Publications (2)1.54 Total impact
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Article: Conversion of canalolithiasis to cupulolithiasis in the course of a horizontal benign paroxysmal positional vertigo case.
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ABSTRACT: The benign paroxysmal positional vertigo of the horizontal semicircular canal is manifested with either geotropic or apogeotropic horizontal nystagmus. A 61-year-old male patient who experienced repeated episodes of positional vertigo is presented in this study. The vertigo was reported to be more severe while rotating his head to the left and then to the right. The initial examination revealed a geotropic purely horizontal nystagmus at the lateral positions of the head compatible with canalolithiasis of the left horizontal semicircular canal. In this case, the otoconia debris migrates from the vestibule into the horizontal semicircular canal through its nonampullary end, where they float freely (canalolithiasis). Five days later, the geotropic nystagmus transformed to apogeotropic. Thus, it may be assumed that the otoconia debris adhered to the cupula and converted the canalolithiasis to cupulolithiasis of the horizontal semicircular canal on the same side. With rotation of the head to the left while the patient was in the supine position, gravity causes the weighted cupula to deflect ampullofugally, resulting in apogeotropic nystagmus; the opposite was noticed when the head was rotated to the right. The so-called barbecue maneuver was initially effective curing the geotropic form of the condition and consequently the modified Semont maneuver for the apogeotropic form.American journal of otolaryngology 05/2010; 32(2):174-6. · 0.77 Impact Factor -
Article: Cartilage-wire-fascia compact total ossicular replacement prosthesis in one-stage cholesteatoma surgery.
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ABSTRACT: Retraction pocket and extrusion of the ossicular prosthesis remain significant problems after tympanoplasty in cholesteatoma surgery. This study presents an alternative surgical technique with a total compact ossicular prosthesis including cartilage, wire, and temporalis fascia. A total of 42 patients (27 adults, 15 children) underwent an ear operation for cholesteatoma requiring total ossicular chain replacement during a 10-year period. Surgery included canal wall down mastoidectomy and reconstruction of the middle ear in one stage. The total ossicular replacement prosthesis was made by a stainless steel wire passed and secured through a piece of conchal cartilage and temporalis fascia positioned on the free end of the wire. The analysis of our data included hearing results pre-surgery and post-surgery, complications recorded in the case notes, and postoperative otoscopic findings. The mean air-bone gap decreased from 39.2 to 22.4 dB in the early postoperative period (mean follow-up, 12.8 months). Eight patients with a long-term follow-up (mean, 7.1 years) presented a small deterioration of their postoperative hearing improvement. The bone conduction did not present significant changes. Three patients developed postoperative infection and treated successfully with medical therapy. No significant complications as displacement or extrusion of the prosthesis and retraction pocket were detected postoperatively. This is an alternative tympanoplasty technique with a stable cartilage-wire-fascia total ossicular prosthesis. This technique has a low complication rate; good hearing results and offers another surgical option to the surgeon especially for cases where the cost is a concern.American journal of otolaryngology 29(6):393-7. · 0.77 Impact Factor
