International Conference  on Aesthetic Medicine and ENT July 06 - 08, 2017 Kuala Lumpur, Malaysia

Biography:

Reshma Ghedia is a surgical trainee with a specialist interest in ENT. She has done her core surgical training in London and has worked in busy quaternary ENT departments including Charing Cross Hospital and the Royal London Hospital.

Abstract:

Background

An infected pinna collection is a serious otological condition that can lead to cosmetic and audiological sequelae. They are often secondary to a piercing. Pseudomonas aeruginosa has been found to be the most common pathogen. There is no general consensus in the literature regarding management. The use of modified nasal splints has been described to treat a perichondrial haematoma and we describe a similar technique to treat an infected pinna collection

Technique

The ear should be prepared with appropriate antiseptic solutions and injected with Lignospan Special® (2% Lidocaine hydrochloride with 2% Adrenaline 1: 80 000).  A full-thickness 2-3cm skin incision should be made along the helical crease on the lateral aspect of the pinna. The pus must be irrigated with copious sodium chloride solution. Necrotic tissue should be debrided. The incision should not be closed. Exmoor® nasal silicone splints should be cut to fit under the helix. These should be used to sandwich the pinna with the use of 3 non-absorbable monofilament mattress sutures to prevent further infection. We recommend the use of Jelonet ®  in between to prevent excessive pressure. The patient should continue on anti-pseudomonal intravenous antibiotics until improvement is seen, when they can be converted to an appropriate oral equivalent. The patient should be reviewed in 1 week to remove the splints. We have had good outcomes for 2 patients treated this way at 1 month after the intervention

Discussion

Modified nasal splints act as a mould by providing firm even pressure to the pinna thereby preventing recollection. This reduces fibrosis leading to a ‘cauliflower ear’. In addition the splints look clean throughout their use. 

Biography:

Fazel Khaliq Omari was born in 1972 in Kabul Afghanistan. He was graduated from Kabul Medical University in 1997. He has been working in the field of otolaryngology since1997.He was graduated from ENT residency program in National Military Hospital as an ENT Specialist in2005.

Abstract:

Introduction

Eagle syndrome is characterized by recurrent pain in the oropharynx and face due to an elongated styloid process or calcified stylohyoid ligament. Eagle syndrome (ES) first described in1937, by an otolaryngologist at Duke University, Watt W. Eagle. The stylohyoid complex is made of styloid process, stylohyoid ligament, and the small cornus of the hyoid bone.The normal length of the styloid process is individually variable, but in the majority of patients it is about 20 mm.Eagle’s syndrome is treated surgically and nonsurgically. A pharmacological approach by transpharyngeal infiltration of steroids or anesthetics in the tonsillar fossa has been used, but styloidectomy is the treatment of choice. Styloidectomy can be performed by an intra- or an extraoral approach.

Case presentation

A 22 years old male, presented with complain of recurrent sore throat with frequently odynophagia and sometime earache on both side (predominantly on left side) since one year. By taking the history, pharyngoscopy and evaluating the radiography, the diagnosis of elongated processus styloideus and recurrent acute tonsillitis was made. After completing the blood examination and anesthesia consultation, patient selected for tonsillectomy and bilateral styloidectomy under local anesthesia. At first tonsillectomy was done, then processus styloideus identified intraorally and dissected from periost, and 1cm from the middle end catted. The pharyngeal wall was repaired no serious bleeding, Augmentin injection advised preoperatively and postoperatively, patient discharged from hospital after 48hr. Three months after procedure patient checked again with no complain.

conclusion

Already eagle syndrome is a rare case, sometime the coexistence of recurrent acute tonsillitis(RAT) and chronic tonsillitis(CT) at the same patient may mask the diagnosis of elongated process styloideus and for that reason if the odynophagia is persistent in a patient with RAT and CT, for evaluation of processus styloidus it is better to do at least the plain neck lateral radiography.

Biography:

Abstract:

Biography:

Professor Klapan graduated from Zagreb University School of Medicine. He has completed two postdoctoral studies from the same University (Clinical Immunology&Allergology, Otorhinolaryngology-Head&Neck Surgery) and his PHD (Zagreb University and Eye&Ear Institute, Pittsburgh University, PA, USA) at the age of 30 years. He is the founder/director of Klapan Medical Group University Polyclinic. He has published more than 110 papers in reputed journals; citations/355; h-index: >25; 14 medical books (7/Croatian and 7/English language; editor, author and co-autor); chaired and headed a number of international surgical courses and symposia.

Abstract:

Biography:

DR. Mohamed Osama Hegazy is an otorhinolaryngologist, from Damietta ,Egypt. He is the owner and manager of Damietta ENT Center which is one of the biggest ENT centers in Egypt.he took his M.Sc from Benha university and the thesis was about uses of coblation in management of Obstructive sleep apnea under local anaethesia. His main expertise are in Endoscopic Nasal surgery especially those done under local anaethesia.Hegazy now is Instructor in biggest Basic&advanced FESS workshops in Egypt (last was in military medical academy Nov 2016 ), and a guest speaker in biggest Rhinology conferences in Egypt(like RhinoEgypt conference).

Abstract:

Surgery for repair of a septal perforation is one of the most difficult , annoying, bad outcome surgery for an ENT surgeon.

 My objective is to let rhinologists know that there is a technique that may help with good results in certain types of perforations.

