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Journal Cover   International Archives of Otorhinolaryngology
  [SJR: 0.162]   [H-I: 2]   [1 followers]  Follow
  This is an Open Access Journal Open Access journal
   ISSN (Print) 1809-9777 - ISSN (Online) 1809-4864
   Published by Thieme Publishing Group Homepage  [158 journals]
  • Research Awards 2015
    • Int. Arch. Otorhinolaryngol. 2015; 19: 099-099
      DOI: 10.1055/s-0035-1549262

      Thieme Publicações Ltda Rio de Janeiro, Brazil

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

      Int. Arch. Otorhinolaryngol. 2015; 19: 099-0992015-04-07T14:47:47+01:00
      Issue No: Vol. 19, No. 02 (2015)
  • Hearing Health in Agricultural Aviation Pilots from Cindacta II Wearing
           Earplugs and a Helmet

    • Authors: Fonseca; Vinicius Ribas, Zeigelboim, Bianca Simone, Lacerda, Adriana Bender Moreira, Ribas, Angela, Spanhol, Guilherme
      Abstract: Introduction Agricultural aviation pilots, exposed daily to intense vibration and noise, are likely to develop noise-induced hearing loss (NIHL). Objectives The aim of this study was to investigate the presence of audiograms consistent with NIHL in agricultural aviation pilots who use earplugs and helmets. Methods We conducted a cross-sectional cohort and observational study. The data were taken from the medical records and audiograms of 94 pilots. Results NIHL was identified in 9.5% of individuals with hearing loss by audiograms at 3,000, 4,000, or 6,000 Hz. Normal audiograms were observed in 46.8% of pilots surveyed. Bilateral hearing loss was more frequent than unilateral hearing loss, occurring in 64.8% of cases. Conclusion Although there was a low incidence of audiograms compatible with NIHL in the records of the pilots examined, the disorder still occurs despite the doubled use of individual hearing protection equipment (helmets and earplugs) for agricultural aviation pilots. Nevertheless, even with the use of earplugs and helmets as noise protectors, the data showed that agricultural pilots suffer inner ear damage caused by occupational noise. Prevention and periodic audiologic evaluations must be conducted in noise-exposed occupational groups.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-05-07T14:14:55+01:00
      DOI: 10.1055/s-0035-1549448
  • Effectiveness of a Vestibular Rehabilitation Protocol to Improve the
           Health-Related Quality of Life and Postural Balance in Patients with

    • Authors: Tsukamoto; Heloísa Freiria, Costa, Viviane de Souza Pinho, Silva, Rubens Alexandre da, Pelosi, Gislaine Garcia, Marchiori, Luciana Lozza de Moraes, Vaz, Cláudia Regina Sanches, Fernandes, Karen Barros Parron
      Abstract: Introduction Dizziness can be characterized as a balance disorder that causes discomfort, leading to several functional limitations. Currently, vestibular rehabilitation has been highlighted as a possible treatment. Objective Analyze the effects of completing a vestibular rehabilitation treatment protocol on quality of life and postural balance in patients with vestibular complaints, as well as to compare these effects between the patients taking or not taking antivertigo drugs. Methods A nonrandomized controlled trial was performed with 20 patients previously diagnosed with vestibular diseases. Information regarding vertigo symptoms, quality of life as assessed through the Dizziness Handicap Inventory, visual analog scale of dizziness, and stabilometry using force platform was collected. Patients were treated for 12 weeks by a custom protocol. The sample was divided into two groups according to the use (medicated group, n = 9) or not (control group, n = 11) of antivertigo drugs. Results There was improvement in quality of life (p 
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-05-06T15:53:14+01:00
      DOI: 10.1055/s-0035-1547523
  • Radiofrequency Thermal Ablation versus Bipolar Electrocautery for the
           Treatment of Inferior Turbinate Hypertrophy: Comparison of Efficacy and
           Postoperative Morbidity

