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Journal Cover International Archives of Otorhinolaryngology
  [SJR: 0.141]   [H-I: 4]   [2 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  [185 journals]
  • Identification of Fungal Pathogens in Otomycosis and Their Drug
           Sensitivity: Our Experience

    • Authors: Ali; Khaled, Hamed, Mahmood A., Hassan, Hameda, Esmail, Amira, Sheneef, Abeer
      Abstract: Introduction Otomycosis is a common problem in otolaryngology practice. However, we usually encounter some difficulties in its treatment because many patients show resistance to antifungal agents, and present high recurrence rate. Objectives To determine the fungal pathogens that cause otomycosis as well as their susceptibility to the commonly used antifungal agents. Additionally, to discover the main reasons for antifungal resistance. Methods We conducted an experimental descriptive study on 122 patients clinically diagnosed with otomycosis from April 2016 to April 2017. Aural discharge specimens were collected for direct microscopic examination and fungal culture. In vitro antifungal susceptibility testing was performed against the commonly used antifungal drugs. We tested the isolated fungi for their enzymatic activity. Results Positive fungal infection was found in 102 samples. The most common fungal pathogens were Aspergillus and Candida species, with Aspergillus niger being the predominant isolate (51%). The antifungal susceptibility testing showed that mold isolates had the highest sensitivity to voriconazole (93.48%), while the highest resistance was to fluconazole (100%). For yeast, the highest sensitivity was to nystatin (88.24%), followed by amphotericin B (82.35%), and the highest resistance was to terbinafine (100%), followed by Itraconazole (94.12%). Filamentous fungi expressed a high enzymatic ability, making them more virulent. Conclusion The Aspergillus and Candida species are the most common fungal isolates in otomycosis. Voriconazole and Nystatin are the medications of choice for the treatment of otomycosis in our community. The high virulence of fungal pathogens is owed to their high enzymatic activity. Empirical use of antifungals should be discouraged.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2018-04-12T00:00:00+01:00
      DOI: 10.1055/s-0038-1626702
  • Do Otolaryngology Patients Show Gender Preference When Choosing a
           Surgeon' — A Quantitative and Qualitative Analysis

    • Authors: Chitguppi; Chandala, Brar, Tripti
      Abstract: Introduction Otorhinolaryngology has always been considered a gender-neutral specialty, whereas in several other specialties, such as obstetrics, gynecology and urology, gender preference has been consistently shown by patients when choosing their treating surgeon. To date, no study has been performed to analyze whether this practice of gender preference is prevalent in otorhinolaryngology patients too. Objectives To identify if gender preference exists in the field of otorhinolaryngology, specifically in its four subspecialties, namely otology, pediatric otolaryngology, laryngology and head and neck surgery. Methods Patients attending our outpatient department were asked to complete a preformed proforma. The pro forma consisted of two parts, demographic details of the subjects and gender preference in the following subspecialties: otology, pediatric otolaryngology, laryngology and head and neck oncosurgery. Results A total of 1,112 subjects took part in the study, out of which 1,089 subjects were included in the final analysis. Female gender preference was highest in the field of pediatric otolaryngology, while male preference was highest for head and neck oncosurgery. Conclusion Though otorhinolaryngology and head and neck surgery has been considered a gender-neutral field, subspecialties of this field show considerable gender preference.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2018-04-12T00:00:00+01:00
      DOI: 10.1055/s-0038-1641165
  • Supracricoid Laryngectomy: The Function of the Remaining Arytenoid in
           Voice and Swallowing

    • Authors: Buzaneli; Elaine Cristina Pires, Zenari, Marcia Simões, Kulcsar, Marco Aurélio Vamondes, Dedivitis, Rogerio A., Cernea, Cláudio Roberto, Nemr, Kátia
      Abstract: Introduction Supracricoid laryngectomy still has selected indications; there are few studies in the literature, and the case series are limited, a fact that stimulates the development of new studies to further elucidate the structural and functional aspects of the procedure. Objective To assess voice and deglutition parameters according to the number of preserved arytenoids. Methods Eleven patients who underwent subtotal laryngectomy with cricohyoidoepiglottopexy were evaluated by laryngeal nasofibroscopy, videofluoroscopy, and auditory-perceptual, acoustic, and voice pleasantness analyses, after resuming oral feeding. Results Functional abnormalities were detected in two out of the three patients who underwent arytenoidectomy, and in six patients from the remainder of the sample. Almost half of the sample presented silent laryngeal penetration and/or vallecular/hypopharyngeal stasis on the videofluoroscopy. The mean voice analysis scores indicated moderate vocal deviation, roughness and breathiness; severe strain and loudness deviation; shorter maximum phonation time; the presence of noise; and high third and fourth formant values. The voices were rated as unpleasant. There was no difference in the number and functionality of the remaining arytenoids as prognostic factors for deglutition; however, in the qualitative analysis, favorable voice and deglutition outcomes were more common among patients who did not undergo arytenoidectomy and had normal functional conditions. Conclusion The number and functionality of the preserved arytenoids were not found to be prognostic factors for favorable deglutition efficiency outcomes. However, the qualitative analysis showed that the preservation of both arytenoids and the absence of functional abnormalities were associated with more satisfactory voice and deglutition patterns.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2018-03-29T00:00:00+01:00
      DOI: 10.1055/s-0038-1625980
  • Determination of Factors Associated with Critical Weight Loss in Oral
           Cavity Carcinoma Patients: A Retrospective Cohort Study

    • Authors: Iftikhar; Haissan, Suhail, Anwar, Nathani, Karim Rizwan, Urooba, Amna, Shahzad, Noman, Awan, Sohail, Dhanani, Rahim
      Abstract: Introduction Critical weight loss is defined as an unintentional weight loss of ≥ 5% at 1 month or ≥ 10% at 6 months from the start of treatment. Critical weight loss leads to deterioration of the immune function and reduced tolerance to treatment (surgery ± radiochemotherapy) as well as increased complication rates. Objective Critical weight loss, defined as a weight loss of ≥ 5% after 1 month or ≥ 10% after 6 months from the start of treatment, is not uncommon in head and neck cancer patients. We aimed to assess the factors associated with critical weight loss during the treatment of oral cavity squamous cell carcinoma patients. Methods A retrospective cohort study was performed at the Aga Khan University Hospital, in Karachi, Pakistan, on 125 patients. Patients receiving adjuvant therapy were considered exposed, and the outcome was critical weight loss. Results The mean age of presentation was 46.9 ± 12.8 years in patients undergoing surgery and adjuvant therapy, with 119 (79.3%) of them being male and 31 (20.7%) female. One hundred and twelve patients (81.3%) developed critical weight loss at 6 months from the start of treatment, and the only significant variable associated with critical weight loss was the stage of the disease (p = 0.03). Conclusion A large proportion of patients with oral cancer developed critical weight loss requiring a need for intervention. The overall stage of the disease is a significant predictor of critical weight loss in patients undergoing treatment.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2018-03-29T00:00:00+01:00
      DOI: 10.1055/s-0038-1641131
  • Disparity between Preoperative and Pre-Excisional Intraoperative
           Parathyroid Hormone in Parathyroid Surgery

