Correlation between cephalometric data and severity of sleep apnea

AbstractIntroductionObstructive sleep apnea syndrome has a high prevalence among adults. Cephalo- metric variables can be a valuable method for evaluating patients with this syndrome.ObjectiveTo correlate cephalometric data with the apnea-hypopnea sleep index.MethodsWe performed a retrospective and cross-sectional study that analyzed the cephalo- metric data of patients followed in the Sleep Disorders Outpatient Clinic of the Discipline of Otorhinolaryngology of a university hospital, from June 2007 to May 2012.ResultsNinety-six patients were included, 45 men, and 51 women, with a mean age of 50.3 years. A total of 11 patients had snoring, 20 had mild apnea, 26 had moderate apnea, and 39 had severe apnea. The distance from the hyoid bone to the mandibular plane was the only variable that showed a statistically significant correlation with the apnea-hypopnea index.ConclusionCephalometric variables are useful tools for the understanding of obstructive sleep apnea syndrome. The distance from the hyoid bone to the mandibular plane showed a statisti- cally significant correlation with the apnea-hypopnea index

Linear Epidermal Nevus Of The Oral Cavity: A Rare Diagnosis.

Linear epidermal nevus is an uncommon diagnosis of benign lesions of the oral cavity. It is characterized by a congenital malformation arising from the ectoderm cells, which are arranged according to a typical linear configuration known as Blaschko's lines. We report a case of linear epidermal nevus of oral cavity in a 51-year-old lady or woman. The linear epidermal nevus of the oral cavity, although rare, can be considered a differential diagnosis of oral papillomatosis (OP). The histopathological studies and detailed description are the center of the diagnostic and clinical evolution.201220683

Linear Epidermal Nevus of the Oral Cavity: A Rare Diagnosis

Linear epidermal nevus is an uncommon diagnosis of benign lesions of the oral cavity. It is characterized by a congenital malformation arising from the ectoderm cells, which are arranged according to a typical linear configuration known as Blaschko’s lines. We report a case of linear epidermal nevus of oral cavity in a 51-year-old lady or woman. The linear epidermal nevus of the oral cavity, although rare, can be considered a differential diagnosis of oral papillomatosis (OP). The histopathological studies and detailed description are the center of the diagnostic and clinical evolution

Audiogram comparison of workers from five professional categories

Orientador: Reinaldo Jordão GusmãoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: Introdução: O ruído é considerado a terceira maior causa de poluição ambiental e pode ser visto como um risco de agravo à saúde. A Organização Mundial da Saúde estima que 10% da população mundial está exposta a níveis elevados de pressão sonora potencialmente lesivos. Torna-se mais problemático quando se trata de ruído no ambiente de trabalho. A exposição ao ruído, ocupacional ou não, pode acarretar alterações auditivas (hipoacusia, zumbido, dificuldade de compreensão da fala e hiperacusia) e não auditivas (irritação, distúrbios do sono, doenças cardiovasculares, dentre outros). Quando é intenso e a exposição a ele é continuada, podem surgir alterações estruturais na orelha interna, que determinam a ocorrência da Perda Auditiva Induzida por Ruído. O mecanismo de lesão do órgão espiral ocorre na espira basal da cóclea, área responsável pelo som de frequências altas. Objetivos: Avaliar as médias aritméticas dos limiares auditivos tonais das frequências 3, 4 e 6 kHz de trabalhadores de setores industriais diversos e relacioná-las com o tempo de exposição ao ruído e diferentes tipos de trabalho. Metodologia: Foram calculadas as médias aritméticas das frequências audiométricas de 3, 4 e 6 kHz para cada orelha de 2.140 exames audiométricos e verificado suas relações com o tempo de exposição ao ruído, idade e categorias de trabalho. Conclusões: Houve piora significativa das médias aritméticas em 3, 4 e 6 kHz nos quatro grupos, por tempo de exposição, em todas as categorias profissionais analisadas. As médias aritméticas, dos limiares tonais das frequências 3, 4 e 6 kHz, em decibéis, podem ser consideradas úteis para análise de lesões cocleares relacionadas com a exposição contínua a ruído. Na comparação entre as diferentes categorias profissionais, foram observadas diferenças significativas das médias aritméticas em 3, 4 e 6 kHz apenas entre transportadores de cargas e os trabalhadores das demais categorias. A orelha esquerda apresentou limiares audiométricos piores do que a direita, em todas as avaliações, independentemente da categoria profissionalAbstract: Introduction: Noise is considered the third largest cause of environmental pollution and can be seen as a risk to health conditions. The World Health Organization (WHO) estimates that 10% of the world population is exposed to high levels of potentially harmful sound pressure. It becomes more problematic when it comes to noise in the working environment. Exposure to noise, occupational or not, can cause hearing disorders (hearing loss, tinnitus, difficulty in speech understanding and hyperacusis) and not hearing disorders (irritation, sleep disorders, cardiovascular diseases and others). When intense and exposure to it is continued, there may be structural changes in the inner ear, which determine the occurrence of Noise-Induced Hearing Loss. The spiral organ injury mechanism occurs in the basal turn of the cochlea, area responsible for the sound of high frequencies. Objectives: To assess the arithmetic average of audiometric pure tone thresholds in frequencies 3, 4 and 6 kHz of various industrial sectors workers and relating them to the time of exposure to noise and different types of work. Methods: We calculated the arithmetic means of audiometric frequencies of 3, 4 and 6 kHz for each ear of 2.140 audiometry and verified its relations with the noise exposure time, age and job categories. Conclusions: There was a significant worsening of the arithmetic averages in 3, 4 and 6 kHz in the four groups, exposure time, in all occupational categories analyzed. The averages, of pure tone thresholds of frequencies 3, 4 and 6 kHz, in decibels, can be considered useful for analysis of cochlear injury related to continuous exposure to noise. Comparing the different professional categories, significant differences of arithmetic means were observed in 3, 4 and 6 kHz only between carriers of cargo and workers in other categories. The left ear had audiometric thresholds worse than the right, in all evaluations regardless of professionMestradoOtorrinolaringologiaMestre em Ciências Médica

