A simple way of managing auricular hematomas

Auricular hematomas are sometimes difficult to manage by the conventional technique of aspiration and pressure bandages. Moreover with bulky bandages it is difficult for the patient to return to work early despite it being a small problem.
I have started using a simple way of managing it effectively and with the added advantage that the patient can return to work the next day.
Tiny bits of a nasogastric tube, about 3 mm in length are cut to make small splinters, which are then cut in midline to halve them. The hematoma is simply aspirated and these tiny bolsters are secured on medial and lateral aspect of the pinna with convexity to the skin, using a 4-0 prolene mattress suture. The application is done at multiple spots depending upon the dimension of hematoma. These are removed at tenth day with good results and no recurrences.

--
Dr Harpreet S Kochar
MBBS (AIIMS), MS (AIIMS)
Consultant
Dept of ENT and Head Neck Surgery
Kailash Hospital (Greater Noida) and Delhi ENT hospital (Jasola, New Delhi)
India
Ph: 09873898361
Web: www.entgreaternoida.com

A novel technique for treating auricular hematomas in mixed martial artists (ultimate fighters).

Am J Otolaryngol. 2010 Jan-Feb;31(1):21-4. Epub 2009 Mar 26.

Roy S, Smith LP.

Department of Otolaryngology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA. sohamroy0@gmail.com
Abstract
PURPOSE: This study aimed to describe a "bolsterless" technique for managing auricular hematomas in professional fighters. METHODS: Eight auricular hematomas were drained under local anesthesia by incising along an anatomical auricular crease. After evacuation of the hematoma and copious irrigation, the resultant skin flap was replaced in anatomical position, and through-and-through absorbable mattress sutures were used to secure the flap in place. Incision sites were left open and dressed with antimicrobial ointment. No bolsters were placed. The patients were given 1 week of oral antibiotic therapy. RESULTS: All 8 hematomas resolved without further intervention. All 8 ears returned to their preinjury cosmetic state. Fighters were able to return to training within a week of the initial injury. No postoperative infections or other complications were noted. CONCLUSIONS: In contrast to wrestlers, mixed martial artists (also called "ultimate fighters") do not routinely wear protective head gear. As a result, they are at increased risk of recurrent auricular hematomas, often resulting in severe auricular deformities (cauliflower ear). These patients are anxious to return to training and fighting, and are reluctant to wear a bolster after repair. At their urging, we agreed to attempt this bolsterless technique. Although 2 patients in this series already had a significant cauliflower ear before being treated for the current hematoma, in all cases the auricle returned to its preinjury condition. Bolsterless treatment using mattress sutures and cosmetically placed incisions represents a successful technique for management of auricular hematomas in this population.

Diagnostic contributions of videolaryngostroboscopy in the pediatric population.

Arch Otolaryngol Head Neck Surg. 2010 Jan;136(1):75-9.

Mortensen M, Schaberg M, Woo P.

Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, PO Box 800713, Charlottesville, VA 22903, USA. mm6nj@virginia.edu

Abstract

OBJECTIVE: Videolaryngostroboscopy (VLS) is a standard technique used for evaluating adult patients with dysphonia. However, while pediatric dysphonia affects 5% of children, children with dysphonia are traditionally examined with a flexible nasal endoscope. The purpose of this study was to determine whether VLS provides additional diagnostic yield in children. DESIGN: A retrospective medical chart review was conducted from 2001 to 2006. SETTING: Tertiary care center. PATIENTS: Pediatric patients aged 3 to 17 years (mean age, 11 years) who presented with prolonged dysphonia. All patients were previously examined by flexible laryngoscopy and treated with speech therapy for a presumed diagnosis of vocal cord nodules. INTERVENTIONS: Flexible or rigid VLS was performed. MAIN OUTCOME MEASURE: The diagnosis per patient established after VLS. RESULTS: Eighty patients were included in the study: 50 underwent rigid VLS; 28 underwent flexible VLS; and 2 did not tolerate either procedure. A total of 132 diagnoses were made, including 68 benign mucosal diseases (41 nodules, 15 polyps, 8 cysts, and 4 sulci), 41 inflammatory disorders, 11 functional disorders, 6 congenital disorders, 4 traumatic injuries, and 2 neurologic disorders. Many patients received more than 1 intervention for their dysphonia, including antireflux medication and speech therapy, but 16 patients also underwent phonomicrosurgery. CONCLUSIONS: Patients with a history of prolonged dysphonia for whom treatment has failed should be referred for evaluation by VLS. Videolaryngostroboscopy elucidates subtle features of different disease processes; clarifies the differences between benign mucosal disorders that might require surgical intervention; and helps identify inflammatory processes that contribute to dysphonia. To our knowledge, these findings have not previously been reported in the pediatric population. Although most pediatric dysphonia can be attributed to benign nodules, our results show that inflammatory conditions and benign lesions other than nodules contribute to dysphonia and are often overlooked and undertreated.

