Transiently Evoked Otoacoustic Emissions in Children with Otitis Media with Effusion

Introduction. Otitis media with effusion is a common pediatric disease whose diagnosis is based on pneumatic otoscopy, pure-tone audiometry, and tympanometry. The aim of this study was to evaluate transiently evoked otoacoustic emissions in the diagnosis of otitis media with effusion as compared to tympanometry. Patients and Methods. 38 children with bilateral otitis media with effusion were studied. 40 normal children of similar age and sex were used as controls. All subjects underwent pneumatic otoscopy, standard pure-tone audiometry, tympanometry, and transiently evoked otoacoustic emissions. Results. In the group of children with bilateral otitis media, transiently evoked otoacoustic emissions were absent in 51 ears (67%). In the remaining 25 ears (33%) the mean emission amplitude was reduced, as compared to the mean value of the control group. Conclusions. Transiently evoked otoacoustic emissions should be included in the diagnostic workup of otitis media with effusion because it is a fast, reliable, and objective test. Transiently evoked otoacoustic emissions should always be used in conjunction with tympanometry, because a more meaningful interpretation of transiently evoked otoacoustic emissions measures is possible

Therapeutic approach to Gradenigo's syndrome: a case report

Abstract Introduction Traditional management of Gradenigo's syndrome requires aggressive and radical surgery without any attempt to preserve hearing. Recent reports, however, describe a successful outcome after conservative surgical intervention without labyrinthectomy. A similar outcome has also been reported in patients who were only prescribed with antibiotics and did not undergo myringotomy. Case presentation We report the case of a 24-year-old Caucasian Greek woman with Gradenigo's syndrome who was treated by draining her petrous apex via an infralabyrithine approach between her posterior semicircular canal and the jugular bulb. Her inner ear was not sacrificed during the procedure. She presented pre-operatively with ipsilateral conductive hearing loss, which recovered completely four weeks after the surgery. Conclusions Patients with Gradenigo's syndrome may be successfully treated with a combination of long-term permanent drainage and ventilation of the apical cells with corresponding hearing preservation. This can be achieved via a combination of transmastoid, infralabyrinthine and suprajugular approaches, if such would be allowed by the anatomy of the region or if there is enough space between the posterior semicircular canal and the jugular bulb.</p

Auditory brainstem responses in patients under treatment of hemodialysis

This study evaluated auditory function in patients with chronic renal failure. The experimental group included 31 patients with end-stage renal failure on chronic hemodialysis. The control group consisted of 31 healthy volunteers. The patients were examined prior to and following a session of hemodialysis. Measurements included pure tone audiometry, tympanometry and acoustic reflex measurements, Auditory Brainstem Responses (ABR), and blood chemistry parameters. Controls underwent the same test battery, with the exception of biochemical and hematological assessment. A comparison between experimental group before hemodialysis and controls shows that all ABR measures were significantly prolonged in the experimental group, with the exception of interpeak latency I-III. A comparison between controls and the experimental group following hemodialysis, indicated that wave V absolute latency and interpeak latencies III-V and I-V were significantly prolonged in the slow repetition rate[10hz] . In the fast repetition rate [60hz] , absolute latencies of waves I and V and III-V interpeak latencies were prolonged in the experimental group. Comparison of ABR recordings prior to and following hemodialysis showed a significant improvement in absolute latency of wave V after hemodialysis. This study showed that neural conduction along the auditory pathway is delayed in patients with CRF as compared to healthy subjects. Dialysis sessions improve overall neural auditory function. However, patients with CRF show delayed conduction even after a session of hemodialysis.Η μελέτη αυτή αξιολογεί την ακουστική λειτουργία ασθενών με χρόνια νεφρική ανεπάρκεια . Η πειραματική ομάδα συμπεριελάμβανε 31 ασθενείς με χρόνια νεφρική ανεπάρκεια τελικού σταδίου που ακολουθούσαν περιοδική αιμοκάθαρση .Η ομάδα των μαρτύρων περιελάμβανε 31 υγιείς ταυτόσημοι εθελοντές .Οι ασθενείς εξετάσθηκαν πρίν και μετά μια συνεδρία αιμοκάθαρσης .Οι μετρήσεις περιελάβαναν τονική ακουομετρία , τυμπανομετρία , ακουστικά αντανακλαστικά , ακουστικά προκλητά δυναμικά εγκεφαλικού στελέχους καί εξετάσεις αίματος .Οι μάρτυρες εκτελούσαν τον ίδιο έλεγχο εκτός απο τις αιματολογικές και βιοχημικές εξετάσει . Σύγκριση της πειραματικής ομάδας μετά μια συνεδρία αιμοκάθαρσης σε σχέση με τους μάρτυρες έδειξε ότι ο απόλυτος λανθάνων χρόνος του κύματος V και οι μεσολανθάνοντες χρόνοι των κυμάτων Ι-V και III-V ήταν σημαντικά παρατεταμένοι στην αργή συχνότητα επανάληψης [10ΗΖ] και στην γρήγορη συχνότητα επανάληψης [60ΗΖ] οι απόλυτοι λανθάνοντες χρόνοι των κυμάτων I και V και ο μεσολανθάνων χρόνος του κύματος III-V ήταν παρατεταμένοι στην πειραματική ομάδα . Σύγκριση των αποτελεσμάτων των ΑΠΔ των ασθενών πριν από μια συνεδρία αιμοκάθαρση και των μαρτύρων έδειξαν ότι οι λανθάνοντες και μεσολανθάνοντες χρόνοι ήταν σημαντικά παρατεταμένοι εκτός από τον μεσολανθάνων χρόνο του κύματος Ι-III . Η μελέτη αυτή έδειξε οτι η νευρογενής αγωγιμότητα της ακουστικής οδού παρουσιάζεται μειωμένη στους ασθενείς με χρόνια νεφρική ανεπάρκεια σε σχέση με τους μάρτυρες . Σύγκριση των αποτελεσμάτων ασθενών πρίν και μετά την συνεδρία της αιμοκάθαρσης έδειξαν ότι απόλυτος λανθάνων χρόνος του κύματος V βελτιώνεται σημαντικά. . Η διαδικασία της αιμοκάθαρσης βελτιώνει την νευρωνική λειτουργία , όμως οι χρόνοι των ασθενών μετά την αιμοκάθαρση παραμένουν ακόμη παρατεταμένοι σε σχέση με τους μάρτυρες

Cervical Diffuse Idiopathic Skeletal Hyperostosis: Rare Cause of Emergency Tracheostomy

Diffuse idiopathic skeletal hyperostosis (DISH) is a rare and potentially life-threatening syndrome. We present the case of a patient complaining about severe dyspnoea and diagnosed with vocal cord paresis. An emergency tracheotomy was performed to restore his breathing. Diagnostic imaging revealed large mass-occupying cervical osteophytes compressing the larynx. The osteophytes were removed via an anterior cervical approach, and vital signs were normalized. However, postoperatively, a fistula was discovered between the upper part of the oesophagus and the trachea. As a result, a gastrostomy tube had to be placed indefinitely. Literature review confirms the rare frequency of emergency tracheostomy due to DISH syndrome. The aim of the present study is to expand on our knowledge of a rare pathological entity that can frequently be misdiagnosed