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EN
Round window’s movability measurements with helping of LDV in evaluation of ossicular chain functioning. Aim of study: Quantitive evaluation of round window movability in normal conditions and after malleus stapes assembly reconstruction were aims of the study. Methods and materials: In the experiment there were taken 10 non-frozen temporal bones harvested within 48 hours.Temporal bones specimens were prepared like in closed technique with antromastoidectomy and large posterior tympanotomy. Hearing system before and after MSA reconstruction were evaluated by measurement of round window movement. Measurements were performed at four frequencies: 1000 Hz, 2000 Hz, 4000 Hz, 8000 Hz. Results: In the normal ossicular chain the biggest movability were stated at frequency of 1 kHz. After reconstruction at all frequencies measurements were signifi cantly worse. In reconstructed ears the highest movabilities were stated at frequencies 2000 Hz and 4000 Hz. Conclusions: Round window movability could be measured by Laser Doppler Vibrometry in posterior tympanotomy approach. Before reconstruction the biggest movability were evaluated at 1000 Hz and after MSA at 2000 Hz
EN
Introduction: Ossiculoplasty can be carried out in a number of ways, depending on the anatomical and functional conditions encountered during otosurgery and the experience of a given centre. The extent of damage to the ossicular chain determines the reconstruction method. Aim: The objective of the study was to analyse treatment effects in terms of postoperative hearing improvement in patients with chronic otitis media, with a particular emphasis on stapedial superstructure preservation. Material and method: The records of 294 consecutive patients undergoing their first ENT surgery due to chronic otitis media at the Department of Otolaryngology of Collegium Medicum, Jagiellonian University of Kraków in 2009–2013 were analysed. In order to assess the role of preserved stapedial superstructure, 96 patients were eligible for further analysis. Results: The analysis points to a significant hearing improvement after ossiculoplasty with the preserved stapedial superstructure as compared with the patients after footplate mobilisation. On the other hand, the research results point to significantly smaller hearing improvement in those patients, in whom only stapes was preserved, as compared with those, in whom a more extensive reconstruction of the ossicular chain was possible. Conclusions: The air-bone gap measured before otosurgery often fails to reflect the extent of abnormalities and cannot, therefore, be considered as the only prognostic factor for postoperative hearing improvement. Stapes preservation is crucial for hearing improvement after middle ear surgery.
EN
Introduction: Ossiculoplasty can be carried out in a number of ways, depending on the anatomical and functional conditions encountered during otosurgery and the experience of a given centre. The extent of damage to the ossicular chain determines the reconstruction method. Aim: The objective of the study was to analyse treatment effects in terms of postoperative hearing improvement in patients with chronic otitis media, with a particular emphasis on stapedial superstructure preservation. Material and method: The records of 294 consecutive patients undergoing their first ENT surgery due to chronic otitis media at the Department of Otolaryngology of Collegium Medicum, Jagiellonian University of Kraków in 2009–2013 were analysed. In order to assess the role of preserved stapedial superstructure, 96 patients were eligible for further analysis. Results: The analysis points to a significant hearing improvement after ossiculoplasty with the preserved stapedial superstructure as compared with the patients after footplate mobilisation. On the other hand, the research results point to significantly smaller hearing improvement in those patients, in whom only stapes was preserved, as compared with those, in whom a more extensive reconstruction of the ossicular chain was possible. Conclusions: The air-bone gap measured before otosurgery often fails to reflect the extent of abnormalities and cannot, therefore, be considered as the only prognostic factor for postoperative hearing improvement. Stapes preservation is crucial for hearing improvement after middle ear surgery.
