Anamarija Šestak - Academia.edu (original) (raw)
Papers by Anamarija Šestak
Psychiatria Danubina, Apr 22, 2022
Background: The Behavioral Subcommittee of the Bárány Society Committee for Classification of Ves... more Background: The Behavioral Subcommittee of the Bárány Society Committee for Classification of Vestibular Disorders recently established the diagnostic criteria for a persistent postural-perceptive dizziness (PPPD). Objectives: This study aims to determine how significant the degree of anxiety and depression of PPPD patients is, compared to the patients with other dizziness. Subjects and methods: The study was conducted on 78 patients, 39 (50%) of whom suffer from PPPD, and of a control group consisting of the same number of patients with other types of dizziness. All the patients filled out the DHI and HADS questionnaire and were subjected to a VNG and VEMP examination. Results: The DHI showed significant disability in the majority of patients, slightly more in the control group. The HADS showed an equal degree of anxiety in both groups of patients, but significantly higher pathological anxiety in the PPPD group (49%:31%). Conclusions: Majority of the patients in both groups experienced mild anxiety, while those with the pathological degree were more represented in the PPPD group. Depression was more expressed in the group of other dizziness. We can consider only the patients with a pathological degree of anxiety as predisposed to the emergence of PPPD.
Medica Jadertina
Uvod: Metastaze u nosnu šupljinu, paranazalne sinuse i nazofarinks su rijetke, ali ako su prisutn... more Uvod: Metastaze u nosnu šupljinu, paranazalne sinuse i nazofarinks su rijetke, ali ako su prisutne tada je najčešće sijelo maksilarni sinus. Prateći simptomi metastaze u navedenim sijelima mogu imitirati druga benigna i češća stanja, a prava etiologija se može predvidjeti i propustiti tijekom duljeg razdoblja. Prikaz slučaja: Prikazujemo dva slučaja s prisutnim tumorskim tvorbama u nosnoj šupljini, paranazalnim sinusima i nazofarinksu s različitom kliničkom slikom i konačnim ishodom. Prvi je slučaj šesnaestogodišnjeg bolesnika sa suspektnom metastazom ekstraosealnog Ewingovog sarkoma lijeve potkoljenice u nazofarinks i desni maksilarni sinus. Sumnja je postavljena nakon snimanja PET/CT-a, a bolesnik nije imao tegobe od strane nosa i paranazalnih šupljina. Patohistološka analiza bioptata ukazala je na upalne promjene bez tumorskih stanica. Drugi je slučaj pedesetsedmogodišnje bolesnice koja se žalila na otežano disanje i učestale epistakse iz lijeve nosnice. Kliničkim pregledom i rad...
Uvod: Karcinom paratireoidne žlijezde je vrlo rijedak oblik karcinoma koji se rijetko primarno pr... more Uvod: Karcinom paratireoidne žlijezde je vrlo rijedak oblik karcinoma koji se rijetko primarno prezentira kao hematom vrata i medijastinuma. Svrha ovoga prikaza slučaja je da se naglasi važnost uzimanja u obzir spontanog krvarenja karcinoma paratireoidne žlijezde kao diferencijalne dijagnoze prilikom nastanka spontanog hematoma vrata i medijastinuma i da odgađanje operativnog zahvata u takvim slučajevima može dovesti do fatalnih komplikacija. Prikaz slučaja: Šezdesetčetverogodišnji muškarac javlja se u hitnu otorinolaringološku ambulantu zbog bolova u vratu, oticanja vrata i promuklosti. Prema anamnestičkim podacima nije bilo traume, te dan prije hitnog pregleda nije imao prisutnu oteklinu vrata i bolove. U kliničkom statusu bila je prisutna manja oteklina lijeve strane hipofarinksa, a lijeva strana larinksa bila je slabije pomična sa suficijentnom rimom, a na prednjoj i lijevoj strani vrata se palpirala difuzna, tvrda i bolna oteklina. Učinio se CT vrata i toraksa na kojem se opisa...
CILJ ISTRAŽIVANJA: Mali broj studija pokazuje utjecaj vestibularne rehabilitacije (VR) na sva ves... more CILJ ISTRAŽIVANJA: Mali broj studija pokazuje utjecaj vestibularne rehabilitacije (VR) na sva vestibularna osjetila, a s time i na izolirano oštećenje otolitičkog osjetila. Cilj ove studije je bio prikazati utjecaj VR-a na sva vestibularna osjetila kod pacijenata s različitim tipovima unilateralne vestibularne hipofunkcije (UVH). NACRT STUDIJE: Istraživanje je ustrojeno kao prospektivna kohortna studija u kojoj su izvor podataka bili rezultati snimanja kalorijskog testa, video head impulse testa (vHIT), okularnih i cervikalnih evociranih mišićnih potencijala (oVEMP i cVEMP), te upitnika Dizziness Handicap Inventory (DHI) i 36-Item Short Form Health Survey (SF-36). Svi ispitanici su praćeni kroz 12 tjedana nakon postavljanja dijagnoze UVH-a. ISPITANICI I METODE: U istraživanje je uključeno 80 ispitanika s tri različita tipa UVH-a; kombinirano oštećenje, izolirano kupularno i izolirano otolitičko oštećenje vestibularnog osjetila. Svi ispitanici su provodili individualno prilagođene vj...
