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OBJECTIVE: The main objective of this study is to test the reliability of a non-invasive objective method for the measurement of biomechanical parameters of cervicofacial muscle groups, with the purpose of diagnosis and evaluation of voice disorders' treatments, especially focused on muscle tension dysphonia. STUDY DESIGN: Prospective study. METHODS: The device used is a handheld myotonometer (MyotonPRO) that measures biomechanical and viscoelastic properties in superficial soft tissues frequency, stiffness, elasticity, relaxation time and creep. It is used in the field of medicine, sport and research. This pilot study includes 10 subjects, who have been measured in the masseter, sternocleidomastoid, orbicularis oris, semispinalis capitis, suprahyoid, infrahyoid and trapezius muscles on each side. Measurements were performed by 2 evaluators to assess inter-evaluator reliability. Subsequently, one of them repeated the measurements to assess intra-evaluator reliability. RESULTS: The results revealed good to excellent inter-rater reliability for the masseter, sternocleidomastoid, trapezius and suprahyoid muscles, with lower ICCs for the stiffness and creep properties. Intra-rater reliability was good to excellent for the masseter, sternocleidomastoid, semispinalis capitis and suprahyoid muscles. The lowest ICCs were found in the stiffness and creep properties. CONCLUSION: The use of a myotonometer to measure the mechanical properties of selected cervical and orofacial muscles is a reliable and reproducible method. Future research is needed to establish an association between the properties of these muscles and their role in voice disorders, as well as to determine whether this tool can aid diagnosis with quantifiable and objectifiable indicators, and for monitoring and treatment efficacy.
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This case aims to report an unusual clinical situation with uncommon and severe side effects, which can even be life threatening for the patient. The ENT and Hematology specialist should be aware of diagnosing and treating adequately.
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PURPOSE: Since the beginning of cochlear implant (CI) surgery, several techniques to fixate the electrode array at the cochleostomy and stabilize it have been described; however, most techniques use autologous tissues such as fascia, muscle, fat or fibrin glue. We describe a new surgical technique aimed to stabilize the electrode array of a CI without using autologous tissues or artificial materials. MATERIALS AND METHODS: The surgical technique described consists in creating three stabilizing channels in the temporal bone for the electrode array. The first one in a partially opened aditus, the second one in a partially preserved Koerner's septum (KS) and the last one in the sinodural angle. The procedure was performed in five human temporal bones using a straight array; a radiography was made to confirm the correct placement of the electrode array and afterwards all temporal bones were shaken using a Titramax 1000 platform. The correct placement of the array post-shaking was then confirmed using the microscope and another radiography. RESULTS: No migration of the electrodes outside the cochlea was observed. The CI cable remained in the same position at the aditus and the KS in all the temporal bones. In three cases (60%), the electrode array moved away from the groove carved in the sinodural angle. CONCLUSIONS: The new surgical technique described stabilizes the electrode array using the temporal bone's normal anatomy, preserving the middle ear spaces, facilitating the ulterior explantation and reimplantation if necessary, and may reduce cost and surgery time.