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1.
Orv Hetil ; 163(21): 838-845, 2022 May 22.
Artigo em Húngaro | MEDLINE | ID: mdl-35598213

RESUMO

Introduction and objective: Mastoid obliteration technique combines the advantages of canal wall-up (CWU) and canal wall-down (CWD) approaches in the surgery of chronic suppurative otitis media with cholesteatoma. We aim to demonstrate our experience with mastoid obliteration technique using bone dust and BonAlive® (S53P4) bioactive glass granule in a comparative prospective clinical study. Patients and methods: Between 1st of March 2012 and 31st of November 2021, mastoid obliteration surgery was performed in 14 patients using bone dust (7 cases) and BonAlive® granule (7 cases). Prior to these interventions, the patients had undergone more than three ear surgeries (CWU and CWD) generally in both groups. Changes of complaints, audiological results, and changes in quality of life were analysed in both groups, postoperatively. Results: Having performed the mastoid obliteration technique, cochlear damage did not occur in either patient group. Long-term ear discharge and vertigo were occasionally observed after performing obliteration with bone dust. However, these complaints disappeared after a while. Complications were not reported in the case of obliteration with BonAlive®. Outstanding improvement was experienced in both groups. Conclusion: In our practice, mastoid obliteration surgery, using either bone dust or BonAlive® granule, has proved to


Assuntos
Colesteatoma da Orelha Média , Otite Média Supurativa , Procedimentos Cirúrgicos Otológicos , Substitutos Ósseos/administração & dosagem , Transplante Ósseo/métodos , Osso e Ossos , Colesteatoma da Orelha Média/complicações , Colesteatoma da Orelha Média/cirurgia , Poeira , Vidro , Humanos , Processo Mastoide/cirurgia , Otite Média Supurativa/complicações , Otite Média Supurativa/cirurgia , Procedimentos Cirúrgicos Otológicos/efeitos adversos , Procedimentos Cirúrgicos Otológicos/métodos , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento
3.
Behav Brain Res ; 340: 106-116, 2018 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-28249729

RESUMO

Traumatic microbleeds (TMBs) and non-hemorrhagic lesions (NHLs) on MRI are regarded as surrogate markers of diffuse axonal injury. However, the actual relation between lesional and diffuse pathology remained unclear, since lesions were related to clinical parameters, largely influenced by extracranial factors. The aim of this study is to directly compare TMBs, NHLs and their regional features with the co-existing diffuse injury of the normal appearing white matter (NAWM) as measured by diffusion tensor imaging (DTI). Thirty-eight adults with a closed traumatic brain injury (12 mild, 4 moderate and 22 severe) who underwent susceptibility weighted imaging (SWI), T1-, T2 weighted and FLAIR MRI and routine CT were included in the study. TMB (on SWI) and NHL (on T1-, T2 weighted and FLAIR images) features and Rotterdam scores were evaluated. DTI metrics such as fractional anisotropy (FA) and mean diffusivity (MD) were measured over different NAWM regions. Clinical parameters including age; Glasgow Coma Scale; Rotterdam score; TMB and NHL features were correlated to regional NAWM diffusivity using multiple regression. Overall NHL presence and basal ganglia area TMB load were significantly, negatively correlated with the subcortical NAWM FA values (partial r=-0.37 and -0.36; p=0.006 and 0.025, respectively). The presence of any NHL, or TMBs located in the basal ganglia area indicates diffuse NAWM damage even after adjusting for clinical and CT parameters. To estimate DAI, a conventional lesional MRI pathology evaluation might at least in part substitute the use of quantitative DTI, which is yet not widely feasible in a clinical setting.


Assuntos
Lesões Encefálicas Traumáticas/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Hemorragia Cerebral/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Substância Branca/lesões , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Hemorragia Cerebral/etiologia , Imagem de Tensor de Difusão , Feminino , Traumatismos Cranianos Fechados/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Adulto Jovem
4.
Neurosci Lett ; 617: 207-12, 2016 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-26912192

RESUMO

BACKGROUND AND PURPOSE: Susceptibility weighted imaging (SWI) is a very sensitive tool for the detection of microbleeds in traumatic brain injury (TBI). The number and extent of such traumatic microbleeds (TMBs) have been shown to correlate with the severity of the injury and the clinical outcome. However, the acute dynamics of TMBs have not been revealed so far. Since TBI is known to constitute dynamic pathological processes, we hypothesized that TMBs are not constant in their appearance, but may progress acutely after injury. MATERIALS AND METHODS: We present here five closed moderate/severe (Glasgow coma scale≤13) TBI patients who underwent SWI very early (average=23.4 h), and once again a week (average=185.8 h) after the injury. The TMBs were mapped at both time points by a conventional radiological approach and their numbers and volumes were measured with manual tracing tools by two observers. TMB counts and extents were compared between time points. RESULTS: TMBs were detected in four patients, three of them displaying an apparent TMB change. In these patients, TMB confluence and apparent growth were detected in the corpus callosum, coronal radiation or subcortical white matter, while unchanged TMBs were also present. These changes caused a decrease in the TMB count associated with an increase in the overall TMB volume over time. CONCLUSION: We have found a compelling evidence that diffuse axonal injury-related microbleed development is not limited strictly to the moment of injury: the TMBs might expand in the acute phase of TBI. The timing of SWI acquisition may be relevant for optimizing the prognostic utility of this imaging biomarker.


Assuntos
Hemorragia Encefálica Traumática/diagnóstico , Lesão Axonal Difusa/diagnóstico , Doença Aguda , Adulto , Encéfalo/patologia , Hemorragia Encefálica Traumática/patologia , Lesão Axonal Difusa/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
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