[Functional hearing examinations in patients suffering from diabetes mellitus type 1 in regard to disease duration].

INTRODUCTION: Problems of hearing disturbances in persons suffering from diabetes have been attracting great attention for many decades. MATERIAL AND METHODS: In this study we examined the auditory function of 50 patients suffering from diabetes mellitus type 1 of different duration by analyzing results of pure-tone audiometry and brainstem auditory evoked potentials. The obtained results of measuring were compared to 30 healthy subjects from the corresponding age and gender group. The group of diabetic patients was divided according to the disease duration (I group 0-5 years; II group 6-10 years, III group over 10 years). RESULTS AND DISCUSSION: A statistically significant increase of sensorineural hearing loss was found in the diabetics according to the duration of their disease (I group = 14.09%, II group = 21.39%, III group = 104.89%). The results of the brain stem auditory evoked potentials, the significance threshold being p = 0.05 between the controls and the diabetics at all levels of absolute latency of right and left sides, did not show significant differences in the mean values. In the case of interwave latencies, the diabetic patients were found to have a significant qualitative difference of intervals I-III and I-V on both ears in the sense of internal distribution of response. In cases of sensorineural hearing loss we found a significant connection with prolonged latencies of I wave on the right ear and of I and V waves on the left ear. In all probability, the cause of these results could be found in distinctive individuality of the organism reactions to the consequences of this disease (disturbance in the distal part of N. cochlearis). CONCLUSION: The results of research have shown the existence of a significant sensorineural hearing loss in the patients with diabetes mellitus type 1 in accordance to the disease duration. We also found qualitative changes of brainstem auditory evoked potentials in the diabetic patients in comparison to the controls as well as significant quantitative changes in regard to the presence of sensorineural hearing loss of the patients.

[Esophageal foreign bodies: retrospective study in 203 cases].

INTRODUCTION: A retrospective study of Rigid Esophagoscopy, with the suspect of foreign body, was performed in General Hospital Zrenjanin "Djordje Joanovic" at the Department of Otorhinolaryngology during the period of 1988-2007. RESULTS AND DISCUSSION: The result of 517 esophagoscopies performed in the above period was 203 (39.26%) foreign bodies, with the average of 7.8 annually per 100.000 inhabitants. The patients age ranged from I to 91 years, (X = 48.98). Considering the gender, there were 95 male patients (46.79%), and 108 female patients (53.21%). The highest number of foreign bodies was found in the patients from the age group 60-69, (43/22.15%). According to the structure type of foreign bodies the most frequent were bones of animal origin (86/42.36%), followed by meat bolus (67/33%), metal coins (23/11.33%), and bodies of vegetable origin (14/6.89%). Metal coins were most frequently found in the age group 1-9. In regard to the level at which a foreign body was found (described in 157 cases, (77.30%)), 94 (59.87%) were found at the pharyngoesophageal junction, 58 (36.94%) were found in middle constriction of oesophagus, and in the area of diaphragmatic constriction and cardia there were 5 (3.18%) cases. The efficiency of removing foreign bodies by rigid esophagoscopy in the above mentioned sample was 99.01% (201/203). In 2 cases (0.99%), due to the impaction of foreign body, the patients were referred to the higher referent tertiary unit institution. CONCLUSION: Foreign bodies represent a constant casuistics in Zrenjanin Municipality, dominantly connected to work of an otorhinolaryngologist on duty. Rigid esophagoscopy is safe and efficient diagnostic and therapeutic method.

[Correlation of hearing function findings in regard to other, subsequent complication of diabetes mellitus type 1].

INTRODUCTION: Hearing loss is considered to be a subsequent complication of diabetes. MATERIAL AND METHODS: Auditory function was analyzed in 50 patients suffering from diabetes mellitus type I, and through results of pure-tone audiometry and brainstem auditory evoked potentials in regard to the existence of subsequent complications of the disease, diabetic neuropathy (n=20) and retinopathy (n=13). RESULTS AND DISCUSSION: The results were correlated with the ones in those having a disease, but without these complications and the control group of 30 healthy examinees of the adequate gender and age. Patients suffering from this disease for over 10 years (83.33%), were found to have high frequency of diabetic neuropathy, increased average sensorineural hearing loss (73.04%). The average age was significantly higher (35.5 +/- (3SD = 5.3) in accordance with 23.2 +/- (3 SD = 6.3), and the disease lasted much longer (17.5 years towards 5.7 years) in those suffering from neuropathy. In the presence of diabetic retinopathy it was found that the average sensorineural hearing loss was increased for 50.43%, in comparison to those without signs of retinopathy. The average sensorineural hearing loss was found to be higher for 62.58% to 76.81% in patients with retinopathy preproliferance and retinopathy profilerance than in those with established retinopathy nonprolferance. In the presence of diabetic retinopatlhy, a significant difference was observed in latencies of ll and IV waves from the right, and latencies of I, IV and V waves from the left ear, this is, interwaves latencies of I-III on the right ear and III-V and I-V on the left ear. CONCLUSION: Subsequent complications of diabetes mellitus type I (neuropathy and retinopathy) have positive correlation with the significant level of sensorineural hearing loss, particulary expressed in function of patients' age, and latencies extention of brainstem auditory evoked potentials.

Correlation of hearing function findings in patients suffering from diabetes mellitus type 1 in regard to age and gender.

Ageing of an individual affects hearing impairment and associated diseases can have a cumulative affect. In 50 examined subjects suffering from Diabetes Mellitus type 1, who were divided into groups according to age, gender and disease duration, auditory function was tested by analyzing results of pure-tone audiometry and brainstem auditory evoked potentials. The obtained results were correlated with the results of 30 healthy controls adequately represented by age and gender. Starting from the age group 30-39 we noticed a significant reduction in the percentage of regular findings in comparison with the control group, as well as an increase in the percentage of sensorineural hearing impairment and mean values of hearing impairment (-dB). In regard to gender, we found a continuing and significant increase in sensorineural hearing impairment in the examined male subjects from the group with the disease. The analysis and correlation of brainstem auditory evoked potentials regarding the age of the examinees did not show any significant impact on the increase in the mean values of the diseased and the controls, whereas regarding the gender, we noticed a significant impact on the increase in the mean values of absolute latencies II (Fd/l = 5.1249/9.8144), III (Fd/l = 14.0413/9.3169), IV (Fd/l =7.1413/6.3410) and V (Fd/l = 12.8753/6.1208) waves as well as of interwave latencies I-III (Fd/l = 5.2193/4.9628) mutually in the male examinees. In the diseased group there were significant differences of interwave latencies I-III in men and women both on the left and the right side, M here the values in the female subjects were significantly shorter than in the males.