The safety of posterior tympanotomy in otitis media with effusion during cochlear implantation: clinical retrospective cohort study

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.

The safety of bipolar mode radiofrequency (BMRF) on cochlear implant integrity test; a clinical prospective study

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.

Evaluation of ethanolamine oleate sclerotherapy on the submandibular glands of canines as a potential therapy for sialorrhea

BACKGROUND

Sialorrhea can have major negative effects on the physical and social well-being. Sclerotherapy may be useful in patients with sialorrhea by decreasing the amount of saliva production. The aim of this study was to test the effect of ethanolamine oleate (EO) in an experimental model as a preliminary step for its application in humans.

METHODS

Histopathological and morphometric analysis of submandibular glands from thirteen dogs was preformed. A total of 25 glands were injected with 1ml of 2.5% EO (n=5), 1ml of 5% EO (n=5), 5ml of 2.5% EO (n=5) and 5ml of 5% EO (n=5). Five glands were used as control.

RESULTS

EO significantly induced a dose dependent scaring of the gland ending in lobular transformation (salivary gland cirrhosis). Morphometric measurements showed that 1ml of 2.5% or 5% EO significantly induced fibrosis compared to normal glands (p=0.014 and 0.021, respectively). Fibrosis significantly increased and was more apparent when a dose of 5ml of 2.5% EO or 5% EO were injected [by semi-quantitative evaluation (p=0.016 and 0.002, respectively) and morphometric measurements (p=0.016 and 0.008, respectively)]. This scarring effect was significantly associated with reduction of area of acinar cells when a dose of 1ml-5%, 5ml-2.5% or 5ml-5% EO were applied (p=0.03. 0.012 and 0.004, respectively). Moreover, ductal injury was only significant when a dose of 5ml of 5% EO was used (p=0.034). This dose and concentration (i.e. 5ml-5% EO) had a significant synergetic effect [p=0.0119].

CONCLUSION

In this model, treatment with EO proved to permanently reduce the acinar area through induction of progressive, irreversible and dose dependant scarring (medical sialoadenectomy).

Stem cells: a tree model

A tree model is presented in order to illustrate the hypotheses that earlier stem cells will respond differently than later progenitors to the same stimuli. Experimental data and decision analysis tools are shown to demonstrate the concept.

Game theoretic analysis of interferons effect on hematopoietic progenitors growth

The effects of recombinant alpha, beta and gamma interferons (IFN), alone or in combinations were studied in a case of essential thrombocythemia, using the mixed colony formation assay. This assay allows growth of multipotent (CFU-Mix), and unipotent granulocytic-macrophage (CFU-GM), erythroid (BFU-E) and megakaryocytic (CFU-Meg) progenitors. The bone marrow precursors were cultured in the presence of each type of IFN at 100 U/ml and all possible combinations performed. The results were analysed using the Shapley formula, a game theoretic approach. It is concluded that IFN alpha would be the best candidate for reducing megakaryocytic progenitors while growth of other hematopoietic precursors would be stimulated. These types of analytical biological experiments controlled by using six permutations and calculation of the Shapley value for the three types of IFNs are suggested as a fair approach for a rational choice.