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Introduction Among cochleovestibular schwannoma (CVS) cases, unilateral multifocality is a rare phenomenon. Multifocal unilateral CVS occurring in the cerebellopontine angle (CPA), internal auditory canal (IAC), or inner ear has been documented in patients with neurofibromatosis 2-related schwannomatosis and those with mosaicism of the NF2 gene. Unilateral multifocal CVS of sporadic origin however appear to be extremely rare. Material and Methods In two adult patients with multifocal unilateral schwannomas of the inner ear and the IAC or CPA, the tumors were surgically removed in either a single or two-stage procedure. Hearing was rehabilitated with a cochlear implant (CI). Histological and genetic characteristics of each tumor were analyzed through immunohistochemistry and a 340-gene parallel sequencing panel. Next-generation sequencing of the NF2 gene was performed on unaffected tissue. Results Intraoperatively, both cases exhibited two unilateral, macroscopically distinct tumors. Genetic analysis of peripheral blood cells revealed no NF2 mutations. In Case 1, a pathogenic NF2 variant was found to be identical in both tumors. Conversely, NF2 variants differed between the tumors in Case 2. Word recognition score for monosyllables at 65 dB SPL with CI was 55% at 6 years follow up and 60% at 4.5 years follow up, respectively. Conclusion The occurence of multifocal unilateral cochleovestibular schwannomas without pathogenic NF2 variants in unaffected blood leukocytes can be linked to mosaic NF2-related schwannomatosis or sporadic mutations, which might be overlooked due to their extreme rarity. We were able to demonstrate that although being challenging, single or two-stage resections of both unilateral tumors in the inner ear and the IAC/CPA were possible with successful hearing rehabilitation with CI.
Julia Charlotte Reiber
Date of Birth: August 27, 1995, in Leipzig
Email: julia.reiber@uk-halle.de
Education:
• 6/2013: General University Entrance Qualification at Evangelical School Center (Grade 1.4)
• 10/2013-5/2020: Martin Luther University Halle, Medical Faculty
• 10/2015: First State Examination
• 4/2019: Second State Examination
• 5/2020: Third State Examination
Professional Experience:
• 07/2020-04/2021: Research Assistant, ENT University Hospital Halle
• Since 10/2020: Assistant Doctor, ENT University Hospital Halle
Julia Reiber 1, Dr. Jonas Scheffler 1, Prof. Dr. Katrin Hoffmann 2, Prof. Dr. Per Cayé-Thomasen 3, Prof. Dr. Sabrina Kösling 4, Dr. Sandra Leisz 5, Dr. Arne Liebau 1, Prof. Dr. Christian Mawrin 6, Prof. Dr. Torsten Rahne 1, Prof. Dr. Christian Strauss 5, PD Dr. Udo Siebolts 7, 8, , Prof. Dr. Stefan Plontke 1,
Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Germany 1
Institute of Human Genetics, Martin Luther University Halle-Wittenberg, University Medicine Halle, Germany 2
Department of Otorhinolaryngology, Head and Neck Surgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark 3
Department of Radiology, Martin Luther University Halle-Wittenberg, University Medicine Halle, Germany 4
Department of Neurosurgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Germany 5
Institute of Neuropathology, University Hospital Magdeburg, Magdeburg, Germany 6
Institute of Pathology, Martin Luther University Halle-Wittenberg, University Medicine Halle, Germany 7
Institute of General Pathology and Pathological Anatomy, Department of Molecular Pathology Diagnostics, University Hospital, Cologne, Germany 8
Introduction: Infratemporal approaches (IFT) are part of transtemporal approaches utilized to manage complex pathological processes affecting the lateral skull base. Methods: We retrospectively evaluated patients who underwent surgery for lateral skull base pathology using infratemporal approaches from January 2016 to December 2023 (men/women = 11/24; 7-77 years). Malignant tumors were treated in 8 cases (carcinoma: 2, sarcomas: 4, metastatic pleomorphic adenoma: 1, melanoma: 1), and benign tumors in 20 cases (paragangliomas: 14, meningiomas: 3, schwannomas: 3), petrous cholesteatoma: 6, and one aneurysm of the petrous segment of the internal carotid artery (ICA). Results: IFT A (21 cases) with VII nerve transposition was used for pathologies affecting the infralabyrinthine petrous bone, petrous apex, jugular bulb, and horizontal segment of the petrous ICA with potential intradural extension. The peel-off modification of anterior rerouting of the VII nerve preserved nerve function (HBS1) in most patients. The incidence of IX-XI nerve dysfunction was determined by the pathology type. IFT B (8 cases) with mobilization of the petrous ICA was used for pathologies extending medially from the horizontal and vertical parts of the petrous ICA to the central clivus. Preoperative balloon occlusion tests (BOT) and ICA stenting were performed in most patients. IFT C (1 case) was used for a malignant tumor spreading peritubally into the infratemporal fossa, nasopharynx, and parasellar region. IFT D (5 cases) addressed processes affecting the middle skull base with extra- and intracranial extension. Two patients experienced severe postoperative bleeding from the ICA after IFT A, with one case resulting in death. Conclusion: IFTs enable effective management of complex pathological processes affecting the lateral skull base. A multidisciplinary approach is optimal for minimizing complications. This work was supported by the research project of Charles University - Cooperatio 43 Surgical Disciplines.
Zuzana Urbaniova
CV is not available
Zuzana Urbaniova 1,
Urbániová Z. 1, Verešpejová L. 1, Trnková K. 1, Netuka D. 2, Charvát F. 2, Chovanec M. 1, 1 Charles University, Third Faculty of Medicine, University Hospital Královské Vinohrady, Department of Otorhinolaryngology, Prague, Czech Republic 2 Charles University, First Faculty of Medicine, Central Military Hospital, Department of Neurosurgery and Neurooncology, Prague, Czech Republic 1
Introduction Optimal position of the electrode array during a cochlear implant surgery is crucial for a performance outcome. Ideally, the array should be placed close to modiolus in the scala tympani with a minimal insertion trauma. An electrode position in the cochlea can be checked either electrophysiolocally (by ECoG, transimpedance matrix), or X-ray (fluoroscopy, HRCT, CBCT). Methodology So far, the electrode position after a surgery was checked in a surgical theatre by fluoroscopy only during one session. Nevertheless, there was a need to monitor an array insertion on-the-run. This requirement is fulfilled both by electrocochleography or by a transimpedance matrix algorithm. Results On a routine basis, an array insertion is monitored by electrocochleography in case of a certain number of surviving hair cells, or, de novo, by a transimpedance matrix. This method, which is company specific, is ideal for a detection of a tip-foldover in precurved arrays. Conclusions The transimpedance matrix algorithm is a reliable method, comparable with a fluoroscopy, to detect anomalous intracochlear position of the electrode array during a cochlear implantation.
