Conference Schedule

Day1: May 27, 2019

Keynote Forum

Tracks

  • Septoplasty
  • Obstructive sleep apnea
  • Pediatric ENT
  • Laryngology
  • Sinus Surgery
  • Salivary gland pathology
Location: singapore

Biography

Dr. Shikowitz attended Syracuse University where he graduated in 1976 Cum Laude as biology major. Dr. Shikowitz then attended the University Of Dominica School Of Medicine where he received his M.D. in 1981.  He then completed his general surgery internship at Maimonides Medical Center in Brooklyn, New York from 1981 to 1982.  He was a resident and chief resident in Otolaryngology and Head and Neck surgery at the Long Island Jewish Medical Center from 1982 to 1986.   Following the completion of his residency training, he received a three-year career development award from the National Institute of Health to study human papillomavirus disease where he worked on photodynamic therapy, which was experimental at that time.  Eventually, this therapy became FDA approved and was used for several years on patients suffering with papillomavirus diseases of the upper aero-digestive tract.  Dr. Shikowitz received his MBA from the George Washington University, Washington, D.C. in 2010. Since 1986, Dr. Shikowitz has been on the staff of the Long Island Jewish Medical Center and the Northwell Health system. Professor and Vice Chairman of Otolaryngology and Head and Neck surgery both at Zucker School of Medicine and the Albert Einstein College of Medicine.

 


Abstract

Introduction:

Years of controversy and taboo have surrounded performing pediatric Septoplasty. Most of the negatives were concerning the possible loss or destruction of the nasal growth centers and alterations of facial growth. However, recent studies have demonstrated the safety and efficacy of performing pediatric Septoplasty.

Materials and Methods:

A retrospective review of 300 patients who underwent a Septoplasty ages 15 or below over a 25 year period all performed by the author were studied. The average age was 11.8 years. These were performed alone or as a combined procedure. The youngest was 10 days old. The various indications, surgical technique, use of intranasal splints where indicated and post-operative management will be discussed.

Results:

Of the 300 patients that underwent pediatric Septoplasty there were no significant complications. No discernable alterations in nasal or facial growth or development. Only 2 patients required a revision when they reached 18-19 years of age respectively. Children who had deviated septum’s without surgical correction were at risk for developing mid face deformities

Conclusion:

Pediatric Septoplasty is a safe and efficacious procedure when performed properly. The discussed surgical techniques may be crucial to the successful outcome. The need for surgical intervention on a case to case basis will be discussed. The taboo should finally be broken.

Location: singapore

Biography

Dr. Debashis Acharya is passionate about Otorhinolaryngology (E.N.T.), completing 25 years in the field including his training period at Delhi, India.

 An ex- Indian Army Medical Corps officer ( Lieutenant Colonel) served as  E.N.T. Specialist in the forces for approx. 12 years until 2008 when he left the services.
He has worked as Medical Superintendent in a private Medical College Hospital at Gujarat, India after that for almost one year. Subsequently held the appointment as H.O.D. & Associate Professor at Ahmedabad, Gujurat, India. for approx. two years before moving to Qatar in 2011. Presently working as Consultant E.N.T. in PHCC (Primary Health Care Corporation) - QATAR since 2014


Abstract

Statement of the Problem : Provides an overview of vertigo and its management. It is useful for students of vertigo and clinicians managing vertigo.It introduces clinicians to a systematic approach of assessing dizzy patients. Verigo is a very difficult subject to master. The cornerstone of managing a dizzy patient is first and foremost a good history. This is followed by appropriate examination and investigations. The general practitioner is the first expert to be involved in the management of dizzy patient followed by specialists in particular Otorhinolaryngologists, Audiovestibular Medicine Specialists and Neurologists and finally, allied healthcare personnel. The key concepts in assessing, diagnosing and managing common vestibular disorders are briefly described. Differential diagnosis of vertigo along with certain characteristic traits are mentioned. Etiology and pathophysiology of associated symptoms of dizziness are discussed . Importance of timing and triggering factors are highlighted. Discussion on balance and gait along with role of nystagmus in differentiating central from peripheral vertigo is done.Usage of certain specific drugs including special role of Betahistidine is mentioned. Vertigo from peripheral vestibular diseases normally improves within 2 to 3 months from a number of processes known as cerebral compensation. Here vestibular rehabilitation exercises play a very crucial part in management of a dizzy patient. Special vestibular investigations like ENG / VNG is computer based and runs a battery of tests which assess the occulomotor function of the affected patient. Video Head Impulse Test (VHIT) and Vestibular Evoked Myogenic Potentials (VEMP) are done for diagnosing vestibular neuritis. The role of traditional Caloric testing and EcochG which is a variant of BSERA cannot be undermined in a dizzy patient. Newer methods to assess balance like Dynamic Posturography, Rotatary Chair are computer driven tests for analysing vision, proprioception and vestibular function. These are useful to detect malingering. Finally, summary and conclusions are drawn upon.

