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Yasser Shewel

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Moravian University

mohamed shabana

Jessica Raignieri

manish nalamwar

DeWet Swanepoel

University of Pretoria

De Wet Swanepoel

University of Pretoria

Siti Hajar Haryuna

University of Sumatera Utara

Accra Technical University

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Papers by Yasser Shewel

Effect of loading of the central part of the tympanic membrane on pure tone audiometry

Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale, 2018

SUMMARY This study was conducted to determine the effects of loading of the central part of the t... more SUMMARY This study was conducted to determine the effects of loading of the central part of the tympanic membrane by different weights on pure tone audiometry of healthy ears. Sixty patients with normal otoscopic view, normal pure tone audiometry and wide external auditory canal to allow direct and endoscopic visualization of TM, but without any history of ear surgeries, were selected and divided equally and randomly into two groups. Loading of the central part of the TM was carried out using weights ranging from [(1 λ) 13.6 mg] to [(40 λ) 544 mg]; (λ) is a symbol for the weight of 1 microliter of mercury. The study was carried out in two steps assisted by direct oto-endoscopy, and pure tone audiometry was used to measure the effects of loading on both air and bone conduction hearing. Air conduction hearing thresholds increased in a statistically significant pattern at low frequencies, 500 Hz, 1000 Hz and 2000 Hz, when the TM was loaded by 340 mg (25 λ). The maximal effect was recor...

Alar lift: Sail excision technique for alar overhanging in the Middle Eastern Nose

Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 2015

The alar rim has been a neglected part of the nose in rhinoplasty procedures. Excessive alar over... more The alar rim has been a neglected part of the nose in rhinoplasty procedures. Excessive alar overhanging is not uncommon to be seen while performing rhinoplasty and sail excision technique has a role in this deformity. Objective: The sail excision technique idea is that the hanging ala can be lifted via the removal of a piece of triangular vestibular skin shaped like a sail. Due to the frequency and esthetic importance of this deformity to the patients we evaluated this technique. Methods: The sail excision technique is described in detail. Quantitative analysis of excision parameters was performed using statistical analysis. Results: Survey responses were received from 24 patients. Patient satisfaction was recorded by a score from 0 to 10, with 0 being the least satisfied by the result of surgery and 10 being the highest satisfaction. The minimum satisfaction score was 5 and the maximum was 9 with a mean of 7.41. Conclusions: The greatest advantage of this technique is that all of the incisions were placed in the vestibular skin thus hiding the scars into the depth of the normal alar rim. Level of evidence V: Evidence from systematic reviews of descriptive and qualitative studies.

Use of Cone Beam Computed Tomography to Assess Cochlear implant Electrode Position with Correlation to Performance

Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 2020

Aim: Cone Beam Computed Tomography (CBCT) has been used in a variety of maxillodental application... more Aim: Cone Beam Computed Tomography (CBCT) has been used in a variety of maxillodental applications and recently, it has proved to be effective in the otorhinolaryngology field. In this study, we used CBCT for assessment of scalar location, insertion length and distance between the cochlear implant electrode array and modiolus and correlate these factors to speech performance.Materials & Methods: This study was carried out on 30 children with bilateral severe to profound prelingual sensorineural hearing loss that had undergone cochlear implantation. Radiological assessment of electrode arrays position using CBCT was performed and correlated with speech recognition score..Results: CBCT revealed that the electrode array was inserted in the scala tympani in 26/30 children (86.66%) and showed better speech recognization score than scala vestibule insertion. The mean distance between the modiolus and electrode arrays was 0.53 ± 0.11 mm and the average length of insertion was 21.49 ± 3.65m...

Endoscope-assisted surgery ( a major adjunct in cholesteatoma surgery)

