International Webinar on

Otorhinolaryngology
November 22, 2021

Time Zone in Dubai -

United Arab Emirates (GMT+4)
International Webinar on Otorhinolaryngology
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International Webinar on Otorhinolaryngology

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 International Webinar on Otorhinolaryngology
www.otorhinolaryngology.scientexconference.com/webinar
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 International Webinar on Otorhinolaryngology
November 22, 2021 | GMT+4

Day 01 (November 22, 2021)

09:00-09:20 Introduction

Title: Vertigo: Eustachian tube function should be tested before vestibular

09:20-09:40 function
Hee-Young Kim, Kim ENT Clinic, Republic of Korea
Title: Sphenopalatine artery ligation for life-threatening epistaxis in a 4-year-old
09:40-10:00 child with Glanzmann’s Thrombasthenia
Nayellin Reyes-Chicuellar, Royal Darwin Hospital, Australia

Title: The saccular otoconial theory as a cause in Meniere’s disease

10:00-10:20
Jeremy Hornibrook, Christchurch Hospital, New Zealand
Title: Clinical evaluation after introduction of stem cell supernatant Biocell Shot
10:20-10:40 65 by electroporation
Ryusuke Suzuki, SHEM Co., Ltd, Japan
Title: Optogenetic manipulation of parvalbumin-positive neurons in the basal
forebrain projecting to thalamic reticular nucleus in mice: Implications in sleep
10:40-11:00 medicine and neurosurgery
Sung-Jun Lee, Gwangju Institute of Science and Technology (GIST), Republic of
Korea
Title: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC):
A retrospective review of its diagnostic utility at Johns Hopkins Aramco
11:00-11:20 Healthcare, Saudi Arabia
Muataz H Alhashem, Johns Hopkins Aramco Healthcare, Saudi Arabia

Title: Epistaxis in pregnancy- A rare case report

11:20-11:40
Shradha Karkamkar Pandhare, Kelkar Hospital, India
Title: Noise induced hearing loss in low frequencies in employees in a hospital
11:40-12:00 microbiology department
Konstantina Chrysouli, Penteli Children’s Hospital, Greece
Title: Novel classification of laryngomalacia and burden of disease grading
12:00-12:20 scoring system
Mashudu Tshifularo, University of Pretoria, South Africa

Title: Management of stage IV carcinoma temporal bone and review of literature

12:20-12:40
Yash Mittal, All India Institute Of Medical Sciences, India

Title: Ten year review of cholesteatoma in a tertiary institution

12:40-13:00

Mashudu Tshifularo, University of Pretoria, South Africa

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 Title: Raising awareness regarding BPPV in Telangana population before it
13:30-13:50 leads to catastrophic events

Lashkar Pravalika, Vaagdevi Pharmacy College, India

Title: Systematic review of thyroid surgeries in Johns Hopkins Aramco

13:50-14:10 Healthcare (JHAH)

Abdulaziz Alabidi, Johns Hopkins Aramco Hospital, Saudi Arabia

Title: COVIDTrach: The outcomes of mechanically ventilated COVID-19 patients

14:10-14:30 undergoing tracheostomy in a single center in the UK

Shayan Shahidi, John Radcliff Hospital, United Kingdom

Title: Titanium Vs silicon myringotomy ventilation tubes, a case-control study of

14:30-14:50 outcome and complications

Sarah Faydhi Al-Othman, King Abdul-Aziz University, Saudi Arabia

Title: Use of EIDO leaflets in head and neck surgery outpatient clinics
14:50-15:10
Javaria Faiz, Morriston Hospital Swansea, United Kingdom
Title: Factors associated with facial weakness following surgery for benign
15:10-15:30 parotid disease: A retrospective multicenter study
Ahmad Albosaily, King Saud University, Saudi Arabia
Title: Lymph Node Yield (LNY) as a prognostic factor in clinically node negative
15:30-15:50 oral cavity squamous cell carcinoma
Ahmed Altuwaijri, King Abdulaziz University Hospital, Saudi Arabia

Title: Ultrasonic rhinoplasty

15:50-16:10
Gustavo Bravo, Clinica Alemana, Chile
Title: Effects of water aerobics on sleep quality in active and sedentary
16:10-16:30 pregnant women
Claudiane Marinho Resende, John Paul II Marist College, Brazil

Title: Personalized Perioperative Pain Program (PPP)

16:30-16:50
Ronen Shechter, Johns Hopkins University, USA

Title: Hidden hearing loss: Diagnosis and treatment

16:50-17:10
Yunfang Zheng, Central Michigan University, USA

Title: Communication disorders: An overview for ear, nose and throat surgeons
17:10-17:30
Lemmietta McNeilly, American Speech-Language-Hearing Association, USA

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 Title: Lipoflavonoid benefits in patients with tinnitus
17:30-17:50
Lori Lonczak, ELab/WCBA/ABCT, USA

Title: Local anesthesia, complications and management

17:50-18:10
Rehana Lakhani, JK Health Link Clifton Karachi, Pakistan

Title: Powered instrumentation in ORL practice- A surgical review

18:10-18:30
Amira Nasser I H Al Hail, Al Wakra Hospital-Hamad Medical Corporation, Qatar
E-Posters

Title: Fungal necrotizing external otitis: Place of antifungal treatment

SCOTO-EP01
Marwen Ghabi, EPS Charles Nicolle, Tunisia
Title: Complications associated with management of juvenile nasopharyngeal
SCOTO-EP02 angiofibroma: Institutional audit
Yash Mittal, All India Institute Of Medical Sciences, India

Title: Mucormycose: Diagnosis and treatment

SCOTO-EP03
Marwen Ghabi, Habib Thameur Hospital, Tunisia
Title: Outcomes of tracheostomy in COVID-19 patients in National Guard Health
SCOTO-EP04 Affairs, Riyadh, Saudi Arabia
Abdulaziz Alsalem, King Abdulaziz Medical City, Saudi Arabia
B2B meetings & Panel discussions

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International
International
Conference
Webinar Neuroscience
on on Otorhinolaryngology
and Psychiatry
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International Webinar on

Otorhinolaryngology
November 22, 2021

Day 1 Oral Presentations

Oral Presentations

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 Oral Presentations

Vertigo: Eustachian tube function should be tested before

vestibular function
Hee-Young Kim
Kim ENT Clinic, Republic of Korea

ABSTRACT

E ustachian Tube Dysfunction (ETD) is defined by symptoms and signs of pressure dysregulation in the middle ear.
Vertigo associated with ETD is caused in most (and perhaps all) instances by unilateral eustachian tube obstruction
or by more complete obstruction one side than the other. Vertigo due to unilateral ETD was first defined as “Alterno Baric
Vertigo” (or) “Vertigo Alteno Barica”, by Dr. Claes Lundgren who coined the term in 1965 to describe vertigo in deep-
sea divers. Alterno Baric Vertigo (ABV) results from unequal pressure between the middle ears and is usually caused
by bilateral middle ear pressures changing at different rates, causing the brain to erroneously perceive the difference as
movement. The fundamental mechanism of ABV is asymmetrical middle ear pressures. This diagnosis can also be applied
to cases at ground level, no matter how minute the difference in pressure is. Persistent ABV at ground level is associated
with abnormal vestibular function test results. ABV should be differentiated from any condition conferring active risk of
vertigo or severe disequilibrium. This includes peripheral causes such as Menière’s disease, benign paroxysmal positional
vertigo and vertebrogenic dizziness, as well as central disorder. Vestibular organ dysfunction is caused by poorly regulated
pressure in the middle ears. Vestibular organs are dependent variable organs. Every clinical test currently used to assess
vestibular function should ideally be performed in a state where pressures in the middle ear cavities are well within
normal range and perfectly balanced between the ears. Taking these points into consideration, I would like to (1) propose
that ABV be included in the ETD consensus statement as an official symptom of ETD, (2) reiterate that eustachian tube
function should be tested before vestibular function and (3) call for case studies and research into cases of vertigo where
eustachian tube function was assessed before vestibular function.

