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PURPOSE: To compare the hearing results and clinical safety of patients undergoing stapes surgery with conventional technique and diode laser. METHODS: Retrospective observational study, which included patients treated with primary stapes surgery performed between January 2009 and January 2020. Three audiometric measurements (PTA, GAP and SDS) were evaluated as main results, evaluated by analysis of covariance (controlling the preoperative value). Intraoperative and postoperative complications were also analyzed. Outcomes were measured 6 months (± 1 month) after surgery. RESULTS: 153 cases were included, 97 operated with conventional technique and 56 with laser technique. Postoperative GAP ≤ 10 dB was obtained in 85.6% of the total sample, 82.5% in the conventional technique and 91.1% in the laser technique. Analysis of covariance showed no significant differences in the three surgery outcomes between the two groups (PTA, p = 0.277; GAP, p = 0.509 and SDS, p = 0.530). Regarding surgical complications, sensorineural damage was higher in the conventional technique group (p = 0.05). On the other hand, there were four cases of facial paresis, all in the laser group, three of them with the 980 nm laser. CONCLUSIONS: Stapedotomy offered a high percentage of hearing success in the two groups studied. There were no significant differences in audiometric result, but there was a differential presentation of complications, being more frequent sensorineural hearing loss in the conventional technique group and facial paresis in the laser group.

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OBJECTIVE: To determine whether surgical section of attachment of the medial crural footplates to the quadrangular cartilage produces loosening of the nasal tip. STUDY DESIGN: Prospective, observational, before-and-after study. SETTING: Tertiary care center. SUBJECTS AND METHODS: Hispanic patients undergoing septoplasty who required a transfixion incision were included. A six-month postoperative assessment of the nasal tip support was compared with preoperative values. As measures of the nasal tip support, we included tip recoil test, nasolabial angle, tip rotation angle, nasofacial angle, and the Goode method for determining tip projection. RESULTS: Twenty-seven patients completed the follow-up, and their results are reported. There were no statistically significant differences after septoplasty in any of the five measurements used to assess the nasal tip support (P > 0.05). CONCLUSION: In this preliminary cohort of Hispanic patients, surgical section of the attachment of the medial crural footplates to the quadrangular cartilage does not produce significant changes in nasal tip support.

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OBJECTIVE: To determine the diagnostic value of the cochlear hydrops analysis masking procedure (CHAMP) in patients with definite Ménière's disease. STUDY DESIGN: Prospective validation study for a diagnostic test, study phase 2. SETTING: Tertiary referral centers. PATIENTS: Subjects with definite Ménière's disease (Group 1), differential diagnosis (Group 2: another audiovestibular diseases or neurologic disorders), and normal hearing (Group 3) were included. Sample sizes were calculated. INTERVENTIONS: Study test (CHAMP) was compared with the current clinical criterion standard described by the guidelines of the American Academy of Otolaryngology-Head and Neck Surgery. MAIN OUTCOME MEASURE: Sensitivity, specificity, and other indicators of diagnostic validation. RESULTS: One hundred ten cases completed the follow-up, and their results are presented. Sensitivity at 31.3% and specificity at 100% were found in subjects with definite Ménière's disease, features that are more helpful in confirming the diagnosis than in rejecting it. Group 1 showed significantly shorter latency delays than Groups 2 and 3 (p < 0.001). CONCLUSION: If definite Ménière's disease is suspected, an abnormal result confirms the diagnosis; however, a normal result does not rule out the Ménière's disease diagnosis.

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La construcción de una base de datos es un aspecto importante durante la realización de una investigación. Aunque hay varios programas que permiten construir bases de datos, sugerimos utilizare paquetes estadísticos que provean el armamentario bioestadístico necesario para hacer los posteriores análisis. El programa SPSS es uno de los que tienen mayor acogida y es fácil de manejar, por ello lo utilizamos para los ejemplos. Antes de comenzar a construir la base de datos es muy importante determinar el nivel de medición de la variables, ya que de ello depende en gran parte el tipo de pruebas estadísticas que se van a utilizar. Hay cuatro tipo de variables de acuerdo al nivel de medición: nominales, ordinales, interválicas y proporcionales. Para las variables nominales y ordinales se utilizan pruebas no paramétricas; mientras que para las interválicas y proporcionales se utilizan pruebas paramétricas. Se describe paso a paso cómo ingresar una variable nominal y una variable proporcional, haciendo énfasis en aspectos de formato del paquete estadístico. Se hacen varias recomendaciones para sacar el máximo provecho a la base de datos.

