Audiological findings in patients treated with radiotherapy for head and neck tumors.

UNLABELLED: Radiotherapy has been widely used given its increase in the successful outcomes and cure of some cancers. AIM: To evaluate the functionality of the auditory system in patients who underwent radiotherapy treatment for head and neck tumors. MATERIALS AND METHODS: From May 2007 to May 2008, otorhinolaryngological and audiological evaluation (Pure Tone Audiometry (air and bone conduction), Speech Audiometry, Tympanometry, Acoustic Reflex testing and Distortion Product Otoacoustic Emissions) were performed in 19 patients diagnosed with head and neck neoplasia and treated with radiotherapy. Prospective case series study. RESULTS: 10.5% left ears and 26.3% right ears had bilateral hearing loss soon after radiotherapy according to ASHA criteria. CONCLUSIONS: Radiotherapy treatment for head and neck cancer has ototoxic effects. Early programs of auditory rehabilitation should be offered to these patients.

Achados audiológicos em pacientes tratados com radioterapia para tumores de cabeça e pescoço / Audiological findings in pacients treated with radiotherapy for head and neck tumors

A radioterapia é uma modalidade terapêutica muito utilizada, uma vez que o aumento de resultados satisfatórios e a cura de algumas neoplasias através deste tipo de tratamento estão sendo observados. OBJETIVO: Avaliar a funcionalidade do sistema auditivo em pacientes submetidos ao tratamento radioterápico em região de cabeça e pescoço. MATERIAL E MÉTODO: Estudo realizado no período de maio de 2007 a maio de 2008. Foram realizadas avaliações otorrinolaringológicas e audiológicas como audiometria tonal limiar por via aérea e óssea, audiometria vocal, timpanometria, pesquisa do reflexo do estapédio e Emissões Otoacústicas Evocadas por Produto de Distorção em 19 pacientes com diagnóstico de neoplasia em região de cabeça e pescoço e indicação do tratamento radioterápico. Estudo de série prospectivo. RESULTADOS: 10,5 por cento orelhas esquerdas e 26,3 por cento orelhas direitas apresentaram diminuição dos limares auditivos tonais logo após o término do tratamento radioterápico, segundo os critérios da ASHA. CONCLUSÃO: O tratamento radioterápico apresentou efeitos ototóxicos quando realizado em região de cabeça e pescoço. Programas de monitoramento audiológico e reabilitação auditiva precoce devem ser oferecidos aos pacientes submetidos a esse tipo de tratamento.

Radiotherapy has been widely used given its increase in the successful outcomes and cure of some cancers. AIM: To evaluate the functionality of the auditory system in patients who underwent radiotherapy treatment for head and neck tumors. MATERIALS AND METHODS: From May 2007 to May 2008, otorhinolaryngological and audiological evaluation (Pure Tone Audiometry (air and bone conduction), Speech Audiometry, Tympanometry, Acoustic Reflex testing and Distortion Product Otoacoustic Emissions) were performed in 19 patients diagnosed with head and neck neoplasia and treated with radiotherapy. Prospective case series study. RESULTS: 10.5 percent left ears and 26.3 percent right ears had bilateral hearing loss soon after radiotherapy according to ASHA criteria. CONCLUSIONS: Radiotherapy treatment for head and neck cancer has ototoxic effects. Early programs of auditory rehabilitation should be offered to these patients.

Audiological findings in patients treated with radio- and concomitant chemotherapy for head and neck tumors.

OBJECTIVE: To evaluate the functionality of the auditory system in patients who underwent radiotherapy and chemotherapy treatment with cisplatin to treat head and neck tumors. STUDY DESIGN: Case series with planned data collection. SETTING: From May 2007 to May 2008 by the Department of Otorhinolaryngology and the Department of Oncology/Radiotherapy at Faculdade de Medicina de Marília. SUBJECTS AND METHODS: Audiological evaluation (Pure Tone Audiometry (air and bone conduction), Speech Audiometry, Tympanometry, Acoustic Reflex testing and Distortion Product Otoacoustic Emissions) was performed in 17 patients diagnosed with head and neck neoplasia and treated with chemotherapy, using cisplatin, and radiotherapy. RESULTS: 12 left ears (70.5%) and 11 right ears (64.7%) presented bilateral decreased hearing soon after the treatment for the frequency 1 kHz (mild auditory damage) and for the frequency 8 kHz (more significant auditory damage). CONCLUSION: Patients with head and neck cancer submitted to the conventional radiotherapy treatment, combined with the chemotherapy with cisplatin, presented a high incidence of decreased hearing by the end of treatment. Strong evidence was observed linking auditory alteration to the amount of radiotherapy treatment.

