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1.
Braz. j. otorhinolaryngol. (Impr.) ; 87(6): 683-688, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1350346

ABSTRACT

Abstract Introduction: As a supplement, beta-glucan has various therapeutic healing effects generated by the immune cells. It has been scientifically approved and proven to be a biological defense modifier. The aim of this study was to investigate the effects of beta-glucan on treatments administered in an acute otitis media model Objectives: This study investigated the effect of beta-glucan on the treatment of acute otitis media in an acute otitis media -induced animal model. Efficacy was evaluated both immunologically and histologically. Methods: The study sample comprised 35 adult rats, randomly separated into 5 groups of 7: Group 1 (control), Group 2 (acute otitis media, no treatment), Group 3 (acute otitis media + antibiotic), Group 4 (acute otitis media + beta-glucan) and Group 5 (acute otitis media + beta-glucan + antibiotic). Analyses were made of the histopathology and immunology examination results in respect of thickening of the tympanic membrane, epithelium damage, inflammation, and sclerosis. In all groups the serum levels of TNF-α, IL-4, IL-6 and IL-1β were evaluated. Results: All serum cytokine levels were significantly lower in the beta-glucan and antibiotictreated groups compared to the acute otitis media Group. Significant differences in tympanic membrane thickness, inflammation, epithelium damage, and sclerosis values were observed between the acute otitis media + antibiotic and acute otitis media + beta-glucan Groups. According to these parameters, the values in aute otitis media + antibiotic + beta-glucan Group were markedly lower than those of the other groups. There was a significant difference in the acute otitis media + antibiotic + beta-glucan Groups compared to acute otitis media Group (p < 0.001). Conclusions: Both antibiotic and beta-glucan treatment reduced acute otitis media signs of inflammations in an acute otitis media-induced rat model, decreasing histological damage and cytokine levels. Co-administration of antibiotic and beta-glucan led to a significant reduction in tympanic membrane thickness, inflammation, and epithelium damage. Antibiotic + beta-glucan treatment resulted in a greater decrease in tympanic membrane thickness, inflammation, and epithelium damage than in the other groups. From these results, it can be suggested that beta-glucan, in combination with antibiotics may provide an alternative for the treatment of acute otitis media.


Resumo Introdução: Como suplemento, o beta-glucano apresenta vários efeitos terapêuticos gerados pelas células imunológicas. Cientificamente aprovado, mostrou ser um modificador de defesa biológica. Objetivo: Investigar os efeitos do beta-glucano nos tratamentos administrados em um modelo de otite média aguda induzida em um modeloanimal. A eficácia foi avaliada imunológica e histologicamente. Método: A amostra do estudo foi composta por 35 ratos adultos, divididos aleatoriamente em 5 grupos de 7: grupo 1 (controle), grupo 2 (otite média aguda, sem tratamento), grupo 3 (otite média aguda + antibiótico), grupo 4 (otite média aguda + beta-glucano) e grupo 5 (otite média aguda + beta-glucano + antibiótico). Foram feitas análises dos resultados dos exames histopatológicos e imunológicos em relação ao espessamento da membrana timpânica, dano ao epitélio, inflamação e esclerose. Os níveis séricos de TNF-α, IL-4, IL-6 e IL-β foram avaliados em todos os grupos. Resultados: Todos os níveis séricos de citocinas foram significativamente mais baixos nos grupos tratados com beta-glucano e antibióticos em comparação com o grupo otite média aguda. Diferenças significativas na espessura da membrana timpânica, inflamação, dano do epitélio e esclerose foram observadas entre os grupos otite média aguda + antibiótico e otite média aguda + beta-glucano. De acordo com esses parâmetros, os valores no grupo otite média aguda + antibiótico + beta-glucano foram acentuadamente inferiores aos dos demais grupos. Houve uma diferença significante no grupo otite média aguda + antibiótico + beta-glucano em comparação ao grupo otite média aguda (p < 0,001). Conclusão: Ambos os tratamentos com antibiótico e com beta-glucano reduziram os sinais de inflamação da otite média aguda em um modelo de rato com otite média aguda induzida, diminuíram os danos histológicos e os níveis de citocinas. A administração concomitante de antibiótico e beta-glucano levou a uma redução significativa na espessura da membrana timpânica, inflamação e danos ao epitélio. O tratamento com antibióticos + beta-glucano resultou em maior diminuição na espessura da membrana timpânica, inflamação e danos no epitélio do que nos outros grupos. A partir desses resultados, pode-se sugerir que o beta-glucano, em combinação com antibióticos, pode fornecer uma opção para o tratamento da otite média aguda.


Subject(s)
Animals , Rats , Otitis Media/drug therapy , beta-Glucans , Tympanic Membrane , Acute Disease , Cytokines , Anti-Bacterial Agents/therapeutic use
2.
Braz. j. otorhinolaryngol. (Impr.) ; 87(1): 53-58, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153598

ABSTRACT

Abstract Introduction: Traumatic tympanic membrane perforations tend to heal spontaneously. However, in this study, several perforations exhibited abnormal healing, where the morphology of healing tympanic membranes differed from that of non-perforated tympanic membranes. Pseudo-healing of the tympanic membrane was characterized by the accumulation of thickened tissue in the perforated area. Objective: The purpose of this study was to evaluate the utility of epidermal growth factor in cases showing pseudo-healing of traumatic tympanic membrane perforations. Methods: A total of 26 traumatic tympanic membrane perforations showing pseudo-healing were included in this study. In all cases, tissue that accumulated in the perforated area was removed, which subsequently caused a new perforation to form. An epidermal growth factor solution was applied to the tympanic membrane once daily to keep the tympanic membrane moist. Closure rates and times were evaluated at 6 months. Results: During the 6 months follow-up period, two patients were lost. Of the remaining 24 patients, the closure rate was 100% (24/24) and the closure time was 6.1 ± 2.3 days (range: 3-12 days). The morphology of the healed tympanic membrane was not significantly different from that of the remnant tympanic membrane. Conclusions: Pseudo-healing of traumatic tympanic membrane perforations affects sound conduction. This can be associated with various symptoms, including tinnitus, aural fullness, and ear discomfort. The excision of excessive epithelial tissue and topical application of epidermal growth factor can correct the pseudo-healing of traumatic tympanic membrane perforations.


