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1.
Cureus ; 14(5): e25451, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35774686

RESUMO

We conducted a systematic review and meta-analysis to compare round window (RW) and cochleostomy (C) surgical approaches for the placement of cochlear implants (CIs). After obtaining the Institutional Review Board (IRB) approval, 213 peer-reviewed articles published between January 1, 2000, and August 1, 2021, comparing RW and C approaches were identified via a search on Google Scholar, Cochrane, and PubMed. The inclusion criteria were articles having an English version and involving only human subjects (cadaveric or alive). Statistical analysis of compiled electrode-to-modiolus distances was performed with two-sample independent t-tests. Live patients were categorized as having complete hearing preservation (<10 dB threshold shift), partial hearing preservation (10-20 dB shift), or minimal hearing preservation (>20 dB shift). Chi-squared testing was used to compare the distribution of hearing preservation categories between surgical approaches. Due to the heterogeneous nature of the data, only summative information was provided on the effects of approaches on trauma, electrical impedance, speech perception, vestibular dysfunction, ease of scala tympani insertion, and scalar shift. A total of 3,797 CI patients were evaluated. The RW approach resulted in a smaller (0.15 mm smaller on average, p<0.05) electrode-to-modiolus distance when compared to the C approach. The RW approach (93.0%) led to statistically better hearing preservation than the C approach (84.3%) (p<0.05). The RW approach was also associated with better outcomes in terms of speech perception, ease of scala tympani insertion, and reduced scalar shift. No difference between approaches was found with regard to trauma, electrical impedance, and vestibular dysfunction. Based on our findings, the RW approach appears to have several benefits compared to the C approach.

2.
Artigo em Inglês | MEDLINE | ID: mdl-35678249

RESUMO

For cochlear implants (CI) a final position of the electrode array (EA) along the inner wall of the spirally shaped cochlea is considered to be beneficial because it results in a closer proximity to the auditory nerve fibers. A shape memory effect (SME) could facilitate such shift of the EA toward the cochlear inner wall, but its implementation remains to be solved. The current study presents an EA prototype featuring the SME with minute adjustments of the material properties of Nitinol, a shape memory alloy, in combination with a suitable cooling strategy to prevent premature curling. Ten samples were successfully inserted by a CI surgeon into an artificial cochlear model submerged into a temperature-controllable water bath to simulate temporary hypothermia of the inner ear (31°C). Gentle insertions were possible, with an average insertion speed of 0.81 ± 0.14 mm/s. After recovery of body temperature, the desired position shift toward the modiolus was observed in all trials. Angular insertion depth increased by approximately 81.8° ± 23.4°. We demonstrate for the first time that using the body temperature responsive SME for perimodiolar EA positioning is feasible and does not impede a gentle surgical insertion.

3.
BMC Med Educ ; 22(1): 386, 2022 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-35596162

RESUMO

BACKGROUND: The objective of this study was to demonstrate the utility of an approach in training predoctoral medical students, to enable them to measure electrode-to-modiolus distances (EMDs) and insertion-depth angles (aDOIs) in cochlear implant (CI) imaging at the performance level of a single senior rater. METHODS: This prospective experimental study was conducted on a clinical training dataset comprising patients undergoing cochlear implantation with a Nucleus® CI532 Slim Modiolar electrode (N = 20) or a CI512 Contour Advance electrode (N = 10). To assess the learning curves of a single medical student in measuring EMD and aDOI, interrater differences (senior-student) were compared with the intrarater differences of a single senior rater (test-retest). The interrater and intrarater range were both calculated as the distance between the 0.1th and 99.9th percentiles. A "deliberate practice" training approach was used to teach knowledge and skills, while correctives were applied to minimize faulty data-gathering and data synthesis. RESULTS: Intrarater differences of the senior rater ranged from - 0.5 to 0.5 mm for EMD and - 14° to 16° for aDOI (respective medians: 0 mm and 0°). Use of the training approach led to interrater differences that matched this after the 4th (EMD) and 3rd (aDOI) feedback/measurement series had been provided to the student. CONCLUSIONS: The training approach enabled the student to evaluate the CI electrode position at the performance level of a senior rater. This finding may offer a basis for ongoing clinical quality assurance for the assessment of CI electrode position.


