Hasil untuk "Otorhinolaryngology"

Prasenjit Das, Debasis Ray, Biplab Nath et al.

Introduction: Allergic Rhinitis (AR), affecting 10-25% of the global population, is commonly treated with antihistamines and corticosteroids. H2-blockers, when combined with H1 antihistamines, enhance treatment efficacy and reduce symptoms. There is a need to conduct studies to establish more evidence around this combination and aid in the informed clinical decision-making process. Aim: To compare the efficacy of Bilastine versus Bilastine combined with Famotidine in the management of AR at days 7 and 14 and also to compare serum IgE levels at days 0 and 14 among both groups. Materials and Mehods: This open-label Randomised Controlled Trial (RCT) was conducted in the Pharmacology and Otorhinolaryngology department of Agartala Government Medical College (AGMC) and Govind Ballabh Pant Hospital (GBPH) between 1st February 2023 and 30th June 2024. The study included 340 newly diagnosed acute AR patients aged 18 years and above from the ENT OPD. Participants were diagnosed by clinicians based on signs and symptoms such as nasal itching, sneezing, a runny nose, and nasal obstruction, with symptoms persisting for more than four consecutive weeks. Randomised participants received either Bilastine 20 mg daily or Bilastine combined with Famotidine 40 mg daily for 14 days. The primary outcomes were nasal and non nasal symptom scores, while secondary outcomes included serum IgE levels. Data were collected in an approved Case Report Form (CRF) and statistically analysed using the Independent t-test, Mann-Whitney U test, Wilcoxon signed-rank test, and Chi-square test. Results: The study included 340 participants aged between 18 and 80 years, comprising 178 (52.4%) males and 253 (74.4%) from urban areas. Rhinorrhea (83 cases, 24.4%) and nasal congestion (79 cases, 23.2%) were the most common symptoms. The combination therapy led to a significantly faster reduction in nasal symptoms (p-value=0.001). Serum IgE levels decreased in both groups (p-value=0.001 in Group A, p-value<0.001 in Group B), with a cut-off for serum IgE being <150 mg/dL. Adverse reactions were minimal, with two cases of nausea and bloating in Group A and two cases of nausea in Group B. Conclusion: AR predominantly affected younger adults (ages 21 25 years). Combination therapy showed no adverse effects and provided faster symptom relief while reducing serum IgE levels.

Ebraheem Albazee, Fahad Allafi, Abdulwahab Alsalem et al.

Abstract Objective To evaluate the analgesic role of ropivacaine local infiltration in patients undergoing thyroidectomy. Data Sources PubMed, Google Scholar, CENTRAL, Scopus, and Web of Science. Review Methods A systematic review and meta‐analysis synthesizing evidence from randomized controlled trials (RCTs). Our specific endpoints include pain severity, total opioid analgesia consumption, patient satisfaction, length of hospital stay, postanesthesia care unit (PACU) length of stay, surgery duration, and the incidence of postoperative nausea and vomiting (PONV). Using Stata, we pooled dichotomous outcomes and continuous outcomes using risk ratio (RR) and standardized mean difference (SMD) or mean difference (MD), respectively, with a 95% confidence interval (CI). Results Eight RCTs and 633 patients were included. Ropivacaine significantly decreased pain after 1 to 2 hours postoperatively (SMD: −1.40, 95% CI [−2.30, −0.51]). However, there was no difference between both groups after 4 hours (P = .11), 6 to 8 hours (P = .05), 16 to 18 hours (P = .10), and 24 hours (P = .37). Also, ropivacaine significantly decreased analgesia consumption (SMD: −0.75, 95% CI [−1.30, −0.20]), with no effect on surgery duration (P = .59), length of hospital stays (P = .32), patient satisfaction score (P = .25), and PACU length of stay (P = .25). Finally, there was no difference between both groups regarding the incidence of PONV (RR: 1.01, 95% CI [0.70, 1.45]). Conclusion Ropivacaine local infiltration after thyroidectomy significantly decreased pain for up to 1 to 2 hours and analgesia consumption compared to control, but with uncertain evidence. However, ropivacaine had no effect on pain from 4 to 24 hours, surgery duration, length of PACU stay, length of hospital stay, and patient satisfaction.

