Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 2nd International Conference and Exhibition on Rhinology and Otology Dubai, UAE.

Day 2 :

Keynote Forum

Patrick C M Wong

The Chinese University of Hong Kong
China

Keynote: Central auditory processing: From molecule to behavior

Time : 09:00-09:25

OMICS International Otolaryngology-2015 International Conference Keynote Speaker Patrick C M Wong photo
Biography:

Patrick C M Wong, PhD, CCC-SLP is Professor in Linguistics at The Chinese University of Hong Kong and Adjunct Professor of Otolaryngology and Communication Sciences and Disorders at Northwestern University. Research by his team concerns central auditory processing and neurophysiology, especially speech perception and learning, auditory deficits, and interactions between speech and music. His scholarly publications have appeared in Nature Neuroscience, Journal of Neuroscience, Cerebral Cortex, among others. His work has also attracted much public attention, such as coverage by the New York Times.

Abstract:

Most of us live in an auditory world. We use spoken language to communicate, we tune in to environmental sounds, and we listen to music. Formal and informal experiences with these acoustically and functionally complex sounds are linked to our neural systems (from neurotransmitters to network) on the one hand, and our cultural traditions on the other. In this talk, a series of experiments from the author’s research group that investigate factors influencing auditory processing and learning, including genetic profiles, neuroanatomy, neurophysiology, instructional paradigms, and culture will be reported. For examples, the author will talk about how genetic polymorphism and neural characteristics may be tied to spoken language learning success, how different learners may require distinct training methods, and how auditory training focusing on cognitive skill development can improve language communication in individuals with cochlear implants. This hodgepodge of findings form a starting point for a more comprehensive understanding of the human auditory system that takes into account the connection between the context in which we live and the building blocks of our physiology.

Keynote Forum

Ahmad Al-Amadi

Al Baraha Hospital Ministry of Health
United Arab Emirates

Keynote: The dizzy patient: Four by four approach to intervention

Time : 09:25-10:25

OMICS International Otolaryngology-2015 International Conference Keynote Speaker Ahmad Al-Amadi photo
Biography:

Ahmad Al Alamadi graduated from Glasgow Medical School in United Kingdom in 1993 and completed his training in Scotland by obtaining his Fellowship of Royal College of Surgeons of Glasgow in 1998. He followed his higher surgical training by doing a clinical neurotology fellowship program in Toronto University in Canada. He is currently a consultant Otologist and Neurotologist and Medical Director at Al Baraha Hospital in Dubai. He is also a Clinical Associate Professor at Sharjah University. His expertise lies in Otological surgeries and management of dizzy patients.

Abstract:

Objective: To present a systematic approach to the practical management of the dizzy patient in the office setting. This approach is based on the experience from the Multidisciplinary Neurology Clinic of the University Health Network, Toronto General Hospital.
\\r\\nMethod & Results: The dizzy patient presents challenges in a busy clinic even for an experienced physician. Having a consistent systematic approach will minimize the time required to reach a most probable diagnosis so that further investigations can be directed appropriately. With a carefully directed history and by following our four by four approach we have found that in >90% of the dizzy patients the cause can be confidently diagnosed. The distinction between dizziness and the true vertigo can be made by allowing the patient time to describe their feelings in their own words. Patients with true vertigo have vestibular pathology which can be peripheral or central in origin. Peripheral vestibular disorders are often associated with other inner ear symptoms such as hearing loss, tinnitus and aural fullness. Patients with central vestibular disorders are more likely to have complaints of focal neurological dysfunction, for example diplopia, dysphagia, parasthesia or paresis. Clinical examination of a dizzy patient should include a relevant otological and neurological examination.
Conclusion: By following our four by four method physicians can diagnose majority of the dizzy patients. Special vestibular tests and diagnostic maneuvers are valuable and easy skills to learn for assessment of the dizzy patient.

Break: Coffee Break 10:25-10:45 @ Al Dhiyafah Pre Function Hall
  • Track 7: Ear Disorders
    Track 8: Diseases of Middle and Inner Ear
    Track9: Hearing Impairment and Deafness- Causes and Treatment
    Track 10: Endoscopy, Diagnosis and Imaging Techniques
Location: Breakout @ Al Dhiyafah 4
Speaker

Chair

Jing Zheng

Feinberg School of Medicine, USA

Speaker

Co-Chair

Xue Zhong Liu

University of Miami, USA

Session Introduction

Mohammed Iqbal Syed

The Royal Infi rmary of Edinburgh
United Kingdom

Title: Management of meniere’s syndrome/disease: Has the quality of evidence based medicine changed over the past two decades?

Time : 10:45-11:05

Biography:

Mohammed Iqbal Syed completed his MBBS and a Master’s degree in Otolaryngology from the Pune University in India. He completed his specialist training (DLO and FRCS) from the United Kingdom and was awarded a travelling fellowship to the University Hospital in Zurich and the TWJ clinical fellowship in Otology/Skull base surgery at the University of Toronto. He has published over 25 peer reviewed papers and presently is a Consultant in Otology and Skull base surgery at the Royal Infi rmary/Western Infi rmary in Edinburgh.

Abstract:

Background: Several reviews have looked at treatment(s) for Meniere’s syndrome/disease (MS/D) characterized by episodic vertigo, fluctuating hearing loss, tinnitus and aural fullness, and there is no strong evidence to support any particular medical or surgical intervention.
Objective: To evaluate the evidence and trends on published literature on the treatment of Meniere’s syndrome/disease in the last two decades.
Search strategy: A literature search was performed using the PubMed database. Combinations of ‘‘Meniere’’ or ‘‘endolymphatichydrops’’ combined with ‘‘treatment’’ or “management”.
Evaluation methods: Studies were evaluated to report trends in the management of this condition, the diff ering levels of evidence published far for each treatment modality, evaluate whether AAOHNS-CHE guidelines had been correctly employed and whether the Randomized Controlled Trials (RCT’s) were compliant with the CONSORT guidelines. We found that the evidence base on published literature on MS/D had improved over the last decade. Th ere was an increase in emphasis on Quality of life studies, and a signifi cant increase in the number of RCT’s with an improvement in their quality. Th ere was a decline in surgery, and an increase in the use of the Meniett device and in the use of intratympanic steroid therapy.

Majid A Aldossary

University of Dammam
Kingdom of Saudi Arabia

Title: Ear trauma at King Fahad Hospital of the University: A fi ve-year review

Time : 11:05-11:25

Speaker
Biography:

Majid Aldossary received a Bachelor of Medicine and surgery from college of medicine, University of Dammam, Kingdom of Saudi Arabia in May 2014 and is currently working as an intern in King Fahad Hospital of the University, Khobar, Kingdom of Saudi Arabia.

Abstract:

Introduction & Objectives: Trauma to the ear can be a consequence of several aetiologies that may include motor vehicle accidents, violence, or accidental traumas. Ear trauma can range from simple blunt trauma to the pinna, through uncomplicated rupture of tympanic membrane to temporal bone fracture. Th e aim of this study is to review the various aetiologies, types, and presentations of ear trauma among trauma patients admitted to KFHU from 2008 to 2013.
Methods: All medical charts of trauma patients admitted to KFHU over a fi ve years period (2008–2013) were retrospectively reviewed and the data regarding ear trauma were extracted. Diff erent aetiologies of ear trauma were identifi ed including: Motor vehicle accidents, violence, accidental traumas, and occupational causes. Regarding the types of ear trauma; it has been classifi ed into 1) soft tissue injury, 2) temporal bone fracture, and 3) mixed injury (combination of soft tissue and temporal bone injury). Th e data retrieved were entered and analyzed descriptively using the Statistical Package for Social Science (SPSS).
Results: Over a fi ve years period (2008-2013), a total number of 3203 trauma patients were admitted to the hospital. Fift y four percent were cases of motor vehicle accident, 30% were accidental traumas, and 8.96% were due to violence. Out of these 3203 trauma cases, thirty three (1.03%) suff ered from ear trauma. Th e mean age was found to be 25.61 years. Th e most common aetiologies of these ear traumas were motor vehicle accident (60.6%), followed by violence (27.3%). Regarding the types of ear trauma; thirty one (93.9%) patients presented with soft tissue injury, one patient with temporal bone fracture, and one patient with mixed injury. Th e most common clinical presentations of ear trauma were laceration of the auricle (81.8%), bleeding from the ear (21.2%), hematoma of the auricle (15.2%), and hearing loss (12.1%).
Conclusion: Trauma to the ear is an uncommon injury among trauma patients. Ear trauma patients presented with soft tissue injury are more frequent than trauma causing temporal bone fracture. We should keep in concern that there may be a lot of unrecorded or missed cases of temporal bone fractures due to its occurrence with severe trauma which takes the physician attention towards more serious life threatening findings.

