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Modern therapeutic options for Frey syndrome – analysis of five cases Frey综合征的现代治疗选择——附5例分析
Pub Date : 2023-05-19 DOI: 10.48095/ccorl202391
M. Hudečková, E. Minks, P. Urbánková, B. Gál
Introduction: Frey‘s syndrome (SF), auriculotemporal syndrome, is an often neglected complication occurring in 6–96% of patients after parotid gland surgery according to recent studies. It arises on the basis of aberrant ingrowth of parasympathetic fi bers into the sheaths of denervated sweat glands after auriculotemporal nerve damage. The syndrome is characterized by a triad of symptoms: sweating, redness and burning or even pain in connection with food intake. Diagnosing these problems is not a time-consuming process and there are a number of therapeutic options. However, the vast majority of approaches, whether surgical or non-surgical, have only a short-term effect and carry a number of complications. The application of botulinum toxin A (BTXA) represents a relatively simple, effective and safe treatment option consisting of intradermal application of the solution according to a predetermined Frey syndrome activation map. Objectives: Presentation and evaluation of pilot results of therapeutic application of BTXA in patients dia gnosed with Frey‘s syndrome. Material and methods: Retrospective analysis of a group of 5 patients who underwent parotid gland surgery of various extents at the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital at St. Anny in Brno between 2006 and 2019, in whom there was a signifi cant manifestation of SF symptoms on the basis of which BTXA was therapeutically applied. Results: Evaluating the subjective manifestations of SF in all patients in our cohort, after the application of BTXA, showed that the problems signifi cantly decreased from “annoying and reducing their quality of life” to “never” or “almost never” occurring. Objective results of the Minor test interpreted by SketchAndCalc showed a decrease in SF activation of 91.6% on average. Only two patients required re-administration of BTXA at 6 and 19 months intervals. No adverse reactions to BTXA were reported or observed with any of the patients. Conclusion: BTXA is an eff ective and safe way to treat patients with Frey‘s syndrome. Keywords: parotidectomy – Frey syndrome – auriculotemporal syndrome – gustatory sweating – botulinum A toxin
简介:Frey’s syndrome (SF),即耳颞综合征,是一种常被忽视的并发症,根据最近的研究,6-96%的腮腺手术后患者发生这种并发症。它是在耳颞神经损伤后副交感神经纤维异常长入失神经汗腺鞘的基础上产生的。该综合征的特点是三种症状:出汗、发红、灼热甚至与食物摄入有关的疼痛。诊断这些问题不是一个耗时的过程,而且有许多治疗选择。然而,绝大多数的方法,无论是手术还是非手术,只有短期的效果,并伴有一些并发症。肉毒毒素A (BTXA)的应用代表了一种相对简单、有效和安全的治疗选择,包括根据预先确定的Frey综合征激活图皮内应用该溶液。目的:介绍并评价肉毒毒素在弗雷氏综合征患者中的应用。材料与方法:回顾性分析2006年至2019年在布尔诺圣安妮大学医院耳鼻喉头颈外科接受不同程度腮腺手术的5例患者,其中有明显的SF症状表现,并在此基础上应用肉毒酶a进行治疗。结果:对本组所有患者SF的主观表现进行评估,在应用肉毒毒素后,SF的问题从“恼人并降低其生活质量”明显减少到“从未”或“几乎从未”发生。通过SketchAndCalc解析Minor测试的客观结果显示,SF激活平均下降91.6%。只有两名患者需要每隔6个月和19个月重新给药。没有报告或观察到任何患者对肉毒毒素的不良反应。结论:肉毒毒素是一种有效、安全的治疗弗雷氏综合征的方法。关键词:腮腺切除术-弗雷综合征-耳颞综合征-味觉出汗-肉毒杆菌A毒素
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引用次数: 0
Hearing loss in patients with Fabry disease 法布里病患者的听力损失
Pub Date : 2023-05-19 DOI: 10.48095/ccorl202365
Hana Nováčková, S. Coufal, Marie Radilová, R. Kaňa