MUDr. Jiří Skřivan CSc.
CV is not available
MUDr. Jiří Skrivan , CSc.1, MUDr. Jurovcik Michal 1, MUDr. Aksenova Zdenka , Ph.D.1, Ing. Oklusky Miroslav 1, Ing. Bauer Lukas 1, Doc. MUDr. Cada Zdenek , Ph.D.1,
Department of Otorhinolaryngology, The Second Faculty of Medicine, Charles University in Prague, University Hospital in Motol 1
The aim of the presentation is to describe the differences between canal wall up and canal wall down middle ear surgeries with an emphasis on the differences in audiological results. Medical records of 47 patients who had a primary surgery due to middle ear cholesteatoma between December 2019 and December 2023 were reviewed retrospectively. Hearing thresholds of CWU and CWD surgeries were compared.
MUDr. Martin Huška
Martin Huška, M.D.
Mailing adress
Department of Otorhinolaryngology Head and Neck Surgery
Hospital České Budějovice
B. Němcové 585/54, 370 01, České Budějovice
e-mail: huska.martin@nemcb.cz
Cell phone: +420 775 247 654
Born
18th March 1990
Degrees
2020 Postgraduate diploma in Otorhinolaryngology and Head and Neck Surgery
2009 – 2015 2nd Faculty of Medicine in Prague, Charles University, Prague (M.D.)
Working experience
From 2020 Department of Otorhinolaryngology Head and Neck Surgery,
Hospital České Budějovice, Consultant
2015 – 2020 Department of Otorhinolaryngology Head and Neck Surgery,
Hospital České Budějovice, Resident
2010 – 2011 Department of Histology and Embryology, Charles University, 2nd Faculty of
Medicine in Prague , Lecturer of practical training
Martin Huška 1,
Department of Otorhinolaryngology and Head and Neck Surgery, Ceske Budejovice Hospital 1
Introduction: Canal wall down (CWD) mastoidectomy is a surgical technique used for successful eradication of middle cholesteatoma. The remaining open tympanomastoid cavity is often associated with several problems. To prevent them obliteration technique was described using synthetic or autologous material. Further, a favourable effect on hearing loss is expected. In our study, we focused on type of tympanoplasty on hearing gain after CWD mastoidectomy with mastoid obliteration. Methods: In our retrospective study a total of 100 patients underwent CWD with mastoid obliteration at our ENT department in 2017-2023. 36 patients were obliterated during the first surgery (primary obliteration) and 64 of them during revision surgery (mostly after CWD mastoidectomy without obliteration – secondary obliteration). Every patient underwent pure tone audiometry preoperatively and 3-6 months postoperatively - PTAs and mean ABGs were obtained. Data were statistically evaluated. Results: 42 women and 58 men were included, mean age of 42 years. We operated on 49 left ears and on 51 right ears. As a material of obliteration we used in 29 patients bioactive glass and in 71 bone paté. Partial obliteration (excluding epitympanum) was performed in 28 cases and total (including epitympanum) in 71 cases. In the reconstructive part of otosurgery we used PORP in 40 cases, TORP in 37 and only myringoplasty in 7 cases; 16 patients needed no reconstruction. A statistically significant difference in hearing gains was observed in type of tympanoplasty. Mean hearing gains in PTA postoperatively in myringoplasty, PORP and TORP were 3,6;10,6;12,2 dB (p<0,01); mean differences of ABG in myringoplasty, PORP and TORP were 4,4;7,5;10 dB (p<0,1). Conclusion: The type of tympanoplasty represents an important factor in hearing outcomes.
MUDr. Lukas Dvorak
CV is not available
MUDr. Lukáš Dvořák 1, MUDr. Iva Bártová 1, Mgr. Petra Macounová 3, MUDr. Jan Vodička , Ph.D1, 2, ,
Department of Otorhinolaryngology and Head and Neck Surgery, Hospitals of the Pardubice Region - Pardubice hospital, Pardubice, Czech Republic 1
Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic 2
Department of Epidemiology and Public health, Faculty of Medicine, University of Ostrava 3
MRI using 3D-T2 heavily weighted sequence and 3D-T1 thin slices sequence after a contrast application is a golden standard for imaging of vestibular schwannoma. The goal of imaging is to prove/exclude involvement of internal auditory canal (IAC) or cerebellopontine angle (CPA), differential diagnosis particularly CPA meningioma and facial nerve schwannoma, staging (Koos classification). Therefore MRI would help to plan a treatment strategy – either wait and scan, surgical approach (retrosigmoid, subtemporal, translabyrintine) or Leksell gamma knife (LGK). MRI is used to follow patients usually every 1 year, either who are undergoing the wait and scan algorithm or after treatment. The knowledge of a surgical technique (potential graft application) and behaviour of a tumour after LGK is an important information for evaluation of a possible recurrence of a tumour or regrow of tumour residuum. Detailed clinical information allows better evaluation of an imaging finding.
