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11, 11523
t. 210 6435141, f. 210 6435141
e. info@hellasorl.gr, w. www.hellasorl.gr

Congress & Exhibition Organizer

40, 151 24
t. 210 6107213, f. 210 6107864
e. info@themateam.gr, w. www.themateam.gr

Site
www.orl2013.gr


Alexiou C. - Germany
Boci B. - Albania
Celik O. - Turkey
Davies E. - United Kingdom
Heppt W. - Germany
Hosemann W. - Germany
Jovic R. - Serbia
Kalcioglu - Turkey
Knezevic V. - Montenegro
Kountakis S. - USA
MilisavljevicD. - Serbia
Muhlfay G. - Romania
Sarafoleanu C. - Romania
Serbekioglu B. - Turkey
Spremo S. - Bosnia & Herzegovina
StankovicM. - Serbia
Uzun C. - Turkey
Van Cauwenberge P. - Belgium
Vitcheva D. - Bulgaria


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DAMPLAID
DIAMAND MEDICAL EQUIPMENT
ELPEN
FARMASYN
GALENICA
GETREMED
GP MEDICAL
INTELLIGENT GROUP
IPOKRATIS
KARL STORZ ENDOSCOPE
KITE HELLAS
KOSTADARAS MEDBOOKS
MEDICAL EXPERTS
MEDICAL LITE
MEDTRONIC HELLAS
MSD HELLAS
NOVIS PHARMA
OLVOS SCIENCE
PHARMAQ
PHARMATHEN
PROTON
SIEMENS - .
UNIPHARMA
VIANEX
VOLONAKIS ENT

- SIEMENS & REXTON


HEARING


10 2013

15.00 - 20.30
15.00 - 16.00
16:00 - 17:00 Lectures

Chairman: D. Vicheva
The use of surgical ultrasound in the treatment of hypertrophy
of nasal turbinates and tonsils - A. Kounounis
Contributions to the diagnostic and management
of the Pneumosinus Dilatans - G. Muhlfay

17.00 - 18.30
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18.30 - 19.00

19.00 - 19:30 Lecture



Chairman: J. Constantinids
Nanomedicine - new applications in diagnostics and therapy
of cancer - C. Alexiou

19.30 - 20.00

20.00 - 20.30
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20.30


10


15.00 - 20.30
15.30 - 16.30
16.00 - 17.30 Lectures

Chairman: S. Spremo

Malignant tumors of skull base - M. Stankovic

Stomal recurrence after total laryngectomy - D. Milisavjevic

17.00 - 18.30



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10 2013 / 16

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17.00

17.00 - 18.30



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Functional results of treatment neurogenic lesions of the vocal
cords - R. Jovic

11 2013 / 18

11 2013

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08.00 - 09.00

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11 2013 / 19

09.00 - 10.30

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of Chronic Rhinosinusitis - C. Sarafoleanu

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11.00 - 12.00


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Role of IgE in chronic rhinosinusitis with polyps and its therapeutic
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11 2013 / 20

16.00 - 17.30



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18:00 - 18:15 - .
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Trans-nasal neurosurgery - W. Hosemann

11 2013 / 21

19.45 - 21.15

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Failure and reoperation. Lessons - W. Heppt

11 2013 / 22

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09.00 - 10.00 Round Table

Otology

Chairmen: V. Knezevic, C. Uzun


Moderators: M. Tsalighopoulos

Tympanoplasty with primary reconstruction


in cholosteatoma surgery: our experience - S. Spremo

Revision cholosteatoma surgery - M. Stankovic

Cartilage tympanoplasty - C. Uzun

10.00 - 11.30


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11 2013 / 26


20.00 - 21.30

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11 2013 / 29

22

COGNITIVE BIASES IN ENT CLINICAL PRACTICE


Iordanis Sidiropoulos, Paschalis Giaramazidis, Ilias Karasmanis,
Argyris Maganaris, Athanasios Skouras
Otolaryngology Department,
Ippokrateion General Hospital of Thessaloniki
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08.00 - 20.30
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11 2013 / 34

47 A MERKEL-CELL CARCINOMA METASTTATIC TO THE TONSIL:


A CASE REPORT AND REVIEW OF THE LITERATURE
Ioannis Vasileiadis 1,2, Athanasios Sakellaridis 1,
Michalis Sofopoulos 3, Niki Arnogiannaki 3, Stavros Georgopoulos 1

 epartment of Otolaryngology - Head and Neck Surgery,


D
Hellenic Anticancer Institute, Saint Savvas Hospital, Athens,
Greece
2
Department of Otolaryngology - Head and Neck Surgery, Royal
London hospital, Barts and the London, London, United Kingdom
3
Department of Pathology, Hellenic Anticancer Institute, Saint
Savvas Hospital, Athens, Greece
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Bibas A., Kikidis D., Bellos C., Koutsouris D., Fotiadis D.,
Sismanis A.

University of Athens, A ORL Clinic, Hippokrateion Hospital,


Athens, Greece

National Technical University of Athens, Athens, Greece
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11 2013 / 39

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12 2013

08.00 - 19.30
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09.00 - 10.00 Lectures



Chairman: T. Terzis
Frontal surgery: From balloon sinuplasty to osteoplastic
obliteration - E. Davies

Do we need aggressive surgery in Chronic Rhinosinusitis


with Nasal Polyps? - C. Sarafoleanu

10.00 - 11.30

Round Table

Modern techniques in endoscopic sinus surgery

Chairman: J. Constantinidis
Moderator: W. Hosemann

Endoscopic surgical approach to frontal disease - E. Davies

The modified lothrop (Draf III) procedure - T. Terzis

The four-hand technique in FESS - Iord. Konstantinidis

Endoscopic skull base approaches: Beyond the pituitary


C. Georgalas
How to avoid complications in revision sinus surgery
S. Kountakis
11.30 - 12.00

12 2013 / 47

12.00 - 13.30 Lectures



Chairman: J. Giotakis
Maximal medical treatment for chronic rhinosinusitis with and
without polyps - P. Van Cauwenberge

Training in facial skin tumor surgery - W. Heppt

13.30 - 14.30
14.30 - 16.30 -
16.30 - 18.00 Round table
Education and further education with specific reference to ENT
allergy

Chairman: J. Contantinidis
Moderator: P. Maragoudakis

Multidisciplinary approaches in allergic rhinitis - romanian


experience - G. Muhlfay, D. Vicheva

The significance of the allergic map - M. Katotomichelakis

18.00 - 18.30
18.30 - 20.00 Lectures

Chairman: V. Daniilidis
A landmark based approach to endoscopic sinus surgery
S. Kountakis
Recent developments and innovation in endoscopic endonasal
sinus surgery - W. Hosemann

12 2013 / 48

B
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11.30 - 12.00

13.30 - 14.30

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Ossiculoplasty with bone cement - M. T. Kalcioglu

Use of cartilage in ear surgery - O. Celik


Lectures
Chairman: E. Ferekidis

Novel technique of diagnostic ABR in auditory pathologies


B. Serbetcioglu

12 2013 / 50

16.30 - 18.00



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12 2013 / 55

78 SYMMETRICAL LIPOMATOSIS OF THE TONGUE: A RARE CASE


OF MACROGLOSSIA. DIAGNOSIS, SURGICAL TREATMENT AND
LITERATURE REVIEW.