SPEAKER PROFILE:
Hee-Young Kim is a respected otolaryngologist and president of Kim Ear, Nose and Throat Clinic, Seoul, Republic of Korea. He
received his doctor of medicine, master of science and PhD in pathology from Chung-Ang University, South Korea. His area of
academic interest is Eustachian Tube Disfunction and he has published on topics such as Alterno Baric Vertigo (ABV): Eustachian
tube function should be assessed before vestibular function, Eustachian tube catheterization: fundamental skill for competent
otolaryngologists, eustachian tube catheterization, vertigo due to eustachian tube obstruction, the history of eustachian tube
catheterization and the reciprocal causal relationship between laryngopharyngeal reflux and eustachian tube obstruction in peer
reviewed journals. He was awarded the Albert Nelson Marquis Lifetime Achievement Award. Since 2016, he has served as the
editor-in-chief of the Journal of Otolaryngology-ENT Research.

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Oral Presentations

Sphenopalatine artery ligation for life-threatening

epistaxis in a 4-year-old child with Glanzmann’s
Thrombasthenia
Nayellin Reyes-Chicuellar*, Neela Mouli Doddi, Akash Kalro and Hemi Patel
Royal Darwin Hospital, Australia

ABSTRACT
Glanzmann's Thrombasthenia (GT) is a rare autosomal recessive platelet disorder caused by a deficiency or dysfunction
of the glycoprotein IIb-IIIa receptor complex on platelets, resulting in a defective haemostatic plug formation.
Glanzmann's Thrombasthenia is characterized by unexplained spontaneous mucocutaneous bleeding in children with
epistaxis as one of the most common presentations. Medical treatment with antifibrinolytic drugs, platelet transfusions
and recombinant factor VIIa is the standard of care, with exceptional cases presenting with severe uncontrolled
haemorrhage needing an allogeneic stem cell transplant as the only known curative modality. However, in intractable life-
threatening epistaxis in children with Glanzmann's Thrombasthenia, there have been no previous reports of successful
surgical management.
We report the first case of paediatric endoscopic sphenopalatine artery ligation to control severe posterior epistaxis
due to Glanzmann's Thrombasthenia in a 4-year-old child. We believe that this procedure is an effective way of treating
uncontrollable epistaxis, not responding to medical management.

SPEAKER PROFILE:
Nayellin has completed her master’s in surgery at the University of Sydney and currently is working as an otolaryngology registrar
with a particular interest in head and neck, pediatrics and aboriginal health. As part of her surgical experience, she had the privilege
of working in Mexico City, New South Wales and Hobart, Australia. It gives her great pleasure to provide professional and patient-
centred care to the community of the Northern Territory, Australia.

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 Oral Presentations

The saccular otoconial theory as a cause in Meniere's

disease
Jeremy Hornibrook
Christchurch Hospital, New Zealand

ABSTRACT

A fter 160 years the true underlying cause of Meniere's disease remains elusive. Briefly, theories have been inner
ear ischemia, variation in the size or position of the endolymphatic sac or duct, autoimmunity or allergy, a viral
infection of the sac, or (assuming a provable family history) a genetically determined abnormality of endolymph control,
or some combination. There have been two predominant competing theories as to the attack mechanism. Reappraisal
of Victor Hensen's 1863 first description of the ductus reuniens discovered his prediction that saccular otoconia might
enter the duct and the cochlea. Hensen also commented that otoconia had been seen in semi-circular canals at least a
hundred years before the suspected cause of BPPV was confirmed. That saccular otoconia might cause a ductus reuniens
obstruction, as well as at other sites in the endolymphatic system, is discussed with its available evidence in regard to the
main Meniere's attack theories.

SPEAKER PROFILE:
Jeremy has specialized in vestibular medicine and has an interest in perilymph fistula, vestibular paroxysmic and Meniere's disease
in particular. The presentation is based on Hornibrook J, Mudry A, Curthoys I, Smith C. Ductus reuniens and its possible role in
Meniere's disease, to be published in Otology and Neurotology in 2021.

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Oral Presentations

Clinical evaluation after introduction of stem cell

supernatant Biocell Shot 65 by electroporation
Ryusuke Suzuki
SHEM Co., Ltd, Japan

ABSTRACT
Objectives: The objective of this study is clinical evaluation after introduction of stem cell supernatant Biocell Shot 65
by electroporation.
Background: There is a clinical report of psoriasis treatment by umbilical cord blood-derived stem cells, in which there
was a beneficial result. We suppose that the supernatant has the esthetic effect of improving skin condition, thus, we
planned to make a clinical evaluation. However, it is difficult to set judgement criteria and human judgement tends to
be subjective. Therefore, in this study, as a new clinical evaluator, we used an AI skin diagnostic device with learning
function.
Methods: Stem cell culture supernatant Biocell Shot 65 was used as an introduction solution. After it was applied to the
full faces of four patients, electroporation with BeBe pinocchio DM-5 SUPER DX Plus promoted infiltration deep in the
keratinized layer. The patients were all healthy women in their forties. This procedure was performed every two weeks for
three months. Wrinkles, fine lines around eyes, stains, pores and 4V, which is considered as one diagnostic criteria, were
evaluated at baseline and after each procedure with the skin diagnostic device HiMirror-Professional.
Results: In all four patients, 4V did not change remarkably. The mean values of all the patients were plotted and compared
before and after each procedure, there was a trend toward improvements after the fifth procedure.
Conclusion: In addition to application of supernatant culture to the skin, introduction of the solution to the skin by
electroporation might improve stains, wrinkles and pores. Our evaluation was performed with a facial diagnostic device
during three months after the start of the procedure.

SPEAKER PROFILE:
Ryusuke Suzuki has completed his PHD at the age of 28 years from Kitasato University, USA. He was the visiting researcher of
R&D center for Artificial Skin, School of Allied Health Sciences, Kitasato University, Japan. He has over 10 publications. He is the
president of SHEM Co., Ltd. He is an advisor to more than 10 pharmaceutical, cosmetics and health equipment manufacturers,
helping to develop new products.

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 Oral Presentations

Optogenetic manipulation of parvalbumin-positive

neurons in the basal forebrain projecting to thalamic
reticular nucleus in mice: Implications in sleep medicine
and neurosurgery
Sung-Jun Lee
Gwangju Institute of Science and Technology (GIST), Republic of Korea

ABSTRACT

P arvalbumin Neurons (PV) in the Basal Forebrain (BF) play pivotal roles in promoting wakefulness. Interestingly,
BF PV neurons have dense projections to the Thalamic Reticular Nucleus (TRN) that is known to generate sleep
spindles and protect Non-Rapid Eye Movement (NREM) sleep. However, the function of this anatomical connection in
sleep-wake control is still unclear. We hypothesized that the BF PV neurons that project toward the TRN (PVBF→TRN)
might modulate sleep and wakefulness. Intermittent optogenetic stimulation of these neurons with blue light at 8 Hz
could modulate NREM sleep, including the continuity of NREM sleep, Slow Wave Activity (SWA) and Slow Wave Energy
(SWE) in mice. This novel role of PVBF→TRN neurons was associated with increasing SWA or SWE, leaving the sleep
spindle density unchanged. These findings suggest that the PVBF→TRN subpopulation among the BF PV neurons could
operate as sleep-promoting neurons in addition to their well-known wake-promoting function, depending on their
firing frequency and pattern. Altogether, this study may also provide important insights in developing novel therapeutics
in sleep medicine, especially for patients suffering from major sleep disorders such as insomnia, as well as potential
techniques for neurosurgery, though there are various challenges to overcome for clinical applications.

SPEAKER PROFILE:
Sung-Jun Lee has earned his B.S in February 2017 from Handong Global University at Pohang, South Korea. After graduation, he
enrolled in M.S-PhD integrated course in March 2017 at Gwangju Institute of Science and Technology (GIST), located in Gwangju,
South Korea. He is currently affiliated in the Translational Neuroscience Laboratory in the department of biomedical science and
engineering as a PhD candidate. His primary research field involves basic neuroscience using animal models, including sleep
disorders as well as neuropsychiatric disorders such as Autism Spectrum Disorder (ASD).

