Prohlášení
Vážená paní, pane,
upozorňujeme Vás, že webové stránky, na které hodláte vstoupit, nejsou určeny široké veřejnosti, neboť obsahují odborné informace o léčivých přípravcích, včetně reklamních sdělení, vztahující se k léčivým přípravkům. Tyto informace a sdělení jsou určena výhradně odborníkům dle §2a zákona č.40/1995 Sb., tedy osobám oprávněným léčivé přípravky předepisovat nebo vydávat (dále jen odborník).
Vezměte v potaz, že nejste-li odborník, vystavujete se riziku ohrožení svého zdraví, popřípadě i zdraví dalších osob, pokud byste získané informace nesprávně pochopil(a) či interpretoval(a), a to zejména reklamní sdělení, která mohou být součástí těchto stránek, či je využil(a) pro stanovení vlastní diagnózy nebo léčebného postupu, ať už ve vztahu k sobě osobně nebo ve vztahu k dalším osobám.
Prohlašuji:
Pokud vaše prohlášení není pravdivé, upozorňujeme Vás, že se vystavujete riziku ohrožení svého zdraví, popřípadě i zdraví dalších osob.
This site uses cookies. By continuing to use this site you agree to our use of cookies in accordance with our Cookie Policy, Close
Pouze služby, které si účastník sám zvolí, lze sponzorovat zde:
Sponzoring účastníků
Registrace vystavujících firem a jejich reprezentantů
Nabídky a registrace vystavujících firem
Prosím začněte vložením Vaší emailové adresy.
Na tuto akci jste již přihlášen. Pro zrušení účasti či úpravu objednávky nás prosím kontaktujte na +420 731 006 620 nebo pošlete email na martin.horna@mhconsulting.cz
Pro přehled objednaných služeb přejděte do svého profilu Přejít do mého profilu
Introduction: Retraction pocket is the pre-stadium of the cholesteatoma disease, and there is still no consensus on its management. The course is usually much worse in cleft palate patients because of severe Eustachian tube malformation and functional changes. Material and methodics: We evaluated 80 patients with retraction pocket surgery, 23of them with cleft palate, followed for minimum 10 years after surgery. The parameters were type of the tympanoplasty according to the grade of retraction, extent of the sanation procedure according to the grade of retraction and incidence of the re-retraction. Audiometry outcomes were evaluated and compared cleft to non cleft patients. Results: Those with cleft palate had significantly lower audiometric improvement after the surgery. Sanation procedures in cleft palate patients were also more extensive, probably because of higher grade of retraction process. Conclusion: The course and prognosis of adhesive otitis is more severe in cleft palate patients. To prevent cholesteatoma development is according to our experience most important careful follow up with otomicroscopic monitoring and early indication to surgical treatment according to the severity of changes and process dynamics.
MUDr. Lukáš Otruba Ph.D.
ENT surgeon and otologist with one of the interests in otologic pathology in cleft palate patients. 1993-2018 ENT dep 3.rd Medical Faculty Charles University Prague - member of the interdisciplinary ENT- plastic surgery Cleft palate research team. Published in The Journal of Laryngology and Otology, Czech Otorinolaryngology etc., Author of chapters in ENT and plastic surgery monographies. 2018 till now ENT dep. 1.st Medical Faculty Charles University Prague, head of the ENT dep. regional hospital Mělník.
Lukáš Otruba 1,
ORL Oddělení nemocnice Mělník a VFN Praha 1
Colloaural fistulas in children - diagnosis and treatment Introduction: Anomalies of the first branchial cleft are rare. Developmental disorders associated with the branchial apparatus most commonly involve the second branchial cleft. Only approximately 6% of cervical fistulas/cysts originate from the first branchial cleft. These are referred to as cystae/fistulae colloaurales. They essentially represent a duplication of the external auditory canal. Colloaural fistulas do not include small fistulas located at the anterior, and very rarely at the posterior, margin of the auricle, which result from incomplete fusion of the six auricular hillocks of the first and second branchial arches, from which the auricle develops (fistula auris congenita). Based on their structure, two types of colloaural fistulas are distinguished according to the presence of cartilage. Based on the presence of both openings, they are classified as complete or incomplete. The aim of this study is to present the experience of our department with this rare clinical entity, specifically in pediatric patients. Methods: This retrospective study is based on the experience of the Department of Otorhinolaryngology of the Second Faculty of Medicine, Charles University, and Motol University Hospital and Homolka Hospital between 2011 and 2025. The study included patients from birth to 18 years of age. The anomaly was unilateral in all cases; no bilateral lesions were recorded. Both male and female patients were included. All patients underwent surgical treatment. Results: In clinical practice, we encounter both types of fistulas. Clinically, first branchial cleft anomalies present as cystic swellings or fistulas around the ear or within the external auditory canal, while the external opening in the neck is often inflamed. This opening may remain unrecognized until the first episode of inflammation, after which inflammatory swelling develops. The cervical course of the fistula may also be palpable. The finding very often mimics abscess-forming lymphadenitis; less commonly, patients present with chronic otorrhea or merely with the presence of an internal fistula in the external auditory canal without discharge. Diagnosis is not difficult when the anomaly is known to the physician. Typical findings include the clinical presentation and the location of the external fistula opening in the neck, and less commonly the presence of an internal fistula within the external auditory canal. Among imaging modalities, magnetic resonance imaging is the method of choice, as it demonstrates the course of the fistula and its relationship to surrounding structures. Fistulography has now been almost completely abandoned. The definitive treatment is complete excision of the fistulous tract while preserving essential structures, particularly the facial nerve (CN VII), through a superficial parotidectomy approach. Most patients underwent at least one inadequate procedure before definitive excision, most commonly simple incision and drainage. Patients were subsequently followed regularly until 19 years of age. Conclusion: Failure of obliteration of the branchial clefts results in branchiogenic fistulas and cysts. The external opening is located along the medial border of the sternocleidomastoid muscle, while the internal opening is determined by the branchial origin. Clinically, these anomalies most commonly present as small openings near the sternocleidomastoid muscle. They frequently become inflamed. Fistulas are present from birth but may be overlooked. Cysts tend to appear at a later age. Magnetic resonance imaging is the principal imaging modality used in the diagnostic process. During the acute inflammatory phase, antibiotic treatment is appropriate to control the inflammation, followed by surgical excision as the treatment of choice. Identification and dissection of the facial nerve trunk and neuromonitoring of its function are fundamental components of surgery for first branchial cleft anomalies.
