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1.
Filiz Gülüstan Zahide Mine Yazıcı Wesam M.E. Alakhras Omer Erdur Harun Acipayam Levent Kufeciler Fatma Tulin Kayhan 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(1):28-33
Introduction
Controversy surrounds the use of salvage therapies to treat sudden sensorineural hearing loss (SSNHL), with no consensus on recommendations. While several studies have demonstrated the effectiveness of intratympanic administration of steroids (ITS) and hyperbaric oxygen (HBO) treatment, few have compared the efficacy of ITS and HBO therapy in patients with refractory SSNHL.Objective
We evaluated the efficiency of ITS and HBO therapy in patients with refractory SSNHL.Methods
Patients who did not adequately benefit from systemic treatment were evaluated retrospectively. Refractory patients were defined as those who gained less than 20 dB in hearing after initial treatment. All refractory patients were informed about salvage therapy options: ITS or HBO therapy, the advantages and disadvantages of which were explained briefly. ITS involved 4 mg/mL dexamethasone administered through a 25 gauge needle. Patients underwent HBO therapy in a hyperbaric chamber where they breathed 100% oxygen for 120 min at 2.5 atmospheric pressure. The hearing levels of both groups were evaluated before the salvage therapy and at 3 months after treatment. Improvements in hearing were evaluated according to the Furahashi criteria. We also compared the two therapies in terms of speech discrimination scores (SDSs) and the recovery of all frequencies.Results
The salvage therapies generated similar results. Changes in pure tone averages and SDSs were similar for ITS and HBO therapy (p = 0.364 and p = 0.113). Comparison of SDSs and hearing thresholds at all frequencies showed similar levels of improvement.Conclusion
ITS and HBO therapy produced similar improvements in SSNHL patients, but the sample size was too small to draw definitive conclusions. Further randomized controlled studies are needed to identify the best therapy for patients with refractory sudden hearing loss. 相似文献2.
Lee JD Park MK Lee CK Park KH Lee BD 《Clinical and experimental otorhinolaryngology》2010,3(3):122-125
Objectives
Intratympanic steroids are being increasingly used in the treatment of sudden sensorineural hearing loss (SSNHL) after the failure of systemic therapy. This study evaluated the efficacy of administering intratympanic dexamethasone (ITD) as a salvage treatment for severe to profound SSNHL.Methods
We reviewed the medical records of patients who presented with severe to profound SSNHL between January 2007 and December 2009. ITD was given about 14 days after the initial systemic treatment. Successful recovery was defined as complete or partial recovery using Sigel''s criteria. We compared the results of treatment between the severe SSNHL (S-SSNHL) and profound SSNHL (P-SSNHL) groups.Results
All the patients in the S-SSNHL group showed significant improvement, as compared to the P-SSNHL group (P=0.017). The recovery rate after the initial systemic treatment was 36% (9/25) in the S-SSNHL group and 18.1% (4/22) in the P-SSNHL group (P=0.207). In comparison, the recovery rate of ITD as a salvage treatment was 37.5% (6/16) in the S-SSNHL group and 5.5% (1/18) in the P-SSNHL group (P=0.03).Conclusion
Our comparative study dose not support the efficacy of ITD as salvage treatment for patients with P-SSNHL as compared with that for S-SSNHL. We recommend that patients with P-SSNHL be informed about the low efficacy of ITD as a salvage treatment. 相似文献3.
N.K. Prenzler B. Schwab D.M. Kaplan S. El-Saied 《American journal of otolaryngology》2018,39(1):46-49
Purpose
The purpose of this study was to describe the role of explorative tympanotomy in patients with Profound Sudden Sensorineural Hearing Loss (SSNHL) without clinical evidence of perilymphatic or labyrinthine fistula and to compare intraoperative findings with the postoperative hearing outcome.Study design
Retrospective study of all patients diagnosed with SSNHL who underwent explorative tympanotomy between 2002 and 2005.Settings
Tertiary care university-affiliated hospital.Subjects and methods
Eighty-two patients were diagnosed with unilateral profound SSNHL and underwent tympanotomy with sealing of the round and oval windows. Values of pure tone audiograms and percentage hearing loss of patients with and without intraoperative diagnosed perilymphatic fistula (PLF) were compared and analyzed.Results
PLF was diagnosed in 28% cases intraoperatively. In most cases, hearing improved significantly after surgery. Interestingly, patients with PLF had a 2.4 times greater decrease of percentage hearing loss compared to patients without PLF.Conclusions
Explorative tympanotomy seems to be useful in patients with profound SSNHL. Patients with PLF benefit more from the surgical procedure and have better outcome than patients without PLF. 相似文献4.
