scholarly journals Prognostic significance of tympanosclerotic plaques localization and their morphological and histological characteristics for the outcome of surgical treatment

2012 ◽  
Vol 69 (2) ◽  
pp. 190-194 ◽  
Author(s):  
Milanko Milojevic ◽  
Dragoslava Djeric ◽  
Dusan Bijelic
Keyword(s):  
Surgical Treatment ◽  
Middle Ear ◽  
Prognostic Significance ◽  
Morphological Characteristics ◽  
Histological Findings ◽  
Surgical Success ◽  
Surgery Outcome ◽  
Military Medical Academy ◽  
Medical Academy ◽  
Histological Characteristics

Background/Aim. Tympanosclerosis is a sequela of inflammation of the middle ear usually causing conductive hearing loss. The aim of the study was to determine the significance of tympanosclerotic plaques localization in the middle ear and their morphological and histological characteristics for surgical treatment outcome. Methods. This retrospective study included a total of 73 patients operated on for tympanosclerosis in the Clinic for Otorhinolaryngology, Military Medical Academy (MMA) in a period 1996-2010. The results of surgical treatment as well as the last audiometry findings were analyzed. considering follow-up periods of 6 months to 8 years. The patients were divided into 4 groups according to tympanosclerotic plaques localization in the middle ear and the classification suggested by Wieling and Kerr. The patients were also divided based on intraoperatively noticed morphological characteristics of tympanosclerotic plaques, while the third division was done as per histological findings. Surgical success was assessed using the suggestions of the Japan Otological Society. Results. The analyzed results showed the surgical success especially in the group II according to Wieling and Kerr, while histological findings had no impact on the outcome of the surgery. Conclusion. Surgical treatment has good results especially in patients with the mobile stapes. Results are satisfactory in other localizations, while various morphological and histological characteristics do not have impact on the surgery outcome.

scholarly journals Outcomes of ophtalmologic surgical procedures of esotropia in children and adolescents

2008 ◽  
Vol 65 (8) ◽  
pp. 627-631
Author(s):  
Tamara Kljakovic-Avramovic ◽  
Miroslav Vukosavljevic ◽  
Sinisa Avramovic
Keyword(s):  
Surgical Treatment ◽  
Prospective Study ◽  
Children And Adolescents ◽  
Deviation Angle ◽  
Group Iii ◽  
Military Medical Academy ◽  
Group I ◽  
Medical Academy ◽  
Group Ii ◽  
Common Manifestation

Background/Aim. Esotropia is the most common manifestation form of strabism accompanied by refraction deviations and amblyopia. The aim of this prospective study was to present the outcomes of surgical treatment of esotropia in children and adolescents. Methods. Within the period from January 1st 2006 to February 1st 2007 at the Clinic for Ophtalmology, Military Medical Academy, Belgrade a total of 25 patients with esotropia (34 eyes) and previously corrected refraction anomaly and treated amblyopia were operated on. The patients were 4-19-year of age. All of the patients were submitted to a complete ophtalmologic and orthoptic examination prior to the surgery, and a month, three months and six months after the surgery. The surgery was performed under general anesthesia. Out of the total number of the patients nine were operated on both eyes, while 16 patients on one eye with amblyopia or frequent esodeviation. Nine patients were submitted to retroposition of the inner straight muscle, two to myectomy of the outer straight muscle, while in 14 of the patients a combination of retroposition and myectomy was performed. The patients were divided into three groups according to the preoperative angle at the distance and followed-up accordingly after the surgery. Deviation angle at the distance in the group I was 18-25 DP, in the group II 26-35 PD, while in the group III it was 36-60 PD. Results. The most numerous, group I (12 patients; 48%), a month following the surgery showed angle reduction by 55.58%, after three months 63.25%, and after six months 63.92%. The group II consisted of 8 patients (32%) showed angle reduction by 70.75% a month following the surgery, by 76% after three months, and by 79.12% after six months. The group III (5 patients; 20%) showed angle reduction by 72.20% a month following the surgery, 79.20 after three months, and 80.12% after six months following the surgery. Conclusion. The best postoperative outcomes after a month, three and six months were obtained in the group of patients with the highest esodeviation angle at the distance solved by the surgery on both eyes. Timely surgical treatment befell into major precondition for developing and maintaining the elements of binocular vision in the operated on patients. .

