A study of brainstem auditory evoked responses in normal human subjects and normal variations as a function of stimulus and subject characteristics

Background: Brainstem auditory evoked responses (BAERs) are electrophysiological investigations have widespread clinical utility in neurology, audiology, neonatology and anesthesiology. BAER responses exhibit a normal variability due to various non-pathologic factors and age is one of the variables suggested to have considerable influence on normal BAE responses. Aging changes in the auditory system may significantly influence the interpretation of the auditory brainstem responses in comparison with younger adults. The present study was undertaken to study the different parameters of brainstem evoked responses in normal subjects and their variations with changing stimulus and subject characteristics among average Indian people.Methods: The test was conducted on 50 neuro-audiologically normal subjects (age-group of 5-60 years) selected from the OPD of ENT Department. Various audio-vestibular tests they were subjected to brainstem evoked response audiometry and responses were studied regarding various parameters of ABR details. An attempt was made to find out a normal range, normative values of various parameters and their variations with respect of their stimulus intensity and subject characteristics.Results: In the present study it was observed that absolute latencies of all waves decreased with increasing stimulus intensity. The mean absolute latency values of all waves were prolonged in male than those of female subjects. The mean inter-peak latency values of I-III, III-V and I-V were also prolonged in male. Effects of change in stimulus rate on absolute latencies of all waves were observed. There were increases in absolute latencies of all waves with increasing stimulus rate.Conclusions: Increased stimulus intensity caused decrease in latency values of all values. Wave V showed lesser degree of variation than the other components. Increase in stimulus rate caused increase in latency of all waves. Wave V showed lesser degree of variation than the other components. BERA can be performed with a wide range of stimulus variations. But what was clear in conclusion was that 60dB SL was the suitable intensity level. Also a wide variety of stimulus rate can be used in combination with either of the stimulus polarity. So any combination of stimulus intensity, rate and polarity may be used for clinical application of BERA. But essence is that there should be a prior adjustment of parameter norms according to subject and stimulus characteristics

Evaluation of paranasal sinus diseases by computed tomography: A tertiary care hospital based study

Background: Paranasal sinus (PNS) diseases affect a wide range of population and include a broad spectrum of diseases ranging from inflammatory conditions to neoplasms, both benign and malignant. The application of computed tomography (CT) in the paranasal sinuses study has allowed the detail assessment of inflammation, cysts, benign, and malignant conditions. CT has increased the accuracy of patient management with a consequent decrease in morbidity and mortality. Materials & Methods: This hospital based prospective study was carried out in Department of ENT and Radio diagnosis of a tertiary care teaching hospital, Haldia, West Bengal from January 2018 to March 2019. Institutional Ethical Approval was obtained for the study. A total of 44 patients fulfilling the inclusion criteria, were included in the present study. The CT was done using Philips 16 Slice BRILLIANCE 190P MDCT and images were acquired in both axial and coronal planes. Post contrast study was done in those who required further evaluation. Soft tissue window level and width (50/200) and bone window level and width (350/2500). Contrast agent Omnipaque 350 was used if indicated and consent was obtained from the patient. CT findings were evaluated in all the patients and characterisation of the various sinonasal lesions were done with the help of various CT parameters. Results: Our study included 30 males (68.18%) and 14 females (31.82%)) aged between 4 yrs and 78 years, as all the patients with suspected sinonasal pathologies presented during the specified period of study were included without taking age as criteria for exclusion. Most common sinonasal pathology in present study was chronic sinusitis (other than fungal) 19 (43.18%) followed by sinonasal polyps 11 (25%) and antrochoanal polyp 5 (11.36%). Only 2 cases out of 44 (4.54%) sinonasal pathologies diagnosed to be malignant lesions on CT findings. The chief presenting complaints were of a headache (70.45%) followed by nasal discharge (43.2%), nasal obstruction (47.73%), facial pain (38.64%), allergic symptoms (15.91%), hyposmia (11.36%), epitaxis (6.82%), and mouth breathing (20.45%). Conclusion: CT is considered the gold standard for preoperative evaluation of PNS diseases for appropriate patient selection for functional endoscopic sinus surgery. CT of the sinuses uses special x-ray equipment to evaluate the paranasal sinus cavities – hollow, air-filled spaces within the bones of the face surrounding the nasal cavity

Conservative approach in the management of oral pyogenic granuloma by sclerotherapy

Background: Pyogenic granuloma is a common, non-neoplastic reactive growth of the oral cavity. Treatment consists of conservative surgical excision, cryosurgery, or laser surgery. These are usually adequate but often result in scars and recurrence. Therefore, this study was undertaken to determine the effectiveness of sclerotherapy in the treatment of oral pyogenic granuloma. Materials and Methods: Forty clinically diagnosed cases of oral pyogenic granuloma were included in the study. After topical anesthesia application, 0.2–0.5 mL of sodium tetradecyl sulfate was delivered by insulin syringe into the base of lesions till the solution leaked out. Each patient was recalled after 1 week and evaluated. If the lesion did not resolve, second and third injections were given consecutively. Results: All the 40 patients showed complete regression of the lesion after one to four consecutive shots in weekly interval. Conclusion: Intralesional sclerotherapy can be considered as an effective non-surgical treatment procedure for oral pyogenic granuloma

A study of brainstem auditory evoked responses in normal human subjects and normal variations as a function of stimulus and subject characteristics

Background: Brainstem auditory evoked responses (BAERs) are electrophysiological investigations have widespread clinical utility in neurology, audiology, neonatology and anesthesiology. BAER responses exhibit a normal variability due to various non-pathologic factors and age is one of the variables suggested to have considerable influence on normal BAE responses. Aging changes in the auditory system may significantly influence the interpretation of the auditory brainstem responses in comparison with younger adults. The present study was undertaken to study the different parameters of brainstem evoked responses in normal subjects and their variations with changing stimulus and subject characteristics among average Indian people.Methods: The test was conducted on 50 neuro-audiologically normal subjects (age-group of 5-60 years) selected from the OPD of ENT Department. Various audio-vestibular tests they were subjected to brainstem evoked response audiometry and responses were studied regarding various parameters of ABR details. An attempt was made to find out a normal range, normative values of various parameters and their variations with respect of their stimulus intensity and subject characteristics.Results: In the present study it was observed that absolute latencies of all waves decreased with increasing stimulus intensity. The mean absolute latency values of all waves were prolonged in male than those of female subjects. The mean inter-peak latency values of I-III, III-V and I-V were also prolonged in male. Effects of change in stimulus rate on absolute latencies of all waves were observed. There were increases in absolute latencies of all waves with increasing stimulus rate.Conclusions: Increased stimulus intensity caused decrease in latency values of all values. Wave V showed lesser degree of variation than the other components. Increase in stimulus rate caused increase in latency of all waves. Wave V showed lesser degree of variation than the other components. BERA can be performed with a wide range of stimulus variations. But what was clear in conclusion was that 60dB SL was the suitable intensity level. Also a wide variety of stimulus rate can be used in combination with either of the stimulus polarity. So any combination of stimulus intensity, rate and polarity may be used for clinical application of BERA. But essence is that there should be a prior adjustment of parameter norms according to subject and stimulus characteristics