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1.
Am J Otolaryngol ; 42(4): 102984, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33610925

RESUMO

PURPOSE: Intralabyrinthine schwannomas (ILS) are rare, benign, slow-growing tumors arising from schwann cells of the cochlear or vestibular nerves within the bony labyrinth. This study provides insight into the management of this rare tumor through a large case series. MATERIALS AND METHODS: After Institutional Review Board approval, a retrospective chart review was performed of all ILS patients treated at our institution between 2007 and 2019. RESULTS: 20 patients (9 male, 11 female) with ILS were managed at our institution. The right ear was affected in 9 patients (45%) and the left in 11 (55%). Subjective hearing loss was endorsed by all 20 patients. Average pure tone average at presentation was 72 dB nHL. Nine tumors (45%) were intravestibular, 6 (30%) were intracochlear, 4 (20%) were transmodiolar and 1 (5%) was intravestibulocochlear. Hearings aids were used in 3 patients (15%), BiCROS in 2 (10%), CI in 2 (10%), and bone conduction implant in 1 (5%). Vestibular rehabilitation was pursued in 5 patients. Surgical excision was performed for one patient (5%) via translabyrinthine approach due to intractable vertigo. No patients received radiotherapy or intratympanic gentamicin injections. CONCLUSION: ILS presents a diagnostic and management challenge given the similarity of symptoms with other disorders and limited treatment options. Hearing loss may be managed on a case-by-case basis according to patient symptoms while vestibular loss may be mitigated with vestibular therapy. Surgical excision may be considered in patients with intractable vertigo, severe hearing loss with concurrent CI placement, or in other case-by-case situations.


Assuntos
Vestibulopatia Bilateral/etiologia , Vestibulopatia Bilateral/terapia , Neoplasias da Orelha/terapia , Orelha Interna , Perda Auditiva/etiologia , Perda Auditiva/terapia , Doenças do Labirinto/terapia , Neuroma Acústico/terapia , Idoso , Vestibulopatia Bilateral/reabilitação , Implante Coclear , Neoplasias da Orelha/complicações , Neoplasias da Orelha/reabilitação , Feminino , Auxiliares de Audição , Perda Auditiva/reabilitação , Humanos , Doenças do Labirinto/complicações , Doenças do Labirinto/reabilitação , Masculino , Pessoa de Meia-Idade , Neuroma Acústico/reabilitação , Procedimentos Cirúrgicos Otológicos/métodos , Estudos Retrospectivos
2.
Laryngoscope ; 130(9): 2220-2228, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-31758583

RESUMO

OBJECTIVES: To determine independent risk factors for 30-day readmission, prolonged length of stay (PLOS), and discharge to a rehabilitation facility for those with malignant otitis externa. METHODS: Retrospective cohort study of patients hospitalized with malignant otitis externa (International Classification of Diseases, 9th edition, code 380.14) in the Nationwide Readmissions Database (2013-2014). Overall and disease-specific complication and mortality data were analyzed using chi-squared and multivariate analysis. RESULTS: There were 1267 cases of malignant otitis externa extracted. A PLOS of ≥8 days (90th percentile) was found in 14.2% (n = 180) of patients, and 13.7% (n = 174) were discharged to a facility. Patients were readmitted within 30 days at a rate of 12.5% (n = 159). The overall rates of uncomplicated and complicated diabetes were found to be 42.1% and 17.8%, respectively. Factors independently associated with PLOS included undergoing a surgical procedure (odds ratio [OR] 2.08, P < .001), and having central nervous system complications (OR 3.21, P < .001). Independent risk factors for disposition to a facility included nutritional deficiency (OR 1.91, P = .029), PLOS (OR 4.61, P < .001), and age 65-79 years (OR 6.57, P = .001). Readmission was independently linked to PLOS (OR 3.14, P < .001). Diabetes was not an independent risk factor for any outcome. CONCLUSIONS: Thirty-day readmission, PLOS, and ultimate discharge to a rehabilitation facility were common and closely intertwined. Despite the classic association between diabetes and malignant otitis externa, diabetes was not an independent risk factor for any of our outcomes. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:2220-2228, 2020.