Amani Al-Qarni

University of Dammam
Kingdom of Saudi Arabia

Title: Awareness of External otitis as compared to awareness about diabetic foot

Time : 11:25-11:45

Biography:

Amani M. AL-Qarni Graduated from Dammam University with honor degree, June 2014 and currently she is a Medical intern ( 7th year programme) at King Fahd Hospital of the University Alkhobar, Kingdom of Saudi Arabia.

Abstract:

General Objectives: Evaluate awareness of diabetic patients as regards malignant external otitis as compared with their awareness about diabetic foot.
Specifi c Objectives: Estimate awareness of diabetic patients about the possibility of occurrence of morbid condition in the external canal as a result of diabetes.
• Infl uence the need for awareness campaigns to improve their knowledge about the condition and how to avoid it.
• Infl uence the need to change the name into easier and simple name to remember by patients.
Study Design & Methodology: Th is is a qualitative questioner study to be performed in King Fahad Hospital of Dammam University in Al-Khober, KSA. 100 patients will be selected from patients attending the diabetic clinic in the hospital from January 2015 all patients should meet the following selection criteria:
• Age; above 30 years of age
• Duration of diabetes not less than 5 years
• Education, minimum primary school
Written consent aft er explanation will be signed by patients. The first paper of the questioner will be given to the patient (Questioner attached). If patient marked foot & did not mark ear in question (3) he will be given paper II only. If marked ear & not foot will be given paper III only. If patients marked both will be given paper II & III. Data will be collected and analyzed as regards, knowledge about the two complications in general. Data also will be analyzed with respect to knowledge compared with duration of the disease and level of education.

Speaker
Biography:

Taiwo Olugbemiga had his MBChB degree from Obafemi Awolowo University Ile–Ife, Nigeria. He obtained his Post graduate fellowship of the National Postgraduate Medical College of Nigeria, faculty of ORL (FMCORL) in May, 2012 and he is a member of the West African College of Surgeons. He is a Consultant in the department of ORL-H&NS of LAUTECH Teaching hospital, Osogbo, Nigeria. He coordinates the academic program of the residency training in the department of ORL. He has published more than 16 papers in reputed journals and serving as a reviewer of reputable journals.

Abstract:

Background: Th is study highlighted the challenges associated with the management of congenital and early onset childhood hearing loss in a sub-Saharan African country.
Methods: A retrospective descriptive study between January 2008 and December 2013
Result: A total of 223 children consisting of 124 (55.6%) males with (M: F) of 1.3:1. Th e age ranged from 1 to 15 years and age group 1 to 5 years constituted the largest proportion (56.5%). congenital hearing impairment, febrile illness and hypoxia were the leading causes. Over 93% had moderately severe to profound hearing loss while 64.6% had delayed speech development. Only 16.5% of patients with congenital and birth asphyxia presented within the fi rst year (X2=40.648, p=0.001). Less than 5% had hearing aid fi tted and patients with profound hearing impairment were referred for cochlear implant.
Conclusion: Th ere is a need for the government of developing countries to recognize the importance of hearing loss and allocate resources to promote primary, secondary and tertiary prevention of hearing impairment. Th is will be possible through eff ective obstetric care, incorporation of measles, mumps and rubella into the national immunization program, public and health workers enlightenment. A program for early hearing detection and intervention with readily available and aff ordable rehabilitative facilities is imperative as a secondary and tertiary prevention strategy. Th ere is also a need for more funding of research in our environment to facilitate the diagnosis of Congenital and Genetic hearing loss

Moonef Al-Otaibi

King Fahad Medical City
Kingdom of Saudi Arabia

Title: Lobular capillary hemangioma of external ear

Time : 12:05-12:25

Speaker
Biography:

Moonef Al-Otaibi has completed his Bachelor degree of Medicine and Surgery from King Abdulaziz University. Now he’s working as otolaryngology, Head and Neck surgery resident in King Fahad Medical City. He had the chance to work with well-known unique staffs.

Abstract:

A 30-year old healthy lady came with left ear hearing loss and blood discharging from her ear since three months. On physical examination, there was a red mass arising externally from auditory canal which bleeds easily with a touch. She did not have any neck mass. Computerize tomography showed a soft tissue mass in anterior wall of the canal and. During the surgery, the mass invaded the cartilaginous part of the canal anteriorly. Th e whole mass was excised with a piece of cartilage. Th e histopathology revealed variable sized blood vessels in dermis. Strong positive staining of blood vessels with the CD 31 stain endothelial cell markers confirmed Lobular capillary hemangioma. Here we report a rare case of pyogenic granuloma arising from external auditory canal.

Billy Wong

Cambridge University Hospitals NHS Foundation Trust
United Kingdom

Title: A bizarre case of Tension pneumocephalus

Time : 12:25-12:45

Speaker
Biography:

Billy Wong is a core surgical trainee aiming to pursue Otolaryngology as a career. He has special interest in Paediatrics Otolaryngology and Head and Neck Surgery. He was a part of Addenbrooke’s Hospital for 12 months and published a number of articles during that period there.

Abstract:

Pneumocephalus is defined as the presence of air within the cranial cavity, while tension pneumocephalus is a progressively expanding pneumocephalus with signs of raised intracranial tension. Th e commonest cause of pneumocephalus is head or craniofacial trauma; others common causes are tumor or infection. We discuss a case of spontaneous tension pneumocephalus which represents a diagnostic conundrum. A 35-year-old lady presented with sudden onset, severe occipital headaches, rightsided deafness and intermittent vertigo. She had been performing regular valsalva maneuver for past six weeks in order to improve her hearing. Neurological, ENT and fundoscopic examinations were unremarkable. Successive CT-scans of head revealed a gradually expanding extradural pneumocephalus in right parieto-occipital region, with minimal midline shift . Puretone audiometry revealed profound right-sided sensory neural hearing loss. Patient underwent right mastoid exploration to ascertain the cause of pneumocephalus. Intra-operatively the mastoid cavity was highly pneumatised. Th e middle-fossa dura and sigmoid sinus was fully exposed due complete absence of bony covering. Th e Eustachian tube opening in the middle ear was also unusually wide. Otogenic pneumocephalus results from temporal bone defects, in which air gains entry into the cranial cavity via middle ear or eustachian tube with pneumocephalus in middle and/or posterior cranial fossa. Spontaneous otogenic tension pheumocephalus is a rare complication of auto-insuffl ation for eustachian tube dysfunctions. Considering high prevalence of temporal bone defects (15-52% tegmen-tympani defects on autopsy and also a large number of patients with surgical bony defects as from cochlear implant surgery, clinicians should be aware of the risk and educate patients when needed.

Break: Lunch Break 12:45-13:25 @ Al-Dana Restaurant
Speaker
Biography:

Jing Zheng is an Associate Professor in the Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine of Northwestern University. She also holds joint appointments in the Interdepartmental Neurosciences Program and Department of Communication Sciences and Disorders. She is a Fellow of the Hugh Knowles Center for Hearing Research. She received her PhD degree from Michigan State University, USA. She has published more than 40 papers in peerreviewed research journals and serving as Editorial Board Members for several journals.

