RESUMO
BACKGROUND: Congenital aural atresia, which is usually unilateral, causes hearing loss and aesthetic impairment. Besides tympanoplasty with/without canalplasty and bone conduction devices, active middle ear implants are also available for functional rehabilitation. OBJECTIVE: This article aims to present a contemporary review on the treatment possibilities for middle ear malformations, with a focus on audiological rehabilitation with the Vibrant Soundbridge. MATERIALS AND METHODS: A selective literature search for treatment possibilities was performed in PubMed up to October 2020, and personal clinical experiences are reported. RESULTS: The Vibrant Soundbridge, which is approved for children ≥â¯5 years, is suitable for treatment of middle ear malformations with a Jahrsdoerfer score ≥â¯5. Although implantation of a Vibrant Soundbridge is surgically more demanding than implantation of a bone conduction device, the method is safe, delivers good auditory results (superior to bone conduction devices in terms of speech understanding and spatial hearing), does not involve intensive postsurgical care, and rarely requires revision surgery. The Vibrant Soundbridge can be coupled to (remnants of) the ossicular chain or the round window. CONCLUSION: The Vibrant Soundbridge is an appropriate treatment method in patients with middle ear malformations who have suitable anatomical preconditions.
Assuntos
Orelha , Prótese Ossicular , Criança , Humanos , Resultado do Tratamento , Orelha/cirurgia , Audição , Orelha Média/cirurgia , Orelha Média/anormalidadesRESUMO
The current paper reports on a patient with recurrent rotational vertigo and persistent dizziness and imbalance lasting several weeks, who underwent extensive neuro-otological and radiological examinations. Pathological findings initially included right-sided benign paroxysmal positional vertigo (BPPV), persistent horizontal spontaneous nystagmus (SPN) to the left, and a pathological bedside and video head impulse test (HIT) on the left. The pathological HIT on the left and the SPN to the left indicated a central origin. Therefore, cranial magnetic resonance imaging was performed which revealed a left-sided ischemic stroke in the territory of the medial branch of the posterior inferior cerebellar artery (mPICA).
Assuntos
Vertigem Posicional Paroxística Benigna/etiologia , Doenças Cerebelares/diagnóstico , Infarto Cerebral/diagnóstico , Tontura/etiologia , Doença de Meniere/etiologia , Nistagmo Patológico/etiologia , Doenças Vestibulares/etiologia , Doença Aguda , Audiometria de Tons Puros , Vertigem Posicional Paroxística Benigna/diagnóstico , Vertigem Posicional Paroxística Benigna/reabilitação , Doenças Cerebelares/complicações , Doenças Cerebelares/reabilitação , Cerebelo/irrigação sanguínea , Infarto Cerebral/complicações , Infarto Cerebral/reabilitação , Diagnóstico Diferencial , Tontura/diagnóstico , Tontura/reabilitação , Feminino , Teste do Impulso da Cabeça , Humanos , Imageamento por Ressonância Magnética , Doença de Meniere/diagnóstico , Doença de Meniere/reabilitação , Pessoa de Meia-Idade , Nistagmo Patológico/diagnóstico , Nistagmo Patológico/reabilitação , Modalidades de Fisioterapia , Equilíbrio Postural/fisiologia , Síndrome , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/reabilitação , Gravação em VídeoRESUMO
The current paper reports on a patient with recurrent rotational vertigo and persistent dizziness and imbalance lasting weeks, who underwent extensive neurootological and radiological examination. Pathological findings initially included right-sided benign paroxysmal positional vertigo (BPPV), persistent horizontal spontaneous nystagmus (SPN) to the left and a pathological bedside and video head impulse test (HIT) on the left. The pathological HIT on the left and SPN to the left indicated a central genesis. Therefore, cMRI was performed and revealed a left-sided cerebral infarction in the territory of the medial branch of the posterior inferior cerebellar artery (mPICA).
Assuntos
Vertigem Posicional Paroxística Benigna , Nistagmo Patológico , Acidente Vascular Cerebral , Vertigem Posicional Paroxística Benigna/etiologia , Tontura , Teste do Impulso da Cabeça , Humanos , Nistagmo Patológico/etiologia , Acidente Vascular Cerebral/complicaçõesRESUMO
We report the case of a patient with episodic rotational vertigo for years. Ear symptoms were negated. The clinical diagnosis was not clear - Menière's disease, vestibular migraine and recurrent vertigo after vestibular neuritis all qualified for differential diagnoses. A locally enhanced inner-ear MRI established clarity by showing an endolymphatic hydrops in the vestibulum. Besides the classical triad of Menière's disease there are other clinical appearances of endolymphatic hydrops, which can be visualized with inner-ear MRI.
Assuntos
Hidropisia Endolinfática/complicações , Hidropisia Endolinfática/diagnóstico , Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética/métodos , Vertigem/diagnóstico , Vertigem/etiologia , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Gold standard in the evaluation of upper aerodigestive tract (UADT) lesions is white light endoscopy followed by invasive tissue biopsy. This procedure is time consuming and expensive. Optical coherence tomography (OCT) is a noninvasive method, which provides high resolution, cross-sectional images of superficial tissue layers in real time. OBJECTIVE: This article aims to present a contemporary and comprehensive review on the role of OCT in differentiating between epithelial dysplasias and early invasive carcinomas of the UADT. MATERIALS AND METHODS: PubMed was searched using "optical coherence tomography/larynx" and other appropriate search strings in August 2015. RESULTS: OCT enables differentiation between benign, premalignant, and early malignant lesions of the UADT with high sensitivity and specificity. In addition, OCT holds promise as a clinical tool for guidance of surgical biopsies, follow-up of recurrent lesions, and for demarcation of tumor margins. Inadequate evidence and technical limitations hamper implementation of OCT into clinical routine. CONCLUSION: If the aforementioned problems are successfully solved, OCT seems to have the potential to substantially improve both diagnosis and management of precancerous and early cancerous lesions of the UADT.
Assuntos
Detecção Precoce de Câncer/métodos , Neoplasias Gastrointestinais/patologia , Neoplasias Epiteliais e Glandulares/patologia , Lesões Pré-Cancerosas/patologia , Neoplasias do Sistema Respiratório/patologia , Tomografia de Coerência Óptica/métodos , Humanos , Aumento da Imagem/métodos , Invasividade Neoplásica , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: Optical diagnostic methods may simplify and improve the early diagnosis of tumours of the upper aerodigestive tract; however, these have not yet found their way into clinical routine. OBJECTIVE: This article aims to define the problems that have prevented routine use of optical diagnostic methods so far, as well as listing and also explaining potential trendsetting approaches to overcome these difficulties. MATERIALS AND METHODS: The study is based on a combined analysis of publically accessible databases (PubMed MEDLINE, Thompson Reuters Web of Science, SPIE. Digital Library; full time period available; search strings: "oral cavity", "pharynx", "larnyx", "optical diagnosis", "optical biopsy", "optical coherence tomography", "confocal endomicroscopy", "fluorescence endoscopy", "narrow band imaging", "non-linear imaging", "fluorescence lifetime imaging"), as well as personal experiences. RESULTS: Both conceptual and methodical problems were determined, and possible solutions based on current developments are discussed. CONCLUSION: Optical diagnostic methods have the potential to revolutionise early diagnosis of upper aerodigestive tract malignancies, providing the different hurdles listed in this review can be overcome.