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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  [173 journals]
  • Award-Winning Research in 2017
    • Int Arch Otorhinolaryngol 2017; 21: 109-109
      DOI: 10.1055/s-0037-1600519



      Thieme-Revinter Publicações Ltda Rio de Janeiro, Brazil

      Article in Thieme eJournals:
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      Int Arch Otorhinolaryngol 2017; 21: 109-1092017-03-31T00:00:00+01:00
      Issue No: Vol. 21, No. 02 (2017)
       
  • The Surgical Treatment of Vertigo – A Historical Perspective
    • Int Arch Otorhinolaryngol 2017; 21: 178-178
      DOI: 10.1055/s-0037-1599241



      Thieme-Revinter Publicações Ltda Rio de Janeiro, Brazil

      Article in Thieme eJournals:
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      Int Arch Otorhinolaryngol 2017; 21: 178-1782017-03-31T00:00:00+01:00
      Issue No: Vol. 21, No. 02 (2017)
       
  • Endolymphatic Sac Surgery for Ménière's Disease – Current Opinion and
           Literature Review

    • Authors: Flores García; Maria de Lourdes, Llata Segura, Carolina de la, Cisneros Lesser, Juan Carlos, Pane Pianese, Carlo
      Pages: 179 - 183
      Abstract: Introduction The endolymphatic sac is thought to maintain the hydrostatic pressure and endolymph homeostasis for the inner ear, and its dysfunction may contribute to the pathophysiology of Ménière's disease. Throughout the years, different surgical procedures for intractable vertigo secondary to Ménière's disease have been described, and though many authors consider these procedures as effective, there are some who question its long-term efficacy and even those who think that vertigo control is achieved more due to a placebo effect than because of the procedure itself. Objective To review the different surgical procedures performed in the endolymphatic sac for the treatment of Ménière's disease. Data Sources PubMed, MD consult and Ovid-SP databases. Data Synthesis We focus on describing the different surgical procedures performed in the endolymphatic sac, such as endolymphatic sac decompression, endolymphatic sac enhancement, endolymphatic sac shunting and endolymphatic duct blockage, their pitfalls and advantages, their results in vertigo control and the complication rates. The senior author also describes his experience after 30 years of performing endolymphatic sac surgery. Conclusions The endolymphatic sac surgery, with all its variants, is a good option for patients with incapacitating endolymphatic hydrops, providing a high percentage of vertigo control and hearing preservation.
      Citation: Int Arch Otorhinolaryngol 2017; 21: 179-183
      PubDate: 2017-03-31T00:00:00+01:00
      DOI: 10.1055/s-0037-1599276
      Issue No: Vol. 21, No. 02 (2017)
       
  • Labyrinthectomy and Vestibular Neurectomy for Intractable Vertiginous
           Symptoms

    • Authors: Alarcón; Alfredo Vega, Hidalgo, Lourdes Olivia Vales, Arévalo, Rodrigo Jácome, Diaz, Marite Palma
      Pages: 184 - 190
      Abstract: Introduction Labyrinthectomy and vestibular neurectomy are considered the surgical procedures with the highest possibility of controlling medically untreatable incapacitating vertigo. Ironically, after 100 years of the introduction of both transmastoid labyrinthectomy and vestibular neurectomy, the choice of which procedure to use rests primarily on the evaluation of the hearing and of the surgical morbidity. Objective To review surgical labyrinthectomy and vestibular neurectomy for the treatment of incapacitating vestibular disorders. Data Sources PubMed, MD consult and Ovid-SP databases. Data Synthesis In this review we describe and compare surgical labyrinthectomy and vestibular neurectomy. A contrast between surgical and chemical labyrinthectomy is also examined. Proper candidate selection, success in vertigo control and complication rates are discussed on the basis of a literature review. Conclusions Vestibular nerve section and labyrinthectomy achieve high and comparable rates of vertigo control. Even though vestibular neurectomy is considered a hearing sparing surgery, since it is an intradural procedure, it carries a greater risk of complications than transmastoid labyrinthectomy. Furthermore, since many patients whose hearing is preserved with vestibular nerve section may ultimately lose that hearing, the long-term value of hearing preservation is not well established. Although the combination of both procedures, in the form of a translabyrinthine vestibular nerve section, is the most certain way to ablate vestibular function for patients with no useful hearing and disabling vertigo, some advocate for transmastoid labyrinthectomy alone, considering that avoiding opening the subarachnoid space minimizes the possible intracranial complications. Chemical labyrinthectomy may be considered a safer alternative, but the risks of hearing loss when hearing preservation is desired are also high.
      Citation: Int Arch Otorhinolaryngol 2017; 21: 184-190
      PubDate: 2017-03-31T00:00:00+01:00
      DOI: 10.1055/s-0037-1599242
      Issue No: Vol. 21, No. 02 (2017)
       
