Efficacy of sublingual immunotherapy for house dust mite allergic rhinitis.

In the present study, we investigated the outcomes of sublingual immunotherapy (SLIT) in house dust mite-induced allergic rhinitis (HDM-AR) patients. In this prospective, multicentric study, 186 patients with AR who had positive skin prick test results for HDMs were included. The patients were administered SLIT using Staloral 300 for 1 year. Evaluation of the patients regarding symptom scores, clinical findings and Rhinitis Quality of Life Questionnaire (RQLQ) scores was performed at baseline, and then at 6 and 12 months of therapy. Our results showed that, for all of the evaluated items (symptom scores, clinical findings and RQLQ scores), 12-month values were significantly lower than those at 6 months and baseline. Similarly, 6-month values were significantly lower than those at baseline. There were no complications in any of our patients. SLIT for HDM-AR is a treatment modality that can be used safely. We obtained better results than expected, and the treatment showed a positive psychological effect; the patients believed that SLIT was the final step of treatment and, which made them feel better.

Effect of type I tympanoplasty on the quality of life of children.

OBJECTIVES: Quality-of-life issues related to chronic otitis media (COM) include physical symptoms, emotional symptoms, hearing loss, speech symptoms, social symptoms, and parents' emotional symptoms. In this study we evaluated the effects of tympanoplasty on the quality of life of pediatric patients. METHODS: In a questionnaire-based outcome study, we reviewed 56 of 78 pediatric patients with COM who were treated with type I tympanoplasty at our institution between December 2008 and February 2010. All patients were asked to fill out the COM-5 questionnaire with their parents, before operation and 6 months after operation. Preoperative and postoperative total ear scores, preoperative and postoperative ear scores with an intact tympanic membrane, preoperative and postoperative ear scores with a perforated tympanic membrane, and preoperative and postoperative audiological results were assessed. RESULTS: After type I tympanoplasty, 45 patients (80.3%) had successful closure of the tympanic membrane, but 11 patients (19.7%) had unsuccessful closure of the tympanic membrane. There was a significant decrease in physical suffering, hearing loss, emotional distress, activity limitations, and caregiver's concerns scores in patients with intact tympanic membranes after operation (p < 0.01). CONCLUSIONS: Children with COM had a significant increase in their quality of life after successful tympanoplasty. Our results also suggested that tympanoplasty was successful in pediatric patients with COM.

Does adenoid hypertrophy really have effect on tympanometry?

OBJECTIVE: The goal of this study is to determine the correlation between the radiographic measurements of adenoid size and tympanometric findings. STUDY DESIGN: Prospective study. SETTING: Haydarpasa Numune Research and Education Hospital, Istanbul, Turkey. SUBJECTS AND METHODS: Nine five consecutive children complaining of one or more of the symptoms of upper airway obstruction (UAO) (presence of snoring, mouth breathing or difficulty in breathing during sleep, obstructive breathing or apnea during sleep) were included in the study. Symptom severity was assessed by a standardized questionnaire. All patients underwent digital lateral soft tissue radiographs. Assessment of nasopharyngeal obstruction in radiographs was done according to four different methods. Tympanometry was used to evaluate the middle ear. RESULTS: Of 190 ears, 79 were type A, 49 were type B and 62 were type C tympanograms. The symptom severity of 14 patients was graded as mild, 56 patients as moderate and 25 patients as severe. There was no statistically significant difference between UAO symptom severity groups and tympanogram types (p>0,05). Each one of the four methods of radiologic measurements of the adenoid enlargement showed no statistically significant difference between the tympanogram types (p>0,05). CONCLUSION: The adenoid hypertrophy in both means of radiologic measurements and symptom severity does not correlate with the changes in tympanograms. These findings do not support the hypothesis that adenoidal size plays a major role in the etiopathogenesis of middle ear effusion (MEE).

Bilateral aberrant internal carotid arteries: a case report presenting with pulsatile middle ear discharge.

An aberrant internal carotid artery (AICA) is a rare vascular anomaly. Misdiagnosis may lead to massive hemorrhage or other life threatening complications during even a minor surgical procedure of the tympanic membrane or middle ear. Knowledge of this rare entity is essential to any surgeon who undertakes myringotomy and middle ear surgery. Only 14 cases of bilateral AICA were reported in literature. We present a very rare case with bilateral AICA presenting with pulsatile middle ear discharge from his left ear and left sided conductive hearing loss. Tympanic membrane perforation and middle ear discharge were evaluated inaccurately as chronic otitis media on otoscopic appearance. The definitive diagnosis made after CT (computed tomography) and MRA (MR angiography). Otolaryngologists should keep in mind that the diagnosis of AICA may be obscured by chronic otitis media without radiologic examination. In this report, clinical presentation, relevant radiologic findings and management of AICA were discussed with the literature knowledge.