Biomedical subjects

M Bernal Sprekelsen

Publications and source records attributed to M Bernal Sprekelsen.

At least 19 recordsLinked to original sources

PubMed2003

[Technical aspects in endoscopic surgery of frontal mucopyocele].

The term mucocele is applied to define a chronic, expanding, mucosa-lined lesion of the paranasal sinus characterized by mucous retention that can be infected becoming a mucopyocele. Until recently the majority of patients with frontoethmoidal mucoceles were treated through an external approach, however, selected cases of mucoceles can be approached endoscopically, decreasing the morbidity associated to external approaches. We report the case of a frontal mucopyocele with rapid expansion and erosion of the anterior wall. Surgical aspects and postoperative follow-up are described.

Aged↗

PubMed2003

[Sinusitis in immunocompromised patients. A multicenter study].

This paper evaluates different aspects of sinusitis in patients with a decreased immunological system, such as its prevalence and clinical evolution, its peculiar bacteriology and the altered response to treatment, and the prognosis, especially in patients with AIDS. There seems to be an increased prevalence of sinusitis in these patients, with a relationship between their immunological status and the severity and aggressiveness of the sinusitis. Bacteriological studies reveal the pressure of more aggressive species, such as P. aeruginosa, and specific sinusitis are more frequent, which may explain why the treatment with common antibiotics often remains uneffective. The simultaneous therapy of concomitant infections leads to a higher resistance towards common drugs. A standard treatment is therefore needed. The results of three studies, retrospective and prospective, on HIV-infected patients reveal a high incidence of acute sinusitis with aggressive bacteria.

Acquired Immunodeficiency Syndrome↗

PubMed2002

[Tympanic-ossicular reconstruction. Functional results using cartilage palisades and titanium prostheses].

The Eustachian tube disfunction and abnormalities in gas exchange through the middle ear mucosa may produce negative pressure and retraction pockets, adhesions, atelectasis and cholesteatomas. If this problem is present postoperatively, it may again lead to retraction, reperforation, and/or extrusion of the reconstructed ossicular chain. This applies especially if conventional autologous material, such as fascia and perichondrium, are used to reconstruct the tympanic membrane. This paper reviews the indications, surgical technique, and functional results of 23 tympanoplasties using cartilage and titanium prostheses, with range follow-up of 20-55 months and a mean of 30 months. Seven out of sixteen canal wall down (43.7%) and three out seven canal wall up (42.9%) had a postoperative air-bone gap between 0 and 10 dB.

Adolescent↗

PubMed2001

[Alterations of the basal membrane in middle ear cholesteatoma].

Cholesteatoma epithelium is characterized by a keratinocyte disregulation accompanied by destruction of the ossicles and other bony parts of the temporal bone. Immunohistochemical methods using antibodies to fibronectin, tenascin and metalloproteinases were used to assess the alterations of the instrinsic and extrinsic components of the basement membrane. Spatial orientation of the basement membrane was preserved in histological sections. Collagen type IV, tenascin, fibronectin, basic fibroblastic growth factor (bFGF), and matrix metalloproteinases (MMPs) are related to the matrix, perimatrix of normal or pathological tissues. They were studied immunohistologically in twenty cholesteatomas, eight samples of normal auditory canal skin, and six specimens of normal middle ear mucosa. Cholesteatomas displayed alterations of the basal membrane, with presence of MMPs and a linear immunoreactivity for collagen type IV and laminin, disrupted in areas with intense inflammation. The electronic microscope revealed protrusions, duplications, thickening and disruptions of the lamina densa of the basement membrane. Thus, we conclude, that MMPs and bFGF could play an important role maintaining the proliferative activity and the aggressive behaviour of cholesteatoma in the middle ear.

Basilar Membrane↗

PubMed2000

[Comparative analysis of the proliferative capacity of cholesteatomas].

Cholesteatomas of the middle ear are frequently aggressive and produce bone destruction. Stimulation of the surrounding inflammatory tissue and autocrine mechanisms could be responsible for the keratinocytic dysregulation of cholesteatomas, as well as for abnormal proliferation patterns. The proliferative capacity of human cholesteatoma of the middle ear was studied through the kinetics of the epithelial cells of cholesteatomas and external ear canal. The APAAP method was used to study the monoclonal antibody MIB-1, which recognizes an antigen of cells in the division phase. Biopsies taken from the outer ear canal (n = 7) revealed an MIB-1 level (the ratio of MIB-1 positive cells to all cells) of 7.6% +/- 2.2%. Cholesteatoma samples (n = 13) showed an MIB-1 level of 17.4% +/- 8.9%, and heterogeneity of the proliferative areas. Epithelial invaginations into the surrounding stroma were characterized by intense mitotic activity. The results confirmed a statistically significant increase in keratinocytes in the cholesteatomas, with an MIB-1 level 2.3 times higher than that of meatal keratinocytes. PCNA, a nuclear proliferation antigen which expresses the growth phase of cells in normal and tumoral tissue, was determined in 15 biopsies of meatal skin and 7 specimens of cholesteatoma in the phase of infection and 8 non-infection. Although the number of proliferative cells changed depending on the site of the cholesteatorna, the amount of PCNA-positive cells was significantly higher in the cholesteatoma (2.5-15, mean 9.3) than in normal skin (1-2.8, mean 1.5) (p < 0.001). Finally, AgNOR (argyrophyllic nucleolar organizer regions), which express proliferative activity, were determined in 12 specimens of meatal skin and in 19 acquired and 2 congenital cholesteatomas. A mean of 3.71 AgNOR dots were counted in the cholesteatomas and 1.54 dots in meatal skin specimens. The immunohistological study with three different markers expressing cellular proliferative capacity showed hyperproliferation associated with keratinocyte dysregulation in cholesteatoma samples, which could explain the clinically aggressive and destructive behavior of these lesions.

