Sensorineural hearing loss among children at risk: A 16-year audiological records review in a tertiary referral center.

OBJECTIVES: Hearing loss (HL) constitutes an increasing worldwide health problem. Neonatal hearing screening improved early detection and management to alleviate HL detriments on the person and society. Still, HL in childhood, beyond infancy, is under-investigated, especially in developing countries. This study aimed to explore the prevalence of HL in childhood amongst Jordanian children with HL risk factors and investigate the associated risk factors. METHODS: Retrospective cross-sectional review of audiological records in a tertiary public and teaching hospital. The data of 1307 children aged 0-15 years who underwent audiological assessment from 2000 to 2016 were included. A review of diagnostic audiological and medical records was conducted to investigate the prevalence of sensorineural HL in high-risk (HR) children and the most contributing risk factors. RESULTS: Descriptive statistical analysis showed that the prevalence of sensorineural HL was 29.2% in the study sample. The HL was bilateral in 95% and mild to moderate HL in 73%. The mean age at the diagnosis was around 4.5 years. The most common risk factors were parental concern about their child's hearing, ototoxic drug use, and developmental and speech delay. The Chi-squared test showed that parental concern and ototoxic drug use were associated with an increased probability of having HL. CONCLUSION: The prevalence of HL amongst at-risk children in Jordan is relatively high, and the diagnosis is delayed. The results highlight the importance of implementing a hearing screening program in at-risk children. This needs to start from birth and include a serial follow-up to detect cases of delayed-onset HL.

Assessment of occupational noise-related hearing impairment among dental health personnel.

OBJECTIVES: The purpose of the study was to examine hearing thresholds among dental personnel. The secondary aim was to evaluate sound levels among dental equipment that dental personnel are exposed to. METHODS: Two hundred forty-four dentists, dental technicians, dental assistants, and dental students participated. Sixty-two participated as a control group. Audiological thresholds for the test groups were compared to the control group. All participants were from Jordan University Hospital. Participants completed a questionnaire in addition to their audiometric testing. Otoscopy, tympanometry, and pure tone audiometry were included in their assessment. Three-factor ANOVA and t tests were utilized to assess the statistical differences of hearing thresholds among the groups and between the two ears. Pearson correlation test was used to assess the effect of age, experience, and duration of exposure on the degree of hearing loss in the test groups for both ears. RESULTS: The authors reported statistically significant differences among hearing thresholds between the control group and others. Left hearing thresholds were noted to be significantly poorer in the left versus right ear at 1000, 2000, 4000, and 8000 Hz in dental assistants. The authors also reported a significant relationship between the degree of hearing impairment among dental assistants and the daily duration of exposure to dental occupational noise, followed by age. CONCLUSION: Hearing impairment was higher among dental professionals than the control group and especially among dental assistants and technicians. The authors recommended screening guidelines and adapting hearing protection methods for dental professionals and particularly for dental assistants and technicians.

Orbital emphysema after a protracted episode of sneezing in a patient with no history of trauma or sinus surgery.

Orbital emphysema is a benign self-limiting condition. It can occur directly (as a result of trauma to the face) or indirectly (secondary to a blowout fracture). We report a case of orbital emphysema in a 38-year-old man who presented with ecchymosis of the right eye, pressure within the right orbit, and periorbital swelling following a protracted episode of vigorous sneezing. The diagnosis was confirmed by computed tomography. Systemic antibiotics were given, and the patient was cautioned to avoid blowing his nose. His signs and symptoms resolved within 1 week.

Evaluation of dizziness at Jordan University Hospital.

