Úvod: Preaurikulárny sínus (PAS) je vrodená vývinová chyba mäkkých tkanív lokalizovaná v preaurikulárnej oblasti. Môže byť po celý život asymptomatický. K jeho manifestácii dochádza zvyčajne pri infikovaní. Chirurgická drenáž je indikovaná v prípade sformovania abscesového ložiska. Kompletná exstirpácia je liečbou voľby v prípade prekonania akútnej infekcie alebo v prípade dlhodobej secernácie zo sínusu. Úskalím chirurgickej liečby sú časté recidívy, najmä z dôvodu nekompletnej exstirpácie PAS. Cieľom práce je oboznámiť sa s témou PAS, vykonať analýzu sledovaného súboru a vyhodnotiť rizikové faktory pre recidívu po exstirpácii PAS. Materiál a metódy: Vyhodnotili sme súbor 51 detských pacientov s diagnózou PAS (55 chirurgických exstirpácií PAS; n = 55) operovaných na Detskej otorinolaryngologickej klinike LF UK a NÚDCH počas 15-ročného sledovaného obdobia. Jedná sa o retrospektívnu analýzu zameranú na chirurgickú liečbu a recidívu PAS. Výsledky: V sledovanom súbore operovaných PAS (n = 55) sa preaurikulárna oblasť po exstirpácii PAS u 49 pacientov (89,09 %) zahojila bez recidívy, avšak u 6 pacientov (10,91 %) sme zaznamenali recidívu PAS. Záver: Väčšina pooperačných recidív je výsledkom neúplného odstránenia PAS, najmä z dôvodu problematickej identifikácie presného priebehu celého sínusového kanála. Existujú faktory, ktoré znižujú mieru recidívy PAS. Dôležitá je precízna disekcia PAS, skúsený chirurg, výkon v celkovej anestézii, identifikácia celého PAS a jeho vetiev použitím instilácie metylénovej modrej, sondáže a mikroskopu, na identifikáciu temporálnej fascie použitie predĺženého supraaurikulárneho prístupu, úplné odstránenie všetkých epitelových zložiek sínusu spolu s odstránením časti ušnej chrupky, ktorá adheruje k sínusu, zabránenie prasknutiu a uvoľneniu obsahu sínusového kanála počas operácie a zmenšenie mŕtveho priestoru rany precíznou sutúrou, bez použitia drenáže.
Introduction: Preauricular sinus (PAS) is a congenital defect of soft tissue located in the preauricular region. Its manifestation usually occurs when the sinus is infected but there is a possibility that preauricular sinus will not manifest at all. Surgical drainage is indicated in case of abscess formation. Complete extirpation is the method of choice in case of acute infection or long-lasting secernation from sinus. Failure to completely excise preauricular sinus is a common complication of the surgical intervention. The aim of this article is to get familiar with PAS, analyze group of observed patients and evaluate risk factors leading to recurrence of PAS. Material and methods: We evaluated a group of 55 patients with the PAS diagnosis (55 surgical extirpations PASS, N = 55) who underwent surgery at the Department of children otorhinolaryngology of MFCU and NICD during 15-years long period. It is retrospective analysis that is focused on surgical intervention and PAS recurrence. Results: In the observed group of patients (N = 55), 49 patients (89.09%) fully healed without any recurrence and 6 patients (10.91%) had a PAS recurrence. Conclusion: The most of PAS recurrences are results of an incomplete extirpation. The main reason for this is problematic identification of the PAS in its entirety. There are factors which lead to lower prevalence of PAS recurrence. They are precise dissection of PAS, an experienced surgeon, surgical procedure in general anaesthesia, identification of PAS in its entirety with all its branches using instillation of methylene blue, using a sondage and microscope, using an extended supra-auricular approach to identify temporal fascia, total removal of all epithelial components of the PAS with extraction of auricular cartilage that adheres to the sinus, prevention of rupture and leaking of a content of the PAS during surgery and reduction of a dead space in the wound using precise suture without drainage.