Resumo Introdução: As perfurações traumáticas da membrana timpânica tendem a cicatrizar espontaneamente. Entretanto, neste estudo, várias perfurações exibiram cicatrização anormal, na qual a morfologia da cicatrização das membranas timpânicas diferiu da de membranas timpânicas não perfuradas. A pseudocicatrização da membrana timpânica foi caracterizada pelo acúmulo de tecido espesso na área perfurada. Objetivo: Avaliar a utilidade do fator de crescimento epidérmico em casos que apresentaram pseudocicatrização de perfurações traumáticas da membrana timpânica. Método: Um total de 26 casos de perfurações traumáticas da membrana timpânica apresentando pseudocicatrização foram incluídos neste estudo.. Em todos os casos, o tecido que se acumulou na área perfurada foi removido, o que subsequentemente causou uma nova perfuração. Uma solução de fator de crescimento epidérmico foi aplicada à membrana timpânica uma vez ao dia para manter a membrana timpânica úmida. As taxas de fechamento e os tempos foram avaliados aos 6 meses. Resultados: Dois pacientes foram perdidos no período de 6 meses de acompanhamento. Dos 24 pacientes restantes, a taxa de fechamento foi de 100% (24/24) e o tempo de fechamento foi de 6,1 ± 2,3 dias (variação: 3 a 12 dias). A morfologia da membrana timpânica cicatrizada não foi significativamente diferente daquela da membrana timpânica remanescente. Conclusões: A pseudocicatrização de perfurações traumáticas da membrana timpânica afeta a condução do som. Isso pode estar associado a vários sintomas, inclusive zumbido, plenitude aural e desconforto auditivo. A excisão do tecido epitelial excessivo e a aplicação tópica de fator de crescimento epidérmico podem corrigir a pseudocicatrização de perfurações traumáticas da membrana timpânica.


Subject(s)
Humans , Tympanic Membrane Perforation/drug therapy , Epidermal Growth Factor , Tympanic Membrane , Wound Healing
3.
Article in Chinese | WPRIM | ID: wpr-942424

ABSTRACT

Objective: To explore the clinical characteristics, intervention and treatment of tympanic osteoma at different locations. Methods: The medical history, audiological and imaging examination, operation and follow-up results of two patients with tympanic osteoma at different sites were reviewed and summarized. Furthermore, the clinical characteristics and interventions of 36 patients reported in literatures with tympanic osteomas were also summarized and analyzed. Results: Osteoma of the two patients collected in this study located at promontory and incus respectively;both of them presented with intact tympanum and conductive deafness, without obvious etiology or predisposing factor. Both of them underwent surgeries and the hearing improved significantly. For patient one, the ossicular chain was intact and restored to activity after removed the osteoma. For patient two, an artificial ossicle was implanted after removed the osteoma and incus. In the 36 patients reported in literatures, the average age was 26.5 years, and 39.47% of them located at promontory; in addition, the main symptoms of them were progressive hearing loss, tinnitus and ear stuffy. Conclusions: Patients with tympanic osteoma are characterized by conduction deafness with intact tympanic membrane, and the most common lesion is promontory. Hearing can be restored by excision of the osteoma and maintenance or reconstruction of the ossicle chain.


Subject(s)
Adult , Ear Ossicles/surgery , Ear, Middle/surgery , Hearing Loss, Conductive/surgery , Humans , Osteoma/surgery , Tympanic Membrane
4.
Braz. j. otorhinolaryngol. (Impr.) ; 86(6): 727-733, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1142607

ABSTRACT

Abstract Introduction: Perforation of the tympanic membrane is a reasonably frequent diagnosis in otorhinolaryngologists' offices. The expectant management is to wait for spontaneous healing, which usually occurs in almost all cases in a few weeks. However, while waiting for healing to be completed, the patients may experience uncomfortable symptoms. Although some research suggests the use of various materials to aid in the recovery of the tympanic membrane, none presented robust evidence of improvement in the cicatricial process. Nevertheless, the occlusion of the perforation with some material of specific texture and resistance can alleviate the patients' symptoms and accelerate the healing process. Objective: To evaluate the clinical (symptomatic and functional) improvement after the placement of bacterial cellulose film (Bionext®) on tympanic membrane perforations (traumatic). Methods: We evaluated 24 patients, victims of traumatic perforations of the tympanic membrane, who were evaluated in the Otorhinolaryngology Emergency Room. Following otoscopy and audiometric examination was performed, before and after the use of cellulose film occluding the tympanic membrane perforation. Results: Twenty-four patients were included, whose degree of overall discomfort caused by the tympanic membrane perforation and the presence of symptoms of autophonia, ear fullness and tinnitus were investigated. The mean score attributed to the overall annoyance caused by tympanic membrane perforation was 7.79, decreasing to a mean value of 2.25 after the film application. Symptom evaluation also showed improvement after using the film: autophonia decreased from a mean value of 6.25 to 2.08, tinnitus from 7 to 1.92 and ear fullness from 7.29 to 1.96. The auditory analysis showed mean threshold values still within the normal range at low and medium frequencies, with slight hearing loss at acute frequencies, but with significant improvement at all frequencies, with the exception of 8000 Hz, after film use. Conclusion: The use of bacterial cellulose film fragment on traumatic perforations of the tympanic membrane promoted immediate functional and symptomatic recovery in the assessed patients.


Resumo Introdução: A perfuração da membrana timpânica é uma condição clínica relativamente frequente em consultórios de otorrinolaringologistas. A conduta é quase sempre expectante, aguardando cicatrização espontânea, que costuma ocorrer na quase totalidade dos casos em algumas semanas. No entanto, enquanto não se completa, os pacientes mantêm sintomas desconfortáveis. Embora algumas pesquisas sugiram o uso de materiais diversos para auxiliar na recuperação da membrana timpânica, nenhuma apresentou evidência substancial de melhoria no processo cicatricial. Por outro lado, a oclusão da perfuração com alguns materiais de textura e resistência específicas poderia aliviar os sintomas dos pacientes durante o processo cicatricial. Objetivo: Avaliar a melhoria clínica (sintomática e funcional) após a colocação de película de celulose bacteriana (Bionext®) sobre a perfuração da membrana timpânica (traumática). Método: Foram avaliados pacientes com perfurações traumáticas da membrana timpânica que deram entrada no pronto-socorro de otorrinolaringologia. Eles foram avaliados em relação a suas queixas e exame audiométrico, antes e após a aplicação de película de celulose que oclui a perfuração da membrana timpânica. Resultados: Foram incluídos 24 pacientes, nos quais foram pesquisados o grau de incômodo global causado pela perfuração da membrana timpânica e a presença de sintomas de autofonia, plenitude auricular e tinnitus. A média da nota atribuída ao incômodo global causado pela perfuração foi de 7,79; caiu para valor médio de 2,25 após a aplicação da película. A avaliação dos sintomas também apresentou melhoria após uso da película, autofonia caiu de valor médio de 6,25 para 2,08; zumbido de 7 para 1,92 e plenitude auricular de 7,29 para 1,96. A análise auditiva apresentou um valor médio de limiares ainda dentro da normalidade em frequências baixas e médias, com perda de audição leve em frequências agudas, porém com melhoria significante em todas as frequências, com exceção de 8000 Hz, após a colocação da película. Conclusão: A aplicação de fragmento de película de celulose bacteriana sobre perfurações traumáticas da membrana timpânica promoveu recuperação funcional e sintomática imediata nos pacientes estudados.


