Využití autologního materiálu ve středoušní chirurgii

• Main Author: Školoudík, Lukáš
• Other Authors: Vokurka, Jan
• Format: Doctoral Thesis
• Language: Czech
• Published: 2012
• Online Access: http://www.nusl.cz/ntk/nusl-305949

Use of Autologous Material in Middle Ear Surgery The use of autologous material in kofosurgery has been preferred to that of homologous or aloplastic materials in most situations. However, the use of autologous material in patients with cholesteatoma has been limited by the risk of harbouring residual disease. In the clinical part of the study we investigated the relationship between residual cholesteatoma and the method of reconstruction of the middle ear ossicles. Regarding the histological findings, two methods of middle ear ossicle treatment were suggested. The first method tested was mechanical clearance of the ossicles by stripping and burring their surfaces under microscopic view. The mechanical treatment was successful in all cases of mildly eroded ossicles. In cases of severely eroded ossicles, this method was unsuccessful. The second method tested was autoclaving of the ossicle for four minutes at 134 řC after mechanical cleaning. The combination of mechanical and thermal treatment eliminated the cholesteatoma entirely in all cases, including those with severely eroded ossicles. In the experimental part of the study we investigated the reaction of the middle ear mucosa after autoclaving the ossicles and also observed any changes to the ossicles over time since implantation. In an animal experiment...