Acquired Atresia of the External Auditory Canal: Recurrence and Long-Term Results

2009 ◽  
Vol 118 (5) ◽  
pp. 345-349 ◽  
Author(s):  
Giuseppe Magliulo
Keyword(s):  
External Auditory Canal ◽  
Clinical Symptoms ◽  
Pure Tone Audiometry ◽  
Long Term Results ◽  
Hearing Results ◽  
Weighted Magnetic Resonance Imaging ◽  
Echo Planar ◽  
Acquired Atresia

Objectives: I describe the clinical symptoms and signs of acquired atresia of the external auditory canal (EAC) and the technique used to manage it. Methods: Forty-one consecutive patients affected by acquired atresia of the EAC were assessed by otoscopy, pure tone audiometry, computed tomography, and traditional and echo-planar diffusion-weighted magnetic resonance imaging. The anatomic and functional hearing results were evaluated. Results: At surgery for acquired atresia of the EAC, an EAC cholesteatoma was found in 3 of the 41 patients. Twenty-three of the 41 patients were followed for at least 5 years. Recurrence was seen in 9 of the 25 ears (36%) over the entire period of observation. Twenty-one, 23, and 22 of the patients had a normal or nearly normal contour and size of the ear canal at 6 months, 1 year, and 5 years, respectively. The results were similar for the air-bone gap. Conclusions: The main complication following surgery was recurrence. There was recurrence at 6 months in 4 patients (16%). Recurrence was seen in 12% of the cases at the 5-year follow-up. Similar findings were clear on evaluation of the hearing results. This result demonstrates that the surgical procedure, even when performed correctly, did not afford a stable, long-lasting outcome in a cohort of patients.

scholarly journals Percutaneous Closure of PFO in Patients with Reduced Oxygen Saturation at Rest and during Exercise: Short- and Long-Term Results

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Céline De Cuyper ◽  
Tristan Pauwels ◽  
Eric Derom ◽  
Michel De Pauw ◽  
Daniël De Wolf ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Clinical Symptoms ◽  
Systemic Circulation ◽  
Percutaneous Closure ◽  
Long Term Results ◽  
Sf 36 ◽  
Short And Long Term

Background. A patent foramen ovale (PFO) is a rare cause of hypoxemia and clinical symptoms of dyspnea. Due to a right-to-left shunt, desaturated blood enters the systemic circulation in a subset of patients resulting in dyspnea and a subsequent reduction in quality of life (QoL). Percutaneous closure of PFO is the treatment of choice. Objectives. This retrospective multicentre study evaluates short- and long-term results of percutaneous closure of PFO in patients with dyspnea and/or reduced oxygen saturation. Methods. Patients with respiratory symptoms were selected from databases containing all patients percutaneously closed between January 2000 and September 2018. Improvement in dyspnea, oxygenation, and QoL was investigated using pre- and postprocedural lung function parameters and two postprocedural questionnaires (SF-36 and PFSDQ-M). Results. The average follow-up period was 36 [12–43] months, ranging from 0 months to 14 years. Percutaneous closure was successful in 15 of the 16 patients. All patients reported subjective improvement in dyspnea immediately after device deployment, consistent with their improvement in oxygen saturation (from 90 ± 6% to 94 [92–97%] on room air and in upright position) (p<0.05). Both questionnaires also indicated an improvement of dyspnea and QoL after closure. The two early and two late deaths were unrelated to the procedure. Conclusion. PFO-related dyspnea and/or hypoxemia can be treated successfully with a percutaneous intervention with long-lasting benefits on oxygen saturation, dyspnea, and QoL.

