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Journal Cover   International Archives of Otorhinolaryngology
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   ISSN (Print) 1809-9777 - ISSN (Online) 1809-4864
   Published by Thieme Publishing Group Homepage  [173 journals]
  • International Archives of Otorhinolaryngology: 20 Years of Excellence!
    • Int Arch Otorhinolaryngol 2017; 21: 1-3
      DOI: 10.1055/s-0036-1596039

      Thieme-Revinter Publicações Ltda Rio de Janeiro, Brazil

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

      Int Arch Otorhinolaryngol 2017; 21: 1-32017-01-02T00:00:00+0100
      Issue No: Vol. 21, No. 01 (2017)
  • The Accuracy of Digital Radiography for Diagnosis of Fishbone Foreign
           Bodies in the Throat

    • Authors: Kasemsiri; Pornthep, Mahawerawat, Kanokkan, Ratanaanekchai, Teeraporn, Puttarak, Warinthorn, Munkong, Waranon
      Abstract: Introduction Some patients with a fishbone as a foreign body of difficult diagnosis may require further investigations. Generally, radiography is used as the first choice for finding the fishbone. Objective The objective of this study is to determine the accuracy of digital radiography for diagnosis of fishbone foreign body in the throat Methods This descriptive experimental study design has three phases. In the first phase, we assessed subject contrast and visibility of fishbone on a homogeneous background; as for the second phase, we evaluated the embedded fishbone in the fresh cadaver's throat. In the last phase, we studied the accuracy of radiography in diagnosing the fishbone foreign body at any site of the cadaver's throat. Results The subject contrast of 15 fishbones ranged from 0.94 to 0.99. All types of fishbone were obvious in the first phase, whereas, in the second phase, visibility of fishbone was varied. The subject contrast and diameter of fishbone did not show statistically significant correlation with visibility (p = 0.09 and p = 0.24, respectively). In the third phase, embedded fishbone in the base of tongue was detected with the highest accuracy (sensitivity of 1.00 (95%CI: 0.44–1.00) and specificity of 0.92 (95%CI: 0.65–0.99)); whereas, the tonsil was of difficult interpretation with poorest diagnostic value (sensitivity of 0.00 (95%CI: 0.00–0.56) and specificity of 1.00 (95%CI: 0.76–1.00)). Conclusion The digital radiography provides the highest accuracy and benefit to the diagnosis of a fishbone foreign body at the base of the tongue; whereas, the tonsil was of difficult interpretation.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-01-04T00:00:00+0100
      DOI: 10.1055/s-0036-1597811
  • Differentiating Benign from Malignant Sinonasal Lesions: Feasibility of
           Diffusion Weighted MRI

    • Authors: El-Gerby; Khaled M., El-Anwar, Mohammad Waheed
      Abstract: Introduction Appearance of nasal masses on routine CT and MRI are not pathognomonic. We utilized the apparent diffusion coefficient (ADC) value obtained from diffusion weighted image (DWI) to detect the differences in the microstructures of tumor and non-tumor tissues. Objective The objective of our study was to evaluate the diagnostic role of DWI and ADC values in differentiating between malignant and benign sinonasal lesions and its correlation with histopathological results as the reference standard. Methods Patients with nasal and / or paranasal mass underwent CT, MRI, and DWI before any surgical intervention. We used diagnostic sinonasal endoscopy and biopsy to confirm the diagnosis after MRI. Results When we used ADC value of (1.2 × 10–3 mm2/s) as a cut-off value for differentiating benign from malignant sinonasal lesions, we achieved 90% accuracy, 100% sensitivity, 88.4% specificity, 77.8% positive predictive value, and 100% negative predictive value. At this cut-off, benign lesions show statistically significant higher ADC value than malignant tumors. Conclusion DW MRI and ADC value calculation are promising quantitative methods helping to differentiate between malignant and benign sinonasal lesions. Thus, they are effective methods compared with other conventional methods with short imaging time thus it is recommended to be incorporated into routine evaluations.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-01-04T00:00:00+0100
      DOI: 10.1055/s-0036-1597323
  • HMGB1 in the Pathogenesis of Nasal Inflammatory Diseases and its
           Inhibition as New Therapeutic Approach: A Review from the Literature

    • Authors: Bellussi; Luisa Maria, Cocca, Serena, Passali, Giulio Cesare, Passali, Desideri
      Abstract: Introduction This study is a systematic review on recent developments about the importance of HMGB1 protein in the pathogenesis of rhino-sinusal inflammatory diseases. We also report data on the use of 18-β-glycyrrhetic acid (GA), which has been shown able to inhibit the pro-inflammatory activities of HMGB1, in young patients affected by allergic rhinitis and complaining of nasal obstruction as main symptom. Objectives The objective of this study was to review the literature to demonstrate the importance of HMGB1 in the pathogenesis of nasal inflammatory disorders and understand whether the inhibition of this protein may be an efficacious and innovative therapeutic strategy for patients with rhino-sinusal inflammation. Data Synthesis 
      Authors searched for pertinent articles indexed in PubMed, Scopus, and other health journals between 2004 and 2015.In total, the authors gathered 258 articles: 219 articles through Pubmed and 39 articles from other search engines. The search terms used were as follows: HMGB1 AND “respiratory epithelium,” “airway inflammation,” “rhinitis,” “allergic rhinitis,” “rhinosinusitis,” “nasal polyposis,” “glycyrrhetic acid,” “children.” Conclusions Patients with severe symptoms have the highest serum levels and the highest extracellular expression of HMGB1. GA inhibits HMGB1 chemotactic and mitogenic function by a scavenger mechanism on extracellular HMGB1 accumulation stimulated by lipopolysaccharides in vitro. Treatment of allergic rhinitis with GA is not associated with local or systemic side effects in children and adults.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-01-04T00:00:00+0100
      DOI: 10.1055/s-0036-1597665
  • Late-term Effects of Surgery on Nasal Functions in Patients who Underwent
           Total Laryngectomy Surgery

