The Use of a Unilateral Curved Spreader Graft in the Management of Crooked Nose Deformity.

AIM OF WORK: The aim of this study is to present a new technique of using spreader grafts in the correction of crooked nose deformity with C-shaped deviation of the middle third of the nose. PATIENTS AND METHODS: This is a prospective case series study conducted on 18 patients with crooked nose deformity with C-shaped deviation of the middle third of the nose. All of the patients were managed by open septorhinoplasty. During surgery, a curved spreader graft was harvested from the nasal septum and placed on the convex side of the C-shaped deviation of the dorsal part of the nasal septum. Objective measurements of the angles of external nasal deviation (END) and the internal nasal valve (INV) angles were performed before and 6 months after the surgery. Subjective assessment of aesthetic satisfaction by the visual analog scale and nasal function by the nasal obstruction symptom evaluation scale was also performed before and 6 months after surgery. RESULTS: Eighteen patients were enrolled in the study and completed the minimum follow-up period of 6 months. The mean follow-up period was 17.3 months. Objectively, there was highly significant ( P < 0.00001) improvement of the END angle and INV angle. Subjectively, there was also highly significant ( P < 0.00001) improvement of both the nasal obstruction symptom evaluation score and the visual analog scale score for aesthetic satisfaction. CONCLUSIONS: The insertion of a curved unilateral spreader graft over the convexity of the deviated nasal dorsum can correct the END, improve the collapsed INV on both sides, and consequently achieve satisfactory aesthetic and functional outcomes.

Sudden Sensorineural Hearing Loss: Comparative Study of Different Treatment Modalities.

Introduction Idiopathic sudden sensorineural hearing loss (ISSNHL) is hearing loss of at least 30 dB in at least 3 contiguous frequencies within at least 72 hours. There are many different theories to explain it, and many different modalities are used for its management, such as: systemic steroids (SSs), intratympanic steroid injection (ITSI), hyperbaric oxygen therapy (HOT), antiviral drugs, and vasodilators or vasoactive substances. Objectives This study aims to evaluate the efficacy of the combination of the most common treatment modalities of ISSNHL and to compare the results if HOT was not one of the treatment modalities administered. Methods The study was conducted with 22 ISSNHL patients with ages ranging from 34 to 58 years. The patients were divided into 2 groups; group A included 11 patients managed by SSs, ITSI, antiviral therapy, and HOT simultaneously, and group B included 11 patients exposed to the aforementioned modalities, with the exception of HOT. Results After one month, all of the patients in group A showed total improvement in hearing in all frequencies, with pure tone average (PTA) of 18.1 ± 2.2, while in group B, 5/11 (45.5%) patients showed total improvement, and 6 /11 (54.5%) patients showed partial improvement, with a total mean PTA of 28.1 ± 8.7. Conclusion The early administration of HOT in combination with other clinically approved modalities (SSs, ITSI, antiviral therapy) provides better results than the administration of the same modalities, with the exception of HOT, in the treatment of ISSNHL.

Sudden Sensorineural Hearing Loss: Comparative Study of Different Treatment Modalities

Abstract Introduction Idiopathic sudden sensorineural hearing loss (ISSNHL) is hearing loss of at least 30 dB in at least 3 contiguous frequencies within at least 72 hours. There are many different theories to explain it, and many differentmodalities are used for its management, such as: systemic steroids (SSs), intratympanic steroid injection (ITSI), hyperbaric oxygen therapy (HOT), antiviral drugs, and vasodilators or vasoactive substances. Objectives This study aims to evaluate the efficacy of the combination of the most common treatmentmodalities of ISSNHL and to compare the results if HOTwas not one of the treatment modalities administered. Methods The study was conducted with 22 ISSNHL patients with ages ranging from 34 to 58 years. The patients were divided into 2 groups; group A included 11 patients managed by SSs, ITSI, antiviral therapy, and HOT simultaneously, and group B included 11 patients exposed to the aforementioned modalities, with the exception of HOT. Results After one month, all of the patients in group A showed total improvement in hearing in all frequencies, with pure tone average (PTA) of 18.1 ± 2.2, while in group B, 5/11 (45.5%) patients showed total improvement, and 6 /11 (54.5%) patients showed partial improvement, with a total mean PTA of 28.1 ± 8.7. Conclusion The early administration of HOT in combination with other clinically approved modalities (SSs, ITSI, antiviral therapy) provides better results than the administration of the same modalities, with the exception of HOT, in the treatment of ISSNHL.