    • Authors: Uluyol; Sinan, Karakaya, Nermin Erdas, Gur, Mehmet Hafit, Kilicaslan, Saffet, Kantarcioglu, Esin Ozlem, Yagiz, Ozlem, Arslan, Ilker Burak
      Abstract: Introduction Numerous surgical methods are used to treat nasal obstruction due to inferior turbinate hypertrophy. The primary goal of the therapy is to maximize the nasal airway for as extended a period of time as possible while minimizing therapeutic complications. Objectives The aim of this study was to assess the effects of radiofrequency thermal ablation (RFTA) and bipolar electrocautery (BEC) on the removal of nasal obstruction in patients with inferior turbinate hypertrophy and on nasal mucociliary clearance (MCC). Patients in both groups were also evaluated in terms of postoperative morbidity. Methods We compared the outcomes of two groups of patients: those treated with RFTA (n = 23) and those who underwent BEC (n = 20). Nasal obstruction was graded using a visual analog scale (VAS) and MCC was measured using a saccharin clearance test. Both measurements were performed before and 2 months after treatment. Results Pre- and postoperative VAS scores showed significant improvement for both groups. However, MCC results did not significantly differ between two groups. Neither edema nor crust formation persisted for more than 1 week in any patients. Conclusion Submucosal cauterization with preservation of the nasal mucosa and periosteum is as effective and safe as RFTA and should be considered when planning inferior turbinate interventions.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-04-30T14:18:35+01:00
      DOI: 10.1055/s-0035-1551553
  • Membrane Stress in the Human Labyrinth and Meniere Disease: A Model

    • Authors: Pender; Daniel J.
      Abstract: Introduction The nature and extent of membrane damage encountered in Meniere disease remains unexplained. Pressure-induced membrane stress may underlie the characteristic hydropic distention. Analysis of stress in the several vestibular chambers may offer insight into the nature and progression of Meniere disease. Objective Membrane stress levels will be assessed by constructing a specific model of the human membranous labyrinth through the application of human dimensions to an existing generic model of the mammalian labyrinth. Methods Nominal dimensions for a model of the human membranous labyrinth were obtained from fixed human tissue. Stress proclivities were calculated and normalized based on shell theory applied to the various geometric figures comprising the model. Results Normalized peak stress levels were projected to be highest in the saccule (38.8), followed by the utricle (5.4), then ampulla (2.4), and lowest in the canal system (1.0). These results reflect macrostructural variations in membrane shape, size, and thickness among the several chambers of the labyrinth. These decreasing stress proclivities parallel the decreasing frequency of histologic lesions found in documented cases of Meniere disease. Conclusions This model analysis of a human membranous labyrinth indicates that substantial disparities in stress exist among the several vestibular chambers due to macrostructural membrane configuration. Low stress levels in the canals are the result of thick highly curved membranes, and the high levels computed for the saccule reflect its thin and relatively flat membranes. These findings suggest that chamber configuration may be a factor controlling the progression of endolymphatic hydrops in Meniere disease.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-04-07T19:06:05+01:00
      DOI: 10.1055/s-0035-1549157
  • Tinnitus Neural Mechanisms and Structural Changes in the Brain: The
           Contribution of Neuroimaging Research

    • Authors: Simonetti; Patricia, Oiticica, Jeanne
      Abstract: Introduction Tinnitus is an abnormal perception of sound in the absence of an external stimulus. Chronic tinnitus usually has a high impact in many aspects of patients' lives, such as emotional stress, sleep disturbance, concentration difficulties, and so on. These strong reactions are usually attributed to central nervous system involvement. Neuroimaging has revealed the implication of brain structures in the auditory system. Objective This systematic review points out neuroimaging studies that contribute to identifying the structures involved in the pathophysiological mechanism of generation and persistence of various forms of tinnitus. Data Synthesis Functional imaging research reveals that tinnitus perception is associated with the involvement of the nonauditory brain areas, including the front parietal area; the limbic system, which consists of the anterior cingulate cortex, anterior insula, and amygdala; and the hippocampal and parahippocampal area. Conclusion The neuroimaging research confirms the involvement of the mechanisms of memory and cognition in the persistence of perception, anxiety, distress, and suffering associated with tinnitus.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-03-30T21:58:26+01:00
      DOI: 10.1055/s-0035-1548671
  • Open Reduction and Internal Fixation of Mandibular Fracture without Rigid
           Maxillomandibular Fixation