Evaluation of the relationship between audiometric exams and auditive and non-auditive symptoms of workers exposed to occupational noise

Orientador: Agrício Nubiato CrespoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: Introdução: Por muito tempo negligenciada, a importância da poluição ambiental pelo ruído vem aumentando progressivamente. A presença de som em ambiente pode ser desejável quando auxilia na comunicação, no relaxamento ou no entretenimento. A classificação de um som como desagradável é subjetiva e depende das preferências pessoais, de aspectos culturais, da atividade na qual está presente. O ruído está presente no nosso cotidiano, em utensílios domésticos, atividades comerciais, igrejas, casas noturnas, indústrias, grandes rodovias. Muitas vezes não opcional, a incorporação do ruído às nossas vidas como algo natural, pode se tornar bastante perigoso e nocivo para a saúde. Embora as pessoas tendam a habituar-se a exposição ao ruído, o grau de habituação difere entre os indivíduos. Torna-se mais problemático quando se trata de ruído no ambiente de trabalho. A exposição ao ruído, ocupacional ou não, pode causar alterações auditivas como hipoacusia, zumbido, dificuldade de compreensão da fala e hiperacusia e não-auditivas como irritação, distúrbios do sono e doenças cardiovasculares. Objetivo: Este estudo tem por objetivo avaliar trabalhadores expostos a ruído ocupacional, suas alterações audiométricas, queixas auditivas e queixas não auditivas e suas correlações utilizando as médias aritméticas dos limiares auditivos tonais das frequências 3, 4 e 6 kHz, em decibéis (NA). Avaliar a correlação das médias com o tempo de exposição ao ruído. Avaliar os reflexos estapedianos dos trabalhadores e suas correlações com as queixas auditivas: perda auditiva, dificuldade de entendimento de fala, hiperacusia e zumbido. Metodologia: Este é um estudo observacional com corte transversal com dados obtidos de prontuários médicos de trabalhadores avaliados em serviço de Otorrinolaringologia Ocupacional. Foram incluídos trabalhadores de empresas da região metropolitana de Campinas. Inicialmente foi realizada uma triagem dos exames audiométricos destas empresas realizados do período de 1998 a 2016, totalizando 18.973 exames. Foram excluídas as audiometrias com alterações não sugestivas de PAIR, com timpanogramas alterados, com tempo de repouso auditivo menor que 14 horas, com dados incompletos e audiometrias de trabalhadores de locais sem exposição a ruído. Foi utilizado apenas o exame mais recente de cada trabalhador, restando 3.550 audiogramas. Conclusão: A média dos limiares tonais das frequências 3, 4 e 6 kHz, em decibéis (NA), pode ser usada como forma de seguimento dos trabalhadores expostos ao ruído. Em todas as categorias analisadas houve aumento estatisticamente significante das médias aritméticas em 3, 4 e 6 kHz de acordo com o tempo decorrido. Em metalúrgicos com PAIR, as queixas auditivas mais prevalentes foram hiperacusia e dificuldade de entendimento de fala e as não auditivas foram cervicalgia e cefaleia. As queixas de perda auditiva e dificuldade de entendimento de fala apresentaram correlação estatística positiva com as médias aritméticas. As queixas não auditivas não apresentaram correlação estatisticamente significantes com as médias. As queixas perda auditiva, dificuldades para reconhecer a fala, irritação com sons intensos, zumbidos, faixa etária e tempo de exposição apresentaram correlação estatística positiva com a ocorrência de recrutamento de Metz, em 3 e 4 kHzAbstract: Introduction: For a long time forgotten, the importance of environmental pollution by noise has been increasing progressively. The presence of surround sound may be desirable when it helps in communication, relaxation, or entertainment. The classification of a sound as unpleasant is subjective and depends on personal preferences, cultural aspects, the activity in which it is present. It is present in our daily lives, in household utensils, commercial activities, churches, nightclubs, industries, large highways. Often not