Background: Otitis media with effusion (OME) is one of the most common diseases in children. It manifests with hearing loss, which could lead to delayed speech or poor school performance. In recent years, novel etiopathogenetic factors, such as changes of microbiome of the adenoids and the middle ear, have emerged. The aim of this study is to analyze and compare the composition of adenoidal and middle ear microbiome in children with and without OME. Methods: A total of 31 children with adenoids and OME (study group), and 30 children with adenoids without OME (control group) were enrolled in study. Children in study group underwent endoscopic adenoidectomy and myringostomy. Samples of both adenoids and middle ear effusion were collected. Children in control group underwent adenoidectomy with samples collection. Collected samples were examined using molecular methods for detection of the DNA of common respiratory pathogens – Streptococcus pneumoniae (SRPN), Streptococcus pyogenes, Haemophillus influenzae (HAIN), Staphylococcus aureus and Mycoplasma pneumoniae. The microbiome of samples was also analyzed using 16s rRNA sequencing. Results: At least one pathogen was detected in adenoid samples in almost 97% of children in each group. In both groups, the most common pathogens were HAIN (23 and 20 positive samples) and SRPN (24 positive samples in each group). The relative abundance was significantly higher in the study group. Furthermore, pathogens were detected in middle ear fluid in children with OME, positivity was recorded in a total of 17 children. The most common pathogen was HAIN (n=9), followed by SRPN (n=7). Conclusions: The adenoidal microbiome may influence the development of otitis media with effusion. The presence of HAIN, which was significantly more common in adenoid tissue of children with OME than in children without OME, appears to be significant. This pathogen was also the most frequently found in middle ear effusion.
MUDr. Tomáš Valenta
Životopis není k dispozici
MUDr. Tomáš Valenta 5,
Department of Otorhinolaryngology and Head and Neck Surgery, St. Anne’s University Hospital in Brno, Masaryk University, Faculty of Medicine 1
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove 2
Department of Clinical Microbiology, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove 3
4th Department of Internal Medicine, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove 4
Department of Otorhinolaryngology and Head and Neck Surgery, St. Anne’s University Hospital in Brno, Masaryk University, Faculty of Medicine 5
Tinnitus aurium is defined as an objecitv or a subjectiv sound of the inner ear and it's recognition within the central hearing region of the brain. It’s a clinical symptom, that still today isn’t really completely understood, cause it has multiple factors or causes to consider (e.g. sudden hearing loss, presbycusis, infections, trauma or a tumor on the acoustic nerve). Considering numbers named by the „Deutsche Tinnitus Liga“ (a german self-help group) there are at least 1,5 million patients yet in Germany alone, suffering from tinnitus aurium; the annual first diagnosis led by 250.000 patients with a chronic illness. Worldwide 740 million patients suffer from tinnitus aurium; yet alone 120 million patients who feel strongly restricted or limited to live there everyday life. The german guide line for acute tinnitus aurium is still under surveillance and is yet to be published within 2026. While the german guide line for chronic tinnitus aurium (meaning the tinnitus aurium has been lasting for more than 3 months) is still in charge. Considering chronic tinnitus aurium this guideline recommends “tinnitus retraining”, which mainly includes psycho-therapy with focus on behavioural therapy, hearing training and the learning of relaxation methods such like PMR or autogenic training. Due to changes within the german health care system, but also because of limited amount of specialists it’s difficult for german patients to find a clinical psychotherapist specialised on behavioural therapy and tinnitus aurium. So as a modern solution in a technological society, but also as an answer to the lack of health care specialists the “Digital health Applications” (DIGA) are on the rise. Still the question is, if there are still any other ways to treat patients with tinnitus aurium and if the “Autonomous sensory meridian response” might be another way to treat these patients more effectively.
Dr.med. Claudia Quast Dr. med.