    • Authors: Karaoglu; Deniz, Kocyigit, Murat, Ortekin, Safiye Giran, Adali, Mustafa Kemal
      Abstract: Introduction There is a common opinion that losing airway functions in total laryngectomy patients cause changes in nasal physiological rates. Studies conducted to review the subject present gaps, especially in terms of objective measurements. Objective We evaluated late-term effects of surgery on nasal functions in patients who underwent total laryngectomy surgery more than two years ago. Methods We included in the study 22 patients who had undergone total laryngectomy, as well as 24 healthy subjects with similar demographic characteristics as the control group. We performed acoustic rhinometry for intranasal volume and cross-sectional area measurements, saccharin test for measurement of nasal mucociliary clearance, and smell identification test for evaluation of olfactory function in the patient and control groups. We compared and statistically analyzed the data obtained from the groups. Results In our study, although late-term (>2 years) measurements were not statistically significant, we detected more nasal passage patency in the patient group than in the control group. In smell identification test, lower scores were obtained in the patient group. The difference between measurements in both groups was statistically significant. Conclusion We believe that since the upper respiratory tract is disabled due to tracheostomy in patients with total laryngectomy, atrophy occurs in the late term and, consequently, nasal mucociliary clearance is impaired. We also see diminished olfactory function in total laryngectomy patients.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-01-04T00:00:00+0100
      DOI: 10.1055/s-0036-1597972
  • Prof. Dr. Aroldo Miniti – A Great Master
    • Int Arch Otorhinolaryngol 2016; 20: 291-293
      DOI: 10.1055/s-0036-1592419

      Thieme Publicações Ltda Rio de Janeiro, Brazil

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

      Int Arch Otorhinolaryngol 2016; 20: 291-2932016-10-13T00:00:00+01:00
      Issue No: Vol. 20, No. 04 (2016)
  • Primary Concurrent Chemoradiation in Head and Neck Cancers with Weekly
           Cisplatin Chemotherapy: Analysis of Compliance, Toxicity and Survival

    • Authors: Iqbal; Muhammad Shahid, Chaw, Cheng, Kovarik, Josef, Aslam, Shahzeena, Jackson, Aaron, Kelly, John, Dobrowsky, Werner, Kelly, Charles
      Abstract: Introduction Concurrent chemoradiation is the standard of care in inoperable locally advanced squamous cell head and neck cancers. The most widely accepted schedule of concomitant cisplatin is 100mg/m2 given on a 3 weekly basis but the optimal regime is unknown. Objective The objective of this study is to assess the tolerability, compliance, and clinical outcomes of weekly cisplatin (40mg/m2). Methods During the period of January 2007–December 2009, we analyzed retrospectively 122 patients with histologically proven squamous cell carcinoma of head and neck (nasopharynx, oropharynx, larynx, hypopharynx, and oral cavity) treated with definitive chemoradiation. All patients received 63 Gy in 30 daily fractions with concomitant weekly cisplatin 40mg/m2. We assessed treatment toxicities and patient compliance. We estimated overall survival using the Kaplan-Meier method. Results Sixty-eight percent of patients managed to complete all six cycles of chemotherapy while 87% of patients completed at least 5 cycles of weekly cisplatin. Incidence of grade 3/4 toxicity was as follows: mucositis 33%, dermatitis 41%, dysphagia 15%, mouth/neck pain 17%, neutropenia 2%, and renal impairment 3%. 53% patients required at least one hospital admission for symptom control. The 5-year overall survival rate was 60%. Conclusion Concurrent chemoradiotherapy using weekly cisplatin at 40mg/m2 per week is an effective, well tolerated regimen allowing most patients to receive at least 5 cycles of chemotherapy. However, a phase III randomized control trial comparing the standard dose of 100mg/m2 cisplatin tri-weekly with a weekly regimen is needed to establish the long term clinical outcome.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-12-19T00:00:00+0100
      DOI: 10.1055/s-0036-1594020
  • Perception of Noise Pollution in a Youth and Adults School in Curitiba-PR

    • Authors: Borges Filho; Orlando, Ribas, Angela, Gonçalves, Claudia Giglio De Oliveira, Lacerda, Adriana Bender Moreira, Riesemberg, Renato, Klagenberg, Karlin
      Abstract: Introduction Nowadays noise remains the third largest cause of environmental pollution on Earth. It appears that despite the existing noise control legislation the issue deserves further supervision by the public authorities so that the ceilings established for the various activities are observed. People exposed to noise are more likely to develop numerous auditory and non-auditory problems directly impacting persona family and working life. Objectives The objective of this study is to research and consequently understand how the population of students of a youth and adult school in Curitiba perceives noise pollution as well as look into the actions that the school adopts in order to guide the students on the topic. Method We applied a structured questionnaire to 120 individuals and assessed the following variables: characterization of the place of residence occupation leisure health and perception of soundscapes. We also applied a closed questionnaire about educational actions for noise pollution to the school's geography teacher. Results Questionnaire responses show that people perceive noise in the most diverse environments they frequent and are able to identify the source of the noise but this perception proved fragile as the majority does not take measures to prevent or mitigate these noises. At school there are no actions aimed at environmental education on the subject studied. Conclusion The studied group does not perceive the noise as a harmful agent and does not prevent themselves from it and the school not work contents related to noise pollution leaving a significant gap in the awareness process of this population.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-12-19T00:00:00+0100
      DOI: 10.1055/s-0036-1597118
  • Evaluation of the Prevalence of Maxillary Sinuses Abnormalities through
           Spiral Computed Tomography (CT)

