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1.
Orv Hetil ; 161(19): 780-788, 2020 05.
Artigo em Húngaro | MEDLINE | ID: mdl-32365050

RESUMO

Otosclerosis is a human-specific ear disease characterised by complex bone-remodelling with multifactorial aetiology. It affects the bony labyrinth capsule and consequently fixates the stapes to the oval window rim. The fixation of the ossicular chain leads to a decrease in the middle ear's acoustic impedance-fitting and amplifier function that leads to conductive hearing loss. The process is progressive and when it involves the inner ear structures, it deteriorates the sensorineural function as well. The course of the illness can be prevented or delayed if hearing reconstructive surgery is performed on time. The development of stapes surgery spans the 20th century, and despite the major surgical steps - laid down by Shea and Marquet in the 1960s - are quite conservative, fine adjustments are still being made mainly due to technical progress. Several studies confirm that stapedotomy remained the first-to-offer therapeutic option in otosclerosis. With an adequate surgical technique, significant improvement can be achieved in the air conduction threshold, the air-bone gap may be minimalized or ceased over the speech frequencies, which significantly improves the quality of life of the patients. In this quest, we reviewed the Hungarian and the international literature as well in context with otosclerosis, with special attention to the newest methods in diagnostics and treatment management. Orv Hetil. 2020; 161(19): 780-788.


Assuntos
Perda Auditiva/cirurgia , Prótese Ossicular , Otosclerose/cirurgia , Cirurgia do Estribo/métodos , Condução Óssea/fisiologia , Perda Auditiva/etiologia , Perda Auditiva Condutiva , Humanos , Otosclerose/complicações , Otosclerose/diagnóstico , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento
3.
J Laryngol Otol ; 134(4): 293-301, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32301406

RESUMO

BACKGROUND: Ménière's disease is a debilitating chronic peripheral vestibular disorder associated with psychiatric co-morbidities, notably depression. METHODS: Database searches were performed to identify studies that assessed depression in Ménière's disease. Metrics used to diagnose depression were extracted, along with the prevalence of depression in each study. RESULTS: Fifteen studies from 8 different countries reported on 6587 patients. The weighted average age was 55.3 years (range, 21-88 years). Depression was measured by eight different scales, with Zung's Self-Rating Depression Scale used most often. A weighted proportion of 45.9 per cent of patients (confidence interval = 28.9-63.3) were depressed. Weighted averages (± standard deviations) of Beck's Depression Inventory and the Illness Behavior Questionnaire - Dysphoria were 8.5 ± 7.9 and 2.4 ± 1.7, respectively. CONCLUSION: The prevalence of depression in patients with Ménière's disease is nearly 50 per cent. Treating otolaryngologists should have a low threshold to screen and refer appropriately. Identifying and treating depression should allow for improvement of overall quality of life in patients with Ménière's disease.


Assuntos
Depressão/epidemiologia , Depressão/psicologia , Doença de Meniere/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Depressão/diagnóstico , Depressão/etiologia , Feminino , Perda Auditiva/diagnóstico , Perda Auditiva/etiologia , Humanos , Masculino , Doença de Meniere/complicações , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Índice de Gravidade de Doença , Zumbido/diagnóstico , Zumbido/etiologia , Vertigem/diagnóstico , Vertigem/etiologia
4.
Medicine (Baltimore) ; 99(13): e19651, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32221091

RESUMO

RATIONALE: Intracranial solitary fibrous tumors (SFTs) and hemangiopericytomas (HPCs) are rare spindle cell tumors of mesenchymal origin that include benign and malignant neoplasms. PATIENT CONCERNS: We present a 66-year-old male with a 5-year history of headache and dizziness, with left progressive sensorineural hearing loss over 1 month. DIAGNOSES: WHO grade II SFT/HPC originating from the internal auditory canal in the left cerebellopontine angle. INTERVENTIONS: surgical resection. OUTCOMES: No local recurrence or metastases were observed in the follow-up 3 months after the surgery. LESSONS: Intracranial SFTs/HPCs are rare mesenchymal neoplasms that are challenging to manage. If the imaging characteristics of tumor are not typical, clinicians should depend on tissue biopsy and immunohistochemistry to make a definitive diagnosis.