Subject(s)
Humans , Tympanic Membrane , Audiometry , Cellulose , Tympanic Membrane Perforation/etiology , Tympanic Membrane Perforation/therapy , Otoscopy
5.
Braz. j. otorhinolaryngol. (Impr.) ; 86(1): 74-82, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1089366

ABSTRACT

Abstract Introduction Microsurgery of the ear requires complete evaluation of middle ear surgical anatomy, especially the posterior tympanic cavity anatomy. Preoperative assessment of the middle ear cavity is limited by the permeability of eardrum and temporal bone density. Therefore, middle ear exploration is an extremely useful method to identify structural abnormalities and anatomical variations. Objective The aim of this study is to determine anatomic variations of the middle ear in an autopsy series. Methods All evaluations were performed in the Forensic Medicine Institute Morgue Department. The cases over 18 years of age, with no temporal bone trauma and history of otologic surgery included in this study. Results One hundred and two cadavers were included in the study. The mean age was 49.08 ± 17.76 years. Anterior wall prominence of the external auditory canal was present in 27 of all cadavers (26.4%). The tympanic membrane was normal in 192 ears (94%) while several eardrum pathologies were detected in 12 ears (6%). Agenesis of the pyramidal eminence and stapedial tendon was found in 3 ears. While the ponticulus was bony ridge-shaped in 156 of 204 ears (76.4%), it was bridge-shaped in 25 ears (12.3%). The ponticulus was absent in 23 ears (11.3%). While complete subiculum was present in 136 of all ears (66.7%), incomplete subiculum was present in 21 ears (10.3%). Subiculum was absent in 47 ears (23%). Facial dehiscence was found in 32 ears and the round window niche was covered by a pseudomembrane in 85 ears (41.6%). A fixed footplate was present in 7.4% of all ears, and no persistent stapedial artery was seen in any cases. Conclusion The pseudomembrane frequency covering the round window niche was found different from reports in the literature. In addition, the frequency of the external auditory canal wall prominence has been reported for the first time.


Resumo Introdução A otomicrocirurgia requer avaliação completa da anatomia cirúrgica da orelha média, especialmente da anatomia da cavidade timpânica posterior. A avaliação pré-operatória da cavidade timpânica é limitada pela permeabilidade do tímpano e densidade do osso temporal. Portanto, a exploração da orelha média é um método extremamente útil para identificar anormalidades estruturais e variações anatômicas. Objetivo Determinar as variações anatômicas da orelha média em uma série de autópsias. Método Todas as avaliações foram realizadas no necrotério do Instituto Médico-Legal. Os casos com mais de 18 anos, sem trauma do osso temporal e história de cirurgia otológica foram incluídos neste estudo. Resultados Cento e dois cadáveres foram incluídos no estudo. A média de idade foi de 49,08 ± 17,76 anos. A proeminência da parede anterior do conduto auditivo externo estava presente em 27 de todos os cadáveres (26,4%). A membrana timpânica era normal em 192 orelhas (94%), enquanto várias alterações do tímpano foram detectadas em 12 orelhas (6%). Agenesia da eminência piramidal e do tendão do estapédio foi encontrada em 3 orelhas. Enquanto o pontículo tinha formato de crista óssea em 156 das 204 orelhas (76,4%), tinha o formato de ponte em 25 orelhas (12,3%). O pontículo estava ausente em 23 orelhas (11,3%). Enquanto o subículo completo estava presente em 136 de todas as orelhas (66,7%), encontrava-se incompleto em 21 orelhas (10,3%). O subículo estava ausente em 47 orelhas (23%). Deiscência facial foi encontrada em 32 orelhas e o nicho da janela redonda estava coberto por uma pseudomembrana em 85 orelhas (41,6%). A platina fixa foi observada em 7,4% de todas as orelhas e a artéria estapediana persistente não foi vista. Conclusão A frequência da pseudomembrana que cobre o nicho da janela redonda foi diferente daquela encontrada na literatura. Além disso, a frequência da proeminência da parede do canal auditivo externo foi relatada pela primeira vez.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Ear, Middle/anatomy & histology , Endoscopy/methods , Anatomic Variation/physiology , Autopsy/statistics & numerical data , Stapedius/diagnostic imaging , Tympanic Membrane/anatomy & histology , Sex Distribution , Cholesteatoma, Middle Ear/pathology , Dissection/statistics & numerical data , Ear, External/anatomy & histology
6.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(3): 290-298, set. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058699

ABSTRACT

RESUMEN Introducción: La gentamicina transtimpánica se utiliza en el manejo de pacientes con vértigo crónico refractario al manejo médico. Objetivo: Describir y analizar las características clínicas, epidemiológicas, y resultados de pacientes sometidos a tratamiento con gentamicina transtimpánica en el Hospital Clínico de la Universidad de Chile. Material y método: Estudio retrospectivo, descriptivo, incluyendo los pacientes con patología otorrinolaringológica que hayan recibido gentamicina transtimpánica entre los años 2008 y 2018. Se analizaron variables epidemiológicas, clínicas, y función vestibular. Resultados: La serie está constituida por diez pacientes, con una edad promedio de 52,4 años; siete mujeres y tres hombres. El diagnóstico fue en su mayoría enfermedad de Ménière (7 pacientes). El número promedio de inyecciones de gentamicina fue de 2,8. En el período de seguimiento (rango 1-96 meses), se logró mejoría del vértigo en la mayoría de los pacientes (8 de 10). Conclusión: El tratamiento con inyecciones de gentamicina transtimpánica es una opción importante para aliviar la sintomatología de pacientes con vértigo crónico intratable. Debe indicarse en casos seleccionados, y siempre realizar un estudio auditivo y vestibular completo antes y después del tratamiento con gentamicina.


ABSTRACT Introduction: Transtympanic gentamicin is used for treatment of patients with chronic vertigo refractory to medical management. Aim: To describe and analyze the clinical outcome of patients whom underwent treatment with transtympanic gentamicin at the Clinical Hospital Universidad de Chile. Material and method: Retrospective and descriptive study including patients with otolaryngologist disease whom underwent treatment with transtympanic gentamicin between 2008 and 2018. Epidemiological, clinical variables and vestibular function were analyzed. Results: The serie consists of ten patients, 7 men and 3 women, with an average age of 52,4 years. The most frequent diagnosis was Ménière disease (7 patients). The average number of gentamicin injections was 2,8. The follow up varies from 1 to 96 months, presenting improvement of vertigo in the majority of the cases (8 of 10 patients). Conclusion: The treatment with transtympanic injections of gentamicin is a relevant option to decrease symptoms in patients with chronic intractable vertigo. It should be indicated in selected patients. Prior and posterior the treatment, patients must be studied with a complete evaluation of the auditory and vestibular function.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Gentamicins/therapeutic use , Vertigo/drug therapy , Meniere Disease/drug therapy , Tympanic Membrane , Vestibular Function Tests , Gentamicins/administration & dosage , Retrospective Studies , Follow-Up Studies , Treatment Outcome
7.
Int. arch. otorhinolaryngol. (Impr.) ; 23(3): 281-291, July-Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040016

