TY - JOUR AU - Kovács, Márton AU - Uzsaly, János Gáspár AU - Bodzai, G AU - Pap, István AU - Lippai, Bálint AU - Dergez, Tímea AU - Németh, Adrienn AU - Gerlinger, Imre AU - Szanyi, István AU - Bakó, Péter TI - Efficacy of high dose systemic versus combined (systemic and intratympanic) corticosteroid therapy in idiopathic sudden sensorineural hearing loss : A prospective randomized trial and risk factor analysis JF - AMERICAN JOURNAL OF OTOLARYNGOLOGY J2 - AM J OTOLARYNG VL - 45 PY - 2024 IS - 1 PG - 8 SN - 0196-0709 DO - 10.1016/j.amjoto.2023.104099 UR - https://m2.mtmt.hu/api/publication/34335469 ID - 34335469 N1 - University of Pécs, Medical School, Department of Otorhinolaryngology, Munkácsy M St 2, Pécs, H-7621, Hungary University of Pecs, Szentagothai Research Centre, Ifjusag Str 20, Pécs, H-7624, Hungary University of Pécs, Medical School, Institute of Bioanalysis, Honved St 1, Pécs, H-7624, Hungary Export Date: 20 November 2023 CODEN: AJOTD Correspondence Address: Szanyi, I.; University of Pécs, Munkácsy M St 2, Hungary; email: szanyi.istvan@pte.hu AB - The pathophysiology and the proper treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) are an ongoing subject of debate. Locally or systemic administered corticosteroids are the most accepted drugs of treatment in reference to ISSNHL (idiopathic sudden sensorineural hearing loss), however, no strong evidence nor guidelines regarding their effectiveness yet exists. In our prospective, randomized, controlled trial 78 participants were enrolled. Patients were randomly assigned based on the day of admission to two groups according to treatment: group SS (n = 43) received intravenous systemic methylprednisolone alone, and group CT (n = 35) received intratympanic dexamethasone + systemic methylprednisolone. The primary outcome was to compare the hearing outcomes between the treatment groups based on different, widely accepted categories (Siegel, Kanzaki, modified Siegel and PTA4 gain). In consideration of the secondary outcome, we examined the effect of the various risk factors on the hearing improvement. No differences were detected regarding hearing improvement between the two groups, based on any criteria [Siegel's criteria (p = 0.604); Kanzaki's criteria (p = 0.720); modified Siegel's criteria (p = 0.524) and PTA 4 gain (p = 0.569)]. However, several clinical factors such as vertigo (p = 0.039), or cardiovascular comorbidity (p = 0.02) and the severity of initial hearing loss (p = 0.033) were found to bear a significant impact upon the hearing outcome. To the best of our knowledge, this is the first randomized controlled trial comparing high dose systemic and combination corticosteroid therapy in ISSNHL patients. Our findings suggest coexisting cardiovascular comorbidity, vertigo and severity of the initial hearing loss may bear a significantly higher impact upon hearing improvement, than the additional intratympanic steroid administration. The presented trial was registered in the European Union Drug Regulating Authorities Clinical Trials Database (name: Combinated systemic and intratympanic steroid therapy in idiopathic sudden sensorineural hearing loss, No.: 2017-000658-20) and with the ethical approval of The National Institute of Pharmacy and Nutrition (OGYÉI) (protocol No.: 7621, on 2017.02.16.). LA - English DB - MTMT ER - TY - JOUR AU - Pap, István AU - Kovács, Márton AU - Bölcsföldi, Barbara AU - Szakács, Zsolt AU - Gerlinger, Imre AU - Imreh, Bence AU - Szántóné Csongor, Alexandra AU - Warta, Vilmos AU - Szanyi, István TI - Quality-of-life outcomes with endoscopic and microscopic type I tympanoplasty-a prospective cohort study JF - EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY J2 - EUR ARCH OTO-RHINO-L VL - 280 PY - 2023 IS - 10 SP - 4401 EP - 4408 PG - 8 SN - 0937-4477 DO - 10.1007/s00405-023-07938-6 UR - https://m2.mtmt.hu/api/publication/33728524 ID - 33728524 N1 - Department of Otorhinolaryngology, Head and Neck Surgery (ENT), Medical School, University of Pécs, Munkácsy M. Street, No. 2, Pécs, 7621, Hungary Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary Kanizsai Dorottya County Hospital, Nagykanizsa, Hungary Export Date: 29 January 2024 CODEN: EAOTE Correspondence Address: Pap, I.; Department of Otorhinolaryngology, Munkácsy M. Street, No. 2, Hungary; email: pap.istvan@pte.hu AB - Endoscopic type I tympanoplasty was originally introduced in the 1990s