Antibodies, Monoclonal↗

PubMed2000

[Sinonasal intestinal-type adenocarcinoma: report of 7 cases].

The intestinal-type adenocarcinoma of the nasal cavity and paranasal sinuses are uncommon tumors, with less than 4% of the total of malignancies of this region. They have histological similitudes with the glandular estructure of the intestinal mucosa. In some aspects they are similar to others tumors of this area, symptoms, an etiological relation with the exposure to wood dust ... but they have differences in the local aggressivity, this is important for the tractament, evolution and survival. The authors present a revision about clinic characteristics, diagnostic and tractament of seven cases of nasosinusal intestinal type adenocarcinoma.

Adenocarcinoma↗

PubMed1997

[Indications, techniques and anatomic results of the tympanoplasty using palisade cartilage].

One of the major unsolved problems of the middle ear is Eustachian tube disfunction and abnormalities in gas exchange through the middle ear mucosa, which produces negative pressure and may cause retraction pockets, adhesions, or atelectasis. Postoperatively, ear surgeons face a similar problem when conventional autologous material was used to reconstruct the tympanum. Sooner or later, the new tympanic membrane experience retraction, re-perforation and/or extrusion or displacement of the reconstructed ossicular chain. This paper proposes using cartilage as an alternative method of tympanic membrane reconstruction in a personal modification of Heermann's technique. The indications for the "palisade" reconstruction technique with cartilage, technical aspects, and anatomic results after an average of 20 months after surgery are discussed.

Ear Cartilage↗

PubMed1994

[Results of endoscopically controlled dacryocystorhinostomies].

The results of 104 endoscopically controlled dacryocystorhinostomies performed in 93 patients from June 1989 to June 1993 are presented. Postoperatively, 38 patients had a hematoma, 12 a subcutaneous emphysema and three patients an intraorbital emphysema. All complications were transitory. On 89 sides (85.57%) dacryorrhea was completely cured, on ten sides (9.61%) it was eased considerably, and it was not resolved in five cases, of whom, two had been operated through an external approach previously. A closed postoperative care is important in order to achieve good results. In 25.6% of the cases, the anterior ethmoid displayed patterns of a chronic inflammation. Its involvement in the pathogenesis of chronic dacrocystitis has to be discussed. In many cases, the localisation of the lacrimal gland is more posteriorly than described in anatomy leading to an impeded drainage and subsequently to dacryoadenitis. In our hands, the endoscopically controlled dacryocystorhinostomy presents as a save approach and a good alternative to the procedure described by Toti.

Aged↗

PubMed1992

[Alloplastic materials in otological surgery. An update].

Alloplastic materials have been employer as replacement of the ossicular chain, in the reconstruction of the posterior wall of the outer ear and even in filling up the mastoid process. But owing to the restrictive laws in some countries relative to the transplantations of homologous ossicles and first of all for fear of viral transmissions through the procedures a new light is shed in this field of the ear surgery. In the paper the AA, make a critical revision of replacement alloplastic prosthesis considering the lately introduced materials. The majority of the prosthesis, specially those in plastic, give not, either in short or long term, worthy results. Autologous tissues are, as always have been, the first choice in the reconstructive management of the anatomy of the middle ear. Alloplastic materials being the second chance, by virtue of its recognized intolerance at long terms.

Biocompatible Materials↗

PubMed1991

[Reoperations in otosclerosis. Indications, intraoperative findings, and results].

The audiological outcome of 140 stapedectomy revisions done between 1977 and 1987, as well as the pre- and intraoperative findings and the subjective appraisal of the revisions, are presented. The recurrence of the conductive deafness was the most often indication for the surgical revision and the shift of the prosthesis, verified intraoperatively, the most encountered finding. Audiological results showed, as mean value, an important reduction of the transmissive hearing loss whilst the bone conduction remained unaltered. Patients' subjective evaluation of the results were worse than audiometric controls. From the retrospective study of these 140 revisions the AA' experience is that the stapedectomy revision offers no major risk for the inner ear.

Adolescent↗

PubMed1991

[Perioperative prophylaxis in patients with head and neck tumors].

