Browsing by Author "Čvorović, Ljiljana (16229375800)"

The Clinic for Otorhinolaryngology and Maxillofacial Surgery at the University Clinical Center of Serbia celebrates its 100th anniversary in 2024. Established in 1924, the clinic has significantly contributed to the development of otorhinolaryngology in Serbia, keeping pace with European advancements. Its origins trace back to the early 1870s with Dr. Jovan Jovanović Zmaj, a physician who pioneered laryngoscopy in the country, and to Dr. Vladan Đorđević in 1871. Both were pioneers of laryngoscopy – Dr. Jovanović Zmaj in Novi Sad, and Dr. Đorđević in Belgrade. The clinic initially operated at the General State Hospital in Belgrade, before expanding and relocating multiple times. It has continually grown, introducing cutting-edge treatments and technologies, including endoscopic procedures, pediatric care, and advanced head and neck surgeries. Today, the clinic has 115 beds, six operating rooms, and specialized departments, offering comprehensive care in otorhinolaryngology and maxillofacial surgery. With a strong educational focus, it trains future medical professionals and continues to lead innovations in ENT and maxillofacial surgery. The clinic’s strategic goals include modernizing equipment and expanding capacities, aiming to maintain its position as a leader in the field. © 2025, Serbia Medical Society. All rights reserved.

COVID-19 infection is associated with a variety of neurological manifestations. Since the inner ear is vulnerable to viruses, sensorineural hearing loss (SNHL) has been reported to occur following SARS-CoV-2 infection. We present here two cases of profound SNHL following SARS-CoV-2 infection. Pure-tone audiograms confirmed profound SNHL. The tympanogram and Auditory Brainstem Responses showed no abnormal symptoms. MRIs and CTs identified some changes but no significant anatomical nor physiological manifestations explaining the obvious cause for hearing loss. High doses of oral corticosteroids with additional conservative therapy were given with no therapeutic response, and therefore, cochlear implant surgery was performed. One case was bilaterally treated, and the other one received an implantation on one side. Both surgeries were carried out without intra- nor postoperative complications. Interestingly, in both cases, advanced fibrotic tissue was found during surgery. Both cases reported successful rehabilitation and are satisfied with their new sound perception following cochlear implantation. © 2023 by the authors.

Objective: The role of neurogenic inflammation in pathogenesis of chronic rhinitis is well known. However, very little is known about its importance in pathogenesis of nasal polyposis (NP), especially in form of NP which appears as a part of aspirin-exacerbated respiratory disease (AERD). The aim of this study was to examine the concentrations of neuropeptides substance P (SP) and bradykinin (BK) in nasal secretions of patients with NP. Methods: Fourteen patients with NP as a part of AERD with mild persistent asthma, 14 patients with NP without aspirin sensitivity, and 14 control subjects without nasal inflammation (C) entered this cross-sectional study. Clinical parameters (symptoms, endoscopic, and radiological findings) were assessed. The concentrations of SP and BK were measured in the nasal secretion samples using commercial human enzyme immunoassay kits. Results: The concentration of SP in nasal secretions was significantly higher in NP patients without aspirin sensitivity and AERD patients compared to controls (p =.022; p <.0001, respectively), but higher in AERD than in non-AERD patients (p =.018). The level of BK in nasal fluid was higher in non-AERD and AERD NP patients than in controls (p <.0001; p <.0001, respectively), but also higher in AERD than in non-AERD patients (p <.0001). We found high positive correlations between BK in nasal fluid and Lund–Mackay computed tomography (CT) score in both non-AERD and AERD groups of NP patients. Conclusion: Our results suggest more intense release of SP and BK from the nasal mucosa in patients with AERD than in patients with NP who do not have aspirin sensitivity. The strong correlation between concentration of BK in nasal secretions and CT score suggests that BK in nasal fluid could be used as a marker for disease severity as measured by the Lund–Mackay score. © 2022 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.

