Are there auditory processing and perception disorders in children with dyslexia?

BACKGROUND: In this paper the dichotic tests and the CERA (Cortical Evoked Response Audiometry) of children with dyslexia had been examined, in order to find out if there are auditory processing and perception disorders. PATIENTS AND METHODS: 33 children with dyslexia had been compared with 28 children without problems of writing and reading. The mean age of the children was 9 years. All of the children had been examined by the following audiometric measurements: tympanometry, pure-tone-audiometry, speech-audiometry, dichotic Tests by Uttenweiler and Feldmann and the Cortical Evoked Response Audiometry (CERA) rated according to Esser. RESULTS: The intelligence quotients were in the group of dyslexic children significantly lower. The Uttenweiler and Feldmann tests were in dyslexic children significantly lower in the control group as well. The late cortical responses ware normal or near normal in both groups. CONCLUSION: Dichotic speech tests indicate central auditory processing and perception deficits in dyslexia. These tests are confounded, however, by attention and memory deficits. The CERA rated according to Esser does not point out to these auditory disorders in dyslexia.     

Are second primary head and neck cancers with previous hematological malignancy more aggressive than de novo head and neck cancers?

ObjectivesSecondary solid tumors can occur after the treatment of hematological malignancies and are associated with a poor prognosis. We evaluated the survival outcomes of patients with second primary head and neck cancers according to the site of cancer origin, type of hematological malignancy, and age.Materials and methodsWe enrolled all patients who underwent surgery for second primary head and neck cancer and were previously treated for hematological malignancy between 1997 and 2020. We analyzed the survival outcomes of patients with second primary head and neck cancer, and compared them with 3126 de novo head and neck cancer patients diagnosed during the same period at our hospital.ResultsThe 5-year overall survival (OS) rate was significantly worse for second primary head and neck cancer patients than de novo cancer patients (52.0 % and 77.9 %, respectively; p = 0.04) and those results were similarly observed in second primary oral cavity cancer (33.3 % and 75.7 %, respectively; p < 0.01). Patients with myelodysplastic syndrome and acute myeloid leukemia showed significantly worse 5-year OS rate than those with other types of hematological malignancies (p = 0.036). Multivariate analysis showed that bone marrow transplantation (BMT) was a risk factor for the recurrence of head and neck cancers (odds ratio = 6.635, p = 0.042).ConclusionPatients with second primary head and neck cancer, particularly of the oral cavity, had a worse prognosis than patients with de novo head and neck cancer. BMT predicts recurrence in second primary head and neck cancer patients.     

Are computed tomography and densitometric measurements useful in otosclerosis with mixed hearing loss? A retrospective clinical study

The objective of the study was to investigate the relationship between extent of otosclerotic foci and audiological findings in otosclerotic patients with mixed hearing loss using high-resolution computed tomography (HRCT) and also to measure the density of bony labyrinth in otosclerotic patients and compared with control group. This was a retrospective study. Twenty-five patients with clinical otosclerosis and mixed hearing loss were included in the study. The average threshold of air-bone conductions (AC, BC) within the 0.5–4 kHz frequency range, and average air bone gap (ABG) were calculated. Eleven patients with normal HRCT who received cochlear implant were included in the study as the control group. The lesions in HRCT were staged according to their extension. Eight different points of the otic capsule in each patient were measured using HRCT. Fifty ears total, from 25 patients, had bilateral otosclerosis. The mean AC of all the ears was 63 dB, mean BC was 35.2 dB, and mean ABG was 27.8 dB. HRCT staging indicated 22 ears had Grade 1, 21 ears had Grade 2, and 7 ears had Grade 3 lesions. There was a statistically significant difference between the mean AC, BC of ears with Grade 1 and Grade 2 when compared with the mean AC, BC of ears with Grade 3. When comparing the densitometric measurements of fissula ante fenestram localizations, a statistically significant difference was observed. HRCT examination and densitometric measurements in otosclerotic patients with mixed hearing loss presented significant results. We were unable to show a significant relationship between early stage and hearing thresholds, but there was a significant relationship in advanced stage. Densitometric measurements may provide significant results for otosclerosis, particularly for the FAF region when comparing with control group.     

