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Journal Cover International Archives of Otorhinolaryngology
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  This is an Open Access Journal Open Access journal
     ISSN (Print) 1809-9777 - ISSN (Online) 1809-4864
     Published by Thieme Publishing Group Homepage  [157 journals]
  • Skull Base Surgery in the 21st Century: Accelerated Revolution
    • Int. Arch. Otorhinolaryngol. 2014; 18: S121-S122
      DOI: 10.1055/s-0034-1390326

      Thieme Publicações Ltda Rio de Janeiro, Brazil

      Article in Thieme eJournals:
      Table of contents     open access Full text

      Int. Arch. Otorhinolaryngol. 2014; 18: S121-S1222014-10-10T15:45:16+01:00
      Issue No: Vol. 18, No. S 02 (2014)
  • Advances in Computed Tomography Evaluation of Skull Base Diseases

    • Authors: Prevedello; Luciano M.
      Pages: S123 - S126
      Abstract: Introduction Computed tomography (CT) is a key component in the evaluation of skull base diseases. With its ability to clearly delineate the osseous anatomy, CT can provide not only important tips to diagnosis but also key information for surgical planning. Objectives The purpose of this article is to describe some of the main CT imaging features that contribute to the diagnosis of skull base tumors, review recent knowledge related to bony manifestations of these conditions, and summarize recent technological advances in CT that contribute to image quality and improved diagnosis. Data Synthesis Recent advances in CT technology allow fine-detailed evaluation of the bony anatomy using submillimetric sections. Dual-energy CT material decomposition capabilities allow clear separation between contrast material, bone, and soft tissues with many clinical applications in the skull base. Dual-energy technology has also the ability to decrease image degradation from metallic hardwares using some techniques that can result in similar or even decreased radiation to patients. Conclusions CT is very useful in the evaluation of skull base diseases, and recent technological advances can increase disease conspicuity resulting in improved diagnostic capabilities and enhanced surgical planning.
      Citation: Int. Arch. Otorhinolaryngol. 2014; 18: S123-S126
      PubDate: 2014-10-10T15:45:16+01:00
      DOI: 10.1055/s-0034-1395269
      Issue No: Vol. 18, No. S 02 (2014)
  • Advances in Magnetic Resonance Imaging of the Skull Base

    • Authors: Kirsch; Claudia F.E.
      Pages: S127 - S135
      Abstract: Introduction Over the past 20 years, magnetic resonance imaging (MRI) has advanced due to new techniques involving increased magnetic field strength and developments in coils and pulse sequences. These advances allow increased opportunity to delineate the complex skull base anatomy and may guide the diagnosis and treatment of the myriad of pathologies that can affect the skull base. Objectives The objective of this article is to provide a brief background of the development of MRI and illustrate advances in skull base imaging, including techniques that allow improved conspicuity, characterization, and correlative physiologic assessment of skull base pathologies. Data Synthesis Specific radiographic illustrations of increased skull base conspicuity including the lower cranial nerves, vessels, foramina, cerebrospinal fluid (CSF) leaks, and effacement of endolymph are provided. In addition, MRIs demonstrating characterization of skull base lesions, such as recurrent cholesteatoma versus granulation tissue or abscess versus tumor, are also provided as well as correlative clinical findings in CSF flow studies in a patient pre- and post-suboccipital decompression for a Chiari I malformation. Conclusions This article illustrates MRI radiographic advances over the past 20 years, which have improved clinicians' ability to diagnose, define, and hopefully improve the treatment and outcomes of patients with underlying skull base pathologies.
      Citation: Int. Arch. Otorhinolaryngol. 2014; 18: S127-S135
      PubDate: 2014-10-10T15:45:15+01:00
      DOI: 10.1055/s-0034-1390013
      Issue No: Vol. 18, No. S 02 (2014)
  • Evolution of Minimally Invasive Approaches to the Sella and Parasellar

    • Authors: Louis; Robert G., Eisenberg, Amy, Barkhoudarian, Garni, Griffiths, Chester, Kelly, Daniel F.
      Pages: S136 - S148
      Abstract: Introduction Given advancements in endoscopic image quality, instrumentation, surgical navigation, skull base closure techniques, and anatomical understanding, the endonasal endoscopic approach has rapidly evolved into a widely utilized technique for removal of sellar and parasellar tumors. Although pituitary adenomas and Rathke cleft cysts constitute the majority of lesions removed via this route, craniopharyngiomas, clival chordomas, parasellar meningiomas, and other lesions are increasingly removed using this approach. Paralleling the evolution of the endonasal route to the parasellar region, the supraorbital eyebrow craniotomy has also been increasingly used as an alternative minimally invasive approach to reach this skull base region. Similar to the endonasal route, the supraorbital route has been greatly facilitated by advances in endoscopy, along with development of more refined, low-profile instrumentation and surgical navigation technology. Objectives This review, encompassing both transcranial and transsphenoidal routes, will recount the high points and advances that have made minimally invasive approaches to the sellar region possible, the evolution of these approaches, and their relative indications and technical nuances. Data Synthesis The literature is reviewed regarding the evolution of surgical approaches to the sellar region beginning with the earliest attempts and emphasizing technological advances, which have allowed the evolution of the modern technique. The surgical techniques for both endoscopic transsphenoidal and supraorbital approaches are described in detail. The relative indications for each approach are highlighted using case illustrations. Conclusions Although tremendous advances have been made in transitioning toward minimally invasive transcranial and transsphenoidal approaches to the sella, further work remains to be done. Together, the endonasal endoscopic and the supraorbital endoscope-assisted approaches are complementary minimally invasive routes to the parasellar region.
      Citation: Int. Arch. Otorhinolaryngol. 2014; 18: S136-S148
      PubDate: 2014-10-10T15:45:14+01:00
      DOI: 10.1055/s-0034-1395265
      Issue No: Vol. 18, No. S 02 (2014)
  • Panorama of Reconstruction of Skull Base Defects: From Traditional Open to
           Endonasal Endoscopic Approaches, from Free Grafts to Microvascular Flaps

    • Authors: Reyes; Camilo, Mason, Eric, Solares, C. Arturo
      Pages: S179 - S186
      Abstract: Introduction A substantial body of literature has been devoted to the distinct characteristics and surgical options to repair the skull base. However, the skull base is an anatomically challenging location that requires a three-dimensional reconstruction approach. Furthermore, advances in endoscopic skull base surgery encompass a wide range of surgical pathology, from benign tumors to sinonasal cancer. This has resulted in the creation of wide defects that yield a new challenge in skull base reconstruction. Progress in technology and imaging has made this approach an internationally accepted method to repair these defects. Objectives Discuss historical developments and flaps available for skull base reconstruction. Data Synthesis Free grafts in skull base reconstruction are a viable option in small defects and low-flow leaks. Vascularized flaps pose a distinct advantage in large defects and high-flow leaks. When open techniques are used, free flap reconstruction techniques are often necessary to repair large entry wound defects. Conclusions Reconstruction of skull base defects requires a thorough knowledge of surgical anatomy, disease, and patient risk factors associated with high-flow cerebrospinal fluid leaks. Various reconstruction techniques are available, from free tissue grafting to vascularized flaps. Possible complications that can befall after these procedures need to be considered. Although endonasal techniques are being used with increasing frequency, open techniques are still necessary in selected cases.
      Citation: Int. Arch. Otorhinolaryngol. 2014; 18: S179-S186
      PubDate: 2014-10-10T15:45:13+01:00
      DOI: 10.1055/s-0034-1395268
      Issue No: Vol. 18, No. S 02 (2014)
  • Esthesioneuroblastoma, Neuroendocrine Carcinoma, and Sinonasal
           Undifferentiated Carcinoma: Differentiation in Diagnosis and Treatment