Assuntos
Neoplasias Cerebelares/patologia , Ângulo Cerebelopontino/patologia , Hemangiopericitoma/patologia , Tumores Fibrosos Solitários/patologia , Idoso , Neoplasias Cerebelares/diagnóstico , Neoplasias Cerebelares/cirurgia , Diagnóstico Diferencial , Tontura/etiologia , Cefaleia/etiologia , Perda Auditiva/etiologia , Hemangiopericitoma/diagnóstico , Hemangiopericitoma/cirurgia , Humanos , Masculino , Gradação de Tumores , Neuroma Acústico/diagnóstico , Tumores Fibrosos Solitários/diagnóstico , Tumores Fibrosos Solitários/cirurgia
5.
Ann Otol Rhinol Laryngol ; 129(8): 821-828, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32126822

RESUMO

INTRODUCTION: Middle ear pathologies have been linked with HIV. The onset and development of these pathologies in individuals with HIV have not been categorized; and clarity has not been gained regarding whether their presentation is any different in this population when compared to HIV negative control group. PURPOSE: The aim of this study was to explore and document published evidence reflecting trends in middle ear pathologies in adults living with HIV. METHODS: A systematic review of literature from January 1982 to December 2018 was conducted using Medline, CINAHL, PubMed, and Psych Info. Studies that reported the occurrence rate of middle ear pathologies in adults with HIV and published in English were included. RESULTS: Twelve articles met the inclusion criteria. Evidence suggests that the reported occurrence rates of middle ear pathologies ranges from 2.5% to 58% in this population. The variability in assessment measures as well as the different cut-off criteria used in studies seem to have an influence in the findings, with pure tone audiometry identifying more middle ear pathologies in the current review than tympanometry with 226 Hz probe tone and clinical examination. Otitis media, conductive hearing loss, and type B tympanogram were common findings reported in this study. No evidence of an association between the use of antiretroviral therapy (ART) and the rates of middle ear pathologies was found. CONCLUSION: Although there are very few studies that have reported on middle ear pathologies in adults living with HIV, the available studies have sufficiently established a link between HIV and middle ear disease in this population, and have revealed that the rate of occurrence is influenced by a number of factors. Key amongst these is the type of assessment measure used. Careful analysis of middle ear pathologies in this population through well controlled research designs that include different assessment measures. The use of case-control and longitudinal designs to determine differences between groups and to establish the time of onset and development of middle ear pathologies is required.


Assuntos
Orelha Média/diagnóstico por imagem , Infecções por HIV/complicações , HIV , Perda Auditiva/epidemiologia , Testes de Impedância Acústica , Adulto , Audiometria de Tons Puros , Perda Auditiva/diagnóstico , Perda Auditiva/etiologia , Humanos
6.
Medicine (Baltimore) ; 99(11): e19284, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176052

RESUMO

High levels of albuminuria have been demonstrated to associate with hearing loss in non-diabetic people, while the clinical impact of low-grade albuminuria has attracted less attention. This cross-sectional population-based study aimed to examine whether hearing loss in non-diabetic United States (US) adults is independently associated with low-grade albuminuria or reduced estimated glomeruli filtration rate (eGFR).A total of 2518 participants aged 20 to 69 years were selected from the US National Health and Nutritional Examination Survey database. Participants with diabetes or high-grade albuminuria were excluded. Hearing loss was assessed using low-frequency pure-tone average (LFPTA) thresholds (0.5, 1.0, 2.0 kHz) and high-frequency pure-tone average (HFPTA) thresholds (3.0, 4.0, 6.0, 8.0 kHz). Logistic and linear regression analyses were used to evaluate associations between renal function indicators and hearing loss.The median age of included participants was 37.4 years, and 55% of them were female. Multivariate analysis revealed that participants with urinary albumin-to-creatinine ratio (UACR) in the highest tertile had a significantly higher risk of hearing loss (OR, 1.79; 95% CI, 1.01-3.19) and higher HFPTA thresholds (ß: 2.23; SE: 0.77). Participants with eGFR <60 mL/min/1.73 m had higher LFPTA thresholds (ß: 4.31; SE: 1.79). After stratification by sex, a significant risk remained only for males in the highest UACR tertile, with 2.18 times the risk of hearing loss (95% CI, 1.06-4.48).Non-diabetic US males with low-grade albuminuria are at increased risk of hearing loss, independent of eGFR.