    • Authors: El-Anwar; Mohammad Waheed, Sayed El-Ahl, Magdy Abdalla, Amer, Hazem Saed
      Abstract: Introduction The ability to treat fracture with open reduction and internal fixation (OR/IF) has dramatically revolutionized the approach to mandible fracture. With OR/IF, the postoperative role of rigid maxillomandibular fixation (MMF) has declined, but it is used to maintain proper occlusion until internal fixation of the fracture is achieved. Objective To assess intraoperative manual MMF during OR/IF of selected cases of mandibular fractures. Methods This prospective study was conducted on 80 patients with isolated mandibular fractures managed by OR/IF using two titanium miniplates. The patients were classified into two groups: a control group (40 patients) treated by OR/IF after intraoperative rigid MMF followed by immediate MMF removal, and a study group (40 patients) treated by rigid MMF, which was replaced by temporary intraoperative manual MMF (3MF) until plate fixation. Results There were no significant differences of the postoperative complication and dental occlusion, although a highly significant reduction of operative time was achieved in the 3MF group. Patient who received the 3MF technique had statistically significantly better average intrinsic vertical mouth opening in the early postoperative period (1 week after surgery), and normal mouth opening could be achieved in all cases in both groups 8 weeks after surgery. Conclusions Intraoperative rigid MMF is not mandatory and can be replaced in selected cases of fracture mandible by manual maintenance of proper dental occlusion until hardware fixation, gaining the advantages of shorter operative time and less risk of blood-transmitted diseases to the surgical team and the patient in addition to the benefits of immediate postoperative mandible mobilization.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-03-30T21:58:24+01:00
      DOI: 10.1055/s-0035-1549154
  • Is There Any Benefit of Drain Placement on Postoperative Complications in
           Patients Undergoing the Sistrunk Procedure'

    • Authors: Qureshi; Talha Ahmed, Suhail, Anwar, Zaidi, Syed Sajjad Ali, Siddiq, Wasif
      Abstract: Introduction Same-day, outpatient Sistrunk procedure is commonly performed to manage thyroglossal duct cyst anomalies and may lead to postoperative complications. Surgical drains are placed to prevent complications, but recent observations show no advantage and rather increased health care costs and patient discomfort. Objective The study evaluated if drain placement in the Sistrunk procedure offers any benefit on postoperative complications. Methods A retrospective analysis of patient records having undergone same-day, outpatient Sistrunk procedure from 2004 to 2014 was done. Of 58 (38 male and 20 female) patients included, 38 did not have drains placed and the remaining 20 had drains placed. Mean and median age of patients was 18.1 and 13.5 years, respectively. Postoperative complications of patients with drains versus those without drains were statistically analyzed. Results Overall, about 10% of patients had hematoma/seroma (H-S), with 6.9% of patients needing aspiration for H-S; 3.4% had wound infections; and 1.7% had pus formation. No statistically significant differences in Sistrunk-related complications between patient groups (with drain or without drain) were seen using Fisher exact (two-sided) test: H-S (p = 0.08); need for aspiration (p = 0.29); wound infection (p > 0.05); and pus formation (p = 0.35). Chi-square test also did not show any significant difference in the groups in terms of number of follow-ups. Conclusion Surgical placement of a drain in the Sistrunk procedure does not seem to offer any advantage in terms of reducing common postoperative complications. Same-day Sistrunk procedure without any drain placement may be a safer alternative without necessitating hospitalization. More studies with larger sample size are needed for further substantiation.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-03-27T20:44:27+0100
      DOI: 10.1055/s-0035-1549156
  • Venous Thromboembolism—Incidence of Deep Venous Thrombosis and
           Pulmonary Embolism in Patients with Head and Neck Cancer: A Tertiary Care
           Experience in Pakistan

