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Biomedical subjects

K Ojala

Publications and source records attributed to K Ojala.

At least 37 records · Page 2Linked to original sources
PubMed1982

Late results of obliterative cholesteatoma surgery.

Radical obliterative cholesteatoma surgery was performed on 463 ears. Post-operative cholesteatomas were found in 22 of 463 of the ears during the follow-up periods that ranged from five to 15 years. Eight of them were of the residual type, and 14 were of the recidive type. A substantial portion of the postoperative cholesteatomas (11 cases) was discovered as late as the sixth to the tenth postoperative years. Four of the postoperative cholesteatomas extended to the antrum or the operation cavity from the tympanic cavity or meatus, but none of them originated in the cavity area. The surgical method that was used was safe. Annual follow-up examinations for at least ten years are recommended after the obliterative radical operation for ears with cholesteatomas.

Cholesteatoma↗
PubMed1982

Late changes in ear canal volumes after mastoid obliteration.

In this study, preoperative and postoperative ear canal volumes of ears subjected to obliterative radical mastoidectomy were assessed. The measurements were performed using sterile saline solution both at the preoperative stage (V0) and at the early (one year, V1) and the late (five to 13 years, V2) postopertive stages. The mean V0 was 0.8 mL (SD, 0.2 mL; V1, 1.0 mL (SD, 0.3 mL); and V2, 1.2 mL (SD, 0.4 mL). The differences were highly significant. Clinically, the widening of the ear canals was mainly slight and appeared evenly in the epitympanic area and in the posterior ear canal wall.

Chronic Disease↗
PubMed1982

Late changes in hearing results after mastoid obliteration with tympanoplasty.

Hearing results are presented for 627 ears with chronic otitis media that were operated on radically and obliterated (Palva flap) and in which a tympanoplasty was performed. The ears were examined annually for five to 14 years (mean, 8.8 years). The long-term improvement (five to 14 years after the surgery) was the greatest in ears with an intact ossicular chain and in ears with ossicular reconstruction using autograft or homograft ossicles or autogenous cortical bone columellae. As a whole, the early (one year after the operation) improvement in the air-bone gap was 8.0 dB when compared with the preoperative gap and the late deterioration in gap after the first year was 6.0 dB. To detect the late changes in hearing results, the ears operated on must be followed up for a least five to ten years.

Adolescent↗
PubMed1982

Correlation of postoperative ear canal volumes with obliteration material and with volume of operation cavity.

In this study the preoperative and early and late postoperative volumes of ear canals of 131 operated chronic ears were measured by filling the ear canals with saline solution. The ears were operated on using the Palva method of obliteration of the operative cavity and reconstruction of the ear canal after removing the posterior, bony canal wall at operation. The average preoperative ear canal volume (V0) was 0.8 ml, the early postoperative volume (V1) was 1.0 ml, and the late postoperative volume (V2) was 1.2 ml. There was significantly more widening of the volume of the ear canals in the ears with a larger (greater than 7 ml) operation cavity as compared to ears with smaller (3-7 ml) operation cavity (p less than 0.05). Widening of the ear canals was smaller in the 12 ears with obliteration of the surgical cavity with musculoperiosteal flap and anorganic bone (Ossar) as compared to the 119 ears obliterated with musculoperiosteal flap only, but the difference was not statistically significant (p greater than 0.05).

Bone Transplantation↗
PubMed1982

Bacteriology in chronic otitis media correlated with the clinical state of ears.

Bacteriologic findings in 702 cases of chronic otitis media were correlated with the clinical conditions of the ears. Statistically significant correlations with the severity of the clinical infection were noticed concerning Pseudomonas aeruginosa, St, aureus and E. coli. The bacteriological findings did not correlate with the results of Valsalva test. Pseudomonas aeruginosa was statistically more often present in ears without than in ears with cholesteatoma.