Introduction: Fabry disease (FD) is a rare hereditary lysosomal storage disease aff ecting diff erent organs, including the cochlea-vestibular system. It can lead to premature hearing loss and tinnitus. Early and correct dia gnosis of FD is important with a view of available therapy. Purpose: The aim of this study is to evaluate the degree of hearing loss in patients with FD. Additionally, to compare diff erences between male and female patients as well as the diff erences of types of FD in patients with diff erent phenotypes. Methods: This is a retrospective study of patients that had been examined in our out-patient offi ce in the years 2016–2020. We used 7-tone pure-tone audiometry (0,125–8 kHz). We compared audiograms of patients right and left ear, calculated average Fowler percentage of hearing loss on left ear, right ear and combined. We compared combined Fowler percentage of hearing loss in diff erent types of FD based on the disease phenotype. Moreover, we compared the progress of hearing loss in time in patients that were examined in our offi ce more than once. Results: We examined 121 patients (55 male, 66 female) with dia gnosed FD. Female patients exhibited 48.5% hearing loss in the right ear and 50% in the left ear. Mixed hearing loss occurred in 1.5% of females in the group. We observed sensorineural hearing loss in 63.6% in the right ear and 65.5% in the left ear within male patients. Mixed hearing loss appeared in 1.8% of male patients. Combined mean Fowler percentage of hearing loss in females was 8.8 % and in males 14.8 %. Female patients with the classic type of FD had signifi cantly worse hearing than females with any other type of FD. This was not observed in the male group. Conclusion: Patients with FD in our group of patients had mostly sensorineural hearing loss. Hearing loss of male patients with FD was signifi cantly worse than females. Keywords: hearing loss – Fabry disease – phenotype – alpha-galactosidase – audiometry
简介:法布里病(FD)是一种罕见的遗传性溶酶体贮积病,累及不同器官,包括耳蜗-前庭系统。它会导致过早的听力丧失和耳鸣。早期和正确的诊断是重要的,以有效的治疗观点。目的:本研究的目的是评估FD患者的听力损失程度。另外,比较男女患者之间的差异以及不同表型患者FD类型的差异。方法:对2016-2020年在我院门诊检查的患者进行回顾性研究。我们使用7音纯音测听(0,125-8 kHz)。比较左耳、右耳患者的听音图,计算左耳、右耳及合并听力损失的平均福勒百分比。我们比较了基于疾病表型的不同类型FD的综合福勒听力损失百分比。此外,我们还比较了在我们办公室检查过一次以上的患者的听力损失进展情况。结果:我们检查了121例确诊为FD的患者(男性55例,女性66例)。女性患者右耳听力损失48.5%,左耳听力损失50%。该组中1.5%的女性出现混合性听力损失。我们观察到在男性患者中,感觉神经性听力损失在右耳占63.6%,在左耳占65.5%。1.8%的男性患者出现混合性听力损失。综合平均福勒听力损失百分比女性为8.8%,男性为14.8%。经典型FD女性患者的听力明显差于其他类型FD女性患者。这在男性组中没有观察到。结论:本组FD患者以感音神经性听力损失为主。男性FD患者的听力损失明显高于女性。关键词:听力损失法布里病表型半乳糖苷酶测听
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引用次数: 0
Cochlear implantation as a solution for unilateral deafness in children – first experience 人工耳蜗植入术治疗儿童单侧耳聋-首次经验
Pub Date : 2023-05-19 DOI: 10.48095/ccorl202372
Zdenka Aksenovová, J. Skřivan, Pavel Hermann, Z. Čada, M. Okluský
Introduction: Single-sided deafness (SSD) is characterized by hearing loss in one ear (pure tone average – PTA – 70 dB HL and more) with practically normal hearing in the other ear (losses up to 30 dB HL). One of the solutions is cochlear implantation, which, unlike other compensatory mechanisms (CROS system, direct bone conduction systems), is the only one that enables binaural hearing. Material and methods: Six pediatric patients with SSD who underwent cochlear implantation at FN Motol in 2020–2021 were included in the study. We monitored the development of auditory perception with a cochlear implant, the ability of directional hearing and the average daily time of use of the sound processor. Results: All patients use the sound processor regularly, subjectively and objectively their hearing