scholarly journals Result of using a minimally invasive method of surgical treatment of purulent-necrotic complications in a patient with diabetic foot syndrome

2020 ◽  
Vol 39 (3) ◽  
pp. 60-64
Author(s):  
Sergey Y. Ivanusa ◽  
Boris V. Risman ◽  
Andrey V. Yanishevskiy
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Diabetic Foot ◽  
Pain Syndrome ◽  
Diabetic Foot Syndrome ◽  
Military Medical Academy ◽  
Results Of Treatment ◽  
Medical Academy ◽  
Invasive Method ◽  
Short Time

The article presents an analysis of the results of treatment of a patient with purulent-necrotic complications of diabetic foot syndrome, who, in the framework of surgical treatment, used a minimally invasive method of treatment of purulent-necrotic complications of diabetic foot syndrome, developed at the departments of general surgery and normal anatomy of the S.M. Kirov Military Medical Academy. The effectiveness of the developed method has been demonstrated, which makes it possible to sanitize the purulent cavity in a short time, stop pain syndrome and restore the support ability of the foot (4 figs, 1 table, bibliography: 7 refs).

scholarly journals Condition of hearing sense and tinnitus before and after the treatment of otosclerosis

2010 ◽  
Vol 63 (9-10) ◽  
pp. 648-651
Author(s):  
Negra Terzic ◽  
Vladimir Jakovljevic ◽  
Nada Milanovic ◽  
Violeta Jacimovic ◽  
Ljubica Zivic
Keyword(s):  
Surgical Treatment ◽  
Subjective Assessment ◽  
Hearing Improvement ◽  
Functional Diagnostics ◽  
Bony Labyrinth ◽  
Military Medical Academy ◽  
Medical Academy ◽  
Before And After ◽  
Stapes Prosthesis ◽  
One Year

Introduction. Otosclerosis is an osteodystrophy disease of the bony labyrinth of the ear which leads to stapes fixation and to bradyecoia of a conductive type. The microsurgical treatment by the use of a stapes prosthesis provides hearing improvement and a reduction or disappearing of tinnitus. The aim of our study was to determine the hearing condition and tinnitus before and after the treatment of otosclerosis. Material and methods. A hundred patients with otosclerosis, aged 20 to 70, were surgically treated at the Otorhinolaryngology Clinic and the Functional Diagnostics, Military Medical Academy, Belgrade. After the treatment, the audiometric examinations were performed in order to assess the hearing condition and tinnitus was assessed by a questionnaire. The subjective assessment of tinnitus was ranged as present, reduced or absent. Results. Before the treatment, hearing impairment was present in all the patients, while tinnitus was found in 91% of them. One year following the surgical treatment hearing improvement was found in 96% of the patients, and tinnitus cessation in 89% of them. Conclusion. The surgical treatment can result in hearing improvement and cessation or reduction of tinnitus.

scholarly journals Early postoperative complications in children with secretory otitis media after tympanostomy tube insertion in the Military Medical Academy during 2000-2009

2012 ◽  
Vol 69 (5) ◽  
pp. 409-413 ◽  
Author(s):  
Milan Erdoglija ◽  
Jelena Sotirovic ◽  
Nenad Baletic
Keyword(s):  
Postoperative Complications ◽  
Otitis Media ◽  
Middle Ear ◽  
Tympanostomy Tube ◽  
Secretory Otitis Media ◽  
Early Postoperative Complications ◽  
Military Medical Academy ◽  
Medical Academy ◽  
Children And Parents ◽  
The Military

Background/Aim. Secretory otitis media (SOM) is a chronic, nonpurulent inflammation of the middle ear, characterized by a long-term presence of liquids of different density in the middle ear for at least three consecutive months, different degrees of hearing loss and the absence of perforation of the eardrum. The aim of this study was to estimate the early postoperative complications after insertion of tympanostomy tube (TT) in children with secretory otitis media (SOM) in an 18-month period after TT insertion. Methods. This retrospective study included children with SOM (n = 478), aged from 2.5 to 16 years, operated from 2000 to 2009. During these ten years 365 children had TT in both ears, 131 children had TT in one ear and 55 children were operated two or more times. Totally 843 ears were operated on. Date were obtained by regular fallow up in Out-patient clinic concerning symptoms reported by children and parents, otomicroscopy findings and hearing measurements (audiometry and tympanometry). Results. Transient otorrhea was the most common early postoperative complication (16.5%), then obstruction (9.5%), premature extrusion of TT (3.9%), chronic otorrhea (3.1%), granulation tissue (1.1%) and medial displacement (0.5%). According to our experience gold and silicone TT were shown less successful than others. The incidence of premature extrusion of TT was significantly higher with gold TT, comparing to others (6/33, 18%; p < 0.001). We also found significantly more frequent medial displacement with silicone TT than with other ones (2/4, 50%; p < 0.001). Conclusion. There are many early postoperative complications of TT insertion, but they depend on the meticulous surgery techniques, regular postoperative examinations and the type of TT. The type of TT should be determined according to own experience.