 Making a good surgery needs certain steps to get a great outcome,1st is good infiltration with xylocaine-adrenalin solution to get good decongestion and hydro dissection, 2nd is refreshing the edges of the perforation all around, 3rd is elevating the right nasal septal flap, 4th is freeing the lower edge of the flap, 5th is freeing posterior edge of the flap to create a superiorly based flap taking its blood supply from anterior ethmoidal artery, 6th is anterior rotation of the flap, 7th is suturing the flap using 3/0 sutures> this procedure could be done under general anesthesia or local anesthesia with moderate sedation. 

 Advantage of this technique is that you have vascular flap ensure good graft taking

 On the other hand we face some limitations like that you should have a cartilaginous rim to get good fixation of the flap and good healing.

 Finally we can say that using anterior ethmoidal artery flap in repairing anterior septal perforation is a good option with good post-operative results.

Biography:

Professor Klapan graduated from Zagreb University School of Medicine. He has completed two postdoctoral studies from the same University (Clinical Immunology&Allergology, Otorhinolaryngology-Head&Neck Surgery) and his PHD (Zagreb University and Eye&Ear Institute, Pittsburgh University, PA, USA) at the age of 30 years. He is the founder/director of Klapan Medical Group University Polyclinic. He has published more than 110 papers in reputed journals; citations/355; h-index: >25; 14 medical books (7/Croatian and 7/English language; editor, author and co-autor); chaired and headed a number of international surgical courses and symposia.

Abstract:

Biography:

Dr Masroor Ahmad Wani is gold medalist, has done MD from medical college Kolkata. He is practicing aesthetic and skin medicine at Health zone Medicate Srinagar India. He has published many articles in newspapers and magazines, has attended more than 22 national and international dermatological conferences.

Abstract:

A compound peel is a treatment in which a corrosive arrangement is utilized to expel the harmed external layers of the skin. In performing concoction peels, we apply alpha hydroxy acids, trichloroacetic corrosive, or phenol to the skin. The synthetic peel is one of the most established corrective systems on the planet, and was performed in old Egypt, Greece, and Rome to enable individuals to accomplish smoother, more excellent skin. Today, concoction facial peels are prominent everywhere throughout the world since they offer almost quick outcomes and can be executed as an outpatient strategy. Patients with reasonable skin and light hair are the best concoction peel hopefuls. Be that as it may, patients with other skin pigmentation and hair shading can accomplish great outcomes also. Synthetic peels once in a while result in genuine intricacies, yet certain dangers do exist. These dangers incorporate scarring, disease, swelling, changes in skin tone, and mouth blister. A concoction facial peel can give a few advantages to the skin. The strategy can reestablish a more energetic appearance to skin and diminish wrinkles, uneven pigmentation and sun-harm.

Biography:

Hoseok Lee, MD  at the age of 35 from Bucheon St. Mary’s hospital, Catholic University college of Medicine. Working in otolaryngology and Head and Neck sugery department as an otology clinical fellow .  

Abstract:

Perforations of the tympanic membrane (TM) can result from trauma, middle-ear disease, or the treatment of middle-ear disease. I aim to assess the level of hearing loss in different sizes and sites of TM perforation in patients undergoing myringoplasty or tympanoplasty and to correlate the size and site of TM perforation. Records from 128 patients who had undergone tympanoplasty or myringoplasty at our clinic between August 2008 and November 2012 were examined retrospectively for this study. For evaluating the TM, the site of the perforation was classified as the following divisions: 3 quadrants (Anterior, Posterior and Central). Audiometric evaluation was performed using a clinical audiometer calibrated according to ISO standard. Hearing level was measured as the mean air conduction and mean air-bone gap(ABG) threshold at 500, 1000, 2000, and 3000 Hz and, we also categorized the frequencies as low frequency(250,500,1000) and high frequency (2000,3000,4000, 6000) for analyze the hearing in detail. We categorized the location of TM perforation simply as anterior 56(43.8%), posterior 42(32.8%) and central 30(23.4%) based on the relation of the center of the perforation with the line extending from the malleus handle. According to the mean ABG among the groups, ANOVA analysis revealed that, they have significant difference. (p= 0.008) Categories of the hearing loss was classified as low frequency(250, 500, 1000Hz) and high frequency (2000, 3000,4000, 6000Hz). We found that the posterior perforation in TM showed increasing air conduction and ABG at low frequency hearing level.. (p= 0.023, p= 0.072)

Biography:

Dr Kaukab Rajput is an expert in diagnosis of hearing loss in children with complex problems. She has worked at Great Ormond Street Hospital (GOSH) for over twelve years and currently leads the Cochlear Implant Department.

Abstract:

Two year results of clinical efficacy of cisplatin in combination with Sodium Thiosulfate (STS) vs cisplatin alone in a randomized phase III trial for standard risk hepatoblastoma (SR-HB) SIOPEL 6.

Background:  A serious permanent side effect of cisplatin (Cis) therapy is bilateral high-frequency hearing loss which is particularly debilitating when it occurs at a young age. Sodium thiosulfate (STS) has been shown to dramatically reduce hearing loss in children treated with cisplatin containing chemotherapy without tumor protection in localized disease: COG ACCL0431: 2014 ASCO Annual Meeting Abstract No: 10017. 