Telemedicina je pojam koji obuhvaća sve postupke podržane komunikacijskom tehnologijom čiji je ci... more Telemedicina je pojam koji obuhvaća sve postupke podržane komunikacijskom tehnologijom čiji je cilj pružanje zdravstvenih usluga na određenoj prostornoj udaljenosti. To je područje koje se brzo razvija i pronašlo je posebnu primjenu u laringologiji. Razvoj telemedicine u laringologiji predstavlja novi pristup dijagnostičkim i terapijskim postupcima, posebno razvojem 5G tehnologije. Najvažnije što nam donosi primjena 5G tehnologije je brz i pouzdan prijenos podataka, izuzetno niska latencija, te pokrivenost i energetska učinkovitost potrebna za takav prijenos podataka. Ovo je jedno od brzo razvijajućih područja koje zasigurno uvodi novinu u svakodnevnu praksu, poboljšava kvalitetu i dostupnost medicinske njege u područjima u kojima nedostaje liječnika. Jedna od najranijih primjena telemedicine u laringologiji bilo je provođenje glasovne rehabilitacije, dok se do danas uvelike proširila primjena. Primjena telekirurgije je pravi primjer razvoja tehnologije i njezine primjene u medicini...
Cilj rada: Cilj studije je usporediti endoskopsku i standardnu septoplastiku na temelju prijeoper... more Cilj rada: Cilj studije je usporediti endoskopsku i standardnu septoplastiku na temelju prijeoperacijske i postoperacijske simptomatologije i nalaza kompjuterizirane rinomanometrije. Materijali i metode: U prospektivnu studiju uključeno je ukupno 40 bolesnika koji su podijeljeni u dvije skupine. Prvu skupinu čini 20 bolesnika kojima je učinjena standardna septoplastika, a drugu čini 20 bolesnika kojima je učinjena endoskopska septoplastika. Postoperacijske kontrole provedene su 7., 14. i 30. dan. Rinomanometrija je učinjena na kompjuteriziranom rinomanometru. Sve septoplastike su učinili iskusni specijalisti. Rezultati: Kod 80% bolesnika kojima je učinjena standardna septoplastika došlo je do subjektivnog poboljšanja disanja na nos, te u 95% bolesnika kojima je učinjena endoskopska septoplastika. Simptomi glavobolje i postanazalne sekrecije su nestali kod 50% i 70% bolesnika kojima je učinjena standardna septoplastika, te kod 80% i 85 % bolesnika kojima je učinjena endoskopska septo...
Medica Jadertina, 2020
Otkada su po prvi put spomenute i opisane, pa sve do danas, vratne vrtoglavice imaju svoje zagovo... more Otkada su po prvi put spomenute i opisane, pa sve do danas, vratne vrtoglavice imaju svoje zagovornike i oponente, a vjerojatno će i ubuduće ostati polemička tema, sve dok se ne riješi pitanje pouzdanih dijagnostičkih testova i konsenzusom uspostave valjani kliničko-dijagnostički kriteriji. Premda postoje različite teorije o mehanizmu koji povezuje vrtoglavice s vratnim simptomima, još uvijek nemamo jasne i općeprihvaćene patofiziološke potpore ovom fenomenu. Suvremenom vestibularnom dijagnostikom se kod više od 90% ovakvih bolesnika dobije neki drugi uzrok poremećaja ravnoteže. Brojna klinička zapažanja, anatomsko-fiziološke i epidemiološke studije sugeriraju povezanost bola u vratu i općenito vratnih simptoma s vrtoglavicom, pa bi ovu činjenicu trebalo s punim uvažavanjem uzeti u obzir pri diferencijalnodijagnostičkom razmatranju. Konačnu dijagnozu vratne vrtoglavice trebalo bi postaviti bolesnicima s bolom i otežanom pokretljivošću u vratu, kojima smo isključili sve ostale moguće uzroke vrtoglavice i kojima je usto liječenje dovelo do značajnog poboljšanja, kako vratnih, tako i simptoma poremećaja ravnoteže. Nju potkrjepljuje i kratko vrijeme proteklo od ozljede vrata do pojave simptoma vrtoglavice, pozitivan nalaz testa torzije vratne kralježnice i patološki nalaz MR-a gornjega dijela vratne kralježnice. Liječenje vratne vrtoglavice ne bi smjelo biti uskraćeno niti jednom bolesniku jer rasprava o postojanju ili nepostojanju vratnih vrtoglavica i mehanizmu njihova nastanka ima samo akademski, a gotovo nikakav praktični značaj. Pritom treba istaknuti da se kod većine bolesnika dobri rezultati postižu liječenjem metodama fizikalne terapije, posebice manualne, dok farmakoterapija i vestibularna rehabilitacija ne dovode do značajnijega poboljšanja.