Assuntos
Albuminúria/complicações , Albuminúria/diagnóstico , Comorbidade , Perda Auditiva/epidemiologia , Perda Auditiva/etiologia , Adulto , Distribuição por Idade , Idoso , Audiometria/métodos , Glicemia/análise , Estudos Transversais , Diabetes Mellitus , Taxa de Filtração Glomerular , Perda Auditiva/diagnóstico , Humanos , Incidência , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Inquéritos Nutricionais , Valores de Referência , Medição de Risco , Índice de Gravidade de Doença , Estados Unidos , Urinálise/métodos
7.
Medicine (Baltimore) ; 99(11): e19487, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176085

RESUMO

RATIONALE: Chondromyxoid fibroma (CMF) is a rare form of benign bone tumor and easily misdiagnosed as fibrosarcoma. Hence, to explore the clinical manifestations, diagnostic tests, and therapeutic procedures for temporal bone cartilage myxoid fibroma, it is important to optimize patient treatment and avoid overtreatment. Previous research has discussed cases of CMF, but this paper presents a systematic, complete, and comprehensive introduction of this disease based on this case and related literature. PATIENT CONCERNS: A 52-year-old male patient presented with pain in his right ear for 2 years and hearing loss in his right ear with tinnitus for 1 year. The patient had a history of hypertension for 9 years and it was well-controlled. DIAGNOSIS: A computed tomography (CT) scan of the temporal bone showed an expansive growth on the right temporal bone plate and tympanic plate, presenting as a cloud-like ground glass opaque shadow involving the temporom and ibular joint, middle skull base, and small auditory bones. A magnetic resonance imaging (MRI) of the temporal bone showed a large and irregular soft tissue mass shadow on the right temporal bone plate. The right temporal bone plate was occupied by the lesion, consistent with a bone origin. From the results of the imaging examination of the patient, a lesion occupying the temporal bone in the right ear and mastoiditis in the right middle ear was initially diagnosed. INTERVENTIONS: Right ear temporal bone tumor resection and abdominal fat extraction were conducted. OUTCOMES: Postoperative pathological results demonstrated myxoid fibroma of the temporal bone cartilage. No recurrence or severe complications were observed in 8 months of follow-up. LESSONS: A finding of myxoid fibroma of the temporal bone cartilage is rare in the clinic. The growth of such tumors is slow. The temporal bone CT and inner ear MRI were helpful in diagnosis. Surgery was the principal treatment.


Assuntos
Condroma/diagnóstico por imagem , Neoplasias Cranianas/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem , Condroma/complicações , Condroma/cirurgia , Diagnóstico Diferencial , Perda Auditiva/etiologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias Cranianas/complicações , Neoplasias Cranianas/cirurgia , Zumbido/etiologia , Tomografia Computadorizada por Raios X
8.
HNO ; 68(3): 143-149, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-32030453

RESUMO

The aging of society observed during the past century in industrialized countries has not only led to a longer life expectancy, but also an increased frequency of age-related diseases and multimorbidity. In addition to dysphagia and vertigo, sensory deficits such as olfaction and hearing disorders are common in elderly persons and have a significant influence on quality of life. Alzheimer's disease is the most common form of dementia. Epidemiological studies have recently shown that disorders of olfaction and hearing are not only associated with dementia, but also represent specific risk factors for development and progression of the disease. Recognition and adequate treatment, e.g., of hearing loss, by otorhinolaryngologists is thus assuming an increasingly important role, not only to preserve patients' quality of life, but also to reduce the risk of developing dementia in the future.