Adolescent↗
PubMed1982

The preoperative state of infection in chronic otitis media correlated with postoperative hearing results.

The postoperative long-term hearing results, with special reference to the state and management of the tympanic mucosa at operation, in 627 ears (574 patients) after an annual clinical follow-up period of 5-14 years are presented. The ears were operated on radically due to chronic otitis media, using the obliterative radical operation technique developed by T. Palva. The air-bone gap improved from the preoperative level significantly more in ears where the tympanic mucosa had been preserved than in ears where it had been removed at operation (p less than 0.001). The improvement was also significantly better in dry ears than in ears which were moist or discharging at operation (p less than 0.05). The mean late deterioration in the air-bone gap after the first follow-up year was significant in all the groups of ears (p less than 0.05), and the mean long-term change in air-bone gap from pre- to late postoperative examination was the improvement of 3.0 dB in ears with, and a deterioration of 2.0 dB in ears without ossicular reconstruction.

Adolescent↗
PubMed1982

Post-operative cholesteatomas and retraction pockets after obliterative surgery in ears without cholesteatoma.

The frequency of post-operative cholesteatomas, epidermizations and retraction pockets in a series of 343 chronically infected ears (315 patients) without cholesteatoma at primary surgery was evaluated. The ears were operated on radically, exclusively by the Palva method, with removal of the bridge in 248 ears and preservation of it in 95 ears. Musculo-periosteal obliteration and seclusion of the aditus were performed in every case with a Palva flap and with a temporalis muscle-fascia graft. The primary operations took place over the period 1964-1972, and all the ears without cholesteatoma at primary surgery were included; they were followed up annually. The evaluation of this material was carried out in 1976-1979 and the follow-up time was on an average of 8.5 years (5-15 years). Cholesteatoma was found in six (6/343; 1.7 per cent), epidermization of the tympanum in four (4/343; 1.2 per cent), and retraction pockets without cholesteatoma in six (6/343; 1.7 per cent) of the ears. Preservation or removal of the bridge at operation did not cause any significant difference in the frequency of the post-operative complications mentioned (p greater than 0.05). Most of the complications were discovered after the first postoperative year.

Adolescent↗
PubMed1982

Bacteriological studies after obliterative mastoid operations.

This study evaluates the post-operative bacteriology and the clinical state of postoperatively infected ears which were operated on using obliterative techniques and relates these bacteriological findings with the disease present. Out of the 85 ears with post-operative infection, the discharge was mucous in nine ears, mucopurulent in 18 ears, and seropurulent in 34 ears. Twenty-four ears were moist. Epitympanal or antral cholesteatoma was noticed in seven ears and meso- or hypotympanal cholesteatoma in 12 ears. The post-operative Valsalva-test was positive in 61 ears and negative in 24 ears. The types of bacteria did not significantly depend on the quality of the post-operative discharge, existence of post-operative cholesteatoma, or clinical function of the Eustachian tube (estimated by the Valsalva test). This study indicates that the bacteriology of the post-operatively moist or discharging ear does not significantly depend of the clinical state of the ear, nor can it be predicted on the basis of the clinical picture of the ear. A bacteriological examination of the ear seems to be the only way to control chemotherapy properly.

Adolescent↗
PubMed1982

[Bacteria in the middle ear and nasopharynx in patients with chronic otitis media].

The pre- and postoperative aural and postoperative nasopharyngeal bacteriology of 104 ears (100 patients), still moist or discharging after surgery, were studied. Preoperatively aural and postoperatively dry ears (83 patients) of reference group were registered as well. All ears had been operated on radically with obliterative technique as described by Palva (1963, 1973) because of chronic otitis media with or without cholesteatoma. The preoperative bacteriology of the postoperatively moist or discharging cars did not differ statistically from that of the ears in the reference group. The same bacteria were detected pre- and postoperatively in the same ears in 44.1% of the ears in the former group and this situation was noticed highly significantly often regarding Pseudomonas aeruginosa (p less than 0.001) and almost significantly often regarding Proteus sp. (p less than 0.05). The postoperative nasopharyngeal bacteriology of the two groups mentioned did not differ statistically and only in six out of 100 cases the same pathogenic bacteria could be simultaneously cultured in the postoperatively moist or discharging ear and nasopharynx of the same patient.