The Egyptian Journal of Otolaryngology, Apr 1, 2013

The purpose of this study was to evaluate the role of middle-ear endoscopy in the effective contr... more The purpose of this study was to evaluate the role of middle-ear endoscopy in the effective control over cholesteatoma through visualizing hidden areas of the middle-ear cleft. Materials and methods A total of 60 ears with retraction pocket cholesteatoma were operated upon. They were subdivided into 40 cases operated upon using the canal wall up technique and another 20 cases operated upon using transcanal atticotomy. Endoscopically guided ear surgery was incorporated complementary to the microscope as a principal part in the procedure. Results The incidence of cholesteatoma in the facial recess that was visualized by the endoscope was 25% compared with 20% by the microscope, whereas the incidence of detection of cholesteatoma in the sinus tympani by the endoscope was 35% compared with 5% by the microscope. Cholesteatoma in the anterior epitympanic recess was detected by the endoscope in 10% of ears compared with 0% by the microscope. In this series, no morbidity or complication was encountered secondary to the use of endoscopes in the mastoid or the middle ear. Conclusion Endoscope-assisted ear surgery has many benefits in cholesteatoma surgery as endoscopy helps explore hidden areas of the middle-ear cavity with a much lesser requirement for surgical exposure and the need to drill healthy bone; therefore, effective control over the disease can be achieved, thus establishing the concept of functional endoscopic ear surgery.

Cadaveric Study of Crista Fenestra: Revisited

OBJECTIVES Since there is great confusion in the literature about the anatomy and terms of the cr... more OBJECTIVES Since there is great confusion in the literature about the anatomy and terms of the crista fenestra (CF) and the crista semilunaris, this paper is confined to the anatomy of the inferior margin of the round window (RW). METHODS This study was carried out on 20 cadaveric temporal bones. We measured the maximal height of the RW and the maximum height of the inferior bony edge of the RW, (termed CF type A), in this study. The ratio of the maximum height of CF type A to the maximum height of the RW was calculated. After drilling the CF type A, the scala tympani was visualized using a sialendoscope, and any bony projection in the inferior wall of the scala tympani just behind the round window membrane (RWM) was assessed and reported (termed CF B in this study). RESULTS We identified CF type A in 19/20 of cases (95%), and it was absent in only 1 case (5%). Its height ranged from 0.228 to 1.329 mm with an average of 0.604±0.347 mm. The percentage of CF type A to RW ranged from 1...

Endoscopic evaluation of the patency of the aditus in tubotympanic type of chronic suppurative otitis media

The Egyptian Journal of Otolaryngology, 2016

Endoscopic evaluation of the aditus in tubo-tympanic chronic suppurative otitis media (CSOM). Stu... more Endoscopic evaluation of the aditus in tubo-tympanic chronic suppurative otitis media (CSOM). Study design Prospective escriptive study. Methods This study carried out on 50 patients presenting with inactive tubo-tympanic CSOM with only mild or moderate conductive hearing loss, attending the Alexandria university hospital (tertiary referral center). Tympanoplasty was done for all patients. The patency and dimensions of the aditus were assessed by performing antral window through which 30º endoscope was introduced. Biopsy was taken from unhealthy mucosa to detect the presence of hidden cholesteatoma or granulation tissue. Results Ten out of 50 (20%) patients had blocked aditus. The dimensions of the aditus were measured. Biopsy taken from these cases revealed a granulation tissue in all cases. No hidden cholesteatoma was detected. Conclusion In inactive tubo-tympanic CSOM with mild or moderate conductive hearing, the aditus was not always patent. It was obstructed in 20% of our study.

Recidivism of childhood cholesteatoma and surgical techniques: a meta-analysis study

The Egyptian Journal of Otolaryngology

Background There is a debate in the literature about surgical management of childhood cholesteato... more Background There is a debate in the literature about surgical management of childhood cholesteatoma. We aimed to conduct a meta-analysis study about the recidivism of acquired cholesteatoma in children after two primary surgical procedures, namely canal wall up (CWU) and canal wall down (CWD) mastoidectomy. Main body of the abstract A Medline search of English language literature on PubMed and Cochrane Collaboration from their dates of inception until August 2019 was conducted using the following search terms: “pediatric or child and Cholesteatoma Surgery”. Twenty-eight full-text papers fulfilled the selection criteria and were included in this meta-analysis This analysis showed an odd risk of 1.72 for recidivism of childhood cholesteatoma in single-stage canal wall up procedure relative to canal wall down procedures. The 95% confidence interval (CI) for the overall odds ratio was 1.27–2.34. The I2 statistic was 37%, representing low heterogeneity. Comparing the rate of recidivism b...