    • Authors: Masood; Maheer M., Hackman, Trevor G.
      Abstract: Introduction Intraoperative parathyroid hormone (ioPTH) testing is a widely accepted standard for assessing the parathyroid gland function. A decline of preoperative parathyroid hormone (PTH) levels by more than 50% is one accepted measure of parathyroid surgery adequacy. However, there may be a variation between preoperative PTH levels obtained at a clinic visit and pre-excisional ioPTH. Objective Our study explores the differences between preoperative PTH and pre-excisional ioPTH levels, and the potential impact this difference has on determining the adequacy of parathyroid surgery. Methods A retrospective study that consisted of 33 patients that had undergone parathyroid resection between September 2009 and March 2016 at a tertiary academic center was performed. Each subject's preoperative PTH levels were obtained from clinic visits and pre-excisional ioPTH levels were recorded along with the time interval between the measurements. Results There was a significant difference between the mean preoperative PTH and the pre-excisional ioPTH levels of 147 pg/mL (95% confidence interval [CI] 11.43 to 284.47; p = 0.0396). The exclusion of four outliers revealed a further significant difference with a mean of 35.09 pg/mL (95% CI 20.27 to 49.92; p 
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2018-03-29T00:00:00+01:00
      DOI: 10.1055/s-0038-1635574
  • Effect of HIV and Antiretroviral Treatment on Auditory Functions

    • Authors: Minhas; Ravinder S., Iyengar, Dhanashree A., Thakur, Jagdeep S., Azad, Ramesh K.
      Abstract: Introduction Numerous studies have evaluated auditory functions in human immunodeficiency virus (HIV) patients; however, these studies had a few major limitations in terms of methodology as they used mainly evoked audiometry although this method is expensive, time consuming and not widely available. Therefore, we conducted a study in naïve HIV subjects with routine audiometry. Objective To determine the effect of HIV and of the drugs used to treat it on the auditory functions. Methods A prospective observational study was conducted in a medical college with 25 naive HIV-seropositive patients for over a year. Pure tone audiometry (250–8,000 Hz) and CD4 T-lymphocyte count were performed at the time of enrollment and 6 months after commencement of highly active antiretroviral treatment. Results The subjects had increased hearing thresholds at high frequencies (4 KHz and 8KHz) in both ears at the time of enrollment that persisted at the same level (p > 0.05) on follow-up at 6 months. None of the subjects had any other otological symptom during the 6 months of observation. Seven subjects had sensorineural hearing loss in one or both ears at 0 and 6 months. These observations did not show any significant difference on Wilcoxon-signed-rank test. Spearman correlation did not find a significant correlation (p > 0.05) between CD4 T-lymphocyte counts and pure tone audiometry during the study. Conclusion We found high-frequency hearing loss in all subjects with no relation with highly active antiretroviral therapy (HAART) and severity of the disease. This study advocates hearing assessment with pure tone audiometry in HIV subjects so that intervention can be initiated in a timely manner.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2018-03-29T00:00:00+01:00
      DOI: 10.1055/s-0038-1639594
  • Effect of Fractal Tones on the Improvement of Tinnitus Handicap Inventory
           Functional Scores among Chronic Tinnitus Patients: An Open-label Pilot

    • Authors: Simonetti; Patricia, Vasconcelos, Laura Garcia, Oiticica, Jeanne
      Abstract: Introduction Music-based sound therapies become recently a trend in the treatment of tinnitus. Few publications have studied the therapeutic use of fractal tones to treat chronic tinnitus. Objective The aim of this study was to determine the benefits of using fractal tones as a unique sound therapy for chronic tinnitus sufferers. Methods Twelve participants were recruited; however, six could not be assigned. At baseline and at 1, 3 and 6 months, the participants were provided with the Tinnitus Handicap Inventory (THI) and Hearing Handicap Inventory for Adults (HHIA) questionnaires, and their visual analog scale score was recorded. Tinnitus pitch and loudness matching was performed before fitting and after 6 months of use. Results The visual analog scale (VAS) score, pitch and loudness matching and minimal masking levels did not result in significant improvement at the end of the treatment. The mean THI measured at baseline was 45, and the final one was 25. A paired sample t-test showed that this 20-point difference was statistically significant. Conclusions We measured the benefits of using fractal tone therapy for the treatment of chronic tinnitus and found that most of the benefits were in the THI functional domain, which includes concentration, reading, attention, consciousness, sleep, social activities, and household tasks. For all patients with bothersome chronic tinnitus and high scores on the THI functional scale, fractal tones should be considered a promising initial sound therapy strategy. The findings from this open-label pilot study are preliminary, and further trials are needed before these results can be generalized to a larger tinnitus population.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2018-03-29T00:00:00+01:00
      DOI: 10.1055/s-0038-1635575
  • Anatomical Variations of the Middle Turbinate Concha Bullosa and its
           Relationship with Chronic Sinusitis: A Prospective Radiologic Study

    • Authors: Kalaiarasi; Raja, Ramakrishnan, Venkataramanan, Poyyamoli, Santhosh
      Abstract: Introduction A pneumatized turbinate, also called concha bullosa, is a normal anatomical variant of the paranasal sinus region. Depending on the site of pneumatization, the concha is classified into extensive, bulbous or lamellar type. The middle turbinate concha bullosa has been implicated as a possible etiological factor in chronic sinusitis. Objectives The aim of this study was to investigate the anatomical variations of the concha bullosa, based on paranasal sinus imaging, and its possible association with sinusitis. Methods This prospective descriptive study was performed at the Department of ENT and Head Neck Surgery over a period of one year, from 2016 to 2017. We studied the computed tomography scans of the nose and paranasal sinuses— in axial, coronal and sagittal planes—of patients who had symptoms of nasal obstruction, or headache and features of chronic sinusitis. Results Out of the 202 scans studied, the prevalence of concha bullosa was 31.7%. The concha was bilateral in 35 (54.7%) patients and unilateral in 29 (45.3%) patients. Out of 99 conchae, 54 were on the right side and 45 were on left side. Ipsilateral sinusitis was found in 40.4% of the sides in the scans of subjects with concha. There was no statistically significant association between any type of middle turbinate concha with sinusitis, but sinusitis was more predominant with the extensive type of concha (p > 0.05). Conclusion Multiple air cells, mucocele, pyocele and inflammatory mucosal thickenings in the concha are relatively rare. Detailed knowledge of anatomic variations of the concha bullosa is imperative for the radiologists and the operating surgeons.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2018-03-13T00:00:00+0100
      DOI: 10.1055/s-0038-1625978
  • Otomyiasis: Systematic Review

    • Authors: Rodríguez-Ruiz; María Teresa, Acosta, Ana María, Cifuentes-Cardozo, Eduardo, Chirveches, María Alejandra, Rosselli, Diego
      Abstract: Introduction Myiasis is a disease caused by fly larvae that grow in the tissues of animals and humans. It can cause a variety of local symptoms, like erythema or pain, depending on its location, and generalized symptomatology, such as fever and malaise. Myiasis can generate severe complications, for instance sepsis, or directly impact vital tissues. Its management varies depending on the location, and on the preferences of the doctor that faces this challenge. Myiasis usually occurs in tropical countries, and, in many places, it is not a rare condition. The cases are rarely reported, and there are no published management protocols. Objective To review the literature regarding the most common agents, the predisposing factors and the treatment alternatives for otic myiasis, a rare form of human myiasis caused by the infestation of fly larvae in the ear cavities. Data synthesis We present a systematic review of the literature. The search in five databases (Medline, Embase, Cochrane Database of Systematic Reviews, LILACS and RedALyC) led to 63 published cases from 24 countries, in the 5 continents. The ages of the patients ranged from newborn to 65 years old. The most common agents belong to the Sarcophagidae or Calliphoridae families. Chronic otitis media, previous otic surgical procedures, mental deficit, alcohol or drug abuse, sleeping outdoors, prostration, and malnutrition were predisposing factors. The treatment alternatives are herein discussed. Conclusion The results highlight the need for monitoring, follow-up and standardization of medical approaches.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2018-03-13T00:00:00+0100
      DOI: 10.1055/s-0037-1617427
  • Periosteal Graft Myringoplasty: Our Experience

