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Journal Cover International Archives of Otorhinolaryngology
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  This is an Open Access Journal Open Access journal
     ISSN (Print) 1809-9777 - ISSN (Online) 1809-4864
     Published by Thieme Publishing Group Homepage  [157 journals]
  • Official Publication of the Otorhinolaryngology Foundation and Societas
           Oto‐Rhino‐Laryngologia Latina
    • International Archives of Otorhinolaryngology 2014; S 01

      Article in Thieme eJournals:
      Table of contents     Congress

      Int. Arch. Otorhinolaryngol. 2014; 182014-09-04T14:38:37+01:00
      Issue No: Vol. 18, No. S 01 (2014)
  • The Etiology of Möbius Syndrome: A Social Problem?
    • Int. Arch. Otorhinolaryngol. 2014; 18: 227-228
      DOI: 10.1055/s-0034-1383548

      Thieme Publicações Ltda Rio de Janeiro, Brazil

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

      Int. Arch. Otorhinolaryngol. 2014; 18: 227-2282014-07-02T18:53:57+01:00
      Issue No: Vol. 18, No. 03 (2014)
  • Hairy Polyp of the Supratonsillar Fossa Causing Intermittent Airway

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

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

    • Authors: Pradhananga; Rabindra Bhakta, Dangol, Kripa, Shrestha, Anjan, Baskota, Dharma Kanta
      Abstract: Introduction Rosai-Dorfman disease (RDD) is a rare histiocytic proliferative disorder of unknown etiology. Usually it presents with massive painless cervical lymph node enlargement. Histologically, it shows proliferation of distinctive histiocytic cells that demonstrate emperipolesis in the background of a mixed inflammatory infiltrates. Immunohistochemically, the cells are positive for markers such as CD68 and S100. Objective To report a case of a 12-year-old patient with multiple sites of cervical lymphadenitis, which was diagnosed as RDD histopathologically as well as immunohistologically. Resumed Report A 12-year-old girl presented with multiple painless sites of cervical lymphadenitis without any systemic and other ear, nose, and throat manifestations. The biopsy report of the lymph node showed dilatation of the sinuses, filled with histiocytes having foamy cytoplasm. Many of the histiocytes were engulfing mature lymphocytes. The sinus histiocytes were strongly positive for S-100 protein. Conclusion RDD must be considered in the differential diagnosis of massive or multiple lymphadenopathies.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-08-25T14:01:10+01:00
      DOI: 10.1055/s-0034-1387163
  • Extranasopharyngeal Angiofibroma Originating in the Inferior Turbinate: A
           Distinct Clinical Entity at an Unusual Site

    • Authors: Baptista; Marco Antonio Ferraz de Barros, Pinna, Fábio de Rezende, Voegels, Richard Louis
      Abstract: Introduction The extranasopharyngeal angiofibroma is histologically similar to juvenile nasopharyngeal angiofibroma, differing from the latter in clinical and epidemiologic characteristics. Objectives We present a case of extranasopharyngeal angiofibroma originating in the inferior turbinate. Resumed Report The patient was a girl, 8 years and 6 months of age, who had constant bilateral nasal obstruction and recurrent epistaxis for 6 months, worse on the right side, with hyposmia and snoring. Nasal endoscopy showed a reddish lesion, smooth, friable, and nonulcerated. Computed tomography showed a lesion with soft tissue density in the right nasal cavity. We used an endoscopic approach and found the lesion inserted in the right inferior turbinate. We did a subperiosteal dissection and excision with a partial turbinectomy with a resection margin of 0.5 cm. Histopathology reported it to be an extranasopharyngeal angiofibroma. Conclusion Although rare, extranasopharyngeal angiofibroma should be considered in the diagnosis of vascular tumors of the head and neck.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-08-25T14:01:10+01:00
      DOI: 10.1055/s-0034-1387811
  • Association between Ear Fullness, Earache, and Temporomandibular Joint
           Disorders in the Elderly