Ear, Middle↗
PubMed1981

Atlantoaxial subluxation. An unusual complication after local anesthesia for tonsillectomy.

After tonsillectomy, atlantoaxial subluxation occurred in two patients. Operations had been performed with the use of local anesthesia, and it was assumed that, during the injection of anesthetics, bacteria infected the prevertebral space. The initial symptoms of the prevertebral space infection were neck pain and stiffness; the movements of the neck were minimal, and opening of the mouth caused pain due to spasm of the deep cervical muscles. Both patients had persistent fever. The roentgenographically observed subluxation developed in one to two months after tonsillectomy. One of the patients was treated only with antibiotics; the other patient required atlantoaxial spondylodesis. Healing of the subluxation lasted about six months in both cases.

Adult↗
PubMed1981

Late hearing results after paraffinplasty or silastic sheeting.

The long-term hearing results are presented for 135 ears operated on radically. In 59 of the ears temporary paraffin filling of the tympanic cavity was employed after the removal of the tympanic mucosa ot operation. The filling material was removed, and the ossiculoplasty was performed about 6 months later. In 76 ears a one-stage operation with tympanoplasty and Silastic sheeting was employed. There were no statistical differences between the groups of ears mentioned according to hearing results early (1 year) or late (5-15 years) postoperatively or in the deterioration of the air-bone gaps after the first postoperative year (P greater than 0.05). The late change in the air-bone gap was significant in both groups (paraffin group: 6.1 dB; Silastic sheeting group: 5.7 dB; P less than 0.05). The total improvement of hearing late after surgery (as compared to the preoperative hearing) was significantly better in the paraffin group than in ears with Silastic sheeting (P less than 0.05). Paraffinplasty seems to be a suitable way to avoid tympanic adhesions.

Adolescent↗
PubMed1981

Comparison of pre- and post-operative bacteriology of chronic ears.

The over-all distribution of the pre-operative bacteria of 806 ears and the post-operative bacteria of 109 post-operatively moist or discharging ears correlated very well, the only clear difference being the detection of diphtheroid bacilli more often post-operatively than pre-operatively. When comparing the pre- and post-operative bacteriology of 109 post-operatively infected chronic ears which had undergone radical surgery and obliteration with Palva flaps (and which were drawn from a group of 806 ears originally operated on and followed yearly for 5-14 years) it was noticed that Pseudomonas aeruginosa and Proteus sp were cultured more often post-operatively than pre-operatively in the same ears. Statistically, other bacteria were not found to be significantly present in the same ears.

Adolescent↗
PubMed1979

The effect of gemfibrozil on serum lipids in diabetic patients.

The effect of gemfibrozil, a new hypolipidaemic compound, on serum lipids, lipoproteins and ophthalmic signs was studied in 20 diabetics during a 28 week trial. Ten of the patients were taking oral hypoglycaemic agents and another ten insulin. Genfibrozil elevated the proportion of alpha-lipoproteins (HDL) (P less than 0.005) in patients on oral agents to the same level as in those using insulin, who experienced no change in HDL. The pre-beta-lipoprotein proportion (VLDL) decreased (P less than 0.001) along with the serum triglyceride level in patients on oral agents only. The proportion of beta-lipoproteins (LDL) remained unchanged in both groups. The serum cholesterol and total lipid levels decreased significantly whether the patients were on oral treatment or insulin. The gemfibrozil was well tolerated. A minor increase in diabetic therapy was made in 9 patients in order to control the blood sugar levels. The ophthalmic signs were generally unchanged.

Administration, Oral↗