László Rovó

Endoscopic Arytenoid Lateropexy for Isolated Posterior Glottic Stenosis

Objectives/Hypothesis: A posterior glottic stenosis (PGS) may limit the abduction of the arytenoid cartilages. One option for the treatment of dyspnea in lower grade stenoses is endoscopic laterofixation of the vocal cords after scar excision. In our prospective study, we assess a refined method for effective endoscopic mobilization and lateropexy of the arytenoid cartilages.

Severity of Autonomic and Sensory Neuropathy and the Impairment of Visual- and Auditory-Evoked Potentials in Type 1 Diabetes: Is there a relationship?

It became clear in the last decades that neuropathy is not a separate clinical entity, but a component of several related complications (1). Although the functional consequences of neuropathy are well defined in various organ systems, the relationship of the alterations in the networks of the neuronal system is still poorly documented. Assessment of the potential common alterations of the different neuronal functions in patients with diabetic neuropathy may provide new pathogenetic and diagnostic considerations. Previously, we observed correlations between the delay of certain auditory-evoked potentials and the severity of autonomic and peripheral sensory neuropathy in patients with type 1 diabetes (2). In addition, we found a relationship between the latency of visual-evoked potentials and the peripheral neuronal function (3). The aims of this study were to analyze the possible correlations between the central auditory and visual afferentations and the severity of autonomic and sensory neuropathy in patients with long-standing type 1 diabetes. A total of 10 middle-aged type 1 diabetic patients …

A New Thread Guide Instrument for Endoscopic Arytenoid Lateropexy

The varied etiology of bilateral vocal cord immobility (BVCI) requires a wide range of surgical approaches. A new endolaryngeal thread guide instrument (ETGI) is presented here for a minimally invasive endoscopic lateropexy of the arytenoid cartilage, which might serve as a basis for a simple solution for the main types of BVCI.

Clinical assessment of a new computerised objective method of measuring facial palsy.

Clin. Otolaryngol. 2011, 36, 313–319

A comparison between transoral glottis-widening techniques for bilateral vocal fold immobility

Comparison of different endoscopic glottis‐widening procedures designed for bilateral vocal cord immobility (BVCI) is a challenge. This is because a statistically efficient analysis and comparable clinical series is hard to obtain considering the variable aspects of the results and the evaluation methods. This study of a large number of cadaver larynges provides comparable, objective data for the evaluation of the possible postoperative breathing and voicing function.

Brainstem auditory-evoked potential examinations in diabetic patients

Brainstem auditory-evoked potential (BAEP) examinations were performed in 15 patients with long-standing type-1 diabetes mellitus (DM). Cardiovascular reflex tests were applied for assessment of autonomic neuropathy. The aim of our investigation was to compare the BAEP results of this patient group with controls and to look for a possible correlation between the alteration of the auditory brainstem function and the cardiovascular autonomic neuropathy. Analysis of the latencies (waves I, II, III and V) and the inter-peak latencies (waves I-III and I-V) of BAEPs revealed a significant difference between diabetics and healthy controls. The amplitudes of waves I, III and V were definitely lower in comparison with those of healthy controls. A positive correlation was observed between the overall autonomic score and the latencies (waves III and V) and inter-peak latencies (waves I-III and I-V). These data support the hypothesis that long-standing DM and diabetic neuropathy might be related as a cause of certain dysfunctions of the central auditory pathways.

The combined endoscopic management of congenital laryngeal web

Laryngeal web in the anterior commissure is a rare congenital anomaly often leading to severe dyspnea. Endoscopic procedures based on a simple transsection in these cases may worsen the condition because vocal folds have a tendency for fibrosis and granulation tissue formation after surgical interventions. Thus the traditional treatment of choice is the demanding, externally performed laryngotracheal reconstruction generally with a rib cartilage graft and longer period of stenting. This report presents the successful endoscopic management of a congenital laryngeal web in a 2-year-old boy, who previously underwent an uneffective scar laser transsection that led to excessive glotto-subglottic refibrosis. After the CO(2)-laser transsection the authors applied Mitomycin-C and inserted a combined silicon stent by extra-endolaryngeal technique. After the removal of the stent the patient could be decannulated and his voice improved. The application of these minimally invasive endoscopic techniques was successful, hence it may be an effective alternative treatment option for laryngeal webs.

Distortion-product otoacoustic emission (DPOAE) following pure tone and wide-band noise exposures

The aim of our investigations was to determine how the intensity of distortion-product otoacoustic emission (DPOAE) changes following different sound and noise exposures. We performed examinations on 20 healthy people with normal hearing. DPOAEs were recorded scanning the 0.5-6 kHz frequency interval before and after the exposures. We exposed the subjects to 0.5, 1, 2, 4 and 6 kHz pure tones and wide-band noise (intensity: 80 dB HL, duration: 3 minutes). We conclude that the amplitudes of DPOAEs changed immediately after exposures at most frequencies. DPOAE intensities decreased at some frequencies in the middle frequency range (1-2 kHz), and increased at low and particularly at high frequencies.

The −509 C/T genotype of TGFβ1 might contribute to the pathogenesis of benign airway stenosis

Benign airway stenosis (BAS) is one of the most severe complications of endotracheal intubation. The aim of this pilot study was to compare the frequencies of four polymorphisms of the transforming growth factor (TGF) β1 gene in patients with BAS due to endotracheal intubation (n = 36) and a control group of intensive care patients who had also undergone endotracheal intubation but did not present BAS (n = 30). One of the studied polymorphisms, the −509 C/T, demonstrated a differential genotype distribution between the affected and the control population: the ratio of heterozygous mutants was significantly (P = 0.0116) higher among the control patients. These data suggest a protective function of the frequent heterozygous C/T genotype against BAS; alternatively, the C/C genotype might be a susceptibility factor for BAS (OR 4.5; 95% CI 1.5123–13.3902). Our findings suggest that, besides other iatrogenic factors, a genetic predisposition might contribute to the pathogenesis of BAS.

Pharyngeal and hypopharyngeal reconstruction after mutilating surgery for malignant hypopharyngeal cancers

Abstract The authors summarise their reconstructive surgical experience after the radical excision of hypopharyngeal tumours. In selective cases the preservation of the larynx is a reliable surgical option and supraglottic surgery is sufficient to remove the tumour. Myocutaneous paddle flaps were used in every case after the surgical resection for the reconstruction of the pharyngo-oesophageal entrance. After total circular pharyngo-laryngectomy, the continuity of the upper digestive tract was reconstructed by tubed myocutanous flaps.