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Register a new userEfficacy of Canal Wall Up Mastoidectomy in Management of Cholesteatoma
فعالية حج الخشاء بالطريقة المغلقة في علاج الورم الكولسترولي
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محمد نبيل دندشلي( باحث )
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إن الهدف الأساسي لأي عمل جراحي لحالة ورم كولسترولي هو الاستئصال التام له من أجل الوصول إلى توقف للسيلان إضافة إلى منع المـضاعفات و الـنكس, أمـا الهدف الثاني فهو المحافظة على سمع ما قبل العمل الجراحي أو تحسينه. تهدف الدراسـة إلى عرض لحالات ورم كولسترولي عولجت بحج الخشاء بالطريقة المغلقة و مناقشة فعالية هذه الطريقة و ذلك بتحديد نسبة النكس و عرض النتائج السمعية.
The primary goal of any surgery for cholesteatoma is complete eradication of this lesion aiming to reach a dry ear and to prevent the complications and recurrence. The second goal is to preserve hearing or to improve it. This study aims to discuss cases of Cholesteatoma treated by canal wall-up mastoidectomy (Closed technique) and to determine the efficacy of this technique by studying the recurrence rates and hearing results.
Artificial intelligence review:
Research summary
تهدف الدراسة إلى تقييم فعالية عملية استئصال الخشاء مع الحفاظ على جدار القناة في إدارة حالات الكولستيوماتوما. أجريت الدراسة على 29 أذنًا تم علاجها بهذه التقنية في مستشفى المواساة الجامعي بجامعة دمشق. تم متابعة المرضى لمدة تتراوح بين 28 إلى 50 شهرًا، وتمت إعادة تقييمهم سريريًا بعد 18 شهرًا باستخدام الفحص السمعي والأشعة المقطعية. أظهرت النتائج تحسنًا في السمع لدى 16 مريضًا بينما تدهورت الحالة السمعية لدى 11 مريضًا. تم تقسيم المرضى إلى مجموعتين: الأولى لم تظهر أي علامات سريرية أو إشعاعية للانتكاس، بينما خضعت المجموعة الثانية لعملية جراحية ثانية بسبب الانتكاس السريري أو وجود عتامة في الأذن الوسطى. بعد العمليات الجراحية، تم الحفاظ على تقنية جدار القناة في 93% من الحالات، وانخفض الفارق بين الهواء والعظم في 48% من المرضى. خلصت الدراسة إلى أن تقنية استئصال الخشاء مع الحفاظ على جدار القناة فعالة في إدارة حالات الكولستيوماتوما.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة لأنها تقدم بيانات طويلة الأمد حول فعالية تقنية استئصال الخشاء مع الحفاظ على جدار القناة في إدارة الكولستيوماتوما. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها. أولاً، حجم العينة صغير نسبيًا مما قد يؤثر على تعميم النتائج. ثانيًا، لم يتم توضيح تفاصيل حول العوامل التي قد تؤثر على نتائج السمع مثل العمر والجنس والحالة الصحية العامة للمرضى. أخيرًا، كان من المفيد تضمين مجموعة مقارنة تستخدم تقنية أخرى لاستئصال الخشاء لتقديم مقارنة أكثر شمولية.
Questions related to the research
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ما هو الهدف الرئيسي من الدراسة؟
الهدف الرئيسي هو تقييم فعالية تقنية استئصال الخشاء مع الحفاظ على جدار القناة في إدارة حالات الكولستيوماتوما من خلال دراسة معدلات الانتكاس ونتائج السمع.
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كم عدد المرضى الذين شملتهم الدراسة؟
شملت الدراسة 29 مريضًا.
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ما هي مدة المتابعة للمرضى بعد العملية الجراحية؟
تمت متابعة المرضى لمدة تتراوح بين 28 إلى 50 شهرًا.
-
ما هي نسبة المرضى الذين لم يظهروا أي علامات للانتكاس بعد العملية الأولى؟
لم يظهر 15 مريضًا أي علامات سريرية أو إشعاعية للانتكاس بعد العملية الأولى.