    • Authors: ElTaher; Mostafa, Othman, Yosry, Mohammed, Ibrahim, Ali, Khaled
      Abstract: Introduction Different types of autologous graft materials are used for myringoplasty, with the temporalis fascia and cartilage being the most frequently used tissues. Periosteal tissue has been used for a long time in our department, and many advantages support its use in myringoplasty. To the best of our knowledge, this issue is scarcely discussed in the previously published literature. Objective To present our experience with periosteal graft myringoplasty, describing the technique and the anatomical and functional outcomes. Methods A prospective clinical study involving 88 patients (72 females and 16 males) with a mean age 26.9 years. The patients underwent myringoplasty using the mastoid cortex periosteum; they were all operated using the postauricular approach, and the graft was applied using the underlay technique. The patients performed pre- and postoperative pure tone audiometry for tested frequencies (0.5 kHz, 1 kHz, 2 kHz, and 4 kHz). All patients were followed-up for at least 12 months after the operation. Results The anatomical success rate among all patients was of 93%, which is comparable to the rate of success in procedures using other usual grafting materials. In addition, there was a highly significant postoperative improvement in pure tone audiometry results as compared with the preoperative ones (the main hearing gain was of ∼ 11 dB; p 
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2018-02-16T00:00:00+0100
      DOI: 10.1055/s-0037-1613716
  • Translation to Brazilian Portuguese and Cultural Adaptation of the
           Craniocervical Dysfunction Index

    • Authors: Dias; Ana Carolina Marcotti, Doi, Marcelo Yugi, Mesas, Arthur Eumann, Fillis, Michelle Moreira Abujamra, Branco-Barreiro, Fatima Cristina Alves, Marchiori, Luciana Lozza de Moraes
      Abstract: Introduction Functional disorders of the craniocervical region affect 77.78% of Brazilian teachers. Among the most common instruments used to assess craniocervical disorders in a detailed and objective way, none had been translated to Brazilian Portuguese and adapted to Brazilian culture. Objectives To translate to Brazilian Portuguese and to culturally adapt the Craniocervical Dysfunction Index (CDI). Method The first phase of the study consisted of the translation, synthesis, back-translation, and review of the contents by a committee of experts, who developed a trial version and sent all the steps to the original author. The trial version was applied to 50 teachers of an institution. The reliability and internal consistency were evaluated by Cronbach α. For the validation, the Brazilian Portuguese version of the CDI was correlated with the Visual Analogue Scale (VAS) domains for cervicalgia and evaluated by Spearman ρ. Result Some expressions were adapted to the Brazilian culture. Among the participants who did not report neck pain in the VAS, 84.21% suffered from craniocervical dysfunction acording to the CDI. Among the participants who reported neck pain in the VAS, 100% suffered from craniocervical dysfunction according to the CDI. The CDI showed good internal consistency and satisfactory reliability measured by Cronbrach α (α = 0.717). There was a strong correlation between the CDI and the VAS score (ρ = 0.735). Conclusion No difficulties were encountered in the translation and back-translation of the CDI, and no problems were observed regarding the trial version developed; therefore, the Brazilian Portuguese version of the CDI is a valid and reliable instrument to evaluate the functional alteration of the craniocervical region.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2018-01-18T00:00:00+0100
      DOI: 10.1055/s-0037-1621743
  • A Comparison of the Operative Techniques and the Postoperative
           Complications for Bone-Anchored Hearing Aid Implantation

    • Authors: Steehler; Mark W., Larner, Sean P., Mintz, Joshua S., Steehler, Matthew K., Lipman, Sidney P., Griffith, Shane
      Abstract: Introduction Bone anchored hearing aids (BAHA) represent a useful surgical option for patients with single sided deafness. Objectives To compare multiple techniques for BAHA implantation regarding postoperative complications, operative time, and duration between the surgery and the first use of the BAHA. Methods A retrospective study was conducted of all patients receiving implantation of a BAHA from August of 2008 to October of 2014. Data collected included: patient age, gender, side operated, abutment length, operative time, duration until first use of the BAHA, operative technique, and postoperative complications. The statistical analysis was performed using analysis of variance (ANOVA), Tukey pairwise comparison, chi-square, and paired t-test. Statistical significance was determined using a level of p 
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2018-01-18T00:00:00+0100
      DOI: 10.1055/s-0037-1613685
  • Long-Term Evaluation of Nasal Septoplasty Followed by Inferior Turbinate
           Cauterization for the Treatment of Nasal Obstruction using Objective and
           Subjective Methods

    • Authors: Valsamidis; Konstantinos, Titelis, Konstantinos, Rachovitsas, Dimitrios, Konstantinidis, Iordanis, Markou, Konstantinos, Triaridis, Stefanos
      Abstract: Introduction Nasal septoplasty is considered the treatment of choice for nasal obstruction due to septal deviation. An ongoing discussion among rhinologists is whether it is reasonable to perform objective measurements of nasal patency pre or postoperatively routinely. Objective The primary aim of this study was to identify the short- and long-term functional benefits for patients undergoing septal surgery, as assessed by acoustic rhinometry (AR). The secondary goal was to evaluate the short- and long-term perception of symptom relief and disease-specific quality of life (QoL) outcomes on the part of the patients. Methods This was a prospective observational study in which AR was utilized for the assessment of nasal patency preoperatively and 1, 6 and 36 months after septoplasty. Total 40 patients who underwent septoplasty filled out the Nasal Obstruction Septoplasty Effectiveness (NOSE) questionnaire and the Glasgow Benefit Inventory (GBI) to assess their subjective improvement in nasal obstruction symptoms and the changes in their QoL. Results There were statistically significant improvements in nasal patency, mean postoperative NOSE and GBI scores postoperatively. However, there was no correlation between the mean NOSE and GBI scores and the AR measurements. Furthermore, the GBI scores tended to decrease as the postoperative period increased. Conclusion The present study confirms that septoplasty significantly increases nasal patency and causes a significant subjective improvement in nasal obstruction symptoms. The absence of a statistically significant correlation among the objective measurements, the symptom scores, and the patients' low GBI scores indicates that factors other than the anatomical findings may also contribute to the patients' perception of QoL.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2018-01-18T00:00:00+0100
      DOI: 10.1055/s-0037-1613688
  • Effect of Blood Group on Ultrahigh Frequency Auditory Sensitivity

    • Authors: Prabhu; Prashanth, Chandrashekhar, Akhila, Cariappa, Janani, Ghosh, Nayanika
      Abstract: Introduction Individuals with blood group O are reported to have reduced otoacoustic emissions (OAEs) compared with individuals with different blood groups. Objective The present study attempted to determine if the blood group has any effect on high-frequency auditory sensitivity using ultrahigh-frequency audiometry and ultrahigh-frequency distortion product otoacoustic emissions (DPOAEs). Methods High-frequency thresholds and high-frequency DPOAEs were measured in 60 individuals with normal hearing and different blood groups. Results The results of the study showed that there was a significant reduction in DPOAE amplitude for individuals with blood group O compared with individuals with other blood groups. However, there was no significant difference in ultrahigh-frequency thresholds across the blood groups. Conclusion This reduction in OAE amplitude may be attributed to a lower number of healthy outer hair cells in individuals with blood group O. Further studies on larger groups of individuals are essential for a better generalization of the results.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-12-15T00:00:00+0100
      DOI: 10.1055/s-0037-1613711
  • Level V Clearance in Neck Dissection for Papillary Thyroid Carcinoma: A
           Need for Homogeneous Studies