  • Surgical Treatment for Recurrent Benign Paroxysmal Positional Vertigo

    • Authors: Corvera Behar; Gonzalo, García de la Cruz, Miguel Alfredo
      Pages: 191 - 194
      Abstract: Introduction Benign paroxysmal positional vertigo is a generally benign condition that responds to repositioning maneuvers and frequently resolves spontaneously. However, for some patients it can become a disabling condition in which surgery must be considered. Two different surgical techniques exist, singular neurectomy and posterior semicircular canal occlusion. Objective The objective of this study is to review the current status of singular nerve section and posterior semicircular canal occlusion as treatments for intractable benign paroxysmal positional vertigo, and to determine if there are published data available that favors one over the other. Data Sources MEDLINE and OLDMEDLINE databases of the National Library of Medicine. Data Synthesis Four studies regarding singular neurectomy and 14 reports on semicircular canal occlusion were analyzed. Both techniques are reported to provide similar symptomatic benefit, with low risk of hearing loss and balance impairment. However, anatomical and clinical studies of singular neurectomy show it to be a more challenging technique, and considering that it is indicated in a very small number of cases, it may be difficult to master. Conclusions Both singular neurectomy and semicircular canal occlusion can be safe and effective in those few patients that require surgery for intractable positional vertigo. Although semicircular canal occlusion requires a postauricular transmastoid approach, it is ultimately easier to learn and perform adequately, and thus may be considered the best alternative.
      Citation: Int Arch Otorhinolaryngol 2017; 21: 191-194
      PubDate: 2017-03-31T00:00:00+01:00
      DOI: 10.1055/s-0037-1599784
      Issue No: Vol. 21, No. 02 (2017)
       
  • Superior Semicircular Canal Dehiscence Syndrome – Diagnosis and
           Surgical Management

    • Authors: Palma Diaz; Marite, Cisneros Lesser, Juan Carlos, Vega Alarcón, Alfredo
      Pages: 195 - 198
      Abstract: Introduction Superior semicircular canal dehiscence syndrome was described by Minor et al in 1998. It is a troublesome syndrome that results in vertigo and oscillopsia induced by loud sounds or changes in the pressure of the external auditory canal or middle ear. Patients may present with autophony, hyperacusis, pulsatile tinnitus and hearing loss. When symptoms are mild, they are usually managed conservatively, but surgical intervention may be needed for patients with debilitating symptoms. Objective The aim of this manuscript is to review the different surgical techniques used to repair the superior semicircular canal dehiscence. Data Sources PubMed and Ovid-SP databases. Data Synthesis The different approaches are described and discussed, as well as their limitations. We also review the advantages and disadvantages of the plugging, capping and resurfacing techniques to repair the dehiscence. Conclusions Each of the surgical approaches has advantages and disadvantages. The middle fossa approach gives a better view of the dehiscence, but comes with a higher morbidity than the transmastoid approach. Endoscopic assistance may be advantageous during the middle cranial fossa approach for better visualization. The plugging and capping techniques are associated with higher success rates than resurfacing, with no added risk of hearing loss.
      Citation: Int Arch Otorhinolaryngol 2017; 21: 195-198
      PubDate: 2017-03-31T00:00:00+01:00
      DOI: 10.1055/s-0037-1599785
      Issue No: Vol. 21, No. 02 (2017)
       
  • 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:
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      Int Arch Otorhinolaryngol 2017; 21: 1-32017-01-02T00:00:00+0100
      Issue No: Vol. 21, No. 01 (2017)
       
  • The Effects of Prognostic Factors in Idiopathic Sudden Hearing Loss

    • Authors: Bulğurcu; Suphi, Şahin, Behçet, Akgül, Gökhan, Arslan, İlker Burak, Çukurova, İbrahim
      Abstract: Introduction Sudden hearing loss is one of the otologic emergencies. The treatment of this disease is affected negatively by some prognostic factors. Objective In this study, the effects of early treatment initiation in patients with idiopathic sudden hearing loss and of prognostic factors in early treated patients were investigated. Methods Out of the 216 patients admitted between September 2007 and September 2015, 154 were identified as having idiopathic sudden hearing loss; they were followed-up for a mean time of 7.4 months, and evaluated retrospectively. The effects of several parameters on the success of the treatment were statistically evaluated, such as the time the treatment was initiated, being of the female gender, the severity of the hearing loss, having descending type audiogram patterns, being older than 60 years old, and the co-presence of vertigo. Results Success rates were found to be significantly higher in idiopathic hearing loss patients that were admitted within the first week (p  0.05). Parameters such as female gender, severe hearing loss, descending type audiogram, being older than 60 years old, and co-presence of vertigo didn't reveal statistically significant effects on the outcome (p >0.05). Conclusion The aforementioned prognostic factors, which are well-known in the literature, did not have significant effects when the idiopathic sudden hearing loss treatment was initiated within the first 7 days of the onset of the hearing loss.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-05-17T00:00:00+01:00
      DOI: 10.1055/s-0037-1603108
       
  • Platelet-Rich Plasma in Reconstruction of Posterior Meatal Wall after
           Canal Wall Down Mastoidectomy

