Day 2 :
Biography:
Alessandro Bucci pursued his PhD (Rhinology and Rhino-Allergology) in 2006 at UCSC (Catholic University), Rome (Italy). He completed his Residency in Otolaryngology-Head and Neck Surgery at UCSC - Gemelli Hospital in Rome. His fellowship credentials include: Fellowship in Otolaryngology in Spain (University Hospital, Cadiz); Fellowship trained in Facial Plastic Surgery (AMC) and OSAS (Sint Lucas Andreas Hospital) in Amsterdam, The Netherlands; Facial Plastic Surgery (Calixto Garcia
University Hospital), Havana, Cuba. He is currently the Head of Sleep Apnea Center and Rhinology/Rhino-Allergology Center in the Otolaryngology Department of ASUR Marche AV2, Senigallia, Italy. He is an International Faculty Member of the XXXV Pan-American Congress of Otorhinolaryngology 2016, Cuba. He has been the past
Director of the 1st International Conference on Rhinology and Rhino-Allergology; 5th Bulgarian Italian Rhinology Meeting, 2016 Senigallia (Italy). His credentials include: University Professor at the Marche Polytechnic University, Ancona, Italy; International Faculty Member of the VI Bulgarian Italian Meeting of Rhinology, Medical School: Catholic University (UCSC) of Rome; He served as Reserve Medical Officer of the Italian Navy. His research focuses on Rhinology/Rhino Allergology, Sleep Apnea/OSAS. His main interest include: humanitarian and international outreach. He served as: Vice-President of the National Association of Tracheotomized patients- ONLUS ( nonprofit organization of social utility); Member of the ERS (European Rhinologic Society).
Abstract:
Obstructive sleep apnea (OSA) is characterized by intermittent, repeated upper airway narrowing or obstruction occurring during sleep. Most authors agree that rigorous patient selection is logical and mandatory. Successful surgical treatment of OSA is based on the accurate identification of the pattern of airway obstruction and targeted, effective treatment. Nevertheless, surgical results in OSA vary greatly, whatever the surgical technique or site treated. For many years, the primary surgical treatment for obstructive sleep apnea was soft palate surgery, and this worked well for patients with blockage of breathing in the palate region alone. Unfortunately, many patients also appear to have blockage of breathing in the tongue region, and multiple procedures have been developed to address this in the hope of improving surgical outcomes. DISE (Drug induced sleep endoscopy) was introduced almost two decades ago and used extensively since the 2000s. Nevertheless, there are still limited data about the real role of sleep endoscopy in obstructive sleep apnea syndrome. DISE offers a unique structure-based assessment of the airway, compared to other commonly-used evaluation techniques. It mimics sleep in order to observe the upper airway on flexible endoscopy. Because surgical procedures are ultimately directed at specific structures, DISE may improve procedure selection and outcomes. DISE involves a certain number of limitations: natural sleep is not precisely reproduced, the anesthesia protocol is not standardized, and there is no gold-standard validation. Classification is imperfect, indications remain to be standardized. Despite the lack of standardization in clinical examinations, the type of drugs used for sedation and the classification system used, the results obtained till date favor the inclusion of DISE in the investigation of obstruction sites in patients with OSA.
Keynote Forum
George J. Bitar
Bitar Cosmetic Surgery Institute, USA
Keynote: Ethnic Rhinoplasties: A 16 year experience
Biography:
George J. Bitar, MD, FACS is an award-winning, the medical director, fellowship-trained, board certified plastic surgeon and has performed over 5,000 cosmetic facial and body procedures. Dr. Bitar obtained his medical degree from the George Washington University School of Medicine in Washington, DC, where he now serves as an Assistant Clinical Professor. He then finished a general surgery residency at the Albert Einstein Medical Center in Philadelphia. His plastic surgery residency was completed at the University of Virginia Plastic Surgery Program, which provided him with a strong foundation in reconstructive surgery, for people injured in accidents or who have facial deformities or severe burns, and in hand surgery and microsurgery.
Abstract:
Introduction: Performing ethnic rhinoplasties successfully requires many skills. Technical expertise is must. A plastic surgeon should have the skill-set to perform a rhinoplasty and accept to perform such surgeries commensurate with his or her level of expertise, resulting in naturally looking results. Various ethnic rhinoplasties include Caucasian nose (European white), Hispanic nose, Middle Eastern nose (Arabic, Turkish, North African, and Persian Descent), Asian Nose (Chinese, Japanese, Filipino, Korean, and Indonesian) and African nose.
