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10Moldovan Medical Journal. October 2018; 61(3) BOOK REVIEW
The monograph "The operated ear disease"
Print-Caro Printing Company, Chisinau, 2018, 224 p.
The author: Sergiu Vetricean, MD, PhD, Associated Professor, Department of Otorhinolaryngology Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of Moldova
The classical radical operation made for the sanitation of the middle ear system and the profilaxy of the otogenic complications is the most used surgical procedure in the world. It has a low rate of recurrent or/and residual lesions, it facilitates the control of the recidivant cholesteatome and of the infection, and it also offers the possibility of treatment in ambulatory conditions, fact that reduces the costs and the waiting lists. Nevertheless this method has an imperfection as the healing is not definitive. The operated ear continues to represent the patient's suffering cause. There are a lot of ENT surgeons that use the radical-conservative method of sanitation in order to get rid of the consequences of the radical intervention. Patients who have experienced an ear intervention often have a condition called "the operated ear disease".
The work is presented on 224 pages; it consists of introduction, 8 chapters, general conclusions, 99 figures, 19 annexes and bibliographic index with 221 references.
In the introduction there are presented the scientific importance and the topicality of the problem, its theoretical and practical value. The general part of the monograph is composed of 4 chapters.
In the first chapter - there is a detailed description of the contemporary data of the embryology, clinical anatomy, physiology and pathophysiology of the vestibular - acoustic system. There is brief and well presented information concerning the morphology and the morphopathology of the temporal bone, the hearing physiology and the balance function.
The second chapter - has the most recent data on the ear se-miology. The otological syndromes like hypoacusia, tinnitus, ear pain, othoreea, prurritus and the vestibular periferic syndrome are described with the precision of different clinical variants that permits to correctly diagnose and apply the adequate method of conservative or surgical treatment.
In the third chapter - there are widely described principles and the order of the otological contemporary diagnosis steps. The applicative value of this method of clinical and imagistic research, are also specified. The oto-endoscopy and the video-endoscopy are the new methods in the mastoid surgery and in the middle ear surgery.
The use of the endoscope elevates the safety in the total cho-leasteatome removal. It allows the surgeon to keep the EAC untouched.
The knowledge of the prevailing species and the antimicrobial sensibility guides the clinicians towards a correct empiric treatment. The patients will benefit of better management, a more specific one and of a lower rate of intracranial and otomastoidian complications of SCOM.
The fourth chapter - is totally dedicated to the chronicle inflammation of the middle ear system. There is presented the pathogenesis and the differentiations of the clinical forms of the SCOM. The diagnosis, surgical treatment and the profilaxy of this disease are given in detail. There are described advantages and disadvantages of different mastoidectomy techniques. There are 3
types of traditional surgical procedures: 1) simple mastoidectomy (cortical, complete), 2) radical mastoidectomy, 3) modified radical mastoidectomy. The fourth procedure is the mastoidectomy with tympanoplasty. The objectives of this method besides the cure of the disease are also the maintenance or the reconstruction of the posterior-superior wall of the EAC and the osicular chain. These procedures can be categorized in 2 types: with the opened cavity CWD or with the closed cavity CWU.
The special part is based on the personal research results and is exposed in 4 chapters.
In the fifth chapter - there is a description of the causes and complications of the operated ear disease. A special part is taken by the methods and the treatment techniques in surgery. There are described the methods of reconstruction of the posterior wall of the CWR, timpanoplasty and the mastoidian obliteration (mas-toidoplasty). Special attention is paid to the influence of the reconstructive surgery on the life quality of the patients with the OED.
The sixth chapter - represents the experimental argumentation of the autogenic bone graft with bone inductive properties of the AOMF in the reconstructive surgery of the ear. After the experimental research the author concludes that the autogenic graft "Osteomatrix forte" is a biocompatible material which shows the osteocunductive and osteoinductive capacity, it is moderately resorbed which guides and stimulates the tissue regeneration till the total substitution with the grown and organospecific bone tissue.
The seventh chapter - reflects the details on the revision surgeries on the patients with the OED with the traditional reconstruction and with the reconstruction with the autograft bone having osteoinductive properties of the AOMF, and surgeries of sanitation on patients with medium cronical suppurated otitis with traditional reconstruction and with the use of bone autografts having osteoinductive properties AOMF.
In the eighth chapter - the comparative analysis is done concerning the anatomical and functional results of the primary reconstructive interventions and the revision interventions. It is shown that the results of surgical interventions, made after an elaborate method are better and more stable than the results of surgical interventions made after the known method.
The work is finished by 8 general well formulated conclusions that come from the results of the research done by the author.
The work fully complies with the requirements, is elaborated by a thorough study, with multifactorial analysis, with recommendations addressed to the public health services, offering distinct management solutions for practicing physicians and doctors of different specialties as well as to all those interested in this pathology and may be recommended for publishing.
Vladimir Popa, MD, PhD, Professor Department of Otorhinolaryngology Nicolae Testemitsanu State University of Medicine and Pharmacy Chisinau, the Republic of Moldova
