The surgical treatment results of otosclerosis at the Department of Otolaryngology Silesian Medical University in Zabrze in years 2000–2010

2017 ◽  
Vol 71 (2) ◽  
pp. 16-21 ◽  
Author(s):  
Gabriela Czerwińska ◽  
Wojciech Ścierski ◽  
Grzegorz Namysłowski ◽  
Grażyna Lisowska ◽  
Maciej Misiołek
Keyword(s):  
Hearing Loss ◽  
Surgical Treatment ◽  
Bone Conduction ◽  
University Hospital ◽  
Disease Stage ◽  
Treatment Results ◽  
Mean Values ◽  
The Impact ◽  
Change In Mean ◽  
Age And Sex

Background: Otosclerosis is a cause of 5–9% of all hearing loss. The most effective treatment of otoslerosis is stapedotomy. Aim: The aim of this study was to evaluate the results of otosclerosis surgical treatment and to examine the impact of disease stage, time of the signs, age and sex on the results. Material and methods: 105 patients who underwent operation due to otosclerosis at the Department of Otolaryngology University Hospital in Zabrze at the age of 18–65 were analyzed. In 25 patients stapedotomy was bilateral. 130 cases of treated ears were included in the statistical analysis. The state of hearing after operation was evaluated with regard to guidance of Hearing and Balance Committee of American Academy of Otolaryngology – Head and Neck Surgery and with consideration of suggestions made by European Academy of Otolaryngology and Neurootology. Mean values of bone and air conduction, air bone gap before, one year after treatment, and at least 4 years after surgery were compared. The influence of stage of the disease in terms of Shambaugh index, lasting of signs, age and sex were evaluated with regard to change of mean hearing loss according to Bell Telephone Laboratories. Results: On the basis of hearing examination evaluating improvement in air and bone conduction and reduction of cochlear reserve, very good and good treatment results were obtained in over 90% of patients in short and long term observations. No influence of disease stage, time of signs lasting, age and sex on the results of treatment – with regard to change in mean hearing loss was shown.

scholarly journals Impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology Classification of Thyroid Nodules in the Treatment of Indeterminate Follicular Lesions: Five-Year Results at a Single Center

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
M. Pastoricchio ◽  
A. Cubisino ◽  
A. Lanzaro ◽  
M. Troian ◽  
F. Zanconati ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Needle Aspiration ◽  
Italian Society ◽  
University Hospital ◽  
Ras Mutation ◽  
Autoimmune Thyroid ◽  
Anatomic Pathology ◽  
Surgery Department ◽  
The Impact

Purpose. Aim of the study was to assess the impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology (SIAPEC) classification of 2014, on the treatment of indeterminate thyroid lesions (TIR3). Methods. We retrospectively analyzed patients undergoing thyroid surgery for TIR3 lesions between 2013 and 2018, at the General Surgery Department of Trieste University Hospital. According to the SIAPEC classification, patients were divided into TIR3A and TIR3B groups. All patients treated before 2014 underwent surgical treatment, and surgical specimens were retrospectively classified after revision of fine-needle aspiration cytology. Starting 2014, TIR3A patients were treated only when symptomatic (i.e., coexistent bilateral thyroid goiter or growing TIR3A nodules), whereas TIR3B patients always received surgical treatment. Hemithyroidectomy (HT) was the procedure of choice. Total thyroidectomy (TT) was performed in case of concurrent bilateral goiter, autoimmune thyroid disease, and/or presence of BRAF and/or RAS mutation. Lastly, we analyzed the malignancy rate in the two groups. Results. 29 TIR3A and 90 TIR3B patients were included in the study. HT was performed in 10 TIR3A patients and 37 TIR3B patients, respectively, with need for reoperation in 4 TIR3B (10.8%) patients due to histological findings of follicular thyroid carcinoma >1  cm. The malignancy rates were 17.2% in TIR3A and 31.1% in TIR3B, (p=0.16). Predictability of malignancy was almost 89% in BRAF mutation and just 47% in RAS mutation. Conclusions. The new SIAPEC classification in association with biomolecular markers has improved diagnostic accuracy, patient selection, and clinical management of TIR3 lesions.

