Loudness perception is influenced by long-term hearing aid use.

The aim of this study was to explore possible differences in the perception of loudness between long-term hearing aid full-time users and non-users. Categorical loudness scaling using pure-tone stimuli was carried out by hearing-impaired subjects. The mean levels of loudness categories at one frequency (hearing threshold: 50-75 dB HL) in a group of 18 hearing aid users (daily use < or = 15 hours per day) were compared with the corresponding levels found in 18 hearing-impaired non-users with the same distribution of hearing thresholds. The results show that, for hearing losses of 50-75 dB HL, the mean level rated as 'loud' by long-term full-time users of hearing aids is 4.5 dB above the mean level of the corresponding category rated by non-users. This difference is statistically significant (P<0.05). No significant differences were found for the lower categories. Among those subjects who had been wearing hearing aids for at least six months, no significant correlation was found between the levels of the 'loud' category and the length of time that hearing aids had been used.     

The effects of alcohol and smoking upon the age, anatomic sites and stage in the development of cancer of the oral cavity and oropharynx in females in the south west Netherlands

A retrospective review of 303 women, aged 40 or over, with squamous cell carcinomas of the oral cavity or oropharynx was conducted in the south-west Netherlands to study the effects of smoking and alcohol upon the age of onset, site and stage of disease. It was noted that patients presenting with oropharyngeal cancers were younger and had a higher incidence of smoking and history of heavy drinking. Age at presentation was also affected by the amount of alcohol and tobacco consumed with non-users presenting with tumors approximately 15 years later. A specific finding was that heavy drinkers and smokers tended to present with late-stage-disease.     

Incidence and age at onset of cancers of the mouth and oropharynx since 1960. The epidemiologic context in East Austria

Between 1960 and 1987, a total of 709 carcinomas of the floor of the mouth, tongue and oropharynx (BOPC) were diagnosed at the first ENT Clinic of the University of Vienna (555 men, 154 women). Patients under 50 years of age increased steadily in number of proportion. Age-specific rates in men based on the actual population of eastern Austria showed a highly significant increase in younger patients and a slight decrease in older patients. Crude regional mortality increased considerably in men during the whole period, and in women since 1982. The evolution of age-specific mortality in men was similar to that of the incidence at our clinic. In women the increase affected all ages. The rate of tobacco and alcohol consumption of male patients between 1977 and 1983 was compared with that of patients with chronic otitis and hypopharyngeal carcinoma. Smoking and drinking rates were substantially higher in the BOPC group than in the otitis group, and their distribution differed from that of the hypopharyngeal cancer group: heavy consumption of both tobacco and alcohol was equally frequent, but smoking rates were lower and heavy drinking more frequent in the BOPC group. High consumption in BOPC patients was more common in patients under 60 years of age. The increasing incidence of the disease and the shift to younger patients may be linked with the alcohol component within the field of influence of combined tobacco and alcohol abuse.     

Masculinizing effects on otoacoustic emissions and auditory evoked potentials in women using oral contraceptives

The otoacoustic emissions (OAEs) and auditory evoked potentials (AEPs) measured in two separate large scale studies were examined retrospectively for potential differences between those women using, and those not using, oral contraception (OC). Fourteen dependent variables were examined, all of which exhibited substantial sex differences. For 13 of those 14 dependent variables, the means for the users of OC were shifted away from the means of the non-users in the direction of the males. Specifically, for four different measures of OAE strength, for seven of eight measures of AEP latency or amplitude, and for two cognitive tests (mental rotation and water level), the means for the users of OC were located intermediate to those of the non-users of OC and the males. Few of these differences between users and non-users of OC achieved statistical significance, but the near universality of the direction of the difference suggests that oral contraceptives do produce a weak masculinizing effect on some auditory structures. These weak masculinizing effects appear to run contrary to the facts that the levels of both free testosterone and estradiol are lower in women using OC than in normal-cycling women. Past findings on auditory sex differences may have underestimated those sex differences.     

Tobacco and alcohol consumption in relation to oral cancer

The present case control study was done on 50 cases of oral cancer and 50 controls These two groups are compared after taking the history in detail with special emphasis on the tobacco and alcohol intake. My various statistical tests, we correlated the strength of association between tobacco/alcohol intake and development of oral cancer. Tobacco only and combined exposure to tobacco and alcohol was found to be strongly related to the development of oral cancer but alcohol alone does not have significant role in causation of oral cancer.     

