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Biomedical subjects

D Djerić

Publications and source records attributed to D Djerić.

At least 19 recordsLinked to original sources

[Carcinoma of the skin of the external auditory meatus].

Carcinoma of the external meatus is a rare disease and a challenge to treat. Demographic and clinical characteristics of this disease are discussed for 14 patients treated in the Institute of Otorhinolaryngonlogy and Maxillofacial Surgery during the period 1993-2003. using four different clasification of the disease. All patients were treated surgically with postoperative radiotherapy. Five years survival is 100% for the II and II stage of the disease for all clasifications, and 75% for the III stage according to Pitsburg clasiffication. Reccurence of the disease in the first year after treatment is 66.6% and, 84% in the second year. The diagnostic protocol is clinical examination, computed tomography of the temporal bone, nuclear magnetic resonance of the temporal bone and endocranium, ultrasound examination of the neck and parotid region and tumor biopsy. The surgical approach could be less radical, through mastoid, with postoperative

Adult↗

[Mastoiditis in adults: diagnostic and therapeutic aspects].

The purpose of the present study is to report our experience in the diagnosis and treatment of mastoiditis in adults. Five patients with an active chronic otitis and mastoiditis were presented. All of them had a history of chronic ear discharge for long period of time and have been diagnozed and treated sufficiently. All relevant data were analyzed from the medical records. The most common symptoms of the disease were otalgia, otorrhea and hearing loss, but the physical signs of mastoiditis (swelling, erithema and tenderness of the retroauricular region) were presented in all cases. Localization and enlargement of the pathological process within the middle ear spaces was determined by CT. All patients were treated surgically and with intravenous antibiotics. In one patient the other treatment was applied due to a specific (TBC) process in the ear. Early diagnosis and adequate treatment (surgery combined with an effective antibiotics therapy) is most important to prevent a serious complications of mastoiditis (extracranial and/or intracranial).

Adult↗

Fibrous dysplasia of the temporal bone and maxillofacial region associated with cholesteatoma of the middle ear.

Fibrous dysplasia of the temporal bone is a rare disease which may lead to progressive stenosis of the external auditory canal and the development of cholesteatoma. We present a case in which minimal symptoms were present despite a massive temporal bone fibrous dysplasia. Cholesteatoma resulted most probably secondary to external auditory canal stenosis. Retroauricular fistula developed as a result of destructive effect of cholesteatoma, that influenced previous diagnosis and treatment of this clinically silent disease.

Adult↗

Otogenic facial paralysis. A histopathological study.

The histopathological changes of the facial canal and nerve in facial paralysis due to chronic suppurative otitis madia are described in six temporal bones. Bony destruction of the facial canal was found in its tympanic segment and in its upper mastoid part in all cases, but it was particularly notable in the labyrinthine segment as well. The pathological process, cholesteatoma or granulation tissue surrounding the exposed facial nerve was inflamed in all cases. The affected facial nerve showed degenerative and inflammatory changes throughout its tympanic segment in all cases, but its mastoid segment appeared to be relatively normal. Our findings suggest that facial paralysis occurs us chronic suppurative otitis when the inflammatory process specifically involves the facial nerve trunk.

Chronic Disease↗

Neuropathy of the facial nerve in chronic otitis media without associated facial paralysis. A human temporal bone study.

In the present study we examined whether pathologic changes can exist in the facial nerve in chronic otitis media (COM) when facial nerve function is clinically normal. In so doing, 20 human temporal bones were examined. Each case had a premortem history of COM without facial paralysis. Nine normal temporal bones were also studied. Signs of degenerative neuropathy involving the facial nerve were found in 2 out of the 20 cases studied. In the first of these 2 cases the tympanic segment of the facial nerve showed focal areas of demyelinization, as well as hypertrophy and proliferation of the Schwann cells but without loss of the axons. These areas were also occasionally associated with increased numbers of mast cells. In the second case the most striking finding was the presence of small dark globules in the mastoid segment of the facial nerve. These formations were assumed to be products of cellular and myelin degeneration. Our studies suggest that COM may be associated with degenerative changes in the facial nerve without clinical impairment of its function. Nonetheless these changes may have the potential for the development of facial paralysis during COM.