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Oral Presentations

The Bethesda System for Reporting Thyroid

Cytopathology (TBSRTC): A retrospective review of its
diagnostic utility at Johns Hopkins Aramco Healthcare,
Saudi Arabia
Muataz H Alhashem
Johns Hopkins Aramco Healthcare, Saudi Arabia

ABSTRACT
Purpose: Fine Needle Aspiration (FNA) is the gold standard for assessment of thyroid nodules, with The Bethesda
System for Reporting Thyroid Cytopathology (TBSRTC) used to predict the malignancy risk of these nodules. Our aim
was to evaluate the diagnostic utility of the TBSRTC for a Saudi population, by comparing the malignancy risk based on
histopathology to FNA-based diagnosis of each of the TBSRTC categories and to previously published malignancy risk
in other population.
Materials and methods: This was a retrospective study of the data of 241 patients who underwent FNA assessment of
thyroid nodules and surgical resection with histopathology at John Hopkins Aramco Healthcare, Dhahran, Saudi Arabia,
between January 2016 and December 2019.
Results: The malignancy risk for each of the TBSRTC categories was as follows: non-diagnostic, 25%, benign; 5.74%;
atypia of undetermined significance, 37%; suspicious for follicular neoplasm, 38%; suspicious for malignancy, 100%;
and malignant, 95%. Our finding was comparable to previously published malignancy risks, except for a higher rate of
malignancy in the benign category at 18% compared to 0-3%.
Conclusion: Our findings validate the diagnostic reproducibility of the TBSRTC for a Saudi population, with the risk
of malignancy confirmed by histopathological assessment being consistent with those previously reported for other
populations.

SPEAKER PROFILE:
Muataz Alhashem is an otolaryngology specialist. He recently graduated from the Saudi Board of Otolaryngology Head and Neck
Surgery.

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 Oral Presentations

Epistaxis in pregnancy- A rare case report

Shradha Karkamkar Pandhare
Kelkar Hospital, India

ABSTRACT

P yogenic granuloma is a benign lesion of skin and mucous membrane. It has been reported as a common lesion in
oral and nasal cavity. This is a presentation of a 22-year-old female patient with 7 months amenorrhoea came with
complaints of epistaxis and swelling in left nasal cavity ultimately diagnosed as pyogenic granuloma. The patient was
treated with endoscopic excision of nasal mass under general anesthesia. The management of a pregnant female with
such lesion was challenging, so we had to operate her. Even radiation exposure was a risk while radio imaging before
surgery. Pyogenic granuloma is a rapidly growing lesion that should be considered in the differential diagnosis of gravid
patient with oral and nasal mass which bleeds heavily on touch. Early excision of mass helped in avoidance of further
complications such as fetal distress, low birth weight and reduces maternal morbidity and mortality.

SPEAKER PROFILE:
Shradha Karkamkar Pandhare has completed her M.S (ENT) at the age of 27 years from MGMIHS, Navi Mumbai, India. She is
author of book ‘Allergic Rhinitis and Skin Prick Test’ by Lambert publications, Germany and the book is for sale on amazon and
more books. Recently she has received Young Achiever’s Award from Institute of Scholars, Bangalore. She has published 6 articles
in various international journals. She is practicing as a consultant ENT surgeon. She is a finalist of Diadem Mrs. Maharashtra, 2021.

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Oral Presentations

Noise induced hearing loss in low frequencies in employees

in a hospital microbiology department
Konstantina Chrysouli
Penteli Children's Hospital, Greece

ABSTRACT
Noise Induced Hearing Loss (NIHL) is regarded as a serious problem and one of the most recorded occupational
disorders in Europe and in the rest of the world and amounts to between 7% and 21% of the hearing loss.
Aim of this study is to explore the development and the prevalence of low frequency Noise-Induced Hearing Loss
(NIHL) in a hospital, especially in microbiology laboratory workers. Generally, it is known that 4 KHz is the main
NIHL frequency. Despite current theories, this study suggests for the first time the impact of low frequency noise in
hearing loss among laboratory workers. According to the results, the population examined, namely the employees at
the microbiology department of the hospital, showed lower hearing levels compared to the control group, who had no
history of occupational exposure to noise. There are many other studies which suggest that prolonged exposure to high
noise levels have negative physiological and psychological effects on workers. The finding of the correlation of noise
frequency with the frequency of the generated hearing loss is involved in the controversy about the pathophysiology of
noise effect.

SPEAKER PROFILE:
Konstantina Chrysouli works as a specialist otorhinolaryngologist at Penteli Children’s Hospital, Athens, Greece. She is a member
of the European Rhinologic Society, of the European Society for Medical Oncology (ESMO), of the European Head & Neck Society
(EHNS) and of the European Society of Pediatric Otorhinolaryngology (ESPO). She received her training in otorhinolaryngology in
the 1st ENT department of University Hospital of Athens Hippocrates at the age of 32 years old. She also holds a master’s degree
in rhinology (with high distinction) from and the University of Athens and the University of Patras. She has participated in several
international and panhellenic conferences with speeches and oral presentations, among which in the 4th Congress of European
ORL - HNS, Barcelona, in the 28th Congress of the European Rhinologic Society in conjunction with the 39th Congress of the
International Society of Inflammation and Allergy of the Nose (ISIAN) and 21st Congress of the International Rhinologic Society
(IRS) and in many international congresses on head and neck cancer. She has received several awards and honors, among which
the ‘Best Oral Presentation’ award in the 24th Panhellenic Otorhinolaryngology-Head & Neck Surgery Congress. Her current clinical
and research interests cover the full breadth of pediatric otorhinolaryngology, with a particular interest, though, in rhinology and
neuroaudiology. She has many publications that have been cited many times. She also serves as a reviewer and as an editorial
advisory board member of international peer-reviewed ENT journals.

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 Oral Presentations

Novel classification of laryngomalacia and burden of

disease grading scoring system
Mashudu Tshifularo
University of Pretoria, South Africa

ABSTRACT

L aryngomalacia is the commonest congenital stridor in new-borns. There are many classification literatures but none
of them record burden of disease and management plan in laryngomalacia. A novel classification and burden of
disease into mild, moderate and severe is presented.

SPEAKER PROFILE:
Mashudu Tshifularo an academic professor at University of Pretoria for 21 years in RSA. He is the head of department of ORL. He
has published more than many publications. He is the pioneer and an innovator of middle ear transplant 3D-TOP technology, first
case done in 2019. He is busy with second PhD on “Clinical trial for transplant and new stapedectomy technique and prosthesis
with preservation of both joints and stapedius tendon”.

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Oral Presentations

Management of stage IV carcinoma temporal bone and

review of literature
Yash Mittal
All India Institute of Medical Sciences, India

ABSTRACT
Background: The management of stage I-III carcinoma temporal bone yields good outcome in majority of patients. In
stage IV lesions the treatment protocols are guided by disease extent and anticipated complications due to involvement/
proximity of vital structures. The objective of the review was to analyse our results based on factor specific survival.
Methodology: A retrospective review of patients with stage IV squamous cell carcinoma of temporal bone treated
surgically at our institute from June 2014 to December 2019 was done. A total of 21 patients were included. Modified
Pittsburgh staging system was used to stage the disease. All patients were treated with lateral temporal bone resection
or subtotal temporal bone resection, with parotidectomy and supra-omohyoid neck dissection, followed by chemo-
radiotherapy.
Results: The average blood loss and hospital stay was 784 ml and 11.5 days respectively, with a higher disease incidence
in males. Histopathologically margin negative excision was attained in 13 patients. Post-operative complications
encountered were facial nerve palsy, ICA injury, CSF otorrhoea, meningitis, skin necrosis and swallowing difficulty.
The follow-up ranged from 1.8 years to 6 years. The 2-year disease free survival was 66.66%. Statistically significant
correlation with survival was seen with grade of tumor differentiation, nodal positivity, carotid artery involvement and
perineural/lymphovascular invasion. Age, sex, positive margin status and dural/intracranial involvement did not have
any significant correlation with survival.
Conclusion: Factors associated with poor prognosis were poorly differentiated histology, nodal metastasis, carotid
artery >180* encasement and presence of lymphovascular/perineural invasion. Margin positivity and dural/intracranial
involvement though suggestive of an aggressive disease did not have a significant impact on survival. We recommend
total conservative parotidectomy and SOND in all cases with stage IV disease, based on our results.