Transpetrosal approaches represent lateral transbasal routes They often allow access to midline lesions without significant manipulation of the brain, thereby reducing the risk of new postoperative neurological deficits. These approaches frequently provide better visualization of anatomical structures and enable more radical surgical resection. Additionally, they can be combined with other commonly used approaches. Depending on which part of the petrous bone is resected, these approaches are classified into anterior, posterior, and combined petrosal approaches. In recent years, we have been performing surgeries requiring petrous bone resection in cooperation with ENT surgeons. Particularly for large lesions, surgeon rotation is highly beneficial, allows the surgeon to keep full concentration throughout the procedure. Posterior petrosal resection involves partial resection of the petrous pyramid to allow access to the petroclival region, the anterior cerebellum, and the brainstem at the level of cranial nerves III-VIII. There are several variations of posterior petrosal resection, differing in the extent of the petrous bone resected. retrolabyrinthine, translabyrinthine, transotic, and transcochlear approaches. In our patient series, we have always been able to resect the lesion using a conservative retrolabyrinthine approach, or occasionally a combined anterior and posterior petrosal resection. Anterior petrosal resection (Kawase approach) - involves drilling off the petrous apex, allowing direct subtemporal access to the anterolateral pons and the peritrigeminal safe entry zone for brainstem lesions. This approach also allows for the elegant removal of tumors in the Meckel's cave region. The main use of transpetrosal approaches are surgeries of petroclival and cerebellopontine angle lesions. Particularly for large tumors with brainstem deviation extending beyond the midline and significant mass effect in the posterior fossa, these approaches reduce complications caused by retraction, ischemia, and separation of the tumor from brain tissue. They are also useful for lesions with supratentorial extension and similarly for meziotemporal tumors and pseudotumors. For lesions in the ventrolateral pontine region, petrosal approaches, whether anterior or combined petrosectomy, allow for wide and multi-angled access to the peritrigeminal safe entry zone to brainstem.
MUDr. Kroupa Robert
CV is not available
MUDr. R. Kroupa 1, MUDr. M. Formanek , Ph.D.2, MUDr. M. Macejka 1, MUDr. E. Misiorzová 1, MUDr. P. Seichter 1,
Department of Neurosurgery, City Hospital Ostrava-Fifejdy 1
Department of Otorhinolaryngology, City Hospital Ostrava-Fifejdy 2
The first specialized elective lectures on otology at the Charles-Ferdinand University in Prague were organized by the Czech German lecturer Ferdinand Artl from 1843 to 1854. These lectures, the first of their kind in the Austrian monarchy, primarily focused on the anatomy of the ear. Among their participants was Anton von Tröltsch, the founder of German otolaryngology, whose ideas later influenced Prof. Emanuel Zaufal. In 1869, Prof. Zaufal introduced otology education for medical students at the Prague Medical Faculty, a field that had not been represented at the university until then and was little respected by both the public and the medical community. Thanks to Prof. Zaufal's efforts, otology was established as a respected discipline at the university. Thus, Prague became one of the first medical faculties in Europe where the issue of ear diseases was systematically taught. After several difficulties, the ear clinic was opened on May 1, 1874, and after the university was divided in 1882, it was assigned to the German Medical Faculty. Thanks to this clinic, a number of specialists were trained, among whom the first protagonists of Czech otolaryngology were constituted – Assoc. Prof. Czarda, Prof. Kaufmann, and Prof. Kutvirt. These experts were at the birth of the otological-pharyngological clinic, which was founded on May 15, 1892, at the Czech Medical Faculty of Charles-Ferdinand University in Prague. At the German otolaryngological clinic, which operated until the end of World War II, significant experts such as Otto Piffl (Prague), Karl Amersbach (Düsseldorf), Leonhard Kraus (Marburg), Karl Mündnich (Mainz, Münster), and Rudolf Link (Berlin, Hamburg) worked. Czech and German otolaryngology are historically closely linked and interdependent. It is important to remember this cooperation and continue to develop mutual relationships based on it.
MUDr. Ivan Kalivoda MBA
Absolvent Lékařské fakulty Univerzity Palackého v Olomouci a oboru managementu zdravotnictví na Central European Management Institute Praha. Od roku 2012 pracuje na Oddělení otorinolaryngologie a chirurgie hlavy a krku Nemocnice AGEL Nový Jičín, od roku 2020 jako zástupce primáře. Složil evropskou atestaci z oboru otorinolaryngologie a chirurgie hlavy a krku. Postgraduálně se vzdělával na předních českých i zahraničních odborných pracovištích (Praha, Řím, Würzburg, Salzburg, Londýn). Je členem České lékařské komory, členem České společnosti otorinolaryngologie a chirurgie hlavy a krku ČLS JEP, členem České kooperativní společnosti pro nádory hlavy a krku a Evropské rinologické společnosti. Je hlavním autorem jedné monografie, publikoval přes 20 prací v odborných časopisech i sbornících a obdobný počet přednášek, podílel se jako spoluřešitel jednoho grantu.
Působí jako předseda revizní komise OS ČLK Nový Jičín. Je držitelem licence ČLK k výkonu soukromé praxe a lektora v oboru otorinolaryngologie a chirurgie hlavy a krku, licence k výkonu funkce vedoucího lékaře a primáře v oboru otorinolaryngologie a chirurgie hlavy a krku a diplomu celoživotního vzdělávání ČLK. Mluví anglicky a německy.