Anna-Marie R. Leemeyer, Andrew K. Ross, Tjasse D. Bruintjes et al.

Abstract Introduction Vertigo is a common symptom that strongly impacts patients’ quality of life. More than 80% of patients experiencing vertigo are primarily treated by their general practitioner (GP). The GP’s'diagnostic toolkit' for vertigo has serious limitations, though, because diagnostic accuracy studies on conditions that may cause vertigo have never been performed in a general practice setting. Our aim was to determine which tests should be investigated in a diagnostic accuracy study for patients with vertigo in general practice. Method We conducted an online Delphi procedure involving national and international experts. The experts were asked to judge a selection of 40 diagnostic tests based on the Dutch GP guideline on vestibular symptoms, supplemented by tests identified during a systematic review. Panellists were allowed to suggest additional tests after the first round. In case of consensus of at least 70%, a test was included or excluded. We also conducted a secondary sub-analysis of our Delphi procedure to demonstrate non-dominance of Dutch experts within our expert panel. Data were analysed using descriptive statistics and content analysis. Data were analysed using descriptive statistics and content analysis. Results A panel of 20 experts from five countries, including 7 specialists in otolaryngology, 6 neurologists and 7 GPs, participated in the Delphi procedure. The panel judged 46 diagnostic tests in total, with 6 additional tests added to the original selection based on suggestions by experts. After the first two rounds (100% response rate), 16 tests were included, 22 tests were excluded and no consensus was reached on 8 tests. During the consensus round, one of the 8 tests was added to the included 16 tests. Of these 17 tests, 15 are recommended by the Dutch GP guideline, supplemented by the non-recommended Tandem walking test and the Romberg test. Conclusions An international expert panel reached consensus on 17 tests for vertigo in general practice that should be investigated in a diagnostic accuracy study.

Meng Lian, Boxuan Han, Jiaming Chen et al.

Abstract Sinonasal squamous cell carcinoma (SNSCC) is an aggressive cancer affecting the nasal and sinus regions, with its progression factors, particularly genetic ones, not yet fully understood. Here, we first conducted a retrospective study with 219 SNSCC patients to identify clinical factors affecting SNSCC prognosis. Additionally, we mined a vast literature dataset to uncover genetic factors associated with SNSCC progression. Based on this data, we constructed SNSCC prognosis pathways and performed a gene set enrichment analysis (GSEA). Clear operative margins were linked to a 73.5–86.3% improvement in overall survival and a 73.5–88.9% lower risk of recurrence. Nasal cavity-originated cases exhibited a 67.6–97.4% decrease in mortality and an 80.7–96.7% lower recurrence rate. Patients at T1-2 staging had a 65.0–80.6% reduced risk of death and recurrence compared to those at T3 stage. Additionally, we identified 53 genes associated with SNSCC, with 14 also implicated in primary tumor site, T stage, and operative margin. These genes, including EGFR, PIK3CA, ERBB2, PTEN, BCL2, BRAF, KRAS, and PRL, form a complex SNSCC-prognosis pathway and were significantly enriched in 42 KEGG pathways and Gene Ontology (GO) terms (FDR-corrected p-value < 0.001), influencing cell growth, apoptosis, and oncogenic signaling pathways. Our study suggests that three clinical parameters (operative margin type, primary tumor site, and T-stage) and 14 genetic factors may influence SNSCC prognosis post-surgery. These findings deepen our understanding of SNSCC and offer potential avenues to enhance its treatment and outcomes.

Dilshan Rajan, Sebahattin Cureoglu, Meredith E. Adams et al.