Methods: Non-surgical algorithm: Nonsurgical or filler rhinoplasty is becoming more popular due to safe and readily available fillers. Injectables are commonly done on all nose types with calcium based fillers for primary noses or when more volume needs to be achieved, and hyaluronic acid fillers for primary noses that need contour changes or secondary noses with concern for blood supply. Surgical algorithm: A nose should be thought of as a pyramid and should look good from all angles after a rhinoplasty is completed. My algorithm for rhinoplasty will be discussed.
Conclusion: Ethnic rhinoplasty is a precise and demanding operation due to many factors discussed in this talk. The upside is that
if all the considerations are addressed, then our patients will be very happy and have noses that match their identity and sense of
beauty.
Keynote Forum
Santosh Kumar Swain
Siksha O Anusandhan University, India
Keynote: Primary laryngeal tuberculosis: Experiences at a tertiary care teaching hospital of India
Time : 10:30-11:00
Biography:
Santosh Kumar Swain pursued MS in Otorhinolaryngology from VSS Institute of Medical Sciences and Research, India; completed Senior Residency from Christian Medical College, Vellore, India; passed Diplomate of National Board (DNB) in Otorhinolaryngology. He is the Head of the Department of Otolaryngology and Head-Neck
Surgery at the Institute of Medical Sciences and SUM Hospital, Siksha O Anusandhan University, India. He is a Member of National Academy of Medical Sciences, New Delhi. Currently, he is also working as a mentor for the Department of Science and Research Government of India on the research project: “Development of molecular kit to minimize the ciprofloxacin and amoxyclav resistance strains from chronic suppurative otitis media.” He has published more than 70 research articles in peer reviewed journals. In 2017, he was awarded Medical Talent of the Year at New Delhi, India.
Abstract:
Primary laryngeal tuberculosis is a chronic bacterial infection of the larynx by Mycobacterium tuberculosis without affecting the lungs. It is a rare type of extrapulmonary tuberculosis seen in clinical practice. This study aimed to evaluate the clinical presentation, diagnosis, and treatment of primary laryngeal tuberculosis at a tertiary care teaching hospital in eastern India. This is a retrospective study of 11 cases of primary laryngeal tuberculosis managed between December 2013 and January 2018. The detailed clinical presentations, investigations, and treatment of primary laryngeal tuberculosis of the patients were studied. Primary laryngeal tuberculosis is common in men with mean age of 38.63 years. Hoarseness of the voice is the most common symptom, and the most common site for primary laryngeal tuberculosis is the vocal fold with ulcerative lesion. Endoscopic examinations of the larynx in laryngeal tuberculosis are nonspecific and are to be confused with laryngeal cancer. Histopathological and bacteriological examinations are confirmatory tests for the diagnosis. After confirmation of the diagnosis, all patients had taken antitubercular therapy for 6 months, which gave excellent outcome. Delayed diagnosis or untreatable laryngeal tuberculosis will lead to high morbidity and mortality of the patient. Although primary laryngeal tuberculosis has nonspecific clinical presentations, it is very important to have a high index of suspiciousness to rule out tubercular lesion in the larynx as this disease is curable.
- Otology | Cleft-Lip and Palate Repair | Rhinology | Autogenous Bone Grafting for Orbital Floor Fracture | Hearing Impairment and Deafness Causes | Craniofacial Congenital Syndromes
Location: Bleroit 1
Chair
Alessandro Bucci
Hospital of Senigallia, Italy
Co-Chair
Santosh Kumar Swain
Siksha ‘O’ Anusandhan University, India
Session Introduction
Anas Ghonem Alhariri
SEHA Facility, UAE
Title: Laryngo-Pharyngeal Reflux Disease (LPRD) in pedia patients
Biography:
Anas Ghonem Alhariri is Consultant E.N.T - Head & Neck Surgeon. He is a European & Arab board certified. He completed his Masters in Damascuss University and postdoctoral studies from ALMuassat Damascuss University School of Medicine. He is Head Department of Madinet Zayes Hospital at Abu Dhabi. Presently he is working at Abu Dhabi-UAE- SEHA facility as ENT Consultant HAAD and MOH Licenced since 2015.