Assuntos
Neoplasias da Orelha/patologia , Tempo de Internação/estatística & dados numéricos , Otite Externa/patologia , Alta do Paciente/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Neoplasias da Orelha/reabilitação , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Otite Externa/reabilitação , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Estados Unidos , Adulto Jovem
3.
J Oral Maxillofac Surg ; 71(8): e232-42, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23866953

RESUMO

PURPOSE: Auricular reconstruction is a challenging surgical intervention that requires perfect surgical skills, exact planning, and esthetic knowledge. It is necessary to use a suitable method of reconstruction for each patient. From 10 years of experience, the authors have developed a general concept for auricular reconstruction. PATIENTS AND METHODS: Seventy-five patients (62 male, 13 female; age range, 8 to 92 yr; mean age, 65.9 yr) underwent partial to total auricular reconstruction. Tissue loss occurred from different causes: 19 cases of squamous cell carcinoma (25.3%), 18 cases of basal cell carcinoma (24%), 14 cases of Bowen disease (18.7), 11 cases of malignant melanoma (14.7%), 7 cases of trauma (9.3%), 3 different malignant tumors (4%), and 3 cases of congenital deformity (4%). RESULTS: Defects smaller than one fourth the vertical auricular size (15 to 20 mm) could be treated by primary closure. A larger defect closed by this method caused visible deformity. In defects larger than one to three fourths the vertical auricular size (40 to 55 mm), a reversed retroauricular flap was used successfully if there was no contraindication or rejection. This flap can be combined with other flaps, depending on the flap location, size, and tissue involved. In defects exceeding three fourths the vertical auricular size, an implant-retained prosthesis was preferred. CONCLUSION: The location and size of a defect, the medical condition of the patient, and the desired esthetic outcome play an important role in choosing the appropriate method. According to the authors' experience, the only contraindications for the reversed retroauricular flap are medical condition, poor prognosis, and patient refusal.


Assuntos
Pavilhão Auricular/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pavilhão Auricular/patologia , Neoplasias da Orelha/reabilitação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
4.
J Prosthet Dent ; 105(2): 78-82, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21262404

RESUMO

The method of fabricating an auricular prosthesis by digitally positioning a mirror image of the soft tissue, then designing and using rapid prototyping to produce the mold, can reduce the steps and time needed to create a prosthesis by the traditional approach of sculpting either wax or clay. The purpose of this clinical report is to illustrate how the use of 3-dimensional (3-D) photography, computer technology, and additive manufacturing can extensively reduce many of the preliminary procedures currently used to create an auricular prosthesis.


Assuntos
Desenho Assistido por Computador , Neoplasias da Orelha/reabilitação , Orelha Externa , Imageamento Tridimensional/métodos , Próteses e Implantes , Desenho de Prótese/métodos , Adulto , Carcinoma Basocelular/reabilitação , Carcinoma Basocelular/cirurgia , Neoplasias da Orelha/cirurgia , Orelha Externa/diagnóstico por imagem , Humanos , Masculino , Modelos Anatômicos , Fotogrametria , Implantação de Prótese , Tomografia Computadorizada por Raios X
5.
Implant Dent ; 18(4): 291-6, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19667816

RESUMO

This clinical report describes the rehabilitation of a patient with a compromised temporal bone anatomy caused by resection of bone due to squamous cell carcinoma of external auditory canal. Tumor resection was followed by placement of three implants. The implants were intentionally malpositioned in the anterior-posterior plane due to the lack of temporal bone. Prosthodontic treatment included customized implant bar-supported auricular prosthesis.


Assuntos
Neoplasias da Orelha/reabilitação , Orelha Externa , Próteses e Implantes , Implantação de Prótese/instrumentação , Osso Temporal/cirurgia , Adulto , Carcinoma de Células Escamosas/reabilitação , Orelha Externa/cirurgia , Humanos , Masculino
6.
J Craniofac Surg ; 20(2): 321-5, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19276832

RESUMO

Reconstructing auricular defects is a challenging task for facial reconstructive surgeons. Although autologous reconstruction is the first choice for reconstruction, there may be circumstances of inconvenience such as previously attempted surgery, radiotherapy, systemic conditions, or patient's wish. Auricular restorations with facial prosthesis have produced promising results, but there are still problems to be tackled for improved results. Rapid prototyping in the production of an auricular prosthesis uses the mirror image of contralateral ear and produces excellent forms, eliminating the subjective perception of the prosthodontist. Rapid prototyping also lowers the production costs by reducing the need for several sessions in the process of producing the prostheses. Between 2004 and 2007, 10 patients applied to our department with the absence of an ear on a single side. All patients were male, with an average age of 23.1 years. The etiology for the loss of the ear was mostly tumors, followed by congenital deformities and trauma, respectively. In this study, we present our application of rapid prototyping technique and report our case series of 10 patients, two of which are presented in detail.