Assuntos
Implante Coclear , Implantes Cocleares , Cóclea/cirurgia , Implante Coclear/métodos , Eletrodos Implantados , Humanos , Estudos Prospectivos
4.
J Assoc Res Otolaryngol ; 22(6): 681-691, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34622375

RESUMO

Incomplete partition type II (IP-II) is frequently identified in ears with SLC26A4 mutations. Cochleae with IP-II are generally observed to have 1½ turns; the basal turns are normally formed, and the apical turn is dilated or cystic. The objective of this study was to characterize the pathomorphogenesis of the IP-II cochlear anomaly in Slc26a4-null mice. Otic capsules were dissected from Slc26a4Δ/+ and Slc26a4Δ/Δ mice at 1 and 8 days of age and at 1 and 3 months of age. X-ray micro-computed tomography was used to image samples. We used a multiplanar view and three-dimensional reconstructed models to calculate the cochlear duct length, cochlear turn rotation angle, and modiolus tilt angle. The number of inner hair cells was counted, and the length of the cochlear duct was measured in a whole-mount preparation of the membranous labyrinth. X-ray micro-computed tomography mid-modiolar planar views demonstrated cystic apical turns in Slc26a4Δ/Δ mice resulting from the loss or deossification of the interscalar septum, which morphologically resembles IP-II in humans. Planes vertical to the modiolus showed a similar mean rotation angle between Slc26a4Δ/+ and Slc26a4Δ/Δ mice. In contrast, the mean cochlear duct length and mean number of inner hair cells in Slc26a4Δ/Δ mice were significantly smaller than in Slc26a4Δ/+ mice. In addition, there were significant differences in the mean tilt angle and mean width of the modiolus. Our analysis of Slc26a4-null mice suggests that IP-II in humans reflects loss or deossification of the interscalar septum but not a decreased number of cochlear turns.


Assuntos
Cóclea/anormalidades , Cóclea/diagnóstico por imagem , Orelha Interna/diagnóstico por imagem , Células Ciliadas Vestibulares , Transportadores de Sulfato/genética , Animais , Cóclea/anatomia & histologia , Ducto Coclear , Orelha Interna/anormalidades , Células Ciliadas Auditivas Internas , Camundongos , Camundongos Knockout , Tomografia Computadorizada por Raios X , Microtomografia por Raio-X
5.
Front Surg ; 8: 667248, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34355012

RESUMO

Background: Menière's disease (MD) is an inner ear disorder characterized by recurrent episodes of spontaneous vertigo, unilateral low-frequency sensorineural hearing loss, tinnitus, and aural fullness. Current diagnosis still often has to rely on subjective and audiometric criteria only, although endolymphatic hydrops is recognized as the pathophysiological substrate of the disease, having been demonstrated in anatomical pathological studies and by magnetic resonance (MRI). The modiolus has a close functional and anatomical relationship with the cochlear nerve and membranous labyrinth and can be evaluated with MRI but no data exist on the modiolar size in MD. Purpose: Our purpose is to examine the following hypothesis. Is cochlear modiolus smaller in symptomatic ears in MD? Methods: We used a retrospective 3 Tesla MR study (heavily T2-weighted 3D fast asymmetric spin-echo images and 0.5 mm slice thickness) comparing the mean modiolar area (MMA) in the index and best ears of eight patients with definite MD based on audiometric data. The obtained MMA values were compared against the audiometric data and the presence of vestibular endolymphatic hydrops. Results: No differences were seen in MMA between best and worst ears. Ears with a pure tone average (PTA) ≥25 dB and more pronounced endolymphatic hydrops showed lower MMA (not statistically significant). Two patients with extreme endolymphatic hydrops showed a noteworthy ipsilateral decrease in the cochlear modiolus area. Conclusion: No differences were seen in MMA between best and worst ears in definite MD. Worse hearing function (PTA ≥ 25dB) and more pronounced endolymphatic hydrops seem to be associated with lower MMA. This might be related to bone remodeling as a consequence of endolymphatic hydrops. Further research is needed to corroborate and explore these findings.