ABSTRACT

Abstract Introduction Posterior tympanotomy through facial recess (FR) is the conventional and most preferred approach to facilitate cochlear implantation, especially when the electrode is inserted through the round window. The complications of the FR approach can be minimized by proper understanding of the anatomy of the FR. Objective The present study was undertaken to assess the various parameters of FR and round window visibility, which may be of relevance for cochlear implant surgery. Methods Thirty-five normal wet human cadaveric temporal bones were studied by dissection for anatomy of FR and posterior tympanum. Photographs were taken with an 18megapixels digital camera, which were then imported to a computer to determine various parameters. Results The mean distance from the take-off point/crotch of the chorda tympani nerve (CTN) to the stylomastoid foramen was 4.08 ± 0.8 mm(range of 2.06 - 5.5mm). The variations in the course of the CTN included origin at the level of the lateral semicircular canal. Themean chorda-facial angle in our study was 26.91° ± 1.19°, with a range of 25° to 28.69°. The mean FR length ranged between 9.4 mm and 18.56 mm (mean of 12.41 ± 2.91mm) and varied with the origin of the CTN and pneumatization of temporal bone. The average maximum width of the FR was 2.93 ± 0.4 mm (range 2.24-3.45 mm) and the mean width of the FR at the level of the round window was 2.65 ± 0.41 mm. Conclusion The FR approach provides good access to the round windowmembrane in all cases. In some cases, table adjustment is required.


Subject(s)
Humans , Adult , Round Window, Ear/anatomy & histology , Cochlear Implantation , Facial Nerve/anatomy & histology , Temporal Bone/anatomy & histology , Tympanic Membrane/anatomy & histology , Cadaver , Chorda Tympani Nerve/anatomy & histology , Dissection
8.
Braz. j. otorhinolaryngol. (Impr.) ; 85(4): 435-446, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1019586

ABSTRACT

Abstract Introduction: Various aspects of the round window anatomy and anatomy of posterior tympanum have relevant implications for designing cochlear implant electrodes and visualizing the round window through facial recess. Preoperative information about possible anatomical variations of the round window and its relationships to the adjacent neurovascular structures can help reduce complications in cochlear implant surgery. Objective: The present study was undertaken to assess the common variations in round window anatomy and the relationships to structures of the tympanum that may be relevant for cochlear implant surgery. Methods: Thirty-five normal wet human cadaveric temporal bones were studied by dissection for anatomy of round window and its relation to facial nerve, carotid canal, jugular fossa and other structures of posterior tympanum. The dissected bones were photographed by a digital camera of 18 megapixels, which were then imported to a computer to determine various parameters using ScopyDoc 8.0.0.22 version software, after proper calibration and at 1× magnification. Results: When the round window niche is placed posteriorly and inferiorly, the distance between round window and vertical facial nerve decreases, whereas that with horizontal facial nerve increases. In such cases, the distance between oval window and round window also increases. Maximum height of the round window in our study ranged from 0.51-1.27 mm (mean of 0.69 ± 0.25 mm). Maximum width of round window ranged from 0.51 to 2.04 mm (mean of 1.16 ± 0.47 mm). Average minimum distance between round window and carotid canal was 3.71 ± 0.88 mm (range of 2.79-5.34 mm) and that between round window and jugular fossa was 2.47 ± 0.9 mm (range of 1.24-4.3 mm). Conclusion: The distances from the round window to the oval window and facial nerve are important parameters in identifying a difficult round window niche. Modification of the electrode may be a better option than drilling off the round window margins for insertion of cochlear implant electrodes.


Resumo Introdução: Vários aspectos da anatomia da janela redonda e da anatomia da caixa timpânica posterior são relevantes, devido a suas implicações no desenho dos eletrodos para o implante coclear e na visibilidade da janela redonda através do recesso facial. Informações prévias sobre possíveis variações anatômicas da janela redonda e suas relações com as estruturas neurovasculares adjacentes podem ajudar a reduzir as complicações dessa cirurgia. Objetivo: O presente estudo foi realizado para avaliar as diversas variações da anatomia da janela redonda e sua relação com as estruturas adjacentes, o que pode ser relevante para a cirurgia de implante coclear. Método: Trinta e cinco ossos temporais normais de cadáveres humanos frescos foram dissecados para avaliação da anatomia da janela redonda e sua relação com o nervo facial, canal carotídeo, fossa jugular e outras estruturas da caixa timpânica posterior. Os ossos dissecados foram fotografados com uma câmera digital de 18 megapixels e as imagens importadas para um computador para determinar diversos parâmetros, utilizando-se o software ScopyDoc versão 8.0.0.22, após a calibração adequada e com ampliação de 1×. Resultados: Quando o nicho da janela redonda se encontra posicionado posteriormente e inferiormente, a distância entre a janela redonda e o nervo facial vertical diminui, enquanto aquela com o nervo facial horizontal aumenta. Em tais casos, a distância entre a janela oval e a janela redonda também aumenta. A altura máxima da janela redonda em nosso estudo variou de 0,51 a 1,27 mm (média de 0,69 ± 0,25 mm). A largura máxima da janela redonda variou de 0,51 a 2,04 mm (média de 1,16 a 0,47 mm). A distância mínima média entre a janela redonda e o canal carotídeo foi de 3,71 ± 0,88 mm (variação de 2,79 a 5,34 mm) e entre a janela redonda e a fossa jugular, em nosso estudo, foi de 2,47 ± 0,9 mm (variação de 1,24 ± 4,3 mm). Conclusão: A distância da janela redonda a partir da janela oval e do nervo facial são parâmetros importantes para a identificação do difícil nicho da janela redonda. A modificação do desenho do eletrodo pode ser uma opção melhor do que o broqueamento das margens da janela redonda para a inserção dos eletrodos no implante coclear.


