Engineering
functional biomaterials surfaces that resist biofilm
formation triggered by unspecific protein adsorption is a key challenge,
and these biosurfaces hold a huge potential in implant-associated
infection. Herein, we report a water-based facile approach to install
carboxylated-hyaluronic acid and sulfated-fucoidan on cationically
tethered polydimethylsiloxane (PDMS) implant. We showed that these
hydrophilic, charged, polysaccharide-based biosurfaces/biocoatings
provide long-term stability, no adsorption of proteins (albumin and
fibrinogen), similar to zwitterionic polymers, and enhanced resistance
to plasma deposition and growth of Staphylococcus aureus pathogen. These findings shall pave the way in developing novel
biocoatings, thereby broadening the applicability of PDMS-based implants
in complex biological applications.
Hyperpneumatization of the temporal bone with extension into the occipital bone and even the parietal bones is a rare condition. According to a review of the literature, it mostly appears unilaterally in men and on the right side. Often it is discovered when complications like pneumatocele or pneumocephalus appear. The authors review and analyze all reported cases of hyperpneumatization, its symptoms, complications and treatment. We present a patient with extensive pneumatization found in the mastoid process, temporal bone, occipital bone and both parietal bones, who was discovered accidentally. The cause of the extension of pneumatization into the occipital and parietal bone is probably incomplete closure of the occipitomastoid synchondrosis and lambdoid and sagital sutures, which usually close in early adulthood and later, even in the 30s. Asymptomatic patients should be aware of possible complications, and in case of complications, operative therapy is often indicated.
Silicones are widely used medical materials that are also applied for tympanostomy tubes with a trending goal to functionalise the surface of the latter to enhance the healing of ear inflammations and other ear diseases, where such medical care is required. This study focuses on silicone surface treatment with various antimicrobial coatings. Polysaccharide coatings in the form of chitosan nanoparticles alone, or with an embedded drug mixture composed of amoxicillin/clavulanic acid (co-amoxiclav) were prepared and applied onto silicone material. Plasma activation was also used as a pre-treatment for activation of the material’s surface for better adhesion of the coatings. The size of the nanoparticles was measured using the DLS method (Dynamic Light Scattering), stability of the dispersion was determined with zeta potential measurements, whilst the physicochemical properties of functionalised silicone materials were examined using the UV-Vis method (Ultraviolet-Visible Spectroscopy), SEM (Scanning Electron Microscopy), XPS (X-Ray Photoelectron Spectroscopy). Moreover, in vitro drug release testing was used to follow the desorption kinetics and antimicrobial properties were tested by a bacterial cell count reduction assay using the standard gram-positive bacteria Staphylococcus aureus. The results show silicone materials as suitable materials for tympanostomy tubes, with the coating developed in this study showing excellent antimicrobial and biofilm inhibition properties. This implies a potential for better healing of ear inflammation, making the newly developed approach for the preparation of functionalised tympanostomy tubes promising for further testing towards clinical applications.
The technique of facial nerve repair with side-to-end hypoglossalfacial anastomosis is presented and evaluated in five patients who were operated on for facial nerve paralysis after acoustic schwannoma surgery, or had cranial base trauma. The end-to-end hypoglossal-facial anastomosis is accompanied by hemilingual paralysis, with difficulty in swallowing, chewing and speaking. In this new technique, the facial nerve is mobilised in the temporal bone, transected at the second genu and transposed to the hypoglossal nerve where a tensionless side-to-end anastomosis is performed. The hypoglossal nerve is transected in oblique fashion to about one third of its circumference. We were able to achieve a tensionless anastomosis in all patients. The idea is to bring about re-innervation of the previously denervated tissue via a collateral sprouting of axons of the donor nerve through the site of coaptation without sacrificing the innervation of the donor nerve's original targets. With side-to-end hypoglossal-facial anastomosis, two patients attained a House-Brackmann grade of III (one of them with independent movement of eyelids and mouth); one achieved grade IV, another grade V and grade VI. No patient had hemilingual atrophy nor any problems associated with swallowing or chewing.
Gadolinium-enhanced T1-weighted MRI findings of the depth of penetration into the lateral aspect of the IAC do not always correlate with intraoperative findings and thus may have implications in the selection of surgical approaches to acoustic neuromas.
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