The Impact of Petrosal Vein Preservation on Postoperative Auditory Function in Surgery of Petrous Apex Meningiomas

2006 ◽  
Vol 59 (suppl_1) ◽  
pp. ONS-68-ONS-74 ◽  
Author(s):  
Alireza Gharabaghi ◽  
Andrei Koerbel ◽  
Löwenheim Hubert ◽  
Jan Kaminsky ◽  
Madjid Samii ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Clinical Study ◽  
Surgical Treatment ◽  
Auditory Nerve ◽  
Petrous Apex ◽  
Auditory Function ◽  
Petrosal Vein ◽  
Superior Petrosal Vein ◽  
Nerve Dysfunction ◽  
The Impact

Abstract OBJECTIVE: The importance of preserving the superior petrosal vein has received increasing attention in the surgical treatment of pathologies involving the petrous apex. Recent reports have associated postoperative auditory nerve dysfunction with petrosal vein sacrifice. However, there is no systematic clinical study available thus far focusing on the postoperative auditory function after petrosal vein obliteration. METHODS: In 55 patients with meningiomas involving the petrous apex, pre- and intraoperative findings including petrosal vein sectioning were analyzed retrospectively concerning their impact on postoperative auditory function. RESULTS: The petrosal vein was preserved in 26 (47%) cases. In 27 (49%) cases, this vein was not preserved. Hearing loss occurred in 11% of all cases. In the preserved-vein group, postoperative hearing loss occurred in 3 of 26 (11%) cases and in the sacrificed-vein group in 3 of 27 (11%) cases. CONCLUSION: Sacrifice of the petrosal vein during surgery of petrous apex meningiomas seems not to have an impact on postoperative auditory function.

Improving Acceptance of Background Noise with Sound Enrichment

2020 ◽  
Author(s):  
Susan Gordon-Hickey ◽  
Shelby Davis ◽  
Leah Lewis ◽  
James Van Haneghan
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Background Noise ◽  
Control Group ◽  
Random Assignment ◽  
Treatment Results ◽  
Adult Participants ◽  
Future Work ◽  
The Impact ◽  
Experimental Group

Background: Acceptance of background noise serves as a means to predict likelihood of hearing aidsuccess. Individuals that are able to accept background noise are more likely to be successful with hearingaids.Purpose: The aim of the study was to assess the impact of sound enrichment on the acceptable noiselevel (ANL).Study Sample: Nineteen young adult participants served as listeners. Participants were randomlyassigned to the experimental or control group.Research Design: An experimental design with random assignment to experimental or control groupwas used.Data Collection and Analysis: One group used sound enrichment procedures for 2 weeks, whereas theother group served as a control group. Sound enrichment procedures required that participants add lowlevelbackground sound to any quiet environment encountered during the study. Most comfortable listeninglevel (MCL) and background noise level (BNL) were measured at three sessions, each 1 weekapart (baseline, after 1 week of treatment, and after 2 weeks of treatment).Results: Analytical statistics revealed that ANL improved for the sound enrichment group but remainedthe same for the control group. For both groups, there was no significant change in MCL across sessions.However, for the experimental group, BNL improved (increased) over the 2-week period while usingsound enrichment.Conclusions: Results of this study indicate that ANL can be improved with the use of sound enrichmentprocedures over a 2-week period. Future work should examine the use of sound enrichment proceduresfor older adults with hearing loss.

Acute Invasive Fungal Rhinosinusitis in Immunocompromised Patients: Role of an Early Diagnosis

2018 ◽  
Vol 159 (2) ◽  
pp. 386-393 ◽  
Author(s):  
Ignacio Javier Fernandez ◽  
Francesco Maria Crocetta ◽  
Marco Demattè ◽  
Paolo Farneti ◽  
Marta Stanzani ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Early Diagnosis ◽  
Treatment Protocol ◽  
University Hospital ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
Time Required ◽  
The University ◽  
The Impact ◽  
Invasive Fungal Rhinosinusitis