Assuntos
Demência , Perda Auditiva , Idoso , Demência/complicações , Demência/terapia , Progressão da Doença , Transtornos da Audição , Perda Auditiva/etiologia , Perda Auditiva/terapia , Humanos , Qualidade de Vida
9.
Codas ; 32(1): e20180278, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32049152

RESUMO

PURPOSE: To compare the frequency of risk indicators in preterm and full-term babies; to analyze the possible relationships among the presence of risk for hearing loss with language acquisition and socioeconomic, demographic and obstetric variables. METHODS: This is a longitudinal cohort study, with a sample of 87 babies. Gestational, obstetric and sociodemographic data were collected from mothers and babies. The socioeconomic classification status of the families were classified using the Brazilian Criteria for Economic Classification. The risk for language was assessed using the Language Acquisition Enunciation Signs and the Denver II test. The data were analyzed using the STATISTICA 9.1 software, using the chi-square and the Mann-Whitney U tests and simple and multiple linear regression models. RESULTS: Permanence in a neonatal intensive care (65.52%), ototoxic (48.28%), mechanical ventilation (39.66%) and hyperbilirubinemia (46.55%) were the more frequent risk indicators in the sample. Regarding socioeconomic, demographic and obstetric factors, there was a correlation among prenatal care, gestational age, birth weight, feeding with hearing risk. Acquisition and development of language showed statistical significance with varicella, HIV, Apgar score and birth weight >1500 grams. CONCLUSION: Preterm babies showed higher frequency of risk indicators compared to full-term babies. Among environmental factors, prenatal care, which interferes in the outcome of gestational age, birth weight, Apgar score and presence of infectious diseases, as well as feeding, emerged as significant factors related to hearing and language acquisition. Prematurity was the relevant biological factor related to hearing and language risk.


Assuntos
Surdez/etiologia , Perda Auditiva/etiologia , Estudos de Coortes , Surdez/prevenção & controle , Feminino , Perda Auditiva/prevenção & controle , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Desenvolvimento da Linguagem , Estudos Longitudinais , Masculino , Nascimento Prematuro , Cuidado Pré-Natal , Fatores de Risco , Fatores Socioeconômicos
10.
Otolaryngol Head Neck Surg ; 162(4): 530-537, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31986971

RESUMO

OBJECTIVE: To ascertain the relationship among vestibular schwannoma (VS) tumor volume, growth, and hearing loss. STUDY DESIGN: Retrospective cohort study. SETTING: Single tertiary center. SUBJECTS AND METHODS: Adults with observed VS and serviceable hearing at diagnosis were included. The primary outcome was the development of nonserviceable hearing as estimated using the Kaplan-Meier method. Associations of tumor volume with baseline hearing were assessed using Spearman rank correlation coefficients. Associations of volume and growth with the development of nonserviceable hearing over time were assessed using Cox proportional hazards models and summarized with hazard ratios (HRs). RESULTS: Of 230 patients with VS and serviceable hearing at diagnosis, 213 had serial volumetric tumor data for analysis. Larger tumor volume at diagnosis was associated with increased pure-tone average (PTA) (P < .001) and decreased word recognition score (WRS) (P = .014). Estimated rates of maintaining serviceable hearing at 6 and 10 years following diagnosis were 67% and 49%, respectively. Larger initial tumor volume was associated with development of nonserviceable hearing in a univariable setting (HR for 1-cm3 increase: 1.36, P = .040) but not after adjusting for PTA and WRS. Tumor growth was not significantly associated with time to nonserviceable hearing (HR, 1.57; P = .14), although estimated rates of maintaining serviceable hearing during observation were poorer in the group that experienced growth. CONCLUSION: Larger initial VS tumor volume was associated with poorer hearing at baseline. Larger initial tumor volume was also associated with the development of nonserviceable hearing during observation in a univariable setting; however, this association was not statistically significant after adjusting for baseline hearing status.


