840. [PMID: 33655644 DOI: 10.1111/coa.13750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/09/2021] [Accepted: 02/21/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The study aimed to assess the association between the preoperative CT findings and the patency outcome of the frontal sinus after endoscopic frontal sinusotomy in the early follow-up period. DESIGN A prospective cohort study. SETTING Tertiary hospital centre. MAIN OUTCOME MEASURES The study measures the association between the frontal sinusotomy outcome and the standard preoperative radiological scores, including Harvard, Kennedy and Lund-Mackay. It also measures the impact of the degree of sinus mucosal thickness on the outcome. Furthermore, it measures the effect of the anteroposterior lengths of both the frontal sinus ostium and the frontal recess on postoperative frontal sinus patency. RESULTS Harvard, Kennedy and modified Lund-Mackay scores showed no evidence of association with the frontal sinusotomy patency outcome (P-values .397, .487 and .501), respectively. Still, the Lund-Mackay score showed a negative correlation with symptom improvement. Sinuses with a high-grade mucosal thickness on CT scan were associated with high failure rates (P-value: .009*). The anteroposterior length of the frontal sinus ostium significantly affects the outcome (P-value: .001*). In contrast, there was no association between the anteroposterior length of the frontal recess and the outcome (P-value: .965). CONCLUSION The Harvard, Kennedy and Lund-Mackay scores could not predict the frontal sinusotomy patency outcome. Failed cases were associated with advanced degrees of mucosal pathology in the preoperative CT scan. Sinuses ostia with anteroposterior diameters less than 5.36 mm showed more susceptibility for sinus restenosis postoperatively. The variability of the anteroposterior length of the frontal recess did not affect the surgical outcome.
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Affiliation(s)
- Yasser Khafagy
- Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed Ghonim
- Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed Elgendy
- Department of Otorhinolaryngology, Faculty of medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Saad Elzayat
- Department of Otorhinolaryngology, Faculty of medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
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Elzayat S, Nada I, El sherif H, Mahrous A. The safety of posterior tympanotomy in otitis media with effusion during cochlear implantation: clinical retrospective cohort study. Acta Otolaryngol 2021; 141:1-4. [PMID: 32921210 DOI: 10.1080/00016489.2020.1813905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Posterior tympanotomy (PT) is an important step in cochlear implant (CI) surgery, as it is the main access to the round window. Some CI candidates, especially children, may have concomitant otitis media with effusion (OME) which may result in technical issues during PT. There is still a debate whether to wait for OME resolution preoperatively or to proceed to surgery with suspected difficulties. AIMS/OBJECTIVE To evaluate the safety of PT during CI surgery in patients with OME. MATERIAL AND METHODS we included 102 consecutive pediatric candidates in this retrospective study with an age range of 12 months to 6 years. All the patients underwent CI surgery using trans-mastoid, PT to access round window (RW) area. We investigated the effect of the pathology caused by OME on the operative procedure in PT and post-operative consequences. THE RESULTS out of 102 patients included in this study, there were 22 patients with OME who had unilateral cochlear implantation with no major operative or post-operative events. Nevertheless, some minor intra operative events and difficulties were encountered. CONCLUSION AND SIGNIFICANCE The presence of OME in CI surgery indicates possible surgical challenges such as difficult PT, minor intra-operative risks and with no major post-operative events.
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Affiliation(s)
- Saad Elzayat
- ENT Department, Kaferelsheikh University, Kaferelsheikh, Egypt
| | - Ihab Nada
- ENT Department, MISR Univesity for Science & Technology, Cairo, Egypt
| | | | - Ali Mahrous
- ENT Department, Al-Azhar University, Cairo, Egypt
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Elzayat S, Elsherif H, Aouf M. Trans-oral endoscopic assisted radio-frequency for adenoid ablation; A randomized prospective comparative clinical study. Auris Nasus Larynx 2020; 48:710-717. [PMID: 33261981 DOI: 10.1016/j.anl.2020.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/07/2020] [Accepted: 11/18/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study compared the efficacy and safety of conventional adenoidectomy using a curette and the Radio-frequency (RF) adenoid ablation using endoscope via the trans-oral technique. METHODS A randomized prospective comparative study was conducted in a tertiary care hospital. The study included 80 patients with a diagnosis of adenoid hypertrophy, which was confirmed by X-ray of a lateral view of the skull. The patients were submitted into two groups 40 for each: curettage group and Radiofrequency group. Patients with bleeding diathesis, congenital anomalies, previous adenoidectomy, and morbid illness were excluded from the study. We evaluated the time consumption, the adenoid tissue remnant by the endoscope, blood loss, and clinical correlations like pain by Visual Analog Scale, halitosis, and secondary bleeding in both study groups. RESULTS Intra-operative blood loss was 20-40 ml in the Radio-frequency (RF) group, but in the curettage group was 36 - 55 ml. Post-operative pain in the (RF) group was lower than the curettage group. Secondary bleeding was reported mostly in the curettage group (15%). The duration of the operation in (RF) group was relatively long. Halitosis decreased mainly after curettage adenoidectomy. CONCLUSION The endoscopic radio-frequency adenoid ablation surpassed the conventional method. We encourage using Radio-frequency in adenoid surgery as a replacement for the traditional method.
