Transitory evoked otoacoustic emission (TEOAE) and distortion product otoacoustic emission (DPOAE) outcomes from a three-stage newborn hearing screening protocol.

OBJECTIVE: Comparison of the efficacy of Transitory Evoked Otoacoustic Emissions (TEOAEs) and Distortion Product Otoacoustic Emissions (DPOAEs) in a neonatal hearing screening protocol, based on a three-stage strategy. METHODS: In the first stage, a hearing screening using both evoked emissions was conducted in 3,480 neonates from March 2006 through January 2012. Both TEOAEs and DPOAEs were recorded. Neonates, who did not undergo the test before being discharged, were examined within 30 days at a scheduled appointment. Follow-up of the referred newborns (second-stage screening) was performed as an outpatient re-screening, within a month. The third-stage evaluation, i.e., the diagnostic testing, included a clinical otolaryngological examination, high-frequency tympanometry at 1,000 Hz and Auditory Brainstem Response (ABR) measurements. RESULTS: A total of 3,480 (97%) newborns (n =1,765 males) out of 3,595 infants were enrolled in the study. In the first-stage evaluation, 8.9 % of the infants were referred according to TEOAEs, while the percentage of the referred infants for DPΟΑΕs was 25.7 %. At this initial assessment stage, the specificity of TEOAES and DPOAEs were determined as 92% and 75%, while positive predictive values (PPV) were 3.8 % and 1.3 %, respectively. In the second stage of evaluation, the specificity of TEOAES and DPOAEs were 86 % and 76 %, while the PPV increased to 18 % and 15 %, respectively. CONCLUSIONS: With a lower follow-up rate, TEOAEs testing was significantly easier to perform and more reliable compared to the DPOAEs test. Hippokratia 2016, 20(2): 104-109.

Multiparametric comparison of cold knife tonsillectomy, radiofrequency excision and thermal welding tonsillectomy in children.

OBJECTIVE: This is a prospective study evaluating certain intraoperative and postoperative parameters, comparing the relatively new technique of thermal welding tonsillectomy with cold knife tonsillectomy, and radiofrequency excision in pediatric population. METHODS: Ninety children aged from 5 through 13 years were enrolled a randomized prospective trial comparing cold knife tonsillectomy, radiofrequency excision, and thermal welding tonsillectomy. Indications included recurrent acute tonsillitis and/or obstructive sleep apnea syndrome. All techniques were compared by means of length of surgery time, blood loss, postoperative bleeding and postoperative pain. RESULTS: Sixty-eight patients underwent tonsillectomy for obstructive sleep apnea, whereas 22 children underwent tonsillectomy due to recurrent acute tonsillitis. Median values of all variables tested, length of surgery time, blood loss, postoperative bleeding and postoperative pain, were found to differ significantly among the three surgical techniques (P<0.001). Particularly, a statistically significant higher median duration (P<0.001) and intraoperative blood loss (P<0.001), as well as, a statistically significant lower median pain score in each day tested (P<0.001) of the cold knife group, compared to each one of the other two groups, were found. Tissue welding and radiofrequency groups did not differ significantly in any aspect tested. CONCLUSIONS: Both thermal welding and radiofrequency excision techniques have shown comparable results regarding intraoperative blood loss, postoperative hemorrhage, and pain. Compared with cold knife tonsillectomy, welding and radiofrequency excision techniques were associated with less intraoperative blood loss and duration, though cold knife tonsillectomy seems to prevail over the two techniques in terms of the postoperative pain.