Usporedba praga sluha dobivenog pomoću ASSR (auditory steady state responses) i ranim auditivnim evociranim potencijalima kod djece

Current recommendations proposed by pediatric audiologists are to commence with hearing amplification in children aged 6 months and above, after previous determination of the type and degree of hearing impairment and audiometric configuration. The goal of this study was to compare results obtained by click-evoked auditory brainstem response (c-ABR) and auditory steady state response (ASSR) in a group of children. This study included 68 children with different degrees of hearing impairment evaluated by c-ABR and ASSR. It is well-known that the c-ABR threshold highly correlates with behavioral hearing level at 2 kHz. In our study, the correlation between the c-ABR and ASSR thresholds in the whole sample was 0.58, 0.73, 0.97, 0.96, 0.95, 0.97; in the group of children with c-ABR thresholds up to 40 dBHL, it was 0.42, 0.73, 0.86, 0.74, 0.81, 0.81; and in the group with c-ABR thresholds worse than 40 dBHL, it was 0.46, 0.56, 0.89, 0.83, 0.85, 0.89 at 0.5, 1, 2, 4, 1-4, 2-4 kHz, respectively. Individual differences between the c-ABR and ASSR thresholds in the whole sample were up to 95, 90, 20, 25 dB at 0.5, 1, 2, 4 kHz, respectively. Study results indicated that there was strong correlation between the c-ABR and ASSR thresholds at 2, 4, 1-4, 2-4 kHz. The ASSR can be used as a valuable clinical tool and an excellent complementary method which, along with other audiologic techniques, provides more accurate hearing threshold estimation at an early age in children.Trenutne preporuke pedijatrijskih audiologa su da slušnu amplifikaciju kod djece treba započeti od 6. mjeseca, nakon prethodnog određivanja tipa i stupnja oštećenja sluha i audiometrijske konfiguracije. Cilj ove studije bio je usporediti rezultate dobivene pomoću ranih auditivnih evociranih potencijala (c-ABR) i ASSR (auditory steady state responses) kod djece. Ovo istraživanje je obuhvatilo 68 djece s različitim stupnjem oštećenja sluha procijenjenim pomoću c-ABR i ASSR. Poznato je da je prag sluha određen pomoću c-ABR u visokoj korelaciji s razinom sluha na 2 kHz. U našem istraživanju je korelacija između pragova sluha određenh pomoću c-ABR i ASSR u cijelom uzorku bila 0,58, 0,73, 0,97, 0,96, 0,95, 0,97; u skupini djece s c-ABR pragovima sluha do 40 dBHL bila je 0,42, 0,73, 0,86, 0,74, 0,81, 0,81; a u skupini s c-ABR pragovima sluha nižim od 40 dBHL bila je 0,46, 0,56, 0,89, 0,83, 0,85, 0,89 na 0,5, 1,2, 4, 1-4 odnosno 2-4 kHz. Pojedinačne razlike između pragova sluha određenih pomoću c-ABR i ASSR u cijelom uzorku bile su do 95, 90, 20, 25 dB na 0,5, 1, 2 odnosno 4 kHz. Rezultati studije su pokazali da postoji statistički značajna korelacija između pragova sluha određenih pomoću c-ABR i ASSR na 2, 4, 1-4, 2-4 kHz. ASSR se može koristiti kao značajan klinički alat i odlična komplementarna metoda koja, zajedno s drugim audiološkim tehnikama, omogućava precizniju procjenu praga sluha kod djece

Incidence of sensitization to specific inhalatory allergens in patients suffering from allergic rhinitis

Backgound/Aim. Allergic rhinitis is the most frequent type of rhinitis affecting more than 600 million people worldwide. As incidence increases, it is important to know about the characteristics, the allergens that exacerbate it as well as effects of allergic rhinitis on population. The aim of this study was to determine among patients with chronic rhinitis the number of patients positive to standard inhaled allergens, their distribution by sex, age and to determine the type and frequency of allergic sensitization to specific inhalatory allergens. Methods. Data was collected from 514 patients tested for standard inhalatory allergens via the skin prick test from 01.01.2016 to 31.12. 2016. Age, sex and concomitant diseases as well an analysis of type and frequency of hypersensitivity to different allergens were assessed and recorded. Results. Of 514 patients, 307 patients, with an average age of 29.6 ± 8.88 years had a positive skin prick test. The sex ratio was 1.2 : 1 in favor of the females. Outdoor allergens affected 81.2% of all patients while indoor allergens 66.4% of them. Weed pollen (71%), grass pollen (61%) and Dermatophagoides pteronyssinus (46%) were the most common allergens. Most patients were sensitized to 1 (22%) or 2 (22%) allergens, while 20% of patients were simultaneously sensitized to 3 allergens. Conclusion. Most patients with the symptoms of chronic rhinitis had a positive allergic reaction. Those in their third decade of life were the most commonly affected. Outdoor allergens were the most prevalent allergen group, and weed pollen was the most frequent type of allergen

