Understanding the relationship between the anatomy of the fallopian canal and a variety of ear diseases is necessary. In this study, our purpose was to identify the incidence of facial nerve ...dehiscence in patients undergoing surgery for a variety of chronic ear diseases. The operative records of 219 patients were reviewed retrospectively for dehiscence of the facial canal. The diagnoses were cholesteatoma (n = 49), tympanosclerosis (n = 51), adhesive otitis media (n = 38), and chronic otitis media (n = 81). Only 17 of 219 who underwent tympanoplasty without mastoidectomy were excluded from the calculations. Dehiscence of the facial canal was encountered in 18 (8.9 per cent) of 202 patients. The dehiscence rate was highest with cholesteatoma, followed by adhesive otis media, chronic otis media and tympanosclerosis (p < 0.01). The canal dehiscence was mainly seen in the tympanic segment and second genu, and was rare in the mastoid segment. Labyrinthine fistula was the most common pathology that coexisted with the dehiscence. It was encountered in two (11.1 per cent) of 18 patients. In conclusion, the likelihood of dehiscent bone covering the tympanic segment of the fallopian canal is significantly higher in cholesteatoma than the other chronic ear diseases. The surgeon can feel somewhat more confident while performing surgery for tympanosclerosis as far as the dehiscence in the fallopian canal is concerned.
Tinnitus and neurovascular compression Bayazit, Yildirim A; Goksu, Nebil
O.R.L. Journal for oto-rhino-laryngology and its related specialties,
01/2008, Letnik:
70, Številka:
3
Journal Article
MESNA is a synthetic sulfur compound that produces mucolysis by disrupting disulfide bonds. This study aimed to address indications and technique of MESNA application in otologic surgery, especially ...in retraction pockets and adhesive otitis media.
MESNA application was performed in 42 ears of 39 patients. The diagnoses were retraction pockets fixed to incudostapedial joint, stapes or promontorium, and adhesive otitis media in 24 and 17 ears, respectively. Calculations were performed according to 24 ears of 23 patients with follow-up data.
One or more of the following surgical interventions were performed: MESNA application alone and ventilation tube insertion, reinforcement or mastoidectomy in addition to MESNA application. Sensorineural hearing loss was not encountered after MESNA application. The operation was successful in 79.2%. Overall revision surgery was needed in 20.8% of the ears. In 71.4% of the ears treated with MESNA alone, revision surgery was needed.
In the light of our experience, we advocate the use of MESNA in atelectatic ears, because it makes the operation easy and safe by allowing elevation of the tympanic membrane by its mechanical and chemical actions.
We aimed to evaluate the results of our experience in vestibular nerve sectioning (VN), which was performed using combined retrosigmoid-retrolabyrinthine approach.
Medical records of 280 patients who ...were consecutively operated on for incapacitating peripheral vertigo were retrospectively evaluated, and 210 patients who completed 2 years follow-up and had adequate follow-up data were found to be suitable for inclusion in the study.
Hearing results, vertigo control rates, and complications of the retrosigmoid-retrolabyrinthine VN were evaluated.
The patients were suffering from vertigo for a mean period of 32.2 months. Bilateral Meniere's disease occurred in 5.7% of the patients in the follow-up period. A complete or substantial vertigo control could be achieved in 94.4% of the patients (191 90.1% in Class A and 9 4.3% in Class B). Preoperative speech reception threshold, pure-tone average, and speech discrimination score of the patients were 56.5 dB, 47.4 dB, and 73.6%, respectively. Postoperative corresponding values were 62.2 dB, 43.4 dB, and 68.5%, respectively (p > 0.05). The complication rate was low (2.5%). Most common complication was abdominal hematoma, which was seen in 4.5%.
VN performed using retrosigmoid-retrolabyrinthine approach has low complication and high vertigo control and hearing preservation rates. It can be applied as an initial surgery or reserved as the last step when the other surgical treatments have failed to control vertigo.
Objective: The objective of this study was to assess significance of insulin receptor substrate (IRS) ‐1 gene polymorphism (Gly972Arg) at codon 972 in obstructive sleep apnea syndrome (OSAS).
...Methods: Using the polymerase chain reaction technique, the codon 972 polymorphism of the IRS‐1 gene was analyzed in the DNA obtained from leukocytes of 50 patients and 143 healthy controls.
Results: An overall comparison between the genotypes and allele frequencies of the patients and controls did not reveal any statistically significant difference between the patients and controls (P > .05). Gender‐specific comparisons were not significantly different except for a significant difference between the genotypes and allele frequencies of the male patients and male controls (P < .05). The heterozygous, Gly/Arg variant of the IRS‐1 gene was overrepresented and the homozygous, Gly/Gly variant was less frequent in male patients compared with male controls. In the patients with OSAS, there was no correlation between the genotypes and polysomnography parameters on correlation analyses (P > .05). There was no relationship between the genotypes and diabetes mellitus (P > .05). Body mass indices and polysomnography parameters of the patients with and without diabetes mellitus were not significantly different (P > .05).
Conclusion: The polymorphism of the IRS‐1 gene at codon 972, especially Gly/Arg variant, or the presence of the allele for Arg appears to be associated with occurrence of OSAS in male patients, whereas this polymorphism is not related to severity of OSAS.
Objectives
We evaluated outcomes of otologic surgeries with a special interest in learning curves of residents in a tertiary referral setting.
Methods
A retrospective review of the outcomes of 811 ...otologic operations was performed. The outcomes of faculty staff (group 1), senior residents (fifth year; group 2), and residents (fourth year) under supervision of the faculty staff (group 3) were assessed and compared. The faculty staff were available for consultation if needed and were ready to intervene at any stage for group 2.
Results
There were 397 female patients (48.95%) and 414 male patients (51.04%) from 17 to 71 years of age. There was no statistically significant difference between the groups regarding graft take rate or hearing outcome (p > .05).
Conclusions
The otologic training of residents appears to be successful in Turkey, as the surgical outcomes of residents were comparable to those of faculty staff.
We assessed the morphological and radiological characteristics of ethmomaxillary sinus (EMS), which is an enlarged posterior ethmoidal air cell occupying the superior portion of the maxillary sinus ...while draining into superior meatus. This study is based on 1450 patients submitted to CT examination of the paranasal sinuses between 1998 and 2002. Sequential CT scans were obtained in the coronal plane in all the patients with 2.5- to 5-mm section thickness and were evaluated for EMS. The diagnosis of EMS was made when there was a posterior ethmoidal cell occupying the superior part of the maxillary sinus while draining to the superior meatus. When EMS was diagnosed, the morphology of the septum between the and maxillary sinus, and width of the superior meatus, were noted. The EMS was found in 10 of 1450 (0.7%) patients. The coexisting anatomic variations were concha bullosa (50%), upper concha pneumatization (20%), maxillary sinus hypoplasia (20%), uncinate bulla (10%), hypertrophied inferior concha (10%), paradoxic middle concha (10%), and septate maxillary sinus (10%). There was no relation between EMS and sinus disease. The EMS is a rare anatomic variation and does not appear to be associated with sinusitis. The EMS is not a well-studied anatomic variation, and the literature is lacking adequate information about this anatomic variation. This study performed in a large series of patients will possibly contribute to better understanding of this particular anomaly.
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