APPLICATION OF ANTIBIOTIC-CONTAINING EAR DROPS IN TREATMENT OF ACUTE OTITIS MEDIA.

Otitis is a serious and noteworthy disease. Only timely and adequate treatment guarantees to cure it and prevent complications. The present study involved 250 patients, raining in age from 2 to 64 years. Patients' data were anonymous and cannot be identified. 125 patients were diagnosed with middle purulent otitis, 20 with middle secretory otitis, 78 with external diffuse otitis, and 27 with external otitis media.The aim of the research was to determine the efficacyof antibiotic-contained ear drops in the treatment of acute otitis media, in combination with mono- or systemic antibiotics. The data were analyzed utilizing the descriptive statistics. The frequency distribution of variables was also determined and the results were presented in appropriate numeric values and percentages.

STUTTERING: INITIATING FACTORS, EVOLUTION, HEALING PERSPECTIVES.

Despite high amount of incidents, no scientific paper existed up to now in Georgia dealing with the stuttering. In present essay the views over are collated. It is confirmed that the phenomenon reflects the speech rate and/or the rhythm distortions created by convulsive type involuntary contractions of voice-producing muscles. The disorder is either congenital or acquired. Complicated pregnancy and/or delivery, heavy and/or recurred somatic diseases, speech-formation delay, conflicting social situations appear the main provoking/supporting factors of. The stuttering covers physical and psychological symptoms. The physicals are manifested in speech muscle twitches, while the psychological in phobias. Neurotic and neurotic-like stuttering types are differentiated. The neurotics arise on the background of psychological disorders, the linkage of the neurotic-likes with any concrete factor being mostly difficult or impossible. It is emphasized that the stuttering treatment demands the complex application of pedagogical and medical means and aims the cure of the whole organism, while predominantly of the nervous system, and improvement of mode-of-life conditions of the sufferer. The necessity of the cure of associated diseases is emphasized. It is stated that the stuttering psychotherapy implies the blockage of mental disturbances, while the speech recovery trials intends the establishment of adequate voice, articulation, and respiratory functions. In utilized habilitation/rehabilitation means the particular attention has to draw to initiation of well-balanced logo-rhythms. The regulation of hemisphere speech-center function is a primary target of the vocal exercises applied. Achievements attained in study sessions are regularly spread over the vital situations. The favorable social environment is also regarded as an important item for the pathology defeat. The significance of the systematic cure interventions is emphasized the frequent and/or long-term pauses between being judged as the cause of habit remissions happened. Just compound and customary treatment and active involvement of parents and other family members in applied efforts ensure the better chances for the positive care output.

EFFECT OF SMOKING ON TRASIENTLY EVOKED OTOACOUSTIC EMISSION.

Evoked otoacoustic emissions, EOAEs, are proved to be sounds aroused in response to external acoustic stimulus by the cochlear outer hair cells. Transiently evoked otoacoustic emissions, TEOAEs, are the most clinically utilized EOAEs. TEOAEs are detectable in 98% of people with normal hearing, regardless of age or sex, while two ears of any individual produce similar TEOAEs waveforms. The objective of the presented study was the comparison of TEOAE magnitudes in cigarette smokers and nonsmokers. The TEOAE occurrence and characteristics in individuals of both samples with audiometrically proved hearing losses and in those without were also specifically examined. 30 smokers and and 30 nonsmokers within the age range of 30-59 years were involved in the present study after informed concent. OAEs were performed to each subject by Madsen Capella's-OAE/middle ear analyzer-GN Otometrics, (Danmark). After OAE testing each subject was performed routine pure-tone audiometry and tympanometry. Obtained results were statistically treated by the student's t-distribution. According to our results 76.6% of smokers and 3.33% of nonsmokers had marked different level decrease in TEOAE amplitude. Audiographic measurments showed altered audiogram in 6.7% of smokers and in 3.33% of nonsmokers. Based on the above mentioned results we suppose that smoking has significant influence on hearing function, especially on cochlear apparatus; At the same time, TOEAE, as a sensitive method can be used for very early detection of hearing loss, even when there are neither any subjective complains nor some changies on audiogram.

Influence of smoking on audiological characteristics of hearing function.

Cigarette smoking and related diseases are global problem of health. Discussion regarding influence of smoking on hearing function has been continued about 20 years. The aim of our study was estimation of relation between smoking and development of cochlear neuritis. Research was conducted at Ltd. National Centre of ENT - Japaridze-Kevanishvili clinic and Ltd.Audiology National Center. The data were collected from September 2011 to December 2013. Cross- sectional observational study was carried out. 600 persons (mean age - 45.4±10.4) were enrolled in the research. After filling the informed consent persons were divided into two groups: smokers (300 smokers, apparently healthy persons, mean age 44.3±10.6 years) and control group (300 healthy non-smoker persons, mean age 46.5±10.2 years). All persons completed a questionnaire, which includes questions about smoking status too. The inclusion criterion in smokers group was a smoking habit during 5 years at least 10 cigarettes per day. Otoscopy and Acoustic impedance test (timpanometry, reflexometry, testing for Eustachian tube conductivity) were used for verification of outer and middle-ear normality. Pure Tone Audiometry was performed for hearing measure and identifies hearing nerve condition. Obtained results were statistically treated by the student's t-distribution. For minimal level of significance was taken p<0,05. In smokers group hearing loss was proved in 31.33% (94 persons) and in control group - in 17.34% (52 persons). Hearing-loss vs. normal-hearing ratio amounted hence to 0.46 (P<0.01) in the smokers group and to 0.21 (P<0.01) in the nonsmokers'. Hearing loss in smokers may be provided by different pathological mechanisms.

