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1.
J Biomed Opt ; 24(8): 1-10, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31436071

RESUMEN

Hearing impairment affects ∼460 million people worldwide. Conservative therapies, such as hearing aids, bone conduction systems, and middle ear implants, do not always sufficiently compensate for this deficit. The optical stimulation is currently under investigation as an alternative stimulation strategy for the activation of the hearing system. To assess the biocompatibility margins of this emerging technology, we established a method applicable in whole-mount preparations of murine tympanic membranes (TM). We irradiated the TM of anesthetized mice with 532-nm laser pulses at an average power of 50, 89, 99, and 125 mW at two different locations of the TM and monitored the hearing function with auditory brainstem responses. Laser-power-dependent negative side effects to the TM were observed at power levels exceeding 89 mW. Although we did not find any significant negative effects of optical stimulation on the hearing function in these mice, based on the histology results further studies are necessary for optimization of the used parameters.


Asunto(s)
Materiales Biocompatibles/química , Oído Medio/patología , Rayos Láser , Técnicas Fotoacústicas , Membrana Timpánica/patología , Animales , Apoptosis , Vasos Sanguíneos/patología , Oído Medio/irrigación sanguínea , Electrofisiología , Potenciales Evocados Auditivos del Tronco Encefálico , Femenino , Audición , Audífonos , Luz , Ratones , Ratones Endogámicos CBA , Microscopía Fluorescente , Necrosis , Óptica y Fotónica , Estimulación Luminosa , Temperatura , Membrana Timpánica/irrigación sanguínea
2.
Acta Med Port ; 32(6): 469-470, 2019 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-31292030

RESUMEN

New generation oral anticoagulants - rivaroxaban, apixaban and edoxaban - represent an important medical achievement. Their therapeutic effectiveness and ease of use make them essential in the management of thromboembolic conditions. However, as warfarin, they have known haemorrhagic risks. This paper reports the case of a 50-year-old female who presented with ear pain and spontaneous blood discharge in her right ear, after a two-week treatment with rivaroxaban. The physical examination revealed a spontaneous tympanic haematoma in the inferior quadrants, adjacent to the umbus. She denied any manipulation of the ear canal. Our goal is to alert for a presumable side effect of this drug in clinical practise.


A nova geração de anti-coagulantes orais ­ rivaroxabano, apixabano e edoxabano ­ constitui um avanço significativo na medicina. Estes fármacos têm, atualmente, um papel fundamental no tratamento de doenças tromboembólicas, pela sua facilidade de administração. No entanto, tal como a varfarina, têm efeitos adversos, nomeadamente aqueles relacionados com o risco hemorrágico. Neste artigo, apresentamos o caso de uma doente de 50 anos de idade, do género feminino, que se apresentou no serviço de urgência com otalgia e otorragia espontânea à direita, após duas semanas de tratamento com rivaroxabano em dose profilática. No exame objetivo, destacava-se a presença de hematoma nos quadrantes inferiores do tímpano, adjacente ao umbus. Não havia história de manipulação do ouvido. O nosso objetivo é alertar para um provável efeito adverso deste fármaco, na prática clínica.


Asunto(s)
Inhibidores del Factor Xa/efectos adversos , Hematoma/inducido químicamente , Rivaroxabán/efectos adversos , Membrana Timpánica/irrigación sanguínea , Femenino , Humanos , Persona de Mediana Edad
3.
Eur Arch Otorhinolaryngol ; 275(11): 2633-2641, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30191303

