SUMMARY
The aim of this study is to analyse the long-term anatomical and functional outcomes and prognostic factors of the canal wall down (CWD) tympanoplasty for the treatment of tympano-mastoid cholesteatoma. A total of 895 patients treated for tympano-mastoid cholesteatoma with follow-up longer than 10 years were included. Recidivism (recurrent and residual) cholesteatoma rates and functional results were analysed. The rate of recidivism was 7.7% (6.7% persistence and 1% recurrent disease). Recidivism was higher in paediatric patients (10.1% versus 5.0% of adults). Pathological middle ear mucosa and pars tensa was associated with increased rates of recidivism. Postoperatively, air pure-tone-average (aPTA) ≤ 30 dB was achieved in 36.4% of patients. Of 895 patients, a revision CWD tympanoplasty for chronic otorrhoea was performed in 14 cases (1.5%) with complete recovery in all cases. Nine of those patients had a recurrence of cholesteatoma and five had cavity problems related to granulation, de-epithelisation or recurrent infection. Paediatric patients and absence of stapes superstructure were associated with the worst auditory outcomes. Six-month results were always better than long-term results. A CWD approach was demonstrated to be effective, achieving the goals of cholesteatoma treatment.
Thirty male 20-month-old Wistar rats were divided into groups: IC—initial control (n = 6), FC—final control (n = 6), AC—anabolic hormone control (n = 6), ST—strength trained (n = 6) and STA—strength trained with anabolic hormone (n = 6). All groups were submitted to adaptation, familiarization and maximum load carrying test (MLCT). Strength training (6–8×/session with loads of 50%–100% MLCT, 3×/week and pause of 120 s) was performed in ladder climbing (LC) for 15 weeks. The administration of testosterone propionate (TP) was performed 2×/week (10 mg/kg) in animals in the AC and STA groups. After the experimental period, animals were euthanized and the tibial nerve and plantaris muscle removed and prepared for electron transmission and histochemistry. To compare the groups we used one-way ANOVA (post hoc Bonferroni), student’s t-tests for pre vs. post (dependent and independent variables) comparisons and significance level set at p ≤ 0.05. The following significant results were found: (a) aging decreased the number of myelinated axon fibers; (b) use of isolated TP increased the diameter of myelinated fibers, along with increased thickness of myelin sheath; (c) ST increased area of myelinated and unmyelinated fibers, together with the myelin sheath. These changes made it possible to increase the area occupied by myelinated fibers keeping their quantity and also reduce the interstitial space; and (d) association of anabolic steroid and ST increased the area of unmyelinated axons and thickness of the myelin sheath. Compared to ST, both strategies have similar results. However, Schwann cells increased significantly only in this strategy.
The aim of this study was to investigate the pattern of nasal mucosal involvement in patients with Systemic Lupus Erythematosus (SLE). The authors selected patients affected by SLE with a symptomatology based on bad nasal breathing, in absence of anatomical deformities of the nose. Specimens representing eighteen histological sections of nasal mucosa were examined under the light microscope to establish a set of histopathologic and immunophahologic features. A number of significant alterations were identified. The authors indicate the possible physiopathogenetic relationship between nasal mucosal involvement and systemic disease.
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