 

Location: singapore

Biography

Presently working as senior resident doctor at Patna medical college&hospital,in dept. Of ENT.He has done MBBB,MS (ENT)from ,Darbhanga medical college &hospital,INDIA.PGD in Hospital Management from,National  Institute of health and family welfare,New  delhi. Trained in Otology from st.stephens Hospital ,delhi.

 


Abstract

Myiasis  is disease cause by fly larvae. The term myiasis is derived from the geerk word myia meaning fly. Myiasis  is one of the most common problem encountered  in  out patient department of Ear ,Nose ,throat in Bihar ,INDIA. A case study of 50 children of aural myiasis was done at Patna medical college &hospital. Presenting  complain was mainly of pain,aural discharge, maggot in ear. predisposing factor was ASOM,CSOM, Unhygienic condition and otitis externa with discharge. Two cases were of child suffering from mental retardation .Myiasis is also known as screw worm.In the field of otolaryngology it may affect the ear ,nose,and paranasal  sinuses,nasopharynx,oral cavity and permanent tracheostomy site.

In the lower age group,prevelance of ASOM and CSOM is common and the child is not aware of the fly,so the over all incidence rate were high in 0-4 years age group was 60%.second most common age group was 5-8 year.The majority of cases of human myiasis involve fly species that are facultative parasites.Human represents only a target of opportunity,presented through neglected wounds or lack of sanitary  measures which is reflected in series of study that majority of cases belongs to low socioeconomic group.

 

Location: Singapore

Biography

Anders Sideris is the Otolaryngology/ Head and Neck Research Fellow at Prince of Wales Hospital in Sydney Australia. He has particular research interests in the field of Head and Neck Oncology, the nexus of biomedical engineering and surgery and is currently involved in early work developing novel methods for sustained local drug delivery in Otolaryngology.


Abstract

Acinic cell carcinoma is a malignant epithelial neoplasm of the salivary glands that classically follows an indolent clinical course. However, presentation can be variable and a high-grade variant has been associated with higher chance of metastasis and poorer survival outcomes. Surgical treatment is generally curative but there is little consensus as to the benefit of radiotherapy in this disease. The aim of this research was to characterise the experience of three major hospitals in Sydney, Australia with a focus on clinico-pathologic features of disease and their associations with morbidity and survival outcomes.

 

Methods: Cases of acinic cell carcinoma in the time period 1979 to 2018 were identified in the hospital medical records and oncology databases at all institutions. Patients’ medical records were reviewed for baseline demographics, clinical data (including TNM staging data), treatment and survival data. Formal histopathology slides were reviewed by a consultant pathologist, and data on key pathological features were collected.

 

Results: Thirty-two cases were pooled for analysis (29 adult and 3 paediatric). Thirty tumours (93.8%) were parotid primary tumours. Mean overall survival (± SEM) for the entire cohort was 16.9 ± 0.75 years and 96.9% at final follow up. Mean disease free survival was 15.58 ± 1.0 years and 93.8% at final follow up. Multiple pathological phenomena were associated with poorer survival including presence of >2 mitoses per 10 HPF (p=0.008), high-grade disease (p=0.006), focal necrosis (p=0.008), perineural invasion (p=0.031) and higher nuclear grade (p=0.029). cT staging >1 (primary tumour greater than 2cm in diameter) (p=0.04), presence of clinical facial nerve deficit (p=0.025), tumour involvement of both superficial and deep lobes of the salivary gland (p=0.03) and extra-organ spread as defined by spread to non salivary gland tissue (p=0.018) were also associated with mortality. Clinical facial nerve deficit (p=0.048), perineural invasion (p=0.019) and extra organ spread (p=0.02) were associated with recurrence.

