Caffeine and Meniere’s Disease

Meniere’s disease is characterized by recurrent vertigo, fluctuating hearing loss, and persistent tinnitus. Caffeine consumption in modern society is a widespread and culturally accepted habit; however, there is no consensus about its mechanism of action in various organs and systems, including the auditory and vestibular. The few clinical studies have shown that abstention from caffeine has little effect in patients with Meniere’s disease, both in relation to vertigo, tinnitus and hearing loss

The potential use of melatonin for preventing cisplatin ototoxicity : an insight for a clinical approach

Cisplatin, one of the most effective and potent anticancer drugs, is used in the treatment of a wide variety of both pediatric and adult malignancies. However, the chemotherapeutic use of cisplatin is limited by its serious side effects, such as nephrotoxicity and ototoxicity. Ototoxicity produced by cisplatin is usually persistent, depending on the age of the patient, the cumulative number of doses, the number of chemotherapy cycles, the history of noise exposure, and deteriorating renal function. The mechanism of the ototoxicity caused by cisplatin is based on the generation of reactive oxygen species, which interfere with the antioxidant protection of the organ of Corti. Thus, protecting the cochlea with antioxidants ameliorates ototoxicity from cisplatin. In this context, melatonin appears as a therapeutic option for preventing the ototoxic effects of cisplatin, since the research in the last decade has proven its ability to be both a direct free radical scavenger and indirect antioxidant. In this sense, some of the evidence suggesting that melatonin is efficient for combating cisplatin-induced ototoxicity is summarized and discussed in this paper

Intratympanic Drug Delivery for Tinnitus Treatment

Objective: The aim of the study to evaluate the effectiveness of oral and injection intratympanic methylprednisolone to treat acute tinnitus associated with idiopathic sudden sensorineural hearing loss

Emissões otoacústicas evocadas por produto de distorção em trabalhadores normo-ouvintes expostos ao ruído ocupacional

Introdução: O teste das Emissões Otoacústicas tem tido destaque pela possibilidade de detectar precocemente alterações cocleares advindas da exposição ao ruído, não identificadas pela audiometria tonal. Objetivo: Avaliar as emissões otoacústicas evocadas por produto de distorção em trabalhadores normo-ouvintes expostos ao ruído ocupacional. Método: Trata-se de um estudo transversal, realizado em indústrias metalúrgicas do Distrito Federal, nas quais avaliou-se, por meio das Emissões Otoacústicas por Produto de Distorção trabalhadores de ambos os sexos, com idades entre 18 e 35 anos, limiares de audibilidade igual ou inferior a 25 dBNA, sem alterações auditivas. Resultados: Foram encontradas alterações significantes nas emissões otoacústicas em ambas as orelhas. Na amplitude e na relação sinal/ruído observou-se que quanto mais alta é a frequência menores são as médias encontradas nas emissões otoacústicas. A frequência com piores registros é a de 6 KHz. Conclusão: As emissões otoacústicas evocadas por produto de distorção em trabalhadores normo-ouvintes revelam alterações cocleares capazes de detectar precocemente o surgimento da lesão nas células ciliadas externas

Intratympanic corticosteroid for sudden hearing loss: does it really work?

AbstractIntroductionSudden deafness is characterized by an abrupt hearing loss of at least 30dB in three sequential frequencies in the standard pure tone audiogram over three days or less. Treatment is based on its etiology, and oral corticosteroids are widely used. Intratympanic corticosteroids are included as primary or secondary treatment when there is no improvement with the use of oral corticosteroids.ObjectiveTo determine the effectiveness of therapy with intratympanic steroids in sudden deafness.MethodsA systematic review was performed of publications on the topic in the databases of PubMed/MEDLINE, with the keywords: sudden deafness, sudden hearing loss, and corticosteroids.ResultsThirty scientific studies were analyzed. As to the objectives of the study analyzed, 76.7% sought to evaluate the use of intratympanic therapy salvage after failure to conventional treatment, and intratympanic therapy was used as the primary treatment 23.3% of the studies.ConclusionIntratympanic corticosteroid therapy is prescribed primarily when there is failure of conventional therapy and when it is limited to use systemic corticosteroids, such as the diabetic patient

