The Impact of Virtual Reality Training on the Quality of Real Antromastoidectomy Performance.

BACKGROUND: The aim of this paper is to analyze the results of virtual reality (VR) antromastoidectomy simulation training and the transferability of the obtained skills to real temporal bone surgery. METHODS: The study was conducted prospectively on a group of 10 physicians, and was composed of five VR simulation training sessions followed by live temporal bone surgery. The quality of performance was evaluated with a Task-Based Checklist (TBC) prepared by John Hopkins Hospital. Additionally, during every VR session, the number and type of mistakes (complications) were noted. RESULTS: The quality of performance measured by the TBC increased significantly during consecutive VR sessions. The mean scores for the first and fifth sessions were 1.84 and 4.27, respectively (p < 0.001). Furthermore, the number of mistakes in consecutive VR sessions was gradually reduced from 11 to 0. During supervised surgery, all the participants were able to perform at least part of an antromastoidectomy, and the mean TBC score was 3.57. There was a significant strong positive correlation between the individual results of the fifth VR session and the individual results of supervised surgery in the operating room (rp = 0.89, p = 0.001). CONCLUSIONS: Virtual reality for temporal bone training makes it possible to acquire surgical skills in a safe environment before performing supervised surgery. Furthermore, the individual final score of virtual antromastoidectomy training allows a prediction of the quality of performance in real surgery.

Evaluation of quality of life in patients after cochlear implantation surgery in 2014-2017.

INTRODUCTION: Profound hearing loss significantly affects the quality of life of deaf people as well as their families. Observation of the benefit from the use of cochlear implants in deaf patients allows to assess the success of treatment with this method and its impact on the quality of life of these patients. The aim of this study was to determine the quality of life in patient after the cochlear implantation in the material of Department of Phoniatrics and Audiology of the Medical University in Poznan. MATERIAL AND METHODS: The study involved implanted patients who voluntarily joined to the project entitled "Observational study of the implanted patient (Cochlear-IROS)". It has a prospective character, it is an international and long-term study, covering the observation of patients up to three years after implantation. Standardized HUI and SSQ questionnaires were used. 70 patients were included in the analysis, the mean age at the time of the cochlear implantation was 47.6 years. In the research group there were 33 men and 37 women. In the whole group, the patients' age at implantation was at least 18 years, max. 80 years. RESULTS: The results of the SSQ questionnaire, which deals with the self-assessment of hearing ability in everyday situations, indicate that in the subjective assessment of patients one year after surgery the speech hearing improved by 77%, spatial hearing by 84%, and the quality of hearing by 49%. The general quality of life before the first connection of the sound processor according to the HUI questionnaire, the patients rated at 0.49 (0-1 scale, where 0 - corresponds to the death condition and 1 - full health). After one year from the implantation, this rating increased to 0.56. CONCLUSIONS: The implantation of the cochlear implant significantly increases the patient's quality of life, its physical and emotional functioning. Statistically significant better self-assessment of patients mainly concerned hearing speech and spatial hearing - especially after 1 year of connecting the speech processor.

Differences between sexes in the standard and advanced dimensioning of lateral meniscal allografts.

BACKGROUND: There are many different methods of meniscal allograft measurements, which depend on individual tissue bank procedures. Due to the lack of a standardised method of dimensioning, measurement results may vary between individual cases. Consequently, allograft may be mismatched to the patient's knee anatomy. The purpose of this study was to measure four meniscal dimensions - two standard and two specific - and then compare them between sexes. METHODS: Fourteen cadaveric lateral menisci (seven male and seven female) were scanned using a microtomography scanner. The obtained three-dimensional (3-D) models of each meniscus were analysed, taking into account four dimensions: circumference, width, central meniscal concavity, and total meniscal volume. The computer researcher was not informed of the original data of the meniscal samples until the calculations were completed. RESULTS: No statistical between-sex differences were found in the standard dimensions. The specific dimensions, in turn, presented statistically significant between-sex differences (P>0.05). The mean difference between male and female total volume of the meniscus was equal to 36.59%, and the mean difference between male and female central meniscal concavity surface was equal to 31.22%. CONCLUSION: This study found that sex should be taken into account as an important factor during a matching procedure performed by tissue bank staff.

Effect of Th1/Th2 cytokine administration on proinflammatory SKOV-3 cell activation.

INTRODUCTION: Interleukin(IL)-1ß, IL-6 and IL-12 might associate with inflammatory processes in a tumor progression and create a specific microenvironment for tumor growth. The aim of the study was to assess whether the Th1 and Th2 type cytokines, such as IL-2 and IL-10, affect ovarian carcinoma continuous cell line (SKOV-3) pro-inflammatory activation. MATERIAL AND METHODS: SKOV-3 ovarian cells and peripheral blood mononuclear cells (PBMCs) were stimulated by IL-2 and IL-10. Additionally, SKOV-3 ovarian cells and PBMCs were co-cultured together. Proinflammatory activation of cancer cells was evaluated by measurement of IL-1ß and IL-6 levels in culture fluid after 72 h of incubation. RESULTS: SKOV-3 cells and PBMCs secreted IL-1ß and IL-6. After stimulation by IL-2 and IL-10, secretion of studied parameters was changed in a dose-dependent manner. The addition of a higher IL-2 level gave rise to an increase of IL-1ß, IL-6 and IL-12 secretion in SKOV-3 cells. Stimulation by IL-10 increased only IL-1ß secretion in SKOV-3 cells. However, IL-6 secretion decreased after stimulation with 25 ng/ml IL-10. Activatory effects of IL-2 and inhibitory effects of IL-10 in co-culture of SKOV-3 and PBMCs were observed. CONCLUSIONS: Our results suggested that Th1/Th2 type of cytokines might influence pro-inflammatory activation of SKOV-3 ovarian cells. Co-cultures of SKOV-3 and PBMCs showed significant changes in cross-talk between cancer and immune cells.

Preservation and sterilization methods of the meniscal allografts: literature review.

Nowadays, there are four types of meniscal allografts known: fresh, cryopreserved, deep-frozen and lyophilized ones but only two of them are widely used in clinical practice. Use of different types of meniscal allografts still remains controversial due to preparation method, their biomechanical properties as well as cost which is connected with processing and storage. The main aim of this review is to present the current status of knowledge concerning meniscal allograft preservation and sterilization, especially the advantages and disadvantages of each method. Authors wanted to show a broad spectrum of methods used and conceptions presented by other authors. The second aim is to gather available information about meniscal preservation and sterilization methods in one paper. Deep-frozen and cryopreserved meniscal allografts are the most frequently used ones in the clinical practice. The use of fresh grafts stays controversial but also has many followers. Lyophilized grafts in turn are not applied at present due to some serious drawbacks including reduction of tensile strength, poor rehydration, graft shrinkage and post-transplantation joint effusion as well as increased risk of meniscal size reduction. An application of sterilizing agents make the meniscal allograft free from the bacteria and viruses, but also it may cause serious structure changes. Therefore, choosing just one ideal method of meniscal allograft preservation and sterilization is complicated and should be based on broad knowledge and experience of surgeon performing the transplantation.