RESUMEN

PURPOSE: Because successful healing of a tympanic membrane perforation (TMP) depends upon the maintenance of blood supply to the injured area, we assessed the usefulness of narrow band imaging (NBI) video endoscopy to evaluate its vascularization. To our knowledge, the use of NBI to assess tympanic membrane (TM) vascular patterns has never been attempted. METHODS: Prospective observational study. NBI and cold white light (CWL) flexible videoendoscopy was used to explore perforated TMs of 100 patients. Main outcome measures were visualization of vessels among abnormal TM findings: monomeric areas (MA) (n = 6), myringosclerosis plaques (MP) (n = 65) and perforation edges (n = 100). They were graded by a vascular otoendoscopic score (VOS) comparing both types of lights (Wilcoxon test). Location and vascularization patterns were analyzed (Fisher's test). RESULTS: NBI was better to observe vascularization of 32% of perforation edges and 75.4% of MP (p < 0.001). NBI displayed higher (better) VOS when evaluating TMP edges (1.05 vs. 0.73) and MP (1.56 vs. 0.81, p < 0.001). The majority of TMP edges showed a ring pattern (66%), followed by irregular (19%), avascular (12%) and radial patterns (3%). The avascular pattern was more frequent in posterior perforations (p = 0.003). The radial pattern was most frequently found in MP, especially at posterior quadrants (p = 0.048). MA presented an irregular pattern in 83.3% of TMs. CONCLUSIONS: NBI videoendoscopy is a promising non-invasive technique, superior to CWL for visualizing vessels among TMP edges and MP, based on further study, could become a supplementary diagnostic tool in the workup of TMP and the decision-making surgical field.


Asunto(s)
Endoscopía , Imagen de Banda Estrecha , Perforación de la Membrana Timpánica/diagnóstico por imagen , Membrana Timpánica/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Miringoesclerosis/diagnóstico por imagen , Estudios Prospectivos , Membrana Timpánica/irrigación sanguínea , Grabación en Video , Adulto Joven
4.
Laryngoscope ; 127(3): 698-701, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-27311645

RESUMEN

OBJECTIVES/HYPOTHESIS: To highlight the phenomenon of cholesteatoma arising from the vascular strip following tympanoplasty and tympanomastoidectomy. STUDY DESIGN: Multi-institutional retrospective chart review. METHODS: Consecutive adult and pediatric patients evaluated between 2000 and 2015 with acquired cholesteatoma arising from the skin of a prior vascular strip were identified. Patients with evidence of residual or recurrent cholesteatoma elsewhere in the middle ear, mastoid, or ear canal were excluded. RESULTS: Seventeen cases (71% female, 53% right-sided) were identified, and the mean age at presentation was 39.2 years. Patients presented on average 12.9 years following prior otologic surgery, which was most commonly tympanoplasty without mastoidectomy (59%). However, younger patients presented with symptoms sooner following prior surgery (r = 0.61, r2 = 0.37, P = 0.0095). The most common presenting symptom was otorrhea (76%). All patients were found to have mastoid cholesteatoma with bony erosion, and three patients exhibited additional tegmen or posterior fossa bone defects. The middle ear was not involved with cholesteatoma in any case. A canal wall down procedure was performed due to extensive bony canal erosion in 29% of cases. CONCLUSION: The vascular strip is an uncommon source of iatrogenic cholesteatoma that can present years following an otherwise uncomplicated otologic surgery. The findings presented herein highlight the importance of careful vascular strip orientation at the conclusion of otologic surgery. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:698-701, 2017.


Asunto(s)
Colesteatoma del Oído Medio/epidemiología , Colesteatoma del Oído Medio/etiología , Enfermedad Iatrogénica/epidemiología , Apófisis Mastoides/cirugía , Membrana Timpánica/irrigación sanguínea , Timpanoplastia/efectos adversos , Adolescente , Adulto , Distribución por Edad , Edad de Inicio , Niño , Preescolar , Colesteatoma del Oído Medio/diagnóstico por imagen , Colesteatoma del Oído Medio/cirugía , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Reoperación/métodos , Estudios Retrospectivos , Medición de Riesgo , Distribución por Sexo , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Membrana Timpánica/patología , Timpanoplastia/métodos , Adulto Joven
5.
Eur Arch Otorhinolaryngol ; 273(10): 3035-41, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26796878

