Assessment of Different Middle Vault Reconstruction Techniques in Rhinoplasty from Multiple Patient-Reported Outcome Measures

It is important to assess the patient satisfaction with shape and function by patient-reported outcome measures (PROMs) following structural or dorsal preservation rhinoplasty (DPR) techniques on the middle nasal vault. To analyze the results of different middle vault rhinoplasty techniques with multiple PROMs and compare their differences according to the findings of PROMs. Four different techniques were performed for the middle vault: spreader graft, L-strut graft, DPR with high strip (DPRwHS), DPR with low strip. The outcomes were evaluated preoperatively, 2 and 12 months postoperatively with the following PROMs: Nasal Obstruction Symptom Evaluation (NOSE), Rhinoplasty Outcomes Evaluation, and Standardized Cosmesis and Health Nasal Outcomes Survey. This study included 129 patients. All techniques provided significant improvements in all PROMs ( p 0.05), unlike structural techniques. In this comparative study of different middle nasal vault rhinoplasty techniques, we did not detect a difference in the improvement of the patient-reported outcomes of DPR techniques from as early as 2 months to 1 year postoperative

The new cubism graft technique in tympanoplasty: A randomized controlled trial

Objectives The aim of this prospective, randomized-controlled study is to analyze the outcomes of a new graft technique in tympanoplasty and compare its outcomes with cartilage island graft plus extra perichondrium. Methods A total of 44 patients with noncomplicated chronic otitis media were included in this prospective randomized-controlled clinical trial. Patients were randomly divided into 2 double-layer graft groups: The cartilage island graft + cubism graft (study group) and the cartilage island graft + extra perichondrium (control group). The main outcome measures of the study were the air-bone gap (ABG), ABG gain, and graft status. Results Graft success rate was 100% and 95.5% in the study group and the control group, respectively. There were statistically significant differences in the postoperative first month ABG and ABG gain between study and control groups (P .05). Conclusion This study revealed that both graft techniques have satisfactory functional and morphological results compared to preoperative findings. The use of cubism graft with cartilage island graft has significantly better auditory outcomes in short-term and similar results in long-term compared to double-layered cartilage island graft with extra perichondrium. Cubism graft is a highly promising graft technique with its many advantages. Level of Evidence 1b

Transcutaneous Suture Tip Plasty: The Technique and Outcomes

###EgeUn###Purpose: Radical resections and invasive techniques have been mostly replaced with more conservative techniques. The aim of this study was to assess the objective and the subjective functional and aesthetic outcomes of transcutaneous suture tip plasty. Methods: A total of 20 patients were included in the study. Patients were treated with transcutaneous suture tip plasty. Functional results were assessed with pre- and postoperative 6-month Sino-Nasal Outcome Test (SNOT-22) and acoustic rhinometry. The pre- and postoperative 6-month mean values of first minimal cross-sectional area (MCA1), second minimal cross-sectional area (MCA2), the distance from the tip of the probe to the first minimal cross-sectional area, the distance from the tip of the probe to the second minimal cross sectional area, nasal volume 1, and nasal volume 2 were measured. Facial analysis was made with the Rhinobase software, designed for facial analysis. Results: The mean pre- and postoperative SNOT-22 scores were 25.55 +/- 6.64 and 15.70 +/- 8.11, respectively (P < .05). The mean pre- and postoperative nasolabial angles were 82.26 degrees +/- 5.69 degrees and 101.47 degrees +/- 7.70 degrees, respectively (P < .05). The mean pre- and postoperative nasofrontal angles were 144.30 degrees +/- 3.81 degrees and 138.25 degrees +/- 3.26 degrees, respectively (P < .05). The mean pre- and postoperative nasal length was 54.22 +/- 4.62 mm and 49.95 +/- 2.75 mm, respectively (P < .05). The mean pre- and postoperative tip projection was 25.77 +/- 3.64 mm and 28.40 +/- 2.97 mm, respectively (P < .05). Only postoperative MCA2 values on the right and left side were significantly different from preoperative MCA2 values (P < .05). None of the remaining postoperative acoustic rhinometry scores significantly differed from preoperative scores. Two patients (10%) required revision at around 1 month after surgery due to suture loosening and breakage. Conclusions: Especially in the era of minimal invasive surgery, transcutaneous suspension tip plasty is promising, with rapid and reliable functional and cosmetic results. Further studies with longer follow-up durations are needed to assess the long-term outcomes of this technique

Evaluation of significant gene expression changes in congenital and acquired cholesteatoma

Avci, Cigir Biray/0000-0001-8251-4520WOS: 000554430700001PubMed: 32740796Etiopathogenesis of acquired and congenital cholesteatoma is still unclear. the clinical behavior of adult acquired, pediatric acquired and congenital cholesteatomas show differences. the scope of the this study was to detect thematrix metalloproteinase(MMP),tissue inhibitors of metalloproteinase(TIMP) andepidermal growth factor receptor(EGFR) gene expression changes in cholesteatoma perimatrix and to compare these changes among congenital cholesteatoma, adult acquired cholesteatoma and pediatric acquired cholesteatoma. A total of 16 genes includingMMPs,TIMPs andEGFRwere analyzed in the samples of 32 cholesteatoma tissues. Real-time PCR was used for detection of the gene expression levels. Data analyses were achieved by Delta Delta CT method (Light Cycler 480 Quantification Software) and Statistical Package for Social Sciences (SPSS) version 22.0. the expression levels ofMMP-2,-9,-10,-11,-13,-14,-15,-16andEGFRgenes were significantly higher in acquired cholesteatoma than healthy tissue (p < 0.05). There was a statistically significant decrease (3.34 times more) in the meanTIMP-2gene expression level in acquired cholesteatoma compared to healthy tissue (p < 0.05). There was a significant increase in the mean expression level ofMMP-7gene and a decrease in the mean expression level ofTIMP-1gene (3.12 times more) in congenital cholesteatoma compared to healthy tissue (p < 0.05). This study indicates that increased expression levels of some particularMMPgenes andEGFRgene and decreased expression levels ofTIMPgenes may play an important role in the development of cholesteatoma. Further,MMP-9,MMP-13andMMP-14genes may have a remarkable role in the development of more aggressive cholesteatoma forms. the authors concluded that overexpression ofMMP-9,MMP-13andMMP-14may cause stronger inflammation associated with cholesteatoma