Ioannis Vasileiadis 1,2, Georgios Mastorakis 3, Aristotelis Petousis 1,


Panagiotis Ieromonachou 4, Ioannis Logothetis 3

 epartment of Otolaryngology - Head and Neck Surgery,


D
Venizeleio - Pananeio General Hospital, Heraklion, Greece
2
Department of Otolaryngology - Head and Neck Surgery,
Royal London hospital, Barts and the London, London,
United Kingdom
3
Department of Oral and Maxillofacial Surgery,
Venizeleio - Pananeio General Hospital, Heraklion, Greece
4
Department of Pathology, Venizeleio-Pananeio General Hospital,
Heraklion, Greece


09.00 - 10.00
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12 2013 / 59

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18.00 - 18.30 : . , .
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12 2013 / 61

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62 
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12 2013 / 63

66  -
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12 2013 / 64

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12 2013 / 65

78 

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79 

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80 POTTS PUFFY TUMOR :



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12 2013 / 66

84 


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86 
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12 2013 / 67

90  .

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13 2013 / 68

13 2013

08.00 - 12.30
08.00 - 09.00

: . , .
94 


. , . , . , . ,
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 ,

95 

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97  -


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99



Otogenic Lateral Sinus Thrombosis (OLST)
 , , ,

- [..]

13 2013 / 69

09.00 - 10.30
 :


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13 2013 / 70


08.00 - 12.30
08.00 - 09.00

: . , .
100

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13 2013 / 71

104

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.
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13 2013 / 72


08.00 - 12.30
08.00 - 09.00




: .


.

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09.00 - 10.00



: . , .
: . , . , .

13 2013 / 73

(Posters)
10.30 - 11.00 : . , .
91 
.
;

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2

92 



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,

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95

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., .

..

13 2013 / 74

96 

 ., ., .,
., .
 ..

97

 ., ., ., .,
.
 ..

98 
(Case report)
. 1, . 2, . 3,
.

, 2 , 3

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99 

().
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 ., ., ., .,
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100 

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101  .

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.

13 2013 / 75

102 
:

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104

- -

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107

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13 2013 / 76

108 

( )

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..

109

., ., ., .,
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110 


. , . , . ,
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111

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,

, ....
112 

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.
... ,
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113

., ., .

... ..

13 2013 / 77

114

. 1, . 2, . 2,
. 1, . 1

1  ,

: .
2

 ,

: . . .
115 Concomitant chemotherapy and Radiotherapy
in Nasopharyngeal carcinoma

Besim Boi

ENT-Service, University Hospital Center of Tirana, Albania

116
:
127

 ., ., ., .,
.

, ...

117 
:
.
 1, - 1,
2
 ,
,

1


2

13 2013 / 78

118 

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,

119


.
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,
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120 

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,
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121 

., *., .

... .. , ..

122

., *., .

... .. , ..

123
.

2011-2012.
 1, 2,
2, 2,
2

1
2

ENT Department of Countess of Chester Hospital


... ... .

13 2013 / 79

124 
:
 ., ., .,
., .

... ..

125

 , , ,
, ,
,

126 MULTIPLE-PROJECTILE PENETRATING NECK INJURY


BY A MODIFIED NAILS-CONTAING CAS PISTOL

Pazardzhikliev Dimitar, Bakatinaki Artemis

127 
28
 1, 2,
1, 1,
1

128

., *., .

... .. , ..

, ..
, ..

129  BURKITT:
.
 ., ., ., .,
.

.. ..

130

 ., ., .,
., .

... ..

13 2013 / 80

131  LASER
-

 , , ,
, ,

, ... .

132

 . , . , . , . ,


.. .
... .. .

133 

., *., .

... .. , ..

134

., *., .

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135 EKK -

.

 . 2, . 1, . 1,

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2

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, .. .

136 
.
2010-2012
 , ,
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13 2013 / 81

137 

. 2, . 1, . 1, . 1

1
2

,
, .. .

138 

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139  :
- H

., ., ., .,
.

.., ...

140

 ,



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82

83

84

EA 2 -

.
;
. , . , . ,
. , .

. 183 (56.13%) .



(p=0.033), E (p=0.003)
(p=0.006).

:

1-1.5% 3-5.6% .

:



.

: , ,
.

EA 3 -

: 326 6 . :
)
,
, )
, )
)
.
: 326
, 183 (56.13%) .

(89.6%).
16.7%,
8.3%
14.6%.
() >3/ 81 (24.84%) , () 34 (10.4%)
.
88 (27.1%) , 64 (19.63%) 17 (5.2%)
-

Z. , . , . ,
. , .

:
,

.
:


.. .
: 2008
2013 3480 .
..
: )
, ) , )

, (ABR)

(ASSR).

85

: TEOAEs 92%
DPs 75%,
3.8% 1.3% . TEOAEs DPs
86% 76%, , 18%
15% .
,
3.4%, 0.5%,
1.1%, 5.2%
2.8%.

11%. ABR (
ASSR) 37 (12
25
).
:

.
EA 4 -
965
. 1, . 1,
. 1, . 1, .
1
, . 1, .. 1

, 1
:

15
().
:

.

: 1995-2010,

(481 484 ,
18-87 ).
(Dix-Hallpike Roll
test).

1 18 .

Epley Barbeque
, .

48 7 ,
6 .
: 819 (85%)
. 19 (2%)
3 . 74 .
139 .



(p
<0,001).
: (LE-IV)

(),
.

.

86

EA 5 -
- 10

,
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.


.
:

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.
: 2003
2012
83 . 8
5 .
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.
.
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. , . ,
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.
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.
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-

87

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.
,
.
EA 7 -
-

,
, -
, ,
,
,
,

: 2010 ,
/
.
:

.
: TEOAEs 2886 .

: 51,5%
48,4% . 83,6%
Pass , 8,4%
Refer 7,7% Refer
. refer ,
28,5% (135)
. 80%
, 46,6% , 45,7%
, 8,1%
4,4%
, 3,7% APGAR<8-8
2,9% .
473 Refer 261
257
pass, 212 4
Refer.
: 2886 , 473
Refer
261. 257
Pass 4 Refer
.
EA 8 -


*, *,
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:
.
.
:
-

88

.
:
40
. 15

, ,
25

.
15 2,2 Atm.