RESUMEN

The objective of this study is to investigate the effect of topical and systemic enoxaparin sodium on the healing pattern of experimentally induced tympanic membrane perforation and formation of myringosclerosis. A total of 24 Wistar-Albino strain rats were included in the study. Standard myringotomies were performed on each rat. In the first group, isotonic serum physiologic was dropped on external ear canal (control group). Topical enoxaparin was dropped on external ear canal and daily topical doses of enoxaparin were dropped on external ear canal of the rats for 14 days (topical treatment group). Third group received subcutaneous injections of enoxaparin for 14 days (systemic treatment group). Five micrometer thick sections of the bullae of the rats were stained with H&E. Inflammation, edema and sclerotic lesions and neovascularization observed in the lamina propria layer of the tympanic membrane, and total thickness of the tympanic membrane were evaluated. In intergroup comparisons, significant difference in the distribution pattern of severity of inflammation in all three groups was not observed (p = 0.784, p > 0.05). Total TM thickness differed among all three groups (p = 0.028, p < 0.05). A statistically significant difference was observed between the systemic enoxaparin and the control groups (p = 0.022, p < 0.05). A statistically significant difference was observed between the topical enoxaparin and the control groups (p = 0.037, p < 0.05). However, comparison between the topical and systemic treatment groups could not reveal any statistically significant intergroup difference (p = 0.682, p > 0.05). A significant difference was not observed among three groups as for the distribution of myringosclerotic plaques, severity of edema and neovascularization in the lamina propria (p = 0.539, p > 0.05), (p = 0.063, p > 0.05), (p = 0.152, p > 0.05). Topical and systemic enoxaparin treatment did not prevent formation of sclerotic plaques; however, it decreased TM thickness significantly in comparison with the control group.


Asunto(s)
Anticoagulantes/administración & dosificación , Enoxaparina/administración & dosificación , Ventilación del Oído Medio , Miringoesclerosis/tratamiento farmacológico , Perforación de la Membrana Timpánica/tratamiento farmacológico , Membrana Timpánica/efectos de los fármacos , Cicatrización de Heridas/efectos de los fármacos , Administración Tópica , Animales , Traumatismos Craneocerebrales/cirugía , Inyecciones Subcutáneas , Miringoesclerosis/patología , Otitis Externa/patología , Otitis Externa/prevención & control , Ratas , Ratas Wistar , Suero , Membrana Timpánica/irrigación sanguínea , Membrana Timpánica/patología , Membrana Timpánica/cirugía , Perforación de la Membrana Timpánica/patología , Cicatrización de Heridas/fisiología
6.
J Laryngol Otol ; 128(5): 416-20, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24865375

RESUMEN

OBJECTIVE: To produce a high-resolution, three-dimensional temporal bone model from serial sections, using a personal computer. METHOD: Digital images were acquired from histological sections of the temporal bone. Image registration, segmentation and three-dimensional volumetric reconstruction were performed using a personal computer. The model was assessed for anatomical accuracy and interactivity by otologists. RESULTS: An accurate, high-resolution, three-dimensional model of the temporal bone was produced, containing structures relevant to otological surgery. The facial nerve, labyrinth, internal carotid artery, jugular bulb and all of the ossicles were seen (including the stapes footplate), together with the internal and external auditory meati. Some projections also showed the chorda tympani nerve. CONCLUSION: A high-resolution, three-dimensional computer model of the complete temporal bone was produced using a personal computer. Because of the increasing difficulty in procuring cadaveric bones, this model could be a useful adjunct for training.


Asunto(s)
Anatomía/educación , Simulación por Computador , Imagenología Tridimensional/métodos , Otolaringología/educación , Procedimientos Quirúrgicos Otológicos/educación , Hueso Temporal/anatomía & histología , Anciano de 80 o más Años , Arteria Carótida Interna/anatomía & histología , Arteria Carótida Interna/cirugía , Oído Interno/anatomía & histología , Oído Interno/irrigación sanguínea , Oído Interno/cirugía , Nervio Facial/anatomía & histología , Nervio Facial/irrigación sanguínea , Nervio Facial/cirugía , Humanos , Venas Yugulares/anatomía & histología , Venas Yugulares/cirugía , Masculino , Microcomputadores , Estapedio/anatomía & histología , Estapedio/irrigación sanguínea , Estapedio/cirugía , Hueso Temporal/irrigación sanguínea , Hueso Temporal/cirugía , Bancos de Tejidos , Membrana Timpánica/anatomía & histología , Membrana Timpánica/irrigación sanguínea , Membrana Timpánica/cirugía
7.
J Forensic Leg Med ; 20(2): 119-21, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23357399

