Surgical and audiological evaluation of the Baha BA400.

OBJECTIVE: Despite extensive soft tissue reduction, the most common complications associated with bone-anchored hearing aid systems, also known as bone-anchored hearing implants, are related to adverse skin reactions around the abutment. The necessary soft tissue reduction also adds complexity to the surgical procedure. This study aimed to evaluate the surgical and audiological outcomes of a new connective interface of the Cochlear™ Baha® BA400 device implanted using the one-stage surgical technique. METHOD: A multicentre, retrospective case series is presented, including data collected from three tertiary care institutions. RESULTS: In total, 16 patients who had undergone bone-anchored hearing aid surgery over a 10- to 12-month period were assessed for hearing performance, implant stability and surgical complications. CONCLUSION: This case series indicates that new abutments with a hydroxyapatite coating can be implanted percutaneously without soft tissue reduction. Furthermore, device implantation using this surgical technique may have some advantages compared with a conventional device and procedure combination over 12- to 16-months of follow up.

Polymorphic variants of MnSOD Val16Ala, CAT-262 C < T and GPx1 Pro198Leu genotypes and the risk of laryngeal cancer in a smoking population.

OBJECTIVE: To investigate the relationship between development of laryngeal cancer and the presence of polymorphisms of the MnSOD Val16Ala, CAT-262 C < T and GPx1 Pro198Leu genes in a smoking population. PATIENTS AND METHODS: Single nucleotide polymorphisms were determined in DNA from the peripheral blood erythrocytes of 48 heavy smokers (25 patients with laryngeal cancer and 23 cancer-free controls), using polymerase chain reaction. RESULTS: There were no significant differences in age, smoking duration or smoking intensity, comparing the two groups. The homozygous AA genotype of MnSOD Val16Ala was significantly more prevalent in the cancer group than the control group (92 vs 13 per cent, respectively), while the heterozygous AV genotype of MnSOD Val16Ala was more prevalent in the control group than the cancer group (87 vs 8 per cent, respectively) (p < 0.001). There were no significant differences between the cancer and control groups regarding GPx1 Pro198Leu or CAT-262 C < T polymorphisms. CONCLUSION: Polymorphism of the MnSOD Val16Ala gene may contribute to susceptibility to laryngeal cancer among smokers.

Incus and stapes necrosis associated with diabetes mellitus.

Chronic otitis media is often associated with ossicular defects, the most frequent being necrosis of the long process of incus. Except for infection and cholesteatoma; trauma and local pressure by chorda tympani are uncommon causes leading to incus erosion. In the literature, no case of incus necrosis has been reported associated with type II diabetes mellitus (DM). A patient is presented in this report with incus and stapes suprastructure necrosis and associated type II DM who was admitted to the out-patient clinic with complaints of conductive hearing loss.

The role of allergy in recurrent otitis media with effusion.

OBJECTIVE: To compare the OME groups that improved when treated with adenoidectomy, VT and medication, and which of them recurred. METHODS: Twenty-two consecutive children with recurrent OME (11%) were selected among 200 children who had adenoidectomies and had been inserted a ventilation tube (VT) for OME. The patients were selected for allergy evaluation because of recurrent OME not responsive to medical therapy and adenoidectomy, requiring more than one myringotomy with tubes. The control group consisted of 24 healthy children that were treated with adenoidectomy and VT, and had no recurrence. RESULTS: Eight (36.4%) patients had positive skin tests for inhalant and food allergens. Two subjects of the control group (8.3%) had positive skin tests for inhalant and food allergens. This was statistically significant (p:0.032). A pattern to multiple positive nasal and food reactions was shown in the study group rather than in the control subjects. CONCLUSIONS: The possibility of allergy should be considered in OME cases that did not improve with drug treatment and adenoidectomy and VT insertion but recurred, and a thorough search for allergen was made for proper diagnostic and therapeutic management.

Allergic rhinitis in Rosa domescena cultivators: a novel type of occupational allergy?

After the diagnosis of allergic rhinitis due to Rosa domescena was suspected in one subject with skin prick and nasal provocation tests, we recruited all other workers employed in rose cultivation in Yakaören village, Isparta. From May 2000 to July 2000 (exposure period 'time of rose handling'), we studied 600 individuals employed in rose cultivation. A questionnaire was administered by a physician, and skin testing was done by a nurse on 75 individuals suffering from asthma and/or rhinitis. Sera from these 75 subjects were available for immunologic testing. The diagnosis of atopy against rose was based on the presence of work-related symptoms, positive skin prick test (SPT) with rose extracts, and positive RAST. While no subject reported asthmatic symptoms, twenty of them reported either rhino-conjunctivitis, rhinitis or both on exposure to Rosa domescena. Fourteen of these subjects had increased specific IgE levels to Rosa domescena. Eleven (78.5%) also had a positive skin reaction to Rosa domescena. Out of the six negative sera with normal specific IgE levels to rose, only two (33.3%) had positive skin reactivity. No subject had significant daily peak expiratoy flow rate (PEFR) variations. We conclude that exposure to Rosa domescena may represent a risk for allergic rhinitis. The possibility of an occupational rose allergy should therefore be taken into consideration in the subjects working in rose cultivation.