Ivan Kalivoda 1,
Department of ENT Head and Neck Surgery, Nemocnice Novy Jicin, Czech Republic 1
Surgical therapy of sinonasal cancer – external/endonasal approaches (case reports) M. Plášek, M. Formánek Introduction Sinonasal malignancies make up <5% of all head and neck neoplasms, with an incidence of 0.5-1.0 per 100,000. Symptoms like nasal obstruction, secretion, epistaxis, hyp/anosmia are typical for these neoplasms, especially when asymmetric. We present surgical therapy of 3 patients with exhibition both – external and endonasal approaches. Case reports 1) 74- year old male visited our ENT outpatients clinic with nasal obstruction on both sides lasting 6 months. Examination (including CT/MRI scans) showed tumor infiltration of external nose, nasal cavities and top of the hard palate, histology: spinocellular carcinoma. External approach was used in radical resection, adjuvant radiotherapy followed. After 6 months, patient is without relaps, epithesis of external nose is going to be made (3D print). 2) 74- year old male with pain and erythema of external nose was referred from local ENT outpatients to our department. At first, condition looked like phlegmon of external nose with septal hematoma, conservative therapy was without improvement. Biopsy proved spinocellular carinoma. CT/MRI showed tumor infiltration of external nose, nasal septum (both sides). External approach was used in radical resection, adjuvant radiotherapy followed, after 6 months patient is without relaps, epithesis of external nose is going to be made. 3) 79-year old male came to our outpatients with nasal obstruction on the left side and repeated epistaxis. Endoscopy showed black tumor attached to nasal septum without infiltration of lateral nasal wall and hard palate (also according to CT/MRIs), biopsy proved mucosal melanoma. Endonasal endoscopic radical resection was done, short follow up is without persitence of the tumor with good local healing, adjuvant imunotherapy is considered. Conclusion Best therapeutic results (5-year survival) in patients with sinonasal malignancies are achieved with radical surgical resection + adjuvant radio(chemo)therapy. We present surgical therapy of 3 patients from our department in last 6 months with exhibition both – external and endonasal approaches. Marek Plášek, MD Otorhinolaryngology head and neck surgery Městská nemocnice Ostrava marek.plasek@mnof.cz
MUDr. (MD) Marek Plášek
Otorhinolaryngologist and HN surgeon (especailly rhinosurgery) with 10 years of practice.
Work Experience:
Medical Doctor (Consultant), ENT department, City hospital Ostrava (January 2024 - Present).
Medical Doctor (Consultant), ENT department, Hospital Frýdek-Místek (2022 - 2023).
Medical Doctor (Consultant), ENT department, University hospital Ostrava (2020 - 2021).
Medical Doctor, ENT department, University hospital Ostrava (2016 - 2020).
Medical Doctor, Hospital Frýdek Místek (2015 - 2016).
Intership at ENT department, St. Barbara's Hospital, Hamm, GER (December 2019 - December 2019).
Intership at ENT department, University Hospital Kuopio, FIN (March 2017 - March 2017).
Admin of ocal web and social media - Czech ORL society (2018 - 2021).
Lector of ENT, Faculty of Medicine, University Ostrava (2018 - 2021).
Education: Specialisation exam (Otorhinolaryngology and head and neck surgery) (October 2020).
Specialisation exam (Somnology, Sleep apnea) (September 2021).
MUDr. (M.D.), Faculty of Medicine, Masaryk University, Brno (2015).
Hobbies: Running, Ice-hockey, Basketball, Formula 1.
MD Marek Plášek 1, MD Martin Formánek , PhD, MBA1,
Městská nemocnice Ostrava 1
Introduction: Myxoma, first described by Virchow in 1871, is a rare mesenchymal tumor that predominantly affects the heart's atrium but can also occur in various tissues such as bone, skin, muscle, and subcutaneous tissues. Myxomas are typically found in the mandible, maxilla, and facial soft tissues in the head and neck region, with rare occurrences in the nasal cavity and paranasal sinuses. Nasal myxomas, though uncommon, should be considered in the differential diagnosis of nasal masses, especially when common etiologies do not fully explain the clinical presentation. This article discusses a unique case of a nasal myxoma that extensively involved all paranasal sinuses and the anterior skull base, emphasizing the importance of a thorough diagnostic and surgical approach for such rare conditions. Methodology: A 16-year-old male patient presented with progressive bilateral nasal obstruction over several years, which worsened notably in the last two years. Initial evaluations elsewhere suggested antrochoanal polyps, but MRI imaging at our clinic revealed a large expansile mass in the nasal cavity extending toward the anterior cranial fossa. The mass measured approximately 10 cm cranio-caudally and 6.4 cm transversely at the level of the anterior cranial fossa, demonstrating marked hyperintensity on T2-weighted MRI and facilitated diffusion on diffusion-weighted imaging. An endoscopic biopsy confirmed the diagnosis of myxoma. Despite the benign nature of the tumor, its locally invasive behavior and extension into the anterior skull base necessitated a comprehensive surgical approach. Results: The surgical procedure involved meticulous removal of the myxoma through a combination of middle meatus exploration and a posterior approach to access the anterior skull base. During the surgery, the tumor was successfully resected up to the dura mater, although an intraoperative cerebrospinal fluid (CSF) leak occurred due to defects in the anterior skull base. The defect was repaired using temporal fascia and muscle with a layered approach. Despite achieving a wide resection, complete gross total resection was not possible due to the extensive nature of the tumor and intraoperative complications. Postoperative management included monitoring for CSF leakage and addressing potential complications related to the extensive resection. Conclusions: This case underscores the importance of considering nasal myxoma in the differential diagnosis of nasal masses in adolescents, particularly when conventional diagnoses do not fully account for the clinical symptoms. Advanced imaging techniques like MRI are crucial for accurate diagnosis and surgical planning. Early diagnosis and intervention are vital for managing nasal myxomas due to their invasive nature and potential for significant complications. This case highlights the challenges in managing extensive nasal myxomas and the need for a multidisciplinary approach to ensure optimal surgical outcomes and long-term follow-up to monitor for recurrence and assess functional outcomes. Continued research is necessary to refine treatment strategies for these rare and complex tumors.
Resident Doctor Enes Dogan MD, MRCS(ENT)
2013-2019 Medical Degree-Istanbul University Cerrrahpasa Medical Faculty
2020-Now Specialty Training- Hacettepe University Hospital, Department of ENT
2023- Member of Royal College of Surgeons of England, MRCS ENT
2023- Member of European Rhinology Society
2021- Member of Turkish Otolaryngology Society
Mr Enes Dogan , MD, MRCS ENT1, Mr Serdar Ozer , Prof.1,
Hacettepe University Hospital, Department of Otorhinolaryngology and Head and Neck Surgery 1
Epistaxis is a potentially life-threatening condition. It is a very common condition with a high frequency in our ENT praxis and it requires urgent treatment. The prevalence of epistaxis in the general population is approximately 12%, but only 10% of the patients with epistaxis seek medical attention. The majority of patients treated in the ENT clinic profit from the conservative treatment of epistaxis, only approximately 1% of all patients reach surgical treatment during hospitalization. Our ENT department of the Rudolf and Stefania Hospital in Benešov treated 1621 cases of epistaxis from 1/1/2021 to 30/6/2024. Only 27 patients had to be treated during hospitalization, of which 10 were revised surgically - mainly coagulation of sphenopalatine artery. In the follow up 9 patients were without further surgical revision. Indications for surgical revision is based on many aspects and the condition of the patient, which is often life-threatening. The lecture presents the case report of the patient in whom surgical treatment was combined with interventional embolization. Both methods had their successes, but also undesirable complications, which in the postoperative period affected the patient's quality of life.