Abstract:

Humans require outer hair cell (OHC)-associated amplifi cation for their high sensitivity and sharp frequency selectivity. Unfortunately, OHC loss is involved in a majority of sensorineural hearing loss because OHCs are extremely sensitive to aging, acoustic trauma, antibiotics and chemotherapeutic drugs. The key function of OHCs is primarily carried out by OHCs’ unique motor protein called prestin. It is known that cholesterol amounts in the plasma membrane of OHCs infl uence prestin’s function. Recently, hydroxypropyl -cyclodextrin (HP CD) was used to treat patients of Niemann-Pick disease type C1, a fatal genetic disease characterized by a failure to metabolize and dispose of cholesterol and lipids. It was discovered that HPCD induced hearing loss in mice. Because OHCs seem to be the only cells aff ected by this cholesterol-chelating agent, we wondered if this vulnerability might depend on prestin, which is only expressed in OHCs. Our data show that prestin directly binds to cholesterol in vitro. It is, therefore, conceivable that OHC death in response to cholesterol manipulation may result from disruption of the cholesterol-prestin interaction. In order to investigate this possibility, we treated wild-type and prestinknockout (KO) mice with HPCD and analyzed their organs of Corti using immunofl uorescence microscopy on cochlear whole-mount preparations. Consistent with the report by Crumling and colleagues, extensive OHC death was observed in wild-type mice. In contrast, OHCs from prestin KO mice were preserved. Th is observation suggests that a prestin-dependent mechanism underlies HPCD ototoxicity.

Mohammed Iqbal Syed,

The Royal Infirmary of Edinburgh
United Kingdom

Title: Surgical Management of CSF leaks involving the temporal bone

Time : 13:45-14:05

Biography:

Mohammed Iqbal Syed completed his MBBS and a Master’s degree in Otolaryngology from the Pune University in India. He completed his specialist training (DLO and FRCS) from the United Kingdom and was awarded a travelling fellowship to the University Hospital in Zurich and the TWJ clinical fellowship in Otology/Skull base surgery at the University of Toronto. He has published over 25 peer reviewed papers and presently is a Consultant in Otology and Skull base surgery at the Royal Infi rmary/Western Infi rmary in Edinburgh.

Abstract:

Cerebrospinal fluid (CSF) otorrhoea most commonly occurs as a result of trauma (surgical and non-surgical), neoplasms, infections, congenital malformations and sometimes spontaneously. Leakage of cerebrospinal fluid (CSF) though the ear structures is a rare but potentially life-threatening situation that requires rapid intervention. The presence of an abnormal communication of the sterile subarachnoid space with the flora of the sinonasal tract places the patient at great risk for meningitis or in fact, an episode of meningitis may be the presenting problem for a person with CSF otorrhoea. The presentation looks at the aetiopathogenesis, clinical presentations and management options for the condition, and looks at our experience of last 20 years in managing such patients in a tertiary referral centre in Edinburgh. 34 cases were identifi ed in the last 20 years. Surgical repair was carried out using either a transmastoid or middle cranial fossa approach for smaller defects or combined cranioplasty for larger defects. The primary success rate of surgery was 91.7% (31 of 34

Peter Catalano

St. Elizabeth’s Medical Center/Tufts University School of Medicine
USA

Title: Middle meatal nasal surgery for Obstructive sleep apnea

Time : 14:05-14:25

Speaker
Biography:

Peter Catalano, MD completed his Doctor of Medicine from Mount Sinai School of Medicine in NY. He is currently Professor of Otolaryngology at the Tufts University School of Medicine, Chief of Otolaryngology at St. Elizabeth’s Medical Center. He has published over 74 publications in reputed journals; written over 21 book chapters; been invited to over 175 lectures; completed 80 presentations.

Abstract:

The curative impact of nasal surgery on patients undergoing septal and turbinate surgery for obstructive sleep apnea (OSA) has been minimal. New models of nasal airfl ow mechanics have shed important light on key functional elements of nasal obstruction. Based on this information, we evaluated middle meatal nasal surgery targeting areas of maximum nasal airfl ow as an appropriate treatment option for patients with OSA. An IRB-approved study was performed including consecutive adult patients with the diagnosis of “obstructive sleep apnea” who underwent nasal surgery by a single rhinologic surgeon during an 18-month period. Th e types of nasal surgery included: Uncinectomy, anterior ethmoidectomy, reduction of a middle turbinate concha bullosa, shaving of the lateral aspect of an enlarged middle turbinate, endoscopic septoplasty and submucous inferior turbinate resection, and nasal valve repair. Th e primary outcome measure was change in apnea-hypopnea index (AHI). Additional outcome measures included change in body mass index and oxygen-saturation (O2)-nadir. 27 patients were identifi ed with pre- and postoperative polysomnography results. Average preoperative AHI was 34.3; Range 7.5-97.3 and decreased to postoperative mean of 15.5; Range 3.3-47.5 (n=27; p<0.0001). However, O2-nadir and BMI remained relatively stable (Δ O2-nadir 0.1%; ΔBMI -0.1). No surgical complications occurred in this cohort. As illustrated by computational fl uid dynamics, nasal surgery for OSA is further optimized by concurrent targeted middle meatal surgery. Our surgical protocol is the first to demonstrate signifi cant reduction in AHI for OSA patients for all BMI categories regardless of severity.

Xue Zhong Liu

University of Miami
USA

Title: Cochlear implantation in common forms of genetic deafness

Time : 14:25-14:45

Speaker
Biography:

Xue Zhong Liu is a Professor of Otolaryngology, Human Genetics, Biochemistry, & Pediatrics and Vice Chair and Director of Research of the Department of Otolaryngology at the University of Miami. He completed general surgery and otolaryngology residency at University of Miami and obtained his PhD in the University of Manchester in England. He is board certifi ed in Otolaryngology in USA. He is the author of over 140 papers in top journals and is the most successfully NIH funded Otolaryngologist in the world. He has received national and international recognition for his clinical activities and research in the field of otology.

Abstract:

Genetic factors are among the main etiologies of severe to profound hearing loss and play an important role in cochlear implantation (CI) outcomes. Genomic technologies facilitate the discovery of new deafness genes at an unprecedented rate, thereby translating to improved patient care through more rapid diagnosis while also advancing our understanding of the molecular physiology of hearing and deafness. While genes for common forms of deafness have been cloned, eff orts to correlate the functional outcome of CIs with a genetic form of deafness carried by the patient have been largely anecdotal to date. It has been suggested that the diff erences in auditory performance may be explained by differences in the number of surviving spiral ganglion cells, etiology of hearing loss, and other factors. Knowledge of the specifi c loci and mutations involved in patients who receive cochlear implants may elucidate other factors related to CI performance. In this presentation, current advances of genetic deafness and their impacts on CI will be discussed. Th ere are few reasons not to off er cochlear implantation to children, such as advanced age or nonverbal language. Rather, many individuals implanted with genetic forms of hearing loss, especially those implanted at a young age, do remarkably well due to preservation of the spiral ganglion and upper CNS pathways. Future studies of larger cohorts of patients are necessary to support very positive preliminary fi ndings. Additionally, greater focus should be placed on appropriate screening and counseling of individuals with hearing loss.

Speaker
Biography:

Georgios Kontorinis having obtained his training in Otorhinolaryngology and his MD on active middle ear implantation in Hannover Medical School in Germany, completed advanced fellowships in Paediatric Otolaryngology in Sheffi eld Children’s Hospital and in complex Otology, auditory implantation and Skull Base Surgery in Manchester University Hospitals. He also completed a Masters degree in Medical Education in Karolinska University in Stockholm, Sweden. He has published widely in peer-review journals and presented numerous papers in international and national meetings. He is a Fellow of the Royal College of Surgeons in Glasgow, member of the advisory board of Facial Palsy, UK and reviewer in leading peer-review journals in Otolaryngology and Neuroradiology. Since 2013 he has been a Consultant ENT Surgeon and Neurotologist at the Institute of Neuroscience in Southern General Hospital in Glasgow. He has also been appointed Honorary Senior Clinical Lecturer in Glasgow University. Most of his clinical practice involves complex Otology and Neurotology and Skull Base Surgery and predominantly the management of vestibular schwannomas. He has a special clinical and research interest in hearing loss, tinnitus and balance disorders as well as in facial nerve palsy.