    • Authors: Elbary; Mohammad El-Sayed Abd, Nasr, Wail Fayez, Sorour, Samir Sorour
      Abstract: Introduction Canal wall down (CWD) mastoidectomy has many drawbacks, including chronic otorrhea not responding to medications, granulations, dizziness on exposure to cold or hot water, and tendency of debris accumulation in the mastoid cavity, demanding periodic cleaning. Many of these problems can be solved by reconstruction of the posterior meatal wall (PMW). Objectives To assess the results of PMW reconstruction after CWD mastoidectomy for cholesteatoma using titanium mesh and platelet-rich plasma (PRP) mixed with bone pate. Methods This study was conducted with 20 patients that have atticoantral chronic suppurative otitis media. All cases were subjected to CWD mastoid surgery with complete elimination of the disease and reconstruction of the PMW by titanium mesh and the mixture of PRP with bone pate. All patients were exposed to a full preoperative evaluation and full postoperative assessment of the complications, the appearance of the external auditory canal contour, and the hearing gain expressed by the change of the air bone gap postoperatively. Results The PMW reconstructed by titanium mesh and the mixture of PRP with bone pate showed a smooth contour. During the follow-up of 12 to 36 months, the postoperative appearance of the external auditory canal contour was found to be smooth without hidden pouches, irregularities or stenosis in all cases. No granulation, foreign body reaction, or extrusion and/or displacement of the titanium mesh were registered. No facial palsy or recurrent cholesteatoma was reported. Conclusion The surgical reconstruction of the PMW using PRP, bone pate and titanium mesh after CWD mastoidectomy appears to be reliable without considerable complications, giving a smooth appearance to the PMW.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-05-17T00:00:00+01:00
      DOI: 10.1055/s-0037-1602694
       
  • Short-Term Audiological Results of Diode Laser in Comparison with Manual
           Perforation in Stapes Surgery

    • Authors: Hamerschmidt; Rogerio, Saab, Stephanie Sbizera, Carvalho, Bettina, Carmo, Carolina do
      Abstract: Introduction Diode laser is a new alternative in stapes surgery for otosclerosis. The present study is the first to compare the short-term results of the surgery performed using diode laser to those obtained through the conventional fenestration technique. Objective To use audiometry to establish a comparative analysis between the functional results obtained through surgery for otosclerosis using diode laser and the conventional technique. Method Audiometric evaluation of 12 patients submitted to stapes surgery for otosclerosis, using diode laser or conventional fenestration by needle and drills, between 2014 and 2015. Each group was composed of 6 patients. Pre and post-operative measures were compared for three months in both groups. The speech recognition threshold, the air and bone conduction threshold, as well as the gap between them at 500 Hz, 1 KHz, 2 KHz and 4 KHz were measured. Results Significant difference in bone conduction and SRT was observed when compared post- and preoperative results in the diode group. However diode and conventional technique groups presented significant differences in air conduction and air-bone gap, suggesting that both can provide functional improvement. Conclusion Laser stapedotomy is a safe technique with good results. Both laser surgery and the conventional technique have improved the hearing of patients with a discreet advantage for the diode laser. Further prospective and randomized clinical trials are required to disclose all possible benefits of the stapes surgery using diode laser.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-05-17T00:00:00+01:00
      DOI: 10.1055/s-0037-1602703
       
  • Adenotonsillar Hypertrophy in Pre-School Children with Sickle Cell Disease
           and Diagnostic Accuracy of the Sleep Disturbance Scale for Children

    • Authors: Góis; Carlos Rodolfo Tavares de, D'Ávila, Jeferson Sampaio, Cipolotti, Rosana, Lira, Amanda da Silva, Silva, Ana Letícia Leite
      Abstract: Introduction Adenotonsillar hypertrophy is more common in children with sickle cell disease, and can lead to sleep-disordered breathing. Objectives To determine the frequency of adenotonsillar hypertrophy in pre-school children with sickle cell disease and assess the diagnostic accuracy of the sleep-disordered breathing subscale in the Sleep Disturbance Scale for Children. Method Observational study with a group of 48 children with sickle cell disease and a control group of 35 children without the disease. The children underwent oropharingoscopy and video nasal endoscopy. The parents and/or guardians answered the questions of the subscale. Results Adenotonsillar hypertrophy was observed in 25% of the children in the study group, and in 20% of the children in the control group, with no statistical difference between the groups. The subscale score ranged from 3 to 11 in both groups. There was a statistical significance in the study group. The average was 4.79 (standard deviation [SD] ± 2.50), with 4.19 (SD ± 1.72) among the children without adenotonsillar hypertrophy, and 6.5 (SD ± 3.40) among the children with adenotonsillar hypertrophy. There was also a statistical significance in the control group. The average was 5.23 (SD ± 2.81), with 4.44 (SD ± 2.2) among the children without adenotonsillar hypertrophy, and 7.87 (SD ± 2.89) among the children with adenotonsillar hypertrophy. Conclusion Adenotonsillar hypertrophy was not associated with sickle cell disease in pre-school children. The subscale of sleep-disordered breathing in the Sleep Disturbance Scale for Children was a useful tool for the diagnostic suspicion of adenotonsillar hypertrophy in children in this age group.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-05-02T00:00:00+01:00
      DOI: 10.1055/s-0037-1602702
       
  • Clinical Features and Treatment of Fibrous Histiocytomas of the Tongue: A
           Systematic Review

