The role of atopy in otitis media with effusion among primary school children: audiological investigation

Objective of this study is to value the role of atopy in otitis media with effusion (OME) in children attending primary school in Western Sicily focusing on the audiological characteristics among atopic and non atopic subjects suffering from OME. 310 children (5-6 years old) were screened by skin tests and divided into atopics (G1) and non atopics (G2). The samples were evaluated for OME by pneumatic otoscopy, tympanogram and acoustic reflex tests. The parameters considered were: documented persistent middle ear effusion by otoscopic examination for a minimum of 3 months; presence of B or C tympanogram; absence of ipsilateral acoustic reflex and a conductive hearing loss greater than 25 dB at any one of the frequencies from 250 Hz through 4 kHz. 56 children (18.06%) resulted atopics while 254 were non atopics. OME was identified in 24 atopic children and in 16 non atopic children for a total number of 40 children; the overall prevalence rate was 12.9% (42.85% for G1 and 6.30% for G2). OME was bilateral in 28 children (70%), with a significative difference between G1 (79.17%) and G2 (56.25%). The prevalence of B tympanogram was 70.59%, corresponding to 79.07% for G1 and 56% for G2. The mean air conduction pure tone was respectively 31.97 dB for G1 and 29.8 dB for G2. The prevalence value of OME in atopics children, also supported by the higher predominance of bilaterality, B tympanogram and hearing loss among this group, could suggest the important role of allergy in the pathogenesis of OME

Tinnitus e Sordità

OBIETTIVI Con il termine di "Acufene" o "Tinnitus" definiamo la percezione di un rumore in assenza di qualunque sorgente sonora esterna al nostro organismo. La presenza di acufeni aumenta progressivamente con l'età (12% dopo i 60 anni), e questo, secondo gli Autori, non è tanto correlato con la senescenza quanto con la concomitante sordità, la cui prevalenza aumenta con l'età. L'obiettivo di questo studio è quello di mettere in evidenza la correlazione fra il tipo di sordità e il tipo di acufene. MATERIALI Lo studio è stato condotto dalla Sezione di Audiologia del Dipartimento di Bio‐technologie dell'Università di Palermo su 197 soggetti affetti da acufene e sordità. I pazienti sono stati sottoposti ad indagini audiologiche che comprendevano: visita audiologica, esame audiometrico,impedenzometria ed acufenometria. In base al tipo di sordità è stata individuata una sordità di trasmissione, una sordità neurosensoriale (limitata alle alte frequenze:4‐8KHz; limitata alle medie frequenze:1,2,3 KHz; limitata alle basse frequenze:0,25‐0,5 KHz; pantonale) ed una sordità di tipo misto. L'acufenometria ha rilevato la frequenza del tinnitus. RIASSUNTO Sono stati esaminati 197 pazienti con sordità; nel 10,66% la sordità era indentificata come trasmissiva, nel 74,62% come neurosensoriale e nel 14,72% di tipo misto. La perdita uditiva era limitata alle alte frequenze nel 58,50%, alle basse frequenze nel 11.56% e pantonale nel 29.93% dei casi. È stata rilevata una sordità lieve nel 58,88% dei casi, moderata nel 22,34%, severa nel 15,74 e profonda nel 3,05%. La frequenza dell’acufene, misurata con l'acufenometria, era calibrata alle alte frequenze nel 61,42% dei casi, alle medie frequenze nel 22,84%, alle basse frequenze nel 12,69% mentre è risultata variabile e non identificabile nel 3,04%. Dei 147 pazienti con sordità neurosensoriale il 72,10% avevano un acufene tarato alle alte frequenze mentre dei pazienti con sordità neurosensoriale limitata alle alte frequenze il 88,37% avevano un acufene tarato alle alte frequenze. CONCLUSIONI In questo studio, condotto su un totale di 197 pazienti, la perdita uditiva si è rilevata con una netta prevalenza di tipo neurosensoriale (74,62%), sostenendo le attuali teorie per cui una riduzione della funzionalità cocleare rappresenta la causa più comune di tinnitus. La sordità neurosensoriale, nella maggioranza dei casi, era limitata alle alte frequenze (58,50%), questi risultati dimostrano che esiste una correlazione tra tinnitus a tonalità acuta e sordità neurosensoriale limitata alle alte frequenze, suggerendo che la riorganizzazione delle vie uditive, indotto dalla perdita uditiva, potrebbe essere una delle principali cause del sintomo tinnitus

