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Lassaletta L, Acle Cervera L, Altuna X, Amilibia Cabeza E, Arístegui Ruiz M, Batuecas Caletrio Á, Benítez Del Rosario J, Cabanillas Farpón R, Costales Marcos M, Escada P, Espinosa-Sánchez JM, García Leal R, Gavilán J, Gómez Martínez J, González-Aguado R, Martinez-Glez V, Guerra Jiménez G, Harguindey Antolí-Candela A, Hernández García BJ, Orús Dotú C, Polo López R, Manrique M, Martín Sanz E, Martínez Álvarez R, Martínez H, Martínez-Martínez M, Rey-Martinez J, Ropero Romero F, Santa Cruz Ruiz S, Vallejo LÁ, Soto Varela A, Varela-Nieto I, Morales Puebla JM. Clinical practice guideline on the management of vestibular schwannoma. Acta Otorrinolaringol Esp (Engl Ed) 2024; 75:108-128. [PMID: 38346489 DOI: 10.1016/j.otoeng.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/19/2023] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Vestibular schwannoma (VS) is the most common tumour of the cerebellopontine angle. The greater accessibility to radiological tests has increased its diagnosis. Taking into account the characteristics of the tumour, the symptoms and the age of the patient, three therapeutic strategies have been proposed: observation, surgery or radiotherapy. Choosing the most appropriate for each patient is a frequent source of controversy. MATERIAL AND METHODS This paper includes an exhaustive literature review of issues related to VS that can serve as a clinical guide in the management of patients with these lesions. The presentation has been oriented in the form of questions that the clinician usually asks himself and the answers have been written and/or reviewed by a panel of national and international experts consulted by the Otology Commission of the SEORL-CCC. RESULTS A list has been compiled containing the 13 most controversial thematic blocks on the management of VS in the form of 50 questions, and answers to all of them have been sought through a systematic literature review (articles published on PubMed and Cochrane Library between 1992 and 2023 related to each thematic area). Thirty-three experts, led by the Otology Committee of SEORL-CCC, have analyzed and discussed all the answers. In Annex 1, 14 additional questions divided into 4 thematic areas can be found. CONCLUSIONS This clinical practice guideline on the management of VS offers agreed answers to the most common questions that are asked about this tumour. The absence of sufficient prospective studies means that the levels of evidence on the subject are generally medium or low. This fact increases the interest of this type of clinical practice guidelines prepared by experts.
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Affiliation(s)
- Luis Lassaletta
- Servicio de Otorrinolaringología, Hospital Universitario La Paz, Madrid, Spain.
| | | | - Xabier Altuna
- Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, Spain
| | - Emilio Amilibia Cabeza
- Servicio de Otorrinolaringología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Miguel Arístegui Ruiz
- Servicio de Otorrinolaringología, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Ángel Batuecas Caletrio
- Servicio de Otorrinolaringología, Complejo Asistencial Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Jesús Benítez Del Rosario
- Servicio de Otorrinolaringología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain
| | | | - María Costales Marcos
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Pedro Escada
- Servicio de Otorrinolaringología, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Juan Manuel Espinosa-Sánchez
- Servicio de Otorrinolaringología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
| | - Roberto García Leal
- Servicio de Neurocirugía, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Gavilán
- Servicio de Otorrinolaringología, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Justo Gómez Martínez
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Rocío González-Aguado
- Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Victor Martinez-Glez
- Center for Genomic Medicine, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autónoma de Barcelona, Sabadell, Barcelona, Spain
| | - Gloria Guerra Jiménez
- Servicio de Otorrinolaringología, Complejo Hospitalario Universitario Insular Materno Infantil de las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, Spain
| | | | | | - Cesar Orús Dotú
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Rubén Polo López
- Servicio de Otorrinolaringología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Manuel Manrique
- Servicio de Otorrinolaringología, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain
| | - Eduardo Martín Sanz
- Servicio de Otorrinolaringología, Hospital Universitario de Getafe, Getafe, Madrid, Spain
| | | | - Henry Martínez
- Servicio de Otorrinolaringología, Hospital Universitario Clínica San Rafael, Sur Bogotá D. C., Colombia; Servicio de Otorrinolaringología, Hospital San José, Bogotá, Colombia
| | | | - Jorge Rey-Martinez
- Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, Spain
| | | | - Santiago Santa Cruz Ruiz
- Servicio de Otorrinolaringología, Complejo Asistencial Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Luis Ángel Vallejo
- Servicio de Otorrinolaringología, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Andrés Soto Varela
- Servicio de Otorrinolaringología, Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Complexo Hospitalario Universitario de Santiago, Universidade de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, A Coruña, Spain
| | - Isabel Varela-Nieto
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain; Grupo de Audición y Mielinopatías, Instituto de Investigaciones Biomédicas Alberto Sols, CSIC-UAM, CIBERER-ISCIII, Madrid, Spain
| | - José Manuel Morales Puebla
- Servicio de Otorrinolaringología, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain
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Fernández-Cedrón C, Sánchez-Fernández P, Guntín-García M, Sandoval-Menéndez I, Gómez-Martínez J, Llorente-Pendás JL, Núñez-Batalla F. Enlarged vestibular aqueduct as a cause of postneonatal deafness. Acta Otorrinolaringol Esp (Engl Ed) 2024:S2173-5735(24)00018-8. [PMID: 38342426 DOI: 10.1016/j.otoeng.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/02/2023] [Indexed: 02/13/2024]
Abstract
INTRODUCTION The enlarged vestibular aqueduct (EVA) is the most frequent malformation of the inner ear associated with sensorineural hearing loss (5-15%). It exists when the diameter in imaging tests is greater than 1.5 mm at its midpoint. The association between hearing loss and EVA has been described in a syndromic and non-syndromic manner. It can appear as a familial or isolated form and the audiological profile is highly variable. The gene responsible for sensorineural hearing loss associated with EVA is located in the same region described for Pendred syndrome, where the SCL26A4 gene is located. OBJECTIVE To describe a series of children diagnosed with EVA in order to study their clinical and audiological characteristics, as well as the associated genetic and vestibular alterations. METHOD Retrospective study of data collection of children diagnosed with EVA, from April 2014 to February 2023. RESULTS Of the 17 cases, 12 were male and 5 were female. 5 of them were unilateral and 12 bilateral. In 5 cases, a cranial traumatism triggered the hearing loss. Genetic alterations were detected in 3 cases: 2 mutations in the SCL26A4 gene and 1 mutation in the MCT1 gene. 13 patients (76.5%) were rehabilitated with hearing aids and 9 of them required cochlear implantation. DISCUSSION The clinical importance of AVD lies in the fact that it is a frequent finding in the context of postneonatal hearing loss. It is convenient to have a high suspicion to diagnose it with imaging tests, to monitor its evolution, and to rehabilitate early.
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Affiliation(s)
- Carmen Fernández-Cedrón
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Paula Sánchez-Fernández
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Maite Guntín-García
- Instituto de Atención Temprana y Seguimiento, Fundación Padre Vinjoy, Oviedo, Asturias, Spain
| | | | - Justo Gómez-Martínez
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Jose Luis Llorente-Pendás
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Faustino Núñez-Batalla
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
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Braite N, da Cruz Fernandes L, Rissatto Lago MR, de Andrade CLO, Alves CAD. Subclinical neural hearing alterations in school children with type 1 diabetes mellitus. Acta Otorrinolaringol Esp (Engl Ed) 2023; 74:365-371. [PMID: 37717624 DOI: 10.1016/j.otoeng.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 04/08/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND AND OBJECTIVES Evidence has shown a cause-and-effect relationship between type 1 diabetes mellitus and auditory and cognitive dysfunctions. This study aimed to investigate the effect of type 1 diabetes mellitus (T1DM) on central auditory and cognitive functions in school-age children and adolescents. METHODS The study sample consisted of 101 children and adolescents, 50 with T1DM, of both sexes, aged between 7 and 18 years. All participants were selected for a structured interview on hearing, behavioral, and cognitive health and assessment of brainstem auditory evoked potentials (BAEP) and event-related potentials (P300). RESULTS Significant differences were observed in memory (p=0.002) and attention (p=0.021) complaints between participants with and without T1DM. In the BAEP responses, there were differences between wave III latencies in the right (p=0.017) and left (p=0.019) ears and in wave V latencies in the left ear (p=0.001) between the evaluated groups. In addition, there was an association between BAEP findings and metabolic control in the T1DM group in the left ear in waves III (p=0.006) and V (p=0.005) and in the right ear in wave V (p=0.026). No differences were observed in the latencies of P300 between the evaluated groups. CONCLUSION This study demonstrated the existence of a subclinical finding in the central auditory pathway, offering an increased risk for retrocollear alterations, which may be a consequence of poor metabolic control.