Retrograde mastoidectomy with canal wall reconstruction with bone graft in acquired cholesteatoma

The Egyptian Journal of Otolaryngology

Background: This study aimed to report the surgical outcomes of retrograde mastoidectomy with can... more Background: This study aimed to report the surgical outcomes of retrograde mastoidectomy with canal wall reconstruction using a bone graft that secured in place using glass ionomer cement (GIC) in adult patients with acquired cholesteatoma. Results: This study was conducted on 50 adult patients with acquired cholesteatoma who underwent retrograde mastoidectomy with a reconstruction of canal wall using a bone graft from the mastoid cortex. The preoperative and postoperative audiological evaluation was done; in addition, non-echoplanar (EPI) diffusion-weighted MRI was obtained at least 1 year postoperatively to detect recidivism of cholesteatoma. Recidivism of cholesteatoma was observed in 4/50 ears (8%) using diffusion-weighted MRI and confirmed during revision mastoidectomy. The audiological assessment showed a marked and statistically significant improvement of preoperative ABG from 30 to 21 dB in addition to the improvement of preoperative AC from 42 to 33 dB. ABG of 20 dB or less was achieved in 50% of the ears. No reaction occurred to GIC in all the ears. Conclusions: Retrograde mastoidectomy with canal wall reconstruction with bone graft was associated with a low rate of recidivism and significant improvement of the hearing. GIC is safe and effective in stabilization of bone graft in canal wall reconstruction.

Intratympanic injection of dexamethasone 4 mg/mL versus 10 mg/mL for management of idiopathic sudden sensorineural hearing loss

The Egyptian Journal of Otolaryngology

Background The aim of this study was to determine whether different concentrations of intratympan... more Background The aim of this study was to determine whether different concentrations of intratympanic (IT) injection of dexamethasone at a dose of 4 and 10 mg/mL have an effect on hearing outcomes in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Results Our study was conducted on 30 adult patients with unilateral ISSNHL who failed to respond or with contraindications to systemic steroids. Patients were categorized into two groups; each one included 15 patients. IT injection of 4 mg/mL dexamethasone was done in one group (IT dexamethasone (Dex) 4 mg/mL), while 10 mg/mL dexamethasone was administered intratympanically in the other group (IT Dex 10 mg/mL). IT injection was performed twice weekly for two successive weeks. PTA thresholds were assessed at 0.5, 1, 2 and 4 kHz before and 1 month after the treatment. In the group with IT Dex 10 mg/mL, the average PTA improved significantly from 75.50 ± 12.59 to 49 ± 24.04 dB with an average gain of 26.50 ± 14.25 (p = 0.0...

Comparative immunohistochemical study of acquired cholesteatoma in children and adults

The Egyptian Journal of Otolaryngology

Quitting smoking reverses nasal mucosal changes

European Archives of Oto-Rhino-Laryngology

Immunohistochemical Study of the Possible Role of Osteoprotegrin OPG in Inhibition of Otic Capsule Remodeling

Otolaryngology-Head and Neck Surgery

Detection of gastric pepsin in middle ear fluid of children with chronic otitis media with effusion

The Egyptian Journal of Otolaryngology, 2014

Evaluation of the effect of intratympanic injection of gentamicin for resistant cases of Meniere′s disease on hearing and vestibular functions

by Yasser Shewel and Samir Asal

The Egyptian Journal of Otolaryngology, 2015

Immunohistochemical study of the possible role of osteoprotegerin OPG in inhibition of otic capsule remodeling

Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 2015

A COL1A1 SP1 Binding Site Polymorphism is Associated with Otosclerosis in Two Independent Populations

Bull. Alex. Fac. …, 2008

Introduction: Otosclerosis is one of the most common causes of acquired hearing loss. Although th... more Introduction: Otosclerosis is one of the most common causes of acquired hearing loss. Although the etiology of otosclerosis is unknown, there is a well established genetic predisposition. One of the most important candidate genes is the collagen type I-1 gene (COL1A1). A single nucleotide polymorphism affecting a binding site for the transcription factor Sp1 in COL1A1 has been associated with an increased risk of otosclerosis. Aim: To verify the possible association between the polymorphism of the Sp1 binding site of COL1A1 and otosclerosis. Methods: Polymerase chain reaction followed by restriction enzyme digestion was used to determine the polymorphic distribution of the COL1A1 Sp1 binding site in patients with otosclerosis and in control subjects. In the first part of the study, we enrolled 89 Egyptian otosclerotic patients and 89 healthy control subjects. The second part was conducted in Switzerland, on 52 patients with otosclerosis and 52 controls. Results: The Sp1 allelic frequencies in the Egyptian and Swiss populations were very similar. The T allele frequencies were 0.36 and 0.33 in patients from Egypt and Switzerland, respectively. However, among the controls, the frequency was 0.14 in the Egyptians and 0.13 in the Swiss subjects. This study showed a significant association between otosclerosis and the T allele in the Egyptian population (p< 0.0001). Analysis of the independent Swiss population replicated this association (p= 0.0005). Conclusion: The study confirms the association of COL1A1 Sp1 binding site polymorphism with the risk of otosclerosis.