perception improved. Directional hearing is not yet demonstrable. We will continue to monitor the patients and the knowledge gained will need to be verified on a larger set in the future. Conclusion: Cochlear implantation can be a suitable way to solve unilateral deafness in children. When indicating, it is necessary to consider the etiology of the hearing defect, the duration of the deafness, and the motivation of the children and their parents to regularly use the sound processor. Keywords: cochlear implantation – speech perception – single sided deafness
单侧耳聋(SSD)的特征是一只耳朵的听力损失(纯音平均- PTA - 70 dB HL以上),而另一只耳朵的听力几乎正常(损失高达30 dB HL)。解决方案之一是人工耳蜗植入术,与其他补偿机制(CROS系统,直接骨传导系统)不同,它是唯一一种能够实现双耳听力的方法。材料与方法:选取2020-2021年在FN Motol行人工耳蜗植入术的6例SSD患儿为研究对象。我们通过人工耳蜗监测了听觉感知的发展,定向听力的能力和平均每天使用声音处理器的时间。结果:所有患者均定期使用声音处理器,主观上和客观上听力感知均有改善。方向性听力尚未得到证实。我们将继续监测患者,所获得的知识将需要在未来的更大范围内得到验证。结论:人工耳蜗植入术是治疗儿童单侧耳聋的较好方法。提示时,要考虑听力缺陷的病因、耳聋的持续时间、患儿及其家长定期使用声音处理器的动机等因素。关键词:人工耳蜗;语言感知;单侧耳聋
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引用次数: 0
Heerfordt’s syndrom – a rare manifestation of sarcoidosis from an ENT perspective Heerfordt综合征-一种罕见的结节病的表现,从耳鼻喉科的角度
Pub Date : 2023-03-20 DOI: 10.48095/ccorl202333
L. Dostálová, D. Kalfeřt, Alžběta Fíková, M. Kuchař, J. Plzák
Summary Sarcoidosis is a systemic granulomatous disease that mainly affects the pulmonary and lymphatic systems. In its rare, acute forms, it can manifest as Lofgren’s syndrome (combination of erythema nodosum, bilateral pulmonary hilar lymphadenopathy, joint pain, fever and general symptoms) and even more rarely as Heerfordt’s syndrome (combination of fever, anterior uveitis, bilateral edema of the parotid area and uni or bilateral facial nerve paresis). Although this dia­gnosis is rare, it belongs to the differential dia­gnosis of sudden paresis of the facial nerve and swelling of the parotic area. In our case report, we describe Heerfordt’s syndrome in a 50-year-old woman. The pathophysiology, symptomatology, dia­gnosis, and treatment of this rare syndrome are discussed. Key words sarcoidosis – uveoparotid fever – facial nerve paresis
结节病是一种系统性肉芽肿性疾病,主要影响肺和淋巴系统。在罕见的急性形式中,它可以表现为Lofgren综合征(结节性红斑、双侧肺门淋巴结病、关节疼痛、发烧和一般症状的合并),甚至更罕见的是Heerfordt综合征(发烧、葡萄膜前炎、双侧腮腺区水肿和单侧或双侧面神经麻痹的合并)。虽然这种诊断很少见,但属于面神经突发性瘫瘫及瘫区肿胀的鉴别诊断。在我们的病例报告中,我们描述了一位50岁女性的Heerfordt综合征。本文讨论了这种罕见综合征的病理生理学、症状学、诊断和治疗。结节病;葡萄膜腮腺热;面神经麻痹
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引用次数: 0
Schwannoma of the mastoid part of the facial nerve 面神经乳突部分的神经鞘瘤
Pub Date : 2023-03-20 DOI: 10.48095/ccorl202336
Simona Motalová, K. Zeleník, P. Hurník, P. Komínek
Summary Facial nerve schwannoma is a rare benign tumour, which originates from the neural sheath of Schwann cells. Schwannoma can affect any part of the nerve from the cerebellopontine angle to the distal extratemporal segment. Intratemporal localization of the tumour is the most common. Localization of the tumour and the extent of nerve affliction are reflected in clinical symptomatology of schwannoma. The case presented is of a patient with facial nerve schwannoma propagating to the external auditory canal, which manifested clinically by progressive facial nerve paralysis. The correct dia­gnosis was made years later because another etiology (stroke) was considered to be the cause of the paresis at first. Key words facial nerve schwannoma – facial nerve paresis
面神经神经鞘瘤是一种罕见的良性肿瘤,起源于神经鞘的雪旺细胞。神经鞘瘤可影响从桥小脑角到颞外远端神经的任何部分。颞内肿瘤定位是最常见的。神经鞘瘤的临床症状反映了肿瘤的定位和神经病变的程度。本文报告一例面神经鞘瘤向外耳道扩散,临床表现为进行性面神经麻痹。正确的诊断是几年后才做出的,因为另一种病因(中风)最初被认为是麻痹的原因。关键词面神经神经鞘瘤;面神经麻痹