Objective The aims of the present study were to evaluate the clinical significance of the delay for surgical treatment and the prognostic value of other clinical, pathologic, and microbiological variables among hematologic patients affected by acute invasive fungal rhinosinusitis (AIFRS). Furthermore, we propose our early diagnosis and treatment protocol, reporting its 10-year results. Study Design Monocentric retrospective analysis. Setting The study was conducted from 2001 to 2017 at the University Hospital of Bologna, Italy. Subjects and Methods The impact of time to treatment and clinical, pathologic, and microbiological variables were analyzed among patients with histologically and microbiologically proven AIFRS. The outcomes of patients treated before the introduction of the early diagnosis protocol were compared with those treated afterward. Results Nineteen patients affected by AIFRS were eligible for the study. Treatment delay >4 days ( P = .002), infection caused by Mucorales ( P = .015), and extension of the disease were negative prognostic variables ( P = .017). The application of our protocol significantly reduced the delay for diagnosis and appropriate treatment by an average of 7.3 days ( P = .02). Conclusion The promptness of the diagnosis and surgical treatment may play a significant role in the management of AIFRS, as it appears to be significantly associated with the disease outcome. Our protocol may help to reduce the time required for diagnosis of high-risk hematologic patients.

scholarly journals Oncoplastic approach in the conservative treatment of breast cancer: analysis of costs

2012 ◽  
Vol 27 (5) ◽  
pp. 311-314 ◽  
Author(s):  
Débora Eleotério de Lima ◽  
Joel Veiga Filho ◽  
Leda Marques Ribeiro ◽  
Thiago Bezerra de Morais ◽  
Luiz Roberto Martins Rocha ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Direct Costs ◽  
University Hospital ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Public System ◽  
National Health Care ◽  
The Impact

PURPOSE: To analyze the direct costs of conservative surgical treatment of breast cancer, performed in a university hospital, to the Brazilian National Health Care Public System (SUS), checking the impact of the oncoplastic approach on these costs. METHODS: One hundred thirty eight breast cancer patients who had undergone conservative treatment with oncoplastic approach (n=36) or not (control group, n=102), in the period from 2005 to 2010, were enrolled. Sociodemographic and clinical data were recorded. The direct costs of the surgical procedure were obtained and analyzed. RESULTS: Groups did not differ in regard to age (p=0.963), and patients in oncoplastic group had a longer time of hospital stay (p=0.000). The median direct cost for the oncoplastic group was R$461.00 and for the control group was R$229.00 (p=0.000). CONCLUSION: The oncoplastic approach has generated higher direct costs in conservative surgical treatment of breast cancer to SUS.

Stapedotomy in osteogenesis imperfecta patients

2000 ◽  
Vol 114 (6) ◽  
pp. 424-428 ◽  
Author(s):  
E. Ferekidis ◽  
P. Stavroulaki ◽  
I. Vossinakis ◽  
J. Yiotakis ◽  
L. Manolopoulos ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Osteogenesis Imperfecta ◽  
Bone Conduction ◽  
Connective Tissue Disorder ◽  
Long Term Results ◽  
Mixed Hearing Loss ◽  
Post Test ◽  
Operative Findings ◽  
Blue Sclerae ◽  
The Impact

Osteogenesis imperfecta (OI) is a connective tissue disorder characterized by osseous fragility, blue sclerae and hearing loss. In order to assess the impact of stapedotomy on improving hearing on OI, a retrospective, one-group, pre-test-post-test design was used to compare the pre-operative and postoperative audiograms of nine OI patients, treated with stapedotomy for their mixed hearing loss. Operative findings included fixation or thickening of the stapes footplate with normal superstructure configuration and hypervascularization of the promontory mucosa. Immediate post-operative results showed a significant improvement (p<0.05) from 250–4000 Hz in air conduction and from 250–2000 Hz in bone conduction. A significant closure of the air-bone gap between 250–2000 Hz was also achieved (p<0.05). The long-term results remained satisfactory with a mean threshold shift of 8 dB HL and an almost unchanged air-bone gap. These satisfactory results and the lack of complications make stapedotomy an appealing method for the management of OI-associated hearing loss.

scholarly journals Multiple and Secondary Hormone Secretion in Patients With Metastatic Pancreatic Neuroendocrine Tumours

2016 ◽  
Vol 101 (2) ◽  
pp. 445-452 ◽  
Author(s):  
Joakim Crona ◽  
Olov Norlén ◽  
Pantelis Antonodimitrakis ◽  
Staffan Welin ◽  
Peter Stålberg ◽  
...  
Keyword(s):  
Progressive Disease ◽  
Clinical Symptoms ◽  
Hormone Secretion ◽  
University Hospital ◽  
Disease Stage ◽  
Disease Course ◽  
Advanced Disease Stage ◽  
Pancreatic Neuroendocrine Tumours ◽  
Close Time ◽  
The Impact