Conclusion: Our results suggest that disease free and overall survival in acinic cell carcinoma of the salivary gland is generally favourable and in the majority of cases is adequately treated with surgical resection alone. Poor survival outcomes are predicted by primary tumour size (>2cm in diameter), preoperative facial nerve deficit, extra organ spread, involvement of both lobes of the parotid gland and pathologic features of high-grade disease.

 

Location: Singapore

Biography

Cassie Dow is a medical student from the University of New South Wales in Sydney, Australia. She has particular research interests in safety in sino-nasal surgery.

 


Abstract

Abstract

Topical adrenaline is used as a vasoconstrictor in sino-nasal surgeries to provide visualisation for the surgeon and reduce blood loss. Concerns exist around the use of concentrated 1:1000 adrenaline due to its potential for systemic effects.

Aim: To determine whether 1:1000 topical adrenaline produces worse intraoperative hemodynamic stability compared to 1:10,000 topical adrenaline and whether it provides improved visualization.

Methods: A randomised, blinded, prospective non-inferiority trial was performed. Topical 1:1000 or topical 1:10,000 was placed in one nasal passage. Haemodynamic parameters (heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure) were measured prior to insertion and minutely for ten minutes after insertion. This was repeated in the other nasal passage of the same patient with the other concentration. The surgeon was asked to grade the visual field of each passage using the Boezaart Scale (1). 

Results: Nineteen patients were assessed (9 females, 32.79±11.36 years). The means of the greatest absolute change in parameters were compared between concentrations using a linear mixed effects model, where the upper bounds of the confidence interval for all remained below the pre-determined clinical non-inferiority margin (Δ = 10mmHg, 10bpm). There was a statistically significant greater change in HR in the 1:1000 group (p= 0.046). The 1:10,000 had a mean visual grade of 2.11, while the 1:1000 had a mean of 1.53. A Wilcoxon Rank-Signed test found this difference significant (p=0.012). 

Conclusion: Topical 1:1000 adrenaline provides no worse intraoperative haemodynamic stability compared to topical 1:10,000 but affords superior visualisation and thus should be used to optimise surgical conditions. 

Location: Singapore

Biography

Anders Sideris is the Otolaryngology/ Head and Neck Research Fellow at Prince of Wales Hospital in Sydney Australia. He has particular research interests in the field of Head and Neck Oncology, the nexus of biomedical engineering and surgery and is currently involved in early work developing novel methods for sustained local drug delivery in Otolaryngology


Abstract

Abstract

Acinic cell carcinoma is a malignant epithelial neoplasm of the salivary glands that classically follows an indolent clinical course. However, presentation can be variable and a high-grade variant has been associated with higher chance of metastasis and poorer survival outcomes. Surgical treatment is generally curative but there is little consensus as to the benefit of radiotherapy in this disease. The aim of this research was to characterise the experience of three major hospitals in Sydney, Australia with a focus on clinico-pathologic features of disease and their associations with morbidity and survival outcomes.

Methods: Cases of acinic cell carcinoma in the time period 1979 to 2018 were identified in the hospital medical records and oncology databases at all institutions. Patients’ medical records were reviewed for baseline demographics, clinical data (including TNM staging data), treatment and survival data. Formal histopathology slides were reviewed by a consultant pathologist, and data on key pathological features were collected.

Results: Thirty-two cases were pooled for analysis (29 adult and 3 paediatric). Thirty tumours (93.8%) were parotid primary tumours. Mean overall survival (± SEM) for the entire cohort was 16.9 ± 0.75 years and 96.9% at final follow up. Mean disease free survival was 15.58 ± 1.0 years and 93.8% at final follow up. Multiple pathological phenomena were associated with poorer survival including presence of >2 mitoses per 10 HPF (p=0.008), high-grade disease (p=0.006), focal necrosis (p=0.008), perineural invasion (p=0.031) and higher nuclear grade (p=0.029). cT staging >1 (primary tumour greater than 2cm in diameter) (p=0.04), presence of clinical facial nerve deficit (p=0.025), tumour involvement of both superficial and deep lobes of the salivary gland (p=0.03) and extra-organ spread as defined by spread to non salivary gland tissue (p=0.018) were also associated with mortality. Clinical facial nerve deficit (p=0.048), perineural invasion (p=0.019) and extra organ spread (p=0.02) were associated with recurrence.

