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Introduction: Single-sided deafness (SSD) is characterized by hearing loss in one ear (pure tone average - PTA - 70 dB HL and more) with practically normal hearing in the other ear (losses up to 30 dB HL). One of the solutions is cochlear implantation, which, unlike other compensatory mechanisms (CROS system, direct bone conduction systems), is the only one that enables binaural hearing. Material and methods: Six pediatric patients with SSD who underwent cochlear implantation at FN Motol in 2020-2021 were included in the study. We monitored the development of auditory perception with a cochlear implant, the ability of directional hearing and the average daily time of use of the sound processor. Results: All patients use the sound processor regularly, subjectively and objectively their hearing perception improved. Directional hearing is not yet demonstrable. We will continue to monitor the patients and the knowledge gained will need to be verified on a larger set in the future. Conclusion: Cochlear implantation can be a suitable way to solve unilateral deafness in children. When indicating, it is necessary to consider the etiology of the hearing defect, the duration of the deafness, and the motivation of the children and their parents to regularly use the sound processor. [ABSTRACT FROM AUTHOR]

Implants for bone-conducted hearing and active middle ear implants transfer information about sound and speech to middle ear in the form of vibrations. Vibrations quiver inner ear fluids, stimulate the hair cells and evoke the sound percepts. That is how they differ from cochlear implants, which stimulate nervous structures by electric impulses. The implant for bone-conducted hearing transfers vibrations into the skull bones, whereas the active middle ear implant transfers the vibrations aiming at midle ear structure (middle ear ossicles, oval window membrane). [ABSTRACT FROM AUTHOR]

Basic principles of a cochlear neuroprosthesis and its history from an experimental beginning to presence are described in the overview article. [ABSTRACT FROM AUTHOR]

A foreign body in the orbit is a relatively uncommon but serious complication of a penetrating orbital injury. The clinical manifestations of a chronic foreign body may be insignificant. Also, dia gnostics and accurate localization of foreign bodies in orbit (especially organic) using imaging methods may not always be unambiguous. In the case report, we describe the case of a two-year-old boy with a woody foreign body in the orbit, whose dia gnosis was delayed, despite repeated surgical interventions and imaging, and the foreign body was removed more than six months later laterally. [ABSTRACT FROM AUTHOR]

The article summarizes experience from a fitting of sound processors, complications and the first experience of adult patients implanted with a cochlear implant (CI). At the Department of Phoniatrics, the fitting of patients with CI of the Australian company Cochlear started 1st January 2005 and of the Austrian company MED-EL two years later. There were performed fittings of 100 patients from the very beginning up to a half of year 2012. [ABSTRACT FROM AUTHOR]

We have observed material differences in the quality of care of tracheostomized patients, with the process often being incomplete or insufficient in scope. The level of care afforded to trachestomized children and adults differs notably. The main differences are found in fundamental procedures including the surgical method, the use of suitable type of tracheostomy tube, the frequency of replacement of tracheostomy tube and the training of parents. The care of tracheostomized child should be known multidisciplinary, mainly by anesthetists, pediatricians, neurologists, rehabilitation specialists. Between 2014–2020 138 tracheostomies were made on pediatric patients. Separately we have gained experience with other tracheostomized patients from other hospitals. We find an inappropriate level of education in how to care for tracheostomized children as extremely important given the high risk of suffocation, caused by obstruction or dislodgement of tracheostomy tube. In this article we provide specific details on how to improve the care for tracheostomized pediatric patients. [ABSTRACT FROM AUTHOR]

Surgical and outpatient care of a patient with ear disease is an integral part of otorhinolaryngology. It includes a wide range of procedures in the region of the external auditory canal, middle ear and other parts of the pyramid bone with various indications. The objective increase in the number of ear procedures at the department of the authors was the impulse to map the situation of ear surgery in the Czech Republic. Data were collected in the period from January 2020 to August 2020, using a questionnaire, which was sent to the heads of all ENT departments in the Czech Republic. The yield of the questionnaire was 100%. Overall 80% of all ENT departments perform ear surgeries, of which almost 85% perform pediatric ear surgeries too. The maximum of ear surgery proceeds in the university departments where an increase in the number of operated patients has been observed in the last 10 years. These departments also cover specialized procedures such as cochlear implantations and more extensive surgeries on the temporal bone. [ABSTRACT FROM AUTHOR]

Introduction: Almost all patients with cleft palate suffer from Eustachian tube insufficiency.The result is usually the development of otitis media with effusion. Its first manifestation can be observed in newborns. The aim of this work is to detect the first symptoms of the disease during the first phase of the surgical solution - the primary suture of the lip, which we perform in neo-neonatal age. Another goal is to evaluate the value of objective audiological methods in relation to the diagnosis of middle ear fluid. Material and methods: In a ten-year period, a group of 314 patients with cleft defects were evaluated, who had primary lip suture in the neonatal period. Prior to the procedure, OAE, standard 226 Hz and high frequency 1000 Hz tympanometry were examined. However, it was not possible to complete all examinations in all patients. In case of suspicion of presence of middle ear secretion, otomicroscopy with diagnostic paracentesis was performer. Results: Over ten years, lip surgery was performed in 314 newborns, 241 to 7 days of age. Most patients (57) were operated on the third postpartum day. 178 patients had cleft lip and palate, 136 patients had cleft lip. A total of 394 ears with a 1000 Hz probe and a 408 standard 226 Hz probe were examined. Middle ear fluid was detected in 74% of patients with cleft palate (unilaterally or bilaterally). The middel ear fluid appeared regularly on the non-cleft side, where the tubular torus was normally morphologically configured. In 96% the result of 1000 Hz tympanometric examination (B curve) coincided with the finding of middle ear fluid. Conclusion: Middle ear secretion was detected in newborns, but only in those who had cleft palate. In all patients with isolated cleft lip, the middle ear was airy. The presence of secretion does not depend on the cleft side. High-frequency tympanometry is a highly conclusive method for determining the presence of middle ear fluid in newborns. [ABSTRACT FROM AUTHOR]

Otolaryngologist deals with foreign bodies in children quite often. This is mainly due to the presence of five easily accessible body openings in its area. Foreign bodies in the esophagus and oropharynx are potentially the most serious group and should be given extra attention. Large foreign bodies can close the larynx and cause acute life-threatening choking. Sharp foreign bodies may perforate the esophagus and, for example, batteries may cause severe burns. Chronic foreign bodies often cause serious inflammatory complications. Correct and timely diagnosis is essential to determine treatment. It is based on anamnesis, clinical examination, imaging methods and endoscopic examination. Finding a battery in the esophagus is an indication for urgent removal. Even a minimal delay can have fatal consequences. Foreign bodies from the esophagus can be extracted using a rigid or flexible technique. The choice of method depends on the character of the department and its habits. However, because of the risk of iatrogenic damage, endoscopy should be performed by an experienced endoscopist with appropriate background. [ABSTRACT FROM AUTHOR]

Introduction: Congenital stridor is the symptom of many different congenital respiratory diseases with a wide variety of clinical difficulties. Correct and timely diagnostic of the causes of stridor facilitates the recommendation of an adequate therapy. The most common reason for congenital stridor is laryngomalacia. Objective: The main goal of our research was to evaluate each different clinical unit manifesting by stridor, particularly laryngomalacia, then to document diagnostic procedures and evaluate them relative to procedures used abroad. At the same time alternative options for therapy of stridor were investigated. Methods: During the time period of 2013- 2015 the files of 272 patients were reviewed. At the serious stridor or in a case of suspected subglottic stenosis laryngotracheal endoscopy in general anesthesia was indicated directly. Depending on the results of endoscopy either second endoscopy check was recommended or surgery. Results: In 180 patients the laryngomalacia was the reason of a stridor. In a case of 8 patients with laryngomalacia, a tracheostomy was necessary. For 5 patients, a supraglotoplasty was undertaken. Stridor was also diagnosed in a case of 21 patients with tracheomalacia, 13 patients with laryngotracheomalacia, 26 patients with a subglottic stenosis, 8 patients with a choanal stenosis, 3 patients with a laryngeal web, 5 patients with a laryngeal hemangioma, 7 patients with a recurrent laryngeal nerv paralysis, 5 patients with a laryngotracheal cleft, 4 patients with a laryngeal cyst and 1 patient with an agenesis of epiglottis. [ABSTRACT FROM AUTHOR]

