Hearing loss in divers in Red sea

As the popularity of Scuba diving [diving with self contained underwater breathing apparatus] continues to grow scientists are better able to determine what the long-term effects on the human body, the group at high risk for adverse effects is professional divers making repeat deep dives with shortened decompression times. The most well-known injuries of diving are dysbaric osteonecrosis, hearing loss, and permanent neurological deficits, usually the result of a decompression accident; these effects may occur without decompression incident or injury. Reports of cognitive dysfunction and damage to the liver, retina, and heart of the diver with no history of decompression sickness are now emerging, these symptoms may occur gradually and away from the dive site, physicians should be aware of the signs and symptoms related to adverse events of diving in order to minimize its morbidity and mortality to detect the effect of scuba diving on the hearing threshold of sport divers who have no history of excessive noise exposure or of diving-related inner ear damage. Thirty of sport divers were included in our study compared with thirty control group of non divers, both groups were subjected to clinical assessment, tympanometry, pure tone audiometery. Divers group shows significant difference in sensory neural hearing loss at high frequency 4KHz,6KHz,8KHz, while there were no significant difference in low frequency at 0.5KHz1KHz,2KHz. Sport diving is risky for long term diving as it affect inner ear causing high tone sensory neural hearing loss, follow up is advised for hearing sport divers especially the professionals

Role of laryngo-pharyngeal reflux in otitis media with effusion in young children [new technique]

Background: Otitis media [OM] has the highest incidence among all medical conditions in children younger than age five, Otitis media with effusion [OME] is the most common cause of childhood deafness. Gastroesophageal reflux disease [GERD] refers to the symptoms and complications of abnormal passage of gastric contents into the esophagus. Laryngopharyngeal reflux [LPR] is the movement of gastric contents beyond the esophagus up to the laryngeal and pharyngeal area. As well as pepsin and acid of gastric contents can include bile acids and pancreatic enzymes, all of which can injure tissues not adapted to them. Although Gasteroesophogeal Reflux [GER] may be normal, LPR [Laryngopharyngeal Reflux] should never be considered physiologic. LPR has been implicated in the OME pathogenesis: therefore, it is necessary to identify the presence or absence of gastric juice in the middle ear

Hypothesis: The objective was to investigate the potential use of pepsin and pepsinogen as diagnostic marker for Laryngopharyngeal reflux disease in otitis media with effusion

Study design: We studied 100 children with symptoms suggestive of either gasroeosophgeal reflux [GER] or OM clinically; all patients were subjected to pharyngeal PH test, Tympanometry, middle ear fluid samples [obtained by myringotomy from patients with Otitis media with effusion] were examined for the presence of pepsin and pepsinogen by using a proteolytic enzyme assay

Result [s]: There was a statistical significant difference as regarding the effect of LPR proved by pharyngeal PH <4.0,in cases of otitis media with effusion. Of 34 patients with OME subjected to myringotomy 61.76% were positive for pepsin and pepsinogen

Conclusion: A strong significant relation was found between LPR and OME [evidenced by pharyngeal PH <4.0 and Middle ear fluid pepsin and pepsinogen] We suggest a causative link between LPR and OME in young children