scholarly journals Assessment of middle ear risk index in predicting the outcome of treatment of CSOM

2020 ◽  
Vol 6 (11) ◽  
pp. 2075
Author(s):  
Anil S. Harugop ◽  
Somashekhar Abhilasha ◽  
Pratibha S. Desai
Keyword(s):  
Surgical Treatment ◽  
Success Rate ◽  
Middle Ear ◽  
Risk Index ◽  
Prognostic Significance ◽  
Favourable Outcome ◽  
Suppurative Otitis Media ◽  
History Of ◽  
The Cost ◽  
Outcome Of Surgery

<p class="abstract"><strong>Background: </strong>Chronic suppurative otitis media (CSOM) accounts for highly prevalent and serious health problems especially in developing countries. Even though there are good numbers of studies demonstrating the success rate of the procedures to treat CSOM, there is lack of uniformity in assessing the predictors for the outcome of the same. If we can predict the outcome of the surgical procedure depending upon the pathologic condition of the middle ear, the cost effectiveness of the surgery can be improved, and this will also improve the patient’s compliance. The objective of this study is to evaluate a group of patients who underwent surgical treatment for chronic CSOM with reference to the prognostic significance of Middle ear risk index (MERI).</p><p class="abstract"><strong>Methods:</strong> It is a retrospective observational study of patients who underwent surgical treatment for CSOM from the year 2008 to 2020.</p><p class="abstract"><strong>Results: </strong>Out of 1010 surgeries done, total of 287 cases were included in study. In our study the success rate in mild risk index was 76.9%, moderate was 62.2% and only 18% in severe risk index.</p><p class="abstract"><strong>Conclusion: </strong>The outcome of surgery in the patients who undergo surgical treatment for CSOM can be predicted well using MERI. Presence of cholesteatoma and granulation tissue reduces the favourable outcome of surgery justifying the numerical value given in the score. However, presence of ear discharge and history of smoking doesn’t alter the outcome of surgery as long as complete clearance of disease is done.</p>

scholarly journals Experience in treatment of diaphragm hernias

2020 ◽  
Vol 39 (3) ◽  
pp. 32-39
Author(s):  
Petr N. Zubarev ◽  
Aleksey V. Khokhlov ◽  
Igor E. Onnitsev ◽  
Vladislav M. Trofimov ◽  
Valeriy L. Belevich ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
General Surgery ◽  
Clinical Manifestations ◽  
Military Medical Academy ◽  
Medical Academy ◽  
Laparoscopic Techniques ◽  
The Military ◽  
Positive Effect

Hernias of the diaphragm are a common pathology that negatively affects the quality of life of patients and in some cases requires high-quality surgical correction. This pathology has a progressive course, which leads to an increase in the severity of clinical manifestations with the age of the patient. The article presents the experience of surgical treatment of hernias of the diaphragm on the basis of general surgery clinics of the military medical academy. The aim of the study is to determine the effectiveness of surgical treatment of hernias of the diaphragm in different categories of patients. The total number of treated patients was 216. All patients were operated on. Thirty-four patients underwent a sympultal laparoscopic cholecystectomy. The operation used laparoscopic access. The closest excellent and good results of clinical treatment occurred in 92% of cases, satisfactory and unsatisfactory results accounted for 5.4 and 2.7%, respectively. According to the results of the instrumental survey, 40.6 and 54%, respectively, achieved excellent and good results; Satisfactory and unsatisfactory 2.7 and 2.7%. The introduction of laparoscopic techniques in surgery has reduced the number of early and late post-operative complications in the treatment of hernias of the diaphragm. The recommendations of the American Association of Endoscopic Surgeons for the operational treatment of gastroesophageal reflux disease shows the positive effect of laparoscopic fundoplications in 8593% of patients whose medicinal therapy has proved ineffective. In general, the results of the immediate and long-term outcomes of the surgical treatment of hernias of the diaphragm at the General Surgery Clinic of Military Medical Academy showed similar results (8 figs, bibliography: 16 refs).