Introduction: Juvenile nasopharyngeal angiofibroma is a benign, highly vascularised tumor, which affects boys and young men. Among the dominant subjective complaints of patients are nasal obstruction and epistaxis, whereas endoscopic finding and imaging methods (CT, MRI) are crucial in diagnosis. Methods: Retrospectively a set of twelve patients who underwent endoscopic resection of juvenile nasopharyngeal angiofibroma during 2010-2016 was analyzed. In nine cases it was a primary surgery and the three remaining cases comprise reoperations for recurrences after a non-radical endoscopic or external surgery in the past. Results: Eleven tumors, including those involved in the pterygopalatine and infratemporal fossa, were eliminated radically, in one patient minor residue in the sinus cavernosus area has been left. All patients are disease-free, the residue remains without growth progression. There were no major surgical or postoperative complications. Conclusion: The use of endoscopic endonasal surgery in the resection of juvenile nasopharyngeal angiofibroma in combination with preoperative embolization becomes the method of choice even for large tumors. Compared to external techniques, this is a more gentle approach, with lower postoperative morbidity and better cosmetic effect. [ABSTRACT FROM AUTHOR]

Aim: To summarize data for the Baha (Bone anchored hearing aid) implantable hearing system based on the principle of bone conduction for the single-sided deafness (SSD) compensation, regardless of aetiology that may be congenital, vascular (Sudden Sensorineural Hearing Loss; SSNHL), infectious, traumatic, tumorous or iatrogenous. Patients and methodology: 59 patients with an SSD were examined between September 2010 and August 2014 and included into the study. The SSD aetiology included sudden hearing loss, temporal bone fracture, ototoxic effects of a treatment, chronic otitis and a growing vestibular schwannoma. Results: All patients were tested for the effect by the Baha Softband and 23 decided to undergo the surgery. During the entire course of the study, three generations of the Baha implants were used (BI300, BIA400, Attract) without any intraoperative or postoperative complications. The effectivity of the Baha system was shown during testing of a sentence comprehension in noise, with a significant improvement after six weeks and one year respectively. In this testing, the signal was coming to the deaf side and noise to the hearing side, on a loudness level of 65 dB SPL and 70 dB SPL, respectively. Conclusion: Baha represents an effective option for correction of patients with SSD. Patients should be offered to test an implantable and/or non-surgical options for compensation as part of routine care for patients with single-sided deafness. [ABSTRACT FROM AUTHOR]

Vestibular migraine (VM) is a paroxysmal vertigo, which is characterized by impaired balance with/ without headaches and possibly other symptoms accompanying classical migraine according to the IHS (Headache Classification Subcommittee of the International Headache Society, 2004). It is a clinical diagnosis whose terminology and unambiguous criteria are not always clearly defined. This article presents this diagnosis in the form of case report and demonstrates possible therapy from the view of ENT doctors respectively otoneurologists. Although the disease is normally diagnosed and treated abroad, according to our experience, for some Czech ENT physicians and even neurologists diagnose is not very well known, as is also evidenced by the fact that we sometime get in a conflict of opinion with ENT specialists and with neurologists. [ABSTRACT FROM AUTHOR]

Downbeat nystagmus (DBN) is the central oculomotor disorders based on different causes. Unlike the Upbeat nystagmus or nystagmus of vestibular origin DBN belongs to chronic nystagmus that may persist in a patient for years or throughout life. Clinically it is manifested with oscilopsia DBN, and balance dysfunction. In this case report is presented patient with Downbeat nystagmus diagnosed in the otoneurological ambulance at the University Hospital Motol. Although DBN is the type of central nystagmus and certainly belongs to the hands of neurologists, we consider that it necessary every ENT specialist should have knowledge about this problem and be able to direct the patient to appropriate specialists. More than once we have seen that nystagmus of peripheral origin was described ENT doctors in a patient with DBN. This mistake may harm the patient. This report should also highlight the complexity of this issue, including its extensive differential diagnosis and also the fact that despite all diagnostic efforts a clear cause of DBN is not always reveal. [ABSTRACT FROM AUTHOR]