Infarto acuto dell'AICA e sordità improvvisa

OBIETTIVI Gli autori descrivono un caso clinico, uomo adulto di 57 anni, di sordità improvvisa come sola manifestazione di infarto della arteria cerebellare antero‐inferiore (AICA) di destra in presenza di un quadro radiologico da interessamento della regione pontina di destra la cui valutazione radiologica, eseguita in urgenza ha permesso l’identificazione del quadro. MATERIALI Il colpo ischemico acuto nella distribuzione dell’AICA conosciuto come “Sindrome AICA” è un quadro clinico patologico che generalmente è accompagnato da una sintomatologia mista di tipo otologica e neurologica; si caratterizza infatti per: sordità improvvisa, vertigini di tipo periferiche e/o centrali da irritazione acuta con nistagmo ed atassia omolaterale con lateropulsione. Il coinvolgimento pontino inoltre si traduce con un deficit a carico del nervo facciale (debolezza facciale) e del trigemino. Anatomicamente l’AICA nel 75% dei casi nasce dal terzo caudale della arteria basilare e vascolarizza la regione anteromediale del cervelletto, la porzione laterale del ponte, l’emergenza del V°, del VII°, dell’VIII° nervo cranico ed il tratto spinotalamico. La sofferenza ischemica delle strutture del condotto uditivo interno e dell’orecchio interno nella ‘Sindrome AICA’ sono legate al deficit dell’arteria uditiva interna che, trattandosi nel 90% dei casi di un ramo diretto dell’AICA, è la diretta responsabile della sintomatologia labirintica. L’ipotesi diagnostica di Sindrome AICA scaturisce dalla presenza contemporanea di sintomi ot‐neurologici che inducono lo specialista ad avvalersi di TC e RMN (SE T2W; DWI; FLAIR) in urgenza. RIASSUNTO La presenza in corso di infarto dell’AICA della sola sordità improvvisa con caratteristiche cocleari è rara oltre che di difficile reperimento per la mancata effettuazione della RMN ma comunque deve essere sempre tenuta in considerazione. CONCLUSIONI La diagnosi eziologia di sordità improvvisa da ‘Sindrome AICA’ è eseguita solamente tramite l’ausilio di RMN eseguita in regime di urgenza per cui gli autori suggeriscono fortemente l’inserimento di RMN in urgenza tra le indagini diagnostiche di sordità improvvisa

E-ABR in patients with cochlear implant: A comparison between patients with malformed cochlea and normal cochlea

OBJECTIVES: This study aims to compare the electrical auditory brainstem response (EABR) following cochlear implant (CI) surgery in pediatric subjects with cochlear malformation and a normal cochlea, in order to assess the sensitivity of EABR and to evaluate the surgery outcome. MATERIALS and METHODS: A total of 26 pediatric subjects who were deaf and scheduled for CI surgery were enrolled into this case control study. Group A (n=20) included subjects with a normo-conformed cochlea. Group B (n=6) included subjects with cochlear malformation. Subjects were evaluated with EABR immediately (T0) and 6 months (T1) post-CI surgery. The EABR Waves III and V average amplitude and latency were compared across time, separately for each group, and across groups, separately for each time. RESULTS: Auditory brainstem response (ABR) could only be recorded in Group A. We were able to record EABR from all subjects at T0 and T1, and waves III and V were present in all the recorded signals. There were no statistically significant differences between T0 and T1 in EABR Waves III and V in terms of average amplitude and latency in neither group. When comparing Groups A and B, the only statistically significant difference was the average amplitude of wave V, both at T0 and T1. CONCLUSION: EABR is a valid tool to measure the auditory nerve integrity after CI surgery in patients with a normal and malformed cochlea, as shown by its ability to measure waves III and V when ABR is absent. The EABR testing should be performed before and after CI surgery, and EABR should be used as a measure of outcome, especially in patients with a malformed cochlea

Cavernous haemangioma of the external auditory canal: clinical case and review of the literature

Although benign vascular lesions are frequent in the head and the neck region, clinical evidence of cavernous haemangioma of the external auditory canal is extremely rare; when present, the lesion invades the middle ear space. Herein, a rare case of a soft mass filling the external auditory canal, not involving the tympanic membrane, in a symptomatic 59-year-old male is described. Clinical and audiological characteristics, imaging studies and surgical treatment with histological evaluation are reported, which led to a diagnosis of a cavernous haemangioma. This is only the seventh case described in the literature, to date, not involving the tympanic membrane and the middle ear space. In addition, a review has been made of the relevant literature with respect to epidemiology, presentation, evaluation, pathology, and management options for haemangiomas arising in the external auditory canal