Conclusion: Our results suggest that disease free and overall survival in acinic cell carcinoma of the salivary gland is generally favourable and in the majority of cases is adequately treated with surgical resection alone. Poor survival outcomes are predicted by primary tumour size (>2cm in diameter), preoperative facial nerve deficit, extra organ spread, involvement of both lobes of the parotid gland and pathologic features of high-grade disease.

 

Day2: May 28, 2019

Keynote Forum

Tracks

  • Ear disorders
  • Otolaryngology
  • Laryngology
  • otology
  • Pediatric ENT
  • Rhinitis
  • Septoplasty
  • Tonsillectomy
Location: Singapore

Biography

Biography: Dr. Bina graduated from Medical School with Audiology major he has been practicing as an Audiologist since 2000. Dr. Bina has many publications in Audiology and Hearing Science and attended many international congresses in Audiology and Ear Nose Throat around the world as a plenary speaker. Dr. Bina is Board Certified in Audiology by the American Board of Audiology and Licensed as an Audiologist in the state of Texas. When he is not working he loves to do exercise, study, watching movies and spending time with his family.

 


Abstract

There are some studies which confirmed that dysfunction in Central Nervous System(CNS) may cause a malfunction in the Peripheral Auditory system (Cochlea_ Auditory Nerve, Auditory Neuropathy), but the question is could Brain Disorder without any lesion in Cochlea and/or Auditory nerve cause Sensorineural Hearing Loss?

It seems that there are a lot of Sensorineural hearing loss which they have neither Sensory nor Neural lesion, Brain is involved in causing them. We deal with this subject in this paper and we propose a new theory that External Ear Canal is not the only input of Auditory Signals, Sounds could receive by the head and Cerebral Cortex and approach to the Cochlea (Backward Auditory input of Sounds)

Key words: Otosclerosis- Meniere’s Syndrome-Central Auditory System

 

Location: Singapore

Biography

Dr Andrew Lange is an Otolaryngology resident at Prince of Wales Hospital in Sydney. He has research interests in Head and Neck oncology with a particular focus on funding models and equitable distribution of services. 


Abstract

Abstract

Head and Neck Cancer is a major cause of morbidity and mortality in the community and is a costly disease. According to the Cancer Council in 2014, 4537 head and neck cancers were diagnosed in Australia and 1080 deaths occurred due to this disease in 2016 alone. Due to the complexity of head and neck cases, multidisciplinary care is required to achieve good outcomes, which is an expensive endeavour. Major expenses include the cost of large multi-team and multi-stage surgeries, intensive care stays, prolonged ward stays, prolonged courses of radiotherapy and the cost of associated morbidity and end of life care. Coding accuracy of surgical data has significant implications for sufficient funding in large public Head and Neck units. Lack of funding can lead to poor outcomes for our patients.

Methods: Operation reports for all patients undergoing complex major head and neck surgery in the period 2013-2018 from our center were gathered. Investigators examined each operation report and NSW Health funding codes were reviewed. Inaccuracies in coding were tallied and the cost of corrected codes was calculated for all patients.

Results: Coding inaccuracies for complex major head and neck operations were commonly encountered and funding losses were found in up to 40% of all major head and neck cases. Unclear documentation in operation reports was found to be a common contributor to funding losses.   

Conclusion: Operative coding inaccuracies are a significant source of funding loss for complex head and neck cancer patients. The most common contributor to funding losses was unclear documentation in operation reports. The authors are developing a documentation strategy to prevent funding losses

Biography

Sajidxa Mariño is an Otolaryngologist, specialized in endoscopic surgery. In 2017 he created the Centro Respira Libre, dedicated exclusively to the treatment of nasal obstructions and snoring with diode laser in the office of any patient from 2 years of age. 


Abstract

Diode's Laser for In Office Endoscopic Surgery Center a new type of ENT Center exclusive for patients with obstructive nasal diagnosis.

Description of a new technique  of Laser Diode's for Endoscopic Turbinal Surgery IN OFFICE with topical anethesia for inmediatly reincorperation to rutine  for patients between 2 years and ancients

Only a one hour preparation with drops and cotton's anesthesia, and five minutes procedure.