    • Authors: Su; Shirley Y., Bell, Diana, Hanna, Ehab Y.
      Pages: S149 - S156
      Abstract: Introduction Malignant sinonasal tumors comprise less than 1% of all neoplasms. A wide variety of tumors occurring primarily in this site can present with an undifferentiated or poorly differentiated morphology. Among them are esthesioneuroblastomas, sinonasal undifferentiated carcinomas, and neuroendocrine carcinomas. Objectives We will discuss diagnostic strategies, recent advances in immunohistochemistry and molecular diagnosis, and treatment strategies. Data Synthesis These lesions are diagnostically challenging, and up to 30% of sinonasal malignancies referred to the University of Texas MD Anderson Cancer Center are given a different diagnosis on review of pathology. Correct classification is vital, as these tumors are significantly different in biological behavior and response to treatment. The past decade has witnessed advances in diagnosis and therapeutic modalities leading to improvements in survival. However, the optimal treatment for esthesioneuroblastoma, sinonasal undifferentiated carcinoma, and neuroendocrine carcinoma remain debated. We discuss advances in immunohistochemistry and molecular diagnosis, diagnostic strategies, and treatment selection. Conclusions There are significant differences in prognosis and treatment for esthesioneuroblastoma, neuroendocrine carcinoma, and sinonasal undifferentiated carcinoma. Recent advances have the potential to improve oncologic outcomes but further investigation in needed.
      Citation: Int. Arch. Otorhinolaryngol. 2014; 18: S149-S156
      PubDate: 2014-10-10T15:45:12+01:00
      DOI: 10.1055/s-0034-1390014
      Issue No: Vol. 18, No. S 02 (2014)
  • Nuances in the Treatment of Malignant Tumors of the Clival and Petroclival

    • Authors: Mohyeldin; Ahmed, Prevedello, Daniel M., Jamshidi, Ali O., Filho, Leo F.S. Ditzel, Carrau, Ricardo L.
      Pages: S157 - S172
      Abstract: Introduction Malignancies of the clivus and petroclival region are mainly chordomas and chondrosarcomas. Although a spectrum of malignancies may present in this area, a finite group of commonly encountered malignant pathologies will be the focus of this review, as they are recognized to be formidable pathologies due to adjacent critical neurovascular structures and challenging surgical approaches. Objectives The objective is to review the literature regarding medical and surgical management of malignant tumors of the clival and petroclival region with a focus on clinical presentation, diagnostic identification, and associated adjuvant therapies. We will also discuss our current treatment paradigm using endoscopic, open, and combined approaches to the skull base. Data Synthesis A literature review was conducted, searching for basic science and clinical evidence from PubMed, Medline, and the Cochrane Database. The selection criteria encompassed original articles including data from both basic science and clinical literature, case series, case reports, and review articles on the etiology, diagnosis, treatment, and management of skull base malignancies in the clival and petroclival region. Conclusions The management of petroclival malignancies requires a multidisciplinary team to deliver the most complete surgical resection, with minimal morbidity, followed by appropriate adjuvant therapy. We advocate the combination of endoscopic and open approaches (traditional or minimally invasive) as required by the particular tumor followed by radiation therapy to optimize oncologic outcomes.
      Citation: Int. Arch. Otorhinolaryngol. 2014; 18: S157-S172
      PubDate: 2014-10-10T15:45:11+01:00
      DOI: 10.1055/s-0034-1395267
      Issue No: Vol. 18, No. S 02 (2014)
  • Management of Carotid Artery Injury in Endonasal Surgery

    • Authors: Padhye; Vikram, Valentine, Rowan, Wormald, Peter-John
      Pages: S173 - S178
      Abstract: Introduction Carotid artery injury (CAI) is the most feared and potentially catastrophic intraoperative complication an endoscopic skull base surgeon may face. With the advancement of transnasal endoscopic surgery and the willingness to tackle more diverse pathology, evidence-based management of this life-threatening complication is paramount for patient safety and surgeon confidence. Objectives We review the current English literature surrounding the management of CAI during endoscopic transnasal surgery. Data Synthesis The searched databases included PubMed, MEDLINE, Cochrane database, LILACS, and BIREME. Keywords included “sinus surgery,” “carotid injury,” “endoscopic skull base surgery,” “hemostasis,” “transsphenoidal” and “pseudoaneurysm.” Conclusions Review of the literature found the incidence of CAI in endonasal skull base surgery to be as high as 9% in some surgeries. Furthermore, current treatment recommendations can result in damage to critical neurovascular structures. Management decisions must be made in the preoperative, operative, and postoperative setting to ensure adequate treatment of CAI and the prevention of its complications such as pseudoaneurysm. Emphasis should be placed on surgical competency, teamwork, and technical expertise through education and training.
      Citation: Int. Arch. Otorhinolaryngol. 2014; 18: S173-S178
      PubDate: 2014-10-10T15:45:09+01:00
      DOI: 10.1055/s-0034-1395266
      Issue No: Vol. 18, No. S 02 (2014)
  • International Archives of Otorhinolaryngology—New Developments!
    • Int. Arch. Otorhinolaryngol. 2014; 18: 337-337
      DOI: 10.1055/s-0034-1390025

      Thieme Publicações Ltda Rio de Janeiro, Brazil

      Article in Thieme eJournals:
      Table of contents     open access Full text

      Int. Arch. Otorhinolaryngol. 2014; 18: 337-3372014-10-10T15:31:33+01:00
      Issue No: Vol. 18, No. 04 (2014)
  • Intralabyrinthine Penetrating Ventilation Tube with Preservation of
           Hearing: An Unusual Clinical Situation

    • Authors: Raoelina; Tantely Razafimahefa, Elziere, Maya, Michel, Justin, Devèze, Arnaud
      Abstract: Introduction Traumatic perilymphatic fistula is not a rare event with regards to sport activities or traffic accident. However, iatrogenic damage to the inner ear can occur following the common use of grommets and ventilation tube insertion. Objectives To report an unusual case of insertion of aeration tube into the vestibule trough the stapes footplate. Resumed Report A 62-year-old woman experienced iatrogenic penetration into the vestibule from a ventilation tube inserted for retraction pocket management. The event was misdiagnosed both by the surgeon and by the emergency room physicians, leading to delay in the management. However, preservation of the hearing function lasted for 2 weeks prior to deafness, thanks to the valve of Bast, which preserved the cochlear fluid. Conclusion This case gives us the opportunity to stress the need for systematic clinical examination of traumatic injury to the ear and to recommend performing multiplanar millimetric computed tomography scan with accurate interpretation. Traumatic injuries should be referred to a dedicated traumatic emergency referral center.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-12-12T18:13:08+0100
      DOI: 10.1055/s-0034-1386505
  • Massive Plexiform Neurofibroma of the Neck and Larynx

    • Authors: Mobashir; Mohammad Kamal, Mohamed, Abd ElRaof Said, El-Anwar, Mohammad Waheed, El Sayed, Ahmad Ebrahim, Fouad, Mouhamad A.
      Abstract: Introduction Laryngeal neurofibromas are extremely rare, accounting for only 0.03 to 0.1% of benign tumors of the larynx. Objectives To report the first case of massive neck plexiform neurofibroma with intralaryngeal (supraglottic) extension in a 5-year-old boy with neurofibromatosis type 1 and to describe its treatment. Resumed Report This massive plexiform neurofibroma was surgically removed, relieving its significant respiratory obstructive symptoms without recurrence to date. Conclusion Massive neck plexiform neurofibroma with supraglottic part was found in a child with neurofibromatosis type 1; it should be included in differential diagnosis of stridor and neck mass in children. It was diagnosed and removed in early in childhood without recurrence.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-12-12T17:59:12+0100
      DOI: 10.1055/s-0034-1396793
  • The Video Head Impulse Test in a Case of Suspected Bilateral Loss of
           Vestibular Function