    • Authors: Battoo; Azhar Jan, Sheikh, Zahoor Ahmad, Thankappan, Krishnakumar, Mir, Abdul Wahid, Haji, Altaf Gowhar
      Abstract: Introduction Papillary thyroid carcinoma has a very high rate of lateral neck node metastases, and there is almost unanimity concerning the fact that some sort of formal neck dissection must be performed to address the clinical neck disease in these cases. Although there is an agreement that levels II to IV need to be cleared in these patients, the clearance of level V is debatable. Objectives We herein have tried to analyze various papers that have documented a structured approach to neck dissection in these patients. Moreover, we have also tried to consider this issue through various aspects, like spinal accessory nerve injury and the impact of neck recurrence on survival. Data Synthesis The PubMed, Medline, Google Scholar, Surveillance, Epidemiology, and End Results (SEER), and Ovid databases were searched for studies written in English that focused on lateral neck dissection (levels II–IV or II–V) for papillary thyroid carcinoma. Case reports with 10 patients or less were excluded. Conclusions The current evidence is equivocal whether to clear level V or not, and the studies published on this issue are very heterogeneous. Level II-IV versus level II-V selective neck dissections in node-positive papillary thyroid carcinoma patients is far from categorical, with pros and cons for both approaches. Hence, we feel that there is a need for more robust homogeneous data in order to provide an answer to this question.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-12-13T00:00:00+0100
      DOI: 10.1055/s-0037-1608909
  • The Middle Turbinate Resection and Its Repercussion in Olfaction with the
           University of Pennsylvania Smell Identification Test (UPSIT)

    • Authors: Mariano; Fernando Cesar, Hamerschmidt, Rogerio, Soares, Caio Marcio Correa, Moreira, Ana Tereza
      Abstract: Introduction Nasal obstruction is a common complaint, and, for some, the middle turbinate resection is still a controversial issue among the surgical options due to the possibility of deleterious effects on olfaction. The University of Pennsylvania smell identification test (UPSIT) is considered the gold standard of smell identification tests, but data about it is still incipient in Brazil. Objective To evaluate if the middle turbinectomy has any repercussion on the sense of olfaction by using the UPSIT as an assessment tool. Methods A prospective study performed between 2013 and 2015 with 27 patients who were treated with middle turbinectomy by the same surgeon and tested with the UPSIT pre- and post-surgery, with a minimum interval of 3 months. Results Twenty-five patients completed the study. The mean age was 27.9 years. There was no statistical correlation between middle turbinectomy and the UPSIT score, or between gender and the UPSIT score. Conclusion There was no clinical repercussion on olfaction from partial middle turbinectomy.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-12-06T00:00:00+0100
      DOI: 10.1055/s-0037-1608679
  • Headphone Evaluation for App-Based Automated Mobile Hearing Screening

    • Authors: Pickens; Adam W., Robertson, Lakshmi Dakuri, Smith, Matthew Lee, Zheng, Qi, Song, Sejun
      Abstract: Introduction With the need for hearing screenings increasing across multiple populations, a need for automated options has been identified. This research seeks to evaluate the hardware requirements for automated hearing screenings using a mobile application. Objective Evaluation of headphone hardware for use with an app-based mobile screening application. Methods For the purposes of this study, hEAR, a Bekesy-based mobile application designed by the research team, was compared with pure tone audiometric tests administered by an audiologist. Both hEAR and the audiologist's test used 7 frequencies (125 Hz, 250 Hz, 500 Hz, 1,000 Hz, 2000 Hz, 4,000 Hz and 8,000 Hz) adopting four different sets of commercially available headphones. The frequencies were regarded as the independent variable, whereas the sound pressure level (in decibels) was the dependent variable. Thirty participants from a university in Texas were recruited and randomly assigned to one of two groups, whose only difference was the order in which the tests were performed. Data were analyzed using a generalized estimating equation model at α = 0.05. Results Findings showed that, when used to collect data with the mobile app, both the Pioneer HDJ-2000 (Pioneer, Bunkyo, Tokyo, Japan) (p > 0.05) and the Sennheiser HD280 Pro (Sennheiser, Wedemark, Hanover, Germany) (p > 0.05) headphones presented results that were not statistically different from the audiologist's data across all test frequencies. Analyses indicated that both headphones had decreased detection probability at 4kHz and 8kHz, but the differences were not statistically significant. Conclusion Data indicate that a mobile application, when paired with appropriate headphones, is capable of reproducing audiologist-quality data.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-12-06T00:00:00+0100
      DOI: 10.1055/s-0037-1607438
  • The Contribution of Surface Electromyographic Assessment for Defining the
           Stage of Peripheral Facial Paralysis: Flaccid or Sequelae Stage

    • Authors: Bernardes; Daniele Fontes Ferreira, Bento, Ricardo Ferreira, Goffi Gomez, Maria Valeria Schimidt
      Abstract: Introduction Surface electromyographic activity may not be symmetric, even in subjects with no facial paralysis history. Objective To evaluate the contribution of the index of electromyographic (IEMG) activity in the identification of the two extremes of the facial paralysis course. Methods Thirty-four subjects with unilateral peripheral facial paralysis were selected. A control group was composed of volunteers without a history of facial paralysis. The electromyographic assessment of the facial muscle was performed by placing surface electrodes during movements of the forehead, eyes and lips using MIOTEC equipment, such as the MIOTOOL (Miotec, Porto Alegre, Brazil) software. The electromyographic activity was also recorded in other channels during the primary activity to identify the presence of synkinesis. The statistical analysis was performed using the Statistical Package for Social Sciences for Macintosh (SPSS Inc, Chicago, IL, USA). The IEMG activity was obtained from the division of the electromyographic activity root mean square (RMS) values on both sides. Results There was a statistically significant difference among the groups in all the analyzed indexes. The ocular-oral synkinesis in all patients must be correctly identified (with 100% sensitivity and specificity) using an IEMG activity of 1.62 as a cutoff point. The oral-ocular synkinesis must be correctly identified (93.3% sensitivity and 95.9% specificity) using the IEMG activity of 1.79 as a cutoff point. Conclusion The IEMG activity is below the normal scores in patients in the flaccid stage, whereas patients in the sequelae stage can either show normal values or values above or below the normal scores. The IEMG activity was shown to have high sensitivity and specificity in the identification of synkinesis.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-10-26T00:00:00+01:00
      DOI: 10.1055/s-0037-1607335
  • Vocal Symptoms and Associated Risk Factors between Male and Female
           University Teachers

    • Authors: Korn; Gustavo Polacow, Park, Sung Woo, Pontes, Antonio Augusto de Lima, Pontes, Paulo
      Abstract: Introduction Many recent studies on teachers warn of the adverse effects that voice problems have on work performance. However, only a few of these studies included university teachers. Objective To compare the vocal symptoms and risk factors between male and female university teachers in a private institution within the city of São Paulo. Methods In a cross-sectional survey, a voice self-evaluation form prepared by the Ministry of Labor in Brazil was administered to 846 university teachers at a private institution in the city of São Paulo. Results The percentage of hoarseness, vocal tract discomfort, neck pain and foreign body sensation was significantly higher in female than in male subjects. A significantly higher percentage of males participated in other professional activities in addition to teaching, reported working in a calm environment compared with working in a moderately or severely tense and stressful environment, and rated themselves as calm, slightly stressed and anxious or moderately stressed and anxious rather than very stressed and anxious. A significantly higher percentage of females spent most of their time teaching compared with performing other professional activities, and rated themselves as chatty or impulsive. Conclusion Among university teachers, a significantly higher percentage of females than males reported hoarseness, vocal tract discomfort, neck pain and foreign body sensation. Some risk factors related to work organization, workplace environment, voice care and quality of life variables were related to this higher prevalence in females.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-10-26T00:00:00+01:00
      DOI: 10.1055/s-0037-1606604
  • Changing Trends in the Treatment of Mandibular Fracture
    • Int Arch Otorhinolaryngol
      DOI: 10.1055/s-0037-1606645

      Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

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

      Int Arch Otorhinolaryngol ; : -2017-10-25T00:00:00+01:00
  • Efficacy of Drainless Total Thyroidectomy in Intrathyroidal Lesions of