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Affiliation(s)
- Saad Elzayat
- Otorhinolaryngology, Faculty of Medicine, Kafr Elsheikh University, Egypt
| | - Hossam Elsherif
- Otorhinolaryngology, Faculty of Medicine, Tanta University, Egypt
| | - Mohammad Aouf
- Otorhinolaryngology, Faculty of Medicine, Kafr Elsheikh University, Egypt.
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Amer MA, Elsherif HS, Abdel-Hamid AS, Elzayat S. Early recovery patterns of olfactory disorders in COVID-19 patients; a clinical cohort study. Am J Otolaryngol 2020; 41:102725. [PMID: 32979666 PMCID: PMC7489267 DOI: 10.1016/j.amjoto.2020.102725] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/29/2020] [Accepted: 09/08/2020] [Indexed: 01/08/2023]
Abstract
Introduction A rapidly evolving evidence suggests that smell dysfunction is a common symptom in COVID-19 infection with paucity of data on its duration and recovery rate. Objectives Delineate the different patterns of olfactory disorders recovery in patients with COVID-19. Methods This cross-sectional cohort study included 96 patients with olfactory complaint confirmed to be COVID-19 positive with recent onset of anosmia. All patients were inquired for smell recovery patterns using self-assessment questionnaires. Results Ninety six patients completed the study with mean age 34.26 ± 11.91 years. Most patients had sudden anosmia 83%. Loss of smell was accompanied by nonspecific inflammatory symptoms as low-grade fever (17%) and generalized body ache (25%). Nasal symptoms were reported by 33% of patients. Some patients reported comorbidities as D.M (16%), hypertension (8%) or associated allergic rhinitis (25%), different patterns of olfactory recovery showed 32 patients experiencing full recovery (33.3%) while, 40 patients showed partial recovery (41.7%) after a mean of 11 days while 24 patients (25%) showed no recovery within one month from onset of anosmia. Conclusion The sudden olfactory dysfunction is a common symptom in patients with COVID-19. Hyposmia patients recover more rapidly than anosmic ones while the middle age group carried the best prognosis in olfactory recovery. Females possess better potentiality in regaining smell after recovery and the association of comorbidities worsen the recovery rate of olfactory dysfunction in patients with COVID19. Level of evidence Level 2b a cross-sectional cohort study.
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Elzayat S, Nosair N, Ghazy AA, Abdulghaffar IA. Otitis media with effusion is not a sterile inflammatory process: scanning electron microscope evidence. Eur Arch Otorhinolaryngol 2020; 278:2713-2721. [PMID: 32889624 DOI: 10.1007/s00405-020-06338-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/28/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE We aimed to demonstrate whether chronic otitis media with effusion (OME) is a sterile condition or biofilms-related disease through direct visualization of middle ear mucosa by Scanning electron microscopy (SEM) and culture of the effusion. METHODS This case-control study included 60 children in two groups; the case group included 50 patients undergoing ventilation tube insertion (VTI) for Chronic OME (COME), and the control group included ten patients undergoing cochlear implantation (CI) surgery presenting normal middle ear mucosa. Biopsies from both groups' middle ear mucosa were evaluated for biofilm formation using scanning electron microscopy (SEM). Middle ear effusion (MEE) samples from COME patients were cultured on blood agar to detect and identify any bacterial growth. The adenoid size was evaluated and correlated to the biofilm formation in COME patients. RESULTS There was a significant difference between case and control groups regarding biofilm formation (p-value < 0.001*). Biofilm was evident in 84% of the COME patients (cases group) and absent in the control group. Only 12 COME patients (24%) had positive MEE culture, however, 76.2% of patients with biofilm had a negative culture. Streptococcus pneumonia was the most common otopathogen found either alone or combined with other otopathogens. There was a significant negative correlation between adenoid size and biofilm grade among the studied patients. CONCLUSION The visual identification of middle ear biofilms indicated their role in chronic OME. Middle ear biofilms need to be expected in children with OME, especially those who do not need adenoid surgery.