MUDr. Michal Sisák
2015 – 2021 všeobecné lékařství, 2. Lékařská fakulta, Univerzita Karlova
2021 - zařazen do specializačního vzdělávání v oboru otorinolaryngologie a chirurgie hlavy a krku
od 8/2021 - sekundární lékař na oddělení ORL a chirurgie hlavy a krku, Nemocnice Rudolfa a Stefanie Benešov
od 2018 - lektor anatomie na fakultě tělesné výchovy a sportu, Univerzita Karlova
stáže:
7/2021 - 4 - týdenní stáž - department of Otolaryngology, American University of Beirut, Faculty of medicine and medical center
5/2023 - týdenní stáž - klinika ORL a cervikofaciální chirurgie v Paříži
MUDr. Michal Sisák 1, prim. MUDr. Adam Kešner 1,
Oddělení ORL a chirurgie hlavy a krku Nemocnice Rudolfa a Stefanie Benešov 1
Introduction Sinonasal inverted papillomas (SIPs) are uncommon benign tumours arising from the Schneiderian membrane of the nasal cavity and paranasal sinuses, typically in the maxillary and ethmoid regions. Although they are considered as benign lesions, they are locally aggressive and with potential for malignant transformation. SIPs typically present with symptoms such as nasal obstruction and epistaxis. Surgical resection is the primary treatment modality for SIPs, with approaches ranging from endoscopic techniques to open surgery, depending on the extent and location of the tumour. Methods This retrospective study was conducted at St. Anne’s University Hospital, Brno, Czech Republic, covering the period from 2012 to 2022. It analysed data from 66 patients who were diagnosed with SIPs, focusing on demographics, clinical manifestations, treatment methods, histopathological results, and postoperative outcomes. The primary objective was to evaluate recurrence rate and the incidence of malignant transformation. Results Patients included 24 males and 42 females, with an average age of 57 years. Key symptoms included unilateral nasal obstruction (54 cases) and epistaxis (24 cases). Predominant tumour sites were the maxillary sinus (34 cases) and ethmoid cells (16 cases). Histopathological examination identified predominantly benign tumours (63 cases), malignant transformation was observed in 4.55% (3 cases), all synchronous. Most tumours were classified as Krouse stage III (30 cases), recurrence rate was 28.1% (16 cases). Surgical interventions comprised endoscopic resection (55 cases), combined approaches (10 cases), 1 patient was primarily treated by radiotherapy due to inoperability after histopathological verification of malignancy in SIP environment. The average disease-free interval was 21 months, with patients without recurrence followed up for an average of 28 months. Conclusion In conclusion, our study focused on sinonasal inverted papillomas, showing that most were benign with mostly unilateral nasal obstruction. The tumours were commonly found in the maxillary sinus and were typically surgically removed at an advanced stage. Patients generally remained free of the disease for 21 months after treatment.
MUDr. Vlastimil Vlček
Resident at Clinics of ENT-HNS at FNUSA Brno, with aim on rhinology and rhinosurgery, usage of biologics in treatment in rhinology.
MUDr. Vlastimil Vlček 1, MUDr. Jan Hanák , Ph.D.1, doc. MUDr. Břetislav Gál , Ph.D.1,
Klinika otorinolaryngologie a chirurgie hlavy a krku, FNUSA Brno 1
Introduction: The authors present a single centre results of skull base defect reconstruction with vascularized pedicled flaps. Methods: Results of skull base defect reconstruction with vascularized pedicled flaps (nasoseptal flap or pericranial flap) performed from 2010 to June 2024 were reviewed retrospectively and rate of postoperative cerebrospinal fluid leak (CSF) was assesed, according to the type of flap, diagnosis and type of approach. Results from 2010-2016 and 2017-2024 were compared to asses the learning curve. Results: A total of 139 surgeries with skull base reconstruction with a pedicled flap were performed from 2010 to June 2024, in 75 females and 64 males, mean age 53 (min. 5, max. 79). The most frequent diagnoses were meningioma (47/139, 33,8 %), craniopharyngioma (20/139, 14,4 %) and spontaneous CSF leak (14/139, 10,1 %). Total rate of postoperative CSF leak was 10,8 %, with all the cases of CSF leak occuring in reconstructions using nasoseptal flap (15/133, 11,2 %). No postoperative CSF leak occured in cases in which a pericranial flap was used. According to diagnosis, postoperative CSF leak occured most frequently in meningiomas (6/47, 12,7 %). According to approach, CSF leak was the most frequent in transcribriform approach (4/29, 13,8 %), and according to the time period, it occured more frequently in 2010-2016 period (8/53, 15,1 %), compared to the 2017-2024 period (7/86, 8,1 %). Conclusions: Skull base reconstruction with vascularized pedicled flaps is a safe and highly effective technique, superior to free grafting techniques. It can be used safely and with good functional results in numerous pathologies of anterior and middle skull base indicated for transnasal endoscopic surgery. The presented results are consistent with the current published data.
MUDr. Lenka Čábalová Ph.D.
An otorhinolaryngology consultant at Department of Otorhinolaryngology and Head and Neck Surgery of University Hospital Ostrava, focusing on transnasal endoscopic skull base surgery, rhinology and lacrimal pathway surgery.