Long-term results with hydroxylapatite middle ear implants

2000 ◽  
Vol 122 (5) ◽  
pp. 635-642
Author(s):  
Robert A. Goldenberg ◽  
Mark Driver
Keyword(s):  
Long Term Results ◽  
Hearing Results ◽  
Factors Associated ◽  
Hearing Result ◽  
Middle Ear Implants ◽  
Long Term Follow Up ◽  
The Mean ◽  
Canal Wall Up

PURPOSE: This study evaluated long-term results in patients who had ossicular reconstruction with a Goldenberg hydroxylapatite implant. METHODS: A total of 233 patients underwent implantation; of these, 77 had 5-year or longer follow-up and are the subjects of this study of long-term hearing results. All 233 patients were included for analysis of extrusion rate and postoperative otorrhea. RESULTS: The hearing success rate at long-term follow-up was 56.8%; the mean air-bone gap was 21.1 dB. Prosthesis extrusion occurred in 5.29% of the 233 patients, and visible slippage occurred in 7.7%. Overall, 50.6% of patients met the criteria for successful hearing, which included no extrusion and a dry ear. Better hearing before surgery and presence of the malleus long process were factors associated with a successful hearing result, as was tympanoplasty alone and canal wall up tympanomastoidectomy. CONCLUSION: Hydroxylapatite hybrid prostheses provide stable hearing results over time with low extrusion and a dry ear overall.

scholarly journals Low- vs. high-dose radiotherapy in Graves’ ophthalmopathy: a retrospective comparison of long-term results

2021 ◽  
Author(s):  
Thomas Weissmann ◽  
Sebastian Lettmaier ◽  
Anna-Jasmina Donaubauer ◽  
Christoph Bert ◽  
Manfred Schmidt ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Treatment Response ◽  
Cumulative Dose ◽  
Clinical Symptoms ◽  
Long Term Results ◽  
High Dose ◽  
Ocular Motility ◽  
Graves Ophthalmopathy

Abstract Purpose Radiotherapy represents an effective treatment option in Graves’ ophthalmopathy (GO), leading to palliation of clinical symptoms. However, there are only a limited number of trials comparing the effectiveness of low- vs. high-dose radiotherapy. Methods We analyzed 127 patients treated with radiotherapy for stage 3/4 GO (NOSPECS classification). Patients were treated with single doses of 2.0 Gy (cumulative dose 20 Gy) until 2007, afterwards a single dose of 0.8 Gy (cumulative dose 4.8 Gy) was applied. With a median follow-up-time of 9.0 years, the treatment efficacy (overall improvement, sense of eye pressure, lid edema, ocular motility, exophthalmos, subjective vision, and diplopia) and adverse effects were analyzed by a standardized survey. Results Overall, 63.8% described improvement of symptoms after radiotherapy. No significant differences in overall treatment response and improvement of main outcome measures between low- or high-dose radiotherapy treatments are detectable, while low-dose radiotherapy leads significantly more often to retreatment (13.1% vs. 1.7%, p = 0.016). The main independent predictor of treatment response is the presence of lid edema (odds ratio, OR, 3.53; p = 0.006). Conclusion At long-term follow-up, the majority of patients reported palliation of symptoms with limited adverse effects, suggesting clinical effectiveness of radiotherapy for amelioration of GO symptoms independent of low- or high-dose radiotherapy.

Long-term Results with Hydroxylapatite Middle Ear Implants

2000 ◽  
Vol 122 (5) ◽  
pp. 635-642 ◽  
Author(s):  
Robert A. Goldenberg ◽  
Mark Driver
Keyword(s):  
Long Term Results ◽  
Hearing Results ◽  
Factors Associated ◽  
Hearing Result ◽  
Middle Ear Implants ◽  
Long Term Follow Up ◽  
The Mean ◽  
Canal Wall Up

PURPOSE: This study evaluated long-term results in patients who had ossicular reconstruction with a Goldenberg hydroxylapatite implant. METHODS: A total of 233 patients underwent implantation; of these, 77 had 5-year or longer follow-up and are the subjects of this study of long-term hearing results. All 233 patients were included for analysis of extrusion rate and postoperative otorrhea. RESULTS: The hearing success rate at long-term follow-up was 56.8%; the mean air-bone gap was 21.1 dB. Prosthesis extrusion occurred in 5.29% of the 233 patients, and visible slippage occurred in 7.7%. Overall, 50.6% of patients met the criteria for successful hearing, which included no extrusion and a dry ear. Better hearing before surgery and presence of the malleus long process were factors associated with a successful hearing result, as was tympanoplasty alone and canal wall up tympa-nomastoidectomy. CONCLUSION: Hydroxylapatite hybrid prostheses provide stable hearing results over time with low extrusion and a dry ear overall.