Abstract Objective To explore the historical evolution of surgical techniques for otosclerosis treatment, viewed through the lens of human temporal bone pathology to aid in understanding the disease and refining surgical interventions. Data sources A review of historical literature on otosclerosis, surgical techniques, and otopathological findings was conducted. Eight temporal bone specimens from the Paparella Otopathology & Pathogenesis Laboratory, University of Minnesota, and one from the University of California, Los Angeles, were analyzed. Review methods We selected two temporal bones from donors who underwent four different types of surgical procedures for otosclerosis: stapes mobilization, fenestration, stapedectomy, and stapedotomy. One successful and one complication case was selected for each procedure. Histopathological analysis was performed to assess the outcomes and complications associated with each technique. Results The study chronicles the progression of otosclerosis surgery from the stapes mobilization to modern stapedectomy and stapedotomy techniques. Initial procedures, like stapes mobilization and fenestration, yielded limited and temporary results with significant complications. The introduction of stapedectomy marked a significant improvement, with better long‐term outcomes. Histopathological analysis revealed insights into the causes of surgical failures and complications. Conclusion Otosclerosis surgery has evolved significantly, driven by advances in otopathology and surgical technology. While earlier techniques offered limited success, modern procedures like stapedectomy and stapedotomy provide improved outcomes and fewer complications. Ongoing research promises further advancements in the field, improving patient care and surgical efficacy. Level of evidence NA.

Zhifeng Chen, Yulin Shang, Xiufeng Zhang et al.

Objective: Asthma, a chronic inflammatory disease in which type 2 T helper cells (Th2) play a causative role in the development of T2 asthma. N6-methyladenosine (m6A) modification, an mRNA modification, and methyltransferase-like 3 (METTL3) is involved in the development of T2 asthma by inhibiting Th2 cell differentiation. Sex determining region Y-box protein 5 (SOX5) is involved in regulating T cell differentiation, but its role in T2 asthma was unclear. The objective of this study was to explore the role of METTL3 and SOX5 in T2 asthma and whether there is an interaction between the two. Materials and methods: Adults diagnosed with T2 asthma (n = 14) underwent clinical information collection and pulmonary function tests. In vivo and in vitro T2 asthma models were established using female C57BL/6 mice and human bronchial epithelial cells (HBE). The expressions of METTL3 and SOX5 were detected by Western blot and qRT-PCR and Western blot. Th2 cell differentiation was determined by flow cytometry and IL-4 level was detected by ELISA. m6A methylation level was determined by m6A quantitative assay. The relationship between METTL3 expression and clinical parameters was determined by Spearman rank correlation analysis. The function of METTL3 and SOX5 genes in asthma was investigated in vitro and in vivo. The RNA immunoprecipitation assay detected the specific interaction between METTL3 and SOX5. Results: Patients with T2 asthma displayed lower METTL3 levels compared to healthy controls. Within this group, a negative correlation was observed between METTL3 and Th2 cells, while a positive correlation was noted between METTL3 and clinical parameters as well as Th1 cells. In both in vitro and in vivo models representing T2 asthma, METTL3 levels decreased significantly, while SOX5 levels showed the opposite trend. Overexpression of METTL3 gene in HBE cells significantly inhibited Th2 cell differentiation and increased m6A methylation activity. From a mechanism perspective, low METTL3 negatively regulates SOX5 expression through m6A modification dependence, while high SOX5 expression is positively associated with T2 asthma severity. Cell transfection experiments confirmed that METTL3 regulates Th2 cell differentiation and IL-4 release through SOX5. Conclusions: Overall, our results indicate that METTL3 alleviates Th2 cell differentiation in T2 asthma by modulating the m6A methylation activity of SOX5 in bronchial epithelial cells. This mechanism could potentially serve as a target for the prevention and management of T2 asthma.

Matteo Riccò, Silvia Corrado, Federico Marchesi et al.