Methods: Newly diagnosed SR-HB patients were randomized to Cis or Cis+STS for 4 preop and 2 postop courses. Cis 80mg/m² was administered i.v. over 6 hrs. STS was administered i.v. exactly 6 hrs. after stop Cis over 15 minutes at 20g/m². Tumor response was assessed after 2 and 4 cycles preop with serum AFP and liver imaging. In case of progressive disease STS was to be stopped and chemotherapy changed to combination therapy with Cis and Doxorubicin 60mg/m².  The primary endpoint of the trial is centrally reviewed absolute hearing threshold, at the age of ≥3.5 yrs, by pure tone audiometry. Secondary endpoints are event free (EFS) and overall survival (OS).

Results:  109 patients (52 Cis and 57 Cis+STS) were recruited at trial closure in December 2014. The combination of Cis+STS was generally well tolerated. The median follow up is 32 months and provisional 2 yr EFS is Cis 86.3% and Cis+STS 89.0%; 2 yr OS is Cis 91.4% and Cis+STS 97.7%. Treatment failure defined as PD at 4 cycles was equivalent in both arms (3 Cis; 3 Cis+STS). As of February 2016, 5 patients had died (4 Cis; 1 Cis+STS), 1 had relapsed (Cis+STS) and 1 was still in PR (Cis+STS). Interim results of centrally reviewed and Brock graded audiograms for 68 pts at age >3.5yrs are encouraging. Definitive results will become available end 2017.

Conclusion: This randomized phase III trial in standard risk hepatoblastoma of cisplatin alone vs cisplatin plus the otoprotectant STS shows comparable 2 year EFS and OS with no evidence of tumor protection. 

Biography:

Younghoon Jeon has completed medical student at the age of 25 years from Kyungpook National University. He is the director of Pain Clinic of Kyungpook National University Hospital. He has published more than 10 papers in reputed journals and has been serving as an editorial board member of Korean Journal of Pain.

Abstract:

Idiopathic sudden sensorineural hearing loss (ISSHL) is considered an otologic emergency requiring immediate treatment. A possible cause of ISSHL includes viral infection, circulatory problems, immunologic disorders, and neurologic disorders. Currently well recognized treatment for ISSHL is administration of steroid. The stellate ganglion block (SGB) is a procedure to block the sympathetic nerve distributed to the head, neck and the upper limb, which is tried for treatment of circulatory insufficiency diseases or sympathetically maintained pain disorders. But it is not cleary that it is not clear that SGB has significant beneficial effect on ISSHL.  The objective of this study was to investigate whether stellate ganglion block (SGB) can enhance the recovery of ISSHL. In a retrospective chart review, a total 135 patients with SSNML was included; Sixty patients received only conservative treatment with steroids and vitamin B (control group) and 75 patients were managed with SGB twice a week, combined with conservative treatment (SGB group). Hearing gain and percentage of recovery were analyzed and compared between the two groups. In SGB group, hearing gain, percentage of recovery, and rate of successful recovery significantly increased, compared to those in the control group SGB group (respectively, P < .05). From these findings, SGB have beneficial effects in the treatment of ISSHL.

Biography:

Dr. Ahmed Mohammed Abdelghany Studied medicine at Benha University and Now presently working as Assistant Professor in Otorhinolaryngology Department at Benha University.

Abstract:

Biography:

Dr Zuraida is a senior medical lecturer in the Audiology Program, School of Health Sciences, Universiti Sains Malaysia (USM). She received her Medical Degree (MD) from USM in 2002 and Master of Science (Medical Audiology) in 2010 from the same university. She was the pioneer in establishing USM Vertigo Clinic since 2008. Apart from her clinical commitment, she has also been an active researcher in the field balance and vestibular. She has been sharing her research findings both locally and internationally and has published more than 60 publications including journal, oral, books and proceeding. Awarded with many research grants, Dr Zuraida has invented many clinical tools for assessing and treating balance disordered and stroke patients. Her home based treatment product, known as Bal Ex, has won many awards (gold and silver medals). She is currently developing a virtual vestibular rehabilitation procedure for balance disordered patients.

Abstract:

Vestibular rehabilitation is one of the optimum treatments to promote the recovery among vestibular disorder and stroke patients. The effectiveness of these physical therapies has been clearly demonstrated. In fact, having an effective therapy that is home based or one to one offers many advantages to the patients and clinicians. Zainun and her colleagues (2009) had developed the first video guided exercise that is home-based known as Bal Ex. Other module and protocols developed for balance rehabilitation are Bal Ex Stand Up: Manual Footplate for Balance Rehabilitation, Bal Ex Mobile Virtual Room for visual vertigo patients, Bal Ex Stroke homebased video module for stroke rehabilitation, Bal Ex Physio homebased physiotherapy module for stroke patients and others. This module has many advantages which are easy to perform as there are step by step instructions presented with audio and visual cues. Second, since it is home-based, the patients are able to use them as self-guidance and they can minimize their follow up to the hospital for treatment. This is also practical for patients with reduced mobility and it also offers more flexibility. Indirectly, it is also cost-effective in a long run. Indirectly having this latest innovation product will improve our current clinical management of vestibular disorder and stroke patients.

Biography:

Dr Zuraida is a senior medical lecturer in the Audiology Program, School of Health Sciences, Universiti Sains Malaysia (USM). She received her Medical Degree (MD) from USM in 2002 and Master of Science (Medical Audiology) in 2010 from the same university. She was the pioneer in establishing USM Vertigo Clinic since 2008. Apart from her clinical commitment, she has also been an active researcher in the field balance and vestibular. She has been sharing her research findings both locally and internationally and has published more than 60 publications including journal, oral, books and proceeding. Awarded with many research grants, Dr Zuraida has invented many clinical tools for assessing and treating balance disordered and stroke patients. Her home based treatment product, known as Bal Ex, has won many awards (gold and silver medals). She is currently developing a virtual vestibular rehabilitation procedure for balance disordered patients.