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Affiliation(s)
- Saad Elzayat
- Otorhinolaryngology, Faculty of Medicine, Kafrelsheikh University, El-geish street, Kafrelsheikh, 33155, Egypt
| | - Nahla Nosair
- Clinical Pathology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Amany A Ghazy
- Pathology (Microbiology & Immunology Unit), College of Medicine, Jouf University, Sakaka, Saudi Arabia.,Microbiology and Immunology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Ibrahim A Abdulghaffar
- Otorhinolaryngology, Faculty of Medicine, Kafrelsheikh University, El-geish street, Kafrelsheikh, 33155, Egypt.
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Elzayat S, Elsherif H, Nada I, Youssef R. The safety of bipolar mode radiofrequency (BMRF) on cochlear implant integrity test; a clinical prospective study. Am J Otolaryngol 2020; 41:102584. [PMID: 32505991 DOI: 10.1016/j.amjoto.2020.102584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/24/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE We aimed to assess the effect of bipolar mode radiofrequency (BMRF) tonsillectomy as a model of oro-pharyngeal surgical maneuver on the integrity of the internal device in patients with cochlear implants (CIs). MATERIALS AND METHODS This prospective case series included 15 consecutive pediatric patients with CIs (age range 4 to 8 years, mean 5.2 years) who underwent BMRF tonsillectomy. The postoperative integrity of the internal device was evaluated by comparing the electric current response tested preoperatively with that tested 2 days postoperatively. RESULTS There were differences in the current levels in the main regions of the cochlea; (the apical, mid-turn, and basal) after comparing preoperative and postoperative values, but they were not statically significant. CONCLUSION BMRF seems to be safe for tonsillectomy in children with CIs without negative impact on the integrity of the internal device.
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Affiliation(s)
| | | | - Ihab Nada
- ENT Department, Misr University for Science and Technology, Egypt
| | - Ragaey Youssef
- Audiology Unit, ENT Department, Beni-Suef University, Egypt
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Abstract
OBJECTIVE to detect, analyze and discuss the different ear nose throat (ENT) manifestations those were reported in COVID19 positive patients in the reviewed and published literatures. METHODS We performed a search in the PubMed databases, Web of Science, LILACS, MEDLINE, SciELO, and Cochrane Library using the keywords; COVID-19, Novel coronavirus, corona, 2019-nCoV, SARS-CoV-2, ENT, ear, nose, throat, otorhinolaryngology, ORL, pharynx, ORL, smell, larynx, different ENT related symptoms. We reviewed published and peer reviewed studies that reported the ENT manifestations in COVID-19 laboratory-confirmed positive patients. RESULTS within the included 1773 COVID-19 laboratory-confirmed positive patients, the most common ENT manifestations of COVID-19 were sore throat (11.3%) and headache (10.7%). While the other reported ENT manifestations were pharyngeal erythema (5.3%), nasal congestion (4.1%), runny nose or rhinorrhea (2.1%), upper respiratory tract infection (URTI) (1.9%), and tonsil enlargement (1.3%). CONCLUSION ENT manifestations for COVID-19 are not common as fever and cough. But, a universal questionnaire using well-defined COVID-19 manifestations is needed to make the COVID-19 data precisely defined, complete and homogenous.
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Affiliation(s)
- Mohammad Waheed El-Anwar
- Professor of Otorhinolaryngology, Head and Neck Surgery, Otorhinolaryngology, Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Egypt.
| | - Saad Elzayat
- Professor of Otorhinolaryngology, Head and Neck Surgery, Otorhinolaryngology, Head and Neck Surgery Department, Faculty of Medicine, Kafrelsheikh University, Egypt
| | - Yasser Ahmed Fouad
- Assistant professor of Otorhinolaryngology, Head and Neck Surgery, Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Egypt
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Elzayat S, El-Sobki A, El-Deeb ME, Moussa HH. Managing obstructive sleep apnea patients with CPAP failure with a novel Lateral Pharyngoplasty as a stand-alone procedure. Am J Otolaryngol 2020; 41:102500. [PMID: 32402692 DOI: 10.1016/j.amjoto.2020.102500] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS) is caused by a complete or partial obstruction of the upper airway. A new Cahali lateral pharyngoplasty as a stand-alone procedure for the treatment of OSA patients, whatever the level and pattern of airway obstruction in patients with CPAP failure or non-compliant patients, is it? PATIENTS AND METHODS 40 patients with known OSAS non-compliant with CPAP or CPAP failures included. BMI, Stop-Bang score, and sleep study parameters were reported before and after the new Cahali pharyngoplasty operation. Preoperative DISE was done for all cases. RESULTS There were 28 (70%) cases with successful operation outcomes, and 12 (30%) failed cases. Postoperative Stop Bang score, AHI, snoring index were significantly reduced in comparison to preoperative data (p-value <0.001); however, minimal SpO2 and baseline SpO2 were significantly increased in comparison to preoperative data. There was a significant improvement in AHI postoperative. Patients collapse at the level of lateral wall hypopharynx, high tongue collapse, laryngeal collapse, tongue palate interaction, all significantly predict failure outcome of the operation (p-value = 0.022). However, the absence of laryngeal collapse (L0) had a successful prediction outcome. The high snoring index significantly predicts operation failure. However, preoperative high baseline SpO2 predicts operation success significantly. CONCLUSION The new Cahali lateral pharyngoplasty can be used as a stand-alone procedure in the absence of lateral wall collapse at the level of the hypopharynx (LH), high tongue base collapse (TH), laryngeal collapse (L1) or tongue palate interaction.
