Head and Neck Conference: The Multidisciplinary Approach December 10-11, 2018 Dubai, UAE

Biography:

Fabio Fanfoni is a ENT Consultant at Concordia Community Outpatients / Associate Specialist at Croydon University Hospital, London, United Kingdom. He worked as a Locum Specialty Doctor ENT at Heatherwood and Wexham Park Hospital NHS Foundation Trust. He has done his M.D, Specialty in ENT and Otoehinolaryngology, Specialty in Audiological Medicine and Phoniatry in Sapienza University of Rome. 

Abstract:

Aim is to evaluate endoscopic eustachian tube balloon dilatation (ENTellus®) outcomes as treatment of Eustachian Tube Dysfunction (ETD) in selected patients who did not respond to medical treatment and/or not improve after Grommet insertion or not keen on Grommet. It is a prospective study of 6 months follow up, conducted in secondary care academic center. Patient’s selected those who diagnosed with persistent Eustachian tube dysfunction refractory to medical treatment. No concomitance of chronic otitis media, tympanic membrane perforations, labyrinthine dysfunction, Meniere’s disease, patulous eustachian tube. Patient’s symptoms feedback evaluated through comparison of the 7-items Eustachian Tube Dysfunction Questionnaire (ETDQ-7) score before and after the procedure. Primary safety endpoint was complication rate. Fourteen (14) patients were selected and underwent endoscopic eustachian tube balloon dilatation. Mean pre-operative EDTQ-7 score was 4.5, post-operative 2.6 with a mean change of -1.9. No surgical complications were reported. Balloon dilatation is a promisingly safe procedure and effective treatment option that can be offered to patients with persistent ETD. Further studies with increased number of representative sample of participants and longer terms results will certainly help confirming effectiveness.

Biography:

Sadq Ghaleb Kadem has completed his Doctor of Medicine – MD, Medicine from Basrah University/ Iraq and Fellowship in General Surgery from Iraqi Council of Medical specializations( FICMS). He is the Director of Department Of Surgery in Al-Shifa General Hospital, Iraq. His interest is in the thyroid surgery and has published more than 6 papers in reputed journals.

Abstract:

Introduction: The transoral endoscopic thyroidectomy vestibular approach is a new pioneering procedure, natural orifice surgery, truly scar free and involves minimal dissection, thus resulting in excellent cosmetic results and decreased post-operative complications. In this series, we describe the results of the first ten cases of Trans Oral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) performed in Iraq.

Method: Between August 2017 and December 2017, the data of ten cases of transoral endoscopic thyroidectomy by vestibular approach was collected prospectively. All operations was done using 3 laparoscopic ports inserted at the oral vestibule.

Result: One out of 10 patients have bilateral benign thyroid pathology and undergoes near total thyroidectomy, the remaining cases have single lobe pathology and undergoes thyroid lobectomy. The operative time was range from ( 90-150 min), the duration of drain removal was range from ( 20-24 hr), the amount of drainage per drain was range from ( 15-25 ml), the duration of hospital stay was range from (33-47hr), the final histopathological results were benign for all cases and the only complications recorded in this series are the mild cervical emphysema that reported in one case and resolved completely within 24 hour and one case of temporary mental nerve palsy that resolved completely within a few weeks, no reported cases of conversion to open thyroidectomy or mortality.

Conclusion: The Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) is a safe, feasible procedure when the patient selected properly.

Biography:

He is a Consultant of Palliative Care and Family Medicine at the Postgraduate Education of Family Medicine, Ministry of Health, Saudi Arabia and Consultant of Palliative Care department at King Fahad Medical City since 2010. Dr. AlShammary completed his      Bachelor Degree in Medicine (MBBS) at King Saud University, Riyadh in 1997, and received his Arab Board and Jordanian Board of Family Medicine in 2005. He also earned his Saudi Board in Family Medicine in 2004. In 2010, he completed APHN Diploma in Palliative Care at National Cancer Centre, Singapore and Fellowship in Palliative Care at University of British Columbia, Vancouver, in Canada. In 2009, he completed a Palliative Medicine Fellowship at King Faisal Specialist Hospital and Research Centre, Riyadh and Graduate Certificate & Diploma in Palliative Care at Flinders University, Adelaide, Australia.  Dr. Sami obtained Master of Medical Education (MME) at King Saud bin Abdulaziz University for Health Sciences, Riyadh on August 2010.