RESUMEN

It is important to determine whether a person has been strangulated and the diagnosis is not always straightforward since ligature marks are not always present. In forensic medicine the physical examination recommended is careful inspection of the head and neck region, oral cavity, examination of the eyes including the conjunctiva on both the upper and lower eyelids and photo documentation. Petechial hemorrhages of the conjunctiva are considered marker of life threatening hanging or strangulation. Hemorrhage from ears, perforated tympanic membrane and haematotympanum are scarcely described in case reports of strangulated patients. To our knowledge we are the first to report petechial hemorrhages of the tympanic membrane in a patient following attempted suicide by hanging. We believe that the petechial hemorrhages develop from the capillaries located in lamina propria of the epidermal layer above the fibrous layer. This assumption is made on the basis of our assessment of a normal tympanic membrane with light microscopy. Petechial hemorrhages of the tympanic membrane might in fact be the only sign of life threatening pressure applied to the neck. This is a very important finding and prospective studies should be conducted for further clarification on the matter.


Asunto(s)
Asfixia/patología , Traumatismos del Cuello/patología , Púrpura/patología , Intento de Suicidio , Membrana Timpánica/irrigación sanguínea , Membrana Timpánica/patología , Patologia Forense , Humanos , Masculino , Microscopía , Persona de Mediana Edad
8.
Interv Neuroradiol ; 18(3): 255-8, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22958762

RESUMEN

Atypical origin of the middle meningeal artery from the cervical internal carotid artery is a rare angiographic finding. We describe a case of the pharyngo-tympano-stapedial variant of the middle meningeal artery in a young patient. In this vascular variation the proximal segment of the middle meningeal artery, corresponding to an annexed inferior tympanic artery, originates from the cervical carotid artery. Then over the promontory it unites with the superior tympanic artery and continues with its intracranial course via the petrous branch.


Asunto(s)
Arterias Meníngeas/anomalías , Adolescente , Angiografía , Arteria Carótida Interna/anomalías , Arteria Carótida Interna/diagnóstico por imagen , Hematoma Subdural/diagnóstico por imagen , Hematoma Subdural/etiología , Hemofilia B/complicaciones , Humanos , Masculino , Arterias Meníngeas/diagnóstico por imagen , Faringe/diagnóstico por imagen , Estribo/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Membrana Timpánica/irrigación sanguínea
9.
Clin Otolaryngol ; 37(5): 355-61, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22950578

RESUMEN

OBJECTIVES: To evaluate the vascularisation process of the grafted fascia or perichondrium in active and inactive chronic mucosal otitis media. DESIGN: Prospective study. SETTING: University-based, secondary referral hospital. PARTICIPANTS: Two hundred thirty-two patients who underwent type 1 tympanoplasty or myringoplasty by one experienced surgeon. MAIN OUTCOME MEASURES: After postoperative days 5-7, the graft was inspected using a binocular operating microscope at least twice weekly until vascularisation was confirmed to have commenced. This point was defined as the time of vascularisation. An intact graft at 3 months postoperatively was considered a closure success. RESULTS: The mean time of vascularisation of 232 grafts was 14.2 ± 3.6 days (range 8-25). The vascularisation time differed according to the perforation size. The perforations involving 50% and less of the pars tensa were revascularised earlier than those involving 75% and more. There was no relationship between vascularisation time and closure success or failure. Age itself did not influence the vascularisation time or the risk of closure failure. Postoperative otorrhea was higher in patients with a preoperative wet middle ear mucosa than among those with a dry one. CONCLUSION: The vascularisation time was shorter in perforations of 50% and less than those of 75% and more but the rate of closure success was not different between two. The graft failure was not attributed to the failure of vascularisation. Age itself seemed not to be a contraindication for myringo-/tympanoplasty in otherwise healthy elderly patients.