    • Authors: Ali; Naeem Sultan, Nawaz, Ahmad, Junaid, Montasir, Kazi, Maliha, Akhtar, Shabbir
      Abstract: Introduction Although venous thromboembolism (VTE) is seen with morbidity and mortality in various surgical specialties, scarce data are available in the head and neck surgery domain. Objective We aim to determine the incidence of VTE in patients receiving surgery for head and neck cancer. Methods Four hundred thirteen patients who underwent head and neck surgery procedures between 2005 and 2013 were reviewed retrospectively. All patients with head and neck surgery had received thromboprophylaxis (i.e., compression stockings and subcutaneous heparin). Patient demographics, operating time, and length of hospital stay were analyzed. The incidence of symptomatic deep venous thrombosis (DVT) and pulmonary embolism (PE) during the initial postoperative hospitalization was assessed. Results Twelve patients were identified who developed VTE. Three patients developed DVT, and nine developed PE. The incidence of DVT and PE was 0.72 and 2.17%, respectively. Interestingly, all of these patients had undergone excision of extensive head and neck cancers accompanied by a reconstructive procedure. Patients who developed PE had a longer hospital stay compared with those who only had DVT. There were overall three mortalities in the nine patients who developed PE. Conclusion Although VTE has a low incidence, it is a known complication of extensive head and neck surgeries with life-threatening outcomes. We recommend early mobilization and physiotherapy with the possible aid from appropriate mechanical and pharmacologic thromboprophylaxis.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-03-27T20:44:27+0100
      DOI: 10.1055/s-0035-1549153
  • Sternocleidomastoid Muscle Flap after Parotidectomy

    • Authors: Nofal; Ahmad Abdel-Fattah, Mohamed, Morsi
      Abstract: Introduction Most patients after either superficial or total parotidectomy develop facial deformity and Frey syndrome, which leads to a significant degree of patient dissatisfaction. Objective Assess the functional outcome and esthetic results of the superiorly based sternocleidomastoid muscle (SCM) flap after superficial or total parotidectomy. Methods A prospective cohort study for 11 patients subjected to parotidectomy using a partial-thickness superiorly based SCM flap. The functional outcome (Frey syndrome, facial nerve involvement, and ear lobule sensation) and the esthetic results were evaluated subjectively and objectively. Results Facial nerve palsy occurred in 5 cases (45%), and all of them recovered completely within 6 months. The Minor starch iodine test was positive in 3 patients (27%), although only 1 (9%) subjectively complained of gustatory sweating. The designed visual analog score completed by the patients themselves ranged from 0 to 3 with a mean of 1.55 ± 0.93; the scores from the blinded evaluators ranged from 1 to 3 with a mean 1.64 ± 0.67. Conclusion The partial-thickness superiorly based SCM flap offers a reasonable cosmetic option for reconstruction following either superficial or total parotidectomy by improving the facial deformity. The flap also lowers the incidence of Frey syndrome objectively and subjectively with no reported hazard of the spinal accessory nerve.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-03-27T20:44:24+0100
      DOI: 10.1055/s-0035-1549155
  • The Efficacy of Nasal Steroids in Treatment of Otitis Media with Effusion:
           A Comparative Study

    • Authors: El-Anwar; Mohammad Waheed, Nofal, Ahmad Abdel-Fattah, Khazbak, Alaa Omar, Sayed, Ahmad Ebrahim El, Hassan, Mohammad Ramadan
      Abstract: Introduction Otitis media with effusion (OME) continues to be an important pediatric clinical problem, and more studies are needed to decide the proper treatment for it. Objective To assess the efficacy of nasal steroids in the management of OME by comparing its results with that of oral steroid and that of nasal saline spray as placebo. Methods This study was carried on 60 patients with OME who were divided into three groups: in group 1, 20 patients received mometasone furoate spray, one puff in each nostril daily, for 3 months; in group 2, 20 patients received oral prednisolone, 5 mg three times per day for the first 3 weeks; in group 3, 20 patients received nasal saline spray, one puff in each nostril daily for 3 months. Results A highly significant difference between systemic or topical (nasal spray) steroid therapy and saline nasal spray was detected (p  0.05). Conclusion Nasal steroid spray can be used as an effective treatment for OME, giving a significant result similar to systemic steroid. Further studies are needed to investigate its use for longer duration and in recurrent cases.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-03-18T13:37:53+0100
      DOI: 10.1055/s-0035-1548535
  • Foreign Body in Jugal Mucosa