    • Authors: Albernaz; Pedro L. Mangabeira, Cusin, Flavia Salvaterra
      Abstract: Introduction A patient who had no symptoms suggestive of bilateral loss of vestibular function presented no responses in rotational and caloric tests. Objectives To demonstrate the importance of the video head impulse test in neuro-otologic diagnosis. Resumed Report This patient had a neuro-otologic evaluation and presented no responses in torsion swing tests, caloric tests, and rotational tests in a Bárány chair. The video head impulse test elicited responses in four of the six semicircular canals. Conclusion Absent responses in caloric and rotatory tests alone are not sufficient to diagnose bilateral loss of vestibular function.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-12-10T16:41:36+0100
      DOI: 10.1055/s-0034-1395999
  • Lipidomic Profiling of Mastoid Bone and Tissue from Patients with Chronic

    • Authors: Fazlollahi; Farbod, Kongmanas, Kessiri, Tanphaichitr, Nongnuj, Suh, Jeffrey, Faull, Kym, Gopen, Quinton
      Abstract: Introduction Chronic otomastoiditis causes pain, otorrhea, and hearing loss resulting from the growth of tissue within the normally hollow mastoid cavity. Objectives In this report, we used a lipidomics approach to profile major mastoid bone and tissue lipids from patients with and without otomastoiditis. Methods The bone dust created during mastoidectomy, as well as the mastoid tissue, was analyzed from seven patients. Bone dust was also collected and analyzed in an additional four otologic cases (parotidectomy requiring mastoidectomy). Samples were subjected to a modified Bligh/Dyer lipid extraction, then high-performance thin-layer chromatography (HPTLC), combined gas chromatography/electron impact-mass spectrometry (GC/EI-MS), and flow-injection/electrospray ionization-tandem mass spectrometry (FI/ESI-MSMS). Data were analyzed for identification and profiling of major lipid components. Results HPTLC revealed the presence of various lipid classes, including phosphatidylcholines, cholesterol, and triacylglycerols. GC/EI-MS analysis revealed the presence of cholesterol and several fatty acids. FI/ESI-MSMS analysis revealed a host of phosphatidylcholines, phosphatidylethanolamines, and cholesteryl esters. Conclusion We used a lipidomics approach to develop an efficient (both in time and tissue amount) methodology for analysis of these tissues, identify the most abundant and common lipid species, and create a base of knowledge from which more focused endeavors in biomarker discovery can emerge. In an effort toward improved patient categorization and individualized intervention, the ultimate goal of this work is to correlate these lipid molecules to disease state and progression. This is the first reported study of its kind on these tissues.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-12-08T16:23:59+0100
      DOI: 10.1055/s-0034-1396522
  • Is Primary Hyperparathyroidism a Risk Factor for Papillary Thyroid
           Cancer' An Exemplar Study and Literature Review

    • Authors: Cinamon; Udi, Levy, Dalia, Marom, Tal
      Abstract: Introduction Primary hyperparathyroidism (PHPT) is associated with several cancer types, including papillary thyroid carcinoma (PTC). Objective To explore further the relation between PHPT and PTC. Methods By considering patients with PHPT as extra-suspicious for PTC, we studied an exemplar group of patients with PHPT with a small (≤1 cm) thyroid nodule, which was negative in preoperative cytologic examination. During parathyroidectomy, a frozen section biopsy of the thyroid nodule confirmed PTC, as did the final surgical specimen, revealing that the preoperative cytology was false-negative. Additionally, relevant reports retrieved from the English literature addressing thyroid cancer and hyperparathyroidism were reviewed and processed. Results Four patients with PHPT were studied. Three had a multifocal thyroid disease, and three had neck lymph node metastasis. Processing previous report data supported an association between PHPT and PTC. Although thyroid nodularity among patients with PHPT was similar to the general population, PTC incidence was higher. This was true also for patients with secondary hyperparathyroidism. Conclusions This study emphasized that PHPT should be considered as a noteworthy risk factor for PTC. Fine needle aspiration of a thyroid nodule is the most valuable diagnostic procedure for thyroid cancer. Yet, false-negative results were reported in up to 10% of cases, especially in small, subcentimeter nodules. In line with our data and the literature, patients with PHPT should have both a detailed ultrasound addressing the thyroid and cytology of any thyroid nodule, including small subcentimeter lesions. Moreover, surgical flexibility, allowing intraoperative thyroid nodule sampling, should be considered even for “innocent” nodules.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-12-08T16:18:57+0100
      DOI: 10.1055/s-0034-1396520
  • Preoperative Imaging Modalities to Predict the Risk of Regional Nodal
           Recurrence in Well-Differentiated Thyroid Cancers

    • Authors: AlNoury; Mohammed K., Almuhayawi, Saad M., Alghamdi, Khalid B., Al-Noury, Khaled I.
      Abstract: Introduction Thyroid cancer incidence has increased in the previous 2 decades. Preoperative identification of lymph node metastasis is a suggested risk factor associated with recurrence following thyroidectomy. Objectives We aimed to evaluate the accuracy of preoperative radiologic investigations of nodal status in determining the postoperative risk of regional nodal recurrence in cases of well-differentiated thyroid cancer. Methods This is a case series. We retrospectively reviewed data, including preoperative ultrasonography and/or computed tomography results, on patients who underwent total thyroidectomy for thyroid cancer at our hospital between 2006 and 2012. Prognostic factors for predicting recurrence, including age, sex, tumor diameter, and nodal diameter, were evaluated. Results Total thyroidectomy was performed on 24 male and 74 female patients (median age, 43 years). The median follow-up time was 21 months. Sixty-eight patients had papillary thyroid cancer, and 30 had follicular cancer. Nodal recurrence was evident in 30% of patients, and 4% of patients died. Identification of lymph node involvement during preoperative radiologic investigations was strongly prognostic for recurrence: 35.3% of patients with positive preoperative ultrasonography findings and 62.5% of those with positive preoperative computed tomography findings had recurrence (p = 0.01). Conclusions Preoperative identification of lymph node metastasis on radiologic studies was correlated with an increased risk of regional nodal recurrence in well-differentiated thyroid cancer. Computed tomography was superior to ultrasonography in detecting metastatic nodal involvement preoperatively and is therefore recommended for preoperative assessment and postoperative follow-up.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-12-08T16:15:19+0100
      DOI: 10.1055/s-0034-1396521
  • Quality of Life in Swallowing Disorders after Nonsurgical Treatment for
           Head and Neck Cancer

    • Authors: Silveira; Marta Halina, Dedivitis, Rogerio A., Queija, Débora Santos, Nascimento, Paulo César
      Abstract: Introduction Radiotherapy or chemoradiotherapy can result in severe swallowing disorders with potential risk for aspiration and can negatively impact the patient's quality of life (QOL). Objective To assess swallowing-related QOL in patients who underwent radiotherapy/chemoradiotherapy for head and neck cancer. Methods We interviewed 110 patients (85 men and 25 women) who had undergone exclusive radiotherapy (25.5%) or concomitant chemoradiotherapy (74.5%) from 6 to 12 months before the study. The Quality of Life in Swallowing Disorders (SWAL-QOL) questionnaire was employed to evaluate dysphagia-related QOL. Results The QOL was reduced in all domains for all patients. The scores were worse among men. There was a relationship between oral cavity as the primary cancer site and the fatigue domain and also between advanced cancer stage and the impact of food selection, communication, and social function domains. Chemoradiotherapy association, the presence of nasogastric tube and tracheotomy, and the persistence of alcoholism and smoking had also a negative effect on the QOL. Conclusions According to the SWAL-QOL questionnaire, the dysphagia-related impact on QOL was observed 6 to 12 months after the treatment ended.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-12-05T04:16:25+0100
      DOI: 10.1055/s-0034-1395790
  • Prospective Study of the Surgical Techniques Used in Primary Rhinoplasty
           on the Caucasian Nose and Comparison of the Preoperative and Postoperative
           Anthropometric Nose Measurements