Indicated  for patients with Turbinate Hipertrophy (inferior turbinate or inferior and medial turbinate) with oral respiration, snoring, posterior rhinorrea, or with facial algias,  in  patients complicated for general anesthesia, athletes who needs training the day after, executives or students who needs work or study the same day of the surgery, or any patiens who needs to correctly brieth without been in a operating room and have the postoperative desincorporation of their routine. Also in patients who has previously turbinate surgery in OR or septoplasty without success.

With preoperative and postoperative CT scan and endoscopic evaluation were shows turbinate disminution, and clinical changes like considerate workout in nasal brieth, less snoring, notably disminution of posterior rhinorrea and no more presences of facial Algias for contact of middle turbine with Trigeminal gangly.

The 10 years implementation of this new technology at the office with 1000 patients experience has been proved as the only model of resolution of patients at the first Laser In Office Center for Otolaryngology at Caracas, Venezuela, with excellent quality of life results.


 

Biography

Usha M, Speec​​h Language Pathologist currently pursuing PhD final year in Manipal Academy of Higher Education, Manipal, India. I have completed my graduation in Speech and Hearing, and Post graduation in Speech Language Pathology form All India Institute of Speech and Hearing, Mysore, India in 2015. I am a certified yoga practitioner and my area of interest being Voice & its Disorders, currently working on a Department of Science and Technology project – “Effects of Yoga and Pranayama on voice”. Also working in the field of voice rehabilitation for professional voice users with hyperfunctional voice disorders. I have got three international publications in this field and have presented more research works in national and international conferences and symposiums. Also have delivered talks on importance of Yoga-Pranayama and its therapeutic effects in the field of Speech and Hearing.

 


Abstract

Voice plays a major role in communication and is a multidimensional entity which reveals the speaker’s physical, emotional health, personality and identity. There are certain groups of people who are dependent on their voice for their livelihood and are called as professional voice users. A small change or deviation in their voice can interfere their career. As per the literature survey, professional voice users are at the maximum risk of developing hyperfunctional voice disorders due to their vocal usage and demand in their profession(1).

Yoga and pranayama which are nothing but postures and breathing techniques gaining a lot of attention in the field of health science(2). These are used for the therapeutic managements of many disorders and its efficacy has been documented. Breathing techniques like surya bedha pranayama helps in aerating the lungs efficiently and makes the availability of the oxygen level to a greater extent(3). Ocean wave breathing or Ujjayi pranayama helps in the maximum expansion of the lungs, increasing the usage of the lung volume. Also many techniques help in reducing anxiety, hyperactivity, laziness, appetite, and thirst(4). One of the pranayama technique which includes voicing and humming during breathing “Brahmari pranayama” has been proved to improve the voice quality in terms of acoustic characters(5).

Since respiration is the source for voice production, good lung capacity and inspiratory-expiratory ratio is very important in producing a good voice quality, a very famous and well proved breathing technique named Ujjayi pranayama or ocean wave breathing is evaluated in this current study. Twenty female Speech Language Therapists after an hour of vocal usage were made to perform this technique. Parameters of aerodynamic, acoustic and self perceptual were analyzed for pre and post practice.

 

Location: Singapore
Location: Singapore

Biography

Dr Sarvejeet Singh has studied Masters of Surgery (ENT) from University of Delhi, India. He currently heads ENT care hospital in Delhi-NCR, India. He has special interests in Microscopic Ear and Endoscopic Nasal Surgeries and has organised Delhi medical Council accredited temporal Bone dissection workshop and Cadaveric FESS Dissection Workshop along with Lady hardinge Medical College, Delhi
Dr Singh is a renowned National Faculty of ENT for Preparation of various entrance/ Licencing exams since 2008. His online teaching platform “ENT App by Dr Sarvejeet Singh” and Live Lectures “Conceptual ENT Classes” are the most followed lectures by MBBS Students preparing for exams in India.

Dr Singh has also been associated with various social projects such as “Shruti: an initiative for hearing” and "Lifeline Express", world's first hospital train through which he helps the poor and needy people.