scholarly journals Contribution of the staff of the Military medical academy to the development of peripheral nerve surgery

2020 ◽  
Vol 22 (1) ◽  
pp. 238-241
Author(s):  
A I Gaivoronsky ◽  
N G Gubochkin ◽  
L I Churikov ◽  
D M Isaev ◽  
D E Alekseev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Peripheral Nerve ◽  
Rapid Development ◽  
Peripheral Nerve Surgery ◽  
Peripheral Nerve Damage ◽  
Military Medical Academy ◽  
Medical Academy ◽  
Combat Injuries ◽  
Nerve Surgery ◽  
The Military

The formation of the neurosurgical service in our country, as well as the development of peripheral nerve surgery, is inextricably linked with prominent figures - employees of the S. M. Kirov Military Medical Academy: L.M. Puseppa, V.N. Shamova, V.I. Grebenyuk, B.A. Samotokina, A.N. Solomina, E.I. Usanova, E.D. Alekseeva, F.S. Govenko, B.V. Martynova, A.E Belousova, etc. Already from the beginning of the 20th century, Ludwig Martynovich Pusepp has been actively engaged in the diagnosis and surgical treatment of peripheral nerve damage at the Imperial Military Medical Academy. In the second half of the XX century. peripheral nerve surgery undergoes an important stage: the transition to microsurgery. This stage is marked by the rapid development and implementation of microsurgical techniques in the treatment of patients suffering from traumatic lesions of limbs and nerves. The Academy is actively developing revascularization and reinnervation techniques for injuries to the limbs. Based on the analysis of the data of the Great Patriotic War and the war in Afghanistan, the Academy staff published works on the organization of medical care and surgical treatment of combat injuries of peripheral nerves. Thanks to the active scientific and practical work of A.E. Belousova, N.G. Gubochkina, E.D. Alekseeva, F.S. Govenko, B.V. Martynova at the beginning of the XXI century. Clinic of Neurosurgery of the S. M. Kirov Military Medical Academy becomes a leading institution in Russia, where they provide assistance to patients suffering from injuries and diseases of the peripheral nervous system.

scholarly journals Choledocholithiasis: modern possibilities of diagnosis and surgical treatment

2021 ◽  
Vol 23 (3) ◽  
pp. 109-116
Author(s):  
Eveniy S. Zherebtsov ◽  
Pavel N. Romashchenko ◽  
Nicolay A. Maistrenko
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Diagnostic Value ◽  
Alternative Methods ◽  
Two Stage ◽  
One Stage ◽  
Military Medical Academy ◽  
Rendezvous Technique ◽  
Medical Academy ◽  
Examination Methods

Studies have examined various approaches in the diagnosis and surgical treatment of patients with cholelithiasis complicated by choledocholithiasis, evaluated the possibilities of using modern methods of treating the disease, and proposed a strategy to prevent the abandonment of bile duct concretions. The relevance of this problem is related to the variety of diagnostic and surgical treatment methods of choledocholithiasis, high disease frequency, and nonexistence of a unified approach to the examination and choice of surgical treatment in patients with cholelithiasis complicated by choledocholithiasis. These issues indicate the need to study this problem and identify optimal approaches to examination and treatment, including modern minimally invasive methods of treatment. The analysis of the diagnostic value of various examination methods and surgical outcomes was based on the experience of treating 154 patients with cholelithiasis complicated by choledocholithiasis in the clinic of the S.P. Fedorov Faculty of Surgery of the S.M. Kirov Military Medical Academy. An algorithm for examining patients with cholelithiasis was formed based on the diagnostic value of various research methods, which allows timely detection of choledocholithiasis. The results of various approaches to the surgical treatment of patients with cholelithiasis complicated by choledocholithiasis were analyzed. In the absence of general somatic contraindications and the availability of technical capabilities, a one-stage approach to surgical treatment was suggested. Moreover, an individual approach is necessary for the treatment of patients with cholelithiasis complicated by choledocholithiasis, taking into account the nature of the disease course and its complications, comorbid status of the patient, and technical capabilities of a particular hospital. The sequence and timing of operations with a two-stage approach should be determined, taking into account the acute conditions and comorbidities of the patient. The use of modern minimally invasive technologies, such as transpapillary and trans-bubble choledochoscopy, dosed papillotomy, and rendezvous technique for the cannulation of the large papilla of the duodenum, allows us to improve the results of surgical treatment and reduce the risk of complications. Transpapillary and trans-bubble nanoelectroimpulse lithotripsy are alternative methods of resolving major choledocholithiasis in both one-stage and two-stage treatment.

