RESUMEN
In the field of otolaryngology, fat injection is mainly performed for glottic insufficiency. We encountered a patient of tracheoesophageal fistula with a voice prosthesis after total laryngectomy, in whom the fistula grew too wide. This condition was difficult to treat by conservative therapy. We performed fat injection around the tracheoesophageal fistula, achieving sufficient reduction in the size of to prevent leakage. This treatment allowed continuous use of the voice the prosthesis by the patient.
Asunto(s)
Tejido Adiposo/trasplante , Laringe Artificial , Complicaciones Posoperatorias/terapia , Fístula Traqueoesofágica/terapia , Anciano , Humanos , Laringectomía , Masculino , Neoplasias Faríngeas/cirugía , Trasplante Autólogo , Resultado del TratamientoRESUMEN
The route of the cochlear nerve can be imaged using computed tomography (CT) or magnetic resonance imaging (MRI). To gain information about the cochlear nerve, we conducted a trial measuring the width of the cochlear nerve canal (CNC) using CT. When we examined images of the route of the cochlear nerve on MRI, both in ears with congenital sensorineural hearing loss (SNHL) and normal ones, we found that in ears in which the CNC was narrower than 1.5 mm with CT, images of cochlear nerve deficiency could be seen in that ear with MRI.
Asunto(s)
Nervio Coclear/patología , Pérdida Auditiva Sensorineural/congénito , Pérdida Auditiva Sensorineural/patología , Adolescente , Niño , Preescolar , Nervio Coclear/diagnóstico por imagen , Pérdida Auditiva Bilateral/congénito , Pérdida Auditiva Bilateral/patología , Pérdida Auditiva Sensorineural/diagnóstico , Humanos , Lactante , Imagen por Resonancia Magnética , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos XRESUMEN
Extramedullary plasmacytoma (EMP) is a rare plasma cell neoplasm that occurs in the soft tissues, especially in the upper airways. We report two cases of laryngeal EMP, both of which were treated by surgical resection, one with and one without combination radiotherapy. A 39-year-old male was diagnosed with a laryngeal tumor localized in the left arytenoid region in October 1999. Biopsy showed the tumor to be a plasmacytoma. He underwent a direct laryngoscopy and resection of the tumor with a KTP laser. Consequently, he received radiotherapy to a total dose of 60 Gy. He has remained clear, with no local recurrence during 6 years of follow-up. A 59-year-old male was diagnosed with an epiglottic tumor in December 1989. He underwent a direct laryngoscopy and removal of the tumor. Histopathological study of the tumor showed a diffuse proliferation of plasmacytoid cells. He has remained diseasefree during 15 years of follow-up.
Asunto(s)
Neoplasias Laríngeas/patología , Plasmacitoma/patología , Adulto , Proliferación Celular , Terapia Combinada , Supervivencia sin Enfermedad , Humanos , Neoplasias Laríngeas/radioterapia , Neoplasias Laríngeas/cirugía , Laringoscopía , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Plasmacitoma/radioterapia , Plasmacitoma/cirugía , Resultado del TratamientoRESUMEN
OBJECTIVE: To determine the extent of audiometric correlation with CT findings. METHODS: Forty-four patients (82 ears) with surgically confirmed otosclerosis underwent preoperative CT examination. Based on the computed tomography (CT) findings, the ears were classified into five groups as follows: Group A, the group with no pathological CT findings; Group B1, the group with demineralization localized in the region of the fissula antefenestram; Group B2, the group with demineralization extending towards the cochleariform process from the anterior region of the oval window; Group B3, the group with extensive demineralization surrounding the cochlea; and Group C, the group with thick anterior and posterior calcified plaques. RESULTS: There were 32 ears (39.0%) in Group A, 21 ears (25.6%) in Group B1, 16 ears (19.5%) in Group B2, 7 ears (8.5%) in Group B3, and 6 ears (7.3%) in Group C. The mean bone conduction levels were greater in the order of the extent of demineralization: Groups A, B1-B3 suggesting positive relationship between the cochlear function and the degree of labyrhinthine otosclerosis. CONCLUSION: A good correlation between the preoperative CT findings and audiometry findings suggests that CT with a slice intervals between 0.5 and 1mm could provide useful informations in assuming the extent of otosclerosis in the inner ear.
Asunto(s)
Audiometría de Tonos Puros , Otosclerosis/diagnóstico por imagen , Otosclerosis/diagnóstico , Tomografía Computarizada por Rayos X , Adolescente , Adulto , Anciano , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Otosclerosis/epidemiología , Factores Sexuales , Tomografía Computarizada por Rayos X/métodosRESUMEN
Tracheoesophageal shunt phonation is one method of voice restoration after total laryngectomy. Singer and Blom reported an endoscopic technique for voice restoration after laryngectomy, but this is not easy for all cases, because introducing nonflexible endoscope is difficult due to of scarring in the neck and reconstruction with free jejunum. We conducted tracheoesophageal puncture with a tracheal tube and flexible endoscope, finding this useful for all cases of secondary shunt procedures.
Asunto(s)
Endoscopía/métodos , Esotropía/cirugía , Intubación Intratraqueal , Voz Alaríngea/métodos , Tráquea/cirugía , Humanos , Laringe Artificial , PuncionesRESUMEN
Inner hair cells (IHCs) of guinea-pigs were separately isolated from the apical and basal turn and the potassium currents were measured by the whole-cell voltage-clamp technique. The potassium current flows through two types of membrane conductance: a fast (I(k,f)), tetraethylammonium (TEA)-sensitive conductance and a slow (I(k,s)), TEA-resistant conductance. Membrane conductance demonstrated no significant differences between apical IHCs and basal IHCs. Reversal potentials were -65+/-2 mV and -68+/-5 mV in apical and basal IHCs, respectively. The rate of outward current activation was voltage dependent and faster in basal IHCs than in apical IHCs. TEA effect was stronger on basal IHCs than on apical IHCs, suggesting that I(k,f) is dominant in basal IHCs.
Asunto(s)
Células Ciliadas Auditivas Internas/fisiología , Canales de Potasio/fisiología , Animales , Conductividad Eléctrica , Cobayas , Células Ciliadas Auditivas Internas/efectos de los fármacos , Cinética , Potenciales de la Membrana , Técnicas de Placa-Clamp , Bloqueadores de los Canales de Potasio/farmacología , Tiempo de Reacción , Tetraetilamonio/farmacologíaRESUMEN
Mucoid otitis media (MOM), one of the leading causes of acquired hearing loss in children, is characterized by mucous cell hyperplasia in the middle ear cleft associated with mucin accumulation in the middle ear cavity. The factors that stimulate mucous cell metaplasia-hyperplasia and mucin hyperproduction are poorly understood. Recent studies demonstrated that tumor necrosis factor alpha (TNF-alpha), present in human middle ear effusion, stimulated mucin production in vitro and up-regulated mucin gene expression in vivo. These findings suggest that TNF-alpha is important in the development of mucous cell metaplasia-hyperplasia. This study demonstrated that inoculation of TNF-alpha into the middle ear cavity followed by eustachian tube obstruction stimulated mucous cell metaplasia-hyperplasia in the middle ear cleft, accompanied by abundant mucin or mucin-like glycoproteins in the middle ear effusion--a phenotype of MOM in humans. This finding suggests that TNF-alpha plays a key role in the pathogenesis of MOM through induction of mucous cell metaplasia-hyperplasia and mucin production.