Other ENT Topics

Use of tragal cartilage grafts in rhinoplasty: An anatomic study and review of the literature

April 27, 2015     Amr N. Rabie, MD; Jerry Chang, MD; Ahmed M.S. Ibrahim, MD; Bernard T. Lee, MD; Samuel J. Lin, MD
article

Abstract

We conducted a cadaveric study to determine the size of cartilage grafts that can be taken from the tragus without distorting tragal anatomy. Our subjects included 7 fresh cadavers-3 male and 4 female (age at death: 61 to 87 yr). Tragal cartilage grafts were harvested while leaving the lateral 3 mm of the tragal cartilage in situ to preserve the anatomic shape of the tragus. The grafts were measured and their dimensions recorded. The craniocaudal dimensions of the tragal cartilages ranged from 15 to 30 mm (mean: 21.6), and the width of each specimen ranged from 10 to 23 mm (mean: 15.3). The thickness of the cartilage was approximately 1 mm. The grafts were slightly curved along their long axis. We also review the literature regarding the dimensions of different grafts used in rhinoplasty, knowledge of which can help in preoperative planning. Tragal cartilage grafts have been used as shield, alar contour, alar batten, lateral crural onlay, dorsal onlay, and infratip lobule grafts. When a straight and/or thick graft is needed, two strips of tragal cartilage can be sutured in a mirror-image configuration.

Unexpected cholesteatoma in a very young child with a congenital aural duplication anomaly

April 27, 2015     Moo Kyun Park, MD
article

Cholesteatoma can develop in very young children with congenital aural stenosis and a duplication anomaly, and physicians should consider this condition in affected children with otalgia and otorrhea.

Distortion-product otoacoustic emissions testing in neonates treated with an aminoglycoside in a neonatal intensive care unit

April 27, 2015     Iosif Vital, MD; George Psillas, MD; Nikolaos Nikolaides, MD; George Kekes, MD; Stavros Hatzopoulos, MD; John Constantinidis, MD
article

Abstract

We evaluated the ototoxic effect of aminoglycosides on the outer hair cells of newborns in a neonatal intensive care unit (NICU) by means of distortion-product otoacoustic emissions (DPOAE) testing. Our study population was made up of 164 newborns who were divided into three groups: group A consisted of 105 infants who were given aminoglycoside therapy (either gentamicin or amikacin, or a combination of the two) as treatment for suspected or proven bacterial infection and septic states; group B included 30 newborns who were not given an antibiotic or who were given an antibiotic other than an aminoglycoside; group C, a control group, was made up of 29 healthy neonates who were hospitalized in the well-baby nursery. All the neonates underwent DPOAE testing in both ears (the f2 primary tone was presented at 2.0, 2.5, 3.2, and 4.0 kHz). We found that 41 patients in group A (39.0%) and 13 in group B (43.3%) failed the DPOAE test in one or both ears; the difference between these two groups was not statistically significant (p = 0.673). In group C, the DPOAE fail rate was 13.8% (4 newborns). In group A, there was no statistically significant association between the pass/fail rate and the specific aminoglycoside that was administered, or in the duration of antibiotic treatment, the number of doses, and the size of the mean daily dose and the mean total dose. In clinical practice, DPOAE testing is a sensitive method of evaluating the integrity of the outer hair cells in the basal turn of the cochlea after exposure to ototoxic drugs such as aminoglycosides. However, our study did not demonstrate that the aminoglycosides had any ototoxic effect on the hearing of neonates in the NICU.

The paramedian forehead flap for nasal lining reconstruction

March 2, 2015     Joshua D. Rosenberg, MD; Nikita Gupta, MD
article

The importance of reconstructing nasal lining defects cannot be overstated, especially for composite defects also involving the framework and skin soft-tissue envelope.

Cherubism

January 19, 2015     Lester D.R. Thompson, MD
article

When there is significant infraorbital maxillary involvement, the inferior rim of the sclera is more prominent, resulting in the classic “eyes to heaven” appearance.

Unusual presentation of a midline neck mass

January 19, 2015     Yann-Fuu Kou, MD; Gopi Shah, MD, MPH; Ronald Mitchell, MD; Larry L. Myers, MD
article

Venous malformations are usually visible at birth, although deeper lesions may have normal overlying skin or a bluish discoloration. They grow proportionately with the child and can expand in adulthood.

Lingual hamartoma associated with a cleft palate in a newborn

October 17, 2014     Opeyemi O. Daramola, MD; Mariko Suchi, MD, PhD; Robert H. Chun, MD
article

Abstract

A hamartoma is a benign malformation of native tissue that may occur in any area of the body. Hamartoma of the tongue is a rare developmental lesion. We describe the case of a pendulant lingual hamartoma in a 2-day-old girl that had not been identified on prenatal ultrasonography. We also review the utility of prenatal imaging options, the role of preoperative imaging, the mechanical relationship between lingual hamartoma and cleft palate, the histopathology of this tumor, surgical treatment, and emergency airway management.

Congenital airway anomaly of double aortic arch in a 2-day-old infant

October 17, 2014     Seo Moon, MD; Jessica Mayor, MD; Ramzi Younis, MD
article

Double aortic vascular ring is a complete vascular ring that is formed when the distal portion of the right dorsal aorta fails to regress and the ascending aorta bifurcates to surround and compress both trachea and esophagus and rejoins to form the descending aorta.

Role of the otolaryngologist in the management of asthma

September 17, 2014     Mahmoud Ghaderi, DO, FAOCO
article

[Editor's note: This Guest Editorial has been adapted with permission from its publication in the Fall 2012 issue of Soundings, the Pennsylvania Academy of Otolaryngology-Head and Neck Surgery's newsletter.]

Evidence-based update on tympanostomy tube placement for otitis media in children

July 13, 2014     Jeffrey Cheng, MD; Lisa Elden, MD
article

Controversy has grown over the indications, timing, and efficacy of tympanostomy tube placement compared with watchful waiting.

Pediatric rhabdomyosarcoma

July 13, 2014     Rosemary Ojo, MD; Si Chen, MD; Liset Pelaez, MD; Ramzi Younis, MD
article

All children with rhabdomyosarcoma require multimodality therapy to maximize local tumor control. This can involve different combinations of chemotherapy, surgery, and radiation therapy.

Survival characteristics of injected human cartilage slurry in a nude mouse model: A preliminary study

July 13, 2014     Bounmany Kyle Keojampa, MD; Jacob Pieter Noordzij, MD; Bohdana Burke, MD; Joseph Alroy, DVM; Vartan Mardirossian, MD; Alphi Elackttu, MD; Zhi Wang, MD
article

Abstract

We conducted a study to examine the viability, host response, and volume retention characteristics of drilled human septal cartilage slurry when injected into an athymic nude mouse model. We injected 0.2 ml of the slurry into the hind limbs of 6 mice. The mice were sequentially sacrificed over a period of 180 days. Histologic reviews of the hind limbs were performed to determine the viability of injected chondrocytes, host response, and volume retention. Specimens were obtained and histomorphologic analysis was performed at 1, 30, 90, and 180 days after injection. We identified viable cartilage throughout the study. Cartilage injection was well tolerated, and minimal inflammatory reaction occurred without significant adverse effects. The injected bolus of cartilage was found to have progressively dispersed throughout the muscle over time. Our findings warrant further investigation with a larger cohort of nude mice or possibly human subjects.

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