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Affiliation(s)
- Nadja Braite
- Department of Life Science, State University of Bahia, Salvador, Bahia, Brazil.
| | - Luciene da Cruz Fernandes
- Department of Speech Therapy, Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | | | - Crésio Aragão Dantas Alves
- Pediatric Endocrinology Unit, University Hospital Prof. Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil
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Baldizán Velasco L, Morales-Angulo C. Otologic manifestations of IgG4-related disease. Acta Otorrinolaringol Esp (Engl Ed) 2023; 74:320-331. [PMID: 36427792 DOI: 10.1016/j.otoeng.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 11/25/2022]
Abstract
IgG4-related disease (IgG4-RD) is a systemic autoimmune fibroinflammatory disease characterized by multiorgan infiltration of IgG4-positive plasma cells, fibrosis and vasculopathy that determine dysfunction of the affected organ. This review aims to characterize the otologic manifestations of the disease. We have conducted a systematic review of the biomedical literature published describing cases of IgG4-RD with otologic manifestations. For the review, the bibliographic databases utilized were Pubmed, Web of Science and Scopus. We selected 48 cases from which we extracted several data collections. About 52% of the patients were male between the ages of 19 and 79 years. Otologic findings were characterized by pseudotumoral lesions that most often caused a clinical presentation similar to otitis media with effusion, with cochlear involvement or sensorineural hearing loss (uni- o bilateral). Less frequent presentations included auricular chondritis, eosinophilic otitis, or hypertrophic pachymeningitis. In 32 patients (67%) the otologic manifestation was the first symptom of the ER-IgG4. Sixteen patients (33%) were treated with mastoidectomies as a result of delayed diagnosis and lack of knowledge about this entity. Two patients needed a cochlear implant. Although the otologic manifestations of IgG4-RD are unusual, it is important for the otorhinolaryngologist to know the otologic manifestations of this entity as it can be the onset of the disease, in order to allow early diagnosis and adequate treatment, avoiding permanent sequelae.
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Affiliation(s)
| | - Carmelo Morales-Angulo
- Facultad de Medicina, Universidad de Cantabria, Santanter, Cantabria, Spain; Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital Universitario Marqués de Valdecilla, Santanter, Cantabria, Spain; IDIVAL, Santander, Cantabria, Spain.
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Manrique MJ, Batuecas Á, Cenjor C, Ferrán S, Gómez JR, Lorenzo AI, Marco J, Matiñó E, Morant A, Morera C, Pérez N, Polo R, Ramos Á, Sánchez S, Nuñez F. Presbycusis and balance disorders in the elderly. Bibliographical review of ethiopathogenic aspects, consequences on quality of life and positive effects of its treatment. Acta Otorrinolaringol Esp (Engl Ed) 2023:S2173-5735(23)00031-5. [PMID: 36906066 DOI: 10.1016/j.otoeng.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/15/2022] [Indexed: 03/11/2023]
Abstract
At this time, we still do not have adequate knowledge and awareness of the consequences of hearing loss in the elderly on quality of life. Similarly, there is also insufficient information on the relationship of presbycusis and balance disorders with other comorbidities. Such knowledge can contribute to improve both prevention and treatment of these pathologies, to reduce their impact on other areas such as cognition or autonomy, as well as to have more accurate information on the economic impact they generate in society and in the health system. Therefore, with this review article we aim to update the information on the type of hearing loss and balance disorders in people over 55 years of age, and their associated factors; to analyze the impact on the quality of life of these people and the one which can be generated at a personal and population level (both sociological and economic) if an early intervention in these patients is pursued.
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García-Rodríguez EA, Mancilla-Mejía FJ, Dirzo-Cuevas SL, Hernández-Mundo A, Méndez-Saucedo LM. Hearing results with combination steroid therapy for sudden sensorineural hearing loss. CIR CIR 2023; 91:816-823. [PMID: 38096857 DOI: 10.24875/ciru.22000394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/17/2022] [Indexed: 12/18/2023]
Abstract
BACKGROUND Sudden Sensorineural Hearing Loss was described by Mc. Cabe in 1979 and, since then, many authors have tried to define, explain and correctly treat this disease. The National Institute on Deafness and Other Communication Disorders defines it as sudden sensorineural hearing loss of at least 30 dB in three contiguous audiometric frequencies in a period of 72 hours. Among the therapeutic strategies, corticosteroids have been shown to have the greatest benefit due to their anti-inflammatory and anti-cellular stress effects. OBJECTIVE To determine the hearing results with combined steroid therapy in patients with sudden sensorineural hearing loss (SSHL), according to the Siegel recovery criteria scale. METHOD Study carried out in the otorhinolaryngology and head and neck surgery service of the Centro Médico Naval, Ciudad de México, where 150 patients diagnosed with SSHL and who received combined therapy with intratympanic dexamethasone and systemic prednisone were included. RESULTS Therapeutic effectiveness was demonstrated by correlating therapeutic success in 82% of cases and therapeutic failure in 18% of cases, by correlating it with the Siegel recovery criteria scale. When evaluating the general average of the pure tone average levels at the beginning and 6 weeks after treatment, a statistically significant difference was obtained (p = 0.001). The average of the speech audiometry at the beginning and 6 weeks later had a statistically significant difference (p = 0.001). CONCLUSIONS Initial combined steroid treatment for SSHL has been shown to have beneficial results according to Siegel recovery criteria scale.
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Affiliation(s)
- Edgar A García-Rodríguez
- Departamento de Otorrinolaringología y Cirugía de Cabeza y Cuello, Centro Médico Naval, Ciudad de México, México
| | - Francisco J Mancilla-Mejía
- Departamento de Otorrinolaringología y Cirugía de Cabeza y Cuello, Centro Médico Naval, Ciudad de México, México
| | - Silvia L Dirzo-Cuevas
- Departamento de Otorrinolaringología y Cirugía de Cabeza y Cuello, Centro Médico Naval, Ciudad de México, México
| | - Abraham Hernández-Mundo
- Departamento de Otorrinolaringología y Cirugía de Cabeza y Cuello, Centro Médico Naval, Ciudad de México, México
| | - Luis M Méndez-Saucedo
- Departamento de Otorrinolaringología y Cirugía de Cabeza y Cuello, Centro Médico Naval, Ciudad de México, México
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Rodríguez AC, Gómez JAJ, Rojas MD. Audiological profile and handicap levels in people with vestibular disorders at Centro Equilibra, Vértigo and Equilibrio, San José, Costa Rica. Acta Otorrinolaringol Esp (Engl Ed) 2022; 73:271-278. [PMID: 36031109 DOI: 10.1016/j.otoeng.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 04/30/2021] [Indexed: 10/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Vestibular disorders are linked to a group of pathologies that can affect the vestibular part, the auditory part, or both parts of the inner ear. The problem in this study is the little information that exists about the audiological profile of people suffering from vestibular disorders in Costa Rica. There are international research studies on this topic, but there are no records of studies conducted in the Costa Rican population. This is why there is interest in developing this research which aims to characterize the audiological profile and the levels of handicap in people with vestibular disorders under Centro Equilibra, Vertigo and Equilibrio consultation during the months of September to November 2019. PATIENTS AND METHODS A descriptive, cross-sectional, quantitative, and observational analytical study with patients over 18 years old who attended Centro Equilibra. The main variables analysed were sex, age, personal pathological history, medical diagnosis, main vestibular symptoms, auditory manifestations, and levels of handicap. RESULTS The data was obtained from 177 people; vestibular disorders occurred more in the female sex (ratio 2.6:1). The mean age was 56 years. Fifty-three point seven percent presented slight sensorineural hearing loss, gradually decreasing. Of the population, 33.9% presented tinnitus, mostly at high frequencies. In the adult population, 52% presented some level of hearing handicap, unlike older adults, where the majority (77%) did not present any level of handicap. People with vestibular disorders perceive greater physical handicap (83%). CONCLUSIONS Hearing loss was the most common hearing manifestation and although statistical analysis shows that it is not directly related to vestibular disorders, it is related to concomitant metabolic diseases. For this reason, it is necessary to promote the prevention of metabolic diseases as one of the measures to improve hearing health, even from an early age.