Assuntos
Perda Auditiva/etiologia , Neuroma Acústico/complicações , Neuroma Acústico/patologia , Carga Tumoral , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
11.
Int J Pediatr Otorhinolaryngol ; 128: 109685, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31610440

RESUMO

BACKGROUND: Hearing assessment in children is considered necessary in all cases involving a doubt regarding hearing acuity. Due to the fact that the number of referrals may be much greater than the actual capacity of a hearing institute, it would be desirable to have a filtering tool in order to detect the cases with higher suspicion of hearing loss. OBJECTIVE: To evaluate whether anamnesis details can be used as a sorting tool for detection of highly suspicious cases of hearing loss in preschool children. The anamnesis details may be one or more of the following: the reason for performing hearing test, which caregiver indicated the need for hearing evaluation, the parent's comprehension of their child hearing, and the medical history. METHODS: the parents of preschool children, who were referred to the hearing institute at Soroka university medical center, were asked to fill a questionnaire containing 18 questions. The questions referred to details such as: the reason for performing the hearing test; who suggested the existence of hearing impairment; medical history issues and questions regarding details that may indicate a risk of hearing loss. Details such as Otoscopy results were taken from the medical record of the patient. RESULTS: 317 preschool and school patients were recruited to the study. Hearing loss was found in 42% of the cases. The most common reason for performing the hearing test was speech disturbance (33%). In cases which the parents were those who raised the suspicion of hearing loss - hearing impairment was found in 61% of the cases, compared to 36% when the speech therapist was the one raising the doubts and to only 18% when the kindergarten teacher was the one raising the doubt. The positive predictive value of patient that their parents suspected the hearing loss combined with pathologic otoscopy result was 82.6% when the reason for the test was hearing impairment suspicion, and 91.3% when the reason for the hearing test was speech disturbance. CONCLUSIONS: Parents are the best in assessing their child's hearing followed by the speech therapist and the least sensitive is the school teacher.


Assuntos
Perda Auditiva/diagnóstico , Encaminhamento e Consulta , Criança , Pré-Escolar , Feminino , Perda Auditiva/etiologia , Testes Auditivos , Humanos , Masculino , Anamnese , Pais , Valor Preditivo dos Testes , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Professores Escolares , Fonoterapia
13.
Int J Pediatr Otorhinolaryngol ; 128: 109691, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31562995

RESUMO

OBJECTIVE: The objective of this study was to establish the local incidence of hearing screening failure rate in newborns with all three stages of hypoxic ischemic encephalopathy (HIE). METHODS: This retrospective cohort study was undertaken in a tertiary neonatal intensive care unit. Medical records and hearing secreening test results were collected for two years. RESULTS: One hundred and ninety seven infants diagnosed with HIE, 20 of them died, 177 screened. Thirty five of 177 (19%) infants failed in screening test for hearing. Screening failure rate was 10/51 (19%), 20/105 (19%) and 5/21 (23%) in stage 1, 2 and 3, respectively and did not differ between HIE stages (p = 0.88). Furthermore failure rates were similar between infants who received therapeutic hypothermia or not (20% vs 19%, p = 0.84). CONCLUSION: Hearing screening failure rate in HIE is quite high even in Stage 1 infants. Management and treatment of these infants should be made carefully concerning additional risks for hearing loss and long term follow-up even in Stage 1 HIE infants should be planned strictly.


Assuntos
Perda Auditiva/diagnóstico , Testes Auditivos , Hipóxia-Isquemia Encefálica/complicações , Triagem Neonatal , Feminino , Perda Auditiva/congênito , Perda Auditiva/epidemiologia , Perda Auditiva/etiologia , Humanos , Incidência , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Estudos Retrospectivos , Fatores de Risco
14.
Arch Dis Child ; 105(2): 187-189, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-30498058