SPEAKER PROFILE:
Yash Mittal is a junior resident in the department of ENT in AIIMS, Bhubaneswar in India. Having graduated from the “All India
Institute of Medical Sciences”, New Delhi. He has actively participated and himself led various research projects. He has been the
leading researcher in 3 projects (1 published and 2 awaiting publication). He won the ICMR STS Excellency Award 2019 and has
presented papers in various international and national conferences. He has a keen interest in head and neck and reconstructive
surgery and wish to specialize in the same. Besides the academics, he is an acoustic guitar player and a vocalist.

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 Oral Presentations

Ten year review of cholesteatoma in a tertiary institution

Mashudu Tshifularo
University of Pretoria, South Africa

ABSTRACT
Cholesteatoma has been common ear infection in most otology clinic. The impact of HIV on progress complication and
outcome has not been done in our tertiary center. The demographic results and clinical epidemiology will be presented.

SPEAKER PROFILE:
Mashudu Tshifularo an academic professor at University of Pretoria for 21 years in RSA. He is the head of department of ORL. He
has published more than many publications. He is the pioneer and an innovator of middle ear transplant 3D-TOP technology, first
case done in 2019. He is busy with second PhD on “Clinical trial for transplant and new stapedectomy technique and prosthesis
with preservation of both joints and stapedius tendon”.

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Oral Presentations

Raising awareness regarding BPPV in Telangana

population before it leads to catastrophic events
Lashkar Pravalika
Vaagdevi Pharmacy College, India

ABSTRACT

B enign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vestibular vertigo. It is incarnate by a
sudden transient gyratory sensation accompanied by characteristic nystagmus. Symptoms may include dizziness,
nausea, vomiting and loss of balance and lasting less than one minute but episodes of BPPV can disappear for some time
and reoccur. Symptoms are triggered by certain changes in head position such as tipping the head down or up or left and
right. Most of the incidences of BPPV happens to be idiopathic in derivation and perhaps arise from disintegration of
macula. Dix-Hallpike maneuver is the decisive test for posterior canal BPPV. Uncommonness of BPPV made it harder
for Telangana individuals to have knowledge of the ailment. People may ignore the symptoms in their early stage by
mistaken it with normal giddiness until it leads to severe complications like nystagmus, imbalance. A comprehensive
clinical history is very imperative while diagnosing it. However, diagnosis with the illness and education level was
generally associated with knowledge of the different aspects of the disease. We have decreased information of human
otoconial physiology and pathology in our clinical practice this leads to misdiagnosis. Furtherly resulting in unnecessary
tests and waste of time. The principal objective of this article is to bring awareness in community about the BPPV.

SPEAKER PROFILE:
Lashkar Pravalika, currently working as a duty doctor in a private hospital. She completed graduation in doctor of pharmacy at the
age of 23yrs from Vaagdevi Pharmacy College, Telangana, India. She has published 3 articles and receiving a good response.

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 Oral Presentations

Systematic review of thyroid surgeries in Johns Hopkins

Aramco Healthcare (JHAH)
Abdulaziz Alabidi
Johns Hopkins Aramco Hospital, Saudi Arabia

ABSTRACT
Objective: Systematic review of thyroid surgeries, at John Hopkins Aramco Healthcare between 2016 and 2019, including
histopathology, epidemiology and surgical outcomes in order to improve practice and build efficient protocol.
Materials and methods: Retrospective cohort study of all thyroidectomy cases including total thyroidectomy,
hemithyroidectomy and completion thyroidectomy for different indications from January 2016 till December 2019.
Results: Majority of our papulation study were female patients representing 71.3%, while male patient represented only
28.2%. 65.6% of patients were found to have benign lesions while 34.4% patients had malignant lesions, papillary thyroid
carcinoma, PTC was found to be the commonest malignant pathology in our patients, followed by follicular thyroid
carcinoma, then MALT, medullary carcinoma were found to be the least common.
In total surgical complications ratio were few, majority of them were female which is related to high gender affection
81.2%, patients who had temporary hypocalcemia represent 9.1%. Patients who had permanent hypocalcemia were
found to be 2.9%. While patients who had hematoma as a complication were 1.1%. patients who had temporary RLN
injury were 1.4% patients. Patients who had permanent RLN injury were 0.36%.
Conclusion: After reviewing our data and results, thyroidectomy was a safe and efficient surgical procedure, our results
were similar to international standards. Auditing and reporting of thyroidectomy surgery outcomes in all national centers
can help to establish local guidelines which will boost patient care.

SPEAKER PROFILE:
Abdulaziz Alabidi graduated from King Saud University, Saud Arabia 1990, work as an assistant professor and consultant at 3 major
institutions at the Kingdom, involved in postgraduate training for the last 20 years, with special interest in head and neck surgery.

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Oral Presentations

COVIDTrach: The outcomes of mechanically ventilated

COVID-19 patients undergoing tracheostomy in a single
center in the UK
Shayan Shahidi
John Radcliff Hospital, United Kingdom

ABSTRACT
Objective: To evaluates the outcomes of tracheostomy in patients diagnosed with COVID-19 who are receiving invasive
mechanical ventilation in a tertiary center in the UK. In parallel, data was collected on the use of Personal Protective
Equipment (PPE) and rates of COVID-19 infection amongst operators.
Method: Prospective study between 6th April and 11th May 2020, when UK was dealing with the first peak of the
COVID-19 pandemic.
Results: 40 patients were identified during the period. The majority of patients were male (n=28, 70%) and BMI ranged
from 18.5 to <25 (18%), 25 to <30 (32%), 30 to <40 (40%) and >40 (10%). The number of days from intubation to
tracheostomy ranged from 1-31 (median 10, IQR 12, 17). An open method of tracheostomy was used for 8% of the cases
and 92% of cases had the operation through percutaneous method A negative pressure environment were used for only
three cases.
Seventy eight percent of patients who had undergone tracheostomy were still alive and weaned from mechanical
ventilation at point of completing survey. A further 82 % had been discharge from the intensive care unit. In hospital
mortality following tracheostomy in COVID-19 patients was 15%. None of the operators contacted COVID-19 within
14 days of performing the procedure.
Conclusion: As many of the patients are yet to complete their critical care, the mortality and weaning rates are likely to
change with time. PPE should be viewed as mandatory for tracheostomy in COVID-19 patients due to the significant
potential for aerosol generation.

SPEAKER PROFILE:
Shayan Shahidi has recently finished his core surgical training in the UK and is currently a junior fellow working in John Radcliff
Hospital in Oxford, UK. He is keen on research and innovation in the field of ENT, as well as holding local roles to promoted
education and research, he has been the SFO regional representative for ENT-UK, where he was working closely with other junior
doctors to promote ENT within the medical schools. He has keen interest for research and education. Besides from publishing his
research results in respected journals and presenting them in various conferences, he has organized and delivered two national
courses on ENT subjects for medical students and junior trainees.

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 Oral Presentations

Titanium Vs Silicon myringotomy ventilation tubes, a

case-control study of outcome and complications
Sarah Faydhi Al-Othman
King Abdul-Aziz University, Saudi Arabia

ABSTRACT

O titis Media with Effusion (OME) is fluid filled middle ear in the absence of acute symptoms. Around 25% will develop
and Chronic Otitis Media with Effusion (COME). COME can affect the healthcare system. Therefore, Ventilation
Tubes (VT) are recommended. There are different types of tubes shapes and materials only a few study that investigated
the effect and function of different VT materials, specifically the titanium tubes. The objective of our study is to compare
the results of implanting a titanium tympanostomy tube in children in compared to silicone-based tubes. Records of
patients undergoing myringotomy with ventilation tubes insertion for recurrent otitis media, using a titanium tube
from January 2018 to December 2020 were reviewed and showed 31 patients who underwent the procedure of which 14
Patients and 17 control patients. A follow up first at 2 weeks, then at 3 months intervals for a duration of 12 months or
until the tubes were extruded. The ear infection was insignificant between the Silicon and Titanium groups (P =0.534).
The complications of otitis media according to type of tympanostomy ventilation tube (hearing loss, drainage from ears,
odour from ear using oral antibiotics treatment with ear drops to treat ear infections) showed insignificant difference
between Silicon and Titanium subgroup of patients (P >0.050). Early postoperative complications were blockage of tube
in (6.5%) patients; recurrent ear infections in (6.5%) patients; persistence otorrhea in (3.2%) patient; late extrusion of the
tubes in (19.4%) patients with insignificant difference between Silicon and Titanium subgroup of patients (P >0.050). The
duration of tube extrusion was longer in Titanium than Silicon subgroup (P <0.038). Late postoperative complications
were retraction in (6.5%) patients; permanent perforation in (3.2%) in Silicon subgroup; need for a second tube in (3.2%)
patient; tympanosclerosis in (3.2%) patient and cholesteatoma in (3.2%) patient.