    • Authors: Battoo; Azhar Jan, Haji, Altaf Gauhar, Sheikh, Zahoor Ahmad, Thankappan, Krishnakumar, Mir, Wahid Abdul
      Abstract: Introduction There is difference of opinion about the placement of the drain in thyroid surgeries, and, to the best of our knowledge, the efficacy of drainless total thyroidectomy regarding various parameters of thyroid lesions has not been well-established. Objective To report our experience with drainless total thyroidectomy, and to define an appropriate patient population for its performance. Methods This is a retrospective case analysis of the patients who underwent total thyroidectomy for intrathyroidal lesions with or without central neck dissection in a tertiary referral hospital (number = 74). The patients, who had undergone total thyroidectomy without any drain insertion, were analyzed, and the relationships among various parameters of thyroid lesions were noted in relation to seroma and hematoma formation. Results Seroma formation was noted only in 5 out of 74 patents (6.75%). All of the seromas that occurred were observed in patients with thyroid lesions  5 cm)
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-10-25T00:00:00+01:00
      DOI: 10.1055/s-0037-1606183
  • Evaluation of the Facial Recess and Cochlea on the Temporal Bone of
           Stillbirths regarding the Percutaneous Cochlear Implant

    • Authors: Braga; Gabriela Pereira Bom, Gebrim, Eloisa, Balachandran, Ramya, Noble, Jack, Labadie, Robert, Bento, Ricardo Ferreira
      Abstract: Introduction The literature shows that there are anatomical changes on the temporal bone anatomy during the first four years of life in children. Therefore, we decided to evaluate the temporal bone anatomy regarding the cochlear implant surgery in stillbirths between 32 and 40 weeks of gestational age using computed tomography to simulate the trajectory of the drill to the scala timpani avoiding vital structures. Objectives To measure the distances of the simulated trajectory to the facial recess, cochlea, ossicular chain and tympanic membrane, while performing the minimally invasive cochlear implant technique, using the Improvise imaging software (Vanderbilt University, Nashville, TN, US). Methods An experimental study with 9 stillbirth specimens, with gestational ages ranging between 32 and 40 weeks, undergoing tomographic evaluation with individualization and reconstruction of the labyrinth, facial nerve, ossicular chain, tympanic membrane and cochlea followed by drill path definition to the scala tympani. Improvise was used for the computed tomography (CT) evaluation and for the reconstruction of the structures and trajectory of the drill. Results Range of the distance of the trajectory to the facial nerve: 0.58 to 1.71 mm. to the ossicular chain: 0.38 to 1.49 mm; to the tympanic membrane: 0.85 to 1.96 mm; total range of the distance of the trajectory: 5.92 to 12.65 mm. Conclusion The measurements of the relationship between the drill and the anatomical structures of the middle ear and the simulation of the trajectory showed that the middle ear cavity at 32 weeks was big enough for surgical procedures such as cochlear implants. Although cochlear implantation at birth is not an indication yet, this study shows that the technique may be an option in the future.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-10-25T00:00:00+01:00
      DOI: 10.1055/s-0037-1606612
  • Papillary Thyroid Carcinoma within Thyroglossal Duct Cyst: Case Series and
           Literature Review

    • Authors: Iftikhar; Haissan, Ikram, Mubasher, Rizwan Nathani, Karim, Yar Muhammad, Adnan
      Abstract: Introduction Thyroglossal duct cyst (TGDC) is the most common congenital anomaly of the neck, and approximately 7% of all the adult population presents it. Ectopic thyroid tissue is found in the thyroglossal duct cyst wall in up to 65% of cases. This thyroid tissue has the potential to develop some type of malignancy, the most common of which is the papillary carcinoma of the thyroid. There are just over 270 cases of thyroglossal duct cyst malignancy reported in the literature. Objectives We aimed to study our population of patients in order to identify cases with thyroglossal duct cyst malignancy. Methods A retrospective chart review was conducted in the section of otolaryngology/head and neck surgery at a hospital in Karachi, Pakistan, from January of 2004 to December of 2014 on patients with the diagnosis of thyroglossal duct cyst. Results Fifty-eight patients were diagnosed with TGDC, two of whom also presented with thyroglossal duct cyst carcinoma. Both patients revealed papillary thyroid carcinoma on histopathology. Case 1 had an open biopsy before undergoing definitive surgery. Both patients underwent subsequent total thyroidectomy after Sistrunk procedure, and case 2 had selective neck dissection revealing lymph node metastasis. Conclusion Thyroglossal duct cyst carcinoma is a rare finding that comes as a surprise to both the patient and the surgeon. We report 2 out of 58 cases diagnosed with thyroglossal duct cyst carcinoma.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-10-25T00:00:00+01:00
      DOI: 10.1055/s-0037-1606277
  • Probable Association of Hearing Loss, Hypertension and Diabetes Mellitus
           in the Elderly

    • Authors: Meneses-Barriviera; Caroline Luiz, Bazoni, Jéssica Aparecida, Doi, Marcelo Yugi, Marchiori, Luciana Lozza de Moraes
      Abstract: Introduction The aging process causes changes in body structure in a continuous manner, and contributes to clinical disorders. Life expectancy is increasing, especially in developing countries. Objective To assess the prevalence of hearing loss and its possible association with hypertension and diabetes mellitus (DM) in the elderly. Methods A cross-sectional study with 519 elderly individuals aged over 60 years who underwent an audiological evaluation (pure tone audiometry), and answered a comorbidity questionnaire that included questions about age, gender, tinnitus and medical history, with data concerning DM. The dependent variable was the presence of hearing loss. The independent variables were age, gender, DM and hypertension. The variables were presented in absolute numbers and proportions, and enabled us to estimate the prevalence. The statistical analysis was performed through multiple logistic regression with 95% confidence intervals and values of p 
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-10-25T00:00:00+01:00
      DOI: 10.1055/s-0037-1606644
  • Outcomes of Automated Auditory Evoked Potential Performed in Different
           Settings and the Factors Associated with Referred Cases

    • Authors: Silva; Daniela Polo Camargo da, Ribeiro, Georgea Espíndola, Castilho, Gustavo Leão, Mantovani, Jair Cortez
      Abstract: Introduction For the population with risk factors for hearing loss, the first option to assess the hearing status is the performance of the automated brainstem auditory evoked potential (BAEP) test because of its efficacy in identifying retrocochlear hearing loss. Objective To verify the outcomes of automated BAEP performed in different settings as well as the factors associated with the prevalence of hearing impairment. Methods Cross-sectional study conducted from October of 2014 to May of 2015. The sample consisted of 161 infants with at least one risk factor for hearing loss who underwent automated BAEP during the hospital stay or at the outpatient clinic. After 30 days, the altered cases were referred for BAEP diagnosis. Results One hundred and thirty-eight infants (86%) had a result of “pass” and 23 (14%) of “failure” in the automated BAEP. There was no statistically significant difference in the rate of “referred” results between examinations performed in different settings. The infants' ages did not influence the number of abnormal cases. All of the 23 infants who presented a “referred” result in the automated BAEP, unilateral or bilateral, were sent for BAEP diagnosis, and out of these, 9 (39%) remained with at least some degree of alteration. The average age of diagnosis was 2.7 months. Conclusion The results of the automated BAEP were similar when performed during hospitalization or after discharge. Neither the age at the examination nor the gender of the patient influenced the prevalence of hearing loss.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-10-25T00:00:00+01:00
      DOI: 10.1055/s-0037-1607334
  • Hyoid Bone Suspension as a Part of Multilevel Surgery for Obstructive
           Sleep Apnea Syndrome