OBJECTIVE: This study was performed prospectively to evaluate the dizzy patients in the Neurotology Outpatient clinic at Jordan University Hospital, Amman, Jordan during the period 1993-2000 and to discuss the prevalence and etiology of dizziness. METHODS: Data were collected from 108 patients (52 males and 56 females) with a mean age of 45.6-years. Diagnosis was made on the basis of history, physical, otolaryngological and neurological examination and confirmed by relevant investigation including laboratory, radiological and audio vestibular tests. RESULTS: Secure diagnosis were made in 98% of patients (14% had one cause alone and 84% had multiple causes). Cardiovascular disorders accounted for 31.5% of primary and 49% of secondary causes, peripheral vestibular disorders, 25% of primary and 3% of secondary causes, central vestibular disorders 17% of primary and 9% of secondary causes, metabolic endocrine 13% of primary and 38% of secondary causes, cervical osteoarthritis 5.5% of primary and 28% of secondary causes and psychogenic 4.6% of primary and 6.5% of secondary causes. CONCLUSION: Our findings demonstrate that vertigo is the most common subtype of dizziness (50%). Multiple causes are more prevalent in older age and the single cause is more prevalent in younger age. Cardiovascular was the most common cause of dizziness followed by vestibular disorders, metabolic and cervical osteoarthritis. Vestibular disorders are primary causes and non vestibular are predominantly secondary causes of dizziness. Hyperlipidemia, diabetes and cervical causes are major secondary contributors to dizziness. We recommend a multi disciplinary setting and application of a comprehensive diagnostic and treatment approach without unnecessary protracted investigative scheme and installment of rehabilitation facilities.

Objective high-frequency tinnitus of middle-ear myoclonus.

Tinnitus produced by middle-ear myoclonus is a rare condition. In this article, a rare case of unilateral continuous high-frequency objective tinnitus caused by middle-ear myoclonus is described. This condition appears to be the second case reported in the literature. Otoscopic examination revealed visible rhythmic movements of the tympanic membrane. Weak clicking sounds were heard around the right ear by auscultation. Direct stimulation of the soft palate showed no evidence of palated myoclonus. Tympanometry confirmed rhythmic changes in the middle-ear compliance. The condition was effectively treated with a muscle relaxant (orphenadrine citrate).

Cauterization of inferior nasal turbinate for idiopathic headache.

OBJECTIVE: Idiopathic headache is a stressful complaint, whose treatment is not well established. Our study is an attempt to examine the relationship between idiopathic headache and inferior turbinate cauterization as a surgical treatment, and to explain the central physiological effect of cauterization. METHODS: Thirty-four patients, 15 females and 19 males complaining of idiopathic headache were treated by inferior turbinate cauterization. Cauterization of the inferior-medial aspect of the turbinate was carried out once under local anesthesia for few seconds. This study was performed between November 1993 and December 1996, a joint project of the Zarka Government Hospital, Zarka and Faculty of Medicine, University of Jordan, Amman, Jordan. RESULTS: More than 82% of the patients showed significant improvement in the sense of decreased headache. CONCLUSION: Cautery of the nasal turbinate could be a novel method for treatment of idiopathic headache.

Cauterization of inferior nasal turbinate for idiopathic headache.

OBJECTIVE: Idiopathic headache is a stressful complaint, whose treatment is not well established. Our study is an attempt to examine the relationship between idiopathic headache and inferior turbinate cauterization as a surgical treatment, and to explain the central physiological effect of cauterization. METHODS: Thirty-four patients, 15 females and 19 males complaining of idiopathic headache were treated by inferior turbinate cauterization. Cauterization of the inferior-medial aspect of the turbinate was carried out once under local anesthesia for few seconds. This study was performed between November 1993 and December 1996, a joint project of the Zarka Government Hospital, Zarka and Faculty of Medicine, University of Jordan, Amman, Jordan. RESULTS: More than 82% of the patients showed significant improvement in the sense of decreased headache. CONCLUSION: Cautery of the nasal turbinate could be a novel method for treatment of idiopathic headache.

Effectiveness of treatment of tonsillopharyngitis: comparative study.

This study was performed to find out the effectiveness of three different treatments of patients having acute tonsillopharyngitis. Three groups of patients were selected (50 patients in each group). Group I received one antibiotic according to the result of culture and sensitivity test, while groups II and III received two antibiotics or one antibiotic respectively without a culture and sensitivity test. Diagnosis was based on the acutely subjective symptoms of sore throat and positive clinical examination findings. The effectiveness of treatment in group I (96 per cent) was statistically significant (p<0.05) and higher than group II (82 per cent) and group III (74 per cent), while the difference between group II and III was not statistically significant (p>0.05). Our findings demonstrate that a culture and sensitivity test of the throat swab is necessary before treating acute tonsillopharyngitis. It was suggested that there should be appropriate selection of antibiotics to preserve normal flora, avoidance antibiotics for viral infections, patient compliance with prescription and educational programmes directed at patients and physicians. All of these measures would assist in reducing the volume of antibiotic use, bacterial resistance and the overall cost of treatment of tonsillopharyngitis.