A Multifactorial pattern for the understanding of the psychological development of the child with impaired hearing and its clinical-therapeutic implications

The Authors propose a multifactorial pattern for the understanding of the psychological development of the child with impaired hearing. According to this pattern the psychological development is determined by a variety of factors that can be regrouped intothree categories: • family features • aspects concerning the rehabilitation and the acoustic prosthesis • social and socio-environmental factors. In order to apply an effective action it is necessary to consider the interaction of the different factors and to adapt the therapeutic plan to that particular situation

Psychopathologic disease in patients with tinnitus: a case control of an outpatient cohort

The goal of this work was to study if patients suffering from tinnitus, that affects 14.5% of Italian people, are more susceptible to psychological distress than those who are not affected by tinnitus; to evaluate the prevalence of psychopathological disorders among the cohort, their relationship with the severity of tinnitus and eventual correlation between the distress caused by tinnitus and age of patients. 191 cases and 237 controls were enrolled between 2009-2011. Cases were 80 females and 111 males with mean age of 48.06. Controls were 106 females and 131 males with mean age of 47.09. Overall subjects completed Symptom CheckList-90 R (SCL 90-R) and some brief questionnaire about audiological history while Tinnitus Handicap Inventory (THI) was compiled by cases. Our study indicates that there is a significance correlation between tinnitus and psychopathological disorders, especially with anxiety (\u3c72=8.08; p=0.004) and sleep disturbance (\u3c72=38.85; p=0.0001) and there is a slight correlation between higher THI score and lower age subjects (r=0.76). Especially causing working impairment, the highest correlation resulted for ages 25-50 (r=0.96)

UNILATERAL SENSORINEURAL HEARING LOSS IN SCHOLASTIC AGE SUBJECTS: PSYCHOPEDAGOGICAL ASPECTS

The Authors want to assess a probable significant relation between the unilateral sensorineural hearing loss and some learning difficulties and language acquisitions, often found, through our observation, in impaired children. The Authors have examined a group of subjects in their scholastic age who have this kind of hearing loss and, through several dialogues with them, they have gathered some relevant data about the difficulties that children have at school, and drawn up a questionnaire

FOLLOW-UP AFTER PEDIATRIC MYRINGOPLASTY: OUTCOME AT 5 YEARS

Aim. The aim of this paper was to evaluate anatomical and functional outcomes 5 years after myringoplasty in children affected by perforated eardrum. To analyze the main differences in the frequency of postoperative complications between patients under and over 9 years of age. Methods. One hundred and thirty-two children, aged from 4 to 15 years, who underwent myringoplasty with or without mastoidectomy, were followed for a five-year period after surgery. The cohort was divided in two groups: children from 4 to 9 years old (G1) and patients older than 9 years (G2); all subjects underwent a pre- and post-operatively clinical exam and were evaluated through audiometry and impedenzometry. Adenoidectomy, if necessary, was performed three months before myringoplasty. Results. Of the total 132 children of our cohort, the 32.58% were from 4 to 9 years old (G1) and the 67.42% were older than 9 years (G2). Twenty-five (58.13%) G1 and 2 (2.24%) G2 patients underwent adenoidectomy before myringoplasty (P<0.0001); in 18 (41.86%) G1 and 23 (25.84%) G2 subjects a mastoidetomy was associated to myringoplasty (P=0.062). The main postoperative complications observed were respectively retraction pockets (9.3%) and recurrent seromucous otitis (9.3%) in G1 group and myringosclerosis (4.4%) in G2 group. The GAP index (IG) resulted >2 (good-excellent degree) in the 89.36% of G1 and 91% of G2 children (P>0.5). Conclusion. Nevertheless good audiologic outcomes in patients under and over 9 years of age, our study evidenced a different percentages of success after myringoplasty in G1 and G2 groups (P=0.0024). Thus, considering the higher percentage of postoperative complications in children with less than 9 years of age, myringoplasty should be considered cautiously due to the risk of reperforation and/or cholesteatoma

TINNITUS PATIENTS: ETIOLOGIC, AUDIOLOGIC AND PSYCHOLOGICAL PROFILE

Tinnitus represents one of the most frequent symptoms observed in the general population in association with different pathologies, although often its etiology remains unclear. Objective of this work is to evidence the main aspects concerning epidemiology, causes, audiological characteristics and psychological consequences of tinnitus

TREATMENT OF TINNITUS AND DIZZINESS ASSOCIATED VERTEBROBASILAR INSUFFICIENCY WITH A FIXED COMBINATION OF CINNARIZINE AND DIMENHYDRINATE

