The objective was to compare the outcomes of spontaneous closure and hyaluronic acid (HA) ester patching (Epifilm®) in subjects with traumatic tympanic membrane (TM) perforation. This was a prospective, controlled study performed at a tertiary teaching and research hospital. During 6-month period, subjects were divided into spontaneous closure (group A) and HA ester patch-Epifilm® (group B) group. Demographic data, presenting symptoms, closure rate, closure time and audiometric data were evaluated and compared between groups. In total, 155 subjects were evaluated. Group A consisted of 62.6 % (n = 97) of the subjects, whereas group B consisted of 37.4 % (n = 58) of the subjects. Group B had significantly shorter closure times when compared with group A (6.61 ± 4.59 vs. 10.60 ± 5.23 weeks, p = 0.001). When the closure time was evaluated according to perforation size both grade 1 and 2 perforations have significantly shorter closure times when compared with group A (6.33 ± 4.54 vs. 10.80 ± 5.69 weeks, for grade 1 and 6.650 ± 2.07 vs. 10.30 ± 4.32 weeks for grade 2 perforations). Closure rates were not significant between groups (85.6 % for group A and 94.8 % for group B). When the closure rate was evaluated according to perforation size no significant difference exists for grade 1, 2 and 3 perforations between groups. Both air conduction and air-bone gap were significantly improved in both groups. HA ester patch (Epifilm®) is a non-toxic material that can be used in traumatic tympanic membrane perforations. In this study, use of HA ester patching was resulted with earlier closure time but not resulted with higher closure rates.
OBJECTIVE:This study aimed to present the follow-up results of newborns after universal newborn hearing screening at a Training and Research Hospital in İstanbul and to determine the ages of diagnosis, hearing aid fitting, and cochlear implantation in newborns with hearing loss.
MATERIALS and METHODS:A total of 5985 newborns were screened between December 2009 and August 2011 using the transient evoked otoacoustic emission test as the first two steps and automated auditory brainstem response (ABR) test as the third step. Newborns who failed the screening tests were referred to a tertiary hospital for clinic ABR and were followed up at least for 2 years.
RESULTS:Of 5985 newborns, 5116 (85.5%) completed the screening. Of 53 newborns who were referred to a tertiary hospital, 13 (0.25%) had a hearing impairment. The mean age of diagnosis, hearing aid fitting, and cochlear implantation were 6.1, 9.5, and 24.5 months, respectively. Among the risk factors for hearing impairment, neonatal intensive care (60%) and consanguineous marriage (50%) were the most common ones that were encountered.
CONCLUSION:Our results were consistent with the national literature. Consanguineous marriage may be a risk factor for hearing impairment where it is commonly practiced because consanguineous marriage is significantly high in parents of deaf children. The ages of diagnosis and hearing aid fitting are still beyond the recommended ages by the Joint Committee on Infant Hearing.
The feasibility and effectiveness of transoral robotic surgery (TORS) in children with tongue base masses (TBMs) were evaluated. Eight pediatric patients who were treated with TORS for TBMs between January 2010 and January 2016 at a tertiary hospital included in the study. All pathologies were congenital lesions: four were lingual thyroglossal ductus cysts (LTGDCs), one was a minor salivary gland tumor, one was a vallecular cyst, one was a bronchogenic cyst, and one was an ectopic thyroid tissue. TORS was performed successfully in all cases. The mean robotic set-up and exposure time was 13.0 ± 2.1 min (range 10-16 min) and the mean robotic surgery time was 8.8 ± 6.9 min (range 4-25 min). Estimated blood loss was lower than 5 ml for one patient and lower than 50 ml for another one. The remaining patients' estimated blood loss was lower than 10 ml. No patient required tracheostomy intra- or post-operatively. Only one minor complication occurred on day 10 after surgery (minor bleeding), which was resolved without intervention. No major complications or recurrence were observed. Better visualization and small, flexible arms allow surgeons to treat TBM faster and easily using TORS. This leads to decreased morbidity compared to open and transoral endoscopic/microscopic surgical methods. In the future, we believe that TORS may become the gold standard method for the treatment of pediatric TBM with continued development of robotic technology.
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