and the extensive spread of this practice can be easily observed. The conventional technique performed involves the repair of a tympanic membrane perforation and is defined as microscopic type I tympanoplasty. The aim of this study is the comparison of quality-of-life (QoL) outcomes with endoscopic to that with microscopic type I tympanoplasty.All patients, or in the case of children with the aid of a parent, were asked to complete a novel QoL questionnaire drafted by our study group. The analysis was performed with descriptive statistics-mean, SD and relative frequency-and with a mixed model (generalized least squares fit). A two-sided p value of < 0.05 was regarded as statistically significant.A total of 83 patients completed the questionnaire, 38 in the endoscopic group and 45 in the microscopic group. Every question represented a different. A statistically significant result was found in favor of the endoscopic approach regarding average hospitalization rate (p = 0.003) and cosmetic outcomes (p = 0.015). No statistically significant difference was otherwise observed between the groups.Based on our prospective cohort study, the QoL outcomes of endoscopic type I tympanoplasty in terms of postoperative pain, headache, nausea, vomiting, dizziness, taste disorder and hearing were comparable to the microscopic type I tympanoplasty. In regard to cosmetics, an increase in desirable results was achieved in the endoscopic group, particularly the average hospitalization rate proved to be statistically significantly lower than in the microscopic group. LA - English DB - MTMT ER - TY - JOUR AU - Bölcsföldi, T Barbara AU - Pap, István AU - Tóth, Tamás Ferenc AU - Tóth, István AU - Révész, Péter AU - Gerlinger, Imre AU - Szanyi, István TI - A szelektív epitympanalis dysventilatiós szindróma műtéti megoldása. JF - ORVOSI HETILAP J2 - ORV HETIL VL - 163 PY - 2022 IS - 36 SP - 1440 EP - 1446 PG - 7 SN - 0030-6002 DO - 10.1556/650.2022.32563 UR - https://m2.mtmt.hu/api/publication/33079688 ID - 33079688 N1 - Case Reports AB - The selective epitympanic dysventilation syndrome is a new theory of the cholesteatoma formation, the description of which was allowed by a minimally invasive surgical technique - the transcanal endoscopic ear surgery - some years ago. The transcanal endoscopic ear surgery provided the possibility of a certain amount of detailed anatomical knowledge to identify the new factor behind this process, namely obstruction of the ventilation pathways of the middle ear. Our goal was to draw the ear surgeons' attention to this clinical picture as cholesteatoma development and subsequent worsening of the quality of life caused by ear discharge and conductive hearing loss may be reversible or preventable. We make the syndrome more understandable by using our own anatomical drawings. In this paper, the authors present a case of selective epitympanic dysventilation syndrome, and emphasize the importance of recognition and the endoscopic ear surgical treatment as well as review the international literature. Orv Hetil. 2022; 163(36): 1440-1446. LA - Hungarian DB - MTMT ER - TY - JOUR AU - Gerlinger, Imre AU - Szabó, Éva AU - Szanyi, István AU - Rostás, Tamás AU - Pap, István AU - Révész, Péter AU - Kopjár, Eszter TI - Mastoidobliterációhoz használt csontpor és bioaktív üveggranulátum a cholesteatoma sebészetében. JF - ORVOSI HETILAP J2 - ORV HETIL VL - 163 PY - 2022 IS - 21 SP - 838 EP - 845 PG - 8 SN - 0030-6002 DO - 10.1556/650.2022.32477 UR - https://m2.mtmt.hu/api/publication/32838757 ID - 32838757 AB - Mastoid obliteration technique combines the advantages of canal wall-up (CWU) and canal wall-down (CWD) approaches in the surgery of chronic suppurative otitis media with cholesteatoma. We aim to demonstrate our experience with mastoid obliteration technique using bone dust and BonAlive® (S53P4) bioactive glass granule in a comparative prospective clinical study.Between 1st of March 2012 and 31st of November 2021, mastoid obliteration surgery was performed in 14 patients using bone dust (7 cases) and BonAlive® granule (7 cases). Prior to these interventions, the patients had undergone more than three ear surgeries (CWU and CWD) generally in both groups. Changes of complaints, audiological results, and changes in quality of life were analysed in both groups, postoperatively.Having performed the mastoid obliteration technique, cochlear damage did not occur