[Evaluation of hearing in patients with multiresistant tuberculosis]. / Avaliação da Perda Auditiva em Doentes com Tuberculose Multirresistente.

INTRODUCTION: Multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis constitute a major threat to worldwide tuberculosis control. The treatment demands the use of a therapeutic regimen in second-line drugs for a minimum period of 20 months, which includes aminoglycosides over a period of about eight months. These are associated with permanent cochleovestibular changes. MATERIAL AND METHODS: This cross-sectional study aims to evaluate the auditory function in individuals who completed treatment for multidrug-resistant tuberculosis (with scheme that included aminoglycosides) at the Center of Regional Reference for multidrug-resistant tuberculosis located in the North of Portugal, between the years 2009 and 2012. Patients who met the inclusion criteria were submitted to tonal and vocal audiograms, otoacoustic emissions at 2000-5000 Hz frequencies, and a tympanogram. RESULTS: Between 2009 and 2012, 27 patients were referred to the Centre of Regional Reference for multidrug-resistant tuberculosis, in the North Region of Portugal, resulting in five deaths. Of the 22 individuals invited, 11 attended. These were aged between 31 and 59 years (41 ± 10). Amikacin was used in 80% of patients. Six patients (60%) had sensorineural hearing loss. DISCUSSION/CONCLUSION: The results of this study suggest the need for a more frequent audiological monitoring in patients with multidrug-resistant tuberculosis treated with aminoglycosides allowing early detect hearing loss.

Introdução: A tuberculose multirresistente e a extensivamente resistente constituem atualmente a principal ameaça ao controlo da tuberculose a nível mundial. O seu tratamento exige o uso de um esquema terapêutico com fármacos de segunda linha por um período mínimo de 20 meses, onde se incluem aminoglicosídeos durante um período de cerca de oito meses. Estes estão associados a alterações cocleovestibulares permanentes. Material e Métodos: Estudo transversal que pretende avaliar a função auditiva em indivíduos que terminaram tratamento por tuberculose multirresistente (com esquema que incluia aminoglicosídeos) no Centro de Referência Regional para a Tuberculose Multirresistente da Sub-Região de Saúde do Norte entre os anos de 2009 e 2012. Os doentes que preencheram os critérios de inclusão foram convocados para a realização de: exame objetivo otorrinolaringológico, audiograma tonal e vocal, otoemissões acústicas por produtos de distorção nas frequências de 2000-5000 Hz e timpanograma. Resultados: Entre 2009 e 2012 foram referenciados 27 casos para o Centro de Referência para a tuberculose multirresistente da Região Norte, tendo-se verificado cinco óbitos. Dos 22 indivíduos convocados, compareceram 11. Estes possuíam idades compreendidas entre os 31 e os 59 anos (41 ± 10). A amicacina foi usada em 80% e a capreomicina nos restantes. Seis (60%) dos utentes estudados apresentaram surdez neurossensorial. As otoemissões acústicas foram negativas em todos os doentes com hipoacúsia neurossensorial, o que confirma a sua origem coclear. Discussão/ Conclusão: Os resultados deste estudo sugerem a necessidade de existir uma monitorização audiológica mais frequente nos indivíduos com tuberculose multirresistente tratados com aminoglicosídeos permitindo detectar mais precocemente a perda auditiva.

Conceptos y aplicaciones de la ingeniería tisular en Otorrinolaringología / The concepts and applications of tissue engineering in Otorhinolaryngology

Introducción: La ingeniería de tejidos es un campo en rápido desarrollo, haciendo unos sustitutos biológicos para la reparación y regeneración de tejidos dañados, jugará un papel importante en el futuro de la Otorrinolaringología. Objetivo: En este artículo se explican los principios de la medicina regenerativa y sus posibles aplicaciones en Otorrinolaringología. Materiales y métodos: Los autores han buscado en la literatura publicada sobre el tema, eligieron referencias pertinentes y se extrajo y sistematizado de la fecha. Resultados y conclusiones: Hay posibilidades muy interesantes para futuros tratamientos en Otorrinolaringología que aplican los conceptos de la ingeniería de tejidos (AU)

Introduction: Tissue engineering is a rapidly developing field that, making biological substitutes for the repair and regeneration of damaged tissues, will play an important role in the future of otorhinolaryngology. Objective: In this article we explain the principles of regenerative medicine and its potential applications in Otorhinolaryngology. Materials and methods: The authors searched the published literature on this topic, chose relevant references, and extracted and systematized the data. Results and conclusion: There are some exciting possibilities for future treatments in otorhinolaryngology applying the concepts of tissue engineering (AU)

The concepts and applications of tissue engineering in otorhinolaryngology.

INTRODUCTION: Tissue engineering is a rapidly developing field that, making biological substitutes for the repair and regeneration of damaged tissues, will play an important role in the future of otorhinolaryngology. OBJECTIVE: In this article we explain the principles of regenerative medicine and its potential applications in Otorhinolaryngology. MATERIALS AND METHODS: The authors searched the published literature on this topic, chose relevant references, and extracted and systematized the data. RESULTS AND CONCLUSION: There are some exciting possibilities for future treatments in otorhinolaryngology applying the concepts of tissue engineering.

Needle in the external auditory canal: an unusual complication of inferior alveolar nerve block.

Inferior alveolar nerve block is used to anesthetize the ipsilateral mandible. The most commonly used technique is one in which the anesthetic is injected directly into the pterygomandibular space, by an intraoral approach. The fracture of the needle, although uncommon, can lead to potentially serious complications. The needle is usually found in the pterygomandibular space, although it can migrate and damage adjacent structures, with variable consequences. The authors report an unusual case of a fractured needle, migrating to the external auditory canal, as a result of an inferior alveolar nerve block.