- Klíčová slova
- preaurikulární sinus,
- MeSH
- absces chirurgie etiologie MeSH
- ambulantní chirurgické výkony metody MeSH
- dítě MeSH
- infekce měkkých tkání chirurgie etiologie patologie MeSH
- lidé MeSH
- otologické chirurgické výkony metody MeSH
- recidiva MeSH
- terapie měkkých tkání metody MeSH
- ucho * chirurgie patologie MeSH
- vrozené vady * chirurgie klasifikace MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Geografické názvy
- Slovenská republika MeSH
Úvod: Jednostranná hluchota (single sided deafness – SSD) je charakterizovaná sluchovou ztrátou na jednom uchu (pure tone average – PTA – 70 dB HL a více) při prakticky normálním sluchu na druhém uchu (ztráty do 30 dB HL). Jedním ze způsobů řešení je kochleární implantace, která na rozdíl od jiných kompenzačních mechanizmů (CROS systém, systémy pro přímé kostní vedení) jako jediná umožňuje binaurální slyšení. Materiál a metodika: Do studie bylo zahrnuto 6 dětských pacientů s dg. SSD, kteří podstoupili kochleární implantaci ve FN Motol v letech 2020–2021. Sledovali jsme rozvoj sluchové percepce s kochleárním implantátem, schopnost směrového slyšení a průměrnou denní dobu používání zvukového procesoru. Výsledky: Všichni pacienti používají zvukový procesor pravidelně, u všech se subjektivně i objektivně zlepšila sluchová percepce. Směrové slyšení zatím není prokazatelné. Pacienty budeme nadále sledovat a získané poznatky bude třeba do budoucna ověřit na rozsáhlejším souboru. Závěr: Kochleární implantace může být vhodným způsobem řešení jednostranné hluchoty u dětí. Při indikaci je nutno zvažovat etiologii sluchové vady, délku trvání hluchoty a motivaci dítěte a jeho rodičů k pravidelnému užívání zvukového procesoru
Introduction: Single-sided deafness (SSD) is characterized by hearing loss in one ear (pure tone average – PTA – 70 dB HL and more) with practically normal hearing in the other ear (losses up to 30 dB HL). One of the solutions is cochlear implantation, which, unlike other compensatory mechanisms (CROS system, direct bone conduction systems), is the only one that enables binaural hearing. Material and methods: Six pediatric patients with SSD who underwent cochlear implantation at FN Motol in 2020–2021 were included in the study. We monitored the development of auditory perception with a cochlear implant, the ability of directional hearing and the average daily time of use of the sound processor. Results: All patients use the sound processor regularly, subjectively and objectively their hearing perception improved. Directional hearing is not yet demonstrable. We will continue to monitor the patients and the knowledge gained will need to be verified on a larger set in the future. Conclusion: Cochlear implantation can be a suitable way to solve unilateral deafness in children. When indicating, it is necessary to consider the etiology of the hearing defect, the duration of the deafness, and the motivation of the children and their parents to regularly use the sound processor.
- MeSH
- audiometrie MeSH
- dítě MeSH
- jednostranná nedoslýchavost * diagnóza etiologie terapie MeSH
- kochleární implantace * MeSH
- lidé MeSH
- mladiství MeSH
- percepce řeči MeSH
- předškolní dítě MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
BACKGROUND: Cochlear implantation (CI) is associated with changes in the histopathology of the inner ear and impairment of vestibular function. OBJECTIVE: The objectives of our study were to evaluate patients for clinical manifestations of space perception and balance changes before surgery, compare them with asymptomatic subjects (controls), and report changes in posturography and subjective visual vertical (SVV) during the acute post-surgery period in patients. METHODS: Examination was performed using static posturography and the SVV measurement. We examined 46 control subjects and 39 CI patients. Patients were examined pre-surgery (Pre), 2nd day (D2) and then 14th day (D14) after implantation. RESULTS: Baseline SVV was not different between patients and control group. There was a statistically significant difference (p < 0.001) in SVV between subgroups of right- and left-implanted patients at D2 (-1.36±3.02° and 2.71±2.36°, right and left side implanted respectively) but not Pre (0.76±1.07° and 0.31±1.82°) or D14 (0.72±1.83° and 1.29±1.60°). Baseline posturography parameters between patients and control group were statistically significantly different during stance on foam with eyes closed (p < 0.05). There was no statistically significant difference in posturography among Pre, D2 and D14. CONCLUSIONS: CI candidates have impaired postural control before surgery. CI surgery influences perception of subjective visual vertical in acute post-surgery period with SVV deviation contralateral to side of cochlear implantation, but not after two weeks.