We have been treating endoscopically different kinds of inverted papilloma including malignant in... more We have been treating endoscopically different kinds of inverted papilloma including malignant inverted papilloma since 1995. This is a retrospective study which demonstrates our experience in the treatment of inverted papilloma. Inverted papilloma is defined as a benign, locally aggressive tumor with malignant transformation and frequent recurrence. The aim of the study is to investigate whether the malignancy starts developing at the beginning of disease or later, and whether we can consider deviated septum as a etiologic factor of inverted papilloma. We also wanted to show endoscopic endonasal surgery as a method of choice in the treatment of inverted papilloma. Data in the period from 1998 to 2017 were analyzed retrospectively. Out of a total number of 62 patients, three (4.8%) were diagnosed with inverted papilloma with squamous cell carcinoma in some part of the lesion and 59 (95.2%) were diagnosed like inverted papilloma. The patients diagnosed with inverted papilloma and wit...
Cilj rada: Hipertrofija donjih nosnih školjki koja je refraktorna na konzervativnu terapiju je je... more Cilj rada: Hipertrofija donjih nosnih školjki koja je refraktorna na konzervativnu terapiju je jedan od najčešćih problematika u rinologiji. Redukcija donjih nosnih školjki s diodnim laserom je minimalno invazivna i sigurna metoda koja se može provesti u lokalnoj anesteziji. Cilj rada je prikazati efikasnost redukcije donjih nosnih školjki diodnim laserom na temelju subjektivnih simptoma nazalne opstrukcije, nazalne sekrecije, glavobolje i smanjenog osjeta mirisa, te nalaza rinomanometrije.
Poremećaji disanja tijekom spavanja vrlo su česti i u odraslih i u djece. Opstruktivna apneja u s... more Poremećaji disanja tijekom spavanja vrlo su česti i u odraslih i u djece. Opstruktivna apneja u spavanju (OSA) najčešći je poremećaj disanja tijekom spavanja i ozbiljan javnozdravstveni problem. OSA je kronična bolest udružena s kardiovaskularnim i metaboličkim poremećajima. Prevalencija OSA kreće se između 2% i 4% u odrasloj populaciji. Dijagnoza OSA postavlja se cjelonoćnom polisomnografijom ili kardiorespiracijskom poligrafijom a endoskopskim pregledom gornjeg dišnog puta za vrijeme medikamentozno induciranog spavanja (eng. drug induced sleep endoscopy – DISE). Određujemo mjesto, težinu i konfiguraciju opstrukcije. Na temelju dobivenih nalaza moguće je planirati individualnu konzervativnu i kiruršku terapiju.
NeuroRehabilitation, 2019
BACKGROUND: The minimal number of studies have documented the impact of Vestibular rehabilitation... more BACKGROUND: The minimal number of studies have documented the impact of Vestibular rehabilitation (VR) on the recovery rate of patients with Chronic Unilateral Vestibular Hypofunction (CUVH) and Bilateral Vestibular Hypofunction (BVH). OBJECTIVES: The goal of the study was to show and compare the impact of vestibular rehabilitation (VR) in patients with CUVH and BVH. METHODS: We analysed the data of 30 patients with CUVH and 20 with BVH treated with VR. The patients with CUVH during their eight-week treatment were controlled every two weeks, while the patients with BVH were controlled every three months during their one-year treatment; they filled in the DHI and ABC questionnaires every time. RESULTS: In both groups of patients, there was significantly less disablement between the initial and final DHI scores (from 59-20 in CUVH and 74-41 in BVH group). There was a significant increase in the balance confidence between the initial and final ABC Scale in both groups of patients (from 49.5-90% in CUVH and 42-73% in BVH group). CONCLUSIONS: Well-planned and individually adjusted system of vestibular exercises leads to a significant decrease in clinical symptoms and improvement of functioning and confidence in activities in both the CUVH and the BVH patients.
The Laryngoscope, 2018
We present the case of a 27-year-old male who presented with vertigo when pressing the entrance o... more We present the case of a 27-year-old male who presented with vertigo when pressing the entrance of his right auditory meatus and exposing his right ear to loud noise. A diagnostic procedure revealed bilateral labyrinth weakness, which was confirmed by caloric and rotational testing. The ocular vestibular evoked myogenic potentials investigation demonstrated a significant weakness of the right utriculus, whereas the cervical vestibular evoked myogenic potentials were normal, indicating preservation of the saccular response. Radiologic studies did not show evidence of labyrinthine dehiscence. We suspect the newly described association of this clinical syndrome with the previously described histopathology of vestibular atelectasis accounts for these findings.
