To establish whether covering the tympanic membrane perforation after war blast injury with silicon foil can enhance the ear drum healing rate and to determine the appropriate timing of silicon ...patching.
We retrospectively analyzed the charts of 210 patients wounded during the Homeland War in Croatia 1991-1995, with 315 blast tympanic membrane perforations. In 44 patients (61 perforations), the eardrum perforation was covered by silicon foil, whereas in 166 patients (254 perforations) it was left to heal spontaneously. The patients who underwent the patching procedure were divided in two groups according to the time period between the blast injury and the procedure: 38 perforations were treated within 3 days and 23 perforations were treated 4 to 6 days after the blast injury.
The rate of tympanic membrane healing in the silicon foil patching group was significantly higher (91.8%) than that in the group of perforations left to heal spontaneously (79.9%, P=0.029). The healing rate was significantly higher in the group treated within 3 days after the blast injury (97.4%) than in the group treated 4 to 6 days after the injury (82.6%, P=0.042).
Covering the perforation after the war blast injury with silicon foil significantly improves the rate of tympanic membrane healing. To obtain the best healing outcome, the procedure should be performed within the first 72 hours after the trauma.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The aim of the study was to analyze clinical characteristics, surgical treatment, complications, and prognosis related to thyroid surgery in children and adolescents in a 10-year study at a single ...institution.
Retrospective study.
We performed a retrospective analysis of clinical data of children and adolescents who underwent thyroid surgery due to benign thyroid disease and thyroid cancer from January 2011 to May 2020. We presented the clinical characteristics and type of surgical treatment for different thyroid diseases.
We present data on surgical procedures and complication rates following surgery, which was comparable to other published data. We emphasize the importance of radioiodine and hormone replacement postoperative therapy in cancer patients and our opinion on total thyroidectomy and neck dissection in thyroid cancer surgery.
This study demonstrated that thyroid surgery in children and adolescents is a safe and efficient procedure in the hands of experienced surgeon for adult thyroid surgery. For children and adolescents with thyroid carcinoma, our method of choice is total thyroidectomy with occasionally paratracheal neck dissection, whereas lateral cervical lymph node dissection is only necessary in fine needle aspiration positive lymph nodes. Our results according to postoperative outcomes and complications are comparable to other recently published data.
The term Bell's palsy is used for the peripheral paresis of the facial nerve and is of unknown origin. Many studies have been performed to find the cause of the disease, but none has given certain ...evidence of the etiology. However, the majority of investigators agree that the pathophysiology of the palsy starts with the edema of the facial nerve and consequent entrapment of the nerve in the narrow facial canal in the temporal bone. In this study the authors wanted to find why the majority of the paresis are suprastapedial, i.e. why the entrapment of the nerve mainly occurs in the proximal part of the canal. For this reason they carried out anatomical measurements of the facial canal diameter in 12 temporal bones. By use of a computer program which measures the cross-sectional area from the diameter, they proved that the width of the canal is smaller at its proximal part. Since the nerve is thicker at that point because it contains more nerve fibers, the authors conclude that the discrepancy between the nerve diameter and the surrounding bony walls in the suprastapedial part of the of the canal would, in cases of a swollen nerve after inflammation, cause the facial palsy.
Noise-induced hearing loss is a sensorineural hearing impairment with symptoms that slightly differ from other types of sensorineural hearing loss. This type of hearing deficit is characterized by ...threshold shifts that first occur in the frequency range of 3 to 6 kHz, and most commonly around 4 kHz. Career in music often entails quite a few occupational diseases, and one of them is noise-induced hearing loss acquired when performing or practicing music. Numerous investigations on hearing impairment in musicians have been conducted. The results of studies on orchestral musicians show that they are indeed exposed to high noise levels. Brass, woodwind and percussion players are the most exposed, and are therefore prone to experience the greatest threshold shifts in the frequency range of 3 to 6 kHz. Rock musicians suffer from hearing loss even more often due to their exposition to even greater noise levels, and, among them, drummers are at the highest risk. Music academy students are mostly too young to develop any type of hearing loss. DJs suffer from the hardest noise induced hearing impairment among the musicians. Furthermore, they often show threshold shifts in the frequency range of 125 Hz to 500 Hz because they are more exposed to lower frequencies with high sound pressure level. Investigations present great benefit from various personal noise protection tools, and musicians ought to be encouraged to implement some of them.
Ustanoviti postiže li se terapijom prednizonom bolji oporavak zamjedbene nagluhosti nakon ratnih blast ozljeda unutarnjeg uha u odnosu na spontani oporavak.
Retrospektivna studija na 115 ispitanika, ...odnosno 183 ozljede unutarnjeg uha sa zamjedbenom nagluhošću nakon ratnih ozljeda. Skupina od 67 ispitanika (107 uha) primala je prednizon 7 dana u dozi 20 mg i nakon toga još 7 dana u dozi 10 mg. Preostalih 48 ispitanika (76 uha) u kontrolnoj skupini nije primalo nikakvu terapiju i kod njih je došlo do određenog stupnja spontanog oporavka.
Iako je u obje skupine ispitanika nakon 4 mjeseca praćenja došlo do značajnog oporavka sluha u odnosu na početno oštećenje (p<0,001), ispitanici koji su primali kortikosteroide (prednizon) imali su značajno bolji oporavak zamjedbene nagluhosti u odnosu na bolesnike u kontrolnoj skupini koji nisu primali nikakvu terapiju (p=0,002). Između početnih i završnih vrijednosti zamjedbene nagluhosti nije postojala korelacija niti u ispitivanoj niti u kontrolnoj skupini.