.
:
(7/15 , 46.6%)
(4/25 , 16%).


53.4 dB HL ( , 11.9 dB),

(74 dB HL,
, 4.1 dB).
:



.
-: , , .

EA 9 -
NAVIGATION
;
. 1, . 2,
. 2, . 3
1
.. ,

/

2


3



:


Sella.
:
,
Navigation.
- : 49 5
Navigation
12
.
:
,
.
:

89

Navigation system



avigator.
EA 10 -

, ,
, ,
, ,

... ... .
:

.
, (, )
.
.

.
.
:
106

,
: 19 (13
4 , 2 revision),
3 , 5
(combined
approach), 75 I(
1 revision), 4 ( 2 III 2 IV).
, 37,9
11-75 .
12%
77%.

: ,

.

,

.
EA 11 -

MENIERE
, ,
,
,
,

,
: () , , ,
, , ,
.
, Meniere.
:
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Meniere.
, , .
.

90

: 29

233 .
Meniere
, :
1) . 2) . 3)
. 4)
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.
:
eniere

,


.
EA 12 -

. ,. , .

:
30 dB 3 , 3 .
: 90 2009-12
.
:
, , ,
,
, .
:


5 59% 3 7 42% 34%.
(ascending, descending,
flat)
68%, 37% 41% .

46% 5 53%
5
.
41% ,
, 44%. ,
50 dB 55,28%,
50 dB, 35 %,
tvalue= 2,168
p= 0,05.
:

, ,

,

.
EA 13 -

-
, ,
,
,
.
-
:
-


- .

91

.
:
.
-: 01/06/2010 -01/08/2013 58
(21 , 37
), 20 80 .
-
-
-


(250, 500, 1000,
2000, 4000, 8000 ).
5 (-, -,
-, - )
.
(-)


.
:
73 , 15 ,24 , 19

57 , 7 -, 4
-, 3- 2
- ) 2% 90% 30-80db (60%
, 40% ).
(p=0.01, r=0.05)
:

.

EA 14 -


., ., .,
., .
, .. ,
.
:
,
,



.
,
. ,
.


.
:

.
: .
:
,
,
,

( 24
3 ),

92

.
,
.
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EA 15 -
.


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: 5% .
,
.
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Furnas, )

Mustardee )

Stenstroem.
:


,
.
M:
,
.
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Furnas. 6 (12
) 5-12 .

.
:
. .
:


Mustardee
.


.
EA 16 -

, ,
,
,
-
-

:
14-22%
.
: ,

,
, 5 .
: ,
2008 - 2013, 30

93



.
,
.
, .
, ,
.
: 18
, 2
10 . , 13
2 . 2
.
6
2
.
:
.
. ,

.

EA 17 -
(ASSR)

. 1, . 1,
. 1, . 1, . 1,
. 1, .. 1
, 1
:
500, 1000, 2000 4000 kHz.

ASSR .
:


ASSR
.
: 2012
2013. 14
17 ( <35
)
ASSR 500,
1000, 2000 4000 kHz .
(TEOAE).
: ,
.
500,
, .

94

: ,
500 kHz
.
EA 18 -





. 1, . 1,
. 1, . 1,
. 2, . 1,
.. 1

, 1
2
:
16.000
.
70%.
:

,
.
:

2006 2012. 78
group ,
.


PTA (pure tone average) 4 .
: -

.

2 kHz
.
:
.
2 kHz,

.
EA 19 -


, . ,
. , . , .
,


: 350 1.5
17 .
,
.
12 24 ,

.
:
51 (37
14 ) 40 , 11 -.
30 -
3.5
10 4-5 .
4 40 -
3.5 . -
6-12 .

95

: -

3.5 /
12-24 . -
4-5
/
12-36
. - 6 .
,
12-36 .
: ,

.
EA 20 - (TORS)

, ,

: ,

, , .
:


Laser CO2 ,
,
,

Laser
.
Weinstein OMalley,
2004
.
: 2010 , 26 TORS
, , ,
,
,
.
:

, ,
,
.
:

, .
,
,


. ,


.

96

EA 21 -
& .

.
,
, ,
,

... ...
:

, .

.
, ,
.
:
1
34
20 ,
.
--
.
.
2
10
.
. .
3
9 5 -

.

- .
. .
:

.
EA 22 - COGNITIVE BIASES IN ENT
CLINICAL PRACTICE
Iordanis Sidiropoulos, Paschalis
Giaramazidis, Ilias Karasmanis, Argyris
Maganaris, Athanasios Skouras
Otolaryngology Department, Ippokrateion
General Hospital of Thessaloniki
Introduction: In 1972 eight patients were
seen in various psychiatric hospitals across
the USA claiming to be hearing voices for
the last few months. All the patients were
admitted with a diagnosis of schizophrenia.
The patients were actually pseudopatients
who were sent by Professor Rosenhan as a
part of a now very famous experiment. After
admission, the pseudopatients acted completely normal claiming to have no symptoms at all. Nevertheless, they remained
hospitalized for an average of 19 days and
they were eventually discharged with a diagnosis of schizophrenia in remission. The
hospitals included in this experiment ranged
from community hospitals to major academic units. The reason for the misdiagnosis was
not the low quality of the clinicians or the
institutions but the way we think and act as
humans and as physicians.

97

Aim: Bearing in mind the major differences


between Psychiatry and Otolaryngology, we
aim to explore the cognitive biases that can
lead Otolaryngologists to mistakes in clinical
diagnosis and management.

Methods: Review of cognitive/social psychological literature as well as relevant medical


literature.

:


2011 2013,

.

Results: Failures of perception, the confirmation bias, the hindsight and the expectation bias, the availability bias and the Linda
problem are reviewed among others and
the way they can cloud clinical reasoning in
Otolaryngologic clinical practice is explored.
Conclusions: A culture of metacognition
among clinicians, i.e. thinking about the way
we think and reason in clinical practice can
lead to a significant improvement of the
quality of care we offer to our patients.
EA 23 -


, ,
, ,
,


:
.
/
: 1. , 2. , 3. , 4.
, 5. , 6.
7. .
: -

: 148
106
.
10 (9.4%) ,
31(29.2%),
44(41.5%),
62(58.5%), 70(66%),
30(28.3%),
57(53.7%)
2 (1.8%).
7 .
:
.

.

98

EA 24 -

. , ., . ,
.
.. ,
:




. .
:
, 31 ,
,
,
.
.
:
.
.

.
EA 25 -
35

Ramsay-Hunt
., ., ., ., .
... ..., ....
: Ramsay-Hunt



.

:



.
: 35
Ramsay-Hunt,
17 18 ,
18 83 .

House-Brackmann (HB).

excitability test
.
: VI , 4
V, 2 IV, 15
III, 1 II. 25
excitability test , 3 ,
6
( ).
22% 100%.

excitability test HB
VI. ,
(70-100%)

( -).
: Ramsay-Hunt,


excitability test


.