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引用次数: 0
Experience with secondary voice prostheses implantations at the Department of Otorhinolaryngology and Head and Neck Surgery at the Olomouc University Hospital in 2016–2021 2016-2021年在奥洛穆茨大学医院耳鼻喉科和头颈外科进行二次语音假体植入的经验
Pub Date : 2023-03-20 DOI: 10.48095/ccorl202315
Petra Beláková, Martin Brož, R. Salzman
Summary Introduction: Total laryngectomy is one of the treatment options for patients with advanced laryngeal cancer. As a result of this procedure, patients lose their capacity to create natural voice. It is associated with a psychological and social stigma. Currently, implantation of a voice prosthesis is the most modern and preferred option for voice restoration. Voice prostheses are either implanted primarily during total laryngectomy or secondarily after the surgery. At our workplace, we started the secondary implantation of voice prostheses in May 2016. Methodology: The retrospective study aims to evaluate the average interval of voice prosthesis replacements, the frequency, and reasons for replacements in patients with a secondarily implanted voice prosthesis at the Department of Otorhinolaryngology and Head and Neck Surgery at the Olomouc University Hospital from May 2016 to June 2021. Results: We performed a total of 94 exchanges in the group of 17 patients. The average lifespan of a voice prosthesis in our study is 127 days. The most frequent indication for prosthesis replacement was leakage in 52% of all cases. Conclusion: The lifespan of prostheses in our group is longer than the one reported in the literature. Leakage is the most common indication for prosthesis replacement. Key words voice prosthesis – total laryngectomy – laryngeal cancer
摘要简介:全喉切除术是晚期喉癌患者的治疗选择之一。手术的结果是,病人失去了创造自然声音的能力。它与心理和社会耻辱有关。目前,人工植入术是最现代和首选的语音修复方法。在全喉切除术期间或手术后,首先植入语音假体。在我们的工作场所,我们于2016年5月开始了二次植入术。方法:回顾性研究旨在评估2016年5月至2021年6月在奥洛穆茨大学医院耳鼻喉头颈外科进行二次植入术的假体患者的平均置换间隔、频率和置换原因。结果:我们共对17例患者进行了94次交换。在我们的研究中,语音假肢的平均寿命是127天。假体置换最常见的指征是渗漏,占所有病例的52%。结论:本组假体的使用寿命比文献报道的要长。渗漏是假体置换术最常见的指征。关键词假声全喉切除术喉癌
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引用次数: 0
Myiasis of the ear as a rare cause of otorrhea 耳蝇蛆病是引起耳漏的罕见原因
Pub Date : 2023-03-20 DOI: 10.48095/ccorl202339
Ivan Kalivoda, J. Syrovátka, K. Zogatová
Summary Myiasis – infestation of tissues by fly maggots is a relatively rare disease in our country, rarer still is a solitary affliction of the ear. The case we report is of a patient who was dia­gnosed with and treated for ear myiasis. Ear myiasis should be included in the differential dia­gnosis of otorrhea, especially in patients with low socioeconomic status. Key words myiasis of the ear – otomyiasis – otorrhea – otalgia – maggots – poor hygiene
蝇蛆病是一种由蝇蛆侵入人体组织的疾病,在我国是一种比较罕见的疾病,更罕见的是一种孤立的耳朵疾病。我们报告的病例是一个病人谁被诊断为和治疗耳虫病。耳漏的鉴别诊断应包括耳蝇病,特别是社会经济地位较低的患者。关键词:耳蝇蛆病;耳漏;耳痛
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引用次数: 0
An accuracy of whisper hearing test together with screening otoacoustic emissions in the detection of hearing loss 耳语听力测试与筛选耳声发射在听力损失检测中的准确性
Pub Date : 2023-03-20 DOI: 10.48095/ccorl20238
Michaela Bukvová, Hana Faitlová, Vít Blanař, J. Vodička
