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Székely L, Gáborján A, Dános K, Szalóki T, Fent Z, Tamás L, Polony G. Mid-term evaluation of perioperative i.v. corticosteroid treatment efficacy on overall and audiological outcome following CO 2 laser stapedotomy: a retrospective study of 84 cases. Eur Arch Otorhinolaryngol 2020; 277:1031-1038. [PMID: 31993767 PMCID: PMC7072067 DOI: 10.1007/s00405-020-05816-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/19/2020] [Indexed: 12/12/2022]
Abstract
Purpose Our aim was to determine whether perioperatively administered corticosteroid treatment has any beneficial effect on the outcome of stapes surgery, with special regard to the audiological results and early postoperative morbidity. Methods 84 CO2 laser stapedotomies performed in our institute between 2013 and 2018 were included in our investigation. All cases underwent preoperative and mid-term postoperative pure-tone audiometric evaluation. Vestibular complications were also evaluated. The cases were subdivided into two groups, 23 patients received perioperative i.v. methylprednisolone treatment (“S”) while the other 61 patients (“nS”) did not receive any adjuvant pharmacological therapy. The data were analyzed retrospectively using IBM SPSS Statistics. Results CO2 laser stapedotomy proved to be a successful intervention with a significant improvement in ABG and AC thresholds as well. Long-term BC levels were significantly better compared to preoperative ones in the S group; however, in the nS group, no difference could be shown. Hearing and ABG gain were significantly superior in group S [28.1 dB (SD11.2) vs. 18.1 dB (SD 10.9) and 23.9 dB(SD 9.8) vs. 17.2 dB (SD 9.5), respectively]. Conclusion No significant inner ear damage was detectable in the results of our CO2 laser stapedotomy method; however, the positive effect of corticosteroid treatment could be demonstrated through the postoperative hearing levels. We found no statistical difference in early postoperative morbidity. According to our data, the routine administration of corticosteroids during stapes surgery could be an issue worthy of consideration. The effects of perioperative treatment vs that on the first day after surgery, and topical vs. systemic treatment could be the subject of further investigation in a prospective manner.
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Affiliation(s)
- L Székely
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Semmelweis University, Szigony Str. 36, Budapest, 1083, Hungary.
| | - A Gáborján
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Semmelweis University, Szigony Str. 36, Budapest, 1083, Hungary
| | - K Dános
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Semmelweis University, Szigony Str. 36, Budapest, 1083, Hungary
| | - T Szalóki
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Semmelweis University, Szigony Str. 36, Budapest, 1083, Hungary
| | - Z Fent
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Semmelweis University, Szigony Str. 36, Budapest, 1083, Hungary
| | - L Tamás
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Semmelweis University, Szigony Str. 36, Budapest, 1083, Hungary
| | - G Polony
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Semmelweis University, Szigony Str. 36, Budapest, 1083, Hungary
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Wang Y, Liang M, Zheng Z, Shi L, Su B, Liu J, Kaplan DL, Zhang B, Wang X. Adhesion Prevention after Laminectomy Using Silk-Polyethylene Glycol Hydrogels. Adv Healthc Mater 2015; 4:2120-2127. [PMID: 26386268 DOI: 10.1002/adhm.201500392] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 07/03/2015] [Indexed: 11/07/2022]
Abstract
Laminectomy is a common operation in spine surgery to reduce spinal cord and nerve pressure. However, scar tissues often form in the spinal canal and adhere to the dura surface, resulting in low back pain postsurgery. In the present study, biodegradable silk-polyethylene glycol (PEG) hydrogels are evaluated for adhesion prevention after laminectomies in New Zealand rabbits, with nondegradable expanded polytetrafluoroethylene (ePTFE) membranes and saline as controls. No significant difference among the three groups is observed within 2 weeks. Silk is fully degraded within 6 weeks, leaving a gap separating the scar tissue and the dura mater. Severe dural scar adhesion form in the saline control group after 8 weeks, while no or mild adhesion is observed in the ePTFE membrane and silk-PEG hydrogel samples. Human dermal fibroblasts (HS-865-SK cells) are cultured in the silk-PEG hydrogel extracts and on top of gel surfaces. Compared to the controls of tissue culture plate (no silk) and sonicated silk hydrogels (no PEG), the proliferation of fibroblasts in both conditions is significantly reduced initially but resumes after 120 h, suggesting the surface properties of the hydrogels and local, temporal release of PEG accounts for the adhesion prevention observed in vivo in this study.
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Affiliation(s)
- Yansong Wang
- Institute of Hard Tissue Development and Regeneration, the Second Affiliated Hospital of Harbin Medical University and Heilongjiang Academy of Medical Sciences, Harbin, 150001, Heilongjiang, China
- Department of Spine Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Min Liang
- Institute of Hard Tissue Development and Regeneration, the Second Affiliated Hospital of Harbin Medical University and Heilongjiang Academy of Medical Sciences, Harbin, 150001, Heilongjiang, China
| | - Zhaozhu Zheng
- National Engineering Laboratory for Modern Silk, Soochow University, Suzhou, 215123, China
| | - Liangchen Shi
- Institute of Hard Tissue Development and Regeneration, the Second Affiliated Hospital of Harbin Medical University and Heilongjiang Academy of Medical Sciences, Harbin, 150001, Heilongjiang, China
| | - Bo Su
- Institute of Hard Tissue Development and Regeneration, the Second Affiliated Hospital of Harbin Medical University and Heilongjiang Academy of Medical Sciences, Harbin, 150001, Heilongjiang, China
| | - Jian Liu
- National Engineering Laboratory for Modern Silk, Soochow University, Suzhou, 215123, China
| | - David L Kaplan
- Department of Biomedical Engineering, Tufts University, Medford, MA, 02155, USA
| | - Bin Zhang
- Institute of Hard Tissue Development and Regeneration, the Second Affiliated Hospital of Harbin Medical University and Heilongjiang Academy of Medical Sciences, Harbin, 150001, Heilongjiang, China
- Department of Spine Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Xiaoqin Wang
- National Engineering Laboratory for Modern Silk, Soochow University, Suzhou, 215123, China
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