in either patient group. Long-term ear discharge and vertigo were occasionally observed after performing obliteration with bone dust. However, these complaints disappeared after a while. Complications were not reported in the case of obliteration with BonAlive®. Outstanding improvement was experienced in both groups.In our practice, mastoid obliteration surgery, using either bone dust or BonAlive® granule, has proved to be a safe and effective method in the management of chronic suppurative otitis media with cholesteatoma, resulting in continuous putrid ear discharge after CWU or CWD tympanoplasty. Obliteration with BonAlive® granule provides several advantages for patients, such as antibacterial effect, osteoconductive effect ensuring frame for bone growth and osteoproductive effect stimulating the ossification. Orv Hetil. 2022; 163(21): 838-845. LA - Hungarian DB - MTMT ER - TY - JOUR AU - Pap, István AU - Jakab-Péter, Kinga AU - Uzsaly, János Gáspár AU - Tóth, István AU - Barabás, Márta-Andrea AU - Fábián, György AU - Lujber, László TI - Transorbitomaxillaris percutan endoszkópos gastrostomia JF - ORVOSI HETILAP J2 - ORV HETIL VL - 163 PY - 2022 IS - 3 SP - 116 EP - 119 PG - 4 SN - 0030-6002 DO - 10.1556/650.2022.32286 UR - https://m2.mtmt.hu/api/publication/32604752 ID - 32604752 AB - Összefoglaló. Fej-nyaki daganattal diagnosztizált és kezelt betegeknél a szájon keresztüli táplálás gyakran nem lehetséges vagy nehezítetté válik a kezelés valamelyik fázisában. A beteg enteralis táplálásának biztosítására tartós és hatékony megoldást kell nyújtanunk, erre megfelelő választás lehet a percutan endoszkópos gastrostomia. A fej-nyaki régióban a daganat elhelyezkedése, kiterjedtsége és a műtétek miatt megváltozott anatómiai viszonyok sokszor gátat szabnak a gasztroszkóp hagyományos, szájon át történő sikeres levezetésének, és így különleges megoldásokra lehet szükség. Közleményünkben egy, a szakirodalomban is ritkán alkalmazott percutan endoszkópos gastrostomakészítésről számolunk be. A bemutatott esetben egy kiterjedt, rosszindulatú fej-nyaki daganat miatt totális maxillectomián és orbitaexenteratión átesett betegben a műtét következtében kialakult arcdefektuson át történt a gastroscopia és a tápszonda levezetése, ugyanis komplett szájzár következtében a beteg a táplálkozásra képtelen volt. A fent említett módszerrel sikerült a beteg hosszú távú enteralis táplálását megoldani minimálinvazív módon. Az összetett kóros esetek gyakran állítják kihívások elé a gyakorló klinikust. Esetbemutatásunkkal szeretnénk felhívni a figyelmet a hagyományos, megszokott módszerek helyett sokszor nagyobb sikerrel alkalmazható, személyre szabott terápiás lehetőségekre. Orv Hetil. 2022; 163(3): 116-119. Summary. Peroral, enteral feeding is often impossible in patients with head and neck cancer. Percutaneous endoscopic gastrostomy is a well-established, quick, minimally invasive, and safe procedure for providing long-term enteral feeding. Space-occupying tumour mass and altered anatomy due to surgery inhibit the gastroscope's peroral introduction and the feeding tube's placement in some instances. Various access routes and modified insertion techniques are recommended to overcome the feeding tube insertion challenges. We present a rare case of a 64-year-old head and neck cancer patient who was unable to eat orally due to trismus and had a facial soft tissue defect following total maxillectomy and orbital exenteration. A complete oesophago-gastro-duodenoscopy and feeding tube insertion were performed transfacially. Percutaneous endoscopic gastrostomy was successful and uneventful via the maxillary and orbital soft tissue facial defect. No complication was noted, and long-term enteral feeding of the patient was provided in a minimally invasive way. Surgeons often face challenging cases when treating patients with head and neck cancer. The modification of standard procedures is sometimes required to adapt surgical techniques to the patient's specific case. Orv Hetil. 