Tick-borne encephalitis (TBE) represents a potential health threat for tourists in high-risk areas, including the Dolomite Mountains in northeastern Italy. The present questionnaire-based survey was, therefore, designed in order to assess knowledge, attitudes, and preventive practices (KAP) in a convenience sample of Italian tourists visiting the Dolomite Mountains, who were recruited through online discussion groups. A total of 942 participants (39.2% males, with 60.2% aged under 50) filled in the anonymous survey from 28 March 2023 to 20 June 2023. Overall, 24.1% of participants were vaccinated against TBE; 13.8% claimed to have previously had tick bites, but no cases of TBE were reported. The general understanding of TBE was relatively low; while 79.9% of participants acknowledged TBE as a potentially severe disease, its occurrence was acknowledged as high/rather high or very high in the Dolomites area by only 51.6% of respondents. Factors associated with the TBE vaccine were assessed by the calculation of adjusted odds ratios (aOR) and 95% confidence intervals through a logistic regression analysis model. Living in areas considered at high risk for TBE (aOR 3.010, 95%CI 2.062–4.394), better knowledge on tick-borne disorders (aOR 1.515, 95%CI 1.071–2.142), high risk perception regarding tick-borne infections (aOR 2.566, 95%CI 1.806–3.646), a favorable attitude toward vaccinations (aOR 3.824, 95%CI 1.774–8.224), and a tick bite(s) in a previous season (aOR 5.479, 95%CI 3.582–8.382) were characterized as being positively associated with TBE vaccination uptake. Conversely, being <50 years old (aOR 0.646, 95%CI, 0.458–0.913) and with a higher risk perception regarding the TBE vaccine (aOR 0.541, 95%CI 0.379–0.772) were identified as the main barriers to vaccination. In summary, tourists to the high-risk area of the Dolomites largely underestimate the potential occurrence of TBE. Even though the uptake of the TBE vaccine in this research was in line with European data, public health communication on TBE is required in order to improve acceptance of this effective preventive option.

Sheetal Agarwal, Richa Gautam, Jyoti Kumar et al.

Purpose Our aim was to assess the sinonasal magnetic resonance imaging (MRI) features of acute invasive fungal rhinosinusitis (AIFRS) in coronavirus disease (COVID)-associated mucormycosis (CAM) and to correlate these with histopathology and patient outcome in terms of duration of hospital stay and survival at 10 weeks. Methods Twenty patients with histopathologically confirmed sinonasal CAM underwent MRI (including postcontrast T1-weighted and diffusion-weighted imaging). Histopathological findings (presence of coagulative necrosis, granulomatous reaction, and fungal burden) were recorded and all patients were followed up at 6 and 10 weeks. Statistical analysis was done using chi-square test and Fischer's exact test. Results Enhancement patterns seen in our subjects included homogeneous, heterogeneous, and lack of contrast enhancement (LOC), with LOC being the most common (65%). Diffusion restriction was found in 90% patients. Statistically significant correlation was found between LOC pattern and presence of coagulative necrosis (p-value = 0.007), extent of fungal hyphae (p-value = 0.047), and duration of hospital stay (p-value = 0.004). Restricted diffusion was also seen to correlate with a high fungal load (p-value = 0.007). Conclusion Our study describes the MRI findings of AIFRS in CAM and highlights the imaging features which may be surrogate markers for coagulative necrosis and fungal burden.

Lorena Carvalho Cavalcanti Lagreca, Edison Roberto Parise, João Luiz Rodrigues de Farias et al.

RESUMO Objetivo Verificar se o tratamento com os antivirais de ação direta para a hepatite C provocam efeitos adversos na audição. Métodos A casuística foi composta por 16 indivíduos portadores do vírus da hepatite C, de ambos os gêneros, com média de idade de 51 anos. Foram excluídos do grupo indivíduos com perda auditiva do tipo condutiva ou mista e que apresentassem fatores de risco para perda auditiva. A avaliação foi realizada em dois momentos: antes do uso dos antivirais de ação direta e após o término do tratamento de três meses. Incluiu os seguintes procedimentos: anamnese, inspeção do meato acústico externo, audiometria tonal liminar, limiar de recepção de fala, índice de reconhecimento de fala, medidas de imitância acústica e emissões otoacústicas evocadas por estímulo transiente e produto de distorção. Resultados: Houve baixa ocorrência de zumbido e vertigem. Não houve diferença estatisticamente significativa entre os resultados da avaliação pré-tratamento e pós-tratamento. Conclusão O tratamento com antivirais de ação direta contra o vírus da hepatite C não provocou efeitos adversos na função auditiva.

Zell Fenja, Ibbeken Alina, Hagen Christina et al.

Computational fluid dynamics can be used to analyze the flow pattern and the anatomical predisposition of the airway collapse in patient-specific simulations of sleep apnea patients. Especially the nasal geometry is a major challenge, because of the complex structures and high calculation effort. Due to this limitations the nasal cavity is often excluded. To investigate the influence of the exclusion of the nasal geometry on the flow in the pharynx, four digital models were created. One, which includes the complete nasal structure, and three simplified models, neglecting the nasal geometry using different cutting planes. Airflow simulations using the k-ε turbulence model are performed with an inlet flow rate of 10 l/min. The results show a good agreement of the average velocities. Deviations of the velocity and pressure values occur particularly in the region of the oropharynx and indicate that the type of simplification has a significant influence on the pressure distribution.

