The effect of ventilation tube insertion in central auditory processing disorders in children with otitis media with effusion.

INTRODUCTION: Otitis media with effusion is one of the most common diseases among children. The purpose of this research is to investigate whether the resolvement of conductive hearing loss from the insertion of a ventilation tube also improves central auditory processing disorders in children with otitis media with effusion. METHOD: In this cross-sectional study, 20 children between 6 and 12 years old were diagnosed with otitis media with effusion and 20 normal children were included in the study. The central auditory processing status was evaluated in all patients before ventilation tube insertion and after six months by Speech Discrimination Score, Speech Reception Threshold, Words-in-Noise, Speech in Noise, Consonant Vowel in Noise tests, and the results were compared. RESULTS: The mean score of Speech Discrimination Score and Consonant Vowel in Noise tests in the control group were significantly higher than the patient group before ventilation tube insertion and after surgery, in the patient group, the mean scores increased significantly. The mean scores of the Speech Reception Threshold, Words-in-Noise, and Speech in Noise tests in the control group were significantly lower than the patient group before ventilation tube insertion and after the operation, in the patient group, the mean scores significantly decreased. After VT insertion, these tests were close to the control group. CONCLUSION: Restituting normal hearing by ventilation tube treatment improves central auditory abilities as shown in speech reception, speech discrimination, the ability to hear, the ability to recognize monosyllabic words, and the power of speech in the presence of noise.

Therapeutic effects of Rosa canina, Urtica dioica and Tanacetum vulgare herbal combination in treatment of tinnitus symptoms: A double-blind randomised clinical trial.

OBJECTIVE: To evaluate the effect of Neurotec® herbal capsule (100 mg twice a day for 3 months) on the tinnitus symptoms in comparison with the placebo. DESIGN: A double-blind randomised clinical trial. SETTING: Otolaryngology clinic of Baqiyatallah Hospital. PARTICIPANTS: Patients suffering from subjective tinnitus. MAIN OUTCOME MEASURES: Pure tone audiometry was measured at .5, 1, 2, 4 and 6 kHz frequencies before and after the third month of intervention. In addition, Tinnitus Handicap Inventory (THI) questionnaire as well as visual analogue scale (VAS) for tinnitus loudness, daily annoyance, daily life or sleep disturbance, daily perception and mood alteration were evaluated. RESULTS: Finally, 103 (69 males and 34 females) patients with a mean age of 51.33 ± 13.91 years were analysed. In contrast with control group, patients in intervention group showed a remarkable decrease in THI score after 3 months of treatment (p < .05). Although both groups had improvements in VAS scores, mood disturbance, daily tinnitus perception and daily life alteration scores were only improved in the intervention group. The mean pure tone air and bone conduction were not significantly different between the control and the intervention group at baseline and 3 months after the intervention at .5, 1, 2 and 4 kHz (p > .05). CONCLUSION: A 3-month treatment with Neurotec capsules in addition to patient education is of benefit for managing symptoms in patients with chronic tinnitus.

Computerized cognitive training for improving cochlear-implanted children's working memory and language skills.

Sensory deprivation, including hearing loss, can affect different aspects of a person's life. Studies on children with hearing impairment have shown that such patients, especially those with cochlear implants (CIs), suffer from cognitive impairments, such as working memory problems and poor language skills. The present study aimed to examine the efficacy of cognitive computer training in improving working memory and language skills in children with a CI. This research was a quasi-experimental study with a pre-test-post-test design and a control group. Fifty-one children with a CI aged 6-12 years were recruited through convenience sampling and randomly assigned to the control and treatment groups. The Wechsler Working Memory Subtest and the Test of Language Development (TOLD) were used to evaluate children's working memory and language skills pre- and post-treatment. The treatment group attended twenty 50-60-minute cognitive computer training sessions three times a week. Sina-Working Memory Training was used to provide the treatment group with working memory training, whereas no intervention was provided to the control group. Univariate and multivariate analyses of covariance were used to analyze data. The results demonstrated the efficacy of cognitive computer training in improving the performance of cochlear-implanted children's working memory (auditory and visual-spatial) (P < 0.01). The results also pointed to improved performance in sentence imitation (P < 0.01), word discrimination (P < 0.01), and phonemic analysis subtests (P < 0.01). Overall, the findings indicated that cognitive computer training might improve working memory and language skills for children with CI. Therefore, the development and execution of such programs for children with CIs seem to improve their cognitive functions, such as working memory and language skills.

Vocal tract discomfort and voice handicap index in patients undergoing thyroidectomy.

PURPOSE: This study aims to investigate the frequency and severity of vocal tract discomfort (VTD) symptoms and to determine the relationship between VTD and type of thyroidectomy, voice problem history, vocal abuse, and misuse behaviors, and the voice handicap index (VHI) in the thyroidectomy patients undergoing thyroidectomy, pre- and post-operatively pre- and post-thyroidectomy. MATERIALS: The sample comprised 21 thyroidectomy patients undergoing thyroidectomy, including 10 patients with total thyroidectomy and 11 patients with partial thyroidectomy. The participants underwent videolaryngoscopy examination and completed the voice history questionnaire, the VTD scale, and the VHI, before and after the surgery. RESULTS: Dryness was the most frequently occurring symptom, pre- and post-thyroidectomy. Participants with total thyroidectomy reported significantly higher frequency and severity of tickling than those in the preoperative status (p<.05). The frequency and severity of many VTD symptoms in the participants with voice problems and a vocal abuse and misuse history were higher than those without such a history at both assessment times (p<.05). There was significant correlation between the frequency and severity of VTD and VHI scores, pre-thyroidectomy pre-operatively (r = 0.488-0.575, p<.05). CONCLUSIONS: An increment in the frequency and severity of tickling was reported by total thyroidectomy patients, post-thyroidectomy post-operatively. The type of thyroidectomy, voice problem history, and vocal abuse and misuse behaviors seem to influence the frequency and severity of VTD. Considering the correlation between VTD and VHI, the VTD scale provides important clinical information and can be used for evaluation and consultation purposes.

Prevalence of Hearing Disorders among Type 2 Diabetes Mellitus Patients with and without Vitamin D Deficiency.

Most of the previous studies have marked hearing loss as another complication of diabetes mellitus, while some other authors had different ideas. The relation between diabetes mellitus and sensorineural hearing loss has been under investigation for a century. However, it has remained controversial. Changing in the metabolism of glucose alters inner ear function and leads to hearing and vestibular disorders. We performed a study on type 2 diabetes mellitus patients with vitamin D deficiency, vitamin D insufficiency and with normal levels of vitamin D in an attempt to find out the prevalence of hearing loss among them. Prevalence of hearing loss was significantly higher in the group with vitamin D insufficiency/deficiency based on X2 test. Results showed that diabetic patients with abnormal levels of vitamin D had a higher risk to develop hearing loss compared to those with normal levels. There was a significant difference between subjects with normal and abnormal levels of vitamin D in terms of hearing loss degree based on the X2 test. In general, hearing loss was more prevalent in patients with abnormal levels of vitamin D, the severity of the loss mostly including slight and mild degrees. The results of the present study suggest that abnormal levels of vitamin D may be associated with a higher risk of hearing loss.

Comparing the Effects of Epley Maneuver and Cinnarizine on Benign Positional Paroxysmal Vertigo; A Randomized Clinical Trial.

BACKGROUND: The fastest and safest treatment method of BPPV is repositioning maneuvers. In Iran, this methods are not widely used, and many physicians use medical therapy, despite their side effects, for management of BPPV. MATERIALS AND METHODS: In this randomized clinical trial patients with BPPV were randomly allocated to Epley repositioning maneuver or Cinnarizine (25mg every 8 hours) for two weeks. The patients were evaluated for symptoms using visual analogue scale (VAS) scoring system before intervention, first and second weeks after intervention. In the second and third visitd the results of hallpike test was recorded for both groups. RESULTS: 43 patients with a mean age of 46.88±11.08 years in two Epley and Cinnarizine group underwent analysis. The mean VAS score for improvement of symptoms after intervention was 1.66±1.06 in Epley and 1.50±0.91 in Cinnarizine group (P=0.57). CONCLUSION: we found that there is no significant difference between Epley maneuver and Cinnarizine for treatment and controlling symptoms of BPPV.

Effect of ESS on Olfactory Threshold of Patients with CRS without Nasal Polyps.