Brazilian Journal of Otorhinolaryngology, 2017
Introduction: Benign paroxysmal positional vertigo is the most common cause of dizziness in the g... more Introduction: Benign paroxysmal positional vertigo is the most common cause of dizziness in the general population. It is a condition with potential impact of reduced levels of vitamin D on its recurrent attacks. Objectives: The aim of this study was to measure the serum levels of 25-hydroxyvitamin D3 (25-OH D3) in patients with benign paroxysmal positional vertigo and determine whether there is a difference in the serum levels of vitamin D3 between patients with and without recurrence, as well as between the different clinical forms of benign paroxysmal positional vertigo. Methods: The study included 40 patients who came to the regular medical examination, diagnosed with posterior canal-benign paroxysmal positional vertigo based on the positive Dix-Hallpike's test. All patients underwent Epley manoeuvre after the diagnosis. Patients were classified according to current guidelines for levels of vitamin D3 in the serum in three groups: the deficiency, insufficiency and adequate level. Results: The average serum level of 25-OH D3 among respondents was 20.78 ng/mL, indicating a lack or insufficiency of the aforementioned 25-OH D3. According to the levels of 25-OH D3, most patients suffer from deficiency (47.5%). 7 (17.5%) respondents had adequate blood level of 25-OH D3, and 14 (35%) respondents suffer from insufficiency. A significant difference was
Diving and Hyperbaric Medicine Journal
Introduction: Previous studies suggest the effectiveness of hyperbaric oxygen treatment (HBOT) in... more Introduction: Previous studies suggest the effectiveness of hyperbaric oxygen treatment (HBOT) in idiopathic sudden sensorineural hearing loss (ISSNHL) but it is mostly used as an adjuvant and salvage treatment. This study evaluated the effect of primary HBOT according to pretreatment hearing grades and hearing recovery outcomes using modified Siegel’s criteria in patients with ISSNHL. Methods: Fifty-nine ISSNHL patients treated with only HBOT were included. A pure-tone audiogram was recorded before and after a course of HBOT (90 min at 203 kPa daily for 20 days). Using the modified Siegel’s criteria, patients were divided into groups according to hearing threshold before and after treatment. Results: Hearing thresholds were significantly lower after HBOT compared to pre-treatment values across all patients (P < 0.001) with a median value of recovery of 22.5 dB (interquartile range 12.5-33.7 dB). Significantly lower hearing threshold values were recorded at 500, 1,000, 2,000, and...
NeuroRehabilitation, 2020
BACKGROUND: Only a few studies in the literature demonstrate the effect of vestibular rehabilitat... more BACKGROUND: Only a few studies in the literature demonstrate the effect of vestibular rehabilitation (VR) on all vestibular receptor organs. Furthermore, very little evidence of the effect of VR on isolated otolith dysfunction (IOD) is available. OBJECTIVE: The study aimed to investigate the effect of VR on all vestibular receptor organs in patients with different types of unilateral vestibular hypofunction (UVH). METHODS: We enrolled 80 patients with three different types of UVH; combined and isolated loss of semicircular canal and otolith organ function. All patients performed a 12-week customized program of VR and received a full battery of vestibular function tests, before and after the VR. The DHI and SF-36 were performed before, after 6 weeks, and 12 weeks of the VR. RESULTS: Parameters of the caloric test, video head impulse test, ocular and cervical vestibular evoked myogenic potentials were significantly improved after VR. A total of 59 (74%) patients fully recovered, with ...
Acta Clinica Croatica, 2020
-Papillary thyroid cancer accounts for 80-85% of diagnosed thyroid cancers, while follicular, med... more -Papillary thyroid cancer accounts for 80-85% of diagnosed thyroid cancers, while follicular, medullary, and anaplastic cancers are diagnosed significantly less frequently. This study aimed to show the characteristics of malignant thyroid tumors. in this retrospective study, we analyzed data from 320 patients who underwent thyroid surgery from January 2018 to december 2019. We recorded and statistically analyzed basic demographic data, data of the cytological and pathohistological findings, and tumor characteristics (size, multifocality, extrathyroidal and lymphovascular invasion). Thyroid cancer was diagnosed in 95 patients. The incidence of thyroid cancer was higher in women than in men, but without a significant difference (p=0.46). There was a significant difference between preoperative cytological findings and definitive pathohistological diagnosis (p=0.001). There was no significant difference between genders in tumor size, extrathyroidal and lymphovascular invasion, and multifocality. There were significantly more thyroid cancers with a lymphovascular invasion that were less than 2 cm in size (p=0.04). in our opinion, it is important to emphasize the value of early diagnostics and analysis of the malignant tumor characteristics that are major prognostic factors for survival in patients with thyroid cancer.
