1,720,968 research outputs found
Menieres' disease symptomatology in relation to the AAO-HNS 1995 guidelines
No full textAim. Meniere's disease (MD) is a complex progressive disorders of the inner ear characterized by sensorineural hearing loss, episodic vertigo, tinnitus and aural fullness. MD diagnosis is essentially clinical and specialized test equipment should not be required. In 1995 the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology - Head and Neck Surgery published recommended guidelines for the diagnosis of the MD (3) classifying it in certain, definite, probable and possible. It was the aim of this paper to determine, in a large series of subjects affected by MD according to the AAO-HNS 1995 criteria, the distribution of the different forms, their relationship with clinical paramters and the aspects of the evolution of the disease over time. Methods. The study group consisted of 384 consecutive subjects affected by MD according to the AAO-HNS 1995 guidelines. In each case we have carried out an exhaustive anamnesis regarding all the aspects of the disease and audiometric threshold. Results. According to AAO-HNS classification 228 subjects (59%) at the moment of the first control in our department were affected by definite MD, 30 (8%) by probable MD and 126 (33%) by possible MD. In this sample, among the 129 subjects of this group 90 (73%) were affected only by hearing loss and 36 (27%) only by vertigo. Age at the beginning of the disease was not different among definite, probable and possible forms while subjects affected by the certain MD were older and presented a longer duration of the disease. Disability level was lesser in the possible forms, condition in which the lower degrees are more represented. Among the 228 definite forms, MD appeared with both vertigo and hearing loss together (temporal delay less than 24 hours) in 79 cases (35%), with hearing loss alone in 96 cases (42%) and with vertigo alone in 53 cases (23%). PTA mean threshold at 0.5-1-2-3 kHz at the first control in the 228 cases of definite MD is worse than in the 90 subjects subjects affected by possible MD in its cochlear form. Conclusion. In conclusion definite form represents the most common form of MD at diagnosis and comprises the most disabling cases. However in the larger part of cases it begin as possible and transforms in definite later, normally within 5 years
Laryngeal carcinoma and professional exposure: Critical review of the literature
No full textINTRODUCTION: Cigarette smoking and alcohol abuse have always been considered the risk factors most involved in the etiology of laryngeal carcinoma. In recent years Literature has been increasingly questioning the possible etiological role of occupational exposure factors, both as complementary risk factors to smoking and alcohol and as indipendent risk factors. The aim of this paper was to take stock of the main occupational risk factors that could affect, independently and/or complement, on the development of laryngeal carcinoma. EVIDENCE ACQUISITION: A careful analysis of the Literature regarding the possible etiological role of the professional activity in laryngeal neoplasia has been carried out, focusing mainly on the years 1990-2017. In total 2200 articles were consulted, of which 71 were the most relevant and significant. EVIDENCE SYNTHESIS: Many substances and professional activities have been identified that would seem to play an active role in the etiopathogenesis of the tumor. Prolunged exposure to inorganic powders and vapors, to numerous chemicals and materials in the mechanical industry are currently showing an active role in the disease determinism. CONCLUSIONS: The numerous reports in the Literature make us suspect that some professional exposures can contribute to the development of the neoplasia in a significant way. It is important, in our opinion, to continue to investigate this risk factor with the aim of improving more and more primary prevention programs and reducing the neoplastic risk in the professional field
Underlay or overlay myringoplasty in children: Which approach is better?
No full textBACKGROUND: Bilateral tympanic membrane perforation may cause a loss of hearing resulting in impaired social interactions and academic performance, delayed language and cognitive development, and lower learning abilities in children, the overlay and the underlay techniques are the two standard methods for perforation repair, with much debate between which of the two is better, especially from the functional point of view. We compared the perforation closure rates and hearing improvement after surgery with the overlay and the underlay techniques to determine which of the two is preferable for tympanic membrane perforation repair in children. METHODS: This retrospective study involved 149 patients who had undergone myringoplasty. Pure tone audiometry was conducted before and after surgery and functional results were defined considering the air bone gap. RESULTS: The overall perforation closure rate was 91.9% in underlay and 90% in overlay technique and the air-bone gap <10 dB was respectively 60.6% and 38%. CONCLUSIONS: In conclusion, myringoplasty may be safe even in younger children and both techniques can achieve high rates of anatomical success. The optimal results after the underlay technique suggest that it should be more widely used and that it should be the first option when considering repair of tympanic membrane perforation
A case of extensive squamous cell carcinoma of the external auditory canal with multiple negative biopsies
No full textWe present the case of a squamous cell carcinoma of the external auditory canal, with double negative biopsy and an imaging before surgery non indicative. The histological examination of the surgical piece did not found any cellular atypies, and the diagnosis was made based upon the clinical and the postsurgical radiological findings
Clinical features and long-term outcome of ipsilateral delayed endolymphatic hydrops