 


Abstract

More than 360 million people live with disabling hearing loss. India is estimated to have a hearing-disabled population of 63 million. Middle ear infection is an important but preventable causative factor. “Shruti” programme was launched with the vision to provide low-cost otology care including awareness, screening, diagnosis, and treatment to the underserved in densely populated, low-income urban and rural settlements by leveraging medical technology, telecommunication and frugal innovation. It is a hallmark example of health system innovation, serving dual objects of social impact and business viability simultaneously.                                               

With an ENT surgeon as the central point of care, the programs are operationalized through trained community health workers (CHW) equipped with a specially developed Ear screening device Known as “ENTraview device”. A WHO based field evaluation helps them to identify population with diminished hearing. Patients with a positive provisional diagnosis are routed to the point of care for receiving low-cost treatment, including advanced diagnosis, medicines, audiometric tests and surgical interventions. A telemedicine application transmits images of the patient’s middle ear via a smart phone to the Shruti programme staff and an ENT surgeon via a smart phone. Any complex infections and hearing loss diagnosed are referred to an ENT surgeon for treatment and potential surgery. Shruti Program is currently operational across seven self-funded cities across India. Currently more than 2,70,000 people have been screened under this programme. Over 25% of screened population needs some form of ear care, about 8% need a combination of medical and surgical intervention and 3-5 % population need hearing aids. 

Biography

Professor Dr. S.K.Kashyap is specialized in field of Otorhinolaryngology, head, neck and Skull base surgery with a very vast experience. He is currently heading the chair as the Head of department of ENT and Head Neck surgery at M.L.B. Medical college, Jhansi ,India.

 


Abstract

The ear ossicles are the three smallest bones in the human body and their function is to transmit the sound from vibrating tympanic membrane to the oval window. Erosion of ossicles or discontinuity of their joints is common in middle ear pathologies and this causes significant conductive hearing loss in the patients. Squamosal chronic otitis media is the commonest cause for ossicular discontinuity with other causes being mucosal COM, adhesive otitis media and trauma. Lenticular process and long process of incus erosion is the commonest defect found followed by stapes superstructure, handle of malleus, body of incus, head of malleus etc.

The term Ossiculoplasty refers to the operation performed to restore the continuity of  ossicular chain. Over the years, various materials like tissue grafts (autografts/homografts/allografts) and synthetic biomaterials have been used for ossiculoplasty. Thees are incus, tragal or septal cartilages, cortical bone. Commercially available prostheses (PORP/TORP) like Titanium, Plastipore, Teflon, Hydroxyapatite.   

Our study is aimed at using sculptured Spine of Henle to do the ossiculoplasty. Spine of Henle is a small and dense bony projection in the surface of temporal bone which can be encountered and harvested during post aural approach to middle ear. We have used Spine of Henle in various ossicular defects like lenticular and long process erosions, total or near total erosion of incus, erosion of stapes superstructure.

Contraindications are extensive cholesteatoma  eroding outer cortex.

 

Biography

Vladislav Kuzovkov is Head of Hearing Implantation Group in Saint-Petersburg Research Institute of Ear, Nose, Throat and Speech, Russia.

He performed more than 5500 Cis in total since 2007. At the CI2018 in Antwerp, Belgium, he was awarded with Buriani-Helms Prize for contribution in the field of cochlear implants.

 


Abstract

Cochlear implantation (CI) has become the standard treatment for profound sensorineural deafness in the last 30 ears, but some patients are denied from the surgery due to anesthesiology related reasons. The other problems are anesthesia risks in elderly patients, mainly related to the development of cognitive dysfunction postoperatively.

The aim of the study was to assess the possibilities to increase the accessibility of CI for different populations groups. 

Twelve adults (aged 21 – 74 years) underwent unilateral CI under LA at our institution between 2014 and 2017. All subjects had an ASA Physical Status classification of 3-4, corresponding 
with significant comorbidity.

No conscious sedation was used at our institution due risk of adverse side effects. However, patients were controlled by the anesthetist. Naropin 7.5 mg/ml with Epinephrine (1:80 000) was used for infiltration.

A series of prepared cue-cards were shown to the patient throughout the procedure, these cards included questions and instructions.

The mean operating time was 27 ± 5.2 min. The time included electrode impedances testing and our originally developed electrically evoked audiometry (evA). All patients had hearing sensations and low intraoperative impedances.

Subjects’ pain was assessed intraoperatively, in 6 and 24 h after surgery with the Numeric Pain Rating Scale (NRS-11).

Ten subjects did not experience any pain during surgery and reported the NRS score was 0 (no pain). In two patients NRS score was 2. All subjects, however, reported that they were comfortable during the procedure.