Adults with mild hearing impairment: Are we meeting the challenge?

Objective: Acquired hearing impairment is recognized by the World Health Organization as the third leading cause of disability, with a mild impairment being the most prevalent. The aim of this study was to review research literature concerned with adults with acquired mild hearing impairment; the definitions and prevalence, the resulting activity limitations and participation restrictions, and hearing-aid interventions. Design: This study involved a systematized review of research literature identified through searches in citation databases and through reference checking. Study sample: A total of 151 papers were identified and of these, 33 papers were included in this review. Results: Prevalence rates are significantly influenced by the definition used for mild hearing impairment, and range from 1 in 3 to 1 in 5 adults. The weak correlations between audiological assessments and self-reported difficulties suggest that further assessment of individuals with mild hearing impairment is warranted. The most common intervention is the provision of hearing aids with varying rates of use, benefit, and satisfaction. Conclusions: The development of appropriate audiological assessment in the clinic, and further evaluation of the real-world listening needs and performance of people with mild hearing impairment is required to provide a more effective pathway for this clinical population.     

Are patients with severe epistaxis caused by hereditary hemorrhagic telangiectasia satisfied with nostril closure surgery?

Objective

Recurrent epistaxis as a manifestation of hereditary hemorrhagic telangiectasia (HHT) is usually difficult to control. Although no treatment is regarded to be completely efficacious, nostril closure is considered a modality of choice for the most severe cases. The cessation of airflow resulting from this procedure can stop bleeding by minimizing risk factors. However, loss of nasal functions is a disadvantage of nostril closure. We conducted a questionnaire survey of patients who underwent nostril closure surgery, regarding the effects and disadvantages of the operation.

Methods

Seven patients were asked questions on issues including frequency and severity of epistaxis pre- and post-operatively, satisfaction of treatment, and impairment in daily living activities.

Results

Most patients reported complete cessation of bleeding. Some still had bleeding, but the frequency and severity were far lower. No transfusions were required in any of the cases. Patients reported some disadvantages, for example, respiratory, olfactory, and phonatory issues. Six out of seven patients were very satisfied with the outcome of surgery.

Conclusion

Nostril closure surgery can remarkably reduce frequency and volume of epistaxis. Our survey indicated that satisfactory results were achieved. However, difficulties caused by complete nasal obstruction varied. Thus, individualized coping strategies are required.     

Are demographic and socioeconomic factors predictive for perceived tinnitus impairment?

Patients suffering from chronic tinnitus were analyzed to examine whether tinnitus impairments can be predicted by demographic and socioeconomic factors. For this purpose, subjective tinnitus complaints were measured in 153 patients using the tinnitus impairment questionnaire (THI-12) that distinguishes between emotional-cognitive and functional-communicative factors. Age, gender, marital status, and education levels were assessed and treated as predictive variables. In computing canonical correlations, only the level of education served as a significant emotional-cognitive predictor for tinnitus impairment. Patients with lower education demonstrated impairments in the emotional-cognitive domain that were more marked than those in higher-educated people. The results indicated that demographic and socioeconomic variables have no predictive value for tinnitus impairments, with the exception of a person's level of education.     

Vocal process granuloma and glottal insufficiency: An overlooked etiology?

Objectives/Hypothesis:

Vocal process granuloma has been attributed to intubation, laryngopharyngeal reflux, and phonotraumatic/hyperfunctional vocal behaviors. Vocal process granuloma has recurrence rates following surgical excision approaching 92%. We hypothesize that a portion of persistent or idiopathic cases of vocal process granuloma result from underlying glottal insufficiency (GI) caused by paresis, scar, or atrophy. Our goal was to examine our vocal process granuloma population and determine the incidence of GI, treatment interventions, and outcomes.