Personal Data:
Name: Claudia Quast
Day of Birth and Place of Birth: 22. April 1984, in Siegen
Adress: Wachsbleiche 28B,
49076 Osnabrück
Specialist in ENT since 06/2021
Place of Work: ENT-Practice in Osnabrück, Germany
Former Places of Work:
ENT-Departement of the Marienhospital Osnabrück (Chief Prof. Dr. med. Konrad Sommer) from 07/2019 til 03/2022
ENT-Departement of the Klinikum Bielefeld Mitte, Bielefeld from 04/2016 til 06/2019
Universiy:
Rheinische Friedrich-Wilhelms-University Bonn from 10/2008 til 11/2015
Claudia Quast 1,
ENT-Practice Osnabrück 1
Endoscopic access to the middle ear has become a standard surgical approach in otologic surgery. It is particularly advantageous for the repair of tympanic membrane perforations, especially those located in the anterior quadrants. Owing to the excellent visualization of the retrotympanum, it also facilitates the management of mesotympanic retraction pockets. Furthermore, endoscopy enables the exclusive transcanal treatment of epitympanic pathologies extending to the aditus ad antrum. We present two case reports demonstrating the endoscopic management of two foreign bodies in the middle ear. The first case: The foreign body consisted of a fragment of mill scale that had entered through the external auditory canal, perforated the tympanic membrane, and become impacted in the bony portion of the Eustachian tube. Endoscopic tympanotomy was performed; however, the fragment of mill scale could not be identified within the middle ear. Therefore, a Eustachian tube balloon dilation catheter was introduced transnasally into the pharyngeal orifice of the Eustachian tube. The balloon was not inflated; instead, the catheter was used to gently displace the fragment of mill scale into the mesotympanum, where it was subsequently removed endoscopically. An underlay myringoplasty was performed simultaneously to repair the tympanic membrane perforation caused by the foreign body. The perforation healed uneventfully, and normal Eustachian tube function was preserved. The second case involved a pediatric patient with iatrogenic dislocation of the stapes following T-tube insertion. This case illustrates the importance of exploratory tympanotomy whenever a foreign body is visible beneath the posterosuperior quadrant of the tympanic membrane. The endoscopic approach provides excellent visualization of the incudostapedial joint and the retrotympanum, allowing safe assessment and management of pathology in this anatomically challenging region.
MUDr. Jan Vodička Ph.D.
Životopis není k dispozici
Jan Vodička 1,
Department of Otorhinolaryngology and Head and Neck Surgery, Regional Hospital Pardubice and Faculty of Health Studies, University of Pardubice, Czech Republic 1
Background & Aim Neurootologic challenges like vertigo, hearing loss and tinnitus have been attributed to hypoxemia. As hypoxemia in sleep by obstructive sleep apnea (OSA) recently has been defined with “Hypoxic burden” we looked at its relation to neurootologic challenges. Material & Methods Between 2021-20026 4000 patients underwent fully attended polysomnography with and without CPAP in the sleeplab of the Heilig-Geist Hospital, Bensheim Germany. Different neurologic and cardiorespiratoric parameters have been related. Results The severity of the cardiorespiratory parameters during sleep do not directly relate to any neurotologic symptoms. Conclusions Despite sleep in humans is one third of life and so the hypoxic burden in OSAS is expected to lead to neurotologic symptoms there has been not statistical evidence. References Hörmann, K.: Rheological effects of pharmacologic treatment of inner ear disorders. ScanAudiol:Suppl.26(1987)47-48 Karl Hörmann,Thomas Verse: Surgery of Sleep related Sleep disorders,2nd ed. Springer 2009, Azarbarzin A, Sands SA, Stone KL et al. The hypoxic burden of sleep apnoea predicts cardiovascular disease-related mortality: the Osteoporotic Fractures in Men Study and the Sleep Heart Health Study. Eur Heart J. 2019;40:1149-57 Solelhac G, Sánchez-de-la-Torre M, Blanchard M et al. Pulse Wave Amplitude Drops Index: A Biomarker of Cardiovascular Risk in Obstructive Sleep Apnea. Am J Respir Crit Care Med. 2023;207:1620-32 Keywords Hypoxic burden OSA Neurootologic challenges
Adenotomy has long been the most frequently performed surgical procedure in children. Since the mid-19th century, when the relationship between adenoid tissue and ear diseases was first described and when the first adenotomy was performed, there has been an interesting development in surgical techniques. The blind spot was the conservative procedure, where radioactivity was applied to the nasopharynx. Over the course of about 30 years, more than 2.5 million patients were irradiated before the connection of this procedure with carcinogenicity was described in the 1960s. The introduction of general anesthesia was a milestone for the safety and quality of the procedure. Currently, adenotomy is performed under endoscopic control using several possible techniques. Each of them has advantages and disadvantages. However, there has been a significant decrease in bleeding complications in particular. Individual techniques (especially laser, shaver and plasma coblation) will be described and evaluated with regard to safety and benefit for the patient. According to our own sample of more than 700 patients operated on using plasma coblation, we have recorded less than 0.5% bleeding complications and less than 0.4% recurrences. The disadvantages are a shallow learning curve and a greater risk of prolonged healing requiring the use of antibiotics compared to classic adenoidectomy.