SPEAKER PROFILE:
At the age of 23, Sarah Al-Othman graduated from King Abdul-Aziz University Medical School, class of 2021, with an excellent
cumulative grade and first honors. She is currently a medical intern who rotates around various departments. Two papers have
been published (systematic review – cross sectional) and three more are in the works. Between 2019 and 2021, three posters and
one oral presentation were submitted.

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Oral Presentations

Use of EIDO leaflets in head and neck surgery outpatient

clinics
Javaria Faiz
Morriston Hospital Swansea, United Kingdom

ABSTRACT
Background: EIDO healthcare has a collection of digital products which provide the patient with reliable information
about their proposed treatment, and a record of this. This includes details of all the benefits, alternatives and complications
of their procedure, ensuring their decision is fully informed. EIDO helps reduce the risk of litigation and improves patient
engagement with clinical consent content, solutions and procedures developed by surgeons for surgeons. Consent related
claims should be the easiest to avoid yet are still very prevalent in today’s society. Failure to properly supply a patient with
clear and relevant information before their procedure is negligent and can lead to consent-related litigation.
Aim: To improve the use of EIDO leaflets in head and neck surgery outpatient clinics in at Morriston Hospital Swansea
Wales.
Methods: Data was collected retrospectively from online clinic letters on Welsh clinical portal.
Results: A total of 17 and 74 patients were booked for surgery in the head and neck surgery clinics in month of March
and September respectively. The data analyzed from loop 1 showed that out of the 17 patients listed 53%(n=9) were not
given EIDO leaflets while 29% (n=5) were given EIDO leaflets during the consent process. After implementing change
and re-auditing the quantitative data from 2nd cycle showed gross improvements with 54%(n=26) of patients provided
with EIDO leaflets and 33% (n=16) not provided with EIDO leaflets during consent process. Additionally looking into
the statistics n=2 patients from 1st cycle and n= 26 patients from 2nd cycle underwent procedures with majority listed for
skin cancer excisions and reconstruction, with no EIDO leaflet available at all to provide poses a high risk for litigation
in case complications occur.
Conclusion: Besides improving the use of existing EIDO leaflets in other head and neck surgery cases, we suggest making
and implementing use of EIDO Leaflets in skin cancers and reconstruction surgeries to reduce the risk of litigation
furthermore..

SPEAKER PROFILE:
Javaria Faiz has done her foundation training from East Suffolk and North Essex University Hospital, UK. She has completed her
MRCS and currently working at Morriston Hospital Swansea Wales as a plastics themed core surgical trainee. Whilst working
on her quality improvement, audits and research projects contributing to evidence-based medicine, she is also doing MBA in
leadership and management from Robert Kennedy College.

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 Oral Presentations

Factors associated with facial weakness following surgery

for benign parotid disease: A retrospective multicenter
study
Ahmad Albosaily
King Saud University, Saudi Arabia

ABSTRACT
Background: Facial nerve weakness is the most common and most concerning complication after parotidectomy. Risk
factors for this complication following surgery for benign diseases remain controversial.
Objectives: Review the frequency and prognosis of facial nerve weakness after parotidectomy and analyse potential risk
factors.
Design: Retrospective review of medical records.
Settings: Two tertiary care centers.
Patients and methods: We included all parotidectomies performed for benign diseases from January 2006 to December
2018. Details about the development and recovery of postoperative facial weakness were recorded. Patient, disease and
surgery-related variables were analyzed using bivariate and multivariate analyses to identify risk factors.
Main outcome measures: Frequency, recovery rates and risk factors for facial nerve weakness
Sample size: 191 parotidectomies, 183 patients, 61 patients with facial weakness.
Results: The frequency of postoperative facial weakness was 31.9% (61/191 parotidectomies). Among patients with
temporary weakness, 90% regained normal facial movement within 6 months. Steroid therapy was not associated with
a faster recovery. Postoperative weakness was not associated with age, diabetes, smoking, disease location, use of an
intraoperative facial nerve monitor or direction of facial nerve dissection. Risk factors for temporary weakness were total
parotidectomy and surgical specimens larger than 60 cubic centimetres. Revision surgery was the only identified risk
factor for permanent weakness.
Conclusions: Larger parotid resections increase the risk of temporary facial nerve weakness while permanent weakness
is mainly influenced by previous surgeries.
Limitations: Retrospective nature, underpowered sample size, selection bias associated with tertiary care cases.

SPEAKER PROFILE:
Ahmad Albosaily is a board-certified Otolaryngologist who has completed his residency training in 2018. Since Jan 2019 he has
been a fellow of head and neck oncological surgery and microvascular reconstruction at King Saud University, Riyadh, Saudi
Arabia.

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Oral Presentations

Lymph Node Yield (LNY) as a prognostic factor in

clinically node negative oral cavity squamous cell
carcinoma
Ahmed Altuwaijri
King Abdulaziz University Hospital, Saudi Arabia

ABSTRACT
Background: Selective neck dissection with a higher Lymph Node Yield (LNY) increases the prognosis and survival of
early-stage Oral Cavity Squamous Cell Carcinoma (OCSCC) patients.
Objective: To determine the prognostic significance of nodal yield in patients with clinically node-negative (cN0)
OCSCC.
Method: This retrospective observational study included 40 patients with cN0 OSCCC who underwent treatment with at
least six months of follow-up data. We recorded the variables, including patient demographics, cancer site, Tumor-Node-
Metastasis (TNM) staging, type of treatment, LNY, histopathologic diagnosis and recurrence.
Results: Our study comprised of 27 male and 13 female patients with a mean age of 60.08+13.153 years. Tongue (55%) was
the commonly affected site. 17 (42.5%) patients belonged to TNM stage II. The mean LNY in our study was 38.65±25.41
(range 7-98). Following surgery, 19(47.5%) patients further received adjuvant therapies. Recurrence was reported only
in 4(10%) patients. There was no significant difference between the number of lymph node yield and the recurrence rate
(p= 0.892). Factors including, age (p=0.121), gender (p=0.209), site (p=0.519), size of tumor (p=0.416) did not influence
the LNY.
Conclusion: There is no correlation between LNY and recurrence in cN0 OSCCC patients. Meticulous neck dissection
and thorough pathologic reporting prevents TNM under staging and improves the overall survival and prognosis.

SPEAKER PROFILE:
Ahmed Altuwaijri is an assistant consultant of otolaryngology, head and neck oncology fellow of head & neck surgical oncology King
Abdulaziz University Hospital.

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 Oral Presentations

Ultrasonic rhinoplasty
Gustavo Bravo
Clinica Alemana, Chile

ABSTRACT

I n rhinoplasty surgery, management of the bony vault and lateral walls is most often performed with mechanical
instruments: saws, chisels, osteotomes and rasps. Evolution of the technique utilizing piezoelectric device offer a short
recovery with less oedema and ecchymosis. With extensive exposure, surgeons can make an accurate diagnosis of bony
deformity and safely contour the bones to achieve narrowing and symmetry of the bony dorsum. Stable osteotomies can
be performed under direct vision with precise mobilization and control. We would like to show our operative techniques
with piezoelectric device.

SPEAKER PROFILE:
Gustavo Bravo Cordero is an ENT and facial plastic and reconstructive surgeon practising in Santiago de Chile. He is a fellow of the
European Board of Otorhinolaryngology, head and neck surgery and completed his fellowship in facial plastic and reconstructive
surgery with the Australasian Academy of Facial Plastic Surgery (AAFPS) in Perth with Dr. Tuan Pham. He sat the American Board
Examination in facial plastic and reconstructive surgery in Washington DC for which he was awarded the Claus Walter Award
for academic excellence achieving the highest international score in the 2016 IBCFPRS examination. He is a member of the
International Association of Paediatric Otolaryngology (IAPO), AAFPS and several other local and international societies. He is an
associate professor at Universidad de Chile, teaching both graduates and post graduates students and he works at the University
Hospital and Clínica Alemana, a leading hospital in Latin-American.

