5^th European Otolaryngology-ENT Surgery Conference August 24-26, 2020 Barcelona, Spain

Biography:

Taisa Giannecchini from Dr. Taisa Giannecchini, Speech Pathology and Audiology, University of Sao Paulo, Brazil.

Abstract:

Purpose: This study analyzed the applicability in the speech pathology clinic of a praxis-productive intervention program for children with phonological disorder, by its implementation. Methods: the study proposed a theoretical model of the program, based on a literature review on speech motor control, which orders muscle contraction for the execution of praxis, including the planning, preparation of movements and execution of plans, aiming at muscle contractions and movements of structures that ultimately lead to speech articulation. Thereafter, the material was applied to 12 children aged 6 to 8 years with phonological disorder, to show the applicability of the praxis-productive intervention program in practice. Results: the results showed improvement of speech in all individuals within the time defined by the instrument, with higher scores for the evaluative evidence of phonology and oral praxis after intervention compared to the scores before intervention. Conclusion: the praxis-productive intervention program was useful, simple easy to apply by the speech pathologist and well understood by the participants, with favorable responses for the acquisition of phonemes.

Biography:

Lidia Guimarães is a ENT and Head and Neck Surgeon and her expertise is Functional and Aesthetic Rhinoplasty , acquired in the best Centers of speciality all over the world with some of the best masters in this kind of surgery. Learning , practising , and choosing the best for each individualised pacient is the support for these challenging surgeries! Providing healthcare, wellbeing and self -esteem to each one , is her goal She works exclusively in private practice for more then 20 years . She works at Cuf Hospital - Porto - Portugal , one of he most accredited Hospitals of the country,besides her private office. She frequently participates in national and international cientific events , mostly under the auspices of Portuguese ENT Society , Portuguese Medical Association , EAFPS or AAO-HNS or SEORL .

Abstract:

Statement  of the problem:
Being a individualized surgery , rhinoplasty  has different procedures  according with  the facial surgical past of the pacient.
According  to the best results, a secondary  , terciary (or even more ) rhinoplasty  surgery ,comparing with a primary one, should consider different parameters for support and contour, as well as  facial framing  ,wich means more precise techniques and skills acquired
The purpose of this presentation is to alert for these different perspectives , and to be aware  of the modification of the nose , each time we  operate in  a nose for a second time , specially  if it is not a revision.
Theorical orientations begins with the pacient evaluation  and explanation  of the case,( to him or her ) and understanding and delineation of a surgical plan for the surgeon to achieve  the best result.
Findings are sometimes quite different from case to case  .
What to preserve , and what to simplify , is sometimes the key for a good result.
In conclusion , the learning curve never stops for  the surgeon , and people´s self esteem is always the key for individual success

Biography:

Head of the Department of Head and Neck Surgery at the All-Russian Center for Eye and Plastic Surgery of the Ministry of Health of Russia. Surgeon-otorhinolaryngologist at JSC "Medicine" - Clinic of Academician Roitberg. Former Chief Freelance Otorhinolaryngologist at Department of Health of the Tyumen Region. Former Professor of the Department at Tyumen State Medical University.

Abstract:

Introduction: Surgical treatment of the empty nose syndrome is a complex, poorly developed, general medical problem.

The aim of the study: to determine the aerodynamics disorders of the nasal cavity in patients with the empty nose syndrome and to develop the principles of surgical treatment

Materials and methods: Two groups were formed for the study. Group 1 - patients with empty nose syndrome after resection of the lower nasal concha (32 people), group 2 - patients with perforation of the nasal septum (31 people). Based on the obtained CT in the Slicer program (BSD license, Open Source Initiative OSI), three-dimensional models of the nasal cavity were constructed in both groups. Modeling of the air flow in the nasal cavity was carried out using the ANSYS software system (certified No.10000741 QM15, ISO 9001: 2015).