    • Authors: Drumond; João Paulo Nunes, Allegro, Bruna Bianca, Novo, Neil Ferreira, de Miranda, Sérgio Luís, Sendyk, Wilson Roberto
      Abstract: Introduction Maxillary sinus disease is common and numerous disorders can affect this anatomical area. Abnormalities can be classified as: non-neoplastic, neoplastic benign, and neoplastic malignant. Objective Evaluate through CT the prevalence of diseases in maxillary sinuses, using the Radiology Department's database of a hospital in São Paulo city. Methods The sample consisted of 762 facial CT scans that we divided into three groups: Group A (12–19 years old); Group B (20–49 years old); Group C (above 50 years old); and male or female. We considered the following pathological processes: I - Mucoperiosteal Thickening; II - Chronic Sinusitis; III - Chronic Odontogenic Sinusitis; IV - Rhinosinusitis; V - Polypoid Lesions; VI - Bone Lesions; VII - Neoplasms; VIII - Antrolith; IX - Foreign Bodies; X - Oroantral Fistula. Results Our study found that 305 exams (40.02%) were normal and 457 exams (59.97%) were abnormal. We found the following disease frequencies: focal mucoperiosteal thickening (21.25%); polypoid lesions (10.76%); chronic sinusitis (7.48%); chronic odontogenic sinusitis (2.29%); neoplasms (2.03%); rhinosinusitis (1.77%); bone lesions, foreign bodies and oroantral fistula in 0.65%; 0.13% and 0.06% respectively. There was no significant difference between male and female, and Groups A, B, or C when relating the frequencies of abnormalities found. There was no significant difference between male and female and the age group for the side of the altered maxillary sinus. Conclusion We observed a high prevalence of sinus maxillary diseases. Mucoperiosteal thickening; acute, chronic, and odontogenic sinusitis; polypoid lesions and neoplasms have high prevalence in maxillary sinuses. Thus, facial CT exam was effective for the evaluation of diseases in maxillary sinuses.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-12-16T00:00:00+0100
      DOI: 10.1055/s-0036-1593834
  • Study of Various Prognostic Factors Affecting Successful Myringoplasty in
           a Tertiary Care Centre

    • Authors: Dangol; Kripa, Shrivastav, Rakesh Prasad
      Abstract: Introduction Myringoplasty is a commonly performed otologic surgery. Objectives The objective of this study is to evaluate the effect of prognostic factors like - size, site of perforation, status of operating ear, approach, status of contralateral ear, experience of surgeon, primary or revision myringoplasty, and smoking in graft uptake, as well as to evaluate the hearing results after myringoplasty. Methods This is a prospective study. We included in our sample patients aged over 13 years with a Tubotympanic Chronic Otitis Media diagnosis. The patients underwent preoperative evaluation and Pure Tone Audiogram within one week prior to surgery. We performed myringoplasty using temporalis fascia graft with conventional underlay technique. We evaluated postoperative graft uptake and various factors related to the study and did a Pure Tone Audiogram at one year after surgery. Results The graft uptake rate after myringoplasty was 83.1% at one year in 219 patients. Graft uptake with normal opposite ear was 88.2%, and with Tubotympanic Chronic Otitis Media was 75% (statistically significant). We found no statistically significant difference in graft uptake results with other factors. We calculated hearing results of 132 patients with normal ossicular status who underwent myringoplasty. The average Air Conduction Threshold improvement was 11.44dB (p 
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-11-28T00:00:00+0100
      DOI: 10.1055/s-0036-1593818
  • Effectiveness of Low Cut Modified Amplification using Receiver in the
           Canal Hearing Aid in Individuals with Auditory Neuropathy Spectrum

    • Authors: Prabhu; Prashanth, Barman, Animesh
      Abstract: Introduction The studies on hearing aid benefit in individuals with auditory neuropathy spectrum disorder (ANSD) shows limited benefit. Low cut modified amplification is found to be effective in few individuals with ANSD. With advancement in technology, receiver in the canal (RIC) hearing aids have proven to be more effective than traditional behind the ear (BTE) hearing aids. Objective Thus, the present study attempts to determine the effectiveness of low cut modified amplification using RIC and BTE. Method Twenty participants with ANSD were fitted with BTE and RIC using traditional and low cut modified amplification. We divided them into good and poor performers based on unaided speech identification scores (SIS). We then compared aided SIS and aided benefit across conditions in good and poor performers with ANSD across both conditions using BTE and RIC. Results The results of the study showed that the aided performance improved with low cut modified amplification in both BTE and RIC hearing aids. The improvement noticed with low-cut modified fitting with RIC was significant in more than BTE, especially in good performers with ANSD. Conclusion The improved clarity and naturalness of sound with RIC may have led to better aided scores and better acceptance of the hearing aid. Thus, low-cut modified amplification, preferably with RIC, needs to be attempted in fitting individuals with ANSD, especially in those with good unaided SIS in quiet.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-11-22T00:00:00+0100
      DOI: 10.1055/s-0036-1593471
  • Fibrotic Tissue and Middle Turbinate Exhibit Similar Mechanical
           Properties. Is Fibrosis a Solution in Nasal Polyposis'

