Full Thickness Cartilage Palisade Tympanoplasty with Malleus Interposition; A Study of the Long Term Results

The aim of this retrospective study is to review long term results of full-thickness cartilage palisade tympanoplasty (FTCPT) with malleus head interposition performed on 51 patients (56 ears); 36 women and 15 men (7-73 years, 44 years average). The pathology of ears which encourages this technique of tympanoplasty is presented. On average 12 years after surgery we have elaborated anatomic and functional results. Anatomic results were categorized based on empiric evaluation of the new tympanic membrane status: 40 (71%) tympanic membranes without anatomic irregularities, 14(25%) with irregularities and 2(4%) with secondary perforation. Functional results (tonal audiogram) are based on pure tone average air-bone gap (PTA-ABG) at 4 frequencies. Main functional results of 51 ears (51 audiograms performed): pre- and post-operative average PTA-ABGs were 27.07±9.98 and 10.77±7.85 dB (t=10.36; p<0.001). In the group of ears with a tympanic membrane with no anatomic irregularities, pre- and post-operative average PTA-ABGs were 27.30±10.56 and 10.82±8.33 dB (t=8.09; p<0.001). In the group of ears with cartilage resorption, pre- and post-operative PTA-ABGs were 24.92±8.19 and 9.33±6.58 dB (t=6.21; p<0.001). The differences between the two groups are irrelevant. Postoperative PTA-ABG values of ears after first surgery (n=34) and revision surgery (n=17) was significantly different (8.75±5.75 and 15.16±9.62 dB) (t=2.60; p=0.016). In spite of the thickness of the new tympanal membrane, FTCPT is a successful technique for solving advanced ear pathology

Ekstruzija elektrode umjetne pužnice – je li reimplantacija izvediva? – prikaz slučaja

Aim: To present two cases of late complications of cochlear implantation. Case report: In both cases extracochlear extrusion of the implant electrode occurred. More than ten years after successful cochlear implantation, the hearing performance gradually worsened to the point of no intelligibility in both patients. Otomicroscopy revealed chronic otitis media (COM) with an electrode in the external ear canal in implanted ears of both patients. Extracochlear electrode extrusion was noticed on CT scans in both cases. In the first case the device was explanted, the electrode was left in the cochlea and tympanoplasty was performed. Regardless the normal status of the middle ear, extracochlear extrusion occurred again. Conclusion: After extracochlear electrode extrusion, the reimplantation is likely to be unsuccessful.Cilj: Prikazati dva slučaja kasnih komplikacija kohlearne implantacije. Prikaz slučaja: U oba slučaja radilo se o ekstrakohlearnoj ekstruziji elektrode umjetne pužnice. Više od deset godina nakon implantacije u oba pacijenta sluh je postepeno slabio do potpune nerazumljivosti. Otomikroskopijom je u oba pacijenta utvrđena kronična upala uha uz prisutnost elektrode u zvukovodu. Učinjena je kompjutorizirana tomografija koja je potvrdila ekstrakohlearnu ekstruziju elektrode. U prvom slučaju učinjena je eksplantacija umjetne pužnice, pri čemu je elektroda ostavljena u kohleji te timpanoplastika. Usprkos urednom cijeljenju uha, ekstruzija elektrode se ponovila. Zaključak: Nakon ekstrakohlearne ekstruzije elektrode velika je mogućnost da će reimplantacija biti neuspješna

The Quantitative Analysis of the Vascularization Following Two Basic Auditory Canal Skin Incisions

Three groups of nine patients each were analyzed. The first two groups consisted of those that underwent tympanoplastic due to chronic inflammation of middle ear. Two different standard auditory canal skin incisions were applied, i.e. tympanomeatal flap (TMF) or vascular strip (VS). The third control group consisted of non-operated patients. All the operated patients were subjected to a quantitative analysis of the auditory canal revascularization by means of the Weibel stereological test method, i.e. the B 100 double network system. The density of capillaries, arterioles, venulolymphatic spaces and a total volume density of all vascular elements of the auditory canal skin were measured. The obtained results of vascularization were compared with those of the target control group. It was found out that there were no significant differences in vascularization of auditory canal skin between TMF and VS patients from one side and the control group on the other side

Lateralizacija glasnice - primjer

Respiracijska insuficijencija uzrokovana parezom ili paralizom obje glasnice najčešće je posljedica kirurških intervencija, tj. jatrogene je etiologije i predstavlja životno ugrožavajuće hitno stanje. Možemo ga tretirati različitim postupcima, a lateralizacija glasnice jedna je od manje invazivnih metoda, što ju čini povoljnijom terapijskom opcijom za bolesnika. Riječ je o postupku koji se može izvoditi vanjsko-unutarnjim ili unutarnje-vanjskim pristupom. U našem primjeru prikazan je slučaj obostrane paralize glasnica, primarno u hitnoći zbrinute traheotomijom. U cilju bržeg dekanilmana, nakon 3 dana učinjena je lateralizacija lijeve glasnice vanjsko-unutarnjim pristupom, metodom trostrukoga uboda. Prilikom postupka, za uvođenje konca korištena je epiduralna igla, a uvedeni konci poput omče obuhvatili su lijevu glasnicu, te su učvršćeni čvorom površno, na koži vrata. Time je lijeva glasnica zadržana u lateraliziranom položaju i omogućena je respiracija po dekanilmanu. U raspravi prikazujemo druge modalitete i instrumente koji se mogu koristiti za ovaj postupak

Mucormycosis of the Nasal Ala in a Leukemic (M7 AML) Child. Is Surgery of the Nasal Defect Indicated?

Anterior tamponade with Surgicel (oxidized cellulose) was performed on a 5-year-old girl with megakaryoblastic leukemia (M7 AML) and epistaxis. Several days later necrosis of the nasal ala occurred. Debridement was performed and mucormycosis caused by Rhizopus was found in the material. Having cured mucormycosis, a defect of the complete nasal ala remained. The question of a surgical resolution of the disfiguring nasal defect arises

Pathological and Non-pathological Irregularities of Nystagmus

Irregularities of nystagmus can be found almost in every electronystagmographic record, but only a few are pathological. In this investigation, the authors try to define the border line between pathological and nonpathological irregularities of nystagmus and according to this measure the diagnostic use of findings of irregularities of nystagmus