A database construction is an important step in research development. Although several software packages permit you to building a database, we would suggest you to use a statistics software packages that supply you with biostatistics options to do any wished analysis. SPSS software package has wide reception and is easy to run, for that reason we used it for the following examples. Before anything else, to determine measurement level of study variables it is a central point, which is the main determinant to select a statistic test. Four variables are described according to measurement level: nominal, ordinal, interval and ratio variables. For nominal and ordinal variables non-parametric tests are used; otherwise, interval and ratio variables are analyzed with parametric tests. Step by step instructions to enter nominal and ratio variables are described; format topics of software package are highlighted. Some recommendations for maximum advantage of database are outlined.

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Introducción: Con el objetivo de realizar una auditoría clínica de resultados y comparar nuestros resultados con el estándar de tratamiento realizamos este estudio en dos instituciones de cuarto nivel. Métodos: Se incluyeron pacientes sometidos a cirugía otomastoidea por secuelas y complicaciones del oído crónico entre enero de 2001 y noviembre de 2006. Se excluyeron pacientes a quienes se les realizó osciculoplastia o una mastoidectomía radical convencional. La evaluación de resultados se hizo a los 6 meses para los casos sin colesteatoma y a los 24 meses cuando había colesteatoma.Resultados: Se incluyeron 244 pacientes, el porcentaje global de éxito fue del 78,7 por ciento(192/244). En casos de colesteatoma el éxito fue del 74,8 por ciento (n = 74) y sin no había colesteatoma fue del 87,2 por ciento (n =166). La mastoidectomía de muro bajo (radical modificada) fue el procedimiento con mejores resultados: éxito del 91 por ciento. El resultado funcional en pacientes con cadena íntegra y móvil (n = 98) mostró que se cerró el gap a menos de 10dB en el 74,5 por ciento y a menos del 20dB en 92,3 por ciento. Discusión: Al revisar la literatura encontramos que para pacientes con colesteatoma los resultados a corto plazo, 24 meses, muestran porcentajes de recaída entre el 10 porciento al 20 por ciento, similar a lo encontrado en el presente estudio (éxito del 74,8 por ciento). Para casos sin colesteatoma los porcentajes de cierre de la perforación timpánica son de alrededor del 90 por ciento, también similares a lo que encontramos (éxito del 87,2 por ciento). No hubo diferencias estadísticamente significativas entre los reportes de las series internacionales y nuestros resultados (p > 0.05). Conclusión: Nuestros resultados para cirugía timpanomastoidea en casos con y sin colesteatoma son similares al estándar de tratamiento. Actualmente hay algunas modificaciones técnicas que podrían incrementar un poco más los porcentajes de éxito quirúrgico.

Aim: This study was accomplished in two tertiary referral centers with the objective to develop a clinicalaudit of the results and to make a comparison between our results and those found in the literature. Methods: Patients with otomastoid surgical procedures between January 0f 2001 and November of 2006 as a result of sequels or complications of chronic ear disease were included. Patients who had ossicular chain reconstruction or conventional radical mastoidectomy were excluded The results were evaluated 6 months after surgery when there was not a cholesteatoma and 24 months after the procedure when a cholesteatoma was removed. Results: 244 patients were included. The overall success rate was 78,7 percent (192/244). With cholesteatoma the success rate was 74,8 percent (n=74) and without cholesteatoma was 87,2 percent (n=166). The modified canal wall down mastoidectomy was the procedure with the best results obtained, with a success rate of 91%. Patients with intact and mobile ossicular chain (n=98) close the air-bone gap to a less than 10 db HL in 74,5 percent and to a less than 20 db HL in the 92.3 percent of the patients. Discussion: In the literature, a recurrence rate of cholesteatoma at short term follow up (24 months) was between 10 to 20 percent; similar to our findings (25 percent). In patients without cholesteatoma the percentage of closure of the ear drum perforation is around 90 percent, also similar to our results (success of 87,2 percent). There were not statistical significant differences between the reports of the international series and our results (p > 0.05). Conclusion: Our results in tympanomastoid surgery in cases with and without cholesteatoma are similar to the conventional procedures of treatment. Nowadays, we have.

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