EN
Introduction: Chronic otitis media is characterized by tympanic membrane perforation and conductive hearing loss. In the active form of this disease, there will also be periodic or permanent otorrhea. With a number of surgical techniques available depending on intraoperative findings, otosurgery is the treatment of choice in such cases, the extent of which depends on the type and extent of the pathological changes. Material and Method: We carried out an analysis of 79 patients with chronic otitis media undergoing surgery at the Department of Otolaryngology, Jagiellonian University Medical College in Kraków between 2005 and 2014. Total audiometry was used as a part of hearing assessment, before the surgery, 6 months after the surgery and in the distant 10-year observation period. In addition, each patient completed the questionnaire and was examined by an otolaryngologist. Results: The analysis included 79 patients operated on due to chronic otitis media. The mean bone conduction (for frequencies 500,1000 and 2000 Hz) before surgery was 31.8 dB, it did not differ significantly (p = 0.355) after 6 months after surgery (32.8 dB), while it significantly increased (p < 0.001) in a distant 10-year control of 43.4 dB. The mean air conduction (for frequencies 500, 1000 and 2000 Hz) before the procedure was 57.6 dB, it significantly improved in the early control by 50.5 dB, at p < 0.001. In long-term follow-up it increased again to 61.3 dB and was significantly different from the early postoperative period (p < 0.001). The mean air-bone gap for frequencies 500, 1000 and 2000 Hz before surgery was on average 26.4 dB, it was significantly (p < 0.001) reduced in the postoperative period by 17.6 dB. The level of air-bone gap remained at a similar level in distant control. Conclusions: (1) A completely preserved ossicular chain in the absence of active chronic otitis media is the best prognosis for stable hearing improvement over the years with normal inner ear function; (2) Reoperation worsens the long-term results of a hearing test compared to the first operation.
EN
Introduction: Chronic otitis media is characterized by tympanic membrane perforation and conductive hearing loss. In the active form of this disease, there will also be periodic or permanent otorrhea. With a number of surgical techniques available depending on intraoperative findings, otosurgery is the treatment of choice in such cases, the extent of which depends on the type and extent of the pathological changes. Material and Method: We carried out an analysis of 79 patients with chronic otitis media undergoing surgery at the Department of Otolaryngology, Jagiellonian University Medical College in Kraków between 2005 and 2014. Total audiometry was used as a part of hearing assessment, before the surgery, 6 months after the surgery and in the distant 10-year observation period. In addition, each patient completed the questionnaire and was examined by an otolaryngologist. Results: The analysis included 79 patients operated on due to chronic otitis media. The mean bone conduction (for frequencies 500,1000 and 2000 Hz) before surgery was 31.8 dB, it did not differ significantly (p = 0.355) after 6 months after surgery (32.8 dB), while it significantly increased (p < 0.001) in a distant 10-year control of 43.4 dB. The mean air conduction (for frequencies 500, 1000 and 2000 Hz) before the procedure was 57.6 dB, it significantly improved in the early control by 50.5 dB, at p < 0.001. In long-term follow-up it increased again to 61.3 dB and was significantly different from the early postoperative period (p < 0.001). The mean air-bone gap for frequencies 500, 1000 and 2000 Hz before surgery was on average 26.4 dB, it was significantly (p < 0.001) reduced in the postoperative period by 17.6 dB. The level of air-bone gap remained at a similar level in distant control. Conclusions: (1) A completely preserved ossicular chain in the absence of active chronic otitis media is the best prognosis for stable hearing improvement over the years with normal inner ear function; (2) Reoperation worsens the long-term results of a hearing test compared to the first operation.
EN
Introduction: Surgical treatment of conductive hearing loss runs the risk of damage to the inner ear in the mechanism of acoustic trauma. Aim: The aim of this study was to evaluate the function of the organ of Corti, expressed as bone conduction threshold at the frequency of 4000 Hz for selected operations: mastoidectomy and canal-wall-down procedure. Material and methods: The material was collected from patients with chronic otitis media in the Department of Otolaryngology and ENT Oncology, Collegium Medicum of Nicolaus Copernicus University in Bydgoszcz in 2004–2009. All patients were examined with pure tone audiometry threshold before surgery and at least three years after surgery. The analyzed group of patients was divided into subgroups depending on the type of operation according to To classification and procedures for resection: mastoidectomy and canal-wall-down procedure. The results were statistically analyzed. Results: In the analyzed period of three years after surgery there was no statistically significant difference between groups, although there were higher values for tympanoplasty type 1 with mastoidectomy compared with tympanoplasty type 1 without mastoidectomy - respectively 25.67 dB and 18.53 dB. In the study, there was no statistically significant the difference in bone conduction threshold for frequency 4000 Hz within the type 2 tympanoplasty according to Tosa comparing canal wall-up and canal-wall-down procedure. Conclusions: Mastoidectomy or canal-wall-down procedure do not affect the bone conduction threshold for a frequency of 4000 Hz after tympanoplasty in long-term observation.