- MeSH
- kochleární implantace * MeSH
- lidé MeSH
- posturální rovnováha MeSH
- vestibulární aparát * MeSH
- vnímání prostoru MeSH
- zraková percepce MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- kochleární implantace * metody MeSH
- kochleární implantáty MeSH
- lidé MeSH
- předškolní dítě MeSH
- roboticky asistované výkony * MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- dítě MeSH
- kochleární implantace * metody MeSH
- kochleární implantáty trendy MeSH
- lidé MeSH
- roboticky asistované výkony * metody trendy MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- novinové články MeSH
- rozhovory MeSH
PURPOSE: Taste perception is often affected after stapes surgery despite effort to preserve chorda tympani nerve. The aim was to examine changes of particular taste qualities and their recovery after operation of otosclerosis. MATERIALS AND METHODS: Taste function was prospectively investigated with a questionnaire and a taste strip test (TST) preoperatively, 3-5 days and 1 year after stapes surgery with the preservation of CTN. RESULTS: In the early postoperative examination, 34/42 patients had a lower TST score, 7/42 decrease of taste in the questionnaire. One year after surgery, 11/42 patients had a lower TST score, 1/42 patients decrease of taste in the questionnaire. The most pronounced decrease in the TST score was in sweet (- 1.76 points, p < 0.001), followed by bitter (- 1.71 points, p < 0.001), salty (- 1.64 points, p < 0.001) and sour taste (- 1.33 points, p < 0.001). The sour taste had a significant lower alteration compared to others. Men had significantly pronounced alteration in salty taste compared to women. The complete recovery was proved in bitter taste. Better recovery in bitter taste was observed in patients younger than 45 years of age. CONCLUSIONS: Gustatory changes after stapes surgery are mostly transient with different impairment and recovery rate for particular taste qualities. A sour taste seems to be relatively resistant to damage. The best recovery rate is in a bitter taste, especially in younger patients.
- MeSH
- chirurgie třmínku * MeSH
- chorda tympani MeSH
- chuť MeSH
- chuťová percepce * MeSH
- chuťový práh MeSH
- lidé MeSH
- prospektivní studie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: Endoscopic ear surgery (EES) is considered a minimally invasive technique. It is hypothesized that patients after endoscopic procedures experience less pain and require fewer painkillers. Our aim was to compare patients' postoperative pain and need for analgesics in patients undergoing microscopic and endoscopic ear surgeries. METHODS: a single-institution, prospective study included 92 patients undergoing ear procedures (48 cholesteatoma and 44 reconstructive);(43 endoscopic and 49 microscopic) during 1/2016-1/2018. The postoperative pain (visual analogue scale (VAS) 0-10) and painkillers consumption were recorded and compared in each subgroup. RESULTS: VAS (P=0.02) and analgesics consumption (P=0.06) were lower after endoscopic ear surgeries. In the cholesteatoma group, 94% of endoscopic patients reported VAS 0-2 in contrast to 58 % of microscopic patients on day 1 (P=0.04). Similar tendencies were revealed in reconstructive cases, i.e. 92% compared to 73% (P>0.05). On day 1, 92% of endoscopic, and 77% of microscopic reconstruction patients received no painkillers group (P=0.06). In the cholesteatoma patients, 88% of endoscopic patients, 43% of microscopic patients using endaural approach, and 75% of microscopic patients using retroauricular approach, required no painkillers on the postoperative day 1 (P>0.05). CONCLUSIONS: Our study revealed that the EES is associated with less postoperative pain than the conventional microscopic ear surgery. It seems that it is rather the transmeatal approach, and not the endoscope itself that reduces postoperative pain. The removal of the same size cholesteatoma using endoscope (rather than using microscope) leads to less intensive postoperative pain. Consequently, it was not surprising that patients after endoscopic ear surgery very rarely took painkillers.
HYPOTHESIS: Higher light intensity settings do not yield improved image quality in endoscopic ear surgery. BACKGROUND: Light intensity is a parameter with major impact on the quality of digital images. For ear surgery, light produces heat associated with a thermal risk to ear structures and the light source setting should be accordingly optimized. METHODS: Several series of still images were acquired during live middle ear surgery, using cadaveric and plastic temporal bone models and with three-dimensional printed models. Images obtained under varying light intensities were compared with the image acquired at maximum intensity of a light emitting diode light source. We analyzed digital image brightness and noise using quantitative methods. RESULTS: Our measurements revealed significantly decreased image brightness with light intensities set below 20% with an increase in noise at light intensities lower than 30%. CONCLUSION: The optimal light source setting corresponded to 30% intensity in our experimental set-up. Special attention should be given to those cases where faster image quality degradation is expected (dark or bloody scenes or larger cavities). The results were strongly dependent on the equipment used. The methods described in this study can serve as a general guide for determining the optimal light source setting in any specific set-up.
- MeSH
- endoskopie MeSH
- lidé MeSH
- otologické chirurgické výkony * MeSH
- spánková kost MeSH
- střední ucho chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH