Laryngotracheal fibrosis is a rare but severe complication of prolonged intubation, leading to airway narrowing, respiratory distress, dysphonia, and, in advanced cases, life-threatening airway obstruction. Current treatments are primarily surgical, while pharmacologic approaches such as mitomycin C, corticosteroids, or 5-fluorouracil show inconsistent efficacy and potential toxicity. Thus, there remains a critical need for safe and effective antifibrotic therapies. Transforming growth factor-beta (TGF-β) is a key mediator of fibrosis, promoting fibroblast activation, migration, and expression of profibrotic markers such as alpha-smooth muscle actin (α-SMA). This study aimed to evaluate the antifibrotic potential of tilorone dihydrochloride, a synthetic small molecule, in human respiratory fibroblasts in vitro. Fibrotic alterations were assessed in human laryngotracheal fibrosis tissue samples. An in vitro model using MRC-5 human lung-derived fibroblasts was employed to investigate the effects of tilorone. Molecular analyses (RT-qPCR, immunocytochemistry, western blotting) quantified mRNA and protein expression of key signaling markers. Cell proliferation and viability were performed to evaluate potential cytotoxic effects of tilorone. Functional assays, including wound scratch and single-cell tracking, assessed fibroblast motility, and atomic force microscopy (AFM) measured extracellular matrix elasticity. Phosphorylation of Smad1/5/8, a key transcription factor in the bone morphogenetic protein (BMP) signaling, was reduced in both human laryngotracheal fibrosis tissue and TGF-β-treated MRC-5 fibroblasts. Tilorone treatment did not affect MRC-5 cell viability or proliferation but increased BMP2, BMP4, BMP7, and BMP14 (GDF5; Growth Differentiation Factor 5) mRNA expression, enhanced Smad1/5/8 phosphorylation, and suppressed TGF-β-induced Smad2/3 phosphorylation. Functionally, tilorone inhibited TGF-β-driven fibroblast migration and α-SMA expression, downregulated collagen I and III mRNA levels, and restored extracellular matrix elasticity, as confirmed by AFM. Tilorone counteracts TGF-β-mediated profibrotic signaling and restores BMP pathway activity in MRC-5 fibroblasts in vitro. These findings identify tilorone as a promising therapeutic candidate for fibrotic airway diseases such as laryngotracheal fibrosis.

Warsaw Breakage Syndrome (WABS) is an ultra-rare autosomal recessive disorder, presenting with multiple abnormalities including sensorineural hearing loss due to cochlear malformation. Cochlear implant is a viable treatment for hearing loss in these patients. We report an implantation in a 2.91 year old girl with WABS who presented 1 year prior with bilateral severe sensorineural hearing loss. Radiological investigations revealed a bilateral Type-I Cochlear Hypoplasia). Using radiological images, we generated a 3D reconstruction of the labyrinth and auditory ossicles using the 3D Slicer image computing platform. The resulting models were 3D printed from a biocompatible resin and insertion of the cochlear implant electrode array was tested using a range of electrode models. Following this pre-surgical planning, an optimal electrode (Med-El Compressed) was selected based on size and positioning within the cochlea. The patient then underwent cochlear implantation and postoperatively has shown signs of hearing assessed through both electrophysiological and subjective approaches. The patient presented with severe bilateral cochlear malformation - hypoplasia of the basal turns, absent modiolus and cyst-like merging of the 2nd and 3rd turns. The preoperative 3D visualisation and printed model were instrumental in electrode array insertion, positioning, and selection of the ideal individual electrode. This consequently led to successful cochlear implantation (proper electrode placement, minimal complications, improved hearing thresholds and successful rehabilitation). Our findings, coupled with a review of similar rare cases in the literature, suggest that this approach could be broadly applicable to paediatric cases of cochlear hypoplasia with the future aim of optimizing postoperative outcomes.

PURPOSE:Early cochlear implantation during the critical period of neuroplasticity leads to better auditory and language outcomes but presents unique anesthetic challenges in infants. This study retrospectively examined anesthesia-related events throughout the full diagnostic and surgical process over a 10-year period, focusing on pediatic population undervent cochlear implantation - especially under the age of 18 month. METHODS:Data from 175 children under age 3 were analized who received cochlear implants between 2014 and 2024. Anesthesia-related events during audiological tests (BERA/ASSR), imaging (CT/MRI), and surgery were recorded. Collected variables were demographics, comorbidities, ASA and Mallampati scores, anesthetic techniques, procedure durations, complications, and ICU admissions. A subgroup analysis was conducted for patients implanted before 18 months. RESULTS:Of the 175 patients, 35 (20.2%) received implants before 18 months and 8 (4.6%) before 12 months. Anesthesia-related complications occurred in 14 cases (8.1%) in the study population, with laryngospasm during extubation being the most frequent (n = 8); all resolved without reintubation. Difficult intubation was noted in 3 patients, mainly those with craniofacial anomalies. Four children required postoperative ICU care. No complications were observed during diagnostic procedures. No significant association was found between complication rates and age, ASA status, or Mallampati score. CONCLUSION:Cochlear implantation, even in infants under one year, is safe with appropriate anesthesia and experienced teams. Complications were rare and manageable. Recognizing anesthesia risks helps optimize care and reassure parents, supporting timely intervention within the neuroplastic window.

Autosomal dominant non-syndromic hearing loss (ADNSHL) is a genetically heterogenic condition. The transformation/transcription domain associated protein (TRRAP) gene has been recently associated with ADNSHL, and only four variants of the gene have so far been reported in this disease. Here, we report on a Hungarian ADNSHL family in which the affected individuals exhibited sensorineural hearing loss with similar clinical symptoms, including initial impaired high frequencies that subsequently affected speech and lower frequencies. Whole exome sequencing and screening of the shared genetic variants of the affected individuals was performed. Our results revealed a novel heterozygous missense variant (NM_001244580.2, c.5360A>G, p.Lys1787Arg) in the TRRAP gene. This variant is completely co-segregated with hearing impairment. It is present in a heterozygous form in the affected mother and daughter but not carried by any unaffected family members. This study highlights the importance of elucidating the germline genetic background of ADNSHL, which may help to predict individual risk and the risk of family members. This will improve prevention, screening, and therapeutic measures for each patient and hearing loss-prone families.

Patients exhibited progressive saddle nose deformity as a result of GPA. To reconstruct the nose, a single-stage open rhinoplasty was conducted involving the placement of an independent L-shaped costal cartilage implant. Graft formation and fixation were performed according to the author-developed method. From 2012 to 2023, seven patients with severe saddle nose deformity underwent implantation of modified L-shaped costal cartilage strut grafts. Except for one complicated case, all patients reported satisfaction with the surgical outcomes. In this study, the visual appeal of the nose and the respiratory capabilities of the patients improved significantly. The L-shaped costal cartilage strut graft is an effective technique for saddle nose deformity correction. This technique provides excellent outcomes, including improved nasal function and aesthetics. Further studies with a larger sample size are needed to confirm these findings. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The prenatal detection and neonatal definitive management of congenital expansive lesions affecting the oral cavity – due to potential airway compromise and feeding difficulties – represent a complex, multidisciplinary task requiring high-level professional and technical expertise. In this case report, we present the urgent management and subsequent definitive surgical excision of a cystic mass causing severe oral obstruction in a neonate, identified prenatally by ultrasound examination. The fetus was delivered at 38 weeks of gestation via elective cesarean section with a birth weight of 3400 g. Due to a protruding cyst approximately 6 × 6 cm in size arising from the oral cavity, immediate airway management was performed using a Mayo tube, along with multiple punctions of the cystic mass. This intervention successfully secured the airway. The infant was fed via a nasogastric tube. Following MR imaging, the cyst originating from the sublingual area was completely excised in toto on day 8 of life. The postoperative period was uneventful. Oral feeding was gradually initiated two weeks after surgery. Histopathological examination confirmed an enteric duplication cyst, a rare occurrence in the sublingual region. During an 11-month follow-up period, no signs of recurrence were observed. The infant experienced no breathing or feeding difficulties, and growth in weight and length was appropriate for age. Prenatal care is essential for detecting fetal congenital anomalies. In these cases with potential to cause respiratory compromise, expertise in emergency airway management during planned cesarean delivery is critical. Definitive neonatal treatment of oral cavity masses causing respiratory or feeding difficulties can shorten hospitalization and minimize the physical and psychological burden associated with repeated surgeries. Orv Hetil. 2025; 166(36): 1431–1437.

The effects of unilateral vocal fold paralysis on voice production and swallowing can lead to a significant deterioration in the quality of life. Isolated injury to the recurrent laryngeal nerve results in limited movement of the affected vocal fold and its fixation in a paramedian position. The leading symptom of paralysis is decreased vocal performance, less commonly aspiration and difficulty breathing on exertion. The selection of the optimal therapeutic method depends on the etiology of vocal fold paralysis, the position of the vocal folds, the prognosis of the disease, the time elapsed since the paralysis, the patient’s comorbidities and motivation. Several types of phonosurgical methods are available to solve the problem, the common goal of which is the medialization of the abnormally positioned, immobile vocal fold in order to optimize phonatory closure. Among the interventions, injection laryngoplasty stands out with its simplicity and versatility, which can correct the position of the paralyzed vocal fold, as well as its volume and, at the same time, its mass. Based on a review of the international literature and our own experiences, we present the methodology for applying the procedure, with particular attention to the different surgical techniques and the types of injectable materials. With the optimal choice of these factors, injection laryngoplasty is a safe, inexpensive, relatively easy to learn, and favorable solution for the treatment of mild to moderate glottic insufficiency due to various causes. Orv Hetil. 2025; 166(26): 1017–1024.

Idiopathic subglottic stenosis (iSGS) is a rare fibroinflammatory disorder characterized by scar tissue formation in the subglottic and tracheal regions. This study evaluated the long-term outcomes of a novel, single-step surgical technique that redefines the glottic and subglottic airway using local tracheal grafts. Thirteen patients (2 male and 11 female) diagnosed with iSGS who underwent slide laryngotracheopexy were enrolled in this study. The diagnosis of iSGS was confirmed through endoscopic assessment, CT scanning, and autoimmune blood testing. Patients completed post-operative Voice Handicap Index (VHI), Quality of Life (QoL), and MD Anderson Dysphagia Inventory (MDADI) questionnaires, and spirometry assessments were conducted. All patients were successfully extubated in the operating room following surgery. None of the patients required intensive care unit treatment. The average hospital stay was 14 days. A temporary tracheotomy was needed in one case because of excessive crusting. Adjuvant endolaryngeal laser surgery was performed in three cases. In one case, mitomycin-C therapy was administered to treat granulation. Post-operative quality of life (QoL) assessment, peak inspiratory flow (PIF), and scores from the MDADI and VHI questionnaires were 9.0 (± 2.2), 2.8 l/s (± 0.83), 95.6 (± 4.3), and 18.7 (± 13.4), respectively. Slide laryngotracheopexy was a safe and dependable technique for cases classified as Cotton-Myers II-IV grade iSGS. The use of a tracheal flap was advantageous to ensure optimal mucosal function. Slide laryngotracheopexy may be employed following multiple endolaryngeal interventions, whereas adjuvant CO2 laser surgery or mitomycin-c therapy may be considered in cases involving granulation tissue formation. 4. Retrospective case series review.

Rhabdomyosarcoma (RMS), the most common soft tissue sarcoma in children, arises from skeletal muscle cells that fail to differentiate terminally. Two subgroups of RMS, fusion-positive and fusion-negative RMS (FPRMS and FNRMS, respectively), are characterized by the presence or absence of the PAX3/7-FOXO1 fusion gene. RMSs frequently exhibit increased expression of human epidermal growth factor receptor-2 (HER2). Trastuzumab is a humanized monoclonal antibody targeting HER2, and its potential role in RMS treatment remains to be elucidated. Syndecan-4 (SDC4) is a heparan sulfate proteoglycan (HSPG) affecting myogenesis via Rac1-mediated actin remodeling. Previously, we demonstrated that the SDC4 gene is amplified in 28% of human FNRMS samples, associated with high mRNA expression, suggesting a tumor driver role. In this study, after analyzing the copy numbers and mRNA expressions of other HSPGs in human RMS samples, we found that in addition to SDC4, syndecan-1, syndecan-2, and glypican-1 were also amplified and highly expressed in FNRMS. In RD (human FNRMS) cells, elevated SDC4 expression was accompanied by low levels of phospho-Ser179 of SDC4, leading to high Rac1-GTP activity. Notably, this high SDC4 expression in RD cells decreased following trastuzumab treatment. Trastuzumab decreased the levels of G1/S checkpoint regulators cyclin E and cyclin D1 and reduced the cell number; however, it also downregulated the cyclin-dependent kinase inhibitor p21. The level of MyoD, a transcription factor essential for RMS cell survival, also decreased following trastuzumab administration. Our findings contribute to the understanding of the role of SDC4 in FNRMS. Since HER2 is expressed in about half of RMSs, the trastuzumab-mediated changes observed here may have therapeutic implications.

Objective:Endoscopic arytenoid abduction lateropexy (EAAL) is a minimally invasive surgical technique for the immediate management of bilateral vocal fold palsy (BVFP). Specifically, it achieves a stable and adequate airway by lateralizing the arytenoid cartilage without resecting laryngeal structures. Thus, this study evaluated the effect of EAAL on swallowing in cases of BVFP. Methods:The participants consisted of 17 adult patients (15 female, 2 male) who underwent unilateral EAAL for BVFP. Swallowing function was evaluated by using the fiberoptic endoscopic evaluation of swallowing (FEES) on the 6th postoperative day and in the 6th postoperative month. The results were assessed by using the pharyngeal residue severity scale (PRSS) and the modified penetration-aspiration scale (mPAS). Additionally, the M.D. Anderson Dysphagia Inventory (MDADI) questionnaire was self-administered during the 6th postoperative month. Results:Overall, 16 of the 17 patients demonstrated normal swallowing function during the early and late postoperative periods. Moreover, one patient experienced mild fluid aspiration early on, but initially managed it with dietary adjustments and eventually resolved it with a head flexion compensatory maneuver. There was no significant deterioration in swallowing-related quality of life according to the MDADI assessments. Conclusion:Based on this evaluation of unilateral EAAL, our results confirmed that this procedure is not only a reliable solution for BVFP from the perspective of respiratory function and phonation but also in terms of swallowing quality. Level of Evidence:4.

Introduction: Chat Generative Pre-Trained Transformer (ChatGPT) is a recently developed artificial intelligence (AI)-based language model that has become an increasingly common source of health-related information due to its accessibility. However, there is limited evidence regarding the accuracy and reliability of its responses. Objective: This study aimed to assess ChatGPT’s usability in otolaryngology by analyzing its answers to common patient questions. Method: 24 patient-oriented questions were created across 10 otolaryngological disease categories and submitted sequentially to ChatGPT version 4.0. The generated responses were evaluated from a linguistic perspective and 6 board-certified otolaryngologists using a three-point scale: incorrect (1), correct but incomplete (2), and correct (3). Results: Language evaluations indicated that the responses were generally clear, well-structured, and of good quality for further medical evaluations. ChatGPT’s medical accuracy scores ranged from 2.00 to 2.83. Three specific questions (Q4, Q9, Q24) received significantly lower ratings. Four raters (R1, R2, R4, R6) showed strong agreement in their evaluations, while significant differences emerged between the scores of R3 and R5 (p<0.001). Conclusion: ChatGPT’s responses in otolaryngology were coherent and well-structured, but the accuracy of medical content varied by topic. While the tool may be beneficial for basic patient education, it is not currently reliable enough to support clinical decision-making. Future development of validated, specialty-specific artificial intelligence systems based on trustworthy medical sources will be crucial for safe implementation in healthcare. Orv Hetil. 2025; 166(42): 1666–1674.

Background: Esophageal perforations can lead to air entering the mediastinum, resulting in pneumomediastinum and potentially life-threatening complications. Prompt identification and management of foreign bodies are critical in such cases. Case Presentation: This case presents the incidental discovery of a hyperdense foreign body in the middle two-thirds of a patient’s esophagus, identified on computed tomography (CT) imaging following a prior diagnosis of pneumomediastinum of unknown origin. The foreign body’s potential involvement in the pneumomediastinum presented diagnostic and management challenges for the medical team, as the patient had no prior history of ingesting a foreign object. Further investigation into the patient’s dietary habits, coupled with the CT findings, ultimately revealed that the hyperdense object was bubble gum. Conclusion: The hyperdense appearance of bubble gum on X-ray and CT scans resembles bone, making it difficult to distinguish without a detailed patient history. Although no causal relationship between the foreign body and the pneumomediastinum was identified, this case underscores the significance of meticulous imaging evaluation and the necessity of considering both prevalent and uncommon etiologies during the diagnostic process.

OBJECTIVES:Our study aimed to evaluate the impact of magnetic resonance (MR) image artefacts caused by the OSI300 implant system on the ability to visualize specific cranial structures. METHODS:One cadaveric head was unilaterally implanted and underwent MR imaging in 1.5 and 3 Tesla magnetic fields under the following conditions: (1) no device, (2) Cochlear BI300 plus OSI300 with magnet, (3) Cochlear BI300 plus OSI300 with spacer, (4) Cochlear BI300 plus OSI300 without magnet or spacer using the institutional head and inner ear protocol and with metal artefact reduction (MAVRIC SL). Blinded image scoring was performed independently by three radiologists. RESULTS:Excluding diffusion and susceptibility weighted imaging (DWI and SWI) anatomical structures contralateral to the OSI300 implant were highly visible in all conditions. Artefact size was clearly improved after magnet removal and with metal artefact reduction technique. DISCUSSION:The OSI300 system produces image artefacts in both 1.5 and 3.0 Tesla MR imaging and, as previous research has reported, with the coil magnet removed, offers the least amount of distortion and artefact. CONCLUSION:While certain sequences such as DWI, FLAIR and SWI showed notably reduced diagnostic value, the MAVRIC SL sequences proved to reduce implant artefact resulting in diagnostic quality examinations.

A szájüreget érintő congenitalis térfoglaló folyamatok praenatalis felismerése és a neonatalis korban történő definitív ellátása a légút veszélyeztetettsége és a táplálási nehezítettség miatt nagy szakmai és technikai felkészültséget igénylő komplex, multidiszciplináris feladat. Esetismertetésünkben egy praenatalis ultrahangvizsgálat során felismert, súlyos szájüregi obstrukciót okozó cystosus terime sürgős ellátását, illetve neonatalis korban végzett definitív sebészi eltávolítását mutatjuk be. Az ultrahangvizsgálattal in utero nagy méretű szájüregi cystával diagnosztizált magzat a 38. terhességi héten, 3400 g születési súllyal, elektív császármetszéssel jött világra. A szájüregből előboltosuló, kb. 6 × 6 cm-es cysta miatt Mayo-tubussal azonnali légútbiztosítás, illetve a terime többszörös pungálása történt. Ezt követően az újszülött légútja teljes mértékben szabaddá vált. Táplálását nasogastricus szondán keresztül biztosítottuk. MR-vizsgálatot követően a sublingualis területről kiinduló cystát az újszülött 8 napos korában in toto eltávolítottuk. A posztoperatív időszakban szövődményt nem észleltünk. A per os táplálás két héttel a műtétet követően progresszíven megkezdhető volt. A szövettani vizsgálat a sublingualis régióban rendkívül ritkán kialakuló, enteralis eredetű duplikációs cystát véleményezett. A 11 hónapos utánkövetési idő alatt recidívára utaló jelet nem észleltünk. Nehézlégzés vagy táplálási nehezítettség nem jelentkezett. A csecsemő súly- és hosszgyarapodása megfelelő volt. A rendszeres várandósgondozás a magzati fejlődési rendellenességek kiszűrése szempontjából elengedhetetlen fontosságú. Potenciálisan légzési nehezítettséget okozó anomáliák esetén a tervezett császármetszés során készen kell állni a sürgősségi légútbiztosításra. A légzési vagy táplálási problémát okozó szájüregi terimék újszülöttkorban történő definitív ellátása lehetővé teszi a hospitalizációs időszak lerövidítését és az ismételt műtétekkel járó fizikális és pszichés terhek minimalizálását. Orv Hetil. 2025; 166(36): 1431–1437.