RESUMO

OBJECTIVE: While several perinatal risk factors for permanent childhood hearing impairment (PCHI) are known, association with gestational length remains unclear. We hypothesised that shorter gestational length predicts higher PCHI risk. DESIGN: 19 504 participants from the UK Millennium Cohort Study (born 2000-2002, prior to newborn screening). METHODS: Multivariable discrete-time survival analysis to examine associations between parent-reported PCHI by age 11 years and gestational length, plus other prespecified factors. RESULTS: PCHI affected 2.1 per 1000 children (95% CI 1.5 to 3.0) by age 11; however, gestational length did not predict PCHI risk (HR, 95% CI 1.00, 0.98 to 1.03 per day increase). Risk was increased in those with neonatal illness, with or without admission to neonatal care (6.33, 2.27 to 17.63 and 2.62, 1.15 to 5.97, respectively), of Bangladeshi or Pakistani ethnicity (2.78, 1.06 to 7.31) or born to younger mothers (0.92, 0.87 to 0.97 per year). CONCLUSION: Neonatal illness, rather than gestational length, predicts PCHI risk. Further research should explore associations with ethnicity.


Assuntos
Perda Auditiva/epidemiologia , Criança , Feminino , Idade Gestacional , Perda Auditiva/etiologia , Humanos , Recém-Nascido , Doenças do Recém-Nascido , Masculino , Estudos Prospectivos , Medição de Risco , Fatores de Risco
15.
Ann Otol Rhinol Laryngol ; 129(4): 380-387, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31771342

RESUMO

PURPOSE: To compare intra- and postoperative outcomes between the standard linear incision with tissue preservation and the Minimally Invasive Ponto Surgery (MIPS). STUDY DESIGN: A non-randomized retrospective cohort series. METHODS: Medical files were reviewed of adult and pediatric bone anchored hearing implant recipients. Extracted outcomes included patient characteristics, implant survival, operative time, anesthesia use, intra and postoperative complications, soft tissue tolerability assessed by the Holger's classification, and implant stability assessed by the Resonance Frequency Analysis (RFA). Outcomes were compared between two surgeries. RESULTS: A total of 59 implants were placed (21 MIPS; 38 linear). Conductive hearing loss was the most common etiology for implantation. Surgery was conducted under local anesthesia in 67% of MIPS patients and 16% of linear patients. No intraoperative complications were reported for both surgical approaches and no implants were lost. Patients undergoing implantation via the MIPS approach displayed less skin reaction postoperatively, however this was not significant (P = .2848). The most common Holgers score for both groups was grade 1. The median and mean surgical duration for the MIPS group was statistically lower than the linear group (P = .0001). Implant stability measured by the RFA implant stability quotient was greater in the MIPS cohort. CONCLUSION: The MIPS approach seems either similar or superior to the linear approach in all perioperative outcomes evaluated. Outcomes such as surgical duration, anesthesia choice and implant stability measurements support implantation through the MIPS approach for patients meeting eligibility criteria.


Assuntos
Prótese Ancorada no Osso , Perda Auditiva , Complicações Pós-Operatórias , Implantação de Prótese , Adulto , Anestesia/métodos , Anestesia/estatística & dados numéricos , Canadá/epidemiologia , Criança , Feminino , Perda Auditiva/diagnóstico , Perda Auditiva/etiologia , Perda Auditiva/cirurgia , Testes Auditivos/métodos , Testes Auditivos/estatística & dados numéricos , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Duração da Cirurgia , Avaliação de Processos e Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Falha de Prótese , Implantação de Prótese/efeitos adversos , Implantação de Prótese/métodos , Retenção da Prótese/métodos , Retenção da Prótese/estatística & dados numéricos , Estudos Retrospectivos
16.
J Craniofac Surg ; 31(2): 468-471, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31842083

