Coincidence of chronic inflammatory paranasal sinus disorders and cochleo-vestibular disorders

In the course of initial examination the authors frequently observed a coincidence of labyrinthine symptoms with radiologic signs of chronic sinusitis. Of 72 patients who were hospitalized for acute labyrinthine symptoms, 72% presented with these signs. On the other hand, 49% of the patients admitted to sinus surgery manifested labyrinthine symptoms. A well-pneumatized mastoid was found in both groups. In the control group, consisting of patients whose consultation was unconnected to ear or nose complaints, chronic sinusitis was found in 28% and labyrinthine symptoms in 24%, but the two together were only found in 11%. It was shown by means of the chi2 test that the two symptom complexes are interdependent (p less than 0.01). Histologic examination of the mucosa of paranasal sinuses and peri-labyrinthine cells does not at the moment provide a satisfactory explanation. Pathologic autonomic nerve connections between the two systems may lead to higher vulnerability of the labyrinths of patients with chronic sinusitis. Other possible explanations, i.e., relating to certain neuropeptides and a well-pneumatized mastoid, are discussed. The authors wish to emphasize that their study is based on clinical data. At the moment a satisfactory pathophysiological explanation is lacking. In addition to antiphlogistic and rheologic medication, long-term planning of sinus surgery should be recommended for all patients in whom the two symptoms occur simultaneously. Whether this can help prevent recurrences, or put an end to progressive processes, can only be determined after a longer observation period.     

Communication disorders and emotional/behavioral disorders in children and adolescents

Recent research in child psychiatry has demonstrated a high prevalence of speech, language, and communication disorders in children referred to psychiatric and mental health settings for emotional and behavioral problems. Conversely, children referred to speech and language clinics for communication disorders have been found to have a high rate of diagnosable psychiatric disorders. Most of the emerging knowledge regarding relationships between communication disorders and psychiatric disorders has been presented in the child psychiatric literature. Speech-language pathologists and audiologists also need to be familiar with this information; an understanding of the complex interrelationship between communication disorders and emotional and behavioral disorders is important for diagnosis, assessment, and treatment. The purpose of this article is to review recent research and discuss clinical implications for professionals in speech-language pathology and audiology working with children and adolescents who have, or who are at risk for, developing emotional and behavioral disorders. Issues to be addressed include differential diagnosis, prevention, intervention, and the role of speech-language pathologists serving these children and adolescents.     

Neurologic disorders and aspiration

Many neurologic disorders impair normal swallowing. In this article, the spectrum of neurologic disease in which aspiration can be a complication is reviewed.     

Differentiation of organic and functional voice disorders in slight adduction disorders of the larynx

Patients with organic or functional voice disorders show a considerable agreement between the individual aerodynamic phonatory pattern and the appearances on indirect laryngoscopy during phonation. Both groups were characterized by incomplete dorsal glottic closure. The aerodynamic data (subglottal pressure and transglottal flow) and the laryngeal efficiency support a pathophysiological explanation of abnormal and breathy voicing. Division of the transglottal flow into modulated and unmodulated parts explains how a better voice will be obtained with equal or lower flow values by relaxation of the musculature. The decreased tension of the muscles also produces phonation with a lower subglottal pressure. The onset of fatigue is therefore delayed. It is concluded that mild adduction disorders are neither organic nor functional disorders. Rather there is a continuum of organic alterations with different laryngeal functional disturbances.     

Communications disorders and the interactions and relation(s) to other disorders susceptibility

Communication is the action and process of transmitting a message and the way in which this message is received and interpreted. We observe the social character of this action and its effectiveness. Evidently, in order to make communication effective, it is necessary for the attitude of the receiver to be socially, ideologically and psychologically receptive. Communication and language are practically two indistinguishable terms. In the case of a deaf child, the learning of cognitive abilities depends absolutely on how his environment educates him. Today we depend on new communication skills and their particular mission and meaning with reference to otolaryngology. In the age of communication in the 21st century, society will direct its resources toward strategy of preventive and medical care that will optimize the population's health communication. Otolaryngology will continue to grow and prosper by responding to these pressing human and social needs and building upon communications, and by incorporating them in this new domain, of language, thus we will be able to find the medical and surgical cures for communication disorders.