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Affiliation(s)
- Adriana Chacón Rodríguez
- Licenciada en Audiología de la Universidad de Costa Rica, Centro Equilibra, Escazú, San José, Costa Rica
| | | | - Mónica Dávila Rojas
- Médica especialista en Otorrinolaringología con subespecialización en vértigo y rehabilitación funcional de los trastornos del equilibrio de la Universidad de París, Francia. Centro Equilibra, Escazú, San José, Costa Rica
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López-Simón E, Corriols-Noval P, Castillo-Ledesma N, Rodríguez-Martín M, Morales-Angulo C. Audiovestibular Symptoms in Patients With Idiopathic Hypertrophic Pachymeningitis: Systematic Literature Review. Acta Otorrinolaringol Esp (Engl Ed) 2021; 72:387-393. [PMID: 34844678 DOI: 10.1016/j.otoeng.2020.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/18/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVE Hypertrophic pachymeningitis is an infrequent inflammatory disease resulting in thickening and fibrosis of the dura mater. In most cases, the cause in unknown and is called idiopathic hypertrophic pachymeningitis (IHP). Audiovestibular symptoms are infrequent and the pathogenesis is still unclear. MATERIALS AND METHODS A systematic literature review of cases with IHP and vestibular symptoms from 2000 to February 2020 was performed. PRISMA Checklist was followed and PubMED database, Web of Science and Cochrane library were searched. We report a case of an adolescent with a diagnosis of vestibular neuritis in the context of IHP attended in our clinic. RESULTS We reviewed 5 articles related to IHP and vestibular disorders. A total of 7 cases (5 women and 2 men), with ages between 27 and 68 years with IHP were found. They all had audiovestibular symptoms. In contrast to our patient, uni or bilateral neurosensorial hearing loss was reported in all cases. Furthermore, there is no other case report published describing the association between IHP and vestibular neuritis. High dose steroids improved symptoms in 85.7% of the patients. CONCLUSION Vestibular symptoms in IHP are uncommon and the pathogenesis is still debatable. Entrapment of nerves in the internal auditory canal and secondary neuronal damage could be suspected as the main cause of hearing and vestibular loss.
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Affiliation(s)
- Eugenia López-Simón
- Unidad de Otoneurología, Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), Spain.
| | - Patricia Corriols-Noval
- Unidad de Otoneurología, Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), Spain
| | - Nathalia Castillo-Ledesma
- Unidad de Otoneurología, Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), Spain
| | - Minerva Rodríguez-Martín
- Unidad de Otoneurología, Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), Spain
| | - Carmelo Morales-Angulo
- Unidad de Otoneurología, Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), Spain
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Sánchez-Canteli M, Núñez-Batalla F, Martínez-González P, de Lucio-Delgado A, Antonio Villegas-Rubio J, Gómez-Martínez JR, Luis Llorente-Pendás J. Ototoxicity in cancer survivors: Experience and proposal of a surveillance protocol. An Pediatr (Barc) 2021; 95:290-297. [PMID: 34702687 DOI: 10.1016/j.anpede.2020.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/26/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Ototoxicity occurs in different percentages in patients after treatment with platinum-based chemotherapy or cranial radiation therapy. The aim of this study was to present our experience in ototoxicity monitoring. MATERIAL AND METHODS A review was made of the registry of paediatric cancer patients referred to the Children's Hearing Loss Unit from 1999 to 2019. RESULTS Of the 46 patients referred to this unit, 41 had received platinum as part of their treatment, 17 patients underwent neurosurgery, and 18 patients received cranial radiation therapy. An anamnesis and otoscopy were performed on all of them, and the monitoring was carried out with tone-verbal audiometry and/or distortion products. Hearing loss was observed in eight patients (21.05% of patients referred for audiological follow-up) as a consequence of the treatment. It was impossible to determine the audiological situation in eight patients at the end of treatment. Hearing aid adaption was necessary in two patients. In coordination with Paediatric Oncology, a change from cisplatin to carboplatin due to bilateral grade two ototoxicity was considered appropriate during treatment in one patient. CONCLUSION Adequate coordination with Paediatric Oncology is essential to carry out active surveillance for ototoxicity and to modify, if possible, the dosage or type of chemotherapy in case hearing is affected. In our experience, and following current recommendations, a pre-treatment assessment is usually performed, as well as monitoring during treatment, at the end of treatment, and annually thereafter due to the risk of a later development of hearing loss.
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Affiliation(s)
- Mario Sánchez-Canteli
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.
| | - Faustino Núñez-Batalla
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Universidad de Oviedo, Oviedo, Spain
| | - Patricia Martínez-González
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ana de Lucio-Delgado
- Oncología Pediátrica, Servicio de Pediatría, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Justo Ramón Gómez-Martínez
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Universidad de Oviedo, Oviedo, Spain
| | - José Luis Llorente-Pendás
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Universidad de Oviedo, Oviedo, Spain
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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J, Olleta Lascarro I. New-born Hearing Screening Programmes in 2020: CODEPEH Recommendations. Acta Otorrinolaringol Esp (Engl Ed) 2021; 72:312-323. [PMID: 34535222 DOI: 10.1016/j.otoeng.2020.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/18/2020] [Indexed: 10/20/2022]
Abstract
Programmes for early detection of congenital hearing loss have been successfully implemented mainly in developed countries, after overcoming some conceptual errors argued against their implementation and some criticism of their efficacy. However, some difficulties and weaknesses are still identified in these programmes: the detection of late-onset hearing loss and the percentage of children who did not pass the screening and did not complete the process of diagnosis and treatment, these being cases that are lost in the process. The purpose of this Document is to analyse these problems to determine areas for improvement and to emphasize one of the basic principles for the success of the programmes: continuous training for the interdisciplinary team. The result of the review process carried out by CODEPEH has been drafted as Recommendations for updating the Programmes with the evidence of the last decade, including advances in screening technology, the impact of the present knowledge on congenital infection by cytomegalovirus, genetic hearing loss research and control systems of lost to follow-up cases, treatment and follow up.
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Casanova MJ, Ferraz SM, Coutinho MB, Magalhães A, Almeida E Sousa C. Hearing rehabilitation with osseointegrated hearing implant in bilateral congenital external auditory canal atresia. Acta Otorrinolaringol Esp (Engl Ed) 2021; 72:288-294. [PMID: 34535219 DOI: 10.1016/j.otoeng.2020.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/05/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND OBJECTIVES Congenital atresia of the external auditory canal (EAC) is a congenital defect present in one in every 10,000-20,000 births. It causes conductive hearing loss, with an air-bone gap of 50-60dB. Early amplification is essential in bilateral cases to ensure normal language development. The aim of this study is to present the osseointegrated hearing implant as a treatment for bilateral EAC atresia, reviewing the audiometric results and the rate of complications. MATERIAL AND METHODS Retrospective analysis of patients diagnosed with bilateral congenital EAC atresia under follow-up in the pediatric ENT clinic of the ENT and Head and Neck Surgery department of a Portuguese Tertiary Hospital, between 2003 and 2019. We reviewed the medical records and collected information on the assessment of the initial audiometric status. In the cases submitted for implantation with an osseointegrated hearing implant, we analyzed the details of follow-up, including immediate and long-term post-operative complications, as well as the audiometric results. RESULTS We present 8 pediatric patients, 6 girls and 2 boys, with a diagnosis of bilateral congenital EAC atresia. The audiometric assessment revealed moderate to severe bilateral conductive hearing loss with a mean speech recognition threshold (SRT) of 51dB. Six patients underwent osseointegrated hearing implantation. All 6 patients showed good audiometric results, with an average SRT of 20dB and closure of the air-bone gap. CONCLUSIONS The osseointegrated hearing implant was an effective treatment option in these patients, without significant morbidity or complications. Osseointegrated hearing implantation should be considered first line treatment for children with bilateral congenital EAC atresia, as it presents good functional results and a high level of patient satisfaction.
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Affiliation(s)
- Maria Jorge Casanova
- Department of Otolaryngology and Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Portugal.
| | - Sara Moreira Ferraz
- Department of Otolaryngology and Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Portugal
| | - Miguel Bebiano Coutinho
- Department of Otolaryngology and Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Portugal
| | - António Magalhães
- Department of Otolaryngology and Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Portugal
| | - Cecília Almeida E Sousa
- Department of Otolaryngology and Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Portugal
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Morales Puebla JM, López Juanes N, Varo Alonso M, Sánchez Cuadrado I, Gavilán Bouzas J, Lassaletta Atienza L. Clinical-radiological Correlation in Temporal Bone Fractures. Acta Otorrinolaringol Esp (Engl Ed) 2021; 72:295-304. [PMID: 34535220 DOI: 10.1016/j.otoeng.2020.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 09/02/2020] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The diagnosis of temporal bone fractures (TBF) is based on radiological imaging. The most widely used classification divides fractures into longitudinal, transverse, and mixed. In recent years, other classifications have emerged to better predict clinical manifestations. OBJECTIVES To review computed tomography (CT) images of TBF, define their radiological pattern, and study the concordance of the observed findings with those described in the radiological report. To analyse the association between fracture types and clinical findings. To study the impact of mastoid pneumatization on fracture characteristics. METHODS Retrospective study of 110 TBF diagnosed with CT between January 2016 and May 2019. RESULTS Fifty-two transverse (47%), 34 longitudinal (30%), and 19 mixed fractures (17%) were identified with good interobserver agreement (k = .637). Longitudinal fractures were associated with conductive hearing loss (P < .001) and transverse fractures with sensorineural hearing loss (P = .005). Of the fractures, 8.2% showed involvement of the otic capsule, and were associated with sensorineural hearing loss (P < .001), facial paralysis (P = .019) and vertigo (P= .035). Fractures were more frequent in cases of greater pneumatization, and the involvement of the otic capsule in cases of very good pneumatization (P = .024). CONCLUSIONS The traditional classification of TBF is reproducible. Its association with clinical findings improves when the involvement of the otic capsule is also analysed. Mastoid pneumatization is not a protective factor for TBF or for involvement of the otic capsule.