Kapeena Sivakumaran, Jennifer A Ritonja, Haya Waseem et al.

Background: Exposure to acute noise can cause an increase in biological stress reactions, which provides biological plausibility for a potential association between sustained noise exposure and stress-related health effects. However, the certainty in the evidence for an association between exposures to noise on short- and long-term biomarkers of stress has not been widely explored. The objective of this review was to evaluate the strength of evidence between noise exposure and changes in the biological parameters known to contribute to the development of stress-related adverse cardiovascular responses. Materials and Methods: This systematic review comprises English language comparative studies available in PubMed, Cochrane Central, EMBASE, and CINAHL databases from January 1, 1980 to December 29, 2021. Where possible, random-effects meta-analyses were used to examine the effect of noise exposure from various sources on stress-related cardiovascular biomarkers. The risk of bias of individual studies was assessed using the risk of bias of nonrandomized studies of exposures instrument. The certainty of the body of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: The search identified 133 primary studies reporting on blood pressure, hypertension, heart rate, cardiac arrhythmia, vascular resistance, and cardiac output. Meta-analyses of blood pressure, hypertension, and heart rate suggested there may be signals of increased risk in response to a higher noise threshold or incrementally higher levels of noise. Across all outcomes, the certainty of the evidence was very low due to concerns with the risk of bias, inconsistency across exposure sources, populations, and studies and imprecision in the estimates of effects. Conclusions: This review identifies that exposure to higher levels of noise may increase the risk of some short- and long-term cardiovascular events; however, the certainty of the evidence was very low. This likely represents the inability to compare across the totality of the evidence for each outcome, underscoring the value of continued research in this area. Findings from this review may be used to inform policies of noise reduction or mitigation interventions.

Iqra Zakir, Ahmad Ahmad, Hamdan Pasha et al.

Introduction:Tympanoplasty is a common surgery for chronic otitis media and has conventionally been performed with a microscope for decades. The trend of endoscopic minimally invasive surgeries has been increasing worldwide for the last few decades. Few studies have discussed the outcomes of microscopic and endoscopic tympanoplasty. This study aims to compare results of tympanoplasty done with microscope vs endoscope in terms of graft take rate and improvement in conductive hearing loss.Materials and Methods:We did a retrospective review of 120 patients (54 male and 66 female) who underwent Type I tym­panoplasty at Liaquat National Postgraduate Medical Center from January 2019 to January 2020. We included 60 patients who underwent microscopic tympanoplasty and 60 patients who underwent endoscopic tympanoplasty. Postoperative graft uptake and hearing improvement were studied. Results:Overall mean preoperative hearing loss was 30.24 (±9.61) dB as compared to mean postoperative hearing loss, which was reduced to 19.36 ( ±8.54) dB, and the difference was significant (P-value <0.001. No statistically significant difference was found for air-bone gap closure between the two groups (P-value 0.78). Out of 120 patients, overall successful graft uptake was seen in 109 (90.8%). In microscopic tympanoplasty, graft take was 90.0%, compared to 91.6% in endoscopic patients. There was no significant difference in graft take in the two groups.Conclusions:The endoscopic tympanoplasty is comparable to microscopic in terms of graft uptake and hearing improvement.

Payam Entezami, Bennett Thomas, Jobran Mansour et al.

Abstract Low‐income patients have worse head and neck cancer outcomes than those with high‐income. Yet, few targets have been identified to specifically improve outcomes in the low‐income population. Here, we conduct a review on the current literature on head and neck cancer outcomes in the low‐income population and identify targets for intervention. The degree of disparity is in the range of 20%‐90% worse overall survival in the low‐income population. Eliminating smoking would have the greatest effect on head and neck cancer mortality rates in the low‐income population. Additionally, access to oral cancer exams, assistance with transportation, and continued expansion of telemedicine would facilitate early diagnosis and timely treatment in patients who develop head and neck cancer.

