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We report a case of rupture of a reconstructed anterior cruciate ligament (ACL) combined with avulsion of the inferior patellar ligament. The two lesions were repaired during one operation using the quadriceps tendon as a graft for the damaged ACL.

Objectives: Cochlear implant is traditionally performed using a mastoidectomy, posterior tympanotomy and cochleostomy using a surgical microscope. Because of the anatomical and physiological understanding of the mastoid cells and their role in maintaining ventilation and pressure equalization in the middle ear, and the possible risk of facial nerve injury, some techniques without mastoidectomy and without posterior tympanotomy have been introduced as an alternative approach, showing excellent results. The aim of the study was to describe totally endoscopic technique without mastoidectomy in 6 patients with bilateral profound hearing loss who underwent cochlear implantation from January 2012 to February 2013, showing its viability and the advantages and disadvantages. Methods: All cases were selected based on computed tomography, magnetic resonance, audiological tests and psychological evaluation. Surgical steps, intra- and postoperative complications were analyzed. Each procedure duration was recorded. Surgical procedure was described step by step focusing on the anatomy of the round window (RW) niche. Results: The mean duration of the procedure was 62 minutes. No facial nerve injury was observed. All cases showed a normal RW conformation and endoscopic cochleostomy was conducted. No difficult insertion of the IC electrode was observed. The longest follow-up is 2 years. No postoperative complications were observed in this series. Conclusions: Totally endoscopic cochlear implantation is safe and allows a direct approach to the RW and cochlea. A larger series is paramount to evaluate its total benefits and may represent a breakthrough in the ongoing process of developing scientific knowledge.

Presentation schedule is subject to change. For the most up-to-date information, visit www.entannualmeeting.org. Results: Manufacturers often recommend a range of doses. With acetaminophen, even when assuming the highest recommended doses were used, we found that children would have received on average 16% less acetaminophen than they would have had in hospital. (P = .048). With ibuprofen, assuming the lowest recommended doses were used, children would receive 25% less ibuprofen than as inpatients (P = .037). If the highest recommended doses were used, they would have taken 7% more ibuprofen than we would have found safe to prescribe (P = .06).Conclusions: Over-the-counter acetaminophen and ibuprofen come with dosing advice guided by age. Our analysis demonstrated that this could often be substantially different from the ideal dose, which is based on the child's weight. With the global trend of increasing body weight, we can expect this disparity to get bigger in the future. Good pain management is important in pediatric otolaryngology, but this result is relevant to all clinicians caring for children.

Amyand's Hernia (AH) is defined as the protuberance of the vermiform appendix, inflamed, infected, perforated or normal, within the inguinal hernia sac. The prevalence of the AH in the world population is around 0.4-0.6%. While among children, it is about three times more prevalent, owing to patency of the vaginal peritoneum conduit and is more common in men. This Article report a case of AH in an eleven-month-old male who was diagnosed intraoperatively during an elective surgical treatment of bilateral inguinoscrotal herniorrhaphy (as evidence suggests to be what occurs in most cases of AH), when an appendectomy was performed with no unforeseen circumstances. It is essential discussing the diagnosis and treatment of Amyand's hernia as a way of making surgeons aware of this differential diagnosis.