    • Authors: Nguyen; Austin, Vaudreuil, Adam, Haun, Paul, Caponetti, Gabriel, Huerter, Christopher
      Abstract: Introduction Benign fibrous histiocytomas are common lesions of the skin that rarely affect the tongue. Such cases are available in the literature exclusively as case reports. Similarly, malignant fibrous histiocytoma, now classified as undifferentiated pleomorphic sarcoma, is exceedingly rare in the tongue and not fully understood. Objectives This study systematically reviews the available literature discussing the clinical and pathological features of malignant and benign fibrous histiocytomas. Data Synthesis A total of 20 cases were included in this review. Patient-level data were extracted from cases to include clinical presentation, workup, treatment, and outcome. Conclusion Benign fibrous histiocytomas are consistent in clinical and histopathologic presentation. Surgical treatment provides excellent outcome, with no recurrence in all excised cases. Malignant tumors have a more aggressive clinical and pathological presentation. Surgical treatment with possible adjuvant radiotherapy resulted in recurrence in 40% of cases (follow-up of 24 months), and death due to disease in 47% of patients (follow-up of 19 months).
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-05-02T00:00:00+01:00
      DOI: 10.1055/s-0037-1602819
       
  • The Effect of the Cholesterol Levels on Noise-Induced Hearing Loss

    • Authors: Demir; Mehmet Gokhan, Aydin, Sedat
      Abstract: Introduction Noise-induced hearing loss (NIHL), which is one of the most common occupational diseases among industrialized populations, is associated with longstanding exposure to high levels of noise. The pathogenesis of NIHL is not clear, but some genes and their activity at the tissue level have been investigated. Hypercholesterolemia, which can disturb the microcirculation, can be one of the underlying pathologies in hearing loss. Objective To investigate the relationship between NIHL and hypercholesterolemia. Methods The study group was selected among workers who had an occupational exposure of 85 dB of noise for at least 10 years. The audiologic assessment was recorded at seven frequencies (500 Hz, 1,000 Hz, 2,000 Hz, 3,000 Hz, 4,000 Hz, 6,000 Hz and 8,000 Hz). A total of 456 workers were included in the study and divided into two groups: the control group (252 patients) and the NIHL group (204 patients). After the audiologic measurement, blood samples were taken and investigated for blood cholesterol levels. According to these results, the groups were compared. Results Both groups were similarly distributed regarding age and occupational exposure time (p > 0.05). We could not detect any association between cholesterol levels and noise-induced hearing loss (p  0.05). Conclusion Noise-induced hearing loss is still a common occupational problem that can be prevented by hearing conservation programs and occupational health and safety training. Still, we know little about the relationship between NIHL and hypercholesterolemia. According to our findings, we cannot detect any relationship. Controlled studies and studies with human individuals can be made possible in the future with diagnostic innovations in tissue imaging and tissue microcircular sampling.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-04-28T00:00:00+01:00
      DOI: 10.1055/s-0037-1602774
       
  • Computerized Auditory Training in Students: Electrophysiological and
           Subjective Analysis of Therapeutic Effectiveness

    • Authors: Melo; Ândrea de, Mezzomo, Carolina Lisbôa, Garcia, Michele Vargas, Biaggio, Eliara Pinto Vieira
      Abstract: Introduction Computerized auditory training (CAT) has been building a good reputation in the stimulation of auditory abilities in cases of auditory processing disorder (APD). Objective To measure the effects of CAT in students with APD, with typical or atypical phonological acquisition, through electrophysiological and subjective measures, correlating them pre- and post-therapy. Methods The sample for this study includes14 children with APD, subdivided into children with APD and typical phonological acquisition (G1), and children with APD and atypical phonological acquisition (G2). Phonological evaluation of children (PEC), long latency auditory evoked potential (LLAEP) and scale of auditory behaviors (SAB) were conducted to help with the composition of the groups and with the therapeutic intervention. The therapeutic intervention was performed using the software Escuta Ativa (CTS Informática, Pato Branco, Brazil) in 12 sessions of 30 minutes, twice a week. For data analysis, the appropriate statistical tests were used. Results A decrease in the latency of negative wave N2 and the positive wave P3 in the left ear in G1, and a decrease of P2 in the right ear in G2 were observed. In the analysis comparing the pre- and post-CAT groups, there was a significant difference in P1 latency in the left ear and P2 latency in the right ear, pre-intervention. Furthermore, eight children had an absence of the P3 wave, pre-CAT, but after the intervention, all of them presented the P3 wave. There were changes in the SAB score pre- and post-CAT in both groups. The presence of correlation between the scale and some LLAEP components was observed. Conclusion The CAT produced an electrophysiological modification, which became evident in the effects of the effects of neural plasticity after CAT. The SAB proved to be useful in measuring the therapeutic effects of the intervention. Moreover, there were behavioral changes in the SAB (higher scores) and correlation with LLAEP.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-04-28T00:00:00+01:00
      DOI: 10.1055/s-0037-1600121
       
  • Computer-Based Auditory Training Programs for Children with Hearing
           Impairment – A Scoping Review

    • Authors: Nanjundaswamy; Manohar, Prabhu, Prashanth, Rajanna, Revathi Kittur, Ningegowda, Raghavendra Gulaganji, Sharma, Madhuri
      Abstract: Introduction Communication breakdown, a consequence of hearing impairment (HI), is being fought by fitting amplification devices and providing auditory training since the inception of audiology. The advances in both audiology and rehabilitation programs have led to the advent of computer-based auditory training programs (CBATPs). Objective To review the existing literature documenting the evidence-based CBATPs for children with HIs. Since there was only one such article, we also chose to review the commercially available CBATPs for children with HI. The strengths and weaknesses of the existing literature were reviewed in order to improve further researches. Data Synthesis Google Scholar and PubMed databases were searched using various combinations of keywords. The participant, intervention, control, outcome and study design (PICOS) criteria were used for the inclusion of articles. Out of 124 article abstracts reviewed, 5 studies were shortlisted for detailed reading. One among them satisfied all the criteria, and was taken for review. The commercially available programs were chosen based on an extensive search in Google. The reviewed article was well-structured, with appropriate outcomes. The commercially available programs cover many aspects of the auditory training through a wide range of stimuli and activities. Conclusions There is a dire need for extensive research to be performed in the field of CBATPs to establish their efficacy, also to establish them as evidence-based practices.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-04-28T00:00:00+01:00
      DOI: 10.1055/s-0037-1602797
       
