Health scan: Lend me your ear

Plastic surgeons at Soroka University Medical Center in Beersheba have carried out an innovative reconstruction of the external ear using a readymade synthetic platform.

By JUDY SIEGEL-ITZKOVICH
Ear, nose, and throat (Illustration) (photo credit: TNS)
Ear, nose, and throat (Illustration)
(photo credit: TNS)
Plastic surgeons at Soroka University Medical Center in Beersheba have carried out an innovative reconstruction of the external ear using a readymade synthetic platform. The patient was a 17-year-year old youth from the south who was born without an ear lobe.
In a conventional technique for this purpose, surgeons take cartilage from the ribs and fashion it into an ear lobe in three separate operations. But the new operation, using the “alloplastic” material called Medpor, does not require taking cartilage from other pars of the body, according to Dr. Eldad Zilberstein, who led the team This saved the youth a lot of pain and complications, he said. Of course, he does not hear through the ear.
A few months have passed since the operation, and he is recovering as expected.
The readymade lobe is designed to match the existing ear. The template is put in place and covered with connective tissue from a part of the scalp hidden by hair and a piece of skin. Zilberstein noted that the new technique makes it possible to do the operation at a younger age and minimize the psychological damage that lacking an ear could cause to a smaller child.
Depression lowers women’s pregnancy chances
Women with severe depressive symptoms have a decreased chance of becoming pregnant, while the use of psychotropic medications does not appear to harm fertility, a study by researchers from the Boston University Schools of Public Health and Medicine shows.
The study, published in the American Journal of Obstetrics and Gynecology, found a 38 percent decrease in the average probability of conception in a given menstrual cycle among women who reported severe depressive symptoms, compared to those with no or low symptoms. The results were similar, regardless of whether the women were on psychotropic medications.
Despite associations in prior studies between infertility and the use of antidepressants, antipsychotics or mood stabilizers among already infertile women, “current use of psychotropic medications did not appear to harm the probability of conception,” said the lead author, psychiatry Prof. Yael Nillni of the School of Medicine and a researcher with the National Center for PTSD. “Our findings suggest that moderate to severe depressive symptoms, regardless of current psychotropic medication treatment, may delay conception.”
Although the study does not answer why women with more symptoms of depression may take longer to become pregnant, the authors noted several potential mechanisms for future study.
Depression has been associated with dysregulation of the hypothalamic- pituitary-adrenal axis, which may influence the menstrual cycle and affect the ability to conceive, for example.
Data for the study came from more than 2,100 female pregnancy planners, aged 21 to 45 and looked at factors influencing fertility. The participants were asked to report their current depressive symptoms and psychotropic medication use, among many other factors. Overall, 22% reported a clinical diagnosis of depression in their medical histories, while 17% were former users of psychotropic medication, and 10.3 percent were current users of psychotropic drugs.
Among the study’s secondary findings was that current use of benzodiazepines – sedatives used to treat anxiety and other disorders – was associated with a decrease in fecundability (the probability of obtaining a clinically recognized pregnancy in a menstrual cycle among couples not pregnant in the previous cycle).
Also, women who were formerly treated with a class of antidepressants known as SSRIs (selective serotonin reuptake inhibitors) had improved chances of conception, regardless of depressive symptom severity. The authors speculated that former SSRI users could experience some long-term psychological or neurobiological benefits from past treatment that influence fertility. However, the numbers of individual classes of medications were small, and further study is needed, they said.
An estimated 10 to 15% of couples in the US suffer from infertility.
Past research shows that women have a higher prevalence of depressive and anxiety disorders during their childbearing years than during other times of life.
BBQ wire bristles can cause serious injuries
There almost isn’t an Israeli alive who hasn’t done a “mangal” (barbeque) in honor of a holiday or at the drop of a hat. Now researchers at the University of Missouri School of Medicine have discovered that the wire-bristle brushes used to clean the grill cause serious damage when loose metal pieces fall into the food. The study encompassed more than 1,600 injuries from wire-bristle grill brushes treated in emergency rooms since 2002. The loose bristles can fall off the brush during cleaning and end up in the grilled food, which, when eaten, can lead to injuries in the mouth, throat and tonsils.
Researchers advise individuals to inspect their food carefully after grilling or consider alternative grill-cleaning methods.”
“Wire-bristle brush injuries are a potential consumer safety issue, so it is important that people, manufacturers and health providers be aware of the problem,” said ear-nose-and-throat Prof. David Chang. “If doctors are unaware that this problem exists, they may not order the appropriate tests or capture the correct patient history to reach the right diagnosis,” he said. The article was published in Otolaryngology-Head and Neck Surgery.
“One little bristle unrecognized could get lodged in various areas of the body, whether in the throat, tonsil or neck region,” Chang said.
"If the bristle passes through those regions without lodging itself, it could get stuck further downstream in places like the esophagus, stomach or the intestine. The biggest worry is that it lodges into those areas and gets stuck in the wall of the intestine. The bristles could migrate out of the intestine and cause further internal damage.”
"If cautionary measures fail and individuals do experience problems with swallowing or pain after eating something that has been barbecued or grilled, they should seek advice from a physician or an emergency department and let the physician know that they were just at a barbecue event or they just grilled food.”