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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  [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)
  • Quality of Life in Pediatric Patients with Allergic Rhinitis treated at
           the Medical Clinic of Integrated Education – Unisul

    • Authors: Dziekanski; Mariana, Marcelino, Taíse de Freitas
      Abstract: Introduction Allergic rhinitis is a common disease among children and adolescents, reaching up to 40% of the population. During childhood, it is usually underdiagnosed because it has nonspecific symptoms. It has a negative impact on quality of life and may predispose to comorbidities. The diagnosis is clinical and treatment aims prevention. Objective The objective of this study is to evaluate the quality of life in pediatric patients with allergic rhinitis. Methods This is an observational study with cross-sectional design. The population consisted of pediatric patients with allergic rhinitis treated at the Medical Clinic of Integrated Education (MCIE) – Universidade do Sul de Santa Catarina - Unisul, Tubarão, SC, Brazil. We collected data from March to June 2016 through the application of the Sociodemographic and Health Questionnaire, rhinitis module of the International Study of Asthma and Allergies in Childhood Questionnaire and the Rhinoconjunctivitis Quality of Life Questionnaire Modified. Results Out of the 69 respondents, 52.2% were boys with a mean age of 10.13 years old. The predominant education level of parents/guardians was incomplete second grade and average income level was two minimum wages. 81.2% said they had previous treatment for AR, 30.4% had asthma and 7.2% eczema. Incidence of patients smoking was absent and family (parents/guardians) smoking was 17.4%. March to July were the months of highest symptom occurrence, slightly disturbing daily activities. The mean value of severity was 51.9, nasal symptoms were the most uncomfortable, and nasal itchiness was the most cited. Conclusion Our results highlight that allergic symptoms negatively impact the life of people with allergic rhinitis, with a predominance of nasal symptoms, especially nasal itchy, representing a poor quality of life of the interviewed.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-03-15T00:00:00+0100
      DOI: 10.1055/s-0037-1599095
  • Cortical Auditory Evoked Potentials with Simple (Tone Burst) and Complex
           (Speech) Stimuli in Children with Cochlear Implant

    • Authors: Martins; Kelly Vasconcelos Chaves, Gil, Daniela
      Abstract: Introduction The registry of the component P1 of the cortical auditory evoked potential has been widely used to analyze the behavior of auditory pathways in response to cochlear implant stimulation. Objective To determine the influence of aural rehabilitation in the parameters of latency and amplitude of the P1 cortical auditory evoked potential component elicited by simple auditory stimuli (tone burst) and complex stimuli (speech) in children with cochlear implants. Method The study included six individuals of both genders aged 5 to 10 years old who have been cochlear implant users for at least 12 months, and who attended auditory rehabilitation with an aural rehabilitation therapy approach. Participants were submitted to research of the cortical auditory evoked potential at the beginning of the study and after 3 months of aural rehabilitation. To elicit the responses, simple stimuli (tone burst) and complex stimuli (speech) were used and presented in free field at 70 dB HL. The results were statistically analyzed, and both evaluations were compared. Results There was no significant difference between the type of eliciting stimulus of the cortical auditory evoked potential for the latency and the amplitude of P1. There was a statistically significant difference in the P1 latency between the evaluations for both stimuli, with reduction of the latency in the second evaluation after 3 months of auditory rehabilitation. There was no statistically significant difference regarding the amplitude of P1 under the two types of stimuli or in the two evaluations. Conclusion A decrease in latency of the P1 component elicited by both simple and complex stimuli was observed within a three-month interval in children with cochlear implant undergoing aural rehabilitation.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-03-15T00:00:00+0100
      DOI: 10.1055/s-0037-1600122
  • Frequency Dependence Hearing Loss Evaluation in Perforated Tympanic

