Comparison of conventional and extended middle meatal antrostomy for the treatment of antrochoanal polyps.

OBJECTIVE: The objective was to compare the recurrence rate and complications between endoscopic middle meatal antrostomy (MMA) and extended MMA for the treatment of antrochoanal polyps (ACPs). METHODS AND MATERIALS: 95 ACPs were prospectively enrolled to undergo MMA (n = 48) or extended MMA (n = 47). The recurrence rate and complications were compared between these groups. RESULTS: All patients completed 24 months of follow-up. The recurrence of ACP was demonstrated by only endoscope at 6 and 12 months postoperatively but at 24 months postoperatively by endoscope and CT. Rates of recurrence of ACP differed between groups and significance at postoperative month 6 (7/48 patients in the MMA group and 0/47 patients in the extended MMA group, P = 0.02), month 12 (16/48 vs. 2/47, P < 0.01) and month 24 (21/48 vs. 3/47, P < 0.01). No MMA closure was found in any group, 19.15% (9/47) patients complained of cheek numbness in the extended MMA group, however, no major complications were observed in both groups. CONCLUSIONS: Extended MMA via antidromic extended medial wall of MS may effectively reduce the recurrence of ACP with lower complications.

Healing large Traumatic Tympanic Membrane Perforations Using Vaseline Gauze and Gelfoam Patching Alone.

OBJECTIVE: The aim of this study was to evaluate the effect of vaseline gauze (VG) patching on the treatment of large traumatic perforation of tympanic membrane (TM). MATERIAL AND METHODS: 90 patients with traumatic perforation larger than 25% of the TM were randomly allocated into the control group of observation only, VG group, and Gelfoam patch alone group. The closure rate and closure time among the 3 groups were compared at 3 months. RESULTS: In total, 82 large traumatic perforations were analyzed in this study. The closure rates in the control, VG, and gelfoam patch groups were 84.6%, 100.0%, and 89.3%, respectively (P = 0.637). Post-hoc multiple comparisons showed that the difference between the control and VG groups was significant (P = 0.047), but the difference wasn't significant between gelfoam alone and control groups (P = 0.699) or VG groups (P = 0.236). The mean closure times were 5.41 ± 1.47, 2.14 ± 0.93, and 3.00 ± 0.62 weeks for the control, VG, and gelfoam patch groups, respectively (P < 0.001). Post-hoc multiple comparisons showed that the difference was significant between the control and VG groups (P < 0.001) or gelfoam alone group (P < 0.001) or VG and gelfoam groups (P < 0.05). CONCLUSIONS: VG improved the closure rate and shortened the closure time compared with observation only, which could be an effective patch material for repairing traumatic lager perforations in the outpatient setting, which is readily available and convenient.

Low-temperature plasma radiofrequency ablation tuboplasty and myringotomy: A preliminary report.

OBJECTIVE: To evaluate the efficacy of Low-temperature plasma radiofrequency ablation (RF) tuboplasty and myringotomy for treating chronic otitis media with effusion (COME) with chronic obstructive eustachian tube dysfunction (COETD) involving hypertrophic tissue of the ET orifice. METHODS AND MATERIALS: This was a prospective study of 43 ears with COME and COETD who underwent RF tuboplasty. Outcomes included the ability to perform a Valsalva maneuver, tympanometry results, and TM status. Success was defined by an improvement in tympanogram type and Valsalva maneuver. Follow-up ranged from 4 weeks to 12 months. RESULTS: A total of 43 ears (43 patients) were included in the study. Mucosal hypertrophy of the ET orifice was seen in 35 (81.4 %) patients, while polypoid tissue was observed in 8 (18.6 %) patients. All patients completed the 12-month follow-up, the success rate was 95.3 % (41/43) at postoperative 3 months, 39/43 (90.4 %) at postoperative 6 months, and 37/43 (86.0 %) at postoperative 12 months. No procedure-related serious adverse events were reported for any patient, and there were no cases of patulous ET. Stenosis/scar of anterior-post wall in the ET orifice occurred in two patients at 6 months postoperatively and in one patient at 12 months postoperatively, which the Valsalva maneuver was positive. Thus, no further treatment was applied for the ET orifice in 3 patients. The risk of stenosis of the ET orifice was 3/47 (6.4 %). CONCLUSIONS: RF eustachian tuboplasty may be an effective treatment for patients with COME, COETD and hypertrophic mucosa in the ET orifice, particularly as an adjunct to balloon tuboplasty.

[Epidemiological investigation and correlation factors analysis of voice diseases of 5758 business dealers].

OBJECTIVE: To investigate the epidemic features and risk factors of voice diseases of 5758 business dealers. METHOD: Questionnaire survey was conducted among 5785 business dealers of four markets in Yiwu city by random cluster sampling from March to July, 2006. They were also examined by indirect laryngoscopy. The incidence of voice disease was calculated and the risk factors were evaluated in four markets. RESULT: The incidence of voice disease was 39.3%, 18.8%, 28.4% and 58.1% in garment market, crafts market, stock market, and vegetable market, respectively. The average incidence was 30.4% in four markets. The difference of incidence among four markets was statistically significant (P < 0.01). The difference of incidence between female and male was statistically significant in any market. Chronic laryngitis and polyp of vocal cord were found to be the major pathological manifestations in men, while Chronic laryngitis and vocal nodules were found to be the major pathological manifestations in women. In addition, laryngeal carcinoma was confirmed in 8 cases. Market noise, pollution, unhealthy habits of business trade and excessive voice were the high risk factors. The female and the business dealers aged from 30 to 50 were the high risk people. CONCLUSION: Varied relevant measures should be taken to prevent and control voice disease in different subgroups of population. People should be examined thoroughly as soon as they got voice problem. Improvement of market environment and timely intervention may reduce the prevalence rate of voice disease.