Results and discussion: After performing CFD modeling in group 1, it was found that air is distributed mainly in the lower nasal passage, the speed varies 5.5 ± 1.5 m / s, which is significantly lower than with the physiological norm of 15 ± 3.1 m / s. Pressure indicators reach from + 5 ± 2 Pa, which shows a reduced "suction" force of the nose. The air temperature practically does not change, varying 26.8 ± 0.3 Celsius, which indicates violation of heating. Humidity decreased to 88 ± 4.3%. In group 2, it was found that the speed pattern varies from 20 ± 4 m / s, which exceeds the physiological parameters. The presence of perforation creates a shunt between both nasal cavities, which negatively affects the air heating and pressure. The air temperature throughout the nasal cavity during perforation varies 30.4 ± 0.5 Celsius, while in the perforation area it decreases to 25.6 ± 0.2. The pressure indicators slightly deteriorate, varying from -35 ± 5 Pa throughout the nasal cavity and to -50 ± 5 Pa in the nasopharynx. The relative humidity index decreased and amounted to 97 ± 0.34%.

Conclusions. Using the results obtained, the tactics of surgery in Group 1 is the thickening of the nasal septum and augmentation of the lower nasal concha in order to narrow the lower nasal passage so that air can rush into the upper sections. In group 2, the tactic is surgical closure of the perforation of the nasal septum with the mucosal flap on the ethmoid arteries.

Biography:

Dr. Candice Que-Ansorge receive her Doctor of Medicine degree from the University of Santo Tomas College of  Medicine and Surgery.  She is a Diplomate and Fellow of the Philippine Society of Otolaryngology – Head and Neck Surgery.  She had her Fellowship in Maxillofacial Trauma at the Department of Oral and Maxillofacial Surgery, Military Hospital in Ulm. Germany, and in Facial Plastic Surgery  at the Facial Plastic Aesthetic Core of ENT Surgerons.  She is an Asssistant Professor at MCU-FDTMF College of Medicine and the Research Coordinator at MCU-FDTMF Dept. Of ORL-HNS.

Abstract:

This study describes a surgical technique using bony septum, specifically vomer or perpendicular plate of the ethmoid (PPE), as an extended spreader graft (ESG) for securing septal extension graft (SEG) and for correcting internal nasal valve dysfunction.  This is a a descriptive case series done in a tertiary private hospital.  Thirty-two (32) patients who underwent aesthetic rhinoplasty from May 2016 to October 2017 were evaluated, and ten (10) patients presenting with symptomatic obstruction were considered for inclusion. The surgical technique was applied in patients with weak SEG for control of nasal length and tip projection who had inadequate septal cartilage for SEG and ESG intraoperatively.  Results were evaluated grossly under direct vision intra-operatively and post-operatively to check the patency of the internal valve.   Bony septum was used as an ESG in five (5) patients (1 male, 4 females, ages 35 to 50-years-old) with inadequate septal cartilage. Intraoperative evaluation under direct vision showed anterior caudal septal deviation in all 5 patients in whom correction was confirmed after placement of SEG and ESG. Immediate post-operative evaluation confirmed bilaterally patent nasal valve in all 5, who reported subjectively improved breathing at 2 and 4 weeks post-operatively.  Post-operative photographs showed irmprovement of nasal length and tip.   The use of the bony septum as ESG for rhinoplasty is a potentially effective means of supporting and securing the SEG for control of nasal length, preventing tip deviation or rotation and for improving internal valve function. Further trials are needed to establish its reliability and long-term effectivity.

Biography:

Omar Ahmed has completed his  ENT Master degree and MRCS(ENT) at the age of 28 years from Alexandria University and Royal College of Surgeons in England respectively. I have been enrolled in a PHD/MD programme with a thesis about parathyroidectomy.I have joined East Kent Hospitals ENT Department in December 2018 as an ENT Registrar.

Abstract:

Introduction: Closure of the pharyngeal defect after total laryngectomy had been traditionally performed with manual suturing techniques that invert the mucosal edge .This technique though effective yet it is time consuming. Recently the use of stapling devices to successfully close the pharyngeal defect after total laryngectomy has been advocated to shorten the operative time especially in the high risk cancer patients where a prolonged operative time is not preferred.No previous randomized prospective studies comapred the use of stapler to the conventional method of pharyngeal closure after total laryngectomy.

Objectives: The present study aimed at comparing stapler assisted total laryngectomy to suture closure total laryngectomy in a prospective randomized manner.

