Malleostapedotomy in revision surgery for otosclerosis

PURPOSE: The purpose of this study was to analyze the results of malleostapedotomy and to compare them with those of a conventional incus stapedotomy in a series of 82 consecutive surgical revisions in otosclerotic patients. MATERIALS AND METHODS: 82 consecutive revision stapes surgery cases over 5 years were evaluated. The preoperative and postoperative audiometric data of 80 (97.5%) of the patients were obtained. RESULTS: 71 of the patients underwent a functional revision procedure as malleostapedotomy (56, 79%) or as incus stapedotomy (15, 21%). The most common cause of failure of primary surgery was a displaced or malfunctioning prosthesis (86.2%). Pathologic changes of the oval window were found in 80% of the cases. Problems of the incus were identified in 80% and abnormality of the malleus in 48.6% of the cases. The functional success rate of malleostapedotomy (closure within 10 dB) was found to be higher than that of traditional incus stapedotomy (p < 0.05). Overclosure was seen in 12 patients (17%) and a significant sensorineural hearing loss in 2 patients (3%). There were no dead ears in this series. The postoperative hearing results after first revision surgery were better than those after multiple surgical procedures (p < 0.05). CONCLUSIONS: Malleostapedotomy yields better functional hearing results than incus stapedotomy in revision surgery for otosclerosis. The detection of many malleus fixations was the result of the systematic exposure of the anterior malleal process and ligament through an endaural approach with superior canaloplasty

Audio-vestibular evaluation in patients with Behcet's syndrome

A prospective controlled clinical study was carried out at the Department of Ophthalmology and ENT, Inonu University Medical Faculty, Turgut Ozal Medical Center, Research Hospital, to evaluate the audiovestibular involvement in patients with Behcet's syndrome compared with controls

Broncofibroscopia. A atropina é necessária como pré-medicação?

RESUMO: Os autores decidiram analisar a importancia da atropina como premedicação na broncofibroscopia (BFB).Avaliaram 93 doentes que íam ser submetidos à BFB e dividiram-nos em dois grupos.O primeiro grupo (I) era constituído por doentes a quem foi administrado 10mg de diazepam i.m., enquanto que o segundo grupo (II) era constituído por doentes a quemJoram administrados l0mg de diazepam i.m.e 0,5 mg de atropina i.m.A tensão arterial e o pulso foram monitorizados durante e depois da BFB. A glicémia também foi monitorizada antes e depois da BFB.A quantidade de secreções bronquicas e as complicações foram registadas durante e depois do exame.As tensões arteriais foram elevadas em ambos os grupos mas só a diastólica foi significativamente mais elevada comparada com a diastólica medida antes do exame, no grupo que fez atropina. Nao havia diferenóas na comparação intergrupos.A frequência do pulso estava elevada em ambos os grupos antes e depois da BFB. O aumento da frequência do pulso no grupo II era significativamente maior quando comparada como grupo I (<0,05).A glicemia era significativamente maior depois do exame do que antes do exame, contudo não há diferençãs significativas entre os dois grupos.As complicaçãoes e a produção de secreções bronquicas foram identicas nos dois grupos.A administração de atropina como premedicação na BFB não mostrou ter vantagens, pelo contrario podeni ter algumas desvantagens potenciais, tais como hiperglicemias em doentes diabeticos e taquiarritmias nos doentes cardfacos. Palavras-chave: Broncofibroscopia (BFB), Atropina, Premedicaçã

Hammer-chisel technique in endoscopic dacryocystorhinostomy

We performed a prospective evaluation of endoscopic hammer-chisel dacryocystorhinostomy (DCR) procedures on 62 eyes of 44 patients (40 female and 4 male) with chronic epiphora or dacryocystitis (26 unilateral and 18 bilateral). The technique included chisel removal of bone over the lacrimal sac. The follow-up period was 12 to 54 months (mean, 28 months), and the patients' ages ranged from 17 to 67 years (mean, 35.5 years). The success rate of the consecutive endoscopic: hammer-chisel DCR procedures was 87%. During operation, 8 patients had mild mucosal hemorrhage, which did not prevent the successful completion of the operation. Excellent patient tolerance was observed, with minimal morbidity and no major complications. As compared to the external approach, endoscopic hammer-chisel DCR is less traumatic, is less time-consuming, and is practical and cosmetically convenient, with minimal perioperative and postoperative complications. It also allows the simultaneous correction of any intranasal disease. It requires minimal instrumentation and is a relatively easy and fast technique

Facilitated tissue expansion with topical estriol

Tissue expansion is a helpful technique in reconstructive plastic surgery. Unfortunately, tissue expansion still needs to be improved. Twenty-four male Wistar rats were used to evaluate the effect of estriol on tissue expansion. The agents hyaluronidase, estriol, and base cream (as a control) were applied topically to separate animal groups for 5 weeks, and their effects were studied on tissue expansion. Both hyaluronidase (p < 0.05) and estriol (p < 0.001) enhanced the rate of expansion when compared with control animals. Estriol was more effective than hyaluronidase (p < 0.05). Breaking strengths were measured in the estriol and the control groups. Breaking strength was not evaluated in the hyaluronidase group because of the necrotic changes seen at the end of the fifth week. The breaking strength was higher in the control group then in the estriol group (p < 0.05). The authors suggest that topical estriol be used as an adjunctive agent to facilitate tissue expansion

Nasal Cavity and Paranasal Sinus Diseases Affecting Orbit

WOS: 000357569600029PubMed: 26080260Objective: The aim of the authors was to discuss orbital complications of nasal cavity and paranasal sinus diseases. Material and Method: Patients with nasal and paranasal sinus diseases that affected orbit were retrospectively reviewed. Patients with primary orbital abnormality and those without radiologic orbital signs were excluded. Data regarding age and gender distribution, orbital and ocular findings, radiologic findings, and presence of an additional sinonasal disease were analyzed. Results: Disorders affecting orbit were categorized into 6 categories. Mean age was 41.25 +/- 22.14 (range: 6-88) years and male : female ratio was 23 : 18. Overall, there were 41 patients including 11 patients with mucocele, 9 patients with sinusitis, 7 patients with fibrous dysplasia, 4 patients with nasal polyp, 4 patients with paranasal osteoma, and 6 patients with neoplasm. Major clinical presentation was proptosis in these patients. Conclusions: Otolaryngologists should consider the possibility of sinonasal diseases to affect orbit because of vicinity of nasal cavity and paranasal sinuses to orbit. Radiologic imaging is essential to determine the extent, extension, relation with surrounding structures, and initial diagnosis of the disease, and to plan multidisciplinary management