    • Authors: Macedo; Julya, Doi, Marcelo, Oltramari-Navarro, Paula Vanessa, Gorres, Vanessa, Mendes, Marina Stephany, Silva, Izabele Machado, Navarro, Ricardo, Marchiori, Luciana Lozza
      Abstract: Introduction An earache (otalgia or ear pain) is pain in one or both ears that may last a short or long time. Earache is prevalent in the population with temporomandibular joint disorders (TMJDs), but there is a dearth of epidemiologic studies regarding the association between TMJD and ear pain and ear fullness in older people. Objective To assess the presence of earache and ear fullness in elderly patients with TMJD. Methods A cross-sectional study was conducted in independently living, elderly individuals. TMJD was assessed by dental evaluation and earache was verified by medical history. Statistical analysis was performed using the chi-square test and relative risk. Results Of the 197 subjects evaluated in this part of the study, 22 had earache, and 35 was verified by ear fullness. Of the 22 subjects with earache, none had conductive or mixed hearing loss in the ears tested. There was a significant association (p = 0.036) between the TMJD and earache (odds ratio = 2.3), but there was no significant association between the TMJD and ear fullness. Conclusion These results highlight the importance of identifying risk factors for earache that can be modified through specific interventions, which is essential in the prevention of future episodes, as well as managing the process of treatment of elderly patients in general.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-08-25T14:01:10+01:00
      DOI: 10.1055/s-0034-1385844
  • Ambient Noise in Emergency Rooms and Its Health Hazards

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

    • Authors: Pender; Daniel J.
      Abstract: Introduction The membranes of the inferior division of the labyrinth in some mammals appear more vulnerable to hydropic distention than those of the superior division. This finding in guinea pigs, cats, and humans has been attributed to the evidently thinner membranes with implied higher stress levels. Objective The objective of this study is to identify other configurational features, if any, that may contribute to membrane stress proclivity and therefore might act to augment or ameliorate stress in the several chambers of the membranous labyrinth. Methods Stress proclivity can be investigated using shell theory to analyze a geometric model of the labyrinthine membranes in mammals. Such an approach can provide the necessary mathematical descriptions of stress in each chamber of the labyrinth. Results Stress proclivity depends on three physical features: membrane thickness, radial size, and chamber shape. Lower stress proclivities are projected for smaller chambers with thick, highly synclastic membranes. Higher stress levels are projected for larger chambers with thin, flat, or anticlastic membranes. Conclusions In the mammalian labyrinth, pars superior chambers exhibit permutations of membrane thickness, size, and favorable shapes that reduce stress proclivity. In contrast, the pars inferior chambers are characterized by thin membranes with flat contours and adverse shapes that make them especially vulnerable to hydropic distention.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-08-25T14:01:08+01:00
      DOI: 10.1055/s-0034-1385846
  • Sensitization Profile to Allergens in Patients Using Multi-Test II

    • Authors: Maniglia; Sergio Fabricio, Tsuru, Fernanda Miyoko, Santos, Victor Carvalho dos, Ueda, Denis Massatsugu
      Abstract: Introduction Medical intervention in allergies has broadened its perspective, also focusing in the quality of life of patients. Patients are instructed, before using pharmacotherapy agents, to avoid the causal agent. Objective This study aims to analyze the sensitization profile of patients with allergic complaints and identify possible characteristics specific to each age group and gender. Methods A descriptive cross-sectional study included data collected from medical records (from Multi-Test II database, Lincoln Diagnostics Inc. Decatur, Illinois) of 1,912 patients who underwent skin prick test from March to October 2013. Patients were organized and analyzed according to gender, age, and results of the allergens subtypes tested. Results The study was composed of 1,912 patients (60% male and 40% female) of ages between 3 and 87 years. Positive tests were more prevalent in quantity and intensity with the mites Dermatophagoides pteronyssinus and Dermatophagoides farinae, each with 60% of the total analyzed. In second place were pollens, especially Dactylis glomerata and Festuca pratensis. Conclusion The female and male sexes were equally atopic. Fungi and epithelia of dog and cat were not considered potential aeroallergens that could cause symptoms. However, mites are common in Paraná, Brazil. Further studies regarding the pollens are needed, as this study result diverged from the literature.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-08-25T14:01:07+01:00
      DOI: 10.1055/s-0034-1385845
  • Physical Activity in the Prevention of Benign Paroxysmal Positional
           Vertigo: Probable Association

