The role of cytokine gene single nucleotide polymorphism in the development of recurrent acute otitis media.

The study aimed at examining the role of single nucleotide polymorphism (SNP) of cytokine genes in the development of recurrent acute otitis media (AOM) among children. Single nucleotide polymorphism of IFN-, IL-6, IL-10, TNF-α, and TGF-ß1, were analyzed by the polymerase chain reaction with sequence-specific primers (PCR-SSP) in 82 children with recurrent AOM and compared with a similar control group. There was a significant higher incidence of IL-10 polymorphisms (loci -592, -819 and -1082) in children with recurrent AOM (P=0.0137, 0.0137 and 0.0072, respectively). However, there was no significant difference in the distribution of other cytokine genotypes between the two study groups. Among the 5 studied cytokine genes, only IL-10 loci showed significant correlation to the development of recurrent AOM.

Outcomes of Using Otoendoscopy During Surgery for Cholesteatoma.

To determine the impact of using otoendoscopy at the time of primary surgery of cholesteatoma in identifying hidden "cholesteatoma remnant". Study was prospective study. Setting was University tertiary care hospital. One hundred fifty, patients diagnosed clinically and by CT as having cholesteatoma, have been operated. 64 patients operated by using canal up technique and 86 patients operated by using canal down technique. Once all visible cholesteatoma was removed with standard microscopic techniques, otoendoscopy was utilized in every patient to identify any hidden "cholesteatoma remnant". Despite apparent total microscopic eradication of cholesteatoma of the operated cases, otoendoscopy at time of primary surgery revealed an overall incidence of hidden cholesteatoma remnants of 18%. The incidence of hidden cholesteatoma remnants identified by otoendoscopy was 23% in the canal up group and 14% in the canal down group. Otoendoscopy should be used as an adjunct with standard microscopic technique to identify hidden cholesteatoma remnants during surgery of cholesteatoma.

Role of Multislice CT Imaging in Predicting the Visibility of the Round Window in Pediatric Cochlear Implantation.

BACKGROUND: High-resolution computed tomography (HRCT) magnifies the role of preoperative imaging for detailed inner and middle ear anatomical information and enhances more efforts for better dependent correlation and measurements of round window (RW). OBJECTIVE: To find an applicable way by HRCT imaging for the prediction of the visibility of the RW during cochlear implantation (CI) surgery. METHODS: Five radiologic measurements were performed on the axial HRCT and these measurements were correlated with the degree of RW visibility after performing posterior tympanotomy during CI surgery. RESULTS: Sixty ears of 60 children were included in the current study. A significant correlation was found between the degree of RW visibility and the following: 1) the angle between RW, facial nerve (FN), and the coronal axis (p < 0.00001); 2) the vertical distance between RW and FN (p = 0.006552); and 3) FN location to the axis of cochlea (p = 0.000419). On the other hand, nonsignificant correlation was found between the degree of RW visibility and both of the facial recess width and the angle between axis of cochlea and external auditory canal (p = 0.941363 and p = 0.59036 respectively). CONCLUSION: The angle between RW, FN, and the coronal axis and the vertical distance between RW and FN are proportionate with the degree of surgical RW visibility in children during CI. In children, surgeons can depend on those two parameters in addition to the distance between FN location to the axis of cochlea in predicting the RW visibility rather than depending on the measurements related to the external auditory canal.