Mucolytic effects of domiodol in tracheostomized patients after total laryngectomy. Double-blind, placebo-controlled, randomized pilot study with four-month follow-up.

The results obtained in a controlled clinical trial aimed at evaluating the efficacy and tolerability of a mucolytic treatment in laryngectomized patients are described. Domiodol (Mucolitico Maggioni, CAS 61869-07-6), an organic iodinated mucolytic agent, was given at the dosage of 60 mg t.i.d. to 20 patients in the post-operative period after laryngectomy (average 2 weeks in hospital and 4 months follow-up at home). A matched series of patients received a placebo during the hospital period and no treatment after discharge. The patients receiving the active treatment showed a statistically and clinically significant improvement of respiratory parameters (cough intensity, sputum quantity, sputum quality, expectoration difficulty). Such improvement was earlier and greater than that observed in the placebo-treated patients. It is concluded that a mucolytic treatment may be helpful in the post-operative treatment of laryngectomized patients with permanent tracheostomy.

Electric response audiometry in infants and preschool children. Long-term control of the results.

Two hundred and four infants and preschool children (mean age 2 years and 7 months +/- 9 months) with auditory impairment according to ABR and ECochG data, and 33 subjected to SVR were followed up for periods ranging from 1 year to 4 years and 6 months until a reliable conventional pure tone audiogram was obtained. One hundred and fifty-one children had conductive hearing loss, 75 sensorineural, 7 had ABR indicating disorders of the central auditory pathways, 5 were normal. Hit, false positive and false negative rates resulted as follows: 58.62%, 17.24% and 24.14% for SVR: 98.37%, 1.63% and 0% for ABR; 99.15%, 0.85% and 0% for ECochG. In the group with sensorineural hearing loss, 75% of the children gave ECochG detectable responses at 90 dB nHL, against 51.5% with ABR. With 1 kHz tonebursts, 64% of the tested subjects gave threshold responses to ECochG and 12% to ABR. The best strategy for children who failed the behavioral hearing tests, or in whom these tests were not applicable, was that based on ABR and middle ear impedance measures, complemented, when necessary, by ECochG.

Audiological findings in elderly patients with chronic renal failure.

The audiological results of 46 patients (m/f 27/19, mean age; 57.4 +/- 11.1) with chronic renal failure (CRF) undergoing dialysis were compared with those of an age- and gender-matched control group (n = 25). Mean pure tone average from 0.5 to 8 kHz was about 15 dB higher in CRF patients than in control subjects. The ABR parameters of the test group were then contrasted with those recorded in a second control group (n = 47, m/f 26/21, mean age: 56.1 +/- 11.4) matched by age, gender and degree of hearing loss (HL). After assessing the normality of the groups by the usual criteria, using the data of a sample of normal young adults, the ABR were found to be abnormal in 23.9% of the controls and in the 39.13% of the CRF patients. Wave V, I-III, III-V and I-V delays were significantly shorter in the females of the control group; in the CRF group, only the V and the I-V delays were shorter in females. The only age-dependent effect was found in the CRF sample, in which older patients had significantly longer I-III IPLD. The degree of HL influenced the latency of the waves in both groups but only the I-V IPLD was longer in CRF patients with pronounced high tone loss. The most distinguishing feature between the effects of CRF plus ageing and those of normal ageing was the lengthening of the I-III IPLD in the test group. This finding is likely to reflect a subclinical disorder of the VIII nerve function that is a part of the axonal uremic neuropathy.