    • Authors: Bazoni; Jéssica Aparecida, Mendes, William Siqueira, Meneses-Barriviera, Caroline Luiz, Melo, Juliana Jandre, Costa, Viviane de Souza Pinho, Teixeira, Denilson de Castro, Marchiori, Luciana Lozza de Moraes
      Abstract: Introduction Physical inactivity is an important risk factor for many age-related diseases and symptoms such as dizziness and vertigo. Objective The aim of the study was to investigate the possible association between benign paroxysmal positional vertigo (BPPV) and regular physical activity in elderly subjects. Methods This cross-sectional study included 491 elderly individuals who lived independently. Physical exercise was assessed through a questionnaire and BPPV by history and the Dix-Hallpike maneuver. Results The present study indicates no significant association between BPPV with lack of physical activity in men and in the total population. We have confirmed associations between BPPV with lack of physical activity in women (p = 0.01). Women with a sedentary lifestyle who do not practice physical activity are 2.62 more likely to have BPPV than those with regular physical activity. Conclusion These results highlight the importance of identifying risk factors for BPPV that can be modified through specific interventions. Regular physical activity is a lifestyle with potential to decrease the risk of vertigo in women.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-08-25T14:01:06+01:00
      DOI: 10.1055/s-0034-1384815
  • Masticatory Changes as a Result of Oral Disorders in Smokers

    • Authors: Rech; Rafaela Soares, Santos, Karoline Weler dos, Maahs, Márcia Angelica Peters, Vidor, Deisi Cristina Gollo Marques
      Abstract: Introduction For chewing to occur properly, it is necessary that all oral structures are present and of normal standard. Objectives The aim of this study is to verify the presence of oral changes in smokers and the impact of the changes on masticatory function compared with individuals who never smoked. Methods Forty-eight subjects were evaluated, split into two study groups (24 subjects each) of current tobacco users and individuals who have never smoked. The variables halitosis, presence of lesions suggestive of caries and periodontal problems, number of teeth, classification of malocclusions according to angle, standard grinding food, chewing pattern, and speed of chewing were evaluated. Results There was no statistically significant difference in tooth loss between the groups, but the smokers had more losses manifesting malocclusion. Most smokers had halitosis and lesions suggestive of caries and periodontal problems; the halitosis was associated with the latter variable. Masticatory speed was also reduced significantly in these individuals compared with the control group when associated with occlusal alterations, in addition to grinding food with the tongue. No difference was observed regarding the chewing pattern. The presence of halitosis and periodontal problems were more common in those who smoke more than 20 years. Conclusion There is an association between smoking and dental changes, which cause increased masticatory changes.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-08-13T16:15:12+01:00
      DOI: 10.1055/s-0034-1385843
  • Hearing Aid Use and Adherence to Treatment in a Publicly-Funded Health
           Service from the City of São Paulo, Brazil

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

    • Authors: Avila; Daniel D., D'Ávila, Jeferson, Góis, Carlos, Barretto, Luíza
      Abstract: Introduction Premalignant lesions are considered both a hyperplastic and dysplastic stage of epithelial lesions in the glottic larynx that may or may not progress into an invasive carcinoma. The evolution of laryngoscopic procedures in outpatients has provided better access to important information for safe and easy diagnosis of laryngeal pathologies. Objective The goal of this study was to determine the accuracy of the preoperative exam for diagnosis of premalignant laryngeal lesions and their connection with benign diseases of the vocal folds, as well as to assess their epidemiologic characteristics. Methods This is a retrospective and longitudinal cohort study performed through the review of surgical records of patients who underwent laryngeal microsurgery performed by a single surgeon from 1990 to 2009. Results Preoperative assessment of outpatients was 64.4% accurate. Vocal fold cysts were the most frequently associated benign lesions. The patients who apparently had premalignant lesions represented 10.57% of those who underwent laryngeal microsurgery. Premalignant lesions prevailed in men (69.49%) age from 41 to 50 years (32.20%). Conclusion Although the evolution of laryngoscopic procedures in outpatients has provided better access to important information for safe and easy diagnosis of laryngeal pathologies, about one-third of premalignant lesions are diagnosed just during the laryngeal microsurgery. Cysts were the most prevalent concomitant benign lesion of the vocal folds. Males were more prevalent than females and the predominant age bracket was between 41 and 50 years.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-07-22T15:28:23+01:00
      DOI: 10.1055/s-0034-1376431
  • Hearing Profile of Brazilian Forestry Workers' Noise Exposure