OBJECTIVES: Chronic rhinosinusitis (CRS) is characterized by a long-time inflammatory disease of nasal and sinus mucosa. Olfactory dysfunction is common among CRS patients with a prevalence ranging from 48% to 83%. We aimed to assess the effect of ESS on olfactory function of patients with chronic rhinosinusitis without nasal polyps. METHOD: This randomized clinical trial was conducted on 30 patients with chronic rhinosinusitis without nasal polyps. Patients were randomly allocated to two intervention and control groups; patients in intervention group underwent endoscopic sinus surgery by a single surgeon and control group continued standard treatment with nasal irrigation of normal saline (4 times daily) and nasal corticosteroids (one puff in each nostril daily). Olfactory threshold was evaluated using smell threshold test (STT) before, one month and three months after intervention. RESULTS: Eventually 33 patients with a mean age of 42.70 ± 15.50 years in intervention and 43.12 ± 11.50 years in control group underwent analysis (p value=0.930). Mean olfactory threshold was 2.79 ± 0.73 in intervention and 2.67 ± 1.05 in control group prior to intervention (p value=0.345). Mean change of olfactory threshold was 0.30 ± 0.79 in intervention and 0.38±1.09 in control group one month after intervention (p value=0.214). Mean change of olfactory threshold was 0.13 ± 0.94 in ESS and 0.33 ± 0.60 in control group three months after intervention (p value=0.196). CONCLUSION: Our study revealed that changes in olfactory threshold were not significantly different between two ESS and standard medical therapy groups one and three months after intervention.

The effects of cochlear implantation on vestibular function in 1-4 years old children.

OBJECTIVES: Although cochlear implants offer an effective hearing restoration option in children with severe to profound hearing loss, concern continues to exist regarding the possible effects of cochlear implantation on the vestibular system and balance. METHODS: In a prospective cohort study, 27 children with bilateral profound hearing loss (all candidates for cochlear implantation) were evaluated for their vestibular function before and after cochlear implantation. Vestibular evaluations consisted of Vestibular Evoked Myogenic Potentials, caloric testing and the Head-Impulse Test. RESULTS: Mean age at the time of cochlear implantation was 27.19 months. Without considering vestibular evaluation results, one of the ears was selected for surgery. Vestibular tests after surgery were not indicative of any statistically significant change in vestibular system or balance. CONCLUSION: This limited data shows that cochlear implantation did not impair the vestibular system of these patients. By the results of our study we may conclude that round window implantation does not have any disturbing impact on vestibular function in children. The generalization of this result needs further research.

The Effect of PRP-enriched Gelfoam on Chronic Tympanic Membrane Perforation: A Double-blind Randomized Clinical Trial.

OBJECTIVE: To evaluate the effect of PRP-enriched gelfoam on the healing of chronic TM perforation in comparison with gelfoam alone. METHODS: In this double-blind randomized clinical trial Patients with chronic tympanic membrane were randomly allocated to two groups; intervention group underwent tympanoplasty with platelet rich plasma (PRP)- enriched gel foams and control group underwent operation with conventional gel foams alone. Patients information was recorded 4 and 12 months after surgery. RESULTS: Eventually 24 patients (12 males and 12 females) with a mean age of 43.33 ± 12.34 years in intervention and 41.33 ± 10.02 years in control group underwent analysis (p = 0.667). Complete TM healing was seen in 8 (66.67%) patients in intervention group and 3 (25%) patients in control group three months after intervention (p = 0.031, OR = 5.98). CONCLUSION: Addition of PRP to conventional gelfoams used in TM perforation repair increases the complete healing rate of TM perforation with less morbidity and complications.

Post tonsillectomy pain: can honey reduce the analgesic requirements?

BACKGROUND: Tonsillectomy with or without adenoidectomy is one of the most common surgical procedures performed worldwide, especially for children. Oral honey administration following tonsillectomy in pediatric cases may reduce the need for analgesics via relieving postoperative pain. OBJECTIVES: The aim of this study was to evaluate the effects of honey on the incidence and severity of postoperative pain in patients undergoing tonsillectomy. PATIENTS AND METHODS: A randomized, double blind, placebo controlled study was performed. One hundred and four patients, who were older than eight, and were scheduled for tonsillectomy, were divided into two equal groups, honey and placebo. Standardized general anesthesia, and postoperative usual analgesic, and antibiotic regimen were administrated for all patients. Acetaminophen plus honey for the honey group, and acetaminophen plus placebo for the placebo group were given daily. They began to receive honey or placebo when the patients established oral intake. RESULTS: The difference between acetaminophen and acetaminophen plus honey groups was statistically significant both for visual analogue scale (VAS), and number of painkillers taken within the first three postoperative days. The consumption of painkillers differed significantly in every five postoperative days. No significant difference was found between groups regarding the number of awaking at night. CONCLUSIONS: Postoperative honey administration reduces postoperative pain and analgesic requirements in patients after tonsillectomy. As the side effects of honey appear to be negligible, consideration of its routine usage seems to be beneficial along with routine analgesics.