6.
Int. j. morphol ; 38(6): 1837-1841, Dec. 2020.
Artigo em Espanhol | LILACS | ID: biblio-1134517

RESUMO

RESUMEN: La disposición anatómica de los músculos faciales es de una notable complejidad y requiere de un estudio pormenorizado para lograr su reconomiento preciso. La comprensión de la disposición morfológica y la funcionalidad del modiolo del ángulo oral (Modiolus angulis oris) es de gran relevancia al momento de analizar la constitución muscular de la comisura labial, y para comprender clínicamente las lesiones del ángulo de la cavidad oral, lo que permitirá un abordaje terapéutico adecuado, crucial para la preservación y reconstitución de la armonía facial.


SUMMARY: The anatomical arrangement of the facial muscles is of considerable complexity and requires a detailed study to achieve its precise recognition. The understanding of the morphological disposition and the functionality of the angle of the mouth (Modiolus angulis oris) is of great relevance when analyzing the muscular constitution of the labial commissure, and to understand clinically the injuries of the angulus oris, what that will allow an adequate therapeutic approach, crucial for the preservation and reconstitution of facial harmony.


Assuntos
Músculos Faciais/anatomia & histologia , Boca/anatomia & histologia , Lábio/anatomia & histologia
7.
Cochlear Implants Int ; 21(3): 145-152, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31771498

RESUMO

The purpose of this study was to obtain a better understanding of the number and distribution of spiral ganglion cell bodies (SGCB) in the central modiolus trunk of the human cochlea with normal hearing as well as with hearing loss due to various pathological conditions. A literature review was performed using the key words 'human spiral ganglion cell population', 'analysis of spiral ganglion cell population', 'survival of human spiral ganglion cells', 'human Rosenthal's canal', 'human ganglion cell counts', and 'distribution of human spiral ganglion cells' to identify articles published between 1968 and 2018. Articles were included if the number of SGCB in the four segments of the human cochlea and angular depth distribution of the SGCB were stated. Of 236 articles initially identified, 19 articles met the inclusion criteria. SGCB inside the Rosenthal's canal (RC) in the modiolus trunk extended to an angular depth of 630-680° which is near the end of the second turn of the cochlea. SGCBs in Segment IV of the cochlea account for approximately 25-30% of the entire SGCB population irrespective of the cochlear condition (normal vs. pathologic). In normal hearing subjects, the total number of SGCB ranged between 23,910 and 33,702 and in patients with hearing loss between 5733 and 28,220. This literature review elaborates on the current state of knowledge about the number and distribution of SGCB in the human cochlea.


Assuntos
Corpo Celular/patologia , Cóclea/citologia , Perda Auditiva/patologia , Gânglio Espiral da Cóclea/citologia , Humanos
8.
Orv Hetil ; 160(31): 1216-1222, 2019 Aug.
Artigo em Húngaro | MEDLINE | ID: mdl-31352808

RESUMO

Introduction: The cochlear implants vary in electrodes in terms of length, width and proximity to the modiolus. The precurved electrode arrays could be placed closer to the modiolus and the ganglion cells compared to straight electrodes. The two types of electrode arrays provide different electrophysiological characteristics; however, proximity to the modiolus may lead to better hearing performance. Aim: To investigate our preliminary electrophysiological results that suggest that the Slim Modiolar (SM) electrode array has the potential to elicit similar neural responses as the thicker perimodiolar (Contour Advance, CA) electrode from the same generation of implants. Method: Subjects that were implanted either with CA or SM electrodes were enrolled, 54 consecutive subjects in each group. All electrodes were introduced into the cochlea via the round window. The diameter of the largest turn of the electrode arrays within the cochlea was measured through postoperative radiography. The energy consumption parameters were estimated 2 months after implantation. Results: The mean of the largest turns of the arrays within the cochlea was 4.2 ± 0.5 mm in the SM group and 4.9 ± 1.1 mm in the CA group. 'Auto power' was 44.81 ± 5.05% and 50.85 ± 8.35% with SM and CA, respectively. Estimated energy consumption was lower with SM. The differences were statistically significant. Conclusion: Our measurements for a large cohort in each group suggest that the SM electrode array takes a significantly closer position to the modiolus than the CA. This finding supports our earlier electrophysiological result and indicates better performance abilities. Orv Hetil. 2019; 160(31): 1216-1222.


