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Ureterovesical reimplantation after failure of endoscopic treatment of reflux by submucosal injection of polytef paste.

In a homogeneous series of 100 children (174 ureteric units) treated endoscopically (sting) for vesicorenal reflux, 33 children (42 ureters) presented with recurrent reflux after 2 months, 1 child had ureteral dilatation. 12 children (18 ureters) underwent a secondary Cohen's antireflux plasty without particular problems. In light of these cases, we consider that the submucosal injection of polytef paste modifies neither the process nor the immediate postoperative course of antireflux plasty. Histological study of the lower end of the ureters did not show an inflammatory reaction, except the presence inside the polytef paste of multiple macrophages, the long-term result of which is still unknown.

Child, Preschool↗

Reimplantation of a molded scala tympani electrode: impact on psychophysical and speech discrimination abilities.

Revision surgery was successfully performed on two Vienna cochlear implant patients. Twenty months and 40 months, respectively, after initial insertion into the cochleas of two bilaterally deaf patients, electrodes were removed from the scala tympanis and replaced by electrodes of the same design. Psychophysical and speech data gathered before and after the revision surgery were compared. These were thresholds, loudness scalings, amplitude difference limens, pitch scalings, frequency difference limens, and speech tests in the "stimulation only" modality. No negative changes were found. The data available demonstrate a continuous improvement in performance over many months of practice with the sound processor. This development was not impeded by the revision surgery. Thus, it was demonstrated that the removal and replacement of a molded scala tympani electrode is feasible.

Adult↗

Audiologic results following reimplantation of cochlear implants.

Five patients using cochlear implants experienced internal device failure 6 weeks to 4 years following implantation. All devices were removed and new electrodes inserted. Single-channel implants were replaced with multichannel systems in three patients, while the others received identical multichannel implants. The performance on a uniform battery of audiologic tests was the same or better with the second implant in all patients. Replacement of intracochlear electrodes did not induce clinically apparent degeneration of auditory performance in this series.

Adolescent↗

Early reactions after reimplantation of the tendon of supraspinatus into bone. A study in rabbits.

In 14 rabbits we determined the origin of the cells effecting healing of the tendon of supraspinatus inserted into a bony trough. After two weeks both the cellularity of the underlying bone and the thickness of the subacromial bursa were significantly increased in the operated compared with the control shoulders. The cellularity of the stump of the tendon, however, was significantly decreased in the operated shoulders. In this model, both the underlying bone and the subacromial bursa but not the stump of the tendon contributed to the process of repair. We conclude that the medial stump should be debrided judiciously but that cutting back to bleeding tissue is not necessary during repair of the rotator cuff. Moreover, great care should be taken to preserve the subacromial bursa since it seems to play an important role in the healing process.

Acromion↗