Frequency and intensity of symptoms in patients with chronic rhinosinusitis

Introduction/Objective. Chronic rhinosinusitis is one of the most frequent chronic disorders which significantly influences the patients‘ quality of life. The objectivе of this paper was to examine which are the most frequent and intensive symptoms in patients with chronic rhinosinusitis, and also to determine whether there is a correlation between a subjective assessment of the disease as a whole and individual symptoms. Methods. The study encircled 90 patients with clinical diagnosis of chronic rhinosinusitis that was endoscopically proven and computer tomography of the nose and paranasal sinuses. Every possible symptom was recorded in every patient (nasal congestion, nasal discharge, facial pain/pressure, reduction or loss of smell, headache, fatigue, cough, halitosis and ear pain/fullness), the intensity of every possible symptom as well as the disorder as a whole. The patients assessed the intensity of their symptoms on the visual analogue scale. Results. Nose congestion is the most frequent symptom. It occured in 82 patients (91.1%), followed by nasal discharge in 81 patients (90%) and there was no difference in frequency of these two symptoms. Nasal discharge has been recorded as the most intensive symptom (x– = 5.4) and it is significantly more intensive in comparison to nasal congestion which was the second on the intesity list (x– = 4.1, p = 0.002). All other symptoms were significantly less frequently and less intensive. The average intensity value of the disease as a whole is the same as the average intensity value of the nasal discharge (x– = 5.4) while the average intensity values of all other symptoms are statistically significantly lower than the average intensity value of the disease as a whole; in all comparisons p < 0.001. Conclusion. Nasal congestion and nasal discharge are the most common symptoms in the patients with chronic rhinosinusitis. Nasal discharge is the most intensive symptom in patients with chronic rhinosinusitis while its intensity determines the sensation of the intesity of the disorder as a whole

Efficacy of a food supplement Lertal® as an adjuvant therapy of patients with moderate-to-severe seasonal allergic rhinoconjunctivitis

Abstract Background Lertal® is an oral food supplement containing 80 mg of dry extract of Perilla frutescens, 150 mg of bioflavonoid quercetin, and 5 μg of vitamin D3. The aim of this study was to evaluate the efficacy of Lertal® as a complementary therapy to topical therapy of patients with moderate-to-severe seasonal allergic rhinoconjunctivitis (SAR). Results Seventy (n=70) adult patients with moderate-to-severe SAR were included in this prospective study and treated by four different procedures: (1) 21 patients received azelastine intranasal spray for 30 days and, after that, azelastine spray and Lertal® tablets for the next 30 days; (2) 19 patients received combined azelastine with fluticasone intranasal spray for 30 days and azelastine with fluticasone spray and Lertal® tablets for the next 30 days; (3) 15 patients received azelastine spray only for 60 days; (4) 15 patients received combined azelastine with fluticasone spray only for 60 days. Levels of SAR symptoms (sneezing, tearing, ocular itching, rhinorrhea, nasal obstruction, hyposmia, and cough), as well as Total Symptom Scores (TSS), were evaluated at the start of this investigation (visit 0), after 30 days of treatment (visit 1), and after 60 days of treatment (visit 2) using a visual analog scale. After 30 days of treatment, better effects were achieved in groups in which patients were treated with combined (antihistamine with corticosteroid) spray. After 60 days of therapy, we found the best effects in procedure 2 and slightly worse effects in procedure 1. The high differences in the reduction of TSS between the 60th and 30th day were found for procedure 2 (p<0.001) and procedure 1 (p<0.001). The worse improvement of symptoms we found was in procedure 4 (p<0.01), and, for the procedure 3, we found no significant difference (p=0.140). None of the patients reported adverse effects during the therapy. Conclusion Our results suggest that addition of food supplement Lertal® to the standard topical therapy of patients with moderate-to-severe SAR increases the effects of intranasal therapy in reducing nasal and ocular symptoms

Video head impulse test in children after cochlear implantation

Background/Aim. Cochlear implantation (CI) is a therapeutic modality that provides a sense of sound to children and adults with profound sensorineural hearing loss or deafness. The aim of this work was to evaluate the lateral semicircular canal function using a high frequency video head impulse test in children after CI. Methods. A prospective descriptive study included 28 children (6–17 years old) with profound sensorineural hearing loss and unilateral CI. The control group included 20 healthy children with normal hearing. The measurement of vestibular function of the lateral semicircular canal was performed using video head impulse test. After cochlear implantation, the children underwent the vestibular testing. Values vestibulo-ocular reflex of lateral semicircular canal were measured using the video head impulse test in the children with cochlear implant and the control group. The values of vestibulo-ocular reflex were compared between the group. Also, in the children with CI values of vestibulo-ocular reflex were compared between the non-implanted ear and the ear with the embedded CI. Results. All 28 children with sensorineural hearing loss underwent the placement of CI through cochleostomy at the average age of 4.8 ± 2.92 years. Children with the cochlear implant had a significantly lower vestibulo-ocular reflex gain of the lateral semicircular canal measured by a high frequency video head impulse test compared to the control group of children with normal hearing (T test: t = 3.714; p = 0.001). However in these children there was no statistically significant difference of vestibulo-ocular reflex gain in the lateral semicircular canal measured in ears with embedded CI and non-implanted ears (T test: t = 0.419; p = 0.677). Conclusion. The values of vestibulo-ocular reflex gain in the lateral semicircular canal evaluated by the video head impulse test are significantly lower in the children with a profound sensorineural hearing loss compared to the children with normal hearing. The CI did not appear to have a negative impact on the lateral semicircular canal