Papers by Vladan Subarevic
Универзитет у Београду, Sep 27, 2016
Srpski Arhiv Za Celokupno Lekarstvo, 2012
Acta Scientific Orthopaedics, Sep 1, 2022
Aim of study: The aim of this study is to present the incidence of complications following tonsil... more Aim of study: The aim of this study is to present the incidence of complications following tonsilloadenoidectomy and to determine causative factors for complications. Methods: The study is a prospective analysis encompassing 200 children aged 2,5 to 10 years with a history of tonsilloadenoidectomy from October 2017 to April 2018. The results were determined using descriptive statistical methods. Results: 124 or 62% of treated patients were males and 76 or 38% females, 71 or 36% were children aged 2.5 to 4 years, 89 or 44% children aged 5 to 7 years and 40 or 20% children aged 8 to 10 years. Postoperative hemorrhage was classified as either primary (within 24h) seen in 3 patients or secondary (after 24h) seen in 8, with a total post-tonsillectomy hemorrhage rate of 11 (5,5%). Other complications included elevated body temperature seen in 16 (8%) cases, vomiting in 16 (8%), dehydration in 8 (4%), and diarrhea in 6 (3%). Conclusion: Bleeding following tonsilloadenoidectomy appears more often in children with a history of frequent tonsillopharyngitis prior to operation and vomiting and diarrhea were more frequent in children aged 2 to 4 years.
Acta Scientific Orthopaedics
Aim of study: The aim of this study is to present the incidence of complications following tonsil... more Aim of study: The aim of this study is to present the incidence of complications following tonsilloadenoidectomy and to determine causative factors for complications. Methods: The study is a prospective analysis encompassing 200 children aged 2,5 to 10 years with a history of tonsilloadenoidectomy from October 2017 to April 2018. The results were determined using descriptive statistical methods. Results: 124 or 62% of treated patients were males and 76 or 38% females, 71 or 36% were children aged 2.5 to 4 years, 89 or 44% children aged 5 to 7 years and 40 or 20% children aged 8 to 10 years. Postoperative hemorrhage was classified as either primary (within 24h) seen in 3 patients or secondary (after 24h) seen in 8, with a total post-tonsillectomy hemorrhage rate of 11 (5,5%). Other complications included elevated body temperature seen in 16 (8%) cases, vomiting in 16 (8%), dehydration in 8 (4%), and diarrhea in 6 (3%). Conclusion: Bleeding following tonsilloadenoidectomy appears more often in children with a history of frequent tonsillopharyngitis prior to operation and vomiting and diarrhea were more frequent in children aged 2 to 4 years.
Srpski arhiv za celokupno lekarstvo, 2008
INTRODUCTION Chronic suppurative inflammation of the middle ear (HGO) in children represents one ... more INTRODUCTION Chronic suppurative inflammation of the middle ear (HGO) in children represents one of the most frequent infections in childhood, even in children from developed industrial countries. We can distinguish two types of chronic suppurative inflammation: first - HGO without cholesteatoma and second HGO with cholesteatoma. OBJECTIVE The objective of the paper was to point out the characteristics of chronic suppurative inflammation of the middle ear in children and possible methods of treatment. METHOD From 2000 to 2005, our retrospective study involved 92 children, aged 2 to 16 years, treated for chronic suppurative inflammation of the middle ear and subsequent otogenic complications. The diagnosis was established based on clinical symptoms, otoscopic and otomicroscopic findings. Treatment included the removal of the pathological process, reconstruction of the hearing chain and prevention recurrence. RESULTS We performed 111 surgical interventions. Children were divided into ...
Vojnosanitetski pregled, 2016
Background/Aim. Otitis media with effusion (OME) is a common disease among the children aged from... more Background/Aim. Otitis media with effusion (OME) is a common disease among the children aged from 6 months to 4 years, but recurrences are common after the extraction of ventilation tubes. The aim of the study was to determine the risk factors for recurrent OME after extraction of ventilation tubes. Methods. The research was a prospective study with 305 children aged 0 to 10 years with OME. Forty three (14%) of them had recurrent OME. We analyzed the factors that could lead to the redevelopment of the disease after extrusion of the tubes. Results. It was found that the majority of children with recurrent disease was between the ages of 5 to 7 years (56%) and had allergy in significantly higher rate than children without recurrence. In most cases (37.7%), the retention time of ventilating tube was above 10 months and the recurrent disease was diagnosed in 46.5% cases within a period of 10 to 12 months after extrusion of tubes. Conclusion. Children with OME and after ventilation tube extrusion need to be followed up for 1 year after the removal of tubes. It is necessary to inform the parents that the disease can recur. Children in the kindergarten, in preschool age and with a respiratory allergy had higher possibility for recurrent OME.