MUDr Michal Jurovčík
Education: 1st Medical Faculty of Charles University, Prague , 1986-1992
Since 1992 – ENT dpt, 2nd Medical Faculty od Charles University and Motol and Homolka Hospital
Focus of interest: Endoscopy, Pediatric Airway Surgery, Cochlear implantation, Cleft Surgery, Head and Neck
Member of Czech Otolaryngological Society, ESPO and BLA
MUDr Michal Jurovčík 1, MUDr Zuzana Libáková 1, MUDr Karla Smolková 1, prof., MUDr Zdeněk Čada , PhD., MBA1,
ENT Dpt. of 2nd Medical Faculty of Charles University and Motol and Homolka Hospital 1
Introduction The TOTO study (tonsillectomy or tonsillotomy) for recurrent acute tonsillitis (RAT) in children and adults is a controlled, multicentric, randomised, surgical non-inferiority trial aiming to evaluate whether tonsillotomy is as effective as a tonsillectomy in RAT. The objective is to proof the non-inferiority of tonsillotomy (DRKS00020823). Methods About 2200 patients were screened across 24 study centres, a total of 531 patients were recruited. The last patient was included 05/2025, hence data analysis regarding the outcome criteria can start 05/2027 (last patient out). The correction of baseline data has been completed. Results 353 women (66%) and 178 (34%) men aged 24±10 years underwent tonsil surgery based on the German S3 tonsillitis guideline. The amount of treated sore throat episodes was 6±2 per year. Leading symptoms were dysphagia (95%) and recurrent fever (71%)s. Quality of life was at baseline: TOI-14 score 50±18, TAHSI score 57±17, SF-12 PCS score 41.9±5.1 and SF-12 MCS score 44±7. In underage patients(< 16 years; 14%) neither symptoms nor quality of life differed from adult patients (>16 years) except for a higher rate of fever during the episodes. The amount of sore throat episodes did not correlate with the quality of life: TOI-14 score r=0.12; TAHSI score r=0.08; SF-12 PCS score r=0.01 and SF-12 MCS score r=0.04. Conclusion Patient cohort showed representative characteristics for patients with severe RAT. Quality of life was on average moderately reduced and did not correlate with the amount of sore throat episodes. Potentially, measuring tonsil-specific quality of life could be the better way of assessing the severity of RAT than counting sore throat episodes. The study was financially supported by the “Gemeinsamer Bundesausschusses (G-BA)” as a “Erprobungsstudie”.
Dr. Claudio Bücking
I am currently completing my residency in Otorhinolaryngology at the Jena University Hospital.
Dr. Claudio Bücking 1, Prof. Dr. Orlando Guntinas-Lichius 1,
ENT Department, Jena University Hospital, Jena, Germany 1
Positive airway pressure (PAP) therapy represents the gold standard treatment for patients with moderate or severe obstructive sleep apnea (OSA). Despite the high efficacy of this treatment modality, long-term complience remains one of its major limitations in a substantial proportion of patients. Surgical treatment may therefore represent a suitable alternative to PAP therapy in selected patients. Despite numerous advances in surgical techniques, early or delayed postoperative bleeding remains one of the most common postoperative complications, along with pain and swallowing difficulties. Objective: The aim of this presentation is to share our experience and outcomes with the use of self-assembling hemostatic peptides in the surgical treatment of obstructive sleep apnea (OSA) at the Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University and Motol University Hospital. Materials and Methods: A single-center study was conducted between June-September 2024 and April - September 2026 at the Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University, University Hospital Motol and Homolka. Postoperative pain and swallowing difficulties were assessed using patient-reported questionnaires. Results: During the 2024–2025 period, we observed a lower incidence of postoperative bleeding in the PuraStat group compared with the control group, although the difference did not reach statistical significance. In 2026, however, no reduction in postoperative bleeding was observed. The increased incidence of bleeding complications in both groups in 2026 may be related to the transition to a new surgical technique, Barbed Reposition Pharyngoplasty (BRP), and the associated learning curve. Limited experience with the newly introduced technique may therefore have contributed to the higher postoperative bleeding rate. Regarding postoperative pain and swallowing difficulties, questionnaire-based assessment showed no significant differences between the groups. Conclusion: Self-assembling hemostatic polypeptides represent an easy-to-apply and safe method with the potential to reduce postoperative bleeding in patients undergoing surgery for OSA. However, given the relatively small number of patients included in our study, it is currently not possible to confirm that the application of PuraStat leads to a reduction in postoperative bleeding complications.
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.
2021 specialization exam in Otorhinolaryngology and Head and Neck Surgery.
2022 Ass’t Prof.
2025 Ph.D. (thesis: Quality of life in patients with vestibular schwannoma)
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.
2026 two – week internship at the Dpt. of ORL-HNS, Morgagni-Pierantoni Hospital, Forli, Italy.
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.
Czech Sleep Research and Sleep Medicine Society
European Rhinologic Society.
YO – IFOS.