    • Authors: Tantawy; Abd Alzaher, Askar, Sherif Mohammad, Amer, Hazem Saeed, Awad, Ali, El-Anwar, Mohammad Waheed
      Abstract: Introduction Since oropharyngeal surgery alone is often insufficient to treat obstructive sleep apnea (OSA), advances have been developed in hypopharyngeal surgery. Objective To assess hyoid suspension surgery as part of a multilevel OSA surgery, also including palatal surgery. Methods The study included patients with OSA symptoms with apnea hypopnea index (AHI) > 15. They were scheduled for hyoid suspension after a nasoendoscopy during Müller maneuver and drug induced sleep endoscopy (DISE). All patients had body mass index (BMI) 
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-10-25T00:00:00+01:00
      DOI: 10.1055/s-0037-1607227
  • Otitis Externa in Secondary Care: A Change in Our Practice Following a
           Full Cycle Audit

    • Authors: Liu; Zhaobo, Slim, Mohd Afiq Mohd, Scally, Catherine
      Abstract: Introduction Patients presenting with otitis externa are a common thing in otolaryngology units. However, the practice has not been standardized due to a lack of consensus over the management of this condition in secondary care. The National Institute for Health and Care Excellence (NICE) guideline has been published targeting the general practitioners, but it may be relevant in cases of hospital first-time attenders. Objective To conduct an audit of the investigative and prescription practice for hospital first-time attenders in our department against the NICE guideline for otitis externa. Methods The case notes of the patients presenting with otitis externa were reviewed. The data collation included the performance of ear swabs and choice of eardrops. Results An initial audit showed that ear swabs were sent in 14 out of 19 cases, of which 11 grew either Pseudomonas aeruginosa or Staphylococcus aureus (organisms that are sensitive to empirical treatment). A re-audit showed higher adherence to NICE recommendations, with ear swabs sent in only 3 out of 25 cases. The initial audit also demonstrated Sofradex (Sanofi-Aventis, Paris, France) as the most popular empirical eardrop. Following our recommendation, the re-audit showed that Betnesol-N (GSK, Brentford, UK) was administered in 24 out of 25 cases. Conclusion We recommend Betnesol-N due to its cost-effectiveness. Ear swabs should be reserved for refractory cases only. Posters and email reminders are effective means of disseminating information within the hospital.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-09-19T00:00:00+01:00
      DOI: 10.1055/s-0037-1606621
  • Sudden Sensorineural Hearing Loss: Comparative Study of Different
           Treatment Modalities

    • Authors: Khater; Ahmed, El-Anwar, Mohammad Waheed, Nofal, Ahmad Abdel-Fattah, Elbahrawy, Atef Taha
      Abstract: Introduction Idiopathic sudden sensorineural hearing loss (
      ISSN HL) is hearing loss of at least 30 dB in at least 3 contiguous frequencies within at least 72 hours. There are many different theories to explain it, and many different modalities are used for its management, such as: systemic steroids (SSs), intratympanic steroid injection (ITSI), hyperbaric oxygen therapy (HOT), antiviral drugs, and vasodilators or vasoactive substances. Objectives This study aims to evaluate the efficacy of the combination of the most common treatment modalities of
      ISSN HL and to compare the results if HOT was not one of the treatment modalities administered. Methods The study was conducted with 22
      ISSN HL patients with ages ranging from 34 to 58 years. The patients were divided into 2 groups; group A included 11 patients managed by SSs, ITSI, antiviral therapy, and HOT simultaneously, and group B included 11 patients exposed to the aforementioned modalities, with the exception of HOT. Results After one month, all of the patients in group A showed total improvement in hearing in all frequencies, with pure tone average (PTA) of 18.1 ± 2.2, while in group B, 5/11 (45.5%) patients showed total improvement, and 6 /11 (54.5%) patients showed partial improvement, with a total mean PTA of 28.1 ± 8.7. Conclusion The early administration of HOT in combination with other clinically approved modalities (SSs, ITSI, antiviral therapy) provides better results than the administration of the same modalities, with the exception of HOT, in the treatment of
      ISSN HL.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-09-12T00:00:00+01:00
      DOI: 10.1055/s-0037-1605376
  • Applicability of Evoked Auditory Brainstem Responses with Complex Stimuli
           in Adults with Hearing Loss

    • Authors: Peixe; Bruna Pias, Silva, Débora Durigon da, Biaggio, Eliara Pinto Vieira, Bruno, Rúbia Soares, Sanguebuche, Taissane Rodrigues, Garcia, Michele Vargas
      Abstract: Introduction The use of the speech-evoked auditory brainstem response (ABR) shows how the brainstem operates up to the subcortex in a more complex manner than when the click-evoked ABR is used. Objective To study the applicability of the speech-evoked ABR in adults with hearing loss. Methods The sample was composed of a study group of 11 subjects, with ages ranging between 18 and 59 years, and auditory thresholds within normal standards, with loss of up to 65 dB at high frequencies or up to moderately severe symmetric sensorineural hearing loss. The sample underwent a basic audiological assessment, as well as speech-evoked ABR and click-evoked ABR, in which waves I, III and V, and V, A, C, D, E, F were respectively marked. The electrophysiological assessments were performed using the SmartEP device (Intelligent Hearing Systems, Miami, FL, US). Results For the speech-evoked ABR, the reference values were used in the identification and analysis of the study group. Those values found for the study group were: V = 8.56; A = 10.97; C = 21.33; D = 29.51; E = 37.93; F = 46.96; and O = 55.97. In the comparison between groups, the study group presented an increase in latency only in wave C. Conclusion The speech-evoked ABR can be performed in subjects with up to moderately severe hearing loss, and the test proved to be appropriate, because, unlike the click-evoked ABR, the former does not suffer influence of peripheral hearing loss.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-09-12T00:00:00+01:00
      DOI: 10.1055/s-0037-1605341
  • Efficacy of Myofunctional Therapy Associated with Voice Therapy in the
           Rehabilitation of Neurogenic Oropharyngeal Dysphagia: a pilot study

    • Authors: Fraga; Bruno Francisco de, Almeida, Sheila Tamanini de, Santana, Márcia Grassi, Cassol, Mauriceia
      Abstract: Introduction Dysphagia causes changes in the laryngeal and stomatognathic structures; however, the use of vocal exercises is poorly described. Objective To verify whether the therapy consisting of myofunctional exercises associated with vocal exercises is more effective in rehabilitating deglutition in stroke patients. Methods This is a pilot study made up of two distinct groups: a control group, which performed only myofunctional exercises, and an experimental group, which performed myofunctional and vocal exercises. The assessment used for oral intake was the functional oral intake scale (FOIS). Results The FOIS levels reveal that the pre-therapy median of the experimental group was 4, and increased to 7 after therapy, while in the control group the values were 5 and 6 respectively. Thus, the experimental group had a statistically significant difference between the pre- and post-therapy assessments (p = 0.039), which indicates that the combination of myofunctional and vocal exercises was more effective in improving the oral intake levels than the myofunctional exercises alone (p = 0.059). On the other hand, the control group also improved, albeit at a lower rate compared with the experimental group; hence, there was no statistically significant difference between the groups post-therapy (p = 0.126). Conclusion This pilot study showed indications that using vocal exercises in swallowing rehabilitation in stroke patients was able to yield a greater increase in the oral intake levels. Nevertheless, further controlled blind clinical trials with larger samples are required to confirm such evidence, as this study points to the feasibility of conducting this type of research.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-08-28T00:00:00+01:00
      DOI: 10.1055/s-0037-1605597
  • Anatomical Variations in Patients with Ménière Disease: A
           Tomography Study