Tyler A. Janz, MD, Nishat A. Momin, MD, Kirav P. Patel, BS et al.

Objective: To discuss taste disturbance after tonsillectomy and the role of zinc therapy in the treatment of post-tonsillectomy dysgeusia. Methods: We herein report a rare presentation of dysgeusia after an uncomplicated tonsillectomy in an 11-year-old girl which improved post-operatively shortly after starting zinc supplementation. Results: Taste disturbances after tonsillectomy, although rare, may be attributable to multiple causes ranging from inadvertent glossopharyngeal nerve damage during surgery to zinc deficiency. Atypical anatomical distributions of dysgeusia after tonsillectomy prompted the consideration of zinc deficiency as a possible cause of the patient's post-tonsillectomy dysgeusia. Conclusion: When evaluating potential causes of dysgeusia after tonsillectomy, otolaryngologists must be mindful of zinc deficiency as a potential contributing factor.

Meera Niranjan Khadilkar, Nitin Ankle, Sheetal Harakuni

Introduction Controversy regarding treatment of tonsillitis based on throat culture report still persists. If surface culture is a determinant of bacteriology of the core, then rational therapy could be aimed at organisms cultured by surface swab. Materials and Methods A Cross-sectional study was conducted on 100 patients of chronic tonsillitis who underwent tonsillectomy. Tonsil surface and core swabs were studied for aerobic and anaerobic growth. Result Eighty seven percent patients had aerobic growth on tonsil surface and ninety percent in tonsil core. Staphylococcus aureus was the commonest aerobic bacteria isolated. Anaerobic growth was present in 47% patients on tonsil surface, and 48% in core. Porphyromonas sp. was the commonest anaerobic bacterium isolated. Discussion There was no statistically significant difference between aerobic and anaerobic bacteria found in tonsil surface and core.  Conclusion Throat swabs adequately represent core pathogen, and are dependable in detecting bacteriology of chronic tonsillitis.

Daniela Affonso Moreira, Maurício Malavasi Ganança, Heloisa Helena Caovilla

O uso de drogas ilícitas e álcool pode afetar o equilíbrio corporal. OBJETIVO: Avaliar o equilíbrio corporal à posturografia estática em dependentes de drogas ilícitas, com ou sem abuso de álcool. Desenho de Estudo: Caso controle prospectivo. MÉTODOS: Quarenta e sete usuários de drogas ilícitas, com ou sem abuso de álcool e um grupo controle homogêneo constituído de 47 indivíduos hígidos foram submetidos a uma avaliação otoneurológica, incluindo a posturografia do Balance Rehabilitation Unit. RESULTADOS: A média dos valores da área do limite de estabilidade foi significantemente menor (p < 0,0001) no grupo usuários de drogas ilícitas; a média dos valores da velocidade de oscilação e da área de elipse no grupo experimental foi significantemente maior (p < 0,05) do que a do grupo controle em todas as condições avaliadas, com exceção dos valores da área de elipse em superfície firme e olhos abertos (p = 0,168). CONCLUSÃO: O equilíbrio corporal de dependentes de drogas ilícitas, com ou sem abuso de álcool, pode apresentar anormalidades do limite de estabilidade, da velocidade de oscilação e da área de elipse à posturografia estática.<br>The use of illicit drugs and alcohol can affect body balance. AIM: To evaluate balance control with static posturography in individuals addicted to illicit drugs, with or without alcohol abuse. Study design: Case-control, prospective. METHODS: 47 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. RESULTS: The 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). CONCLUSION: The 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.

Sousa, Renato Telles de, Briglia, Maria Francisca Siqueira, Lima, Luiz Carlos Nadaf de et al.