RESUMO

OBJECTIVES: The aim of the present study is to investigate effect of hypertension and diabetes on neuroelectrophysiology, outcomes and complications in patients with hemifacial spasm (HFS) treated by microvascular decompression (MVD). METHODS: From June 2014 to December 2016, 476 consecutive HFS patients who had undergone MVD were divided into 2 groups according to the presence or absence of comorbidities: diabetic group (n = 26) versus non-diabetic group (n = 450), and hypertensive group (n = 141) versus normotensive group (n = 335). Relevant patient data, including preoperative and postoperative neuroelectrophysiology, operative findings, outcome of MVD and complications, were collected and analyzed retrospectively over the 2-year follow-up period. The impact of hypertension and diabetes on the clinical features of HFS patients was investigated by using logistic regression models. RESULTS: Brainstem auditory evoked potential (BAEP), postoperative prognosis and abnormal muscle response (AMR) were not different between any of the 2 groups. Preoperative positive AMR occurred more frequently in the nondiabetic group than diabetic group [OR = 0.202, P = 0.004], whereas hypertension was not independently predictive for neuroelectrophysiology in patients with HFS. Adjusted multivariate analysis indicated that hypertension was the only clinical factor associated with MVD-related complications [OR = 0.482, P = 0.007] and hearing impairment [OR = 0.28, P = 0.004] after various potential confounders were taken into account, whereas diabetes was not predictive for postoperative complications. CONCLUSIONS: Diabetes is associated with low positive rate of preoperative AMR, thus weakening the predictive role of AMR for successful MVD. Hypertension may be an independent risk factor for hearing impairment after MVD.


Assuntos
Complicações do Diabetes , Diabetes Mellitus , Espasmo Hemifacial/cirurgia , Hipertensão/complicações , Perda Auditiva/etiologia , Espasmo Hemifacial/etiologia , Humanos , Modelos Logísticos , Cirurgia de Descompressão Microvascular/efeitos adversos , Complicações Pós-Operatórias , Período Pós-Operatório , Prognóstico , Estudos Retrospectivos
17.
Am J Otolaryngol ; 41(1): 102338, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31732318

RESUMO

OBJECTIVES: To report and analyze three cases of subtotal petrosectomy (SP) in cochlear implant surgery at our institution, and establish the indications, surgical technique and complications encountered. MATERIALS AND METHOD: A retrospective descriptive study is proposed, analyzing a series of three clinical cases of subtotal petrosectomy as surgical technique for cochlear implant surgery at San Ignacio University Hospital (Bogotá, Colombia) from year 2004 to 2019. RESULTS: A total of three cases of subtotal petrosectomy as surgical technique in cochlear implant candidates were analyzed. The indications were the presence of a wide mastoid cavity after canal wall down mastoidectomy, extrusion of the electrode into the external auditory canal with a wide mastoid cavity and erosion of the posterior wall of the ear canal, and the presence of cholesteatoma in a cophotic ear with previous surgery. The ear canal was defunctionalized in all three cases; in two of them with obliteration of the Eustachian tube and in none of the cases the mastoid was obliterated. There was a single complication associated with the procedure corresponding to a small retention cholesteatoma in the skin of the obliterated duct sac, that didn't required surgical intervention. CONCLUSION: Subtotal petrosectomy is a surgical alternative for cochlear implant surgery in patients with chronic ear pathology, wide cavities or cochlear implant extrusion, not associated to significant complications.


Assuntos
Implante Coclear/métodos , Perda Auditiva/cirurgia , Osso Petroso/cirurgia , Adolescente , Idoso , Perda Auditiva/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Osso Petroso/diagnóstico por imagem , Tomografia Computadorizada por Raios X
18.
Otolaryngol Head Neck Surg ; 162(2): 211-214, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31842677

RESUMO

Vestibular schwannomas (VSs) were proposed to arise from the glial-Schwann cell junction within the internal auditory canal (IAC). However, otopathology studies indicate that VS may arise anywhere along the course of the vestibular nerve. Recent studies suggested that the majority of tumors are located centrally within the IAC with an equal distribution near the porus acusticus and the fundus. However, these studies analyzed tumors of all sizes, obscuring their precise origin. Herein, we aim to quantify the position of small intracanalicular tumors (<5 mm), assessing hearing outcomes and growth patterns in relation to tumor position. Of the 38 small intracanalicular tumors analyzed, 61% originated closest to the fundus, 34% at the midpoint, and only 5% closest to the porus acusticus. Tumors were observed with serial magnetic resonance imaging for 3.37 ± 2.65 years (mean ± SD) without intervention. Our findings indicate a lateral predominance of small VS within the IAC, an independence between tumor location and hearing outcomes, and further support the slow natural progression of VS.


