ABSTRACT
Aim of the present study is to evaluate the long term results of ossiculoplasty using titanium clip prosthesis. A retrospective analysis with prospective follow-up has been done including for all patients who had a Clip-PORP implanted between the years 2002-2013. Following this, audiometric hearing results were measured with clinical examination including otoscopy and quality of life evaluation using Glasgow benefit inventory. 48 patients (51 ears, 29 men, 19 women, average age 44.1 years) received followed up after an average duration of 6.3 years. The overall air-bone-gap (0.5-4 kHz) decreased from 22.8 dB preoperatively to 14.6 dB postoperatively (p≤0.001). The most frequent indication for surgical treatment were cholesteatomas and recurrent cholesteatomas (52%), chronic inflammation of middle ear (12%), revision of radical mastoidectomy (8%) and disturbance in sound conduction after previous operation (14%). Tympanic membrane was closed in 47 times (92,2%), 4 times (7,8%) there was a defect. Clip-PORP was in situ 39 times (75%), protrusion and disposal were detected 6 times (11,8%) and 2 times (4%), respectively. However, 1 time (2%) the prothesis was lost or evaluation was not possible (3 times, 5,9%). The overall patient satisfaction and general subscale score after the treatment was beneficially evaluated. There was no change in social support score nore the physical health score. In summary, the ossicular chain reconstruction using titan Clip-PORP is safe and well established. Also in long-term analysis stable hearing results due to reduction of air bone gap are represented. The subjective quality of life is sustainable improved.
Subject(s)
Ear Diseases/surgery , Hearing Loss, Conductive/surgery , Ossicular Prosthesis , Patient Satisfaction , Surgical Instruments , Titanium , Tympanoplasty/instrumentation , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Postoperative Complications/etiology , Postoperative Complications/surgery , Prosthesis Failure , Reoperation , Young AdultABSTRACT
Aim of the present study is to evaluate the long term results of ossiculoplasty using titanium clip prosthesis. A retrospective analysis with prospective follow-up has been done including for all patients who had a Clip-PORP implanted between the years 2002-2013. Following this, audiometric hearing results were measured with clinical examination including otoscopy and quality of life evaluation using Glasgow benefit inventory. 48 patients (51 ears, 29 men, 19 women, average age 44.1 years) received followed up after an average duration of 6.3 years. The overall air-bone-gap (0.5-4 kHz) decreased from 22.8 dB preoperatively to 14.6 dB postoperatively (p≤0.001). The most frequent indication for surgical treatment were cholesteatomas and recurrent cholesteatomas (52%), chronic inflammation of middle ear (12%), revision of radical mastoidectomy (8%) and disturbance in sound conduction after previous operation (14%). Tympanic membrane was closed in 47 times (92,2%), 4 times (7,8%) there was a defect. Clip-PORP was in situ 39 times (75%), protrusion and disposal were detected 6 times (11,8%) and 2 times (4%), respectively. However, 1 time (2%) the prothesis was lost or evaluation was not possible (3 times, 5,9%). The overall patient satisfaction and general subscale score after the treatment was beneficially evaluated. There was no change in social support score nore the physical health score. In summary, the ossicular chain reconstruction using titan Clip-PORP is safe and well established. Also in long-term analysis stable hearing results due to reduction of air bone gap are represented. The subjective quality of life is sustainable improved.
ABSTRACT
Oxygen therapy with hyperbaric oxygen (HBO) or normobaric hyperoxia (NBO) improves outcome in experimental cerebral ischemia. However, an increased formation of reactive oxygen species (ROS) may be an undesirable side effect of oxygen therapy. We investigated the effect of both oxygen therapies on ROS production and adverse effects in murine focal ischemia. 25 min after 90 min filament-induced middle cerebral artery occlusion (MCAO), mice breathed either air, 100% O2 (NBO), or 100% O2 at 3 ata (HBO) for 60 min. ROS were depicted on tissue sections after preischemic injection of hydroethidine, a marker of in vivo superoxide production. Moreover, infarct sizes were quantified in experiments using peroxybutinitrite (PBN) in mice treated with HBO. Effects of oxygen therapy were also tested in superoxide 2 knock-out mice. Both NBO and HBO significantly reduced superoxide radicals compared to air. Application of PBN had no additional protective effect when combined with HBO. Infarct volumes did not differ among SOD2 knock-out mice receiving air (34.0 ± 19.6mm(3)), NBO (35.4 ± 14.3mm(3)) or HBO (33.4 ± 12.2mm(3)). In conclusion, brief episodes of oxygen therapy do not appear to promote damage inflicted by ROS in experimental stroke.
Subject(s)
Brain Ischemia/therapy , Brain/pathology , Hyperbaric Oxygenation/adverse effects , Reactive Oxygen Species/metabolism , Animals , Brain Ischemia/metabolism , Brain Ischemia/pathology , Hyperoxia/metabolism , Male , Mice , Mice, Inbred C57BL , Mice, Knockout , Superoxide Dismutase/geneticsABSTRACT
BACKGROUND: Both normobaric (NBO) and hyperbaric (HBO) oxygen therapy are protective in transient cerebral ischemia. In contrast, in permanent ischemia models, which reflect the majority of clinical strokes, the effectiveness of NBO is unknown, and the effectiveness of HBO is controversial. The goals of the present study were to compare both oxygen therapies in 2 models of permanent ischemia, to study the effect of time window, and to evaluate the combination of both oxygen therapies. METHODS: Distal or proximal permanent occlusion of middle cerebral artery (MCAO) was induced by coagulation or filament, respectively. Mice received air, NBO, a single or repeated HBO (3 ata) treatments. Infarct sizes were quantified at 7 days (coagulation) and 24 h (filament), respectively. RESULTS: Following MCA coagulation, infarct volume was 12.9+/-1.6 mm3 in mice breathing air. When started 45 min or 120 min after MCAO, NBO (10.8+/-2.2) and significantly more potently HBO (7.8+/-0.9) reduced infarct size. Repeated HBO treatments had no additional effect (8.3+/-2.3). HBO also significantly decreased TUNEL cell staining at 24 h. Combination of 60 min NBO plus 60 min HBO resulted in smaller cortical infarcts (8.7+/-1.5) than 120 min NBO alone (11.1+/-3.2). In contrast, infarct volumes in filament-induced permanent MCAO did not differ among rodents receiving air (50+/-24 mm3), NBO (48+/-16), or HBO (46+/-21). After filament-induced transient MCAO, however, HBO reduced infarct volume significantly. CONCLUSIONS: NBO and more effectively HBO protect the brain against permanent cortical ischemia. In extensive focal ischemia, however, oxygen therapy is only effective in case of early recanalization.
