Dysphonia is often caused by polyps which are benign changes of pseudotumors. With their presence they are hampering with glotis oclusion. Laryngomicroscopy of general and endotracheal anaesthesia has been preformed on all of the patients. Microsurgical technique has been used to remove the polyps. Bioptic material was analyzed in pathophysiological laboratory of clinic of pathology in Banjaluka. All of the results were presented through tables and graphic representations. Frequency of polyps through age and sex groups, along with the examination of ethyological factors in emergence of polyps of vocal cords. Results are in accordance with the results of other authors who were involved in similar problematics. Through analysis of our data we percieve that the abuse of voice is part of ethiological factors that lead not only to emergence of vocal fold lesions but aswell as other benign changes.
INTRODUCTION:The aim of the study was to compare hearing results between tympanoplasty with attic wall reconstruction and attic obliteration. MATERIAL AND METHODS:A prospective study included 88 patients who were operated for chronic suppurative otitis media (CSOM) and cholesteatoma in the ENT Department University Clinic Center Banja Luka from 2006 to 2011. Analysis of variance (ANOVA) was conducted to assess the impact of two different techniques of tympanoplasty: attic wall reconstruction and attic wall obliteration on patients' hearing. Hearing outcome was measured comparing preoperative to postoperative pure-tone average (PTA) and postoperative air-bone gap (ABG). RESULTS: Cholesteatoma was found in 54 (61.4%) patients: 31 (35.2%) sinus cholesteatoma, 20 (22.7%) attic cholesteatoma, 3 (3.4%) tensa tympanic cholesteatoma, and 34 cases (38.6%) of CSOM. Lateral attic wall and ossicular chain reconstruction was performed in 33 cases with subsequent attic reconstruction if the long process of the incus and the incudo-stapedial joint were missing. A mixed between-within-subjects analysis of variance showed significant improvement of PTA postoperatively in comparison to preoperative levels: Wilk's Lambda=0.33, F(1,86)=172.1, p<0.001. ANOVA showed significant improvement of ABG postoperatively in comparison to preoperative levels: Wilk's Lambda=0. 23, F(1,86)=286.3, p<0.001. Hearing improvement was measured in both cases, the ABG closure and mean PTA improvement was larger in the attic reconstruction compared to attic obliteration technique. CONCLUSION: Attic wall reconstruction with cartilage provides better postoperative hearing compared to attic obliteration. Attic reconstruction in revision cases for cholesteatoma recurrence is not recommended.Hearing results of tympanoplasty with attic reconstruction vs. obliteration in attic cholesteatoma wall up mastoidectomy for prevention of retraction pocket. Otol Neurotol. 2005 Nov;26 (6):1107-11. 10. Stankovic M. Follow-up of cholesteatoma surgery: open versus closed tympanoplasty. ORL J Otorhinolaryngol Relat Spec. 2007;69(5):299-305
Introduction. The inflammatory mediators play a central role in the pathogenesis of the inflammatory process of the middle ear and cholesteatoma from the aspect of initiating and maintaining the inflammatory response to infection and lesion. The aim of the study was to examine if the presence of acquired cholesteatoma could predict pathomorphological changes of the tympanic cavity mucosa in relation to the control tissue of the inflamed middle ear mucosa and to examine and compare the expression levels of tumor necrosis factor-alpha (TNF-a), interleukin-1 (IL-1) and matrix metalloproteinase 9 (MMP-9) with pathomorphological changes in the middle ear mucosa in chronic otitis media (COM), with and without acquired cholesteatoma (AC). Methods. The immunohistochemical study included 178 patients of both sexes, aged 5 to 75, who underwent microsurgical treatment of COM from 2015 to 2018. Patients were divided into two groups based on the presence or absence of AC of the middle ear: 97 with cholesteatoma (CCOM) and 81 without cholesteatoma (COM). Samples of the perimatrix of AC and inflamed middle ear mucosa were taken intraoperatively. The condition of the tympanic cavity mucosa was examined by otomicroscopy exploration intraoperatively. The expression levels of TNF-a, IL-1 and MMP-9 were determined by immunohistochemical analysis. Results. The difference in the percentage distribution of patients according to the condition of the tympanic cavity mucosa between both groups was statistically significant (p <0.01) where in the COM group the highest frequency was 43.2% of patients with mucosal hypertrophy, and in the CCOM 56.7% with granulations. With highly positive expression of TNF-R2 and IL-1, a higher probability of the presence of mucosal hypertrophy and granulations can be expected, and with highly positive expression of MMP-9 the presence of granulations. Conclusion. Acquired middle ear cholesteatoma is a statistically significant predictor of the occurence of mucosal hypertrophy and granulations in the tympanic cavity in relation to the control tissue of the inflamed middle ear mucosa. The high expression of TNF-R2, IL-1 and MMP-9 shows a statistically significant association with the presence of granulations and mucosal hypertrophy in acquired middle ear cholesteatoma which may have clinical significance in the evaluation and prognosis of the disease.