Asunto(s)
Tejido Conectivo/irrigación sanguínea , Tejido Conectivo/trasplante , Fascia/irrigación sanguínea , Fascia/trasplante , Miringoplastia/métodos , Otitis Media con Derrame/cirugía , Otitis Media Supurativa/cirugía , Perforación de la Membrana Timpánica/cirugía , Membrana Timpánica/irrigación sanguínea , Membrana Timpánica/cirugía , Timpanoplastia/métodos , Adolescente , Adulto , Anciano , Niño , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Neovascularización Fisiológica/fisiología , Complicaciones Posoperatorias/etiología , Adulto Joven
10.
Exp Brain Res ; 219(3): 321-6, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22488130

RESUMEN

In this study, we examined the relationship between a measure of cerebral lateralization--differences in tympanic temperature (T(Ty))--and questionnaire measures of inattentiveness and hyperactivity in both people and dogs. Theories of cerebral lateralization indicate that cerebral asymmetry may improve attentive behaviour. In people, greater left than right T(Ty) was related to increased self-reports of inattentiveness. There was no relationship between lateralized T(Ty) and hyperactivity. In dogs, there was quadratic relationship between lateralized T(Ty) and handler reports of inattentiveness. Increased T(Ty) asymmetry, regardless of direction, was related to more attentiveness. There was no discernable relationship between hyperactivity and lateralized T(Ty). Differences in T(Ty) may be an useful tool for investigating species comparisons of cerebral lateralization.


Asunto(s)
Atención/fisiología , Temperatura Corporal/fisiología , Corteza Cerebral/fisiología , Circulación Cerebrovascular/fisiología , Lateralidad Funcional/fisiología , Membrana Timpánica/fisiología , Adolescente , Adulto , Animales , Corteza Cerebral/irrigación sanguínea , Perros , Femenino , Humanos , Masculino , Modelos Neurológicos , Membrana Timpánica/irrigación sanguínea , Adulto Joven
11.
Am J Otolaryngol ; 33(1): 156-8, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-21392852

RESUMEN

Bleeding during mastoidectomy usually occurs because of injury to the dura mater and/or sigmoid sinus, which, in most cases, can be controlled easily. The other important cause is damage to the internal carotid artery during its course in the middle ear. Bleeding from the external carotid artery or a branch of it is very rare and unknown. We hereby report an extremely rare and first case of delayed torrential bleeding after modified radical mastoidectomy, which was because of infective necrosis and subsequent blowout of the anterior tympanic branch of superficial temporal artery and its management using microcoils via an endovascular approach.


Asunto(s)
Arteria Carótida Externa , Colesteatoma del Oído Medio/cirugía , Embolización Terapéutica , Hemorragia/terapia , Apófisis Mastoides/cirugía , Complicaciones Posoperatorias/terapia , Membrana Timpánica/irrigación sanguínea , Transfusión Sanguínea , Humanos , Masculino , Adulto Joven
12.
Laterality ; 16(2): 156-63, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20169500

RESUMEN

The measurement of tympanic membrane temperature (TMT) using hand-held infrared devices is common in both clinical and experimental research. However, the role that measurement context has on TMT has been overlooked. In the present investigation 94 women and men had their right and left TMT measured by either a male or female investigator. Regardless of participant's gender, when measured by a female investigator the right TMT was significantly lower than the left TMT. When measured by a male investigator, both male and female participants had similar right and left TMT. These lateral TMT results correspond with neuropsychological theories regarding threat appraisal.


Asunto(s)
Temperatura Corporal/fisiología , Miedo/psicología , Lateralidad Funcional/fisiología , Caracteres Sexuales , Conducta Social , Membrana Timpánica/fisiología , Adolescente , Adulto , Femenino , Humanos , Masculino , Prejuicio , Membrana Timpánica/irrigación sanguínea , Adulto Joven
14.
Acta Otolaryngol ; 128(1): 18-21, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-17851907

