Persistent cough: prevalence of gastroesophageal reflux and study of relevant laryngeal signs.

Cough is one of the atypical manifestations of gastroesophageal reflux disorder (GERD). The aim of this study was to evaluate the prevalence of GERD among patients presenting with persistent cough. The study included 80 patients over a period of 3 years. The inclusion criteria were nonsmoker adults with normal chest radiograph whose chief complaint was cough for at least 4 weeks duration. All patients included were subjected to nasal endoscopy, laryngoscopy, and 24-hour pH monitoring. Reflux was recorded in the different positions. Laryngeal signs of reflux were traced for and their significance was calculated. Patients who proved to have GERD received antireflux treatment with a follow-up of 3 months. The response to antireflux treatment was assessed according to subjective and objective improvement. Relapse in the follow-up period occurred in 9% of patients. It is concluded that laryngeal signs of GERD should be well known to diagnose and properly manage persistent cough.

Identification of the auditory hazards of extracorporeal shock wave lithotripsy.

The aim of this work was to determine the effect of extracorporeal shock wave lithotripsy (ESWL) on the hearing of both patients and staff members exposed to such treatment. It used different hearing screening instruments, and compared the sensitivity of these instruments for the detection of the earliest change in hearing induced by this procedure. The results of this study show that ESWL has a potentially hazardous effect on hearing. This effect is subtle, could only be detected by transient evoked otoacoustic emissions (TEOAE), and is manifested in some of the subjects under study as temporary subjective hearing loss and tinnitus, reflecting a state of temporary biomechanical derangement of the outer hair cells. This effect seems to be related to the frequency of exposure to ESWL.