Jin Youp Kim Jae Joon Han Woong Sang Sunwoo Ja-Won Koo Seung-Ha Oh Min-Hyun Park Young Ho Kim 《Auris, nasus, larynx》2018,45(3):447-455
Objective
Although many studies have investigated sudden sensorineural hearing loss (SSNHL) in adults, there were few studies on SSNHL in the pediatric population; especially research on treatment and prognosis of pediatric SSNHL was limited. The aim of this study was to evaluate clinical characteristics, treatment outcomes and prognostic factors in children and adolescents with SSNHL.Methods
A retrospective review of medical records of 67 pediatric patients (67 ears) who had diagnosed with SSNHL at our hospitals was performed to analyze patients’ clinical manifestations and audiograms. All patients were treated with high-dose systemic prednisolone (1 mg/kg), and 17 of them underwent intratympanic steroid injection therapy. Audiological evaluation was carried out before and after treatment, and hearing recovery was defined as complete recovery and partial recovery according to Siegel’s criteria. Patients were divided into two groups: childhood group (ages between 4 and 12 years old) and adolescence group (age > 12 years), and clinical characteristics and treatment outcomes were investigated. In addition, patients were divided into two groups according to degree of hearing recovery, and evaluation was made regarding possible prognostic factors.Results
The recovery rate in total 67 patients was 55.2%. The recovery rate of the childhood group was significantly lower than that of the adolescence group (p = 0.038). While the presence of vertigo did not significantly correlate with prognosis (p = 0.219), the presence of tinnitus was significantly associated with hearing recovery (p = 0.005). Audiological assessment revealed that a low initial hearing threshold, high speech discrimination score, and descending type of audiogram were positively associated with hearing recovery (p = 0.002, p = 0.003, and p = 0.029, respectively).Conclusion
The childhood group had worse treatment outcomes than the adolescence group. High initial hearing threshold and absence of tinnitus were poor prognostic factors of hearing recovery. Active treatment is required for patients with these poor prognostic factors and childhood patients with SSNHL. 相似文献5.
Bo Tang Yanfei Jia Zhe Shi Yunjuan Shen Denghui Li Hailong Huang Baohui Yang Daowen Wang Qian Feng 《American journal of otolaryngology》2018,39(6):676-678
Purpose
This study aimed to analyze outcomes of intratympanic injection of dexamethasone after failure of intravenous prednisolone in simultaneous bilateral sudden sensorineural hearing loss (SSNHL).Materials and methods
The cases of simultaneous bilateral SSNHL treated in our hospital from March 2007 to March 2018 were retrospectively analyzed. During the earlier period (March 2007 to February 2012), the cases were treated by intravenous prednisolone only, and classified into group A. During the late period (February 2012 to March 2018), intratympanic injection of dexamethasone after failure of intravenous prednisolone therapy was employed to treat simultaneous bilateral SSNHL, and these patients were enrolled in group B. Effective rates of the two treatment modalities in groups A and B were compared.Results
In group A, 3 of 40 ears obtained complete recovery, and 4 ears achieved partial recovery after intravenous prednisolone treatment, with the effective rate of only 17.5% (7/40 ears). In contrast, 6 of 44 ears in group B achieved complete recovery, and 10 ears got partial recovery, with the effective rate of 36.4% (16/44 ears). There was significant difference in the effective rate between the two groups.Conclusion
Intratympanic injection of dexamethasone after failure of intravenous prednisolone therapy was a better choice for simultaneous bilateral SSNHL compared to traditional intravenous prednisolone therapy. 相似文献6.