MUDr. Jan Lazák , Ph.D.1, MUDr. Jaroslav Betka , Ph.D.1, MUDr. Michal Matyášek 1, Prof., MUDr. Jan Klozar , CSc.1,
Department of ORL-HNS, 1st Faculty of Medicine, Charles University, University Hospital Motol and Homolka 1
Introduction: Acute epiglottitis (AE) is a rapidly progressing, potentially life-threatening inflammation of the epiglottis. Once primarily a pediatric disease caused by Haemophilus influenzae type b, acute epiglottitis now occurs predominantly in adults due to the widespread vaccination of children. The onset is typically sudden and urgent airway intervention may be necessary. This study aimed to describe the clinical characteristics of patients, assess the occurrence of complications, and identify their potential risk factors. Methods: A single-center study included 41 patients with AE hospitalized between March 2018 and September 2023. Data on age, sex, month of diagnosis, microbiological cultures, antibiotic therapy, and the presence of complications (such as epiglottic abscess, need for airway management, and its duration) were analyzed. Results: The cohort comprised 31 men and 10 women, with a mean age of 46.7 years. Adults predominated (39 vs. 2 children). The most commonly identified pathogens were Streptococcus pyogenes, Haemophilus spp., and anaerobes. An epiglottic abscess occurred in 15 patients (36.6%), but neither age (p = 0.60) nor sex (p = 0.27) was a significant risk factor. Intubation was required in 6 cases (14.6%). A trend toward increased risk was observed in older patients and those with an abscess, though these associations did not reach statistical significance (p = 0.13 and 0.17, respectively). Conclusion: AE occurs more commonly in adults nowadays, with a shifted spectrum of causative pathogens. Airway management is necessary in a minority of patients; however, the prediction of complications remains challenging.
MUDr. Kubec Vojtěch
Narozen 1989 v Plzni. Promoval na LF UK v Plzni v roce 2015. Od roku 2017 je sekundárním lékařem, od roku 2019 odborným asistentem a od roku 2024 zástupcem přednoty pro vědu a výuku na Klinice Otorinolaryngologie a chirurgie hlavy a krku LF UK a FN v Plzni. Klinicky i vědecky se věnuje zejména spánkové medicíně a otologii. Pravidelně publikuje a přednáší na tuzemských i mezinárodních kongresech, aktuální H-index 5.
MUDr. Tomáš Kostlivý , Ph.D.1, MUDr. Petr Škopek 1, doc. MUDr. David Slouka , Ph.D., MBA1,
Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine in Pilsen, Charles University, University Hospital in Pilsen 1
Background/Introduction: VEXAS syndrome is caused by a somatic UBA1 mutation and typically presents in older men with skin/subcutaneous inflammation, chondritis, vasculitis, and coagulopathy, often coexisting with myelodysplastic syndrome (MDS). Diagnosis requires genetic confirmation, but genetically negative cases with a compatible phenotype are increasingly reported. Methods: Case report of a 72-year-old man with low-risk MDS (karyotype 47,XY,+add(5q)) and primary Sjögren's syndrome (ANA+++, anti-Ro52++). He presented repeatedly with massive, painful neck swelling clinically resembling deep neck phlegmon. CT showed no abscess; inflammatory markers were low or only mildly elevated. UBA1 (exons 3–27) was sequenced from lymph node tissue. Results: Antibiotic therapy had no effect. Surgical exploration and lymph node excision were performed on repeated occasions. No pus was found intraoperatively. Histology showed only reactive lymphadenopathy with parafollicular hyperplasia; no malignancy. Rosai-Dorfman disease was considered but ruled out immunohistochemically. Every procedure was followed by severe, poorly controllable wound bleeding related to coagulopathy, requiring repeated local hemostatic packing, blood product support, tracheotomy for airway compromise, and prolonged ICU stay. UBA1 sequencing was negative for pathogenic variants. Clonal hematopoiesis-related variants (IDH2, SRSF2) were found incidentally, consistent with the patient's MDS. Conclusion(s): The clinical picture — recurrent pseudo-phlegmonous neck swelling, coagulopathy, and impaired wound healing in a patient with MDS — was highly suggestive of VEXAS syndrome, despite a negative UBA1 result. Possible explanations include limited assay sensitivity, mosaicism, or an overlapping autoinflammatory phenotype in patients with MDS and coexisting autoimmune disease. This case highlights the risk of pathergy with repeated surgery in such patients and the need for early multidisciplinary involvement (ENT, hematology, rheumatology) before further invasive intervention.