Seventy-eight consecutive subjects, 43 males and 35 females, ranging from 43 to 87 years of age suffering from dizziness and/or tinnitus due to vertebrobasilar insufficiency without other central nervous system diseases were treated with fixed combination of cinnarizine and dimenhydrinate two times a day and for two months. Data were collected considering the following parameters: age, sex, vestibular symptoms (unsteadiness, staggering, tendency to fall, swaying, vertigo due to change of position, bowing, walking, eye movements), headache, tinnitus, impaired hearing and aural fullness. Patients evaluated their vertigo symptoms and/or tinnitus intensities using a graded 3- point visual analog scale ranging from I (no symptoms) to 3 (strong symptoms) and their impact of life with classical tinnitus handicap inventory (THI) and dizziness handicap inventory (DHI) at first appointment, during the treatment and after therapy. The results of THI and DHI evidenced a statistical significant improvement either for tinnitus (t = 3.57; p<0.001) and for vestibular symptoms (t = 4.12; p<0.001); in particular at the final examination, of the 62 patients suffered from tinnitus, the 38.71% (24 cases) did not present the disorder while of the vestibular symptoms; unsteadiness and staggering both evidenced in 65/78 subjects (83.33%) at the beginning of the therapy, disappeared in the 43.08%. In conclusion dual action of the treatment showed improvement of tinnitus and dizziness symptoms, which was confirmed either by symptoms' reduction and by THI and DHI score

THE LINKAGE BETWEEN UPPER RESPIRATORY TRACT INFECTIONS AND OTITIS MEDIA: EVIDENCE OF THE 'UNITED AIRWAYS CONCEPT'

Upper respiratory tract infection (URTI) is a nonspecific term used to describe acute infections involving the nose, paranasal sinuses, pharynx and larynx and resulting from interplay between microbial load (viral and bacterial) and immune response. Infant and young children are prone to developing upper respiratory tract infections, which often result in bacterial complications especially acute otitis media because of the passage of bacteria (colonizing the nasopharynx) in the middle ear via Eustachian tube

Frequenza e fenotipo delle mutazioni GJB2 in pazienti con ipoacusia neurosensoriale non-sindromica congenita: analisi di una coorte della Sicilia Occidentale

Circa il 60% delle ipoacusie congenite sono associate a cause genetiche nei paesi sviluppati. La sordit\ue0 genetica \ue8 classificata in sindromica (30%) e non sindromica (70%), quest\u2019ultima riconducibile in pi\uf9 del 50% dei casi a mutazioni del gene GJB2. Tale gene, espresso nella coclea, codifica per la proteina gap junction \u201cConnessina 26\u201d, la cui funzione \ue8 cruciale per la comunicazione intercellulare. L\u2019obiettivo del nostro lavoro \ue8 stato quello di stimare la frequenza delle mutazioni GJB2 e la loro correlazione con il fenotipo audiologico in 102 pazienti siciliani affetti da sordit\ue0 neurosensoriale congenita non sindromica (NSHL) bilaterale e portatori di almeno una mutazione del gene GJB2. Tutti i soggetti sono stati sottoposti a test genetici (per individuare la presenza di mutazioni dei geni GJB2 e GJB6) ed esame audio-impedenzometrico. Nella coorte studiata sono stati identificati 15 mutazioni differenti e 17 genotipi. Nel 64.72% dei pazienti si \ue8 evidenziata una perdita uditiva di grado profondo (media PTA0.25-4kHz= 88.82\ub126.52 dB HL ). L\u201981.37% dei soggetti \ue8 risultato portatore di almeno un allele c.35delG; le mutazioni c.167delT e c.-23+1G&gt;A sono state identificate nel 10.78% e nel 9.8% dei pazienti rispettivamente. Il genotipo omozigote per la mutazione c.35delG \ue8 risultato associato ad una pi\uf9 severa perdita uditiva e a valori medi di PTA0.25-4kHz pi\uf9 elevati (96.79\ub121.11 dB HL) rispetto ai genotipi c.35delG/non-c.35delG e c.35delG/Wt (P&lt;0.05) Il nostro studio evidenzia il ruolo di c.35delG, c.167delT e c.-23+1G&gt;A come cause principali di NSHL in Sicilia. La variabilit\ue0 del profilo audiologico associato ad un determinato genotipo \ue8 riconducibile all\u2019azione di geni e fattori ambientali in parte non ancora individuati

Extramedullary plasmacytoma of the tonsil: A new management

Introduction: Extramedullary plasmacytoma (EMP) is a rare tumor of all plasma cell neoplasms. The tumor is mainly localized in the head and neck region, but rarely involving the tonsil. Case presentation: The authors report the 5th case of EMP of the tonsil in the literature occurred in a 57-year-old Caucasian male. Conclusions: Through a review of the relevant literature, we consider adjuvant radiotherapy not necessary for EMP of tonsil because of an adequate resection achieved by surgery

Role of cannabinoids in the treatment of Tinnitus

Tinnitus is a frequent symptom in audiological clinical practice characterized by an abnormal noise perceived in one or both ears or in the head, in which a patient has a conscious hearing percept in absence of external sound. Tinnitus might be caused by a homeostatic response of central dorsal cochlear nucleus auditory neurons that makes them hyperactive in compensation to auditory input loss. One hypothesis suggests that tinnitus is a sensory form of epilepsy that involves the cochlear nucleus and the inferior colliculus, which display impairment in the electrical activity in the auditory system. This alteration determines a synaptic plasticity in the dorsal cochlear nucleus that becomes a target for pharmacological compounds able to treat tinnitus. There is no effective drug treatment for tinnitus, but different studies propose the use of cannabinoid receptors agonist for their anti-epileptic activity, although their practical effects are still unclear. In this review, we want to analyze the emerging pharmacological approaches of cannabinoid receptor agonists to the therapy of tinnitus