IMPROVEMENTS IN THE DIAGNOSIS OF OBSTRUCTIVE SLEEP APNEA IN CHILDREN

Obstructive sleep apnea in children is due to adeno-tonsillar hypertrophy, in the majority of cases – a common condition in children that can be cured by the ENT surgeon by a relatively safe surgery. The final diagnosis of Obstructive sleep apnea is possible with polysomnography. This test is difficult to be performed in small children due to the contact sensors that are displaced during the agitated sleep of a child with sleep apnea. We propose a quasi noncontact sensor to be used to record the respiratory movements of children during sleep. The preliminary tests show that the method might be applicable in the clinical settings

COCHLEAR IMPLANTATION IN A CHILD WITH COMPLEX BILATERAL INNER EAR AND COCHLEO-VESTIBULAR NERVE MALFORMATIONS

Introduction: The cochlear implantation in patients with inner ear malformation has always been a challenge even to the most experienced clinicians. We present the case of a child of 8 years old with profound bilateral sensorineural hearing loss and the absence of language development with indication of cochlear implantation as single solution for hearing and speech rehabilitation. Methods: The audiological assessment indicates the cochlear implantation. Preoperative CT scan revealed a bilateral inner ear malformation (cochlear common cavity deformity on the right side, cochlear aplasia on the left ear and bilateral vestibular malformation). Brain magnetic resonance showed the presence of auditory nerve only to the right side. The girl was implanted on the right ear in the common cavity with an Advanced Bionics device, HiRes90K with HiFocus1j electrode. Results: The insertion of the portelectrode inside the malformed inner ear was confirmed by X-ray. Audiological evaluation had shown an average of hearing thresholds at 36,25 dB HL in free field pure tone audiometry at 22 months post-implantation. The speech perception was evaluated according to CAP (categories of auditory performance) index at 5 and to the speech intelligibility rating scale (SIR) to 3. Conclusions: The children with inner ear malformations can safely benefit of cochlear implantation. The results for tonal hearing were close to that of cochlear implanted children with normal ear anatomy, but were limited for speech understanding and speech production

STUDY REGARDING THE ASSOCIATION BETWEEN CHRONIC PERIODONTITIS AND THE PREVALENCE OF HEAD-NECK CARCINOMA

Background and aim Substantial evidence supports an association between chronic infections/inflammation, and cancer. The aim of this study was to assess the effect of chronic periodontitis on head and neck squamouscell carcinoma (HNSCC). Material and methods The study population consisted of 46 patients, divided into two groups. Cases were patients diagnosed with primary HNSCC (n=26). Controls were all patients seen during the same period of time but negative for malignancy (n=20). The severity of periodontitis was assessed through clinical determination of the bleeding index, periodontal index, tooth mobility degree and alveolar bone loss (ABL) on standardized panoramic radiographs. Results and discussions: Each millimeter of ABL was associated with >4-fold increased risk of HNSCC. The strength of the association was greatest in the oral cavity, followed by the oropharynx and larynx. The association persisted in subjects who never used tobacco and alcohol. Patients with periodontitis, whose bleeding and periodontal indices and tooth mobility values were higher, were more likely to have poorly differentiated oral cavity SCC than those without periodontitis (32.8% versus 11.5%; P = 0.038). Conclusions This study suggests that chronic periodontitis is a risk factor for HNSCC. These results have implications for practical and improved strategies for prevention, diagnosis, and treatment of HNSCC