Sensorineural hearing loss in patients with chronic renal failure on hemodialysis in Basrah, Iraq.

OBJECTIVES: The objective of this study is to determine the effect of hemodialysis on the hearing threshold in patients with chronic renal failure (CRF). MATERIALS AND METHODS: Fifty-nine patients with CRF on regular hemodialysis were followed up for 1 year with a pure-tone audiometric examination every 6 months. RESULTS: The mean age of the patients was 41.8 ± 9.2 years (range: 17-50 years). At the beginning of the study, 39 patients (66.1%) had sensorineural hearing loss (SNHL). During the 12-month follow-up, 6 more patients developed SNHL giving a point prevalence rate of 76.3% at the end of the study. The hearing loss was more evident in the higher frequencies. Of the studied patients, 64.4% showed deterioration of the hearing threshold. The mean hearing threshold at the beginning of the study was 29.2 ± 21.1 dB versus 36.9 ± 17.3 dB at the end of the study (P < 0.001). No significant relation was found between age, sex, serum electrolytes, blood urea, and duration of CRF and hearing loss. Multivariate analysis showed that the duration of hemodialysis was the only significant independent predictor of SNHL. CONCLUSION: SNHL is common in patients with CRF on hemodialysis. It was mild to moderate in the majority of patients. Hearing impairment was most obvious at the high frequencies. Most of the patients showed further deterioration in the hearing threshold with the duration of dialysis.

Tonsillectomy for the treatment of halitosis.

BACKGROUND: Halitosis, or oral malodor, is a term used to describe noticeably unpleasant odors exhaled in breathing whether the smell is from an oral source or not. Oral causes have been proposed to be responsible for the majority of halitosis complaints. The study aims to investigate the tonsils as an origin of halitosis and to assess the efficacy of tonsillectomy for the treatment of oral bad breath caused by chronic tonsillitis. METHODS: After excluding dental, periodontal, sinonasal, oral, pulmonary, and gastroenterological diseases as the origin of halitosis, forty-four patients with halitosis caused by chronic tonsillitis which proved by positive Finkelstein's tonsil smelling test (pressing the tonsils and smelling the squeezed discharge), were included in the study. All patients were treated by tonsillectomy. Subjective and objective postoperative assessment was based on self-and-family report and clinical assessment. Patients were reviewed after 4 and 8 weeks postoperatively. RESULTS: Complete improvement of halitosis occurred in 31 patients (70.4%) after 4 weeks, this value increased to 35 patients (79.5%) in the second review after 8 weeks. CONCLUSIONS: Tonsillectomy is significantly effective procedure for the treatment of halitosis caused by chronic tonsillitis.

Hydrogen Peroxide 3%: Is it Beneficial in Tonsillectomy?

OBJECTIVES: The world over, tonsillectomy is one of the operations most frequently performed by otolaryngologists, who are in search of a technique of tonsillectomy where the operation time and operative blood loss is reduced. This study was carried out to evaluate the effect of hydrogen peroxide 3% on tonsillectomy times, blood loss during the surgery and on the number of ties used. METHODS: A pilot study of 30 patients was carried out in the Department of Otolaryngology of Basrah General Hospital, Iraq, in the period from February to July 2006. Tonsillectomy was performed using hydrogen peroxide 3% as a haemostatic agent in Group A (n = 15), while in Group B (n = 15) no agent was used with the gauze pack. RESULTS: The application of hydrogen peroxide 3% in the tonsillar fossae reduced the operation time by 31%, the operative blood loss by 32.9% and also reduced the number of ties used by 50% in Group A. All these results are statistically significant. CONCLUSION: The local application of 3% hydrogen peroxide on the tonsillar bed after tonsillectomy is beneficial in regard to decreasing the procedure time, the volume of blood loss, and the number of ties used.