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Affiliation(s)
| | | | | | - Isabel Sánchez Cuadrado
- Servicio de Otorrinolaringología, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación Hospital Universitario La Paz, Madrid, Spain
| | - Javier Gavilán Bouzas
- Servicio de Otorrinolaringología, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación Hospital Universitario La Paz, Madrid, Spain
| | - Luis Lassaletta Atienza
- Servicio de Otorrinolaringología, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación Hospital Universitario La Paz, Madrid, Spain; Centro de Investigación Biomédica en Red para Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
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Chacón Rodríguez A, Jiménez Gómez JA, Dávila Rojas M. Audiological profile and handicap levels in people with vestibular disorders at Centro Equilibra, Vértigo and Equilibrio, San José, Costa Rica. Acta Otorrinolaringol Esp (Engl Ed) 2021; 73:S0001-6519(21)00084-4. [PMID: 34465442 DOI: 10.1016/j.otorri.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 04/17/2021] [Accepted: 04/30/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Vestibular disorders are linked to a group of pathologies that can affect the vestibular part, the auditory part, or both parts of the inner ear. The problem in this study is the little information that exists about the audiological profile of people suffering from vestibular disorders in Costa Rica. There are international research studies on this topic, but there are no records of studies conducted in the Costa Rican population. This is why there is interest in developing this research which aims to characterize the audiological profile and the levels of handicap in people with vestibular disorders under Centro Equilibra, Vertigo and Equilibrio consultation during the months of September to November 2019. PATIENTS AND METHODS A descriptive, cross-sectional, quantitative, and observational analytical study with patients over 18years old who attended Centro Equilibra. The main variables analysed were sex, age, personal pathological history, medical diagnosis, main vestibular symptoms, auditory manifestations, and levels of handicap. RESULTS The data was obtained from 177 people; vestibular disorders occurred more in the female sex (ratio 2.6:1). The mean age was 56years. Fifty-three point seven percent presented slight sensorineural hearing loss, gradually decreasing. Of the population, 33.9% presented tinnitus, mostly at high frequencies. In the adult population, 52% presented some level of hearing handicap, unlike older adults, where the majority (77%) did not present any level of handicap. People with vestibular disorders perceive greater physical handicap (83%). CONCLUSIONS Hearing loss was the most common hearing manifestation and although statistical analysis shows that it is not directly related to vestibular disorders, it is related to concomitant metabolic diseases. For this reason, it is necessary to promote the prevention of metabolic diseases as one of the measures to improve hearing health, even from an early age.
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Affiliation(s)
- Adriana Chacón Rodríguez
- Licenciada en Audiología de la Universidad de Costa Rica. Centro Equilibra, Escazú, San José, Costa Rica
| | | | - Mónica Dávila Rojas
- Médica especialista en Otorrinolaringología con subespecialización en vértigo y rehabilitación funcional de los trastornos del equilibrio de la Universidad de París, Francia. Centro Equilibra, Escazú, San José, Costa Rica
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López-Simón E, Corriols-Noval P, Castillo-Ledesma N, Rodríguez-Martín M, Morales-Angulo C. Audiovestibular symptoms in patients with idiopathic hypertrophic pachymeningitis: Systematic literature review. Acta Otorrinolaringol Esp (Engl Ed) 2021; 72:S0001-6519(20)30171-0. [PMID: 33648724 DOI: 10.1016/j.otorri.2020.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/15/2020] [Accepted: 08/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Hypertrophic pachymeningitis is an infrequent inflammatory disease resulting in thickening and fibrosis of the dura mater. In most cases, the cause in unknown and is called idiopathic hypertrophic pachymeningitis (IHP). Audiovestibular symptoms are infrequent and the pathogenesis is still unclear. MATERIALS AND METHODS A systematic literature review of cases with IHP and vestibular symptoms from 2000 to February 2020 was performed. PRISMA Checklist was followed and PubMED database, Web of Science and Cochrane library were searched. We report a case of an adolescent with a diagnosis of vestibular neuritis in the context of IHP attended in our clinic. RESULTS We reviewed 5 articles related to IHP and vestibular disorders. A total of 7 cases (5 women and 2 men), with ages between 27 and 68 years with IHP were found. They all had audiovestibular symptoms. In contrast to our patient, uni or bilateral neurosensorial hearing loss was reported in all cases. Furthermore, there is no other case report published describing the association between IHP and vestibular neuritis. High dose steroids improved symptoms in 85.7% of the patients. CONCLUSION Vestibular symptoms in IHP are uncommon and the pathogenesis is still debatable. Entrapment of nerves in the internal auditory canal and secondary neuronal damage could be suspected as the main cause of hearing and vestibular loss.
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Affiliation(s)
- Eugenia López-Simón
- Unidad de Otoneurología, Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España.
| | - Patricia Corriols-Noval
- Unidad de Otoneurología, Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España
| | - Nathalia Castillo-Ledesma
- Unidad de Otoneurología, Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España
| | - Minerva Rodríguez-Martín
- Unidad de Otoneurología, Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España
| | - Carmelo Morales-Angulo
- Unidad de Otoneurología, Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander (Cantabria), España
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Casanova MJ, Ferraz SM, Coutinho MB, Magalhães A, Almeida E Sousa C. Hearing rehabilitation with osseointegrated hearing implant in bilateral congenital external auditory canal atresia. Acta Otorrinolaringol Esp 2021. [PMID: 33419565 DOI: 10.1016/j.otorri.2020.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION AND OBJECTIVES Congenital atresia of the external auditory canal (EAC) is a congenital defect present in one in every 10,000-20,000 births. It causes conductive hearing loss, with an air-bone gap of 50-60dB. Early amplification is essential in bilateral cases to ensure normal language development. The aim of this study is to present the osseointegrated hearing implant as a treatment for bilateral EAC atresia, reviewing the audiometric results and the rate of complications. MATERIAL AND METHODS Retrospective analysis of patients diagnosed with bilateral congenital EAC atresia under follow-up in the pediatric ENT clinic of the ENT and Head and Neck Surgery department of a Portuguese Tertiary Hospital, between 2003 and 2019. We reviewed the medical records and collected information on the assessment of the initial audiometric status. In the cases submitted for implantation with an osseointegrated hearing implant, we analyzed the details of follow-up, including immediate and long-term post-operative complications, as well as the audiometric results. RESULTS We present 8 pediatric patients, 6 girls and 2 boys, with a diagnosis of bilateral congenital EAC atresia. The audiometric assessment revealed moderate to severe bilateral conductive hearing loss with a mean speech recognition threshold (SRT) of 51dB. Six patients underwent osseointegrated hearing implantation. All 6 patients showed good audiometric results, with an average SRT of 20dB and closure of the air-bone gap. CONCLUSIONS The osseointegrated hearing implant was an effective treatment option in these patients, without significant morbidity or complications. Osseointegrated hearing implantation should be considered first line treatment for children with bilateral congenital EAC atresia, as it presents good functional results and a high level of patient satisfaction.
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Affiliation(s)
- Maria Jorge Casanova
- Department of Otolaryngology and Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Portugal.
| | - Sara Moreira Ferraz
- Department of Otolaryngology and Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Portugal
| | - Miguel Bebiano Coutinho
- Department of Otolaryngology and Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Portugal
| | - António Magalhães
- Department of Otolaryngology and Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Portugal
| | - Cecília Almeida E Sousa
- Department of Otolaryngology and Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Portugal
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Sánchez-Canteli M, Núñez-Batalla F, Martínez-González P, de Lucio-Delgado A, Villegas-Rubio JA, Gómez-Martínez JR, Llorente-Pendás JL. [Ototoxicity in cancer survivors: experience and proposal of a surveillance protocol]. An Pediatr (Barc) 2020; 95:S1695-4033(20)30296-4. [PMID: 32998843 DOI: 10.1016/j.anpedi.2020.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Ototoxicity occurs in different percentages in patients after treatment with platinum-based chemotherapy or cranial radiation therapy. The aim of this study was to present experience in ototoxicity monitoring. MATERIAL AND METHODS A review was made of the registry of paediatric cancer patients referred to the Children's Hearing Loss Unit from 1999 to 2019. RESULTS Of the 46 patients referred to this unit, 41 had received platinum as part of their treatment, 17 patients underwent neurosurgery, and 18 patients received cranial radiation therapy. An anamnesis and otoscopy were performed on all of them, and the monitoring was carried out with tone-verbal audiometry and/or distortion products. Hearing loss was observed in eight patients (21.05% of patients referred for audiological follow-up) as a consequence of the treatment. It was impossible to determine the audiological situation in eight patients at the end of treatment. Hearing aid adaption was necessary in two patients. In coordination with Paediatric Oncology, a change from cisplatin to carboplatin due to bilateral grade two ototoxicity was considered appropriate during treatment in one patient. CONCLUSION Adequate coordination with Paediatric Oncology is essential to carry out active surveillance for ototoxicity and to modify, if possible, the dosage or type of chemotherapy in case hearing is affected. In our experience, and following current recommendations, a pre-treatment assessment is usually performed, as well as monitoring during treatment, at the end of treatment, and annually thereafter due to the risk of a later development of hearing loss.