Long-term results of revision stapes surgery

1992 ◽  
Vol 106 (11) ◽  
pp. 971-973 ◽  
Author(s):  
Eero Vartiainen ◽  
Juhani Nuutinen ◽  
Jukka Virtaniemi
Keyword(s):  
Revision Surgery ◽  
Oval Window ◽  
Stapes Surgery ◽  
Long Term Results ◽  
Surgical Trauma ◽  
Hearing Results ◽  
The Mean ◽  
Revision Stapes Surgery

AbstractResults of 45 re-operations for persistent or recurrent conductive deafness after primary stapes surgery were studied. The mean follow-up period after the revision surgery was 7.6 years. Long-term hearing results were found to be disappointing, air-bone gap to within 10 dB was achieved in only 46 per cent of the patients. Mean hearing levels improved by 11 dB or more in 73 per cent. Outcome of surgery was dependent on the surgical pathology, the best hearing results were obtained in cases with re-fixation after stapes mobilization operation. Sensorineural hearing loss as a result of surgical trauma to the inner ear occurred in revision surgery more frequently than in primary operations, cases with regrowth of otosclerotic bone to the oval window after stapedectomy having the greatest risk of labyrinthine trauma.

Endaural Atticotomy for pars flaccida Cholesteatoma

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P55-P55
Author(s):  
John P Leonetti ◽  
Sam J Marzo ◽  
Matthew L Kircher
Keyword(s):  
Clinical Symptoms ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Long Term Results ◽  
Pars Flaccida ◽  
Academic Medical

Objective To present our long-term results using an endaural atticotomy approach for the management of 361 cases of pars flaccida cholesteatoma. Methods This is a retrospective chart review of 361 cases of attic cholesteatoma that were surgically managed at our tertiary care, academic medical center between 7/88 – 7/07. Results 361 of the 2068 cholesteatomas treated at our institution were surgically managed with an endaural atticotomy approach. There were 201 females and 160 males who ranged in age from 17–77 years. The most common clinical symptoms were aural fullness, hearing loss, and otorrhea. Ossiculoplasty was necessary in 170 of 361 or 47% of the patients. Hearing levels were maintained or improved in 297 patients or 82%. Cholesteatoma recurred in 29 of 361 patients (8%) and 24 of these 29 patients failed to return for otoscopic evaluation and PE tube replacement. The mean follow-up was 7.7 years. Conclusions The endaural approach for pars flaccida cholesteatoma is an option for limited retraction cholesteatomas in patients who will reliably be seen for ventilation tube replacement.

Short- and Long-Term Results of Stapedotomy and Stapedectomy with a Teflon-Wire Piston Prosthesis

2001 ◽  
Vol 110 (10) ◽  
pp. 907-911 ◽  
Author(s):  
Maria Izabel Kos ◽  
Pierre B. Montandon ◽  
Jean-Philippe Guyot
Keyword(s):  
Hearing Loss ◽  
Postoperative Complications ◽  
Evaluation Criteria ◽  
Long Term Results ◽  
Hearing Results ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
Residual Air

We analyzed the results of 604 cases of primary stapes surgery performed between 1974 and 1997 with replacement of the stapes by a 0.6- or 0.8-mm Schuknecht Teflon-wire piston. At long-term follow-up (1 to 21 years; mean, 7 years), the residual air-bone gap was 10 dB or less in 79% of the cases. The hearing results and postoperative complications were comparable to those reported by authors who used the same evaluation criteria. Although the aim of the surgery was to perform a small stapedotomy with a narrow footplate perforation (0.8 mm), a large stapedotomy or a stapedectomy was performed in 134 cases (22.2%) because of surgical or anatomic conditions. Our results show that the larger footplate perforations allowed a better correction of the air-bone gap at the lower frequencies. The ears with larger perforations did not show a higher incidence of sensorineural hearing loss.

