Small incision cochlear implantation in children

Objective: Small incision cochlear implant surgery in children has been advocated to reduce post-operative morbidity and have a psychological effect on parents. With small incision techniques, it is not always possible to securely fix the device in place. This risks displacement of the device, particularly in active children. This technique has been used through minimal-access approach in children.Methods: Among 80 cochlear implantations in children performed between January 2003 and December 2010, there were 32 cases with very thin cortical bone in which small incision cochlear implant surgery were performed. As drill - hole fixation methods can carry the potential for dural injury we have used the suture fixation through the cranial periosteum. This method shortened the surgical time and there were no specific postoperative complications. Results: One complication has occurred related to the current technique (maximum follow up 30 months). No flap necrosis, hematoma or infection, nor extrusion or breakdown was encountered with either technique. Revision surgery was performed in 2 patients (1 with small incision due to posttraumatic device failure) and one due to cholesteatoma. The use of this minimally invasive surgical technique did not increase the surgical risk. Conclusion: Cochlear implantation can be performed using small incisions with periosteal sutures of the receiver. The described approach therefore appears to be a safe and time-effective alternative to the standard procedure in cochlear implant surgery

Juvenile Nasopharyngeal Angiofibroma

Introduction: Nasopharyngeal Angiofibroma (NAF), occurring mostly in young men, is histological a benign tumor with aggressive clinical behavior that includes repeated epistaxis and intractable nasal obstruction.Methods: This paper reviews our experience regarding clinical features and the treatment of NAF in E.N.T. Department-Timisoara. 37 patients with diagnosis of NAF from 1984-2009 were included, and their clinical presentations, imaging studies (C.T. and M.R.I.), treatments and outcomes were retrospectively analyzed. The duration of symptoms in the current study was 8-9 months. The current treatment modality was in all cases surgery. The patients underwent combined transpalatal or retropalatal and lateral rhinotomy approach.Results: In present series there were 4 recurrences due to failure in complete removing of the tumor. They were all reoperated by lateral rhinotomy approach and they are now free of disease. The follow up period was at least 12 month for all patients, even in cases of recurrences.Conclusions: Contemporary radiographic methods (C.T., M.R.I.) improve the evaluation of the patients, and provide essential information for the surgeon regarding the approach to use. Complete surgical excision may be impossible and may carry significant morbidity and potential mortality

Tracheobronchial foreign body in children - 10 years experience

Introduction: Presentation of ENT Department - Timisoara 10 years experience of in the diagnosis and treatment of tracheobronchial foreign body in children. We studied 93 children, aged between 10 months and 8 years.Methods: The diagnosis of airways penetrating syndrome was established on history, clinical examination, cardiopulmonary X-ray, CT (virtual bronchoscopy) and rigid videotracheobronhoscopy. Foreign body removal was performed using pediatric Karl-Storz tracheobronhoscopy kit, under general anesthesia and video documentation.Results: The repartition of the cases according to age was: 76 cases were between 10 month and 3 years; 17 cases were between 3 and 8 years. Foreign body localization was: 53 cases in right bronchus, left bronchus 23 cases, 12 cases with bilateral localization, 4 cases in the trachea and 1 case with subglottic localization. In 72 cases there was an organic nature of the foreign body, while in 21 cases there was an anorganic nature. All other patients presented a good evolution, with no complication after extraction of the foreign body. Conclusions: Close cooperation between the ENT specialist, paediatrician, radiologist and anesthesiologist is necessary for the management of tracheobronchial foreign body.Supported by: ENT Department, University of Medicine and Pharmacy, "Victor Babes" TimisoaraDer Erstautor gibt keinen Interessenkonflikt an