Objective
Tinnitus in children has not been studied sufficiently to date. And, there is no consensus regarding the management of tinnitus in children. Tinnitus counseling can be considered as the most basic tool among therapeutic options of tinnitus in children. In this article, the importance of management in children with tinnitus is highlighted through the review of the literature. Also, we present survey results regarding usefulness and necessity of tinnitus counseling provided from parents of children with tinnitus.Methods
Studies reporting the management of pediatric tinnitus were reviewed by searching the Pubmed (MEDLINE) databases for studies published from 1980 through 2017. Three articles were eligible for review in terms of quantitative measurement of tinnitus improvement. Survey for eighteen participants were performed who visited our clinic, improvement by counseling and subjective benefit were evaluated by questionnaire. Various demographic and audiologic parameters were subjected into correlation analysis of benefit of counseling.Results
Three studies which included management of pediatric tinnitus were reviewed. One article reported that children with hearing loss failed to show improvement of tinnitus by hearing aids. However, recent two articles showed that children with or without hearing loss showed fair improvement of tinnitus by tinnitus retraining therapy and noise generator. The survey demonstrated that overall 83.3% showed subjective improvement by tinnitus counseling. Among demographic and audiological parameters, benefit from counseling was significantly associated with age and presence of hearing loss (p = 0.037 and p = 0.005, respectively).Conclusions
Pediatric tinnitus is likely to have a higher chance of improvement by counseling alone or combination therapy without medication. Conservative management of tinnitus based on education and counseling instead of medical or surgical treatment should be developed more. 相似文献7.
Michiba T Kitahara T Hikita-Watanabe N Fukushima M Ozono Y Imai R Inohara H 《Auris, nasus, larynx》2013,40(2):162-166
Objectives
Some patients with sudden sensorineural hearing loss (SSNHL) are frustrated by residual tinnitus even after accomplishment of the treatment for SSNHL. In the present prospective study, we examined patients’ backgrounds of sex, laterality and age together with changes in hearing level and the tinnitus score after the onset of SSHNL to determine the prognostic factors of residual tinnitus after the final day of medical treatment for SSNHL.Methods
Forty-four patients with SSNHL were all treated with systemic administration of steroids for 2 weeks and oral intake of vasoactive drugs and vitamin B12 for 6 months before accomplishment of the treatment for SSNHL. The hearing improvement rate (HIR) was determined by comparing the hearing level before and 6 months after the start of treatment. Tinnitus was subjectively evaluated by the tinnitus scoring questionnaire before, 6 and 24 months after the start of treatment. The score of a five-step evaluation of subjective tinnitus feelings, “loudness”, “duration” and “annoyance”, was recorded.Results
HIR was significantly correlated with tinnitus score improvement (TSI) in “duration” at 6 months after the start of treatment compared with before treatment. The tinnitus score of all 3 items was significantly improved 6 months after the start of treatment compared with that before treatment but it was not significantly changed between 6 and 24 months after the start of treatment. TSI in “duration” between 6 and 24 months was significantly correlated with the patients’ age and HIR using multiple regression analysis.Conclusion
According to the tinnitus scoring questionnaire, “duration” is the most reliable item for subjective evaluation of tinnitus accompanied by SSNHL. Generally, subjective feelings for residual tinnitus 6 months after the start of treatment for SSNHL are supposed to be almost the same, even at the 24th post-treatment month. Especially, younger patients with better hearing improvement are predicted to achieve further improvement of tinnitus between 6 and 24 months after the start of treatment. 相似文献8.