Management of laryngeal precancerous lesions

Objective: The identification of precancerous lesions is the basis of an early diagnosis, and of a treatment that allows, in the great part of cases, the preservation of organ functions. The aims of this study were: the evaluation of the less invasive treatment for precancerous lesion of the larynx to minimize the recurrences, the estimation of number of further operation required. Methods: A prospective study was clone on patients with clinical diagnosis of laryngeal precancerosis. The patients were treated by a transoral endoscopic approach with direct microlaryngoscopy (DML) doing an excision-biopsy with cold blade, consisting in excision of the whole visible lesion with vocal ligament preservation. Results: A recurrence of a clinically evident precancerous lesion was present in 13.2% of patients that had a laryngeal intraepithelial lesion (LIN) 1 lesion and in 28.95% of patients that had a LIN 2 lesion. Conclusion: In order to achieve a control of a precancerous lesion, we suggest: excisional biopsy/subepithelial cordectomy (type 1 cordectomy) for LIN 1 lesions and subligament cordectomy (type 2 cordectomy) in case of LIN 2 cases. In case of recurrences of LIN 1 lesion we suggest directly a type 2 cordectomy

Re: "Relation of the Traditional Mediterranean Diet to Cerebrovascular Disease in a Mediterranean Population"

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Neutron Transfer reactions induced by 8Li on 9Be

Angular distributions for the elastic scattering of 8Li on 9Be and the neutron transfer reactions 9Be(8Li,7Li)10Be and 9Be(8Li,9Li)8Be have been measured with a 27 MeV 8Li radioactive nuclear beam. Spectroscopic factors for 8Li|n=9Li and 7Li|n=8Li bound systems were obtained from the comparison between the experimental differential cross section and finite-range DWBA calculations with the code FRESCO. The spectroscopic factors obtained are compared to shell model calculations and to other experimental values from (d,p) reactions. Using the present values for the spectroscopic factor, cross sections for the direct neutron-capture reactions 7Li(n,g)8Li and 8Li(n,g)9Li were calculated in the framework of a potential model.Comment: 24 pages, 8 Figures, submitted as regular article to PR

Alcohol abuse and insomnia disorder: Focus on a group of night and day workers

The sleep-wake cycle plays a fundamental role in maintaining the physiological balance of our body. Its alteration favours the genesis of several organic alterations and diseases including sleep disorders and the consumption of several substances of abuse. It has been reported that the work activity, especially that carried out during the night, is able to influence the sleep-wake cycle, promoting the development of insomnia, which, in turn, would subject the worker to a stressful condition such as to encourage adverse behaviour such as the use/abuse of psychotropic substances. Based on the above premises, the aim of our research was to evaluate, in night workers: (i) the pattern of consumption of alcoholic beverages; (ii) the presence of insomnia; and (iii) the possible correlation between alcohol consumption and insomnia disorder. We used the AUDIT-C test (the abbreviated version of the Alcohol Use Disorders Identification Test) and the Insomnia Severity Index to assess alcohol consumption and insomnia disorder, respectively. All questionnaires were completed by workers of both sexes belonging to different types of work activities, exclusively day or night. The results of our research show a higher propensity of night workers to consume alcoholic beverages than those who work during daytime hours, often in binge-drinking mode. In addition, an increase in the amount of alcohol consumed was found to be related to insomnia disorder, especially in night workers. This study provides further awareness of the importance of the negative impact of alcohol consumption on sleep quality in night workers

Staple line reinforcement with nebulized cyanoacrylate glue in laparoscopic sleeve gastrectomy: A propensity score-matched study

Background: A dreaded complication of laparoscopic sleeve gastrectomy (LSG) is suture leak. The study aimed to assess the efficacy of the nebulized comonomer Glubran 2® (N-butyl-cyanoacrylate + metacrylosysolfolane) applied to the LSG staple line. Methods: A propensity-matched comparison analysis was conducted in 125 patients undergoing LSG between 2017 and 2019. Groups included those treated with Glubran® (group 1, n = 70) and those without Glubran® treatment (group 2, n = 55). Results: There were differences in the mean body mass index (44.4 vs 43 kg/m2; P < 0.05) between the groups. There was a non-significant increase in the operative time for group 1 compared with group 2 (97 ± 8 vs 93.8 ± 10.7 min; P = 0.07), with a greater amount of estimated blood loss (94.5 mL vs 87.8; P < 0.01). There were more severe complications in group 2 over group 1 cases (8 vs 0%; P < 0.05), although postoperative bleeding did not differ between the two groups (1.4 vs 5.4%). There were no postoperative leaks in group 1 patients, but there were two leaks in group 2 cases with an increased length of hospital stay in patients with a leak. Conclusion: Glubran® LSG support may reduce leak risk without increasing operating time