    • Authors: Serrano; Thiago Luís Infanger, Pauna, Henrique Furlan, Hazboun, Igor Moreira, Dal Rio, Ana Cristina, Correa, Maria Elvira Pizzigatti, Nicola, Ester Maria Danielli
      Abstract: Introduction Foreign body in the oral cavity may be asymptomatic for long time and only sometimes it can lead to a typical granulomatous foreign body reaction. Some patients may complain of oral pain and present signs of inflammation with purulent discharge. A granuloma is a distinct, compact microscopic structure composed of epithelioid-shaped macrophages typically surrounded by a rim of lymphocytes and filled with fibroblasts and collagen. Nowadays, the increase of cosmetic invasive procedures such as injection of prosthetic materials in lips and cheeks may lead to unusual forms of inflammatory granulomas. Objectives Describe an unusual presentation of a foreign body reaction in the buccal mucosa due to previous injection of cosmetic agent. Resumed Report A 74-year-old woman was referred to the Department of Otorhinolaryngology, Head and Neck Surgery to investigate the presence of multiple painless, bilateral nodules in the buccal mucosa, with progressive growth observed during the previous 2 months. The histologic results showed a foreign body inflammatory reaction. Conclusion Oral granulomatosis lesions represent a challenging diagnosis for clinicians and a biopsy may be necessary. Patients may feel ashamed to report previous aesthetic procedures, and the clinicians must have a proactive approach.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-03-13T20:47:19+0100
      DOI: 10.1055/s-0035-1547522
  • Rhinosinusal Polyposis and Inverted Papilloma: A Morphometric Comparative

    • Authors: Andrade; Gabriel Costa, Fujise, Luciana Harumi, Fernandes, Atílio Maximino, Azoubel, Reinaldo
      Abstract: Introduction Nasal obstruction is one of the main rhinologic complaints, and two diseases must be investigated as differential diagnosis: rhinosinusal polyposis and inverted papilloma. Using traditional methods, the differential diagnosis between these diseases may be difficult. The morphometric study may be a useful tool for differential diagnosis and to define prognosis. Objective Calculate the morphometric values of rhinosinusal polyposis and inverted papilloma and compare the average of variables obtained between the groups. Methods The nasal mucus of 10 patients who had surgery in the Department of Otorhinolaryngology and Surgery of Head and Neck was studied; 5 had rhinosinusal polyposis and 5 had inverted papilloma. After the capture and print of corresponding data of each slide, the largest and smallest diameters of the nuclei were measured and the morphometric variables were calculated: average diameter, perimeter, ratio between largest and smallest diameter, volume, area, ratio of volume to area, form coefficient, contour index, and eccentricity. Results We found a significant difference (p 
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-03-12T14:52:00+0100
      DOI: 10.1055/s-0035-1547521
  • Study of the Hearing Threshold of Dance Teachers

    • Authors: Nehring; Cristiane, Bauer, Magda Aline, Teixeira, Adriane
      Abstract: Introduction High sound pressure levels can cause hearing loss, beginning at high frequencies. Objective To analyze the hearing thresholds of dance teachers. Methods This study had a cross-sectional, observational, prospective, and descriptive design. Conventional and high-frequency hearing evaluations were performed with dance teachers and subjects in the control group. Results In all, 64 individuals were assessed, 32 in the research group and 32 in the control group. Results showed that individuals in the research group had hearing loss at frequencies between 4 and 8 kHz, but no significant difference was found between groups. Frequency analysis showed that individuals in the control group had higher thresholds than individuals in the research group at the frequency of 0.25 kHz. In the control group, men showed higher thresholds than women at the frequency of 9 kHz. Conclusion A low prevalence of hearing loss was found, with no difference between teachers and subjects from the control group. No difference was found for hearing thresholds at high frequencies between groups. Results have been partially affected by sex.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-03-10T17:40:20+0100
      DOI: 10.1055/s-0035-1547519
  • Angiosarcoma of the Head and Neck

    • Authors: Mullins; Brandon, Hackman, Trevor
      Abstract: Introduction Angiosarcoma of the head and neck is a rare vascular sarcoma associated with high rates of local recurrence and distant metastasis and a poor prognosis. Objective We describe our experience treating patients with angiosarcoma of the head and neck to evaluate the outcomes, patterns of failure, and current treatments. Methods We identified six patients with angiosarcoma of the head and neck and treated at our institution between 2000 and 2013. We compared our results to the literature from 1979 to 2013. Results Mean follow-up was 42 months. Local recurrence rate was 50% with disease-specific survival and 2-year disease-free survival rates of 33.3 and 20%, respectively. Prognostic factors included tumor size > 5 cm and surgical margin status, with no correlation between histologic grade and survival. Combined-modality therapy was only used for aggressive tumors with positive surgical margins but is suggested to improve local control and overall survival. Conclusions Our data series supports that angiosarcoma of the head and neck has a high rate of recurrence and is associated with a poor prognosis, despite current combined-modality therapy. The study highlights the importance of attaining negative margins during surgical resection, the utility of adjuvant therapies, as well as the need for continued research in developing new management strategies.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-03-10T17:40:20+0100
      DOI: 10.1055/s-0035-1547520
  • Aspects of Oral Language, Speech, and Written Language in Subjects with
           Temporal Lobe Epilepsy of Difficult Control

