Proposal of a timing strategy for cholesteatoma surgery during the COVID-19 pandemic.

The COVID-19 infection is an aggressive viral illness with high risk of transmission during otolaryngology examination and surgery. Cholesteatoma is known for its potential to cause complications and scheduling of surgery during the pandemic must be done carefully. The majority of otological surgeries may be classified as elective and postponed at this time (e.g., stapedotomy, tympanoplasty); whereas, others are emergencies (e.g., complicated acute otitis media, complicated cholesteatoma with cerebral or Bezold's abscess, meningitis, sinus thrombosis) and require immediate intervention. What is the ideal time for the surgical management of Cholesteatoma during the COVID-19 pandemic? Senior otologic surgeons from six teaching hospitals from various countries affected by the COVID-19 from around the world met remotely to make recommendations on reorganizing schedules for the treatment of cholesteatoma which has a risk of severe morbidity and mortality. The recommendations are based on their experiences and on available literature. Due to the high risk of infecting the surgical staff it is prudent to stop all elective ear surgeries and plan cholesteatoma surgery after careful selection of patients, based on the extent of the disease and available resources. Specific precautions including use of appropriate personal protection equipment should be followed when operating on all patients during the pandemic. To facilitate the decision-making in the management of cholesteatoma, timing for surgery can be divided into two categories with 3 and 2 sub-groups based on disease severity. Evidence on the timing of surgery of patients with cholesteatoma during the COVID-19 pandemic is lacking. This manuscript contains practical tips on how cholesteatoma surgery can be reorganized during this pandemic

Rapid quantification of underivatized amino acids in plasma by hydrophilic interaction liquid chromatography (HILIC) coupled with tandem mass-spectrometry

Background: Amino acidopathies are a class of inborn errors of metabolism (IEM) that can be diagnosed by analysis of amino acids (AA) in plasma. Current strategies for AA analysis include cation exchange HPLC with post-column ninhydrin derivatization, GC-MS, and LC-MS/MS-related methods. Major drawbacks of the current methods are time-consuming procedures, derivative problems, problems with retention, and MS-sensitivity. The use of hydrophilic interaction liquid chromatography (HILIC) columns is an ideal separation mode for hydrophilic compounds like AA. Here we report a HILIC-method for analysis of 36 underivatized AA in plasma to detect defects in AA metabolism that overcomes the major drawbacks of other methods. Methods: A rapid, sensitive, and specific method was developed for the analysis of AA in plasma without derivatization using HILIC coupled with tandem mass-spectrometry (Xevo TQ, Waters). Results: Excellent separation of 36 AA (24 quantitative/12 qualitative) in plasma was achieved on an Acquity BEH Amide column (2.1×100 mm, 1.7 μm) in a single MS run of 18 min. Plasma of patients with a known IEM in AA metabolism was analyzed and all patients were correctly identified. Conclusion: The reported method analyzes 36 AA in plasma within 18 min and provides baseline separation of isomeric AA such as leucine and isoleucine. No separation was obtained for isoleucine and allo-isoleucine. The method is applicable to study defects in AA metabolism in plasma

Remedial online teaching on a summer course

This chapter is based on the experiences with remedial online learning from a national collaboration initiative of University of Amsterdam, Erasmus Rotterdam University and Maastricht University (http://www.web-spijkeren.nl). The central question is how prior knowledge tests and online remedial summer courses can contribute to mitigating the problems of heterogeneous enrolment of students. Although the insights gathered in for this chapter come from pilots for first year bachelor programmes, the insights on how to successfully implement an online summer course programme can also be applied to other organisations

EAONO position statement on Vestibular Schwannoma: Imaging Assessment Question: How should growth of Vestibular Schwannoma be defined?

Contains fulltext : 196758.pdf (publisher's version ) (Open Access

Canalplasty in Revision Radical Cavity Surgery Using A Meatal T- Skin Flap Technique.

Background: In literature no technique of canalplasty in revision radical cavity surgery has been reported. Yet, inadequate canalplasty is a known contributing factor in troublesome cavities and should be addressed when necessary. Methods: Retrospective cohort analysis of patients undergoing revision radical cavity surgery in which a canalplasty was indicated. All received a canalplasty using a skin flap technique which enables maximal preservation of the delicate epithelial lining of the osseous external auditory canal (OEAC). Results: The described canalplasty technique resulted in quick re-epithelialization (median 8.9 weeks) and dry ears. Only one minor complication was seen. Conclusions: We describe a canalplasty technique that can be used in revision radical cavity surgery and show it is safe and effective. This technique can easily be combined with radical cavity obliteratio