Correlation between Balance Ability and Speech-Language Development in Children.

The longitudinal study was conducted in order to establish whether the success rate of reflexes related to maintaining balance at birth is in correlation with the success rate of maintaining balance in early childhood, as well as to examine the correlation of a certain level of speech and language development with the ability of maintaining balance at birth and at the age of 5. The main study group included 54 children of both genders, aged 5.0 to 5.4, whose balance ability and speech and language status were evaluated based on the battery of standardized tests, whereas the group of reflexes related to the function of the vestibular sense was clinically tested on the 3rd day upon birth, within the same sample of children. The data at birth and at the age of 5 were recorded by means of a digital camera, then scored and statistically and descriptively processed. The research results indicated a statistically significant correlation between the achieved level of balance ability in the newborns and five-year-olds, as well as between balance skills and a certain level of speech and language development in children at the age of 5. The importance of this research lies in new knowledge in the domain of maturation of vestubular function immediately after birth, given that this segment of physiology of a newborn has not so far been processed in such a way, as well as in the recognition of function of the vestibular sense as another parametre of a child's maturation.

Rhinoplasty: the nasal bones - anatomy and analysis.

BACKGROUND: The analysis of nasal anatomy, and especially the nasal bones including the osseocartilaginous vault, is significant for functional and aesthetic reasons. OBJECTIVES: The objective was to understand the anatomy of the nasal bones by establishing new descriptions, terms, and definitions because the existing parameters were insufficient. Adequate terminology was employed to harmonize the anthropometric and clinical measurements. METHODS: A two-part harvest technique consisting of resecting the specimen and then creating a replica of the skull was performed on 44 cadavers to obtain specific measurements. RESULTS: The nasal bones have an irregular, variable shape, and three distinct angles can be found along the dorsal profile line beginning with the nasion angle (NA), the dorsal profile angulation (DPA) and the kyphion angulation (KA). In 12% of cases, the caudal portion of the nasal bones was straight and without angulation resulting in a "V-shape" configuration. In 88% of cases, the caudal portion of the bone was angulated, which resulted in an "S-shape" nasal bone configuration. The intervening cephalic bone, nasion to sellion (N-S), represents the radix while the caudal bone, sellion to r (S-R), represents the bony dorsum. CONCLUSIONS: By standardizing and measuring existing nasal landmarks and understanding the different anatomic configurations of the nasal bones, rhinoplasty surgeons can better plan their operations within the radix and bony and osseocartilaginous vaults.

[Intratympanic corticosteroid perfusion in the therapy of Meniere's disease].

INTRODUCTION: Over the last two decades the intratympanic perfusion of corticosteroids has been used as a minimally invasive surgical therapy of Meniere's disease. According to experimental studies the antiinflammatory, immunoprotective, antioxidant and neuroprotective role of the locally perfused corticosteroids was noticed in the inner ear structures. The recovery of action potentials in the cells of the Corti organ was confirmed as well as a decreased expression of aquaporine-1, a glycoprotein responsible for labyrinth hydrops and N and K ions derangement. OBJECTIVE: The study showed results of intratympanic perfusion therapy with dexamethasone in patients with retractable Meniere's disease who are resistant to conservative treatment. METHODS: Single doses of 4 mg/ml dexamethasone were given intratympanically in 19 patients with retractable Meniere's disease. Six single successive doses of dexamethasone were administered in the posteroinferior quadrant of the tympanic membrane. Follow-up of the patients was conducted by using a clinical questionnaire a month after completed perfusion series as well as on every third month up to one year. RESULTS: One month after completed first course of perfusions, in 78% of patients, vertigo problems completely ceased or were markedly reduced. The recovery of hearing function was recorded in 68% and marked tinnitus reduction in 84% of patients. After a year of follow-up, in 63% of patients the reduction of vertigo persisted, while hearing function was satisfactory in 52%. Tinitus reduction was present in 73% of patients. CONCLUSION: Intratympanic perfusion of dexamethasone in patients with Meniere's disease is a minimally invasive therapeutic method that contributes to the reduction of the intensity of vertigo recurrent attacks, decrease of the intensity of tinnitus and improvement of the average hearing threshold. Patients with chronic diseases and Meniere's disease who are contraindicted for systemic administration of cortocosteroids (hypertension, diabetes, glaucoma, peptic ulcer, etc.) have an additional therapeutic option by dexamethasone intratympanic perfusion.

Acoustic voice analysis of patients with vocal fold polyp.

OBJECTIVES: The aim of the investigation was to obtain acoustic correlates of the vocal quality of patients with vocal polyps, before and after the endolaryngeal phonomicrosurgery (EPM). METHODS: Acoustic voice tests were carried out on 46 female patients with vocal fold polyp, before the EPM intervention and 3 weeks after its completion. Acoustic voice parameters were compared with the control group without voice pathology. The results of the investigation were analyzed acoustically. RESULTS: The results showed that jitter (%), shimmer (%), fundamental frequency variation (vF(0)), voice turbulence index (VTI), pitch perturbation quotient (PPQ), amplitude perturbation quotient (APQ), and NHR values significantly differentiate the patients with vocal fold polyps from a control group without any pathological changes in the larynx. All of the analyzed parameters improved significantly (P<0.05) after the phonomicrosurgical intervention and tended to reach normal values. CONCLUSIONS: The acoustic voice analysis may be used for presurgical and postsurgical voice-status evaluation.