MUDr. Lenka Čábalová , Ph.D.1, 2, , doc. MUDr. Petr Matoušek , Ph.D., MBA1, 2, , prof. MUDr. Radim Lipina , Ph.D.3, 4, , MUDr. Tomáš Krejčí , Ph.D.3, 4, , prof. MUDr. Pavel Komínek , Ph.D., MBA1, 2, ,
University Hospital Ostrava, Department of Otorhinolaryngology and Head and Neck Surgery 1
University of Ostrava, Faculty of Medicine, Department of Craniofacial Sciences 2
University Hospital Ostrava, Neurosurgery Department 3
University of Ostrava, Faculty of Medicine, Department of Clinical Neurosciences 4
Rhinophyma is the end stage of acne rosacea. There is no evidence-based study justification association with alcohol. Mainly Caucasian men at the age of 50 and above are affected. Rhinophyma can cause major psychosocial problems for the patients due to an extreme disfigurement of the nose and a functional impairment with nasal airway obstruction. Surgery remains the mainstay of treatment. Detailed histo-pathological analysis of the excised tissue is a must as rhinophyma can mask an underlying malignancy.
The maxillary sinus represents a common area of interest for dental implantologists and otorhinolaryngologists. The mass of residual bone in the lateral (subantral) region of the upper jaw is often insufficient. Thus, the insertion of implants may require bone augmentation, typically by the sinus lift method. The aim of the lecture is to summarize the indications of the procedure, techniques and possible complications.
The first part will discuss anatomical notes of rhinobasis. We will analyze the causes of cerebrospinal fluid leakage through damaged meninges. The lecture will then proceed towards the diagnosis of cerebrospinal fluid leakage into the nasal cavity or paranasal sinuses, including the precise localization of meningeal fistulas leak. In the next phase of the lecture, the closure of the fistula with a plug of mesenchymal tissue will be described, as well as the use of multiple layers, including a locking system utilizing cartilage or bony plate. At the end of the lecture, there will be notes on treatment and subsequent care.
Obstructive sleep apnea is a complex disease with multifactorial causes, therefore the approach to its treatment must also be comprehensive. Reduction to a mere mechanistic idea of the causes and thus the therapy of the disease with a simple surgical procedure can be a big mistake and can harm the patient as a result. Yet this approach is still encountered. Non-surgical treatment options for OSA focus on alleviating symptoms and improving patients' quality of life. The so-called regimen measures are very often underestimated, although it is the first thing we should always start with and only then consider surgical treatment. Adjustments in diet, weight reduction, regular exercise, and avoiding alcohol and sedatives can significantly improve the condition of OSA patients. Sleep hygiene and positional therapy (e.g., sleeping on one's side) can also help reduce symptoms. However Continuous Positive Airway Pressure (CPAP) is the most common and effective treatment for OSA. Other possibilities are also oral appliances, upper airway muscle training and even some kind of pharmacotherapy. Non-surgical treatment options for OSA provide patients with effective alternatives to surgical interventions, reduce the risk of complications, and can be tailored to the individual needs and preferences of patients. Optimal treatment often requires a combination of different approaches and multidisciplinary collaboration among healthcare providers from various specialties.
MUDr. Jaroslav Kraus Ph.D., LL.M., MBA
MUDr. Jaroslav Kraus, Ph.D., LL.M., MBA (nar. 1972) po studiu na 1. lékařské fakultě UK nastoupil na ORL oddělení Fakultní nemocnice Na Bulovce v roce 1996. Od roku 1999 pracoval na Klinice otorinolaryngologie a chirurgie hlavy a krku 1. LF UK a FN Motol a v témže roce úspěšně složil atestační zkoušku I. stupně z otorinolaryngologie, v roce 2003 potom II. stupně. V letech 2001-2002 působil v Evropském Institutu Onkologie v italském Miláně se zaměřením na onkologickou a rekonstrukční chirurgii hlavy a krku. Od roku 2005 byl 15 let primářem oddělení ORL a chirurgie hlavy a krku Nemocnice Rudolfa a Stefanie Benešov, jehož součástí je akreditovaná Spánková laboratoř. V roce 2008 složil akreditační zkoušky ze somnologie. Absolvoval studia na Academy of Health Care Management v oborech management ve zdravotnictví a medicínské právo a bioetika. Je držitelem funkční licence F016 umělá výživa a metabolická péče. Doktorandské studium na LF MU Brno v oboru otorinolaryngologie úspěšně ukončil v roce 2016. Je vedoucím Sekce lůžkových oddělení České společnosti ORL a chirurgie hlavy a krku ČLS JEP. Přes dva roky pracoval na ORL oddělení Fakultní Thomayerovy nemocnice, kde pomohl vybudovat Spánkové centrum FTN a stále zde na částečný úvazek působí. V současné době pracuje na ORL klinice Fakultní nemocnice Královské Vinohrady a 3. LF UK.
MUDr. Jaroslav Kraus , Ph.D., LL.M., MBA1, 2, ,
Otorinolaryngologická klinika FN Královské Vinohrady a 3. LF UK, Praha 1
Spánkové centrum FTN, Oddělení ORL a chirurgie hlavy a krku, Fakultní Thomayerova nemocnice, Praha 2
Introduction: The current diagnostic scheme for obstructive sleep apnea (OSA) uses polysomnography or limited polygraphy and requires specialized personnel and equipment. Glycoprotein biomarkers and microRNAs are one of the potential new screening methods. The aim of this study was to evaluate whether some biomarkers and microRNAs in patients with OSA may be influenced by factors such as gender, age and obesity level. Methods: A retrospective analytical study included 130 patients with moderate and severe OSA. The control group consisted of 81 healthy subjects. Serum levels of selected biomarkers and microRNAs were collected in both groups. The group of OSA patients was then stratified according to gender, obesity level and age, and the possible influence of these variables on biomarker levels was investigated. Results: Levels of all studied biomarkers - C-reactive protein (CRP), high-sensitivity troponin I (hsTnI) and pentraxin-3 (PTX-3) - and microRNA-499 were significantly higher in OSA patients compared to controls. In the OSA group, only hsTnI showed a statistically significant relationship with gender. CRP and hsTnI levels showed a significant relationship with obesity level. Age dependence was demonstrated for hsTnI. CRP, PTX-3 and microRNA-499 had no statistically significant association to age. Conclusion: Serum levels of pentraxin-3 and microRNA-499 in patients with moderate and severe obstructive sleep apnoea are independent of gender, obesity level and age. CRP was affected by the degree of obesity, and hsTnI was affected by all 3 variables. We consider these findings important for further research on biomarkers of OSA
MUDr. Tomáš Kostlivý Ph.D.