    • Authors: Dawood; Mohammed Radef
      Abstract: Introduction Tympanic membrane perforation is a relatively common problem that predisposes patients to varying degrees of conductive hearing loss. Objective The objective of this study is to evaluate and analyze the frequency dependence hearing loss in tympanic membrane perforation based on the size and the site of perforation. Methods For the study, I selected 71 patients' (89) ears for the cross-sectional study with tympanic membrane perforations; I examined the size and the site of perforations under the microscope and classified them into small, moderate, large, and subtotal perforations, and into anterior central, posterior central, malleolor central, and big central perforations. I measured mean level of speech frequencies hearing loss, and its relation with the site and the size of the perforation analyzed. Results The mean hearing loss at different sizes of the perforation at all speech frequencies was 37.4 dB, with ABG of 26.6 dB, and its maximum loss was detected in subtotal perforation of 42.3 dB, with ABG of 33.7 dB, at 500 Hz frequency, while in relation to the sites, it was 38.2 dB, with ABG of 26.8 dB, and its maximum loss was detected in big central site perforation of 42.1 dB, with ABG of 33.6 dB, at 500 Hz frequency. Conclusions The hearing loss was proportionally related with the sizes of the perforations, and the posterior site had greater impact on the hearing than anterior site perforations. This was also applied to the frequency dependence hearing level, as was detected to be worse at lower frequencies as 500 Hz, than those of 1000–2000 Hz.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-02-28T00:00:00+0100
      DOI: 10.1055/s-0037-1598597
  • Surgical Treatment of Acquired Atresia of the External Auditory Ear Canal

    • Authors: Droessaert; Valerie, Vanspauwen, Robby, Offeciers, Erwin, Zarowski, Andrzej, Dinther, Joost van, Somers, Thomas
      Abstract: Introduction Acquired atresia of the external auditory canal is characterized by the formation of fibrous tissue in the medial part. The causes include chronic otitis externa, perforated chronic otitis media, postoperative or idiopathic healing problems. Acquired atresia presents with hearing loss and can be associated with otorrhea. Objective We analyzed the results of surgery after six months and two years by checking (1) pre- and postoperative hearing thresholds; (2) presence of otorrhea; and (3) whether a dry and patent ear canal is achieved. Methods We conducted this retrospective study at a tertiary referral center. In total, 27 ears underwent treatment with resection of the fibrotic plug followed by transplantation of a split-thickness skin graft covering the bare bone and tympanic membrane. When necessary, we combined this with a myringoplasty and a (meato-) canalplasty. Results Otorrhea was present in 59.3% of the patients initially and in 14.8% at six months and 11% at two years postoperative. A dry and patent ear canal was obtained in 55.6% after six months and in 89% of the patients after two years (n = 27). The pure tone average before surgery was 39.1 dBHL (SD = 20 dBHL), at six months 31.4 dBHL (SD = 16.4 dBHL), and at 24 months postop 30.9 dBHL (SD = 17.1 dBHL). We observed a statistically significant improvement of hearing in 63% of the patients at six months (p = 0.005) and in 65% after two years (p = 0.022). Conclusions Treatment of acquired atresia remains a challenge. Using the appropriate surgical technique, including skin-grafting and regular postoperative check-up, rendered excellent results regarding otorrhea and a moderate improvement of hearing was achieved in 65% of the patients after two years.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-02-28T00:00:00+0100
      DOI: 10.1055/s-0037-1598604
  • Computed Tomography Measurement of Inferior Turbinate in Asymptomatic

    • Authors: El-Anwar; Mohammad Waheed, Hamed, Atef A., Abdulmonaem, Ghada, Elnashar, Ismail, Elfiki, Inas M.
      Abstract: Introduction The inferior turbinate (IT) is the most susceptible turbinate to enlargement causing nasal obstruction. The common belief ascribes most of the enlargement of the IT to mucosal elements. Objective This study aimed to investigate the detailed computed tomography (CT) measurement of the IT in asymptomatic adult by determining the thickness of both the non-bony (mucosa) and bony parts and their relation to nasal air space in different related areas of the nose. Methods We included in the study paranasal CT scans of 108 individuals (216 IT) that had no paranasal pathology. We acquired axial images with multiplanar reformates to obtain delicate details in coronal and sagittal planes for all subjects. We took separate measurements of the thickness of the medial mucosa, bones, and lateral mucosa of the IT on the anterior and posterior portions of ITs. We also measured the air space of the nasal cavity between the septum and IT anteriorly and posteriorly. Results The difference in the air space between nasal septum, anterior and posterior ends of IT was extremely statistically significant (P 
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-02-28T00:00:00+0100
      DOI: 10.1055/s-0037-1598649
  • P300: Waves Identification with and without Subtraction of Traces