99

EA 26 -

. 1, . 1,
. 1, . 1,
. 2, . 1,
. 1
1
,

EA 27 -

.

.

:
, ,

.
:
.

,
, ,
,


:


(PSG).

:
,
2089
22 ,

.
.

- :
2007 2010,
210
. H (PSG).

, (NC),
(BMI), Mueller
Epworth.

: 1449 (69,3%) 640


(30,7%) .
1601
(76,64%) 488 (23,36%).
,
(chi-square test ,
p-value <0,001)
.
: -

: ,
,
ESS

/ (p<0,05).



(p=0,05).

100

:
,
, ESS

,

,
PSG.
.

.

, .

EA 28 -

FORESTIER
. , . ,
. , . , .
...
.. .

: 3

. H 3

.

: Forestier
.

,
.
: 69


2 . O
, ,
2 .


.

.
- :
Forestier

EA 29 - :
, ,
., ., .,
,
.. ,

:
.


.
: MEDLINE 1989 2011
.

-
2,282 95%
(1,318 , 3,950).
(52% Vs 81%).
H .
:
.

101

52% .
.
EA 30 - CROHN
;
, ,
,
,
.. ..
: Crohn
-
,
. , crohn
.
: 42
.. .

, .

.

crohn.

.
, ,
.
:
crohn.
,

(oral crohns
disease),

.
,
crohn 9
.

.



.
EA 31 -

. 1, . 1,
. 1, . 1,
. 1, . 2,
.. 1

, 1

, 2
: 5% .

.

.
.

.
:
57

102

.
5,5 x 4
cm,
.


,

. .



en block.

. .
:

, .

. .

EA 32 -

. 1, . 2,
. 2, . 3
1
, 2 ,
3


: ,
,

.


,
. 27
, 21 - 56 ,

,
. ,

.


.
EA 33 - BLOWOUT

. 1, . 1,
. 1, . 2, . 1
1
...
.. .
2

.. .

:


,
10,7%.
: 50

.

103


. 2 15

.
.



.
- : blowout
.

66,9% .
EA 34 -


, Sabine Semrau*,
,
, Johannes Zenk,
Heinrich Iro
- ,

* ,


:

.

(salvage surgery).
(induction
chemotherapy, IC)



.
:

.
: 47

.
30%
18F- (PET) 20%.
.
: 38
9
.
2
(74,2%
58,3%
, p=0,563).
80
.
:
,

.

104

.

, ,
/,
, /
, ... .
:
,

,
.
, 50-70
. ,

. ,

(SCC).
:
4.
: 29 ,
8 , 2 , 2
, 1
, 1
, 8 SCC, 2 , 1 1 3:1 58 .
: , /
. ,
,
,
.
: .



,
.
EA 36 -

(MPNST)

. , . , . ,
. .
..

:
:

. 10

.
.
: 56
.. .
4 cm ,
.
, , ,
.
,
.


.

105


2 cm .
.
.
8 .
:
.
.

.

EA 37 -
.

,
... ...
: ou
.

.
90% .

,
.
: 79
() .
,
.
-

, ,
.
.

& 3,5
5 . II- ().

.
. .

.
,
.
:
,
.
EA 38 -



, ,

... ...
:
. -
.


.
,

.

106

: 79

,

-- .

32bM0.
,
, en block .


.

EA 39 - ,
5




,
180.

/
1 2 1
3,
.

: H
5

.

: ,
.

,
.

. , . , . ,
. , .
... ,
- ...
: To 10-12%
(>90% ) 70-80%
. ,
p16
.

- : 28
(20 -8 ), 25-82 , .

(20),
( -).
: 17
(85%) 3 -.
10 (58%)
p16. ,
,
- .
10
68 . 4 (15%),
.

107

: .
5


. p16
,
.
EA 40 -
-
. 1, . 1,
. 1, . 1,
. 1
1
,
. & ,
:
.

.
:



. & .
:
-
13 .
, , , , , , .
: 36
2000-2013. 15 -

(9 -7 ).
8.54 .
,
,
. 5
, 2 Burkitt, 2 Ewing, 3 , 1
1 non hodgkin
1 .
. 2 , 1

1 . 5
(
)
.
:


.



.
EA 41 -
:

,
, Bohr Christopher,
Zenk Johannes, Iro Heinrich
-,

:
1970,
Patey .
(
Warthin). ,

108

.
:

- Erlangen ()

.
:


,
.
: 16 . 11 ( 2 ), 2
, 2 . ( , ,
, , ),
(
)


.
:
( ), ( )
(
). ,


.
EA 42 -


- :

., ., .,
., ., .
, -

:
.
(
).
.
:


-
.
- : 20 (19
, 63 )
.
10 , 6 ,
3
, 1 Ca
. 19
, .

109

:
,
( ). ,

22 .
16
:



, .
43 . , . ,
. , . ,
N.
,

.. .
...
.. .
:
,

.


, , .
:

,
, 60 .
:
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-

.
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.

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.
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.
: 42

.
25- D3-D2


.

.
:
2 <60 >60 . D

2
=7 ng/ml <60 = 11
ng/ml >60 .

D =11,26 ng/
ml,
=
14,4 ng/ml = 13,75 ng/ml
:
D
,
, ( 30 ng/
ml ).

45 - ROBOTIC Assisted L.A.S.E.R.




. , . ,
. , . ,
.

:
ROBOTIC - ssisted LASER Surgery

.
:

.
: 2

2 3
da Vinci LASER. 2
Kastenbauer. 6 Da Vinci 4,
.
: 2,5
.
.

LASER
.
:

111

.

Kastenbauer.
46 -

2019

1,2,
1,
1
, 3,
1,
1, 4,
1
1
,
-
, ,
2
Department of Otolaryngology - Head
and Neck Surgery, Royal London ospital,
Barts and the London, London, United
Kingdom
3

, ,
, ,
4
,
-
, ,

: H
(PTMC),

, .


131.
:
-

PTMC PTMC. ,
PTMC .
: 2019
2001 2008.
319
PTMC
.
, , ,
,
,
.
:
PTMC 77 (24,1%) asuene;iw.

> 5mm (p<0,001),
(p<0,001), (p<0,001)
(p<0,001)
.
5mm,

(p<0,001)

PTMC.
:
5mm

.