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Affiliation(s)
- Mario Sánchez-Canteli
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, España.
| | - Faustino Núñez-Batalla
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, España; Universidad de Oviedo, Oviedo, España
| | - Patricia Martínez-González
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España
| | - Ana de Lucio-Delgado
- Oncología Pediátrica, Servicio de Pediatría, Hospital Universitario Central de Asturias, Oviedo, España
| | | | - Justo Ramón Gómez-Martínez
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, España; Universidad de Oviedo, Oviedo, España
| | - José Luis Llorente-Pendás
- Unidad de Hipoacusia Infantil, Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, España; Universidad de Oviedo, Oviedo, España
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Hidalgo-Gutiérrez R, Suárez-Hortiales S, Giménez-Scherer JA, Fraire-Martínez MI. Neurophysiological findings of auditory evoked potentials in infants with a history of prematurity. Bol Med Hosp Infant Mex 2020; 77:76-82. [PMID: 32225998 DOI: 10.24875/bmhim.19000160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Auditory evoked potentials (AEPS) constitutes the most commonly used neurophysiological test to assess the functional development of the auditory brainstem in infants and allows the evaluation of hearing for high frequencies. Methods An observational, descriptive, cross-sectional and retrospective study was conducted. The AEPS results for 186 infants (372 ears) with a history of prematurity were examined. The bioelectrical response, morphology, amplitude, latencies I, III and V, and intervals I-III, III-V and I-V were compared, as well as auditory thresholds between two groups of premature infants < 32 and ≥ 32 weeks of gestational age (WGA). Results The bioelectrical response, latencies I, III and V, and intervals I-III and III-V were similar between the two groups of premature infants according to their corrected age; no statistically significant differences were found (p > 0.05) for these variables. The amplitude, morphology, and the I-V interval were more affected in the group of premature infants < 32 WGA (p < 0.05). Of the 372 ears evaluated, 275 showed normal hearing and 97 showed some degree of hearing loss for high frequencies, which was more frequent in patients < 32 WGA (p < 0.05). Conclusions The functional development of the auditory brainstem was similar between the groups of premature infants and within the normal range for the respective corrected age. Prematurity produced a directly proportional and statistically significant increase in the frequency of hearing loss for high frequencies.
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Affiliation(s)
- Ricardo Hidalgo-Gutiérrez
- Departamento de Neurofisiología. Unidad Médica de Alta Especialidad Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Sabino Suárez-Hortiales
- Departamento de Neurofisiología. Unidad Médica de Alta Especialidad Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Juan A Giménez-Scherer
- Unidad de Investigación Médica en Inmunología. Unidad Médica de Alta Especialidad Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - María I Fraire-Martínez
- Departamento de Neurofisiología. Unidad Médica de Alta Especialidad Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
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Martínez Pacheco MDC, Sequí Canet JM, Donzo Tobele M. Early Detection Programmes for Child Hearing Loss in Spain: Current Practices. Acta Otorrinolaringol Esp (Engl Ed) 2021; 72:37-50. [PMID: 32156438 DOI: 10.1016/j.otorri.2019.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 09/03/2019] [Indexed: 11/20/2022]
Abstract
INTRODUCTION AND OBJECTIVE In 2003, The Ministry of Health and Consumption, together with the Autonomous Communities (CCAA), approved a minimum and basic document concerning the establishment of Early Hearing Detection and Intervention State Programmes. Since then, the Commission for the early detection of hearing loss (CODEPEH) has made several updates and recommendations to improve these programmes. The objective of this study is to carry out a comparative analysis of how the CCAA established their Early Hearing Detection and Intervention programs and if they integrate the recommendations made by CODEPEH until 2017. MATERIAL AND METHOD The programmes (or related documents) of 16 CCAA available on line or paper are reviewed RESULTS: The 16 Early Hearing Detection and Intervention strategies analyzed are different, either in the number of test to be performed, the time in which they are performed or the techniques used. More than a third of these programmes were published before 2010 and have not been updated. Otoacoustic emissions is the chosen technique as the first screening test in nine of the 16 CCAA. Only one CCAA incorporates the salivary polymerase chain reaction test for cytomegalovirus in children with altered screening test. CONCLUSION All CCAA perform Early Hearing Detection and Intervention programmes but the heterogeneity does not allow drawing reliable conclusions about the result of the screening process and it would be necessary to aim for unification with the elaboration of a national programme and an integrated general database.
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de Juan Gallach A, Alemany Albert M, Marco Hernández AV, Boronat González N, Cernada Badía M, Tomás Vila M. [Neurological sequelae in patients with congenital cytomegalovirus]. An Pediatr (Barc) 2020; 93:111-117. [PMID: 32111550 DOI: 10.1016/j.anpedi.2019.12.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/19/2019] [Accepted: 12/09/2019] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION The infection due to cytomegalovirus is the most common congenital infection in developed countries, and on of the main causes of psychomotor impairment and neurosensory hearing loss of infectious origin. The present study has its objectives to describe the clinical-analytical and neuroimaging of patients with secondary neurological sequelae secondary to the congenital cytomegalovirus infection and then compare them with the group of patients with a congenital cytomegalovirus infection that did not have neurological symptoms during their follow-up. MATERIAL AND METHODS A retrospective, observational, cohort study was conducted that included all the cases of congenital cytomegalovirus infection from 2003 until 2018 and the short-medium term neurological sequelae were evaluated. Prenatal, perinatal, and postnatal data of patients with neurological sequelae were compared against those that did not present with any. RESULTS A total of 60 patients with congenital cytomegalovirus infection were recorded during the study period, with 65% having neurological involvement during their follow-up period (62.2% with psychomotor impairment, 61.5% with microcephaly, 46.2% loss of hearing, 27.8% motor disorders, 20.5% epilepsy, and 5.6% with chorioretinitis). In the patient group that had sequelae, the presence of clinical symptoms during the neonatal period, as well as changes in the neuroimaging study, were the most common, with both being statistically significant compared to the asymptomatic group. The patients with neurological involvement also had a higher score on the Noyola et al. neuroimaging scale. CONCLUSIONS The symptoms at birth, and certain findings in the neuroimaging, like the changes in the white matter or neuronal migration disorders, could predict neurocognitive sequelae in patients with congenital cytomegalovirus infection.
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Affiliation(s)
- Alba de Juan Gallach
- Unidad de Neuropediatría y Neonatología, Hospital Universitario y Politécnico La Fe, Valencia, España.
| | - Marta Alemany Albert
- Unidad de Neuropediatría y Neonatología, Hospital Universitario y Politécnico La Fe, Valencia, España
| | | | - Nuria Boronat González
- Unidad de Neuropediatría y Neonatología, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - María Cernada Badía
- Unidad de Neuropediatría y Neonatología, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - Miguel Tomás Vila
- Unidad de Neuropediatría y Neonatología, Hospital Universitario y Politécnico La Fe, Valencia, España
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Sepúlveda Villegas CA, Santos Armentia E, Utrera Pérez E, Jurado Basildo C, Novoa Ferro M, Del Campo Estepar S. Inner ear MRI: is it always useful to manage intravenous contrast? Radiologia (Engl Ed) 2020; 62:376-383. [PMID: 32089257 DOI: 10.1016/j.rx.2020.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 12/30/2019] [Accepted: 01/15/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the added value of administering intravenous contrast (IVC) routinely to the MRI of patients with audiovestibular symptoms in the assessment of a neuroradiologist and a resident. MATERIALS AND METHODS Retrospective study including patients who had an inner ear MRI for two months. Two radiologists reviewed independently and blinded the images. A first assessment was made analyzing just the sequences acquired without contrast and then a second evaluation of all the sequences, including post-contrast T1 sequences. The interobserver correlation and the correlation between MRI findings and the reason for requesting the study were calculated. RESULTS 40 patients were included. The range age was 36-80 years. The most frequent reason for request the MRI was hearing loss (52.5%). Neuroradiologist without IVC found 82.5% of extraotic pathology and 17.5% of otic pathology, highlighting the neurinoma of the VIII pair (7.5%); ossifying labyrinthitis, retrofenestrated otosclerosis and cholesteatoma. After IVC administration, findings were similar. The resident identified otic pathology in 5% in baseline sequences and 20% using CIV. The interobserver correlation using IVC was excellent (0.97), but weak without IVC (0.52). There was a correlation between the reasons for request the MRI and the findings in the ears, both in protocols without IVC (p = 0.004) and in protocols with IVC (p = 0.002). CONCLUSION Inner ear MRI without contrast gives relevant information to assess audiovestibular symptoms. The use of IVC increases the degree of confidence in a novel radiologist, while in the expert its use is less relevant. A protocol should be proposed in which gadolinium is used in selected patients.
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Affiliation(s)
| | - E Santos Armentia
- Departamento de Radiología, Hospital Povisa, Vigo, Pontevedra, España
| | - E Utrera Pérez
- Departamento de Radiología, Hospital Povisa, Vigo, Pontevedra, España
| | - C Jurado Basildo
- Departamento de Radiología, Hospital Povisa, Vigo, Pontevedra, España
| | - M Novoa Ferro
- Departamento de Radiología, Hospital Povisa, Vigo, Pontevedra, España
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Núñez-Batalla F, Vasile G, Cartón-Corona N, Pedregal-Mallo D, Menéndez de Castro M, Guntín García M, Gómez-Martínez J, Carro Fernández P, Llorente-Pendás JL. Vowel production in hearing impaired children: A comparison between normal-hearing, hearing-aided and cochlear-implanted children. Acta Otorrinolaringol Esp (Engl Ed) 2018; 70:251-257. [PMID: 30086890 DOI: 10.1016/j.otorri.2018.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 05/09/2018] [Accepted: 05/11/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES Inadequate auditory feedback in prelingually deaf children alters the articulation of consonants and vowels. The purpose of this investigation was to compare vowel production in Spanish-speaking deaf children with cochlear implantation, and with hearing-aids with normal-hearing children by means of acoustic analysis of formant frequencies and vowel space. METHODS A total of 56 prelingually deaf children (25 with cochlear implants and 31 wearing hearing-aids) and 47 normal-hearing children participated. The first 2 formants (F1 and F2) of the five Spanish vowels were measured using Praat software. One-way analysis of variance (ANOVA) and post hoc Scheffé test were applied to analyze the differences between the 3 groups. The surface area of the vowel space was also calculated. RESULTS The mean value of F1 in all vowels was not significantly different between the 3 groups. For vowels /i/, /o/ and /u/, the mean value of F2 was significantly different between the 2 groups of deaf children and their normal-hearing peers. CONCLUSION Both prelingually hearing-impaired groups tended toward subtle deviations in the articulation of vowels that could be analyzed using an objective acoustic analysis programme.
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Affiliation(s)
- Faustino Núñez-Batalla
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España.
| | | | | | - Daniel Pedregal-Mallo
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España
| | | | | | - Justo Gómez-Martínez
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España
| | - Pilar Carro Fernández
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, España
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Reis LR, Fernandes P, Escada P. Contralateral Occlusion Test: The effect of external ear canal occlusion on hearing thresholds. Acta Otorrinolaringol Esp (Engl Ed) 2017; 68:197-203. [PMID: 28193471 DOI: 10.1016/j.otorri.2016.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 11/06/2016] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND GOALS Bedside testing with tuning forks may decrease turnaround time and improve decision making for a quick qualitative assessment of hearing loss. The purpose of this study was to quantify the effects of ear canal occlusion on hearing, in order to decide which tuning fork frequency is more appropriate to use for quantifying hearing loss with the Contralateral Occlusion Test. METHODS Twenty normal-hearing adults (forty ears) underwent sound field pure tone audiometry with and without ear canal occlusion. Each ear was tested with the standard frequencies. The contralateral ear was suppressed with by masking. Ear occlusion was performed by two examiners. RESULTS Participants aged between 21 and 30 years (25.6±3.03 years) showed an increase in hearing thresholds with increasing frequencies from 19.94dB (250Hz) to 39.25dB (2000Hz). The threshold difference between occluded and unoccluded conditions was statistically significant and increased from 10.69dB (250Hz) to 32.12dB (2000Hz). There were no statistically significant differences according to gender or between the examiners. CONCLUSION The occlusion effect increased the hearing thresholds and became more evident with higher frequencies. The occlusion method as performed demonstrated reproducibility. In the Contralateral Occlusion Test, 256Hz or 512Hz tuning forks should be used for diagnosis of mild hearing loss, and a 2048Hz tuning fork should be used for moderate hearing loss.
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Affiliation(s)
- Luis Roque Reis
- Department of Otolaryngology of Egas Moniz Hospital, Centro Hospitalar de Lisboa Ocidental (CHLO), NOVA Medical School - Faculdade de Ciências Médicas, Lisbon, Portugal.
| | - Paulo Fernandes
- Department of Otolaryngology of Egas Moniz Hospital, Centro Hospitalar de Lisboa Ocidental (CHLO), NOVA Medical School - Faculdade de Ciências Médicas, Lisbon, Portugal
| | - Pedro Escada
- Department of Otolaryngology of Egas Moniz Hospital, Centro Hospitalar de Lisboa Ocidental (CHLO), NOVA Medical School - Faculdade de Ciências Médicas, Lisbon, Portugal
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Fernández-López C, Morales-Angulo C. Otorhinolaryngology manifestations secondary to oral sex. Acta Otorrinolaringol Esp 2016; 68:169-180. [PMID: 27793330 DOI: 10.1016/j.otorri.2016.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 04/13/2016] [Accepted: 04/17/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Over the last few years, oral and pharyngeal signs and symptoms due to oral sex have increased significantly. However, no review articles related to this subject have been found in the medical literature. The objective of our study was to identify otorhinolaryngological manifestations associated with orogenital/oroanal contact, both in adults and children, in the context of consensual sex or sexual abuse. METHODS We performed a review of the medical literature on otorhinolaryngological pathology associated with oral sex published in the last 20 years in the PubMed database. RESULTS Otorhinolaryngological manifestations secondary to oral sex practice in adults can be infectious, tumoral or secondary to trauma. The more common signs and symptoms found in the literature were human papillomavirus infection (above all, condyloma acuminata and papilloma/condyloma), oral or pharyngeal syphilis, gonococcal pharyngitis, herpes simplex virus infection and pharyngitis from Chlamydia trachomatis. The incidence of human papillomavirus -induced oropharyngeal carcinoma has dramatically increased. In children past the neonatal period, the presence of condyloma acuminatus, syphilis, gonorrhoea or palatal ecchymosis (the last one, unless justified by other causes) should make us suspect sexual abuse. CONCLUSIONS Sexual habits have changed in the last decades, resulting in the appearance of otorhinolaryngological pathology that was rarely seen previously. For this reason, it is important for primary care physicians to have knowledge about the subject to perform correct diagnosis and posterior treatment. Some sexual abuse cases in children may also be suspected based on the knowledge of the characteristic oropharyngeal manifestations secondary to them.
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Affiliation(s)
- Claudia Fernández-López
- Servicio de Otorrinolaringología, Facultad de Medicina, Universidad de Cantabria, HUMV Santander, IDIVAL, Cantabria, Santander, España
| | - Carmelo Morales-Angulo
- Servicio de Otorrinolaringología, Facultad de Medicina, Universidad de Cantabria, HUMV Santander, IDIVAL, Cantabria, Santander, España.
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Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, Vivanco-Allende A, Zubicaray-Ugarteche J, Cabanillas-Farpón R. Aetiological diagnosis of child deafness: CODEPEH recommendations. Acta Otorrinolaringol Esp 2017; 68:43-55. [PMID: 27644946 DOI: 10.1016/j.otorri.2016.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 05/19/2016] [Indexed: 12/18/2022]
Abstract
Important progress in the fields of molecular genetics (principally) and diagnostic imaging, together with the lack of a consensus protocol for guiding the diagnostic process after confirming deafness by neonatal screening, have led to this new work document drafted by the Spanish Commission for the Early Detection of Child Deafness (Spanish acronym: CODEPEH). This 2015 Recommendations Document, which is based on the most recent scientific evidence, provides guidance to professionals to support them in making decisions regarding aetiological diagnosis. Such diagnosis should be performed without delay and without impeding early intervention. Early identification of the causes of deafness offers many advantages: it prevents unnecessary trouble for the families, reduces health system expenses caused by performing different tests, and provides prognostic information that may guide therapeutic actions.