A COL1A1 SP1 Binding Site Polymorphism is Associated with Otosclerosis in Two Independent Populations

Bull. Alex. Fac. …, 2008

Introduction: Otosclerosis is one of the most common causes of acquired hearing loss. Although th... more Introduction: Otosclerosis is one of the most common causes of acquired hearing loss. Although the etiology of otosclerosis is unknown, there is a well established genetic predisposition. One of the most important candidate genes is the collagen type I-1 gene (COL1A1). A single nucleotide polymorphism affecting a binding site for the transcription factor Sp1 in COL1A1 has been associated with an increased risk of otosclerosis. Aim: To verify the possible association between the polymorphism of the Sp1 binding site of COL1A1 and otosclerosis. Methods: Polymerase chain reaction followed by restriction enzyme digestion was used to determine the polymorphic distribution of the COL1A1 Sp1 binding site in patients with otosclerosis and in control subjects. In the first part of the study, we enrolled 89 Egyptian otosclerotic patients and 89 healthy control subjects. The second part was conducted in Switzerland, on 52 patients with otosclerosis and 52 controls. Results: The Sp1 allelic frequencies in the Egyptian and Swiss populations were very similar. The T allele frequencies were 0.36 and 0.33 in patients from Egypt and Switzerland, respectively. However, among the controls, the frequency was 0.14 in the Egyptians and 0.13 in the Swiss subjects. This study showed a significant association between otosclerosis and the T allele in the Egyptian population (p< 0.0001). Analysis of the independent Swiss population replicated this association (p= 0.0005). Conclusion: The study confirms the association of COL1A1 Sp1 binding site polymorphism with the risk of otosclerosis.

Effect of loading of the central part of the tympanic membrane on pure tone audiometry

Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale, 2018

SUMMARY This study was conducted to determine the effects of loading of the central part of the t... more SUMMARY This study was conducted to determine the effects of loading of the central part of the tympanic membrane by different weights on pure tone audiometry of healthy ears. Sixty patients with normal otoscopic view, normal pure tone audiometry and wide external auditory canal to allow direct and endoscopic visualization of TM, but without any history of ear surgeries, were selected and divided equally and randomly into two groups. Loading of the central part of the TM was carried out using weights ranging from [(1 λ) 13.6 mg] to [(40 λ) 544 mg]; (λ) is a symbol for the weight of 1 microliter of mercury. The study was carried out in two steps assisted by direct oto-endoscopy, and pure tone audiometry was used to measure the effects of loading on both air and bone conduction hearing. Air conduction hearing thresholds increased in a statistically significant pattern at low frequencies, 500 Hz, 1000 Hz and 2000 Hz, when the TM was loaded by 340 mg (25 λ). The maximal effect was recor...

Alar lift: Sail excision technique for alar overhanging in the Middle Eastern Nose

Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 2015

The alar rim has been a neglected part of the nose in rhinoplasty procedures. Excessive alar over... more The alar rim has been a neglected part of the nose in rhinoplasty procedures. Excessive alar overhanging is not uncommon to be seen while performing rhinoplasty and sail excision technique has a role in this deformity. Objective: The sail excision technique idea is that the hanging ala can be lifted via the removal of a piece of triangular vestibular skin shaped like a sail. Due to the frequency and esthetic importance of this deformity to the patients we evaluated this technique. Methods: The sail excision technique is described in detail. Quantitative analysis of excision parameters was performed using statistical analysis. Results: Survey responses were received from 24 patients. Patient satisfaction was recorded by a score from 0 to 10, with 0 being the least satisfied by the result of surgery and 10 being the highest satisfaction. The minimum satisfaction score was 5 and the maximum was 9 with a mean of 7.41. Conclusions: The greatest advantage of this technique is that all of the incisions were placed in the vestibular skin thus hiding the scars into the depth of the normal alar rim. Level of evidence V: Evidence from systematic reviews of descriptive and qualitative studies.