    • Authors: Romero; Ana Carla Leite, Reis, Ana Cláudia Mirândola Barbosa, Oliveira, Anna Caroline Silva de, Oliveira Simões, Humberto de, Oliveira Junqueira, Cinthia Amorim de, Frizzo, Ana Cláudia Figueiredo
      Abstract: Introduction The P300 test requires well-defined and unique criteria, in addition to training for the examiners, for a uniform analysis of studies and to avoid variations and errors in the interpretation of measurement results. Objectives The objective of this study is to verify whether there are differences in P300 with and without subtraction of traces of standard and nonstandard stimuli. Method We conducted this study in collaboration with two research electrophysiology laboratories. From Laboratory 1, we selected 40 tests of subjects between 7–44 years, from Laboratory 2, we selected 83 tests of subjects between 18–44 years. We first performed the identification with the nonstandard stimuli; then, we subtracted the nonstandard stimuli from the standard stimuli. The examiners identified the waves, performing a descriptive and comparative analysis of traces with and without subtraction. Results After a comparative analysis of the traces with and without subtraction, there was no significant difference when compared with analysis of traces in both laboratories, within the conditions, of right ears (p = 0.13 and 0.28 for differences between latency and amplitude measurements) and left ears (p = 0.15 and 0.09 for differences between latency and amplitude measurements) from Laboratory 1. As for Laboratory 2, when investigating both ears, results did not identify significant differences (p = 0.098 and 0.28 for differences between latency and amplitude measurements). Conclusion There was no difference verified in traces with and without subtraction. We suggest the identification of this potential performed through nonstandard stimuli.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-02-28T00:00:00+0100
      DOI: 10.1055/s-0037-1599096
  • Relationship of Tumor Thickness with Neck Node Metastasis in Buccal
           Squamous Cell Carcinoma: An Experience at a Tertiary Care Hospital

    • Authors: Ahmed; Sadaf Qadeer, Junaid, Montasir, Awan, Sohail, Choudhary, Moaz M., Kazi, Maliha, Masoom, Aria, Khan, Hareem Usman
      Abstract: Introduction Squamous cell carcinoma is the most common malignancy of the head and neck, with the buccal mucosa being the most common site involved. Early locoregional metastasis is a hallmark of this disease, and early stage tumors may harbor metastatic nodes that are occult. Certain parameters can help identify high-risk patients for whom the pattern of occult nodal metastasis can be predicted. Tumor thickness is one such objective parameter. Objective To determine the relationship of tumor thickness with neck node metastasis in squamous cell carcinoma of the buccal mucosa. Methods A retrospective chart review of 102 patients with biopsy-proven squamous cell carcinoma of the buccal mucosa with N0 Necks was performed. All patients underwent tumor resection with neck dissection, and the tumor thickness was measured. Univariate and multivariate analyses were performed. Results A total of 102 patients, of which 73.53% were males and 26.47% were females. The mean age of the patients was 49.3 ± 11.1 years. It was found that the risk of neck node metastasis in buccal squamous cell carcinoma increases 35.5 times for a tumor thickness ≥ 2 mm, and the risk of neck node metastasis in buccal squamous cell carcinoma decreases by 0.58 times for each centimeter decrease in tumor size, while the rate of occult neck lymph node metastasis was found to be 37%. Conclusion We conclude that tumor thickness is significantly related with neck nodal metastasis in buccal squamous cell carcinoma, considering the age of the patient and the size of the tumor.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-02-21T00:00:00+0100
      DOI: 10.1055/s-0037-1599061
  • The Temporalis Muscle Flap for Palate Reconstruction: Case Series and
           Review of the Literature

    • Authors: Brennan; Tara, Tham, Tristan M., Costantino, Peter
      Abstract: Introduction The temporalis myofascial (TM) is an important reconstructive flap in palate reconstruction. Past studies have shown the temporalis myofascial flap to be safe as well as effective. Free flap reconstruction of palate defects is also a popular method used by contemporary surgeons. We aim to reaffirm the temporalis myofascial flap as a viable alternative to free flaps for palate reconstruction. Objective We report our results using the temporalis flap for palate reconstruction in one of the largest case series reported. Our literature review is the first to describe complication rates of palate reconstruction using the TM flap. Methods Retrospective chart review and review of the literature. Results Fifteen patients underwent palate reconstruction with the TM flap. There were no cases of facial nerve injury. Five (33%) of these patients underwent secondary cranioplasty to address temporal hollowing after the TM flap. Three out of fifteen (20%) had flap related complications. Fourteen (93%) of the palate defects were successfully reconstructed, with the remaining case pending a secondary procedure to close the defect. Ultimately, all of the flaps (100%) survived. Conclusion The TM flap is a viable method of palate defect closure with a high defect closure rate and flap survival rate. TM flaps are versatile in repairing palate defects of all sizes, in all regions of the palate. Cosmetic deformity created from TM flap harvest may be addressed using cranioplasty implant placement, either primarily or during a second stage procedure.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-02-17T00:00:00+0100
      DOI: 10.1055/s-0037-1598653
  • Evaluation of the Efficacy and Tolerability of Oral Ciprofloxacin used in
           the Comprehensive Treatment of External Bacterial Otitis: An Observational
           Prospective Study

