RESUMEN
Head and neck cancers, including nasopharyngeal carcinoma (NPC), are relatively common in Saudi Arabia. Radiotherapy is a standard treatment for NPC, but it can lead to side effects, including post-radiation otitis media with effusion (OME). Managing post-radiotherapy OME remains a topic of debate, with various interventions proposed. This study aims to review the efficacy of different methods to manage post-radiotherapy OME in NPC. This includes tympanostomy tube insertion, frequent myringotomies, and observation. A systematic review was carried out for articles published between 1975 and 2023 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Excluded from the analysis were articles that involved patients undergoing surgical treatment for nasopharyngeal cancer, studies that focused on patients with other head and neck cancers who developed OME after radiotherapy, research investigating the effectiveness of surgical procedures unrelated to tympanostomy tube insertion, studies written in non-English language, and case reports, reviews, or conference letters. A total of 450 studies were screened, of which six studies were included in the review, yielding 328 patients. The mean age ranged between 46 and 52 years. Follow-up varied from six months to 11 years. The intervention in all studies was tympanostomy tube insertion, and the controls were myringotomy, observation, or tympanic membrane fenestration with cauterization. The use of recurrent myringotomies for the treatment of OME in patients with NP post-radiotherapy is associated with improved chances for the resolution of effusion and decreased risk of complications when compared to tympanostomy tube insertion. Hence, we recommend following a step-wise approach when dealing with this group of patients, offering grommets for patients with persistent effusion or those who cannot tolerate frequent procedures.
RESUMEN
Background: Incidence of body contouring surgeries (BCS) rose significantly to overcome problems resulted from post-Bariatric Surgery (BS). We aimed to evaluate satisfaction level and quality of life (QOL) in patients' post-BCS. Methods: In this retrospective prospective study, patients who underwent BCS in Plastic Surgery Department, Salmaniya Medical Complex, Bahrain, in 2017-2018, were enrolled. Demographic and anthropometric data were collected. BS-group's QOL and satisfaction level were assessed using a questionnaire. Results: Of 929 plastic surgery admissions, 316 (34%) were for BCS (249 patients). Fifty-eight (28%) patients underwent 82 BS were recruited, mostly females (n=42, 72.4%). The mean age was 37.4±9.6 years. Excess abdominal skin was the most area of concern (n=50, 86.2%). Median pre-BCS body mass index was 26.9 (interquartile range: 25.6-29.8) kg/m2. Most patients were overweight (n=26, 44.8%). Abdominoplasty was the commonest BCS (n=172, 50.6%). This was also the case in 82 BCS in post-BS group (n=38, 46.3%). In post-BS group, post-operative complications were noted in 25/82 (30.5%) patients with wound problems being the most frequent (n=14, 17.1%). Most patients rated their experience as better in all questionnaire domains and most (n=45, 54.9%) rated their satisfaction level as excellent. Older age gave better overall satisfaction (P<0.001) while employed patients had better overall QOL (P=0.012) and self-confidence (P=0.048). Females had better satisfaction with body appearance (P<0.001) while those underwent abdominoplasty or breast surgeries had lower physical activity (P=0.042). Conclusion: This study showed improvement in patient's QOL post-BCS with excellent overall satisfaction, findings that could be affected by age, sex, and occupation.
RESUMEN
BACKGROUND: Plastic surgery is the most diverse specialty. It deals with a wide spectrum of abnormalities in different genders, age groups and body parts. Data on clinical characteristics of patients admitted in the burn and plastic surgery unit have been reported from our center last in 1993. METHODS: This retrospective cross-sectional study conducted during 1-year from 2017 to 2018 in the burn and plastic surgery unit, Salmaniya Medical Complex, Bahrain. Seven hundred seventy-four patients (929 admissions) were enrolled. Indications of admissions, demographic data including gender, nationality and age were gathered. Different types of burns were categorized. RESULTS: Out of 16,492 surgical admissions, 929 (5.6%) admissions were for burn and plastic surgery. Nine hundred-twelve (98.2%) admissions for 766 patients were included. Burn injuries were the main indication with a total of 345 (37.8%) admissions for 337 (44%) patients. Three hundred eighty-eight (50.7%) patients were males. Five hundred fifty-eight (72.8%) patients were nationals. Most were in the age group of 30-39 years old (24.9%). On comparison, burn injuries were more in males (n=241, 71.5%), nationals (n=175, 51.9%), younger in age (mean age, 23.8±19.6 years) and in pediatric age group (n=122, 36.2%) specifically, (All P<0.0001). Scalded burn was the commonest type (n=184/317, 58%). CONCLUSION: Burn and plastic surgery is a significant part of surgical admissions. Burn injuries were the most frequent reason of admissions. Patients with burn injuries were mainly males, nationals and children. Scalded burn was the most frequent type in our center.