Philippine Journal of Otolaryngology Head and Neck Surgery最新文献

{"title":"Endoscopic Type I Tympanoplasty in 70 Patients with Chronic Otitis Media: A Preliminary Report","authors":"Bikramjit Singh, P. Pal, Hardeep Singh Osahan, A. Sood","doi":"10.32412/pjohns.v36i2.1793","DOIUrl":"https://doi.org/10.32412/pjohns.v36i2.1793","url":null,"abstract":"ABSTRACT \u0000Objective: To evaluate the preliminary surgical results of Endoscopic Type I Tympanoplasty \u0000among patients with inactive chronic otitis media without ossicular pathology. \u0000Methods: \u0000Design: Prospective Series \u0000Setting: Tertiary Government Hospital \u0000Participants: Seventy patients with inactive mucosal chronic otitis media (COM) with air bone gap (ABG) of ≤ 40 dB on the preoperative audiogram scheduled to undergo Type I Tympanoplasty between July 2018 and December 2020 were enrolled. \u0000Results: Seventy-three (73) ears were evaluated. The overall rate of graft uptake was 95.9% at 12 weeks. There was a statistically significant (p<.001) improvement in hearing on comparison of pre-operative (25.74 ± 7.34 dB) and post-operative (14.82 ± 6.55 dB) air bone gap. The duration of surgery was less than one hour in 76.7% and 77.2 % patients experienced only mild post[1]operative pain. \u0000Conclusion: Endoscopic tympanoplasty can provide good results with respect to graft uptake and hearing gain with short surgical duration and minimum postoperative morbidity. Longer follow up of at least 6 months (for graft uptake) and preferably not less than 12 months (for hearing results) may confirm our preliminary findings","PeriodicalId":33358,"journal":{"name":"Philippine Journal of Otolaryngology Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42279827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-traumatic Malleo-Incudal Complex Dislocation","authors":"N. Yang","doi":"10.32412/pjohns.v36i2.1819","DOIUrl":"https://doi.org/10.32412/pjohns.v36i2.1819","url":null,"abstract":"A 27-year-old man undergoes otolaryngologic evaluation for blunt head trauma suffered in a vehicular accident. With regards to the right ear, pertinent otologic findings include an ear canal laceration and a delayed-onset facial nerve paresis. Tuning fork testing reveals an abnormal Rinne test on the right (AC<BC). The radiologist’s interpretation of the computerized tomographic imaging study of the temporal bone indicated the presence of a longitudinal fracture of the right temporal bone with no disruption of the ossicular chain. (Figure 1) However, careful examination of the anatomy of the malleo-incudal complex in relation to the other structures in the epitympanum actually reveals findings indicative of a malleo-incudal complex dislocation. How can this discrepancy in the radiologic interpretation be accounted for? By what objective parameters can the presence of a malleoincudal complex dislocation be identified? \u0000  \u0000Meriot et al.1 described five types of traumatic ossicular dislocation injury: incudomalleolar joint separation, incudostapedial joint separation, stapediovestibular dislocation, incus dislocation, and malleo-incudal complex dislocation. Of these, incudomalleolar joint separation would probably be the most easily identified, as it would manifest as a disruption in the distinctive ice-cream cone appearance of the malleus head and the body and short process of the incus visualized on axial CT imaging of the temporal bone. (Figure 2) In contrast, malleo-incudal complex dislocation would involve movement of both ossicles en-bloc within the tympanic cavity (usually into the mesotympanum), without disruption of the incudomalleolar joint.1 As such, the ice-cream cone configuration may be preserved in this type of injury. Proper identification of this type of injury would be based on identifying any discrepancy in the positional relationship between the ossicular complex and the other structures within the confines of the \u0000tympanic cavity. \u0000  \u0000The malleus head and the body and short process of the incus are located in the most superior portion of the tympanic cavity, the pneumatised area called the epitympanum. Also known as the attic or \u0000epitympanic recess, this region is bordered superiorly by the tegmen tympani and inferiorly by the mesotympanum. The epitympanum is divided into two compartments: the anterior epitympanic space or \u0000recess, and the much larger posterior epitympanum, which houses the epitympanic portions of the malleus and incus. This division is created by a thin bony plate known as the cog, which projects downwards from the tegmen tympani and is located anterior to the malleus head.2 In the axial plane, the malleo-incudal complex is normally centered within the posterior epitympanum with the short process of the incus pointing into the incudal fossa. The position of the malleo-incudal complex may sometimes be slightly lateral, but is never medial in the normal situation.1 \u0000  \u0000Based on these broader anatomical relationsh","PeriodicalId":33358,"journal":{"name":"Philippine Journal of