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Abarca Barriga HH, Trubnykova M, Polar Córdoba V, Ramos Diaz KJ, Aviles Alfaro N. [H syndrome: First reported paediatric case in Latin America]. ACTA ACUST UNITED AC 2016; 87:494-499. [PMID: 27143505 DOI: 10.1016/j.rchipe.2016.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 03/14/2016] [Accepted: 03/20/2016] [Indexed: 02/06/2023]
Abstract
INTRODUCTION H Syndrome is an extremely rare genetic disease, with a multisystemic character and which can be identified in early childhood, offering the opportunity of specific treatment and genetic counselling. OBJECTIVE To present a clinical case with "typical" characteristics of H Syndrome. CLINICAL CASE The case is presented of an 8-year-old male patient who presented with testicular tumours and skin lesions characterised by hyperpigmentation with hypertrichosis, language delay, short stature, and joint deformities. He also presented with bilateral sensorineural hearing loss, anaemia, hypergammaglobulinaemia, and bone disorders. Histopathology studies of the skin and testicular masses reported lymphoplasmacytic infiltration. Sequencing analysis of gene SLC29A3 showed the homozygote mutation c.1087 C>T (p.Arg363Trp; rs387907067). CONCLUSIONS These findings are consistent with H syndrome, and this is the first reported case in Latin America. The key to the diagnosis is the finding of hyperpigmentation with hypertrichosis.
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Affiliation(s)
- Hugo Hernán Abarca Barriga
- Servicio de Genética y Errores Innatos del Metabolismo, Instituto Nacional de Salud del Niño, Lima, Perú.
| | - Milana Trubnykova
- Servicio de Genética y Errores Innatos del Metabolismo, Instituto Nacional de Salud del Niño, Lima, Perú
| | - Victoria Polar Córdoba
- Departamento de Endocrinología Pediátrica, Hospital Nacional Cayetano Heredia, Lima, Perú
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de Paula-Vernetta C, Muñoz-Fernández N, Mas-Estellés F, Guzmán-Calvete A, Cavallé-Garrido L, Morera-Pérez C. Malformation of the eighth cranial nerve in children. Acta Otorrinolaringol Esp 2016; 67:275-81. [PMID: 27055380 DOI: 10.1016/j.otorri.2015.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/15/2015] [Accepted: 11/22/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES Prevalence of congenital sensorineural hearing loss (SNHL) is approximately 1.5-6 in every 1,000 newborns. Dysfunction of the auditory nerve (auditory neuropathy) may be involved in up to 1%-10% of cases; hearing losses because of vestibulocochlear nerve (VCN) aplasia are less frequent. The objectives of this study were to describe clinical manifestations, hearing thresholds and aetiology of children with SNHL and VCN aplasia. METHODOLOGY We present 34 children (mean age 20 months) with auditory nerve malformation and profound HL taken from a sample of 385 children implanted in a 10-year period. We studied demographic characteristics, hearing, genetics, risk factors and associated malformations (Casselman's and Sennaroglu's classifications). Data were processed using a bivariate descriptive statistical analysis (P<.05). RESULTS Of all the cases, 58.8% were bilateral (IIa/IIa and I/I were the most common). Of the unilateral cases, IIb was the most frequent. Auditory screening showed a sensitivity of 77.4%. A relationship among bilateral cases and systemic pathology was observed. We found a statistically significant difference when comparing hearing loss impairment and patients with different types of aplasia as defined by Casselman's classification. Computed tomography (CT) scan yielded a sensitivity of 46.3% and a specificity of 85.7%. However, magnetic resonance imaging (MRI) was the most sensitive imaging test. CONCLUSIONS Ten percent of the children in a cochlear implant study had aplasia or hypoplasia of the auditory nerve. The degree of auditory loss was directly related to the different types of aplasia (Casselman's classification) Although CT scan and MRI are complementary, the MRI is the test of choice for detecting auditory nerve malformation.
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Affiliation(s)
| | - Noelia Muñoz-Fernández
- Servicio de Otorrinolaringología, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - Fernando Mas-Estellés
- Servicio de Radiología, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - Abel Guzmán-Calvete
- Servicio de Otorrinolaringología, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - Laura Cavallé-Garrido
- Servicio de Otorrinolaringología, Hospital Universitario y Politécnico La Fe, Valencia, España
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Sequi Canet JM, Sala Langa MJ, Collar Del Castillo JI. [Results from ten years newborn hearing screening in a secondary hospital]. An Pediatr (Barc) 2015; 85:189-196. [PMID: 26725594 DOI: 10.1016/j.anpedi.2015.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 10/22/2015] [Accepted: 11/03/2015] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION A critical analysis is performed on the results of a newborn hearing screening program in a regional hospital. PATIENTS Screening results from 14,247 newborns in our maternity ward from 2002 to 2013. METHODS Two step recordings of bilateral otoacoustic emissions (initial and repeat, if failed, at about one month of life). Assessment by clinical brainstem responses. RESULTS The first step was performed on 14,015 newborns (98.3% of the total) reaching the screening objective. The first step pass figures were 93.7%, which implies a good pass rate with a few patients to repeat. The second step is also good because it has a pass rate of 88.9% of newborns examined (only 0.63% of initial group needed brainstem responses assessment), but 10.6% were lost to follow up, and that is a major problem. In newborns, scheduled for brainstem responses, the loss to follow-up is worse, with a figure of 29.5%, despite the high accuracy of this test given that 69.4% of those assessed showed hearing loss. This figure represents a 0.31% of the initial group, and is a similar to that published for congenital hearing loss. Including patients that were lost to follow up this figure could be greater. CONCLUSION Newborn hearing screening is useful but needs stronger control to avoid the follow up loss. In order to achieve this, it is crucial to have a good database and a screening coordinator.
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Martín-Santiago A, Rodríguez-Pascual M, Knöpfel N, Hernández-Martín Á. Otologic Manifestations of Autosomal Recessive Congenital Ichthyosis in Children. Actas Dermosifiliogr 2015; 106:733-9. [PMID: 26206273 DOI: 10.1016/j.ad.2015.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Few studies have investigated ear involvement in nonsyndromic autosomal recessive congenital ichthyosis (ARCI). OBJECTIVES To assess the type and frequency of otologic manifestations of ARCI in patients under follow-up at the pediatric dermatology department of our hospital. MATERIALS AND METHODS We prospectively studied the presence of ear pain, ear itching, tinnitus, otitis, cerumen impaction, accumulation of epithelial debris, and hearing loss. Daily hygiene measures, topical treatments, medical-surgical interventions, and frequency of visits to an ear, nose, and throat (ENT) specialist were noted in the patients' medical records. Ear examination and hearing tests were performed in all cases. RESULTS Ten patients were studied: 2 had a self-healing collodion baby phenotype and 8 had ichthyosis. There was mention of otologic manifestations in the records of all 8 patients with ichthyosis (100%); 6 of these patients (75%) had abnormalities in the external auditory canal examination and 2 (25%) had conductive hearing loss. Our findings are limited by the small number of patients studied, all of whom were younger than 19 years. CONCLUSIONS The involvement of both dermatologists and ENT specialists in the management of patients with ichthyosis is crucial to ensure the application of the best therapeutic and preventive measures. More studies are needed to assess the prevalence and impact on quality of life of ear involvement in patients with ichthyosis and to determine the optimal interval between ENT visits for these patients.
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Guerra Jiménez G, Mazón Gutiérrez Á, Marco de Lucas E, Valle San Román N, Martín Laez R, Morales Angulo C. Audio-vestibular signs and symptoms in Chiari malformation type i. Case series and literature review. Acta Otorrinolaringol Esp 2014; 66:28-35. [PMID: 25195076 DOI: 10.1016/j.otorri.2014.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 05/14/2014] [Accepted: 05/19/2014] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Chiari malformation is an alteration of the base of the skull with herniation through the foramen magnum of the brain stem and cerebellum. Although the most common presentation is occipital headache, the association of audio-vestibular symptoms is not rare. The aim of our study was to describe audio-vestibular signs and symptoms in Chiari malformation type i (CM-I). MATERIALS AND METHODS We performed a retrospective observational study of patients referred to our unit during the last 5 years. We also carried out a literature review of audio-vestibular signs and symptoms in this disease. RESULTS There were 9 patients (2 males and 7 females), with an average age of 42.8 years. Five patients presented a Ménière-like syndrome; 2 cases, a recurrent vertigo with peripheral features; one patient showed a sudden hearing loss; and one case suffered a sensorineural hearing loss with early childhood onset. The most common audio-vestibular symptom indicated in the literature in patients with CM-I is unsteadiness (49%), followed by dizziness (18%), nystagmus (15%) and hearing loss (15%). Nystagmus is frequently horizontal (74%) or down-beating (18%). Other audio-vestibular signs and symptoms are tinnitus (11%), aural fullness (10%) and hyperacusis (1%). Occipital headache that increases with Valsalva manoeuvres and hand paresthesias are very suggestive symptoms. CONCLUSIONS The appearance of audio-vestibular manifestations in CM-I makes it common to refer these patients to neurotologists. Unsteadiness, vertiginous syndromes and sensorineural hearing loss are frequent. Nystagmus, especially horizontal and down-beating, is not rare. It is important for neurotologists to familiarise themselves with CM-I symptoms to be able to consider it in differential diagnosis.