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Elzayat S, Mandour M, Lotfy R, Mahrous A. Predicting Round Window Visibility During Cochlear Implantation Using High Resolution CT Scan. J Int Adv Otol 2019; 14:15-17. [PMID: 29764775 DOI: 10.5152/iao.2018.4229] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To predict round window niche (RWN) visibility using high-resolution computed tomography (HRCT). MATERIALS AND METHODS We retrospectively reviewed the pre-surgical axial HRCT scan of 110 patients who underwent cochlear implantation and compared the CT visibility of RWN with the intraoperative findings by reviewing the operative notes and replaying the surgical video recording. The shape of RWN was determined using the HRCT slice with maximum RWN visibility. Accordingly, it was classified as the O-shaped or C-shaped RWN. Based on the surgical view, RWN visibility was classified as clearly visible or difficult to visualize. Radiological findings were correlated with the surgical view. RESULTS Seventy-six cases (69%) showed clear RWN visibility; of them, 66 correlated with the HRCT finding C-shaped RWN. Of the other 34 cases (31%) with difficult RWN visualization, 26 correlated with the HRCT finding O-shaped RWN. The sensitivity and specificity of the HRCT finding in predicting the difficulty in visualization of RWN were 79.4% and 86.8%, respectively. CONCLUSION The RWN shape on HRCT can be a simple and useful method in predicting RWN visibility through posterior tympanotomy approach in cochlear implantation.
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Affiliation(s)
- Saad Elzayat
- Department of ENT, Kafrelsheikh Medical School, Kafrelsheik, Egypt
| | | | - Rasha Lotfy
- Department of ENT, Tanta Medical School, Tanta, Egypt
| | - Ali Mahrous
- Department of ENT, Al-Azhar Medical School, Cairo, Egypt
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Atef A, El-Rashidy MA, Elzayat S, Kabel AM. The prognostic value of sex hormone receptors expression in laryngeal carcinoma. Tissue Cell 2019; 57:84-89. [DOI: 10.1016/j.tice.2019.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 11/25/2022]
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Elzayat S, Ragab S, Eisa M, Amer M, Mandour MF, Mehraz M. Evaluation of Adding Lidocaine to Dexamethasone in the Intra-tympanic Injection for Management of Tinnitus: A Prospective, Randomized, Controlled Double-blinded Trial. Int Tinnitus J 2018; 22:54-59. [PMID: 29993218 DOI: 10.5935/0946-5448.20180009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Assessment of adding lidocaine to dexamethasone in the intratympanic injections for the treatment of subjective idiopathic tinnitus (SIT). METHOD A prospective, controlled, randomized, double-blind study of forty-four patients with SIT diagnosed in the Department of Otolaryngology, Tanta University Hospital, a tertiary academic medical centre from March 2015 to October 2016. 44 patients were recruited in the study and were categorized into two groups; (A) included 22 patients managed with ITLD, and (B) included 22 patients managed with intratympanic postoperative ITD injection. Intratympanic injections were double-blind performed three times with one weak interval. After three and six months, the tinnitus improvement was studied using the following parameters: Arabic tinnitus questionnaires (ATQ), loudness matching test and Tinnitus handicap index (THI). RESULTS The effectiveness rates of ITLD for idiopathic tinnitus reported in the ATQ, THI, and in the loudness matching test were 74.5% in the ITDL group and 50.0%, 50.5%, and 40.0% in the ITD group, respectively. Statistically, there was a significant difference between both groups in 6 months duration. CONCLUSION ITLD seems to be effective for SIT than ITD alone. The indication of ITLD for tinnitus needs to be limited to specific cases of resistant medical treatment.