Assuntos
Desenho Assistido por Computador , Orelha Externa , Próteses e Implantes , Desenho de Prótese , Queimaduras/cirurgia , Criança , Neoplasias da Orelha/reabilitação , Neoplasias da Orelha/cirurgia , Orelha Externa/anormalidades , Orelha Externa/lesões , Orelha Externa/cirurgia , Humanos , Processamento de Imagem Assistida por Computador , Estudos Longitudinais , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Osseointegração/fisiologia , Pigmentação em Prótese , Implantação de Prótese , Tomografia Computadorizada por Raios X , Interface Usuário-Computador , Adulto Jovem
7.
Acta otorrinolaringol. esp ; 59(1): 30-38, ene. 2008. ilus, tab
Artigo em Es | IBECS | ID: ibc-058757

RESUMO

La hipoacusia neurosensorial tiene alta incidencia en nuestra población. Sirva de ejemplo que el 50 % de las personas mayores de 75 años tiene este tipo de discapacidad. Los avances en los dispositivos utilizados para su tratamiento paliativo y su eficacia comprobada hacen necesaria la revisión de sus indicaciones y la descripción detallada de los sistemas audioprotésicos empleados. Éstos pueden ser clasificados en prótesis externas no implantables (audífonos) y prótesis implantables. El grupo de las prótesis implantables se subdivide a su vez en implantes activos de oído externo, implantes activos de oído medio, implantes cocleares e implantes auditivos de tronco cerebral (IATC). Las indicaciones establecidas para cada grupo audioprotésico se definen por la tipología y la topología de la enfermedad subyacente y por las características anatomofuncionales y socioculturales de cada paciente. En esta cuestión debe hacerse hincapié en el protagonismo del especialista a la hora de elegir y seguir el tratamiento. Como norma general, se procura favorecer el acceso del paciente hipoacúsico a su entorno sonoro realzando la comprensión de la palabra hablada restableciendo la binauralidad y, a la vez, se busca mantener la plasticidad de las vías auditivas centrales a través de la estimulación proporcionada por cualquiera de estos sistemas. Se expone las indicaciones emergentes, ya sea en el campo de los implantes cocleares (estimulación bimodal, implantación en pacientes con audición residual, implantaciones bilaterales, etc.) o en el campo de los IATC, en pacientes con afección tumoral previamente tratada con radiocirugía y en pacientes con trastornos no tumorales afectos de osificación coclear bilateral o malformaciones


Sensorineural hearing loss has a high incidence in our population; as a matter of fact, 50 % of people above 75 years of age suffer this impairment. Due to the advances in the devices to alleviate this condition and their verified efficacy, it is now appropriate to review the indications for these devices and provide a detailed description of the audioprosthetic systems used. These systems can be classified as external non-implantable devices (hearing aids) and implantable prostheses. The latter can be sub-divided into active implants in the external ear or middle ear, cochlear implants, and auditory brainstem implants (ABI). Indications for each group are determined by the type and location of the underlying condition as well as by the anatomic, functional, and social characteristics of each patient. It must be stressed that the selection and monitoring of the treatment is up to the specialist. Generally speaking, an attempt is made to facilitate the integration of the hypoacusic patients to their sound setting by enhancing their understanding of the spoken word and restoring binaurality, while at the same time, seeking to retain the plasticity of central auditory routes through the stimulation provided by any of these systems. In the course of this review, we refer to newly-emerging indications in both the field of cochlear implants (bimodal stimulation, implantation in patients with residual hearing, bilateral implants, etc) and in the area of ABI in patients with tumoural disease previously treated with radiosurgery or patients with non-tumour pathologies presenting malformations or bilateral cochlear ossification