[Multidimensional acoustic analysis of pathological voice].

INTRODUCTION: There are subjective and objective ways to examine the effects of vocal therapy in voice disorders. The most precise and objective check-up is the use of computer voice analysis. OBJECTIVE: The aim of the research was to perform a detailed analysis of acoustic structure of the vowel A before and after voice treatment in patients with vocal fold nodules in order to obtain objective verification of the vocal rehabilitation success. METHODS: We examined 30 female patients, aged 34.6 +/- 6.69 years, with vocal fold nodules. Acoustic parameters of voice were compared with the control group consisting of 21 subjects without voice pathology. In all persons the vowel A was recorded and analyzed before and after a month of vocal therapy. The success of the vocal therapy was tracked using computer analysis of vocal structure. Signal, noise and tremor parameters were processed. RESULTS: Of the analyzed vowel A parameters: STD, PER, JITA, JITT, RAP, vFO, ShdB, SHIM, APQ, VTI, SPI, FO, NHR, FTRI, eleven improved (p < 0.05 and p < 0.01). Three parameters (FO, NHR, FTRI) changed showing improvement, but the obtained differences were not statistically significant (p > 0.05). CONCLUSION: Based on the obtained results it was concluded that vocal therapy gave satisfactory results, but that it should be continually applied until full stabilization of the voice.

[Meningitis as cochlear implant complication].

Over the last several decades, cochlear implantation has been fully proven as the treatment for profound hearing losses. The direct electrical stimulation of the spiral ganglion hair cells through the electrode inserted in the cochlear scala tympani is the essence of the cochlear implant (CI) functioning. Modern technological development has introduced unexpected technical quality possibilities of the device itself, as well as coding strategies, which further enable improved patients' rehabilitation results. Nevertheless, in spite of cochlear implantation becoming a routine surgical procedure, which has been changing lives of thousands of profoundly deaf adults and children, it has possible complications. Though rare, these complications could lead to severe, even fatal consequences. Bacterial meningitis represents one of the most severe postoperative complications. In this article, our five-year experience with cochlear implantation is shown, compared to other, much bigger, experiences. Despite severity and a potentially fatal outcome of meningitis, it has rarely been seen, and the precise connection between surgical procedure and this complication is not yet clear. Do cochlear implants increase the risk of bacterial meningitis? Are deafness-associated factors predisposing the bacterial meningitis occurrence, independently from the implant? These are the questions that the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the CI surgeons have been facing, as well as manufacturers and patients with their families.

[Complications of cochlear implant surgery]. / Komplikacije hirurgije kohlearne implantacije.

During the last several decades, cochlear implant has been fully recognized in treatment of severe hearing loss. Development of modern technology enabled inconceivable possibilities of technical qualities of the device as well as development of usable coding strategies, which led to extraordinary results in patient rehabilitation. Although cochlear implantation has become one of the routine operative procedures throughout the world nowadays, it gives rise to certain complications. These complications, though rare, can sometimes be very serious, even with fatal outcome. If cochlear implantation is performed by experienced and well-educated team of experts, the possibility of complications is minimal and is certainly not the argument against cochlear implantation as a method of treatment of severe hearing impairments.

[Cochlear implant application with postlingually deaf patients]. / Primena kohlearnog implanta kod bolesnika sa postlingvalnom gluvocom.

Through last several decades, cochlear implant has been fully recognized for treatment of profound hearing loss. Modern technology development enabled unimagined possibilities in technical qualities of the device, as well as development of usable coding strategies, which led to extraordinary results of patient rehabilitation. It is well known that postlingually deaf implanted patients show better results than prelingually deaf implanted patients. This is to be understood, concerning the fact of matured hearing paths and centers of CNS, presence of developed speech in patients postlingually deaf, contrary to prelingually deaf patients in whom the development of hearing paths and centers is yet to be established only after cochlear implantation. Accordingly, this is a case report of male adult patient B.D. who was implanted because of complete deafness following the application of gentamicin. The results of implantation were excellent and fully justified the choice of the patient for CI application.

[Role of immune factors in the pathogenesis of secretory otitis media]. / Uloga imunskih faktora u patogenezi sekrecionog otitisa medija.

Authors have been analysed the main role of immunological factors in complex pathogenesis of secretory otitis media. Data from recent literature and data from studies that were conducted in ENT city hospital in Belgrade were reviewed. The mucosa of the middle esr belong to the nasopharyngeal associated lymphoid tissue (NALT). The factors of the specific and non specific mucosal defence in middle ear mucosa can influence the mechanism of the chronic inflammation in secretory otitis media. The role of macrophages, mast cells, lymphoplasmocytes and adhesion molecules was emphasized. Concerning that results it is possible to create clinical studies in order improve the diagnostic procedures ant therapy of secretory otitis media.