Incidence of tinnitus in mp3 player users

Exposure to loud noise is one of the main causes of tinnitus.AimTo analyze the incidence of tinnitus in mp3 player users and non-users.Material and methodOne hundred subjects aged from 15 to 30 years were enrolled, 54 of them were regular mp3 player users and 46 were not. Patients with continuous tinnitus for at least 6 months completed the Tinnitus Handicap Inventory (THI) and were tested with high frequency audiometry and transient-evoked otoacoustic emissions (TAOE).Study designA cross-sectional cohort study.ResultsThe incidence of tinnitus in non-users was about 8%; in mp3 player users it was about 28 %, a statistically significant difference. Hearing thresholds at 8kHz were significantly higher in tinnitus patients that used mp3 portable players. TAOE were reduced at 2 kHz in the users group. No statistically significant difference was found in the THI scores between the two groups.ConclusionTinnitus was more frequent in teenagers and young adults who regularly listen to mp3 music in players. Moreover, the incidence of tinnitus among mp3 player users was associated with higher hearing thresholds at 8 kHz and lower TOAE at 2 kHz. Clinicaltrials.gov registration number: NCT 01187251     

Oral hygiene and dental status in patients with squamous cell cancers of the upper aerodigestive tract

Dental status and oral hygiene were investigated in a case-control study of 100 patients suffering from head and neck cancer and 214 age- and sex-matched controls. The dental status and paradontal status are poor in cancer patients. The number of decayed or missing teeth was significantly higher in our patients compared with controls. Furthermore, in the tumour group the rate of moderate or severe gingivitis and the presence of extensive tartar were significantly higher. These findings are mainly due to poor oral hygiene. Few of the cancer patients ever brushed their teeth, and the number of dental check-ups was significantly lower than in control subjects. Poor oral hygiene is predominantly an expression of self-neglect due to chronic alcohol consumption, which was present in nearly all of our patients. Furthermore, it seems to be related to an unsatisfactory health education in the lower social strata, to which most of cancer patients belong.     

Tobacco- and alcohol-associated cancer risk of the upper respiratory and digestive tract

A case-control study of squamous cell carcinoma of the upper aerodigestive tract conducted in the ENT Departments of the University hospitals of Heidelberg and Giessen (FRG) provided information on the role of chronic tobacco and alcohol consumption as risk factors in 200 patients and 800 control subjects (4:1 matched design).--Only 4.5% of the tumour patients were non-smokers in contrast to 29.5% in the control group. The average tobacco and alcohol consumption in the patients was more than twice that high than in the control subjects. The highest alcohol and tobacco consumption was observed in patients suffering from oropharyngeal cancer.--It could be demonstrated that tobacco as well as alcohol increased the risk for head and neck cancer, in a dose-dependent fashion, as separate risk factors. In heavy smokers (greater than 60 pack years) a relative risk of 23.4 (alcohol-adjusted) was calculated. For heavy drinkers (greater than 100 g ethanol/day) a relative risk of 21.4 (tobacco-adjusted) was documented. Combined alcohol and tobacco consumption showed a synergistic effect and increased the cancer risk more in an multiplicative than in an additive manner: A daily ethanol consumption of more than 75 g/day combined with more than 50 pack years caused a risk value of 146.2.     

Human papillomavirus and risk of oral cancer

Although human papillomavirus (HPV), a sexually transmitted virus, is established as a necessary cause for more than 95% of cervical carcinomas, the association with oral squamous cell carcinoma is less well delineated. The purpose of this study was to determine the frequency and types of HPV in squamous cells of a group of patients with newly diagnosed oral or pharyngeal cancer (n = 93) compared with an age-and gender-frequency-matched control group of patients with no history of oral cancer (n = 205). HPV was evaluated from a mouth rinse collection of cells in the oral cavity and tested by ³²P-labeled HPV generic probes and DNA sequencing for HPV types. HPV was identified in 15% of the oral cancer cases but in fewer than 5% of the controls (P < .05). The risk of cancer associated with HPV infection was independent of tobacco and alcohol use (adjusted odds ratio [OR] = 3.70; 95% confidence interval [CI]: 1.47–9.32; P < .05). HPV types included similar and other types not identified previously in the genital tract. There was no statistically significant increased risk of cancer among former tobacco users (former vs. never users: adjusted OR = 0.67, 95% CI: 0.31–1.44, P < .05), but the risk was significantly increased for current users (current vs. never: adjusted OR = 2.63; 95% CI: 1.22–5.71; P < .05). Likewise, former alcohol users were not at increased risk of disease (former vs. never: adjusted OR = 1.78; 95% CI: 0.87–3.67), whereas current alcohol users were (current vs. never: adjusted OR = 2.57; 95% CI: 1.22–5.42; P < .05). HPV-related genital lesions (14.3% vs. 10.6%), oral-genital sexual behavior (42.4% vs. 45.2%), and number (11 or more) of sexual partners (23% v. 17%) were not significantly different between cases and controls. These data suggest that in addition to tobacco and alcohol, HPV plays a role in the development of oral cancer.     