112

47 - A MERKEL - CELL CARCINOMA


METASTTATIC TO THE TONSIL:
A CASE REPORT AND REVIEW
OF THE LITERATURE
Ioannis Vasileiadis 1,2, Athanasios Sakellaridis
1
, Michalis Sofopoulos 3, Niki Arnogiannaki 3,
Stavros Georgopoulos 1
1
Department of Otolaryngology - Head
and Neck Surgery, Hellenic Anticancer
Institute, Saint Savvas Hospital, Athens,
Greece
2
Department of Otolaryngology - Head
and Neck Surgery, Royal London hospital,
Barts and the London, London, United
Kingdom.
3
Department of Pathology, Hellenic
Anticancer Institute, Saint Savvas Hospital,
Athens, Greece
Introduction: Malignant tumors involving
tonsils are, in their majority, primary tumors.
Metastatic tumors to the palatine tonsils are
extremely rare, with nearly 100 cases reported. Only 3 cases of Merkel cell carcinoma of the skin metastasizing to the palatine
tonsil have been reported.
Case Presentation: We present an interesting case of a 61-year-old man with a 7-week
history of moderate dysphagia. He also complained of a foreign body sensation, snoring
and disturbed sleep. Physical examination
revealed an enlargement of the left palatine
tonsil that caused a moderate narrowing of
oropharynx. The surface of the tonsil was
smooth, with no presence of ulcerated lesions. Three years previously he had been
treated for Merkel cell carcinoma (MCC) on
skin of his left shoulder.
The differential diagnosis of the unilateral
tonsillar enlargement included squamous
cell carcinoma, non-Hodgkins lymphoma,
extramedullary
plasmacytoma,
leukemia, Hodgkins disease, metastatic neoplasms, peritonsillar abscess, dermoid cyst,
fibroma,schwannoma, lymphoid polyp,

sarcoidosis, tuberculosis of the tonsil, and


Plaut-Vincent angina.
A tonsillectomy followed by palatoplasty
was performed. Immunohistochemical
staining demonstrated a pronounced reaction for cytokeratin 20, chromogranin and
CD56 histodiagnostic markers. A diagnosis
of metastatic MCC to the tonsil was established. Patient also underwent radiotherapy
to the site, ipsilateral cervical lymph nodes
and synchronous chemotherapy.
Conclusions: Considering the aggressiveness of MCC, an early diagnosis is critical to
enable the choice of adequate therapy at an
early stage. Treatment includes wide local
surgical excision of the tumor, radiotherapy
and chemotherapy. Immunohistochemical
studies are useful diagnostic tools in the establishment of the diagnosis of MCC.
48 -
.

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49 -

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(3%).
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2, 2, 1, SCC 4, BCC
1, 1, 1, .
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10 (14.7%).

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53 -


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124

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126

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131

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.
78 - SYMMETRICAL LIPOMATOSIS OF
THE TONGUE: A RARE CASE OF MACROGLOSSIA. DIAGNOSIS, SURGICAL
TREATMENT AND LITERATURE REVIEW
Ioannis Vasileiadis 1,2, Georgios Mastorakis 3,
Aristotelis Petousis 1, Panagiotis Ieromonachou 4, Ioannis Logothetis 3
1
Department of Otolaryngology - Head
and Neck Surgery, Venizeleio-Pananeio
General Hospital, Heraklion, Greece
2
Department of Otolaryngology - Head
and Neck Surgery, Royal London hospital,
Barts and the London, London, United
Kingdom
3
Department of Oral and Maxillofacial Surgery, Venizeleio-Pananeio General Hospital,
Heraklion, Greece.
4
Department of Pathology, Venizeleio-Pananeio General Hospital, Heraklion, Greece
Introduction: The term lipomatosis was
generated to refer to a disorder characterized by multiple, non-encapsulated lipomas
affecting various areas. Symmetrical lipomatosis of the tongue is an extremely rare condition. To date only 8 cases have been reported in the literature.
Case presentation
We present an extremely rare case of intramuscular lipomatosis of tongue in a 67 year
old man who presented with gradually progressive, diffuse painless swelling on both
lateral borders of the tongue. The swelling
on the right lateral border measured 5.5 x 4
cm and that on the left measured 5 x3.5 cm.
Magnetic resonance imaging showed that
entire muscular mass of tongue has been
replaced by adipose tissue (Figure 3).
Bilateral partial glossectomy and tongue
debulking was performed under general an-

esthesia. Intraoperatively, adipose tissue was


found deeply invading in the lingual muscles.
No capsule formation was detected. The volume of resection in both sides was carefully
decided by taking into consideration the
postoperative shape and size of the tongue.
Histopathological findings revealed lobules
and sheets of mature adipocytes infiltrating
between few atrophic striated muscle fibers, confirming the diagnosis of symmetrical
lipomatosis of tongue.
Conclusions: The present case is unique
because of its infiltrating nature and the extension of the lesion. After extensive review
of the literature, we believe that it is the
bulkiest lipomatous lesion of tongue ever
reported.
Partial glossectomy is the treatment of
choice because of the distinct possibility of
a well differentiated lipoma-like liposarcoma
and the improvement of symptoms after
tongues size reduction.
79 -

K., ., .,
., .
,
..
:
.

,
,
.
438

2004 2012.

32 7,3%.

132

.


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.
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MRI
.
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83 - MALHERBE
E., .,
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134


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Gardner, Rubistein-Taybi,
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Turner. .
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1
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:
.
- : 31
3


.
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Lund-Kennedy .
-
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.
: 16 (38% ,81.25% ) 31
.
12.19 (6.25) . : (68.75%),
/ (56.25%),
- (12.5%),
/ (12.5%). -SNOT-20 (p<0.05).
80%. 3
(17%) .
:
. ,

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. -

135

,
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85 -

LASER CO2,

. 1, . 1,
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1994 2011. 283

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(VAS)
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. ,

(CO2 laser: 3,44 0,99,
: 3.26 0.76, : 3.19 0.79), .


. .
: CO2 laser,

.
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136

: 2.290
6-18 . ,
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(Skin prick tests),
.
-, 80% .
:
- 630
( 27,5%).

(44,1%), Alternaria Alternata (43,7%),
(32,5%),
(31,7%), (14,3%), - (,
, )
41,3%. 54% -.

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,
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87 - DRAF II
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2
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SNOT-22 (SinoNasal Outcome Test 22-item)
SF36 (Short Form Health Survey
36-item),
VAS (visual analogue score)


. SNOT22,VAS. Spearmans rho. Wilcoxon

SNOT-22, VAS .
:
[ : SNOT22=34,53 (4-81)
VAS=8,07(1-10)].

(r=-0.275, p<0.05) 58%
. SNOT22SF36 (r=-0.466, p<0.05) VAS-SF36
(r=-0,203, p<0.05),

. Wilcoxon [SNOT22=-8,368 (p<0.05),


VAS=-7,849 (p<0.05)] .
:

, .