Abstract:
Evaluation: Numerous tests are available for evaluation of patient with laryngeal disease and presumed GERD, Categories
include:
1. Historic instruments and questionnaires,
2. Direct measurements of reflux and acidity,
3. Imaging,
4. Endoscopic and microscopic evaluation of the upper GI mucosa,
5. Direct visual inspection of the airway.
Clinical Manifestation:
Epidemology: Prevalence-According to a large community-based study of children in the United States, the prevalence of various symptoms suggestive of (GER) was 1.8 to 8.2 %. The prevalence of GERD in adults in the western world is approximately 10 to 20 %. Middle East reach 25%.Higher rates of GERD are seen among children with developmental and neuromuscular
disorders such as cerebral palsy and muscular dystrophy. Children with Down syndrome are also at increased risk for GERD and other oesophageal motor abnormalities. These groups of children also appear to be at increased risk for developing respiratory complications related to GERD and represent a significant proportion of children referred for ant reflux surgery.
Managementof LPR disease in children: Several treatment options are available for controlling symptoms and preventing complications, The choice among them depends upon:- the patient's age, the type and severity of symptoms, response to treatment.
Clinical Cases:
1. 3 y old, male Turkish patient has 8 months refractory cough with nausea and vomiting abnormal material ..
2. 7 y old , male Syrian patient has 6 months history of cough with nocturnal aspiration and sever snoring diagnosed as
refractory asthma.
Conclusion: The best initial evaluation for patient with chronic cough is a trial of PPI therapy, which must be maintained for
3 months, The most common cause of stridor in infants is laryngomalacia (LM).
Jumana Hussain
Al- Farwaniya Institute, Kuwait
Title: A case of large deep fibrolipoma in the left subclavicular region that compromised the branchial plexus and thoracic duct: A case report
Biography:
Jumana Hussain is presently working at Al- Farwaniya Institute, Kuwait. She has graduated in Otolaryngology
Abstract:
Introduction: This paper describes a case of a rarely occurring tumor of thesubclavicular region (i.e., fibrolipoma), which belongs to a group ofbenign tumors. It is more frequent in males than in females. In con-trast to our case, it comprises mostly of fibrous connective tissue,well separated from the surrounding tissues. However, in our case,it was deep and painful, and caused neurological symptoms. Thetreatment of fibrolipomas is only surgical. As only few cases havebeen reported in the literature, the present case is worth reportingto provide more information about this rare entity.
Case presentation: A 41-year-old Asian woman was brought to our ENT (ear nose-throat) clinic because of a slowly progressive swelling of the leftsubclavicular region since 10 years before, which became painfulwith time, associated with increasing subpectoral and shoulderpains, left arm swelling, and left forearm paresthesias. The patientcomplained of weak grip, and her
left hand was cold to touch, whichwas associated with the feeling of tremors in her left arm. Con-trast computed tomography (CT) and magnetic resonance imaging (MRI) T1- and T2-weighted sequences by fat-suppression tech-niques revealed a 125- × 72- × 46-mm thinly septated subpectoralhypodense mass extending from the neck to the anterior lefthemithorax. The ovoidal well capsulated the mass in the retroclav-icular and subclavicular regions, between the axillary artery and thevein, displaced the axillary-subclavian bundle anteriorly withoutextension into the neural foramina (Fig. 1). The lesion compressedthe brachial plexus and was consistent with either a lipoma orliposarcoma. Ultrasonography-guided fine-needle aspiration cytol-ogy was
requested and revealed a fibrolipoma. Considering thelocation of the fibrolipoma and the age of the patient, surgicalexcision via the anterior neck approach was planned and dis-cussed with the patient. After obtaining informed consent from thepatient, surgery (i.e., excision of the fibrolipoma) was performedusing the anterior neck approach, and the mass was completelyremoved (Figs. 1 and 2). The patient was discharged on the sec-ond postoperative day and his general condition was good and hewas symptom-free at 1-month follow-up (Fig. 2). A specimen wassubmitted for histopathological examination and was reported todemonstrate features consistent with fibrolipoma (Figs. 3 and 4).