Simple cognitive tests were administered before and after surgery to 5 patients older than 60. None of the patients had evidence of cognitive decline after CI under local anesthesia.

CI surgery under local anesthesia was found to be safe in patients with significant comorbidities where general anesthesia is contraindicated. Moreover, local anesthesia could prevent possible postoperative cognitive decline.

 

Location: Singapore

Biography

Mr Sam Khemani is an Otolaryngologist and Clinical Lead at Surrey and Sussex Healthcare NHS Trust in the UK. He has a specialist interest in paediatric ENT and Otology.

He trained at Guys and St Thomas’ Hospital Medical Schools and completed his specialty training in London, working at a number of prestigious surgical centres including University College Hospital, Charing Cross Hospital and the Royal National Throat Nose and Ear Hospital, before being awarded a fellowship in Surgery from the Royal College of Surgeons of England. He also holds a Masters in Surgical Education from Imperial College London.

Mr Khemani is a regular member of the faculty for training international surgeons in the use of coblation for tonsil surgery.

Mr. Jack Faulkner is a Core Surgical Trainee in Otolaryngology in the South East of England. He is currently working at Surrey and Sussex NHS Trust and is a member of Royal College of Surgeons of England.

 


Abstract

Objectives: The use of Coblation intracapsular tonsillectomy has been described for the treatment of sleep disordered breathing (SDB) / obstructive sleep apnoea (OSA).  However, the results for tonsillitis as the predominant indication for surgery are not as clear. We present our initial results from 80 paediatric cases undergoing Coblation intracapsular tonsillectomy for infective indications.

Design: Prospective case series, January 2016- July 2018, all with completed follow-up

Setting: Secondary paediatric otolaryngologic practice

Participants: 80 consecutive patients (age range 2-16 years and mean 7.2 years) undergoing Coblation intracapsular tonsillectomy (with or without adenoidectomy) predominantly for infective reasons although some also had concomitant adenoidectomy for snoring/ sleep disordered breathing.

Main Outcome measures: We utilised the validated T14 tonsil symptom questionnaire pre- and postoperatively and also collected data regarding postoperative complications.

Results: Mean follow-up was at 13 months postoperatively. 38 children had tonsillitis (with or without snoring) and 42 children had SDB in combination with tonsillitis. The mean over-all total T14 score was 32.7 preoperatively and 2.7 postoperatively (p<0.0001). The mean infective score was 22.1 preoperatively and 1.5 postoperatively (p<0.0001). The mean SDB score was 10.6 preoperatively and 1.5 postoperatively (p<0.0001). There were no cases of haemorrhage, re-admission or regrowth noted.

Conclusion: Coblation intracapsular tonsillectomy appears to be a safe and effective technique for treating children with recurrent tonsillitis. Future studies should incorporate longer term follow-up.

 

Location: Singapore

Biography

Dr. Menwal Abdo Harb, ENT Specialist, Syria, American Crescent Health Care Center, UAE , MD: Faculty of Medicine, Damascus University, Damascus, Syria 2002. ENT Specialist: Ministry of Health, Damascus Syria, 2007._ Arab Board Certified of Otolaryngology Head And Neck Surgery, Arab Board Council, Damascus Syria2008. Fellow of the European Board Of Otolaryngology Head and Neck Surgery, Nov 2018, Vienna, Austria. Licensed to practice as a Senior ENT Specialist, Ministry of Health, Syria, Private Clinic and Private Hospital to 2012.

Licensed to Practice as a Senior ENT Specialist, HAAD(Health Authority of Abu Dhabi), American Crescent Health Care Center, Abu Dhabi, to this date. Attendance and hand work of 2nd Aesthetic and Functional Septorhinoplasty, Lectures and Workshop, Dubai 2014. Attendance and hand work of 2nd Intensive Snoring and Sleep Apnea, Lectures and Workshop, Dubai 2014. Attendance and hand work of 3rd Intensive Snoring and Sleep Apnea, Lectures and Workshop, Dubai 2015.Well experienced in clinical and diagnostic procedures, hearing tests, and Vestibular tests.Well experienced in emergency cases of otolaryngology, Head and Neck Surgery ( Epistaxis, Nasal Fractures, Foreign Body Aspiration).Well experienced in Rhinoplasty, Functional Endoscopic Sinus Surgery, Microscopic ear Otologic Surgery.Interested in clinical researches, updated guidelines, Workshops, and Conferences.