RESUMEN

CONCLUSIONS: King penguins have a venous structure in the form of a corpus cavernosum (CC) in their middle ear (ME) submucosa. The CC may be viewed as a special organelle that can change ME volume for pressure equilibration during deep-sea diving it is a pressure regulating organelle (PRO). A similar CC and muscles also surround the external ear (EE) and may constrict it, isolating the tympanic membrane from the outside. A CC was previously found also in the ME of marine diving mammals and can be expected to exist in other deep diving animals, such as marine turtles. OBJECTIVES: Marine animals require equalization of middle ear (ME) pressure when diving hundreds or thousands of meters to catch prey. We investigated what mechanism enables king penguins to protect their ME when they dive to great depths. MATERIALS AND METHODS: Biopsies and serial sections of the ME and the EE of the deep diving king penguin (Aptenodytes patagonicus) were examined microscopically. RESULTS: It was demonstrated that the penguin ME has an extensive network of small and large submucosal venous sinuses. This venous formation, a corpus cavernosum, can expand and potentially 'flood' the ME almost completely on diving, thus elevating ME pressure and reducing the ME space. The EE has a similar protective mechanism.


Asunto(s)
Presión del Aire , Buceo/fisiología , Oído Medio/anatomía & histología , Spheniscidae/anatomía & histología , Factores de Edad , Animales , Biopsia , Oído Externo/anatomía & histología , Oído Externo/irrigación sanguínea , Oído Medio/irrigación sanguínea , Homeostasis/fisiología , Membrana Mucosa/anatomía & histología , Membrana Mucosa/irrigación sanguínea , Músculo Liso Vascular/anatomía & histología , Tomografía Computarizada por Rayos X , Membrana Timpánica/anatomía & histología , Membrana Timpánica/irrigación sanguínea , Venas/anatomía & histología
15.
Eur J Appl Physiol ; 101(1): 19-30, 2007 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-17534647

RESUMEN

Selective brain cooling in humans, with venous blood returning from the head surface as the relevant heat sink, was proposed more than two decades ago as a mechanism protecting the brain against damage in hyperthermic conditions. Brain cooling was inferred from decreases of tympanic temperature under the premise that it reflected brain temperature closely, even in conditions of external head cooling. In mammals with a well-developed carotid rete selective brain cooling and its quantitative relevance are experimentally well established by directly monitoring brain temperature. For humans, however, the dispute about the existence and physiological relevance of selective brain cooling has remained unsettled, especially, as far as arguments have been exchanged on the basis of thermophysiological data and model calculations considering brain metabolism, brain hemodynamics and the anatomical preconditions for arterio-venous heat exchange. In this essay two seminal studies in support of the existence of human selective brain cooling in the condition of exercise hyperthermia, with and without dehydration, are re-examined from two points of view: first the stringency of the working hypotheses underlying data evaluation and their subsequent fate. Second the minimum theoretical requirements for data interpretation. The working hypotheses supporting data interpretation in favor of selective brain cooling in humans were heuristic and/or had become questionable at the dates of their application; today, they may be considered as outdated. Data interpretation becomes most conclusive, if tympanic temperature simply is not taken into account.


Asunto(s)
Regulación de la Temperatura Corporal , Encéfalo/fisiología , Modelos Biológicos , Membrana Timpánica/fisiología , Animales , Temperatura Corporal , Circulación Cerebrovascular/fisiología , Frío , Deshidratación , Potenciales Evocados Auditivos , Ejercicio Físico/fisiología , Fiebre , Cabeza/irrigación sanguínea , Cabeza/fisiología , Calor , Humanos , Hipotermia Inducida , Condicionamiento Físico Animal/fisiología , Proyectos de Investigación , Temperatura Cutánea/fisiología , Membrana Timpánica/irrigación sanguínea
16.
J Laryngol Otol ; 120(9): 796-9, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16939671

RESUMEN

Benign vascular lesions include various forms whose classification has created some controversies in the literature. The observation of a rare case of vascular bulge of the eardrum in a 57-year-old man prompted us to analyse the essential features of these lesions. This was an incidental finding and the mass was removed by a transcanal approach. The patient is free of disease four years later. Vascular malformations can be differentiated from vascular tumours since they are present at birth, are generally stable, do not involute, and do not necessitate treatment unless symptoms occur.