optional, incorporating noise into our lives as something natural can become quite dangerous and harmful to health. Although people tend to become accustomed to exposure to noise, the degree of habituation differs between individuals. It becomes more problematic when it comes to noise in the work environment. Exposure to noise, occupational or otherwise, can cause auditory changes such as hearing loss, tinnitus, difficulty understanding speech, and hyperacusis and non-hearing, such as irritation, sleep disturbances and cardiovascular diseases. Objective: This study aims to evaluate workers exposed to occupational noise, their audiometric changes, auditory complaints and non-auditory complaints and their correlations using the arithmetic averages of the 3, 4 and 6 kHz tonal auditory thresholds in decibels (HL). Evaluate the correlation of means with the time of exposure to noise. To evaluate the stapedial reflexes of workers and their correlations with hearing complaints: hearing loss, difficulty understanding speech, hyperacusis and tinnitus. Methodology: This is an observational cross-sectional study with data obtained from medical records of workers evaluated in the Occupational Otorhinolaryngology service. Workers from companies in the metropolitan region of Campinas were included. Initially a screening of audiometric exams of these companies was carried out from 1998 to 2016, totaling 18,973 exams. We excluded audiometries with non-suggestive alterations of NIHL, with altered tympanograms, with auditory rest time of less than 14 hours, with incomplete data and audiometry of workers from sites without exposure to noise. Only the most recent exam of each worker was used, remaining 3,550 audiograms. Conclusion: The mean tonal thresholds of frequencies 3, 4 and 6 kHz, in decibels (HL), can be used as a follow-up for workers exposed to noise. In all the analyzed categories there was a statistically significant increase of the arithmetic averages in 3, 4 and 6 kHz according to the elapsed time. In metallurgists with NIHL, the most prevalent auditory complaints were hyperacusis and difficulty in understanding speech, and non-auditory complaints were neck pain and headache. The complaints of hearing loss and difficulty in understanding speech presented a positive statistical correlation with the arithmetic means. Non-auditory complaints did not present a statistically significant correlation with the means. The complaints of hearing loss, difficulties to understanding speech, irritation with loud sounds, tinnitus, age range and exposure time presented a positive statistical correlation with the occurrence of Metz recruitment at 3 and 4 kHzDoutoradoOtorrinolaringologiaDoutor em Ciências Médica

Audiogram Comparison of Workers from Five Professional Categories

Introduction. Noise is a major cause of health disorders in workers and has unique importance in the auditory analysis of people exposed to it. The purpose of this study is to evaluate the arithmetic mean of the auditory thresholds at frequencies of 3, 4, and 6 kHz of workers from five professional categories exposed to occupational noise. Methods. We propose a retrospective cross-sectional cohort study to analyze 2.140 audiograms from seven companies having five sectors of activity: one footwear company, one beverage company, two ceramics companies, two metallurgical companies, and two transport companies. Results. When we compared two categories, we noticed a significant difference only for cargo carriers in comparison to the remaining categories. In all activity sectors, the left ear presented the worst values, except for the footwear professionals (P>0.05). We observed an association between the noise exposure time and the reduction of audiometric values for both ears. Significant differences existed for cargo carriers in relation to other groups. This evidence may be attributed to different forms of exposure. A slow and progressive deterioration appeared as the exposure time increased

Is it necessary to perform occupational audiometric testing at 6-months of employment?