Abstract:

Objective: Despite its potential huge clinical signifi cance, to date, there are no reliable predictors of vestibular schwannoma (VS) growth. Neutrophil-to-lymphocyte ratio (NLR) has been examined in the context of malignant tumours or illness to assess its ability to act as an indicator of growth or prognosis but never in patients with VS. Our objective was to identify any predictive value of the NLR for tumour growth in patients with VS.
Methods: A retrospective analysis of patients with VS managed in a tertiary referral centre was performed. Th e NLR, prior to any intervention and within 12 months of the initial diagnosis, was identifi ed through our prospectively updated database in patients with growing and non-growing VS. Blood tests obtained during acute illness or in the presence of malignancy were excluded. We performed logistic regression and compared NLR with tumour growth, as defi ned on magnetic resonance imaging (MRI) (>1 mm/ year). Level of signifi cance was set at 0.05. We adjusted data for age, gender and side and found specifi city and sensitivity to identify if NLR is a predictive model.
Results: In a period of 15 years, 160 patients with VS and available NLR results were identifi ed. Seventy-four had growing VS and 86 non-growing tumours. P-value for NLR of growing and non-growing VS was 0.001. AUC (area under the curve) when adjusted for age, gender and side was 0.71 showing that NLR is a good, independent prognostic factor for VS growth.
Conclusion: Th ese retrospective results show a trend with growing tumours exhibiting a higher NLR. As NLR is a cost-eff ective and easily obtained value, further prospective investigations and larger case series need and are currently being examined.

Speaker
Biography:

Liu Yang is currently Professor of the center of Otorhinolaryngology PLA, Navy general hospital, China. He graduated from medical science in the Second Military University, Shanghai, at 1989, and got Master Degree of Otorhinolaryngology Sciences, General Hospital PLA, Beijing in 1995. He is a visiting Physicians of House Research Institute, USC at 2011. He is currently committee member of WHO Collaborating Center for Prevention of Deafness, News editor of Chinese Journal of Otorhinolaryngology& Head Neck Surgery, Editor of Chinese Journal of Otology. His professional direction is in clinical otology and research of hearing loss, especially in the surgery treatment of middle ear chronic infectious disease, vertigo surgery, cochlear implantation, facial never surgery. Till date he has published 5 books as author, and 60 papers as original author, in which 5 papers were included in SCI.

Abstract:

Aim: To assess the quality of three-dimensional volume rendered computer tomography (3D-CTVR), multi-planar reformation (MPR) and CT section plane in the fine diagnosis of ossicular chain in middle ear cholesteatoma.
Methods: Sixty patients with middle ear cholesteatoma were selected in this retrospective study. All cases underwent preoperative CT scan. The respective radiologic reports of the ossicles status via three protocols were then compared to surgical findings.
Results: Quality assessment of these three protocols in the fi ne diagnosis of fi ne ossicles buried inside the soft tissue showed that both CTVR and MPR are more superior to conventional section plane, especially CTVR.
Conclusion: Th e uses of CTVR and MPR, in conjunction with conventional section plane, are better able to show where the true and fine ossicular chain in the cholesteatoma mass is. In the fi nal analysis, we believe that the use of CTVR and MPR techniques can have profound contributive value in future clinical work.

Break: Coffee Break 15:45-16:00 @ Al Dhiyafah Pre Function Hall

Petros Vrettakos

General Hospital of Nikaia-Piraeus
Greece

Title: PAGETS DISEASE OF THE INNER EAR – A CASE REPORT
Speaker
Biography:

Petros Vrettakos is a resident of Otorhinolaryngology at the General Hospital of Nikaia-Piraeus “Agios Panteleimon” (Athens, Greece). He is a PhD candidate and conducts a clinical and anatomical research on the innervation of trapezius muscle and levator scapulae muscle by the cervical nerve plexus. He has presented several researches in both Greek and international conferences.

Abstract:

Paget's disease is a chronic metabolic condition characterized by a local imbalance between the resorbing activity of osteoclasts and the osteogenic activity of osteoblasts which leads to the remodeling of bone tissue with richly vascularized foci of loose and compact bone. The cause is believed to be either viral or genetic in origin. We present a rare case of a 40-year-old female diagnosed with Paget's disease of the temporal bone and sphenoid sinus, after having been treated for 5 years for chronic otitis media. The patient presented with a mass anterior to the right ear and severe headache. She had no history of tinnitus or vertigo but complained about hearing loss. Rinne's test was negative and Weber's test showed lateralization to the right side. Otoneurological examination revealed a mild, mixed-type hearing loss to the right side. Cranial nerves including facial nerve were normal. There were no motor/sensory deficits or signs of cerebellar dysfunction. Radiological examination (HRCT & MRI) of the cerebral and visceral skull showed a significant osteosclerotic malformation of the right sphenoid and temporal bone with some evidence of soft tissue in the sphenoid sinus. Biopsies were taken endoscopically and histological examination led to the diagnosis of Paget's disease. It is possible that the chronic inner ear inflammation might have played a role in the development of temporal bone Paget's disease in this patient. Although temporal bone Paget's disease is very rare it can appear early with symptoms of otitis media and ENTs should include it in the differential diagnosis of patients unresponsive to treatment.

  • Track 11: Surgical Approaches for Nasal Disorders
    Track 12: Surgical Approaches for Ear Disorders Track
    13: New Treatment Approaches for Hearing Disorders
Location: Al Dhiyafah 1-3
Speaker

Chair

Adebola Stephen Oluwatosin

LAUTECH Teaching Hospital
Nigeria

Speaker

Co-Chair

Ibrahim El Achkar

St. Elie Center
Lebanon

Session Introduction

Shahad Almohanna

King Saud University
Kingdom of Saudi Arabia

Title: Rhinoplasty awareness and nose shape preference among Saudi adults in Riyadh city Saudi Arabia

Time : 10:45-11:05

Speaker
Biography:

Shahad Mohammad Almohannais currently a 5th year medical student in king Saud University, Kingdom of Saudi Arabia and will soon become an intern starting July 2015. She is genuinely interested in otolaryngology as a future career. Shahad has enrolled in different summer electives for research and clinical training in otolaryngology department and is very eager to work on future research papers. She participated in various extracurricular activities such as volunteering for different health and community campaigns.

Abstract:

Introduction: Rhinoplasty is a reconstructive plastic surgery, usually done due to many diff erent reasons. Th e prevalence of rhinoplasty is increasing worldwide especially in the gulf countries.
Problem: In Saudi Arabia it is considered to be the third most common plastic surgery. And we think there is lack of awareness despite the increasing number and also there is defi ciency of date for the prevalence and nose shape preference.
Methods: Cross-sectional study in Riyadh, Kingdom of Saudi Arabia. Th e sample was selected randomly during October 2014 through self-administered questionnaire. Total number of participants were 545.
Results: 73.4% of participants know about rhinoplasty. Approximately 30% only know the diff erent types of surgical and nonsurgical options for rhinoplasty. 59.3% don’t know about the complication of rhinoplasty. 70% did not encounter or read any information about rhinoplasty from books or brochures. 40.7% expect the success rate for rhinoplasty to be between 50%-70%. 29.5% want to do rhinoplasty themselves. 61.1% think that psychological eff ect could explain the reason behind nose plastic surgery. More than 90% desire straight nose, narrow nostrils and smaller nose size. 58.7% and 82% want the nose tip to be up and sharp respectively. Th e length of the nose was almost disturbed equally between the participants. 61.8% want to have a less prominent side view of the nose and 86.1% want it straight.
Conclusions: Most of the participants were not aware about diff erent types of surgical and non-surgical option of rhinoplasty neither the complication of it. Most of them think that the reason behind increasing number of rhinoplasty is social and psychological eff ect.

Andrzej Sieskiewicz

Medical University of Bialystok
Poland

Title: Endoscopic treatment of orbital pathologies

Time : 11:05-11:25

Biography:

Andrzej Sieskiewicz received PhD from the Medical Academy of Bialystok upon the presentation of Doctoral dissertation in 2000. He is a member of Polish Society of Otolaryngologists Head and Neck Surgeons, Polish Society of Skull Base Surgeons, Polish Rhinologic Society. He is author of over 70 publications in medical journals. He is an invited lecturer on Polish and international conferences and teaching courses on endoscopic surgery of the nose, paranasal sinuses, skull base and orbit. He is the head of many scientifi c and research projects sponsored by Medical University of Bialystok and Polish Ministry of Science and Education focused mainly on endoscopic surgery and interdisciplinary cooperation during skull base pathology treatment.

