Arnošt Pellant

Anterior orbital meningoencephalocele

Basal and syncipital meningoceles and meningoencephaloceles are relatively rare. Otorhinolaryngologists, neurologists, and ophthalmologists should know all the details concerning their incidence, diagnosis, and differential diagnosis. Incorrect interpretation of formations propagating especially into the nasal cavity or the paranasal sinuses and, rarely, into the orbit or the nasopharynx, can lead to serious complications.

Medialization Thyroplasty with a Customized Silicone Implant: Clinical Experience

The authors implemented medialization thyroplasty with a customized silicone implant in a total of 43 operations (36 patients) in 1999–2003. In 5 of these patients, the medialization thyroplasty was combined with cricothyroid subluxation (3 cases) or adduction of arytenoid cartilage (3 cases). One patient received medialization thyroplasty, cricothyroid subluxation and adduction of arytenoid cartilage. Postoperatively 36 patients reported substantial reduction of their complaints, 5 patients found their voice improved and only 2 patients (5.6%) stated that their voice had not changed. The subjective evaluation was consistent with the findings of laryngoscopy and the preoperative and postoperative phonation parameters (maximum phonation time, maximum sound pressure level, jitter and shimmer). Average maximum phonation time was 6.5 s before surgery and 12.5 s after surgery. Maximum vocal sound pressure level was, on average, about 4 dB higher after surgery. Jitter was reduced from 5.3 to 3.7% and shimmer from 32.3 to 18.6%. The differences between presurgical and postsurgical parameters in our study were all statistically significant, indicating voice improvement. Medialization thyroplasty with a silicone implant was proven to be a successful and safe surgical method for the treatment of vocal fold paralysis.

DEVELOPMENT OF THE BRIEF BEDSIDE DYSPHAGIA SCREENING TEST - REVISED: A CROSS-SECTIONAL CZECH STUDY

AIM The purpose of this study was to develop a revised version of the Brief Bedside Dysphagia Screening Test for determining penetration/aspiration risk in patients prone to dysphagia. The priority was to achieve high sensitivity and negative predictive value. METHODS The study screeners conducted bedside assessment of the swallowing function in 157 patients with a neurological (mainly stroke) or an ear, nose, and throat diagnosis (mainly head and neck cancer). The results were compared with a gold standard, flexible endoscopic examination of swallowing. RESULTS For the neurological subgroup (N = 106), eight statistically significant bedside assessment items were combined into the Brief Bedside Dysphagia Screening Test-Revised (BBDST-R). Cut-off score 1 produced the highest sensitivity (95.5%; 95% confidence interval CI [CI]: 84.9-98.7%) and negative predictive value (88.9%; 95% CI 67.2-96.9%). CONCLUSION The BBDST-R is suitable for dysphagia screening in departments caring for patients with neurological conditions.

Reconstruction of an orbital floor fracture in a 4-year-old child.

The authors present a case of a 4-year-old girl with an orbital floor fracture. During surgery absorbable collagenous mesh (Pelvicol) was placed between the bone wall and the orbital periosteum. Pelvicol was selected as a natural xenogeneic tissue (porcine dermis) ready for first use in the reconstruction of the orbital floor fracture. The patient has fully recovered without any symptoms.

CRITERION VALIDITY OF THE SELF-REPORT DYSPHAGIA ASSESSMENT TOOL EAT-10 AMONG NEUROLOGICAL PATIENTS

Aim: The aim was to study criterion validity of the Czech version of the Eating Assessment Tool (EAT-10) by comparing it with the Nursing Dysphagia Screening Tool (NDST). Moreover, the aim was to compare three items of the EAT-10 that focused on swallowing liquids (EAT3) and solids (EAT4) and on cough while eating (EAT9) with one item of the NDST, the swallow test (NDST8). Design: The design was cross-sectional. Methods: The sample included 57 hospitalized patients with a neurological condition. Their swallowing function was assessed using the EAT-10 and NDST. The relationship between the dichotomized EAT-10 and NDST and the selected items of both tools was expressed using the association coefficient phi (φ). Results: For all the studied EAT-10 cut-off scores, the relationship between the EAT-10 and NDST was negative; it was the strongest for a cut-off score of 15 (phi = -0.795; p <0.001). In all but one case, the relationship between the three items of the EAT-10 and the NDST8 was negative; it was the strongest for EAT3 (cut-off score of 3; phi = -0.701; p < 0.001). Conclusion: The results do not provide evidence for criterion validity of the EAT-10 using the NDST. Further research is recommended.