Papers by Cristian Mârţu
Romanian Journal of Rhinology
BACKGROUND. Wildervanck syndrome was described for the first time in 1952. This rare entity is co... more BACKGROUND. Wildervanck syndrome was described for the first time in 1952. This rare entity is composed by the oculo-cervico-acoustic triad, which may be more or less complete. MATERIAL AND METHODS. We present a 5-year-old girl diagnosed with Wildervanck syndrome, exhibiting: Klippel-Feil anomaly (fused cervical vertebrae), Duane Stilling Turk syndrome (bilateral abducens palsy) and congenital bilateral cophosis indicated by ABR. RESULTS. The CT scan revealed major malformations of the brain and calvarium including the petrous part of both temporal bones. Despite all these brain malformations, the psychological development of the child was nearly normal. As it was previously reported in other cases, the child also presented spina bifida cervicalis and cleft palate. The cause of deafness was bilateral lack of cochleae, making impossible the insertion of the cochlear electrode for hearing rehabilitation. When the patients are discovered late (after 3 years of age), the management of h...
Experimental and Therapeutic Medicine, Dec 7, 2021
Serous otitis media (SOM) occurs in children and constitutes one of the most significant causes o... more Serous otitis media (SOM) occurs in children and constitutes one of the most significant causes of hearing loss in young age, posing as an important risk factor for long-term hearing loss. SOM is underdiagnosed, most frequently in infants, or the appointment to the ENT doctor is delayed due to non-acute symptomatology. The aim of the present study was to assess 285 patients with SOM diagnosed within a two-year span. The etiology and pathology of hearing loss in patients with different age groups were examined. The importance of a clinical examination and tympanometry was emphasized as absolutely necessary for a correct diagnosis. Treatment targeted Eustachian Tube permeabilization for satisfactory long-term middle ear aeration. Nasal drops with vasoconstrictor drugs (phenylephrine) and disinfectant (colloidal silver 1%) were commonly used, but some patients also benefitted from dexamethasone intratympanic injection. Patients were evaluated at the end of the treatment and follow-up occurred at one month, one year and three years later.
Experimental and Therapeutic Medicine, Jan 25, 2021
The present study aimed to analyze local and regional changes in regards to odontogenic sinusitis... more The present study aimed to analyze local and regional changes in regards to odontogenic sinusitis in subjects with endo-periodontal lesions and diabetes mellitus and to investigate the effect on the level of glycemic control (glycated hemoglobin) that could be generated by adjunctive therapy with subantimicrobial doses of doxycycline. This study was performed on 51 subjects with diabetes who were divided into two therapeutic groups: 31 patients with diabetes (the study group) who underwent conventional endo-periodontal therapy and subantimicrobial doses of doxycycline and 20 patients with diabetes who followed only conventional endo-periodontal therapy (the control group). Patients underwent endodontic and periodontal clinical examination, with retro-dental-alveolar radiographs and CBCT examinations. For each patient, glycated hemoglobin A1c (HbA1c) was determined. This evaluation was performed at the beginning of the study, as well as 3, 6 and 12 months after baseline. A significant percentage of patients, both in the study group and in the control group, showed radiological signs of odontogenic sinusitis, totaling 29 patients (56.86%). Periodontal parameters revealed lower levels in patients who underwent the regimen which consisted of subantimicrobial doses of doxycycline; these results were maintained over the study period. Moreover, we demonstrated significantly reduced glycated hemoglobin levels throughout the study (12 months) in the doxycycline-treated group. This fact has far-reaching effects in the sphere of loco-regional complications as well, and the risk of odontogenic sinusitis can be significantly reduced.
