Browsing by Author "Milutinovic, Zoran (7003458956)"

[No abstract available]

Objective. Vocal fold polyps (VFPs) are the most common benign laryngeal lesions that require surgery and are routinely managed by microlaryngoscopy (MLS) under general an-aesthesia. Prior to introduction of MLS, VFPs were removed using indirect laryngoscopic surgery (ILS) in local anaesthesia, a procedure that required substantial surgical skill to operate with an unmagnified mirror view of the larynx. With the adoption of wireless en-doscopy equipment and personal computers, we tried to simplify this technique so that it can be easily performed in the office. This study aimed to assess the effectiveness of ILS by comparing voice outcomes with MLS. Materials and methods. ILS and MLS were performed in six patients each. Treatment outcomes were measured using a voice self-assessment and objective acoustic analysis. The total cost of both procedures was calculated. Results. Both techniques allowed successful removal of VFPs in all patients, without sig-nificant intergroup differences in voice outcomes. The cost of ILS was significantly lower. Conclusions. Despite the pilot nature of the study and the small sample size, our data in-dicate the potential value of this technique which, considering its simplicity and economic value could be used as an alternative to MLS in carefully selected patients. © Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale.

OBJECTIVE: To compare the effects of hyperbaric oxygen (HBO) and intratympanic (IT) steroid injection on hearing after the failure of primary treatment in patients with idiopathic sudden sensorineural hearing loss (ISSHL). STUDY DESIGN: A prospective randomized trial. SETTING: Tertiary referral center. PATIENTS: Fifty patients with failure of primary therapy for ISSHL. INTERVENTION(S): After primary treatment with systemic steroids and failure of therapy, defined as less than 10-dB hearing gain, 50 patients were enrolled in the study and received either hyperbaric oxygen or intratympanic steroid treatment. The patients were not matched and not similar. MAIN OUTCOME MEASURE(S): Hearing gain at 0.25, 0.5, 1, 2, and 4 kHz after treatment. RESULTS: There were significant differences between hearing thresholds at all frequencies before and after the HBO treatment. Similarly, there were significant differences between hearing thresholds at most frequencies (except 2 kHz) before and after the treatment in the IT group. The subgroups of patients with pure tone average less than 81 dB and were younger than 60 years had better response to HBO treatment than those with profound deafness and in the elderly. CONCLUSION: HBO and IT steroid therapy could be successfully used as salvage therapies in patients with sudden deafness. Further study is needed to demonstrate superiority of one of the treatments. © 2013, Otology &Neurotology, Inc.

OBJECTIVE: To compare the effects of hyperbaric oxygen (HBO) and intratympanic (IT) steroid injection on hearing after the failure of primary treatment in patients with idiopathic sudden sensorineural hearing loss (ISSHL). STUDY DESIGN: A prospective randomized trial. SETTING: Tertiary referral center. PATIENTS: Fifty patients with failure of primary therapy for ISSHL. INTERVENTION(S): After primary treatment with systemic steroids and failure of therapy, defined as less than 10-dB hearing gain, 50 patients were enrolled in the study and received either hyperbaric oxygen or intratympanic steroid treatment. The patients were not matched and not similar. MAIN OUTCOME MEASURE(S): Hearing gain at 0.25, 0.5, 1, 2, and 4 kHz after treatment. RESULTS: There were significant differences between hearing thresholds at all frequencies before and after the HBO treatment. Similarly, there were significant differences between hearing thresholds at most frequencies (except 2 kHz) before and after the treatment in the IT group. The subgroups of patients with pure tone average less than 81 dB and were younger than 60 years had better response to HBO treatment than those with profound deafness and in the elderly. CONCLUSION: HBO and IT steroid therapy could be successfully used as salvage therapies in patients with sudden deafness. Further study is needed to demonstrate superiority of one of the treatments. © 2013, Otology &Neurotology, Inc.

Reinke's space is a highly specific structure critical for the function of the vocal fold, involved in a majority of pathological changes of the larynx. The aim of the study was to contribute to the understanding of edematous areas of vocal fold mucosa in patients with Reinke's edema using contact telescopy (ConTel). The edematous tissue which could be identified grossly by microlaryngoscopy under general anesthesia was stained topically with methylene blue and then examined using ConTel. The observed changes on contact images were further correlated with corresponding histological sections of biopsied edematous tissue. In patients with Reinke's edema examined using ConTel, we observed longitudinal arranged mucosal "blue lines" (BL). In the histological sections of edematous tissue showing the BL on ConTel, we almost regularly observed well-developed hollow spaces in subepithelia. Also, they were regularly oriented from the middle of the membranous portion of the vocal fold toward the arcuate line distributed almost parallel to the free edge of the vocal fold. BL were a specific feature of Reinke's edema as they were not found in control groups with normal vocal fold mucosa and with vocal fold polyps. For the first time we are describing a new superficial morphological feature of Reinke's edema. The BL could present epithelial ConTel markers of the area between two enlarged neighboring subepithelial crevices of Reinke's space, as indicated on histological sections. Further characterization of BL is required for the understanding of their role in Reinke's edema. © 2009 The Voice Foundation.

Reinke's space is a highly specific structure critical for the function of the vocal fold, involved in a majority of pathological changes of the larynx. The aim of the study was to contribute to the understanding of edematous areas of vocal fold mucosa in patients with Reinke's edema using contact telescopy (ConTel). The edematous tissue which could be identified grossly by microlaryngoscopy under general anesthesia was stained topically with methylene blue and then examined using ConTel. The observed changes on contact images were further correlated with corresponding histological sections of biopsied edematous tissue. In patients with Reinke's edema examined using ConTel, we observed longitudinal arranged mucosal "blue lines" (BL). In the histological sections of edematous tissue showing the BL on ConTel, we almost regularly observed well-developed hollow spaces in subepithelia. Also, they were regularly oriented from the middle of the membranous portion of the vocal fold toward the arcuate line distributed almost parallel to the free edge of the vocal fold. BL were a specific feature of Reinke's edema as they were not found in control groups with normal vocal fold mucosa and with vocal fold polyps. For the first time we are describing a new superficial morphological feature of Reinke's edema. The BL could present epithelial ConTel markers of the area between two enlarged neighboring subepithelial crevices of Reinke's space, as indicated on histological sections. Further characterization of BL is required for the understanding of their role in Reinke's edema. © 2009 The Voice Foundation.