Abstract:

Benign Paroxysamal Positional Vertigo (BPPV) is one of the most common diagnoses among peripheral vestibular disorders. Pathology of this disorder is the presence of otoconia inside the semicircular canal. Posterior canal BPPV is the most common type of BPPV. Nausea and vomiting are the key features for BPPV. Specific maneuver is one of the optimum treatments to promote the recovery among BPPV patients. The effectiveness of these maneuvers has been clearly demonstrated. The best maneuver is the one with highest successfully rate and the lowest recurrent rate. Gan canal repositioning and deep hanging maneuver is one of the latest maneuvers that is able to cure the BPPV problem.

Biography:

Abstract:

Objective: To determine the necessity of collar fixation after canalith repositioning maneuver on posterior canal benign paroxysmal positioning vertigo (BPPV) patients.

Methodology: A prospective study was conducted on 60 patients with posterior canal BPPV. The patients were divided into two groups. Group I: managed by Epply Maneuver and received post-maneuver instructions and the neck were fixed by collar for 4 days. Group II: the same management as group I but without collar fixation.

Results: there was a statistically significant difference in the outcome between the two groups with decrease the chance of recurrence in group I with the serial follow-up.

Conclusion: The use of collar fixation after canalith repositioning maneuver is necessary to improve outcome and decrease the chance of recurrence on posterior canal BPPV patients.

Biography:

Dr. M M T Vasan practices at Apollo Spectra Hospitals. Professional qualification of the Doctor is MBBS, MS, Fellowship in Plastic & Cosmetic Surgery and specializes in Plastic and Cosmetic Surgery. Dr. M M T Vasan has expertise in Cosmetic Surgery with an experience of 7 Years.

Abstract:

Introduction: Hair transplant (HT) is a common cosmetic surgery. Finer & newer techniques are coming up very often.

Materials & Methods: Suction assisted procedure for inserting the hair grafts is very easy and faster technique. Harvesting is done by: 1. Follicular Unit Transplant (FUT) or 2. Follicular Unit Extraction (FUE). For inserting the grafts we can use, 11 blade knife or iris knife to make a slit or 19 or 22 gauge hypodermic needles to make holes and to insert the grafts, for easy insertion of the graft can use suction negative pressure. The needle is attached to a no.14 size suction catheter which in turn is attached to a suction machine which produces a mild vacuum suction pressure (approximately 50-80 mm of Hg). The suction power sucks out the blood making the field clear for easy visualization of the hole. It removes the skin debris produced during piercing. Then the hair graft is inserted.

Results & Analysis: Suction assisted hair transplant was done in 500+ cases in past 6 years. It was noted that, there was a significant decrease in cyst formation post operatively and increased hair growth.

Conclusion: The suction sucks out the dermal skin debris produced by the piercing of the skin with hypo dermic needles and hence avoids the formation of dermal inclusion cysts. 2. Sucks out the oozing blood & hence produces clear field for easy insertion. 3. The suction negative pressure automatically guides the hair graft to enter into the hole easily without much manipulation & hence faster surgery can be done.

Biography:

Dr. Lucio Maci did his Diploma in High School Calasanzio of Campi Salentina (LE) Later his Bachelor’s Degree in Medicine and Surgery  at the University of Padua. After completion of Bachelor’s he did Master’s Specialization in Otorhinolaryngology in the same University with the score 70/70 and praise. After his Master’s he worked as Consultant O.R.L. Centres Medico-Legal I.N.A.I.L.  Brindisi and Lecce. Later he worked at Consultant O.R.L.  A.S.L.LE/1. In his professional career he attended as Speaker at 12 National Congresses and 1 in France. Due to his enthusiastic nature and interest in research has authored and published numerous articles devoted mostly to accidents and occupational diseases to the district ORL.

Abstract:

Laryngeal trauma is an uncommon, diverse, and potentially

life threatening injury presenting acutely to the otolaryngologist. The most common associated injuries with laryngeal fractures are intracranial injuries , open neck injuries , cervical spine fractures  and esophageal injuries. Laryngeal fractures can be categorized as either penetrating or blunt injuries, which can be further categorized as either high or low velocity.] Most commonly, trauma to the larynx occurs as a result of a motor vehicle accident  or clothesline injury. A small percentage of causes include direct blows sustained during assaults, sport injuries, hanging, manual strangulation and iatrogenic causes.

The injury is uncommon due to protection of the larynx superiorly by the mandible (particularly when the head is flexed), inferiorly by the sternum and laterally by the SCM muscle.

Laryngeal trauma is often divided into two main groups—blunt trauma

and penetrating trauma. Laryngeal injuries vary by anatomical location : .