Cochlear implantation is a well-established method of treating bilateral profound cochlear deafne... more Cochlear implantation is a well-established method of treating bilateral profound cochlear deafness. One should be aware that the medical literature is quite poor, in regard to the outcomes of the implantation of adolescents or adults with prelingual deafness. The aim of this study is to evaluate the audio-verbal outcome in late implanted adolescents and adults with congenital deafness. Material and methods: the study included 8 late implanted patients with bilateral profound deafness 4 of them were implanted as adolescents and the other 4 as adults; all of them were implanted at the Clinical Rehabilitation Hospital from Iasi. The patients’ hearing abilities were tested using 2 scales: Speech Perception Rating Scale and Speech Intelligibility Rating Scale. Results: all of the patients have benefited from the implant when their hearing performances were compared to those before implantation. Conclusions: the topic remains open as long as the studies had only a limited number of subjects, but even so it can be affirmed that, with no doubt, all the subjects have had significant improvements after implantation.
Materiale Plastice, Dec 30, 2019
Sutures are classified into non-absorbable and absorbable, and mechanical properties of these mat... more Sutures are classified into non-absorbable and absorbable, and mechanical properties of these materials vary by the composition. In this study we analyze four different types of sutures used commonly in surgery: silk, nylon, polyglycolic acid (PGA) and polytetrafluoroethylene (PTFE). The materials were chosen to represent a wide range of suture material categories: absorbable and nonresorbable, monofilament and multifilament, natural and synthetic in order to assess their mechanical properties but also the bacterial adherence to each type. The objective of this study was to measure the total bacterial adherence by using real time PCR at 7 days postop and to analyze the antibacterial and mechanical properties comparatively depending on the type and composition of sutures. Tensile properties such as maximum tensile load, elongation rate, stiffness and energy absorbed before breakage were taken into consideration. Experimental determination pointed out that the average total bacterial load was lowest for PTFE and highest for silk. The results of the study are useful in choosing an appropriate suture wire according to the mechanical properties taking into account the bacterial load of the surgical site in order to aid in tissue repair.
DOAJ (DOAJ: Directory of Open Access Journals), Apr 1, 2016
Introduction: Auditory Steady State Response (ASSR) is an objective method for determining the au... more Introduction: Auditory Steady State Response (ASSR) is an objective method for determining the auditive threshold, applicable and necessary especially in children. The test is extremely important for recommending cochlear implant in children. The aim of the study was to compare pure tone audiometry responses and auditory steady-state thresholds. Materials and method: The study was performed on a group including both patients with normal hearing and with hearing loss. The main inclusion criteria accepted only patients with normal otomicroscopic aspect, normal tympanogram, capable to respond to pure tone audiometry, and with ear conduction thresholds between 0 and 80 dB NHL. The patients with suppurative otic processes or ear malformations were excluded. The research protocol was followed, the tests being performed in soundproofed rooms, starting with pure tone audiometry followed, after a pause, by ASSR determinations at frequencies of 0.5, 1.2 and 4 KHz. The audiological instruments were provided by a single manufacturer. ASSR was recorded at least two times for both borderline intensities, namely the one defining the auditory threshold and the first no-response intensity. The recorded responses were stored in a database and further processed in Excel. Discussion: The differences observed between pure tone audiometry and ASSR thresholds are important at 500 Hz and insignificant at the other frequencies. When approaching the PTA-ASSR relation, whatever the main characteristic between the PTA and ASSR thresholds in one ear, the profile of the lines gap maintains the same shape on the opposite ear. Conclusions: ASSR is a confident objective test, maintaining attention to low frequencies, where some differences might occur.
Applied Mechanics and Materials, Nov 1, 2015
Premature loss of temporary teeth, both the lateral and the frontal area can have unfavorable con... more Premature loss of temporary teeth, both the lateral and the frontal area can have unfavorable consequences on the development of permanent dentition, the support serving to maintain space for permanent teeth eruption in the dental arches. The aim of the study was assessment of different types of fixed and removable space maintainers in terms of their longevity in the dental arches that were applied as interceptive orthodontic treatment for edentulous space management transiently due to premature loss of deciduous teeth. The study followed the evolution of space maintainers properly applied to clinical cases that required these therapeutic options, and appreciated the success rate and the failure of these devices, important being the time at which the assessments were made. Findings failure rate of applied space maintainers was reported to the main causes that could lead to remove the devices: loss of space maintainers, especially those removable, fracturing both fixed and removable devices, loosening orthodontic rings and of course, taking into account the absence of some subjects at periodic reassessment meetings. The space maintainer was considered a success when it fulfill the main role for which it was applied - transitional management of edentulous space, and then being removed when the permanent succession tooth eruption occurred.