Summary Introduction: The aim of this paper is to evaluate the ability of a whisper hearing test together with an examination of transiently evoked otoacoustic emissions (TEOAE) to detect a hearing loss at the first contact with an adult patient with the indicated hearing impairment. This can be helpful in situations when a threshold pure tone audiometry cannot be performed. Methodology: We included a group of patients who were examined simultaneously with a classical whisper hearing test, TEOAE and a pure tone audiometry at the Department of Otorhinolaryngology and Head and Neck Surgery of the Pardubice Hospital. Sixty-two patients with a hearing impairment and 14 healthy subjects were tested. Results: A sensitivity of the whisper hearing test alone was 85% and that of TEOAE was 71%. The sensitivity increased to 94%, when both of them were used. At the same time, a relatively high specificity (75%) of the examination was present. Using the whisper hearing test and TEOAE, we did not detect 3.3% of patients with hearing loss detected by pure tone audiometry. Conclusion: In the situation when no pure tone audiometry is available a combination of the whisper hearing test and TEOAE may be used to detect a hearing loss. The combination of these two methods can be considered for a recently much-discussed screening for hearing impairment in the elderly. Key words whisper hearing test – transient evoked otoacoustic emissions – TEOAE – hearing loss – screening
摘要简介:本文的目的是评估耳语听力测试和瞬时诱发耳声发射(TEOAE)检查在首次接触有听力障碍的成年患者时检测听力损失的能力。这在阈值纯音测听无法执行的情况下很有帮助。方法:我们纳入了一组患者,他们同时接受了Pardubice医院耳鼻喉科和头颈外科的经典耳语听力测试、TEOAE和纯音听力测试。对62名听力障碍患者和14名健康受试者进行了测试。结果:单独耳语听力测试的灵敏度为85%,TEOAE的灵敏度为71%。当两者同时使用时,灵敏度提高到94%。同时,该检查具有较高的特异性(75%)。使用耳语听力测试和TEOAE,我们没有检测到3.3%的纯音听力测定检测到的听力损失患者。结论:在没有纯音测听的情况下,耳语听力测试和TEOAE联合检测听力损失是可行的。这两种方法的结合可以考虑用于最近讨论较多的老年人听力障碍筛查。【关键词】耳语听力测试;瞬态诱发耳声发射;TEOAE
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引用次数: 0
Functional evaluation of laryngoscopic examination and its relation to voice quality and voice range profile parameters 喉镜检查功能评价及其与语音质量和音域轮廓参数的关系
Pub Date : 2023-03-20 DOI: 10.48095/ccorl202323
M. Frič, B. Mlynarova, M. Kucera
Summary Introduction: Previous laryngoscopy evaluation protocols have mostly focused on assessment of glottal status and morphological description of vocal folds’ shape and oscillations. The basic functional manifestations of laryngeal use, according to new protocols, include a description of supraglottic laryngeal activity. Methods: Laryngoscopic evaluation was performed as a perceptual test, performed online, using a web-based application. The degree and type of glottal insufficiency and the degree of anterior, posterior compression and lateral-medial (L-M) compression separately for each side were evaluated by a total of 15 respondents in a total of 26 video recordings of laryngoscopic examinations. In addition, the correlations between listening evaluations of the voice using modified GRBAS scales and voice range profile parameters were investigated. Results: The ratings of the laryngoscopic scales had well to excellent agreement. Agreement for type of insufficiency was just moderate. The associated ratings of L-M compression on the right and left sides showed correlations. For listening evaluation, medial compression was found to be related to the perception of habitual voice strain, and to strain and instability in the pitch range of the change of registers of the singing voice. Degree of insufficiency predicted less fullness of habitual voice in general but was also related to vocal dyspnea and weakness when calling. At the same time, it was largely