Military Medical and Pharmaceutical Journal of Serbia, 2018
Background/Aim. Otitis media with effusion (OME) is almost universal in children with cleft palat... more Background/Aim. Otitis media with effusion (OME) is almost universal in children with cleft palate with an incidence of more than 90%, but the approach to managing this problem varies significantly among authors. The Eustachian tube dysfunction is the main factor that leads to the presence of the middle ear effusion. This is especially prominent in children with congenital cleft palate and explains the prolonged course of this process. The objective of this study was to determine the effectiveness of early ventilation tubes insertion in children with cleft palate at the time of palatoplasty by monitoring the course and duration of the disease as well as development of complications. Methods. In the prospective study with predefined regular follow-up intervals and parameters, the two groups of children were observed. The group one (E) included 45 children with congenital cleft palate who underwent the early insertion of ventilation tubes during palatoplasty, and the group two (C) had the same number of children with cleft palate who were treated conservatively on an as-needed basis. Assessment parameters were findings of otomicroscopy, tympanometry, play and pure tone audiometry. Each child was followed-up for 5 full years at total of nine follow-up examinations. Results. Result analysis showed that there were no statistically important differences between the two study groups in terms of the course and duration of the presence of the middle ear effusion, or in terms of complications and speech development. Conclusion. Based on the results obtained, we can conclude that there is no significant benefit in early ventilation tubes insertion in children with cleft palate, therefore our recommendation is watchful waiting and a conservative treatment on an as-needed basis, with the ventilation tubes insertion when a surgeon, based on his or her experience and individual findings considers it necessary.
Srpski arhiv za celokupno lekarstvo
Srpski arhiv za celokupno lekarstvo
A 23-month-old boy with the syndrome of hypoventilation, obstructive sleep-apnea, pulmonary hyper... more A 23-month-old boy with the syndrome of hypoventilation, obstructive sleep-apnea, pulmonary hypertension and cor pulmonale due to chronic upper airway obstruction resulting from adenotonsillar hypertrophy, is presented. After the surgical removal of obstructing tissue rapid clinical improvement ensued and signs of cor pulmonale returned to normal within a few days. The relationship between the upper airway obstruction and hypoventilation and cor pulmonale is discussed and the importance of early recognition and removal of enlarged tonsils before life-threatening complications occur, is stressed.
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Srpski arhiv za celokupno lekarstvo
Surgical tracheotomy in newborn children is a rare intervention. It is reserved for heavy patholo... more Surgical tracheotomy in newborn children is a rare intervention. It is reserved for heavy pathological disorders that cause obstruction of airways. In the Mother and Child Health Institute over the period from 1992 to 2001 we treated 141 children with congenital laryngeal anomaly. Most frequent was laryngomalatia in 96 (68%) newborns, then congenital laryngeal stenosis in 17 (12%), laryngeal cysts in 11 (8%) cases, unilateral or bilateral vocal cord palsy in 7 (5%), laryngeal haemangioma in 7 (5%), laryngeal web in 2 infants and laryngeal hypoplasia in 1 case. Tracheotomy was performed in 11 (8%) infants, because their breathing was difficult, and they were at risk from suffocation. In six infants we made successful disannulment and in the others treatment still continues. We decided that surgical tracheotomy must be carried out just in cases with acute respiratory insufficiency, as a step in later treatment.
Medicinski pregled
Suppurative otitis media after tympanostomy tube placement is the most frequent complication of t... more Suppurative otitis media after tympanostomy tube placement is the most frequent complication of this surgical intervention. Otorrhea that occurs in the first two weeks following tube placement is called early, late otorrhea occurs at least two weeks following placement. Early otorrhea is usually a result of either an infection that already existed when the tube was placed, or contamination of the external auditory canal during operation. Late otorrhea is mostly a result of upper respiratory tract infection. Our investigation was performed at the ENT Department, Mother and Child Health Care Institute in Belgrade. The research included children treated for secretory or recurrent otitis media. We have examined 411 children implanted with 796 tympanostomy tubes in the last three years. We investigated changes within two weeks after operation. Suppuration was recorded with 81 children (19.7%). Staphylococcus aureus was established in 33 (40.7%) Pseudomonas aeruginosa in 26 (32%), Haemoph...