    • Authors: Berger; Cezar Augusto Sarraf, Freitas, Renato da Silva, Malafaia, Osvaldo, Pinto, José Simão de Paula, Macedo Filho, Evaldo Dacheux, Mocellin, Marcos, Fagundes, Marina Serrato Coelho
      Abstract: Introduction The knowledge and study of surgical techniques and anthropometric measurements of the nose make possible a qualitative and quantitative analysis of surgical results. Objective Study the main technique used in rhinoplasty on Caucasian noses and compare preoperative and postoperative anthropometric measurements of the nose. Methods A prospective study with 170 patients was performed at a private hospital. Data were collected using the Electronic System Integrated of Protocols software (Sistema Integrado de Protocolos Eletrônicos, SINPE©). The surgical techniques used in the nasal dorsum and tip were evaluated. Preoperative and 12-month follow-up photos as well as the measurements compared with the ideal aesthetic standard of a Caucasian nose were analyzed objectively. Student t test and standard deviation test were applied. Results There was a predominance of endonasal access (94.4%). The most common dorsum technique was hump removal (33.33%), and the predominance of sutures (24.76%) was observed on the nasal tip, with the lateral intercrural the most frequent (32.39%). Comparison between preoperative and postoperative photos found statistically significant alterations on the anthropometric measurements of the noses. Conclusion The main surgical techniques on Caucasian noses were evaluated, and a great variety was found. The evaluation of anthropometric measurements of the nose proved the efficiency of the performed procedures.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-12-02T18:13:02+0100
      DOI: 10.1055/s-0034-1393721
  • Sleep Respiratory Disorders and Clinical Profile in Patients with Type 2
           Diabetes Mellitus

    • Authors: Fontela; Paula Caitano, Winkelmann, Eliane Roseli, Pretto, Luciana Meggiolaro, Berlezi, Evelise Moraes
      Abstract: Introduction Sleep respiratory disorders (SRDs) are often found in patients with type 2 diabetes mellitus (T2DM). Objective The aim was to establish the prevalence of risk to develop an SRD using the Clinical Berlin Questionnaire (CBQ) and Epworth Sleepiness Scale (ESS) in patients with T2DM and verifying the correlation of anthropometric measurements and life quality (LQ) with ESS. Methods A descriptive and analytical study of a case series evaluating 208 patients with T2DM, submitted to clinical and biochemical evaluation and implementation of CBQ, ESS, and WHOQOL-bref to evaluate LQ. Results Mean age was 60.8 ± 8.8 years, and 65.4% were women. Most diabetics were overweight (36.1%), and 29.8% were class I obese. One-third had positive risk signals for a SRD, with 87.0 and 34.1% having high risk in CBQ and sleep disorders in ESS, respectively. There was a significant difference in the general LQ between the low- and high-risk groups in the CBQ. Conclusion In this scenario, it is noteworthy that the active search for sleep disorders must start from simple methods, such as application of protocols.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-12-01T12:25:57+0100
      DOI: 10.1055/s-0034-1395998
  • Characterization of Hearing Thresholds from 500 to 16,000 Hz in
           Dentists: A Comparative Study

    • Authors: Gonçalves; Claudia Giglio de Oliveira, Santos, Luciana, Lobato, Diolen, Ribas, Angela, Lacerda, Adriana Bender Moreira, Marques, Jair
      Abstract: Introduction High-level noise exposure in dentists' workplaces may cause damages to the auditory systems. High-frequency audiometry is an important tool in the investigation in the early diagnosis of hearing loss. Objectives To analyze the auditory thresholds at frequencies from 500 to 16,000 Hz of dentists in the city of Curitiba. Methods This historic cohort study retrospectively tested hearing thresholds from 500 to 16,000 Hz with a group of dentists from Curitiba, in the state of Paraná, Brazil. Eighty subjects participated in the study, separated into a dentist group and a control group, with the same age range and gender across groups but with no history of occupational exposure to high levels of sound pressure in the control group. Subjects were tested with conventional audiometry and high-frequency audiometry and answered a questionnaire about exposure to noise. Results Results showed that 81% of dentists did not receive any information regarding noise at university; 6 (15%) dentists had sensorineural hearing impairment; significant differences were observed between the groups only at frequencies of 500 Hz and 1,000, 6,000 and 8,000 Hz in the right ear. There was no significant difference between the groups after analysis of mean hearing thresholds of high frequencies with the average hearing thresholds in conventional frequencies; subjects who had been working as dentists for longer than 10 years had worse tonal hearing thresholds at high frequencies. Conclusions In this study, we observed that dentists are at risk for the development of sensorineural hearing loss especially after 10 years of service.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-11-28T15:32:40+0100
      DOI: 10.1055/s-0034-1390138
  • Telephone Usage and Cochlear Implant: Auditory Training Benefits

    • Authors: Sousa; Aline Faria de, Carvalho, Ana Claudia Martinho de, Couto, Maria Ines Vieira, Tsuji, Robinson Koji, Goffi-Gomez, Maria Valéria Schmidt, Bento, Ricardo Ferreira, Matas, Carla Gentile, Befi-Lopes, Debora Maria
      Abstract: Introduction Difficulties with telephone use by adult users of cochlear implants (CIs) are reported as a limitation in daily life. Studies to improve the speech understanding of CI users on the telephone are scarce in the Brazilian scientific literature. Objective To develop and evaluate the effectiveness of a training program of auditory abilities on the telephone for an adult CI user. Resumed Report The subject was a 55-year-old woman with a degree in accounting who used a CI for 24 months. The program consisted of three stages: pretraining evaluation, eight sessions of advanced auditory abilities training, and post-training evaluation. Auditory abilities with CI were evaluated before and after training in three conditions: sound field, telephone with the speech processor in the microphone function, and telephone with the speech processor in the telecoil function. Speech recognition was assessed by three different lists: one with monosyllabic and dissyllabic words, another with nonsense syllables, and another one with sentences. The Client Oriented Scale of Improvement (COSI) was used to assess whether the needs established by the CI user in everyday telephone use situations improved after training. The auditory abilities training resulted in a relevant improvement in the percentage of correct answers in speech tests both in the telephone use conditions and in the sound field condition. Conclusion The results obtained with the COSI inventory indicated a performance improvement in all situations presented at the beginning of the program.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-11-28T15:29:14+0100
      DOI: 10.1055/s-0034-1390301
  • Auditory Neuropathy/Dyssynchrony: A Retrospective Analysis of 15 Cases

    • Authors: Unal; Murat, Vayisoglu, Yusuf
      Abstract: Introduction Auditory neuropathy/dyssynchrony (AN/AD) comprises a spectrum of pathology affecting the auditory pathways anywhere from the inner hair cells to the brainstem. It is characterized by an absent or atypical auditory brainstem response (ABR) with preservation of the cochlear microphonics and/or otoacoustic emissions (OAEs). Objective Retrospective analysis of patients with AN/AD. Methods Fifteen patients with AN/AD were included in this study and their records were retrospectively investigated. Results Possible etiology of AN/AD was neonatal hyperbilirubinemia in three patients, family history of hearing loss in three patients, consanguineous marriage in two patients, head trauma in two patients, mental motor retardation in one patient, cerebrovascular disease in one patient, and there was no apparent cause in three patients. Conclusion Otolaryngologists should keep in mind the diagnosis of AN/AD especially in patients complaining of difficulty in hearing and speech and audiological evidence of disassociation between pure tone and speech audiometry. ABR and OAE testing is recommended in these patients for AN/AD diagnosis.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-11-28T15:19:54+0100
      DOI: 10.1055/s-0034-1390328
  • Relationship between Otolaryngologic Complaints and Systemic Comorbidities
           Observed in a Group of Hearing Aid Users