    • Authors: Berberian; Ana Paula, Hopker, Christiane, Mazzarotto, Ingrid, Cunha, Jenane, Guarinello, Ana Cristina, Massi, Giselle, Crippa, Ana
      Abstract: Introduction About 50 million people have epilepsy and 30% of them have epilepsy that does not respond to properly conducted drug treatment. Objective Verify the incidence of language disorders in oral language, speech, and written language of subjects with difficult to control temporal lobe epilepsy (TLE) and compare the occurrence of these disorders in subjects before and after surgery. Methods Cross-sectional study with quantitative analysis, exploratory type. A questionnaire for data collection was administered covering the following aspects: oral language, speech complaints, and writing production and comprehension. Criteria for inclusion of subjects were a diagnosis of TLE refractory to drug treatment and at least 4 years of schooling. Results The sample of 63 patients with TLE was divided into two groups: presurgical (n = 31) and postsurgical (n = 32). In the postsurgical group, there was a higher frequency of left lobectomy (75%) than right (25%). Conclusion Statistical analysis was performed with the chi-square test (significance level of 0.05). Complaints related to speech-language attention were more predominant in postsurgical subjects. Analysis of oral language, speech, and written language in subjects with epilepsy who underwent temporal lobectomy or not showed findings consistent with symptoms related to transient aphasia, with the presence of paraphasias, as well as changes in speech prosody and melody. These symptoms appeared more associated with recurrence after having a temporal lobectomy.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-03-10T17:40:19+0100
      DOI: 10.1055/s-0035-1547524
  • Thickened Pituitary Stalk Associated with a Mass in the Sphenoidal Sinus:
           An Alarm to Suspect Hypophysitis by Immunoglobulin G4'

    • Authors: Batista; Rafael Loch, Ramos, Luciano Silva, Cescato, Valter Angelo, Musolino, Nina Rosa Castro, Borba, Clarissa Groberio, Silva, Gilberto Ochman, Moreno, Lilian Hupfeld, Cunha Neto, Malebranche Bernardo Carneiro
      Abstract: Introduction Hypophysitis is a chronic inflammation of the pituitary gland of complex and still incompletely defined pathogenesis. It belongs to the group of non-hormone-secreting sellar masses, sharing with them comparable clinical presentation and radiographic appearance. Objectives Describe the case of immunoglobulin G4 (IgG4)-related hypophysitis presenting as a mass in the sphenoid sinus. Resumed Report A 40-year-old Brazilian man had a diagnosis of central diabetes insipidus since 2001 associated with pituitary insufficiency. Pituitary magnetic resonance imaging revealed a centered pituitary stalk with focal nodular thickening and the presence of heterogeneous materials inside the sphenoid sinus. The patient was treated with testosterone replacement therapy. Laboratory results revealed increased IgG4 serum. Conclusion IgG4-related hypophysitis should be considered in patients with pituitary insufficiency associated with sellar mass and/or thickened pituitary stalk. IgG4 serum measurement for early diagnosis of IgG4-related hypophysitis should be performed.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-03-05T13:13:36+0100
      DOI: 10.1055/s-0034-1397333
  • Transient Evoked and Distortion Product Otoacoustic Emissions in a Group
           of Neonates