    • Authors: Gurov; Alexander Vladimirovich, Kriukov, Andrey Ivanovich, Kunelskaya, Vera Yakovlevna, Isotova, Galina Nikolaevna, Shadrin, Georgiy Borisovich, Luchsheva, Yuliya Vladislavovna, Yakimov, Vladislav Olegovich, Garg, Amit, Akku, Shyam Prasad, Gupta, Namita
      Abstract: Introduction Otitis Externa is common ear infection with a prevalence of 1%. Objective The objective of this study is to evaluate the clinical and microbiological efficacy and safety profile with oral ciprofloxacin in the external bacterial otitis (EBO) management. Methods This is a prospective observational study conducted with EBO outpatients referred to the otorhinolaryngology center in Moscow between March and August 2013. Our study included patients from two cohorts, acute external bacterial otitis (AEBO) - Group 1 - and exacerbation of chronic otitis externa (CEBO) - Group 2. We administered Ciprofloxacin 500 mg twice daily with standard topical EBO treatment for up to 10 days. Patients underwent evaluation on study visit days 1, 3, 5, and 10 for the severity. Bacteriological examination of ear canal cultures took place on Day 1 and Day 10. Results We collected data from 60 EBO outpatients (AEBO: N = 30 and CEBO: N = 30). Swimming was the major risk factor associated with the disease in addition to the most common pathogenic organisms - Staphylococcus aureus and Pseudomonas aeruginosa. was We attained complete resolution of the inflammatory process in 28 (93%) and 27 (90%) patients in the AEBO and CEBO group, respectively. We confirmed this by microbiological test with almost complete eradication of the causative organisms. Overall, we observed good positive dynamics of ear canal with no major side effects. Conclusion We found that Ciprofloxacin 500 mg, when administered orally twice daily for 7 to 10 days in otitis externa patients is clinically and microbiologically effective and comparatively safer than other antimicrobials.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-02-17T00:00:00+0100
      DOI: 10.1055/s-0037-1598648
  • Variation in the Hearing Threshold in Women during the Menstrual Cycle

    • Authors: Souza; Dayse da Silva, Luckwu, Brunna, Andrade, Wagner Teobaldo Lopes de, Pessoa, Luciane Spinelli de Figueiredo, Nascimento, João Agnaldo do, Rosa, Marine Raquel Diniz da
      Abstract: Introduction The hormonal changes that occur during the menstrual cycle and their relationship with hearing problems have been studied. However, they have not been well explained. Objective The objective of our study is to investigate the variation in hearing thresholds in women during the menstrual cycle. Method We conducted a cohort and longitudinal study. It was composed of 30 volunteers, aged 18–39 years old, of which 20 were women during the phases of the menstrual cycle and 10 were men (control group) who underwent audiometry and impedance exams, to correlate the possible audiological changes in each phase of the menstrual cycle. Results There were significant changes in hearing thresholds observed during the menstrual cycle phases in the group of women who used hormonal contraceptives and the group who did not use such contraceptives. Improved hearing thresholds were observed in the late follicular phase in the group who did not use hormonal contraceptives and the hearing thresholds at high frequencies were better. Throughout the menstrual cycle phases, the mean variation was 3.6 db HL between weeks in the group who used hormonal contraceptives and 4.09 db HL in the group who did not use them. Conclusions The present study found that there may be a relationship between hearing changes and hormonal fluctuations during the menstrual cycle based on changes in the hearing thresholds of women. In addition, this study suggests that estrogen has an otoprotective effect on hearing, since the best hearing thresholds were found when estrogen was at its maximum peak.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-02-17T00:00:00+0100
      DOI: 10.1055/s-0037-1598601
  • Study of Anthropometric Measurements of the Anterior Ethmoidal Artery
           using Three-dimensional Scanning on 300 Patients