Influence of acoustic rhinometry, rhinoresistometry and endoscopic sinus surgery on voice quality.

Twenty-one patients with documented chronic paranasal sinusitis, being in need of endoscopic endonasal sinus surgery were subjected to voice analysis. Tape recordings of sustained vowels were performed both pre- and postoperatively. All voice samples were examined with a system of sound spectrographic analysis. Patients with nasal obstruction, detected by active anterior rhinomanometry were excluded from further studies. Analysis of pre- and postoperative spectograms was focused on changes in center frequency as well as on a bandwidth of the initial four formants. The variations in specific differences of the formant frequencies and amplitudes were also estimated. The different subgroups of patients revealed significant alterations in the parameters studied. The vowels [a:] and [i:] showed inverse changes in measured values. Evaluation of the vowel [u:], on the other hand, was restricted due to artifactual scattering of individual values. In general, the bandwidths diminished postoperatively and energy peaks of formants increased proportinally. In 6 out of 21 patients, one third of the cases examined, after surgery the patients detected perceptual changes in speech. Based on our data obtained it is recommended to inform all patients as well as voice professionals about the possible speech alterations of the speech after endonasal sinus surgery.

A combined application of acoustic rhinometry, rhinoresistometry, and flow simulation of the nose mucosa before and after turbinate surgery: a model study.

The interpretation of rhinometric results seems difficult, particularly in young examiners. In order to follow rhinometric assessments precisely, the knowledge of the nose airflow mechanisms is necessary. In this direction, in a model study the consequences of nasal concha surgery on acoustic rhinometry and rhinoresistometry were systematically investigated. Six nose models were examined through acoustic rhinometry and rhinoresistometry approaches. Each model reflected conditions happened after the nasal concha surgery. All models were also rinsed with the water while the flow outputs were visualized for the checking. The normal nose was represented an even flow distribution over the entire nasal cavity. After the nasal concha resection, a deviant flow course and a significant grow in turbulence activity were seen. A flow resistance dropped in addition considerably. In the model with general lateral wall hyperplasia, a restriction of the inferior and even of the middle nasal concha led to the beneficial functional results. The models demonstrated a positive correlation between the flow data and acoustic rhinometry and rhinoresistometry measures. Both methods complement each other in the diagnostic outcome of the nose functioning.

Investigation of the nasal cycle function through endoscopy, rhinoresistometry and acoustic rhinomety.

The cyclic congestion and decongestion in both nasal cavities systematically accompany the nose respiratory function. The turbulent behavior of the nasal airflow seems to be a prerequisite of the adequate contact of inspired air particles with a nasal mucosa. The aim of the present study was to gain further information regarding the turbulent airflow behavior just during the nasal cycle dynamics. The nasal cycles in 10 healthy human subjects were investigated applying endoscopic imaging, rhinoresistometry, and acoustic rhinometry methods. The nasal function has been estimated at the regular intervals of 20 minutes over a time period of 15 hours. The following parameters were calculated in each case: airflow resistance, hydraulic diameter, friction coefficient , transition from the laminar flow to the turbulent one, and minimal cross-sectional areas. In addition to the previously known cyclic changes of the flow resistance and of the nasal width, periodic alterations in the turbulence function were noted. Under the resting phase, the laminar flow was usually demonstrated. Under the working phase, the turbulences arouse already at low flow velocities. The increases of turbulences that supplemented the working phase were caused by the enlargement of the cross-sectional area in the anterior nasal cavum. The latter followed to the decongestion of the mucosa of the head of the inferior turbinate as well as of the septal tuberculum. Rhinoresistometry and acoustic rhinometry predominantly complement each other. Application of both methods provides therefore valuable information on the functional nasal cycle changes. A combination of these two methods is recommended thus for the proper evaluation of the nasal cavity behavior.

Otosclerosis surgery: approaches, profits and complications.

A systematic analysis of stapedoplasty output in otosclerosis cases was carried out. The operations were done during the period of 2005-2008 years at the Department of Otorhinolaryngology of the Tbilisi State Medical University. From the overall number of 107 patients, 78 were females and 29 males, 72.9% and 27.1%, respectively. The ages ranged from 16 to 57 years. The mean age was 35 years. The conductive and mixed forms of hearing losses were diagnosed in 70 and 37 cases, 65.4% and 34.6%, respectively. Right ear was operated in 46 patients, left ear in 57, and both ears in four, 43.3%, 53.0%, and 3.7%, respectively. 111 ears have been cured thus in sum. Intumescences of external ear tube were observed during the operation in 22 patients, 20.6%. In 7, 6.5%, the facial nerve was located downward. Particularly abnormal placement of the facial nerve was the case in two patients, 1.9%. The endaural approach has been proved to own advantages over the transmeatal one. The data generally confirmed that stapedotomy, as compared to stapedectomy, is a better choice for the surgery output. In beneficial cases the air/bone gaps after the operation closed totally or nearly totally. Such a proper outcome was reached in 93 out of 111 ears operated, 83.8%. In most of remainder ears the gaps after the operation narrowed significantly but far not completely. The definite surgery failure happened in one case only, 0.9%. To balance the preserved middle-ear problems in non-perfect surgery cases, the hearing aids of bone-conduction types have been recommended. In mixed otosclerosis cases, conversely, the aids of air-conduction types were advised to overcome the coexisted inner-ear pathologies.