Etiologia formelor severe de otită externă

Rezumat Otita externă este un proces inflamator al canalului auditiv extern, care poate evolua acut sau cronic. Otita externă acută afectează anual 4 ‰ în timp ce forma cronică afectează 3-5% din populaţie. Incidenţa sa înregistrează un maxim între 5-15 ani, pentru a scădea după vârsta de 50 ani şi este frecvent asociată cu umiditatea crescută, căldura, traumatismele locale, profesii care presupun contactul local cu apa (salvamar), aparate auditive. Frecvenţa relativ mare a afecţiunii precum şi rezistenţa la tratamentul local şi general al unor cazuri determină un interes constant privind acest subiect. Din acest motiv am considerat interesant un studiu privind particularităţile privind etiologia otitelor externe in zona noastră geografică.Summary External otitis is an inflammatory process of the skin that cover external auditory meatus with either chronic or acute evolution. Acute external otitis has an incidence of 0.4% whereas the incidence of chronic external otitis is 3-5%. The most affected group of population is that with age between 5 and 15 years old, than after 50 years of age, the incidence decline. External otitis is associated with: high humidity, high temperature, local trauma, profession that imply water entrance in the auditory canal (swimmers), hearing aids etc. The high frequency of the disease as well as the difficulties encountered in certain cases in treating it explain the constant interest for this subject. In this study we present the particularities regarding the etiology of the disease

Snoring and sleep apneea

Rezumat Sforăitul reprezintă un zgomot rezonant, produs în timpul somnului în căile respiratorii superioare. Dintotdeauna au existat persoane care sforăie, dar relativ recent acest simptom, a fost corelat cu problemele serioase, cardio-pulmonare şi neurologice generate de întreruperea fluxului aerian în timpul somnului. Parafrazând un scriitor francez, putem demasca somnul ca o aventură sinistră, în care ne adâncim în fiecare seară, cu o îndrăzneală care este rezultatul ignoranţei pericolului. După numeroase statistici sforăie 40% dintre bărbaţi şi 26% dintre femeile între 55 şi 84 ani. Este dificil de evaluat însă procentajul exact, deoarece de multe ori nu există martori (persoane singure).Summary Snoring represents a resonant noise produced during sleep în the superior air ways. Snoring people has always existed, but relatively recently this symptom was correlated with serious problems, cardio-pulmonary or neurological generated by disrupting the air flux during sleep. Paraphrasing a French author, we can unmask sleep as a sinister adventure, în which we get deeper every night, with a dear that is the result of ignoring the danger. After numerous statistics 40% of men and 26% of women snores between 55 and 84 years old. It is difficult to evaluate the correct percentage because many times there are no witnesses (lonely people)

OBJECTIVE TESTS FOR THE EVALUATION OF COCHLEAR IMPLANT CANDIDATES

Introduction: Cochlear implant indications have changed during the last decade. The objective tests are important in the cochlear implantation procedure. Purpose of the study: We proposed an evaluation for the objective tests in establishing a corect indication for cochlear implant in patients with bilateral sensorineural deafness. Materials and methods: We studied a group of 34 patients with bilateral sensorineural hearing loss tested by subjective and objective methods for an eventual cochlear implantation. Results: 74% of the patients presented a profound bilateral sensorineural hearing loss, 15% a severe type, 4% medium, 3% fluctuant and 4% cofosis. The examined patients fulfill the auditory criteria that justify the cochlear implant procedure. Discussions: The evaluation by subjective tests is followed by objective tests, offering provative evidence in clear cases and also in unclear ones. As a supplimentary measure, all the patients evaluated by subjective tests in establishing the possibility for cochlear implantations received at least one objective form of testing. Conclusions: Currently, the objective tests represent an important step in the reccomandation for cochlear implant. In all cases (excepting young children) the objective tests are compared/correlated with the subjective tests before the implantation procedure, specially with the subjective evaluation by a conventional prosthesis

Idiopathic sudden hearing loss: Oxidative status before and after corticoid treatment

The aim of this study was to investigate antioxidant enzyme activities and lipid peroxidation levels after systemic corticoid therapy (Solu-Medrol, 250mg/day, for 7 days). The effects of corticoid treatment on superoxide dismutase (SOD) and glutathione peroxidase (GPX) activity were investigated. Fifteen patients diagnosed with sudden sensorineural hearing loss were enrolled. Serum markers of oxidative stress were measured using spectrophotometric methods. In ten cases, the SOD and GPX activities and malondialdehyde (MDA) serum levels before and after corticoid treatment were investigated. Corticoid treatment enhanced antioxidant activity by increasing SOD and GPX activities and decreasing MDA serum levels

Polymicrobial Bacterial Meningitis in a Patient with Chronic Suppurative Otitis Media: Case Report and Literature Review

Polymicrobial meningitis is a rare entity in the adult population, especially in the antibiotic era. However, disorders such as chronic suppurative otitis media (CSOM) or even poor oral hygiene are considered risk factors for the development of such cerebral infection. We report a case of polymicrobial meningitis associated with oto-mastoiditis in a 64-year-old female patient known to have CSOM. The patient presented atypical symptoms for community-acquired meningitis, showing subacute evolution of headache, without fever or neck stiffness. The aerobe microorganisms Streptococcus anginosus and Corynebacterium spp., sensitive to beta-lactamines, and the anaerobe Prevotella spp., resistant to penicillin and metronidazole, were isolated from CSF specimens, while Proteus mirabilis and Enterococcus faecalis were identified from the ear drainage. The diversity of pathogens identified in our case led us to the hypothesis of two different sources of meningitis: otogenic and/or odontogenic. Favorable evolution was obtained after a multi-disciplinary approach, combining surgery and broad-spectrum antibiotics. In addition, we performed a literature review that highlights the low incidence of polymicrobial mixed aerobe–anaerobe meningitis