Utjecaj intraoperativnih nalaza na prag sluha nakon revizijske timpanomastoidektomije

master's thesis

• Title (english): Impact of intraoperative findings on postoperative hearing outcome following revision tympanomastoidectomy
• Author: Josipa Živko
• Mentor: Andro Košec (mentor)
• Committee member: Jakov Ajduk (predsjednik povjerenstva)
• Committee member: Mihael Ries (član povjerenstva)
• Committee member: Andro Košec (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Timpanomastoidektomija je operativni zahvat kojim se rekonstruira defekt bubnjića i lanac slušnih košćica te se odstranjuje patološki proces iz srednjeg uha i mastoida. Indiciran je u liječenju kronične upale srednjeg uha i kolesteatoma. Zahvat se izvodi uz odstranjenje ili očuvanje stražnje stijenke zvukovoda (engl. canal wall up/down - CWD/CWU). Osim odstranjenja patološki promijenjenog tkiva, cilj operacije je i poboljšanje sluha. Sluh se ispituje audiometrijom prije i nakon zahvata. Opći cilj rada je utvrđivanje utjecaja intraoperativnih nalaza na prag sluha nakon revizijske timpanomastoidektomije. Specifični ciljevi su utvrđivanje učestalosti pojedinih lokalizacija bolesti, njihovo povezivanje sa poboljšanjem ili pogoršanjem sluha, utvrđivanje učestalosti povrata kolesteatoma i njegovog utjecaja na sluh i analiziranje utjecaja vrste zahvata na postoperativnu promjenu zračno-koštanog procjepa (engl. air-bone gap – ABG). Izdvojena je skupina od 101 pacijenta od kojih je 32 isključeno zbog nepotpune medicinske dokumentacije. Utvrđeno je 12 lokalizacija povrata bolesti, određena je njihova učestalost i povezanost sa postoperativnom promjenom sluha. Uspoređene su skupine pacijenata podvrgnute CWU i CWD zahvatu te je zaključeno da vrsta zahvata nema bitnog utjecaja na ukupnu promjenu ABG. Značajno poboljšanje sluha neovisno o navedenim parametrima, uočeno je na niskim i srednjim frekvencijama (500 i 1000 Hz).

Abstract (english)

Tympanomastoidectomy is a surgical procedure used to reconstruct tympanic membrane and ossicular chain and to remove abnormal tissue from the middle ear and mastoid cells. The procedure can be done by removing or preserving posterior wall of ear canal (CWU/CWD). Besides removing diseased tissue, its aim is also to improve hearing. Hearing acuity is evaluated before and after surgery. The main purpose of this study is to determine the impact of intraoperative findings on hearing outcome after revision tympanomastoidectomy. The specific aims are to ascertain locations of the disease, their incidence, and their relatedness to postoperative hearing outcome. Furthermore, we analyzed cholesteatoma recurrence rate and its effect on hearing. Lastly, we compared hearing outcomes of two types of surgery. The initial cohort consisted of 101 patients from which we excluded 32 patients due to incomplete medical documentation. In the remaining patients, 12 localizations of disease recurrence were identified, their incidence calculated, and we linked them to postoperative hearing results. There was no significant difference in postoperative ABG between CWU and CWD patients. Regardless previous parameters, significant improvement of hearing was noted on low and mid frequencies (500 and 1000 Hz).

• Keywords: revizijska timpanomastoidektomija; kronična upala srednjeg uha; kolesteatom; sluh
• Keywords (english): revision tympanomastoidectomy; chronic otitis media; cholestatoma; hearing
• Language: croatian
• URN:NBN: urn:nbn:hr:105:970954
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-06-07 08:30:23