Psychiatria Danubina, 2020
Psychiatria Danubina, Apr 22, 2022
Background: The Behavioral Subcommittee of the Bárány Society Committee for Classification of Ves... more Background: The Behavioral Subcommittee of the Bárány Society Committee for Classification of Vestibular Disorders recently established the diagnostic criteria for a persistent postural-perceptive dizziness (PPPD). Objectives: This study aims to determine how significant the degree of anxiety and depression of PPPD patients is, compared to the patients with other dizziness. Subjects and methods: The study was conducted on 78 patients, 39 (50%) of whom suffer from PPPD, and of a control group consisting of the same number of patients with other types of dizziness. All the patients filled out the DHI and HADS questionnaire and were subjected to a VNG and VEMP examination. Results: The DHI showed significant disability in the majority of patients, slightly more in the control group. The HADS showed an equal degree of anxiety in both groups of patients, but significantly higher pathological anxiety in the PPPD group (49%:31%). Conclusions: Majority of the patients in both groups experienced mild anxiety, while those with the pathological degree were more represented in the PPPD group. Depression was more expressed in the group of other dizziness. We can consider only the patients with a pathological degree of anxiety as predisposed to the emergence of PPPD.
Medica Jadertina
Uvod: Metastaze u nosnu šupljinu, paranazalne sinuse i nazofarinks su rijetke, ali ako su prisutn... more Uvod: Metastaze u nosnu šupljinu, paranazalne sinuse i nazofarinks su rijetke, ali ako su prisutne tada je najčešće sijelo maksilarni sinus. Prateći simptomi metastaze u navedenim sijelima mogu imitirati druga benigna i češća stanja, a prava etiologija se može predvidjeti i propustiti tijekom duljeg razdoblja. Prikaz slučaja: Prikazujemo dva slučaja s prisutnim tumorskim tvorbama u nosnoj šupljini, paranazalnim sinusima i nazofarinksu s različitom kliničkom slikom i konačnim ishodom. Prvi je slučaj šesnaestogodišnjeg bolesnika sa suspektnom metastazom ekstraosealnog Ewingovog sarkoma lijeve potkoljenice u nazofarinks i desni maksilarni sinus. Sumnja je postavljena nakon snimanja PET/CT-a, a bolesnik nije imao tegobe od strane nosa i paranazalnih šupljina. Patohistološka analiza bioptata ukazala je na upalne promjene bez tumorskih stanica. Drugi je slučaj pedesetsedmogodišnje bolesnice koja se žalila na otežano disanje i učestale epistakse iz lijeve nosnice. Kliničkim pregledom i rad...
Uvod: Karcinom paratireoidne žlijezde je vrlo rijedak oblik karcinoma koji se rijetko primarno pr... more Uvod: Karcinom paratireoidne žlijezde je vrlo rijedak oblik karcinoma koji se rijetko primarno prezentira kao hematom vrata i medijastinuma. Svrha ovoga prikaza slučaja je da se naglasi važnost uzimanja u obzir spontanog krvarenja karcinoma paratireoidne žlijezde kao diferencijalne dijagnoze prilikom nastanka spontanog hematoma vrata i medijastinuma i da odgađanje operativnog zahvata u takvim slučajevima može dovesti do fatalnih komplikacija. Prikaz slučaja: Šezdesetčetverogodišnji muškarac javlja se u hitnu otorinolaringološku ambulantu zbog bolova u vratu, oticanja vrata i promuklosti. Prema anamnestičkim podacima nije bilo traume, te dan prije hitnog pregleda nije imao prisutnu oteklinu vrata i bolove. U kliničkom statusu bila je prisutna manja oteklina lijeve strane hipofarinksa, a lijeva strana larinksa bila je slabije pomična sa suficijentnom rimom, a na prednjoj i lijevoj strani vrata se palpirala difuzna, tvrda i bolna oteklina. Učinio se CT vrata i toraksa na kojem se opisa...
CILJ ISTRAŽIVANJA: Mali broj studija pokazuje utjecaj vestibularne rehabilitacije (VR) na sva ves... more CILJ ISTRAŽIVANJA: Mali broj studija pokazuje utjecaj vestibularne rehabilitacije (VR) na sva vestibularna osjetila, a s time i na izolirano oštećenje otolitičkog osjetila. Cilj ove studije je bio prikazati utjecaj VR-a na sva vestibularna osjetila kod pacijenata s različitim tipovima unilateralne vestibularne hipofunkcije (UVH). NACRT STUDIJE: Istraživanje je ustrojeno kao prospektivna kohortna studija u kojoj su izvor podataka bili rezultati snimanja kalorijskog testa, video head impulse testa (vHIT), okularnih i cervikalnih evociranih mišićnih potencijala (oVEMP i cVEMP), te upitnika Dizziness Handicap Inventory (DHI) i 36-Item Short Form Health Survey (SF-36). Svi ispitanici su praćeni kroz 12 tjedana nakon postavljanja dijagnoze UVH-a. ISPITANICI I METODE: U istraživanje je uključeno 80 ispitanika s tri različita tipa UVH-a; kombinirano oštećenje, izolirano kupularno i izolirano otolitičko oštećenje vestibularnog osjetila. Svi ispitanici su provodili individualno prilagođene vj...