    • Authors: Silva; Giovanna Cesar, Delecrode, Camila Ribas, Kemp, Adriana Tahara, Martins, Fabiana, Cardoso, Ana Claudia Vieira
      Abstract: Introduction The most commonly used method in neonatal hearing screening programs is transient evoked otoacoustic emissions in the first stage of the process. There are few studies comparing transient evoked otoacoustic emissions with distortion product, but some authors have investigated the issue. Objective To correlate the results of transient evoked and distortion product otoacoustic emissions in a Brazilian maternity hospital. Methods This is a cross-sectional, comparative, and prospective study. The study included 579 newborns, ranging from 6 to 54 days of age, born in a low-risk maternity hospital and assessed for hearing loss. All neonates underwent hearing screening by transient evoked and distortion product otoacoustic emissions. The results were analyzed using the Spearman correlation test to relate the two procedures. Results The pass index on transient evoked otoacoustic emissions was 95% and on distortion product otoacoustic emissions was 91%. The comparison of the two procedures showed that 91% of neonates passed on both procedures, 4.5% passed only on transient evoked otoacoustic emissions, 0.5% passed only on distortion product otoacoustic emissions, and 4% failed on both procedures. The inferential analysis showed a significant strong positive relationship between the two procedures. Conclusion The failure rate was higher in distortion product otoacoustic emissions when compared with transient evoked; however, there was correlation between the results of the procedures.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-03-02T13:40:46+0100
      DOI: 10.1055/s-0035-1546431
  • Voice Outcome after Gore-Tex Medialization Thyroplasty

    • Authors: Elnashar; Ismail, El-Anwar, Mohammad, Amer, Hazem, Quriba, Amal
      Abstract: Introduction Although medialization thyroplasty utilizing Gore-Tex (Gore and Associates, Newark, Delaware, United States) has been discussed in the literature, few reports have assessed voice quality afterward, and they did not use a full assessment protocol. Objective To assess the improvement in voice quality after medialization thyroplasty utilizing Gore-Tex in patients with glottic insufficiency of variable etiology. Methods Eleven patients with glottic insufficiency of different etiologies that failed compensation were operated by type 1 thyroplasty utilizing Gore-Tex. Pre- and postoperative (1 week, 3 months, and 6 months) voice assessment was done and statistical analysis was performed on the results. Results In all postoperative assessments, there was significant improvement in the grade of dysphonia (p 
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-02-26T13:09:50+0100
      DOI: 10.1055/s-0034-1397339
  • Aglossia: Case Report

    • Authors: Bommarito; Silvana, Zanato, Luciana Escanoela, Vieira, Marilena Manno, Angelieri, Fernanda
      Abstract: Introduction Aglossia is a rare condition caused by failure of the tongue embryogenesis process (in the fourth to eighth weeks of gestation). The tongue is an organ used in different activities such as sucking, swallowing, chewing, and talking. It is also responsible for shaping palate dental arches (in its absence, they become atrophic). There are few similar cases reported in the literature. Objective To describe a rare case of aglossia and the multidisciplinary professionals working together for 5 years to treat the patient. Resumed Report An 8-year-old girl with aglossia had an assessment comprising: (1) clinical assessment of the stomatognathic system related to resting posture, tonus, and mobility; (2) orthodontic assessment; (3) surface electromyography of the chewing muscles; (4) swallowing videofluoroscopy. Conclusion The authors confirmed the need of multidisciplinary cooperation to improve the patient's quality of life, because agenesia implicates many activities/functions that depend on the tongue to fully work. Multiprofessional cooperation helps the patient learn compensation mechanisms.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-01-30T12:20:35+0100
      DOI: 10.1055/s-0034-1544116
  • Reflux Laryngitis: Correlation between the Symptoms Findings and Indirect

    • Authors: Silva; Carlos Eduardo Dilen da, Niedermeier, Bruno Taccola, Portinho, Fernando
      Abstract: Introduction The indirect laryngoscopy has an important role in the characterization of reflux laryngitis. Although many findings are nonspecific, some strongly suggest that the inflammation is the cause of reflux. Objective The aim of this study was to evaluate the correlation between reflux symptoms and the findings of indirect laryngoscopy. Methods We evaluated 27 patients with symptoms of pharyngolaryngeal reflux disease. Results Laryngoscopy demonstrated in all patients the presence of hypertrophy of the posterior commissure and laryngeal edema. The most frequent symptoms were the presence of dry cough and foreign body sensation. Conclusion There was a correlation between the findings at laryngoscopy and symptoms of reflux.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-01-09T14:23:44+0100
      DOI: 10.1055/s-0034-1399794
  • An Aggressive Plasmablastic Lymphoma of the Oral Cavity as Primary
           Manifestation of Acquired Immunodeficiency Syndrome: Case Report and
           Literature Review