Born 1989 in Pilsen. Graduated from the Faculty of Medicine in Pilsen, Charles University in 2015. The topic of his dissertation were innovative methods in the diagnosis of obstructive sleep apnea. He continues his research in this area. Since 2017 he has worked as a physician and since 2024 as an assistant professor at the Otorhinolaryngology Department of the Faculty of Medicine and University Hospital in Pilsen. In addition to sleep medicine, he focuses on otology.
Tomáš Kostlivý , M.D., Ph.D.1, Michal Riant , M.D.1, Pavel Klail , M.D.1, assoc. prof. David Slouka , M.D., Ph.D., MBA1,
Department of Otorhinolaryngology, Faculty of Medicine in Pilsen, Charles University, Czech Republic 1
History of microbiome research, global dimensions of the super epidemic, the human microbiome project, the microbiome in the course of life, the gut microbiome and its interactions, QM of the laboratories involved, microbiome and cancer, the gut-brain axis, the microbiome and the immune system, microbiome in interaction with antibiotics and xenobiotics, antibiotics - do's and dont's, news on faecal microbiome transfer, outlook: renewing the microbiome
Dr.med. Stephan Dr Hohner
Born 1963 in Oberhausen, married, four children
Baccalaureate 1983 in Oberhausen
Joined the German Armed Forces in 1983
Studied human medicine at the University-GHS Essen 1983-1989
Graduated with III. state examination 1989
Dissertation at the University-GHS Essen, 1990 (topic: Sonographically assisted fine needle punctures of peripheral lung tumours)
Internship, ENT department of the German Armed Forces Hospital Hamm 1989/90
Assistant doctor, ENT department, German Armed Forces Hospital Detmold 1990/1991
Regimental doctor, Medical Regiment 7 in Hamm 1992-1997
Assistant doctor in the ENT department of the St Barbara Clinic, Hamm-Heessen 1993-97
Training as a doctor for naturopathy 1994-1997
Training in classical homeopathy
Training in manual medicine/chiropractic therapy 1995-1998
Acquisition of specialist qualifications in emergency medicine and radiation protection 1992
Since 1998 in the joint practice for ENT medicine of Dr Bertram/Hohner, since 2017 with a new partner Dr Bayer
Specialisations:
Specialised ENT surgery in children
Nasal and paranasal sinus surgery
Manual medicine
Homeopathy/naturopathy
Attending physician at St Marien Hospital in Ahaus and outpatient operations at the Gescher practice clinic
Memberships:
Scientific society for ENT and head &neck surgery
Professional association of ent physicians
Regional Chairman of the professional ent physicians
Member of the parliament of the association of statuatory health insurance physicians
Stephan Hohner 1,
Hohner, Stephan MD , Ambulatory ENT clinic , 48712 Gescher 1
Hoarsness , cough, throat clearing, lump in a throat etc. are the common symptoms bringing the patients to the ENT specialist. Many of them leaving with the diagnose of laryngopharyngeal reflux (LPR) and given empirical treatment with PPI (Proton Pump Inhibitor) medication. Is the reflux always the cause of the symptoms? Extensive research in the field of LPR was done in recent years and more reliable diagnostic tools are available in the practice. On the top of that The Dubai Definiton and Diagnostic Criteria of Laryngopharyngeal Reflux: The IFOS Consensus was published earlier this year. Several case reports are presented, where the initial diagnose of LPR was misleading. After detailed diagnostic workout including 24h oropharyngeal pH testing, surprising findings were observed.
Renata Taimrova MD
Dr.Taimrova finished her ENT Residency at ENT Dept. of FTN and Dept. of ORL HNS, 1st. Medical Faculty, Charles University, Prague. After that she started to work as an ENT specialist in private practice with dr.Fort. She spent 10 months as visiting clinician at Dept. of ORL HNS at Mayo Clinic during her stay in Rochester, MN, USA, between 2000 - 2002. From 2005 to 2017 she lived in Rotterdam, The Netherlands, where she practice as an ENT specialist and specialised herself in laryngology (Sint Franciscus Gasthuis, Ijssel Kliniek, Rotterdam).
Since 2017 she works back in Prague in FortMedica s.r.o. Private ENT Practice as an ENT specialist and Medical Executive Officer.
Renata Taimrova 1,
FortMedica s.r.o., ENT Private Practice, Prague 1
Abstract Background: There is rising literature evidence on monocular vHIT directional bias. Our previous normative study on binocular video head impulse test (bvHIT) found that recording both eyes simultaneously is preferable over one eye (monocular) recording, because of minimizing the monocular directional bias. Purpose: To investigate whether there are differences in VOR gains between adducting (AD) and abducting (AB) eye movements in patients with a unilateral vestibular deficit (UVL) and to define the most precise VOR measure in those. Setting: Tertiary referral center. Methods: We enrolled 60 UVL patients and 44 healthy adult participants in a cross-sectional, prospective study using a repeated-measures design to assess bVHIT test-retest reliability in UVL. An EyeSeeCam Sci 2 device was used to record bvHIT during impulsive testing in the horizontal plane. Results: In UVL patients, the monocular assessment with the camera placed over the eye ipsilateral to the deficit (lesion side recorded during AD, healthy side in AB) resulted in mean gains of 0,52 (SD 0.06 ) ipsilesional and 0,82 (0.06) healthy side, respectively, with an asymmetry of 26%. With the camera placed contralesionally (deficit side in AB, healthy side in AD), the mean gains were 0,43 (0.05) and 0,92 (0.06), with an asymmetry of 41%. Binocular assessment showed AD- and AB-related asymmetries of 32% and 34%, respectively. Conclusions: Our study provides results from UVL patients reflecting the conjugacy of eye movement responses to horizontal bvHIT. In a previous study, we found larger VOR gains in AD compared to AB. We found a similar pattern in UVL patients. A monocular analysis showed a reduced asymmetry for the ipsilesional camera placing and an increased asymmetry for the contralesional camera. Therefore, ipsilesional camera placement can increase false negatives while contralesional camera placement can increase false positives. To reduce monocular vHIT directional bias and to gain the most accurate asymmetry measurement, we recommend the use of duction-related (AD or AB) VOR gains recorded from both eyes simultaneously during bvHIT.