• Supraglottis
• Glottis: Traumatic force results in cruciate fractures of the thyroid cartilage near the attachment of the true vocal cords.
• Subglottis:
• Hyoid bone:
• Cricoarytenoid joint:
• Cricothyroid joint:
•  
• Complications include the following:

• Acute
  • Airway obstruction
  • Aphonia
  • Dysphonia
  • Odynophagia
  • Dysphagia
  • Postoperative complications (eg, hematoma, infection)
• Chronic
• Voice compromise
• Chronic obstruction
• Vocal cord injuries
• Fistula (tracheoesophageal, esophageal, or pharyngocutaneous)
• Cosmetic deformity
• Chronic aspiration
• Inability to decannulate

·         The overall outcome and prognosis of a patient with a laryngeal fracture depends on several factors, such as extent of injury, timing of repair, and the ability of the otolaryngologist to properly evaluate and treat the patient who has been traumatized. Generally, success is measured in terms of voice and airway function. Minor injuries usually result in return to preinjury airway and voice status. More significant trauma results in voice changes and requires more intensive procedures for airway stabilization.Object of our work are the laryngeal external trauma (open and closed) in various anatomical sites. They have highlighted the process of diagnosis and and especially the forensic investigation with particular reference to possible sequelae and their evaluation in terms of damage according to the italian legislation. 

Biography:

Dr. Irfan iqbal studied MBBS from reputed medical college in Srinagar, India. Later he joined for specialization of Otorhinolaryngology-Head and Neck Surgery and currently working as lecturer in HNS Government Medical College, India.

Abstract:

Biography:

Dr. Awan did his MBBS from Nishtar Medical College in 1990. He did his residency training at Pakistan Institute of Medical Sciences, Islamabad and Aga Khan University Hospital, Karachi and got his post graduate degree (FCPS) from College of Physicians and Surgeons, Pakistan in Otolaryngology and Head and Neck Surgery in 1998. He got his further training in the field of Otology (Ear diseases and surgery) from Wurzberg University, Germany and Portmann Institute, France. Dr. Awan has special interest in Cochlear Implant surgery and started a CI program at AKU in 2005 first of its kind in the country.  Dr. Awan has keen interest in research activities and has 50+ national and international publications to his credit. Currently Dr. Awan is working as Associate Professor and Consultant Otolaryngologist at AKUH, he is head of ENT department and also leading the Cochlear Implant Program at Aga Khan University.

Abstract:

Objective: To analyze the clinical presentation, histopathology, complications and outcomes of parotidectomy.

Material and methods: Retrospective chart review was performed of 193 patients who underwent parotidectomy from January 2005 to December 2015 at the Aga Khan University Hospital, Karachi. Data collected included age, gender, comorbid, signs and symptom, perioperative facial nerve function, details of surgery, FNA, histopathology and complications.

Results: Out of 193 patients undergoing parotidectomy, 110(57 %) were males and 83 (43%) were females, mean age being 48.21 and 43.76 years respectively. Mean duration of symptoms was 41.33 months and most common symptom was pre-auricular swelling present in all patients followed by pain present in 29 patients (15%) and facial nerve weakness in 6 patients (3.1%). FNAC was performed preoperatively and results were compared with final histopathology. 158 patients (81.86 %) underwent superficial parotidectomy while 35 patients (18.14 %) underwent total parotidectomy. The final histological diagnosis showed benign lesion in 147 (76.2%) patients and 46 patients (23.8%) had malignant lesions. 23 (11.9%) patients had transient nerve paralysis while 11 (5.7%) had complete facial nerve paralysis after surgery and majority of them were seen after total parotidectomy. 6 (3.1%) patients developed post-operative hematoma and 2 (1%) developed frey’s syndrome. 33 (71.73%) patients were sent for adjuvant radiation therapy out of 46 patients with malignancy and 9 (19.6%) patients with malignancy developed recurrence.

Conclusion: Parotidectomies are performed for almost all parotid masses and are usually associated with good postoperative outcomes. Malignancies of the parotid are rare with most of the masses benign in nature. FNA can prove to be a valuable tool for preoperative counseling of the nature of the disease and prognosis. With modern day procedures facial nerve can be saved in most of the surgical interventions.

Biography:

Associate Professor Dr.Sethu Thakachy Subha Current Appointment:,Head of Unit ENT Head & Neck Surgery ,Department of Surgery/Otorhinolaryngology  Faculty of Medicine & Health Sciences University Putra Malaysia Serdang,Malaysia. Associate Professor Dr.Sethu Thakachy Subha ,obtained her MBBS degree from the University of Kerala India in 1989 and MS degree in ENT Head & Neck Surgery from University Malaya,Kuala Lumpur Malaysia in  2002.she has published articles in local and international peer reviewed journals. She has also presented her research papers in various international conferences. She has been serving as reviewer for many reputed medical Journals.

Abstract:

Nasopharyngeal carcinoma (NPC)representing about 0.7% of global burden of cancers where as NPC  is the most common cancer of head and neck in Malaysia,South Eastern China ,Hong kong and Singapore.Nasopharyngeal carcinoma has typically metastases to cervical lymphnodes.Majority(>75%) of NPC patients have advanced locoregional disease with cervical metastases at the time of initial presentation. The common sites of distant metastases are bone,liver,lung and rarely metastases to axillary nodes.We report the rare presentation of recurrent NPC with axillary lympnode metastases.Our patient , 44 years old chinese gentleman who was diagnosed to have NPC  with initial staging T2N3bM0  could not  complete  neoadjuvant chempradiotherapy due to severe oral mucositis.subsequent surveillance assessments were unremarkable and after 3 years he has presented with right axillary lymph nodes.Clinical examination revealed  radiotherapy changes at the nasoharynx and absent cervical lymphadenopathy.Fine needle aspiration of nodes showed as metastatic carcinoma.CT  scan showed obliteration of right fossa of Rosenmuller and axillary nodes.PET CT demonstarted right supraclacicular , axillary and mediatinal lymphnodes and patient has been subsequently referred  for palliative chemotherapy.