Abstract:

Development of surgical technology, improvement of operative technique, increased anatomical knowledge during the last two decades enabled the endoscopic surgeons to go far beyond paranasal sinuses. One of the regions that still remain very diffi cult to explore with purely endoscopic technique is the orbit. We aim at presentation of the advantages and limitations of endoscopic surgery of this region. Basing on our own clinical experience endoscopic surgical approaches to various types of orbital pathologies including infl ammatory (abscesses), posttraumatic (hematomas, foreign bodies) and tumors will be discussed. Stress will be put on proper tailoring the endoscopic technique to lesions of diff erent types and locations. Th e endoscopic transnasal, transseptal, transmaxillar and external approach to the orbit will be presented. Th e application of neuronavigation system and intraoperative ultrasonography during these procedures will also be discussed. Both our own experience and data from the relevant literature indicate that intraorbital infl ammatory lesions can be eff ectively treated by means of endoscopy whereas purely endoscopic removal of intraorbital tumor still remains rarity because is technically demanding and requires high experience in this type of surgery. In case of malignancies endoscopy may be used for diagnostic purposes and/or as a method supporting conventional external surgical approaches.

Abhilasha Yadav

Sharad Pawar Dental College
India

Title: The cleft nose

Time : 11:25-11:45

Speaker
Biography:

Abhilasha Yadav has completed her MDS in April 2008 from Nagpur University. She is an Associate Professor in the Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College, Datta Mehge Institute of Medical Sciences (Deemed University), Wardha. She is an accredited Smile Train Surgeon, Smile Train Project, Acharya Vinoba Bhave Rural Hospital, Wardha, since September 2011. She has operated over 500 plus cleft cases under the same project. She has presented around 20 papers in national and international conferences and delivered 8 guest lectures. She has 12 publications to her credit in national and international reputed journals and serving as reviewer for reputed journal.

Abstract:

Rhinoplasty occupies a unique position in facial surgery due to the central position of the nose in the face and the vital functions of the nose. Th e cleft nasal deformity is a complex challenge in surgery involving the skin, cartilage, mucosa, and skeletal platform. Ever since Blair and Brown fi rst described the intricacies of the cleft pathology in 1931, the appropriate approach has been extensively debated in the literature with respect to timing, technique, and extent of surgical intervention. Cleft lip patients may have a variable distortion of the nasal anatomy, with the implications for aesthetical facial appraisal and psycho-emotional well being. Th e deformity of the nose is related to the separation of the lip and/or palatal elements – the wider the cleft , the more severe the associated nasal deformity. Th ere is little functional concern, but the deformity can be quite noticeable. Improvement in the appearance of the nose may be performed at various times. Th e cleft side is elevated and the two sides are brought closer together to improve the symmetry. Th is may require borrowing cartilage from other sites to augment the cleft side. Th e incision across the skin between the two nostrils heals very well. Th is paper aims to focus some specifi c surgical issues relating to cleft -lip rhinoplasty.

Ibrahim El Achkar

St. Elie Center, Lebanon

Title: Secondary rhinoplasty

Time : 11:45-12:05

Speaker
Biography:

Ibrahim Elachkar has completed his studies from Saint Joseph University of Beirut and from Paris University School of Medicine. He invented “EL ACHKAR Bone Injector” that is used in facial plastic surgery and published in the British Journal of Oral and Maxillofacial Surgery and The European Journal of Facial Surgery. He is a member of the French Society of Aesthetic Surgery, the French Society of ENT and head and neck surgery, The Lebanese Society of ENT and Head and Neck Surgery, The International Society of Lipolysistherapy, and The International ReCon Surgical.

Abstract:

Natural sculpturing of the nose during secondary rhinoplasty is the goal of every rhinoplastic surgeon. Th e aim of this study is to assess secondary rhinoplasty on patients by presenting the functional and aesthetic techniques, and evaluating the results of the surgical interventions. Between January 2000 and January 2014, 1242 secondary rhinoplasties were performed on 162 males and 1080 females with a mean age of 26 years old. Open and closed rhinoplasties were performed on 1170 and 72 patients respectively. Local and general anaesthesia were applied on 108 and 1134 surgeries respectively with or without submucosal reduction of septal deviation and inferior turbinectomy. Septal, auricular or costal cartilage and fat graft reconstruction were also performed. Th e reconstructive and aesthetic techniques were performed on 13 diff erent categories: 234 nasal tip deformities; 180 short or pig snout noses; 108 beak nose deformities; 126 nostril deformities; 198 saddle noses; 108 residuals cartilages or bone humps; 54 deviated noses; 36 pinched noses and fi brous prominent tips; 18 short, broad, oblique, showing columella; 36 fl at noses; 36 inverted V; 108 over projected nose; 1 bilateral internal cantus tearing. Th e functional results were evaluated using a questionnaire that addressed the degree of nasal obstruction for respiration, the degree of aesthetic satisfaction and the odorant quality of pre and post operational procedure. An independent observer evaluated the aesthetic results based on pictures taken before and more than 6 months aft er Rhinoplasty. Highly satisfactory outcomes were reported in the majority of the cases, along with olfactory and respiratory improvements.

Biography:

Abstract:

In rhinoplasty surgery, use of deep temporalis facia in different techniques for solving the problems of middle osseocartilaginous vault irregularity, radix depression, saddling of the nose. The used of temporalis fascia in rhinoplasty as a blanket over the osseocartilaginous framework is very effective technique in solving a lot of postoperative unsatisfaction reasons of the patients. Of these reasons are nasal irregularities, radix depression and saddle nose. Deep Temporalis fascia is a fascia that covers the temporal is muscle and measures 10 x 12 cm. In this study we used temporal is fascia with diced cartilage, or gort-ex prosthesis. Gort-ex is one of the alloplastic materials named polytetrafluoroethylene, which is widely used recently. The cartilages were taken either from autologous rip or concha. Several other cases have temporal is fascia without any of the mentioned method depending on the patient nasal condition. This paper represents our experience with temporalis facial graft in primary and revision septorhinoplasty either with close or open techniques.
Study design and Methods: A retrospective review was done on 69 patients (51 male and 19 female) and the age range from (19-60) years, cases varied between 31 patients underwent septorhinoplasty with temporal is facia and 38 patients without temporal is facia The corresponding author perform all operations over a period of 3 years at the department of otorhinolaryngology, head and neck surgery at king Abdullah medical city, makkah almokarama Saudi Arabia.
Results: The nasofrontal angel improved in (10) cases ho underwent diced cartilage with temporal is facia (7) case, gortex with value = 0.008. -p 0,temporal is facia (3) cases, the angel decreased 6.6. No statistically significant differences in patients who underwent rhinoplasty with temporal is facia as a camouflage no. (21) Cases nor rhinoplasty without temporalis facia no. (38) Cases. Follow up (3) years we observe one patient only from (31) case complaint of nasal dorsal irregularity about 3.2% when we use temporalis facia , but 11 patient from 38 cases complaint of irregularity in the dorsum about 28.9% of all cases without temporalis facia . According to patient satisfaction score (1-5), Score 1 patient not satisfied but score 5 patients with Excellency in satisfaction. We divided the patients into 2 groups 31 cases with temporalis facia, the second group 38 without temporalis facia. From the aesthetic patient satisfaction view in the first group 1 patient not satisfied from 31, (3.2 %) but in the second group 6 patients not satisfied from 38 cases, (15.5%). From the functional view (breathing quality) score in the first group 31 patient satisfied from 31, (100%) but in the second group 38 patients satisfied from 38 (97.4%).
Conclusion: Excellent results were achieved using temporalis facia either as a blanket, with diced cartilage graft, with alloplastic graft (as a new innovation no one in the literature use this technique) or for radix augmentation ,so the nasofrontal angel was reduced , no dorsal nasal irregularity happened to most of our patients ,also most of our patients satisfied aesthetically and functionally.

