[Genetic causes in mild speech acquisition delay with/without mild developmental delay: significance for ENT physicians]. / Genetische Ursachen bei Störungen der Sprachentwicklung mit/ohne allgemeine Entwicklungsstörung : Bedeutung für HNO-Arzte.

Mental retardation (MR) has a prevalence of about 2%, and developmental speech disorders with unknown cause about 7%. Very often, developmental delay represents an early warning sign of later developmental problems, such as mental retardation and other developmental disorders (DD). Prognosis depends on many factors, most notably the limiting factor provided by the severity of the underlying brain dysfunction and its consequences for communication, cognition and other behaviour. Chromosomal aberrations are the major cause of MR and also play a role in mild forms of DD and speech acquisition delay. ENT specialists are confronted with children with DD or language acquisition disorders. If the suspicion of hearing impairment as the cause of problems in daily life is not confirmed in a patient, ENT specialists should also consider genetic causes in the differential diagnosis.

[Autism spectrum disorders. Current knowledge and importance for ENT specialists]. / Autistische Kommunikationsstörungen. Aktueller Wissensstand und Bedeutung für HNO-Arzte.

Autism is a behavioural syndrome, present from early life and defined by deficient social interaction, language and communication, and play. Variations in symptomatology and in prognosis among characteristic persons display a variety of other signs such as attention deficits, mental retardation and seizures that are not specific to autism and that denote dysfunction in other brain systems. Its aetiology is unknown in the vast majority of cases. There is a small minority of persons in whom autism has a known aetiology, such as fragile X chromosome abnormality, congenital rubella, tuberous sclerosis and a variety of structural abnormalities and metabolic diseases of the brain. A causal treatment is so far not possible, and there remains a regrettable lack of evaluated treatment standards. Prognosis depends on many factors, most notably the limiting factor provided by the severity of the underlying brain dysfunction and its consequences for communication, cognition and other behaviour. ENT specialists are confronted with children, adolescents and even adults in whom autistic disease has already been diagnosed in the course of investigations/treatment. If the suspicion of hearing impairment as the cause of problems in daily life is not confirmed in a patient not hitherto known to have autism ENT specialists should also consider autism in the differential diagnosis. In this report the diagnostic and therapeutic strategies currently applied for autism and its importance for ENT specialists are presented.

[Attention deficit and hyperactivity disorder: what is currently known and its significance for ENT specialists]. / Störungen der Aufmerksamkeit und Aktivität (ADHS): Aktueller Wissensstand und Bedeutung für HNO-Arzte.

Attention deficit hyperactivity disorder (ADHD) is a behavioural disorder characterised by marked problems with inattention and increased impulsiveness, with or without hyperactivity; in most cases it becomes obvious in nursery-school-age children, and the latest point for its initial appearance is while the child affected is at primary school. Even in children of normal intelligence, the cognitive, emotional, and social development is decidedly limited, which can have corresponding ramifications for adult life. If left untreated it can progress to dissocial development and give the impression of an impulsive personality disorder in adulthood.ENT specialists are also confronted with children, adolescents and even adults in whom ADHD has already been diagnosed in the course of investigations/treatment. If the suspicion of hearing impairment as the cause of problems in daily life is not confirmed in a patient not hitherto known to have ADHD ENT specialists should also consider ADHD in the differential diagnosis. In this report the diagnostic and therapeutic strategies currently applied for ADHD and their importance for ENT specialists are presented.

[Dementia-current knowledge and significance for ENT specialists]. / Demenz-Aktueller Wissensstand und Bedeutung für HNO-Arzte.

Because of the growing number of elderly people, the incidence of dementia is increasing. This disease is a heavy burden for patients and their relatives, and has growing social and financial implications. The essential feature of dementia is an impairment in both short and long-term memory which is associated with an impairment in abstract thinking, impaired judgment, other disturbances of higher cortical functions, and/or personality change. Mild cognitive impairment represents a transitional state between the cognitive changes of normal aging and very early dementia, and is becoming increasingly recognized as a risk factor for Alzheimer's disorders. ENT specialists require knowledge on the basic problems in patients with (early) dementia and the most common diagnostic/therapeutic assessments. New therapeutic concepts such as cholinesterase inhibitors have been shown to interfere with the progression of Alzheimer's disease. In this report, the strategies in diagnostics and therapy which should be known by ENT specialists are presented.