  • Adenomatous Tumors of the Middle Ear: A Literature Review

    • Authors: Cardoso; Flavia Amarante, Monteiro, Eduardo Machado Rossi, Lopes, Livia Bernardi, Avila, Marianna Novaes da Costa, Scarioli, Bernardo Oliveira
      Abstract: Introduction Neuroendocrine adenomas of the middle ear (NAME) are uncommon causes of middle ear masses. Mostly limited to case reports and small series, the literature is poor in providing an overall assessment of these tumors. Objective To review the current literature about all aspects of the disease, including its etiology, clinical manifestations, diagnosis, and treatment. Data Synthesis The pathogenesis of adenomatous tumors of the middle ear is not clear yet. One potential explanation is that an undifferentiated pluripotent endodermal stem cell may still be present in the middle ear mucosal surface, and may be the origin of the tumors. It typically appears as a nonspecific retrotympanic mass. The average age of onset for the disease is the fifth decade, and the most common clinical symptom is conductive hearing loss. Malign behavior is rare. There are numerous differential diagnoses of NAME. The final diagnosis depends on microscopic findings. The preoperative evaluation should include the use of computed tomography and magnetic resonance imaging. The adjunctive therapy of middle ear adenomatous tumors with radiotherapy, chemotherapy or somatostatin analogs is generally not recommended. Conclusion There is still much debate on pathogenesis and classification of NAME. Saliba's classification is currently the most complete and preferable one. Aggressive surgical procedure with ossicular chain excision is the gold standard treatment. Follow-up with physical and radiological exams is mandatory, particularly if the first procedure was conservative, without the removal of the encased ossicles.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-04-28T00:00:00+01:00
      DOI: 10.1055/s-0037-1601400
       
  • Modified In-Office Maxillary Balloon Sinus Dilation for Post-Procedure
           Sinus Monitoring and Access

    • Authors: Nishioka; Gary J.
      Abstract: Introduction As experience grows with in-office balloon sinus dilation (BSD) procedures, technique modifications will evolve to meet specific needs. The major disadvantage with the maxillary BSD procedure is that the intact uncinate process prevents visualization of and instrument access into the maxillary sinus both intraoperatively and postoperatively. Combining a partial or complete uncinectomy procedure with maxillary BSD could be beneficial in selected patients with certain maxillary sinus problems. Objective The primary objective of this study was to see if, in selected patients, combining an uncinectomy and maxillary sinus BSD together allowed visualization of and access to the maxillary sinus cavity at the time of the procedure and at follow-up visits. Method A chart review was completed for BSD cases performed from 2013 through mid-2015 identifying patients who underwent partial or complete uncinectomy with in-office maxillary sinus BSD. A total of 14 patients were identified, with 26 sinuses treated. The data collected included: difficulty or problems in performing an uncinectomy with the maxillary sinus BSD; visualization and access to the maxillary sinus cavity both intraoperatively and at follow-up visits; and occurrence of complications or late adverse sequelae. All patients completed a minimum 6-month follow-up. Results Combined uncinectomy and maxillary sinus BSD procedures were easily completed for all patients without complications, and no late adverse sequelae were encountered. The maxillary sinuses could be visualized and accessed, if needed, intraoperatively and at all follow-up visits. Conclusions In selected subsets of maxillary sinus conditions this procedure modification can provide significant benefits. A case is presented for illustration.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-04-27T00:00:00+01:00
      DOI: 10.1055/s-0037-1601562
       
  • Evaluation of Dizziness Handicap in Adolescents and Adults with Auditory
           Neuropathy Spectrum Disorder

    • Authors: Prabhu; Prashanth, Jamuar, Pratyasha
      Abstract: Introduction Vestibular symptoms and damage to the vestibular branch of the eighth cranial nerve is reported in individuals with auditory neuropathy spectrum disorder (ANSD). However, the real life handicap caused by these vestibular problems in individuals with ANSD is not studied. Objective The present study attempted to evaluate the dizziness-related handicap in adolescents and adults with ANSD. Method The dizziness handicap inventory (DHI) was administered to 40 adolescents and adults diagnosed with ANSD. The study also attempted to determine if there is any gender effect on DHI scores and its correlation to the reported onset of hearing loss. Results The results of the study showed that adolescents and adults with ANSD had a moderate degree of dizziness-related handicap. The dizziness affected their quality of life, causing emotional problems. There was no gender effect, and the level of the handicap was greater in the cases in which the onset of the hearing loss was reported soon after the diagnosis of ANSD. There could be a vestibular compensation that could have resulted in a reduction in symptoms in individuals in whom the onset of the hearing loss was reported later on. Conclusion Thus, a detailed assessment of vestibular problems and their impact on quality of life is essential in adolescents and adults with ANSD. Appropriate management strategies should be considered to resolve their vestibular problems and improve their quality of life.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-04-27T00:00:00+01:00
      DOI: 10.1055/s-0037-1602693
       