Study Design:

Retrospective chart review.

Methods:

Thirty‐four patients with vocal process granuloma were divided into surgically or conservatively managed groups. Patients were identified if they carried a diagnosis of GI. The time to resolution and number of recurrences within the overall treatment period was recorded and compared between subgroups. Pre‐ and post‐treatment Voice Handicap Index‐10 (VHI‐10) and Reflux Symptom Index (RSI) scores were compared.

Results:

Eighteen of 34 patients (53%) carried an underlying diagnosis of GI, 13/34 (38%) were treated surgically, and 8/13 (62%) surgical patients had underlying GI. VHI‐10 and RSI scores significantly improved after disease resolution (P < .05).

Conclusions:

The incidence of GI among patients with vocal process granuloma was 53%. Conservative therapies including treatment of laryngopharyngeal reflux and voice therapy may lead to resolution despite underlying glottal incompetence. If conservative measures fail, recognizing and treating glottal incompetence with true vocal fold augmentation may lead to a shorter surgical treatment course. Laryngoscope, 2010     

Erythropoietin in patients with head and neck carcinomas?

BACKGROUND: Various studies have demonstrated the prognostic significance of the pretherapeutic blood hemoglobin concentration for patients with head and neck cancer following surgery or primary definitive or adjuvant radio- or radiochemotherapy. It was the aim of this study to evaluate whether the prognosis of these patients might be improved when correcting decreased pretherapeutic hemoglobin values by administering erythropoietin. METHOD: In a prospective placebo-controlled double-blind study (Cochrane "evidence-based medicine" level Ib) the effect of erythropoietin was analyzed in patients with locally advanced head or neck tumours with low blood hemoglobin values (women: < 12 g/dL; men: < 13 dL) and a Karnofski value of > 60 following primary definite or adjuvant radiotherapy (up to 70 Gy). The time to local tumour progression and survival was evaluated. Kaplan-Maier estimates were applied and, the relative risk of well-known prognostic factors tested for with a Cox Proportional Hazards model. RESULTS: 157 patients of the Freiburg University ENT-clinic were recruited from 1997 to 2001. Study conduct was performed according to the GCP guidelines. A rapid increase of the blood hemoglobin value happened during the first five weeks of treatment under epoetin beta. Placebo patients experienced only minor changes of the hemoglobin value. Following adjuvant radiotherapy local tumour control probability at two years was 68 % +/- 7 % and 72 +/- 7 % for placebo and epoetin beta patients, respectively (p = 0.64). Patients who had undergone primary definite radiation experienced a local control probability of 36 % +/- 11 % in the placebo arm after two years, compared to epoetin beta with 23 % +/- 11 % (p = 0.05). CONCLUSION: Epoetin beta resulted in prompt and stable correction of blood hemoglobin values in anemic patients with advanced head or neck tumours, but tumour control and survival was impaired particularly in patients with a high tumour burden.     

Are estrogen receptors alpha detectable in normal and abnormal thyroid tissue?

The aims of this study is to evaluate the presence of estrogen receptors alpha (ERα) in thyroid lesions and to assess the practicality of this test in view of numerous disagreements on the subject. Immunohistochemical stains were performed for ERα, for the evaluation of immunoreactivity in 296 pathological thyroid tissue samples. We evaluated the intensity of the nuclear and cytoplasmatic staining and the spread of the stain over the sample. Thirty cases of the breast cancer served as a control group. None of the histological thyroid samples showed immunoreactivity for ERα. No difference was found between the various lesions in regard to this absence. The ERα rate of expression in the breast cancer samples was 60%. The ERα is undetectable in the histological samples of benign and malignant thyroid lesions. Further investigation is necessary in the laboratory immunohistochemical workup in order to exclude a possibility of non-specific staining.