Methods: This a prospective clinical study was conducted on 60 patients undergoing total laryngectomy at Alexandria Main University Hospital, Egypt. Patients with tumor extension to the hypopharynx or base of tongue were excluded from the study.

Results and conclusion: The use of the stapler is technically easy to perform and as equally as effective as the traditional neopharyngeal suturing techniques in patients undergoing total laryngectomy. The surgical time is reduced with shorter hospital stay and no increase in postoperative complications rate.

Biography:

Dr. Candice Que-Ansorge receive her Doctor of Medicine degree from the University of Santo Tomas College of  Medicine and Surgery.  She is a Diplomate and Fellow of the Philippine Society of Otolaryngology – Head and Neck Surgery.  She had her Fellowship in Maxillofacial Trauma at the Department of Oral and Maxillofacial Surgery, Military Hospital in Ulm. Germany, and in Facial Plastic Surgery  at the Facial Plastic Aesthetic Core of ENT Surgerons.  She is an Asssistant Professor at MCU-FDTMF College of Medicine and the Research Coordinator at MCU-FDTMF Dept. Of ORL-HNS.

Abstract:

This study aims to determine the prevalence of Ear Nose throat (ENT) complications in patients with Human Immunodeficiency Virus (HIV) and its association with age, sex, CD4 count, and antiretroviral treatment.  A total of 360 subjects were included in the study, age ranged from 19 to 65 years with a mean age of 32.87 years, confirmed to be with HIV, on antiretroviral (ARV)  drugs > than 3 months, seen at the in-patient and outpatient department of H4 and TB ward in a National Tertiary Infectious Disease Hospital from February to July, 2019 were included. Majority were males at 97%. Otologic manifestations were SNHL (6.1%), AOM (1.1%), BPPV (1.9%),  CSOM (1.4%), Malignant Otitis Externa (0.3%) and CHL (0.6%). Similar number of patients had acute rhinitis, allergic rhinitis and acute rhinosinusitis at 1.1%. Oropharyngeal manifestations were oral candidiasis (1.1%), aphthous stomatitis (0.8%), tonsillar papilloma (0.3%)  and chelitis (0.3%). Laryngeal manifestations noted were LPRD (1.4%), acute laryngitis (0.3%), vocal cord paralysis (0.3%), chronic laryngitis (0.3%) and candidiasis (0.3%). TB adenitis was noted in 37 (10.3%) patients. There was a significant association noted between ARV treatment and baseline and current CD4 counts with ENT complications as proven by all p values <0.01. The duration of ARV treatment was significantly longer among those with complications than those without with a mean of 3.78 years and 2.64 years respectively. For baseline and current CD4 count, significantly higher proportion of subjects with complications had lower baseline CD4 count. On the other hand, age, sex and BMI were not significantly associated with ENT complications (p>0.05).

Biography:

Youssef Aladham has graduated from Faculty of Medicine, Alexandria University, Egypt in 2009, completed his ENT training in Alexandria Main University Hospitals, and obtained a master’s degree in ENT from Alexandria University. He holds the membership of The Royal College of Surgeons of England in ENT. He currently works as a head and neck surgery fellow in University Hospitals of Derby and Burton, United Kingdom

Abstract:

Aim: To evaluate the effectiveness of multi-channel electromyographic monitoring of the facial nerve in improving the detection of mechanically-elicited EMG activity and providing new predictive criteria for post-operative facial nerve function.

Study design: Prospective study

Patients and Methods: The Study was conducted on 20 patients undergoing vestibular schwannoma resection in a tertiary referral center (Alexandria Main University Hospital). All patients have been subjected to facial nerve monitoring during the surgery by a 5-channel set-up monitoring the frontalis, O.oculi, nasalis, O.oris, and mentalis muscle. Mechanically elicited EMG activities of the monitored facial muscles were recorded for analysis. After tumor removal, the facial nerve was stimulated proximal to the tumor site using 2 different types of probes (Prass and flush-tip). Post- operative facial nerve function was assessed using the House-Brackmann scale immediately post- operatively and after six months and was correlated to the study tested parameters.