Reva Darina
Životopis není k dispozici
Darina Reva 1, MUDr. Jan Vodička , Ph.D.1,
Department of Otorhinolaryngology and Head and Neck Surgery, Regional Hospital Pardubice and Faculty of Health Studies, University of Pardubice, Czech Republic 1
Introduction: Peritonsillar abscess (PTA) is the most common acute complication of tonsillitis. Comprehensive knowledge linking etiology, clinical presentation, and laboratory results is crucial for effective patient care. Methods: A retrospective study analyzed 577 hospitalized PTA surgical patients. Data included medical history, admission laboratory markers, operative findings, and postoperative outcomes. Statistical analysis comprised univariate methods (Fisher's exact test, Mann-Whitney U test), multivariable logistic regression (aOR), species co-occurrence, ROC curve analysis, and k-means cluster phenotyping. Results: Polymicrobial infection (≥ 2 pathogens) was present in 8.7% of patients (n = 50) and associated with significantly higher admission CRP (median 115.9 vs. 88.9 mg/L, p = 0.0299). A CRP threshold ≥ 160 mg/L optimally predicted polymicrobial etiology (specificity 76.7%, AUC = 0.595, p = 0.0299). Previous outpatient incision attempts (19.4%, n = 76) were associated with lower admission CRP (66.2 vs. 92.6 mg/L, p = 0.0276), reduced WBC count (12.7 vs. 14.3 × 10⁹/L, p = 0.0087), and shorter postoperative hospital stays (IQR 0.0 vs. 1.0, p = 0.0465). Multi-drug resistance (MDR) strain prevalence decreased with age (p = 0.0084), highest under 30 years (10.7%) versus over 50 years (1.1%; aOR = 0.955, p = 0.042). Significant microbial synergy was confirmed between Streptococcus anginosus group (SAG) and aerobes (p = 0.0001) and SAG with Prevotella spp. (p = 0.0469). K-means clustering identified three phenotypes: Low-reactive Monomicrobial (58.4%, n = 328), Complicated Polymicrobial with High MDR rate (8.4%, n = 47; 19.1% MDR rate), and Hyper-inflammatory Monomicrobial (33.3%, n = 187; median CRP 175.7 mg/L). Conclusion: Polymicrobial PTA accentuates acute inflammation, whereas outpatient incision attempts blunt admission inflammatory responses. MDR strains primarily affect young adults. Multi-parametric phenotyping enhances risk stratification and targeted empirical antibiotic selection.
MUDr. Bálint Tóth
MUDr. Bálint Tóth is an Otorhinolaryngology resident and PhD candidate at the Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Medicine, Comenius University and University Hospital Bratislava, Slovakia. His doctoral research focuses primarily on sleep medicine, alongside a clinical interest in sialendoscopy. He combines his medical practice with a strong affinity for programming and data science, and has experience creating precise anatomical illustrations for medical communications.
MUDr. Bálint Tóth 1, MUDr. Dimitros Paouris 1, MUDr. Žofia Füssy 2, 3, , prof. MUDr. Miroslav Tedla , PhD., MPH1,
Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Medicine Comenius University and University Hospital Bratislava, Slovakia 1
Department of Urology, St. Cyril and Methodius Hospital, University Hospital Bratislava, Slovakia 2
Institute of Microbiology, Faculty of Medicine, Comenius University and University Hospital Bratislava 3
Background: Increasing evidence supports the use of surface functional electrical stimulation (FES) as a complementary therapy for treating patients with complete denervated facial paralysis. However, standardised studies using objective methods are needed to quantify its therapeutic effects. This pilot study examined the safety and feasibility of home-based FES for treating denervated muscle atrophy and improving facial symmetry, using ultrasound and automated image analysis. Methods: Ten patients (median age: 61 years; median duration of denervation: 130 days) with complete facial paralysis were enrolled in a prospective, monocentric feasibility study. They performed home-based FES with long (initially 100 to 250 ms phase duration), triangular biphasic impulses to evoke contractions of the zygomaticus muscle twice daily 20 minutes for up to one year. Monthly follow-ups included stimulation adjustments, sonography, and standardised photographs. To eliminate reinnervation bias, data points were excluded as soon as electromyography indicated voluntary muscular activity. Synkinesis as long-term sequel after 1 – 2 years after reinnervation were compared by blinded raters with photos of historic controls. Results: No serious adverse events occurred. The stimulation parameters were progressively adapted (reduction of phase duration from mean 150 to 50 ms after 20 weeks) while frequency could be increased (from mean 1 to 5 Hz), demonstrating effective muscle engagement. The cross-sectional area of the zygomaticus muscle increased significantly, in contrast to the decrease observed in non-stimulated muscles. Automated image analysis revealed a significant deterioration in the non-stimulated areas compared to the stimulated facial region. There was a trend to less synkinesis in the FES-group compared with no-stimulated historic controls. Conclusions: FES is a safe and feasible therapy model for patients with complete facial paralysis. Atrophy of the stimulated muscles could be reversed, as could facial asymmetry. These promising results justify conducting a future controlled, randomised, double-blind study to further investigate these initial findings. Sponsored by a research grant from MED-EL, Innsbruck, Austria, DFG GU-463/12-1 and IZKF
Ballmaier Jonas
Životopis není k dispozici
Prof. Dr. Gerd Fabian Volk 1, 2, 3, , Dr. Johannes Kraus 1, 2, , Dr. Gabriel Meinke 1, 2, , Dr. Maren Geitner 1, 2, 3, , Lukas Hirsch 1, 2, , Dr. Anna-Maria Kuttenreich 1, 2, , Dr. Dirk Arnold 1, 2, , Prof. Dr. Winfried Mayr 4, Prof. Dr. Orlando Guntinas-Lichius 1, 2, 3, , Jonas Ballmaier 1, 2, 3, ,