Otolaryngology Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42684340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Operative Temporal Bone CT Scan Readings and Intraoperative Findings During Mastoidectomy","authors":"Dominador Toral, Chris Robinson Laganao","doi":"10.32412/pjohns.v36i2.1839","DOIUrl":"https://doi.org/10.32412/pjohns.v36i2.1839","url":null,"abstract":"ABSTRACT \u0000Objective: To determine the correlation between pre-operative in-house temporal bone CT scan readings and intraoperative findings during mastoidectomy for cholesteatoma in a tertiary government hospital from January 2018 to December 2019. \u0000Methods: \u0000Design: Review of Records \u0000Setting: Tertiary Government Hospital \u0000Participants: A total of 25 charts were included in the study. Surgical memoranda containing intraoperative findings were scrutinized. Data on key structures or locations were filled into a data gathering tool. Categorical descriptions were used for surgical findings: “present” or “absent” for location, and “intact” or “eroded” for status of ossicles and critical structures. Radiological readings to describe location and extent of disease were recorded as either “involved” or “uninvolved,” while “intact” or “eroded” were used to describe the status of ossicles and critical structures identified. Statistical correlations were computed using Cohen kappa coefficient. Sensitivity, specificity, and predictive values were also computed. \u0000  \u0000Results: No correlation between radiologic readings and surgical findings were found in terms of location and extent of cholesteatoma (κ < 0). However, moderate agreement was noted in terms of status of the malleus (κ = .42, 95% CI, .059 to .781, p<.05), substantial agreement noted for the incus status (κ = 0.682, 95% CI, .267 to .875, p<.05), and fair agreement noted for the stapes status (κ = .303, 95% CI, -.036 to .642, p>.05). Slight agreement was also noted in description of facial canal and labyrinth (κ =.01, 95% CI, -.374 to .394, p>.05), while no correlation was noted for the status of the tegmen (κ = 0, 95% CI, -.392 to .392, p<.05). \u0000Conclusion: Our study shows the unreliability and shortcomings of CT scan readings in our institution in detecting and predicting surgical findings. An institutional policy needs to be considered to ensure that temporal bone CT scans be obtained using techniques that can appropriately describe the status of the middle ear and adjacent structures with better reliability.","PeriodicalId":33358,"journal":{"name":"Philippine Journal of Otolaryngology Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42673176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acantholytic Squamous Cell Carcinoma","authors":"S. Maganito, J. Carnate","doi":"10.32412/pjohns.v36i2.1823","DOIUrl":"https://doi.org/10.32412/pjohns.v36i2.1823","url":null,"abstract":"A 63-year-old Filipino man presented with a one-month history of painful ulceration on the alveolar socket of a molar tooth of the right hemimandible. The patient consulted at a tertiary hospital, where he underwent incisional biopsy. \u0000  \u0000Microscopically, the biopsy specimen showed neoplastic cells arranged in a pseudoglandular alveolar pattern with cystic spaces lined with atypical polygonal cells. (Figure 1) Detached “glassy” keratinocytes which are dyskeratotic acantholytic cells were seen within these cystic spaces. (Figure 2) Areas with features of more conventional squamous cell carcinoma, i.e., intercellular bridges and abundant eosinophilic cytoplasm, were also present. (Figure 3) Immunohistochemical staining for p40 showed diffuse nuclear positivity. (Figure 4) Given these findings, a diagnosis of acantholytic squamous cell carcinoma (ASCC) was made.1 \u0000  \u0000Acantholytic squamous cell carcinoma (historically known as adenomatoid squamous cell carcinoma or adenoacanthoma) is a histologic variant of squamous cell carcinoma (SCC) that most often presents as an ulcer on sun-exposed areas, mostly in elderly males.1,2 ASCCs of the oral cavity are rare, with fewer than 60 cases reported in the literature.3 In a series of 55 cases describing intraoral ASCCs, the most common sites of ASCC were the tongue (24/55) and the maxilla/maxillary gingiva and/or palate (11/55).3 \u0000  \u0000The presence of a pseudoglandular or alveolar pattern might suggest the diagnosis of an adenocarcinoma. However, the findings of tumor lobules with a distinctly squamoid morphology, along with the presence of intercellular bridges, will point to the correct diagnosis. Furthermore, ASCC does not present with intracellular mucin, clear cells, and intermediate cells – an important distinguishing point with mucoepidermoid carcinoma. The absence of true glands also militates against the differential diagnosis of an adenosquamous carcinoma.1 \u0000  \u0000Although the diagnosis of ASCC may be established through histomorphology alone, p40 immunohistochemistry – a useful marker for squamous cell differentiation - strengthens the diagnosis.4 Loss of E-Cadherin expression – a protein involved in cell adhesion and binding - is usually seen in the discohesive