Patogeneza poremećaja sluha kod osoba s rascjepom nepca

master's thesis

• Title (english): Pathogenesis of hearing impairment in people with cleft palate
• Author: Ema Brumerček
• Mentor: Jakov Ajduk (mentor)
• Committee member: Davor Vagić (predsjednik povjerenstva)
• Committee member: Mihael Ries (član povjerenstva)
• Committee member: Jakov Ajduk (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Rascjepi nepca su među najčešćim malformacijama današnjice te se vežu uz mnoge dugoročne komplikacije kao što su poteškoće hranjenja, govora i sluha. Poteškoće sluha uzrokovane su poremećajem rada srednjeg uha uslijed nepravilne funkcije Eustachijeve cijevi. Zbog nepravilnog razvoja nepca mišići mekog nepca koji su zaslužni za otvaranje Eustachijeve cijevi ne mogu obavljati svoju funkciju, što dovodi do poremećaja ventilacije i nemogućnosti izjednačavanja tlakova između okoline i srednjeg uha. Iako se to smatra glavnim mehanizmom disfunkcije i drugi faktori poput izmijenjene bakterijske flore i hipertrofije adenoida igraju ulogu. Poremećaj sluha često je bez primjetnih simptoma kod mlađe djece te zahtijeva veliku pažnju kao i redovite preglede kako bi se moglo dovoljno rano intervenirati. Iako se sekretorni otitis većinom može primijetiti već pri otoskopiji, nužno je napraviti daljnje pretrage kako bi se utvrdilo koliko je opsežan gubitak sluha, koliko dugo traje te koje je vrste. Pristup pacijentu mora biti individualan kako bi se postigao najveći terapijski uspjeh. Iako se miringotomija uz inserciju ventilacijskih cjevčica već dugo razdoblje koristi kao terapija za perzistentni sekretorni otitis, ona nije optimalna za svakog pacijenta te može prouzročiti više poteškoća i komplikacija uz neznatno bolji sluh. Potrebno je svakog pacijenta pratiti te donositi individualne odluke u vezi terapije. Timpanoplastika je neizostavan dio terapije oboljelih kod kojih je došlo do razvoja kronične upale.

Abstract (english)

Cleft palate is one of the most common malformations today and it is connected to several long-term complications such as feeding, speaking or hearing difficulties. Hearing impairment is caused by middle ear dysfunction due to improper functioning of the Eustachian tube. Because of the incorrect formation of the palate, soft palate muscles are unable to perform their function, which results in difficulties in ventilation and the inability to equalize the pressure between the middle ear and the outside. Even though this is considered the main mechanism of dysfunction, other factors such as altered bacterial flora and adenoid hypertrophy also play a role. Hearing difficulties are often without notable symptoms in younger children, who require great attention and frequent examinations in order for doctors to be able to intervene early enough. Although otitis media with effusion can be detected with otoscopy, hearing examinations like pure tone audiometry or play audiometry are necessary to assess the type and degree of hearing loss. The treatment approach has to be individual in order to achieve the best possible therapeutic outcome. Even though miringotomy with ventilation tube insertion has been a key therapy for otitis media with effusion for a long period of time, it is not optimal for every patient and can cause more difficulties and complications with a barely better hearing outcome. It is necessary to observe the patient and make decisions for each case individually. Tympanoplasty is also an unavoidable part of therapy in patients in which chronic inflammation has resulted in atrophic scarring and retraction of the eardrum.

• Keywords: rascjep nepca; sekretorni otitis; poremećaj sluha; konzervativno liječenje; kirurško liječenje
• Keywords (english): cleft palate; otitis media with effusion; hearing loss; conservative treatment; surgical treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:265229
• 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: 2021-05-12 10:25:58