    • Authors: Lucinda; Lucas Resende, Cristoff, Daniela Dranka, Coelho, Luiz Otávio De Mattos, Zanini, Otávio Pereira Lima, Guimarães, Rita De Cassia Cassou
      Abstract: Introduction The etiology of Ménière disease (MD), a difficult-to-treat condition with great morbidity, remains controversial in the literature. The possible clinical and diagnostic impact of anatomical variations of the temporal bone among patients with MD has been recently studied. Objective To identify anatomical variations of the temporal bone associated with the diagnosis of MD. Methods Thirty-seven patients were included, although each ear was considered separately (n = 74). A case group (nA = 33) was composed of the affected ears of patients with definite MD and a control group (nB = 41) was used consisting of the ears of individuals who did not meet the criteria for MD and of the contralateral ears from patients with unilateral disease. Tomographic images from the individuals included in the study were submitted to a blinded and systematic evaluation regarding a broad variety of anatomical variations of the temporal bone. Obtained data were compared statistically between the groups and after stratifying the study sample. Significance level was set at 0.05. Results Among the affected ears, it was observed an increased number of tomographic scans in which the vestibular aqueduct could not be identified (p = 0.01, Fisher exact test). No statistically significant differences were observed when comparing the affected and contralateral ears from patients with unilateral MD, between affected ears from patients with unilateral and bilateral disease or between contralateral ears of patients with unilateral affection and patients without the disease. Conclusion Some anatomical variations might be more frequent in the affected ears of patients with MD, such as the lower rates of individualization of the vestibular aqueduct.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-08-28T00:00:00+01:00
      DOI: 10.1055/s-0037-1604463
  • Parameters for Applying the Brainstem Auditory Evoked Potential with
           Speech Stimulus: Systematic Review

    • Authors: Gabriel; Luísa Bello, Vernier, Luíza Silva, Ferreira, Maria Inês Dornelles da Costa, Silveira, Adriana Laybauer, Machado, Márcia Salgado
      Abstract: Introduction Studies using the Brainstem Auditory Evoked Potential with speech stimulus are increasing in Brazil, and there are divergences between the methodologies used for testing. Objectives To analyze the parameters used in the study of the Brainstem Auditory Evoked Potentials with speech stimulus. Data Synthesis The survey was performed using electronic databases. The search strategy was as follows: “Evoked potentials, auditory” OR “Brain stem” OR “Evoked potentials, auditory, brain stem” AND “Speech.” The survey was performed from June to July of 2016. The criteria used for including articles in this study were: being written in Portuguese, English or Spanish; presenting the description of the testing parameters and the description of the sample. In the databases selected, 2,384 articles were found, and 43 articles met all of the inclusion criteria. The predominance of the following parameters was observed to achieve the potential during study: stimulation with the syllable /da/; monaural presentation with greater use of the right ear; intensity of 80 dB SPL; vertical placement of electrodes; use of in-ear headphones; patient seated, distracted in awake state; alternating polarity; use of speech synthesizer software for the elaboration of stimuli; presentation rate of 10.9/s; and sampling rate of 20 kHz. Conclusions The theme addressed in this systematic review is relatively recent. However, the results are significant enough to encourage the use of the procedure in clinical practice and advise clinicians about the most used procedures in each parameter.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-08-28T00:00:00+01:00
      DOI: 10.1055/s-0037-1605598
  • Physical Therapy for Posterior and Horizontal Canal Benign Paroxysmal
           Positional Vertigo: Long-term Effect and Recurrence: A Systematic Review

    • Authors: Rodrigues; Daniele Leite, Ledesma, Alleluia Lima Losno, Oliveira, Carlos Augusto Pires de, Bahamad Júnior, Fayez
      Abstract: Introduction Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo, and it is characterized by episodes of vertigo roundabout when the head is moved. A systematic review was performed using the most important scientific databases. This review included studies published in English in the last ten years, performed in adults, with emphasis on the diagnosis and treatment of BPPV. Objective To investigate the long-term effectiveness of vestibular rehabilitation (VR) in patients with BPPV and the rate of recurrence of symptoms. Data Synthesis A total of 38 studies were identified, of which only 12 met the inclusion criteria. The majority of the studies stated that VR is effective in decreasing the symptoms, with a short-term efficacy of 84.7%, and 89.2% in the long term in the reviewed studies. Conclusion Valuable studies show the beneficial effects of the maneuvers for the treatment of BPPV and their long-term effectiveness. This strengthens the conclusion that this treatment is effective in resolving symptoms and decreasing recurrences.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-08-28T00:00:00+01:00
      DOI: 10.1055/s-0037-1604345
  • The Effect of Methylphenidate on the Hearing of Children with Attention
           Deficit Hyperactivity Disorder

    • Authors: İsmi; Onur, Yildirim, Veli, Vayisoglu, Yusuf, Togrul, Anis, Toros, Fevziye, Unal, Murat
      Abstract: Introduction There has been a sudden idiopathic hearing loss case presented after methylphenidate treatment in a child with attention deficit hyperactivity disorder (ADHD). Objective This study was performed to reveal the probable ototoxic side effects of methylphenidate use in patients with ADHD. Methods Thirty pediatric patients with ADHD were included in the study. Pure tone audiometry, speech discrimination scores, waves I, III, V absolute latencies and waves I-III, I-V, III-V interpeak latencies at the 80 dB nHL intensity after click stimulus auditory brainstem response (ABR) results were compared before and 3 months after methylphenidate treatment. Results There were no statistically significant difference between pretreatment and posttreatment pure tone and speech audiometry findings and ABR results (p > 0.05 for all parameters). Conclusion Methylphenidate can be regarded as a safe drug regarding ototoxic side effects. Additional studies with a larger sample size and longer follow-up may be needed.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-08-07T00:00:00+01:00
      DOI: 10.1055/s-0037-1605367
  • Hearing Disorders in Congenital Toxoplasmosis: A Literature Review

    • Authors: Corrêa; Camila de Castro, Maximino, Luciana Paula, Weber, Silke Anna Theresa
      Abstract: Introduction Several studies show correlations between congenital toxoplasmosis and hearing loss, with a broad diversity of levels of hearing loss and specifications of hearing disorders. Objective To describe the studies found in the literature regarding hearing disorders in congenital toxoplasmosis. Data Synthesis A literature review was conducted on the Lilacs, SciELO, PubMed and Scopus databases by combining the following keywords: congenital toxoplasmosis and hearing. Based on this search strategy, 152 papers were found, the majority published on the Scopus and PubMed databases from 1958 to 2015. After the application of the inclusion criteria, 8 articles published between 1980 and 2015 were included in the present study. Conclusion This review showed a moderate evidence of the association between hearing disorders and congenital toxoplasmosis, which is characterized by sensorineural hearing loss. However, there are gaps in the description of the specific characteristics of the type and level of hearing loss, or of other possible disorders involved in the auditory processing.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-08-07T00:00:00+01:00
      DOI: 10.1055/s-0037-1605377
  • Suspensory Tethers and Critical Point Membrane Displacement in
           Endolymphatic Hydrops

    • Authors: Pender; Daniel J.
      Abstract: Introduction Grossly displaced membranes are characteristic of endolymphatic hydrops. The process whereby physiological membrane displacement becomes pathological may be mediated by stress, but the membrane biomechanics underlying this transition are unclear. Objective This study seeks to determine the role of suspensory tethers during pressure-induced membrane displacement in the generation of the membranous lesions seen in this disease entity using a biomechanical model approach. Methods The location of membrane suspensory tethers was identified histologically. The influence of tethers on model membrane configuration during displacement was assessed graphically. The relationship of membrane configuration during displacement to curvature radius was quantified trigonometrically. The relationship of curvature radius to stress susceptibility was determined mathematically. The net effect of suspensory tethers on membrane stress levels for various degrees of membrane distention and displacement was then calculated numerically. Results In the inferior labyrinth, suspensory tethers are found to occur on the membranes' boundaries. Such tethering is found to impose a biphasic effect on membrane curvature with increasing degrees of displacement. As a consequence, tensile stress susceptibility is found to decline with initial membrane displacement to a critical point nadir beyond which stress then increases monotonically. No such effect was found for the superior labyrinth. Conclusion Boundary tethers in the inferior labyrinth are associated with significant tensile stress reductions until a critical point of membrane displacement is reached. Displacements short of the critical point may be physiological and even reversible, whereas such displacements beyond the critical point are apt to be overtly hydropic and irreversible.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-07-25T00:00:00+01:00
      DOI: 10.1055/s-0037-1604474
  • A Review of Traditional Vaccine-Preventable Diseases and the Potential
           Impact on the Otolaryngologist