Use of Cone Beam Computed Tomography to Assess Cochlear implant Electrode Position with Correlation to Performance

Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 2020

Aim: Cone Beam Computed Tomography (CBCT) has been used in a variety of maxillodental application... more Aim: Cone Beam Computed Tomography (CBCT) has been used in a variety of maxillodental applications and recently, it has proved to be effective in the otorhinolaryngology field. In this study, we used CBCT for assessment of scalar location, insertion length and distance between the cochlear implant electrode array and modiolus and correlate these factors to speech performance.Materials & Methods: This study was carried out on 30 children with bilateral severe to profound prelingual sensorineural hearing loss that had undergone cochlear implantation. Radiological assessment of electrode arrays position using CBCT was performed and correlated with speech recognition score..Results: CBCT revealed that the electrode array was inserted in the scala tympani in 26/30 children (86.66%) and showed better speech recognization score than scala vestibule insertion. The mean distance between the modiolus and electrode arrays was 0.53 ± 0.11 mm and the average length of insertion was 21.49 ± 3.65m...

Endoscope-assisted surgery ( a major adjunct in cholesteatoma surgery)

The Egyptian Journal of Otolaryngology, Apr 1, 2013

The purpose of this study was to evaluate the role of middle-ear endoscopy in the effective contr... more The purpose of this study was to evaluate the role of middle-ear endoscopy in the effective control over cholesteatoma through visualizing hidden areas of the middle-ear cleft. Materials and methods A total of 60 ears with retraction pocket cholesteatoma were operated upon. They were subdivided into 40 cases operated upon using the canal wall up technique and another 20 cases operated upon using transcanal atticotomy. Endoscopically guided ear surgery was incorporated complementary to the microscope as a principal part in the procedure. Results The incidence of cholesteatoma in the facial recess that was visualized by the endoscope was 25% compared with 20% by the microscope, whereas the incidence of detection of cholesteatoma in the sinus tympani by the endoscope was 35% compared with 5% by the microscope. Cholesteatoma in the anterior epitympanic recess was detected by the endoscope in 10% of ears compared with 0% by the microscope. In this series, no morbidity or complication was encountered secondary to the use of endoscopes in the mastoid or the middle ear. Conclusion Endoscope-assisted ear surgery has many benefits in cholesteatoma surgery as endoscopy helps explore hidden areas of the middle-ear cavity with a much lesser requirement for surgical exposure and the need to drill healthy bone; therefore, effective control over the disease can be achieved, thus establishing the concept of functional endoscopic ear surgery.

Cadaveric Study of Crista Fenestra: Revisited

OBJECTIVES Since there is great confusion in the literature about the anatomy and terms of the cr... more OBJECTIVES Since there is great confusion in the literature about the anatomy and terms of the crista fenestra (CF) and the crista semilunaris, this paper is confined to the anatomy of the inferior margin of the round window (RW). METHODS This study was carried out on 20 cadaveric temporal bones. We measured the maximal height of the RW and the maximum height of the inferior bony edge of the RW, (termed CF type A), in this study. The ratio of the maximum height of CF type A to the maximum height of the RW was calculated. After drilling the CF type A, the scala tympani was visualized using a sialendoscope, and any bony projection in the inferior wall of the scala tympani just behind the round window membrane (RWM) was assessed and reported (termed CF B in this study). RESULTS We identified CF type A in 19/20 of cases (95%), and it was absent in only 1 case (5%). Its height ranged from 0.228 to 1.329 mm with an average of 0.604±0.347 mm. The percentage of CF type A to RW ranged from 1...