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89 -

(F.E.S.S.):
. . , . . ,
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: 2010-2013,
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(0, 30,45)
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: 152
, 64% 36%

138

. 19
88 (.. 50,104).
: 135 / (88,8%), 4
(2,6%), 3
(1,98%), 2 Thornwald (1,33%), 3
(1,98%), 2
(1,33%), 2 (1,33%) 1 (0,65%).
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139

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: 16 (38% ,
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.
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(68.75%), /
(56.25%), - (12.5%), /
(12.5%).
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(17%) .
:
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92- BALOON SINOPLASTY. 14
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4 balloon-sinoplasty. -

140

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: balloon - sinoplasty




94 -


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:

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143

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:
1:2 37.
CT

MRI .

,
. ,
, .

:
,
.
- :

18 . : , ,
, ,
.
: 3% . 34
31(62%) 13(38%)

144

44 .
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, 3 , 15 , 3 7 . /


. 9 25 . 2
o
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.
:

.


.
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.

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:



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.

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145

105 -


1999 - 2013.

. , . ,
. , . ,
.
..
:

. .

. , , ,
(),

(hot potato voice), . .
.
: ,
.

, ,

.
- : 86
, 1999 - 2013 ,

, .
: (66,3%)
.

20 39 (55,8%).
.
(52,5%). 54
32. 7 (8%) ,
25 (29%)
.
31 .
:
.
.
,

.

146

AA1 -


3

.

,
,
,

,
..

:

.

:
,

.

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:

- : 3 312
. 11
8
.

.

.
: 6%
.
100% ,
17
( Sjogren).
10 19
stent . 1

,
,
,

,
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:

.
:


.
- : 454
2010-2013,
48 . 21
-

.

147

250 mg
10ml
(.. 2,4).
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.


2-3 -.
.

: 48 54,2 (
: 39-73). 41
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.
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. 15
. (18/63), (20/63), (3/63)
(8/63). 42 (87,5%)
.

:

.

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- :
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21 5-14 (9
,12 ) .
5,2
.
.

.

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: 21 10
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.
: (19/21),
(18/21), (20/21) (4/21). 9
. 12
3 .

:
.

: ,

:



.
AA3 -

148

.
AA4 - Semantic Infostructure Finite
Element Modelling (SIFEM) of the
cochlea: preliminary results
Bibas A, Kikidis D., Bellos C, Koutsouris D.,
Fotiadis D., Sismanis A.
University of Athens, A ORL Clinic,
Hippokrateion Hospital, Athens, Greece
National Technical University of Athens,
Athens, Greece.
Introduction: The study of the normal function and pathology of the inner ear has
unique difficulties as it is inaccessible during life and so, conventional techniques of
pathologic studies such as biopsy and surgical excision are not feasible.
Aim: To present preliminary results of an ongoing EU-funded research program, focused
on the mathematical modeling of the cochlea function with our clinics participation.
Materials and Methods: SIFEM focuses on
the development of a Semantic Infostructure interlinking an open source Finite Element Tool with existing data, models and
new knowledge for the multi-scale modeling of the inner-ear with regard to the sensorineural hearing loss. The experts, including bioengineers and software developers
have access to both the data (micro-CT images, histological data) and inner ear models. These SIFEM tools and services enhance
and accelerate the delivery of validated and
robust multi-scale models by focusing on:
(i) Finite Element Models manipulation and
development, (ii) cochlea reconstruction and
(iii) 3D inner ear models visualization.
Results: The final outcome is the development of a functional, 3D, multi-scale and
validated inner-ear model that includes
details of the micromechanics, cochlea ge-

ometry, supporting structures, surrounding


fluid environment and vibration patterns.
A current model is already produced and
during the lifetime of the project It will be
improved and validated.
Conclusion: Results can be used to better
identify the mechanisms that are responsible for the highly sensitive and dynamic
properties of hearing loss. These result to
the description of alterations that are connected to diverse cochlear disorder leading
to more efficient treatment and rehabilitation planning and, in long-term, to personalized healthcare.
AA5 -
:

..
,
,
,

...
..
:

.
,
/
,
.



.
:
2010-2013,
.
-

149

/ .

.
:
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, ,
,
(CT MRI ).

,
,

.
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-
STENT.

CPAP
,
, ,

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.


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.
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stent . Visual
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.
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. .
:
CPAP
.
.

150

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: ()BMI=
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ESS=5,08. .

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.

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:

(0,04% )
.
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Brackman Grading System). 10
.
.


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151

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[ Grade V Grade -], ,
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Ziehl-Nielsen
.

CT
.


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:
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.
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:




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. . , . . ,
. . , . .

:

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.
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: 132
2011-2013.
30 . 65
67 .

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p<0,05.
: T
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.
.
3 .
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.

152

AA10 -






. . , . . ,
. . , . . ,
. . , . .

:

, - -
40%
.

.
:


.
: 64
...
2010-2013. 2
33 (14 19
.. 43,72) 31 (18
13 .. 39,51)
. 1
()
2

().
/ .
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8 . 2 ,

74,2%.
.
:
,

,
,


.

.
AA 11 -

1, 2, 2, 2, 2,
2
1
,
,
,
.
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.
:
:


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.

153

:
.
: 2011
2013, 4 .

.
:
.
.
.
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AA12 -
DOCETAXEL-CISPLATIN-PANITUMUMAB


-
. 1, . 1, . 1,
. 1, . 2,
. 2, . 2,
. 2, . 1
1

2

: -EGFR
.

cetuximub, panitumumab
-EGFR ,
.
: docetaxel/cisplatin/panitumumab
-
.
: 21 -
docetaxel 50mg/
m2, cisplatin 50mg/m2 panitumumab
6mg/kg 2 ,
G-CSF .
A: 5/2010 21 . K
14
7 .

.
14 (70%), 3
(15%) 3 -

154

(15%).
7 12 .
:
//panitumumab
-



.
AA 13 -
:

1,
1, 1,
1, 1,
2,
1, 1,
1, . 1
1
,
,
2
,
,

: 48
(87.5% , 58.314.1 ).

(54.2%)
(33.3%). (66.7% III-IV, 66.7%
WHO III).
,
43 (89.6%) . 5
58.3% (n=28). I-II
(III-IV)
(75.0% 50.0%, log-rank p=0.1).

: WHO I 100%, WHO II
64.3% WHO III 53.1%.
<60 5
60 (68.2% 50.0%, log-rank
p=0.2).

:
()

., .,
.

:
,
5 59-76.1%.
(58.3%)
.

:
.

AA14 -

DANDY-WALKER

:

1990-2008.
. follow-up
.
KaplanMeier log-rank test.

. , . ,
.
K

:
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,

155

.
:
24

. .
, Dandy-Walker

.
,
, ABR, VEMPs
.


,
.


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:


.
AA15 -
:

. , . , . ,
. , .


:
.


0,3% .


(cyber-knife gammaknife) .
[Lutetium (177Lu)DOTATATE]

.
: 47
, ,

.
,
cyber-knife , gamma-knife
, .
H


.
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,
,
. , -
IGF-1- , .
:
.