Romanian Journal of Oral Rehabilitation, 2016
Phoniatrics is the medical specialty that deals with the normal and pathological spoken and sung ... more Phoniatrics is the medical specialty that deals with the normal and pathological spoken and sung voice. So any patient presenting with voice and speech disorders, regardless of age, needs phoniatrics and vocal exercises. Depending on the causes that led to dysphonia, phoniatrics exercises will be accompanied by microsurgery and psychotherapy. Today there are a variety of concepts, theories, methods and especially a lot of the vocal exercises that have the aim to achieve the recovery of the voice, according to the schools, authors, the types of the disorder of the voice and the patient needs.
Nowadays, cochelar implant is the only choice of treatment in deep bilateral deafness. Aim: To ev... more Nowadays, cochelar implant is the only choice of treatment in deep bilateral deafness. Aim: To evaluate the benefits of binaural implantation of a single receiver-stimulator device by using audiometric tests at 3 and 6 months intervals. Material and methods: The study included 3 patients with bilateral sensorineural deafness of cochlear origin. Following implantation they were assessed by pu-re tone audiometry (PTA), speech audiometry (SA), and sound localization tests (LT). Results: PTA showed a significant decrease in hearing thresholds level during the 6-month interval following implantation. As to the degree of speech discrimination in both quiet and noisy environment, SA showed evident progress at 6 months compared to the results at 3 month. The location tests revealed improved sound localization in both ears at 6 months compared to the results at 3 months. Conclusions: Compared to unilateral implant, the binaural cochlear implant has the advantage of stereophonic hearing, faci...
Revista De Cercetare Si Interventie Sociala, 2021
As a prominent problem in the modern society and showing an increasing prevalence, sleep disorder... more As a prominent problem in the modern society and showing an increasing prevalence, sleep disorders including frequently obstructive sleep apnea (OSA) raises the issue of the multiple health and socio-professional debilitating effect. This study aimed to assess by Pittsburgh Sleep Quality Index (PSQI) questionnaire the sleep disturbances and their impact on socio-professional capacities in patients with OSA. We evaluated through the PSQI a group of 144 patients with suspected sleep disorders, whom 22 were diagnosed with OSA by polysomnography. For OSA patients, we analyzed the associated comorbidities and the characteristics of sleep disturbances and their influence on quality of socio-professional life. The main associated comorbidities to our OSA patients were the hypertension (90.90%), the type II diabetes (40.91%) and the metabolic syndrome (31.83%). We found that the most important sleep disturbances that affected the quality of life are the sleep interruptions, the waking up to...
Balkan Journal of Dental Medicine, 2015
Summary: Substantial evidence supports an association between chronic infections/inflammation, an... more Summary: Substantial evidence supports an association between chronic infections/inflammation, and cancer. The aim of this study was to assess the effect of chronic periodontitis on head and neck squamous-cell carcinoma (HNSCC).: The study population consisted of 46 patients, divided into two groups. Cases were patients diagnosed with primary HNSCC (n=26). Controls were all patients seen during the same period of time but negative for malignancy (n=20). The severity of periodontitis was assessed through clinical determination of the bleeding index, periodontal index, tooth mobility degree and alveolar bone loss (ABL) on standardized panoramic radiographs. All patients were asked to fill in a questionnaire regarding aspects of quality of life before the diagnostic was established.: Each millimetre of ABL was associated with >4-fold increased risk for HNSCC. The strength of the association was greatest in the oral cavity, followed by the oropharynx and larynx. The association persi...