Brainstem evoked response audiometry in normal hearing subjects.

UNLABELLED: Brainstem Evoked Response Audiometry (BERA) is an objective and non-invasive method of hearing assessment which detects electrical activity from the inner ear to the inferior colliculus. AIM: To assess the hearing pathway in normal hearing individuals and compare differences associated with gender, age and ear side (left and right). STUDY DESIGN: A retrospective study. MATERIALS AND METHODS: Sixty normal hearing individuals, aged between 09 and 66 years old, were subjected to clinical ENT examination and audiologic tests. RESULTS: Wave latencies differed significantly between males and females, although there were no differences regarding right or left ear sides. Comparing latency averages regarding age and gender we noticed important differences. By the same token, significant differences were also seen comparing this study with the information present in the handbook of the BERA device used and results published by Fukuda, in another study. CONCLUSION: Knowing the great importance of BERA, it is crucial that each service develops its own standards in order to enhance the accuracy of the electrophysiological diagnosis of the hearing pathway.

Brainstem evoked response audiometry in normal hearing subjects / Estudo das latências das ondas dos potenciais auditivos de tronco encefálico em indivíduos normo-ouvintes

Brainstem Evoked Response Audiometry (BERA) is an objective and non-invasive method of hearing assessment which detects electrical activity from the inner ear to the inferior colliculus. AIM: To assess the hearing pathway in normal hearing individuals and compare differences associated with gender, age and ear side (left and right). Study Design: A retrospective study. MATERIALS AND METHODS: Sixty normal hearing individuals, aged between 09 and 66 years old, were subjected to clinical ENT examination and audiologic tests. RESULTS: Wave latencies differed significantly between males and females, although there were no differences regarding right or left ear sides. Comparing latency averages regarding age and gender we noticed important differences. By the same token, significant differences were also seen comparing this study with the information present in the handbook of the BERA device used and results published by Fukuda, in another study. CONCLUSION: Knowing the great importance of BERA, it is crucial that each service develops its own standards in order to enhance the accuracy of the electrophysiological diagnosis of the hearing pathway.

Potencial Auditivo de Tronco Encefálico (PEATE) é um método objetivo e não-invasivo de avaliação das vias auditivas, que detecta a atividade elétrica desde a orelha interna até o colículo inferior. OBJETIVO: Avaliar as vias auditivas em pacientes normo-ouvintes e comparar diferenças de acordo com sexo, idade e lado da orelha (direita e esquerda). Desenho do estudo: Estudo retrospectivo horizontal. MATERIAL E MÉTODOS: Sessenta pacientes normo-ouvintes, com idades entre 09 e 66 anos, foram submetidos a exame otorrinolaringológico e testes audiológicos. RESULTADOS: A disparidade entre as latências das ondas de homens e mulheres foi estatisticamente significante, entretanto, não mostrou diferença entre os lados das orelhas. Comparando as médias das latências de acordo com idade e sexo também foram detectadas significativas desigualdades. Do mesmo modo, foram diagnosticadas diferenças comparando este estudo com o manual do aparelho utilizado e com os resultados encontrados por Fukuda, em outro estudo. CONCLUSÃO: Frente à grande importância do PEATE, torna-se imprescindível que cada serviço desenvolva sua própria normatização, aumentando a precisão diagnóstica eletrofisiológica das vias auditivas.

Rendu-Osler-Weber Syndrome: case report and literature review.

Hereditary Hemorrhagic Telangiectasia or Rendu-Osler-Weber Disease is a rare fibrovascular dysplasia that makes vascular walls vulnerable to trauma and rupture, causing skin and mucosa bleeding. It is of dominant autosomal inheritance, characterized by recurrent epistaxis and telangiectasia on the face, hands and oral cavity; visceral arteriovenous malformations and positive family history. Epistaxis is often the first and foremost manifestation. It's associated to arteriovenous malformations in several organs. There are possible hematologic, neurologic, pulmonary, dermatologic and gastrointestinal complications. Treatment is supportive and helps prevent complications. This study is a case report of a patient with this syndrome who came to the ENT Outpatient Ward of the Faculdade de Medicina de Marília; and we have done a bibliographic review of the disease's etiopathogenesis, clinical manifestations and clinical-surgical treatment options.