Assuntos
Perda Auditiva/diagnóstico , Audição/fisiologia , Imagem por Ressonância Magnética/métodos , Neuroma Acústico/diagnóstico , Nervo Vestibular/patologia , Idoso , Audiometria de Tons Puros , Feminino , Perda Auditiva/etiologia , Perda Auditiva/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Neuroma Acústico/complicações , Neuroma Acústico/fisiopatologia , Estudos Retrospectivos , Nervo Vestibular/fisiopatologia
19.
World Neurosurg ; 135: e488-e493, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31843724

RESUMO

BACKGROUND: Vestibular schwannoma (VS) is the most common benign tumor originating in the cerebellopontine angle. In most cases, tumors tend to grow and deserve proper treatment. Sometimes they stabilize, and rarely they decrease in size spontaneously. METHODS: We evaluated retrospectively the images of patients with spontaneous tumor regression. We describe the common neuroimage findings of patients with spontaneous tumoral regression. RESULTS: Four patients with diagnosis of VS were followed with magnetic resonance imaging (MRI). There were some relevant features in MRI: a heterogeneous contrast enhancement in the outer layer of the tumor and presence of a cerebrospinal fluid column between the tumor and the entrance of the internal auditory canal. The percentage of tumor diameter reduction ranged from 20% to 40%. CONCLUSIONS: Some MRI features may demonstrate a spontaneous involution of VS and may be closely followed in asymptomatic or oligosymptomatic patients.


Assuntos
Neoplasias Cerebelares/patologia , Ângulo Cerebelopontino/patologia , Neuroma Acústico/patologia , Adulto , Idoso , Neoplasias Cerebelares/complicações , Feminino , Perda Auditiva/etiologia , Perda Auditiva/patologia , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Regressão Neoplásica Espontânea/patologia , Neuroma Acústico/complicações , Estudos Retrospectivos , Zumbido/etiologia , Zumbido/patologia
20.
World Neurosurg ; 135: e686-e694, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31884127

RESUMO

OBJECTIVE: To describe the morphology and anatomical relationship of the jugular process (JP) and to elucidate its utility as a surgical landmark in the lateraland posterior lateral approaches to the jugular foramen. MATERIALS AND METHODS: Eight dry adult skulls and 10 silicon-injected cadaver heads were used for this study. The distances to selected structures and the thickness of the JP at 3 selected sites were measured. We also included the data of 20 thin-sliced 3-dimensional computed tomography scans. The radiology data of these patients were transferred to a workstation for 3-dimensional reconstruction. RESULTS: The JP, an irregular trapezoid structure, is an important surgical landmark when approaching the jugular foramen. Laterally the JP is rough with 1 or 2 prominences to which the rectus capitis lateralis is attached. The JP is relatively flat medially. The condylar part of the occipital bone could be conceived as a "3-story building." The JP, hypoglossal canal, and lateral and posterior condylar emissary veins are located on the middle floor. The stylomastoid foramen is found constantly in the triangle formed by the styloid process, JP, and the base of the mastoid process. CONCLUSIONS: The JP is an important surgical landmark in the identification of jugular foramen, especially in the lateral and posterior approaches. A better understanding of its morphology and its relationship with the surrounding structures is a prerequisite for accurate surgical planning and intraoperative orientation.


Assuntos
Pontos de Referência Anatômicos , Forâmen Jugular/anatomia & histologia , Osso Occipital/anatomia & histologia , Adulto , Neoplasias Encefálicas/patologia , Cadáver , Feminino , Perda Auditiva/etiologia , Humanos , Imageamento Tridimensional , Forâmen Jugular/diagnóstico por imagem , Imagem por Ressonância Magnética , Microcirurgia/métodos , Neuroma Acústico/patologia , Osso Occipital/diagnóstico por imagem , Tomografia Computadorizada por Raios X
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