Asunto(s)
Malformaciones Arteriovenosas/diagnóstico , Membrana Timpánica/irrigación sanguínea , Malformaciones Arteriovenosas/cirugía , Pérdida Auditiva/etiología , Pérdida Auditiva/fisiopatología , Humanos , Hallazgos Incidentales , Masculino , Persona de Mediana Edad , Examen Físico
17.
Hear Res ; 200(1-2): 29-37, 2005 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-15668036

RESUMEN

The annulus fibrosus and its attachment to the bony tympanic ring were studied in a series of mammals. In the pallid bat, Antrozous pallidus, there is an extensive plexus of large interconnected blood sinuses in the part of the annulus that borders the tympanic bone. The spaces between the sinuses are packed with smooth muscle cells. Most of the cells have a predominately radial orientation; they extend from the bony tympanic sulcus to a dense collagenous matrix (apical zone) where radially oriented fibers of the pars tensa are confluent with the annulus. The muscles and vessels constitute a myovascular zone. A structurally similar myovascular zone is also present in the European hedgehog. In rodents, the annulus lacks the large interconnected blood sinuses but many small vessels are present. Smooth muscle is concentrated in the broad area of attachment of the annulus to the tympanic bone. In the gerbil, smooth muscle seems to be concentrated in the central part of the width of the annulus where it is attached to bone and radiates toward the tympanic membrane. In humans collections of radially oriented smooth muscle cells were found in several locations. The smooth muscle in all species studied appears to form a rim of contractile elements for the pars tensa. This arrangement suggests a role in controlling blood flow and/or creating and maintaining tension on the tympanic membrane.


Asunto(s)
Membrana Timpánica/anatomía & histología , Anciano , Animales , Quirópteros , Femenino , Gerbillinae , Erizos , Humanos , Lactante , Masculino , Ratones , Persona de Mediana Edad , Músculo Liso/anatomía & histología , Músculo Liso/irrigación sanguínea , Filogenia , Ratas , Especificidad de la Especie , Membrana Timpánica/irrigación sanguínea
18.
Ter Arkh ; 76(3): 20-3, 2004.
Artículo en Ruso | MEDLINE | ID: mdl-15108453

RESUMEN

AIM: To study efficacy of low-intensive infrared laser radiation impact on the tympanic membrane in patients with bronchial asthma (BA) and concomitant rhinosinusitis (RS). MATERIAL AND METHODS: 78 patients with moderate BA of a mixed type and concomitant chronic RS were divided into 3 groups: group 1 patients received medication plus infrared laser radiation of the tympanic membrane and paranasal sinuses; group 2 patients were exposed to supravenous laser radiation (0.63 mcm); group 3 received pharmacotherapy alone. The effect of the treatment was assessed by spirometry, peakflowmetry and paranasal sinuses findings. RESULTS: The highest response was achieved in group 1 which manifested with positive changes in clinical, device and spirometric data on BA and x-ray data on RS courses. The least effective treatment was observed in group 3. CONCLUSION: Use of infrared laser radiation of the tympanic membrane and paranasal sinuses projection in the treatment of BA patients with RS is effective, nontoxic and easy to use both in hospitals and outpatient departments.


Asunto(s)
Asma/radioterapia , Sangre/efectos de la radiación , Terapia por Luz de Baja Intensidad , Rinitis/radioterapia , Sinusitis/radioterapia , Membrana Timpánica/efectos de la radiación , Adolescente , Adulto , Antiasmáticos/uso terapéutico , Asma/sangre , Asma/complicaciones , Asma/tratamiento farmacológico , Terapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Rinitis/sangre , Rinitis/complicaciones , Sinusitis/sangre , Sinusitis/complicaciones , Resultado del Tratamiento , Membrana Timpánica/irrigación sanguínea
19.
Eur J Pharmacol ; 482(1-3): 313-8, 2003 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-14660037

RESUMEN

We studied the damage to the cochlear lateral wall induced by otitis media and the therapeutic effects of intratympanic administration of steroid and nitric oxide (NO) synthase inhibitor. In Sprague-Dawley rats, right middle ear cavities were inoculated with lipopolysaccharide, followed after 30 min by intratympanic administration of dexamethasone, NOS-inhibitor or PBS. Twenty-four hours after lipopolysaccharide inoculation, cochlear blood flow was measured by laser-Doppler flowmetry. Prostaglandin E(1) was topically applied to the round window membrane of the right ear and changes in cochlear blood flow were calculated. Changes of cochlear blood flow were significantly different among the three groups. Increases in cochlear blood flow following PGE(1) application were higher in the group that received NOS-inhibitor. Electron microscopic examination revealed that changes in the stria vascularis were less severe in rats treated with dexamethasone or NOS-inhibitor. Our results show the effectiveness of intratympanic dexamethasone or NOS-inhibitor in treating cochlear lateral wall damage caused by otitis media.