Endoscopic evaluation of the patency of the aditus in tubotympanic type of chronic suppurative otitis media

The Egyptian Journal of Otolaryngology, 2016

Endoscopic evaluation of the aditus in tubo-tympanic chronic suppurative otitis media (CSOM). Stu... more Endoscopic evaluation of the aditus in tubo-tympanic chronic suppurative otitis media (CSOM). Study design Prospective escriptive study. Methods This study carried out on 50 patients presenting with inactive tubo-tympanic CSOM with only mild or moderate conductive hearing loss, attending the Alexandria university hospital (tertiary referral center). Tympanoplasty was done for all patients. The patency and dimensions of the aditus were assessed by performing antral window through which 30º endoscope was introduced. Biopsy was taken from unhealthy mucosa to detect the presence of hidden cholesteatoma or granulation tissue. Results Ten out of 50 (20%) patients had blocked aditus. The dimensions of the aditus were measured. Biopsy taken from these cases revealed a granulation tissue in all cases. No hidden cholesteatoma was detected. Conclusion In inactive tubo-tympanic CSOM with mild or moderate conductive hearing, the aditus was not always patent. It was obstructed in 20% of our study.

Recidivism of childhood cholesteatoma and surgical techniques: a meta-analysis study

The Egyptian Journal of Otolaryngology

Background There is a debate in the literature about surgical management of childhood cholesteato... more Background There is a debate in the literature about surgical management of childhood cholesteatoma. We aimed to conduct a meta-analysis study about the recidivism of acquired cholesteatoma in children after two primary surgical procedures, namely canal wall up (CWU) and canal wall down (CWD) mastoidectomy. Main body of the abstract A Medline search of English language literature on PubMed and Cochrane Collaboration from their dates of inception until August 2019 was conducted using the following search terms: “pediatric or child and Cholesteatoma Surgery”. Twenty-eight full-text papers fulfilled the selection criteria and were included in this meta-analysis This analysis showed an odd risk of 1.72 for recidivism of childhood cholesteatoma in single-stage canal wall up procedure relative to canal wall down procedures. The 95% confidence interval (CI) for the overall odds ratio was 1.27–2.34. The I2 statistic was 37%, representing low heterogeneity. Comparing the rate of recidivism b...

Retrograde mastoidectomy with canal wall reconstruction with bone graft in acquired cholesteatoma

The Egyptian Journal of Otolaryngology

Background: This study aimed to report the surgical outcomes of retrograde mastoidectomy with can... more Background: This study aimed to report the surgical outcomes of retrograde mastoidectomy with canal wall reconstruction using a bone graft that secured in place using glass ionomer cement (GIC) in adult patients with acquired cholesteatoma. Results: This study was conducted on 50 adult patients with acquired cholesteatoma who underwent retrograde mastoidectomy with a reconstruction of canal wall using a bone graft from the mastoid cortex. The preoperative and postoperative audiological evaluation was done; in addition, non-echoplanar (EPI) diffusion-weighted MRI was obtained at least 1 year postoperatively to detect recidivism of cholesteatoma. Recidivism of cholesteatoma was observed in 4/50 ears (8%) using diffusion-weighted MRI and confirmed during revision mastoidectomy. The audiological assessment showed a marked and statistically significant improvement of preoperative ABG from 30 to 21 dB in addition to the improvement of preoperative AC from 42 to 33 dB. ABG of 20 dB or less was achieved in 50% of the ears. No reaction occurred to GIC in all the ears. Conclusions: Retrograde mastoidectomy with canal wall reconstruction with bone graft was associated with a low rate of recidivism and significant improvement of the hearing. GIC is safe and effective in stabilization of bone graft in canal wall reconstruction.

Intratympanic injection of dexamethasone 4 mg/mL versus 10 mg/mL for management of idiopathic sudden sensorineural hearing loss

The Egyptian Journal of Otolaryngology

Background The aim of this study was to determine whether different concentrations of intratympan... more Background The aim of this study was to determine whether different concentrations of intratympanic (IT) injection of dexamethasone at a dose of 4 and 10 mg/mL have an effect on hearing outcomes in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Results Our study was conducted on 30 adult patients with unilateral ISSNHL who failed to respond or with contraindications to systemic steroids. Patients were categorized into two groups; each one included 15 patients. IT injection of 4 mg/mL dexamethasone was done in one group (IT dexamethasone (Dex) 4 mg/mL), while 10 mg/mL dexamethasone was administered intratympanically in the other group (IT Dex 10 mg/mL). IT injection was performed twice weekly for two successive weeks. PTA thresholds were assessed at 0.5, 1, 2 and 4 kHz before and 1 month after the treatment. In the group with IT Dex 10 mg/mL, the average PTA improved significantly from 75.50 ± 12.59 to 49 ± 24.04 dB with an average gain of 26.50 ± 14.25 (p = 0.0...

