Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 4)
Prognostic value of serum parathyroid hormone in ST-elevation myocardial infarction patients
Authors:
Milan Erdoglija, Milanko Milojević, Uglješa Grgurević, Jelena Sotirović, Nada Milanović, Snežana Cerović, Milena Jović, Nenad Baletić
Background/Aim. Attic cholesteatoma is an epithelial cysticpseudotumor which arises in the top compartment of the
middle ear. Surgery is the only therapeutic treatment for attic
cholesteatoma. The aim of this study was to analyze the
surgical and audiological results in tympanoplasties that use
a logical application of several techniques for the management
of attic cholesteatoma. Our hypothesis was that the
tympanoplasty technique with cartilage/bone reconstruction
of the achieve better outcome than the tympanoplasty
technique with only temporal fascia reconstruction of the
lateral attic wall. Methods. This retrospective clinical study
included 80 patients, aged 16–65 years, with attic cholesteatoma
undergoing canal “wall up” tympanoplasty with lateral
attic wall reconstruction, under general anesthesia in the
Eear, Nose and Throat Clinic, Military Medical Academy in
Belgrade between 2006 and 2010. The patients were divided
into two groups according to the type of lateral attic wall reconstruction:
the group I of 60 patients with cartilage/bone
plus temporalis fascia lateral attic wall reconstruction and
the group II of 20 patients with only temporal fascia lateral
attic wall reconstruction. Postoperative follow-up examinations
were done at least 5 years after the surgery. The χ2 test
was used to compare postoperative sequelae for two groups
of operated patients with lateral attic wall reconstruction.
The independent and paired samples t-test of air conduction
and air-bone gap were used to compare the results of preoperative
and postoperative hearing tests. Results. The differences
between hearing measurements of the two groups
according to preoperative and postoperative auditory
thresholds of the air conduction and the air-bone gap were
considered no statistically significant. The difference between
the two groups recarding to recurrent attic retraction
pocket appearance and recurrence of cholesteatoma was
considered statistically significant and the results were much
better in the group I of the operated patients with cartilage/
bone lateral attic wall reconstruction. Conclusion.
“Wall up” tympanoplasty for attic cholesteatoma with lateral
attic wall reconstruction leads to good anatomical and audiological
results. A significant hearing improvement was obtained
in both the types of lateral attic wall reconstructions
in this study. Reconstruction with cartilage or mastoid cortex
bone showed favorably long-term functional and anatomical
results compared to primary tympanoplasty using
only temporal fascia for lateral attic wall reconstruction in
cases of attic cholesteatoma.