Conclusion: This case illustartes the fact that ,eventhough NPC is highly radio and chemo sensitive ,these patients needs close follow up for early detection of recurrence and distant metastases.Despite the effectiveness of radiation and chemotherapy in the mangement of npc ,local or regional failure still occurs.Knowledge of potential mode of spread is not only vital to surgeons and also must be conveyed to patients for self examination.FDG-PET CT is better than CT in detecting residual or recurrent disease in NPC.

Biography:

Dr. Shakeel Uz Zaman completed his MBBS from King Aga Khan University, Later he joined for specialization of Otorhinolaryngology at Liaquat National Hospital & Medical College, Karachi, Pakistan.

Abstract:

Objective: The purpose of this study was to identify the significant predictors of locoregional recurrence in early stage SCCA of buccal mucosa with pathologically clear surgical margins and negative neck.

Materials & Methods: We retrospectively reviewed records of 73 patients who underwent per oral wide excision and supraomohyoid neck dissection for early stage buccal SCCA between 2007 and 2011 with clear surgical margins (>5 mm margins each) and negative neck (N0). None of the patients received postoperative radiotherapy or chemotherapy. The primary endpoint of the study was local, regional or locoregional recurrence. Univariate and multivariate analyses were used to identify independent predictors of locoregional recurrence.

Results: Recurrence was observed in 22 of 73 (30%) patients at the end of this study. Twelve (54.5%) had local, seven (31.8%) had regional and three (13.6%) developed locoregional recurrences. Sixteen patients (72.2%) had recurrence within the first 2 years of primary treatment. Both univariate and multivariate analyses demonstrated that lymphovascular invasion (LVI) and non-T4 muscular invasion (non-T4MI) were independent predictors affecting locoregional control.

Conclusion: Our results demonstrate that LVI and non-T4MI significantly increased the locoregional recurrence rate in early stage buccal SCCA with clear surgical margins and negative nodal status. Adjuvant treatment with either radiation or chemoradiation should be considered when one or both of these factors present.

Biography:

Mohamed Saleh Elarbi is a renowned Professor in Ali Omar Askar Neurosurgery Centre, Libya. He has many publications to his credit.

Abstract:

Aim: To review medical records from patients who had maxillofacial infections between january2008-January 2016.

Methods: Retrospective analysis of 91 patients  ,51 males(56%) and 40 females(44%) admitted in Ali Omar Askar(AOA) University hospital for Neurosurgery ,Oral &Maxillofacial surgery department, Esbea ,Tripoli Libya. Epidemiology, causes of infection treatment carried out and complications were discussed.

Results: A total of 91 patients with maxillofacial infection of which 51 were male (56%) , 40 females (44%), 85 patients had Odontogenic infections (93%) , 45 males (52,9%) & 40 females (47,1%)and 6 had non-Odontogenic infections(7%). The Odontogenic infections occurred mostly at the mandible and its associated spaces 74 cases (87%) involving the posterior teeth (82%). The main cause was dental caries 80 cases (94%). The most commonly affected facial anatomic region was the submandibular 39 cases (45,9%)Surgical treatment was required in all the  cases.

Conclusions: Maxillofacial infections require proper urgent treatment, to avoid complications, which can be serious. Their Management is primarily surgical (incison ,drinage with extraction  of offending tooth as required which require  skilled anaesthetic airway management. Immedate admision, monitoring vital signs  and  high doses of antibiotics ,with intravenous fluids  for rehydration  .

Early diagnosis and national oral health preventive programme required in all age groups with emphasis on younger age group will reduce the incidence of Odontogenic infections and its serious consequences.

Complications; Mediastinitis, Cavernous sinus thrombosis were reported in two cases.

Keywords: Odontogenic infection, non-Odontogenic;, epidemiology, retrospective analysis.

Biography:

Md Monjurul Alam has been working as Professor of Otolaryngology & Head - Neck Surgery at Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka since 2010. He Passed MBBS from Rajshahi Medical College, FCPS (ENT) from Bangladesh College of Physicians & Surgeon, Qualified MS in Otolaryngology from Dhaka University,obtained  FICS from USA. He got advanced training in Micro-ear Surgery, FESS & RhynoPlastic Surgery, Snoring & Sleep Surgery, LASER Surgery, Skull-Base surgery from USA, UK, Australia, India, Singapore, Bangkok, Malaysia & different countries of Europe. He is a pioneer of Endoscopic Ear surgery in Bangladesh. He activly perticipated in workshop, seminer, conference, Congress in different countries. He has more than 80 articles published in different national & international journals.More than 5 research works has been  going on under his supervision in BSMMU.

Abstract:

Background: Endoscopic ear surgery is an emerging technique with recent advancement highlighting advantages over the traditional microscopic approach. In Bangladesh  we started doing myringoplasty since 2005 with otoendoscope and stopped due to few problems But again, since 2007,  all types of middle ear surgeries  with nasal endoscopes has been being done with bright , wide & clear view. We did different types of Transcanal  Tympanoplasties, ossicluplasties, stapedotomies, also few cholesteatoma surgeries by endoscope.As Rigid endoscopy allows for wide-field view of the surgical field improved resolution with high magnification, and the ability to look around corners , enabling direct visualization of the hidden recesses including the retrotympanum, epitympanum, supratubal recess, peritympanum  and hypotympanum, granulation tissue or cholesteatoma matrix can be removed easily.

