Ceskoslovenska otolaryngologie最新文献

Evaluation of the working capacity in different vertiginous conditions. General view of the problem and evaluation of the work capacity in different nosological units of vertiginous conditions.

Tinnitus is a very serious problem in otolaryngology. The authors used for torpid cases the intratympanic administration of Gentamicin sulphate, administered twice a day. Nine patients with Ménière's disease were treated. The results were very favourable, deterioration of hearing did not occur and the tinnitus disappeared or improved markedly.

The author compared in an open clinical trial during treatment of acute sinusitis the therapeutic results of two new quinoline chemotherapeutic preparations--Tarivid and Ciproxine. The drugs were administered to a total of 40 patients. In both groups (à 20 patients) clinical recovery occurred in 95% of the patients. The preparations were well tolerated and no manifestations of allergy or marked intolerance were observed. Regular haematological and biochemical tests did not reveal a pathological rise of parameters. No difference was revealed in the therapeutic effectiveness of the two drugs.

In a group of 33 patients with chronic inflammations of the upper airways and deglutition pathways the effect of treatment with autovaccines in the form of nasal drops was investigated. In 77.7% a therapeutic success was recorded still after an interval of 1-3 years following termination of treatment. In the entire group parameters of humoral and cellular immunity were tested. In none of the patients severe forms of immunodeficiency were found. In 16 patients an immunological check-up was made after termination of autovaccine treatment. Although differences were revealed in the immunological picture, none of them attained the level of statistical significance. The action of autovaccines could be explained by the non-specific action of bacterins. Common immunological examinations methods are so far unable to define all cooperative relations between different immunocompetent cells and systems.

Defects of the facial skeleton cause frequently severe aesthetic facial changes with negative repercussions also on the patient's mental state. The skeleton may be affected by injury, a neoplastic disease and iatrogenically when it is necessary to remove a part of the skeleton during operation. One possible way how to replace and reconstruct the skeleton is to use bone cement Pallacos R. This method was used in 8 patients with skeletal affections. The use of Pallacos R has the advantage that it can be used quickly, that it is easy to work with directly at the site of the defect and that its tolerance is satisfactory. It permits also to preserve the physiological shape of the paranasal sinuses. The method is one approach to individually indicated reconstruction.

Burn injuries are very serious injuries. Their prognosis is markedly adversely affected by burns of the respiratory organs. The author describes the aetiology, clinical picture and therapeutic principles of these injuries. Fibroptic tracheobronchoscopy made not only documentation of findings on the respiratory organs possible, but due to its sparing character it makes also endobronchial treatment possible. Despite this the prognosis of these injuries is very poor, as apparent from an analysis of 36 patients hospitalized in 1981-1986 in the Centre for the Treatment of Burns in the Factory Institute for National Health in the East Slovakia Ironworks, which serves the entire Slovak territory; the patients were examined and treated in collaboration with the ENT department of the Factory Institute for National Health of the East Slovakian Ironworks.

A musculocutaneous flap is according to data in the literature and the author's own experience the best solution for covering large defects after extensive operations on the neck. As compared with skin flaps, in particular tubular ones, a musculocutaneous flap has a better vitality and small percentage of complications (necrosis, fistula, stenosis). Its use substantially reduces the postoperative course and period of treatment. In otolaryngological practice it is used most frequently to resolve defects in the laryngooesophageal area. For the reconstruction of the pharynx the authors used mostly the m. pectoralis major. From the technical aspect it is a relatively simple and safe operation and the time for releasing the flap is not excessive. A certain disadvantage after healing is swelling of the neck which is due to the muscular stalk under the skin. It is not only a cosmetic defect as the swelling may make palpation during oncological examination in case of a relapse of the disease impossible. After actinotherapy the muscular stalk may fibrillize.

Chronic and usually odontogenic inflammations of the masticatory muscles may be, due to anatomical conditions and inconspicuous inflammatory symptomatology, difficult to differentiate from tumours in this region. The differential diagnosis of both affections is based on the clinical course, sialography and CT examination which along with modern ATB treatment significantly modify hitherto used surgical therapy.

In a group of children aged 4 to 13 years with hypertrophic adenoid vegetation the pulmonary ventilation and mechanics of respiration were examined by global and regional spirography, incl. evaluation of VC, FEV1%, RV, IGV and V-V loops and in six children by whole-body plethysmography. While during global spirography a pathological finding was recorded in 31%, during regional spirographic examination pathological changes of the mentioned functional values were recorded in 86% of the children, which provides evidence that regional spirography combined with the densitographic method can reveal local disorders of pulmonary ventilation which cannot be detected by global spirography. In children under 10 years of age as compared with older children, more marked and more frequent changes of the investigated parameters were observed. Dispensarization of children where a pathological functional funding was present is essential as part of prevention of possible future development of chronic organic lesions of the lower respiratory pathways.