Publications by authors named "Kh M Diab"

14 Publications

  • Page 1 of 1

[Retrofacial approach to remove a rare chondromyxoid fibroma of the infralabyrinthine space].

Vestn Otorinolaringol 2021 ;86(4):106-110

The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia, Moscow, Russia.

A very rare case of 46-yaer-old woman with chondromyxoid fibroma (CMF) of infralabyrinthine area of temporal bone was described in this article. The only manifestation of this disease was a severe temporary pain in the postauricular area with irradiation in the occipital bone and headache during the last 3 months. A detail description of the CT scan and MRI data was presented. Tumor removing was performed through the retrofacial approach with combination of the microscopic and endoscopic assistance technique, which allows to had a good visualization and controlling of tumor separation from the vital structures with hearing and facial nerve function preserve. Also, we presented a brief review of literature with differential diagnosis of the CMF of the temporal bone, which conducted to minimize the diagnosis mismatches in the otologic and head and neck practice and to optimize the treatment of patients with such tumor.
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http://dx.doi.org/10.17116/otorino202186041106DOI Listing
September 2021

[Anatomical and functional results of ossiculoplasty with adjustable length titanium prostheses with and without hydroxyapatite].

Vestn Otorinolaringol 2021 ;86(3):14-19

National Medical Research Center of Otorhinolaryngology, Moscow, Russia.

Objective: To compare the anatomical and functional results of the ossicular chain reconstruction with classic titanium adjustable prostheses and titanium adjustable prostheses with hydroxyapatite cap.

Material And Methods: The 300 patients (360 cases) with chronic suppurative otitis media were examined and operated. The patients are divided into 2 groups. Group A included patients who received an ossicular prosthesis with a hydroxyapatite cap (90 cases with a partial prosthesis and 90 with a full one). Group B included patients who received prostheses without hydroxyapatitis (90 cases with a partial prosthesis and 90 with a complete one). The patients who received a prosthesis with a hydroxyapatite cap were divided into two subgroups, depending on the autotissue, which was placed between the prosthesis cap and the nontympanic membrane: this is an autocartilage plate or perichondrium/fascial graft. The follow-up period after surgery was 38.5±14.4 months (from 12 to 48 months). In the long-term postoperative period, the subjects were assessed the values of the bone-air gap (BAG), the consistency of the nontympanic membrane, and the presence of signs of extrusion of the prosthesis cap. Comparison of anatomical and functional results between patients with full and partial ossicular prostheses was performed separately.

Results: A good result in the form of a 20 dB or more dB BAG reduction was achieved in 82.2% of patients who received a partial prosthesis (85 patients in group A and 63 in group B), and in 57.8% of patients who received a complete prosthesis (45 patients in group A and 59 in group B). The BAG values in the long-term period after surgery did not statistically significantly differ between patients who received a prosthesis with a hydroxyapatite cap or a fully titanium one (=0.939 for patients with full prostheses and =0.745 for patients with partial prostheses). The placement of cartilage or perichondrium/fascial graft between the hydroxyapatite prosthesis cap and the nontympanic membrane also did not affect the functional outcome (with full prostheses - =0.651, with partial prostheses - =0.142).

Conclusion: It is possible to use ossicular prostheses with a hydroxyapatite cap without placing an autocartilaginous plate between the nontympanic membrane and the cap of the prosthesis. In the long term period, functional and anatomical results with hydroxyapatite cap prostheses do not differ statistically significantly from those with all-titanium prostheses.
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http://dx.doi.org/10.17116/otorino20218603114DOI Listing
July 2021

[The 'major' complications of cochlear implantation].

Vestn Otorinolaringol 2018;83(6):8-12

Research Clinical Department of Ear Diseases, Federal Research Clinical Center of Otorhinolaryngology of the Federal Medical Biological Agency of Russia, Moscow, Russia, 123182.