    • Authors: Gregório; Luciano, Pezato, Rogério, Felici, Rafael Souza, Kosugi, Eduardo Macoto
      Abstract: Introduction Nasal polyposis (NP) is a chronic inflammatory condition of the upper airway characterized by overgrowth of nasal mucosa. Recent studies have shown a mechanical dysfunction in the nasal polyp tissue. Objective This study aims to evaluate the mechanical properties of nasal fibrotic tissue. Method This study was an institutional review board approved translational study in 20 participants (8 patients with NP, 7 patients with nasal synechiae, and 5 subjects without sinus disease (control group). We used Controlled Disc Stimulation equipment to compare the curve Pressure/Volume created during the saline solution infusion. Results The increase of pressure in response to solution injection was lower in the nasal polyp group when compared with control middle turbinate group and fibrotic group. No significant difference was found in the pressure response during solution injection between fibrotic group and control middle turbinate group.Inferior turbinate group showed significant difference when compared with control middle turbinate group. Conclusion The mechanical dysfunction found in the nasal mucosa of patients with NP provides new insight into this condition. These data allow the belief that the fibrosis has a potential role in increasing interstitial hydrostatic pressure and, consequently, mitigating edema formation in NP.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-10-26T00:00:00+01:00
      DOI: 10.1055/s-0036-1593728
  • The Impact of Tobacco Smoking Upon Chronic/Recurrent Tonsillitis and Post
           Tonsillectomy Bleeding

    • Authors: Cinamon; Udi, Goldfarb, Abraham, Marom, Tal
      Abstract: Introduction Smoking has many adverse effects on the oral and pharyngeal mucosa. Outcomes may be developing tonsillar infections and predisposing for post tonsillectomy bleeding (PTB). Objective The objective of our study was to determine whether smokers have more chronic/recurrent tonsillitis indicating for tonsillectomy or develop more PTB episodes. Methods We conducted a retrospective study on two groups of adults (age ≥18 years). Cohort 1: Smoking among patients who underwent tonsillectomy for recurrent/chronic tonsillitis. Cohort 2: Smoking among patients requiring control of PTB that were operated primarily for recurrent/chronic tonsillitis. Cohort 1 served as a population-reference for the second. We retrieved the data from medical records. Results Cohort 1: 206 adults aged 18–50 years (mean 26 ± 7.6). 28% (57 patients) were smokers, versus 24% and 20% in the general population (in the years 2000 and 2010; p = 0.5, p = 0.18, respectively). Cohort 2: 114 adults aged 18–73 years (mean 26 ± 7.6). 43% were smokers, double the incidence in the general population (p = 0.004, p = 0.0004, in 2000 and 2010, respectively), and 1.5 times cohort 1 (p = 0.02). Smoking rates among bleeders on post-operative days 8–10 and later than day 10 were 53% and 60% (p = 0.0005 and p 
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-10-26T00:00:00+01:00
      DOI: 10.1055/s-0036-1593835
  • Pathophysiology and Diagnosis of Vertebrobasilar Insufficiency: A Review
           of the Literature

    • Authors: Lima Neto; Arlindo Cardoso, Bittar, Roseli, Gattas, Gabriel Scarabotolo, Bor-Seng-Shu, Edson, Oliveira, Marcelo de Lima, Monsanto, Rafael da Costa, Bittar, Luis Felipe
      Abstract: Introduction Vertebrobasilar insufficiency is defined as transitory ischemia of the vertebrobasilar circulation. Dizziness, vertigo, headaches, vomit, diplopia, blindness, ataxia, imbalance, and weakness in both sides of the body are the most common symptoms. Objective To review the literature regarding the three available diagnostic testing in patients with dizziness complaints secondary to vertebrobasilar insufficiency (VBI): magnetic resonance angiography; transcranial Doppler ultrasound; and vertebrobasilar deprivation testing. Data Synthesis We selected 28 studies that complied with our selection criteria for appraisal. The most frequent cause of the hemodynamic changes leading to VBI is atherosclerosis. The main clinical symptoms are dizziness, vertigo, headaches, vomit, diplopia, blindness, ataxia, imbalance, and weakness in both sides of the body. Even though arteriography is considered the most important exam to diagnose the disease, the inherent risks of this exam should be taken into consideration. The magnetic resonance angiography has been widely studied and is a good method to identify and localize any occlusions and stenosis in both neck and intracranial great vessels. Conclusion Each patient with a suspected diagnosis of VBI should be individually evaluated and treated, taking in consideration the pros and cons of each diagnostic testing and treatment option.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-10-26T00:00:00+01:00
      DOI: 10.1055/s-0036-1593448
  • Relation between Ossicular Erosion and Destruction of Facial and Lateral
           Semicircular Canals in Chronic Otitis Media