    • Authors: Ribas; Angela, Silvestre, Renata, Mottecy, Carla Meller, Kozlowski, Lorena, Marques, Jair Mendes
      Abstract: Introduction Optimization of the selection, adaptation, and benefit of hearing aids is necessary to characterize and manage hearing loss, user expectations, otolaryngologic symptoms, and systemic comorbidities. Objective To compare the occurrence of otologic complaints, systemic diseases, and effective use of hearing aids in men and women with deafness. Methods Patients from a Unified Health System–accredited hearing health service, who reported problems in adapting to their hearing aids, were evaluated by a physician and audiologist. An anamnesis, ENT evaluation, and audiological evaluation were performed. Results During the data collection period, 278 subjects came in for follow-up visits; of these, 61 (21%) reported otologic or operational problems with their equipment. The most prevalent type of hearing loss was basocochlear, a characteristic of presbycusis, in both men and women; the most frequently reported comorbidities were hypercholesterolemia (more significant in women) and hypertension (more significant in men). Fourteen subjects reported using their device discontinuously, with no significant difference between genders; the reasons for discontinuation of use were itching and ringing, with more complaints from women. Conclusion The incidence of systemic and audiological complaints is high in this population. These patients should be evaluated thoroughly, as resolutions of these complaints can contribute to improving the quality of life and assist in the process of hearing aid fitting.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-11-28T15:12:14+0100
      DOI: 10.1055/s-0034-1395997
  • Cochlear Implantation in Isolated Large Vestibular Aqueduct Syndrome:
           Report of Three Cases and Literature Review

    • Authors: Pradhananga; Rabindra, Natarajan, Kiran, Devarasetty, AmarNath, Kameswaran, Mohan
      Abstract: Introduction Large vestibular aqueduct syndrome (LVAS) is characterized by the enlargement of the vestibular aqueduct associated with sensorineural hearing loss. It is the most common radiographically detectable inner ear anomaly in congenital hearing loss. LVAS may occur as an isolated anomaly or in association with other inner ear malformations. Objective To report three cases of isolated LVAS with a focus on preoperative assessment, surgical issues, and short-term postoperative follow-up with preliminary auditory habilitation outcomes. Resumed Report One girl and two boys with LVAS were assessed and cochlear implantation was performed for each. Various ways of intraoperative management of cerebrospinal fluid gusher and postoperative care and outcomes are reported. Conclusion Cochlear implantation in the deaf children with LVAS is feasible and effective.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-11-14T14:40:14+0100
      DOI: 10.1055/s-0034-1395791
  • Olfaction in Neurologic and Neurodegenerative Diseases: A Literature

    • Authors: Godoy; Maria Dantas Costa Lima, Voegels, Richard Louis, Pinna, Fábio de Rezende, Imamura, Rui, Farfel, José Marcelo
      Abstract: Introduction Loss of smell is involved in various neurologic and neurodegenerative diseases, such as Parkinson disease and Alzheimer disease. However, the olfactory test is usually neglected by physicians at large. Objective The aim of this study was to review the current literature about the relationship between olfactory dysfunction and neurologic and neurodegenerative diseases. Data Synthesis Twenty-seven studies were selected for analysis, and the olfactory system, olfaction, and the association between the olfactory dysfunction and dementias were reviewed. Furthermore, is described an up to date in olfaction. Conclusion Otolaryngologist should remember the importance of olfaction evaluation in daily practice. Furthermore, neurologists and physicians in general should include olfactory tests in the screening of those at higher risk of dementia.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-11-14T14:36:57+0100
      DOI: 10.1055/s-0034-1390136
  • Wegener Granulomatosis: Otologic Manifestation as First Symptom

    • Authors: Costa; Carla Fabiane da, Polanski, Jose Fernando
      Abstract: Introduction Wegener granulomatosis is a systemic vasculitis affecting small and medium-sized vessels of the upper and lower respiratory tract and kidneys. Objective To describe a case of Wegener disease with atypical manifestation. Resumed Report We describe the case of a 50-year-old woman with chronic otitis media and sensorineural hearing loss as the primary symptoms, without other manifestations. Conclusion In cases of acute ear manifestations with or without hearing loss and with poor response to usual treatments, Wegener granulomatosis should be included among the possible etiologies. After adequate diagnoses and treatment of this rare disease, there was favorable evolution.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-11-11T16:07:21+0100
      DOI: 10.1055/s-0034-1387164
  • Relationship between Dysphagia and Exacerbations in Chronic Obstructive
           Pulmonary Disease: A Literature Review

    • Authors: Steidl; Eduardo, Ribeiro, Carla Simone, Gonçalves, Bruna Franciele, Fernandes, Natália, Antunes, Vívian, Mancopes, Renata
      Abstract: Introduction The literature presents studies correlating chronic obstructive pulmonary disease to dysphagia and suggesting that the aspiration laryngeal phenomenon related to changes in the pharyngeal phase contributes significantly to the exacerbation of symptoms of lung disease. Objectives This study aimed to conduct a literature review to identify the relation between dysphagia and exacerbations of chronic obstructive pulmonary disease. Data Synthesis We found 21 studies and included 19 in this review. The few studies that related to the subject agreed that the presence of dysphagia, due to lack of coordination between swallowing and breathing, may be one of the triggering factors of chronic obstructive pulmonary disease exacerbation. Conclusions The review noted that there is a relationship between dysphagia and exacerbations of chronic obstructive pulmonary disease, identified by studies demonstrating that the difficulties associated with swallowing may lead to exacerbation of the disease. There was difficulty in comparing studies by their methodological differences. More research is needed to clarify the relationship between dysphagia and exacerbations of chronic obstructive pulmonary disease, making it possible to develop multiprofessional treatment strategies for these patients, catered to specific needs due to the systemic manifestations of the disease.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-11-06T12:46:31+0100
      DOI: 10.1055/s-0034-1376430
  • Evaluation of Swallowing in Infants with Congenital Heart Defect

    • Authors: Pereira; Karine da Rosa, Firpo, Cora, Gasparin, Marisa, Teixeira, Adriane Ribeiro, Dornelles, Silvia, Bacaltchuk, Tzvi, Levy, Deborah Salle
      Abstract: Introduction Surgical repair of congenital heart disease in the first years of life compromises the coordination of the suction, breathing, and swallowing functions. Objective To describe the alterations in swallowing found in infants with congenital heart defect during their hospitalization. Methods Prospective, cross-sectional study in a reference hospital for heart disease. The sample consisted of 19 postsurgical patients who underwent an evaluation of swallowing. The infants included were younger than 7 months and had a diagnosis of congenital heart defect and suspected swallowing difficulties. Results Of the 19 infants with congenital heart defect, the median age was 3.2 months. A significant association was found between suction rhythm and dysphagia (p = 0.036) and between oral-motor oral feeding readiness and dysphagia (p = 0.014). Conclusions The data suggest that dysphagia often occurs after surgery in infants with congenital heart defect. Infants with congenital heart defect had very similar behavior to preterm infants in terms of oral feeding readiness.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-11-05T13:29:32+0100
      DOI: 10.1055/s-0034-1384687
  • Audiological Findings in Patients with Oculo-Auriculo-Vertebral Spectrum

