[Permanent sequelae of injuries in the otorhinolaryngology field]

The present retrospective study was aimed to scrutinize constant traumatic sequelae in otorhinolaryngology on 586 traumatic reports, which have been documented by the Bohemian State Insurance starting from 1965 to 1985. Constant sequelae appeared to be subsequent both to individual damages of otorhinolaryngologic organs and multiple traumas, from them 59.4% affected the ear region. Most frequently were presented the partial hearing loss, deafness, and labyrinth lesions especially in multiple traumas. As to the nasal area, the amount of 22.7 per cent consisted of external nasal shape deformities with the disordered passage, and olfactory disorders in multiple traumas. The remaining 17.9% sequelae was concerned with the anatomical and functional lesions of other otorhinolaryngologic organs. To determine features and the extent of constant sequelae, most current diagnostical approaches and consiliary examinations were used. However, the objective assessment of olfactory disorders and tinnitus aurium is stated to be still diagnostically intricated. Both the simulation and aggravation were found out in 2.5% of insurers. Other relations were also studied, e.g.: insurer vice versa physician. In addition to other causes, the most frequent ones represented an underestimation of traumatic consequences all along with their erroneous treatment, low levelled outpatient care of ORL specialists as to the multiple trauma management outside ORL service. In many instances, the injured subjects were not appropriately recommended to provide them with simple and effective surgical treatment of yet manifested constant sequelae. The proper expertize activity was complicated with the defective trauma documentation, terminology variants and erroneous regulations dealing with the recompensation of injuries.