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Affiliation(s)
- Saad Elzayat
- Department of Otorhinolaryngology, Kaferelsheikh University, Egypt
| | - Sameh Ragab
- Department of Otorhinolaryngology, Tanta university, Egypt
| | - Magdy Eisa
- Department of Otorhinolaryngology, Tanta university, Egypt
| | - Mohamed Amer
- Department of Otorhinolaryngology, Tanta university, Egypt
| | | | - Mai Mehraz
- Department of Otorhinolaryngology, Tanta university, Egypt
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Abstract
<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Nasal obstruction due to persistent hypertrophy of inferior turbinates is very common affecting respiration and daily activity. Partial inferior turbinectomy is a very safe and effective operation overcoming the nasal obstruction and nasal resistance caused by hypertrophied turbinates. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">In this prospective descriptive study, we tried to evaluate the effect of the operation on pulmonary functions and daily activity objectively by using spirometry and 6-minutes walking test before and after the operation. Thirty patients were included in this study. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Significant improvement after the operation. Also, we use a subjective VAS score which revealed the same results, proving that, the pulmonary function tests improved significantly after partial inferior turbinectomy operation. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Partial inferior turbinectomy is a very effective operation in the management of nasal obstruction caused by persistent hypertrophy of inferior turbinates resulting in improvement of the pulmonary function tests and daily activity after the operation without marked complications.</span></p><p class="abstract"> </p>
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Elzayat S, Mandour M, Lotfi R. The role of preoperative computerized tomography in a safe posterior tympanotomy for cochlear implant surgery. Egypt J Otolaryngol 2017. [DOI: 10.4103/ejo.ejo_97_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Amer MA, Kabbash IA, Younes A, Elzayat S, Tomoum MO. Validation and cross-cultural adaptation of the arabic version of the nasal obstruction symptom evaluation scale. Laryngoscope 2017; 127:2455-2459. [DOI: 10.1002/lary.26640] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/17/2017] [Accepted: 03/27/2017] [Indexed: 11/08/2022]
Affiliation(s)
| | - Ibrahim A. Kabbash
- Department of Public Health and Community Medicine; Tanta University; Tanta Egypt
| | - Ahmed Younes
- Department of Otolaryngology; Tanta University; Tanta Egypt
| | - Saad Elzayat
- Department of Otolaryngology; Kafr-El Sheikh University; Kafr-El Sheikh Egypt
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El Tahan AER, Elzayat S, Hegazy H. Adenoidectomy: comparison between the conventional curettage technique and the coblation technique in pediatric patients. Egypt J Otolaryngol 2016; 32:152-155. [DOI: 10.4103/1012-5574.186528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 01/28/2016] [Indexed: 09/02/2023]
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Elzayat S, El-Sherif H, Hegazy H, Gabr T, El-Tahan AR. Tinnitus: Evaluation of Intratympanic Injection of Combined Lidocaine and Corticosteroids. ORL J Otorhinolaryngol Relat Spec 2016; 78:159-66. [PMID: 27245783 DOI: 10.1159/000445774] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 03/22/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Tinnitus is an annoying problem and until now there is no consensus on its treatment. AIMS In this prospective study, we evaluated the effectiveness of intratympanic lidocaine and dexamethasone (ITLD) injections for the management of subjective idiopathic tinnitus (SIT). METHODS Forty patients with SIT attended the Department of Otorhinolaryngology, Tanta University Hospital, Egypt, between May 2013 and May 2014. The patients were categorized into two groups: group A included 20 patients treated with ITLD injection, and group B included 20 patients treated with intratympanic saline injection as a control. Intratympanic injections were performed four times within 4 weeks in a double-blind manner. At the end of the treatment program, we analyzed the improvement and worsening rates of tinnitus using the following parameters: tinnitus questionnaires, Tinnitus Handicap Index (THI), and loudness matching test. RESULTS The effectiveness rates of the ITLD group reported in the tinnitus questionnaires, the THI and the loudness matching test were 74.3% in all tests, compared to 26.7, 40.0 and 26.7%, respectively, in the saline group. There was a statistically significant difference between the groups within 2 months after injection. To analyze the therapeutic effect of ITLD on tinnitus of 6 months duration, the improvement rates reported in the tinnitus questionnaires, the THI and the loudness matching test were 78.5% in all tests in the ITLD group, compared to 40.0, 40.0 and 30.0%, respectively, in the saline group. CONCLUSION There were statistically significant differences between both groups. ITLD seems to be effective for idiopathic tinnitus.
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Affiliation(s)
- Saad Elzayat
- Department of Otorhinolaryngology, Tanta University Hospital, Tanta, Egypt
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