Assuntos
Humanos , Idoso , Audiometria/métodos , Perda Auditiva Neurossensorial/diagnóstico , Implantes Cocleares , Implante Auditivo de Tronco Encefálico , Implantes Auditivos de Tronco Encefálico , Auxiliares de Audição , Ossificação Heterotópica/complicações , Neoplasias da Orelha/reabilitação
8.
In. Barros, Ana Paula Brandäo; Arakawa, Lica; Tonini, Monique Donata; Carvalho, Viviane Alves de. Fonoaudiologia em cancerologia. Säo Paulo, Fundaçäo Oncocentro, 2000. p.105-9.
Monografia em Português | LILACS, Sec. Est. Saúde SP | ID: lil-281511
9.
N Y State Dent J ; 65(7): 26-31, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10500406

RESUMO

Retention of a facial prosthesis is the most important factor in creating a useful prosthesis for the patient. This paper presents a detailed case study of an auricular defect that was rehabilitated using two types of prosthetic retention: adhesive and osseointegration. We present the patient selection criteria, the surgical considerations prior to implant placement, retention component selection, prosthetic fabrication techniques and patient management after prosthetic delivery. The osseointegrated prosthesis made a large improvement in the patient's quality of life.


Assuntos
Orelha Externa , Próteses e Implantes , Implantação de Prótese , Resinas Acrílicas , Adesivos , Idoso , Carcinoma de Células Escamosas/reabilitação , Carcinoma de Células Escamosas/cirurgia , Neoplasias da Orelha/reabilitação , Neoplasias da Orelha/cirurgia , Auxiliares de Audição , Humanos , Masculino , Osseointegração , Equipe de Assistência ao Paciente , Satisfação do Paciente , Seleção de Pacientes , Desenho de Prótese , Retalhos Cirúrgicos
12.
Auris Nasus Larynx ; 20(2): 145-54, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-8216050

RESUMO

Ten patients under 20 years of age, with malignant tumors of the head and neck was treated at the Department of Otorhinolaryngology of Kitasato University Hospital from August 1971 to December 1989. The primary lesions were situated in the nose and paranasal sinuses in 3, middle ear in 2, epipharynx in 2, and parapharynx, esophagus, and neck in 1 patient. Histological examination indicated 3 rhabdomyosarcomas, 2 malignant lymphomas, and 1 each of neuroblastoma, malignant neuroendocrine tumor, transitional cell carcinoma, lymphepithelioma, and squamous cell carcinoma. The sites of origin and histopathology of malignant tumors in such patients usually differ from those in adults. Well differentiated squamous cell carcinoma of head and neck is common in adults but not in children, in whom non-epithelial malignant tumors or sarcomas are not rare. Radiotherapy is more effective for treating malignant tumors of the head and neck in young than in adults. Eight of 10 patients are still alive, 7 of whom for 5 years or more. Two with rhabdomyosarcoma died.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Rabdomiossarcoma/diagnóstico , Adolescente , Adulto , Fatores Etários , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/radioterapia , Criança , Pré-Escolar , Neoplasias da Orelha/patologia , Neoplasias da Orelha/reabilitação , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Japão/epidemiologia , Masculino , Rabdomiossarcoma/epidemiologia , Rabdomiossarcoma/patologia , Rabdomiossarcoma/radioterapia
13.
Laryngorhinootologie ; 70(11): 625-9, 1991 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-1755902

RESUMO

Defects in the head and neck region following extensive tumor removal are sometimes difficult to reconstruct by local or free flaps. An epithesis is a recommended alternative in defects of the ear, the nose or the orbital region. Nevertheless problems may arise in the appropriate fixation of the epithesis. With the intermobile-cylinder-implant-system (IMZ), the epithesis is firmly fixed by means of osseointegration of the implants and an abutment in the area of the defect. The various steps of the operation and clinical applications are presented.


Assuntos
Neoplasias de Cabeça e Pescoço/cirurgia , Próteses e Implantes , Deformidades Adquiridas da Orelha/reabilitação , Deformidades Adquiridas da Orelha/cirurgia , Neoplasias da Orelha/reabilitação , Neoplasias da Orelha/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade
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