Ear,Nose & Throat Journal

There is a significant lack of surgeons in the developing world. Malawi Africa is one of the poorest and medically underserved countries in the World, with surgical care particularly lacking. Providing surgical services has numerous barriers, such as availability of well-trained surgeons, infrastructure, continuity of care, and access to care. There is currently one otolaryngologist in Malawi who provides complete access to this subspecialty. The development of the otolaryngology department was successful through institutional, local, national, and international collaboration, with a long-term goal of sustainability. An established department can train the next generation of surgeons for the preservation and growth of the surgical workforce. Once the department approaches independence, the role of outside collaboration transforms primarily from financial to a bi-directional partnership encompassing education, training, and leadership.

Objective: This study aimed to assess the serum levels of vitamin D in an Egyptian cohort of children with allergic rhinitis (AR) and to evaluate any correlation of vitamin D status with the disease severity. Patient and methods: One hundred twenty children with AR and 100 healthy children were included in our study. We studied the serum levels of vitamin D 25(OH)D and 1,25(OH)2D in all participants. The associations between vitamin D levels and clinical characteristics of AR were examined. Results: In AR group, the serum levels of calcium, (25(OH)D and 1,25(OH)2D levels were significantly lower (p < .0001, p < .001, and p < .0001, respectively) in AR children than in controls. Furthermore, the mean 25-OHD3 levels in patients with moderate/severe AR were significantly lower than those with mild AR (p < .001). We found significant negative correlations between mean 25(OH)D levels and total nasal symptom score (r = −.62, p = .002) and total immunoglobulin E levels (r = −.27, p = .013) in AR group. Conclusions: Vitamin D deficiency is a frequent finding among Egyptian children with AR when compared to the healthy group. A significant inverse association was observed between vitamin D levels and AR disease severity.

The aim of this study is to investigate the outcomes of bilateral same-day endoscopic myringoplasty using tragal cartilage from one ear in patients with bilateral chronic otitis media. In this retrospective study, medical records of 62 (84 ears) patients aged between 18 and 65 years who underwent endoscopic myringoplasty at our center between January 2015 and December 2017 were evaluated. Patients were classified into 2 groups according to surgical procedure they received: unilateral myringoplasty (group 1) and bilateral same-day myringoplasty (group 2). The comparisons were made between groups in terms of anatomical graft success and functional outcomes. There were 40 patients in the unilateral group (group 1) and 22 patients in the bilateral same-day group (group 2). The graft success rates were 92.5% and 93.2% for groups 1 and 2, respectively (P = .904). The mean preoperative air–bone gaps (ABGs) were 21.1 ± 7.1 and 20.5 ± 6.7 dB, respectively, whereas the mean postoperative ABGs were 8.1 ± 2.7 dB and 7.9 ± 3.0 dB, respectively. The difference between pre- and postoperative ABGs for the entire group was statistically significant (P < .001). Mean hearing gain was 12.5 ± 11.0 dB and 15.6 ± 10.1 dB in groups 1 and 2, respectively, (P = .183). Postoperative ABG was ≤10 dB in 33 (82.5%) and 36 (81.8%) ears in groups 1 and 2, respectively. The functional success rates were similar in both groups (P = .582). The average lengths of operation time were 61.6 ± 12.5 minutes and 110.1 ± 25.2 minutes for groups 1 and 2, respectively. Bilateral same-day endoscopic myringoplasty using tragal cartilage from one ear seems to be a safe and satisfactory procedure with a good satisfactory success rate.

To date, no specific biomarkers for idiopathic sudden sensorineural hearing loss (ISSHL) have been used. The aim of this study is to investigate whether prestin, the motor protein of cochlear outer hair cells, could be used as a biomarker candidate for the diagnosis and prognosis judgement of ISSHL. Blood samples of 14 ISSHL patients and 28 control patients without history of hearing loss were collected. Plasma prestin concentration was measured using Human Prestin (SLC26A5) ELISA Kit. The results showed that prestin was detectable in the plasma of all patients and the concentration of prestin was significantly higher in ISSHL patients with about half being above the average range of control patients. Moreover, in treatment responsive group, 6 of 10 patients had decreased prestin levels after treatment compared to those of before treatment, while the prestin levels of all the 4 patients in treatment unresponsive group increased in varying degrees. Our promising preliminary results suggest that prestin has the potential to serve as a biomarker to assist diagnosis and judge response to pharmacological treatments.

Whether the dimension of the osseous external auditory canal (OEAC) is related to chronic otitis media (COM) remains an important but unresolved issue. In the literature, routine canaloplasty has been suggested to help elucidate this problem. In this study, we intended to investigate the relationship between the diameter or shape of OEAC and COM. We retrospectively reviewed the high-resolution computed tomography (HRCT) images of the temporal bones of 62 patients with unilateral COM who underwent tympanoplasty from January 1, 2011, to December 31, 2013. For comparison, the HRCT images of another 62 patients with normal ears were collected to be the control group. The shape of OEAC was categorized into 5 groups according to Mahboubi’s classification, and the dimension of each patient’s OEAC was measured at 2 defined sections (annular section and isthmus/midcanal section). The most prevalent shape of OEAC for the lesion sides of the ears was cylindrical, followed by conical, and hourglass in both the COM and the control groups. As to the dimension of OEAC, there were no significant differences between lesion ears and normal ears among patients in the COM group as well as between lesion ears in the COM group and normal ears in the control group. We concluded that the bony dimension of the external ear canal was not related to COM. This suggested that chronic inflammation or infection of middle ear may not cause bony thickening of OEAC, despite the kind of OEAC shape involved.