Introduction: Current Brazilian legislation requires that all workers exposed to noise are to be given an audiogram upon hiring, after 6 months of employment (first periodic test), and annually after the first periodic test. In other countries, the regulations of hearing conservation programs do not include the requirement for audiometric testing at 6 months of employment, but only annually. There is no evidence that the periodicity adopted by Brazilian legislation is the most appropriate. Objective: The present study aimed to evaluate the first 3 occupational audiometric tests of workers exposed to noise. Methods: Historical cohort study with cross-sectional analysis. Participants were all male met- allurgy workers aged up to 40 years. The first 3 audiograms of each worker were analyzed: pre-employment audiometric test, periodic audiometric test 1, and periodic audiometric test 2. For each worker, mean frequency thresholds were calculated at 3, 4, and 6 kHz in the left and right ears for each test. Statistical analysis was performed using the nonparametric Wilcoxon test. Results: A total of 988 workers were included. There was a significant difference in auditory thresholds between the pre-employment test and the 2 subsequent periodic tests for the right and left ears. There was no significant difference between Test1 and Test2 in either ear

Níveis elevados de pressão sonora: limiares dos reflexos estapedianos e queixas auditivas de trabalhadores expostos

The clinical evaluation of subjects with occupational noise exposure has been difficult due to the discrepancy between auditory complaints and auditory test results. This study aimed to evaluate the contralateral acoustic reflex thresholds of workers exposed to high levels of noise, and to compare these results to the subjects' auditory complaints. This clinical retrospective study evaluated 364 workers between 1998 and 2005; their contralateral acoustic reflexes were compared to auditory complaints, age, and noise exposure time by chi-squared, Fisher's, and Spearman's tests. The workers' age ranged from 18 to 50 years (mean = 39.6), and noise exposure time from one to 38 years (mean = 17.3). We found that 15.1% (55) of the workers had bilateral hearing loss, 38.5% (140) had bilateral tinnitus, 52.8% (192) had abnormal sensitivity to loud sounds, and 47.2% (172) had speech recognition impairment. The variables hearing loss, speech recognition impairment, tinnitus, age group, and noise exposure time did not show relationship with acoustic reflex thresholds; however, all complaints demonstrated a statistically significant relationship with Metz recruitment at 3000 and 4000 Hz bilaterally. There was no significance relationship between auditory complaints and acoustic reflexes.814374383A avaliação clínico-ocupacional de trabalhadores expostos a ruído é dificultada pela discrepância entre queixas auditivas e resultados dos exames audiológicos. Este estudo pretende avaliar limiares dos reflexos estapedianos contralaterais em sujeitos expostos a níveis elevados de pressão sonora, relacionando-os com queixas auditivas. Estudo clínico retrospectivo que analisou 364 trabalhadores e seus limiares de reflexos estapedianos contralaterais, relacionado-os com queixas auditivas, idades e tempos de exposição ao ruído. Dos trabalhadores avaliados, com idades de 18 a 50 anos (média 39,6) e tempos de exposição entre um e 38 anos (média 17,3); 15,1% (55) tinham queixa de perda auditiva bilateral, 38,5% (140) zumbidos bilaterais, 52,8% (192) irritação ao ouvir sons intensos e 47,2% (172) dificuldades para reconhecer a fala. As variáveis: perda auditiva, dificuldade para reconhecimento da fala, zumbidos, faixa etária e tempo de exposição ao ruído não se relacionaram significativamente com limiares dos reflexos estapedianos, mas todas as queixas apresentaram relação estatisticamente significante com o recrutamento de Metz nas frequências de 3000 e 4000 Hz, bilateralmente. Não houve relações significativas entre limiares dos reflexos estapedianos e queixas auditivas

High levels of sound pressure: acoustic reflex thresholds and auditory complaints of workers with noise exposure

INTRODUCTION: The clinical evaluation of subjects with occupational noise exposure has been difficult due to the discrepancy between auditory complaints and auditory test results. This study aimed to evaluate the contralateral acoustic reflex thresholds of workers exposed to high levels of noise, and to compare these results to the subjects' auditory complaints.METHODS: This clinical retrospective study evaluated 364 workers between 1998 and 2005; their contralateral acoustic reflexes were compared to auditory complaints, age, and noise exposure time by chi-squared, Fisher's, and Spearman's tests.RESULTS: The workers' age ranged from 18 to 50 years (mean = 39.6), and noise exposure time from one to 38 years (mean = 17.3). We found that 15.1% (55) of the workers had bilateral hearing loss, 38.5% (140) had bilateral tinnitus, 52.8% (192) had abnormal sensitivity to loud sounds, and 47.2% (172) had speech recognition impairment. The variables hearing loss, speech recognition impairment, tinnitus, age group, and noise exposure time did not show relationship with acoustic reflex thresholds; however, all complaints demonstrated a statistically significant relationship with Metz recruitment at 3000 and 4000 Hz bilaterally.CONCLUSION: There was no significance relationship between auditory complaints and acoustic reflexes