Aim: The objective of the present study was to improve the selected surgical stages of cochlear implantation (CIP) taking into consideration the results of the analysis of the outcomes of re-operations.

Material And Methods: A total of 53 patients (4 adults and 49 children) were referred to our clinic for re-operations deemed to be required for the management the major complications following CI during the period from 2014 to 2017. Primary cochlear implantation was performed in other clinics. Re-operations were carried out at different time intervals after the primary surgical intervention under the guidance of a single experienced surgeon.

Results: The technical malfunction of the inner part of the implant prevailed among the causes behind the major complications of CI. It accounted for 47% of the total number of complications and required the replacement of the device. The next most frequent form of the complications (that accounted for 15% of all the cases) was the introduction of an active electrode into the cells of hypotympanum. The remaining complications occurred only in isolated cases. The detailed analysis of all the revealed complications was undertaken with the description of their causes and variants and the surgical strategy chosen for the management of each concrete patient. The decision about the necessity of either the removal or the substitution of the implant was taken on an individual basis. The successful outcome of the surgical treatment of all the operated patients with the major complications of cochlear implantation was achieved.

Conclusion: The frequency and severity of the major complications of cochlear implantation are directly dependent on the patient's anatomical features, surgeon's qualifications, the quality of the implants, and lifestyle factors (e.g. head trauma, etc.). Cochlear implantation continues to be the only method for hearing rehabilitation in the patients suffering from severe sensorineural impairment of hearing. In the cases of cochlear implantation with the prospects of delayed re-implantation, leaving the active electrode in the scala tympani of the cochlea is a necessary measure to prevent synechiae.
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http://dx.doi.org/10.17116/otorino2018830618DOI Listing
June 2019

[The complications of cochlear implantation and the methods for their treatment].

Vestn Otorinolaringol 2018;83(5):21-25

Research and Clinical Department of Ear Diseases, Research and Clinical Centre of Otorhinolaryngology, Russian Federal Medico-Biological Agency, Moscow, Russia; Department of Otorhinolaryngology, A. Geidarov Republican Hospital, Ministry of Internal Affairs of Azerbaijan, Baku, Azerbaijan.

The objective of the present study was to improve the surgical component of cochlear implantation (CI) with special reference to the prevention and correction of its complications. A total of 967 cochlear implantation were performed on 847 patient treated based at the A. Geidarov Republican Hospital, Ministry of Internal Affairs of Azerbaijan, and the Research and Clinical Centre of Otorhinolaryngology, FMBA of Russia during the period from 2014 till 2017. The majority of the patients (n=540) were the children at the age varying from 1 to 4 years. All surgical interventions were carried out under the supervision of a single experienced specialist. The check-up examinations were performed every three months during the postoperative period. The postoperative complications were categorized in terms of severity (as major and minor) and time of the first manifestation (intraoperative and delayed). The detailed analysis of all documented complications was performed including the description of their variants and causes as well as of the surgical strategy applied in each concrete case. The frequency of major and minor complications was estimated at 2.6 and 1.6% respectively. It is concluded that cochlear implantation performed by an experienced surgeon provides a relatively safe method for the treatment of the patients in the clinics with a low frequency of complications of such interventions. The most common cause of the major complications of cochlear implantation is the technical defect of the implants the frequency of which amounted to 68% in the present study.
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http://dx.doi.org/10.17116/otorino20188305121DOI Listing
June 2019

[Myoclonus of the middle ear].

Vestn Otorinolaringol 2018;83(2):63-66

Federal state budgetary institution 'Research and Clinical Centre of Otorhinolaryngology', Russian Federal Medico-Biological Agency, Moscow, Russia, 123182.

The objective of the present study was to overview the foreign literature concerning middle ear myoclonus (MEM) known to be the most common cause of the manifestations of objective tinnitus. The authors reports two typical clinical cases of myoclonus of the middle ear. The present article is aimed at the enhancement of the awareness of the otorhinolaryngologists, audiologists, and neurologists of the condition of interest as a way to promote the further progress in its treatment.
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http://dx.doi.org/10.17116/otorino201883263-66DOI Listing
September 2018

[The interdisciplinary approach to the rehabilitation of the patients presenting with congenital atresia of the external auditory canal and the concomitant microtia].