Srpski arhiv za celokupno lekarstvo, 2012
Perforation of the tympanic membrane in children may be the cause of recurrent middle ear infecti... more Perforation of the tympanic membrane in children may be the cause of recurrent middle ear infection and loss of hearing. The aim of this study was to analyze the application of different reconstructive materials in surgical technique myringoplasty. We performed 88 myringoplasties due to auricular tragus perforation in 76 children (aged 4 to 16 years, mean 11.9 years) from July 2001 to July 2009. Age, gender, size and the site of perforation, status of the contra lateral ear, underlying cause of the perforations, surgical technique, preoperative and postoperative hearing levels and postoperative complications were recorded and analyzed. In performing myringoplasty we used fascia of the temporal muscle and cartilage of the auricular tragus. In 43 (48%) patients we used fascia of the temporal muscle and in 45 (52%) cartilage of the auricular tragus. Graft success was defined as an intact eardrum at 12 months postoperatively and improvement in the perception of air-bone gap of 10 dB, which we recorded in 73 (83%) cases. Re-perforations were recorded in 12 (13%) patients, of whom in 8 (18.6%) cases we used the temporal fascia and in 4 (9.3%) cases a tragal cartilage. Retraction of the tympanic membrane was recorded in 3 (4%) cases with the temporal fascia. Myringoplasty is a reasonably successful method with good functional results in pediatric patients. Risk factors of surgical failure are young age, the size of auricular tragus perforation and pathological conditions of the contra lateral ear. The tragal cartilage gives better results in cases with bilateral perforations because the possibility of retractions and re-perforations is lower. Relatively small number of patients is probably the reason that, exept for young age, differences between the two groups did not reach the level of statistical significance.
International Journal of Pediatric Otorhinolaryngology, 2009
European Archives of Oto-Rhino-Laryngology, 2006
We present a retrospective study of 37 infants who were operated for acute mastoiditis during the... more We present a retrospective study of 37 infants who were operated for acute mastoiditis during the period 2000-2004 in Mother and Child Health Care Institute, Belgrade, Serbia and Montenegro. About 23 patients (62.2%) were male and 14 (37.8%) were female. Acute mastoiditis developed just after the first infection of the middle ear in 26 patients (70.3%). All patients had local and general symptoms. The most common local symptoms were blurred tympanic membrane in all patients, painful tenderness of mastoid in 21 (57%) and redness of tympanic membrane in 13 (36%). General signs of infection were loss of body weight in 28 (75.7%) patients, fever in 21 (56.8%), vomiting in 19 (51.3%), diarrhea in 19 (51.3%) and severe anemia that requested red blood cell transfusion in 6 (16.2%). Suppuration did not appear in any of the patients. Tympanocentesis had been performed prior to surgery in all patients. The most frequently isolated causative microorganism was Streptococcus pneumoniae which was found in 12 (32.5%) patients, Staphylococcus aureus was found in 8 (21.5%) and Hemophilus influenzae in 2 (5.5%). In 15 (405%) patients there was no bacterial isolation. Eleven patients (29.7%) who had previously had acute otitis media were implanted ventilation tubes during the surgical intervention. All patients were treated with antibiotics prior and after the surgical intervention. The finding on mastoidectomy was positive in all cases. According to the results of our study the combination of antibiotic and surgical treatment is optimal in treating acute mastoiditis. Making a diagnosis of acute mastoiditis might not be easy since there are no specific symptoms. We emphasize that it should always be considered as a differential diagnosis in cases of prolonged acute otitis media with no improvement after 10 days of antibiotic treatment, especially when accompanied with weight loss and general condition worsening.
Srpski arhiv za celokupno lekarstvo, 2008
Uvod Hro nič n o g n o j n o z a p a q e w e s r e d w e g u v a ( h r o n i č ni gnoj ni oti tis... more Uvod Hro nič n o g n o j n o z a p a q e w e s r e d w e g u v a ( h r o n i č ni gnoj ni oti tis -HGO) je jed na od naj če šćih hro nič nih in fekci ja kod de ce, ka ko u raz vi je nim, ta ko i u ze mqa ma u raz vo ju. Ja vqa se u dva ob li ka: s ho le ste a to mom ili bez we ga. Ciq rada Ciq ra da je bio da se uka že na od li ke HGO kod de ce i mo gu će na či ne we go vog le če wa. Metod rada Re tro spek tiv no is tra ži va we je ob u hva ti lo 92 de te ta uzrasta od dve godine do 16 godina ko ja su u pe rio du 2000-2005. go di ne le če na od HGO i pra te ći h o t o g e n i h k o m p l i k a c i j a . D i j a g n o z a j e p o s t a v q e n a n a o s n o v u k l i n i čkih simp to ma bo le sti i oto skop skog i oto mi kro skop skog pre gle da. Leče w e j e o b u h v a t i l o s u z b i j a w e p a t o l o š k o g p r oce sa, re kon struk ci ju slu šnog lan ca i spre ča v a w e r a z v o j a r e c i d i v a b o l e s t i .
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Papers by Vladan Subarevic