ABSTRACT
Vestibular involvements have long been observed in otosclerotic patients. Among vestibular structures saccule has the closest anatomical proximity to the sclerotic foci, so it is the most prone vestibular structure to be affected during the otosclerosis process. The aim of this study was to investigate the saccular function in patients suffering from otosclerosis, by means of Vestibular Evoked Myogenic Potential [VEMP]. The material consisted of 30 otosclerosis patients and 20 control subjects. All participants underwent audiometric and VEMP testing. Analysis of tests results revealed that the mean values of Air-Conducted Pure Tone Average [AC-PTA] and Bone-Conducted Pure Tone Average [BC-PTA] in patients were 45.28 +/- 15.57 and 19.68 +/- 10.91, respectively and calculated 4 frequencies Air Bone Gap [ABG] was 25.64 +/- 9.95. The VEMP response was absent in 14 [28.57%] otosclerotic ears. A statistically significant increase in latency of the p13 was found in the affected ears [P=0.004], differences in n23 latency did not reach a statistically significant level [P=0.112]. Disparities in amplitude of p13-n23 in between two study groups was statistically meaningful [P=0.009], indicating that the patients with otosclerosis had lower amplitudes. This study tends to suggest that due to the direct biotoxic effect of the materials released from the otosclerosis foci on saccular receptors, there might be a possibility of vestibular dysfunction in otosclerotic patients
ABSTRACT
This study has been designed to investigate the clinical association between gastro esophageal reflux disease [GERD] and chronic otitis media [COM] in adults and also the role of GERD treatment on the outcome of COM surgery. In a randomized clinical trial, 58 patients with COM who were candidates for surgery were evaluated for GERD and divided in two groups; GERD positive [case] and GERD negative [control] patients. The GERD positive patients were randomized to either receiving medical treatment for GERD or not prior to surgery. The surgical outcomes were assessed at 3 and 6 months after COM surgery in the three groups. Fifty-eight [26 males] patients were enrolled. Forty-two [72.4%] of these had GERD according to a validated questionnaire. Three months after surgery auditory recovery in GERD negative patients was significantly higher [16[100%]] than those suffering from GERD [28 out of 42 [66.7%]], p=0.008. The figures remained similar at six months follow up as well [100% vs. 72.5% in GERD negative and positive patients respectively, p=0.002]. In the GERD-positive group, 8 of 18 [44.4%] patients who did not receive GERD treatment before tympanomastoidectomy recovered after three months whereas, while 20 of 24 [83.3%] patients who received GERD treatment recovered during this time [p<0.001]. At six months 44.4% of non-treated GERD patients had auditory recovery as compared to 95.5% of those treated for GERD [p<0.01]. Our data show that the effect of GERD on the outcome of COM surgery may be considerable. On the other hand, treating COM patients for GERD medically for two months before tympanoplasty improves the surgical outcomes. Therefore, we suggest that COM patients be evaluated for GERD before undergoing tympanoplasty and if GERD is present, they be treated medically for a couple of months before undergoing surgery.
ABSTRACT
Although the incidence and prevalence of chronic suppurative otitis media [CSOM] has been decreased in recent decades, but it is still a major health problem in both developing and developed countries. CSOM can cause major and life-threatening complications such as hearing loss, meningitis and cerebral abscess. Since hearing loss is the most common complication of CSOM, we aimed to evaluate audiometric profile in patients with CSOM and its relation with intra-operative pathologic findings Between 2008-2010, 80 patients with CSOM subjected to tympanomastoidectomy or tympanoplasty entered this study. The detailed patients' history, physical examination, audiometric evaluations and findings during surgeries were collected. Finally, the associations between data were analyzed. CSOM had higher prevalence among female [67.5%], but difference was not statically significant. Speech recognition test and air-bone gap were significantly associated with CSOM [P<0.001]. While cholesteatoma and granulation significantly associated with air-bone gap [P=0.044] and speech recognition test [P=0.032], respectively, ossicular defects significantly associative with both of them [P=0.001 and P=0.032, respectively]. There was not any association between sclerosis and audiometric parameters. Also presence of the cholesteatoma and ossicular defects associated with size of the tympanic perforation [P=0.001]. The preoperative and surgical findings can predict the patients' conductive hearing loss in chronic otitis media, but this relationship is not significant in all variables
Subject(s)
Humans , Male , Female , Audiometry , Intraoperative Care , Chronic Disease , Hearing Loss, Conductive , Sclerosis , CholesteatomaABSTRACT
Although esophageal liposarcoma is an extremely rare tumor, liposarcoma is the most common soft tissue sarcoma in adults. Liposarcoma is currently classified into the types of well-differentiated, myxoid, round cell, pleomorphic and dedifferentiated liposarcoma. Up to now only a few cases of esophagus liposarcoma have been described in the world literature. We describe a myxoid type liposarcoma of the esophagus in a 68 year old man presented with hoarseness and intermittent dysphagea to solid food. He had a huge mass in his mouth which was mobile with gag reflex. A barium swallow, esophageal manometery and CT scan of the esophagus have not clearly revealed the mass. After endoscopic surgical resection of the tumor the histological examination revealed a myxoid liposarcoma. Both the presenting signs and symptoms and the histology type are rare for such tumor. This case demonstrate a rare differential diagnosis of intermittent dysphagia as early diagnosis is so important in those tumors and should kept in mind them, although they are quite rare