responsible for the deterioration of the quality of the singing voice. Medial compression systematically reduced pitch range and the area of the voice range profile. Conclusion: The results of the perceptual evaluation can be used in further education. On their basis, didactic material for training the assessment of supraglottic laryngeal activity was prepared and published in the form of an online tutorial. The degree of insufficiency generally affects various characteristics of the speaking and singing voice. Medial compression systematically affects only the strain of the speaking voice, while in the singing voice it accentuates the strain and instability of the transitional region between registers and impairs the production of high pitches. Key words laryngoscopy – visual evaluation – voice range profile – GRBAS
简介:以往的喉镜评估方案主要集中在评估声门状态和声带形状和振荡的形态学描述。喉部使用的基本功能表现,根据新的协议,包括声门上喉部活动的描述。方法:喉镜评估作为一种感知测试,使用基于网络的应用程序在线进行。通过26份喉镜检查录像,共15名应答者分别评估声门功能不全的程度和类型以及每侧的前、后压迫和侧内侧(L-M)压迫的程度。此外,还研究了使用改进的GRBAS量表对声音的听力评价与声音范围轮廓参数之间的相关性。结果:喉镜量表的评分有很好的一致性。对供血不足类型的一致性仅为中等。左、右脑L-M压缩的相关评分显示出相关性。在听力评估中,我们发现内侧压迫与习惯性声音张力的感知有关,也与歌唱声音音域变化音高范围的张力和不稳定性有关。不足的程度通常预示着习惯性声音的不饱满,但也与发声呼吸困难和呼叫时的无力有关。与此同时,它在很大程度上导致了歌唱质量的恶化。中间压缩系统地减少了音高范围和声音范围轮廓的面积。结论:知觉评价结果可用于继续教育。在他们的基础上,准备了用于培训评估声门上喉活动的教学材料,并以在线教程的形式发表。不足的程度一般会影响说话和唱歌声音的各种特征。内侧压迫系统地只影响说话声音的紧张,而在唱歌的声音中,它加剧了音域之间过渡区域的紧张和不稳定,并损害了高音的产生。关键词喉镜检查;视觉评价;声域轮廓
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引用次数: 0
Compartmental tongue surgery 隔室舌手术
Pub Date : 2022-12-15 DOI: 10.48095/ccorl2022202
M. Almaši
Introduction: Compartmental tongue surgery is a surgical method that aims at removing of the tumor-affected half of the tongue and the regional lymph nodes en bloc in a standardized way to decrease an option of the locoregional recurrence. Material and methods: Description of the surgical technique, review of the literature and our first experience in the group of 11 patients is presented. Results: Out of 11 patients, 9 males and 2 females, with disease of the clinical stage I–IV, locoregional control has been achieved in 9 patients (81.8%). One female had a local recurrence, 1 female a regional recurrence. Five patients died, one female patient with regional recurrence, 2 patients with distant metastases, 1 patient due to duplex malignancy and 1 patient due to other reasons. R0 resection was detected in 8 patients and the other 3 patients had a close resection margin at different stages of the disease. The postoperative defect was reconstructed in 10 patients with an infrahyoid myocutaneous pedicled flap and in 1 patient with pectoralis myocutaneous flap. Conclusions: Compartment tongue surgery in indicated cases seems to be a good method for achievement of the locoregional control of the disease and negative margins. The data need to be confirmed on a larger group of patients with evaluation of other, particularly functional, parameters. Keywords: glossectomy – tongue cancer – tongue surgery
舌腔室手术是一种以标准化方式切除肿瘤影响的一半舌和区域淋巴结的手术方法,以减少局部复发的可能性。材料和方法:介绍手术技术,回顾文献和我们在11例患者中的首次经验。结果:11例临床I-IV期患者中,男9例,女2例,9例(81.8%)获得局部控制。1名女性为局部复发,1名女性为局部复发。死亡5例,女性1例局部复发,远处转移2例,双恶性肿瘤1例,其他原因1例。8例患者有R0切除,另外3例患者在疾病的不同阶段有近切缘。10例采用舌骨下带蒂肌皮瓣,1例采用胸肌肌皮瓣重建缺损。结论:在有指征的病例中,隔室舌腔手术似乎是实现局部控制疾病和阴性边缘的好方法。这些数据需要在更大的患者群体中得到确认,并评估其他参数,特别是功能参数。关键词:舌切除术舌癌舌外科
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引用次数: 0
期刊
Otorinolaryngologie a foniatrie
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