Telemedicina je pojam koji obuhvaća sve postupke podržane komunikacijskom tehnologijom čiji je ci... more Telemedicina je pojam koji obuhvaća sve postupke podržane komunikacijskom tehnologijom čiji je cilj pružanje zdravstvenih usluga na određenoj prostornoj udaljenosti. To je područje koje se brzo razvija i pronašlo je posebnu primjenu u laringologiji. Razvoj telemedicine u laringologiji predstavlja novi pristup dijagnostičkim i terapijskim postupcima, posebno razvojem 5G tehnologije. Najvažnije što nam donosi primjena 5G tehnologije je brz i pouzdan prijenos podataka, izuzetno niska latencija, te pokrivenost i energetska učinkovitost potrebna za takav prijenos podataka. Ovo je jedno od brzo razvijajućih područja koje zasigurno uvodi novinu u svakodnevnu praksu, poboljšava kvalitetu i dostupnost medicinske njege u područjima u kojima nedostaje liječnika. Jedna od najranijih primjena telemedicine u laringologiji bilo je provođenje glasovne rehabilitacije, dok se do danas uvelike proširila primjena. Primjena telekirurgije je pravi primjer razvoja tehnologije i njezine primjene u medicini...
Cilj rada: Cilj studije je usporediti endoskopsku i standardnu septoplastiku na temelju prijeoper... more Cilj rada: Cilj studije je usporediti endoskopsku i standardnu septoplastiku na temelju prijeoperacijske i postoperacijske simptomatologije i nalaza kompjuterizirane rinomanometrije. Materijali i metode: U prospektivnu studiju uključeno je ukupno 40 bolesnika koji su podijeljeni u dvije skupine. Prvu skupinu čini 20 bolesnika kojima je učinjena standardna septoplastika, a drugu čini 20 bolesnika kojima je učinjena endoskopska septoplastika. Postoperacijske kontrole provedene su 7., 14. i 30. dan. Rinomanometrija je učinjena na kompjuteriziranom rinomanometru. Sve septoplastike su učinili iskusni specijalisti. Rezultati: Kod 80% bolesnika kojima je učinjena standardna septoplastika došlo je do subjektivnog poboljšanja disanja na nos, te u 95% bolesnika kojima je učinjena endoskopska septoplastika. Simptomi glavobolje i postanazalne sekrecije su nestali kod 50% i 70% bolesnika kojima je učinjena standardna septoplastika, te kod 80% i 85 % bolesnika kojima je učinjena endoskopska septo...
Medica Jadertina, 2020
Otkada su po prvi put spomenute i opisane, pa sve do danas, vratne vrtoglavice imaju svoje zagovo... more Otkada su po prvi put spomenute i opisane, pa sve do danas, vratne vrtoglavice imaju svoje zagovornike i oponente, a vjerojatno će i ubuduće ostati polemička tema, sve dok se ne riješi pitanje pouzdanih dijagnostičkih testova i konsenzusom uspostave valjani kliničko-dijagnostički kriteriji. Premda postoje različite teorije o mehanizmu koji povezuje vrtoglavice s vratnim simptomima, još uvijek nemamo jasne i općeprihvaćene patofiziološke potpore ovom fenomenu. Suvremenom vestibularnom dijagnostikom se kod više od 90% ovakvih bolesnika dobije neki drugi uzrok poremećaja ravnoteže. Brojna klinička zapažanja, anatomsko-fiziološke i epidemiološke studije sugeriraju povezanost bola u vratu i općenito vratnih simptoma s vrtoglavicom, pa bi ovu činjenicu trebalo s punim uvažavanjem uzeti u obzir pri diferencijalnodijagnostičkom razmatranju. Konačnu dijagnozu vratne vrtoglavice trebalo bi postaviti bolesnicima s bolom i otežanom pokretljivošću u vratu, kojima smo isključili sve ostale moguće uzroke vrtoglavice i kojima je usto liječenje dovelo do značajnog poboljšanja, kako vratnih, tako i simptoma poremećaja ravnoteže. Nju potkrjepljuje i kratko vrijeme proteklo od ozljede vrata do pojave simptoma vrtoglavice, pozitivan nalaz testa torzije vratne kralježnice i patološki nalaz MR-a gornjega dijela vratne kralježnice. Liječenje vratne vrtoglavice ne bi smjelo biti uskraćeno niti jednom bolesniku jer rasprava o postojanju ili nepostojanju vratnih vrtoglavica i mehanizmu njihova nastanka ima samo akademski, a gotovo nikakav praktični značaj. Pritom treba istaknuti da se kod većine bolesnika dobri rezultati postižu liječenjem metodama fizikalne terapije, posebice manualne, dok farmakoterapija i vestibularna rehabilitacija ne dovode do značajnijega poboljšanja.