EN
Objective: The aim of the study was to evaluate risk factors influencing the results of tympanoplasties on the base of material taken from the Department of Otolaryngology and Laryngological Oncology Collegium Medicum of the Nicolaus Copernicus University in Bydgoszcz between 2004-2009. In this period, 98 operations were performed. The time from operations to hearing examination was 3 to 7 years, mean 5,43. Tympanoplastic operations were divided according to Tos classification. Measuring hearing results, tonal audiometry was done and mean air bone gap on four frequencies was assessed (500, 1000, 2000, 3000 Hz), according to AAO-HNS guidelines (1995). This parameter was compared between groups separated according to risk factors, that could potentially affect the results. Those risk factors were: disfunction of the Eustachian tube, location and size of the perforation of the tympanic membrane, damage of the ossicles, the state of the mastoid process, the number of operations, the presence of the cholesteatoma or granulating tissue, chronic otitis media in the opposite ear, smoking cigarettes, mastoidectomy, canal wall down technique. The results were analyzed using statistical test. Results: The most important risk factor affecting treatment results (besides discharge from the ear) is damage of the ossicles, especially the malleus and stapes. A properly performed operation ensures good hearing results irrespectively of the presence of cholesteatoma or granulating tissue, and also in case of reoperation. For all types of tympanoplasties neither the location, nor the size of perforation influence the hearing results in long-term observation.
EN
Objective: The aim of the study was to evaluate risk factors influencing the results of tympanoplasties on the base of material taken from the Department of Otolaryngology and Laryngological Oncology Collegium Medicum of the Nicolaus Copernicus University in Bydgoszcz between 2004-2009. In this period, 98 operations were performed. The time from operations to hearing examination was 3 to 7 years, mean 5,43. Tympanoplastic operations were divided according to Tos classification. Measuring hearing results, tonal audiometry was done and mean air bone gap on four frequencies was assessed (500, 1000, 2000, 3000 Hz), according to AAO-HNS guidelines (1995). This parameter was compared between groups separated according to risk factors, that could potentially affect the results. Those risk factors were: disfunction of the Eustachian tube, location and size of the perforation of the tympanic membrane, damage of the ossicles, the state of the mastoid process, the number of operations, the presence of the cholesteatoma or granulating tissue, chronic otitis media in the opposite ear, smoking cigarettes, mastoidectomy, canal wall down technique. The results were analyzed using statistical test. Results: The most important risk factor affecting treatment results (besides discharge from the ear) is damage of the ossicles, especially the malleus and stapes. A properly performed operation ensures good hearing results irrespectively of the presence of cholesteatoma or granulating tissue, and also in case of reoperation. For all types of tympanoplasties neither the location, nor the size of perforation influence the hearing results in long-term observation.
EN
Introduction: Surgical treatment of conductive hearing loss runs the risk of damage to the inner ear in the mechanism of acoustic trauma. Aim: The aim of this study was to evaluate the function of the organ of Corti, expressed as bone conduction threshold at the frequency of 4000 Hz for selected operations: mastoidectomy and canal-wall-down procedure. Material and methods: The material was collected from patients with chronic otitis media in the Department of Otolaryngology and ENT Oncology, Collegium Medicum of Nicolaus Copernicus University in Bydgoszcz in 2004–2009. All patients were examined with pure tone audiometry threshold before surgery and at least three years after surgery. The analyzed group of patients was divided into subgroups depending on the type of operation according to To classification and procedures for resection: mastoidectomy and canal-wall-down procedure. The results were statistically analyzed. Results: In the analyzed period of three years after surgery there was no statistically significant difference between groups, although there were higher values for tympanoplasty type 1 with mastoidectomy compared with tympanoplasty type 1 without mastoidectomy - respectively 25.67 dB and 18.53 dB. In the study, there was no statistically significant the difference in bone conduction threshold for frequency 4000 Hz within the type 2 tympanoplasty according to Tosa comparing canal wall-up and canal-wall-down procedure. Conclusions: Mastoidectomy or canal-wall-down procedure do not affect the bone conduction threshold for a frequency of 4000 Hz after tympanoplasty in long-term observation.
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