Prevalence of Hearing disorders in 3-6 year old Children of Kindergartens in Yazd City

Introduction: A hearing– impaired patient is defined as one with abnormal or reduced function in hearing resulting from an auditory disorder. The goal of any preschool and schools screening program should be to accurately indentify those children whose hearing has been impaired due to conductive and / or sensory– neural pathology. Methods: This cross– sectional descriptive study was done on 577 children (299 girls and 278 boys) aged between 3–6 years at kindergartens of Yazd city from September 2005 to January 2006. The otoscopy examination, pure-tone screening and impedance study was conducted after completion of awareness form of the hearing loss existence by the parents. Results: In this study, there were 12.6% abnormal conditions of external ear canal, 34.2% abnormal tympanic membrane, 35.9% abnormal tympanograms and 13.4% hearing loss including 11.5% conductive hearing loss, 1.5% sensory-neural hearing loss and 0.5% mixed hearing loss. Conclusion: With respect to the high prevalence and negative effects of middle ear disorders in learning of preschool children, and also due to the importance of early identification and intervention of hearing loss in aural rehabilitation programs, increasing the awareness and education of people, especially parents about the effects of hearing disorders and its prevention and identification is very importan

The effect of intravenous dexamethasone in reducing periorbital edema, ecchymosis and intraoperative bleeding in rhinoplasty patients

Background: In rhinoplasty, periorbital edema and ecchymosis is due to soft tissue trauma and small vessel injury with subsequent exudation and bleeding. The main purpose of this study is to determine the effect of dexamethasone in reducing periorbital edema and ecchymosis and intraoperative bleeding in rhinoplasty patients.Methods: This double-blind study included 90 patients who underwent rhinoplasty from October 2004 to March 2005. In group A, 8 mg of intravenous dexamethasone was administered only preoperatively. In group B, 8 mg of dexamethasone was administered preoperatively and continued every 8 hours postoperatively. Group C, the control group, received no dexamethasone. Results: The degree of upper lid edema in groups A and B was significantly less than that of group C. During the first and second day the severity of upper lid edema in group B was less than that of group A, but the difference was not significant. The degree of lower lid edema during the first and second days in groups A and B was significantly less than that of group C, although it was identical in all groups during the fifth and seventh days. The degree of upper lid ecchymosis during the first and fifth days in group C was significantly more than that of groups A and B, but it was similar on the seventh day in all groups. The degree of lower lid ecchymosis on the first day in groups A and B was significantly less than that of group C; however, it was similar in all groups during the second, fifth and seventh days. The volume of intraoperative bleeding in the three groups was similar. The mean period of recovery (12 days) was comparable in all groups.Conclusions: Dexamethasone administration leads to the reduction of upper lid edema, ecchymosis and lower lid edema during the first and second postoperative days, and reduction of lower lid ecchymosis on the first postoperative day

Sensorineural Hearing Loss in Chronic Otitis Media

Introduction: Conductive hearing loss due to chronic otitis media (COM) can be treated by surgery. COM, however, may be associated with functional damage to the inner ear. Sensorineural hearing loss (SNHL) due to COM has been found to be significant by some authors, whereas it has been considered negligible by others. The present study aimed to answer the question; Does COM cause SNHL ? Methods: 120 patients with unilateral COM admitted for tympano-mastoidectomy were selected for this observational case-control study. Air conduction threshold (ACT) and bone conduction threshold (BCT) averages were calculated at the speech frequencies (500, 1000, 2000Hz) and 4 KHz, in affected (case ear) and non affected (control ear) and then entered in the questionnaire along with intraoperative findings. Multiple statistical tests were used to clarify the relationships between SNHL and COM. Results: COM was seen to be associated with SNHL. The Threshold shift was more accentuated at 4 KHz in older patients. SNHL at 4 KHz seemed to be higher than that at the speech frequencies. There was a significant positive relationship between the elevated BCT and duration of COM. The relationship between elevated BCT and cholesteatoma was also significant. Conclusion: The inner ear is vulnerable to COM. The proximity of the sensory cells to the potential source of harm (inflamed middle ear) may mean higher exposure, as reflected by the fact that sensory cells processing high frequencies are more seriously damaged. SNHL in affected ear is strongly dependant on duration of disease

Assessment of Surgical Success Rate and Acoustic Test Findings in Children after Tympanostomy Tube Insertion

Introduction: Otoacoustic emissions are low density sounds produced from intact cochlea measureable in the presence of an intact conduction structure. The goal of this study was to assess the surgical success rate after tympanostomy tube insertion by Distortion Product Otoacoustic Emission (DPOAE) and Transient Evoked Otoacoustic Emission (TEOAE) as methods of evaluation of postoperative hearing. Methods: A descriptive-analytic study was conducted on 130 patients with OME. Audiometrical tests included TEOAE, DPOAE that were performed before, one month and three months after surgery on patients and results were compared. Results: Prior to surgery, TEOAE and DPOAE responses were not recordable in any of the patients, whereas after surgery, the responses were significant. Conclusion: OAE tests can be used as objective, simple tests in children, especially in toddlers who are not able to cooperate in performing PTA before surgery. These tests can be also be used for follow up of patients for hearing loss improvement and resolvement of middle ear effusion