Asunto(s)
Amidinas/administración & dosificación , Dexametasona/administración & dosificación , Compuestos Heterocíclicos con 2 Anillos/administración & dosificación , Óxido Nítrico Sintasa/antagonistas & inhibidores , Otitis Media/tratamiento farmacológico , Membrana Timpánica/efectos de los fármacos , Animales , Cóclea/irrigación sanguínea , Cóclea/efectos de los fármacos , Cóclea/enzimología , Cóclea/patología , Inhibidores Enzimáticos/administración & dosificación , Femenino , Óxido Nítrico Sintasa/metabolismo , Otitis Media/enzimología , Otitis Media/patología , Ratas , Ratas Sprague-Dawley , Membrana Timpánica/irrigación sanguínea , Membrana Timpánica/enzimología , Membrana Timpánica/patología
20.
Otol Neurotol ; 24(3): 371-6, 2003 May.
Artículo en Inglés | MEDLINE | ID: mdl-12806286

RESUMEN

HYPOTHESIS: The goal of this study was to evaluate the effects of hyaluronic acid, epidermal growth factor, and mitomycin C on the healing of acute experimental traumatic perforations of the tympanic membrane. BACKGROUND: Most acute perforations of the tympanic membrane heal spontaneously. However, some form of surgical treatment (i.e., myringoplasty) is needed for nonhealing perforations. Because the closure occurs by squamous epithelial migration, drugs that stimulate this regenerative process may aid in the closure of the perforation, obviating the need for more extensive treatments. METHODS: Bilateral perforations of the tympanic membrane were created in 30 rats, divided into three groups (A, B, C). The perforations in the right ears were treated with hyaluronic acid, epidermal growth factor, or mitomycin C. Those in the left ears were left untreated for comparison. To examine the healing process in different periods, 5 animals were killed in each group at days 3, 5, 7, 9 and 14. The other 5 animals in each group were observed daily to determine the duration of perforation closures. Thirty surgical specimens (5 right sides from each group and all 15 left sides in all groups) were histopathologically examined for tympanic membrane thickness, fibroblastic reaction, neovascularization, and crust morphology. RESULTS: Hyaluronic acid and epidermal growth factor applications significantly shortened the healing in acute experimental traumatic perforations of the tympanic membrane (p = 0.0432); however, the difference between them was not significant (p = 0.3160). On the other side, tympanic membrane perforations treated with topical mitomycin C showed no evidence of closure. There were no significant differences in the histologic parameters between the treated groups and their contralateral control ears. CONCLUSION: Hyaluronic acid and epidermal growth factor accelerated the closure of acute tympanic membrane perforations in rats. This may make them clinically useful in augmenting the efficiency of conservative treatments of acute perforations of the tympanic membrane.


Asunto(s)
Adyuvantes Inmunológicos/farmacología , Adyuvantes Inmunológicos/uso terapéutico , Antiulcerosos/farmacología , Antiulcerosos/uso terapéutico , Antibióticos Antineoplásicos/farmacología , Factor de Crecimiento Epidérmico/farmacología , Factor de Crecimiento Epidérmico/uso terapéutico , Ácido Hialurónico/farmacología , Ácido Hialurónico/uso terapéutico , Mitomicina/farmacología , Perforación de la Membrana Timpánica/tratamiento farmacológico , Animales , Fibroblastos/efectos de los fármacos , Distribución Aleatoria , Ratas , Regeneración/efectos de los fármacos , Regeneración/fisiología , Membrana Timpánica/irrigación sanguínea , Membrana Timpánica/efectos de los fármacos , Membrana Timpánica/fisiología
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