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

    • Authors: Pascoto; Gabriela, Abreu, Cassiana, Silva, Maria Laura, Weber, Raimar, Pignatari, Shirley Shizue, Stamm, Aldo
      Abstract: Introduction The eustachian tube is one of the key structures responsible for the functional balance of the middle ear. Some clinical conditions associated with tubal malfunction can cause extremely unpleasant symptoms. These symptoms could be triggered by acute loss of weight, for example, after bariatric surgery. Objective To evaluate the frequency and intensity of auditory tube dysfunction symptoms in obese patients after bariatric surgery. Methods Nineteen patients with accepted formal indications for bariatric surgery underwent a hearing evaluation (otoscopy, tonal and vocal audiometry, and impedanceometry) and a hearing questionnaire before, at the time of, 3 months after surgery (first postoperative evaluation), and 6 months (second postoperative evaluation) after surgery. Patients with a history of ear disease or ear surgery were excluded. Results None of the patients reported tubal dysfunction symptoms before surgery. Postsurgical results showed that 5 (26.3%) patients presented symptoms related to dysfunction of the eustachian tube at the first postoperative evaluation. After the 6-month follow-up, 9 (47.3%) patients reported symptoms of tubal dysfunction. Conclusion This study suggests that bariatric surgery can cause symptoms of eustachian tube dysfunction, probably due to rapid weight loss and the consequent loss of peritubal fat.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-07-18T13:46:09+01:00
      DOI: 10.1055/s-0034-1382097
  • Anatomopathology of the Superstructure of the Stapes in Patients with

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

    • Authors: Moura; Amanda Christina Gomes de, Goffi-Gomez, Maria Valéria Schmidt, Couto, Maria Ines Vieira, Brito, Rubens, Tsuji, Robinson Koji, Befi-Lopes, Debora Maria, Matas, Carla Gentile, Bento, Ricardo Ferreira
      Abstract: Introduction Currently the cochlear implant allows access to sounds in individuals with profound hearing loss. The objective methods used to verify the integrity of the cochlear device and the electrophysiologic response of users have noted these improvements. Objective To establish whether the evoked compound action potential of the auditory nerve can appear after electrical stimulation when it is absent intraoperatively. Methods The clinical records of children implanted with the Nucleus Freedom (Cochlear Ltd., Australia) (CI24RE) cochlear implant between January 2009 and January 2010 with at least 6 months of use were evaluated. The neural response telemetry (NRT) thresholds of electrodes 1, 6, 11, 16, and 22 during surgery and after at least 3 months of implant use were analyzed and correlated with etiology, length of auditory deprivation, and chronological age. These data were compared between a group of children exhibiting responses in all of the tested electrodes and a group of children who had at least one absent response. Results The sample was composed of clinical records of 51 children. From these, 21% (11) showed no NRT in at least one of the tested electrodes. After an average of 4.9 months of stimulation, the number of individuals exhibiting absent responses decreased from 21 to 11% (n = 6). Conclusion It is feasible that absent responses present after a period of electrical stimulation. In our sample, 45% (n = 5) of the patients with intraoperative absence exhibited a positive response after an average of 4.9 months of continued electrical stimulation.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-07-17T13:38:48+01:00
      DOI: 10.1055/s-0034-1372510
  • Therapeutic Options in Idiopathic Burning Mouth Syndrome: Literature

