ABSTRACT
In recent years, huge advances have taken place in understanding of inner ear pathophysiology causing sensorineural hearing loss, tinnitus, and vertigo. Advances in understanding comprise biochemical and physiological research of stimulus perception and conduction, inner ear homeostasis, and hereditary diseases with underlying genetics. This review describes and tabulates the various causes of inner ear disease and defines inner ear and non-inner ear causes of hearing loss, tinnitus, and vertigo. The aim of this review was to comprehensively breakdown this field of otorhinolaryngology for specialists and non-specialists and to discuss current therapeutic options in distinct diseases and promising research for future therapies, especially pharmaceutic, genetic, or stem cell therapy.
Subject(s)
Genetic Therapy/methods , Labyrinth Diseases/drug therapy , Labyrinth Diseases/physiopathology , Labyrinth Diseases/therapy , Otolaryngology/trends , Stem Cell Transplantation/methods , Genetic Therapy/trends , Humans , Labyrinth Diseases/genetics , Models, Biological , Otolaryngology/methods , Stem Cell Transplantation/trendsABSTRACT
OBJECTIVES/HYPOTHESIS: To document the outcome and impact on general and symptom-specific quality of life (QOL) after various types of parotid resection. STUDY DESIGN: General and symptom-specific QOL assessment at least 1 year after performed surgery. Retrospective data and outcome analysis of patients. METHODS: Between 2004 and 2010, 353 parotid resections in 337 patients were conducted at the Department of Otorhinolaryngology, University Teaching Hospital, St. Mary's Hospital Gelsenkirchen, Gelsenkirchen, Germany. A total of 196 patients fit the inclusion criteria and were available for postoperative evaluation. The general QOL assessment was based on both the global health status and global QOL scales of the European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire in 34 patients. Symptom-specific QOL was assessed with the Parotidectomy Outcome Inventory-8 (POI-8). In addition, aesthetic outcome was evaluated with an ordinal scale. RESULTS: Outcome of parotidectomies in benign disease has little impact on general QOL and global health status. However, hypoesthesia or dysesthesia, Frey's syndrome, and cosmetic discontent are quite common and may affect symptom-specific and general QOL. Correlation with extent of surgery and statistically significant differences of patient evaluation for aesthetic outcome, sensory impairment, and Frey's syndrome between various types of limited parotid surgery (enucleation, extracapsular dissection, partial superficial parotidectomy) and superficial parotidectomy could be shown. CONCLUSIONS: An adequate parotid resection technique must be chosen to achieve the least disturbing outcome. In addition, in our patient collective, there was no increased recurrence rate found after limited parotid resection for pleomorphic adenoma or cystadenolymphoma.
Subject(s)
Parotid Diseases/surgery , Parotid Gland/surgery , Postoperative Complications/physiopathology , Quality of Life , Surgical Flaps/blood supply , Adult , Aged , Cohort Studies , Esthetics , Facial Paralysis/etiology , Facial Paralysis/physiopathology , Female , Follow-Up Studies , Humans , Incidence , Male , Middle Aged , Pain, Postoperative/physiopathology , Parotid Diseases/pathology , Parotid Neoplasms/pathology , Parotid Neoplasms/surgery , Postoperative Complications/epidemiology , Reoperation , Retrospective Studies , Risk Assessment , Sickness Impact Profile , Statistics, Nonparametric , Sweating, Gustatory/etiology , Sweating, Gustatory/physiopathology , Treatment OutcomeABSTRACT
Phytotherapeutic pharmaceuticals and herbal medicinal products with its roots in classical phytotherapeutic medicine have a well-established role in otolaryngological therapy, especially for diseases of the upper airways and acute and chronic infections. A thorough selection and application could mean huge benefit for the patient, in particular in cases with contraindications, chemo- and antibiotic resistance or patient request. Besides, it might spare other medications. Phytotherapeutic pharmaceuticals must fulfil the same criteria of quality, effectiveness and harmlessness of evidence-based medicine like chemical pharmaceuticals, although they are often prescribed due to its well established or traditional based use. This review focuses on phytotherapeutic therapies well established within the European Community for otolaryngologic disease patterns by referring to clinical studies or meta-analysis.
Subject(s)
Naturopathy/methods , Otorhinolaryngologic Diseases/drug therapy , Phytotherapy/methods , Administration, Oral , Chronic Disease , Combined Modality Therapy , Dose-Response Relationship, Drug , Evidence-Based Medicine , Gastroesophageal Reflux/drug therapy , Herpes Simplex/drug therapy , Humans , Laryngitis/drug therapy , Naturopathy/adverse effects , Otitis Media/drug therapy , Otorhinolaryngologic Diseases/diagnosis , Pharyngitis/drug therapy , Phytotherapy/adverse effects , Rhinitis/drug therapy , Sinusitis/drug therapy , Stomatitis/drug therapy , Virus Diseases/drug therapyABSTRACT
The efferent system of the ear possesses several distinct functions, in particular noise protection, mediation of selective attention and improvement of signal to noise ratio. It also supports adaptation and frequency selectivity by modification of the micromechanical properties of outer hair cells. There are many differences in anatomy and physiology between the medial and lateral olivocochlear system suggesting that they are functionally separate systems. The efferent system is affected by inner ear stressors, e.g. noise, ototoxic drugs, and might play a key role in tinnitus generation and maintenance. The anatomy, physiology and its realtionships to inner ear pathologies are discussed in this review article.