    • Authors: Bulğurcu; Suphi, Arslan, İlker Burak, Dikilitaş, Bünyamin, Çukurova, İbrahim
      Abstract: Introduction Chronic otitis media can cause multiple middle ear pathogeneses. The surgeon should be aware of relation between ossicular chain erosion and other destructions because of the possibility of complications. Objective This study aimed to investigate the rates of ossicular erosion in cases of patients with and without facial nerve canal destruction, who had undergone mastoidectomy due to chronic otitis media with or without cholesteatoma. Methods We retrospectively analyzed three hundred twenty-seven patients who had undergone tympanomastoidectomy between April 2008 and February 2014. We documented the types of mastoidectomy (canal wall up, canal wall down, and radical mastoidectomy), erosion of the malleus, incus and stapes, and the destruction of facial and lateral semi-circular canal. Results Out of the 327 patients, 147 were women (44.95%) and 180 were men (55.04%) with a mean age 50.8 ± 13 years (range 8–72 years). 245 of the 327 patients (75.22%) had been operated with the diagnosis of chronic otitis media with cholesteatoma. FNCD was present in 62 of the 327 patients (18.96%) and 49 of these 62 (79.03%) patients had chronic otitis media with cholesteatoma. The correlation between the presence of FNCD with LSCC destruction and stapes erosion in chronic otitis media with cholesteatoma is statistically significant (p 
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-09-14T00:00:00+01:00
      DOI: 10.1055/s-0036-1592417
  • A Comparative Study on Hearing Aid Benefits of Digital Hearing Aid Use
           (BTE) from Six Months to Two Years

    • Authors: Verma; Lukeshwari, Sanju, Himanshu Kumar, Scaria, Bibina, Awasthi, Mayank, Ravichandran, Aparna, Kaki, Ashritha, Prakash, Savalam Gnana Rathna
      Abstract: Introduction For many reasons, it is important for audiologists and consumers to document improvement and benefit from amplification device at various stages of uses of amplification device. Professional are also interested to see the impact of amplification device on the consumer's auditory performance at different stages i.e. immediately after fitting and over several months of use. Objective The objective of the study was to measure the hearing aid benefit following 6 months – 1-year usage, 1 year – 1.5 yeaŕs usage, and 1.5 yeaŕs – 2 years' usage. Methods A total of 45 subjects participated in the study and were divided equally in three groups: hearing aid users from 6 months to 1 year, 1 year to 1.5 year, and 1.5 year to two years. All subjects responded to the Hearing Aid Benefit Questionnaire (63 questions), which assesses six domains of listening skills. Result Results showed the mean scores obtained were higher for all domains in the aided condition, as compared with unaided condition for all groups. Results also showed a significant improvement in the overall score between first-time users with hearing aid experience of six months to one year and hearing aid users using hearing aids for a period between 1.5 and 2 years. Conclusion It is possible to conclude that measuring the hearing aid benefit with the self-assessment questionnaires will assist the clinicians in making judgments about the areas in which a patient is experiencing more difficulty in everyday listening environment and in revising the possible technologies.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-09-02T00:00:00+01:00
      DOI: 10.1055/s-0036-1592117
  • Auditory Evoked Potential Mismatch Negativity in Normal-Hearing Adults

    • Authors: Schwade; Laura Flach, Didoné, Dayane Domeneghini, Sleifer, Pricila
      Abstract: Introduction Mismatch Negativity (MMN) corresponds to a response of the central auditory nervous system. Objective The objective of this study is to analyze MMN latencies and amplitudes in normal-hearing adults and compare the results between ears, gender and hand dominance. Methods This is a cross-sectional study. Forty subjects participated, 20 women and 20 men, aged 18 to 29 years and having normal auditory thresholds. A frequency of 1000Hz (standard stimuli) and 2000Hz (deviant stimuli) was used to evoked the MMN. Results Mean latencies in the right ear were 169.4ms and 175.3ms in the left ear, with mean amplitudes of 4.6µV in the right ear and 4.2µV in the left ear. There was no statistically significant difference between ears. The comparison of latencies between genders showed a statistically significant difference for the right ear, being higher in the men than in women. There was no significant statistical difference between ears for both right-handed and left-handed group. However, the results indicated that the latency of the right ear was significantly higher for the left handers than the right handers. We also found a significant result for the latency of the left ear, which was higher for the right handers. Conclusion It was possible to obtain references of values for the MMN. There are no differences in the MMN latencies and amplitudes between the ears. Regarding gender, the male group presented higher latencies in relation to the female group in the right ear. Some results indicate that there is a significant statistical difference of the MMN between right- and left-handed individuals.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-09-02T00:00:00+01:00
      DOI: 10.1055/s-0036-1586734
  • Sudden Sensorioneural Hearing Loss and Autoimmune Systemic Diseases

    • Authors: Rossini; Bruno Almeida Antunes, Penido, Norma de Oliveira, Munhoz, Mario Sergio Lei, Bogaz, Eduardo Amaro, Curi, Renata Souza
      Abstract: Introduction Several authors have demonstrated the relationship between sudden sensorineural hearing loss (SNHL) and systemic autoimmune diseases (SAD). Immune-mediated SNHL can rarely present as unilateral sudden SNHL and manifests itself in the contralateral ear only after years. It presents clinical relevance for being one of the few SNHL that may be reversible given that early and appropriate treatment is applied. Objective The objective of this study is to describe the clinical presentations and audiological findings from patients with idiopathic sudden SNHL and SAD associated with a probable diagnosis of immune-mediated SNHL. Furthermore, we strive to estimate the prevalence of SAD in patients with sudden SNHL. Methods This is an observational retrospective cohort. We have selected and studied patients with SAD. Revision of available literature on scientific repositories. Results We evaluated 339 patients with sudden SNHL. Among them, 13 (3.83%) patients suffered from SAD. Three patients had bilateral involvement, a total of 16 ears. We evaluate and describe various clinical, epidemiological, and audiological aspects of this sample. Conclusion In our sample of patients with sudden SNHL, the prevalence of SAD was found relevant. The majority had tinnitus and dizziness concomitant hearing loss, unilateral involvement and had experienced profound hearing loss at the time of the installation. In spite of instituted treatment, most cases showed no improvement in audiometric thresholds. Apparently, patients with sudden SNHL and SAD have a more severe initial impairment, higher percentage of bilateral, lower response to treatment, and worse prognosis than patients with sudden SNHL of unknown etiology.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-07-26T00:00:00+01:00
      DOI: 10.1055/s-0036-1586162
  • Auditory Speech Perception Development in Relation to Patient's Age with
           Cochlear Implant