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

    • Authors: Nasralla; Heloisa Romeiro, Goffi Gomez, Maria Valéria Schimidt, Magalhaes, Ana Tereza, Bento, Ricardo Ferreira
      Abstract: Introduction The factors that affect the development of children with and without hearing disabilities are similar, provided their innate communication abilities are taken into account. Parents need to mourn the loss of the expected normally hearing child, and it is important that parents create bonds of affection with their child. Objective To conduct a postevaluation of the development and cognition of 20 candidates for cochlear implants between 1 and 13 years of age and to observe important factors in their development. Methods The following instruments were used in accordance with their individual merits: interviews with parents; the Vineland Social Maturity Scale; the Columbia Maturity Scale; free drawings; Bender and Pre-Bender testing; and pedagogical tests. Results The results are described. Conclusion Parental acceptance of a child's deafness proved to be the starting point for the child's verbal or gestural communication development, as well as for cognitive, motor, and emotional development. If the association between deafness and fine motor skills (with or without multiple disabilities) undermines the development of a child's speech, it does not greatly affect communication when the child interacts with his or her peers and receives maternal stimulation. Overprotection and poor sociability make children less independent, impairs their development, and causes low self-esteem. Further observational studies are warranted to determine how cochlear implants contribute to patient recovery.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-06-23T13:18:50+01:00
      DOI: 10.1055/s-0034-1382095
  • The Study of Otoacoustic Emissions and the Suppression of Otoacoustic
           Emissions in Subjects with Tinnitus and Normal Hearing: An Insight to
           Tinnitus Etiology

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

    • Authors: Prestes; Luciano, Hamerschmidt, Rogerio, Tenorio, Sergio, Moreira, Ana Tereza, Tambara, Elizabeth
      Abstract: Introduction According to current research, the number of patients seen in the emergency room is progressively increasing. There are few studies on the characteristics of ear, nose, and throat diseases treated in the emergency room. Objectives (1) To establish the epidemiologic profile of patients with these complaints treated at a referral emergency hospital in locoregional city Curitiba, and (2) to evaluate the calls that truly required emergency care. Methods This is a contemporary cross-study of urgent and emergency referrals to a hospital with otolaryngologic services during the year 2012. Data were collected and epidemiologic characteristics analyzed. Results We analyzed 1,067 patients: 312 presented in spring, 255 in summer, 253 in autumn, and 247 in winter. We found 17 diseases that were common during the year, with 244 (23.99%) upper respiratory tract infections being the most frequent disease. There was no statistically significant difference in the incidence of diseases, except that acute otitis media was most common during the summer (p = 0.02); distribution between the sexes was balanced. The predominant age group was adults. We found 9.27% cases were true emergencies. Conclusion Patients were 20 to 40 years, with upper respiratory tract infection the most incident disease; 9.27% of cases were emergencies.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-06-17T14:18:12+01:00
      DOI: 10.1055/s-0034-1382099
  • Auditory Brainstem Response in Term and Preterm Infants with Neonatal
           Complications: The Importance of the Sequential Evaluation

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

    • Authors: Pradhananga; Rabindra
      Abstract: Introduction Suppurative otitis media is still the most common ear disease in developing countries. Otogenic complications of this disease have decreased considerably because of the advent of antibiotics, and few rare complications have been encountered. Objective To report a case of a patient with scapular abscess and lumber cellulitis that had progressed from Bezold abscess as a complication of squamous-type chronic suppurative otitis media. Resumed Report A 14-year-old girl presented with foul-smelling, purulent, left ear discharge of 1-year duration and decreased hearing on same ear of 6-month duration. She developed painful swelling in left side of neck with restricted neck movement and high-grade fever of 3-day duration and swelling over the left scapular area of 1-day duration. The examination and investigation diagnosed squamous-type chronic suppurative otitis media with Bezold abscess progressing to scapular abscess and lumber cellulitis. Final Comment Chronic suppurative otitis media can lead to abscess in any part of body.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-05-28T14:37:39+01:00
      DOI: 10.1055/s-0034-1372511
  • Screening of Connexin 26 in Nonsyndromic Hearing Loss