Comparative immunohistochemical study of acquired cholesteatoma in children and adults

The Egyptian Journal of Otolaryngology

Quitting smoking reverses nasal mucosal changes

European Archives of Oto-Rhino-Laryngology

Immunohistochemical Study of the Possible Role of Osteoprotegrin OPG in Inhibition of Otic Capsule Remodeling

Otolaryngology-Head and Neck Surgery

Detection of gastric pepsin in middle ear fluid of children with chronic otitis media with effusion

The Egyptian Journal of Otolaryngology, 2014

Evaluation of the effect of intratympanic injection of gentamicin for resistant cases of Meniere′s disease on hearing and vestibular functions

by Yasser Shewel and Samir Asal

The Egyptian Journal of Otolaryngology, 2015

Immunohistochemical study of the possible role of osteoprotegerin OPG in inhibition of otic capsule remodeling

Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 2015

A COL1A1 SP1 Binding Site Polymorphism is Associated with Otosclerosis in Two Independent Populations

Bull. Alex. Fac. …, 2008

Introduction: Otosclerosis is one of the most common causes of acquired hearing loss. Although th... more Introduction: Otosclerosis is one of the most common causes of acquired hearing loss. Although the etiology of otosclerosis is unknown, there is a well established genetic predisposition. One of the most important candidate genes is the collagen type I-1 gene (COL1A1). A single nucleotide polymorphism affecting a binding site for the transcription factor Sp1 in COL1A1 has been associated with an increased risk of otosclerosis. Aim: To verify the possible association between the polymorphism of the Sp1 binding site of COL1A1 and otosclerosis. Methods: Polymerase chain reaction followed by restriction enzyme digestion was used to determine the polymorphic distribution of the COL1A1 Sp1 binding site in patients with otosclerosis and in control subjects. In the first part of the study, we enrolled 89 Egyptian otosclerotic patients and 89 healthy control subjects. The second part was conducted in Switzerland, on 52 patients with otosclerosis and 52 controls. Results: The Sp1 allelic frequencies in the Egyptian and Swiss populations were very similar. The T allele frequencies were 0.36 and 0.33 in patients from Egypt and Switzerland, respectively. However, among the controls, the frequency was 0.14 in the Egyptians and 0.13 in the Swiss subjects. This study showed a significant association between otosclerosis and the T allele in the Egyptian population (p< 0.0001). Analysis of the independent Swiss population replicated this association (p= 0.0005). Conclusion: The study confirms the association of COL1A1 Sp1 binding site polymorphism with the risk of otosclerosis.

A COL1A1 SP1 Binding Site Polymorphism is Associated with Otosclerosis in Two Independent Populations

Bull. Alex. Fac. …, 2008

Introduction: Otosclerosis is one of the most common causes of acquired hearing loss. Although th... more Introduction: Otosclerosis is one of the most common causes of acquired hearing loss. Although the etiology of otosclerosis is unknown, there is a well established genetic predisposition. One of the most important candidate genes is the collagen type I-1 gene (COL1A1). A single nucleotide polymorphism affecting a binding site for the transcription factor Sp1 in COL1A1 has been associated with an increased risk of otosclerosis. Aim: To verify the possible association between the polymorphism of the Sp1 binding site of COL1A1 and otosclerosis. Methods: Polymerase chain reaction followed by restriction enzyme digestion was used to determine the polymorphic distribution of the COL1A1 Sp1 binding site in patients with otosclerosis and in control subjects. In the first part of the study, we enrolled 89 Egyptian otosclerotic patients and 89 healthy control subjects. The second part was conducted in Switzerland, on 52 patients with otosclerosis and 52 controls. Results: The Sp1 allelic frequencies in the Egyptian and Swiss populations were very similar. The T allele frequencies were 0.36 and 0.33 in patients from Egypt and Switzerland, respectively. However, among the controls, the frequency was 0.14 in the Egyptians and 0.13 in the Swiss subjects. This study showed a significant association between otosclerosis and the T allele in the Egyptian population (p< 0.0001). Analysis of the independent Swiss population replicated this association (p= 0.0005). Conclusion: The study confirms the association of COL1A1 Sp1 binding site polymorphism with the risk of otosclerosis.