Discussion and review of literature: Large fibrolipomas/lipomas of the subclavicular/thoracic outletregion are usually represented by an enlarging neck or supraclav-icular mass that is typically associated with upper shoulder or armpain. The actual incidence of thoracic outlet syndrome (TOS) due to fibrolipoma in the general population is not known because ofthe absence of widely recognized signs or cost-effective laboratorytests. Owing to the lack of sufficient diffusion of the syndrome in the medical literature, it is also a poorly defined medical entity. Theactual incidence seems generally low, even though in more recentstudies, the incidence appears to be higher. This disease is an often-misdiagnosed cause of chest, neck, and shoulder pains and one ofthe frequent upper extremity neuropathies.The exact etiology of fibrolipomas remains disputed, andendocrine, dysmetabolic, genetic, and traumatic factors have beenoften considered [1]. A fibrolipoma characteristically grows by simple expansion in a well-encapsulated fashion without the tissueinfiltration that is more characteristic of liposarcomas [9]. Despitetheir benign nature, fibrolipomas may be a challenge to the sur-geon owing to their anatomical setting. The most popular surgicalapproach for TOS is transaxillary first-rib resection [2], where atransverse incision is made over the third rib just inferior to the axil-lary hairline and deepened between the pectoralis major and thelatissimus dorsi muscle [3]. The scalene muscle attachments to thefirst rib are released, and the rib is excised extraperiosteally fromthe chondrosternal articulation to the costotransverse articulation[4]. The rationale for this approach is that the first-rib resectionpermits the widening of both the interscalenic triangle and cos-toclavicular space [5,6]. Other procedures include supraclavicularincision, like in our case, or the posterior subscapular approach,which is reserved for more complicated TOS cases [8–12]. Oursurgical approach was suggested according to mass location andpatient age. Moreover, the benign pathological outcome supportedour strategy.
Conclusion: Benign soft tissue tumors such as infraclavicular subpectoralfibrolipomas may exert pressure on the neurovascular surround-ing structures during their progressive expansion and cause TOS.Therefore, a thorough preoperative study using a radiological imag-ing modality such as MRI or neurophysiological tests should alwaysbe performed to prevent unintentional lesions of the involvedaxillo-subclavicular plexus and plan a correct surgical procedure.Benign subpectoral infraclavicular masses should be consideredwhen evaluating a possible thoracic outlet syndrome in patientswith brachialgia, loss of strength, and Raynaud’s phenomenon. Athorough radiological assessment, preferably with MRI with thefat suppression technique, is mandatory to ascertain neurovascularcompression by large fibrolipomas/lipomas.
Li-Ang Lee
Linkou-Chang Gung Memorial Hospital, Taiwan
Title: IBVR: Image-Based Virtual Reality for innovative teaching and learning in ORL-HNS teaching clinicsx
Biography:
Li Ang Lee pursued his MD from Kaohsiung Medical University (Kaohsiung, Taiwan); Residence from Linkou-Chang Gung Memorial Hospital (Taoyuan, Taiwan) and MSc (Medical Eduction) from Graduate Institute of Clinical Medical Science, Chang Gung Univeristy (Taoyuan, Taiwan). He is the Director of Division of Laryngology, Department of ORL-HNS, Linkou-Chang Gung Memorial Hospital and an Associate Professor of Faculty of Medicine, Chang Gung University (Taoyuan, Taiwan). He has published more than 88 papers in reputed journals and has been serving as Member of Council of International College of Surgeons, Taiwan.
Abstract:
Recent advances in virtual reality (VR) simulation can reduce the complex of learning task and the cognitive load (CL) of the learner and make this novel technology well suited for the initial training of novices. Accordingly, we hypothesize that VRbased instruction can help novices to decrease CL and improve their outcomes of workplace-based assessments. We perfomed a randomized controlled trial to compare CL and learning outcomes between novel image-based VR (IBVR) learning and conventional video-based (VB) learning the ORL-HNS teaching clinics. We recruited 24 undergraduate medical students who were randomly assigned (1:1) to an IBVR group and VB group matched by age, sex, and cognitive style. There were 17 males and 7 females (median age 25 years) receiving the intended intervention. CL questionniare scores of the IBVR group were equal to those of the VB group (all P>.05). The VB partipants had a singicantly increased reaction time at the end of learning (P=.046) whereas the IBVR partipants had the equivalent reaction time in the learning period. Differences in Mini-CEX, global satisfaction, and learning experience between both the groups were not significant (all P>0.05). However, there were 3 IBVR participants who had motion sickness. In conclusion, both the IBVR and VB modules can help learning history taking and physical examination with equivalent CL and outcomes in the ORL-HNS teaching clinics. Although the IBVR module seems to keep the learners alert, it can potentially induce motion sickness. Our preliminary results indicated that we need a larger group to determine the effects of IBVR.