The present study aimed to prepare and optimize lamotrigine-loaded bovine serum albumin nanoparticles (LAM-NP) using the Quality by Design (QbD) approach and to investigate both the in vitro and ex vivo effects of different cross-linking agents glutaraldehyde (GLUT), glucose (GLUC) and 1-(3-dimethylaminutesopropyl)-3-ethylcarbodiimide hydrochloride (EDC) on intranasal applicability. Cross-linked LAM-NP from EDC (NP-EDC-1) showed the lowest Z-average value (163.7 ± 1.9 nm) and drug encapsulation efficacy (EE%) of 97.31 ± 0.17%. The drug release of GLUC cross-linked LAM-NP (NP-GLUC-9), glutaraldehyde cross-linked LAM-NP (NP-GLUT-2), and NP-EDC-1 at blood circulation conditions was higher than the initial LAM. The results of the blood-brain barrier parallel artificial membrane permeability assay (BBB-PAMPA) showed an increase in the permeability of LAM through the BBB with NP-GLUC-9 and an increase in flux with all selected formulations. The ex vivo study showed that LAM diffusion from the selected formulations through the human nasal mucosa was higher than in case of initial LAM. The cytotoxicity study indicated that BSA-NP reduced LAM toxicity, and GLUC 9 mM and EDC 1 mg could be alternative cross-linking agents to avoid GLUT 2% v/v toxicity. Furthermore, permeability through Caco-2 cells showed that nasal epithelial transport/absorption of LAM was improved by using BSA-NPs. The use of BSA-NP may be a promising approach to enhance the solubility, permeability through BBB and decrease the frequency of dosing and adverse effects of LAM.

INTRODUCTION:Slide laryngotracheopexy for cricotracheal stenosis and extended partial laryngectomy combined with tracheopexy for T2-T3 glottic tumors represent novel, complex laryngotracheal surgeries requiring meticulous preoperative planning. METHODS:In addition to conventional diagnostic tools (imaging, endoscopy), digital/virtual 3D techniques along with 3D printing - also referred to as Additive Manufactoring (AM)- allow for the creation and application of CT-based virtual and 3D-printed models of the larynx and the trachea. These 3D technologies can facilitate surgical team preparation and provide an innovative approach to training on complex surgical solutions. DISCUSSION:This paper presents the digital workflow for three cases where patient-specific 3D laryngotracheal models were developed and successfully applied in surgical planning and training. These models serve as high-fidelity anatomical representations for surgical rehearsal, training, and patient communication, demonstrating their potential for broader clinical implementation.

Bevezetés: A Szegedi Tudományegyetem Szent-Györgyi Albert Orvostudományi Karának Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinikáján 1995-ben történt az első cochlearis implantáció. 2022. augusztus 11-én lehetőség nyílt klinikánkon a hazánkban még kevésbé ismert, de nemzetközileg elismert implantátumgyártó cég, az Advanced Bionics által forgalmazott HiRes Ultra 3D implantátum beültetésére. Célkitűzés: Klinikánkon jelenleg a páciensek a Cochlear Ltd., illetve a MED-EL GmbH készülékeivel kerülnek rehabilitációra. Ezen ellátási spektrum kiszélesítése érdekében megtörtént az első Advanced Bionics cochlearis implantációs műtét klinikánkon. A jelen tanulmány célja e tapasztalatok ismertetése. Módszer: Tanulmányunk során beültetésre került egy HiRes Ultra 3D implantátum. Az operáció alatt elektrofiziológiai mérések (elektromosan kiváltott stapediusreflex-küszöb [ESRT], idegiválasz-telemetria [NRT] és impediancia) történtek. Eredményeinket az Active Insertion Monitoring rendszer segítségével rögzítettük. Eredmények: Az impedanciaértékek megfelelőek voltak, az idegi válasz és az elektromos stapediusreflex kiváltható volt. A klinikai protokoll értelmében a közvetlen sebzárás után az elektróda cochleán belüli pozícióját kis dózisú fluoroszkópos felvétellel is ellenőriztük. Megbeszélés: Rövid távú tapasztalataink azt mutatják, hogy az Advanced Bionics implantátum teljes mértékben alkalmas a belsőfül-eredetű irreverzibilis halláskárosodás kezelésére. Következtetés: Eredményeink alapján az implantátum lehetőséget nyújt a hallásmaradvány megőrzésére is. Műtéttechnikai szempontból hasonló konstrukciót kínál, mint a jelenlegi klinikai portfólióban szereplő másik két gyártó készülékei. Orv Hetil. 2024; 165(45): 1772–1778.