    • Authors: Sleifer; Pricila, Gorsky, Natalya de Souza, Goetze, Thayse Bienert, Rosa, Rafael Fabiano Machado, Zen, Paulo Ricardo Gazzola
      Abstract: Introduction Oculo-auriculo-vertebral spectrum, also referred to as Goldenhar syndrome, is a condition characterized by alterations involving the development of the structures of the first and second branchial arches. The abnormalities primarily affect the face, the eyes, the spine, and the ears, and the auricular abnormalities are associated with possible hearing loss. Objective To analyze the audiological findings of patients with oculo-auriculo-vertebral spectrum through liminal pure-tone audiometry and speech audiometry test. Methods Cross-sectional study conducted on 10 patients with oculo-auriculo-vertebral spectrum and clinical findings on at least two of the following areas: orocraniofacial, ocular, auricular, and vertebral. All patients underwent tonal and vocal hearing evaluations. Results Seven patients were male and three were female; all had ear abnormalities, and the right side was the most often affected. Conductive hearing loss was the most common (found in 10 ears), followed by sensorineural hearing loss (in five ears), with mixed hearing loss in only one ear. The impairment of the hearing loss ranged from mild to moderate, with one case of profound loss. Conclusions The results show a higher frequency of conductive hearing loss among individuals with the oculo-auriculo-vertebral spectrum phenotype, especially moderate loss affecting the right side. Furthermore, research in auditory thresholds in the oculo-auriculo-vertebral spectrum is important in speech therapy findings about the disease to facilitate early intervention for possible alterations.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-10-17T15:56:09+01:00
      DOI: 10.1055/s-0034-1390137
  • Predictors of Success in the Treatment of Obstructive Sleep Apnea Syndrome
           with Mandibular Repositioning Appliance: A Systematic Review

    • Authors: Saffer; Fernanda, Lubianca, José Faibes Lubianca, Rösing, Cassiano, Dias, Caroline, Closs, Luciane
      Abstract: Introduction Obstructive sleep apnea syndrome affects up to 4% of middle-aged men and 2% of adult women. It is associated with obesity. Objective The objective of this article is to review the literature to determine which factors best correlate with treatment success in patients with obstructive sleep apnea syndrome treated with a mandibular repositioning appliance. Data Synthesis A search was performed of the PubMed, Cochrane, Lilacs, Scielo, and Web of Science databases of articles published from January 1988 to January 2012. Two review authors independently collected data and assessed trial quality. Sixty-nine articles were selected from PubMed and 1 from Cochrane library. Of these, 42 were excluded based on the title and abstract, and 27 were retrieved for complete reading. A total of 13 articles and 1 systematic review were considered eligible for further review and inclusion in this study: 6 studies evaluated anthropomorphic and physiologic factors, 3 articles addressed cephalometric and anatomic factors, and 4 studies evaluated variables related to mandibular repositioning appliance design and activation. All the studies evaluated had low to moderate methodologic quality and were not able to support evidence on prediction of treatment success. Conclusion Based on this systematic review on obstructive sleep apnea syndrome treatment, it remains unclear which predictive factors can be used with confidence to select patients suitable for treatment with a mandibular repositioning appliance.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-10-17T15:56:09+01:00
      DOI: 10.1055/s-0034-1393957
  • Vocal Variability Post Swallowing in Individuals with and without
           Oropharyngeal Dysphagia

    • Authors: Santos; Karoline Weber dos, Scheeren, Betina, Maciel, Antonio Carlos, Cassol, Mauriceia
      Abstract: Introduction Voice modification after swallowing may indicate changes in the transit of the bolus. Objective The aim of this study is to verify the use of perceptual voice analysis to detect oropharyngeal dysphagia. Study Design Case series. Methods Twenty-seven patients with dysphagia as diagnosed by videofluoroscopy and 25 without were evaluated. The sustained vowel /a/ was recorded before this exam and after swallowing different consistencies (pasty, liquid and solid). For the voice evaluation, the GRBAS scale (grade, roughness, breathiness, asthenia and strain) and the parameter “wet voice” were used. Three judges blinded to study group and time of emission performed voice analysis. Results Individuals with dysphagia showed significant decrease in grade of voice and asthenia and increase in strain after swallowing pasty substances, differing from individuals without dysphagia who showed no modification of the parameters after swallowing. The wet voice parameter showed no difference after swallowing in both study groups. Conclusion The decrease in grade and asthenia and increased strain are indicative of a swallowing disorder, indicating increased vocal strain to clean the vocal tract of food. The modification of vocal production after swallowing proved to be a trusted resource for detection of swallowing disorders.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-10-17T15:56:08+01:00
      DOI: 10.1055/s-0034-1394129
  • Hairy Polyp of the Supratonsillar Fossa Causing Intermittent Airway

    • Authors: İsmi; Onur, Görür, Kemal, Arpacı, Rabia Bozdoğan, Vayisoglu, Yusuf, Özcan, Cengiz
      Abstract: Introduction Dermoids frequently called “hairy polyps” and their nature have not been completely clarified. Objectives To discuss the unusual presentation, symptoms, incidence, histology, and perioperative management of hairy polyps in the light of a case and current literature. Resumed Report A 3-year-old boy presented with intermittent respiratory distress since birth. Oropharyngeal examination revealed a nasopharyngeal mass originating from the supratonsillar fossa. The mass was so mobile that it moved between the oropharynx and the nasopharynx during swallowing. The radiologic and pathologic examinations confirmed the mass as a hairy polyp. Conclusion In a pediatric age group with airway obstruction, hairy polyps of the oropharyngeal region must also be included in the differential diagnosis.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-09-16T20:03:22+01:00
      DOI: 10.1055/s-0034-1387812
  • Childhood Hearing Health: Educating for Prevention of Hearing Loss

    • Authors: Lacerda; Adriana Bender Moreira, Gonçalves, Claudia Giglio de Oliveira, Ribas, Angela, Lacerda, Giselle, Lobato, Diolén Conceição Barros, Santos, Luciana, Cortelazzo, Aline
      Abstract: Introduction The presence of noise in our society has attracted the attention of health professionals, including speech-language pathologists, who have been charged along with educators with developing hearing conservation programs in schools. Objective To describe the results of three strategies for awareness and hearing preservation in first to fourth grades in public elementary schools. Methods The level of environmental noise in classrooms was assessed, and 638 elementary school students from first to fourth grades, 5 to 10 years of age, were audiologically evaluated. After the evaluations, educational activities were presented to children and educators. Results The noise level in the classroom ranged from 71.8 to 94.8 A-weighted decibels. The environment of the classroom was found to promote sound reverberation, which hinders communication. Thirty-two students (5.1%) presented hearing alterations. Conclusion The application of strategies for a hearing conservation program at the school showed that noise is present in the room, and hearing loss, sometimes silent, affects schoolchildren. Students and teachers were aware that hearing problems can be prevented. Avoiding exposure to noise and improving the acoustics in classrooms are essential.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-09-03T16:45:31+01:00
      DOI: 10.1055/s-0034-1387810
  • Ambient Noise in Emergency Rooms and Its Health Hazards