Biography:
Mostafa R Mohamed Khalifa is an Audio-vestibular medicine Consultant and Lecturer at Assiut University, Egypt. He has been practicing in the field of audio-vestibular medicine since 1999, combining academic, research, and clinical activities. He is teaching post-graduate students. In addition, has his clinic for assessing patients with hearing loss, tinnitus and vestibular diseases. He is conducting both diagnostic and rehabilitative maneuvers including acoustical and electrical sound amplification. He has been practicing his field in Egypt, Germany, and Saudi Arabia. His main research interests include: syndromic and non-syndromic genetic hearing loss in Egyptian population, with novel gene mutation discovery which was published in 2010.
Abstract:
Tinnitus is one of the most widespread disorders of the auditory system, affecting approximately 17% of the general population. In addition, it is one of the most difficult to treat symptoms in audiological practice. It is the perception of sound in the absence of an appropriate external Sound source. Reference to tinnitus as “ringing in the ears” dates back in UK to the “Compendium” of 1240. There is considerable evidence that expression of neural plasticity plays a central role in the development of the abnormalities that cause many forms of tinnitus. Tinnitus has similarities with the phantom limb syndrome and central neuropathic pain. These symptoms belong to a group of adverse and harmful effects that can occur when neural plasticity is turned on and they have been termed “plasticity disorders”. Expression of neural plasticity can change the balance between excitation and inhibition, promote hyperactivity, and cause re-organization of specific parts of the nervous system or redirection of information to parts of the nervous system not normally involved in processing of sounds (such as the nonclassical, or extralemniscal pathways). The strongest promoter of expression of neural plasticity is deprivation of input, which explains why tinnitus often occurs together with hearing loss or injury to the auditory nerve. The aim of this presentation is to discuss state of the art insights on neuroplasticity of tinnitus.
Sreesyla Basavaraj
St Mary’s Hospital, UK
Title: Current trends in pathophisology of Meneire’s disease & surgical management
Biography:
Sreeshyla Basavaraj has been a Consultant for the last 9 years. He is currently working at St Mary’s Hospital, Isle of Wight and Queen Alexandra Hospital, Portsmouth, UK respectively. His field of interest is mainly in Otology; has vast experience in management of Chronic Ear Disease (including revision surgeries, cavity reconstruction), surgical management of Meniere’s disease (saccus decompression) and management of vertigo patients. During his training, he gained experience in rare conditions affecting wound healing in implant patients (post-radiotherapy, psoriasis patients), involved in research (OSTRICH study) and invented new surgical technique for keratosis Obturans which was presented at IFOS Paris 2017 (France).
Abstract:
Meniere’s disease is a chronic debilitating condition which varies in its clinical presentation from patient to patient, hence it is categorized into typical and atypical Meniere’s disease. It is believed that in majority of cases the diagnosis is based on clinical history, as most of the investigation will only assist to support clinical diagnosis. It is also believed that the pathology is in the endolymphatic duct, where there is either excess production of endolymphatic fluid or there was blockage of drainage. There has been significant evidence published in recent times questioning the traditional hypothesis of pathophysiology in Meniere’s disease, which not only changes the way we manage this condition but given possibilities to accurately diagnose. I would like to present the published evidence with my surgical outcome for this condition which support new hypothesis.
Biography:
Serap Titiz has completed her Graduation at Hacettepe University, Faculty of Dentistry in 2002; Postgraduation at Ege University, Faculty of Dentistry Department of Orthodontics and PhD in 2012. She was appointed as an Assistant Professor in Orthodontics at Usak University, Faculty of Dentistry since 2017.