Static posturography in addicted to illicit drugs and alcohol

The use of illicit drugs and alcohol can affect body balance.AimTo evaluate balance control with static posturography in individuals addicted to illicit drugs, with or without alcohol abuse. Study design: Case-control, prospective.Methods47 users of illicit drugs, with or without alcohol abuse, and a homogeneous control group consisting of 47 healthy individuals were submitted to a neurotological evaluation including Balance Rehabilitation Unit posturography.ResultsThe stability threshold mean values were significantly lower (p < 0.0001) in users of illicit drugs, with or without alcohol abuse when compared to the control group; the mean values for sway velocity and ellipse area in all evaluated conditions were significantly higher (p <0.05) in the experimental group when compared to the control group, except for the ellipse area in static force surface and opened eyes (p = 0.168).ConclusionThe balance control of individuals addicted to illicit drugs with or without alcohol abuse could present stability threshold, sway velocity and ellipse area abnormalities in static posturography.     

Morphologic alteration induced by short-term smoke exposure in rats

BACKGROUND: It is a well-established fact that cigarette smoking causes degenerative, inflammatory, and respiratory diseases in humans. Because many factors such as air pollution and harsh working conditions can easily be eliminated in animal studies, we conducted this study to identify the effect of tobacco on rat trachea. METHODS: 24 male Wistar rats were divided randomly into an experimental and a control group. The experimental group of rats was exposed to cigarette smoke for 2 h each day over a duration of 60 consecutive days and the control group was treated in an identical fashion yet exposed only to room air. A morphometric study was performed on tracheal specimens taken from 22 rats (10 smoke-exposed rats and 12 control rats). RESULTS: Our results show that many of the morphological changes of the tracheal epithelium were found in the experimental group and significant quantitative differences were observed between the two groups. Loss of cilia, basal cell hyperplasia, goblet cell hyperplasia and an increased number of subepithelial inflammatory cells were observed by light microscopic examination of the trachea of experimental rats. We found very high levels of plasma thiocyanate after exposure to smoke in the experimental group, but no increase in the control group. CONCLUSIONS: The oxidants contained tobacco which could play an important role in the development of these structural and functional abnormalities in the trachea after smoke exposure. In addition, smoking can recruit inflammatory cells to the trachea.     

Smoking cessation in patients diagnosed with head and neck cancer

OBJECTIVE: To determine patients' smoking status after the diagnosis and treatment of squamous cell carcinoma of the head and neck (SCCHN) and to identify factors associated with smoking cessation. DESIGN: Cross-sectional survey study conducted over a 2-year period. SETTING: Head and neck surgery clinic of an academic tertiary care hospital. METHODS: Two hundred thirteen consecutive patients diagnosed with SCCHN were interviewed to ascertain patients' smoking status and the incidence of smoking cessation. Information on demographics, tobacco and alcohol history, disease characteristics, and treatment modality was also collected. MAIN OUTCOME MEASURES: The rate of smoking cessation was evaluated, in which smoking cessation is defined as the use of no cigarettes at least 1 month prior to the interview. Possible predictors of smoking cessation were evaluated. RESULTS: One hundred twenty-five patients were found to be smoking at the time of diagnosis. Among these patients, 53.6% stopped smoking after diagnosis or during treatment. In the univariate analyses, tumour site (p = .01), concurrent alcohol use (p = .03), and number of attempts to quit pre- (p = .03) and postdiagnosis (p = .001) were found to be highly predictive of patient smoking cessation. Multivariable modelling showed that gender, tumour site, and number of attempts to quit smoking were significantly and independently related to smoking cessation. CONCLUSIONS: Although smoking cessation would be presumed to be high after cancer diagnosis, this study has identified patient subgroups in which postdiagnosis smoking cessation intervention programs need to be made more effective.     