Sanjay Parashar

Cocoona Day Surgery Centre
United Arab Emirates

Title: Structured analysis of nose to achieve natural results in rhinoplasty

Time : 12:05-12:25

Speaker
Biography:

Sanjay Parashar has completed his plastic surgery qualifi cation in 1995. He has acquired MCh degree and Dip National Board degree in Plastic surgery from India. He was awarded fellowship of Australian Craniofacial unit after undergoing training under Royal Australasian College of Surgeons program. He is Director of Plastic Surgery at Cocoona centre. He is a faculty for teaching and training in International Society of Plastic Surgery, Emirates Plastic Surgery Society, Indian Association of Plastic surgeons, ICAAM etc. He has published papers in PRS, Annals of Plastic Surgery, Australasian Journal of Surgery, Craniofacial Journal etc.

Abstract:

Rhinoplasty is one of the most demanding surgeries in both men and women. Th ere are various kinds such as augmentation rhinoplasty, reduction rhinoplasty, septorhinoplasty, tip plasty etc. Majority of the patients are seeking aesthetic improvement for their nose and many are looking for perfection. Th e incidence of dissatisfaction rate is very high in both men and women. There is a very thin line between aesthetically acceptable noses to aesthetically unpleasant nose. Patients have varied expectations some to the point of being unrealistic. It is surgeons’ responsibility to perform a thorough assessment physically and psychologically. A structured system of facial analysis helps to identify abnormalities in the nose that may or may not be correctable. In this presentation the author will present a system of analysis of the nose and emphasize on rhinoplasty techniques to avoid unnatural results and achieve a more harmonious outcome.

Waed Jame

Umm AL-Qura University
Kingdom of Saudi Arabia

Title: Outcome of different types of osteotomies in primary and revision rhinoplasty

Time : 12:25-12:45

Speaker
Biography:

Abstract:

Objective: Rhinoplasty enhances facial harmony and the proportions of the nose. Th e ultimate goal of our research is to see the variation between two techniques of lateral osteotomies: low-to-low and low-to-high to weight out the advantages and disadvantages together with the patient fulfi llment.
Methods: It’s a retrospective cohort study containing 104 patients, all above 18 year old that had undergone rhinoplasty surgery with two diff erent technique of lateral osteotomy. 70 patients where low-to-low along with 34 patients were low-to-high. All 104 patients had some sort of nasal deformity. Our research compared the ventral width, patient satisfaction in breathing as well as aesthetic pre and post-operatively.
Results: As the statistical analysis showed the aesthetic calculations showed a signifi cant variation in the results either from the patient satisfaction or the ventral width measurement with a P<.0001. 95.7% of the low-to-low group reached an ideal ventral width according to the Arabic nose values in contrast to the low-to-high group showed only 52.9%. Unlike the breathing result were unremarkable postoperatively P<.78.
Conclusion: Th e aesthetic view of low-to-low group results showed a statistical signifi cant diff erence almost reached the ideal measurements P<.0001. In the other hand Patient satisfaction in breathing and Quality of life improved in both groups equally.

Break: Lunch Break 12:45-13:25 @ Al-Dana Restaurant

Sudipta Chandra

Belle Vue Clinic & Hospital
India

Title: Z-palatopharyngoplasty: The Indian scenario

Time : 13:25-13:45

Speaker
Biography:

Sudipta Chandra has completed his Master of Surgery (ENT) at the age of 30 years from Allahabad University and Post-doctoral studies from Motilal Nehru Medical College. He is a Consultant in the Department of Oto-rhino-laryngology and Head Neck Surgery at Belle Vue Clinic & Hospital. He has published more than 10 papers in reputed journals, serving as a peer reviewer in more than 3 international journals and also serving as an Editorial Board Member of International Journal of Dental & Medical Research.

Abstract:

Objectives: To identify the complications of Z-palatopharyngoplasty in India and to fi nd out its effectiveness in the obstructive sleep apnea/hypopnea syndrome (OSAHS) cases.
Study Design: A prospective study.
Setting: Tertiary private medical centre.
Methods: Twenty fi ve cases with moderate to severe OSAHS cases having concentric velar collapse, failed/ rejected continuous positive airway pressure therapy, and then underwent coblator Z-palatoplasty as a part of single or multilevel procedures done for OSAHS. The subjective symptoms and objective polysomnography parameters were collected preoperatively and at a minimum of 6 weeks postoperatively. Statistical analyses of the results were done.
Results: All the candidates completed the study. None had any serious complications except a phantom uvula syndrome in 8 cases (32%). The success rate was 96% (24/25). 6 weeks post-operatively, the Epworth Sleepiness Scale decreased, the mean apnoea/hypopnoea index decreased, the lowest oxygen saturation improved and the visual analog scale decreased. Conclusion: This study shows signifi cant benefi ts of Z-palatopharyngoplasty in properly selected cases of moderate to severe OSAHS.

Mashudu Tshifularo

University of Pretoria
South Africa

Title: Surgical outcome in myringoplasty: What is a true success?

Time : 13:45-14:05

Speaker
Biography:

Mashudu Tshifularo is among the best ENT specialists in the country well recognized by his peers as such. The fi rst and only Black HOD and Professor in ENT in South Africa who has trained many South African Black local specialists ENT in a period of ten years. He gave the fi rst Black specialist and fi rst Black female specialist in the University of Pretoria since its inception and the fi rst Black female specialist in South Africa (Medunsa). He is the fi rst doctor to have a patented medical device (middle ear and stapes prosthesis registered with patent offi ce) among all ENT specialists in South Africa. Has published more than 30 articles and is currently busy with his PhD studies with the University of Pretoria.

Abstract:

Objectives: To evaluate the role of diff erent prognostic factors (wet, dry, size, aetiology, smoking and status of opposite ear) on the success of tympanic membrane take-up and to determine the success based on satisfaction score rate between the patient and the surgeon. To determine and defi ne what is true success in myringoplasty in patients operated at Polokwane Mediclinic Hospital from 2003 to 2010.
Study Design: Prospective, Case Control /Cohort study (at an academic tertiary hospital).
Methods: Consecutive patients undergoing myringoplasty were invited and an interview with all patients at six months postoperation follow-up looking for state of the graft and patient satisfaction scores were recorded. 105 patients are included, ages 8 to 62 years old, who underwent myringoplasty by the same surgeon in otorhinolaryngology clinic in Polokwane Hospital from 2003 to 2010, totaling 108 procedures. Th e defi nition of success was based on the indication for the operation agreed upon by patient and the doctor; intact tympanic membrane, resolution of indication and satisfactory score of patient and doctor. Th e fi nal evaluation was done aft er six months fallow-up postop period. Th e roles of other prognostic factors according to literature were evaluated.
Results: 105 patients with total of 108 procedures were evaluated. Signifi cant variables (p<0.05) includes patient age, gender, perforation size, site, aetiology, status of middle ear wet or dry and satisfaction score. Th e outcome of myringoplasty graft status (take-up) at six months postoperation follow-up. Th e satisfaction score of success rate perception on operation based on indication between patients and surgeon were recorded. A defi nition of success according to patients and doctors was formulated.
Conclusions: Finally the success of myringoplasty depends on number of factors; however it is still a common operation with good outcome depend on smoking, material, cormobidities (DM,HIV), etiology, site and size of the perforation are statistical signifi cant prognostic success outcome factors. Th e defi nition of success depends on how you defi ne success in your own hands/doctor or patients satisfaction score according to the indication of the operation. Th ere is statistical correlation between the doctor and patients satisfaction score. Th erefore when the doctor is satisfied, the patient is usually satisfi ed too.

Speaker
Biography:

Md Mazharul Shaheen has completed his degree from Dhaka Medical College under University of Dhaka and achieved FCPS (ENT) from Bangladesh College of Physicians and Surgeons in 2002, He did his MS (ENT) from University of Dhaka in 2011 and Masters in Medical Education (MMEd) from Bangabandhu Sheikh Mujib Medical University in 2013. He served as Registrar, Resident Surgeon, and Assistant Professor in different medical colleges of Bangladesh and has teaching experience in ENT for more than 15 years and published more than 20 papers in reputed national and international journals. He is now serving as an editorial board member/reviewer of reputed ENT journals of home and abroad.