Síndrome de Rendu-Osler-Weber: relato de caso e revisão de literatura / Rendu-Osler-Weber Syndrome: case report and literature review

A telangiectasia Hemorrágica Hereditária ou Síndrome de Rendu-Osler-Weber é uma rara displasia fibrovascular que torna a parede vascular vulnerável a traumatismos e rupturas, provocando sangramentos em pele e mucosas. Apresenta herança autossômica dominante. É caracterizada por epistaxes de repetição, telangiectasias mucocutâneas, malformações arteriovenosas viscerais e história familiar positiva. A epistaxe costuma ser a primeira e a principal manifestação. Está associada a malformações arteriovenosas em vários órgãos. São possíveis complicações hematológicas, neurológicas, pulmonares, dermatológicas e de trato gastrointestinal. A terapia é de suporte e de prevenção de complicações. Neste estudo, relata-se um caso de um paciente com a síndrome, atendido no Ambulatório de Otorrinolaringologia da Faculdade de Medicina de Marília, e faz-se uma revisão bibliográfica de sua etiopatogenia, manifestações clínicas e terapêutica clínico-cirúrgica.

Hereditary Hemorrhagic Telangiectasia or Rendu-Osler-Weber Disease is a rare fibrovascular dysplasia that makes vascular walls vulnerable to trauma and rupture, causing skin and mucosa bleeding. It is of dominant autosomal inheritance, characterized by recurrent epistaxis and telangiectasia on the face, hands and oral cavity; visceral arteriovenous malformations and positive family history. Epistaxis is often the first and foremost manifestation. It's associated to arteriovenous malformations in several organs. There are possible hematologic, neurologic, pulmonary, dermatologic and gastrointestinal complications. Treatment is supportive and helps prevent complications. This study is a case report of a patient with this syndrome who came to the ENT Outpatient Ward of the Faculdade de Medicina de Marília; and we have done a bibliographic review of the disease's etiopathogenesis, clinical manifestations and clinical-surgical treatment options.

Hipertrofia adenoamigdaliana como causa de hipertensão pulmonar / Adenotonsillar hypertrophy as cause of pulmunari hypertension

A hipertrofia adenoamigdaliana figura como uma das principais causas de hipertensão pulmonar na infância, mas poucos são seus relatos na literatura, possivelmente devido a pouca investigação e a remissão do quadro após a adenoidectomia...

The hypertrophy adenotonsilar figure as one of the most important causes of pulmonary hypertension in infancy but there are few records in literature had too link inquiry and the remission after the adenotonsillectomy...

Lip reading role in the hearing aid fitting process.

UNLABELLED: Lip reading (LR) is unconsciously practiced as we communicate and has currently been widely used in the assessment of hearing impaired people. The hearing challenged individual is able "to read" lip position and thus interpret the speech sounds of the speaker; however, it is very likely that the best lip reader can only catch 50% of the words uttered. METHODOLOGY: 30 individuals of both gender, with age ranging from 27 to 89 years, carriers of moderate bilateral sensorineural hearing loss. The assessment encompassed speech recognition test of monosyllable words in four situations: without hearing aid (HA) and LR; without HA and with LR; with HA and without LR; and with HA and LR. RESULTS: we noticed an improvement in the percentage of correct answers in 93.5% of the patients with HA and LR when compared to those patients in the other situations. CONCLUSION: Lip reading is an important communication strategy for those with hearing impairment, and it can support the hearing aid fitting process.

Corpo estranho em seio maxilar como causa de halitose / Foreign bodyin the maxillary sinus as cause of halitosis

A fístula oroantral é uma das complicações que podem ocorrer da extração dentária na região maxilar devido à proximidade do ápice dentário com o assoalho do seio maxilar. Essa íntima relação anatômica favorece a entrada de diversos corpos estranhos na cavidade sinusal, em geral após traumas locais ou mesmo durante tratamentos odontológicos. A principal manifestação desse processo é a ocorrência de sinusite, associada à presença do corpo estranho e à contaminação do seio pela flora bucal através da fístula. Os autores relatam o caso de um paciente com queixa de halitose devido à presença de uma fístula oroantral e um corpo estranho de origem dentária no seio maxilar. O paciente foi submetido à sinusectomia pela técnica de Caldwell-Luc, com sucesso e rápida recuperação.

A terapia multidisciplinar no tratamento da respiração bucal e do hábito prolongado de sucção digital ou de chupeta / The team therapy in the treatment of the mouthbreathing and sucking habits

O tratamento ortodôntico da má oclusão advinda de um hábito, como ação isolada, certas vezes não induz à homeostasia de toda a função do sistema estomatognático. Portanto, a terapia multidisciplinar se faz necessária, possibilitando ao paciente uma assistência seqüenciada e/ou concomitante tanto do cirurgião dentista, bem como do otorrinolaringologista, do psicólogo e do fonoaudiólogo.