Subject(s)
Humans , Round Window, Ear/anatomy & histology , Temporal Bone/anatomy & histology , Tympanic Membrane/anatomy & histology , Oval Window, Ear/anatomy & histology , Cadaver , Carotid Artery, Internal/anatomy & histology , Cochlear Implantation , Dissection , Facial Nerve/anatomy & histology
9.
Rev. Assoc. Med. Bras. (1992) ; 65(7): 971-976, July 2019. tab, graf
Article in English | LILACS | ID: biblio-1013016

ABSTRACT

SUMMARY OBJECTIVE To investigate the relations of T lymphocytes, cytokines, immunoglobulin E, and nitric oxide with otitis media with effusion (OME) in children and their clinical significances. METHODS Fifty children with OME treated in our hospital were enrolled in the study (observation group). Fifty healthy children were selected as control. The percentages of CD4+ and CD8+ T lymphocyte and CD4+/CD8+ ratio in peripheral blood, and the levels of cytokine (IL)-2, IL-4, IL-6, immunoglobulin E (IgE) and nitric oxide (NO) in peripheral blood and middle ear effusion (MEE) in both groups were detected. The correlations of these indexes with OME were analyzed. RESULTS The percentage of peripheral blood CD4+ and CD8+ levels, CD4+/CD8 ratio, IgE, and NO levels in the observation group were significantly higher than those in the control group (P < 0.01). In the observation group, the IL-2 and IL-6 levels, and IgE and NO levels in the MEE were significantly higher than those in peripheral blood (P < 0.01). In addition, in the observation group, the MEE IL-2 and IL-6 levels were positively correlated with peripheral blood CD4+/CD8+ ratio, respectively r = 0.366, P = 0.009; r = 0.334, P = 0.018. CONCLUSIONS The levels of peripheral blood CD4+ and CD8+ lymphocytes and MEE IL-2, IL-6, IgE, and NO levels are increased in children with OME. These indexes have provided significant clues for the diagnosis of OME in children.


RESUMO OBJETIVO Investigar as relações entre linfócitos T, citocinas, imunoglobulina E e óxido nítrico e a otite média com efusão (OME) em crianças e sua significância clínica. MÉTODOS Cinquenta crianças com OME tratadas em nosso hospital foram incluídas no estudo (grupo de observação). Selecionamos também 50 crianças saudáveis como controle. As porcentagens de linfócitos T CD4 + e CD8 + e a razão CD4+/CD8+ no sangue periférico, além dos níveis das citocinas IL-2, IL-4, IL-6, imunoglobulina E (IgE) e óxido nítrico (NO) no sangue periférico e de efusão no ouvido médio (MEE) de ambos os grupos foram medidos. A correlação desses índices com a OME foi analisada. RESULTADOS A porcentagem dos níveis de CD4+ e CD8 +, da razão CD4+/CD8+, de IgE e NO no sangue periférico do grupo de observação foram significativamente maiores do que no grupo controle (P < 0,01). No grupo de observação, os níveis de IL-2 e IL-6, IgE e NO em MEE foram significativamente maiores do que no sangue periférico (P < 0,01). Além disso, no grupo de observação, foi encontrada uma correlação positiva entre os níveis de IL-2 e IL-6 em MEE e a razão de CD4+/CD8+no sangue periférico, respectivamente, r = 0,366, P = 0,009; r = 0,334, P = 0,018. CONCLUSÃO Os níveis de linfócitos CD4 + e CD8 + no sangue periférico e IL-2, IL-6, IgE e NO em MEE são mais altos em crianças com OME. Esses índices forneceram evidências valiosas para o diagnóstico de OME em crianças.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Otitis Media with Effusion/blood , Immunoglobulin E/blood , CD4-Positive T-Lymphocytes , Cytokines/blood , CD8-Positive T-Lymphocytes , Nitric Oxide/blood , Reference Values , Tympanic Membrane/metabolism , Case-Control Studies , Lymphocyte Count , Flow Cytometry
10.
Int. arch. otorhinolaryngol. (Impr.) ; 23(1): 77-82, Jan.-Mar. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002183

ABSTRACT

Abstract Introduction Chronic suppurative otitis media is a common ailment in developing countries, and it generally presents with otorrhea and hearing loss. Different surgical procedures have been used to treat otitis media; among them is myringoplasty, which is a procedure that includes repair of the tympanic membrane. Platelet concentrates have been used widely in different types of wounds and are found to improve wound healing. Hence, the use of platelet-rich fibrin in myringoplasty will also improve the tympanic membrane healing. Objectives To assess the safety and efficacy of autologous platelet-rich fibrin on graft uptake in myringoplasty. Methods Eighty-six patients were observed during the study period of two years. Forty-three patients in the study group underwent myringoplasty aided with plateletrich fibrin, and 43 patients in the control group went through the same procedure but without the platelet-rich fibrin. The patients were observed for three months postoperatively by a blinded observer. Results A total of 4.7% of the patients in the study group had postoperative infection, compared with a rate of 19% in the control group (p = 0.039). The graft uptake success rate was found to be 97.7% in the study group as compared with 81% in control group (p = 0.012). The results were found to be statistically significant. Conclusion Being autologous in nature, and by comparing the groups, platelet-rich fibrin is safe for patients. The postoperative graft uptake rate is better in cases in which plateletrich fibrin was used. The postoperative infection rate was also lower in the same group. (AU)


Subject(s)
Humans , Male , Female , Adult , Platelet-Rich Fibrin , Myringoplasty , Otitis Media, Suppurative/surgery , Transplantation, Autologous , Tympanic Membrane/injuries , Wound Healing , Treatment Outcome
11.
Braz. j. otorhinolaryngol. (Impr.) ; 85(1): 17-23, Jan.-Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-984055

ABSTRACT

Abstract Introduction: Most of traumatic tympanic membrane perforations have inverted or everted edges, however, the effects of inverted and everted edges on the spontaneous healing of the eardrum remain controversial. Objective: We investigated the influence of inverted or everted edges on the spontaneous healing of traumatic tympanic membrane perforations. Methods: The clinical records of patients with a traumatic tympanic membrane perforations who met the study criteria were retrieved and categorized into two groups, based on whether the eardrum was inverted or everted. The features along the edge of each inverted or everted eardrum were described using 30º and 70º endoscopes. Results: In total, 196 patients (196 ears) met the inclusion criteria; of these, 148 had inverted or everted eardrums while 48 did not. Of the 148 patients with inverted or everted eardrums, the perforation edges were everted in 77 patients, inverted in 44 patients, drooping in 17 patients, and both inverted and everted in 10 patients. The perforation shape was triangular in 18.9% of patients, sector-shaped in 11.5%, kidney-shaped in 14.2%, ovoid in 20.3%, and irregularly shaped in 35.1% of patients. The difference was not significant between the with and without inverted/everted eardrum edges groups in terms of the closure rate or closure time. Similarly, the difference was not significant between the with and without edge approximation groups in terms of the closure rate or closure time at the end of the 12-month follow-up period. Conclusion: This study suggests that endoscopic inspection can clearly identify inverted/everted eardrum edges using 30º and 70º endoscopes. The edge is glossy in inverted/everted eardrums, whereas the edge is rough and irregular in non-inverted/everted cases. The inverted/everted eardrums gradually became necrotic, but this did not affect the healing process. Additionally, edge approximation did not improve the healing outcome of traumatic tympanic membrane perforations.