  • Microbiology of Tracheal Secretions: What to Expect with Children and
           Adolescents with Tracheostomies

    • Authors: El Cheikh; Mikhael R., Barbosa, Juliane M., Caixêta, Juliana A. S., Avelino, Melissa A. G.
      Abstract: Introduction People with tracheostomies exhibit a higher risk of colonization of the lower respiratory tract, acute tracheitis and pneumonia. Despite this, the culture of tracheal secretions is not a routine in most hospitals, and sometimes empiric therapy is based on personal experience, which is not an ideal situation. Objective To recognize the pathogens present in the tracheal secretions collected from people up to 18 years old with tracheostomies. Methods Prospective evaluation of patients under the age of 18 of a tertiary care hospital. A standardized questionnaire was completed, and tracheal secretion aspirates were sent for microbiological cultures and antibiograms. Results Twenty patients under 18 years of age were evaluated, 65% of whom were male. The microbiological culture was positive in 90% of the patients, and the most common microorganisms found were Pseudomonas aeruginosa (55.5%) and Staphylococcus aureus (27.7%). Discussion Tracheostomized children and adolescents have respiratory tracts colonized by pathogens, the most common of which is Pseudomonas aeruginosa. These patients must undergo tracheal secretion cultures, whether they present symptoms or not, to determine if there is a correlation between the colonization and the infections. This finding could guide the adequate treatment, avoiding the inappropriate use of antibiotics and indicating the better therapy in cases of laryngeal reconstruction. Conclusion In this sample, the culture of tracheal secretions was mainly positive, and the most common agent was P. aeruginosa. We suggest the routine access to Brazilian children and adolescents tracheal secretion cultures, which could help to make a profile of these children and guide the use of antibiotics.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-04-24T00:00:00+01:00
      DOI: 10.1055/s-0037-1601403
       
  • Tomographical Findings in Adult Patients Undergoing Endoscopic Sinus
           Surgery Revision

    • Authors: Socher; Jan Alessandro, Mello, Jonas, Baltha, Barbara Batista
      Abstract: Introduction Many patients undergoing functional endoscopic sinus surgery still have an uncontrolled clinical disease in the late post-operative period. Up to 11.4% of the patients will require a revision surgery. Findings such as the residual uncinated process and the lateralization of the middle turbinate were considered by some studies as being responsible for failure in the primary surgery. Objectives To describe the tomographical findings in adult patients undergoing revision endoscopic sinus surgery, the profile of those patients, and verify the mucosal thickening level of the paranasal sinus. Methods Data were collected from medical records and computed tomography reports of 28 patients undergoing revision sinus surgery on a private service in the city of Blumenau between 2007 and 2014. The score of Lund-Mackay was used to verify the mucosal thickening level. Results Among the 28 patients, 23 were reoperated once, 3 were reoperated twice, and 2 were reoperated 3 times. The most relevant findings were mucosal thickening of the maxillary sinus (89.28%), deviated septum (75%), thickening of the ethmoid (50%) and sphenoidal sinuses (39.28%), and pneumatization of the middle turbinate (39.28%). The average obtained in the Lund-Mackay score was 5.71, with most patients classified in the lower range of punctuation. Conclusion The analysis of the computed tomography scans showed persistent structures that may be responsible for the failure of the primary surgery. Computed tomography is a useful tool to plan the surgery and quantify the post-operative success.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-04-24T00:00:00+01:00
      DOI: 10.1055/s-0037-1601417
       
  • Does Body Mass Index Interfere in the Formation of Speech Formants'

    • Authors: Takaki; Patricia Barbarini, Vieira, Marilena Manno, Said, Angelica Veiga, Bommarito, Silvana
      Abstract: Introduction Studies in the fields of voice and speech have increasingly focused on the vocal tract and the importance of its structural integrity, and changes in the anatomy and configuration of the vocal tract determine the variations in phonatory and acoustic measurements, especially in the formation of the formants (Fs). Recent studies have revealed the functional consequences arising from being overweight and having an accumulation of fat in the pharyngeal region, including obstructive sleep apnea syndrome (OSAS) and impacts on the voice. Objectives To assess the relationship between body mass index (BMI) and analysis of the speech. Methods This study was approved by the Ethics Committee of the Universidade Federal de São Paulo (no. 288,430). The cohort consisted of 124 individuals aged between 18 and 45 with full permanent dentition and selected randomly. The participants underwent a brief medical history taking, BMI assessments and recording emissions of the sustained vowels /a/, /ε/, /i/, and /u/ by acoustic program PRAAT (v. 5.3.85, Boersma and Weenink, Amsterdam, Netherlands). Recordings were taken using a unidirectional microphone headset (model Karsect HT-9, Guangdong, China), with a condenser connected to an external sound card (USB-SA 2.0, model Andrea, PureAudio™, Pleasant Grove, UT, USA), to reduce noise. Results There was a significant correlation between BMI and formant 3 (F3) vowel /a/; however, there was a low degree of correlation intensity. Conclusions We did not observe a correlation between the BMI and the speech formants, but we believe there is a trend in this correlation that leads to changes in speech patterns with increases in BMI.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-04-19T00:00:00+01:00
      DOI: 10.1055/s-0037-1599131
       