Abstract Context: As a group, neuroendocrine tumors (NETs) secrete many different peptide hormones, yet heretofore each NET patient is typically thought to produce at most one hormone that causes a distinct hormonal syndrome. A minority of patients have multiple hormones at diagnosis and may also develop secondary hormone secretion at a later stage. Objectives: The objectives of the study were to determine the frequency and to describe the impact of multiple and secondary hormone secretion in sporadic gasteroenteropancreatic NET patients. Design, Setting, and Participants: This was a retrospective analysis of patients (n = 972) with gasteroenteropancreatic NET treated at Uppsala University Hospital, Uppsala, Sweden. Patients with the secretion of multiple hormones at diagnosis and/or those developing secondary hormone secretion during the disease course were identified and studied in further detail. Results: In pancreatic NETs (PNETs), a total of 19 of 323 patients (6%) had secretion of multiple hormones at diagnosis, and 14 of 323 (4%) had secondary changes during the disease course. These phenomena occurred exclusively in patients with an advanced disease stage, and secondary hormones were detected in a close time span with progressive disease. Patients with secondary insulin hypersecretion had increased morbidity as well as reduced survival (P &lt; .002). In contrast, multiple and secondary hormone secretion was rarely seen in NETs of the small intestine with 0 and 1 of 603 cases, respectively. Conclusion: Diversity of PNET hormone secretion either at diagnosis or during the disease course occurred in a minority of patients (9.3%). These phenomena had a major impact on patient outcome both through increased morbidity and mortality. Our results support that patients with metastatic PNETs should be monitored for clinical symptoms of secondary hormone secretion during the disease course.

Surgical treatment of colorectal cancer liver metastases

2011 ◽  
Vol 18 (4) ◽  
pp. 161-169
Author(s):  
Dainius ŠIMČIKAS ◽  
Marius PAŠKONIS ◽  
Vitalijus SOKOLOVAS ◽  
Eligijus POŠKUS ◽  
Kęstutis STRUPAS
Keyword(s):  
Colorectal Cancer ◽  
Surgical Treatment ◽  
Liver Resection ◽  
Portal Vein ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
University Hospital ◽  
Interdisciplinary Treatment ◽  
Treatment Results ◽  
Vilnius University

Background. Colorectal cancer is a major health problem. Approximately 25% of the patients present with liver metastases at initial diagnosis and more than 50% develop metastases in the course of illness. Over the last few decades, with improvements in therapy, the management of colorectal liver metastases has changed dramatically. In this review, we explore various current modalities of care, with surgical treatment ahead, for patients with colorectal liver metastases and present a brief report about the Vilnius University Hospital Santariskiu Clinics experience in the surgical treatment of metastatic liver disease. Methods. The Medline / PubMed literature database was searched for articles on the topics of colorectal liver metastases, including criteria of surgical resectability, chemotherapy, adjunctive and locoregional therapies. Also, results of the surgical treatment of liver metastases at the Vilnius University Hospital Santariskiu Clinics were analysed. Results. Globally, surgical liver resection for colorectal liver metastases remains the only regular curative treatment with the 5-year survival rates reported as 20–50%. With improvements in therapy, resectability criteria are expanding. Hepatic metastases are primarily resectable in 15–25% cases only. Up to 25% of patients with initially non-resectable metastases become amenable to a potentially curative operation after interdisciplinary treatment involving preoperative chemotherapy, portal vein embolization or ligation, few-stage hepatectomy, and / or locally ablative procedures. We observed good and optimistic survival results in the Vilnius University Hospital Santariskiu Clinics patient population after liver resection: 1-, 2- and 3-year survival was 86.9%, 63.5% and 42.3%, respectively. Conclusions. Over the last ten years, liver surgery has changed dramatically. A thorough selection of patients with colorectal liver metastases in a multidisciplinary team may improve treatment results significantly. Surgical treatment results for liver metastases at the Vilnius University Hospital Santariskiu Clinics are good. Keywords: colorectal liver metastases, liver resection, ablation, chemotherapy, portal vein embolisation

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