Introduction. Intracranial complications of otitis media still occur, despite great progress in the treatment of all forms of inflammation. These are serious conditions which are still life-threatening and require a fast and accurate diagnosis and an adequate treatment. We present an illustrative case of an acute, foudroyant, pneumococcal, suppurative otitis media with infection spreading into endocranium and development of meningoencephalitis and otic hydrocephalus. Case report. A 6-year-old girl was admitted to the University Children's Clinic in Belgrade, Serbia, because of fever, headache, vomiting and disorder of consciousness. Computed tomography scan of the endocranium and temporal bone revealed brain edema and hypodense content in the left mastoid and tympanic cavity. The diagnosis of acute otitis media with meningoencephalitis was made and we started with intensive antibiotic treatment. Lumbar puncture and hemoculture confirmed a pneumococcal infection. Otosurgical treatment was conducted, too, due to an inadequate reaction to the conservative treatment. Firstly, left mastoidectomy with the implantation of a ventilation tube was performed, followed by a radical tympanomastoidectomy, because there was no improvement. Three weeks after the second operation, a magnetic resonance imaging of the endocranium was performed and an otic hydrocephalus was diagnosed. A neurosurgical operation was performed on the same day with the setting of the ventriculoperitoneal shunt. Conclusion. Intracranial complications of acute otitis media in children are extremely rare and they require a multidisciplinary treatment. Surgical treatment of the ear should not be postponed and the choice of the type of otosurgical intervention should be individually adapted. Audiological and neurological complications of the disease are frequent and they further prolong and impair the treatment. © 2021 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Purpose: Otitis media with effusion (OME) associated with Samter’s triad (ST) is a difficult entity to treat. The aim of study was an investigation of the middle ear and nasal production of inflammatory mediators (IM) in patients with ST and analysing differences between them and controls. Methods: Prospective case–control study. Nineteen patients with OME (five had allergic rhinitis, four had nasopharyngeal lymphoid hyperplasia, five had no evident sino-nasopharyngeal disease and five had confirmed ST) and 15 healthy participants were included. The concentrations of IM interleukin–1 beta (IL-1β), interferon-alpha 2 (IFN-α2), interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-18, IL-23 and IL-33 were measured in nasal and middle ear secretions. Results: There was a difference that was close to a level of statistical significance only for IL-1β levels in middle ear fluid (p = 0.052) between the ST subgroup and the other patients with OME. Also, we found a significant difference for IL-23 in nasal secretions between these subgroups (p = 0.040), whereas the difference in nasal fluid IL-33 was close to a level of statistical significance (p = 0.052). There was a significant difference in nasal concentrations of IL-1β, IFN-α2, MCP-1, IL-8, IL-18 and IL-33 (p < 0.001, p = 0.005, p = 0.008, p = 0.011, p = 0.011 and p = 0.011, respectively) between the OME group and the healthy subjects. There were significant positive correlations between concentrations of IL-1β, IFN-α2, IFN-γ, TNF-α, MCP-1, IL-17A, IL-18 and IL-33 (p < 0.001, p < 0.001, p = 0.002, p = 0.028, p < 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively) in nasal and middle ear secretions. Conclusion: This preliminary report showed some differences in IM production between the patients with OME associated with ST and those without it. Our results suggest a uniformity of the production of nasal and middle ear IM and supported the concept of a united airway respiratory disease. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.

Background/Aim. Otitis media with effusion (OME) is a common disease among the children aged from 6 months to 4 years, but recurrences are common after the extraction of ventilation tubes. The aim of the study was to determine the risk factors for recurrent OME after extraction of ventilation tubes. Methods. The research was a prospective study with 305 children aged 0 to 10 years with OME. Forty three (14%) of them had recurrent OME. We analyzed the factors that could lead to the redevelopment of the disease after extrusion of the tubes. Results. It was found that the majority of children with recurrent disease was between the ages of 5 to 7 years (56%) and had allergy in significantly higher rate than children without recurrence. In most cases (37.7%), the retention time of ventilating tube was above 10 months and the recurrent disease was diagnosed in 46.5% cases within a period of 10 to 12 months after extrusion of tubes. Conclusion. Children with OME and after ventilation tube extrusion need to be followed up for 1 year after the removal of tubes. It is necessary to inform the parents that the disease can recur. Children in the kindergarten, in preschool age and with a respiratory allergy had higher possibility for recurrent OME. © 2017, Inst. Sci. inf., Univ. Defence in Belgrade. All Rights Reserved.

Introduction. The elongated styloid process is a very rare clinical entity. In most cases it is asymptomatic, but also could cause Eagle’s syndrome. We presented a rare case of the anatomic variation of styloid process and its clinical implication. Case report. In the left tonsillar fossa an unexpected bony structure was found during the routine tonsillectomy on a 16-year-old female patient. Computed tomography showed the elongated styloid process. No further treatment was necessary because it was asymptomatic in the follow-up period. Conclusion. The elongated styloid process is a very rare condition, but physicians should be aware of it and keep it in mind in order to make the diagnosis in patients with suggestive symptoms. © 2017, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.