  • Persistent Tracheostomy after Organ Preservation Protocol in Patients
           Treated for Larynx and Hypopharynx Cancer

    • Authors: Chiesa Estomba; Carlos Miguel, Betances Reinoso, Frank Alberto, Martinez Villasmil, Virginia, González Cortés, Maria Jesus, Santidrian Hidalgo, Carmelo
      Abstract: Introduction Squamous cell carcinoma of the larynx is currently the second most common malignancy of the airway after lung cancer, and hypopharyngeal cancer accounts for fewer than 5% of head and neck cancers. The nonsurgical options for patients with this disease are related to significant long-term toxicities and the need for persistent tracheostomy, which adversely affects the quality of life of these patients. Objective To evaluate the need for tracheostomy, and the influence of this in the overall and specific survival rates of patients diagnosed with all stages of laryngeal carcinoma treated by chemoradiotherapy. Methods A retrospective study of patients diagnosed with laryngeal carcinoma was performed according to the criteria of the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC) 7th edition, in a tertiary hospital. Results A total of 21 patients were evaluated, 8 patients required a tracheotomy (31%) during the treatment protocol, 7 (35%) men and 1 (100%) women. According to subsite 4/4 patient with glottis cancer (p ≤ 0.001), 2/10 patients with supra glottis cancer and 2/7 patients with hypopharyngeal cancer. During follow up, just in 1 patient was possible to close the tracheostomy. Conclusion Persistent tracheostomy dependence after primary chemoradiation increases significantly the morbidity, and decreases the quality of life of those patients. Patients with glottis cancer are prone to need a tracheostomy, but no statistical difference regarding the oncological stage and the need for a tracheostomy were detected. A more thorough selection of the patients is needed to improve the quality of life and reduce permanent tracheostomy dependence.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-04-03T00:00:00+01:00
      DOI: 10.1055/s-0037-1601416
       
  • The Effects of Yoga in Patients Suffering from Subjective Tinnitus

    • Authors: Köksoy; Sümbüle, Eti, Can Mehmet, Karataş, Meltem, Vayisoglu, Yusuf
      Abstract: Introduction Tinnitus is a perception of sound in the absence of an external source and it is a distressing issue. Yoga is a system of mind-body practices with the goal of uniting the body, mind and soul. It has been shown to reduce anxiety and stress, as well as improving the quality of life. Objective The aim of this study is to investigate the effects of yoga in patients suffering from chronic subjective tinnitus. Methods Twelve subjects previously diagnosed with chronic subjective tinnitus were selected for the study. The patients were asked to attend to yoga classes once a week and to practice yoga at home using a worksheet for 3 months. Each yoga class consisted of body exercises (asana), breathing (pranayama) and meditation (shavasana and yoga nidra). Tinnitus scores before and after the yoga classes were compared using the Wilcoxon test. Results Among the 12 patients, there were 4 men and 8 women and their mean age was 52.5 years. The median duration of tinnitus among the group was 5.4 years. There were statistically significant differences in the stress (p = 0.01), handicap (p = 0.004) and severity (p = 0.007) questionnaires scores. Conclusion This study indicated that yoga practices may reduce life stress and symptoms of subjective tinnitus.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-04-03T00:00:00+01:00
      DOI: 10.1055/s-0037-1601415
       
  • Parameters Influencing Tracheostomy Decannulation in Patients Undergoing
           Rehabilitation after severe Acquired Brain Injury (sABI)

    • Authors: Perin; Cecilia, Meroni, Roberto, Rega, Vincenzo, Braghetto, Giacomo, Cerri, Cesare Giuseppe
      Abstract: Introduction Tracheostomy weaning in patients who suffered a severe acquired brain injury is often a challenge and decannulation failures are not uncommon. Objective Our study objective is to describe the decannulation failure rate in patients undergoing rehabilitation following a severe acquired brain injury (sABI); to describe the factors associated with a successful tube weaning. Methods We conduct a retrospective analysis of charts, consecutively retrieved considering a 3-year window. Variables analyzed were: age, sex, body mass index (BMI), Glasgow Coma Scale (GCS), cause of hospitalization (stroke, trauma, cardiac arrest), date of the pathological event, gap between the index event and the first day of hospitalization, duration of Neurorehabilitation Ward hospitalization, comorbidities, chest morphological alteration, kind of tracheostomy tube used (overall dimension, cap, fenestration), SpO2, presentation and quantification of pulmonary secretion, maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), respiratory frequency and pattern, cardiac frequency, presence of spontaneous cough, cough strength, and blood gas analysis. Results We analyzed 45 tracheostomised sABI patients following stroke, trauma, or cardiac arrest. The weaning success percentage was higher in Head Trauma patients and in patients presenting positive spontaneous cough. Failures seem to be associated with presence of secretions and anoxic brain damage. GCS seemed not related to the decannulation outcome. Conclusions Parameters that could be used as positive predictors of weaning are: mean expiratory pressure, presence of spontaneous cough, and cough strength. Provoked cough and GCS were not predictive of weaning success.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-04-03T00:00:00+01:00
      DOI: 10.1055/s-0037-1598654
       
  • Hearing Loss in the Elderly: Is the Hearing Handicap Inventory for the
           Elderly - Screening Version Effective in Diagnosis When Compared to the
           Audiometric Test?