No full textBACKGROUND: Ipsilateral delayed endolymphatic hydrops (IDEH) is a disease characterized by recurrent acute vertigo that manifests after the appearance of a severe sensorineural non-hydropic hearing loss without symptomatology at the other ear. The cause of hearing loss can be congenital or acquired and, in the latter group, the hearing loss is usually sudden or secondary to head or acoustic trauma, ear surgery, viral infection, otitis media, streptomycin, meningitis, inner ear abnormality or idiopathic. METHODS: Data from 37 IDEH patients, who account for 3.4% of the overall sample of menieric patients at our institution, were analyzed in this retrospective study. RESULTLTS: The mean age of the sample was 58 years. Mean duration of the disease at the moment of diagnosis was 57 months. Follow-up ranged from 24 to 180 months (average: 87 months). Hearing loss at the ear cause of IDEH was due to sudden hearing loss in 23 cases (62%), chronic otitis operated on in five cases (14%) and congenital in one case (3%); in eight cases (21%) the cause of hearing loss was unknown. Mean age of appearance of IDEH was 54 years, mean interval between the appearance of HL and IDEH was 82 months and mean duration of the disease at the time of diagnosis was 57 months. Mean PTATA threshold at the affected ear was 88 dB. After dietetic and medical treatment, with a follow-up of 24 to 180 months (average: 87 months), we have obtained the resolution of vertigo crisis, or an acceptable reduction in crisis intensity and/or frequency, in 50 patients (88%). In the remaining seven patients intratympanic gentamicin, following the titration method, was applied, with the resolution of vertigo in six of them (88%); in one cases we have carried out the labyrinthectomy, that solved vertigo crisis. CONCLUSIONS: In conclusion IDEH is a not frequent form of Ménière's disease with good long-term prognosis and in case on vertigo not responsive to medical therapy intratympanic gentamicin labyrinthectomy can solve symptomatology
Short-term result of mannitol administration on hearing loss improvement in Menière's disease and in sensorineural low-frequency fluctuating hearing loss without vertigo
No full textIn 1995 Menière's disease has been classified by an international guideline, on the basis of auditory and vestibular symptoms, in four different forms: certain, definite, probable and possible. According to this guideline fluctuating low frequency hearing loss was considered as possible Menière's disease. Since the administration of osmotic diuretic, such as mannitol, has been proposed in diagnosis and therapy it is the aim of this paper to evaluate if there are some differences is the hearing threshold modification after mannitol administration in two groups of patients affected by possible and definite Menière's disease. The study was carried out on 137 patients affected by definite (39%) and possible (61%) Menière's disease, according to 1995 guidelines, and submitted to 18% (intravenous) IV mannitol therapy. After therapy we have found in both groups a significant improvement of hearing threshold in about 30% of cases. Improvement was not related with sex, age and age of appearance of symptomatology while it was related with the duration of the disease that was significantly shorter in subjects who showed a significant hearing improvement. In conclusion IV mannitol administration is a reliable therapy in improving acute hearing loss in possible and definite Menière's disease
Vertigo returning to the sitting position after the semont manoeuvre. Is it a prognostic symptom?
No full textBenign paroxysmal positional vertigo (BPPV) is a frequent benign vestibular condition usually managed with particle repositioning manoeuvres, such as Semont manoeuvre (SM). Since few authors have described prognostic aspects of liberatory manoeuvres, the purpose of the present study was to investigate the possibility of considering vertigo in the final sitting position of the SM as a prognostic symptom in the outcome of posterior BPPV. One hundred and thirteen patients with diagnosis of unilateral posterior BPPV were taking into account in our retrospective cohort study: 41 men and 72 women, aged 22 to 85 years. All were submitted to one repositioning SM and afterwards controlled 3 to 5 days later by means of an additional Dix-Hallpike manoeuvre. The main outcomes investigated were the occurrence of Ny and vertigo in the different phases of the SM, as well as their characteristics in relation to outcome of the disease. Among all patients, 75 (66%) presented both orthotropic Ny and vertigo in the second SM position and 72% obtained a complete resolution of the disease after the liberatory manoeuvre. Contrarily, 17 subjects (15%) manifested vertigo in the final sitting position of the SM and among these, only 7 (41%) completely recovered from BPPV. According to our data, in case of sudden vertigo returning to the final sitting position of the SM, the failure rate of the liberatory manoeuvre was higher, even though not statistically significant: therefore, it can be considered as a negative prognostic factor of posterior BPPV after SM
Hearing loss in Menière’s disease and sensorineural low-frequency fluctuating hearing loss without vertigo: are there any differences?
No full textAims: In previous decades Menière’s disease (MD) has been classified into four different categories: certain, definite, probable and possible. Recently, in the need to overcome critical issues in the diagnosis, the Bárány Society proposed new diagnostic criteria on MD excluding the certain and possible categories. Nevertheless, this updated classification raises the risk that many possible MD, namely isolated sensorineural low-frequency fluctuating hearing loss (SLFHL), would not be considered as precursors of definite MD. The aim of the present study is, therefore, to compare clinical aspects and evaluate differences between hearing loss in definite MD and in isolated SLFHL, which could be useful for clinical diagnostic and prognostic purposes. Materials and methods: A total of 662 patients suffering from definite MD (n = 447) and isolated SLFHL (n = 215) according to the 1995 American Academy of Otorhinolaryngology Head and Neck Surgery guidelines were retrospectively considered along a 5-year period. Pure-tone audiometry was performed on all patients. Results: A significantly higher incidence of bilateral pathology and longer duration of disease resulted in patients with definite MD. Differently, no significant differences were demonstrated between the groups either in terms of age at diagnosis or gender. The average 500–3000 Hz hearing threshold was significantly higher in definite MD in comparison with SLFHL. Conclusions: Results support the assumption of the difficulty to perform a differential diagnosis between definite MD and SLFHL and suggest the extent of hearing loss as the main diagnostic element in predicting the onset of vertigo, therefore an evolution to definite MD
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
- …