    • Authors: Filus; Walderes, Lacerda, Adriana Bender Moreira de, Albizu, Evelyn
      Abstract: Introduction The occupational risk due to high levels of noise in the hospital environment has been recognized, and the National Agency of Sanitary Surveillance of the Ministry of Health recommends evaluation and control of noise in hospital areas. Objectives To assess the sound environment in the emergency ward of a general trauma reference hospital in the city of Curitiba, Parana State, Brazil. Methods In this descriptive study, noise levels were assessed on mornings, afternoons, and evenings using an integrating Bruel & Kjaer (Denmark) calibrated sound level meter, type 2230. Ten indoor points in the emergency ward were assessed; the helicopter as well as several available pieces of equipment in the ward were assessed individually. Results Noise levels in sound pressure level ambiance [dBA] ranged from 56.6 to 68.8. The afternoon period was the noisiest. The helicopter at 119 dBA and the cast saw at 90 dBA were the noisiest equipment, and the lowest noise level found was the activated oximeter at 61.0 dBA. Conclusion In all assessed points, noise levels were above the comfort levels recommended by the Brazilian Association of Technical Standards (1987), which may harm users' and professionals' health as well as influence professional performance in the emergency ward. Sound pressure levels of the helicopter and cast saw reach high hearing hazard levels, requiring professionals to use individual protection equipment, and point to the need for creation and implementation of effective control measures of noise levels in emergency wards.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-08-25T14:01:09+01:00
      DOI: 10.1055/s-0034-1387165
  • Hearing Aid Use and Adherence to Treatment in a Publicly-Funded Health
           Service from the City of São Paulo, Brazil

    • Authors: Iwahashi; Juliana Harumi, Jardim, Isabela de Souza, Shirayama, Yoshihisa, Yuasa, Motoyuki, Bento, Ricardo Ferreira
      Abstract: Introduction Periodic follow-up appointments are important to ensure long-term effectiveness of rehabilitation with hearing aids. However, not all users are able to maintain adherence to recommendations prescribed during the fitting process and some do not attend those appointments, which compromises the effectiveness of treatment. Objective Compare hearing aid use after 1 year between subjects who did not attend a follow-up evaluation appointment at a publicly-funded health service (nonattenders) and those who attended the appointment (attenders). Reasons for nonuse of hearing aids and unscheduled appointments were also analyzed. Methods Prospective observational cross-sectional study. Nonattenders and attenders in a follow-up evaluation appointment were interviewed by telephone about hearing aid use, reasons for nonuse, and unscheduled appointments. Results The nonattenders group consisted of 108 subjects and the attenders group had 200 subjects; in both groups, most users kept bilateral use but the nonuse rate was higher in nonattenders. The main reason for nonuse of hearing aids among nonattenders was health problems; fitting problems was the main reason for nonuse in the attenders group. Health problems and issues like unavailable companion and transportation difficulties were the reasons for unscheduled follow-up appointments. Conclusion Nonattenders had a greater nonuse rate and were more likely to abandon hearing aid use. Measures to increase hearing aid use and adherence to prescribed recommendations are also necessary to ensure long-term effectiveness of rehabilitation with hearing aids.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-07-28T15:28:21+01:00
      DOI: 10.1055/s-0034-1384816
  • Hearing Profile of Brazilian Forestry Workers' Noise Exposure

    • Authors: Lacerda; Adriana, Quintiliano, Juliana, Lobato, Diolen, Gonçalves, Claudia, Marques, Jair
      Abstract: Introduction Researchers studying the hearing health of forestry workers have revealed the presence of a noise-induced hearing loss (NIHL) in this population and have concluded that the vibration of the equipment, the carbon monoxide released by motors, and pesticides might also contribute to NIHL. Objective To analyze the noise exposure in the Brazilian forestry industry workers and the effects on hearing. Methods The study sample comprised 109 employees of a company that specialized in reforestation. Their participants' mean age was 35.5 years (21 to 54 years), mean tenure at the company was 3.9 years (1 to 13 years), and mean total duration of noise exposure was 12.3 years (1 to 30 years). The existing documentation reporting on the jobs risk analysis was examined, noise level was measured, and pure tone audiometry was performed in all participants. Participants were divided into three groups according to their noise exposure levels in their current job. Results Of the participants who were exposed to noise levels less than 85 dBA (decibels with A-weighting filter), 23.8% had hearing loss, and 5.5% of the participants who were exposed to noise ranging from 85 to 89.9 dBA and 11% of the participants who were exposed to noise greater than 90 dBA had audiogram results suggestive of NIHL. Conclusion The implementation of a hearing loss prevention program tailored to forestry workers is needed.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-07-22T15:25:40+01:00
      DOI: 10.1055/s-0034-1382098
  • Anatomopathology of the Superstructure of the Stapes in Patients with

    • Authors: Carvalho; Bettina, Hamerschmidt, Rogerio, Telles, Jose Ederaldo, Richter, Nicole
      Abstract: Introduction Otosclerosis is a disease that causes bone resorption and deposition in the auditory structures, leading to deafness. Many studies have evaluated the histopathology of the stapes footplate in this disease (osteoblasts, osteoclasts, vascular proliferation, fibroblasts, and histiocytes), but we found no studies in the literature involving the histology of the superstructure of the stapes. Objectives To perform an analysis under optical microscopy of histopathologic findings of the superstructure of the stapes from patients with otosclerosis. Methods A contemporary cross-sectional cohort study of pathology analysis of superstructures of the stapes of patients with otosclerosis. Results Fifteen superstructures of stapes in patients with otosclerosis operated in our service and four stapes of cadavers used for dissection (controls) were evaluated. No areas of bone resorption or deposition or presence of osteoclasts and osteoblasts in the superstructure of the stapes were found. However, we found in the more distal portions of the crura areas with prominent cementitious lines and woven bone, which was different than the mature trabecular bone found in the head of the stapes or in the controls. Conclusion There were histologic changes in the superstructure of the stapes in patients with otosclerosis operated in our service.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-07-18T13:46:08+01:00
      DOI: 10.1055/s-0034-1382096
  • Therapeutic Options in Idiopathic Burning Mouth Syndrome: Literature

    • Authors: Miziara; Ivan, Chagury, Azis, Vargas, Camila, Freitas, Ludmila, Mahmoud, Ali
      Abstract: Introduction Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue, palate, lips, or gums of no well-defined etiology. The diagnosis and treatment for primary BMS are controversial. No specific laboratory tests or diagnostic criteria are well established, and the diagnosis is made by excluding all other possible disorders. Objective To review the literature on the main treatment options in idiopathic BMS and compare the best results of the main studies in 15 years. Data Synthesis We conducted a literature review on PubMed/MEDLINE, SciELO, and Cochrane-BIREME of work in the past 15 years, and only selected studies comparing different therapeutic options in idiopathic BMS, with preference for randomized and double-blind controlled studies. Final Comments Topical clonazepam showed good short-term results for the relief of pain, although this was not presented as a definitive cure. Similarly, α-lipoic acid showed good results, but there are few randomized controlled studies that showed the long-term results and complete remission of symptoms. On the other hand, cognitive therapy is reported as a good and lasting therapeutic option with the advantage of not having side effects, and it can be combined with pharmacologic therapy.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-07-09T20:30:14+01:00
      DOI: 10.1055/s-0034-1378138
  • The Study of Otoacoustic Emissions and the Suppression of Otoacoustic
           Emissions in Subjects with Tinnitus and Normal Hearing: An Insight to
           Tinnitus Etiology

    • Authors: Serra; Lucieny, Novanta, Gabriela, Sampaio, Andre Lopes, Augusto Oliveira, Carlos, Granjeiro, Ronaldo, Braga, Silvia Cristina
      Abstract: Introduction Analysis of the suppression effect is a simple method to evaluate cochlear status and central auditory mechanisms and, more specifically, the medial olivocochlear system. This structure may be involved in the generation of mechanisms that cause tinnitus and in the pathophysiology of tinnitus in patients with tinnitus and normal hearing. Objective To review the literature of the etiology of tinnitus on the lights of otoacoustic emissions in patients with normal hearing. Data Synthesis Individuals with tinnitus and normal hearing have a higher prevalence of alterations in transient-evoked otoacoustic emissions and distortion-product otoacoustic emissions than normal subjects. This fact suggests that dysfunctions of the outer hair cells (OHCs) might be important in the generation of the tinnitus; however, this feature is not always present in those who have the symptoms of tinnitus. Final Comments These findings suggest that OHC dysfunction is not necessary for tinnitus development—that is, there might be mechanisms other than OHC damage in the tinnitus development. On the other hand, OHC dysfunction alone is not sufficient to cause the symptom, because a great many individuals with OHC dysfunction did not complain about tinnitus.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-06-18T16:50:05+01:00
      DOI: 10.1055/s-0034-1374648
  • Auditory Brainstem Response in Term and Preterm Infants with Neonatal
           Complications: The Importance of the Sequential Evaluation