Implante vestibular : ele realmente funciona? : uma revisão sistemática

Introdução: Pessoas com perda vestibular apresentam um déficit no sistema vestibular, o qual é o principal responsável pelo controle postural, pela estabilização do olhar e orientação espacial enquanto a cabeça se movimenta. Não há tratamento efetivo para uma perda vestibular bilateral. Recentemente, foi desenvolvido um implante vestibular para pessoas com perda vestibular bilateral para melhorar essa função e, consequentemente, a qualidade de vida desses pacientes. Objetivo: Identificar na literatura científica evidências de que o implante vestibular melhora a função vestibular de pessoas com déficit vestibular. Método: Cento e quarenta e seis artigos foram encontrados em cinco bases de dados e 323 artigos da literatura cinzenta, mencionando a relação entre implante vestibular e função vestibular em humanos. A estratégia PICOS (População, Intervenção, Comparação e Desfechos) foi utilizada para definir os critérios de elegibilidade. Os estudos que preencheram os critérios de inclusão para esta segunda etapa foram incluídos em uma síntese qualitativa, e cada tipo de estudo foi analisado de acordo com a avaliação de risco de viés do Joanna Briggs Institute através da critical appraisal checklist for quasi-experimental studies e da critical appraisa lchecklist for case reports. Resultados: Dos 21 artigos incluídos cujos textos completos foram lidos, 10 foram selecionados para a análise qualitativa na presente revisão sistemática. Todos os dez artigos analisados através da critical appraisal checklist mostraram um baixo risco de viés. O número total de amostras nos artigos avaliados foi de 18 pacientes com implantes vestibulares. Conclusões: Em conjunto, esses achados apoiam a viabilidade do implante vestibular para a restauração do reflexo vestíbulo-ocular em uma ampla faixa de frequências e ilustram novos desafios para o desenvolvimento desta tecnologia.Introduction: People with vestibular loss present a deficit in the vestibular system, which is primarily responsible for promoting postural control, gaze stabilization, and spatial orientation while the head moves. There is no effective treatment for a bilateral loss of vestibular function. Recently, a vestibular implant was developed for people with bilateral loss of vestibular function to improve this function and, consequently, the quality of life of these patients. Objective: To identify in the scientific literature evidence that vestibular implants in people with vestibular deficit improves vestibular function. Methods: One hundred and forty six articles were found from five databases and 323 articles from the gray literature mentioning the relationship between vestibular implant and vestibular function in humans. The PICOS strategy (Population, Intervention, Comparison and Outcome) was used to define the eligibility criteria. The studies that met the inclusion criteria for this second step were included in a qualitative synthesis, and each type of study was analyzed according to the bias risk assessment of the Joanna Briggs Institute through the critical assessment checklist Joanna Briggs institute for quasi-experimental studies and the Joanna Briggs institute critical assessment checklist for case reports. Results: Of the 21 articles included in reading the full text, 10 studies were selected for the qualitative analysis in the present systematic review. All ten articles analyzed through the critical assessment checklist Joanna Briggs institute showed a low risk of bias. The total number of samples in the evaluated articles was 18 patients with vestibular implants. Conclusions: Taken together, these findings support the feasibility of vestibular implant for restoration of the vestibulo-ocular reflex in a broad frequency range and illustrate new challenges for the development of this technology

Hearing preservation in cochlear implant surgery

In the past, it was thought that hearing loss patients with residual low-frequency hearing would not be good candidates for cochlear implantation since insertion was expected to induce inner ear trauma. Recent advances in electrode design and surgical techniques have made the preservation of residual low-frequency hearing achievable and desirable. The importance of preserving residual low-frequency hearing cannot be underestimated in light of the added benefit of hearing in noisy atmospheres and in music quality. The concept of electrical and acoustic stimulation involves electrically stimulating the nonfunctional, high-frequency region of the cochlea with a cochlear implant and applying a hearing aid in the low-frequency range. The principle of preserving low-frequency hearing by a “soft surgery” cochlear implantation could also be useful to the population of children who might profit from regenerative hair cell therapy in the future. Main aspects of low-frequency hearing preservation surgery are discussed in this review: its brief history, electrode design, principles and advantages of electric-acoustic stimulation, surgical technique, and further implications of this new treatment possibility for hearing impaired patients

Hair cell alteration prevalence rates in students of a school in Distrito Federal

Os jovens estão cada vez mais expostos à música alta, que pode prejudicar a audição. O teste das Emissões Otoacústicas, por ser mais sensível à exposição ao ruído, permite detectar precocemente alterações cocleares. OBJETIVO: Investigar a prevalência de lesão das células ciliadas externas por meio do teste de emissões otoacústicas em uma amostra de estudantes. MATERIAL E MÉTODO: Foram realizados os testes de emissões otoacústicas por estímulo transiente e por produto de distorção em 134 indivíduos. Os exames foram analisados de acordo com o critério "passa/falha". Tipo de estudo: Estudo seccional descritivo de prevalência. RESULTADOS: Dos 134 participantes, 80,6% apresentaram emissões otoacústicas transiente alteradas, sendo a maioria do gênero masculino; 97,8% apresentaram emissões otoacústicas produto de distorção alterada e 79,9% apresentaram alteração tanto em transiente quanto em produto de distorção, sendo a maioria do gênero masculino e, ainda, 94,0% relataram fazer uso de fones de ouvido; e 82,8% declararam frequentar lugar com música amplificada. CONCLUSÃO: A alta prevalência de testes alterados pode indicar precocemente uma disfunção coclear e, pelo alto número de participantes que relatou exposição à música alta, há a suspeita de que esse hábito pode estar provocando as alterações cocleares. ______________________________________________________________________________________________________________ ABSTRACTExposure to loud music is increasing among young people, and so could be the number of hearing impairment cases in this population. Otoacoustic emission tests are sensitive in capturing the effects of exposure to noise, and allow the detection of early cochlear disorders. OBJECTIVE: This study aims to look into the prevalence rates of injuries to outer hair cells in a population of students through otoacoustic emission testing. MATERIALS AND METHOD: One-hundred and thirty-four subjects were submitted to transient evoked and distortion product otoacoustic emission tests. Subjects were assessed on a "pass/fail" scale. This is a cross-sectional descriptive study on prevalence rates. RESULTS: More than four fifths (80.6%) of the 134 subjects had altered transient otoacoustic emissions, most of whom were males; 97.8% had altered distortion product otoacoustic emissions and 79.9% had altered test results in both transient evoked and distortion product OAEs; most were males; 94.0% reported they used earphones; and 82.8% stated they frequented places where loud music was played. CONCLUSION: The high prevalence rates of altered test results seem to indicate the presence of early cochlear disorders in the studied subjects. A significant number of subjects reported exposure to loud music, a habit that may be conducive to the onset of cochlear disorders

