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To determine the effectiveness of augmentation surgery using polydimethylsiloxane elastomer injection for the management of patulous eustachian tube.
All patients were treated with eustachian tube injection augmentation performed via a combined transnasal-transoral endoscopic approach. Clinical presentation, volume of injection, complications and initial response were all prospectively recorded. Longer-term follow up was conducted through structured telephone interviews using previously described patient-reported outcome measures.
Overall, 8 of 11 patients (73 per cent) derived complete or significant symptom improvement; 1 patient had significant improvements but was dissatisfied, and in 2 patients the symptoms were unchanged. The eight satisfied patients showed improvement in their quality-of-life scores.
This study describes an effective treatment option for patulous eustachian tube. Unlike many prior published reports, previously described patient-reported outcome measures were utilised in order to allow more direct comparison.
Cochlear implant surgery is increasingly being performed through a small incision because of the benefits associated with this technique, such as fewer wound complications. Efforts have been made to maximise surgical exposure in order to improve this evolving technique; this includes the development and use of new retractors. For instance, elasticated stay hooks can retract skin in a radial fashion and they are less bulky than traditional retractors. These hooks are usually attached directly to surgical drapes or to a disposable retractor ring; there are disadvantages to both of these methods.
This paper describes a technique using a laryngeal suspension bar in which the bar acts as a fixed structure to which these elasticated stay hooks can be attached.
This technique was found to be safer, cheaper and more effective for obtaining optimal surgical exposure compared with a technique whereby the stay hooks are attached directly to the drapes or to a disposable retractor ring.
To measure the thermal properties of operative endoscopes used in otorhinolaryngological practice.
A series of endoscopes of varying diameters and angulations were attached to a light source and temperature measurements taken of their shaft and tip; a measurement was also taken 5 mm in front of the endoscope tip.
Temperature changes took place rapidly. The amount of heat produced by the endoscopes was maximal at the tip, with larger diameter endoscopes attaining a higher temperature. Temperatures on the shaft and in front of the tip reached relatively constant temperatures independent of the type of endoscope. The maximum temperature achieved was 104.6°C for the 4 mm, 0° endoscope. Cooling occurred rapidly after the light source was switched off.
The heat produced by some endoscopes is sufficiently great to cause thermal injury to tissues. Awareness of the temperatures produced by these endoscopes should prompt clinicians to actively cool their endoscopes during a procedure, before any thermal injury is caused.
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