Resumo Introdução: A maioria das perfurações de membrana timpânica traumáticas apresenta bordas invertidas ou evertidas; no entanto, os efeitos dessas configurações sobre a cicatrização espontânea do tímpano continuam a ser uma questão controversa. Objetivo: Investigar a influência de bordas invertidas ou evertidas sobre a cicatrização espontânea de perfurações traumáticas de membrana timpânica. Método: Os prontuários clínicos de pacientes com perfuração traumática de membrana timpânica que preencheram os critérios do estudo foram recuperados e categorizados em dois grupos, baseados na configuração invertida ou evertida das bordas da membrana timpânica. As características de configuração da borda de cada membrana foram descritas com o uso de endoscópios de 30º e 70º. Resultados: No total, 196 pacientes (196 orelhas) preencheram os critérios de inclusão; desses, 148 apresentavam bordas de membranas timpânicas invertidas ou evertidas, enquanto 48 não. Dos 148 pacientes, as bordas da perfuração estavam evertidas em 77 pacientes, invertidas em 44 pacientes, caídas em 17 pacientes e ambas invertidas e evertidas em 10 pacientes. O formato da perfuração era triangular em 18,9% dos pacientes, em forma de fatia de pizza em 11,5%, em forma de rim em 14,2%, ovoide em 20,3% e de forma irregular em 35,1% dos pacientes. A diferença não foi significante entre os grupos com e sem membrana timpânica invertida/evertida em termos de taxa ou tempo de fechamento. Da mesma forma, a diferença não foi significativa entre os grupos com e sem aproximação das bordas em termos de taxa de fechamento ou tempo de fechamento no fim do período de seguimento de 12 meses. Conclusões: Este estudo sugere que a avaliação com endoscópios de 30º e 70º pode identificar claramente as bordas invertidas/evertidas das perfurações de membranas timpânicas. A borda da perfuração timpânica em casos invertidos/evertidos é brilhante, enquanto a borda é áspera e irregular em casos não invertidos/evertidos. O rebordo timpânico invertido/evertido gradualmente torna-se necrótico, mas isso não afetou o processo de cicatrização. Além disso, a aproximação das bordas não melhorou o resultado da cicatrização.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Tympanic Membrane/pathology , Tympanic Membrane Perforation/pathology , Remission, Spontaneous , Time Factors , Tympanic Membrane/injuries , Tympanic Membrane/diagnostic imaging , Wound Healing/physiology , Tympanic Membrane Perforation/diagnostic imaging , Sex Distribution , Otoscopy/methods
12.
Article in Korean | WPRIM | ID: wpr-761299

ABSTRACT

Pneumolabyrinth is an uncommon condition in which air is present in the vestibule or cochlear. It is rarely found, even in otic capsule violating fractures or in transverse fracture of the temporal bone. So far, there is no consensus on management of pneumolabyrinth. We describe 2 new cases of pneumolabyrinth by penetrating injury with traumatic tympanic membrane perforation. They presented whirling vertigo with moderate conductive hearing loss. Temporal bone computed tomography clearly demonstrated the presence of air in the vestibule and cochlear.


Subject(s)
Consensus , Hearing Loss, Conductive , Temporal Bone , Tympanic Membrane Perforation , Tympanic Membrane , Vertigo
13.
Article in Korean | WPRIM | ID: wpr-760103

ABSTRACT

Middle ear adenoma is a very rare disease which is benign and originates from the middle ear mucosa. Patients of middle ear adenoma usually come to the clinic for unilateral hearing loss or tinnitus, but rarely for accompanied facial palsy. It is non-gender specific and occurs over a wide range of ages. The recurrence rate is known to be very low, but few authors argue that neuroendocrine adenoma should be considered as a low grade carcinoma due to some cases of recurrence. A 18 years-old male who had a left side facial palsy about 3 years ago but has currently improved as compared with the initial onset, visited our clinic for the left side hearing loss. Pure tone audiogram showed about 30 dB of conductive hearing loss and a pinkish polypoid mass involving the left tympanic membrane. We removed a tumor via transmastoid approach. The final diagnosis was middle ear adenoma with neuroendocrine differentiation. Neither signs of complication nor recurrence were observed after six months of the surgery.


Subject(s)
Adenoma , Diagnosis , Ear, Middle , Facial Paralysis , Hearing Loss , Hearing Loss, Conductive , Hearing Loss, Unilateral , Hearing , Humans , Male , Mucous Membrane , Rare Diseases , Recurrence , Tinnitus , Tympanic Membrane
14.
Article in Korean | WPRIM | ID: wpr-760088

ABSTRACT

BACKGROUND AND OBJECTIVES: Pre-operative eustachian tube function (ETF) is an important factor for the postoperative success after tympanoplasty, though much debates have been reported. In this study, we investigated the tympanogram changes after tympanoplasty, indirectly checking up ETF, to find out the relationship between tympanogram changes and associated factors of tympanoplasty. SUBJECTS AND METHOD: Included in this study were 238 cases of tympanoplasty (canal wall up mastoidectomy with tympanoplasty type I or tympanoplasty type I only) performed by one surgeon for chronic otitis media from January, 2012 to June, 2017. In all cases, tympanometric tests were undertaken at one month, three month, six month, and one year post-operatively, and pure tone audiometry tests were taken at 1 year, post operatively. RESULTS: The average hearing level and air-bone gap were 41.8±19.7 dB, and 17.1±9.3 dB, pre-operatively, and 29.9±21.1 dB, and 6.9±8.5 dB, 1 year post-operatively, respectively. Most of the cases showed improvement in hearing. The results of tympanometry showed that hearing improvement was greater for the A type than for the B or C type (p<0.001). The smaller the size of the tympanic membrane was, the higher, the type A tympanogram appeared to be (p=0.008). CONCLUSION: The estimation of pre-operative ETF using post-operative tympanogram changes can give insight to the degree and process of recovery of the normal middle ear after tympanoplasty.


Subject(s)
Acoustic Impedance Tests , Audiometry , Ear, Middle , Eustachian Tube , Hearing , Methods , Otitis Media , Otitis , Prognosis , Tympanic Membrane , Tympanoplasty
15.
Article in English | WPRIM | ID: wpr-739232

ABSTRACT

OBJECTIVES: Doppler optical coherence tomography (DOCT) is useful for both, the spatially resolved measurement of the tympanic membrane (TM) oscillation and high-resolution imaging. We demonstrated a new technique capable of providing real-time two-dimensional Doppler OCT image of rapidly oscillatory latex mini-drum and in vivo rat TM and ossicles. METHODS: Using DOCT system, the oscillation of sample was measured at frequency range of 1–4 kHz at an output of 15 W. After the sensitivity of the DOCT system was verified using a latex mini-drum consisting of a 100 μm-thick latex membrane, changes in displacement of the umbo and contacted area between TM and malleus in normal and pathologic conditions. RESULTS: The oscillation cycles of the mini-drum for stimulus frequencies were 1.006 kHz for 1 kHz, 2.012 kHz for 2kHz, and 3.912 kHz for 4 kHz, which means that the oscillation cycle of the mini-drum become short in proportional to the frequency of stimuli. The oscillation cycles of umbo area and the junction area in normal TM for frequencies of the stimuli showed similar integer ratio with the data of latex mini-drum for stimuli less than 4 kHz. In the case of middle ear effusion condition, the Doppler signal showed a tendency of attenuation in all frequencies, which was prominent at 1 kHz and 2 kHz. CONCLUSION: The TM vibration under sound stimulation with frequencies from 1 kHz to 4 kHz in normal and pathologic conditions was demonstrated using signal demodulation method in in vivo condition. The OCT technology could be helpful for functional and structural assessment as an optional modality.