Assuntos
Cóclea/diagnóstico por imagem , Implante Coclear/instrumentação , Implante Coclear/métodos , Implantes Cocleares , Discriminação da Altura Tonal/fisiologia , Radiografia/métodos , Cóclea/cirurgia , Eletrodos Implantados , Humanos
9.
Dis Aquat Organ ; 132(3): 181-189, 2019 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31188133

RESUMO

Apicomplexan-X (APX) is a significant pathogen of the flat oyster Ostrea chilensis in New Zealand. The life cycle and host range of this species are poorly known, with only the zoite stage identified. Here, we report the use of molecular approaches and histology to confirm the presence of APX in samples of green-lipped mussels Perna canaliculus, Mediterranean mussels Mytilus galloprovincialis and hairy mussels Modiolus areolatus collected from widely distributed locations in New Zealand. The prevalence of APX infection estimated by PCR was 22.2% (n = 99) and 50% (n = 30) in cultured green-lipped mussels from Nelson and Coromandel, respectively; 0.8% (n = 258), 3.3% (n = 150) and 35.3% (n = 17) in wild Mediterranean mussels from Nelson, Foveaux Strait and Golden Bay, respectively; and 46.7% (n = 30) in wild hairy mussels from Foveaux Strait. Histology detected all cases of PCR that were positive with APX and appeared to be more sensitive. The prevalence of APX estimated by histology in green-lipped mussels from Coromandel was 60% versus 50% by PCR, and 4.3%, 10.7% and 52.9% by histology versus 0.8%, 3.3% and 35.3% by PCR in wild Mediterranean mussels from Nelson, Foveaux Strait and Golden Bay, respectively. The specific identity of the parasite found in mussels was determined by sequencing PCR products for a portion (676 bp) of the 18S rRNA gene; the resulting sequences were 99-100% similar to APX found in flat oysters. Phylogenetic analyses also confirmed that all isolates from green-lipped, Mediterranean and hairy mussels grouped with APX isolates previously identified from flat oysters. This study indicates the wide geographical distribution of APX and highlights the potentially multi-host specific distribution of the parasite in commercially important bivalve shellfish.


Assuntos
Ostrea , Animais , Nova Zelândia , Filogenia , Reação em Cadeia da Polimerase
10.
Mitochondrial DNA B Resour ; 4(2): 4057-4058, 2019 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33366316

RESUMO

In this study, the complete mitochondrial genome of Modiolus comptus was determined and annotated for the first time. The 15,591 bp circular genome has a base composition of 24.3% A, 38.6% T, 12.5% C, and 24.5% G, demonstrating a bias of higher AT content (63.0%) than GC content (27.0%). The mitochondrial genome contains 12 protein-coding genes (PCGs), 20 transfer RNA genes (tRNA), 2 ribosomal RNA genes (12S rRNA and 16S rRNA), and one control region. All genes of M. comptus were encoded on the heavy strand, except trnT(ugu) gene. The whole mitochondrial genome of M. comptus and 21 mitogenomes of other Mytilidae species were used for phylogenetic analysis. The result indicated the newly sequenced species had the closest relationship with Modiolus nipponicus (MK721547) and was clustered within the clade of genus Modiolus.

11.
Am J Otolaryngol ; 39(5): 489-492, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29805061

RESUMO

PURPOSE: Determine the effect of cochleostomy and facial recess packing on cochlear implant electrode distance from the modiolus. MATERIALS AND METHODS: Two otolaryngology residents (PGY5 and PGY6) and one attending ear surgeon performed electrode insertions on a human cochlea model using perimodiolar (Cochlear® Slim Modiolar 532™, CI532) and lateral wall electrodes (Cochlear® Slim Straight 522™, CI522) via a cochleostomy. Packing material was simulated using cotton and placed in the cochleostomy and facial recess under the following conditions: 1) inferior to the electrode, 2) superior, 3) both inferior and superior, and 4) no packing. Distance of the electrode from the modiolus at the proximal, middle, and distal basal turn of the cochlea were measured by photomicrograph analysis. RESULTS: Packing superior to the CI532 resulted in a significant decrease in distance from the modiolus at the middle and distal basal turn compared to the inferior condition, with the largest effect in the middle basal turn (0.25 mm vs. 1.92 mm, respectively, p < 0.001). For the CI522, packing superior similarly resulted in decreased distance to the modiolus when compared to the inferior packing condition at the middle and distal basal turn regions, with the largest effect in the middle basal turn (1.25 mm vs. 1.75 mm, respectively, p = 0.002). CONCLUSIONS: Packing of the cochleostomy site and facial recess has a significant effect on electrode distance from the modiolus in the middle and distal basal turn using a model of a human cochlea. Effects were more pronounced when using the perimodiolar (CI532) electrode.