Atsushi Fukuda Shinya Morita Yuji Nakamaru Kimiko Hoshino Keishi Fujiwara Shigeru Akazawa Tomohiro Sakashita Nobuyuki Obara Akihiro Homma 《Auris, nasus, larynx》2018,45(5):911-915
Objective
Although elevated anti-mumps IgM antibody levels were reported in 5.7%–7.2% of Japanese patients with sudden sensorineural hearing loss (SSNHL), there were several reports of false-positive cases, such as the continually IgM positive case and the IgM positive case in normal adults. To improve specificity, the new enzyme immuno assay (EIA) anti-mumps IgM antibody measurement kit was introduced in December 2009. This study re-examined the frequency of anti-mumps IgM antibody test positivity with SSNHL using the new measurement kit and compared the results with those from a previous report that used old kit.Methods
This is a retrospective multi-institutional study involving patients diagnosed with SSNHL who exhibited the anti-mumps IgM antibody. We compared the positive rate of anti-mumps IgM antibody and the annual average number of mumps cases per sentinel in Hokkaido between the patients in the present study and patients previously evaluated.Results
Overall, 100 patients with SSNHL were enrolled. One case (1.0%) was positive for anti-mumps IgM antibody. Of the 69 patients evaluated in the previous study, 5 cases (7.2%) were positive for anti-mumps IgM antibody. The positive rate of the anti-mumps IgM antibody in the present cases was significantly lower than that previously reported (p = 0.042). The annual average number of mumps cases per sentinel in Hokkaido of the present and previous surveillance period was 34.47 and 42.77, respectively; no significant difference was seen in these data (p = 0.4519).Conclusion
The present study revealed that 1.0% of SSNHL was positive for the anti-mumps IgM antibody using the new EIA-IgM measurement kit. After the introduction of the new EIA-IgM measurement kit, anti-mumps IgM antibody positive rate with SSNHL significantly decreased, indicating that the proportion of asymptomatic mumps among etiology of SSNHL may be lower than those previously reported. 相似文献9.
Filip Matovinović Filip Bacan Elvira Kereković Alan Pegan Ivan Rašić Andro Košec 《American journal of otolaryngology》2018,39(5):515-517
Purpose
Tonsillectomy is one of the most common surgical procedures in otorhinolaryngology. Modern general anesthetic techniques have reduced surgical risks, but performing the procedure under local anesthesia may still offer significant benefit for both the patient and surgeon. This study analyzed the risks and benefits of performing tonsillectomies under local anesthesia.Methods
This is a retrospective longitudinal cohort study analyzing postoperative bleeding rates as a primary outcome measure. Secondary outcome measures were duration of surgery, consumption of analgesics and total surgery cost.Results
The study enrolled 1112 patients undergoing tonsillectomy, with 462 (41.5%) patients treated under general and 650 (58.5%) patients treated under local anesthesia. There were 12 postoperative bleeding incidents in in the local anesthesia group and 9 cases of postoperative bleeding in the general anesthesia group. No significant differences based on gender regarding quantity of intraoperative bleeding or patient age were observed between the patients undergoing local versus general anesthesia. However, significant differences were noted between the groups in analgesic consumption, (Mann-Whitney U test, p?=?0.001), duration of operating room stay (Mann-Whitney U test, p?=?0.001), duration of surgery (Mann-Whitney U test, p?=?0.001) and cost of surgery (Mann-Whitney U test, p?=?0.001).Conclusions
The incidence of postoperative bleeding is not dependent on type of anesthesia. The results suggest that tonsillectomy performed under local anesthesia is a safe alternative to tonsillectomy under general anesthesia, with significant reduction of cost and duration of surgery. 相似文献10.