scholarly journals Most severe consequences of eye contusion injuries: Surgical treatment

2006 ◽  
Vol 134 (7-8) ◽  
pp. 278-282
Author(s):  
Miroslav Vukosavljevic
Keyword(s):  
Surgical Treatment ◽  
Pars Plana Vitrectomy ◽  
Vision Loss ◽  
Vitreoretinal Surgery ◽  
Eye Injuries ◽  
Military Medical Academy ◽  
Combined Operations ◽  
Medical Academy ◽  
Common Causes ◽  
Pars Plana

Introduction. One third of all eye injuries are contusion injuries. The most common causes of contusion eye injuries are squash ball, fist fights, sports, and work with blunt objects. Objective. The objective of our study was to analyze the surgical treatment methods and materials for managing the most severe consequences of eye contusion injuries. Method. A large number of complications of contusion eye injuries were treated at Department for Vitreoretinal Surgery of the Eye Clinic, Military Medical Academy, Belgrade. This paper analyzed two periods, from 1991-1999, and 2000-2004. During these periods, 461 patients with contusion eye injuries were surgically treated. Pars plana vitrectomy and phacoemulsification with PCL implantation were the most commonly performed operations. Results. During the analyzed period, a total of 334 pars plana vitrectomies, 253 combined operations (PHACO+ VPP) and 214 operations with PCL implantation (PHACO+VPP+PCL) were performed. Scleral fixation was carried out in 14 patients. After pars plana vitrectomy, some form of extended tamponade of vitreal space, in relation to degree of injury and complications, was performed in 194 cases. CONCLUSION Eye traumatism is still one of the leading causes of vision loss (from the earliest ages) in our region. Preventive measures that could lead to decrease of eye injuries should be fully supported, not only through expert meetings and publications, but via media as well.

scholarly journals The comparative analysis of clinical symptomatology before and after the operation of otosclerosis

2009 ◽  
Vol 62 (5-6) ◽  
pp. 258-262
Author(s):  
Negra Terzic ◽  
Ljubica Zivic
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Partial Recovery ◽  
Progressive Hearing Loss ◽  
Clinical Symptomatology ◽  
Military Medical Academy ◽  
Medical Academy ◽  
Hearing Recovery ◽  
Before And After

Introduction Otosclerosis is a progressive osteodystrophic disease of the osseous capsule of the labyrinth which leads to the fixation of the stapes and partial deafness. The progressive hearing loss followed by ear tingling - tinitus and vertigo is of great importance for this disease. The aim of the work was to determine the changes of clinical symptomatology before and after the operative treatment of otosceloris. Material and methods The study included 32 subjects between 25 and 60 years of age affected by otosclerosis who had undergone surgical treatment at the VMA (Military Medical Academy) Clinic, Department of Otolaryngology in Belgrade. Besides the clinical examination and detailed case history, audiometry and tympanometry examinations were performed. During the postoperative period the clinical symptomatology was evaluated and audiometry examinations were performed in order to determine the effect of the surgical intervention. Results Of the total number of 32 subjects, partial deafness was present in all of them before the operation, whereas tinitus, vertiginous disturbances and otalgia were found in a certain number of the subjects. During the postoperative period a partial recovery was found in a larger number of the subjects in relation to the total hearing recovery. During the postoperative period tinitus of lower intensity was found in a greater number of the subjects, whereas the number of those without tinitus was smaller. The problem of vertiginous disturbances as well as otalgia were not found during the postoperative period. Conclusion By following the changes of the clinical symptomatology we came to the conclusion that surgical treatment of otosclerosis results in the reduction and disappearance of subjective disturbances, tinitus, vertigo and otalgia and leads to the partial or complete hearing recovery.

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