Vestn Otorinolaringol 2018;83(2):17-21

Research and Clinical Centre of Otorhinolaryngology, Russian Federal Medico-Biological Agency, Moscow, Russia, 123182.

The objective of the present study was to develop and introduce into the clinical practice the method for the combined aesthetic and functional rehabilitation of the patients presenting with congenital atresia of the external auditory canal (CAEAC) and the concomitant microtia. A total of 8 patients at the age from 6 to 21 years with unilateral CAEAC and microtia were given the surgical treatment. During the intervention, atresia was resolved using the trans-mastoid approach, tympanoplasty of autofasciae and ossiculoplasty making use of the partial titanium prosthesis and the placement of cranial osteointegratable titanium implants. At the second stage of the surgical intervention the 3D silicone prosthesis of the auricle shaped on an individual basis were used. The long-term follow-up observations have demonstrated the stable formation of the tube of the external auditory canal, with the bone-air interval amounting to 15-20 dB. The auricular prosthesis was the mirror image of the natural ear and completely concealed the congenital defect.
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http://dx.doi.org/10.17116/otorino201883217-21DOI Listing
September 2018

[The modern view of the radiodiagnostic methods applied for determining the position of the electrode array in cochlear implantation surgery].

Vestn Otorinolaringol 2017;82(6):77-80

Research and Clinical Centre of Otorhinolaryngology, Russian Federal Medico-Biological Agency, Moscow, Russia, 123182.

The objective of the present work was to overview the currently available literature publications dealing with the radiodiagnostic techniques applied to evaluate the position of the electrode array used for the purpose of cochlear implantation surgery including both the conventional methods and the recently proposed approaches. It is shown that the intraoperative control guarantees the timely identification of the possible complications and should meet both the safety criteria and the requirements for obtaining high-quality images and intraoperative usability of the surgical instruments being employed. Moreover, the intraoperative monitoring can be exercised under control of fluoroscopy as well as with the use of the portable computed radiography scanners and navigation systems. The postoperative monitoring is carried out with the use of transorbital X ray visualization, multi-slice computed tomography, cone beam computed tomography, and digital tomosynthesis. Each of the listed methods has specific advantages and disadvantages, but there is yet neither a universally recognized systematic approach to the assessment of their effectiveness nor the generally acceptable criteria for the evaluation of the image quality.
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http://dx.doi.org/10.17116/otorino201782677-80DOI Listing
March 2018

[The results of bilateral cochlear implantation in the children who survived meningitis].

Vestn Otorinolaringol 2017;82(6):39-43

Research and Clinical Centre of Otorhinolaryngology, Russian Federal Medico-Biological Agency, Moscow, Russia, 123182.

The objective of the present study was the prospective analysis of the results of bilateral cochlear implantation (CI) in the children presenting with bilateral ossification of the cochlea after they had survived meningitis. A total of 15 patients underwent the surgical intervention. In those exhibiting bilateral ossification of the basal cochlear helix over the 5 mm segment (up to first bend of the cochlear turn) and partial ossification of the second helix (in 6 children), the affected portions were removed with the placement of two choleostomies, the lower one (from the ossified membrane of the cochlear window) and the upper one (toward the second helix). Activation of the speech processors of the CI systems was carried out within 4-6 weeks after surgery. The hearing abilities of the children were evaluated in accordance with the 'Estimation of the auditory perception categories', 'Estimation of the child's apprehension capacity', and 'Analysis of speech intelligibility rating' guidelines. In all the children with ossification over less than 5 mm of the basal cochlear helix, it proved possible to introduce the whole intracochlear electrode grid whereas only half of the electrode array was implanted in the cases of overall ossification of the basal helix. The first results obtained by telemetry and surdopedagogical testing gave evidence of the possibility of identifying various sources of non-verbal and speech stimuli in all the treated children at a small (up to 3 meters) distance.
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http://dx.doi.org/10.17116/otorino201782639-43DOI Listing
March 2018

[The psychogenic hearing disorders in the children and adolescents].