We have been treating endoscopically different kinds of inverted papilloma including malignant in... more We have been treating endoscopically different kinds of inverted papilloma including malignant inverted papilloma since 1995. This is a retrospective study which demonstrates our experience in the treatment of inverted papilloma. Inverted papilloma is defined as a benign, locally aggressive tumor with malignant transformation and frequent recurrence. The aim of the study is to investigate whether the malignancy starts developing at the beginning of disease or later, and whether we can consider deviated septum as a etiologic factor of inverted papilloma. We also wanted to show endoscopic endonasal surgery as a method of choice in the treatment of inverted papilloma. Data in the period from 1998 to 2017 were analyzed retrospectively. Out of a total number of 62 patients, three (4.8%) were diagnosed with inverted papilloma with squamous cell carcinoma in some part of the lesion and 59 (95.2%) were diagnosed like inverted papilloma. The patients diagnosed with inverted papilloma and wit...
Cilj rada: Hipertrofija donjih nosnih školjki koja je refraktorna na konzervativnu terapiju je je... more Cilj rada: Hipertrofija donjih nosnih školjki koja je refraktorna na konzervativnu terapiju je jedan od najčešćih problematika u rinologiji. Redukcija donjih nosnih školjki s diodnim laserom je minimalno invazivna i sigurna metoda koja se može provesti u lokalnoj anesteziji. Cilj rada je prikazati efikasnost redukcije donjih nosnih školjki diodnim laserom na temelju subjektivnih simptoma nazalne opstrukcije, nazalne sekrecije, glavobolje i smanjenog osjeta mirisa, te nalaza rinomanometrije.
Poremećaji disanja tijekom spavanja vrlo su česti i u odraslih i u djece. Opstruktivna apneja u s... more Poremećaji disanja tijekom spavanja vrlo su česti i u odraslih i u djece. Opstruktivna apneja u spavanju (OSA) najčešći je poremećaj disanja tijekom spavanja i ozbiljan javnozdravstveni problem. OSA je kronična bolest udružena s kardiovaskularnim i metaboličkim poremećajima. Prevalencija OSA kreće se između 2% i 4% u odrasloj populaciji. Dijagnoza OSA postavlja se cjelonoćnom polisomnografijom ili kardiorespiracijskom poligrafijom a endoskopskim pregledom gornjeg dišnog puta za vrijeme medikamentozno induciranog spavanja (eng. drug induced sleep endoscopy – DISE). Određujemo mjesto, težinu i konfiguraciju opstrukcije. Na temelju dobivenih nalaza moguće je planirati individualnu konzervativnu i kiruršku terapiju.
NeuroRehabilitation, 2019
BACKGROUND: The minimal number of studies have documented the impact of Vestibular rehabilitation... more BACKGROUND: The minimal number of studies have documented the impact of Vestibular rehabilitation (VR) on the recovery rate of patients with Chronic Unilateral Vestibular Hypofunction (CUVH) and Bilateral Vestibular Hypofunction (BVH). OBJECTIVES: The goal of the study was to show and compare the impact of vestibular rehabilitation (VR) in patients with CUVH and BVH. METHODS: We analysed the data of 30 patients with CUVH and 20 with BVH treated with VR. The patients with CUVH during their eight-week treatment were controlled every two weeks, while the patients with BVH were controlled every three months during their one-year treatment; they filled in the DHI and ABC questionnaires every time. RESULTS: In both groups of patients, there was significantly less disablement between the initial and final DHI scores (from 59-20 in CUVH and 74-41 in BVH group). There was a significant increase in the balance confidence between the initial and final ABC Scale in both groups of patients (from 49.5-90% in CUVH and 42-73% in BVH group). CONCLUSIONS: Well-planned and individually adjusted system of vestibular exercises leads to a significant decrease in clinical symptoms and improvement of functioning and confidence in activities in both the CUVH and the BVH patients.
The Laryngoscope, 2018
We present the case of a 27-year-old male who presented with vertigo when pressing the entrance o... more We present the case of a 27-year-old male who presented with vertigo when pressing the entrance of his right auditory meatus and exposing his right ear to loud noise. A diagnostic procedure revealed bilateral labyrinth weakness, which was confirmed by caloric and rotational testing. The ocular vestibular evoked myogenic potentials investigation demonstrated a significant weakness of the right utriculus, whereas the cervical vestibular evoked myogenic potentials were normal, indicating preservation of the saccular response. Radiologic studies did not show evidence of labyrinthine dehiscence. We suspect the newly described association of this clinical syndrome with the previously described histopathology of vestibular atelectasis accounts for these findings.