Sixty-one cancerous patients of the larynx, hipopharynx and tongue underwent surgery under perioperative prophylaxis with Cefuroxim and Metronidazole during 3 days. Alterations of the healing process could not be observed and the parameters both clinic and chemical were normal. The seric level of antibiotics was effective against most of the bacteria cultured from tracheal secretions and from the posterior wall of the oral cavity. Perioperative antibiotic prophylaxis is compulsory when major surgery is performed in head and neck.

Bacterial Infections↗

PubMed1990

[Rheological therapeutic effects in diseases of the inner ear].

The aim of the rheological treatment in sudden deafness is the improvement of the microcirculation in the inner ear by hemodilution and decreased viscosity of the blood. Both parameters have been checked in two groups of patients suffering from sudden deafness; one treated with Dextran-40 and Pentoxifylline, the other with Dextran-40 only. Improvement of rheological characteristics of blood was statistically significant in the combined therapy with Dextran-40 and Pentoxifylline. Two cohorts of sudden deafness patients--one selected, one non selected--treated with Pentoxifylline and Dextran 40 have been evaluated in respect of hearing improvement under this rheological results compared with the spontaneous remission rate given by Weinaug in 1984.

Adult↗

PubMed1990

[Sudden hearing loss and the cranio-cervical junction].

Morphological alterations of the craniocervical junction as basilar impressions, a ponticulus posterior, an atlas assimilation, an intervertebral narrowing and spondylosis deformans, were found radiologically in patients with sudden hearing loss. There were no radiological differences to a healthy population. No relationship could be established between static morphological changes of the craniocervical junction of the upper cervical spine and the sudden hearing loss. However, there was a statistically significant reduction of the mobility in the upper cervical spine in patients suffering from sudden hearing loss. Very high standard deviations in the atlanto-occipital and the atlanto-odontoid joints are interpreted as hyper- as well as hypomobile joints. These results indicate a possible correlation between sudden hearing loss and a functional pathology of the craniocervical junction.

Adult↗

PubMedDate not supplied

[Glioma of the sphenoid sinus in an adult].

Benign congenital lesions resulting from the deficient regression of neuroglial tissue in normal embryonic development are called gliomas. They are usually located in the nasofrontal region and are diagnosed in the postnatal period. They are included in the differential diagnosis of nasofrontal midline masses. We review the case of a 62 year-old woman who was originally studied for a polypoid mass in the left nasal cavity. CT revealed occupation of the left ethmoidofrontal recess and turbinate by a glioma. We report this case as a rare finding in a 62 year-old woman because of its importance in differential diagnosis. We reviewed craniofacial gliomas.

Female↗

PubMedDate not supplied

[Calcium phosphates in otological surgery. II. The bony integration of calcium phosphates. An experimental study].

Calcium phosphates have been proposed for obliteration of the mastoid cavity as well as TORP and PORP. Their use is based on a very good biocompatibility and host acceptance. The osseous integration of a dense and a porous hydroxyapatite is studied experimentally in artificially created epitympanic holes of rabbits. Osteoneogenesis was observed from the third week after surgery starting from the walls od the defects themselves. This had been evidenced using intravital fluorescent dyes. Porous granules showed more "osteoconductivity" in the beginning, probably due to their greater surface area. Bonding osteogenesis with both materials did not show differences after six months. No resorption was observed, excepting remodelation processes.

Animals↗

PubMedDate not supplied

[Calcium phosphates in otologic surgery. III. The role of fibrin glue in the integration of calcium phosphate implants. Experimental study].

Obliteration of the mastoid cavity has been realized with calcium phosphates associated to heterologous fibrin glue in otologic surgery. 22 artificially created epitympanic and 65 femoral defects in 22 rabbits were closed by means of dense or porous granulates of hydroxyapatite with homologous fibrin glue. Follow-up was for three weeks to 6 months. Osteo-integration of the implants was significantly delayed in the first weeks, comparing the integration of the same phosphates without fibrin glue.

Animals↗

PubMedDate not supplied

[Calcium phosphates in surgery of the middle ear. I. The concepts and definitions].

The techniques which pursue the closure of radical cavities include the use of local flaps as well as alloplastic material. Calcium phosphates are classified as "degradable" or "not degradable". The paper tries to offer an explanation why hydroxyapatite or tricalcium phosphate, mostly used calcium phosphates, may be include in both groups. The introduction in the use of alloplastic materials should serve as orientation for those who initiate and stimulate to revision of clinical results. The comparison of same calcium phosphates seems not to be possible as their preparation techniques may be completely different.

Biocompatible Materials↗

PubMedDate not supplied

[Endoscopic naso-sinus surgery. Technical aspects].

Perioperative, anaesthetic and special technical aspects of endoscopic surgery of the paranasal sinuses are presented, which helped to reduce intraoperative bleeding and consequently shortened the time of surgery. The realization of certain operative steps has helped to ease the postoperative care accelerating the healing process in more than 400 cases.

Endoscopes↗