Evaluation of Bone Conduction Implant Stability and Soft Tissue Status in Children in Relation to Age, Bone Thickness, and Sound Processor Loading Time.

OBJECTIVE: To measure the stability, as determined by implant stability quotient (ISQ) values, of bone conduction implants placed using FAST (one-stage) surgery in children to look for the differences between various ages and indications. To monitor the status of the peri-implant soft tissue using the classification proposed by Holgers et al. STUDY DESIGN: It was a prospective, open, multicenter study performed in two investigation centers. PATIENTS: Twenty-two subjects under 18 years of age implanted with the Cochlear BIA300 and BIA400 types of devices at the ENT Departments of Children's Hospitals in Bydgoszcz and Lodz in Poland. INTERVENTION(S): Implantation and use of the bone conduction implant system. The implants were placed unilaterally or bilaterally according to a one-stage surgical procedure as per normal practice at the hospitals. Loading time was adjusted to individual patient, and it was based on the assessment of implant stability and status of the soft tissue. MAIN OUTCOME MEASURE(S): The attention was given to the differences in the ISQ values obtained during the subsequent visits in the various age and indication groups. Resonance frequency analysis was performed as per the routine follow-up schedule at the hospital. RESULTS: Age at the time of implantation on average was 9.8 years (min. 5.2 yr; max. 16 yr). On average, ISQ value on each of the study observations in this group equaled to 59.17 (median, 58.79). Seventh to tenth day post-surgery seemed to be a sensitive period as the lowest ISQ values (on average: 56.38 ISQ) were recorded for these dates. On average, implant was loaded 7.5 weeks after surgery in the study group (min. 2 wk, max. 14 wk). In none of the subjects the significant decrease of the implant stability values after sound processor loading was observed. Statistically significant correlation rate (p < 0.05) showed that the thicker the bone the higher the obtained ISQ value on each of the visits. It was also confirmed that the younger the implanted child, the higher the skin reactions grade at the 2 to 4 weeks post-sound processor fitting. There was no correlation observed between the time of the sound processor fitting and the skin reactions status.

Congenital and acquired cytomegalovirus infection and hearing evaluation in children.

OBJECTIVES: Congenital cytomegalovirus (CMV) infection is one of the most common intrauterine diseases. In all, 1% of live births is affected by cytomegalovirus infection, while 90% neonates with perinatal infection do not show symptoms of disease. Symptomatic CMV is present in 5-10% of children. Typical clinical signs of CMV infection are microcephalia, mental retardation, progressive major amblyacousia, and neuromuscular infection. Hypoacusis is present in 30-60% of children with congenital symptomatic CMV - in most cases it is bilateral and applies to high frequency hearing loss. The purpose of this article is to emphasize the importance of hearing evaluation in children with congenital and acquired cytomegalovirus infection. PATIENTS AND METHODS: A group of 70 children had serological and genetic screening for CMV DNA, using PCR method, in urine and blood. In this group, 52 children were diagnosed with congenital CMV and 18 children had acquired CMV. Audiological examinations including PTA, ABR, TEOAE and immittance audiometry were performed. RESULTS: Bilateral sensorineural hearing losses were found in 9 children, associated with mental and physical retardation, brain malformation and microcephalia, and unilateral losses in 3 children. In 40 cases, we did not observe hearing loss, although the level of bilirubin was high, and splenomegaly, hepatomegaly and paralysis of facial nerve were present. In the group of children with acquired CMV, we did not notice hearing loss. CONCLUSIONS: This research proved that CMV infection often caused hearing loss. In spite of this, all children with congenital and acquired CMV should be monitored and assessed throughout their lifetime by an audiologist.

Ossifying fibroma-cementoma of jaw. Differences in histopathological nomenclature.

Ossifying fibroma (cementoma) is a tumor of mesenchymal origin which represents about 1% of odontogenic tumors. It is commonly found in patients under 25, more often so in women. As its growth is slow and painless, it is usually accidentally detected by dental radiological examination. The aim of our study was to present the histopathological dilemma concerning the naming of a rare odontogenic tumor of the jaw. The authors present a rare jaw tumor, a benign ossifying fibroma, in the maxilla of a 12-year-old girl treated surgically, and they discuss the difficulty in making a definitive histopathological diagnosis. The clinical and histological criteria for identifying this type of tumor are still uncertain, as the most common sites, that is the tooth-bearing areas of the mandible, are very rare in the maxilla. The differentiation from the central fibro-osseous lesions in the maxilla bones is discussed. The final diagnosis of ossifying fibroma was based on the WHO classification. A literature search reveals a fundamental flaw in defining a unified classification for this type of change. As there is no clear diagnostic criterion, few repeatable diagnoses can be found. Although individual researchers tend to use their own means of classification in their routine work, the WHO classification should be applied.

[Hiperbilirubinemia- one of the high risk factor influence on hearing level in infants]. / Wplyw podwyzszonego poziomu bilirubiny jako izolowanego czynnika ryzyka na stan sluchu niemowlat.

Hiperbilirubinemia is one of the high risk factor of hearing loss of infants. Hearing loss is present in 60 per cent children with high level of bilirubina in blood serum. The aim of the article is to see how the level of bilirubina, influence on hearing loss. The level of bilirubina in blood serum was marked in children after born and while next hospitalisation. Audiologic diagnosis and otolaryngological examination were done as well. Hiperbilirubinemia was the only one factor of high risk of hearing loss in this group. The analysis of 53 patients showed that separate high level of bilirubina does not influence on hearing loss in children.

[Does the hearing loss affect the child's innate immunity?--preliminary]. / Niedosluch a odpornosc naturalna dziecka? (doniesienie wstepne).

UNLABELLED: Human neutrophiles play a crucial role in inmate immunity. Inmate and aquired immune response depend on their functional condition at the first stage of an inflammation process. Reactive forms of oxygen (RFO) produced by neutrophiles play a significant role in the eradication of pathogens as well as in the regulation of immune response. The aim of this study is question, does the hearing loss affect the inmate immunity? METHOD: The RFO production was directly examined in four systems - without stimulation, after stimulation with fMLP, opsonized zymosan or PMA. Direct RFO measurement was performed chemiluminescency evaluation using the whole blood, which indirectly depend on RFO production. RESULT: In the group of children with hearing loss was observed disturbances in RFO productions. CONCLUSION: This observation is very original and important for general practice.

[Assessment of transient evoked otoacoustic emission (TEOAE) in preterm newborns with low birth weight]. / Badanie wplywu krótkiego czasu trwania ciazy i niskiej masy urodzeniowej noworodków na wystepowanie emisji otoakustycznej wywolanej trzaskiem (TEOAE).

Transient evoked otoacoustic emission (TEOAE) is accepted as a good and universal test for screening of the cochlea function in newborns. This method is particularly useful in the newborn group with risk-factors of hearing losses. Early identification of the cochlear pathology gives possibility of supplying with hearing aid and rehabilitation. In this study 300 newborns were tested with TEOAE, especially patients whose birth weight was below 1500 g and were born preterm--below 33 hbd. The study did not indicate any tendency of changing TEOAE in newborns with hypotrophy. Hypotrophy does not seem to influence the cochlea function monitored by TEOAE analysis.