Methods: A cross sectional study done during March,2010 to June,2014 in otolaryngology & Head-Neck surgery dept of Bangabundhu Sheik mujib Medical University (BSMMU) after having permission from Ehethical review board  of the University.

Results: During the study period 1200 different types of transcanal  Endoscopic  Tympanoplasties like underlay &  interlay tympanoplasty using different graft matrials ;temporalis fascia,perichondrium, cartilage with graft taken up rate & hearing gain equivalent with tympanoplasty done by microscope. 517 different types ossicluplasties  and stapedotomies were done with similar hearing gain  done by microscope.117 cholesteatoma surgery – Atticotomy, attico-antrostomy with reconstruction have been done  without any major  complication or recurrence. Learning curve of surgery among the residents  is higher with endoscope.

Conclusions: Endoscopic ear surgery is a new technique that is gaining momentum in Bangladesh and there is enthusiasm for its incorporation into future practice. Further investment in training courses and guidance for those who looking to start or advance the use of endoscopes in their practice will be vital in the the years to come.

Biography:

Mario Tavolaro Giuseppe is performing the duties of Medical Director of 1st level C/O INAIL Lecce office since 1996. He also performs the assignment of Leadership Medical Major Thickness (B1) carried out at the headquarters of INAIL Jerseys since April, 2008. Dr. Giuseppe is the appointed contact person for the Regional Prevention (Puglia) and he has taken responsibilities in various high ranks in the field. He completed his degree of Medicine & Surgery from the University of Bari in 1985 and specialization in Occupational Medicine from the University of Messina in 1992. He has done extensive work in the field and his work with other authors and co-authors were published in various national and international reputed journals.

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Biography:

Masroor Ahmad Wani is Gold Medalist, has done MD from Medical College, Kolkata. He is practicing Aesthetic and Skin Medicine at Health Zone Medicate, Srinagar, India. He has published many articles in newspapers and magazines, has attended more than 22 national and international dermatological conferences.

Abstract:

A chemical peel is used to improve the appearance of the affected skin. A chemical peel solution is applied to the skin that eventually peels off the affected area. The new, regenerated skin is usually smoother and less wrinkled than the old skin. The new skin is temporarily more sensitive to the sun. Three basic kinds of chemical peels are: Superficial peel: Alpha-hydroxy acid or any another mild acid is used to penetrate only the outer layer of skin to gently exfoliate it. The treatment is used to improve the appearance of mild skin discoloration and rough skin as well as to refresh the affected area. Medium peel: Glycolic acid is used to penetrate the out and middle layers of skin to remove damaged skin cells. The treatment is used to improve age spots, fine lines and wrinkles, acne spots, freckles. Deep peel: Phenol or trichloroacetic acid is applied to deeply penetrate the middle layer of skin to remove damaged skin cells. The treatment removes moderate lines, age spots, freckles and shallow scars. Patients feel good improvement in skin appearance. Who is a good candidate for a chemical peel? Generally, fair-skinned and light-haired patients are better candidates for chemical peels. If you have darker skin, you may also have good results, depending upon the type of problem being treated. But you also may be more likely to have an uneven skin tone after the procedure.

Biography:

Dr.Neeraj Suri is a gold medallist ENT specialist who is trained extensively in cochlear implant. She offers comprehensive medical and surgical services at free of cost to the patients of Gujarat (under school health programme) and at an affordable cost to the patients outside Gujarat. Her prime object is to provide all sorts of advanced treatment in cochlear implant which includes audiology and speech pathology. She believes in combining the latest surgical techniques with a personal approach to each patient for their benefit. She has an experience of more than fifteen years in managing ENT and its specialized areas.Dr. Neeraj Suri currently heads one of the busiest cochlear implant programme, carrying out nearly 20 ci surgeries every month and works closely with foundation and NGO’s to support patients.Dr.Neeraj Suri looks forward to serving you in the future by growing along with scientific advancements. Dr. Neeraj Suri for Best hearing aid in Ahmedabad, Best hearing aid in Gujarat, Best hearing aid in Gandhinagar.

Abstract:

Preoperative Computed Tomography (CT), scan evaluation of the temporal Bones and MRI Brain in Cochlear Implant candidates plays a crucial role in determining candidacy and side of implantation. The CT scans allows the surgeon to carefully review the anatomy of the inner ear and mastoid cavity in order  to predict any potential difficulties or complications the may be encountered during implant insertion. We retrospectively reviewed 200 preoperative CT scans, of the temporal bones in children who have been successfully implanted and also those difficulties faced during surgery. In these scans, we assessed the degree of mastoid pneumatization, cochlear anatomy, and patency, size of vestibular aqueduct, cochlear aqueduct and internal auditory canal, jugular bulb, 7^th/8^th nerve thickness. Findings were analysed and difficulty encountered in insertion of the implant and electrodes in each case, CSF leak, facial nerve trauma were compared with imaging findings. We believe,it is important to recognise the key features in the imaging of temporal bone for planning in preoperative evaluation of cochlear implant candidates.

Biography:

Dr. Alessandro Bucci had an excellent skill in arranging a medical event. He got his medical doctorate degree from Università Cattolica del Sacro Cuore, later continued his residency in otolaryngology and completed in the year 2002 from same university. Later got his Ph.D in rhinology in 2006 from Università Cattolica del Sacro Cuore. Currently working as ENT Surgeon at Azienda Sanitaria Unica Regionale Marche.