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
Nowadays. cochelar implant is the only choice of treatment in deep bilateral deafness. To evaluat... more Nowadays. cochelar implant is the only choice of treatment in deep bilateral deafness. To evaluate the benefits of binaural implantation of a single receiver-stimulator device by using audiometric tests at 3 and 6 months intervals. The study included 3 patients with bilateral sensorineural deafness of cochlear origin. Following implantation they were assessed by pure tone audiometry (PTA), speech audiometry (SA), and sound localization tests (LT). PTA showed a significant decrease in hearing thresholds level during the 6-month interval following implantation. As to the degree of speech discrimination in both quiet and noisy environment, SA showed evident progress at 6 months compared to the results at 3 month. The location tests revealed improved sound localization in both ears at 6 months compared to the results at 3 months. Compared to unilateral implant, the binaural cochlear implant has the advantage of stereophonic hearing, facilitating the communication through a better unders...
DOAJ (DOAJ: Directory of Open Access Journals), 2012
ABSTRACT
Romanian Journal of Rhinology, Feb 18, 2023
BACKGROUND. Wildervanck syndrome was described for the first time in 1952. This rare entity is co... more BACKGROUND. Wildervanck syndrome was described for the first time in 1952. This rare entity is composed by the oculo-cervicoacoustic triad, which may be more or less complete. MATERIAL AND METHODS. We present a 5-year-old girl diagnosed with Wildervanck syndrome, exhibiting: Klippel-Feil anomaly (fused cervical vertebrae), Duane Stilling Turk syndrome (bilateral abducens palsy) and congenital bilateral cophosis indicated by ABR. RESULTS. The CT scan revealed major malformations of the brain and calvarium including the petrous part of both temporal bones. Despite all these brain malformations, the psychological development of the child was nearly normal. As it was previously reported in other cases, the child also presented spina bifida cervicalis and cleft palate. The cause of deafness was bilateral lack of cochleae, making impossible the insertion of the cochlear electrode for hearing rehabilitation. When the patients are discovered late (after 3 years of age), the management of hearing loss is by being taught sign language and lip reading. CONCLUSION. Any cranio-facial malformation and any delay in speech production impose early attention of the otorhinolaryngologist or audiologist for timely diagnosis and rehabilitation of hearing loss. The imaging examination, especially the high-resolution temporal bone CT-scan, is of paramount importance to be performed in all profound congenital deaf children to evaluate the candidacy to cochlear implantation.
ORL.ro, 2018
Purpose . The aim of the study was to observe and to describe the evolution of early diagnosed he... more Purpose . The aim of the study was to observe and to describe the evolution of early diagnosed hearing loss in children with neonatal auditory neuropathy spectrum disorders identified by universal neonatal hearing screening. Materials and method. In the last years, the development of universal auditory newborn screening program, that covers all maternities in our city, allowed us to test initially over 50,000 of babies and to identify and manage newborns with auditory neuropathy spectrum disorders after clinical audiological assessments. The follow-up was done for each child periodically until 18 months for cases fitted by hearing aids and until the cochlear implantation for cases with this indication. Results . We identified 26 children with auditory neuropathy spectrum disorders, six children with normal tonal hearing and 20 cases with different degrees of hearing loss. According to the results of our follow-up process, all children with normal tonal hearing kept their auditory status in time. All deaf children were hearing aid fitted, except the profound hearing loss with direct indication for cochlear implantation. In the group of children with hearing loss, we observed that 35% presented progressive forms and 15% presented fluctuating forms. 57% of progressive hearing loss group evolved to the profound deafness and cochlear implant indication. The greater the initial diagnosed degree of hearing loss, the more the children have progressed to profound deafness. Conclusions . A lot of children with auditory neuropathy spectrum disorders present progressive hearing loss, the profound form being finally present in more than 45% of cases. The periodical follow-up is essential in the first 18 months in order to offer the best medical indication and to avoid the delay of appropriate intervention for hearing rehabilitation and speech development.