Abstract:

Ruqyah defined in Islam as the recitation of the Quran seeking the refuge in Allah, remembrance and supplications that are used as a means of treating sicknesses and other problems as the Quran is a source of healing. Cancer is a life-threatening disease that often has a tremendous impact on patient’s quality of life, also is associated with the experience of uncertainty, vulnerability, hopelessness, isolation, fear, shock, depression, anger and expectation of healing versus death. Cancer is one of the leading causes of mortality worldwide. It places considerable mental, physical and emotional stress on patients and requires them to make significant adjustments in many key areas of their lives. The aim of this study was to explore the impact of Ruqyah on cancer patients among patients admitted to the Comprehensive Cancer Center (CCC) in KFMC, Riyadh, to explore the significance of Ruqyah on cancer patients. Ruqyah satisfaction as part of the religious and cultural influences on general heath well-being of Muslims and provides a better understanding of Ruqyah practice and its implications for counseling and spiritual interventions. The data to validate this satisfaction is lacking; Few study has been done in Muslim countries. Dling this study will provide an understanding the significant Ruqyah.

Biography:

Mohsen Naraghi is a double-board certified facial plastic reconstructive surgeon with more than two decades of academic postgraduate teaching experience in rhinology and facial plastic surgery. He was ranked first among all the national graduates of medicine, was awarded the first rank in the national comprehensive medical examinations, graded first in the national board examinations in otolaryngology-head and neck surgery, and also became the fellow of the European board of otorhinolaryngology-head and neck surgery. He continued his training in facial plastic surgery and rhinology fellowship, receiving the international board for certification in facial plastic and reconstructive surgery.

Abstract:

Sinonasal polyposis is an inflammatory condition of the nose and paranasal sinuses, sometimes associated with chronic rhinitis, aspirin intolerance and asthma. Recent improvements in endonasal surgery such as functional endoscopic sinus surgery, caused more complete removal of polyps and better control of associated rhino sinusitis. However nasal polyposis in the triad patients remains a challenge. Endoscopic surgery alone could not treat the underlying inflammation of the nasal mucosa. Postoperative medical management with follow up endoscpic control is mandatory to prevent recurrence. In this presentation, preoperative, operative and postoperative aspects in the management of sinonasal polyps by endonasal endoscopic surgery will be discussed.

Biography:

Maria Cristina Geraldo is a Head and Neck surgeon at the National Cancer Institute, Brazil. She has done her Master of Science at AC Camargo Cancer Center, Brazil

Abstract:

Primary malignant tumors of the orbit are rare and comprised of many pathologic types. They have broad demographic distribution, but are more common among the elderly. In children, rhabdomyosarcoma, embryonal subtype, is the most frequent tumor involving the orbit.  Fortunately the embryonal form is associated with more favorable biological behavior and prognosis. In adults, one of the most common sites of origin is the lacrimal gland and the most common pathology is cystic adenoid carcinoma. The treatment for these tumors the challenging objectives of disease control and vision preservation when possible.  Loss of vision in the affected orbit and the cosmetic implications of radical surgery can have significant impact on function and quality of life among patients afflicted with these tumors. 

Methods: Fifty-one patients were treated for primary orbital malignancies between January 2000 and December 2010 at the Department of Head and Neck Surgery of the National Cancer Institute and the Department of Head and Neck Surgery and Otorhinolaryngology of AC Camargo Cancer Center, retrospective data was obtained from medical record review.

Results: Lymphoma (36%) was the most frequent histological type, followed by carcinoma (32%) and sarcoma (20%).  Nine patients (39%) presented with stage I tumors; 4 cases (17%) in stage II and 3 (13%) in stage III and 7 cases (30%) in stage IV.  Twenty two patients had surgical treatment, among them, 40% had orbital exenteration. Thirty two patients received radiation therapy and 20 patients had chemotherapy. Bone invasion was detected in 24% of the cases and invasion of the optic nerve, in 13%. Overall 5-year survival was 79% and disease-free survival at 5 years was 51%.

Conclusion: Disease control is favorable in the treatment of primary orbital malignancies even in cases of advanced tumors.