156

AA 16 -

KLESTADT.
1,
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1

2
,

: Klestadt
,
.

. . 0,7%
2,5%
.
: 40
2
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11 .

. : .

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.

.
AA 17 -

.



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17 ,
,
7-12 .
.


(IARC) (IARC monographs vol.102, 2013)
2B (
).
:
.
:
20
5 -
. : 15 20

, 5 20

157

. , 3 5 2 .
6 18
-
10 .
:

,

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.
AA 18 -
STEVENS JOHNSON

,
, ,
,
,
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: Stevens Johnson
.

Stevens Johnson.
: 25

2. ,
. .

. - .
.
Stevens Johnson.
iv
, ,
8 .
:
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, .


.
AA 19 -

.

;

.
1,
Jacobowitz Ofer 2,
1
1
- ...,
... ,
2
Department of Otolaryngology,
Mount Sinai Medical Center, NY, USA.
Center for Sleep medicine,
Orange Regional Medical Center, NY, USA
:
()

.

158


.
CPAP, .

()
.
:


ImThera,

.
, :

.

.
.
. 70-90.

.
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:
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AA 20 -
:

. , . , . ,
.
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:

.
.
: 54


() ,
.

,
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.
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CT
/ ,

,
.
, .



.
5 .
: H .

159

,

.
AA 21 - A
Wii Balance Board
(NintendoR)
1, . 1,
. 2, . 3,
. 2, . 1
1
,

,

2
,

3
, . ,

:


.
- ,
.
:

Wii
Balance Board (Nintendo R).
& : Matlab ,
. (centre of
pressure) ,

,
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, ).
balance board
Matlab, WiiLab.
2
2 , 2
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: ,
,

.
:
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.
AA 22 -



., ., .,
., ., .


:
.
:

160

,



.
:




.

2012
2013.
.
: 52
.

.
:


.
AA 23 - MMP-2
-9

. . 1, . 1,
. 2, . 1, . 1,
. 1, . 2,
. 2, . 3,
. 3, . 1
1
...,
....
2

, ...

3 ,
, .
: (MMPs)
-2 -9 ,


.
:


,
.
: 49 .

.

MMP-2 -9, western blotting.
:

(proMMP-2 -9).
proMMP-2

.
proMMP-9,


0 .

proMMP-2 .
proMMP-9

161

.
:


.
proMMP-2
,
proMMP-9 .
AA 24 -
HPV



. 1, . 2, .,
. 1, . 2, . 1
1


2

:
. ,

,
.
:

.
: 115 280
2010- 2013. -



Realtime PCR.
: 115 14 (12,17%) ,
280 117
(41,79%). 31 (5,21%), 45
(3,47%), 56 (2,6%), 39 (2,6%), 51 (1,73%),
18 (0,86%), 59 (0,86%), 33 (0,86%), 34
(0,86%), 48 (0,86%), 49 (0,86%),
31 (15,71%),
16 (12,14%), 18 (8,21%), 56 (6,07%), 59
(5,71%), 51(4,64%), 52 (2,86%), 39 (2,14%),
35 (2,14%), 58 (1,79%), 33 (1,43%), 45
(0,35%).
:
31. 16

.
AA 25 - -

2008-2012
,
, ,
, A ,



:
:

.

() .

162


.
.
:


2008-2012.
:



.
DCR

. ,
,

.
: 2008 2012,
32
enDCR, 10 22
63 . ( 2 ).

( 2 ).

.
97%.
AA 26 - KIKUCHI-FUJIMOTO:

1,
1,
2,
1,

1,
1
1

.
:
2


.
: Kikuchi-Fujimoto
,
.
,
(, , , ).


.
:
.

( ) , .

.
,
, FNA
.

,

, Kikuchi-Fujimoto.

.

163


.
: Kikuchi-Fujimoto

,

, .
( ) .
1-6 .

, .
AA 27 -
:
. , . , . ,
.
... ,
- ...
:
, , ,
/ , ,
.
: 70

(2006) ,
VII v
. ,

. , .

-

,

, .
(CT, MRI)

.
. .
:

,

.
AA 28 -
.

*, *,
/ *,
*
*
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:

(neurolymphomatosis)


.
: 47
non-Hodgkins
,

164

.
, . ,

,
().
.
:

.


. ,


.
- : ,
, .
AA 29 -

., ., .,
., .
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:
o
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.

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.
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.
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).
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: ,
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,
.

165

AA 30 - V/Y

. 2, . 1,
. 2, . 2, . 2,
. 2, . 2
Goettingen
. 1

2

.


.


.
V/Y
.
AA 31 -
:

. . , . . ,
. . , . . ,
. . , . .
... ...
: ,

1-2%.
. ().
:
61 , , -

,
3
2.
.
,
,
. CT-

, 4,8x2,4x1,8cm.
FNA .
.
, ,

, 3

.

20
.
:
70 , .

.

.
,


.

166

AA 32 -

,
, ,
,

,
.... .
: M

. ,
,
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: 5 ....
2009-2012,

,

,
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3 2 .
: 2, 5


,
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.
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,
.
:
,
.
AA 33 -

. 1, . 1,
. 1, . 3,
. 1, . 2,
.. 1

, 1
, 2
,
,
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, Erlangen, 3
:

. ,

.
: 39
,
-

167


,

.


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.
:
.
,
.
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.

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,
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(),
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.
:
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,
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.
AA 35 - MASSON
:
1, 1,
2, 1,
1,
1
1

.
:
2


.
:
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, 1923
Masson

168

. 2%
.
:
82 ,


, .
, ,

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, 6,5 , ,

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. FNA

. .


, .

.
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.
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.
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.

AA 36 -

. , . , . ,
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,

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.
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169

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.

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.

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.
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., ., .,
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:

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.
:

170


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.
: 777
14
,

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.

. 1
3 ,
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0.39% .
.

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AA 39 -
:

. , . , . ,
. , . ,
. , .

:
.

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.
, , .
,
.
:
.
: 62

.

. ,

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.
:
-

171


,
.
, . ,

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.
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K
:
.
: 14



.
.
, .
-
,
,
,

.
baclofen

, .

:
,

18-24 .
, , - -
(floppy larynx)
.



, .
,
,
, .
AA 41 - DCR
,
.
1,
1, 1,
1,
1,
2, 1,
. 1
1
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: (..)
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.

172


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.
: , 62 ,
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,

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. CT -
. DCR
,
.

. ,
, ,
,
.
follow up ,
,
,
.
: ..
. DCR
,
,
.

AA 42 - .
2002-2013.
.
1,
1,
1, 1,
1,
1,
1
1

..
: 3,5% .
>50%
.
,
. 60-65 .
: ,


, .
: 113
2002
6/2013.
, ,
,
.
: 110
(.. 64,2) 3 , (. 67,3
). 62 , 23 , 3
25 .
, -

173

72 (1-2xMx) 41
(3-41-3x).
,

,
.
5 68%.
: ,
, ,
.
,
.