Abstract:
Statement of the Problem: Cleft lip and palate are congenital defects of the middle third of the face. In Grayson technique for nasal molding, intraoral plate insertion is mandatory for nasal correction. A nasal stent is added when the cleft width is decreased to 5 mm. We used modified nostril retainers instead of nasal stents for nasal molding which enables the separation of the nasal molding and intraoral plate insertion. The aim of this study was to describe a new approach to the traditional method of PNAM for unilateral cleft lip and palate (UCLP) patients.
Methodology & Theoretical Orientation: We used modified nostril retainers to treat 16 UCLP newborn patients with different cleft widths. The modified nostril retainer was manufactured from soft acrylic using a special mold without taking an impression of the nose. Patients with a cleft width of less than 6 mm (10 patients) were treated with modified nostril retainers
without oral palate and patients with a cleft width equal or more than 6 mm (6 patients) were treated with modified nostril retainers with an oral palate. The modified nostril retainers were applied at the first visit of the patient regardless of the amount of the cleft width. Weekly activation was performed by adding soft acrylic to the cleft side of the modified nostril retainer.
Findings: The symmetry of the nose of each patient had improved. In all patients cleft segments touched to each other.
Conclusion & Significance: Different from the nasal stents, the modified nostril retainers apply upward and forward forces to both sides of the columella that can accelerate the uprigthing of the columella. In the modified method, early start of nasal molding and the short duration of the treatment can prevent memory fixation of the cartilage and tissue.
Biography:
Debashis Acharya is presently working as Consultant ENT in PHCC (Primary Health Care Corporation) in Qatar since 2014. He is passionate about Otorhinolaryngology (ENT), completing 25 years in the field including his training period at Delhi, India. He is an ex-Indian Army Medical Corps officer (Lieutenant Colonel) and served as ENT Specialist in the forces for 12 years until 2008. He worked as a Medical Superintendent in a private medical college hospital at Gujarat, India after that for almost one year.
Abstract:
This work provides an overview of vertigo and its management. It is useful for students of vertigo and clinicians managing vertigo. It introduces clinicians to a systematic approach of assessing dizzy patients. Vertigo is a very difficult subject to master. The first and foremost cornerstone of managing a dizzy patient is a good history. This is followed by appropriate examination and investigations. The general practitioner is the first expert to be involved in the management of dizzy patient followed by specialists in particular otorhinolaryngologists, audiovestibular medicine specialists and neurologists and finally, allied healthcare personnel. The key concepts in assessing, diagnosing and managing common vestibular disorders are briefly described. Differential diagnosis of vertigo along with certain characteristic traits are mentioned. Etiology and pathophysiology of associated symptoms of dizziness are discussed. Importance of timing and triggering factors are highlighted. Discussion on balance and gait along with role of nystagmus in differentiating central from peripheral vertigo is done. Usage of certain specific drugs including special role of Betahistidine is mentioned. Vertigo from peripheral vestibular diseases normally improves within 2 to 3 months from a number of processes known as cerebral compensation. Here vestibular rehabilitation exercises play a very crucial part in management of a dizzy patient. Special vestibular investigations like ENG/VNG is computer based and runs a battery of tests which assess the occulomotor function of the affected patient. video head impulse test (VHIT) and vestibular evoked myogenic potentials (VEMP) are done for diagnosing vestibular neuritis. The role of traditional caloric testing and ECochG which is a variant of BSERA cannot be undermined in a dizzy patient. Newer methods to assess balance like dynamic posturography, rotatary chair are computer driven tests for analysing vision, proprioception and vestibular function. These are useful to detect malingering. Finally, summary and conclusions are drawn upon.
Ravjit Singh
Prince of Wales Hospital, Australia
Title: Role of neck dissection in patients with high-grade salivary carcinomas
Biography:
Ravjit Singh pursued his Degree in Medicine from the Univeristy of New South Wales (NSW), Australia (2013). He has been an acitve Memebr of the Prince of Wales ORL Head and Neck Research Group conducting research in the Head and Neck field. He is currently the Research Fellow at Prince of Wales Hospital, Sydney, NSW, Australia.
Abstract:
Aim: The aim of this study is to determine the role of neck dissection in patients with high-grade salivary carcinomas who have
received radiotherapy.