Assuntos
Competência Clínica , Implante Coclear/métodos , Implantes Cocleares , Eletrodos Implantados , Treinamento por Simulação/métodos , Educação de Pós-Graduação em Medicina/métodos , Humanos , Internato e Residência/métodos , Modelos Anatômicos , Otolaringologia/educação , Projetos Piloto , Janela da Cóclea/cirurgia
12.
Mar Environ Res ; 135: 18-28, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29402517

RESUMO

The horse mussel Modiolus modiolus (L.) is a large marine bivalve that aggregates to create complex habitats of high biodiversity. As a keystone species, M. modiolus is of great importance for the functioning of marine benthic ecosystems, forming biogenic habitats used to designate Marine Protected Areas (MPAs). The present study investigates the condition of M. modiolus beds historically subjected to intense scallop fishing using mobile fishing gears. The study, conducted seven years after the introduction of legislation banning all forms of fishing, aimed to establish whether natural habitat recovery occurs after protection measures are put in place. Lower biodiversity and up to 80% decline in densities of M. modiolus were recorded across the current distributional range of the species in Strangford Lough, Northern Ireland. The decline in biodiversity in most areas surveyed was consistent with that observed in biogenic reefs impacted by mobile fishing gears elsewhere. Epifauna, including sponges, hydroids and tunicates, experienced the most substantial decline in biodiversity, with up to 64% fewer taxa recorded in 2010 compared with 2003. Higher variability in community composition and a shift towards faunal assemblages dominated by opportunistic infaunal species typical of softer substrata were also detected. Based on these observations we suggest that, for biogenic habitats, the designation of MPAs and the introduction of fishing bans alone may not be sufficient to reverse or halt the negative effects caused by past anthropogenic impacts. Direct intervention, including habitat restoration based on translocation of native keystone species, should be considered as part of management strategies for MPAs which host similar biogenic reef habitats where condition and natural recovery have been compromised.


Assuntos
Biodiversidade , Conservação dos Recursos Naturais/métodos , Pesqueiros , Peixes , Animais , Ecossistema , Mytilidae , Irlanda do Norte
13.
Artigo em Chinês | MEDLINE | ID: mdl-29871199

RESUMO

Objective:The purpose of this study was analyzing the characteristic of the electrically evoked auditory brainstem responses (EABR) of cochlear implantation (CI) patients with absence of cochlear modiolus (ACM) and comparing the EABR results in deaf patients with normal anatomic structures. Also we assessed the auditory rehabilitation of ACM patients after cochlear implantation.Method:Twenty-eight profoundly deaf patients were contained, 14 of them were ACM (group A) and the rest were normal anatomic structures (group B). They all received Austria cochlear implants from 2004 to 2015. Postoperative EABR were measured and recorded with No. 2, 6, 11 electrodes in patients receving cochlear implantation. The lead-out rate and threshold of EABR between groups were compared and analyzed. Result:The lead-out rates of EABR in group A was 71.4% and group B was 100%. The thresholds of EABR in group A were higher than group B (P< 0.05). In group A, there were no statistical difference in the thresholds of EABR among electrodes No.2,6 and 11. However, in group B, there were statistical difference in the thresholds of EABR between electrodes No.2 and 11 (P< 0.05), and the thresholds of No.2 was lower than No.11Conclusion:EABR could be used in assessing the objective auditory rehabilitation in ACM patients after cochlear implantation.