Eagle's Syndrome

INTRODUCTION: Eagle's syndrome is characterized by cervicopharyngeal signs and symptoms associated with elongation of the styloid apophysis. This elongation may occur through ossification of the stylohyoid ligament, or through growth of the apophysis due to osteogenesis triggered by a factor such as trauma. Elongation of the styloid apophysis may give rise to intense facial pain, headache, dysphagia, otalgia, buzzing sensations, and trismus. Precise diagnosis of the syndrome is difficult, and it is generally confounded by other manifestations of cervicopharyngeal pain. OBJECTIVE: To describe a case of Eagle's syndrome. CASE REPORT: A 53-year-old man reported lateral pain in his neck that had been present for 30 years. Computed tomography (CT) of the neck showed elongation and ossification of the styloid processes of the temporal bone, which was compatible with Eagle's syndrome. Surgery was performed for bilateral resection of the stylohyoid ligament by using a transoral and endoscopic access route. The patient continued to present pain laterally in the neck, predominantly on his left side. CT was performed again, which showed elongation of the styloid processes. The patient then underwent lateral cervicotomy with resection of the stylohyoid process, which partially resolved his painful condition. FINAL COMMENTS: Patients with Eagle's syndrome generally have a history of chronic pain. Appropriate knowledge of this disease is necessary for adequate treatment to be provided. The importance of diagnosing this uncommon and often unsuspected disease should be emphasized, given that correct clinical-surgical treatment is frequently delayed. The diagnosis of Eagle's syndrome is clinical and radiographic, and the definitive treatment in cases of difficult-to-control pain is surgical

Rhinoscleroma

INTRODUÇÃO: Rinoscleroma é uma doença infecciosa crônica do tipo granulomatosa causada pela bactéria Klebsiella rhinoscleromatis. Acomete a mucosa do trato respiratório, mais frequentemente o nariz. É considerada endêmica em determinadas regiões com África e América Central, porém é rara no Brasil. O acometimento nasal ocorre em 3 fases: catarral, granulomatosa e cicatricial. Em todo o seu curso a doença apresenta sintomatologia inespecífica, daí a dificuldade em ser diagnosticada. Seu diagnóstico é estabelecido através de cultura ou pelo encontro de células de Mikulicz ou corpúsculo de Russel no estudo anatomopatológico. O tratamento consiste em antibioticoterapia por longo período, associada ou não a cirurgia. OBJETIVO: Este relato tem por objetivo ilustrar um caso de rinoscleroma em uma paciente jovem com queixa de obstrução nasal bilateral de longa data e cefaleia. O intuito é alertar os otorrinolaringologistas para o diagnóstico desta doença rara, que se apresenta com sintomas inespecíficos e semelhantes a inúmeras patologias que acometem a região nasal.INTRODUCTION: Rhinoscleroma is a chronic granulomatous infectious disease, caused by the bacterium Klebsiella rhinoscleromatis. Affects the respiratory tract mucosa, more frequent in the nose. Is considered endemic in certain regions like Africa and Central America, but is rare in Brazil. The nasal involvement occurs in 3 phases: catarrhal, granulomatous and sclerotic stage. In all its course the disease presents nonspecific symptoms, and because of that, the difficulty of being diagnosed. Its diagnosis is established by culture or by the meeting of Mikulicz cell or Russel corpuscles in the anatomopathological study. The treatment consists in a long-term antibiotic, associated or not to a surgery. OBJECTIVE: This report aims ilustrate a case of rhinoscleroma in a female young patient complaining of bilateral nasal obstruction, long standing and headache. The intent is alert the otorhinolaringologists in diagnosing this rare disease, which presents itself with nonspecific symptoms as like numerous pathologies that affect the nasal region