Brazilian Journal of Otorhinolaryngology, 2017
Introduction: Benign paroxysmal positional vertigo is the most common cause of dizziness in the g... more Introduction: Benign paroxysmal positional vertigo is the most common cause of dizziness in the general population. It is a condition with potential impact of reduced levels of vitamin D on its recurrent attacks. Objectives: The aim of this study was to measure the serum levels of 25-hydroxyvitamin D3 (25-OH D3) in patients with benign paroxysmal positional vertigo and determine whether there is a difference in the serum levels of vitamin D3 between patients with and without recurrence, as well as between the different clinical forms of benign paroxysmal positional vertigo. Methods: The study included 40 patients who came to the regular medical examination, diagnosed with posterior canal-benign paroxysmal positional vertigo based on the positive Dix-Hallpike's test. All patients underwent Epley manoeuvre after the diagnosis. Patients were classified according to current guidelines for levels of vitamin D3 in the serum in three groups: the deficiency, insufficiency and adequate level. Results: The average serum level of 25-OH D3 among respondents was 20.78 ng/mL, indicating a lack or insufficiency of the aforementioned 25-OH D3. According to the levels of 25-OH D3, most patients suffer from deficiency (47.5%). 7 (17.5%) respondents had adequate blood level of 25-OH D3, and 14 (35%) respondents suffer from insufficiency. A significant difference was
Diving and Hyperbaric Medicine Journal
Introduction: Previous studies suggest the effectiveness of hyperbaric oxygen treatment (HBOT) in... more Introduction: Previous studies suggest the effectiveness of hyperbaric oxygen treatment (HBOT) in idiopathic sudden sensorineural hearing loss (ISSNHL) but it is mostly used as an adjuvant and salvage treatment. This study evaluated the effect of primary HBOT according to pretreatment hearing grades and hearing recovery outcomes using modified Siegel’s criteria in patients with ISSNHL. Methods: Fifty-nine ISSNHL patients treated with only HBOT were included. A pure-tone audiogram was recorded before and after a course of HBOT (90 min at 203 kPa daily for 20 days). Using the modified Siegel’s criteria, patients were divided into groups according to hearing threshold before and after treatment. Results: Hearing thresholds were significantly lower after HBOT compared to pre-treatment values across all patients (P < 0.001) with a median value of recovery of 22.5 dB (interquartile range 12.5-33.7 dB). Significantly lower hearing threshold values were recorded at 500, 1,000, 2,000, and...
NeuroRehabilitation, 2020
BACKGROUND: Only a few studies in the literature demonstrate the effect of vestibular rehabilitat... more BACKGROUND: Only a few studies in the literature demonstrate the effect of vestibular rehabilitation (VR) on all vestibular receptor organs. Furthermore, very little evidence of the effect of VR on isolated otolith dysfunction (IOD) is available. OBJECTIVE: The study aimed to investigate the effect of VR on all vestibular receptor organs in patients with different types of unilateral vestibular hypofunction (UVH). METHODS: We enrolled 80 patients with three different types of UVH; combined and isolated loss of semicircular canal and otolith organ function. All patients performed a 12-week customized program of VR and received a full battery of vestibular function tests, before and after the VR. The DHI and SF-36 were performed before, after 6 weeks, and 12 weeks of the VR. RESULTS: Parameters of the caloric test, video head impulse test, ocular and cervical vestibular evoked myogenic potentials were significantly improved after VR. A total of 59 (74%) patients fully recovered, with ...
Acta Clinica Croatica, 2020
-Papillary thyroid cancer accounts for 80-85% of diagnosed thyroid cancers, while follicular, med... more -Papillary thyroid cancer accounts for 80-85% of diagnosed thyroid cancers, while follicular, medullary, and anaplastic cancers are diagnosed significantly less frequently. This study aimed to show the characteristics of malignant thyroid tumors. in this retrospective study, we analyzed data from 320 patients who underwent thyroid surgery from January 2018 to december 2019. We recorded and statistically analyzed basic demographic data, data of the cytological and pathohistological findings, and tumor characteristics (size, multifocality, extrathyroidal and lymphovascular invasion). Thyroid cancer was diagnosed in 95 patients. The incidence of thyroid cancer was higher in women than in men, but without a significant difference (p=0.46). There was a significant difference between preoperative cytological findings and definitive pathohistological diagnosis (p=0.001). There was no significant difference between genders in tumor size, extrathyroidal and lymphovascular invasion, and multifocality. There were significantly more thyroid cancers with a lymphovascular invasion that were less than 2 cm in size (p=0.04). in our opinion, it is important to emphasize the value of early diagnostics and analysis of the malignant tumor characteristics that are major prognostic factors for survival in patients with thyroid cancer.
Psychiatria Danubina, 2020