Telephone use and the factors influencing it among cochlear implant patients

Abstract

Objective

To investigate telephone use in cochlear implant patients and to determine factors most likely to influence telephone use.

Methods

Surveys were mailed to 504 cochlear implant patients treated at Sunnybrook Health Sciences Hospital.

Results

Two hundred four patients returned surveys (49%), 87% were classified as telephone users. No differences were found in age, pre-implant hearing characteristics, and the majority of post-implant behaviors. Education and post-implant sound perception scores were found to be significantly different (P < 0.05) between telephone users and non-users.

Discussion

Telephone use among cochlear implant patients shows a positive increase compared to previous studies. In addition, we find that higher attained education and post-implant hearing scores to be independently correlated to telephone use.     

Changes in the age of illness onset in cancer of the hypopharynx and larynx since 1960. The epidemiologic context in Austria

Between 1960 and 1987, 1567 laryngeal and hypopharyngeal carcinomas were diagnosed at the First ENT Clinic of Vienna University. Patients under 50 years of age increased steadily in number and proportion. Three subgroups of carcinomas were considered: glottic (including subglottic), supraglottic and hypopharyngeal. A total of 1442 cases could be studied in detail. In the supraglottic and hypopharyngeal groups the proportion under 50 years of age rose significantly, whereas in the glottic cases no significant trend is discernible. The subgroups were standardized in 10-year age groups to the population of eastern Austria. The incidence was constant in females. In males two opposite trends were found: in glottic tumours the proportion of middle-aged patients shows a slight decrease, whereas older age groups show a significant decrease. In hypopharyngeal carcinoma, younger age groups show a highly significant increase and the older age groups a slight decrease. Supraglottic carcinoma was intermediate: in younger age groups, a slight increase was found compared with a marked decrease in older ages. The age-specific regional mortality showed a pattern similar to that of the supraglottic and hypopharyngeal tumours seen at our clinic. The alcohol and tobacco consumption of all male patients between 1977 and 1983 was reviewed. Heavy smoking was about equally frequent for all tumour sites. High alcohol intake was more frequent in supraglottic and hypopharyngeal than in glottic tumours, and more frequent in younger than in older patients. Tobacco smoke acts as a carcinogen in the long run, and this effect can be enhanced by heavy drinking.(ABSTRACT TRUNCATED AT 250 WORDS)     

Epidemiologia raka krtani i gardła dolnego w latach 1988–2012 w materiale Kliniki Otolaryngologii Uniwersytetu Medycznego w Białymstoku

Malignant tumour is the second cause of death in Poland, behind cardiovascular disease. 26% of men and 23% of women die of it. Head and neck tumours are the fifth most frequent group of malignant tumours. These are mostly squamous cell carcinomas. The carcinogenic factors of tobacco smoke play an indisputable role in the pathogenesis of these tumours.Aim of workAnalysis comprising: number of patients, sex and age, site and stage of the primary tumour (T), clinical assessment of neck lymph nodes (N). The results underwent statistical analysis.Materials and methodsThe study involved 1313 patients who underwent surgery in the period 1988–2012 in the Otolaryngology Clinic in Bialystok (1199 men and 114 women, aged 32–86 years).ResultsIn the study group the proportion of men was 91.3% and women 8.7%. Histopathological verification confirmed squamous cell carcinomas in 99%. The primary tumour was most often located in the supraglottic area of the larynx (48.0%) and its clinical stage was T3 (33.5%). T1 tumours were statistically significantly more frequently found in the glottis and T4 tumours – in the hypopharynx and in the transglottic area. Swollen lymph nodes in the neck were found in 52.4% of the patients, most often N2 (37.4%). The highest percentage of patients with lymph node reaction was found in the youngest group (76.6%) and the lowest – in the eldest group (30.0%). Swollen lymph nodes were statistically relevantly more frequent in patients with supraglottic or hypopharynx tumour.     