    • Authors: Servidoni; Alexandre Barbosa, Conterno, Lucieni de Oliveira
      Abstract: Introduction Hearing losses inherent to the natural process of aging represent today a major public health issue, despite the little attention that their adequate care still receives. Early recognition and proper management of these shortcomings can significantly improve hearing, as well as the patient's general quality of life, reducing the overall impact of this important and prevalent condition of the aging process. Objective The aim of this research was to evaluate the accuracy of the Hearing Handicap Inventory for the Elderly - Screening Version (HHIE-S) in the diagnosis of hearing loss in the elderly when compared with the audiometric test. Methods Through a cross-sectional study, our target population was composed of 138 individuals, aged over 60 and with any otorhinolaryngological complaints, recruited at the Clinic of Otorhinolaryngology and Speech Therapy of the Faculdade de Medicina de Marília (Famema), in the city of Marília, SP, Brazil. Patients already in the process of auditory rehabilitation were excluded, as well as those who did not demonstrate the minimum level of oral understanding necessary to allow the interview. Results The prevalence of hearing loss according to the questionnaire was of 76.1%, while audiometry showed 79.7%. We found the diagnostic accuracy of the instrument to be of 86.2%, with a sensitivity of 89.1% and a specificity of 75.0%, regardless of gender. Conclusion Thereby, we conclude that the standardized questionnaire under rating is suitable for the screening of hearing loss in the elderly, given its high accuracy and user-friendly quality.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-03-31T00:00:00+01:00
      DOI: 10.1055/s-0037-1601427
       
  • Impact of Successful Choanal Atresia Repair on the Nasal Mucosa: A
           Preliminary Study

    • Authors: Elsheikh; Ezzeddin, El-Anwar, Mohammad Waheed, Abdel-aziz, Hesham Radwan
      Abstract: Introduction The main histological features of the nasal mucosa in choanal atresia are distorted cilia, marked increase of mucous submucosal glands associated with marked reduction of goblet cell density, and lymphocytic cellular infiltration. Objective To study the nasal mucosal changes in cases of choanal atresia after successful repair compared with pre-repair mucosal histological features. Methods Tissue samples were taken from the inferior turbinate of 3 patients (1 bilateral and 2 unilateral) who were successfully operated. Then, the biopsies were subjected to histopathological, histochemical and immunohistochemical studies. After that, the results were compared with pre-repair findings in the choanal atresia side and in the normal side. Results Four biopsies (4 repaired choanal atresia sides) of the mucosa of the inferior turbinate revealed that 1 patient (who had a bilateral choanal atresia repaired), after achieving a patent choana for 8 months, had not completely recovered a normal nasal mucosa. The other 2 patients, after 18 and 23 months of achieving a patent choana, showed normal nasal cavities. Conclusion The main histological features of the nasal mucosa in choanal atresia could be reversed by surgery, making the patients regain their choanal patency, with their mucosae changing back to normal gradually with time.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-03-28T00:00:00+01:00
      DOI: 10.1055/s-0037-1601404
       
  • A Comparative Study between Universal Eclectic Septoplasty Technique and
           Cottle

    • Authors: Amaral Neto; Odim Ferreira do, Mizoguchi, Flavio Massao, Freitas, Renato da Silva, Maniglia, João Jairney, Maniglia, Fábio Fabrício, Maniglia, Ricardo Fabrício
      Abstract: Introduction Since the last century surgical correction of nasal septum deviation has been improved. The Universal Eclectic Technique was recently reported and there are still few studies dedicated to address this surgical approach. Objective The objective of this study is to compare the results of septal deviation correction achieved using the Universal Eclectic Technique (UET) with those obtained through Cottle's Technique. Methods This is a prospective study with two consecutive case series totaling 90 patients (40 women and 50 men), aged between 18 and 55 years. We divided patients into two groups according to the surgical approach. Fifty-three patients underwent septoplasty through Universal Eclectic Technique (UET) and thirty-seven patients were submitted to classical Cottle's septoplasty technique. All patients have answered the Nasal Obstruction Symptom Evaluation Scale (NOSE) questionnaire to assess pre and postoperative nasal obstruction. Results Statistical analysis showed a significantly shorter operating time for the UET group. Nasal edema assessment performed seven days after the surgery showed a prevalence of mild edema in UET group and moderate edema in Cottle's technique group. In regard to complication rates, UET presented a single case of septal hematoma while in Cottle's technique group we observed: 02 cases of severe edemas, 01 case of incapacitating headache, and 01 complaint of nasal pain. Conclusion The Universal Eclectic Technique (UET) has proven to be a safe and effective surgical technique with faster symptomatic improvement, low complication rates, and reduced surgical time when compared with classical Cottle's technique.
      Citation: Int Arch Otorhinolaryngol ; : -
      PubDate: 2017-03-22T00:00:00+0100
      DOI: 10.1055/s-0037-1599275
       
  • Cervical Vestibular-Evoked Myogenic Potentials in Sedated Toddlers

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

    • 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
           Adult

    • 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
       
  • 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
       
  • 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
       
  • 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
       
  • 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
           Disorder

    • 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
       
  • 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
       
  • Treatment Challenges of Group A Beta-hemolytic Streptococcal
           Pharyngo-Tonsillitis

    • 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
       
 
 
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