Surgical treatment of larynx T1N0M0 cancer - partial laryngectomy modified Majer-Piquet's intervention.

The increase of general radiation background in Georgia and some national characteristics such as spicy dishes, high level of alcohol and cigarette consumption, emotional, loud way of speaking result in a high percentage of people suffering from larynx malignant tumor. As generally known, the majority of larynx cancer cases represent surgical indications and only a small percentage submit to radio or chemotherapy. Since the beginning of the previous century, laryngologists have been intensely thinking about maintaining the larynx itself when giving surgical treatment. With this article we aim to introduce you to one of surgical techniques often applied in France. The method is Pr. B. Guerrier's modification of Majer-Piquet's cricohyoidoepiglotopexy, which is very popular in Europe. This consists in reconstructive operation maintaining cricoid cartilage and epiglottis with larynx's pexy when resecting partially. In cases of exact indications the, Majet-Piquet's modified operation provides a perfect: opportunity both to achieve the desirable outcome and maintain the main functions of larynx vocal, swallowing and breathing with a relatively less invasive surgical interference.

Influence of acoustic rhinometry, rhinoresistometry and endoscopic sinus surgery on voice quality.

Twenty-one patients with documented chronic paranasal sinusitis, being in need of endoscopic endonasal sinus surgery were subjected to voice analysis. Tape recordings of sustained vowels were performed both pre- and postoperatively. All voice samples were examined with a system of sound spectrographic analysis. Patients with nasal obstruction, detected by active anterior rhinomanometry were excluded from further studies. Analysis of pre- and postoperative spectograms was focused on changes in center frequency as well as on a bandwidth of the initial four formants. The variations in specific differences of the formant frequencies and amplitudes were also estimated. The different subgroups of patients revealed significant alterations in the parameters studied. The vowels [a:] and [i:] showed inverse changes in measured values. Evaluation of the vowel [u:], on the other hand, was restricted due to artifactual scattering of individual values. In general, the bandwidths diminished postoperatively and energy peaks of formants increased proportinally. In 6 out of 21 patients, one third of the cases examined, after surgery the patients detected perceptual changes in speech. Based on our data obtained it is recommended to inform all patients as well as voice professionals about the possible speech alterations of the speech after endonasal sinus surgery.

A combined application of acoustic rhinometry, rhinoresistometry, and flow simulation of the nose mucosa before and after turbinate surgery: a model study.

The interpretation of rhinometric results seems difficult, particularly in young examiners. In order to follow rhinometric assessments precisely, the knowledge of the nose airflow mechanisms is necessary. In this direction, in a model study the consequences of nasal concha surgery on acoustic rhinometry and rhinoresistometry were systematically investigated. Six nose models were examined through acoustic rhinometry and rhinoresistometry approaches. Each model reflected conditions happened after the nasal concha surgery. All models were also rinsed with the water while the flow outputs were visualized for the checking. The normal nose was represented an even flow distribution over the entire nasal cavity. After the nasal concha resection, a deviant flow course and a significant grow in turbulence activity were seen. A flow resistance dropped in addition considerably. In the model with general lateral wall hyperplasia, a restriction of the inferior and even of the middle nasal concha led to the beneficial functional results. The models demonstrated a positive correlation between the flow data and acoustic rhinometry and rhinoresistometry measures. Both methods complement each other in the diagnostic outcome of the nose functioning.

Investigation of the nasal cycle function through endoscopy, rhinoresistometry and acoustic rhinomety.

The cyclic congestion and decongestion in both nasal cavities systematically accompany the nose respiratory function. The turbulent behavior of the nasal airflow seems to be a prerequisite of the adequate contact of inspired air particles with a nasal mucosa. The aim of the present study was to gain further information regarding the turbulent airflow behavior just during the nasal cycle dynamics. The nasal cycles in 10 healthy human subjects were investigated applying endoscopic imaging, rhinoresistometry, and acoustic rhinometry methods. The nasal function has been estimated at the regular intervals of 20 minutes over a time period of 15 hours. The following parameters were calculated in each case: airflow resistance, hydraulic diameter, friction coefficient , transition from the laminar flow to the turbulent one, and minimal cross-sectional areas. In addition to the previously known cyclic changes of the flow resistance and of the nasal width, periodic alterations in the turbulence function were noted. Under the resting phase, the laminar flow was usually demonstrated. Under the working phase, the turbulences arouse already at low flow velocities. The increases of turbulences that supplemented the working phase were caused by the enlargement of the cross-sectional area in the anterior nasal cavum. The latter followed to the decongestion of the mucosa of the head of the inferior turbinate as well as of the septal tuberculum. Rhinoresistometry and acoustic rhinometry predominantly complement each other. Application of both methods provides therefore valuable information on the functional nasal cycle changes. A combination of these two methods is recommended thus for the proper evaluation of the nasal cavity behavior.

The results of surgical treatment of middle ear cholesteatoma by using open and closed techniques.

Middle ear cholesteatoma caused by repeated ear infections over time, destroys the delicate middle ear bones and causes permanent hearing loss or dizziness. It may grow to involve the facial nerve causing facial paralysis. In some instances, cholesteatomas can expand up into the brain, causing meningitis, sinus thrombosis, facial nerve palsy, vestibulitis and differently localized abscess. Nearly all patients with cholesteatoma require surgery to cure the disease. Therapeutic and rehabilitative surgical procedures were done, using either a closed technique (TCT) or an open technique: tympanoplasty in open technique (TOT). The aim of the work was to compare the advantages of TCT and TOT surgical technique for the treatment of cholesteatoma disease. The research was conducted in Tbilisi State Medical University Otorhino-laryngological Clinic on 65 patients with middle ear cholesteatoma: 21 women and 44 men in 2006-2008. Their average age was 29. The youngest was 7 years old, and the oldest one - 67. The investigation revealed that after TCT recidivations were noted in 16% of patients; after TOT in 42.3% of patients. It is concluded that CT technique is the most appropriate and optimal surgical interference for the treatment of chronic middle ear diseases.