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DISCUSSION Most patients in this study were referred adjacent to the displacement of the dental implant. The medial alveolar recess is the most common area of implant displacement. While either a nasal or oral approach can be used to retrieve the implant in the absence of sinus disease, a nasal approach should be preferred in the presence of such pathology. The collaboration between the otorhinologist and the maxillofacial surgeon, enables both the dental and rhinosinus considerations to be considered. This cooperation allows practitioners to design better treatment plans for patients with dental implants involving the sinuses.OBJECTIVES To characterize a subgroup of patients that were diagnosed with benign paroxysmal positional vertigo of the posterior semicircular canal pBPPV, with findings of geotropic-torsional nystagmus on the roll rest (RT) that intensified on the Dix-Hallpike exam (DH). METHODS The study population consisted of patients with the diagnosis of pBPPV. First, the roll test (RT) and then the DH test were performed. Characteristics were compared between group 1 - patients with a negative RT and positive DH (in keeping with pBPPV), and group 2- patients with a torsional-geotropic nystagmus on the RT, that intensified on DH. Patients from both groups were treated with the Epley maneuver. If the nystagmus continued, further Epley maneuvers were performed until it subsided. Patients continued follow-up visits until they were asymptomatic and the exam was normal. RESULTS Ninety-one consecutive patients were diagnosed with pBPPV. Sixty nine patients belonged to group 1 and 22 to group 2. The average age was just under 60 and the percentage of males was 22 in group 1 and 45 in group 2, which was significantly different. Additional significant differences included 1. Symptom duration, in days, until diagnosis (43.2 in group 1 and 22.3 in group 2). 2. https://www.selleckchem.com/products/piperaquine-phosphate.html The fraction of patients requiring only one Epley maneuver in the first treatment session was 77.4% in group 1 and 23.4% in group 2. CONCLUSIONS The appearance of a torsional-geotropic nystagmus during RT is most probably due to pBPPV, with a more severe clinical presentation, requiring more Epley maneuvers than in patients with a negative RT. These patients had increased symptoms and were diagnosed earlier. However, the response to treatment was similar in both groups. It is most important to differentiate these patients in group 2 from patients with BPPV arising from the horizontal semicircular canal, which has different clinical features and is treated differently.INTRODUCTION The Eustachian tube ventilates the middle ear while keeping pathogens out. Obstructive dysfunction of the Eustachian tube is a common complaint, manifested by the inability to equilibrate middle ear pressure. Middle ear sequelae include inflammation, tympanic membrane retraction and rarely cholesteatoma. Balloon dilation is a new procedure for treating obstructive dysfunction of the Eustachian tube. OBJECTIVES This research evaluates the outcome of balloon dilation of the Eustachian tube (BDET) performed at Hillel Yaffe Medical Center and compares results with those reported in global publications. METHODS Patients indicating that ear pressure had significantly impacted their quality of life were recruited. Most received a conductive hearing loss audiogram and either a B or C tympanogram. BDET was performed. A 12-month follow-up survey was conducted, including an ETDQ7 questionnaire and repeat audiograms and tympanograms. RESULTS A total of 16 patients were recruited and 24 BDETs were conducted. Aside from one patient, who received ambulatory treatment for subcutaneous emphysema, no patients had BDET complications; average ETDQ7 scores improved from 25.9 (n=20) to 15.3 (n=9) 12 months post-op. (P=0.001). CONCLUSIONS BDET is a safe procedure and benefits those who suffer from an obstructed Eustachian tube. A comprehensive literature review also concludes that BDET is safe, that it relieves the obstructive Eustachian tube and is superior to conservative treatments. BDET is increasingly being used on a global scale and the Hillel Yaffe Medical Center is applying it in Israel.BACKGROUND After cochlear implantation (CI) there is concern regarding the potential risks of spread of middle ear infection along the electrode array into the cochlea and central nervous system and regarding late sequela of otitis media (OM) eardrum perforation, atelectasis and cholesteatoma. The age for implantation in children overlaps the peak age incidence of acute OM (AOM) and secretory OM (SOM) and delay of implantation reduces the potential benefit from the intervention. Therefore, control of OM by inserting ventilating tubes (VT) is widely performed in pediatric CI candidates who also suffer from otitis media. OBJECTIVES To refine indications for VT insertion in candidates for cochlear implantation who also suffer from OM. METHODS Of 200 children referred for CI and implanted one after another, 126 were classified as OM-prone, 98 due to AOM and 28 due to SOM. The rate of development of late sequela of middle ear disease was compared between the two subgroups of OM-proneness. RESULTS A total of 15 children (7.5%) developed late sequela of middle ear disease; all belonged to the SOM group; 3.5% developed eardrum perforation; 3.5% atelectasis and 0.5% cholesteatoma. CONCLUSIONS Pre-CI VT insertion in children with SOM who underwent CI did not prevent development of late sequela of middle ear disease; VT insertion with the object of preventing late sequela of middle ear disease in CI candidates who suffer from SOM only is not required; in otitis-prone children a long term oto-microscopic follow-up is needed in order to identify late sequela of middle ear disease.The treatment of patients with advanced head and neck cancers requires an extensive oromandibular and craniomaxillofacial resection in many cases. The reconstruction after these extensive resections presents many challenges to the reconstructive surgical team. The purpose of the reconstruction is not only to rehabilitate the physical facial appearance, but also to rehabilitate function, in order to improve future quality of life. To achieve this goal, the use of free tissue reconstruction is often required. The main challenge with osseous free flap reconstruction of the facial bones is the need of perfect alignment at the defect site. The use of different 3D technologies including computerized models and printed 3D stereolithographic models in the preoperative setting improves the accuracy and the outcome of the reconstruction.
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