Alexander L. Luryi David Wright Juliana Lawrence Seilesh Babu Michael LaRouere Dennis I. Bojrab Eric W. Sargent John Zappia Christopher A. Schutt 《American journal of otolaryngology》2018,39(3):313-316
Purpose
Benign paroxysmal positional vertigo (BPPV) involving the horizontal and superior semicircular canals is difficult to study due to variability in diagnosis. We aim to compare disease, treatment, and outcome characteristics between patients with BPPV of non-posterior semicircular canals (NP-BPPV) and BPPV involving the posterior canal only (P-BPPV) using the particle repositioning chair as a diagnostic and therapeutic tool.Methods
Retrospective review of patients diagnosed with and treated for BPPV at a high volume otology institution using the particle repositioning chair.Results
A total of 610 patients with BPPV were identified, 19.0% of whom had NP-BPPV. Patients with NP-BPPV were more likely to have bilateral BPPV (52.6% vs. 27.6%, p?<?0.0005) and Meniere's disease (12.1% vs. 5.9%, p?=?0.02) and were more likely to have caloric weakness (40.3% vs. 24.3%, p?=?0.01). Patients with NP-BPPV required more treatments for BPPV (average 3.4 vs. 2.4, p?=?0.01) but did not have a significantly different rate of resolution, rate of recurrence, or time to resolution or recurrence than patients with posterior canal BPPV.Conclusions
Comparison of NP-BPPV and P-BPPV is presented with reliable diagnosis by the particle repositioning chair. NP-BPPV affects 19% of patients with BPPV, and these patients are more likely to have bilateral BPPV and to require more treatment visits but have similar outcomes to those with P-BPPV. NP-BPPV is common and should be part of the differential diagnosis for patients presenting with positional vertigo. 相似文献11.
Tristan Tham Sushma Teegala Yonatan Bardash Saori Wendy Herman Peter Costantino 《American journal of otolaryngology》2018,39(6):764-770
Introduction
Human papillomavirus (HPV) is a known prognostic indicator in oropharyngeal cancer. Not much is known about the prognostic role of HPV in Nasopharyngeal cancer (NPC). Here, we performed a systematic review and meta-analysis of the literature to investigate if HPV status was a prognostic factor for NPC.Methods
PubMed (via the web), Embase, Scopus, and the Cochrane Library were searched. A systematic review and meta-analysis was done to generate the pooled Hazard Ratios (HR) for Overall Survival (OS).Results
A total of 7 studies from 2014 to 2018, reporting data on 2646 patients (range 43–1328) were included in this meta-analysis. The pooled data showed that HPV/p16 status was not associated with OS in NPC with HR of 0.77 (95% CI: 0.55–1.09, p?=?0.14). The test for heterogeneity showed little to no heterogeneity of results (I2?=?4%, p?=?0.38). Subgroup analysis showed that in large sample sizes, HPV was significantly associated with survival.Conclusion
Despite the finding in the pooled HR, we could not draw a definitive conclusion as to the prognostic significance of HPV in NPC. Recommendations for future research are given. 相似文献12.
Kaitian Chen Lanying Wen Ling Zong Min Liu Jincangjian Sun Xuan Wu 《American journal of otolaryngology》2019,40(2):274-278
Objective
To explore the hearing outcomes and prognostic factors in patients with sudden sensorineural hearing loss resulting from inner ear hemorrhage.Methods
42 patients (22 male and 20 female) were recruited from January 2016 to December 2017. Intravenous methylprednisolone and/or intratympanic corticosteroid were used as salvage therapy. The main measures included systemic risk factors and audiometric outcomes as proposed by American Academy of Otolaryngology-Head and Neck Surgery Hearing Loss Scale. All individuals were assessed at baseline, discharge (2?weeks post-treatment) and at 1, 3 and 6?months.Results
The mean ages of patients were 39.3?±?14.8?yrs. Cardiovascular disorders were seen in 19.0–33.3% of cases. Restoration of hearing and speech discrimination abilities were assessed at the first month post-treatment versus initial levels (95.5?±?15.5 vs. 109.2?±?9.6?dB, p?=?0.000; and 17.6?±?24.4 vs. 1.3?±?4.0%, p?=?0.003, respectively). Word recognition scores continued to recover at month 6 (38.7?±?35.4%, p?=?0.000), whereas puretone ceased to change (90.8?±?16.2?dB, p?=?0.139). The final percentages of complete, partial and no recovery were 0%, 57.1% and 42.9% respectively. The prognosis was independent of accompanying systemic risk factors as analyzed in this study. Intratympanic intervention was associated with improved word recognition scores, although intravenous corticosteroid was not.Conclusions
Profound sudden sensorineural hearing loss caused by inner ear hemorrhage often has an unsatisfactory prognosis. However, this cohort did experience partial audiological recovery with delayed onset. Immediate and effective intratympanic corticosteroid may have therapeutic potential for this intractable disease. 相似文献13.