Subject(s)
Animals , Ear, Middle , Latex , Malleus , Membranes , Methods , Otitis Media with Effusion , Rats , Tomography, Optical Coherence , Tympanic Membrane , Vibration
16.
Belo Horizonte; s.n; 2019. 139 p. ilus, graf, tab.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-1046196

ABSTRACT

A aferição da temperatura corporal é uma ferramenta essencial no cuidado de pacientes críticos. Para a identificação da temperatura corporal é necessário o uso de um termômetro preciso e ágil. Quando técnicas invasivas não estão sendo utilizadas, a equipe de enfermagem depende de termômetros não invasivos. Atualmente, na literatura, não há um consenso sobre a acurácia e precisão de métodos como as temperaturas oral, axilar, de membrana timpânica ou de artéria temporal. Ademais evidências acerca dos fatores que podem alterar a confiabilidade desses métodos são escassas. Por isso estudos clínicos devem ser realizados com esses métodos para respaldar o uso dessas técnicas na prática. Objetivo: Comparar a acurácia e precisão de métodos de termometria não invasivas (artéria temporal, membrana timpânica, oral e axilar) em comparação a temperatura de artéria pulmonar. Método: Foram realizados uma revisão sistemática e metanálise e um estudo clínico de medidas repetidas. A metanálise foi realizada com dados de 41 artigos pesquisados na literatura. Os dados do estudo clínico foram coletados em duas Unidades de Terapia Intensiva na cidade de Belo Horizonte. Foram incluídos pacientes adultos em uso do cateter de artéria pulmonar. As cinco temperaturas foram aferidas três vezes de cada paciente. Para análise dos dados foi realizada análise descritiva, gráficos de Bland-Altman e análises de regressão. Resultados: A acurácia e precisão das temperaturas na metanálise foram; temperatura axilar, -0,35 e 0,06; temperatura oral, -0,21 e 0,08; temperatura de membrana timpânica, -0,05 e 0,05; e temperatura de artéria temporal, -0,22 e 0,26. A acurácia e precisão após análise dos dados do estudo clínico foram, respectivamente: temperatura axilar, -0,42 e 0,59; temperatura oral, -0,30 e 0,37; temperatura de membrana timpânica, -0,21 e 0,44; e temperatura de artéria temporal, -0,25 e 0,61. Conclusão: Os termômetros não invasivos mostraram uma boa acurácia e precisão em relação a temperatura de artéria pulmonar, entretanto em pacientes com alterações da temperatura os termômetros não invasivos tornam-se pouco acurados.(AU)


The identification of body temperature is an essential tool in critical care nursing. The use of a reliable and agile thermometer is necessary to identify the real body temperature. When available, invasive thermometer are indicated for its precision. Although, when not available, the nursing staff must rely in noninvasive thermometers. Nowadays, in the literature, there isn´t a consensus about the reliability of noninvasive temperature techniques, such as axillary, oral, tympanic membrane and temporal artery. Furthermore, there is a lack of knowledge about factors that alters the reliability of those thermometers. Clinical studies must be developed to back these techniques in nursing care. Aim: Compare the accuracy and precision of noninvasive techniques (axillary, oral, tympanic membrane and temporal artery) with the pulmonary artery temperature. Methods: An Systematic review/Metanalysis and a Cross-sectional Repeated measure clinical study were developed. The Metanalysis used data from 41 published articles. The data for the clinical study were collected in two intensive care units of two hospitals in Belo Horizonte. Patients with pulmonary artery catheter were included. The five temperatures were measured three times in each patient. Descriptive analyses were made, Bland-Altmann graphics were plotted and a four regression models were developed. Results: The accuracy and precision identified in the Metanalysis were: axillary, -0,35 and 0,06; oral, -0,21 and 0,08; tympanic membrane, -0,05 and 0,05; and temporal artery, -0,22 and 0,26. The accuracy and precision of the noninvasive thermometers and the pulmonary artery temperature identified in the clinical study were: axillary -0,42 and 0,59; oral -0,30 and 0,37; tympanic membrane -0,21 and 0,44; and temporal artery -0,25 and 0,61. Conclusion: The noninvasive thermometers showed a good accuracy and precision when compared with the pulmonary temperature, However, in non-normothermic patients the reliability of the thermometers is poor.(AU)


Subject(s)
Humans , Male , Female , Middle Aged , Body Temperature , Thermometry/methods , Nursing Care/methods , Pulmonary Artery , Axilla , Thermometers , Tympanic Membrane , Academic Dissertation , Mouth
17.
Article in French | AIM | ID: biblio-1264235

ABSTRACT

L'absence de méat acoustique externe constitue 5.7% de l'ensemble des malformations de l'oreille. Il peut être isolé ou associé à d'autres malformations de l'oreille dont la fixation du malléus à la paroi latérale de la caisse du tympan. Nous rapportons un cas d'absence de méat acoustique externe gauche associée à une fixation pariétale antérieure bilatérale du malléus à la caisse tympanique


Subject(s)
Benin , Case Reports , Ear Canal , Malleus , Tympanic Membrane
18.
Int. arch. otorhinolaryngol. (Impr.) ; 22(4): 374-377, Oct.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-975610

ABSTRACT

Abstract Introduction Different types of autologous graft materials are used for myringoplasty, with the temporalis fascia and cartilage being the most frequently used tissues. Periosteal tissue has been used for a long time in our department, and many advantages support its use in myringoplasty. To the best of our knowledge, this issue is scarcely discussed in the previously published literature. Objective To present our experience with periosteal graft myringoplasty, describing the technique and the anatomical and functional outcomes. Methods A prospective clinical study involving 88 patients (72 females and 16 males) with a mean age 26.9 years. The patients underwent myringoplasty using the mastoid cortex periosteum; they were all operated using the postauricular approach, and the graft was applied using the underlay technique. The patients performed pre- and postoperative pure tone audiometry for tested frequencies (0.5 kHz, 1 kHz, 2 kHz, and 4 kHz). All patients were followed-up for at least 12 months after the operation. Results The anatomical success rate among all patients was of 93%, which is comparable to the rate of success in procedures using other usual grafting materials. In addition, there was a highly significant postoperative improvement in pure tone audiometry results as compared with the preoperative ones (the main hearing gain was of ∼ 11 dB; p< 0.001). Conclusion The periosteal graft is easily harvested, easy to apply, with excellent anatomical and functional success.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Periosteum/transplantation , Myringoplasty , Audiometry, Pure-Tone , Transplantation, Autologous , Tympanic Membrane/surgery , Cartilage/transplantation , Prospective Studies , Fascia/transplantation
19.
Int. arch. otorhinolaryngol. (Impr.) ; 22(3): 260-265, July-Sept. 2018. tab, graf
Article in English | LILACS | ID: biblio-975582

