1,721,066 research outputs found
Hospital discharge survey on 4,199 peritonsillar abscesses in the Veneto region: what is the risk of recurrence and complications without tonsillectomy?
No full textThe Veneto region's database of hospital discharge records was queried for ICD-9 codes corresponding to: peritonsillar abscess (PTA), PTA incision and drainage, tonsillectomy, pharyngeal-retropharyngeal abscess, cervical phlegmon, cervical abscess, and mediastinitis recorded from 1997 to 2006. All these codes were considered to identify cases of PTA recurrence and severe infectious complications occurring in conservatively treated patients. Among 4,199 patients whose PTA was incised and drained on admission to hospital, 1,532 were treated with tonsillectomy, while 2,667 were treated conservatively (without tonsillectomy). Abscess tonsillectomy was carried out almost exclusively in children (0-14 years of age), and only in 40 young and adult patients (0.95 %). The relapse rate after a single episode of PTA was 11.7 %, while potentially fatal complication occurred in 0.41 % of cases. Incidence of PTA hospital admission has remained stable in the considered period despite a 45 % reduction in the tonsillectomy rate. In conclusion, our data seem to show that conservative treatment for PTA is not associated with a significant risk of recurrence (and becomes minimal after 6-12 months), provided that patients have not suffered from previous PTA episodes
Inner ear malformations and neurological involvement: a review
No full textInner ear malformations are associated with different degrees of hearing loss. Some of these anomalies require cochlear implantation because of the occurrence of profound hearing loss. The radiological imaging necessary for the evaluation of the congenital hearing loss might also reveal the concomitant presence of important collateral findings such as the central nervous system and cranial nerves malformations. These neurological features might be extremely important in the surgical planning of the cochlear implantation and also have a role in the hearing and speech development of the affected children. In addition, anomalies affecting specific structures of the inner ear should be considered predisposing factors for otogenic meningitis and they should be identified as early as possible. The present review aims to summarize the available literature about this specific topic crucial for the patients’ neuropsychological and auditory development
Environmental and genetic factors in age-related hearing impairment.
No full textAge-related hearing impairment (ARHI), or presbycusis, is a complex disease with multifactorial etiology. It is the most prevalent sensory impairment in the elderly, and may have detrimental effects on their quality of life and psychological well-being. The aim of this paper is to give an overview of the current data on ARHI, focusing mainly on environmental agents and genetic predisposition in animal models and in humans. With improvement of our understanding of ARHI, treatment other than with amplification will be hopefully possible in the long term
New drugs, new tests: Can we trust them?
No full textVery few drugs utilized frequently in audiological medicine have undergone rigorous methodological testing to prove their efficacy. The employment of drugs on patients with dizziness, tinnitus, Meniére's disease or sudden sensorineural hearing loss is determined by empirical not scientific premises. Recent progress in genetics, molecular biology and neurobiology raises expectations that a breakthrough will be made before long for the treatment of certain audiological pathologies. While we are keen to see this progress delivered, we need to proceed with caution in the face of the proposed advances
The diagnosis of autoimmune inner ear disease: evidence and critical pitfalls.
No full textThe purpose of this paper is to review the current diagnostic work-up for patients with suspected Autoimmune Inner Ear Disease (AIED). AIED is a rare disease accounting for less than 1% of all cases of hearing impairment or dizziness, characterized by a rapidly progressive, often fluctuating, bilateral SNHL over a period of weeks to months. While specific tests for autoimmunity to the inner ear would be valuable, at the time of writing, there are none that are both commercially available and proven to be useful. Thus far, most of the identified antigens lack a clear association with localized inner ear pathology and the diagnosis of AIED is based either on clinical criteria and/or on a positive response to steroids. For clinical practice, we recommend an antigen-non-specific test battery including blood test for autoimmune disorders and for conditions that resemble autoimmune disorders. Nevertheless, if financial resources are limited, a very restricted work-up study may have a similar efficiency
Tinnitus and cochlear implants.
No full textOBJECTIVE:
Several published studies seem to confirm the clinical observation that cochlear implants (CI) have a suppressive effect on tinnitus in most CI users. The aim of this paper is to present our personal experiences on tinnitus improvement after cochlear implantation.
METHODS:
Before surgery, 51 post-lingually profoundly deaf adults, who underwent cochlear implantation between 2005 and 2007, filled out a questionnaire reporting tinnitus characteristics and the Italian version of the Tinnitus Handicap Inventory (THI-I). Moreover, they were asked to scale tinnitus loudness and annoyance. Six months after implant activation, patients repeated the same evaluations. Scores were statistically analysed by means of a Wilcoxon signed ranks test on the hypothesis that a CI could change the tinnitus magnitude and/or its annoyance.
RESULTS:
In our series of 36 patients, 36.10% reported total loudness suppression and another 41.6% reported a reduction. Annoyance scores reduced in 75% of patients. THI reduced in 72.2% of patients.
CONCLUSION:
Tinnitus reduction after CI may manifest as several mechanisms, such as habituation, acoustic masking, direct electrical nerve stimulation and cortical reorganization. Nevertheless, it is our opinion that data on CI benefits on tinnitus should be interpreted with caution and it seems reasonable to admit that further data is still necessary before considering CI as a treatment of tinnitus especially in unilateral deafness
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Possibile ruolo delle alterazioni genetiche nella presbiacusia
No full textMolti studi hanno ipotizzato la coesistenza di fattori genetici e ambientali nell'eziopatogenesi della presbiacusia,ovvero della riduzione della capacità uditiva che compare tra i 55 e i 65 anni in modo progressivo, di tipo neuro-sensoriale bilaterale e simmetrica, solitamente più accentuata per le alte frequenze (forma sensoriale sec.classificazione di Schuknecht e Gacek,1993). In Europa almeno il 30% delle persone di oltre 60 anni presenta un progressivodecadimento della funzione uditiva. Sebbene esistano, in base ai dati della letteratura, diversi indizi circa la componente ereditaria/genetica della presbiacusia, non esistono dati definitivi in relazione all'identificazione deigeni responsabili.Gli studi di associazione e di linkage che si basano sull'analisi del polimorfismo genetico rappresentano gli approcci più indicati per l'approfondimento dell'ipotesi genetica della presbiacusia
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