 


Abstract

The abstract:

A 30 years old male patient presented with a nasal scar at the junction between the columella and the nasal tip, after one year of exposure to a vehicle accident with an inappropriate suturing, I found that the scar repositioning is the best technique for this patient, so I decided to do external approach Rhinoplasty with changing the position of the new scar to a lower position.

Key words:

Scar revision, external approach rhinoplasty, facial wounds.

The introduction:

The healing of the wound results in a scar, the appearance of the scar depends on the wounding mechanism, wound location, wound tension, initial treatment, infection, and dehiscence.(1).

Successful scar revision begins with a precise analysis of both the scar and the patient expectations. The surgeon should educate the patient on the true realistic goal of surgery, which is to modify the scar to a point of maximized camouflage within the natural shadows, lines and borders tht exist within the head and neck.(2).

The case presentation:

A 30 years old male patient presented with a nasal scar at the junction between the columella and nasal tip at the left side of the nose, after one year of a vehicle accident, with a left side nasal obstruction.

No other complaints, no medical history, no surgical history.

The physical examination:

An external nasal scar, deviation of the nasal axis to the right side,

left septal deviation, the remainder examination is within normal.The goal is to remove the scar and improve the nasal breathing.

The plan: External approach rhinoplasty, which is discussed with the patient and greed.

The surgical technique:

The first step is the scar removal, after that I completed the surgery as a traditional external approach rhinoplasty with septoplaty, hump grasping, bilateral lateral osteotomies, tip plasty, then I retracted the nasal skin and stitched it at the columella at the lowest possible position without any tension at the sutures and wound edges, which was at the middle of the columellar length, then I trimmed   the skin edges to create the nostrils edges.

The result and follow up:  The stitches and the nasal splint are removed one week after the surgery, and the patient returned to his normal daily activities after two weeks.

The follow up after six months: The patient is fully satisfied of the result, functionally and aesthetically,

The conclusion:

The best technique of scar revision is the technique that gives us the best camouflage, by doing the incisions parallel to or in relaxed skin tension lines, at the junction of facial aesthetic units, within margins of orifices, or at the edge of hair line, and staged procedures are often necessary to accomplish the optimal result.

 

Location: Singapore
Location: Singapore

Biography

Pola Emad George Rizk, MBBCh, Alex, Resident, Gamal Abd El Nasser Hospital, Health Insurance, Department of Otorhinolaryngology, Alexandria ,Egypt.

 


Abstract

Background : Tonsillectomy is one of the most commonly performed surgeries in ENT practice. Despite improvements in anesthestic and surgical techniques, post tonsillectomy morbidities continue to be a significant clinical concern. Pain is the cause of most of the post-operative morbidity after tonsillectomy. An effective pain therapy to block or modify the physiological responses to stress has become an essential component of modern pediatric anesthesia and surgical practice.

Aim: The present study compares the results between the effect of Lidocaine 2% infiltration , Lidocaine 10 % spray and Bupivacaine 0.5% spray in tonsillar bed after tonsillectomy on postoperative pain.

Materials and Methods: 120 patients aged 5-18 years who were candidates for tonsillectomy at Otorhinolaryngology department of Alexandria Main University Hospital. Patients were randomly divided into three groups, 40 patients each. Group A received Lidocaine 2% (Xylocaine) peritonsillar infiltration 2 cc in one tonsillar bed and posterior pillar, Group B received Lidocaine 10%(Xylocaine) spray 2 puff in one tonsillar bed, Group C received Bupivacaine 0.5% (Marcaine) solution 2cc in one tonsillar bed spray by syringe and the other tonsillar bed in each group receives pack with similar amount of normal saline for five minutes as a control group after tonsillectomy before recovery from anaesthsia.

Results: There was no statistical difference between the three studied groups as regards age and sex. There is significant statistical difference according to the frequency of throat pain and ear pain by comparing cases and controls of each group within 1st 24 hours after surgery. It appears that increased frequency of postoperative throat pain and ear pain is present with control side (saline).

Conclusion: Topical application of the tonsillar bed with local anaesthetic after tonsillectomy results in significant reduction of postoperative throat pain and referred otalgia, and should be used during surgery for tonsillectomy.

Keywords: Tonsillectomy; Anesthetics,Local; pain,postoperative