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In het sterk verstedelijkte Vlaanderen zijn kleine stukjes natuur uitermate waardevol omdat ze kunnen fungeren als stapsteen of verbindingselement tussen de grotere natuurgebieden. ‘De oude zandgroeve’ in Korbeek Lo, is zo’n waardevol gebiedje in particuliere eigendom dat sinds 2015 beheerd wordt met de ambitie er een biodivers stuk natuur tot ontwikkeling te laten komen. Om de impact van het natuurbeheer op te kunnen volgen werden gestandaardiseerde biodiversiteitsopnames uitgevoerd van loopkevers, spinnen en nachtvlinders. Bijkomende vaak opportunistische observaties van andere soortgroepen werden ook uitgevoerd. Er werden bij de nachtvlinders met een soortenlijst van 202 soorten, evenals bij de 46 soorten wilde bijen verschillende aandachtssoorten aangeduid. Beschermde, en ecologisch interessante soorten zoals de gewone mijnspin (Atypus affinis), en de rode bosmier (Formica rufa) komen ook voor in ‘De oude zandgroeve’. Een soort zoals de zwartwordende wasplaat (Hygrocybe conica) bij de zwammen duidt op de waarde of tenminste de potentie van de graslandvegetatie. Voor soortgroepen zoals sprinkhanen en libellen verwachten we dat het terrein heel wat te bieden heeft als het waterpeil in de vijver niet te lang wegzakt en de waterkwaliteit stabiel blijft.

Dit Standpunt is een aanvulling op de bevindingen en aanbevelingen van de buitenlandse onafhankelijke Denkers die in opdracht van de Academie Vlaanderen hebben bezocht en met betrokken academische, industriële en politieke actoren overleg hebben gepleegd. Op basis van een ruim overleg met de hele watersector en de beleidsstructuren zijn aansluitend actielijnen uitgewerkt die de transitie naar een toekomstgericht waterbeheer in Vlaanderen mogelijk moeten maken.

This report describes a patient with permanent hearing loss after spinal anesthesia. The literature is reviewed, particularly concerning incidence and possible causes. The incidence is surprisingly high and related to the size of the needle. The role of the cochlear aqueduct as a transmitter of a decreased fluid pressure in the subarachnoid space to the perilymph of the labyrinth is discussed.

Sinusitis can spread to the orbital tissues. 'Preseptal' soft-tissue bacterial infections are relatively common during childhood and with appropriate antimicrobial therapy they usually resolve quickly. 'Orbital' soft-tissue infections, in contrast, are relatively rare and frequently cause serious morbidity. Four cases are presented. Symptomatology and pathogenesis are reviewed. Diagnostic procedures, especially CT-scan, are discussed and recommendations are given for medical and surgical management.

The CT-meato-cisternography with air is at the moment the examination of choice in the diagnosis of the intra-canalicular acoustic neuroma. Every time there is a possibility of acoustic neuroma the air-CT-meato-cisternography has to be performed after the CT-scan was negative. The air-CT-meato-cisternography is easily performed on an outpatient basis and complications are never seen. Filtrated air seems to be the best contrast material.

The future of lasers in medicine in general and in otorhinolaryngology in specific appears to be bright. It's use is very simple, but may not weaken the wakefulness of its user. Skill and experience remain very important. The role of the laser is clearly defined. The laser is not the only surgical tool to be used for any given operative procedure.

The endoscopical endonasal surgery is in vogue. Today it has become a functional surgery. A thorough knowledge of the endonasal anatomy is difficult but essential. The antral ostium is reached after infundibulotomy, from which starts the inspection of the locoregional pathology.

Two cases of Noonan syndrome are observed. The Noonan syndrome is a Turner-like syndrome with normal chromosomal constitution. Essential criteria in diagnosing the syndrome are the facial expression (hyper-telorisme, low-set and malformed ears, micrognathie, fish-like mouth). The short webbed neck and the cubitus valgus. These children are rather small and mental retardation can be present, especially in comparison with their siblings. Associated cardiac malformations occur in approximately 50% of the cases. We insist on audiologic findings. One case has a hearing impairment due to a malformation of the middle ear, recognised radiologically. The other has a deafness of perception type. Yet, the familial occurrence of last patient makes it doubtful whether this hearing loss can be linked to the Noonan-syndrome.

Overlooking the literature, Wegener's granulomatosis often seems to have manifestations in the ear-nose-throat region, especially in the beginning. The usual clinical findings are mentioned, to put the attention of the ENT-surgeon on this affection. Indeed, by early recognition and proper treatment of this disease, the prognosis is clearly improving. A case-history is illustrating the clinical picture.

In treating ear disease every otolaryngologist is familiar with topical medications. The choice of the ideal agent for a given clinical situation may be difficult. In order to make this decision more easy, we overlook the composition of ear-drops. The most important disadvantages are ototoxicity, allergy and pain. The place of ototopical agents in otitis externa, otitis media and otomycosis is discussed.

A case is presented of mesenchymal chondrosarcoma. This extremely rare tumor has a characteristic histology. The prognosis is poor. Radical surgery is essential. A lifelong follow-up is recommended.

The white mucus or the opaque mucus lump found in chronic sinusitis may be considered a consequence of hypersecretion, or/of a poor drainage due to ostial dyspermeability, caused by a deficiency of the ciliary system or a modification of the viscosity.