    • Authors: Ciscare; Grace Kelly Seixas, Mantello, Erika Barioni, Fortunato-Queiroz, Carla Aparecida Urzedo, Hyppolito, Miguel Angelo, Reis, Ana Cláudia Mirândola Barbosa dos
      Abstract: Introduction A cochlear implant in adolescent patients with pre-lingual deafness is still a debatable issue. Objective The objective of this study is to analyze and compare the development of auditory speech perception in children with pre-lingual auditory impairment submitted to cochlear implant, in different age groups in the first year after implantation. Method This is a retrospective study, documentary research, in which we analyzed 78 reports of children with severe bilateral sensorineural hearing loss, unilateral cochlear implant users of both sexes. They were divided into three groups: G1, 22 infants aged less than 42 months; G2, 28 infants aged between 43 to 83 months; and G3, 28 older than 84 months. We collected medical record data to characterize the patients, auditory thresholds with cochlear implants, assessment of speech perception, and auditory skills. Results There was no statistical difference in the association of the results among groups G1, G2, and G3 with sex, caregiver education level, city of residence, and speech perception level. There was a moderate correlation between age and hearing aid use time, age and cochlear implants use time. There was a strong correlation between age and the age cochlear implants was performed, hearing aid use time and age CI was performed. Conclusion There was no statistical difference in the speech perception in relation to the patient's age when cochlear implant was performed. There were statistically significant differences for the variables of auditory deprivation time between G3 - G1 and G2 - G1 and hearing aid use time between G3 - G2 and G3 - G1.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-07-20T00:00:00+01:00
      DOI: 10.1055/s-0036-1584296
  • Methods of Hearing Preservation during Cochlear Implantation

    • Authors: Khater; Ahmed, El-Anwar, Mohammad Waheed
      Abstract: Introduction Recent advances in surgical techniques and electrode design have made residual hearing preservation during cochlear implantation (CI) possible, achievable, and desirable. Objectives The objective of this study was to review the literature regarding methods used for hearing preservation during CI surgery. Data Synthesis We performed a search in the LILACS, MEDLINE, SciELO, PubMed databases, and Cochrane Library, using the keywords CI, hearing preservation, CI electrode design, and CI soft surgery. We fully read about 15 studies that met the criteria described in “study selection”. The studies showed that several factors could contribute to possible cochlear damage during or after CI surgery and must be kept in mind; mechanical damage during electrode insertion, shock waves in the perilymph fluid due to implantation, acoustic trauma due to drilling, loss of perilymph and disruption of inner ear fluid homeostasis, potential bacterial infection, and secondary intracochlear fibrous tissue formation. The desire to preserve residual hearing has led to the development of the soft-surgery protocols with its various components; avoiding entry of blood into the cochlea and the use of hyaluronate seem to be reasonably supported, whereas the use of topical steroids is questionable. The site of entry into the cochlea, electrode design, and the depth of insertion are also important contributing factors. Conclusion Hearing preservation would be useful for CI patients to benefit from the residual low frequency, as well as for the children who could be candidate for future regenerative hair cell therapy.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-07-12T00:00:00+01:00
      DOI: 10.1055/s-0036-1585094
  • Longitudinal Comparison of Auditory Steady-State Evoked Potentials in
           Preterm and Term Infants: The Maturation Process

    • Authors: Sousa; Ana Constantino, Didoné, Dayane Domeneghini, Sleifer, Pricila
      Abstract: Introduction Preterm neonates are at risk of changes in their auditory system development, which explains the need for auditory monitoring of this population. The Auditory Steady-State Response (ASSR) is an objective method that allows obtaining the electrophysiological thresholds with greater applicability in neonatal and pediatric population. Objective The purpose of this study is to compare the ASSR thresholds in preterm and term infants evaluated during two stages. Method The study included 63 normal hearing neonates: 33 preterm and 30 term. They underwent assessment of ASSR in both ears simultaneously through insert phones in the frequencies of 500 to 4000Hz with the amplitude modulated from 77 to 103Hz. We presented the intensity at a decreasing level to detect the minimum level of responses. At 18 months, 26 of 33 preterm infants returned for the new assessment for ASSR and were compared with 30 full-term infants. We compared between groups according to gestational age. Results Electrophysiological thresholds were higher in preterm than in full-term neonates (p  0.05) in all the variables described. Conclusion In the first evaluation preterm had higher thresholds in ASSR. There was no difference at 18 months of age, showing the auditory maturation of preterm infants throughout their development.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-07-01T00:00:00+01:00
      DOI: 10.1055/s-0036-1584888
  • Treatment Challenges of Group A Beta-hemolytic Streptococcal

