Comparison of two-step transient evoked otoacoustic emissions (TEOAE) and automated auditory brainstem response (AABR) for universal newborn hearing screening programs.

OBJECTIVE: Both transitory auditory otoemissions (TEOAE) and automated auditory brainstem responses (AABR) are considered adequate methods for universal hearing screening. The goal of this study was to compare the results obtained with each device, applying the same screening procedure. MATERIALS AND METHODS: From 2001 to 2003, all the newborns in our health area (2454 infants) were evaluated with TEOAE (ILO92, otodynamics) and all those born from 2004 to 2006 (3117) were evaluated with AABR (AccuScreen, Fischer-Zoth). The population studied included all well newborns and those admitted to neonatal intensive care units (NICU). The first screening was normally undertaken with well babies during the first 48h of life, before hospital discharge. Infants referred from this first step underwent a second screening after hospital discharge, before they were a month old. RESULTS: The results from each study group were compared and analyzed for significant differences. TEOAE screening yielded 10.2% fail results from the first screening step; AABR gave 2.6%. In the second screening step, 2% of the newborns screened with TEOAE were referred, whereas 0.32% of those screened with AABR were referred. These differences are statistically significant. CONCLUSIONS: Although AABR screening tests involve a slightly higher cost in time and money than TEOAE, the results obtained compensate this difference. AABR gives fewer false positives and a lower referral rate; the percent of infants lost during follow-up is consequently smaller. Therefore, in our environment, universal newborn auditory screening with AABR is more effective than that with TEOAE.

[Trend changes in the adenotonsillar surgery]. / Cambios de tendencia en la cirugía adenoamigdalar.

UNLABELLED: In order to evaluate possible trend changes in the epidemiological factors of adenotonsillar surgery, a total of 1,958 operations performed between 1992 and 2002 were reviewed. RESULTS: One third of the operations were to remove tonsils in comparison with the two thirds that were to remove adenoids. Three procedures were used: 59% adenoidectomies, 28% adenotonsillectomies and 13% tonsillectomies. During the study period, the percentage of adenotonsillectomies decreased, whereas the number of adenoidectomies increased. In general, this kind of surgery is mainly performed on males. CONCLUSIONS: Although we have not discovered variations regarding gender and average age for the operations, adenotonsillar surgery has increased over recent years and the percentage ratio of the various procedures has altered as a result of new indications.

Cambios de tendencia en la cirugía adenoamigdalar / Trend changes in the adenotonsillar surgery

A fin de evaluar posibles cambios de tendencia en los factores epidemiológicos de la cirugía adeno-amigdalar, se revisan 1958 intervenciones realizadas entre los años 1992 y 2002. RESULTADOS: se extirparon 1/3 de anginas frente a 2/3 de vegetaciones adenoideas mediante 3 procedimientos: 59% de adenoidectomías, 28% de adeno-amigdalectomías y 13% de amigdalectomías. Durante el período de estudio se ha ido reduciendo el porcentaje de adeno-amigdalectomías, aumentando el de adenoidectomías. En general es una cirugía que predomina en varones. CONCLUSIONES: Aunque no hemos detectado variaciones en cuanto al sexo y edad media de realización, en esta revisión comprobamos que la cirugía adeno-amigdalar ha ido en aumento a lo largo de estos años modificándose la relación porcentual de los distintos procedimientos, creemos que como resultado de nuevas indicaciones

In order to evaluate possible trend changes in the epidemiological factors of adenotonsillar surgery, a total of 1,958 operations performed between 1992 and 2002 were reviewed. Results: One third of the operations were to remove tonsils in comparison with the two thirds that were to remove adenoids. Three procedures were used: 59% adenoidectomies, 28% adenotonsillectomies and 13% tonsillectomies. During the study period, the percentage of adenotonsillectomies decreased, where as the number of adenoidectomies increased. In general, this kind of surgery is mainly performed on males. Conclusions. Although we have not discovered variations regarding gender and average age for the operations, adenotonsillar surgery has increased over recent years and the percentage ratio of the various procedures has altered as a result of new indications

Resultados de la aplicación del protocolo de detección precoz / Results of the application of the protocol for the early detection of hearing loss in high-risk neonates

En coordinación con el Servicio de Pediatría, elaboramos un protocolo de "Detección precoz de la hipoacusia en neonatos de alto riesgo" basado fundamentalmente en la aplicación secuencias de la impedanciometría y los potenciales evocados auditivos del tronco cerebral (PEATC). Presentamos los resultados obtenidos desde octubre de 1994 a marzo de 2001. De los 240 niños estudiados, hemos encontrado 36 hipoacusias neurosensoriales severas profundas (<60 dBs HL) bilaterales (15 por ciento). El 55 por ciento se asociaba con factores de riesgo. Sin embargo, sólo diagnosticado 2 de estas hipoacusias (5,5 por ciento) gracias al protocolo (enviados por el Servicio de Neonatología por presentar factores de riesgo de hipoacusia), pues el resto (94,5 por ciento) acudieron por sospecha de hipoacusia, con lo que la edad media de diagnóstico es de 3 años. Aunque el procedimiento utilizado presenta alta sensibilidad y especificidad diagnóstica, a la vista de estos resultados, creemos necesario universalizar la exploración auditiva a todos los recién nacidos, a fin de evaluar su efectividad en la detección precoz de la sordera infantil (AU)

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[Neck schwannomas]. / Schwannomas de cuello.

Given the rareness of cervical schwannomas, they are often mistaken for other kinds of lesions. We present 2 clinical cases, make comments on the clinical-pathological features involved and point out the essential elements that ensure the differential diagnosis of these tumours.

[Oropharyngeal tuberculosis. Report of a case in a lingual tonsil]. / Tuberculosis orofaríngea. A propósito de un caso en amígdala lingual.

Pharyngeal tuberculosis is very rare and normally appears as an seemingly malignant process. As a result of which it is essential to perform a differential diagnosis before beginning anticancer treatment. We present a clinical case of lingual tonsil tuberculosis. A review is made of the pathogenic mechanisms, the clinical manifestations and the diagnosis of pharyngeal tuberculosis, whose response to treatment with antituberculous drugs proves to be excellent.

[The role of heredity in the genesis of idiopathic peripheral facial paralysis. A case report]. / Papel de la herencia en la génesis de la parálisis facial periférica idiopática. A propósito de un caso.

After a study of a family with 9 members who had one or more episodes of idiopathic facial palsy at some point in life, we reviewed the literature for the role of heredity as an etiopathogenetic factor in peripheral facial palsy. Differential criteria for the most controversial aspects were considered, such as incidence and the type or mechanism of transmission which conditions the appearance of peripheral facial palsy in patients with possible genetic factors.

[Evaluation of the 1st phonatory results in fistuloplasty patients using the Kaplan and Polow scales]. / Valoración de los primeros resultados fonatorios en las fistuloplastias mediante las escalas de Kaplan y Polow.

Three groups: A) 10 operates of fistuloplastic. B) 10 operates of total laryngectomy competent in esophageal language. C) 10 normal persons. We took Kaplan and Polow scales of voice's qualities (1985). Four judges value independently from "0" to "10" all and every one of the "items". The obtained qualifications are put to the arithmetical mean and are set in the column of each "item". The great mean of deviation in the fistuloplastics was 1.17 while for the group of patients competent in esophageal language was 1.34.