ABSTRACT
Stridor is a symptom with a number of causes, usually identified through careful history taking and examination. When the cause is unclear, as in our case, consider investigations such as blood tests, biopsy, and imaging. We discuss a rare diagnosis of plasma cell mucositis, treated with some success by steroids.
ABSTRACT
AIM: The objective of this study is to review the prevalence and degree of hearing loss in children with trisomy 21, their response to intervention and the presence of concomitant pathologies. The project will also highlight the experiences of the children from their parents' and guardians' perspective and the link between perceived service quality and an objective improvement in their hearing after rehabilitation. METHODS: All patients with trisomy 21 who were referred to district general otolaryngology outpatient clinics between 2014 and 2016 were included. A retrospective analysis of the medical notes and audiograms along with a qualitative questionnaire to the children's parents was utilised to gather the information. RESULTS: The study showed that 77% (17/22) of children suffered from hearing loss, with a moderate degree being most prevalent. The majority of patients (14/17, 82%) were managed conservatively, undergoing a period of watchful waiting (9/17, 53%) or receiving hearing aids (5/17, 30%) and 3 of 17 (17%) were managed with grommet insertion. The improvement in hearing with hearing aids was comparable with grommet insertion and hearing aids scored highest in the post-intervention qualitative assessment with grommet insertion scoring the lowest. CONCLUSIONS: Functional hearing has been shown to be key in developing speech and language skills. In children with trisomy 21, behavioural and anatomical abnormalities make the diagnosis and intervention technically more challenging. This study demonstrates that in the absence of other otological symptoms, hearing loss can be managed effectively and with the least distress to the children with hearing aids.
Subject(s)
Hearing Loss, Conductive/diagnosis , Hearing Loss, Conductive/therapy , Trisomy , Female , Humans , Infant , Ireland , Male , Medical Audit , Outcome Assessment, Health Care , Retrospective StudiesABSTRACT
BACKGROUND: Reconstruction of the stapes superstructure continues to be a problem for otologists. Optimal fixation of implants on the stapes footplate has not yet been achieved. METHODS: We postulated that bony fixation, between implant and stapes, could be confined exclusively to the footplate region by modifying the bioactivity of the implant material. Therefore, after removal of the superstructure in guinea pigs a combined biovitro ceramic implant (Bioverit I and Bioverit II) was placed on the stapes footplate in 10 guinea pigs. As a control, we employed a group of 6 animals in which the stapes superstructure was removed without placing any implant. RESULTS: After 25 weeks the implants were found to be dislocated laterally. We observed fixation with the wall of the middle ear. In the control group we also found new bone formation and even a bow shaped regeneration of the stapes superstructure. CONCLUSION: Combined Bioverit stapedial implants were found to routinely fix to the middle ear wall of the guinea pig. The guinea pigs' enormous potential for bone regeneration in the middle ear ossicular chain make this species unsuitable for exploring hypotheses on human middle ear reconstruction.