Abstract:

Background: Chronic Suppurative Otitis Media (CSOM) is a common community health disorder of childhood in many developing countries including Bangladesh. In children, it may cause signifi cant delays in speech, cognitive, educational and psychological development.
Objectives: To compare prevalence of CSOM between rural and urban primary school children and to see their relationship with certain socio-demographic factors.
Methodology: 681 rural primary school children of Shibpur upazilla of Narsingdi district, Bangladesh and 964 urban primary school children of Dhaka Metropolitan City, Bangladesh had underwent ENT check up by the doctors trained in ENT and their guardians were interviewed regarding their socioeconomic status and other related issues using a pre tested protocol.
Results: Among study population, 6.02% of the rural and 2.07% of the urban primary school children had CSOM. Overall, 3.71% of the population had CSOM. CSOM was found slightly more among girls than boys in both rural (6.05% vs 5.98%) and urban (2.33% vs 1.82%) children. Th ere were signifi cant association of parent/guardian’s occupation, yearly income, housing, total family members, maternal education, and bathing habit with the children having CSOM of the rural and urban community. Th ough, sanitation is an important risk factor of CSOM but there was no signifi cant association of sanitation with the children having CSOM of the rural and urban community.
Conclusion: Primary ear care education to students, teachers can prevent vulnerable children from developing hearing impairment and its resultant complications. Th us, our future citizens would be safeguarded from preventable burning problem of CSOM.

Speaker
Biography:

Che-Ming Wu is a Clinical Associate Professor and Head of Otology of Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital. He is the Executive Councilor and the Chairman of Hearing and Language Training Committee of Taiwan Otolaryngology-Head and Neck Surgery Society. Having been in the fi eld of otology for over 20 years, he has operated on over 5000 patients with middle ear and inner ear diseases and performed more than 300 cochlear implant surgery in Taiwan. For nearly 10 years, he has dedicated his time in the long term follow-up of the outcome of his cochlear implanted patients.

Abstract:

Objectives: (1) To review the radiological and audiological data of 656 children with sensorineural hearing impairment who underwent three-dimensional magnetic resonance imaging (MRI) in our cochlear implant (CI) center to understand the incidence of cochlear nerve defi ciency (CND); (2) to compare post-implant auditory and speech intelligibility outcomes in implantees with cochlear nerve (CN) aplasia, CN hypoplasia and normal CN.
Study Design: A retrospective cohort study.
Setting: A tertiary medical center.
Patients: 656 patients (aged 0-18 years, mean=4.5±4.3 years) who underwent MRI in our center during May 2000 to December 2012. Main outcome measures: Th e radiological/audiological data were reviewed. Th e post-implant outcomes of 13 implantees with CND (7 aplasia, 6 hypoplasia) were compared with 50 non-CND implantees using the Categories of Auditory Performance (CAP) and the Speech Intelligibility Rating (SIR) scales. Results: Upon MRI, 139 patients (21.2%) exhibited CND. Bilateral CN aplasia occurred in 4.3% of the patients with severeto- profound deafness (588 cases) and in one fi ft h of patients with CND. Th e aplasia group showed signifi cantly worse postimplant CAP (p=0.002) and SIR (p=0.009) scores than the non-CND group. No signifi cant diff erence was noted between the hypoplasia group and the non-CND group.
Conclusions: Although the audiological and radiological results may be incompatible, the majority of patients with CND may be well-delineated preoperatively using MRI. Th e type of CND (aplasia/hypoplasia) may aff ect CI outcomes. Patients implanted on the side with CN hypoplasia are more likely to exhibit favorable results compared to patients implanted on the side with CN aplasia.

Biography:

Mohammed Iqbal Syed completed his MBBS and a Master’s degree in Otolaryngology from the Pune University in India. He completed his specialist training (DLO and FRCS) from the United Kingdom and was awarded a travelling fellowship to the University Hospital in Zurich and the TWJ clinical fellowship in Otology/Skull base surgery at the University of Toronto. He has published over 25 peer reviewed papers and presently is a Consultant in Otology and Skull base surgery at the Royal Infi rmary/Western Infi rmary in Edinburgh.

Abstract:

Background: Meniere’s syndrome or disease (MS/D) is typically characterized by episodic vertigo, aural fullness, tinnitus and fl uctuating hearing loss. Th ere are multiple options available for treatment with variation in consensus on the best intervention.
Objective: To evaluate the evidence on the effi cacy of intratympanic therapies [steroids, gentamicin, antiviral therapy and other therapies] on the frequency and severity of vertigo and other symptoms of MS/D Search strategy: A literature search was performed on amed, embase, hmic, medline, psycinfo, bni, cinahl, health business elite, central and Cochrane Ear, Nose and Throat disorders group trials register using various MeSH. Th e search was restricted to English and human subjects and the last date of search was Dec 2014
Selection Criteria: Randomized controlled trials of intratympanic therapies [steroids, gentamicin and antiviral agents, latanoprost] versus a placebo or another treatment.
Results: 8 RCT’s were analyzed comparing intratympanic steroids, gentamicin, Ganciclovir (antiviral) and latanoprost versus another form of intratympanic treatment or placebo.
Conclusions: On the basis of 6 RCT’s (n=242) there is evidence to support the eff ectiveness of intratympanic steroids and gentamicin to control symptoms of vertigo in MS/D albeit with a risk of hearing loss in gentamicin. However, there was no consensus found on doses or treatment protocols. Th ere was no evidence for the use of other forms of intratympanic therapy (antivirals and latanoprost) in MS/D

Ahmad Al-Amadi

Al Baraha Hospital Ministry of Health
United Arab Emirates

Title: Small fenestral stapedotomy - Step re-ordering

Time : 15:05-15:25

Speaker
Biography:

Ahmad Mohd. Alamadi graduated from Glasgow Medical School in United Kingdom in 1993 and completed his training in Scotland by obtaining his Fellowship of royal college of surgeons of Glasgow in 1998. He followed his higher surgical training by doing a clinical neurotology fellowship program in Toronto University in Canada. He is currently a consultant Otologist and Neurotologist and Medical Director at Al Baraha Hospital in Dubai. He is also a Clinical Associate Professor at Sharjah University. His expertise lies in Otological surgeries and management of dizzy patients.

Abstract:

Objective: To demonstrate a small fenestra stapedotomy technique modifi ed from laser stapedotomy technique.
Background: Small fenestra stapedotomies are well established and were proven to give better hearing result and had fewer complications compared to the total removal of the stapes footplate. This technique can be further modifi ed to reduce the possibilities of complications such as floating foot plate and incus dislocation. In this presentation we demonstrate a flexible technique modifi ed according to the footplate exposure and accessibility. Th is technique is safe and effective with minimal vestibular upset.

Speaker
Biography:

Jasenka Broz Frajtag is a Professor of speech pathologist in University Clinical Hospital Centre, Zagreb, Department of Otorhinolaryngology Center for Audiology and Vestibulology in Croatia. Currently she is studying in Medical school Public Health. Work rehabilitation with children and adults who have hearing problems, wear hearing aid/s or cochlear implants and also having problems in speech and language. She has many publications and has delivered talks in international conferences.

Abstract:

Introduction: Otitis media with eff usion is accompanied with conductive hearing loss. Th e aim of the study is to fi nd out the eff ect of long term or recurrent conductive hearing loss on speech discrimination.
Method: Tonal audiometry tympanometry, speech audiometry (free sound fi eld, head phone for left and right ear respectively) were performed on 18 girls (mean age 8y) and 27 boys (mean age 7 year). All the children underwent speech /language screening tests.
Results: Results of speech recognition showed no ear side eff ect in girls and right ear advantage in boys. Girls showed earlier in age central auditory processing disorder. Boys showed lower scores in words discrimination while hearing through the headphones in left ear. Poorer speech recognition in boys is accompanied with motorical immaturity, undeveloped articulation, poor vocabulary, lack of syntax in sentences, substitution of “R”and “L” and unable to focus on school tusk.
Conclusion: Children with conductive hearing loss associated to otitis media with eff usion are pronounced auditory processing disorder and speech/language

Break: Coffee Break 15:45-16:00 @ Al Dhiyafah Pre Function Hall
Speaker
Biography:

Adebola Stephen Oluwatosin completed his residency training in Otolaryngology, Head and Neck surgery at the University of Ilorin Teaching Hospital, Ilorin, Nigeria in October, 2011 with fellowships of both West African College of Surgeons (FWACS-ORL) and National Post-Graduate Medical College of Nigeria (NPMCN) in Otorhinolaryngology. He was Editor of the Nigeria Medical Association (Kwara State chapter), 2008 – 2010 and has published more than 16 papers in reputable peer-reviewed journals, some of which he also serves as a reviewer. Presently he is the Head, Department of Otorhinolaryngology, Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, Ogbomoso, Nigeria. His research interests are in, allergy, head and neck infections, trauma and hearing loss research.