Aliciane Mota G. Cavalcante Isabella Monteiro de Castro Silva Bianca Jessica Neves Carlos Augusto Oliveira Fayez Bahmad Jr 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(4):514-518
Introduction
Otospongiosis is temporal bone osteodystrophy, characterized by disordered bone resorption and neoformation in genetically predisposed individuals. Clinically, otospongiosis is characterized by progressive conductive and/or mixed hearing loss and by tinnitus.Objective
A review of the last two decades of publications that report the degree of tinnitus improvement with stapes surgery.Methods
125 articles published in the last 20 years mentioning the relationship between otosclerosis and tinnitus. Literature has always shown that the hearing improvement after stapes surgery was the main result sought and found. However, recent articles has reinforced the need for surgery for the tinnitus improvement. The ideal time to assess tinnitus through different scales is in the sixth month post-operative. The estimated average hearing improvement is 93% and tinnitus is 85.52%.Results
Summaries of 12 articles were reviewed which fulfilled the search criteria of the survey, and 8 studies were included in the study according the selection criteria. This studies investigating the degree of tinnitus improvement with stapes surgery, using different scales as: tinnitus functional index, visual analog scale, tinnitus functional index and visual analog scale, visual analog scale and “questionnaire asking about tinnitus”, Newman's method and Tinnitus Score Advocated by the Japan Audiological Society. The total of the samples of the evaluated articles was of 254 participants.Conclusion
We conclude that stapes surgery is effective for the treatment of tinnitus (average improvement is 85.52%), and hearing loss (average improvement is 93%). When deciding about the surgical indication in patients with otosclerosis, the presence and level tinnitus should be considered as well as the level of hearing. 相似文献14.
Objectives
This study sought to investigate the impact of involvement of the infrahyoid neck space on the management of non-odontogenic DNI.Method
Eighty-one patients treated for non-odontogenic DNI over 5?years were retrospectively recruited into this study. Demographics, etiology, radiology results, treatments, duration/cost of hospital stay, and complications were recorded. Differences between DNIs with and without infrahyoid involvement, as defined based on an anatomical chart, were analyzed.Results
Sixty-two male and 19 female patients with a median age of 46.22?years were included. Fifteen patients had cellulitis, and 66 patients had abscesses. Streptococcus was the most commonly observed bacterium. Compared with DNIs only in suprahyoid spaces (n?=?60, 74.07%), DNIs with infrahyoid space involvement (n?=?21, 25.93%) were associated with higher incidences of the involvement of ≥3 spaces (85.71%, P?=?0.000), mediastinitis (38.10%, P?=?0.000), tracheostomy (28.57%, P?=?0.008), surgery using a transcervical approach (66.67%, P?=?0.000), and intensive care unit therapy (19.05%, P?=?0.004), as well as longer hospital stays (16?days, P?=?0.000) and higher costs ($2872, P?=?0.000).Conclusion
Infrahyoid involvement should be regarded as a high-risk factor in the management of deep neck infection (DNI). A relatively aggressive plan that includes transcervical surgery and tracheostomy should be considered at earlier stages for DNI with infrahyoid involvement. 相似文献15.