Results: The use of the 5-channel montage has led to significantly higher sensitivity in detecting the mechanically elicited EMG activity than would have been possible with the ordinary 2-channel one. Mentalis muscle has shown significantly higher number and amplitude of spontaneous EMG activities than other facial muscles. Positive correlation was found between the proximal threshold and the post- operative facial nerve outcome. The Prass stimulator has shown significantly lower than the ball-tip probe.

Conclusion: The use of multi-channel facial nerve monitoring allowed earlier and more efficient monitoring of the facial nerve. The use of the "Prass stimulator" is more accurate and correlates more with the real threshold needed for post-resection stimulation of the facial nerve than the ball-tip one.

Biography:

Mahmoud Al Aaraj, graduated from the Medical faculty in the Hashemite University in Jordan in 2017, moved to the United Kingdom in 2019 to continue higher training in surgery, with interest in otolaryngology, currently enrolled for a masters degree in Public Health and Health Promotion in Brunel University London.

Abstract:

Purpose
The purpose of this study was to assess characteristics of MOE and the length of hospital stay for patients with MOE in relation to different factors, retrospectively.

Methods
This study included 20 patients who were diagnosed with Malignant Otitis Externa, and treated in the Otolaryngology department in between the years 2012 and 2019. Factors that were involved in our study are: Age, gender, causative organism, cranial nerve involvement, presence of osteomyelitis, comorbidities, diabetes, immunosuppression and the initial ESR level by the time of the diagnosis. 

Results
The study included 14 male patients and 6 female patients; the mean age of the participants was 77.9 years. In 70% of the cases, the organism isolated was Pseudomonas aeruginosa. 85% of the patients were diabetic. The average length of hospital stay was 23.92 days for patients with HbA1C more than 42, compared to 15.5 days in patients with HbA1C less than 42. However, the difference was insignificant (P>0.05). The mean initial ESR for the sample was 51.36, patients with ESR more than the average had a longer average of hospital stay than the ones with ESR below the mean.

Conclusion
Malignant otitis externa is a serious condition that needs to be detected and treated as early as possible. It is more common in diabetic male patients, no statistical significance was detected between length of hospital stay and the HbA1C level or initial ESR level.

Biography:

Theodore completed his MPH at Tufts University School of Medicine in Boston, MA, and his MD at the University of Arkansas for Medical Sciences in Little Rock, AR. He is now a clinical research fellow for the Rhinology/Skull Base Department at Thomas Jefferson University in Philadelphia, PA.

Abstract:

Introduction:
With oral cavity cancer being the sixth most common cancer worldwide, comprising 30% of all H&N cancers, the submental flap emerged over the past decade as a purported, easier way to fix oral cavity defects. Often defined as a simple method for reconstructing small to moderate size oral cavity defects, the submental flap has continued to gain in populairty. Reported as reliable and rapid to harvest, especially relative to the more common free flap, the submental flap, however, is not foolproof. Despite the purported reduction in operating time and ability to circumvent sophisticated microsurgical techniques required during pedicle division and reconnection during a free flap, the submental flap can still have complications.

Objectives:
This study seeks to analyze and explain the various post-op complications surrounding submental flaps. This study will estimate the potential impact submental flaps may have relative to the traditional method of using free flap reconstruction, once post-op complications are taken into consideration. It will also serve as a warning to new surgeons who consider using a submental flap, as opposed to the more traditional free flap.

Methods:
Retrospective chart review of 9 patients who underwent submental flaps that subsequently failed.

Results:
9 patients underwent submental flaps to correct an array of oral defects. The defects included: composite resection of right floor of mouth, right ventral tongue partial glossectomy, and right marginal mandibulectomy; parotid defect; floor of mouth (FOM), ventral tongue; tongue, (retromolar trigone)RMT; FOM; partial glossectomy; buccal mucosa; ventral tongue, FOM; FOM. After performing submental flaps on all 9 patients, each flap failed, respectively. Reasons for failure ranged from flap congestion and need for debulking to aberrant blood supply and faulty, local vascular circulation.

Conclusions:
Despite their promising potential and numerous cases with positive outcomes, submental flaps still have the potential to fail. In the hands of a young and inexperienced surgeon, the likelihood of flap failure increases even more.