Terapija glukokortikoidima značajno poboljšava oporavak zamjedbene nagluhosti nakon ratnih blast ozljeda u odnosu na spontani oporavak. Na osnovi početnog nalaza sluha ne može se procijeniti očekivani oporavak sluha niti nakon liječenja glukokortikoidima niti nakon spontanog oporavka bez liječenja.
Alergijski rinitis (AR) najčešći je alergijski poremećaj, a njegova je prevalencija u porastu. Prije uporabe smjernica ARIA oko trećine bolesnika s umjereno teškim/teškim simptomima unatoč terapiji ...imalo je i dalje teške simptome. Smjernice ARIA definiraju AR kao upalnu bolest. Liječenje AR-a pretpostavlja točnu procjenu težine bolesti i bilo kakve povezanosti s astmom. Intranazalni kortikosteroidi (IKS) najučinkovitiji su lijekovi u liječenju AR-a uz minimalan rizik od sistemskih nuspojava. IKS mogu biti prva opcija liječenja svih oblika AR jer djeluju na sve simptome AR-a.
With the exception of moderately differentiated neuroendocrine carcinoma of the larynx, neuroendocrine carcinomas are very rare head and neck malignancies. We report a case of a small cell ...neuroendocrine carcinoma in the petrous apex of the temporal bone. This unusual site for this tumour has not yet been reported in the literature. We confirmed the location and extent of the primary tumour by positron-emission tomography scan. The final histopathological diagnosis was of small cell carcinoma, and this was confirmed by immunohistochemistry. We treated this patient with surgery followed by radiotherapy and chemotherapy. After the treatment was completed there was subtotal remission of the tumour, with no distant metastases.
Middle ear infection is one of the most common childhood infections and the leading reason for antibiotic prescriptions. Although the etiological diagnosis is rarely discovered, successful ...identification of pathogens depends on properly collected sample, chosen method and microbiological analysis made on time. The most common bacterial pathogen is Streptococcus pneumoniae. Others include Haemophilus influenzae, Moraxella catarrhalis and Pseudomonas aeruginosa, known as the most common bacterial pathogen of chronic inflamations. Viral or polimicrobial upper respiratory tract infections often precede this infection. Pneumococcal conjugate vaccines given during infancy decrease rates of acute middle ear inflammation. It is a self-limited disease with rare complications. The best treatment is watchful waiting for two days followed by amoxicillin during 7 days, only if it is necessary. If there is resistance, then combination of amoxicillin and beta lactamase inhibitor is second line. The best choice for patients allergic to penicillin are macrolides. Antibiotic treatment has contributed to frequent relapses and increase of multi-drug resistant pathogens by permitting their colonization, which eliminates protective nasopharyngeal flora.
Akutna upala srednjeg uha Branica, Srećko
Medicus (Zagreb, Croatia : 1992),
01/2005, Letnik:
14, Številka:
1_ARI
Journal Article
Recenzirano
Odprti dostop
Upala uha najčešća je upala u djece zbog
koje se propisuju antibiotici. Akutna upala srednjeg uha
(AUSU) kratkotrajna je upala srednjeg uha karakterizirana
bolima u uhu. Obično je udružena sa ...simptomima upale
gornjih dišnih putova poput kašlja i sekrecije iz nosa. AUSU
se dugo smatrala bakterijskom infekcijom, ali danas se zna
da i virusi mogu imati ulogu u njezinu nastanku. Najčešći
bakterijski uzročnici upale su Streptococcus pneumoniae,
Haemophilus infl uenzae i Moraxella catarrhalis. Unatoč
brojnim studijama i istraživanjima, nije postignut konsenzus
o liječenju AUSU. Amoksicilin se u mnogim zemljama
preporučuje kao lijek prvog izbora kod nekompliciranih
upala uha. Među brojnim antibioticima najveću uspješnost
u liječenju postižu amoksicilin s klavulanskom kiselinom,
cefuroksim aksetil i od parenteralnih ceftriakson. Kod
alergije na penicilin lijek izbora su makrolidi. Antibiotici
smanjuju bol u uhu nakon drugog dana terapije i smanjuju
učestalost nastanka upale u drugom uhu. Kod težih upala
koje ne reagiraju odgovarajuće na antibiotsku terapiju
indicirana je paracenteza kojom dobijemo i odgovarajući
materijal za mikrobiološku obradu. Teže komplikacije poput
mastoiditisa, labirintitisa, intrakranijalnog širenja upale i
pareze ličnog živca su rijetke.
BPPV is generally the most common cause of vertigo, caused by a pinch-off of tiny calcium carbonate crystals (called the otoconia or the otoliths) from the macula utriculi, most frequently due to the ...degenerative processes or a trauma, whereby the crystals, under the action of gravity in certain head positions coinciding with its direction, arrive to some of the semicircular canals, usually the posterior one, due to the existent anatomical circumstances and relationships, thus creating an inadequate stimulus of the cupular senses while floating through the endolymph and provoking symptoms of a strong and short-term dizziness. Two main clinical forms can be distinguished: canalolythiasis, with an accommodation of otolithic debris in the semicircular canal, and cupulolythiasis, with their location immediately next to the cupular sense. The diagnosis is established by a positive positioning test, Dix-Hallpike for the posterior and the supine roll for the lateral canal. Although one can expect a spontaneous recovery subsequent to few weeks or months, various methods of otolith repositioning to a less sensitive place lead to a prompt improvement while reducing or withdrawing the symptoms completely. These guidelines are intended for all who treat the BPPV in their work, with an intention to assist in the diagnosis and application of an appropriate therapeutic method.
PDF