AOI Emblem

For official use only for AOI stationary

World No Tobacco Day, 31 May 2010

The World Health Organization (WHO) selects "Gender and tobacco with an emphasis on marketing to women" as the theme for the next World No Tobacco Day, which will take place on 31 May 2010.

Controlling the epidemic of tobacco among women is an important part of any comprehensive tobacco control strategy. World No Tobacco Day 2010 will draw particular attention to the need to protect women and girls from the harmful effects of tobacco marketing and smoke in accordance with WHO Framework Convention on Tobacco Control.

World Voice Congress (VOICE 2010),September 6-9,2010,Seoul

Website www.voice2010.org

Dear Colleagues,

On behalf of the Organizing Committee of the 4th World Voice Congress (VOICE 2010), it is my great honor and pleasure to announce that VOICE 2010 will be held in Seoul from September 6-9. The Congress will bring together a diverse community of clinicians, therapists and scientists of the voice science and therapeutic fields from all over the world to share their cutting-edge expertise and knowledge.

The scientific program on voice disorders, motor speech disorders, dysphagia, craniofacial disorders, speech and hearing disorders, fluency disorders and many others will give the most comprehensive and global view of research and issues challenging the professions, research and science today.

Seoul, the capital of Korea, is a lively metropolitan city teeming with modern and traditional Korean culture. Its historical and cultural background makes Seoul the ideal city to hold the 4th World Voice Congress. The organizing committee is planning many attractive social programs to help you enjoy Seoul and is taking the utmost care to pay attention to every small detail.

I would like to extend to you my warmest welcome to Korea, and look forward to seeing you at the 4th World Voice Congress in Seoul, Korea in 2010.

Sincerely yours,

Hong-Shik Choi, MD
President
The 4th World Voice Congress

MRI and MR sialography of juvenile recurrent parotitis.

Pediatr Radiol. 2010 May 14. [Epub ahead of print]

Gadodia A, Seith A, Sharma R, Thakar A.

Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India, 110029.

Abstract

BACKGROUND: Juvenile recurrent parotitis (JRP) is the second most common inflammatory salivary gland disease of childhood, after mumps. Diagnosis of JRP is usually based on clinical history of recurrent unilateral or bilateral parotid swelling and demonstration of sialectasis. Conventional sialography, digital sialography, US, MRI and sialoendoscopy have been used as investigative tools for the diagnosis of JRP. MR sialography is increasingly recognized as a useful supplement to sialography in salivary duct disorders. OBJECTIVE: To describe the MRI and MR sialographic findings in children with JRP. MATERIALS AND METHODS: MR Sialography was performed using T2-weighted three-dimensional constructive interference in steady-state (CISS) and half fourier acquisition single-shot turbo spin-echo (HASTE) sequences in 62 children with inflammatory salivary gland disease. Out of these 62 children, 6 had JRP. Axial T1- and T2-W images were also performed. RESULTS: The main parotid duct was normal in all six children with JRP. High signal intensity focal lesions suggestive of sialectasis were seen involving both parotid glands in all six children. CISS sequence demonstrated the intraglandular ducts and sialectasis better than HASTE images. CONCLUSION: MRI and MR sialography can non-invasively delineate the parenchymal and ductal system abnormalities of the parotid glands in children with JRP. Although MR and MR sialography cannot substitute US, they can accurately depict findings such as sialectasis and signal intensity changes in the parotid gland depending upon the phase of the disease (acute vs. chronic inflammation). The radiologist should be familiar with MR findings of JRP.

PMID: 20467735 [PubMed - as supplied by publisher]