    • Authors: Corti; Marcelo, Minué, Gonzalo, Campitelli, Ana, Narbaitz, Marina, Gilardi, Leonardo
      Abstract: Introduction Plasmablastic lymphoma is a rare entity that was first described in the jaws and the oral cavity of patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Plasmablastic lymphoma is considered as a diffuse, large, B-cell lymphoma with a unique phenotype and a predilection for the oral cavity. Objective The authors describe a case of an aggressive plasmablastic lymphoma of the oral cavity as the primary manifestation of AIDS. Resumed Report We report a case of plasmablastic lymphoma involving only the oral cavity as the first manifestation of AIDS. Diagnosis was confirmed by the oral lesion biopsy and the histopathologic examination that showed a dense infiltrate composed of atypical lymphocytes with numerous plasmocytes that expressed the plasma cell markers MUM-1 and CD138 and that were negative for the B-cell markers CD3, CD20, and CD45. Immunohistochemical and in situ hybridization revealed the Epstein-Barr virus genome in the atypical cells. Polymerase chain reaction was also positive for human herpesvirus-8 RNA. Conclusion The HIV serologic status should be evaluated in all patients with plasmablastic lymphoma of the oral cavity or extraoral sites.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-01-08T16:08:14+0100
      DOI: 10.1055/s-0034-1397335
  • Monitoring the Hearing Handicap and the Recognition Threshold of Sentences
           of a Patient with Unilateral Auditory Neuropathy Spectrum Disorder with
           Use of a Hearing Aid

    • Authors: Lima; Aline Patrícia, Mantello, Erika Barioni, Anastasio, Adriana Ribeiro Tavares
      Abstract: Introduction Treatment for auditory neuropathy spectrum disorder (ANSD) is not yet well established, including the use of hearing aids (HAs). Not all patients diagnosed with ASND have access to HAs, and in some cases HAs are even contraindicated. Objective To monitor the hearing handicap and the recognition threshold of sentences in silence and in noise in a patient with ASND using an HA. Resumed Report A 47-year-old woman reported moderate sensorineural hearing loss in the right ear and high-frequency loss of 4 kHz in the left ear, with bilateral otoacoustic emissions. Auditory brainstem response suggested changes in the functioning of the auditory pathway (up to the inferior colliculus) on the right. An HA was indicated on the right. The patient was tested within a 3-month period before the HA fitting with respect to recognition threshold of sentences in quiet and in noise and for handicap determination. After HA use, she showed a 2.1-dB improvement in the recognition threshold of sentences in silence, a 6.0-dB improvement for recognition threshold of sentences in noise, and a rapid improvement of the signal-to-noise ratio from +3.66 to −2.4 dB when compared with the same tests before the fitting of the HA. Conclusion There was a reduction of the auditory handicap, although speech perception continued to be severely limited. There was a significant improvement of the recognition threshold of sentences in silence and in noise and of the signal-to-noise ratio after 3 months of HA use.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2015-01-05T11:08:17+0100
      DOI: 10.1055/s-0034-1397338
  • The Effects of Unilateral Adaptation of Hearing Aids on Symptoms of
           Depression and Social Activity Constraints of Elderly

    • Authors: Santos; Fernanda Dutra dos, Teixeira, Adriane Ribeiro
      Abstract: Introduction Hearing loss is one of the most common problems in the elderly population. Besides compromising oral communication, it directly affects social relations and prevents elderly patients from living actively in society, possibly leading to the onset of depression or other conditions. Objective To analyze the effects of unilateral adaptation of hearing aids on symptoms of depression and the social activity constraints of elderly subjects with hearing impairment. Methods The sample consisted of elderly subjects with hearing loss who did not use hearing aids. Data were collected in two phases. Initially, all participants underwent an audiological assessment and answered the Hearing Handicap Inventory for Elderly (summarized version) and the Geriatric Depression Scale. All subjects participated in the selection and hearing aid adaptation processes and became monaural hearing aid users. After 30 days of hearing aid use, they were assessed with the same instruments. The results of the questionnaires before and after hearing aid adaptation were compared. Results The sample consisted of 13 individuals, between 60 and 90 years old (mean 72.85 ± 11.05 years). Data analysis showed that there was significant improvement in social activity constraints (p 
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-12-22T18:19:36+0100
      DOI: 10.1055/s-0034-1396792
  • 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
  • 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
  • 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
  • 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
  • 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
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