RESUMO
KEY POINTS: An unfavorable insertion of the middle turbinate for cryotherapy was present in 74.2% of cases. Placing cryoprobe 15-30 mm above the nasal floor targets the nerves in 95.8% of cases. Centering the cryoprobe 38 mm behind the inferior turbinate axilla targets the nerves in 94.6% of cases.
RESUMO
Auditory neuropathy is caused by the loss of afferent input to the brainstem via the components of the neural pathway comprising inner hair cells and the first order neurons of the spiral ganglion. Recent work has identified the synapse between cochlear primary afferent neurons and sensory hair cells as a particularly vulnerable component of this pathway. Loss of these synapses due to noise exposure or aging results in the pathology identified as hidden hearing loss, an initial stage of cochlear dysfunction that goes undetected in standard hearing tests. We show here that repulsive axonal guidance molecule a (RGMa) acts to prevent regrowth and synaptogenesis of peripheral auditory nerve fibers with inner hair cells. Treatment of noise-exposed animals with an anti-RGMa blocking antibody regenerated inner hair cell synapses and resulted in recovery of wave-I amplitude of the auditory brainstem response, indicating effective reversal of synaptopathy.
Assuntos
Proteínas Ligadas por GPI/antagonistas & inibidores , Perda Auditiva Provocada por Ruído/tratamento farmacológico , Proteínas do Tecido Nervoso/antagonistas & inibidores , Regeneração/efeitos dos fármacos , Estimulação Acústica/métodos , Animais , Limiar Auditivo , Cóclea/citologia , Cóclea/efeitos dos fármacos , Cóclea/patologia , Modelos Animais de Doenças , Feminino , Proteínas Ligadas por GPI/metabolismo , Células Ciliadas Auditivas Internas/efeitos dos fármacos , Perda Auditiva Provocada por Ruído/patologia , Humanos , Masculino , Camundongos , Proteínas do Tecido Nervoso/metabolismo , Sinapses/efeitos dos fármacos , Sinapses/patologiaRESUMO
In front of external otitis in spite of a well-conducted treatment, especially in immunodeficient patient, it is always necessary to look for an osteomyelitis of the skull base that requires an urgent parenteral antibiotic treatment of several weeks. Acute otitis media (AOM) is the most common bacterial infection of the child. In children under 2 years with purulent AOM, antibiotic therapy with amoxicilline is systematic for a period of 8-10 days. After 2 years of age and with mild symptoms of AOM, symptomatic treatment may be justified as first-line treatment. Chronic otitis media is frequent after an episode of AOM and becomes chronic only after 3 months of evolution. Grommets reduce the frequency of AOM episodes. All AOM complicated with meningitis requires monitoring by audiogram and MRI of the ear.