Interaction between childhood vocal fold nodules and allergic diseases.

OBJECTIVES: Vocal fold nodules (VFNs) are benign lesions at the junction of the anterior and middle third of the vocal folds. Although VFNs are often a result of vocal cord trauma due to vocal abuse, childhood allergic diseases, and medications may be a cause. We aimed to investigate the association of detected VFNs with allergic diseases in childhood patients with vocal abuse. METHODS: This is a prospective, cross-sectional, case-control study. Caucasian children in ages 3-12, who speak loud, vocal abuse confirmed with Turkish Children's voice handicap index-10 (TR-CVHI-10) above 9 were enrolled to the study. 33 children with VFN were included as the study group and age-matched 26 healthy children without VFN were included as the control group. Children questioned and tested for allergic diseases with Allergometric tests. RESULTS: Asthma was detected in 42.4% of the study group and absent in the control group. The history of inhaler or nasal steroid use was positive in 30.3% of the study group and 7.7% of the control group (p = 0.032). Dysphonia and the presence of allergic diseases were determined as independent risk factors for the study group (p = 0.001; 0.021, respectively). The median values of blood lymphocyte counts were significantly different among study and control groups (2900 µl vs 2335 µl, respectively; p = 0.04). CONCLUSION: Investigating allergic diseases, especially asthma, for success in the treatment of pediatric patients with VFNs is of utmost importance.

Ocular Disorders in Turkish Children with Sensorineural Hearing Loss: A Cross-Sectional Study and Literature Review.

PURPOSE: To investigate types and frequencies of ocular disorders in children with sensorineural hearing loss (SNHL), and to emphasize the importance of ophthalmological examination in these children. METHODS: A retrospective analysis of the examination records of children examined in our instutititon between January 2011 and September 2014 was performed. Ocular disorders of children with SHNL were selectively reviewed. RESULTS: Among 55340 patients, SNHL was present in 110 (0.2%). SNHL was bilateral in 104 patients (94.5%) and unilateral in 6 (5.5%). Ninety-one cases had congenital hearing loss (83%), and 19 (17%) had acquired SNHL. Forty cases (36%) had an ocular disorder, either refractive or non-refractive or both. Seventy cases (64%) had normal ocular examination. No difference was found between congenital or acquired SNHL cases in terms of possessing an ocular disorder (p=0.0962). The most common ocular abnormality was refractive error, mainly hypermetropia (21%). There was no significant difference between the prevalences of ocular abnormalities among cases with different lateralites or severities of SNHL (p=0.051, p=0.874, respectively). Twenty-six cases (23.6%) had SNHL as a component of a genetically defined syndrome. All of them had coexisting refractive or non-refractive ocular abnormalities. Some genetic, non-syndromic abnormalities, including Achondroplasia, Celiac disease, and focal segmental glomerulosclerosis, were diagnosed in four cases, among whom refractive errors and/or strabismus were detected. CONCLUSIONS: Due to the common coexistence of ocular problems and SNHL in children, ophthalmological screening is crucial. Families and healthcare providers should be informed about the critical role of ophthalmic assesment in these children for their future quality of life.

A case of Langerhans cell histiocytosis mimicking child abuse.

Langerhans cell histiocytosis is a rare non-malignant disease with clinical heterogeneity. The disease may present with various clinical findings and may imitate many other conditions. In this report we describe a 34-month-old girl who presented with chronic otitis and otorrhea, skull fracture, rash, vulvar edema, erythema and erosion in labia majors which initially suggested child abuse but the patient was diagnosed with Langerhans cell histiocytosis.

Are there any novel radiological diagnostic clues in magnetic resonance imaging for vertebrobasilar insufficiency?

BACKGROUND: The aim of the current study was to investigate whether signal intensities on magnetic resonance imaging (MRI) views and radiological findings on Doppler ultrasonography may have a diagnostic value for vertebrobasilar insufficiency (VBI). METHODS: This case-control study was performed on demographic and radiologic data derived from 18 VBI patients and 58 healthy controls in the radiology department of a tertiary care center. The blood flow characteristics including peak systolic and end diastolic flow rates, resistance and pulsatility indices, mean velocities, flow rates, diameters and intensity pattern of vertebral arteries on cervical and cranial MRI sequences were noted. The association between blood flow characteristics and signal patterns on MRI views was investigated in VBI patients and controls. RESULTS: Blood flow and vessel diameter were significantly decreased in VBI patients compared to controls on both sides (P<0.001). In contrast, other parameters did not exhibit any remarkable difference between VBI and control groups. The distribution of hypo- or hyperintense signals in VBI and control groups was similar. No remarkable variabilities were detected in blood flow characteristics of cases presenting with signals having different intensities on MRI sequences. CONCLUSIONS: In conclusion, results of the current study have demonstrated that assessment of blood flow and vascular diameter may be important for ruling in VBI. Nevertheless, the intensity of signals derived from vessels seems not reveal any data of diagnostic significance in these cases. Further studies on larger populations may allow development and exploration of newer diagnostic techniques and clues for VBI.