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

    • Authors: Ribas; Angela, Mafra, Nicoli, Marques, Jair, Mottecy, Carla, Silvestre, Renata, Kozlowski, Lorena
      Abstract: Introduction Elderly individuals with bilateral hearing loss often do not use hearing aids in both ears. Because of this, dichotic tests to assess hearing in this group may help identify peculiar degenerative processes of aging and hearing aid selection. Objective To evaluate dichotic hearing for a group of elderly hearing aid users who did not adapt to using binaural devices and to verify the correlation between ear dominance and the side chosen to use the device. Methods A cross-sectional descriptive study involving 30 subjects from 60 to 81 years old, of both genders, with an indication for bilateral hearing aids for over 6 months, but using only a single device. Medical history, pure tone audiometry, and dichotic listening tests were all completed. Results All subjects (100%) of the sample failed the dichotic digit test; 94% of the sample preferred to use the device in one ear because bilateral use bothered them and affected speech understanding. In 6%, the concern was aesthetics. In the dichotic digit test, there was significant predominance of the right ear over the left, and there was a significant correlation between the dominant side with the ear chosen by the participant for use of the hearing aid. Conclusion In elderly subjects with bilateral hearing loss who have chosen to use only one hearing aid, there is dominance of the right ear over the left in dichotic listening tasks. There is a correlation between the dominant ear and the ear chosen for hearing aid fitting.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-04-04T20:47:43+01:00
      DOI: 10.1055/s-0034-1372508
  • Intraoperative Neural Response Telemetry and Neural Recovery Function: a
           Comparative Study between Adults and Children

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

    • Authors: Bastos; Bárbara Guimarães, Ferrari, Deborah Viviane
      Abstract: Introduction The family has ultimate responsibility for decisions about the use and care during the daily routine and problem solving in the manipulation of hearing aids (HA) in infants and children. Objective The purpose of the study was to assess technical and content quality of Babies' Portal website Hearing Aid section by audiologists. Methods Letters and e-mails were sent inviting professionals to surf the website and anonymously fill out an online form with 58 questions covering demographic data as well as the website's technical (Emory questionnaire with the subscales of accuracy, authorship, updates, public, navigation, links, and structure) and content quality. Results A total of 109 professionals (tree men and 106 women) with mean age of 31.6 years participated in the study. Emory percentage scores ranged from 90.1 to 96.7%. The Hearing Aid section contents were considered good or very good. Conclusion The website was deemed to have good technical and content quality, being suitable to supplement informational counseling to parents of hearing-impaired children fitted with hearing aids.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-02-17T20:28:38+0100
      DOI: 10.1055/s-0034-1368139
  • Nasolacrimal Duct Mucocele: Case Report and Literature Review

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

    • Authors: Arruda; Milena Moreira, Monteiro, Daniela Yasbek, Fernandes, Atilio Maximino, Menegatti, Vanessa, Thomazzi, Emerson, Hubner, Ricardo Arthur, Lima, Luiz Guilherme Cernaglia Aureliano de
      Abstract: Introduction Vascular leiomyoma of the nasal cavity is an extremely rare tumor that represents less than 1% of all vascular leiomyomas. It is more prevalent in women between the fourth and sixth decades, reaching primarily the inferior nasal turbinates. Objectives Reporting and assisting the systematization of more accurate diagnostic methods in clinical and complementary investigation of vascular leiomyoma in the nasal cavity. Resumed Report We present the case of a 49-year-old woman diagnosed with vascular leiomyoma in the nasal cavity, which manifested mainly with nasal obstruction. During investigation, computer tomography was not diagnostic, the cytologic study was not conclusive, and according to the biopsy, it was a squamous papilloma. Conclusion We suggest that the technical difficulty in obtaining an adequate amount of material for preoperative biopsy, associated with the topography of the lesion in the vestibular nasal region, may have contributed to changing the postoperative diagnosis. Thus, pathologic study of the surgical fragment is the more accurate method for diagnosis.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-01-21T14:12:07+0100
      DOI: 10.1055/s-0033-1364173
  • Isolated Schwannoma of the Olfactory Groove: A Case Report

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