Text Box: Abstract: Hypothesis: Percutaneous cochlear access can be performed using bone-mounted drill guides that are custom made on the basis of preintervention computed tomographic scans. Background: We have previously demonstrated the ability to use image guidance based on fiducial markers to obtain percutaneous cochlear access in vitro. A simpler approach that has far less room for application error is to constrict the path of the drill to pass in a predetermined trajectory using a drill guide. Methods: Cadaveric temporal bone specimens (n = 8) were affixed with three bone-implanted fiducial markers. The temporal bone computed tomographic scans were obtained and used in planning a straight trajectory from the mastoid surface to the cochlea without violating the boundaries of the facial recess, namely, the chorda tympani, the incus buttress, and the facial nerve. These surgical plans were used to manufacture a customized drill guide by means of rapid prototyping (Micro-Targeting Platform; FHC Inc.; Bowdoinham, ME, U.S.A.) that mounts onto anchor pins previously used to mount fiducial markers. The specimens then underwent traditional mastoidectomy with facial recess. The drill guide was mounted, and a 1-mm drill bit was passed through the guide across the mastoid and the facial recess. The course of the drill bit and its relationship to the boundaries of the facial recess were photographed and measured. Results: Eight cadaveric specimens were subjected to the study protocol. In seven of eight specimens, the drill bit trajectory was accurate; it passed from the lateral cortex to the lateral wall of the cochlea without compromise of any critical structures. In one specimen, the access to the middle ear was achieved, but the incus was hit by the drill. The average shortest distance T standard deviation from the edge of the drill bit to the boundaries of the facial recess was 0.78 T 0.56 mm (chorda tympani), 2.00 T 1.06 mm (incus buttress), and 1.27 T 0.54 mm (facial nerve). Conclusion: Our study demonstrates the ability to obtain percutaneous cochlear access in vitro using customized drill guides manufactured on the basis of preintervention radiographic studies.  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Text Box: March 4, 2007

Text Box: Otorhinolaryngology News

Text Box: Inside This Issue · LigPercut Cochlear Access.? · ET Dysfunction & mETP..? · TinCOX2 & Ca Ex Pleomorphic Adenoma.? *     Case of the Week

 Case Review

 Clinical Photograph of The Week

A 14-year old male presented with a month history of swelling of the nose, following blunt injury ( had head on collision with his kid brother). He gave a history of initial swollen right eyelid, which subsided after a week. Examination revealed right ptosis, periorbital fullness and ecchymosis of the right upper lid, as well as the sign demonstrated in this picture >>

 

What is the Diagnosis

1.     25th Alexandria Combined ORL Congress, April 18 - 20 2007; Alexandria, Egypt. Deadline for Abstract submission January 15, 2007. Click HERE for Details

2. 

 

 

 

3.      IX éme Congrès Panafricane d'ORL et de Chirugie Cervicofaciaie (PAFOS)  & XXX éme Congrès National Société           Marocaine d'ORL. 2007. April 28 - 31. Abstracts before 15th January, 2007 email benghalem@wanadoopro.ma .         Hotel Booking email fct@menara.ma , Secretariat email bouchra@par3com.com

4.    The 9th International Symposium on Recent Advances in Otitis Media on June 3-7, 2007 in St. Pete Beach, Florida. Website address : www.otitis2007.org ;email address for information and questions: otitis2007@hei.org ; Abstract site is open for submission until March 1, 2007. Click HERE to Register, and Click Here To Submit Abstract.

 
Cyclooxygenase 2 (COX-2), the inflammatory mediator which had been implicated in the etiopathogenesis of OME (recall Vol2, No8) is currently implicated as an immunohistological marker in malignant transformation of pleomorphic adenoma, according to this recent study from Japan (Katori, Nozawa & Zukuda, Auris Nasus Larynx  Volume 34, Issue 1 , March 2007, Pages 79-84)

Abstract:

Objectives: In the present study, we attempted to identify cyclooxygenase-2 (COX-2) expression and Ki-67 index in carcinoma ex-pleomorphic adenoma (Ca ex-PA) using quantitative immunohistochemical analysis and to compare the benign component of the neoplasia. We also aimed to relate the overexpression of COX-2 with the pathways of malignant transformation of Ca ex-PA as evidenced by distinct morphological features.

Materials and methods:Forty Ca ex-PA from patients treated at Department of Otolaryngology, Yokohama City University Medical Center, Yokohama, Japan, from 1999 to 2005, were selected. All Ca ex-PA showed only one malignant histological component: adenocarcinoma (23 cases), adenoid-cystic carcinoma (10), epithelial–myoepithelial carcinoma (7). The tissues were stained with monoclonal antibodies to COX-2 and Ki-67. The results were analyzed using quantitative immunohistochemical analysis. We also analyzed the association of the histological classification of the carcinomatous component.

Results: In the immunohistochemical analysis of COX-2 and Ki-67 index, significant increase was observed in Ca ex-PA, especially with adenocarcinoma, compared to pleomorphic adenoma and sialadenitis. Quantitative assessment is more sensitive as a measure of cellular protein content as compared to standard optical density measurement.

Conclusions: The data support the hypothesis that increased COX-2 expression is associated with early events in malignant transformation of pleomorphic adenoma.

     Journal Watch : Pepsin assay: A marker for reflux in pediatric glue ear , Abd El-Fattah et al, 2007

 1.   DODA 2006, capable of advanced hearing measure, and also paediatric hearing assessment is being developed. If you requested for and got a free copy of DODA, you may also look out for this latest version dubbed DODA-i, as well as for an additional page on outcome of hearing assessment using DODA.

 2.  From  http://www.otolaryngologyinafrica.net/grandround/  is a new addition - a recent conference poster presentation. This presentation is available at http://www.otolaryngologyinafrica.net/grandround/archive.htm .

 3.   DODA has been redesigned. Take time to view the new look of this program at the DODA Images Page..

 4.   otolaryngologyinafrica.net website is being re-organized to enable multi-language access. Take time to review the new HomePage. When Completed, it might be possible to assess the contents of the site in the six major languages widely spoken all over Africa

 5.  Otolaryngologyinafrica.net is experimenting with use of SMS notification of newsletter release. Feel free to air your view on this issue by emailing orl-mailer@otolaryngologyinafrica.net .

 Till Next Week, Welcome to 2007!

 Biodun

 
 

This is a free email newsletter circulating to Otolaryngologists in Africa, and interested Otolaryngologists elsewhere. If you know anyone interested in receiving this free newsletter, feel free to forward a copy to such person or encourage them to email orl-mailer@otolaryngologyinafrica.net for free subscription

 

 

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