Introduction: The first cochlear implantation was performed in 1995 at the Department of Otorhinolaryngology and Head and Neck Surgery of the Albert Szent-Gyorgyi Medical School at the University of Szeged. On August 11, 2022, our clinic had the opportunity to insert the HiRes Ultra 3D implant, distributed by Advanced Bionics, a company that is less known in Hungary but internationally well-recognized. Objective: Currently, patients at our clinic are rehabilitated with devices from Cochlear Ltd. and MED-EL GmbH. To broaden this range of services, the first Advanced Bionics cochlear implantation surgery was performed at our clinic. Method: In our study, a HiRes Ultra 3D implant was implanted. During the operation, electrophysiological measurements (electrically evoked stapedius reflex threshold [ESRT], neural response telemetry [NRT], and impedance) were performed. The results were recorded using the Active Insertion Monitoring system. Hereinafter, we would like to review our initial experience. Results: The impedance thresholds were adequate, and both the neural response and the electrical stapedius reflex were responsible included . In accordance with the clinical protocol, after the immediate wound closure, the position of the electrode within the cochlea was also checked with low-dose fluoroscopic imaging. Discussion: Our short-term experience indicates that Advanced Bionics implant is fully suitable for serve sensorineural hearing loss. Conclusion: Based on our results, the implant offers the possibility of preserving residual hearing. From a surgical technique perspective, it provides a construction similar to the other two manufacturers' current devices in the clinical portfolio.

Bevezetés: A rhinosinusitis az orr- és orrmelléküregek nyálkahártyájának váladékképződéssel és ödémás duzzanattal járó gyulladása. Az akut bakteriális rhinosinusitis főként szövődményes eseteiben gyakran szükséges fekvőbeteg-intézménybe való felvétel. Célkitűzés: A Szegedi Tudományegyetem Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinikájának fekvőbetegosztályára 2016 és 2022 között akut rhinosinusitis miatt felvett gyermekek anyagának retrospektív elemzése, illetve annak megállapítása, hogy a COVID–19-járvány befolyással volt-e a felvételt igénylő esetek arányára. Módszer: Demográfiai és klinikai adatok gyűjtése, az eredmények összehasonlítása hazai és nemzetközi irodalmi adatokkal. Eredmények: 497 gyermekből 471 beteg kezelése kizárólag ambulánsan történt. 26 gyermek, 17 fiú és 9 lány került felvételre (1 fő 2 alkalommal). Az átlagéletkor 7,65 év volt. A felvételek 52%-a a három téli hónapban, az összes felvétel 89%-a a novembertől áprilisig terjedő időszakban történt. 19 esetben akut ethmoiditis, 5 esetben akut sinusitis maxillaris, 2 esetben akut pansinusitis, 1 alkalommal akut sphenoiditis volt a felvételi diagnózis. A felvétel oka 19 gyermeknél a következményes szemhéjödéma, 7 esetben az alkalmazott terápia melletti progresszió volt, 1 betegnél intracranialis szövődmény igazolódott. Az átlagos hospitalizáció 4,2 nap volt. 16 esetben amoxicillin-klavulánsav, 11 esetben cefuroxim parenteralis adása történt. 9 esetben (8 orbitalis, 1 intracranialis szövődmény) elkerülhetetlen volt a műtét. Minden betegnél funkcionális endoszkópos beavatkozás történt. 2 alkalommal, orbitatályog miatt, külső megnyitásra is szükség volt, az intracranialis szövődménynél idegsebészeti műtét is történt. Megbeszélés: A vizsgált paraméterek korrelálnak az irodalmi adatokkal, a COVID–19-járványnak tulajdonítható esetszámváltozást nem tapasztaltunk. Következtetés: Az akut rhinosinusitis konzervatív terápiával általában gyógyítható, de előfordulhatnak súlyos, életet veszélyeztető szövődmények. Bár a kórházi felvételt igénylő esetek száma csökkent, a szövődmények aránya nem változott, ezért nagyon fontos azok gyors felismerése és hatékony kezelés. Orv Hetil. 2024; 165(19): 747–753.