References used
Peter John wormald, FCS(SA), FRCS(Ed); Erik L.K. Nilssen, Fcs(SA0, DLO9London). ThFacial Ridge and the Discharging Mastoid Cavity. Laryngoscope 1998; 108: 92-96
Mark J. Syms, MD; William M. Luxford, MD. Management of Cholesteatoma: Status of the Canal Wall. Laryngoscope 2003 ; 113: 443-8
Edward E. Dodson,MD; George T. Hashisaki, MD; Todd C. Hobgood, BA ; Paul R. Lambert, MD. Intact Canal Wall Mastoidectomy With Tympanoplasty For Cholesteatoma in Children. Laryngoscope 1998; 108: 977-83
rate research
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Aim:
To evaluate and compare the rate of cholesteatoma recurrence after Atticotomy surgery to that after Canal Wall Up Mastoidectomy (CWU).
Material and Methods:
The study involved 57 patients admitted to the ENT Department Almoassat Hospital. A
tticotomy was performed in 30 cases, whilst CWU mastoidectomy within 27 cases. Follow up period was extended for two years to compare the symptoms and the necessity for second Ossiculoplasty surgery.
Results:
The recurrence rate was 23.33 % within atticotomy group, whilst it was 22.21 % in CWU group. CWU mastoidectomy showed better outputs in diffused cholesteatoma cases.
Conclusion:
A limited cystic cholesteatoma can be treated effectively by atticotomy, however CWU mastoidectomy remains the favorable technique to manage a diffused cholesteatoma.
The necessity of Meatoplasty In Radical Mastoidectomy for good postoperative
cleaning of mastoid cavity and to reduce recurrence rate.This study aim to evaluate the results of
Meatoplasty By Rotating door flap method In Radical or modified radical
Mastoidectomy (open
technique).
Due to it`s several properties of Trypsin as an active enzyme in treating wounds, the
aim of this study was to evaluate the efficacy of this material with traditional treatments in
treating dry socket.
Methods:132 patients (20-65 years old) partic
ipated in this study.
The patient were distributed randomly into two groups.
The first group (group 1) was treated with Trypsin whereas the other (group 2) was
treated with traditional technique .
Patients were monitored, to asses healing process, after 24 hours, 48 hourse, and after
1 week.
Results: 43,9% of group 1 and 10,6% of group 2 had no pain P<0,05,wereas 81,8%
of group 1 and 43,9% of group 2 didn`t present dry socket P<0,05. Concerning infection ,7
cases of group 1 and 11 cases of group 2 had infection of soft tissue P<0,05.
Conclusions :Pain, dry socket, and soft tissue infection was less in casese treated
with Trypsin comparing with cases treated with traditional technique.
the sample consisted of 36 patients who were admitted in alassad and tishreen
hospital between 2013-2016 with bacterial arthritis proved by clinical,radiological and
laboratory methods. They went uder surgical intervention ,during it,a continuous i
rrigation
system was accomplished according to designed plan. The irrigation period was 12 days
(mean) with mean hospitalization period 12 days. Irrigation fluid was considered regarding
to culture and susceptibility results in addition to antibiotic qualities .Results were
collected depending on joint functional activitiy return regarding to capacity,bearing and
stability(after a month-3 months- year),as well as natural laboratory and vlinical features
return .we used the criteria healing (irrigation handout). The joint functional activity
returned after a month in (70% mean) ,after 3 months in (77% mean), after a year in (89%
mean).while the clinical infection signs fell back after a week in (85% mean) ,after a
month in (92% mean), after 3 months in ( 97%). The laboratory signs fell back after a
month in (91% mean), after 3 months in (97% mean). A comparing was achieved between
these results and irrigation period ,hospitalization period by using CHI² test . The use of
continuous irrigation system in treatment of bacterial arthritis once it is diagnosed (in
regard to designed plan, irrigation fluid qualities and the host condition) improves the joint
functional activity and reduces hospitalization period so that ,it lessens economic load and
accelerates the return professional activity.
The aim of this study is to compare the efficacy of doxycyclin vs.systemic
isotretinoin in the treatment the second and third forms of rosacea, 50 patients aged
between 22 - 61 years of patients who had a second type II and type III of Rosecea with
at
least eight inflammatory lesions were divided into 2 groups of 25, The first was treated
with isotretinoin and the other with doxycycline. The effectiveness of both treatments was
compared, in addition, the side effects between the two treatments.
Results: In general, there were no significant difference between the 2 drugs in The
number of Papules and pustules, the severity of the erythema and Rhinophyma.
In both groups there was a clear relation between the treatment and DLQI . For side
effects, The results shown that 18 patients in the group of isotretinoin therapy had side
effects and no side effects were observed for patients treated with doxycycline.
Conclusion: The study concluded that isotretinoin therapy had similar efficacy to
doxycycline therapy.
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