    • Authors: Brook; Itzhak
      Abstract: Introduction Despite its in vitro efficacy, penicillin often fails to eradicate Group A β-hemolytic streptococci (GABHS) from patients with acute and relapsing pharyngo-tonsillitis (PT). Objective This review of the literature details the causes of penicillin failure to eradicate GABHS PT and the therapeutic modalities to reduce and overcome antimicrobial failure. Data Synthesis The causes of penicillin failure in eradicating GABHS PT include the presence of β lactamase producing bacteria (BLPB) that “protect” GABHS from any penicillin; the absence of bacteria that interfere with the growth of GABHS; co-aggregation between GABHS and Moraxella catarrhalis; and the poor penetration of penicillin into the tonsillar tissues and the tonsillo-pharyngeal cells, which allows intracellular GABHS and Staphylococcus aureus to survive. The inadequate intracellular penetration of penicillin can allow intracellular GABHS and S. aureus to persist. In the treatment of acute tonsillitis, the use of cephalosporin can overcome these interactions by eradicating aerobic BLPB (including M. catarrhalis), while preserving the potentially interfering organisms and eliminating GABHS. Conclusion In treatment of recurrent and chronic PT, the administration of clindamycin, or amoxicillin-clavulanic acid, can eradicate both aerobic and anaerobic BLPB, as well as GABHS. The superior intracellular penetration of cephalosporin and clindamycin also enhances their efficacy against intracellular GABHS and S. aureus.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-06-03T00:00:00+01:00
      DOI: 10.1055/s-0036-1584294
  • Frequency of Serous Otitis Media in Children without Otolaryngological

    • Authors: Kocyigit; Murat, Ortekin, Safiye Giran, Cakabay, Taliye, Ozkaya, Guven, Bezgin, Selin Ustun, Adali, Mustafa Kemal
      Abstract: Introduction Otitis media with effusion is the fluid in the middle ear with no signs or symptoms of acute ear infection. Objective This study aims to research the frequency of serous otitis media in patients referred to the pediatric clinic between 3–16 years of age without any active ear, nose, and throat complaints. Methods This study included 589 children patients (280 boys, 309 girls; mean age: 9.42; range 3–16) who were administered to the pediatric clinic without otolaryngologic complaints. Patients underwent examination with flexible nasopharyngoscopy for adenoid hypertrophy. An otorhinolaryngologist examined all children on both ears using an otoscope and tested with tympanometry. We used tympanometry results to diagnose SOM. Results The study included 589 patients that underwent fiber optic examination of the nasopharynx with an endoscope. Adenoid vegetation was present in 58 patients (9.8%) and was not detected in 531 patients (90.2%). We found serous otitis media in 94 (15.9%) patients. We obtained Type A tympanogram in 47 (81%) of 58 patients with adenoid vegetation, 6 (10.3%) Type B, and 5 (8.6%) Type C. When comparing 58 patients with adenoid vegetation with 538 patients without adenoid vegetation for serous otitis media, the frequency was not statistically significant (p > 0.05). Conclusion We believe that in children without any ear, nose, and throat complaints, it is possible to detect serous otitis media with adenoid vegetation. Thus, pediatric patients should undergo screening at regular intervals.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-06-03T00:00:00+01:00
      DOI: 10.1055/s-0036-1584362
  • Parental Expectation from Children with Cochlear Implants in Indian
           Context: a Questionnaire Based Study

    • Authors: Kumar; Prawin, Sanju, Himanshu Kumar, Mishra, Rajkishor, Singh, Varun, Mohan, Priyanka
      Abstract: Introduction Parental support is important in the habilitation/rehabilitation of children using cochlear implant devices. Hence, it is important for families to know the realistic expectations regarding outcomes from CIs. Objective The objective of the present study is to know the parents' expectation from children using CIs. Methods For this study, we recruited 23 parents of children using CIs. We administered 15 questions translated in to Hindi related to communication abilities, social skills, academic achievement, change in future life, rehabilitation demand, and stress due to hearing impairment. Results The response of the questions (5-point rating scale) related to communication abilities showed that parents were expecting children using CIs to use the telephone (95%), to be able to detect soft sounds (99%), to listen in crowds (86%), to be able to easily understand others (76%), and to show improvement in communication skills (78%). Similarly, for questions related to social skills showed 90% of the parents expecting that their children with CIs should be able to easily make friends with normal hearing peers, and 80% of the parents were expecting the children to achieve high standards in their reading and writing skills. Questions related to change in future life showed 86% of the parents expecting their children with CIs to act like normal hearing children. Further, 78% parents showed positive response regarding importance of intensive training. However, 70% of the parents reported stress in the family due to the existence of the hearing impaired child. Conclusion Overall, the existing questionnaire-based study showed that parents have high expectations from their children with cochlear implant.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-05-30T00:00:00+01:00
      DOI: 10.1055/s-0036-1584228
  • Use of an Osteoplastic Flap for the Prevention of Mastoidectomy
           Retroauricular Defects

    • Authors: Bento; Ricardo Ferreira, Tsuji, Robinson Koji, Fonseca, Anna Carolina de Oliveira, Alves, Ricardo Dourado
      Abstract: Introduction After mastoidectomy, patients usually complain of bone depressions in the retroauricular region in the surgical site, especially in procedures that require extensive cortical resections. This causes inconveniences such as difficulty wearing glasses, cleaning, and aesthetics complaints. Objective This study aims to describe a vascularized flap surgical technique that uses the mastoid cortical bone adhered to the periosteum, which is pedicled on the anterior portion and repositioned at the end of the surgery. This ensures the coverage of the mastoid cavity generated by surgery and prevents ear retraction into the cavity. This preliminary report describes the technique and intraoperative and immediate postoperative complications. Methods After retroauricular incision, periosteal exposure is performed. A U-shaped incision is required for the procedure and delimits a periosteum area appropriate to the size of the mastoidectomy. The cortical bone is opened using a 2.5 mm drill around the perimeter of the “U,” at a 3 mm depth. A chisel is introduced through the surface cells of the mastoid, and a hammer evolves into the anterior direction. The flap is lifted, leaving the periosteum adhered to it and forming a cap. The flap is anteriorly fixed to not hinder the surgery, and repositioned at the end. The periosteum is then sutured to the adjacent periosteum. Results The first 14 cases had no intraoperative complications and were firm and stable when digital pressure was applied during the intraoperative and immediate postoperative periods. Conclusion The osteoplastic flap pedicle is a safe and simple procedure, with good results in the immediate postoperative period.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-05-30T00:00:00+01:00
      DOI: 10.1055/s-0036-1584266
  • Psychoacoustic Characteristics of Tinnitus versus Temporal Resolution in
           Subjects with Normal Hearing Sensitivity