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Oral Presentations

Effects of water aerobics on sleep quality in active and

sedentary pregnant women
Claudiane Marinho Resende
John Paul II Marist College, Brazil

ABSTRACT

T he objective of the article is to compare the sleep profile in active and sedentary pregnant women and verify the
effects of a water aerobics class on the quality of sleep in sedentary pregnant women. 10 were selected active pregnant
women and 9 sedentary pregnant women with gestation time between 16 and 34 weeks in good health and without risk.
An anamnesis was applied to all pregnant women, for health history, a sleep assessment questionnaire and a sleep protocol
water aerobics. When comparing the subfactors of sleep quality, it was found that sleep disorders are less frequent among
active pregnant women and that a single water aerobics class reduces the incidence of sedentary disorders.
Concluding that pregnant women that practice water aerobics have a lower incidence of sleep disorders when compared
to sedentary pregnant women.

SPEAKER PROFILE:
Claudiane Marinho Resende has a degree and is licentiate in Physical Education from Centro Universitario Euro Americano,
Brasília/Brazil. She is a water activities specialist, with more than 440 hours of study in water activities. She has trained over 60
pregnant women and over 100 children from 0 to 11 years old. She had her first publication in 2019. She has been studying exercise
physiologist applied to personal training.

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 Oral Presentations

Personalized Perioperative Pain Program (PPP)

Ronen Shechter
Johns Hopkins University, USA

ABSTRACT

P ersonalized Perioperative Pain Program (PPP) is important for all surgical patients and especially for patients who
suffer from chronic pain and/or opioid use disorder prior to the surgery. As surgeons account for one third of opioid
prescriptions in the United States and postoperative opioid prescriptions are considered to be a major contributor to the
opioid epidemic, the Johns Hopkins’ Personalized Pain Program (PPP) was established to manage perioperative pain.
The Perioperative Pain Program (PPP) provides continuity of care along 3 stages of the perioperative period: (1) the
outpatient period before surgery, (2) hospitalization after surgery and (3) outpatient follow-up after surgery. Our
multidisciplinary team is composed of acute and chronic pain specialists and a psychiatrist and can readily make referrals
to intensive outpatient substance use treatment, an interventional chronic pain clinic, physical therapy and integrated
medicine. Since established in 2017, our multi-modal/multi-disciplinary approach has been effective in weaning down
opioids and minimizing excessive opioid prescriptions while supporting patient’s recovery and addressing also pre-
surgery challenges in pain and opioid management of chronic pain and opioid use disorder patients.

SPEAKER PROFILE:
Ronen Shechter is an assistant professor of anesthesiology and critical care medicine and the co-director of the Personalized Pain
Program at the Johns Hopkins University. He earned his medical degree in 1999 from the Hebrew University Hadassah Medical
School in Jerusalem and completed his training in anesthesiology and a fellowship in pain medicine at Thomas Jefferson University
Hospital. In 2014, after completing a research fellowship at Johns Hopkins University, he joined the department as a full-time
assistant professor. He is board certified in anesthesiology and pain medicine and has expertise in managing a wide variety of
chronic and acute pain conditions. He believes in a multi-modal and multi-disciplinary approach to pain management.

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Oral Presentations

Hidden hearing loss: Diagnosis and treatment

Yunfang Zheng
Central Michigan University, USA

ABSTRACT

H idden Hearing Loss (HHL), a peripheral hearing disorder with lesions at synapses between inner hair cells and
afferent nerve fibers, is also called cochlear synaptopathy (Kujawa & Liberman, 2009), auditory synaptopathy
(Moser & Starr, 2016), or cochlear neuropathy (e.g., Furman et al., 2013). It cannot be detected by current standard
hearing diagnostic procedures, but the synaptic damage specifically at low-SR nerve endings causing perceptual hearing
difficulties such as difficulty hearing in noise, tinnitus, hyperacusis, etc. will bring negative impact on communication
ability leading to reduced quality of life (Schaette & McAlpine, 2011). Currently more people are struggling with HHL
and it is occurring at a younger age due to increased recreational noise exposure. However, people with perceptual
hearing difficulties but with normal hearing sensitivity will be left untreated or be led to other disorder evaluations due
to a lack of awareness of synaptic dysfunction, easily accessible diagnostic tools and effective treatments. It’s important
to have a better understanding of HHL publicly and professionally to reduce possible health issues caused by HHL.
Studies have been conducted on animals and human subjects trying to identify the etiology and find effective diagnostic
and treatment methods on HHL. This presentation will provide thorough but condensed information about HHL with
emphasis on diagnosis and treatment, so as to guide professionals to a better understanding of this disorder, increase
public awareness for early diagnosis, achieve prompt and proper intervention to prevent further possible auditory
damage, leading to a better quality of life.

SPEAKER PROFILE:
Yunfang Zheng, Sc.D., M.D., CCC-A, is an associate professor of the department of communication sciences and disorders at
Central Michigan University. She was a physician and received her Sc.D. in audiology from Montclair State University. She managed
an audiology department at Saint Peter’s University Hospital in New Jersey for three years and was an adjunct professor at Montclair
State University. Her research interests include diagnostic audiology, amplification, cochlear implants and aural rehabilitation, with
the goal of helping individuals with hearing difficulties achieve a better quality of life. She has been serving as an editorial board
member of several journals and has published her work in several internationally respected professional journals including Ear and
Hearing, Journal of the Acoustical Society of America, American Journal of Audiology, International Journal of Audiology, etc. She
has given many scientific presentations at national and international conventions such as the American Speech-Language-Hearing
Association, American Academy of Audiology, the American Auditory Society, the Conference on Implantable Auditory Prostheses,
etc. She has also received awards and grants from university, industry and professional associations to support her research and
has mentored many doctoral research projects with different research awards/grants.

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 Oral Presentations

Communication disorders: An overview for ear, nose and

throat surgeons
Lemmietta McNeilly
American Speech-Language-Hearing Association, USA

ABSTRACT

E ar, Nose and Throat surgeons (ENTs) diagnose a variety of health conditions in children and adults that result in
communication disorders or co-exist with communication disorders. Speech-language pathologists/phoniatricians/
logopedists assess and treat a variety of communication disorders including dysphagia, voice disorders and
velopharyngeal insufficiency. Speech-Language Pathologists (SLPs) work with individuals from new-borns through
geriatrics that present with communication disorders and or feeding and swallowing problems. The American Speech-
Language-Hearing Association (ASHA) is the national professional, scientific and credentialing association for 218,000
members and affiliates. SLPs have the knowledge, skills and expertise to provide high quality clinical services and actively
pursue professional development to maintain current certification. SLPs work collaboratively with other professionals to
address the functional needs of individuals that present with challenges communicating with others or safely swallowing
a variety of foods and liquids. Areas of service delivery address all aspects of communication, swallowing and related
areas that impact communication and swallowing, specifically, speech production, fluency, language, cognition,
voice, resonance, feeding, swallowing and hearing. The eight domains of speech-language pathology service delivery
are collaboration; counseling; prevention and wellness; screening; assessment; treatment; modalities, technology and
instrumentation; and population and systems. This presentation will focus on assessment and treatment. Competent
SLPs diagnose communication and swallowing disorders but do not differentially diagnose medical conditions. SLPs
conduct evaluations that include administering standardized assessment tools and informal observations of behaviours
and interviews of patients and/or family members. In the United States this includes FEES and stroboscopy. Speech-
language services are designed to optimize individuals’ ability to communicate and swallow, thereby improving quality
of life. SLPs develop and implement treatment to address presenting symptoms of a communication or swallowing
problem. Treatment establishes a new skill or remediates or restores an impaired ability. The goal of therapy is to improve
an individual’s functional outcomes.