Eric J. Formeister A. Sean Alemi Ivan El-Sayed Jonathan R. George Patrick Ha P. Daniel Knott William R. Ryan Rahul Seth Matthew L. Tamplen Chase M. Heaton 《American journal of otolaryngology》2018,39(5):548-552
Purpose
To evaluate how the interval between radiation and salvage surgery for advanced laryngeal cancer with free tissue transfer reconstruction influences complication rates.Materials and methods
This is a retrospective series of 26 patients who underwent salvage laryngectomy or laryngopharyngectomy with vascularized free tissue reconstruction (anterolateral thigh or radial forearm) following radiation or chemoradiation between 2012 and 2017 at a single academic center. The primary outcome was incidence of postoperative complications, including pharyngocutaneous fistula. Secondary outcomes included the need for a second procedure, time to resumption of oral feeding, feeding tube dependence, and hospital length of stay.Results
Salvage surgery was performed for persistence (7/26, 27%), recurrence/new primary (12/26, 46%), and dysfunctional larynges (7/26, 27%). Twenty-two (85%) defects were reconstructed with an anterolateral thigh free flap and 4/26 with a radial forearm free flap (15%). There were no flap failures. There were significantly more complications in patients undergoing surgery within 12?months of completion of radiation therapy (7/12, 58%) versus those undergoing surgery after 12?months (1/14, 7%; p?=?.02). Patients experiencing complications more often required a second procedure (4/7 vs. 0/1; p?=?.02), experienced a longer delay to initiation of oral diet (61 vs. 21?days; p?=?.04), and stayed in the hospital longer (28 vs. 9?days; p?=?.01).Conclusions
Shorter intervals between definitive radiation and salvage laryngopharyngeal surgery with free tissue reconstruction increases postoperative complications, hospital length of stay, and the likelihood of feeding tube dependence. Reconstructive surgeons can use these findings to help guide preoperative patient counseling and assess postoperative risk. 相似文献16.
Daniel C. O&#x;Brien Yuti Desai Robert T. Swanson Uma Parekh Jane Schubart Michele M. Carr 《American journal of otolaryngology》2018,39(5):623-627
Objectives
To investigate the relationships between preoperative sleep study findings of children undergoing adenotonsillectomy anesthesia emergence time, recovery room time, and length of stay.Study design
Retrospective case series with chart review.Setting
Tertiary care children's hospital.Subjects and methods
All children aged 1–17?years who had undergone adenotonsillectomy between 2013 and 2016 were included. Apnea-hypopnea index (AHI), central apnea index (CAI), oxygen saturation nadir, and end-tidal carbon dioxide were compared with the in-operating room times, recovery room time, and length of stay.Results
Three hundred and fourteen patients with a mean age of 6.67 (95% CI 6.25–7.09) years were included. Mean AHI was 9.14 (95% CI 7.33–10.95), mean CI was 0.88 (95% CI 0.50–1.26), mean oxygen saturation nadir was 82.9% (95% CI 81.41–84.32), mean end-tidal carbon dioxide was 50.3 (95% CI 49.39–51.15). Mean emergence time was 16?min (95% CI 15:11–17:13?min), recovery room time was 66?min (95% CI 1:00–1:11?h), and length of stay was 25.7?h (95% CI 21:43–30:00?h).When controlled for age, gender and BMI, linear regression showed that children with a higher AHI had a significantly longer operating room and operative times (p?<?0.001), emergence time (p?<?0.001) and length of stay (p?=?0.01). CAI was related to shorter total operating room times (p?=?0.03). AHI, oxygen saturation nadir, CAI and end-tidal carbon dioxide were not associated with recovery room time.Conclusion
Preoperative sleep study indices are associated with longer in-operating room times and length of stay, and can be useful in planning operating room and hospital flow. 相似文献17.
Background: Combination therapy is the first-line option for total-deafness sudden sensorineural hearing loss (SSNHL). Age may act as a crucial prognostic factor.Objective: The aim of this study was to compare efficacy of combination therapy between adolescent and adult patients with total-deafness SSNHL.Materials and methods: Twenty-five adolescent patients (adolescent group) and 106 adult patients (adult group) with total-deafness SSNHL were recruited. All the recruited patients underwent initial treatment with batroxobin, methylprednisolone, and gastrodin. After 10-day treatment, hearing outcomes were determined by pure-tone average measured by audiometry. Moreover, the total effective rates in the hearing recovery and improvement of tinnitus were calculated.Results: There existed no significant difference between two groups in the total effective rate of the hearing recovery (p?=?.110). However, a significant difference was found in the total effective rate of improvement of tinnitus between two groups (p?=?.016). Both adolescent and adult patients could receive the optimal hearing gains at 500?Hz (20.2?±?13.3 and 23.1?±?13.9dB, respectively), followed by those at 1000?Hz (18.8?±?12.5 and 22.7?±?14.8dB, respectively). Yet, adult patients could get better hearing gains only at 500?Hz than adolescent patients (p?=?.02).Conclusion: Compared with adult patients, adolescent patients with total-deafness SSNHL undergoing combination therapy may be less likely to have hearing recovery and the improvement of tinnitus. 相似文献
18.
