Audiometric and epidemiological analysis of elderly in the Veneto region.

BACKGROUND: Presbyacusis, or age-related hearing loss, has become a problem of increasing social interest due to the rise in the mean age of the population. Investigations performed to date have generally been carried out with the aid of self-reporting questionnaires, without the support of objective findings. OBJECTIVE: The purpose of this study was to analyze an extensive series of elderly people from different areas of the Veneto region to obtain an epidemiological descriptive analysis, as detailed as possible, of their presbyacusis, considering their hearing thresholds at various frequencies, distinguishing findings according to sex and age in classes and the geographical area where the survey was performed. METHODS: The survey was carried out collecting information from the audiometric reports on 13,710 subjects of both sexes aged 60 years and over, with a proportion of males (M/F x 100) of 92.02%, referred spontaneously for hearing examination to the ENT departments of eight hospitals between 1986 and 1994. The catchment area includes three provincial capitals and five mainly rural municipalities. RESULTS: The results show that the hearing threshold rises progressively with age in both sexes. The hearing loss is milder in women than in men, especially at the higher frequencies. No important differences emerged among findings recorded in their 80s and in their 90s or among findings in the different geographical areas considered. CONCLUSIONS: Statistical descriptive analysis confirms the typical trend of the audiometric curve in presbyacusis, tracing the typical audiometric curve of old age described in the literature. The mean values of the audiometric curve reveal no significant differences between people residing in the country and people living in the cities.

[Otology in diseases of internal medicine interest]. / L'otologia nelle malattie di interesse internistico.

Many clinical manifestations present signs of cochleovestibular impairment. In some cases, otological symptoms are a complication of a disease, while in other cases they are the only early signs and can last for a long period preceding the full development of the primary disease. The otological pathology in the former case is useful for investigating the internal pathology and sometimes for delivering correct diagnosis. On the contrary, in the latter case, it does not offer elements for any etiopathogenic hypothesis because it happens in almost all cases with an acute onset in an otherwise healthy subject and it is always underestimated because of the minor functional impairment. However, clinical studies in the last years led to a significant evolution of otological findings as an early important symptom in the etiopathogenic study and in the diagnosis of some internal diseases. This is true for connectivitis, in which the disease is often preceded by a sudden cochleovestibular symptom, in some dismetabolic or vascular diseases that sometimes begin with fluctuating hearing loss, or in some cochlear manifestations due to ototoxic origin.

Epidemiological considerations in sudden hearing loss: a study of 183 cases.

We have studied certain epidemiological problems not often encountered in the literature, involving patients with sudden hearing loss. We performed a retrospective cross-sectional study on 183 patients at the University of Padova and found that: age at the onset of the hearing loss incurred is closely associated with the presence of concomitant diseases; partial or total recovery of hearing is strongly predicated by the variables of age at onset and the interval between onset of hearing loss and the beginning of treatment given. We have also used polar-coordinate diagrams to show that cases of sudden hearing loss tend to be cyclic and are more prevalent in the central months of each season.

A rarely observed case of primary multiple carcinomas of the head and neck.

We report a 71-year-old male patient with five separate primary metachronous squamous cell carcinomas of the head and neck (parotid, tongue, soft palate, larynx and hypopharynx) that occurred over a period of 8 years. The long survival of the patient after discovery of his first neoplasm (parotid) is the result of careful vigilance during the follow-up period and diligently planned therapies for each of his multiple primary tumors after radical surgery had been performed on his first neoplasm.

The physiopathological, clinical and therapeutic aspects of vertigo in peripheral vestibular lesions.

The characteristics of vertigo in the pathology of vestibular peripheral lesions are differentiated and described. Symptomatological and clinical aspects are also discussed in the light of the physiopathological mechanisms of vestibular compensation. The therapeutic problem of vertigo is treated on the basis of experimental research on the inhibitory effect of some drugs on the vestibulo-ocular reflex.

Motion sickness and space sickness: clinical and experimental findings.

Vertigo in motion sickness forms a clear clinical picture. We can confirm that complex symptoms are due to abnormal stimulations of labyrinth receptors subsequent to simultaneous multi-plane angular accelerations. This labyrinth stimulation originates from Coriolis' complementary accelerations. The seriousness of kinetosis symptoms can vary according to different causes; level of labyrinth stimulation, subject's constitution, psychological and physical conditions and whether or not the subject is accustomed to kinetic stimulations. Space sickness shows similar symptoms and similar psychological mechanisms. Recent space experiences have shown that disturbances due to acceleration sickness vary according to labyrinth receptor adaptability to kinetic stimulations in space. In a clinical and experimental study, we investigated the importance of the spacial plane, in which the head movement occurs, in causing the greatest reactions due to Coriolis' complementary accelerations in man. A close relationship between nystagmic responses and the level of endolymphatic shifting in each canal was observed and studied with the help of mathematical models.