SPEAKER PROFILE:
Lemmietta McNeilly is an ASHA Fellow, a distinguished scholar and fellow of the National Academy of Practice and an American
Society of Association Executives Certified Association Executive. Presently she serves as ASHA’s chief staff officer for Speech-
Language Pathology. Her resume includes international publications and presentations to health care executives, practitioners and
academicians across the globe. She consults with the World Health Organization and the National Academy of Medicine. She has
expertise in the following topics; empowering leaders for the changing health care landscape, genomics for health care professionals,
interprofessional education and collaborative practice, effective utilization of Speech-Language Pathology assistants and practicing
at the top of the license. She has expertise managing teams in neonatal intensive care units, using the International Classification
of Functioning, Disability and Health (ICF) to facilitate functional communication outcomes in culturally and linguistically diverse
children living with prenatal drug exposure, human immunodeficiency virus, traumatic brain injury and chronic health conditions.

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Oral Presentations

Lipoflavonoid benefits in patients with tinnitus

Lori Lonczak
ELab/WCBA/ABCT, USA

ABSTRACT
Background: Otolaryngologists are regularly presented with patients experiencing tinnitus who seek treatment to help
with resuming active and productive lives. Lemon bioflavonoid complexes are known to be safe nutritional supplements;
however, data on patient satisfaction are limited.
Objectives: The primary objectives were to better understand symptom severity reduction, symptom improvement and
patient satisfaction when lemon bioflavonoid complexes are taken at the recommended dose and duration of treatment.
Methods: The silent study was conducted from January 2017 to January 2018, with 504 otolaryngologists from six states,
identified from a purchased list. Each physician provided a free, 500-caplet sample of lipo-flavonoid®, a lemon bioflavonoid
complex, to three patients who experienced tinnitus and completed a survey detailing demographics and symptoms. In
total, 719 patients received the sample; 51 patients completed a baseline symptom assessment and five surveys over 10
weeks. IRB approval was deemed unnecessary and the study was overseen by a practicing otolaryngologist. Statistical
analysis was conducted on the reduction of symptom severity and symptom improvement over 10-weeks.
Results: Bothersome ness of ringing or other noises in the ear(s) was reduced by 32% and patients reported a 55%
improvement of all symptoms, which correlated with product satisfaction. Patient satisfaction scores were strong: 33%
extremely satisfied, 49% somewhat satisfied and 18% not satisfied. Compliance was high, with 86% of participants
taking the product as directed for 60 days. The top reasons for physician recommendations (>30%) were positive clinical
experience (71%), good safety profile (66%), supported by data for over 50 years (37%) and efficacy (35%).
Implications for practice: These data support use of this lemon bioflavonoid complex for symptoms of tinnitus, for 60
days (and beyond for those who benefit) to provide the best chance of relief. For clinicians looking for a safe beneficial
intervention for patients, lemon bioflavonoid is a good first-line option.

SPEAKER PROFILE:
Lori is a pharmacist who also has an MBA; both degrees from Rutgers University. Over 20 years of her career was at Johnson and
Johnson, in various commercial and strategic roles, including senior leadership roles. Prior to J&J, she worked in retail pharmacy
and as a clinical oncology pharmacist. Currently, she has a healthcare consulting business and also serves as a healthcare
business coach at ELabNYC, the Accelerator for Biosciences in Connecticut (ABCT) and the Westchester County Biosciences
Accelerator (WCBA), (entrepreneur incubators) in New York and Connecticut. She currently serves on the board of JET Worldwide
and is an advisor to iHealthScreen, both start-up healthcare companies.

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 Oral Presentations

Local anesthesia, complications and management

Rehana Lakhani
JK Health Link Clifton Karachi, Pakistan

ABSTRACT

I n the field of dentistry most of the time local anesthesia create too many problems even for trained and senior dentist,
and of course for fresh graduate it is a big task, today we will discuss right techniques, complications and most
important is management one by one in details. That will help dentists to improve their practice on daily basis and of
course dental growth as well.
Points to know:
1. Anatomical accessory nerve supply, variation in foramen location, and abnormal course of the nerves, thick cortical
plate, might be additional nerve supply.
2. pathological. Infection, inflammation and previous surgery or trauma, limited mouth opening.
3. psychological. Fear and anxiety (Some dentists use sedative, may be helpful).
4. poor injection technique.

SPEAKER PROFILE:
Rehana Younus Lakhani has completed MD Dent and Post Graduate studies from Pakistan, Sri Lanka, Germany. She continues
dental courses in Pakistan, Dubai, Sharjah and USA. She started her career as a dental demonstrator in the Dental College and
Start her own dental practice since 1994 till date as a dentist and orthodontist. Field of interest are cosmetic and laser dentistry.
Worked at her own clinic as a head of dental department and medical director throughout her career in Dubai and Pakistan.
Attended many conferences in different countries as international dental speaker and moderator. Also sharing her research work in
different online international journal as a dental content writer. Now a days working in dentistry & aesthetics in Karachi, Pakistan. At
the moment she owns her clinic with her team of 5 dentists in different branches of dentistry.

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Oral Presentations

Powered instrumentation in ORL practice- A surgical

review
Amira Nasser I H Al Hail
Al Wakra Hospital-Hamad Medical Corporation, Qatar

ABSTRACT
A retrospective study conducted at tertiary center.
Study design: The use of powered instruments in ENT surgery is a definite trend and a way forward. Procedures in the
naso-orbit area are likely to increase the domain of the ENT surgeon towards procedures that were so far purely in the
ophthalmology domain. Application of powered surgery in ear and larynx though not prevalent yet, shows promise of
growth in near future. Cost of instruments is high but not prohibitive. Hopefully, this factor will ease out with wider
usage. Additional caution, hands-on training and choice of instruments with correct parameters are very essential.
Shorter operative time and reduced complications are likely to make powered instruments more popular with surgeons.

SPEAKER PROFILE:
Amira Nasser Al Hail is a senior consultant and head of department in otorhinolaryngology, head & neck surgery in Al Wakra
Hospital - Hamad Medical Corporation in Qatar. She completed her Fachartz in otolaryngology, Muenster, Germany in 2007. She
is one of the faculty of college of medicine, University of Qatar faculty. She is assistant professor of clinical otolaryngology in Well
Cornel College of Medicine-Qatar (since 2016). She is also mentor and examiner in Accredited Arab Board Residency Program
(ACGME) in ORL-HNS in Qatar. She has numerous publications in multiple reputed journals, she is a member and fellow in
American Colleges of Surgeon (ACS) and she is a member of different scientific and educational committees in Hamad Medical
Corporation.

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International Webinar on Otorhinolaryngology
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International Webinar on

Otorhinolaryngology
November 22, 2021

Day 1 E-Poster

Oral Presentations

37
 E-Poster Presentations

Fungal necrotizing external otitis: Place of antifungal

treatment
Lahiani R, Riahi I, Ghabi M*, Gabsi O, Kharrat O, Jaafoura H, Manoubi S,
Tbini M, Ben Salah M
EPS Charles Nicolle, Tunisia

ABSTRACT
Introduction: Necrotizing External Otitis (NEO) is a serious condition. We are increasingly seeing the emergence of
fungal agents that cause this condition.
Methods: A retrospective study carried out over a period of 10 years, from 2010 to 2020, including 21 patients with
fungal NEO treated in our department. The fungal origin was retained in front of an ear sample isolating a fungal agent.
Results: The mean age was 65.76 ± 7.3 years. The sex ratio M / F was 1.6. All our patients were diabetic and 13 patients
had hypertension. The main complaint was otalgia followed by otorea in 16 cases and hearing loss in 4 cases. The median
time between symptom onset and hospitalization was 30 days [14-120]. Oral antibiotic therapy before admission was
prescribed in 20 patients, 8 of whom also received topical antibiotic treatment. Otoscopy showed that External Auditory
Canal (EAC) was stenotic in all cases with an average degree of stenosis of 49.7%. Three patients had clinical involvement
of the Temporo Mandibular Joint (TMJ) (14.3%). Six patients had peripheral facial palsy. Biological examination,
the mean sedimentation rate was 74, the median CRP level was 16.6, the median fasting blood sugar level was 2.3.
Bacteriological and mycological samples were taken in all cases and redone in 6 cases.
The fungal agents isolated were: Candida Albicans in 7 cases, Candida Para psilosis in 5 cases, Aspergillus Niger in 4
cases, Aspergillus Flavus in 3 cases, Candida Tropicalis in 1 case, Candida Famata in 1 case. Nine bacterial cultures were
positive. Aspergillus serology was carried out in 11 cases and were positive in only 2 cases. Computed tomography was
performed in all patients within a median of 2 days of admission, revealed EAC filling and lysis of the tympanic bone in
all cases, extension to TMJ in 11 cases, an extension to the deep spaces of the face in 8 cases (38.1%), an involvement of
the soft parts in 5 cases, an extension to the deep spaces of the face in 8 cases, osteitis of the base of the skull in 2 cases and
lysis of the facial nerve canal in one case. A probabilistic double antibiotic therapy targeting Pseudomonas was started
after taking samples from all patients. Eleven patients received antifungal treatment (8 received voriconazole and 3
received fluconazole). The median length of hospital stay was 29 days [14-117]. Six patients retained PFP after a 3-month
follow-up. Four of the 11 patients treated with an antifungal were readmitted (19%).
Conclusion: The isolation of fungal agents during NEO is probably a result of infection secondary to local and oral
antibiotic therapy initially initiated. The initiation of antifungal therapy during an OEN should be carefully considered
given its many side effects. Confirmation of the diagnosis must be based on biopsies rather than a superficial sample to
be able to incriminate the fungal agent in the genesis of this pathology.