Vestn Otorinolaringol 2017;82(5):77-79

State Scientific Clinical Centre of Otorhinolaryngology, Federal Medico-Biological Agency, Moscow, Russia, 123182.

The psychogenic loss of hearing is characterized by its impairment in the absence of anatomically and physiologically significant changes. These disorders are poorly represented in the scientific literature in comparison with the organic lesions. They are especially frequently overlooked in the children and adolescents. The objective of the present review was to analyze the literature publications concerning this problem and to report two clinical observations of the pathology in question. It is concluded that the clinically significant discrepancy between the audiological symptoms and the results obtained by the objective methods for hearing evaluation should be interpreted with great caution and raise the suspicion of the disease. The diagnosis and the identification of the involved psychogenic factors are of utmost importance for the success of the treatment.
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http://dx.doi.org/10.17116/otorino201782577-79DOI Listing
March 2018

[Acquired atresia and stenosis of the external acoustic meatus].

Vestn Otorinolaringol 2017;82(3):69-74

Research and Clinical Centre of Otorhinolaryngology, Federal Medico-Biological Agency, Moscow, Russia, 123182.

Acquired atresia of the external acoustic meatus is a rare pathological condition characterized by obliteration of the medial part of the external acoustic canal by a soft fibrous plug. The present article presents an overview of a series of cases of acquired atresia and stenosis of the external acoustic meatus with the description of etiology, pathogenesis, and methods for the treatment of this condition. In the majority of the cases, atresia develops at the final stage of granulation external otitis with or without an accompanying dermatological pathology. Another common cause of the acquired atresia of the external acoustic meatus is the fracture of the temporal bone as well as extensive ear surgery, radiation therapy and a neoplasm in the auditory passage. The surgical strategy for the management of the acquired atresia and stenosis of the external acoustic meatus consists, besides the excision of the fibrous plug, of the application of the cutaneous flaps and/or transplants to cover the bare parts of the bone portion of the affected external canal. In spite of such treatment, the state of the external acoustic canal remains unstable, and a relapse of its atresia and stenosis can not be wholly excluded.
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http://dx.doi.org/10.17116/otorino201782369-74DOI Listing
September 2017

[The non-damaging method for the insertion of a standard electrode for cochlear ossification].

Vestn Otorinolaringol 2016 ;81(3):54-56

Research Clinical Centre of Otorhinolaryngology, Federal Medico-Biological Agency, Moscow, Russia, 123182.

The objective of the present study was to develop the non-damaging method for the insertion of a standard electrode for cochlear ossification with a view to improving the results of hearing and speech rehabilitation of the patients presenting with grade IV sensorineural impairment of hearing. Twenty preparations of the cadaveric temporal bone were used to investigate topographic and anatomical relationships in the main structures of the middle and internal ears, viz. the second cochlear coil, vestibulum and its windows, processus cochleaformis, spiral lamina, and modiolus. The optimal method for the insertion of a standard electrode into the spiral canal of the cochlea after the removal of the ossified structures is proposed. The optimal site for constructing the second colostomy is determined that allows the spiral plate and modiolus to be maximally preserved. The proposed method was employed to treat 11 patients with grade IV sensorineural impairment of hearing and more than 5 mm ossification of the basal cochlear coil. With this method, it proved possible to insert the maximum number of electrodes into the cochlear spiral canal and thereby to obtain excellent results of hearing and speech rehabilitation in the patients with the ossified cochlea.
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http://dx.doi.org/10.17116/otorino201681354-56DOI Listing
September 2016

[PECULIARITIES OF ANESTHESIA DURING COCHLEAR IMPLANTATION IN PEDIATRICS.]