    • Authors: Bortoli; Vinicius Tomadon, Martins, Rafael Ferri, Negri, Krystal Calmeto
      Abstract: Introduction The anterior ethmoidal artery (AEA) is one of the main arteries that supply both the nasal mucosa and the ethmoid sinuses. The AEA shows variability regarding its distance from adjacent structures. Several studies have developed techniques to identify the AEA. Objective This study aimed to compare the measurements from the AEA to the ethmoid bulla and to the frontal beak by using computed tomography of the face, while identifying their intraindividual and interindividual variations. Methods We analyzed 300 CT scans of the face performed at the CT scan Center at Hospital. The average age of subjects was 36 ± 15.1 years (range 4–84). Results We found that the average distance from the AEA to the ethmoid bulla was 17.2 ± 1.8 mm and the distance from the AEA to the frontal beak was 15.1 ± 2.2 mm. Regarding the average distance from the AEA to the frontal beak (AEA-frontal beak), there was a difference between the right and left sides, with the former being 0.4 mm higher on average than the latter. Among the age groups, there was a significant difference of distances between the AEA and the ethmoid bulla (AEA-ethmoid bulla), which were shorter in the ≤ 12 years group. There was a positive and significant correlation between both measurements analyzed, with low values (high) of AEA-ethmoid bulla distance corresponding to low values (high) of AEA-frontal beak distance. Conclusion The measurements obtained adds anatomical knowledge that can serve as a parameter in frontal and ethmoid sinus surgery.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-02-13T00:00:00+0100
      DOI: 10.1055/s-0037-1598598
  • Air and Bone Conduction Frequency-specific Auditory Brainstem Response in
           Children with Agenesis of the External Auditory Canal

    • Authors: Sleifer; Pricila, Didoné, Dayane Domeneghini, Keppeler, Ísis Bicca, Bueno, Claudine Devicari, Riesgo, Rudimar dos Santos
      Abstract: Introduction The tone-evoked auditory brainstem responses (tone-ABR) enable the differential diagnosis in the evaluation of children until 12 months of age, including those with external and/or middle ear malformations. The use of auditory stimuli with frequency specificity by air and bone conduction allows characterization of hearing profile. Objective The objective of our study was to compare the results obtained in tone-ABR by air and bone conduction in children until 12 months, with agenesis of the external auditory canal. Method The study was cross-sectional, observational, individual, and contemporary. We conducted the research with tone-ABR by air and bone conduction in the frequencies of 500 Hz and 2000 Hz in 32 children, 23 boys, from one to 12 months old, with agenesis of the external auditory canal. Results The tone-ABR thresholds were significantly elevated for air conduction in the frequencies of 500 Hz and 2000 Hz, while the thresholds of bone conduction had normal values in both ears. We found no statistically significant difference between genders and ears for most of the comparisons. Conclusion The thresholds obtained by bone conduction did not alter the thresholds in children with conductive hearing loss. However, the conductive hearing loss alter all thresholds by air conduction. The tone-ABR by bone conduction is an important tool for assessing cochlear integrity in children with agenesis of the external auditory canal under 12 months.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-02-13T00:00:00+0100
      DOI: 10.1055/s-0037-1598243
  • Tobacco Influence on Taste and Smell: Systematic Review of the Literature

    • Authors: Da Ré; Allessandra Fraga, Gurgel, Léia Gonçalves, Buffon, Gabriela, Moura, Weluma Evelyn Rodrigues, Marques Vidor, Deisi Cristina Gollo, Maahs, Márcia Angelica Peter
      Abstract: Introduction In Brazil, estimates show that 14.7% of the adult population smokes, and changes in smell and taste arising from tobacco consumption are largely present in this population, which is an aggravating factor to these dysfunctions. Objectives The objective of this study is to systematically review the findings in the literature about the influence of smoking on smell and taste. Data Synthesis Our research covered articles published from January 1980 to August 2014 in the following databases: MEDLINE (accessed through PubMed), LILACS, Cochrane Library, and SciELO. We conducted separate lines of research: one concerning smell and the other, taste. We analyzed all the articles that presented randomized controlled studies involving the relation between smoking and smell and taste. Articles that presented unclear methodologies and those whose main results did not target the smell or taste of the subjects were excluded. Titles and abstracts of the articles identified by the research strategy were evaluated by researchers. We included four studies, two of which were exclusively about smell: the first noted the relation between the perception of puff strength and nicotine content; the second did not find any differences in the thresholds and discriminative capacity between smokers and nonsmokers. One article considered only taste and supports the relation between smoking and flavor, another considered both sensory modalities and observes positive results toward the relation immediately after smoking cessation. Conclusion Three of the four studies presented positive results for the researched variables.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-02-13T00:00:00+0100
      DOI: 10.1055/s-0036-1597921
  • Clinical Features and Surgical Treatment of Schwannoma Affecting the Base
           of the Tongue: A Systematic Review

