S46 Otolaryngology-Head and Neck Surgery, Vol 143, No 5S3, November 2010

in a microCT scanner. All specimens had an intact otic capsuleto exclude sectioning artifact, and no alcohol was used to avoidtissue shrinkage. Measurements were taken in a vertical planeto attain distances from the utricle and saccule to the footplate.Three-dimensional reconstructions provided new graphical ev-idence of the spatial relationship of these structures.RESULTS: It was possible to vary distance measurementssignificantly, depending on the vector drawn in the same re-gion, emphasizing perspective distortion of a purely two-di-mensional study. MicroCT allowed analysis in coronal, sagit-tal, and axial planes. Three-dimensional reconstructions werederived of the utricle and saccular membrane as well as therespective maculae in relation to the stapes footplate.CONCLUSION: The safest area of manipulation is the infe-rior half of the footplate in the mid third region.

(11) The impact of Transtympanic Steroid

Application in Round Window Insertion on Hearing

Preservation in Cochlear Implantation: Preliminary

Experiences of a Prospective Study

Jafri Kuthubutheen,* Ranjeeta Ambett,Gunesh Rajan School of Surgery, University of

Western Australia, Western Australia

BACKGROUND: Many individuals have residual low-fre-quency hearing. EAS or PDCI has become a treatment strategyfor these patients by improving hearing in Background noise,sound localization, and music perception. As hearing preser-vation is crucial in EAS, controversy exists about the surgicaltechniques and the use of steroids in order to maximize hearingpreservation. We wanted to investigate the impact of preoper-ative transtympanic steroid application on hearing preservationrates in round window insertion for cochlear implantationMETHODS: Prospective study with 25 subjects so far. Pa-tients with measurable hearing implanted before October 2007were implanted using various MedEL-elctrodes and roundwindow insertion techniques. Patients receiving cochlear im-plants after October 2007 were implanted using MedEL-elec-trodes (FlexEAS or Flex soft), preoperative transtympanic ste-roids, and round window insertion. Subsequently, residualhearing was measured in all patients at three, six, and 12months post implantation, and hearing preservation rates andstability calculated.RESULTS: The final hearing preservation rates and stabilityof both groups will be presented and compared, So far, nolate-onset hearing loss has been observed in both groups.Factors influencing hearing preservation rates will be discussedCONCLUSION: The combination of transtympanic preoper-ative steroid application and round window insertion seems toimprove hearing preservation rates when compared to roundwindow insertion alone, regardless of what kind of electrode is

used for EAS.

(12) Mastoidectomy Reconstruction: A 30-Year

Experience

Bruce Black Royal Children’s Hospital, Queensland

BACKGROUND: Open cavity mastoidectomy surgery notinfrequently Results in chronic cavity symptomatology. Mas-toidectomy reconstruction (wall repair), obliteration (cavityfill-in), or ablation (canal closure) are the available forms ofcavity elimination surgery.METHODS: Wall reconstruction techniques have been usedin this series of 552 cases from 1976 to 2009. Several tech-niques have been employed. These have included organicmaterials, hydroxylapatite (HA), and, more recently, titaniumsheeting. Since 1991, the development and use of the middletemporal flap has been a major factor in long-term successrates. Staged surgery is normally required to ensure the ab-sence of residual disease (16% of cases).RESULTS: HA provided the best outcomes from 1987 to2006, but titanium sheeting or mesh is simpler, more precise,and provides better access for second stage review.CONCLUSION: Staged external canal wall reconstructionusing HA or titanium as a firm support for overlying vascularand skin layers has proven an ideal method of eliminatingtroublesome radical cavity problems.

(13) Management of Otitis Media With Effusion in

Children With Primary Ciliary Dyskinesia

Raewyn Campbell,* Catherine Birman,Lucy Morgan John Hunter Hospital, New South

Wales

BACKGROUND: Primary ciliary dyskinesia is an autosomalrecessively inherited group of disorders of ciliary ultrastruc-ture. Otolaryngologists are frequently involved in the manage-ment of some of the most common symptoms of primaryciliary dyskinesia, including chronic rhinitis, sinusitis, and oti-tis media with effusion. A dilemma for otorhinolaryngologistsis whether ventilation tubes are of benefit in children withprimary ciliary dyskinesia and otitis media with effusion, andwhat effective alternatives exist. This paper aims to addressthis issue via a literature review and case presentation.METHODS: An extensive review of the literature was under-taken, and a discussion of the advantages and disadvantages ofventilation tubes in the management of otitis media with effu-sion in these children is presented and compared with that ofthe general population. We present a case of a nine-month-oldboy with Kartagener’s syndrome (a subgroup of primary cili-ary dyskinesia that includes the triad of sinusitis, bronchiecta-sis, and situs inversus) and chronic bilateral otitis media witheffusion to illustrate our findings.RESULTS: Eight papers were identified, all with small studynumbers. The main outcome measures were hearing, otorrhea,and tympanic membrane structural changes. The natural his-

tory of otitis media with effusion and hearing loss in primary