Biography:

Bharat M Mody completed his Bachelor’s and Master’s in Dental Science in Government Dental College and Hospital Mumbai. He worked as a principle and professor in k.m.shah. dental college Vadodara. He is presently working as a professor at Its dental college, Ghaziabad.

Abstract:

3D printing (3dp) is the next big milestone in health care delivery. This game changer is steadily creating in-roads into medical and allied fields. 3dp creates solutions in diagnostic and treatment procedures. The presentation is in two parts, inside out and seeing the unseen. The first section deals with models to be used for fabricating stents, guide paths, reconstructing lost parts due to surgery or trauma. These involve designing and creating lost parts, aligning to be symmetrical and restoring function of the region. The reconstruction process could be simple or may need CAD designing. Both are showcased in actual cases. The reconstructed parts are in bio-compatible 3 D printed materials like titanium. The second part involves recreating inner tissues and structural changes produced by the disease process by 3dp. The 3dp created models assist in diagnosing, revealing and making more visible the subtle changes in disease process, highlighting the possibly missed lesions, revealing effects on vital tissues close to the disease process be it major blood vessels, organs, etc. The changes seen are easily visible and understandable. Patients do not understand radiographs or laboratory results but can appreciate on these models in effect, creating evidence based informed patient. The models reveal all tissues from skin, fascia, muscles, organs and bone. The models can be used to create probable outcomes of the treatment by doing simulations. The final position of the simulation can be used to produce stents for immediate post-surgical immobilization in the new position. This gives quality assurance, predictability and precision with the help of these simulations and gets enhanced treatment outcomes in patient satisfaction.

Biography:

Aziz Waseem was a Consultant of Neurosurgery & Neuro-endovascular surgery in Alexandria main university hospital, Mostafa Kamel hospital for Armed Forces, Alexandria police hospital, Shark El Madina public hospital, and Gamal Abdelnaser insurance hospital. At present he works at Department of Neurosurgery & Neuro-endovascular surgery at Tawam hospital, Al Ain, UAE

Abstract:

Aim: To report our experience in the treatment of complex brain arteriovenous malformations.

Patients & Methods: From November 2010 to August 2017, 22 patients with brain arteriovenous malformations were treated endovascularly. They were 9 men and 13 women with a mean age of 32 years. A total of 34 endovascular procedures were performed with Onyx or Squid embolic agent.

Results: The course of endovascular treatment was completed in 18 patients. In 8 patients, an angiographic cure was achieved using embolization as the sole therapeutic technique. 6 patients underwent radiosurgical treatment after nidal size reduction <2 cm was accomplished by endovascular treatment. Four cases underwent surgery after embolization. Further endovascular treatment was planned in four patients, procedure-related transient neurologic deficits were observed in one patient, experienced mild transient hemiparesis resolved soon after treatment. There were no procedure related permanent morbidity or deaths.

Conclusion: Liquid embolic material allows obtaining higher rates of anatomic cures compared with those obtained previously with other embolic agents in the treatment of brain arteriovenous malformations.

Biography:

Tarik Djaout completed his studies in medical science at Algiers, 2003.  He started his specialty (2011 to 2016) and He work at hospital in the South of Algeria(2016) where he consulted various types of patients and in particular sick cancer patients on various stages of evolution and where the patients with synchronous metastases because of the delays of diagnosis, raise us of real problems of care in particular as regards the comfort and the life expectancy after treatment.

Abstract:

Laryngeal cancer is one of the cancers of the upper aero-digestive tract that includes a group of tumors of the oral cavity, pharynx, larynx and sinuses of the face. These cancers require multidisciplinary care between ENT physicians, oncologists, radiation therapists and pathologist. The cancers of the superior aero-digestive ways are very lymphophyles, but the systemic metastases are rare, they represent 5% of the cases. The most frequent systemic metastatic sites are the bone, lung and liver. The treatment of the laryngeal metastatic cancers is based essentially on the chemotherapy, even if its profit still very modest. The chemotherapy uses drugs, mainly: The platinum (cisplatine), 5-fluorouracil, taxanes and méthotrexate. The target therapy: Cétoximab is a monoclonal Antibody typifies IgG1, who target and block the receiver of the Epidermal Growth Factor (EGFR) on expressed on the surface of tumoral cells. The immunotherapy which remains used in the second line mainly Nivolumab. By blocking the receiver PCD1 (Program Cell Death), Nivolumab raises the inactivation of the Lymphocyt T which attack the tumoral cells. The first-line protocols use the platinums, the 5-fluorouracil, and the cetoximab during 6 cycles, at the rate of a cycle every 21 days, then interviews by cetuximab with an objective answer of 36% and a global survival of 10.1 months. The protocols of the second line use: the Methotrixate every 14 days with an objective answer of 6% and a global survival of 6 months. And the immunotherapy with Nivolumab every 14 days, with an objective answer of 13% and a global survival of 7.5 mois. The purpose of the chemotherapy is essentially to obtain an improvement of the quality of life, by the local control of the disease; the chemotherapy does not improve the global survival which stays from 6 to 8 months.

Biography:

Abstract:

To compare local versus general anesthesia for endoscopic surgical treatment of sino nasal polyposis during operation as well as early and late postoperative period together with patients acceptance for surgery.

Method: A total of 40 patients of any age with sinonasal polyposis will be included in the study. They are numbered from 1 to 40; patients with odd number were put in group (1) and will undergo endoscopic nasal surgery under local anesthesia. And those with even number were in Group (2) patients will undergo endoscopic nasal surgery under general anesthesia.

Result: Most of patients done under local anesthesia showed good acceptance for surgery, short time of surgery and less bloody field than those done under general anesthesia.

Conclusion: Surgery of sinonasal polyposis under local anesthesia was an effective method for treatment of nasal polyposis as regard patient acceptance for surgery, time of surgery, very good surgical field and less cost.

Biography:

Abdulla Alnakshabandi completed his MBchB, Medicine in Mosul Medical college. He has a membership in surgery, general surgery residency program in Royal college od surgeons in Ireland. Fellowship of European board, ENT in European Board of Medical specialties. He worked as a consultant ENT – member of TQM SEHA at Alian hospital – SEHA. He worked as a adjunct assistant professor in faculty of medicine, UAE university. At present he is working as a consultant otolaryngology/ Alain hospital at Abu Dhabi Health Service Company – SEHA.

Abstract:

A lot of complains against physicians is raised for the last years and some of them have a direct impact on physician’s life and career. Negligence and mal-practice can lead physician to end his life as a surgeon or even end behind bars. Consent and miscommunications is one of most important points which lead to complains against physicians in medicine. Documentations and using of unusual terms is another well known reason of errors is medicine general and ENT specifically. Addressing the law of each country physicians is practicing is very vital. This will touch very important subjects which are specific for ENT as specialty. Having practice in four countries I had a chance to witness and engaged in many cases as physicians or in investigations committees. Working in Quality and Senior Management Positions in many hospitals give a wide exposure for these medicolegal points and I am very keen to share with my colleagues in my home country.

Biography:

Amr Adel Mohammed is a specialist in Otolaryngology and Head & Neck Surgery. He has completed his Graduation from Ain Shams University and later he continued to work as a Resident in ENT department in Ain Shams University. He has also completed his Master’s in in Otolaryngology and Head & Neck Surgery. He is working as a specialist in New Cairo Hospital.

Abstract:

Statement of the Problem: Laryngeal cartilage invasion is of great importance in the staging of laryngeal carcinoma according to TNM classification. The extent of cartilage invasion influences the choice of treatment therefore requires an adequate diagnostic test. The aim of the study is to compare the efficacy of CT neck versus MRI in detection of thyroid cartilage invasion in laryngeal carcinoma.

Method: The study design is meta-analysis study. Literature databases including PubMed, EM base, Google scholar and web of science till year 2017. Two reviewers independently identified the literature according to inclusion and exclusion criteria, extracted data and assessed the quality of the included studies. Statistical analysis was done on a personal computer using Meta-Disc© version 1.4 (Unit of Clinical Biostatistics, Ramóny Cajal Hospital, Universidad Complutense, Madrid). Stata 12.0 and RevMan 5.0 software.