Aged↗

Cholesteatoma in the oval window niche.

The histopathological changes in the oval window niche into which a cholesteatoma is spreading are described in 14 temporal bones. Extension of the matrix into the niche was found commonly. In some cases the matrix passed from the facial canal to the promontory but failed to reach the niche. The perimatrix of the cholesteatoma was composed of inflamed and vascularized granulation tissue or fibrocystic tissue. A matrix covering the walls of the niche and the footplate of the stapes or the oval window was rarely found. It was surrounded by a thin layer of non-inflamed fibrous or fibrocystic tissue which covered the niche. Bone destruction of the superstructures of the stapes was observed in 12 of the 14 cases examined. The footplate of the stapes was partially or totally destroyed in 4 cases. Bone destruction of the tympanic portion of the facial canal adjacent to the oval window niche was present in all cases. Our present studies further suggest that surgical removal of a cholesteatoma from the niche may be difficult, even when done very carefully.

Cholesteatoma↗

The relations of the mastoid segment of the facial canal to surrounding structures in congenital middle ear malformations.

The authors investigated the relations between the mastoid segment of the facial canal and the temporomandibular joint, the posterior wall of the cavum tympani and the external wall of the mastoid process in 19 cases with congenital ear malformations and 10 cases with normal ears. A significantly reduced distance was found between the facial canal and the temporomandibular joint as well as between the facial canal and the posterior wall of the cavum tympani in the groups with malformed ears as compared to the control group with normal ears.

Cephalometry↗

Characteristics of a pathological process in the destroyed tympanic part of the facial canal in chronic otitis media with cholesteatoma.

The authors examined the histopathological characteristics at the sites of destruction of the tympanic part of the facial canal in chronic otitis media with cholesteatoma. Two types of pathological process were observed. The first is characterized by the cholesteatoma at the sites resorption and the second is characterized by pronounced granulation or fibrocystic tissue.

Bone Resorption↗

[Oncocytoma of the nose and ethmoidal and sphenoidal sinuses].

The authors present a patients with oncocytoma, a rare tumor of the nasal cavity and the ethmoidal and sphenoidal sinuses. By using computerised tomography (CT) they localised the tumor and through pathohistological analysis confirmed the nature of the disease. Recurring tumors can also be localised by use of CT.

Adenoma↗

[Variations of the position of the stapes in the fossula of the round window and their surgical value].

The authors studied variations of the position of stapes in the fossula of ovale window on 300 preparations of temporal bones, under operating microscope. They noted three possible positions of the stapes: most commonly downwards to the promontorium (76%), much less frequently (15%) towards the bottom of the fossula, and rarely upwards to the facial canal (9%). Knowledge of these anatomic variations is of great importance in surgical procedures performed in this region.

Adult↗

Anatomical characteristics of the fossula fenestrae vestibuli.

Anatomical characteristics of the fossula fenestrae vestibuli were tested and analysed precisely on 200 samples of temporal bones. The fossula is usually ovoid and shallow but can be, exceptionally, elongated, narrow and deep. It is surrounded by four walls. In 45.5 per cent of cases the upper wall is formed only by the facial canal and in 54.5 per cent of cases a bony lamella is found beneath the facial canal; the promontory forms the lower wall; the front wall is formed by the bony lamella and part of the processus cochleariformis; the back wall is clearly defined in only 22.8 per cent of cases and is formed by the bony lamella of the medial wall of the tympanic cavity. In 13.2 per cent of cases the floor of the fossula partially covers the prominence of the facial canal and in two per cent the eminentia pyramidalis. Bony recesses in this region occur fairly frequently: sinus subfacialis in 60 per cent, sinus retrofenestralis in 77.2 per cent, and sinus subrostralis in 25 per cent of the cases. These anatomical variations can influence the result of surgical intervention.

Female↗

The value of computerized tomography (CT) in the evaluation of the anatomic structure of the attic.

By the use of computerized tomography (CT) the authors have examined and precisely defined the radiological anatomical characteristics of the attic and its relation to other structures of the middle and inner ear. The identification of individual morphological structures has been made on axial, semi-axial and frontal CT sections. Each type of original CT section has been compared with the corresponding original anatomical section.

Ear Diseases↗