The beneficial effect of transparent surgical masks on the communication of adults with hearing loss within clinical settings.

Purpose: The study examined the benefits of transparent versus non-transparent surgical masks on the speech intelligibility in quiet of adult cochlear implant (CI) users, in conjunction with patient preferences and the acoustic effects of the different masks on the speech signal.Methods: Speech tracking test (STT) scores and acoustical characteristics were measured in quiet for live speech in three different conditions, without mask, with a non-transparent surgical mask and with a transparent surgical mask. Patients were asked about their experience with the face masks. The study sample consists of 30 patients using a cochlear implant.Results: We found a significant difference in speech perception among all conditions, with the speech tracking scores revealing a significant advantage when switching from the non-transparent surgical mask to the transparent one. The transparent surgical mask, although it does not transmit high frequencies effectively, seems to have minimal effect on speech comprehension in practice when lip movements are visible. This substantial benefit is further emphasized in the questionnaire, where 82% of the patients express a preference for the transparent surgical mask.Conclusion: The study highlights significant benefits for patients in speech intelligibility in quiet with the use of medically safe transparent facemasks. Transitioning from standard surgical masks to transparent masks demonstrates highly significant effectiveness and patient satisfaction for patients with hearing loss. This research strongly advocates for the implementation of transparent masks in broader hospital and perioperative settings.

In scenarios mandating mask usage, it's advisable for caregivers to opt for transparent surgical masks. Specifically within perioperative settings, where patients might not be able to utilise their hearing aids or cochlear implants, it becomes imperative for all caregivers to consistently wear transparent surgical masks to prevent communication impediments.When utilising a transparent surgical mask, caregivers must recognise that sound may be altered and maintaining a clear view of the face and lips is crucial for effective communication.

Endoscopic-Assisted Canal Wall-up Tympanomastoidectomy for Reduction of Residual Cholesteatoma

Abstract Introduction The treatment of cholesteatoma is generally surgical, and the major obstacle is the high prevalence of recidivism. The endoscopic ear surgery technique is proposed to minimize this problem. Objectives To utilize endoscopes to visualize and manipulate cholesteatoma residues after microscopic removal Methods Cross-sectional study. Thirty-two patients with cholesteatoma underwent microscopic wall-up mastoidectomy combined with the endoscopic approach. The subjects were assessed for the presence and location of covert disease. Results Of the 32 cases, 17 (53.12%) had residual cholesteatoma in the endoscopic phase. Minimal disease was found, usually fragments of the cholesteatoma matrix. Pars tensa cholesteatomas had more covert disease than pars flaccida cholesteatomas (62.50% vs 43.75%). Posterior recesses (47.05%) and tegmen tympani (41.17%) were the locations with more covert disease (p< 0.05). Conclusion Cholesteatomas of the pars tensa presented more residual disease and were significantly more common in the posterior recesses and tegmen tympani.

Endoscopic-Assisted Canal Wall-up Tympanomastoidectomy for Reduction of Residual Cholesteatoma.

Introduction The treatment of cholesteatoma is generally surgical, and the major obstacle is the high prevalence of recidivism. The endoscopic ear surgery technique is proposed to minimize this problem. Objectives To utilize endoscopes to visualize and manipulate cholesteatoma residues after microscopic removal Methods Cross-sectional study. Thirty-two patients with cholesteatoma underwent microscopic wall-up mastoidectomy combined with the endoscopic approach. The subjects were assessed for the presence and location of covert disease. Results Of the 32 cases, 17 (53.12%) had residual cholesteatoma in the endoscopic phase. Minimal disease was found, usually fragments of the cholesteatoma matrix. Pars tensa cholesteatomas had more covert disease than pars flaccida cholesteatomas (62.50% vs 43.75%). Posterior recesses (47.05%) and tegmen tympani (41.17%) were the locations with more covert disease ( p < 0.05). Conclusion Cholesteatomas of the pars tensa presented more residual disease and were significantly more common in the posterior recesses and tegmen tympani.

Prevalence of hypovitaminosis D in patients with juvenile osteochondritis dissecans. / Prevalencia de hipovitaminosis D en pacientes con osteocondritis disecante juvenil.

BACKGROUND: Juvenile osteochondritis dissecans (JOCD) is an acquired joint disease of unknown etiology that affects skeletally immature patients and has the potential to progress to osteoarthritis. Recent studies have reported a high prevalence of vitaminD deficiency in patients with osteochondral lesions. The aim of our study was to determine serum vitaminD levels in patients diagnosed with JOCD. METHODS: Serum 25(OH)D levels of 31 patients (22 males) presenting 40 lesions (29 JOCD of the knee, and 11 of the ankle) were evaluated. The average age was 11.9±2.9years. HypovitaminosisD was defined as a value less than 30ng/mL and was divided into vitaminD insufficiency (20 to 30ng/mL) and vitaminD deficiency (<20ng/mL). RESULTS: HypovitaminosisD was present in 45.2% of the evaluated patients (32.2% insufficiency and 13% deficiency). No significant differences were found in the mean values and incidence of hypovitaminosis between those patients in which the sample was taken in warm or cold season (P=.267 and P=.875, respectively). Patients who required surgery had a higher incidence of hypovitaminosis than those treated conservatively (60% versus 31%, P=.054). There was no correlation in the incidence of hypovitaminosis with sex, location, stability of the lesion, or if the lesion was uni- or bilateral. CONCLUSION: In our series, almost half of the patients diagnosed with JOCD presented abnormal serum levels of vitaminD. A two-fold incidence of hypovitaminosis was observed in patients requiring surgical treatment compared to patients managed conservatively. The association found in this study does not imply causation, but it should be considered within the set of actions for the treatment of these injuries.

Upper limb active joint repositioning during a multijoint task in participants with and without rotator cuff tendinopathy and effect of a rehabilitation program.

STUDY DESIGN: Cross-sectional and longitudinal (exploratory) studies. INTRODUCTION: Rotator cuff (RC) tendinopathy is the most prevalent shoulder diagnosis, and proprioception deficits are often observed in individuals with RC tendinopathy. PURPOSE OF THE STUDY: This study aimed to evaluate upper limb proprioception during a multijoint task in participants with and without RC tendinopathy and to determine if symptoms, functional limitations, and proprioception are improved after a rehabilitation program. METHODS: Twenty participants with and 20 without RC tendinopathy were recruited for the cross-sectional study, and 23 participants with RC tendinopathy were recruited for the longitudinal study. Proprioception was evaluated by an active joint-repositioning task: The upper limb was passively moved to a predetermined position, and the participant was asked to actively replicate the movement. The difference between the predetermined position and the replicated position was measured. The mean errors in positions of lateral, medial, and neutral rotation of the shoulder and the global mean error were reported. In addition to the active-repositioning assessment in the longitudinal study, symptoms and functional limitations were evaluated by the Disability of the Arm Shoulder and Hand questionnaire. RESULTS: Significant deficits in active repositioning (p < .01), independent of the position, were observed in participants with RC tendinopathy compared with controls. The DASH score was improved after rehabilitation intervention (p < .001), and patients with active-repositioning deficits at baseline had reduced repositioning error (p < .05). CONCLUSIONS: Upper limb active joint repositioning was impaired in participants with RC tendinopathy. Symptoms and functional limitations and active joint repositioning in participants with RC tendinopathy and initial deficits were improved after a 6-week global rehabilitation program.