Biomedical subjects

M Zelený

Publications and source records attributed to M Zelený.

At least 19 recordsLinked to original sources

PubMed1990

[Iatrogenic injuries of the facial nerve in the mastoid region].

During the past ten years nine patients were referred to our hospital with lesions of the VIIth nerve. These lesions were inflicted during operation on account of chronic otitis media. One patient recovered after conservative treatment. Based on the EMG examination and clinical picture, eight patients were operated. In one who had an extensive lesion it did not prove possible to find the proximal stump and the patient improved after Normann-Dott's operation. In the remaining seven subjects also severe damage was involved: five times complete severing of the nerve occurred, twice partial severing and contusion, always in the mastoid portion of the VIIth nerve. The authors achieved as a rule a 50-75% restoration of function of the VIIth nerve Ballance-Duel's operation, using a graft of the n. suralis with microsuture of the epineurium and gluing of the nerve by plasma. Evaluation of late functional results was made 1-8 years after Ballance-Duel's operation. The authors recommend to reduce the risk of iatrogenic lesions of the VIIth nerve in beginners by assistance of experienced surgeons at several operations.

Adolescent↗

PubMed1990

[Reconstructive procedures in war injuries of the larynx and trachea].

In recent years the authors operated three casualties from non-European battlefields with severe laryngotracheal stenoses due to war injuries. Median laryngotomy (thyrocricotracheotomy) made a revision and modification of the internal injury possible. An implanted tube from a vascular prosthesis, packed in Hydron kept the replaced cartilaginous cross bar and possibly mucous grafts from a gingivobuccal fold in the correct position. A cross bar made from a cartilaginous or bony portion of a rib also dilated the lumen. It was kept in position by the perichondrium of the cartilaginous cross bar sutured to the margin of the mucosal remnants. All three patients were decannulated.

Humans↗

PubMed1990

[Our surgical approach in the treatment of otosclerosis over the past 10 years].

The most frequently used technique of surgery of otosclerosis used during the past ten years in the Central Military Hospital was Schuknecht's technique of wire and fat. 575 thus operated patients account for 89.4% of the total number of 643 operations. A compensation of the bone reserve to 0-10 dB was achieved in the late results of 56.3% of the operated patients, in another 30% there were auditory gains of speech frequencies, on average above 10 dB. Favourable late results were thus achieved in 86.3% of the operated patients, deterioration of hearing was recorded in 4.8% (13 operated patients). Pistons of Schuknecht's type were used in 23 patients with the obliterating form of otosclerosis. As to late results, in 21 of the evaluated patients compensation of the bone reserve to 0-10 dB was recorded in 28.6%. The mean auditory gains as regards speech frequencies higher than 10 dB were achieved in 47.6%. Favourable late results were thus recorded in 76.2% of operated patients with the obliterating form of otosclerosis. Deterioration of hearing occurred in this group in one operated patient (4.8%).

Humans↗

PubMed1989

[Clinical experience with silastic middle-ear prostheses].

The authors made clinical tests of silastic prostheses of the middle ear, type PORP, TORP and piston. They used 29 X PORP, 26 X TORP and 21 pistons. They did not reveal any signs of tissue intolerance to Silastic MDX 44-516, which is used for making prostheses. They achieved satisfactory anatomical and functional results. They recorded an auditory gain in more than half the patients (early: PORP 97%, TORP 73%, piston 52%; plasty transplants of ossicles obtained from subjects who died accidentallyĕ For preserfic Council of the Ministry of Health, Czech Socialist Republic, recommended, based on the clinical tests, the manufacture of silastic prostheses of the middle ear.

Audiometry↗

PubMed1989

[Late results in the replacement of auditory ossicles with silastic prostheses].

Silastic prostheses of the middle ear proved useful in the reconstruction of the chain of auditory ossicles. Following an observation period of 6 months to 6 years they led in type PORP in a group of 49 subjects to early functional positive results in 78% and late positive results in 71%. The authors tested type TORP in 56 patients with a 57% success as regards early and late results. They used pistons only in obliterated fossae of the fenestra ovalis or in case of thick immobile plates. Despite this they achieved excellent and good early and late auditory gains in 58%. Of 105 prostheses type PORP and TORP administered during the entire observation period rejection occurred only in four subjects, i. e. in 3.8%. They inserted a strip of fascia between the cap of the prosthesis and tympanic membrane.

Follow-Up Studies↗

PubMed1989

A silastic prosthesis for total replacement of the middle-ear ossicular chain, its acoustic properties and clinical application.

The authors designed and made a prosthesis for total replacement of the middle ear ossicular chain (TORP) from Silastic MDX 44-516. A great advantage of this substitute is that it can easily be modified to a prosthesis for partial replacement of the middle-ear ossicular chain (PORP). The transfer properties of the PORP type prosthesis were verified by using an electroacoustic model measurement. Very good anatomical and functional results were obtained in the clinical testing of both types of middle-ear substitutes. No undesired reactions to the implanted polymer were observed.

Acoustic Impedance Tests↗

PubMed1989

[Revision after surgical procedures in the middle ear and mastoid].

In a group of 46 revised operations the most frequent cause of revision was persisting secretion--in 41 patients. After elimination of general causes and after failure of conservative treatment, during revision the following local causes were revealed: relapse of cholesteatoma in 44%, inflammation of the residual or repneumatized spaces in 41%, ostitis of the long process of the incus in 10% and inflammation in the divided trepanation cavities in 5%. By the first revision the authors achieved a dry trepanation cavity in 58.5% of the operated patients. By the second and third revision they increased the number of dry trepanation cavities to 83% and in the remaining ones there was only an occasional secretion. The revision involved usually a more radical procedure. In some of the patients operated by the "closed" technique the authors changed to the "open" technique. A radical approach to the auditory ossicles and the ear drum, if they were preserved during the primary operation, led to a deterioration of hearing in 22 of 41 operated patients, i. e. in 53.66%. This is the cost of obtaining a dry trepanation cavity.

Adolescent↗

PubMed1988