Introduction: The tuberculosis continues being a world problem and in the last years had an increase in his incidence mainly by the growing number of patients with HIV. The tuberculosis has like an etiologic agent the Mycobacterium tuberculosis that possesses a period of latency generally prolonged between the initial infection and the illness. That illness can affect diverse organs and systems. M Method: This study is descriptive, transversal and prospective. Within, patients diagnosed with pulmonary tuberculosis by the service of pneumologia of the outpatient clinic Araújo Lima of the Federal University of the Amazon (UFAM), in Manaus, between the period of July of 2005 and May of 2006 were submitted to otorhinolaryngological exam in search of manifestations of the illness. Objectives: The main objective of the study was estimate the predominance of otorhinolaryngological manifestations in patients with tuberculosis and to describe the frequencies of the different manifestations. Results: They were analyzed 15 cases of pulmonary tuberculosis confirmed by the baciloscopia, being 7 of the female sex and 8 of the male sex. The majority of the patients were young adults between the third and fourth decade of life (46,7%). Only one of the patients had co-infection with the HIV virus. Conclusion: The otorhinolaryngological affection by the tuberculosis was observed in 2 patients corresponding to 13.33% of the sample, being a patient with tubercular medium otitis and a patient with linfoadenopatia cervical.

Geovana de Paula Bolzan, Carla Aparecida Cielo, Débora Meurer Brum

TEMA: som basal em fendas glóticas. PROCEDIMENTOS: participaram desta pesquisa dois sujeitos do sexo feminino, com idades entre 20 e 40 anos e diagnóstico otorrinolaringológico de fenda em ampulheta. Houve gravação da emissão sustentada da vogal /a/ e exame videolaringoestroboscópico, imediatamente a seguir, os sujeitos realizaram o som basal em três séries de 15 repetições, e foram submetidos a novo exame laríngeo e gravação da vogal. Os dados pré e pós-realização do som basal foram submetidos às analises acústica, perceptivo-auditiva e videolaringoestroboscópica, realizadas por juízes (três fonoaudiólogas e três otorrinolaringologistas, respectivamente). RESULTADOS: em ambos os sujeitos, houve melhora no fechamento glótico e amplitude de vibração da mucosa das pregas vocais; piora no tipo de voz; aumento das medidas de ruído e de Jitter. CONCLUSÃO: o som basal promoveu redução das fendas glóticas e aumento da amplitude de vibração da mucosa das pregas vocais; piora do tipo de voz, que ficou mais ruidoso; aumento das medidas de ruído e de Jitter, sugerindo irregularidade vibratória, provavelmente devido ao efeito do ajuste do som basal ao mobilizar intensamente a mucosa.<br>BACKGROUND: vocal fry in incomplete glottal closure. PROCEDURE: two individuals aged between 20 and 40 years old presenting an otolaryngological diagnosis of ampoule chink were part of the study. A recording of the sustained emission of /a/ vowel took place, as well as a videostroboscopic examination. Right after, the individuals completed the vocal fry in three series of 15 repetitions, being submitted to a new laryngeal examination and to the vowel’s recording. Both pre-vocal and post vocal fry data were assessed through acoustic, perceptive-auditive and videostroboscopic analysis, carried out by judges (three speech and language pathologists and three otolaryngologists, respectively). RESULTS: for both individuals, there was an improvement in the glottal coaptation and in the amplitude of the vocal folds mucosa vibration; worsen in the voice type; enlargement of noise and Jitter measurements. CONCLUSION: the vocal fry promoted glottal closure reduction and enlargement in the amplitude of the vocal folds mucosa vibration; worsen in the voice type, which became noisier; enlargement of noise and Jitter measurements, suggesting vibratory irregularities, probably due to the basal fry motor adjustments effects when strongly mobilizing the mucosa.

Seyyed Basir Hashemi, Ayeh Taraghi

Introduction: Intra parotid facial nerve schowannoma is a rare tumor. Case report: In this article we presented two cases of intra parotid facial nerve schowannoma. In two cases tumor presented with asymptomatic parotid mass that mimic pleomorphic adenoma. No preoperative facial nerve dysfunction in cases is detected. Diagnostic result and surgical management are discussed in this paper.

Mehmet Yaşar, Altan Yıldırım, Ali İhsan Bebek et al.

Choanal polyp of sphenoid sinus origin is a rare entity and it may be confused with antrochoanal polyp because it presents in a similar manner to antrochoanal polyp. Computerized tomography and nasal endoscopy are used in the diagnosis of these masses. Simple polypectomy, which leaves some part of polyp inside the sphenoid sinus, carries a high risk of recurrence. We present a case of choanal polyp of sphenoid sinus origin who was operated by endonasal endoscopic approach and the literature was reviewed.