    • Authors: Sitenga; Jenna Lamendola, Aird, Gregory Alan, Nguyen, Austin, Vaudreuil, Adam, Huerter, Christopher
      Abstract: Introduction Schwannomas of the head and neck account for 25–40% of all cases, with presentation at the base of the tongue as the most frequent site for intraoral tumors. Objectives Here, a systematic review was conducted to include 15 cases of patients with schwannoma of the base of the tongue. Data Synthesis Most patients presented with a single, painless, well-encapsulated nodule at the base of the tongue. These nodules were slow-growing, with an average of 13.3 months from onset to presentation. Most cases were accompanied by airway obstruction, indicated by symptoms of dysphagia, dysarthria, snoring, and sleep apnea. Overall, the histological studies were consistent with a benign schwannoma with a palisading Antoni A and Antoni B pattern without malignant changes in cell morphology. These tumors were treated via complete surgical excision, and all cases achieved full remission by final follow-up. Conclusion Surgical removal is the primary mode of treatment with excellent postoperative prognosis and rare instances of recurrence. Given the rarity of this tumor, this review of available case studies serves to comprehensively describe clinical presentation and surgical treatment approaches to tongue base schwannoma.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-02-13T00:00:00+0100
      DOI: 10.1055/s-0037-1598609
  • Nasalance Changes Following Various Endonasal Surgeries

    • Authors: Amer; Hazem Saeed, Elaassar, Ahmed Shaker, Anany, Ahmad Mohammad, Quriba, Amal Saeed
      Abstract: Introduction There is change in nasalance post endonasal surgery which is not permanent. Objectives The objective of this study is to evaluate the long-term nasalance changes following different types of endonasal surgeries. Methods We included in this study patients who underwent sinonasal surgery at the Otorhinolaryngology Department in Zagazig University Hospitals from February 2015 until March 2016. We divided the patients into two groups according to the surgeries they underwent: Group (A) was the FESS group and group (B), the septoturbinoplasty group. We checked nasalance using a nasometer before and after the sinonasal surgery. Results Nasalance increased at one month after the operation in both groups. However, it returned to nearly original levels within three months postoperatively. Conclusion FESS, septoplasty, and turbinate surgery may lead to hypernasal speech. This hypernasal speech can be a result of change in the shape and diameter of the resonating vocal tract. Hypernasal speech in these circumstances may be a temporary finding that can decrease with time. Surgeons should inform their patients about the possibility of hypernasality after such types of surgery, especially if they are professional voice users.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-02-10T00:00:00+0100
      DOI: 10.1055/s-0037-1598035
  • Head and Neck Lymphomas in HIV Patients: a Clinical Perspective

    • Authors: Oishi; Natsuki, Bagán, José Vicente, Javier, Karla, Zapater, Enrique
      Abstract: Introduction Because of the many HIV-related malignancies, the diagnosis and treatment of lymphoma in patients infected with human immunodeficiency virus are challenging. Objective Here, we review current knowledge of the pathogenesis, epidemiology, symptomatology, diagnosis, and treatment of head and neck lymphomas in HIV patients from a clinical perspective. Data Synthesis Although Hodgkin's lymphoma is not an AIDS-defining neoplasm, its prevalence is ten times higher in HIV patients than in the general population. NHL is the second most common malignancy in HIV patients, after Kaposi's sarcoma. In this group of patients, NHL is characterized by rapid progression, frequent extranodal involvement, and a poor outcome. HIV-related salivary gland disease is a benign condition that shares some features with lymphomas and is considered in their differential diagnosis. Conclusion The otolaryngologist may be the first clinician to diagnose head and neck lymphomas. The increasing survival of HIV patients implies clinical and epidemiological changes in the behavior of this disease. Early diagnosis is important to improve the prognosis and avoid the propagation of HIV infection.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-02-01T00:00:00+0100
      DOI: 10.1055/s-0036-1597825
  • 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
  • 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
  • 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
  • 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
  • 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)
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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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