Liječenje otoskleroze LASER-om

master's thesis

• Title (english): LASER use in surgical management of otosclerosis
• Author: Stjepan Brnić
• Mentor: Krsto Dawidowsky (mentor)
• Committee member: Mario Bilić (predsjednik povjerenstva)
• Committee member: Mihael Ries (član povjerenstva)
• Committee member: Krsto Dawidowsky (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Otoskleroza je metabolička koštana bolest koja zahvaća labirintnu kapsulu i pločicu stremena. Zbog patološkog odlaganja kosti u koštanom labirintu, prekida se normalni prijenos zvučnih valova prema unutrašnjem uhu što uzrokuje gubitak sluha. S kliničkom prevalencijom od oko 0,4 % među bjelačkom populacijom, jedan je od najčešćih uzroka stečene nagluhosti, a u žena se javlja gotovo 2 puta češće. Otoskleroza je kompleksna bolest u kojoj se brojni okolišni, genetički te imunološki faktori smatraju dijelom odgovornima u njezinom nastanku, no veliki dio same etiologije i dalje je nerazjašnjen.
Kliničkom slikom dominira progresivna provodna nagluhost koja se javlja između petnaeste i četrdesete godine života, a kao popratni simptomi mogu se javiti i vrtoglavica te šum. Ako sama bolest zahvati i pužnicu, nagluhost može dobiti i zamjedbenu komponentu. Dijagnoza se postavlja uz anamnezu, klinički pregled i audiometrijsko ispitivanje sluha. Tipičan nalaz tonske audiometrije prikazuje provodnu nagluhost, s povećanim razmakom zrak – kost na niskim frekvencijama.
Otoskleroza se liječi konzervativnim metodama i kirurški, a operacijske tehnike pokazuju značajnu prednost u odnosu na farmakološku terapiju. Kirurške tehnike su se kroz povijest značajno razvijale i mijenjale do razvoja današnje metode stapedotomije. U operacijskom liječenju otoskleroze uspješno se koristi laser koji radi svoje visoke preciznosti i manje invazivnosti uzrokuje manje komplikacija uz jednaku ili bolju uspješnost u odnosu na konvencionalne operacijske metode.

Abstract (english)

Otosclerosis is a metabolic bone disease that affects the otic capsule and the stapes footplate. Due to the pathological deposition of bone in the bony labyrinth, the normal conduction of sound waves towards the inner ear is interfered with, causing hearing loss. With clinical prevalence of about 0.4% among the Caucasian population, it is one of the most common causes of acquired deafness, and women are affected almost 2 times more often than men. Otosclerosis is a complex disease in which many environmental, genetic and immune factors are considered partially responsible for its occurrence, but much of the etiology itself remains unclear.
The clinical presentation is dominated by progressive conductive hearing loss that occurs between the ages of fifteen and forty, while dizziness and tinnitus may occur as accompanying symptoms. If the disease itself affects the cochlea, sensorineural hearing loss can develop on top of already developed conductive loss. The diagnosis is based on medical history, clinical examination and audiometric examination of hearing. A typical finding of pure tone audiometry shows an air – bone gap indicative for conductive hearing loss, especially at lower frequencies.
Otosclerosis can be treated conservatively and surgically, but surgical methods show a significant advantage over pharmacological therapy and thus are preferred. Surgical techniques have evolved and changed significantly throughout history until the development of today's stapedotomy method. In the surgical management of otosclerosis, LASER is successfully used, which due to its high precision and reduced invasiveness causes fewer complications with equal or better outcomes compared to conventional surgical methods.

• Keywords: otoskleroza; liječenje laserom
• Keywords (english): otosclerosis; laser treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:432235
• 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: 2023-01-04 10:04:52