Abstract:

Objectives: The study intends to report the profi les of anaerobic bacteria isolated and attempts to evaluate the impact of immune-compromised status of patients on the disease.
Study Design: A cross-sectional prospective study.
Setting: ENT clinic, University of Ilorin Teaching Hospital, Nigeria; a 450-bed tertiary health facility.
Subjects: 104 consecutive consenting participants with clinical evidence of CSOM≥12 weeks.
Methods: A hospital-based study conducted over a seven (7) month period. Th e middle ear aspirate was obtained with the aid of a micropipette and sent immediately for Microscopy, Culture and Sensitivity of both anaerobic and aerobic bacterial isolates.
Results: A total of 11 patients with chronically discharging ears, of the 104 studied had anaerobic bacteria cultured from their middle ear aspirates. Age ranged from 4 to 50 years with a Male:Female ratio of 1:1.8. A total of 32 isolates (11 anaerobic and 21 aerobic) were recovered. All anaerobic organisms were mixed and included both Peptostreptococcus and Bacteroides. Metronidazole had 100% sensitivity to gram negative and 62.5% to gram positive anaerobic organisms tested. 5 patients had immune-compromised states of 11 patients with anaerobic bacteria isolated in middle ear aspirates (group A), while 13 immuno-compromised patients of the remaining 93 patients with no anaerobic bacteria isolated (group B). Proportion in group A was higher (p<0.05) than in group B.
Conclusion: Immuno-compromised state and age appear to play a key role in presence of the anaerobic organisms recovered from the middle ear of the patients studied.

Biography:

Areej Awad Alzaidi is a senior medical student at UMM Al-Qura University and faculty of Medicine. At the age of 24 years he is a member of research Center at King Abdullah Medical City and co-author of 6 articles in Current Contents. He has presented papers International and local conferences and is interested in medical education and research.

Abstract:

In rhinoplasty surgery, deep temporalis facia are used in diff erent techniques for solving the problems of middle osseocartilaginous vault irregularity, radix depression, saddling of the nose. Th e use of temporalis fascia in rhinoplasty as a blanket over the osseocartilaginous framework is very eff ective technique in solving a lot of postoperative unsatisfaction reasons of the patients. Some of these reasons are nasal irregularities, radix depression and saddle nose. Deep Temporalis fascia is a fascia that covers the temporalis muscle and measures 10x12 cm. In this study we used temporalis fascia with diced cartilage, or gort-ex prosthesis. Gort-ex is one of the alloplastic materials named polytetrafl uoroethylene, which is widely used. Th e cartilages were taken either from autologous rip or concha. Several other cases have temporalis fascia without any of the mentioned method depending on the patient nasal condition. Th is paper represents our experience with temporalis facial graft in primary and revision septorhinoplasty either with close or open techniques. Study design & Methods: A retrospective review was done on 69 patients (51 male and 19 female) and the age range from (19- 60) years, cases varied between 31 patients underwent septorhinoplasty with temporal is facia and 38 patients without temporal is facial. Th e corresponding author performed all operations over a period of 3 years at the Department of Otorhinolaryngology, Head and Neck Surgery at King Abdullah Medical City, Makkah Almokarama Saudi Arabia. Results: Th e nasofrontal angel improved in (10) cases who underwent diced cartilage with temporal facia (7) case, gortex with temporal facia (3) cases, the angel decreased 6.60, p- value=0.008. No statistically signifi cant diff erences were seen in patients who underwent rhinoplasty with temporal is facia as a camoufl age no. (21) Cases nor rhinoplasty without temporalis facia no. (38) Cases. Follow up (3) years we observe one patient only from (31) case complaint of nasal dorsal irregularity about 3.2% when we use temporalis facia , but 11 patient from 38 cases complaint of irregularity in the dorsum about 28.9% of all cases without temporalis facial. According to patient satisfaction score (1-5), Score 1 patient not satisfi ed but score 5 patients with Excellency in satisfaction. We divided the patients into 2 groups 31 cases with temporalis facia, the second group 38 without temporalis facia. From the aesthetic patient satisfaction view in the fi rst group 1 patient not satisfi ed from 31, (3.2 %) but in the second group 6 patients not satisfi ed from 38 cases, (15.5%). From the functional view (breathing quality) score in the fi rst group 31 patient satisfi ed from 31, (100%) but in the second group 38 patients satisfi ed from 38 (97.4%). Conclusion: Excellent results were achieved using temporalis facia either as a blanket, with diced cartilage graft , with alloplastic graft (as a new innovation no one in the literature use this technique) or for radix augmentation, so the nasofrontal angel was reduced, no dorsal nasal irregularity happened to most of our patients, also most of our patients satisfi ed aesthetically and functionally.

Mohan Kameswaran

Madras ENT Research Foundation
India

Title: Pediatric auditory brainstem implantation

Time : 16:40-17:00

Speaker
Biography:

Mohan Kameswaran is the Managing Director & Senior ENT Consultant of Madras ENT Research Foundation and Adjunct Professor at the Tamil Nadu Dr. M.G.R.Medical University, Chennai. He is one of the pioneers of Cochlear Implant Surgery in India and was responsible for starting Cochlear Implant surgery in many cities in India, Sri Lanka, Bangladesh, Nigeria & Nepal. He is the First Surgeon in South and South East Asia to have performed the Auditory Brainstem Implant. He is the Founder President of Cochlear Implant Group of India. He has been a recipient of the ‘Padma Shri’ National Award by the Government of India in 2006.

Abstract:

Auditory brainstem implants help bypass damaged/absent cochlear nerves and stimulate the cochlear nucleus in the brainstem directly restoring auditory sensation. Auditory brain stem implants (ABI) have been used in neurofi bromatosis type II (NF 2) patients with bilateral vestibular schwannomas over the past decade. Th e primary aim of ABI in patients with NF 2 is the recovery of hearing aft er reducing or extirpating the tumor. Th e indications for ABI have expanded onto pediatric population (non-tumoral cases) with congenital bilateral cochlear nerve aplasia / hypoplasia. In such cases, the ABI helps stimulate the cochlear nucleus directly thereby restoring auditory sensation. Th is surgery requires a team eff ort involving the neuro-otologist, neuro-surgeon, neuro-anesthetist and the implant audiologist. In this presentation, the author will describe his experience with ABI in the pediatric population.

Maryam AlQaydi

King Abdulaziz Medical City, Kingdom of Saudi Arabia

Title: Our experience with OminGuide co2 laser in Choanal atresia repair

Time : 17:00-17:20

Biography:

Abstract:

Introduction: Choanal atresia (CA) is the developmental failure of the nasal cavity to communicate with nasopharynx. The definitive treatment is surgical, and different surgical techniques and approaches are used. We describe our experience in treating CA using new entity, Omni guide co2 laser.
Material and methods: We retrospectively evaluated 7 patients with CA operated in our Institute in King Abdulaziz Medical City in Riyadh from 2012 to 2014.
Results:. Bilateral presentation was 4 cases and unilateral was 3 cases . OmniGuide co2 laser used in two cases (1 case 3 times). Revision from 1 month to 1 year after first operation with OmniGuide co2 laser . Revision rate with OmniGuide co2 laser 100% . All revsion cases (5 cases) balloon dilation was used, if restonsosis memembrane (granulation tissue) but if restenosis fibers tissue the microdebrider was used.
Conclusion: using Omni Guide co2 laser does not decrease the rate of revision & it is expensive device.