Comparison between endoscopic and microscopic butterfly cartilage graft inlay tympanoplasty: a systematic review and meta-analysis.

PURPOSE: The purpose of this study was to compare the effectiveness of endoscopic and microscopic approaches for butterfly cartilage graft inlay tympanoplasty regarding anatomical and hearing outcomes through a systematic review and meta-analysis. METHODS: A search of PubMed, Embase, MEDLINE, and Virtual Health Library was performed from inception to July 3rd, 2021, using keywords, such as tympanoplasty, cartilage graft, and inlay technique. Data from articles that met inclusion criteria were extracted by two authors independently. The PRISMA statement was followed. RoB-2 and ROBINS-I tools were used to assess risk of bias. The primary outcome was tympanic membrane closure rate. The secondary outcome was improvement of the air-bone gap. RESULTS: Five studies were included, one randomized clinical trial and four retrospective cohorts, in which a total of 318 patients were included. Graft take rate was 91.3% in the endoscopic group and 93.6% in the microscopic group (RR 0.98; 95% CI 0.93-1.03; I2 0%; P = 0.68). Four studies provided data about the secondary outcome, all showing significant reductions in air-bone gap, ranging from 5.7 to 11.0 in the endoscope group and from 5.8 to 11.6 in the microscope group, with a mean difference between groups of 0.85 (95% CI - 0.79 to 2.48). CONCLUSION: Although the overall evidence of the included studies was low, endoscopic and microscopic butterfly cartilage graft inlay tympanoplasties have similar results on anatomical and hearing outcomes, making the selection between such approaches an individual choice for the surgeon.

Comparison of Inlay Cartilage Butterfly and Underlay Temporal Fascia Tympanoplasty.

Objective: To systematically review the results of inlay cartilage butterfly tympanoplasty and standard underlay temporal fascia tympanoplasty for anatomic and functional end points. Data Sources: PubMed, Embase, MEDLINE, and Virtual Health Library (VHL/Lilacs) databases were searched from inception through April 2, 2021. No restrictions on language, publication year, or publication status were applied. Review Methods: The meta-analysis included data from articles that met inclusion criteria and were extracted by 2 authors independently. The PRISMA statement was followed. Risk of Bias 2.0 and Newcastle-Ottawa Scale were used to assess risk of bias. The primary outcome was tympanic membrane closure rate. The secondary outcome was improvement of the air-bone gap. Results: Ten studies were included, 9 cohort studies and 1 randomized clinical trial, with 577 patients. The graft take rate was 82.8% in the butterfly cartilage inlay tympanoplasty group and 85.2% in the temporal fascia underlay tympanoplasty group (relative risk, 1.01; 95% CI, 0.93-1.11; I 2 = 42%, P = .08). The air-bone gap reduction ranged from 6.1 to 11.28 in the butterfly cartilage inlay group and from 5.2 to 12.66 in the temporal fascia underlay group, with a mean difference between groups of -2.08 (95% CI, -3.23 to -0.94; I 2 = 58%, P = .04), favoring temporal fascia underlay. Conclusion: The 2 tympanoplasty techniques analyzed here produced similar results in terms of successful reconstruction of the tympanic membrane and reduction in the air-bone gap. Neither age nor follow-up length of time influenced outcomes.

Intentional exposure to loud music: the second MTV.com survey reveals an opportunity to educate.

OBJECTIVES: Music-induced hearing loss (MIHL), an unconsciously self-inflicted public health concern, could evolve into an epidemic because of the appeal of loud music. After media attention about a previous hearing-loss survey with Music Television (MTV.com), we hypothesized that a repeat survey could compare awareness and behavior trends. STUDY DESIGN: We incorporated the 2002 survey into the new 73-question instrument presented to random visitors on the MTV.com website in 2007. A P < .05 value was used for independent t and z- tests. RESULTS: A total of 2500 completed surveys were analyzed. Hearing loss was considered a problem by 32% of respondents compared with other health issues such as drug/alcohol use (62%). However, nearly half of the respondents admitted experiencing symptoms such as tinnitus or hearing loss after loud music exposure. Health care providers were the least likely source of MIHL awareness despite the respondents favoring provider education for hearing protection behavior modification. CONCLUSION: Most respondents still could not recall learning about prevention of potential hearing loss, although the media has become the most informative source. Most respondents indicated that they would adopt protective ear behavior if made aware of hearing loss risk, especially if informed by health care professionals, revealing an educational opportunity.

The Internet-current trends and future expectations among Brazilian pediatricians and otolaryngologists with a special interest in pediatric otolaryngology.

OBJECTIVE: To assess Internet use among a group of Brazilian pediatricians and otolaryngologists and to inquire about possible Web based medical resources. METHODS: Questionnaires were distributed among attendees of a 2001 Pediatric Otolaryngology meeting in Brazil. Multiple choice or yes/no questions related to the use of the Internet among physicians were presented. RESULTS: All of the 99 respondents of an estimated 900 attendees, had Internet access (high-speed 18%, conventional 77%); 52% at home, 42% in the office and 6% at both sites. Eighty-one percent of those responding regularly used the Internet for medical updating. Sharing a pediatric otolayngology medical association Web site with patients was desired by 73%; an interest in personal Web based medical information and updates was demonstrated by 97%. Five percent of respondents already had established personal practice Web sites and 54% agreed with potential benefits for improving medical practice. CONCLUSION: The potential role of electronic communication and a desire to establish a pediatric otolaryngology Web site that would maximize inclusiveness is appreciated by this group of Brazilian otolaryngologists and pediatricians.

Perda auditiva genética / Genetic hearing loss

O progresso das pesquisas relacionadas a perda auditiva genética tem provocado um importante avanço do entendimento dos mecanismos moleculares que governam o desenvolvimento, a função, a resposta ao trauma e o envelhecimento do ouvido interno. Em países desenvolvidos, mais de 50 por cento dos casos de surdez na infancia é causada por alterações genéticas e as perdas auditivas relacionadas a idade têm sido associadas com mecanismos genéticos. OBJETIVO: O objetivo desta revisão é relatar as informações mais recentes relacionadas as perdas audtivas de origem genética. FORAMA DE ESTUDO: Revisão sistematica. MATERIAL E METODO: A revisão da literatura inclui artigos indexados no MEDLINE (Biblioteca Nacional de Saúde, NIH-USA) e publicados nos últimos 3 anos, além das informações disponiveis na Hereditary Hearing Loss Home Page. CONCLUSÃO: Os recentes avanços no entendimento das perdas auditivas de origem genética têm favorecido a nossa compreensão da função auditiva e tornado o diagnóstico mais apurado. Possivelmente, no futuro, este conhecimento também proporcionará o desenvolvimento de novas terapias para o tratamento das causas genéticas das perdas auditivas

Massa cervical atípica em criança / An unusual pediatric cervical mass

Reporta-se o caso de lactente, com 19 meses de idade, que se apresentou com massa cervical assintomática de dois meses de evolução e que foi submetida a cirurgia. Os achados clinico-patológicos foram consistentes, com cisto de duplicação laríngea. Apresenta-se revisão do diagnóstico diferencial e das características histopatológicas do cisto de duplicação laríngea.

A 19-month-old female who presented with a mo month history of an asymptomatic neck mass and who underwent surgery is reported. The clinicopathologic findings are consistent, with a laryngeal duplication cyst. A review of the differential diagnosis and histopathologic characteristics of laryngeal duplication cyst is presented.