ENT-Department, Jena University Hospital, Jena, Germany 1
Facial-Nerve-Center, Jena University Hospital, Jena, Germany 2
Center of Rare Diseases, Jena University Hospital, Jena, Germany 3
Center for Medical Physics & Biomedical Engineering, Medical University Vienna, Austria 4
To achieve glottal gap closure in unilateral vocal fold paralysis (UVFP) through complementary ansa cervicalis nerve muscle pedicle laryngeal reinnervation (ANMP-LR). INTRODUCTION: ANMP-LR is easy to learn and does not require recurrent laryngeal nerve (RLN) transection. MATERIALS AND METHODS: Twelve patients with unilateral vocal fold paralysis (UVFP) were included, who received ANMP-LR and could be followed up for at least 6-24 months. At baseline, after 3-6 (T1), 12 (T2) and 24 months (T3), Voice Handicap Index (VHI), perceived roughness (R) and breathiness (B), sound pressure level (SPLmax), maximum phonation time (MPT), Dysphonia Severity Index (DSI) and glottal gap (GG) were recorded. RESULTS: R and B were significantly reduced at T1, MPT and SPLmax increased significantly up to T1 (MPT to 15.8 s; SPLmax to 91.5 dB). Similarly, VHI dropped significantly and the residual glottal gap (GG) was significantly reduced between T0 and T1. All outcomes remained stable until T3. There was a non-significant tendency to further improvement until T3 in SPLmax and GG. DISCUSSION: The T1-T3 outcomes of the complementary ANMP-LR are comparable with the standard LR and also with thyroplasty. As with all LR techniques, younger patients and those with shorter paralysis benefit more. Patients with evidence of unfavorable laryngeal synkinesis are more likely to benefit from a standard LR with RLN transection. CONCLUSIONS: Younger patients with insufficient synkinetic reinnervation and persisting or progressive glottis closure insufficiency in UVFP benefit from early reinnervation. When the easy-to-learn ANMP technique is used, any partial rehabilitation that has already been achieved or any remaining chance of spontaneous reinnervation via the RLN is not compromised.
Prof. Andreas Müller MD
Andreas H. Mueller studied medicine in Jena, Germany. He completed his specialist training in Otorhinolaryngology at the University of Jena in 1993 and was ORL consultant in Jena until 2004. Since 2005 he is head of the Department Otorhinolaryngology/Plastic Surgery, SRH Wald-Klinikum Gera, Germany. Prof. Mueller is a specialist for laryngotracheal stenosis, laryngology and rhinology. His main research interests are Neurolaryngology, vocal fold paralysis and laryngeal pacing.
Prof. Andreas H. Müller , MD1, Dr. Gerhard Förster , MD1, Dr. Kathleen Klinge , MD1,
SRH Wald-Klinikum Gera, Dept. ORL 1
Tumours of salivary glands form 3% of all neoplastic involvements. Majority of them is benign, parotid gland is most commonly involved. Risk of malignity is increasing with reduced size of involved gland. Clinical differentiation of salivary gland tumours is difficult. MRI is therefore important in their differential diagnosis. Ultrasound is first method of choice in diagnostics of pathological involvement of salivary glands. MRI is preferred for evaluation of foci involving deep lobe of parotid gland, sublingual gland, minor salivary glands, deeply placed soft tissue, involvement of lymphonodes and possible perineural spread. Pleomorphic adenoma is the most common tumour of salivary glands, mostly in superficial lobe with fibrous capsule. Carcinoma, usually multifocal, can develop later from adenoma. Inhomogeneity of parenchyma with solid and cystic portions, mild enhancement after contrast media application, higher wash out ratio and lower mean ADC value than in malignant tumours are characteristic for Warthin tumour, involving largely smokers. Mucoepidermoid carcinoma of lower grade can mimic pleomorphic adenoma, higher grade carcinoma often metastasizes to lymphatic nodes. Adenoid cystic carcinoma often spreads perineurally, makes recurrence in long delay after surgery. It has intermediate T2W signal, higher grade of tumour has even low T2W signal. Metastases into salivary gland are exceptional, commonly from lung and breast carcinoma, from skin squamous cell carcinoma or melanoma. Multiple small cystic structures in parenchyma of gland are characteristic for Sjögren syndrome. Lymphoma can involve lymphoid tissue of parotid gland or adjacent lymphatic nodes, either primary or secondary by systemic involvement.
MUDr. Jiří Lisý CSc.
PERSONAL DETAILS
Date of birth: 03 November 1967
WORKING EXPERIENCE
2020 - up till now - Radiodiagnostic dept., Hospital Na Homolce, Praha 5, Czech Republic
2011- 2020 – deputy for education, Department of Imaging Methods 2nd Medical Faculty, Charles University, University Hospital Motol, Praha 5
2004- 2020 – head of MRI unit, Clinic of Imaging Methods, University Hospital Motol,
Prague, Czech Republic
1996- 2020 - Assistant Professor Charles University, Prague, Czech Republic, 2nd
Medical Faculty,
1993- up till now - Department of Imaging Methods, University Hospital Motol, Prague Republic,
1992-1993- Radiodiagnostic dept., State Hospital Kladno, Czech Republic
Foreign experience
2000-2026 - Norrlands Universitetssjukhus, Umea, Sweden (neuroradiology) cisiting radiologist
Schoolarship:
2001- RSNA Chicago, International Seminar of Young Radiologists
1997/VII/-1997/IX/- Texas Children Hospital, Houston, USA, Texas
Czech Physician Exchange Program, training in pediatric neuroradiology
1994/XI/-1995/IV/- American Hospital Paris, France, MRI dept., GE´s scholarship, training in
MRI
EDUCATION
1992- Graduation M.D.