cells but may be retained in the well differentiated areas.2 Absence of staining with mucicarmine and CD34 will help rule out mucoepidermoid carcinoma and angiosarcoma, respectively.1,2 The authors felt that the latter two differential diagnoses could be excluded on the basis of the light microscopic features present in the case along with the demonstration of diffuse p40 positivity. It is granted however that in resource-rich settings, these other ancillary diagnostic tests may prove helpful especially for morphologically ambiguous cases or cases with less tissue volume. \u0000  \u0000Current studies show no statistically significant difference in the overall survival rate of ASCCs versus that of conventional SCC.3 ASCC is treated in the same manner as co","PeriodicalId":33358,"journal":{"name":"Philippine Journal of Otolaryngology Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48949042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebro-Spinal Fluid Leak in Skull Base Reconstruction Using Hadad - Bassagasteguy Flap after Endoscopic Endonasal Transsphenoidal Surgery: A Case Series","authors":"J. P. Formalejo, J. P. Amable","doi":"10.32412/pjohns.v36i2.1797","DOIUrl":"https://doi.org/10.32412/pjohns.v36i2.1797","url":null,"abstract":"Objective: To determine the incidence of cerebrospinal fluid (CSF) leak after Hadad[1]Bassagasteguy Flap (HBF) reconstruction after endoscopic endonasal transsphenoidal surgery for skull base pathologies from 2016 to 2020 at the University of the East Ramon Magsaysay Memorial Medical Center. \u0000Methods: \u0000Design: Case Series \u0000Setting: Tertiary Private Training Hospital \u0000Participants: Charts of 35 patients who underwent endoscopic endonasal transsphenoidal surgery with reconstruction using Hadad-Bassagasteguy flap between January 2016 to February 2020 were reviewed and data on demographics, date of procedure, mass size, final diagnosis, presence of preoperative, intraoperative and postoperative CSF leak, placement of lumbar drain and course in the wards were collected. \u0000Results: There were 23 women and 12 men with ages ranging from 21 to 71 years. Four patients (11.4%) had postoperative CSF leak after reconstruction with HBF. Two of these four patients had episodes of nose blowing and sneezing weeks after surgery, prior to the development of the CSF leak. The other two patients experienced CSF leak 3 days postoperatively. \u0000Conclusion: HBF has been a workhorse for reconstruction of skull base defects after transsphenoidal surgery, and based on our experience remains to be so, making it possible for expanded approaches and a wide variety of pathologies to be operated on via the endonasal route","PeriodicalId":33358,"journal":{"name":"Philippine Journal of Otolaryngology Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44478421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 and Climate Change: Signing Up for Our Impossible Dream","authors":"J. F. Lapeña","doi":"10.32412/pjohns.v36i2.1787","DOIUrl":"https://doi.org/10.32412/pjohns.v36i2.1787","url":null,"abstract":"To dream the impossible dream, To fight the unbeatable foe \u0000To bear with unbearable sorrow, To run where the brave dare not go \u0000  \u0000To right the unrightable wrong, To love pure and chaste from afar \u0000To try when your arms are too weary, To reach the unreachable star \u0000  \u0000— Mitch Leigh and Joe Darion, The Impossible Dream1","PeriodicalId":33358,"journal":{"name":"Philippine Journal of Otolaryngology Head and Neck Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41387588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of Ambient Noise Levels in the Medical and Surgical Intensive Care Units and Adult Ward of the Makati Medical Center","authors":"Jacquelyn Chan-Zamora, Joseph Richard Ray Cedeño, Patricio Guzman, Jomar Bigalbal","doi":"10.32412/pjohns.v36i2.1795","DOIUrl":"https://doi.org/10.32412/pjohns.v36i2.1795","url":null,"abstract":"ABSTRACT \u0000Objective: To measure the levels of environmental noise in the medical intensive care unit, surgical intensive care unit, and adult ward of the Makati Medical Center for the morning, afternoon, and evening shifts, on weekdays and weekends, and to compare noise levels across shifts, and between weekdays and weekends. \u0000Methods: \u0000Design: Environmental Noise Survey \u0000Setting: Tertiary Private Training Hospital \u0000Participants: None \u0000Results: The overall mean environment noise levels in all the areas surveyed (medical intensive care unit, surgical intensive care unit and adult ward) exceeded World Health Organization recommendations by more than 20 dB across different working shifts on both weekdays and weekends. There was no significant difference in noise levels between weekdays and weekends across shifts in all areas, except for the afternoon shift in the Medical ICU. Using Repeated Measures ANOVA, results showed that there is no sufficient evidence to conclude that at least one shift has significantly different mean noise level in any of the 3 areas (MICU: F(2)=4.73, p-value=.1124; SICU: F(2)=7.91, p-value=.0540; WARD: F(2)=2.73, p-value=.1948) \u0000Conclusion: The overall environmental noise levels in the different areas of MICU, SICU and Adult ward exceeded the WHO recommendation. It is recommended that a change in strategy is needed for prevention of environmental noise, setting guidelines and policies to assure quality health care and noise control. Further investigations to ascertain exact sources may give rise to feasible solutions.","PeriodicalId":33358,"journal":{"name":"Philippine Journal of Otolaryngology Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42198423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approach to a Sewing Needle in the Parapharyngeal Space: A Case Report","authors":"V. Bettadahalli, R. Bhargava, Sunil Kumar","doi":"10.32412/pjohns.v36i2.1805","DOIUrl":"https://doi.org/10.32412/pjohns.v36i2.1805","url":null,"abstract":"ABSTRACT \u0000Objective: To describe a unique situation of a sewing needle lodged in the parapharyngeal space and elucidate the problems encountered in its successful removal. \u0000Methods: \u0000Design: Case Report \u0000Setting: Tertiary Private Hospital \u0000Patient: One                                                \u0000Result: A 24-year-old male tailor accidentally swallowed a sewing needle that pierced the oropharyngeal wall and was wedged in the parapharyngeal space. After a thorough physical examination, 70 degree rod endoscopy, radiography and doppler ultrasonography and intraoperative C-arm X-ray for intraoperative localization and as a guide for extraction all yielded less than optimal guidance. Although an intra-oral approach was initially taken, the transcervical approach provided the best access. \u0000Conclusion: Removal of a sharp foreign body in the parapharyngeal space should be considered a surgical emergency owing to its close proximity to vital structures and the potential for serious complications. Identifying the exact location may require a variety of imaging modalities, and foreign body extraction may entail multiple surgical approaches.","PeriodicalId":33358,"journal":{"name":"Philippine Journal of Otolaryngology Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41593163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single Stage Transoral Cordectomy and Medialization Thyroplasty in Early Glottic Squamous Cell Carcinoma: A Case Report","authors":"Joyce Anne Regalado-Go, Terrence Jason Flores, A. Santiago","doi":"10.32412/pjohns.v36i2.1807","DOIUrl":"https://doi.org/10.32412/pjohns.v36i2.1807","url":null,"abstract":"ABSTRACT \u0000Objective: To present the case of a 78-year-old man with Glottic SCCa stage I who underwent single stage transoral cordectomy type IV with medialization thyroplasty under general anesthesia. \u0000Methods: \u0000Design: Case Report \u0000Setting: Tertiary Government Training Hospital \u0000Patient: One \u0000Results: Postoperatively, patient was able to phonate and gave a VHI score of 12 and GRBAS score of 4. He was able to resume oral feeding without any signs of aspiration. Postoperative flexible laryngoscopy showed fully mobile vocal cords with good approximation in the midline. \u0000Conclusion: This report suggests that vocal cord medialization via thyroplasty may be performed after cordectomy in a single stage, providing acceptable postoperative voice as well as good swallowing outcome","PeriodicalId":33358,"journal":{"name":"Philippine Journal of Otolaryngology Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47422432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Difficulty in Communication While Wearing a Respirator Mask During the COVID-19 Pandemic by Using a Laryngophone","authors":"Laine Valerie Kongsun Ching, Philip Lance Anthony Liu","doi":"10.32412/pjohns.v36i2.1811","DOIUrl":"https://doi.org/10.32412/pjohns.v36i2.1811","url":null,"abstract":"ABSTRACT \u0000Objective: To describe the use of a laryngophone to aid in verbal communication when wearing elastomeric respirator masks. \u0000Methods: \u0000Design: Instrumentation Innovation \u0000Setting: Tertiary Private Training Hospital \u0000Participants: Five volunteers using elastomeric respirator masks rated laryngophone use, afterwhich they individually rated an additional volunteer on speech intelligibility before and after laryngophone use. \u0000Results: On a scale of 1-10, the average score of the five volunteers for the laryngophone was 8.8 for ease of use, 8.0 for comfort, and 8.0 for ease of communication. Their average speech intelligibility score for the additional volunteer using the respirator mask alone was 2.0, and for use of the respirator mask with laryngophone was 3.6 on a scale of 1-4. \u0000Conclusion: This portable laryngophone speaker may be useful in aiding otolaryngologists and health care providers using elastomeric respirator masks in verbal communication by amplifying speech without needing an external microphone, preventing vocal strain.","PeriodicalId":33358,"journal":{"name":"Philippine Journal of Otolaryngology Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47470195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}