    • Authors: Silva; Daniela da, Lopez, Priscila, Mantovani, Jair Cortez
      Abstract: Introduction Literature data are not conclusive as to the influence of neonatal complications in the maturational process of the auditory system observed by auditory brainstem response (ABR) in infants at term and preterm. Objectives Check the real influence of the neonatal complications in infants by the sequential auditory evaluation. Methods Historical cohort study in a tertiary referral center. A total of 114 neonates met inclusion criteria: treatment at the Universal Neonatal Hearing Screening Program of the local hospital; at least one risk indicator for hearing loss; presence in both evaluations (the first one after hospital discharge from the neonatal unit and the second one at 6 months old); all latencies in ABR and transient otoacoustic emissions present in both ears. Results The complications that most influenced the ABR findings were Apgar scores less than 6 at 5 minutes, gestational age, intensive care unit stay, peri-intraventricular hemorrhage, and mechanical ventilation. Conclusion Sequential auditory evaluation is necessary in premature and term newborns with risk indicators for hearing loss to correctly identify injuries in the auditory pathway.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-05-28T14:43:02+01:00
      DOI: 10.1055/s-0034-1378137
  • Screening of Connexin 26 in Nonsyndromic Hearing Loss

    • Authors: Moreira; Danielle, Silva, Daniela da, Lopez, Priscila, Mantovani, Jair Cortez
      Abstract: Introduction The first locus for nonsyndromic autosomal recessive hearing loss is on chromosome 13q11–22. The 35delG mutation is present in 80% of cases in which GJB2 is involved, which makes the study of this mutation very important. The viability and benefits of screening for mutations in the connexin 26 gene are now beginning to change the diagnostic evaluation and identification of the etiology of hearing loss. Objective To investigate the occurrence of the 35delG mutation in patients with nonsyndromic sensorineural hearing loss and their first degree relatives. Methods This transversal study included 72 patients from the local hospital. The patients were divided into three groups: group A, sensorineural hearing loss (n = 58); group B, first-degree relatives of group A with sensorineural hearing loss (n = 09); and group C, first-degree relatives of patients from group A without hearing loss (n = 05). All patients had audiological evaluation and genetic testing of the 35delG mutation. Results The 35delG mutation was found in four heterozygous mutations (three of them found in the same family). The other heterozygous mutation was found in a female patient with bilateral, moderate, prelingual, sensorineural hearing loss. A single homozygous mutation was found in a male patient, with severe sensorineural hearing loss in his right ear and profound hearing loss in the left ear. Conclusions The 35delG mutation was found in 7% of the cases. The test is easy to perform and inexpensive, but it is necessary to investigate other genes related to hearing loss.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-04-11T16:28:30+01:00
      DOI: 10.1055/s-0034-1373783
  • Intraoperative Neural Response Telemetry and Neural Recovery Function: a
           Comparative Study between Adults and Children

    • Authors: Carvalho; Bettina, Hamerschmidt, Rogerio, Wiemes, Gislaine
      Abstract: Introduction Neural response telemetry (NRT) is a method of capturing the action potential of the distal portion of the auditory nerve in cochlear implant (CI) users, using the CI itself to elicit and record the answers. In addition, it can also measure the recovery function of the auditory nerve (REC), that is, the refractory properties of the nerve. It is not clear in the literature whether the responses from adults are the same as those from children. Objective To compare the results of NRT and REC between adults and children undergoing CI surgery. Methods Cross-sectional, descriptive, and retrospective study of the results of NRT and REC for patients undergoing IC at our service. The NRT is assessed by the level of amplitude (microvolts) and REC as a function of three parameters: A (saturation level, in microvolts), t0 (absolute refractory period, in seconds), and tau (curve of the model function), measured in three electrodes (apical, medial, and basal). Results Fifty-two patients were evaluated with intraoperative NRT (26 adults and 26 children), and 24 with REC (12 adults and 12 children). No statistically significant difference was found between intraoperative responses of adults and children for NRT or for REC's three parameters, except for parameter A of the basal electrode. Conclusion The results of intraoperative NRT and REC were not different between adults and children, except for parameter A of the basal electrode.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-04-02T20:24:08+01:00
      DOI: 10.1055/s-0034-1372509
  • Nasolacrimal Duct Mucocele: Case Report and Literature Review

    • Authors: Britto; Fernanda Carneiro Corujeira de, Rosier, Vitor Veloso, Luz, Tovar Vicente, Verde, Raquel Crisóstomo Lima, Lima, Clara Mônica Figueiredo de, Lessa, Marcus Miranda
      Abstract: Introduction Mucoceles are benign expansive cystic formations, composed of a mucus-secreting epithelium (respiratory or pseudostratified epithelium). Nasolacrimal mucocele occurs in a small proportion of children with nasolacrimal duct obstruction and is characterized by a cystic mass in the medial canthus with dilation of the nasolacrimal duct; although dacryocystoceles are rare in adults, they have been reported in patients with trachoma. Objective Discuss clinical aspects, diagnosis, and therapeutic management of mucocele of nasolacrimal duct based on literature review. Resumed Report The authors report a case of bilateral congenital nasolacrimal duct cysts in a 30-year-old man, identified as a tumor in the topography of both lacrimal sacs since birth without associated symptoms. The patient underwent successive surgical treatments, leading to recurrence of the tumor at the right side and recurrent local infections. Conclusion Endoscopic dacryocystorhinostomy has been increasingly used with good results and success rates similar to the external access.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-02-13T14:52:18+0100
      DOI: 10.1055/s-0034-1366978
  • Isolated Schwannoma of the Olfactory Groove: A Case Report

    • Authors: Nascimento; Luiz Augusto, Settanni, Flávio Aurélio Parente, Filho, José Franscisco de Góis, Sanchez, Isabela Naria Dias, Cavalcante, Bruna Barros, Stávale, João Noberto
      Abstract: Introduction Schwannoma of the olfactory groove is an extremely rare tumor that can share a differential diagnosis with meningioma or neuroblastoma. Objectives The authors present a case of giant schwannoma involving the anterior cranial fossa and ethmoid sinuses. Case Report The patient presented with a 30-month history of left nasal obstruction, anosmia, and sporadic ipsilateral bleeding. Computed tomography of the paranasal sinuses revealed expansive lesion on the left nasal cavity extending to nasopharynx up to ethmoid and sphenoid sinuses bilaterally with intraorbital and parasellar extension to the skull base. Magnetic resonance imaging scan confirmed the expansive tumor without dural penetration. Biopsy revealed no evidence of malignancy and probable neural cell. Bifrontal craniotomy was performed combined with lateral rhinotomy (Weber-Ferguson approach), and the lesion was totally removed. The tumor measured 8.0 × 4.3 × 3.7 cm and microscopically appeared as a schwannoma composed of interwoven bundles of elongated cells (Antoni A regions) mixed with less cellular regions (Antoni B). Immunohistochemical study stained intensively for vimentin and S-100. Conclusion Schwannomas of the olfactory groove are extremely rare, and the findings of origin of this tumor is still uncertain but recent studies point most probably to the meningeal branches of trigeminal nerve or anterior ethmoidal nerves.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2013-11-05T14:32:02+0100
      DOI: 10.1055/s-0033-1353368
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