1986-1992 -University studies, Charles University, Prague, 2nd Medical Faculty
PROFESSIONAL QUALIFICATION
2008- Board Certification in Paediatric Radiology
2007- Board Certification in Neuroradiology
2001- PhD thesis in radiology (Balloon dilation of esophageal and laryngeal strictures in
Children)
1999-Radiology Board Certification of 2st degree
1995-Radiology Board Certification of 1st degree
Jiří Lisý 1,
Radiologické oddělení , Fakultní nemocnice Motol a Homolka, V Úvalu 84/1, Motol, 150 00 Praha 1
Introduction: Benign tumors of the parotid gland are the most common salivary gland tumors and are primarily treated surgically. Although parotid surgery is an established treatment, postoperative morbidity, particularly facial nerve dysfunction, remains a significant clinical concern. Population-based data on surgical treatment patterns and postoperative outcomes for benign parotid tumors are limited. Therefore, this study analyzed the inpatient surgery of benign parotid tumors in Thuringia between 2016 and 2020. Material and Methods: In this retrospective, multicentre, population-based cohort study, clinical routine data of 1,157 patients who underwent surgery for benign parotid tumors in Thuringian hospitals between January 2016 and December 2020 were analyzed. Patient characteristics, preoperative diagnostic procedures, surgical techniques, histopathological findings, postoperative complications, facial nerve function, recurrence, and surgery rates were evaluated. Univariate and multivariate analyses were performed to identify factors associated with postoperative complications, facial nerve palsy, and recurrence. Results: The cohort included 621 men and 536 women, with a mean age of 62.5 ± 13.9 years. Preoperative ultrasound was performed on 97.7% of patients. The most common procedures were partial parotidectomy (50.7%) and lateral parotidectomy (41.0%). Facial nerve monitoring was employed in 99.3% cases. Histologically, Warthin tumors were most common, accounting for 60.8% of cases, followed by pleomorphic adenomas in 31.9%. Complete tumor resection was achieved in 99.3% of patients. Postoperative complications occurred in 16.7% of cases. Facial nerve palsy was documented in 8.2%, including transient palsy in 7.2% and permanent palsy in 1.0%. The median follow-up time was 0,23 months (range, 0-75 months). Recurrence was observed in 3.6% of patients. In univariate analyses, postoperative complications were significantly associated with female sex and more surgical extent (p < 0,05). The surgery rate was highest in the 60- 75 age group with 99-138/100,000 population. Conclusion: In Thuringia, surgery for benign parotid tumors was associated with high rates of complete tumor resection and low rates of permanent facial nerve dysfunction. The extent of surgery was an important factor influencing postoperative morbidity. These population-based data provide a comprehensive overview of current surgical practices and outcomes in treatment of benign parotid tumor and could support future quality assessment and treatment standardization.
Alaa Khalil
Životopis není k dispozici
Holger Kaftan , Prof. Dr. med. 6, Andreas Mueller , Prof. Dr. med. 7, Sylvia Tresselt , Prof. Dr. med. 8, Orlando Guntinas-Lichius , Prof. Dr. med. 1, Daniel Boeger , Prof. Dr. med. 2, Jens Buentzel , Prof. Dr. med. 3, Kerstin Hoffmann , Prof. Dr. med. 4, Jiří Podzimek , Prof. Dr. med. 5,
Department of Otorhinolaryngology, Helios Klinikum Erfurt, Erfurt, Germany 6
Department of Otorhinolaryngology, SRH Wald-Klinikum Gera, Gera, Germany 7
Department of Otorhinolaryngology, Ilm-Kreis-Kliniken, Arnstadt, Germany 8
Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany 1
Department of Otorhinolaryngology, SRH Zentralklinikum Suhl, Suhl, Germany 2
Department of Otorhinolaryngology, Südharz-Krankenhaus, Nordhausen, Germany 3
Department of Otorhinolaryngology, Sophien- und Hufeland-Klinikum, Weimar, Germany 4
Department of Otorhinolaryngology, Klinikum Bad Salzungen, Bad Salzungen, Germany 5
Background/Introduction: Facial nerve function is routinely assessed using clinical examination and standardized grading systems. Other functions of the facial nerve, including taste testing and the Schirmer test, are not routinely performed in ENT practice. The aim was to assess the relationship between facial nerve motor function and taste in patients with different causes of peripheral facial palsy. Methods: Facial nerve function was assessed using clinical examination, the House–Brackmann classification, the Sunnybrook Facial Grading System and objective digital facial analysis using the Rehapple application. Lateralized taste testing was performed using TASENS taste strips. We present three cases: Bell's palsy, facial palsy after parotid surgery and one healthy control. Results: Objective facial asymmetry was detected in both patients with facial palsy, whereas symmetrical facial function was found in the healthy control. Taste impairment was not detected in any examined subject. Conclusion(s): These initial cases demonstrate the feasibility of combining objective facial nerve assessment with lateralized taste testing in routine clinical practice. Larger patient cohorts are needed to evaluate the relationship between facial nerve dysfunction and taste impairment.
Copyright © 2022 MH Consulting s.r.o., Všechna práva vyhrazena.