MUDr. Maja Striteska
ENT doctor, DSP neurology student.
MD Maja Striteska 3, prof. Erich Schneider 4,
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove 3
Institute of Medical Technology, Brandenburg University of Technology Cottbus-Senftenberg, Cottbus, Germany 4
Background/Introduction: Obstructive sleep apnea (OSA) affects nearly 1 billion people worldwide. Surgery is variably effective and patients should be indicated very selectively. This study summarizes and presents our personal experience with TORS (not only) for OSA treatment, with the aim to provide information regarding its safety, efficacy, postoperative complications and its role in the Health system in Czech Republic. Methods: Our experiences with TORS surgery started in 2023 obtaining DaVinci Xi system. TORS is nowadays considered a common surgical minimally approach for Base of Tongue (BOT) reduction in cases of OSA due to a lingual tonsil obstruction. Furthermore, this procedure can be combined with other techniques, such as tonsillectomy, pharyngoplasty and many others in cases of a multilevel obstruction. Our patients have followed the standart indication protocol in OSA treatment (Endoscopy, PG, DISE). Pediatric patients were excluded from TORS program. Results: From 9/2023, 43 patients underwent transoral robotic surgery at our departement, 31 (72%) patients underwent surgery for oropharyngeal carcinoma, 9 (20%) for benign lesions of oropharynx, 3 (6%) for OSA. 3 patients underwent BOT reduction, one patient BOTr together with epiglotopalsty, in one case the multilevel surgery was performed (BOTr, UPPP). There was 68% decrease of AHI in average in the patients after TORS. No patient with OSA had postoperative bleeding. No readmission was experienced. Conclusion(s): TORS for OSA treatment is an effective and safe procedure for adequately selected patients. Considering other effective ways of surgery (upper airway stimulation), in the Czech Republic, TORS is still being in its golden era regarding the surgical treatment of retrolingual space.
Obstructive Sleep Apnea (OSA) is a prevalent and complex disorder characterized by repeated episodes of upper airway collapse during sleep, leading to significant health risks, including cardiovascular disease and metabolic disorders. This presentation provides a comprehensive overview of current and emerging treatment options for OSA, tailored to the needs of an expert medical audience. The gold standard treatment, Continuous Positive Airway Pressure (CPAP), remains the most effective intervention for reducing the Apnea-Hypopnea Index (AHI) and improving overall sleep quality. However, patient adherence to CPAP therapy remains a challenge, necessitating alternative treatment approaches. Mandibular Advancement Devices (MADs) and Hypoglossal Nerve Stimulation (HNS) offer promising alternatives, particularly for patients intolerant to CPAP. MADs are particularly effective in patients with mild to moderate OSA, providing a balance between efficacy and comfort, while HNS shows significant potential in reducing AHI in patients with specific anatomical patterns of airway collapse. Surgical interventions, including Uvulopalatopharyngoplasty (UPPP) and Maxillomandibular Advancement (MMA), are discussed as viable options for patients with anatomical contributors to OSA. MMA, in particular, is highlighted for its high success rates and long-term efficacy in severe OSA cases. Emerging pharmacological therapies targeting specific OSA phenotypes and endotypes are also explored, offering new hope for personalized treatment strategies. The presentation concludes by discussing the future directions of OSA treatment, including the integration of artificial intelligence and novel diagnostic tools like Drug-Induced Sleep Endoscopy (DISE) to enhance treatment precision and outcomes. This review emphasizes the importance of a multidisciplinary approach to OSA management, combining traditional therapies with innovative treatments to optimize patient outcomes.
Abstract is not available
MUDr. Jan Lazák Ph.D.
Main topics and interest: Skull Base Surgery, Sleep Medicine.
Degrees:
2010 – 2016 1st Faculty of Medicine, Charles University, Prague.
2016 – up today Dpt. of ORL-HNS, 1st Faculty of Medicine, Charles University, Motol University Hospital.
2018 – up today postgradual study of biomedicine, Experimental surgery. Thesis: Quality of life in patients with vestibular schwannoma.
2021 specialization exam in Otorhinolaryngology and Head and Neck Surgery.
2022 Ass’t Prof.
Selected scholarships and courses:
2017 Endoskopie und endoskopisches Management der Atemwege – Jetventilation, HNO-Klinik, Universitätsklinikum Jena,
Germany.
ENT Masterclass Europe, Berlin, Germany.
2019 1st Skull Base Surgery Dissection Course & Conference, Medical University of Warsaw, Dpt. of ORL-HNS, Poland.
2020 9th Theoretical Course of Sleep Medicine by Czech Sleep Research and Sleep Medicine Society, Brno, Czech Republic.
2022 Polysomnographic Course, Prague.
2023 two – week internship at the Dpt. of ORL-HNS, University Hospital, Mannheim, Germany.
two – week internship at the Dpt. of ORL-HNS & Audiology, University Hospital Copenhagen, Denmark.
2024 two – week internship at the Dpt. of ORL-HNS La Paz University Hospital Madrid, Spain.
Author and co-author of publications in Czech and foreign scientific journals.
Membership in professional societies:
Czech Society of ENT and Head and Neck Surgery.
General Secretary of Czech-German Society for Otorhinolaryngology, Head and Neck Surgery.
Young Confederation of European ORL – HNS.
European Rhinologic Society.
YO – IFOS.
MUDr. Jan Lazak 1, MUDr. Jaroslav Betka , Ph.D.1, Prof. MUDr. Jan Klozar , CSc.1, MUDr. Michal Matyasek 1, Prof. MUDr. Jan Plzak , Ph.D.1,
Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University, Motol University Hospital 1
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