Phẫu thuật nội soi ngực bụng trong điều trị ung thư thực quản

2020 ◽  
Author(s):  
Vy Pham Trung
Keyword(s):  
Esophageal Cancer ◽  
Survival Time ◽  
Clinical Symptoms ◽  
Long Term Results ◽  
Number Of Patients ◽  
Laparoscopic Esophagectomy ◽  
Swallowing Difficulty ◽  
Overal Survival

Objectives: Evaluating the results of thoraco-laparoscopic esophagectomy to treat esophageal cancer, prospective studies of 35 patients esophageal cancer were conducted from January 2016 to December 2019 at Hue Central Hospital. Results: Average age 57.6±6.3years (44-69), male/female 16.5/1. Clinical symptoms: 82.9% swallowing difficulty, weight loss 34.3%, increased preoperative CEA 31.4%, mean tumor size 2.6±1.2cm(3-6). Stage: I 31.4%; II 45.7%; III of 22.9%. Time of surgery 315.2±49.9minutes(240-420), mean hospital stay 15.6±7.2days(7-25). Postoperative complications: pneumonia 11.4% , leakage of neck anastomosis 8.6%, hoarseness 11.4% and mortality 2.9%. Follow-up time 2-35months, anastomotic recurrence 2.9%, local recurrence 5.9% and metastasis 8.8%. The overal survival time 28.4±1.9months, the survival time after 12 months 84.7% and after 2 years 73.9%. Conclusion: Thoraco-laparoscopic esophagectomy to treat esophageal cancer has many advantages, avoiding to the long thoracotomy-laparotomy, reducing postoperative pain, reducing respiratory complications during the postoperative period. However, a larger number of patients should be studied to accurately evaluate long-term results, especially in oncology results.

scholarly journals Coccygectomy for coccygodynia: a cohort study with a long-term follow-up of up to 29 years

2020 ◽  
Author(s):  
R. Hochgatterer ◽  
M. Gahleitner ◽  
J. Allerstorfer ◽  
J. Maier ◽  
M. Luger ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Clinical Symptoms ◽  
Clinical Results ◽  
Long Term Results ◽  
Level Of Evidence ◽  
Superficial Infection ◽  
Initial Surgery ◽  
Significant Difference

Abstract Purpose We aim to critically review the effectiveness and safety of coccygectomy with special regard to long-term outcomes. Methods Coccygectomy was performed in our clinic in 38 patients between 1990 and 2019. All these patients (32 females vs. 6 males) have failed to respond to conservative treatment for at least 6 months prior to surgery. All patients were available for follow-up after mean 12,3 years (2 months to 29 years, 11 patients had a minimum FUP of 24 years). We evaluated all patients clinically and radiologically. Results Nineteen patients reported traumatic and 17 patients reported idiopathic onset of their symptoms; one patient had clinical symptoms after childbirth and another patient had coccygodynia after extensive low back surgery. 36 of our 38 patients were free of pain at least 6 months after surgery and had good or excellent clinical results according to the VAS which improved from 6.37 (SD 1.08) preoperatively to 0.68 (SD 0.99) at the recent follow-up. Two patients showed an ODI > 22 at the recent follow-up (24 and 28) and 32 had an ODI equal or under 4. There was no statistical significant difference in terms of clinical outcome between the different radiological types of the coccyx. Postoperative complications were rare: 1 superficial infection and one re-operation 6 months after initial surgery due to an pre-existing exostosis which had not been removed at the index surgery; no neurological complications and no major bleeding occurred. No patient had recurrent onset of coccygodynia. 37 out of 38 patients would have coccygectomy again. Conclusions Coccygectomy is a safe treatment option in patients with coccygodynia and shows excellent long-term results. We recommend to perform coccygectomy if patients fail to respond to conservative treatment for 6 months. Level of evidence IV

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