2022; 163(3): 116-119. LA - Hungarian DB - MTMT ER - TY - JOUR AU - Pap, István AU - Tóth, István AU - Szakács, Zsolt AU - Gede, Noémi AU - Koukkoullis, Alexandros AU - Révész, Péter AU - Harmat, Kinga AU - Németh, Adrienn AU - Lujber, László AU - Bocskai, Tímea AU - Hegyi, Péter AU - Varga, Gábor AU - Gerlinger, Imre AU - Szanyi, István TI - Az endoszkópos I-es típusú tympanoplastica ugyanolyan hatékony, mint a mikroszkópos I-es típusú tympanoplastica, de kevésbé invazív - Metaanalízis JF - FÜL-ORR-GÉGEGYÓGYÁSZAT J2 - FÜL-ORR-GÉGEGYÓGYÁSZAT VL - 67 PY - 2021 IS - 4 SP - 139 EP - 146 PG - 8 SN - 0016-237X UR - https://m2.mtmt.hu/api/publication/32508864 ID - 32508864 LA - Hungarian DB - MTMT ER - TY - JOUR AU - Gerlinger, Imre AU - Végh, Ildikó AU - Nepp, Nelli AU - Pap, István AU - Révész, Péter AU - Bakó, Péter AU - Szanyi, István AU - Rostás, Tamás AU - Tóth, István TI - A pars petrosa cholesteatomák korszerű ellátása Pécsi tapasztalatok JF - ORVOSI HETILAP J2 - ORV HETIL VL - 161 PY - 2020 IS - 43 SP - 1840 EP - 1848 PG - 9 SN - 0030-6002 DO - 10.1556/650.2020.31879 UR - https://m2.mtmt.hu/api/publication/31641583 ID - 31641583 LA - Hungarian DB - MTMT ER - TY - JOUR AU - Tóth, István AU - Pap, István AU - Gerlinger, Imre TI - Cholesteatoma update 2019 JF - FÜL-ORR-GÉGEGYÓGYÁSZAT J2 - FÜL-ORR-GÉGEGYÓGYÁSZAT VL - 66 PY - 2020 IS - 1 SP - 9 EP - 18 PG - 10 SN - 0016-237X UR - https://m2.mtmt.hu/api/publication/31383609 ID - 31383609 LA - Hungarian DB - MTMT ER - TY - JOUR AU - Gerlinger, Imre AU - Molnár, Krisztián AU - Nepp, Nelli AU - Tóth, István AU - Tóth, Tamás Ferenc AU - Szanyi, István AU - Bakó, Péter AU - Pap, István TI - Subtotalis petrosectomia – javallatok, műtéti technika, pécsi tapasztalatok JF - ORVOSI HETILAP J2 - ORV HETIL VL - 161 PY - 2020 IS - 14 SP - 544 EP - 553 PG - 10 SN - 0030-6002 DO - 10.1556/650.2020.31691 UR - https://m2.mtmt.hu/api/publication/31269089 ID - 31269089 AB - Introduction: Subtotal petrosectomy (STP) has been known for decades and it is considered being on the borderline between ear and skull-base surgery. Due to its excessive radicalism and adverse effects on hearing, it has been a forgotten surgical technique until recently. Over the last decade, due to its many benefits and the ability to combine it with modern hearing rehabilitation methods, STP has reappeared, providing a definitive solution to a number of problematic middl-ear disorders. Aim: In our retrospective clinical study, we wanted to highlight the effectiveness of STP, analyzing the efficiency of this surgery for the first time in domestic patient records, and to report our own experiences to date. Method: We processed data from 45 surgeries on our 44 patients. In addition to presenting the various surgical indications, we review the steps of the operation, analyze the audiological results, including the various methods of hearing rehabilitation, and also analyze the complications that have occurred. Our results are also summarized in the light of international professional literature. Results: Of our 44 patients, 23 were female and 21 were male. Patients had a mean age of 44.6 ± 20.5 years and a mean follow-up of 23 ± 16 months. Of our patients, 25 (57%) had undergone at least two previous unsuccessful ear operations, and 6 (14%) had deafness before surgery. The most common indication was chronic otitis media with cholesteatoma. 13 patients underwent 14 cochlear implantations (23%), in addition 6 patients received bone anchored hearing aids (BAHA) (14%), and 2 patients (5%) underwent VSB (Vibrant Soundbridge) placement against the round window membrane. Complications occurred in 11 of our patients, the most common of which was cerebrospinal fluid leak (5 cases, 11%) and wound dehiscence (3 cases, 7%). Data from 3 patients were available for processing the audiological results. Conclusion: STP is an extremely favorable surgical solution for a number of middle-ear pathologies that have previously caused major problems. The main reason for its growing popularity is that it can be combined with a number of modern, effective methods of hearing rehabilitation. Orv Hetil. 2020; 161(14): 544-553. LA - Hungarian DB - MTMT ER - TY - JOUR AU - Bocskai, Tímea AU - Kovács, Márton AU - Szakács, Zsolt AU - Gede, Noémi AU - Hegyi, Péter AU - Varga, Gábor AU - Pap, István AU - Tóth, István AU - Révész, Péter AU - Szanyi, István AU - Németh, Adrienn AU - Gerlinger, Imre AU - Karádi, Kázmér AU - Lujber, László TI - Is the bispectral index monitoring protective against postoperative cognitive decline? A systematic review with meta-analysis JF - PLOS ONE J2 - PLOS ONE VL - 15 PY - 2020 IS - 2 PG - 17 SN - 1932-6203 DO - 10.1371/journal.pone.0229018 UR - https://m2.mtmt.hu/api/publication/31180137 ID - 31180137 N1 - * Megosztott szerzőség LA - English DB - MTMT ER -