Endoskopik otolojik cerrahi çağında eski bir teknik: Sıvıların Kırıcılık İndeksi’nin rolü

Amaç: Bu çalışmada kronik otit cerrahisinde terk edilmiş bir uygulama tekniği olan Sıvıların Kırıcılık İndeksi’nin RIOF rolü araştırıldı.Hastalar ve Yöntemler: Bu çok merkezli çalışmaya Temmuz 2013 - Ağustos 2015 tarihleri arasında kronik otitis media cerrahisi planlanan toplam 35 hasta 18 kadın, 17 erkek; ort. yaş 39.3±14.4 yıl; dağılım 17-62 yıl alındı.Bulgular: Hastaların 18’inde sol kulak ve 17’sinde sağ kulak etkilenmişti. Kolesteatom ve epitelyum, bu teknik ile gizli anatomik bölgelerden başarılı bir şekilde çıkarıldı. Takip sırasında nüks veya rezidüel hastalık görülmedi.Sonuç: Çalışma sonuçlarımız, günümüzde gelişmiş teknikler ve fiber optik skopiler ile orta kulak ve mastoid girintilerinin etraflıca görüntülemesi mümkün olsa da, RIOF’un halen geçerli, etkili ve maliyeti düşük bir seçenek olduğunu göstermiştir

An ancient technique in the endoscopic era of otologic surgery: The Role of Refractive Index of Fluids

Objectives: This study aims to investigate the role of Refractive Index of Fluids RIOF , an abandoned practical technique, in chronic otitis surgery. Patients and Methods: This multi-center study included a total of 35 patients 18 females, 17 males; mean age 39.3±14.4 years; range 17 to 62 years who were scheduled for surgery for chronic otitis media between July 2013 and August 2015. Results: The left ear was affected in 18 patients, while the right ear was affected in 17 patients. Cholesteatoma and epithelium were successfully removed from the hidden anatomic areas with this technique. No recurrent or residual disease was observed during follow-up. Conclusion: Our study results show that, although sophisticated techniques and fiber optic scopes enable extensive visualization of the recesses of the middle ear and mastoid today, RIOF is still a valid, effective, and cost-effective option.

___

  • Zini C. Indirect microtympanoscopy. Rev Laryngol Otol Rhinol (Bord) 1967;88:736-8. [Abstract]
  • Farrior JB. Tympanoplasty: the anterior attico- tympanotomy. Surgery of the posterior tympanic recesses. Laryngoscope 1968;78:768-79.
  • Goodhill V. Circumferential tympano-mastoid access. The sinus tympani area. Ann Otol Rhinol Laryngol 1973;82:547-54.
  • Thomassin JM, Korchia D, Doris JM. Endoscopic- guided otosurgery in the prevention of residual cholesteatomas. Laryngoscope 1993;103:939-43.
  • McKennan KX. Endoscopic ‘second look’ mastoidoscopy to rule out residual epitympanic/ mastoid cholesteatoma. Laryngoscope 1993;103:810- 4.
  • Tarabichi M. Endoscopic management of acquired cholesteatoma. Am J Otol 1997;18:544-9.
  • Orhan KS, Polat B, Çelik M, Çomoğlu Ş, Güldiken Y. Endoscopic-Assisted Cochlear Implantation: A Case Series. J Int Adv Otol. 2016;12:337-340.
  • Cheiţă AC, Măru N, Mogoantă CA, Ioniţă E. The recesses of the retro-tympanum. Rom J Morphol Embryol 2010;51:61-8.
  • John A. The World of Physics. Nelson Thornes; 2014.
  • Polyanskiy MN. “Refractive index database,” Available from: http://refractiveindex.info [Accessed: February 30, 2016].
  • Bezold F. “Ueber das cholesteatoma des Mittelohres.” Zeitsch Fuer Ohrenheilk 1891;21:252-71.
  • Haberman J. “Zur Entstehung des Cholesteatomas des Mittelhors. ”Arch Ohren Nasen Kehlkheilkund 1888;27:42-50.
  • Karmody CS, Northrop C. The pathogenesis of acquired cholesteatoma of the human middle ear: support for the migration hypothesis. Otol Neurotol 2012;33:42-7.
  • Ayache S, Tramier B, Strunski V. Otoendoscopy in cholesteatoma surgery of the middle ear: what benefits can be expected? Otol Neurotol 2008;29:1085-90.
  • Tarabichi M, Nogueira JF, Marchioni D, Presutti L, Pothier DD, Ayache S. Transcanal endoscopic management of cholesteatoma. Otolaryngol Clin North Am 2013;46:107-30.
  • Levy LL, Jiang N, Smouha E, Richards-Kortum R, Sikora AG. Optical imaging with a high-resolution microendoscope to identify cholesteatoma of the middle ear. Laryngoscope 2013;123:1016-20.
  • Badr-el-Dine M. Value of ear endoscopy in cholesteatoma surgery. Otol Neurotol 2002;23:631-5.
  • Alicandri-Ciufelli M, Marchioni D, Kakehata S, Presutti L, Villari D. Endoscopic Management of Attic Cholesteatoma: Long-Term Results. Otolaryngol Clin North Am 2016;49:1265-70.