,


.



.
.

1,
1, 1,
3,
2,
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1

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:
40 56 ,
.

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, .

.
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.
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,


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AA 43 -



.

174


.
AA 44 -

., ., .,
., .
, .. ,
:
.
, .

p.os. . ,
,
, .
:



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:
.
:
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(5- 7 ).
, ( 7- 10 ).
,
,

, -


, , INR

. ,
,
RapidRhino, Kaltostat
Surgicel ,

merocel BIPP.
: ,
,
,
,
.
,
,
,
,
.
AA 45 - -
, ,
,
,
.

: -
.
,
, .

. , .

175

Case Report: 120 (54 /66 )


56 (12-84 )
4 . 106 , 5 , 6
3 .
,
(, ),
(CT-MRI).
112 120 .
,
,
. 100
(-)
12 , .
.
:
. ,

.
AA 46 -
:
. , . ,
. , .
... ,
- ...
:

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. ,
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.

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(
).
.

,
.
:
, ,


.
AA 47 -
., .,
., .,
.
...
:
(follicular dendritic
cell sarcoma - FDCS)

176

, (Follicular dendritic cells


- FDCs).
, .
Lennert 1976

, 1986 onda FDCS. 200
FDCS, 1/3 .

.
: 49

6
. 3
. , ,
.

cyberknife
.
.
: FDCS

,

.

AA 48 -
MERKEL
.

., .,
., .,
.

: Merkel

,
,

0,32/100.000. ,
polyomavirus,
Merkel.
29%-46%,
(21%-38%) (7%-23%).
3,4%-12% .
, , .
30%-64%
. 3
.
: 52 Merkel

, 4 cm, .
Merkel.
. o C 20

177

LCA,
CK7,HBMA45,NKI/C3.
:
,
, ,
.
AA 49 -


. 1, . 1,
. 1, . 1,
. 1, . 1,
2, . 1
1
2 ...

:
.
: 62
,
, , .
CT ,
. ,
,
.
Staphylococcus coagulase negative
.
,
-

. i.v.

.


.

30 .
:
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)
.
AA 50 - MELKERSSON ROSENTHAL
. 1, . 1,
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: MelkerssonRosenthal , , ,

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, 24.

178

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.
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: MelkerssonRosenthal
,


.
AA 51 -
.
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179

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.

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.

180



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.

30 .
MRI CT

.


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.
:

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.
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.
.
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,


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.
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.



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AA 55 -


. 2, . 1,
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1
Goettingen
.
2

H


.

181


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.



(
).
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:

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194

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: 34 20 , 14 , 12
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201

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209



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( )

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AA 103 -

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188
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.

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: 188 ,
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65(84.5%) ( 47
-72.3%- 40 ) 12(15.5%)
( 10 -83.3%- 40 ).
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2003-2013 358 16
14 .
, , , ABR, ASSR,
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(open set speech recognition test),
, Bamford
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.


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AA 115 - Concomitant chemotherapy


and Radiotherapy in Nasopharyngeal carcinoma
Besim Boi
ENT-Service, University Hospital Center
of Tirana, Albania
ABSTRACT
Purpose: To assess the role of concomitant
chemotherapy and long-term survival of
patients with nasopharyngeal carcinoma
(NPC) who were treated with conventional
radiotherapy (RT) and concomitant chemotherapy.
Material dhe methods: Ninety eight newly
diagnosed patients are seen at the University Hospital Center of Tirana between January 2001-January 2006 were treated with
RT and concomitant chemotherapy. University Hospital Center of Tirana is the only one
that has a full service in Albania for oncologic patients. The tumor dose was 70 Gy
delivered in 35 fractions, 5 fractions weekly.
Four cycles of chemotherapy, each consisting of cisplatin 100 mg/m2 on day 1, 5-fluorouracil, 1000mg/m2, were administered in
the same time with RT. Twenty two patients
had Stage II, fourty five had Stage III, thirty
one had Stage IV disease (AJCC Staging System 1997). The overall incidence of NPC in
Albania is 0.46 per 100.000 people.
Results: After a period of follow-up for 60
months, the 5-year overall survival rate
for all 98 patients was 75.1%, the disease
free-survival rate was 70.1% and the locoregional control rate was 79%. The 3-year
overall survival rate for Stage II was 87.2%;
it was 73% for Stage III and 64.3% for Stage
IV. The 3-year disease free survival rate for
Stage II was 83%; it was 68% for Stage III,
and 59% for Stage IV.
Conclusions: Radical RT with concomitant
chemotherapy was very effective in our pa-

218

tients with locoregionaly advanced disease.


In Albania unfortunately all patients with
nasopharyngeal carcinoma are presenting in
advanced stage disease. The long term results appear encouraging for patients with
advanced stage disease Stage III and Stage
IV.
AA 116 -
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127


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type and number of projectiles. Although


rarely life threatening, damages by modified
gas pistols may cause continuous or life-time
discomfort and diminished quality of life.

AA 126 - MULTIPLE-PROJECTILE
PENETRATING NECK INJURY BY
A MODIFIED NAILS-CONTAING
CAS PISTOL

AA 127 -
28

Pazardzhikliev Dimitar, Bakatinaki Artemis


Introduction: A gas pistol is a non-lethal
weapon for self-defense. However it can be
modified to fire projectiles and cause damage.
Case report: A 43 y.o. male had been shot
from a close in the neck. He experienced
immediate pain in his right shoulder, pain
and cough. His neck swelled and his voice
changed. There was not any significant
bleeding.
At admission there were several pin-sized
wounds in the neck, a massive subcutaneous
emphysema, no bleeding, no pneumomediastinum and no pneumothorax. He had no
vocal cord paralysis or laryngeal oedema.
CT and x-ray studies revealed 4 foreign bodies in the neck. One was in the arc of the
cricoid cartilage on the right, one in C4-C5
abutting the vertebral artery foramen on the
right, one abutting the T1 root on the left
and one in theT1 body.
Airway was secured via inferior tracheotomy
and the cricoid foreign body was removed
using combined open and endoscopic approach.
It was assumed that an attempt to remove
the remaining projectiles exceeded the risk
of damage to vertebral artery and the patient was left on follow-up. Currently he is
without any complaints except for pain in his
left arm and shoulder.
Conclusions: Modified gas pistols may cause
different degree of damage depending on

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&
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10 13 2013
Astir-Egnatia.

21 .

H .

THEMA team CONGRESS & EXHIBITION ORGANIZER L.T.D.


. 40, 15124
( 1 - 50-52)
. 210 6107213 - F. 210 6107864
E. info@themateam.gr, W. themateam.gr





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