Abstract:

Biography:

Reshma Ghedia is a surgical trainee with a specialist interest in ENT. She has done her core surgical training in London and has worked in busy quaternary ENT departments including Charing Cross Hospital and the Royal London Hospital.

Abstract:

Objectives: Obstructive Sleep Apnoea (OSA) affects around 2% of children and is a result of partial or complete airway obstruction during sleep, which affects the child’s ventilation and results in disordered sleep. This subsequently leads to increased metabolic, cardiovascular and neurogenic morbidity in these children.

The gold standard for investigation is overnight polysomnography (PSG) to identify the severity of the OSA however this can be difficult to obtain and most often a decision to proceed with an adenotonsillectomy is made by history and clinical examination without a sleep study.  Post-operative respiratory complications are well recognised due to previous chronic nocturnal hypoxia and resultant depression of the central ventilatory drive as well as the loss of the positive end expiratory pressure (PEEP) they experienced secondary to the airway obstruction. As a result post-operative high dependency unit (HDU) beds and short stay overnight beds are requested for these children. Specific guidance as to where exactly a child with varying OSA should be monitored post-operatively is lacking and often demand for valuable resources can sometimes be unnecessary and exceed availability. Our study evaluates the post-operative management of children undergoing adenotonsillectomy for OSA at a tertiary referral Centre.

Method: We performed a retrospective case note review of all patients identified to have been listed for an adenotonsillectomy plus a HDU or short-stay bed. This was for children under 16 managed at a tertiary referral Centre over a 1-year period.  We collected data on post-operative length of stay, oxygen desaturations, respiratory support, non-routine medications administered and transfer to higher level of care.

Results: We identified over 150 children who underwent an adenotonsillectomy for OSA. Of these children, Oxygen was given to a small proportion of children and a much smaller proportion required respiratory support in a HDU setting. No child required admission longer than 24 hours. A significant proportion of children did not have a sleep study to accurately risk stratify them.

Conclusion: High dependency care may be necessary for children following an adenotonsillectomy following surgery for OSA. However the majority of children booked for a HDU bed have not been risk stratified appropriately pre-operatively and did not require any HDU resources.  We discuss the benefits and cost of pre-operative sleep studies to aid utilisation of HDU beds for these children and also discuss whether there is a case for adenotonsillectomy for OSA to be done as a day case.

Biography:

Marwa Mohamed Fawzy has completed her PhD from Cairo University and Postdoctoral studies from Cairo University School of Medicine. She is a Professor of Dermatology, Cairo University (since April 2016). She has got International Board Certificate in Dermatopathology (December 2010) passing successfully the 8^th International Board Certifying Examination in Dermatopathology. She has published more than 30 papers in reputed journals and has been serving as an Editorial Board Member of repute.

Abstract:

Background: Alopecia areata (AA) is a common condition causing non-scarring hair loss, yet its pathogenesis is still unclear. Treatment of AA is a difficult challenge. The discovery of epithelial stem cells in the bulge region of the outer root sheath of hair follicles in mice and man has encouraged researchers to utilize the hair follicle as a therapeutic source of stem cells for regenerative medicine.

Objective: The objective of the study is to evaluate the use of follicular stem cells in the treatment of AA.

Patients & Methods: Fifteen patients with AA of the scalp were included in a randomized controlled double blinded clinical trial. Isolation of hair follicle stem cells was done by enzymatic digestion of the bulge areas. Cell tagging using iron oxide particles was performed in order to elucidate the exact fate of the injected cells as a way for in vivo cell tracking. Sham saline injections have been done at control sites on the scalp of the treated patients.

Results: Excellent response was achieved in three patients (20%), good response was achieved in seven patients (47%), while five patients (33%) showed poor response at the end of nine months evaluation. None of the placebo injected sites in all included patients showed any response.

Limitations: Sample size is relatively small. Long-term follow up is mandatory.

Conclusion: It can be concluded that, local follicular stem cell therapy could be a feasible, efficient and safe therapeutic option for Alopecia areata.

Biography:

Abstract:

Biography:

Abstract:

Obstructive sleep Apnoea ( OSA) is a chronic disorder characterized by intermittent upper airway collapse which impairs ventilation and disrupts sleep. Approximately 3-7% of adult men & 2-5% of adult women in general population suffers from OSA associated excessive daytime slerpiness. Nearly 22 million Americans are affected by osa, making it most common disorder. Patients & with undiagnosed & untreated OSA are at incresed risk for cardiovascular and cardiovascular health consequences and co-morbidities. Suspicion of the disease, investigations & diagnosis of OSA is very essential. Usually OSA is observed by bed partners or roommates that the patient having problems of loud snoring sound Apnoea during sleep.Patient's Body mass index, Neck & waist circumference and presence of retrignathia or micrognathia should be taken into account. Mallampati score & Epwarth scale of the parient is also important. Adequate physical exam - oral Exam is essential.Mueller maneuver Fibro optic Nasopharyngo Laryngoscooy is important. Pulse Oximetey is screening test. Polysomnography is a gold standard of all investigations from which AHI, RDI, ODI can assessed. Sleep MRI or dynamic ultrafast MRI is done to detect level of obstructions. Recently Drug Induced Sleep Endoscopy (DISE) is latest method to diagnose OSA detect level of obstructions. Cephalometric methods can also be applied. OSA is associated with subatantial economic costs to society including increased medical costs. So early Suspicion, adequate physical Examination, essential investigations should be done to diagnose OSA timely & treat the patient timely to prevent morbidity mortality from OSA.