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Affiliation(s)
- Gloria Guerra Jiménez
- Servicio de ORL, Complejo Hospitalario Insular Materno Infantil, Las Palmas, Gran Canaria, España.
| | | | | | | | - Rubén Martín Laez
- Servicio de Neurocirugía, Hospital Universitario Marqués de Valdecilla, Santander, España
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Samprón N, Altuna X, Armendáriz M, Urculo E. [Treatment of giant acoustic neuromas]. Neurocirugia (Astur) 2014; 25:247-60. [PMID: 25112178 DOI: 10.1016/j.neucir.2014.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 05/25/2014] [Accepted: 06/03/2014] [Indexed: 11/15/2022]
Abstract
INTRODUCTION AND OBJECTIVES To analyze the treatment modality and outcome of a series of patients with giant acoustic neuromas, a particular type of tumour characterised by their size (extracanalicular diameter of 4cm or more) and high morbidity and mortality. MATERIALS AND METHODS This was a retrospective unicentre study of patients with acoustic neuromas treated in a period of 12 years. In our institutional series of 108 acoustic neuromas operated on during that period, we found 13 (12%) cases of giant acoustic neuromas. We reviewed the available data of these cases, including presentation and several clinical, anatomical, and microsurgical aspects. RESULTS All patients were operated on by the same neurosurgeon and senior author (EU) using the suboccipital retrosigmoid approach and complete microsurgical removal was achieved in 10 cases. In one case, near total removal was deliberately performed, in another case a CSF shunt was placed as the sole treatment measure, and in the remaining case no direct treatment was given. One patient died in the immediate postoperative period. One year after surgery, 4 patients showed facial nerve function of iii or more in the House-Brackman scale. CONCLUSIONS The 4 most important prognostic characteristics of giant acoustic neuromas are size, adhesion to surrounding structures, consistency and vascularity. Only the first of these is evident in neuroimaging. Giant acoustic neuromas are characterised by high morbidity at presentation as well as after treatment. Nevertheless, the objective of complete microsurgical removal with preservation of cranial nerve function is attainable in some cases through the suboccipital retrosigmoid approach.
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Affiliation(s)
- Nicolás Samprón
- Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián, España.
| | - Xabier Altuna
- Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, España
| | - Mikel Armendáriz
- Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián, España
| | - Enrique Urculo
- Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián, España
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Cardemil F, Aguayo L, Fuente A. [Auditory rehabilitation programmes for adults: what do we know about their effectiveness?]. Acta Otorrinolaringol Esp 2014; 65:249-57. [PMID: 24602838 DOI: 10.1016/j.otorri.2013.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 10/25/2013] [Accepted: 10/29/2013] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND OBJECTIVE Hearing loss ranks third among the health conditions that involve disability-adjusted life years. Hearing aids are the most commonly used treatment option in people with hearing loss. However, a number of auditory rehabilitation programmes have been developed with the aim of improving communicative abilities in people with hearing loss. The objective of this review was to determine the effectiveness of auditory rehabilitation programmes focused on communication strategies. MATERIAL AND METHODS This was a narrative revision. A literature search using PUBMED was carried out. This search included systematic reviews investigating the effectiveness of auditory training and individual and group auditory rehabilitation programmes with the main focus on counselling and communicative strategies for adults with hearing loss. Each study was analysed in terms of the type of intervention used and the results obtained. RESULTS Three articles were identified: one article about the effectiveness of auditory training programmes and 2 systematic reviews that investigated the effectiveness of communicative programmes in adults with hearing loss. The "Active Communication Education" programme appears to be an effective group programme of auditory rehabilitation that may be used with older Spanish-speaking adults. CONCLUSIONS The utility of hearing aid fitting and communicative programmes as rehabilitation options are associated with improvements in social participation and quality of life in patients with hearing loss, especially group auditory rehabilitation programmes, which seem to have good potential for reducing activity limitations and social participation restrictions, and thus for improving patient quality of life.
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Affiliation(s)
- Felipe Cardemil
- Servicio de Otorrinolaringología, Hospital Barros Luco Trudeau, Universidad de Chile, Santiago, Chile; Programa de Doctorado en Salud Pública, Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
| | - Lorena Aguayo
- Programa de Magíster en Salud Pública, Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
| | - Adrian Fuente
- Escuela de Fonoaudiología, Universidad de Chile, Santiago, Chile.
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Morales-Angulo C, Vergara Pastrana S, Obeso-Agüera S, Acle L, González-Gay MÁ. [Otorhinolaryngological manifestations in patients with Behçet disease]. Acta Otorrinolaringol Esp 2013; 65:15-21. [PMID: 24094428 DOI: 10.1016/j.otorri.2013.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 06/13/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION AND OBJECTIVES Behçet disease (BD) is a systemic immune-mediated vasculitis of unknown origin characterised by recurrent orogenital ulceration, ocular inflammation and skin lesions. The aim of our study was to identify ear, nose and throat (ENT) manifestations associated with BD. PATIENTS AND METHODS Retrospective review of the medical records of all patients diagnosed with BD who attended a tertiary public hospital in Cantabria (Spain) over a period of 22 years. Clinical manifestations, in particular those concerning ENT, were retrieved from medical records. A medical literature review of ENT manifestations was conducted. RESULTS Thirty-three patients (age range: 17-64 years) were included in the study. Most of them presented oral ulcers (97%). Eight patients (24%) presented oropharyngeal ulcers and 5 patients (15%) experienced audiovestibular symptoms (high frequency sensorineural hearing loss, vertigo and bilateral vestibular hypofunction). One patient had symptoms compatible with vestibular neuronitis as the presentation manifestation of Neuro-Behçet. In 4 patients (12%) the presence of odynophagia secondary to the presence of oropharyngeal lesions, initially interpreted as acute or recurrent tonsillitis, was the first manifestation of the disease, alone or associated with cutaneous or ocular lesions. CONCLUSIONS In addition to the characteristic oral ulcers present in most patients with BD, ulcers in the oropharynx, occasionally interpreted as acute pharyngitis, are also common in these patients. Audiovestibular manifestations frequently appear during the course of the disease and may be the first symptom of central nervous system involvement.
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Affiliation(s)
- Carmelo Morales-Angulo
- Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander, España.
| | - Sandra Vergara Pastrana
- Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - Sergio Obeso-Agüera
- Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - Leticia Acle
- Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Santander, España
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Cardemil F, Esquivel P, Aguayo L, Barría T, Fuente A, Carvajal R, Fromín R, Villalobos I, Yueh B. Transcultural adaptation to Spanish of the instrument "Effectiveness of Auditory Rehabilitation" for the assessment of quality of life in patients using hearing aids. Acta Otorrinolaringol Esp 2013; 64:416-22. [PMID: 24094425 DOI: 10.1016/j.otorri.2013.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 07/18/2013] [Accepted: 07/31/2013] [Indexed: 11/18/2022]
Abstract
INTRODUCTION AND OBJECTIVES It is becoming increasingly important to have reliable and valid questionnaires. This becomes especially important when evaluating hearing loss. THE AIM OF THIS WORK WAS TO VALIDATE the "Effectiveness of Auditory Rehabilitation" (EAR) questionnaire for the Spanish-speaking population. This instrument assesses quality of life and hearing aspects in patients using hearing aids. MATERIAL AND METHOD Cross-sectional validation study. A cultural adaptation through the use of English to Spanish translations and re-translations was carried out. The validity and reliability of the newly adapted instrument were evaluated. RESULTS A total of 69 individuals (44 older adults and 25 younger adults) were examined. The pure-tone averages (PTA, 500, 1,000 and 2,000 Hz) were 47.3 dB HL and 47.1 dB HL for the left and right ears, respectively. The mean maximum speech discrimination in silence for monosyllables were 83.3% and 82.9% for the left and right ears, respectively. Internal consistency presented Cronbach alpha values of 0.85 and 0.77 for the internal and external dimensions, respectively. The intraclass correlation coefficients were 0.80 for the internal module and 0.85 for the external module. Construct validity reported a correlation coefficient of 0.71 at baseline and 0.76 at 3 months after the initial assessment for the internal module, and 0.62 at baseline and 0.74 at 3 months after the initial assessment for the external module. The size effects were 1.3 and 1.1 for the internal and external modules, respectively. DISCUSSION The Spanish version of the EAR questionnaire seems to be a reliable and valid instrument. The evaluation of audiological aspects, as well as aspects relating to aesthetics and comfort are the main strengths of this instrument. Finally, the EAR scale is more sensitive to change than other scales.
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Affiliation(s)
- Felipe Cardemil
- Servicio de Otorrinolaringología, Hospital Barros Luco Trudeau, Universidad de Chile, Santiago, Chile; Programa de Doctorado en Salud Pública, Escuela de Salud Pública, Universidad de Chile, Santiago, Chile.
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