Anesteziol Reanimatol 2016 Jul;61(4):272-274

The Aim: analysis of the use of laryngeal mask in anesthesia for cochlear implantation.

Materials And Methods: 10 patients aged from 1 year to 5 years were operated on according to the classical method KI with the use of laryngeal masks. As anesthesia was performed a balanced multimodal anesthesia by Sevoflurane and Fentanyl.

Results: The use of laryngeal masks in all 10 cases have gave the possible to avoid the use of muscle relaxants and to clear the threshold of detection of acoustic reflexes ofstapes musclestendon, and to reduce time of surgical intervention. A short time surgery provided rapid awakening of the patient, absence of nausea and vomiting in the early postoperative period.

Conclusion: use of laryngeal mask airway is reduces the time of surgery, minimize the patient's trauma, reduce input anesthetic drugs and get good results intraoperative audiological testing.
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July 2016

[Optimization of the approach to the spiral (Rosenthal's) canal of the cochlea in the patients presenting with cochlear-vestibular abnormalities].

Vestn Otorinolaringol 2016 ;81(2):23-25

State Scientific Clinical Center of Otorhinolaryngology, Moscow, Russia, 125310.

The objective of the present study was to improve the effectiveness of cochlear implantation (CI) in the patients presenting with cochlear-vestibular abnormalities based on the development and practical application of the algorithm for the insertion of an electrode arrayinto the spiral (Rosenthal's) canal of the cochlea taking into consideration the specific anatomical features of the middle and inner ears. The study included 25 patients with congenital malformations of the inner ear and bilateral grade IV sensorineural loss of hearing or deafness selected for CI. Indications for drilling a cochleostomy were the high localizationof the jugular bulb and the absence of its bone wall (5 patients, 20%). In the remaining cases, it proved possible to identify the round window and perform the transmembrane insertion of the active electrode. In 15 (69%) patients, the surgical intervention provoked intraoperative leakage of the cerebrospinal fluid that was successfully stopped by the careful tamponade of either the cochleostoma or the round window niche with the use of an automuscular flap. Taken together, good visualization of the round window and the transmembrane insertion of the active electrode into the spiral (Rosenthal's) canal of the cochlea in the patients presenting with cochlear-vestibular abnormalities made it possible to reduce to a minimum the injury to the spiral organ of the cochlea, control liquorrhea, and improve auditory performance in the postoperative period.
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http://dx.doi.org/10.17116/otorino201681223-25DOI Listing
August 2016

[About the surgical treatment of vestibular window abnormalities].

Vestn Otorinolaringol 2015 (1):66-69

Saint Petersburg Institute of Ear, Throat, Nose, and Speech, Russian Ministry of Health, St. Petersburg, Russia, 190013.

The objective of the present study was to develop the sparing strategy for the surgical treatment of the patients presenting with malformations of the vestibular window based on the results of the evaluation of synopty of the main clues of the internal and middle ears. This article contains the analysis of the effectiveness of the surgical treatment of 17 patients with malformations of the vestibular window operated during the period from 2008 till 2013. It presents the results of investigations into the topographic relationships between the principal structures of the internal and middle ears of special importance for the assessment of the possibilities for the surgical treatment of such patients with the minimal risk of development of postoperative complications. The results of the surgical treatment were estimated based on the data of audiological studies in the early and late postoperative periods. It was shown that none of the patients developed the symptoms of dizziness, unstable gait or sensorineural impairment of hearing in the immediate postoperative period. Good functional results in the form of the reduced bone-air interval (15.2±1.0 dB) were achieved in 13 patients. Nevertheless, the considerable decrease in the sound conductivity in the late postoperative period observed in 64.7% of the patients related to the closure of the vestibular fistula dictates the necessity of developing the novel techniques for its prevention.
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http://dx.doi.org/10.17116/otorino201580166-69DOI Listing
June 2015
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