    • Authors: Greenlee; Christopher J., Newton, Stephen S.
      Abstract: Introduction A majority of otolaryngologists have not had direct experience with many vaccine-preventable diseases since the creation of national vaccination programs. Despite the elimination of endemic transmission of some of these diseases in the United States, outbreaks can occur anywhere and still pose a threat to public health around the world. Recent outbreaks and changing trends in exemption rates indicate that it is important for physicians to maintain a working knowledge of how these diseases present and of the recommended treatment guidelines. Objectives This review will evaluate the current state of vaccination rates, vaccine exemption rates and disease incidence in the United States and in the world. It will also examine the clinical presentation and treatment recommendations of these diseases. Data Synthesis United States estimated vaccination rates, vaccine exemption rates and vaccine-preventable disease incidences were obtained from data compiled by the Centers for Disease Control and Prevention. World vaccination rates and disease incidences were obtained from the World Health Organization databases, which compile official figures reported by member states. A PubMed literature review provided information on the current state of vaccination exemptions and outbreaks in the United States. Conclusion Vaccination and vaccine exemption rates continue to put the United States and many areas of the world at risk for outbreaks of vaccine-preventable diseases. Clinical guidelines should be reviewed in the event of a local outbreak.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-07-25T00:00:00+01:00
      DOI: 10.1055/s-0037-1604055
  • Otogenic Lateral Sinus Thrombosis: A Review of Fifteen Patients and
           Changing Trends in the Management

    • Authors: Raja; Kalaiarasi, Parida, Pradipta Kumar, Alexander, Arun, Surianarayanan, Gopalakrishnan
      Abstract: Introduction Otogenic lateral sinus thrombosis is a rare intracranial complication of otitis media in the modern age of antibiotic treatment, but it is potentially a dangerous complication. Objectives The aim of this study is to focus on the various clinical presentations, management options and sequelae in a series of fifteen patients with otogenic lateral sinus thrombosis. Methods Retrospective chart review of inpatients treated for otogenic lateral sinus thrombosis at our tertiary care institution between 2010 and 2015. Results A total of 15 patients (11 males and 4 females) with ages ranging from 9 to 60 years were diagnosed with otogenic lateral sinus thrombosis. The most commonly reported symptoms were headache, ear discharge and hard of hearing, which were experienced by all 15 (100%) patients. In contrast to previous studies found in the literature, 7 (47%) patients in our series presented with neck pain and neck abscess. Imaging studies and microbiological cultures were performed for all patients, who also underwent a mastoidectomy procedure. Internal jugular vein ligation was performed on 5 (33%) patients. Incision and drainage of the neck abscess was performed on 7 (47%) patients. All patients had a satisfactory resolution of their symptoms, and the mortality rate was of 0%. Conclusions Otogenic lateral sinus thrombosis, though a rare complication, can still occur; therefore, keeping a high level of suspicion is important, especially in developing countries. We also describe the patients with neck abscess associated with this rare condition. Combining parenteral antibiotics with surgical intervention is the treatment of choice.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-07-14T00:00:00+01:00
      DOI: 10.1055/s-0037-1604198
  • Holmium Laser for Endoscopic Treatment of Benign Tracheal Stenosis

    • Authors: Verret; D. J., Jategaonkar, Ameya, Helman, Samuel, Kadakia, Sameep, Bahrami, Arash, Gordin, Eli, Ducic, Yadranko
      Abstract: Introduction Laryngotracheal stenosis is a difficult problem with varied etiology and various treatment options. The holmium laser represents another tool for the treatment of benign tracheal stenosis. Objectives To determine the utility of holmium laser treatment for benign tracheal stenosis with regards to safety and efficacy. Methods This was a retrospective case study examining patients with benign tracheal stenosis from 1998–2016 who underwent holmium laser treatment. Determining the safety of this procedure was the primary goal, and complications were monitored as a surrogate of safety. Results A total of 123 patients who underwent holmium laser treatment for benign tracheal stenosis were identified. In total, 123 patients underwent 476 procedures, with follow-up ranging from 1 month to 14 years. No intraoperative or post-operative complications were identified as a direct result of the use of this particular laser. Conclusions The holmium laser is an effective and safe laser to use for tracheal stenosis treatment. It is a contact laser with a short acting distance, which reduces the risk of injury to distal airway structures. Given the favorable experience reported here, the holmium laser should be considered when tracheal surgery is attempted.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-07-14T00:00:00+01:00
      DOI: 10.1055/s-0037-1604201
  • Hearing Loss in Acromegaly - A Review

    • Authors: Teixeira; Liane Sousa, Silva, Isabelle Braz de Oliveira, Sampaio, Andre Luiz Lopes, Oliveira, Carlos Augusto Pires de, Bahamad Júnior, Fayez
      Abstract: Introduction Acromegaly is a chronic disease caused by growth hormone (GH) excess due to a GH-secreting pituitary adenoma in most cases. There is reasonable data to presume the possible influence of chronic GH and insulin-like growth factor I (IGF-I) hyperproduction on the anatomical structures involved in normal sound perception, and on its conductive and/or sensorineural part. Objectives To review the literature about acromegaly and hearing loss. Data Synthesis A systematic literature search was performed using the MEDLINE database, including hand-searching reference lists from original articles. The search was performed using the terms hearing loss and acromegaly, and only 5 studies were found. Conclusion The results are not consistent, but led to different conclusions. Therefore, more studies with greater numbers of patients with acromegaly are needed.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-06-16T00:00:00+01:00
      DOI: 10.1055/s-0037-1603619
  • Cervical Vestibular-Evoked Myogenic Potentials in Sedated Toddlers

    • Authors: Ibraheem; Ola Abdallah, Hassaan, Mohammad Ramadan
      Abstract: Introduction Cervical vestibular-evoked myogenic potentials (cVEMPs) are difficult to test in toddlers who cannot follow instructions or stay calm. Objective Due to the growing need for vestibular testing in very young children as a part of a delayed walking assessment battery, this study aimed to provide a solution to this problem by recording the cVEMPs in toddlers during sedation. Method The cVEMPs measures were assessed in 30 toddlers aged 12 to 36 months with normal motor milestones. They were sedated with chloral hydrate. Then, the head was retracted ∼ 30° backward with a pillow under the shoulders, and turned 45° contralateral to the side of stimulation to put the sternocleidomastoid (SCM) muscle in a state of tension. Results The P13 and N23 waves of the cVEMPs were recordable in all sedated toddlers. The cVEMPs measures resulted in the following: P13 latency of 17.5 ± 1.41 milliseconds, N23 latency of 25.58 ± 2.02 milliseconds, and peak-to-peak amplitude of 15.39 ± 3.45 µV. One-sample t-test revealed statistically significant longer latencies and smaller amplitude of the toddlers' cVEMPs relative to the normative data for adults. Conclusions The difficulty of cVEMPs testing in toddlers can be overcome by sedating them and attaining a position that contracts the SCM muscle. However, the toddlers' recordings revealed delayed latencies and smaller amplitudes than those of adults.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-03-21T00:00:00+0100
      DOI: 10.1055/s-0037-1599151
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