Social hearing measured with the Performance Inventory for Profound and Severe Loss: a comparison between adult multichannel cochlear implant patients and users of acoustical hearing aids

The objective of this study was to investigate social hearing in successful users of multichannel cochlear implants (CIs) and to compare the scores with those of a group of hearing-impaired adults using acoustical hearing aids (HAs). Out of 88 patients who had undergone surgery, 75 CI users with a mean age of 55 years and a mean pre-operative hearing level of 113dB in the better ear were compared with 59 users of acoustical HAs with a mean age of 56 years and a mean hearing level of 82dB in the better ear. Seven CI patients were non-users and were excluded from the study. The Performance Inventory for Profound and Severe Loss, a questionnaire that measures different aspects of hearing handicap, was used. The CI group scored significantly better than the HA group in three of six evaluated categories, measuring subjective intensity of sounds, speech with visual cues, and response to auditory failure. Awareness of environmental sounds, speech with no visual cues and personal reactions did not differ significantly. The group of successful CI users scored higher on a self-report measure than did a group of users of acoustical HAs with moderate- severe-profound deafness. The best CI users scored better than the best HA users, and the worst CI users scored worse than the worst HA users.     

Social hearing measured with the Performance Inventory for Profound and Severe Loss: a comparison between adult multichannel cochlear implant patients and users of acoustical hearing aids

The objective of this study was to investigate social hearing in successful users of multichannel cochlear implants (CIs) and to compare the scores with those of a group of hearing-impaired adults using acoustical hearing aids (HAs). Out of 88 patients who had undergone surgery, 75 CI users with a mean age of 55 years and a mean pre-operative hearing level of 113dB in the better ear were compared with 59 users of acoustical HAs with a mean age of 56 years and a mean hearing level of 82dB in the better ear. Seven CI patients were non-users and were excluded from the study. The Performance Inventory for Profound and Severe Loss, a questionnaire that measures different aspects of hearing handicap, was used. The CI group scored significantly better than the HA group in three of six evaluated categories, measuring subjective intensity of sounds, speech with visual cues, and response to auditory failure. Awareness of environmental sounds, speech with no visual cues and personal reactions did not differ significantly. The group of successful CI users scored higher on a self-report measure than did a group of users of acoustical HAs with moderate- severe-profound deafness. The best CI users scored better than the best HA users, and the worst CI users scored worse than the worst HA users.     

The outcome of hydration in functional dysphonia

Functional dysphonia has high prevalence among professional voice users. Different aspects should be considered in vocal therapy. One of them is hydration. The aim of the present study is to assess the effect of hydration on a few aspect of vocal dysfunction. 75 subjects were distributed into three different groups. 23 participated as a control group, 27 received hydration treatment and 25 received hydration treatment plus voice training. Dryness, mucosity, phonatory effort, hoarseness, fundamental frequency (Fo), maximum phonatory time (MPT), time of speech and laryngeal status were the variables evaluated at time 0 and 14 days later, immediately after the completion of the treatment of each group. Statistical differences regarding dryness (p = 0.003) and hoarseness (p = 0.033) were found between the control group and the groups receiving treatment. There were no statistical differences in severity and frequency of variables measured at time 0 at 14 days later in the control group. However, all variables except laryngeal status, improved significantly in the groups receiving hydration alone. Only clinical variables improved in the combined group. These findings indicated a therapeutic benefit of hydration, with or without voice training, for functional dysphonia. Further studies using acoustic and stroboscopic analysis are required in order to define the effect of hydration on the compliance of glottic sphincter.     

Salivary gland cancer. A case-control investigation of risk factors

Unlike most upper aerodigestive tract cancers, salivary gland cancers are relatively infrequent, are characterized by a diversity of histologic subtypes, and have never been etiologically associated with tobacco exposure. We present the results of a case-control study of risk factors for these cancers, with risk estimates derived from self-administered comprehensive risk-factor questionnaires distributed to patients at The University of Texas M. D. Anderson Cancer Center, Houston. Cases were 64 patients with histologically confirmed salivary gland cancer. Control subjects, randomly selected from the same patient population excluding patients with cancer of the head and neck or nonmelanoma skin cancer, were frequency-matched to the cases by age, sex, and ethnicity to achieve a 2:1 control subjects/cases ratio. On multivariate analysis, prior radiotherapy was a significant risk factor for both men (odds ratio [OR] = 2.1) and women (OR = 2.3). Among women, higher educational attainment (OR = 2.4), alcohol use (OR = 2.0), and hairdye use (OR = 2.5) were also significantly associated with risk. There were no significant differences between cases and control subjects with respect to tobacco exposure or specific occupational or leisure-time exposures. There is biological plausibility for associations with hairdye use and alcohol exposure.