ORL.ro, 2018
<jats:p> Introduction . Speech audiometry is an essential tool in audiological assessment, ... more <jats:p> Introduction . Speech audiometry is an essential tool in audiological assessment, and any clinical test material should contain equivalent and phonetically balanced lists, linguistically adapted to all age categories. Materials and method. The aim of the study was the clinical validation of new speech audiometry material in patients with normal hearing. The original and complex testing material, including lists of bisyllabic words, monosyllabic words and logatoms, was presented to a group of 51 subjects, teenagers and adults, with normal otological aspect and normal tonal hearing, recording the characteristic audiological parameters. Results and discussions . By statistical processing of the parameters obtained in clinical test, the results were similar to those reported in the specialty literature corresponding to normal hearing. For all the three categories of test units, differences of less than 6 dB were obtained between the tonal thresholds and the speech intelligibility threshold, which is a strong correlation factor that supports the validity of the testing material used. Word recognition scores for tested intensities have respected the variation in intelligibility/intensity function characteristic for normal hearing. For the interval of 0-30 dB, there was an increase in the word recognition score with increasing of testing intensity, with values close to 100% at intensities over 40 dB. Every tested list has been validated by computing the Normalized Root Mean Square Error (NRMSE) parameter, demonstrating the correlation of the curve we obtained with an ideal speech comprehension curve. Conclusions . The results obtained by statistical processing validate the speech audiometric test battery, so that the new linguistic material can be safely used for audiological clinical evaluation. </jats:p>
Diagnostics, May 24, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Romanian Journal of Morphology and Embryology, 2020
Vestibular sensorial input is essential for psychomotor development of the very small children. I... more Vestibular sensorial input is essential for psychomotor development of the very small children. In consequence, possible vestibular impairment induced by cochlear implantation in deaf children could affect the balance and walking learning process. Some of cochlear implanted children can present congenital vestibular deficit. The anatomical and embryological relation between auditory and vestibular system explains why congenital neurosensorial hearing loss may associate vestibular impairment. The cochlear implant surgery presents a vestibular lesion risk. Bilateral vestibulopathy, as it appears in early childhood, has a poor prognosis for the psychomotor and cognitive development. Even probably rare, bilateral vestibulopathy induced by simultaneous bilateral cochlear implantation can delay the acquisition of motor skills. This pathology can be avoided by an appropriate surgical indication related to the vestibular preoperative status. This study reports the vestibular saccular functional modifications after the cochlear implantation in children. The cervical vestibular evoked myogenic potentials (cVEMPs) were performed in children before and after the cochlear implantation. Since previous studies report different vestibular impairment related to the portelectrode insertion approach, another objective of our study was to assess the saccular postoperative status depending of the insertion by cochleostomy (CO) or through the round window (RW). We performed cVEMPs for 80 patients (135 cochlear implanted ears) before and after cochlear implantation. We have detected preoperative saccular areflexia in 33 (24.4%) ears. In the group of 102 (75.6%) ears with preoperative normal saccular function, 72 (70.6%) ears preserved the cVEMP response after the surgery, while in 30 (29.4%) ears the cVEMP response was lost. Reporting our findings to the portelectrode insertion method, we found normal saccular function in 73.3% of the cochlear implanted ears by RW surgical approach and in 68.42% ears by CO approach. These results suggest that the RW portelectrode insertion is the recommended strategy in order to avoid the saccular vestibular impairment.
DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2020
Antibiotics represent an important adjunctive method in the complex and effective periodontal the... more Antibiotics represent an important adjunctive method in the complex and effective periodontal therapy. Moreover, beside the curative effects of antibiotics, antibiotic prophylaxis needs to be taken into account when particular cases of infectious risk patients need to be correctly approached. An important criterion in the antibiotic prohylaxis selection includes the physiopathological state of the patient: his general state of health, his immune status, his medical-surgical history, his comorbidities and his current medications. All this in order not to carry out contraindicated associations and to avoid the potentiation of undesirable effects. Compliance with these selection criteria maximizes therapeutic efficacy while limiting individual risks (hypersensitivity, adverse effects) but also collective risks with respect to the emergence of bacterial resistance. In summary, antibiotic therapy must be justified with the best efficacy, the best possible tolerance and at a reasonable cost. In addition, the methods of compliance and the duration of the treatment can direct towards preferred molecules.
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Papers by Cristian Mârţu