Methodology: An ethics approved retrospective case review conducted from January 1969 to December 2015 at a tertiary referral Head and Neck Cancer Center in Sydney, Australia. Patients were selected for those who had previously had a histology proven high-grade untreated salivary gland carcinoma; 47 patients were found meeting this criterion. Patients were assessed as to whether they received primary surgery with or without radiotherapy, and whether they had undergone a neck dissection. The mean follow-up period was 57 months (SD= 56.69 months).
Results: All patients underwent primary surgical resection; only 7 patients (28.7%) did not receive radiotherapy, with 37 (78.7%) patients undergoing neck dissection. The highest incidence at a primary site was found in the parotid gland (72.3%), with the predominant pathology being adenocarcinoma (42.6%). Patients who underwent surgery and radiotherapy and those who underwent surgery only showed no significance difference in rate of recurrence (P=0.7). In the neck dissection group 12 (66.7%) patients had recurrence, at either local or nodal site (P=0.058).
Conclusions: Patients who have under gone radiotherapy and neck dissection for high-grade salivary gland carcinomas, likely do not benefit from a neck dissection in decreasing their risk of recurrence.
Rijuneeta Gupta
Post Graduate Institute of Medical Education and Research, India
Title: Role of neutrophil lymphocyte ratio (NLR) as a predictor of disease severity in nasal polyposis (NP) and allergic fungal rhinosinusitis (AFRS)
Biography:
Rijuneeta Gupta is currently Professor in the Department of Otolaryngology and HNS at the Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Abstract:
The lack of an effective marker to predict recurrences in NP and AFRS puts enormous financial burden on the society. Neutrophil Lymphocyte ratio (NLR) could be cost effective, easily reproducible biomarker to predict recurrences. We present a case control study that included 100 subjects. Disease severity was graded based on Lund Mackay CT and endoscopic scoring. Patients were given preoperative oral steroids for two weeks. The pretreatment neutrophil lymphocyte ratios were calculated from the differential leucocyte counts and compared with the diseases severity and postoperative values. Disease severity graded on Lund Mackay CT and endoscopic score in controls was 0.7 and 0.1 respectively. The CT severity score in patients with NP was 12.9 and changed to 1.2 (p<0.01). In AFRS the pretreatment CT score changed from 15.1 to 0.75
(p<0.01). The endoscopic severity score in NP pretreatment was 2.8, which decreased to 0.03 post treatment. In AFRS this endoscopic severity changed from 3.4 to 0.1 (p<0.01). Patients with NP had a mean pre-treatment NLR of 2.03±0.28, which reduced to 1.68±0.43 post treatment (p<0.01). NLR in AFRS changed from 2.15±0.62 to 1.78±0.36 post treatment (p<0.01). We conclude that NLR correlates to the disease severity and showed a linear correlation with the extent of the disease, which was not statistically significant. NLR can be used as a cost effective novel biomarker in remote areas to predict recurrences and keep track of treatment response.
Gunjan Dhasmana
Himalayan Institute of Medical Sciences, India
Title: Evaluation of hearing in patients with Type 2 diabetes Mellitus
Biography:
Gunjan Dhasmana is currently pursuing her MS in ENT from Swami Rama Himalayan University, Dehradun, India. She successfully presented her work (poster presentation) on malignant ameloblastoma of the mandible and paper presentation on various foreign bodies encountered in ENT. Her recent research was on evaluation of hearing in type 2 diabetic patients. She is mainly interested in Head and Neck Oncology.
Abstract:
Diabetes mellitus (DM) is a non-communicable, chronic metabolic disease with abnormal blood glucose levels caused by relative or absolute insulin deficiency. Long-standing diabetes can manifest a wide range of irreversible medical complications which can practically affect every organ of the body. Diabetes is an important etiological factor for hearing impairment. The relation between hearing loss and diabetes mellitus appears as a controversial topic as different studies have given conflicting results. Therefore we did an observational study to find out the status of hearing in diabetic patients. Audiological examination and Pure tone audiometry was done which revealed high frequency mild sensorineural hearing loss in majority of patients. Special hearing tests were also done to differentiate between cochlear and retro cochlear pathology. Significant association of hearing loss was seen with the severity of diabetes, but no association was found with the duration of diabetes. Thus we conclude that along with screening the diabetics for retinopathy, neuropathy and nephropathy, auditory screening should also be done. Timely detection of hearing loss may prevent further loss by controlling the sugar levels in the diabetics.