¹Klinika za bolesti uha, grla i nosa, Univerzitetski klinički centar Republike Srpske, Banja Luka, Republika Srpska, Bosna i Hercegovina 2 Medicinski fakultet, Univerzitet u Banjoj Luci, Banja Luka, Republika Srpska, Bosna i Hercegovina 3 Univerzitetska bolnica Foča, Republika Srpska, Bosna i Hercegovina Kratak sadržajUvod. Holesteatom se definiše kao cistična, ekspanzivna lezija temporalne kosti, čiju glavnu osobinu karakteriše progresivan rast s erozijom okolne kosti. Cilj istraživanja je bio da se ispita status osikularnog lanca i koštanih zidova kavuma timpani kod ispitanika sa holesteatomom srednjeg uha.Metode. Studija je obuhvatila 100 ispitanika, oba pola, u dobi od 16 do 84 godine, operativno tretiranih zbog hronične upale srednjeg uha u Klinici za bolesti uha, grla i nosa Univerzitetskog kliničkog centra Republike Srpske, u razdoblju od 2015. do 2016. godine. Ispitanici su podijeljeni u dvije grupe od po 50 ispitanika prema prisustvu holesteatoma: eksperimentalnu grupu sa holesteatomom i kontrolnu grupu bez holesteatoma. Intraoperativnom eksploracijom ispitan je status osikularnog lanca i koštanih zidova kavuma timpani.Rezultati. U kontrolnoj grupi bez holesteatoma statistički značajno veći broj ispitanika je imao očuvan anatomski integritet koštanih zidova kavuma timpani (47/50; χ 2 = 38,720; p < 0,001) za razliku od eksperimentalne grupe gdje su statistički značajno učestaliji bili ispitanici s destrukcijom pomenutih anatomskih struktura (41/50; χ 2 = 22,224; p < 0,001). Utvrđena je statistički značajna razlika između grupe sa i bez holesteatoma u odnosu na status osikularnog lanca. U eksperimentalnoj grupi je zabilježena statistički znača-jno veća učestalost ispitanika (36%) s nedostatkom inkusa i drške maleusa i erozijom suprastruktura stapesa, a u kontrolnoj statistički značajno veća učestalost ispitanika (76%) s očuvanim osikularnim lancem.Zaključak. Destrukcija koštanih zidova kavuma timpani i osikularnog lanca je bila statistički značajno učestalija kod ispitanika sa holesteatomom srednjeg uha. Prema stepenu destrukcije osikularnog lanca, statistički najzastupljenija je bila kategorija ispitanika s nedostatkom inkusa, drške maleusa, kao i erozijom suprastruktura stapesa.Ključne riječi: osikularni lanac, holesteatom, upala srednjeg uha
Introduction. Diseases associated with immunoglobulin E hypersensitivity, such as allergic rhinitis, may have different clinical expressions. Patients with allergic rhinitis often have associated diseases, comorbidities, which supports the concept of allergy as a systemic disease. The aim of this study was to evaluate the incidence and types of comorbidities in allergic rhinitis. We also evaluated the possible effects of certain clinical and demographic parameters on the onset of comorbidities. Material and Methods. This retrospective, observational, and cross-sectional study included patients with a clinical diagnosis of allergic rhinitis treated at the Department of Ear, Nose and Throat in the period from October 2011 to April 2013. The collected data were analyzed using the Statistical Analysis System (Institute Inc. NC, USA) program, version 9.1.3. Results. The study included 319 patients with allergic rhinitis. Allergic rhinitis was intermittent in 30.7% of cases, persistent in 37.9%, and persistent with seasonal exacerbation in 31.3% of patients. We found that 86.8% of patients had some form of comorbidity. The most common were conjunctivitis (50.2%), almost equal percentage of asthma (29.8%) and chronic rhinosinusitis (28.8%), followed by otitis media with effusion (8.8%), atopic dermatitis (5.2%), urticaria (4.1%), and laryngitis (3.8%). Persistent allergic rhinitis, with persistent nasal obstruction as the dominant symptom, was significantly associated with chronic rhinosinusitis. Positive family history was significantly associated with the occurrence of asthma and allergic rhinitis. Conclusion. The results of our study showed that allergic rhinitis is rarely an isolated condition and it should always be observed in the context of the allergic respiratory syndrome.
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