Result: A total of seven studies involving 480 cases were included. No significant heterogeneity was found between studies. In our study, MRI seems to be more sensitive than CT in detection of neoplastic cartilage invasion, but seems to have somewhat lower specificity MR image than CT. It seems that CT findings cause an under estimation, whereas MRI findings produce an overestimation of the actual presence of cartilage invasion.

Biography:

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 1^st 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.

Biography:

Abdulmajid Asiri has completed his education from King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. He is a Medical Student Intern in King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Abstract:

Background & Aim: Telemedicine describes a healthcare service where physicians communicate with patients remotely using telecommunication technologies. The Institute of Medicine (IOM) defines telemedicine as the use of electronic information and communications technologies to provide and support health care when distance separates participants. It has been used to provide pre-/postoperative surgical consultation and monitoring, as well as surgical teleconferencing and education across borders. The aim of this systematic review is to provide a broad perspective on telemedicine use in surgical care.

Method: A literature search was carried out through March 2018. The search terms included: cell phones, telemedicine, telecommunications, video, online or on-line, videoconferencing, remote consultation, surgery, preoperative, perioperative, perioperative care, postoperative, postoperative and surgical procedures, operative, monitor. Studies were included if they used telemedicine in surgery for pre-, peri- or post-surgery periods and if they compared usual care with telemedicine. However, the exclusion criteria reviews, case series, case reports and conference abstracts.

Result: A total of 24 studies were included. All reported the effectiveness of telemedicine in surgical care. Most studies that described patient satisfaction included reference to money saved. Most of patients’ comments were about avoiding unnecessary trips to hospitals, saving time and reducing the number of working days missed.

Conclusion: Studies reported that telemedicine in surgical care is safe and effective, it can improve access to the healthcare system and provide significant time savings to both patients and healthcare providers.

Biography:

Haya AlZamami is an enthusiastic medical intern who is interest in otorhinolaryngology led her to participate in several papers interested in tumors and tertiary care of patients in this field.  She has always involved herself in community-based campaigns and activities that are main goal is to raise the awareness of Saudi community.

Abstract:

The inflammatory myofibroblastic tumor is a benign lesion. It occurs most frequently in soft tissues and viscera. In the head and neck region the tumor was reported in the orbit, tongue, naso pharynx, larynx, paranasal sinuses, intramandibular and the central nervous system. Although it is a benign lesion it has some infiltrative and destructive behavior, which necessitates a histopathological examination to confirm the diagnosis. We report a case of 38 years old lady presented to King Fahad University Hospital in July 2014 with right nasolabial fold mass, which was confirmed histologically as an Inflammatory Myofibroblastic Tumor (IMT). Surgical excision of the mass was done by a sublabial approach with a smooth postoperative period. Up to our knowledge, this is the first reported case of IMT in the nasolabial fold.

Biography:

Carmen Rennie has completed her PhD in 2018 and is a Lecturer in the Department of Clinical Anatomy, University of KwaZulu Natal. She is a Member of the Anatomical Society of Southern Africa and has produced 13 articles in international peer reviewed journals (DOHET approved) in the field of clinical anatomy and education. She has a keen interest in the field of craniofacial skeletal development with a focus on paranasal air sinuses.

Abstract:

Craniofacial form may have a bearing on Paranasal Air Sinuses (PAS) morphology; however, few studies have fully illustrated this relationship. The aim was to assess the growth of the craniofacial skeleton in relation to the PAS postnatally. The relationship of the linear parameters of each PAS was assessed with volume of each PAS, nasal cavity and craniofacial skeleton linear parameters. Computerized tomography scans (n=480; 276 males; 204 females) were reviewed with age range 1-25 years. To determine the volume of each PAS, 3840 three-dimensional (3D) models were reconstructed using 3D Slicer program. Linear parameters of the PAS, nasal and cranial cavity were measured from axial, coronal and sagittal planes. Multiple regression analysis assessed the relationship of the parameters. Overall, the results indicated a weak relationship between the linear parameters of the PAS to linear parameters of the nasal cavity and craniofacial skeleton. A similar trend was observed according to age, sex and population groups. Variation in volume of the air sinuses was contributed to the linear parameters of the PAS. The weak relationship between the PAS, nasal cavity and craniofacial skeleton parameters, confirmed that the PAS may be inherently expansive structures with consequently related changes externally.