SPEAKER PROFILE:
To be updated.

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E-Poster Presentations

Complications associated with management of juvenile

nasopharyngeal angiofibroma: Institutional audit
Yash Mittal
All India Institute Of Medical Sciences, India

ABSTRACT
Introduction: Juvenile Nasopharyngeal Angiofibromas (JNA) are benign but aggressive vascular tumours, with origin
epicentered around the pterygoid wedge and sphenopalatine foramen.
Materials and methods: A retrospective analysis of the patients with JNA presenting to a tertiary care center between
June 2015 till June 2020 was done. The clinical and radiological findings, treatment (surgical or non-surgical) and post
intervention follow up data was analyzed.
Results: Out of a total of 94 cases of JNA presenting to us during the aforementioned period, 89 (94.7%) underwent
surgical intervention. The average age of presentation was 14.6 years with epistaxis being the commonest symptom
(85.1%). All except 4 patients underwent surgical intervention without embolization, of whom 78 (83%) were purely
endoscopic. Among the non-surgical group, one patient developed complete blindness following emergency nasal
packing for epistaxis while another patient had non resolving anemia secondary to Flutamide use (not yet reported).
Complications in the surgical group included a case of permanent unilateral vagal palsy (not yet reported), post-operative
temporary compressive ophthalmoplegia secondary to cavernous sinus compression due to hemostat packing and angio-
sarcomatous transformation of JNA post irradiation, who ultimately succumbed to the disease. One case of JNA which
was misdiagnosed as hemangioma and 6 others had recurrences due to failure of complete removal.
Conclusion: Endoscopic approach for JNA is the gold standard of treatment but unusual complications like blindness
and malignant conversion need to be considered when dealing with extensive lesions. Lack of classical radiological
characteristics can lead to misdiagnosis and under treatment. Pterygoid base, middle cranial fossa, vidian canal and
cavernous sinus are the common sites for potential tumor recurrence. Disruption of blood supply to optic nerve can lead
to sudden blindness, even in the absence of direct injury and the same should be included in the consent form.

SPEAKER PROFILE:
Yash Mittal is a junior resident in the department of ENT in AIIMS, Bhubaneswar in India. Having graduated from the “All India
Institute of Medical Sciences”, New Delhi. He has actively participated and himself led various research projects. He has been the
leading researcher in 3 projects (1 published and 2 awaiting publication). He won the ICMR STS Excellency Award 2019 and has
presented papers in various international and national conferences. He has a keen interest in head and neck and reconstructive
surgery and wish to specialize in the same. Besides the academics, he is an acoustic guitar player and a vocalist.

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 E-Poster Presentations

Mucormycose: Diagnosis and treatment

S Nefzaoui, M Ghabi*, N Hamroun, N Romdhane, I Hriga, C Mbarek
Habib Thameur Hospital, Tunisia

ABSTRACT
Introduction: Mucormycoses are opportunistic infections caused by fungi of the order of mucoral mucus. Although they
can reach an immuno competent patient, they develop in immuno compromised patients in more than 95% of cases.
Methods: A retrospective study carried out over a period of 10 years, from 2000 to 2020, compiling the files of 16 patients
diagnosed with rhino-cerebral mucromycoses.
Results: Our study included 16 patients: 9men and 7women with a sex ratio of 1.3. Diabetes mellitus was the most
common underlying condition found in nine patients (56%), followed by haematological malignancy (43%). All patients
presented with rhinorrhea, nasal obstruction, headaches, orbital edema and facial pain. Seven patients had cranial nerve
impairement and one had visual blur. Exophtalmia was noted at 14 cases in the physical exam. Necrotic lesions were
found at nasal cavity in 11 cases, at the palate in two cases and in the internal angle of the eye in one case. Computed
tomography was performed in all patients and it revealed mucosal thickening, air-fluid levels, and bony erosion in all
cases. Calcification at the sinus level were found in 13 cases. Magnetic resonance imaging was performed in 11 patients,
it showed orbital extension in all cases and cavernous sinus thrombosis in one case.
Diagnosis was based on histopathology (necrotic-inflammatory tissue with mycelial filaments) in 11 cases and culture in
5 cases. All patients was treated medically and surgically with controlling underlying conditions as diabetes: Extensive
removal of lesions by endonasal surgery and intavenous anti-fungal therapy (Amphotericin B) during a period of 6-week
average. Death was reported in five cases. Ten patients had a good evolution. We don’t dispose of the evolution of one
patient.
Conclusion: When diagnosis is suspected, rapid management should be initiated including anti-fungal treatment and
surgical debridement to prevent spreading further the disease. Any diagnostic or therapeutic delay is associated with a
significant increase in mortality.

SPEAKER PROFILE:
To be updated.

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E-Poster Presentations

Outcomes of tracheostomy in COVID-19 patients in

National Guard Health Affairs, Riyadh, Saudi Arabia
Abdulaziz Alsalem
King Abdulaziz Medical City, Saudi Arabia

ABSTRACT
Objectives: To evaluate coronavirus disease 2019 (COVID-19) patient tracheostomy outcomes.
Methods: All COVID-19 patients at the National Guard Hospital, Riyadh, Saudi Arabia, were retrospectively recruited.
Those who had tracheostomies between April and December 2020 were included.
Results: The population was 45 patients, of which 30 (66.7%) were males, 15 (33.3%) were females and the mean age
was 66.76±12.74 years. The tracheostomy indications were anticipated prolonged weaning in 40 (88.9%) and failed
extubation in 5 (11.1%) of the patients. The mean intubation to tracheostomy duration was 20.62±7.21 days. Mortalities
were high, with most attributed to COVID-19. Mortality and a pre-tracheostomy C-Reactive Protein (CRP) uptrend
were significantly related (p=0.039). Mortality and intubation to tracheostomy duration were not significantly related.
The mean post-tracheostomy time to death was 10.64±6.9 days. Among the survivors, 20 (44.4%) males and 11 (24.4%)
females were weaned off mechanical ventilation; 9 (20%) remained on ventilation during the study. The mean ventilation
weaning time was 27.92±20 days.
Conclusion: The high mortality rate was attributed to COVID-19. Mortality and a pre-tracheostomy CRP uptrend
were significantly related; uptrend patients experienced far more mortalities than downtrend patients. Unlike previous
findings, mortality and intubation to tracheostomy duration were not significantly related.

SPEAKER PROFILE:
Abdulaziz Alsalem, has graduated from King Saud University with MBBS in 2013, completed his otolaryngology head & neck
surgery residency training at joint residency program that involved tertiary institutions, Riyadh city. As a board-certified specializes
in examining, diagnosing and treating diseases of the Ears, Nose and Throat (ENT), especially those involving the head and neck.
He has multiple publications, and he is a member of many societies related to his filed of interest head and neck surgery.

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 Next Series
2nd International Conference on
Otorhinolaryngology
November 21-23, 2022 | Paris, France

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T hank Yo
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www.otorhinolaryngology.scientexconference.com