Montaser Abdel-Salam Osama G. Abdel-Naby Awad Mohamed El-Badry Ahmed Ibrahim Mahmoud Hosny Ibrahiem 《Auris, nasus, larynx》2018,45(6):1166-1172
Objective
Human menopausal gonadotropin (HMG) is one of the commonest drugs used for ovarian stimulation with no reports on the audio-vestibular system. This study aims to examine HMG on the hearing profile of patients planning intracytoplasmic sperm injection (ICSI).Methods
This prospective study was conducted from June 2016 to June 2017 in a tertiary referral hospital. The audio-vestibular system of a total of 30 patients was evaluated using pure tone audiometry, distortion product otoacoustic emissions (DPOAEs in the form of a DP-gram) and Vestibular-evoked myogenic potential (VEMP) immediately before therapy and at the day 10 after therapy. Audio-vestibular adverse effects including hearing loss, tinnitus, vertigo, and otalgia were also considered.Results
Significant elevations in hearing thresholds were found on comparing thresholds at the day 10 at the onset of the study. The elevations were mostly at frequencies (1000, 2000 and 8000 Hz) and did not affect speech perception. For DPOAE, significant differences were observed at all F2 frequencies on comparing both amplitudes and signal to noise ratios. Otologic complaints were significant for tinnitus and hearing loss.Conclusion
Significant auditory and vestibular adverse effects may result from HMG therapy, indicating the importance of prompt monitoring of auditory functions in these patients. 相似文献19.
Francesco Martines Daniela Bentivegna Enrico Martines Vincenzo Sciacca Gioacchino Martinciglio 《Auris, nasus, larynx》2010,37(6):685-693
Objective
To analyze the clinical characteristics of tinnitus both in normal hearing subjects and in patients with hearing loss.Methods
The study considered 312 tinnitus sufferers, 176 males and 136 females, ranging from 21 to 83 years of age, who were referred to the Audiology Section of the Department of Bio-technology of Palermo University. The following parameters were considered: age, sex, hearing threshold, tinnitus laterality, tinnitus duration, tinnitus measurements and subjective disturbance caused by tinnitus. The sample was divided into two groups: Group 1 (G1) subjects with normal hearing; Group 2 (G2) subjects with hearing loss.Results
Among the patients considered, 115 have normal hearing while 197 have a hearing deficit. There is a slight predominance of males respect to females that is more evidenced in G2 (61.42% of males vs. 38.58% of females). The highest percentage of tinnitus results in the decades 41–50 for G1 and >70 for G2 with a statistically significant difference between the two groups (P < 0.0001).The hearing impairment results in most cases of sensorineural type (74.62%) and limited to the high frequencies (58.50%), moreover the 72.10% of the patients with SNHL had a high-pitched tinnitus while the 88.37% of the patients high-frequency sensorineural hearing loss had a high-pitched tinnitus (P < 0.0001). As for the subjective discomfort, the catastrophic category resulted most representative among subjects with normal hearing with a statistically significant difference between the two groups but no significant correlation was found between the level of tinnitus intensity and the tinnitus annoyance confirming the possibility that tinnitus discomfort is elicited by a certain degree of psychological distress as anxiety, depression, irritability and phobias that do not allow the phenomenon of the ‘habituation’.Conclusion
This work, according to literature data, suggests that the hearing status and the elderly represent the principal tinnitus related factors; moreover tinnitus characteristics differ in the two groups for tinnitus pitch. There is, in fact, a statistically significant association between high-pitched tinnitus and high-frequency SNHL suggesting that the auditory pathway reorganization induced by hearing loss could be one of the main source of the tinnitus sensation. 相似文献20.
Hyun-Min Lee Seok-Hyun Kim Jae-Hwan Jung Se-Joon Oh Soo-Keun Kong Il-Woo Lee 《American journal of otolaryngology》2017,38(5):521-525