    • Authors: Ibraheem; Ola Abdallah, Hassaan, Mohammad Ramadan
      Abstract: Introduction Cochlear or neural mechanisms of tinnitus generation may affect auditory temporal resolution in tinnitus patients even with normal audiometry. Thus, studying the correlation between tinnitus characteristics and auditory temporal resolution in subjects with tinnitus may help in proper modification of tinnitus management strategy. Objective This study aims to examine the relationship between the psychoacoustic measures of tinnitus and the auditory temporal resolution in subjects with normal audiometry. Methods Two normal hearing groups with ages ranging from 20 to 45 years were involved: control group of 15 adults (30 ears) without tinnitus and study group of 15 adults (24 ears) with tinnitus. Subjective scaling of annoyance and sleep disturbance caused by tinnitus, basic audiological evaluation, tinnitus psychoacoustic measures and Gaps in Noise test were performed. Data from both groups were compared using independent sample t-test. Psychoacoustic measures of tinnitus and Gaps in Noise test parameters of the tinnitus group were correlated with Pearson's correlation coefficient. Results Significantly higher hearing threshold, higher approximate threshold and lower correct Gaps in Noise scores were observed in tinnitus ears. There was no significant correlation between psychoacoustic measures of tinnitus and Gaps in Noise test parameters of the tinnitus group. Conclusion Auditory temporal resolution impairment was found in tinnitus patients, which could be attributed to cochlear impairment or altered neural firing within the auditory pathway. It is recommended to include temporal resolution testing in the tinnitus evaluation battery to provide a proper management planning.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-05-05T00:00:00+01:00
      DOI: 10.1055/s-0036-1583526
  • Outcomes of Late Implantation in Usher Syndrome Patients

    • Authors: Hoshino; Ana Cristina H., Echegoyen, Agustina, Goffi-Gomez, Maria Valéria Schmidt, Tsuji, Robinson Koji, Bento, Ricardo Ferreira
      Abstract: Introduction Usher syndrome (US) is an autosomal recessive disorder characterized by hearing loss and progressive visual impairment. Some deaf Usher syndrome patients learn to communicate using sign language. During adolescence, as they start losing vision, they are usually referred to cochlear implantation as a salvage for their new condition. Is a late implantation beneficial to these children' Objective The objective of this study is to describe the outcomes of US patients who received cochlear implants at a later age. Methods This is a retrospective study of ten patients diagnosed with US1. We collected pure-tone thresholds and speech perception tests from pre and one-year post implant. Results Average age at implantation was 18.9 years (5–49). Aided average thresholds were 103 dB HL and 35 dB HL pre and one-year post implant, respectively. Speech perception was only possible to be measured in four patients preoperatively, who scored 13.3; 26.67; 46% vowels and 56% 4-choice. All patients except one had some kind of communication. Two were bilingual. After one year of using the device, seven patients were able to perform the speech tests (from four-choice to close set sentences) and three patients abandoned the use of the implant. Conclusion We observed that detection of sounds can be achieved with late implantation, but speech recognition is only possible in patients with previous hearing stimulation, since it depends on the development of hearing skills and the maturation of the auditory pathways.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-05-04T00:00:00+01:00
      DOI: 10.1055/s-0036-1583306
  • Test-Retest of Long Latency Auditory Evoked Potentials (P300) with Pure
           Tone and Speech Stimuli

    • Authors: Perez; Ana Paula, Ziliotto, Karin, Pereira, Liliane Desgualdo
      Abstract: Introduction Long latency auditory evoked potentials, especially P300, have been used for clinical evaluation of mental processing. Many factors can interfere with Auditory Evoked Potential - P300 results, suggesting large intra and inter-subject variations. Objective The objective of the study was to identify the reliability of P3 components (latency and amplitude) over 4–6 weeks and the most stable auditory stimulus with the best test-retest agreement. Methods Ten normal-hearing women participated in the study. Only subjects without auditory processing problems were included. To determine the P3 components, we elicited long latency auditory evoked potential (P300) by pure tone and speech stimuli, and retested after 4–6 weeks using the same parameters. We identified P300 latency and amplitude by waveform subtraction. Results We found lower coefficient of variation values in latency than in amplitude, with less variability analysis when speech stimulus was used. There was no significant correlation in latency measures between pure tone and speech stimuli, and sessions. There was a significant intrasubject correlation between measures of latency and amplitude. Conclusion These findings show that amplitude responses are more robust for the speech stimulus when compared with its pure tone counterpart. The P300 indicated stability for latency and amplitude measures when the test-retest was applied. Reliability was higher for amplitude than for latency, with better agreement when the pure tone stimulus was used. However, further research with speech stimulus is needed to clarify how these stimuli are processed by the nervous system.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2016-04-26T00:00:00+01:00
      DOI: 10.1055/s-0036-1583527
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