ABSTRACT

Abstract Introduction The literature shows that there are anatomical changes on the temporal bone anatomy during the first four years of life in children. Therefore, we decided to evaluate the temporal bone anatomy regarding the cochlear implant surgery in stillbirths between 32 and 40 weeks of gestational age using computed tomography to simulate the trajectory of the drill to the scala timpani avoiding vital structures. Objectives To measure the distances of the simulated trajectory to the facial recess, cochlea, ossicular chain and tympanic membrane, while performing the minimally invasive cochlear implant technique, using the Improvise imaging software (Vanderbilt University, Nashville, TN, US). Methods An experimental study with 9 stillbirth specimens, with gestational ages ranging between 32 and 40 weeks, undergoing tomographic evaluation with individualization and reconstruction of the labyrinth, facial nerve, ossicular chain, tympanic membrane and cochlea followed by drill path definition to the scala tympani. Improvise was used for the computed tomography (CT) evaluation and for the reconstruction of the structures and trajectory of the drill. Results Range of the distance of the trajectory to the facial nerve: 0.58 to 1.71mm. to the ossicular chain: 0.38 to 1.49 mm; to the tympanic membrane: 0.85 to 1.96 mm; total range of the distance of the trajectory: 5.92 to 12.65 mm. Conclusion The measurements of the relationship between the drill and the anatomical structures of the middle ear and the simulation of the trajectory showed that the middle ear cavity at 32 weeks was big enough for surgical procedures such as cochlear implants. Although cochlear implantation at birth is not an indication yet, this study shows that the technique may be an option in the future.


Subject(s)
Humans , Infant, Newborn , Temporal Bone/anatomy & histology , Temporal Bone/surgery , Cochlea/surgery , Cochlear Implantation/methods , Tympanic Membrane/surgery , Cadaver , Pregnancy , Tomography, X-Ray Computed , Intervention Studies , Minimally Invasive Surgical Procedures , Ear, Middle/anatomy & histology , Ear Ossicles/surgery , Stillbirth , Facial Nerve/surgery , Ear, Inner/surgery
20.
Braz. j. otorhinolaryngol. (Impr.) ; 84(3): 332-337, May-June 2018. tab, graf
Article in English | LILACS | ID: biblio-951831

ABSTRACT

Abstract Introduction: Boric acid, which has antiseptic and acidic properties, is used to treat external and middle ear infections. However, we have not found any literature about the effect of boric acid powder on middle ear mucosa and inner ear. Objective: The purpose of this study is to investigate possible ototoxic effects of boric acid powder on cochlear outer hair cell function and histological changes in middle ear mucosa in a rat animal model. Methods: Twenty healthy, mature Wistar albino rats were used in this study. The rats were divided into two groups, Group A and Group B, each of which consisted of 10 rats. Initially, the animals in each group underwent distortion product otoacoustic emissions testing of their right and left ears. After the first distortion product otoacoustic emissions test, a surgical microscope was used to make a small perforation in both ears of the rats in each group, and a second distortion product otoacoustic emissions test was used to measure both ears in all of the rats. Boric acid powder was applied to the right middle ear of the rats using tympanic membrane perforation, and the distortion product otoacoustic emissions were measured immediately after the boric acid powder application. The histological changes and distortion product otoacoustic emissions were evaluated three days later in Group A and 40 days later in Group B. Results: No significant differences were found at all of the distortion product otoacoustic emissions frequencies. In Group A, mild inflammation of the middle ear mucosa was found on the third day after boric acid powder application. In Group B, boric acid powder caused mild inflammatory changes on the 40th day, which declined over time. Those changes did not lead to significant fibrosis within the mucosa. Conclusion: In rats, boric acid powder causes mild inflammation in middle ear mucosa and it has no ototoxic effects on cochlear outer hair cell function in the inner ear of rats.


Resumo Introdução: O ácido bórico, que tem propriedades antissépticas e ácidas, é usado para tratar infecções de orelha externa e média. No entanto, não encontramos literatura sobre o efeito do ácido bórico em pó sobre a mucosa da orelha interna e da orelha média. Objetivo: Investigar possíveis efeitos ototóxicos do ácido bórico em pó sobre a função das células ciliadas externas cocleares e alterações histológicas na mucosa da orelha média em um modelo animal de rato. Método: Vinte ratos Wistar albinos maduros e saudáveis foram usados neste estudo. Os ratos foram divididos em dois grupos, Grupo A e Grupo B, cada um dos quais com 10 ratos. Inicialmente, os animais de cada grupo foram submetidos a testes de emissões otoacústicas - produto de distorção, nas orelhas direita e esquerda. Após o primeiro teste de emissões otoacústicas - produto de distorção, utilizou-se um microscópio cirúrgico para fazer uma pequena perfuração em ambas as orelhas dos ratos em cada grupo, e um segundo teste de emissões otoacústicas - produto de distorção foi utilizado para medir e avaliar as orelhas em todos os ratos. O ácido bórico em pó foi aplicado na orelha média direita dos ratos utilizando perfuração da membrana timpânica e as emissões otoacústicas - produto de distorção foram medidas imediatamente após a aplicação de ácido bórico em pó. As alterações histológicas e emissões otoacústicas - produto de distorção foram avaliadas três dias depois no Grupo A e 40 dias depois no Grupo B. Resultados: Não foram encontradas diferenças significativas em todas as frequências da emissões otoacústicas - produto de distorção. No Grupo A, foi observada uma ligeira inflamação da mucosa da orelha média no terceiro dia após a aplicação de ácido bórico em pó. No Grupo B, o ácido bórico em pó causou leves alterações inflamatórias após 40 dias, que diminuíram ao longo do tempo. Essas alterações não levaram à fibrose significativa da mucosa. Conclusão: Em ratos, o ácido bórico em pó causa inflamação leve na mucosa da orelha média e não tem efeitos ototóxicos na função das células ciliadas externas da cóclea na orelha interna.


Subject(s)
Animals , Male , Rats , Tympanic Membrane/drug effects , Boric Acids/toxicity , Hair Cells, Auditory, Outer/drug effects , Insecticides/toxicity , Ear, Inner/drug effects , Tympanic Membrane/pathology , Rats, Wistar , Otoacoustic Emissions, Spontaneous/drug effects , Disease Models, Animal , Ear, Inner/pathology
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