Assuntos
Cóclea/fisiopatologia , Implante Coclear , Implantes Cocleares , Surdez/cirurgia , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Limiar Auditivo , Surdez/fisiopatologia , Humanos , Período Pós-Operatório
14.
Methods Mol Biol ; 1427: 513-23, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27259946

RESUMO

Spiral ganglion neurons (SGNs) faithfully encode acoustic waves from hair cells to the cochlear nucleus (CN) using voltage-dependent ion channels. A sizable portion of our knowledge on SGN functions have been derived from pre-hearing neurons. In post-hearing SGNs, the mechanisms of how they encode the massive sound information without delay and precisely are largely unknown. Mature SGNs are housed in the central bony labyrinth of the cochlea, protected by a well-insulated myelin sheath, making it a technical feat to isolate viable neurons for rigorous functional electrophysiology. Recently, we have overcome the previous intractable hindrance in SGN functional analyses. We provide a step-by-step user-friendly protocol with practical applications, including patch-clamp recordings and imaging by using cultured SGNs.


Assuntos
Cóclea/citologia , Neurônios/fisiologia , Gânglio Espiral da Cóclea/citologia , Animais , Células Cultivadas , Cóclea/fisiologia , Canais Iônicos , Camundongos , Técnicas de Patch-Clamp , Gânglio Espiral da Cóclea/fisiologia
15.
Hear Res ; 330(Pt A): 106-12, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26299844

RESUMO

An artificial cochlear sensory epithelium has been developed on the basis of a new concept that the piezoelectric membrane, which converts mechanical distortion into electricity, can mimic the function of the inner hair cell and basilar membrane of the mammalian cochlea. Our previous research demonstrated that the piezoelectric membrane generated electrical outputs in response to the sound stimulation after implantation into the guinea pig cochlea, whereas electrodes for the stimulation of spiral ganglion neurons have not been fabricated, and a method to fix the device in the cochlea is also required to show proof-of-concept. In the present study, to achieve proof-of-concept of hearing recovery by implantation of the artificial cochlear sensory epithelium, we fabricated new electrodes that stick into the cochlear modiolus, which also play a role in the fixation of the device in the cochlea. The efficacy of new electrodes for fixation of the device in the cochlea and for the stimulation of spiral ganglion neurons was estimated in guinea pigs. Four weeks after implantation, we confirmed that the devices were in place. Histological analysis of the implanted cochleae revealed inconspicuous fibrosis and scar formation compared with the sham-operated specimens (n = 5 for each). The terminal deoxynucleotidyl transferase dUTP nick end labeling method was used to assess cell death due to surgical procedures in the cochleae that were harvested after 1 day (n = 6) and 7 days (n = 6) of implantation; there was no significant increase in apoptotic cell death in the implanted cochleae compared with sham-operated cochleae. In seven animals, serial measurements of electrically evoked auditory brainstem responses were obtained, with the electrode positioned in the scala tympani and with the electrode inserted into the cochlear modiolus. With the insertion of electrodes into the cochlear modiolus, significant reduction was achieved in the thresholds of electrically evoked auditory brainstem responses compared with those placed in the scala tympani (p = 0.028). These findings indicated that the new electrodes efficiently fixed the device in the cochlea and were able to stimulate spiral ganglion neurons.


Assuntos
Cóclea/fisiologia , Implantes Cocleares , Eletrodos , Epitélio/metabolismo , Gânglio Espiral da Cóclea/fisiologia , Animais , Apoptose , Membrana Basilar/fisiologia , Implante Coclear , Estimulação Elétrica , Desenho de Equipamento , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Fibrose/patologia , Cobaias , Células Ciliadas Auditivas Internas/fisiologia , Perda Auditiva Neurossensorial/terapia , Imuno-Histoquímica , Inflamação , Agulhas , Neurônios/metabolismo , Rampa do Tímpano/patologia , Uridina Trifosfato/química
16.
J Surg Tech Case Rep ; 4(1): 58-60, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23066468

RESUMO

A 56-year-old woman with a recurrent depressed scar of the commissure, treated with a nasolabial island flap, is presented. On examination, the scar was located on the right modiolus involving the right upper gingivobuccal sulcus. A history of recurrent canine abscess was obtained. After excision of the scar and release of the vestibular fold, reconstruction of the defect was performed with a nasolabial island flap from the same side. The postoperative course was uneventful, with a good aesthetic and functional outcome.

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