Tinnitus: A Stepchild in Our Specialty.

Many patients are not satisfied with their doctor's answer when they complain about tinnitus. The proposed classification can be used to communicate with patients as well as guide future research. Type A itemizes the treatable causes of tinnitus. Type B itemizes tinnitus with a lack of medical explanation. Type C tinnitus is caused by diagnosable and treatable conditions, as listed in tinnitus type A, but the tinnitus persists after the successful treatment of the other symptoms.

Avaliação dos efeitos do subgalato de bismuto na proliferação de miofibroblastos / Assessment of the effects of bismuth subgallate on proliferation of myofibroblasts: an experimental study in rats

Resumo Contexto O subgalato de bismuto é um metal pesado e insolúvel, utilizado por suas propriedades adstringentes e hemostáticas. Objetivo Avaliar os efeitos do subgalato de bismuto na cicatrização mediante observação de miofibroblastos em pele de ratos. Métodos Foram utilizados 60 ratos da linhagem Wistar, que receberam uma ferida no dorso da pele. Os animais foram divididos em dois grupos: controle (aplicação diária de cloreto de sódio a 0,9%) e experimental (aplicação diária de 0,5 mg de subgalato de bismuto). Cada grupo foi subdividido em três subgrupos, que foram reoperados para retirada da ferida em 3, 7 e 14 dias. Foi realizada coloração de hematoxilina eosina, picrosirius e imuno-histoquímica para avaliar contagem de miofibroblastos, resposta inflamatória e síntese de colágeno. Resultados Não foi encontrada diferença entre os grupos controle e experimento com relação ao processo inflamatório – subgrupos 3 dias (p = 1), 7 dias (p = 0,474) e 14 dias (p = 303). A avaliação dos colágenos tipo I e III no grupo-controle não demonstrou benefícios de cicatrização – 3 dias (p = 0,436), 7 dias (p = 0,853) e 14 dias (p = 0,436); já no grupo experimental, houve aumento dos colágenos tipos I e III nos subgrupos 3 e 14 dias (p = 0,005). A imuno-histoquímica confirmou os resultados encontrados na coloração hematoxilina eosina, na qual a área de miofibroblastos entre os subgrupos, nos grupos experimental (p = 0,4) e controle (p = 0,336), foi indiferente. Conclusão A utilização do subgalato de bismuto em ferida de pele de ratos não evidenciou benefícios na cicatrização, ou seja, não houve diferença na fibroplasia quando comparados os grupos experimental e controle.

Abstract Background Bismuth subgallate is an insoluble heavy metal that is used for its astringent and hemostatic properties. Objective To evaluate the effects of bismuth subgallate on the healing process by observation of myofibroblasts in the skin of rats. Methods A sample of 60 Wistar rats was used. Each rat was subjected to a dorsal skin wound and allocated to one of two groups: a control group, in which 0.9% sodium chloride was administered daily, or an experimental group, in which 0.5 mg of bismuth subgallate was administered daily. Each of these groups was further subdivided into three subsets, which were reoperated after 3, 7 and 14 days respectively for excision and collection of the skin wound specimens. Samples were treated with hematoxylin eosin, picrosirius, and immunohistochemical staining to enable assessment of myofibroblast counts, inflammatory response phase, and collagen synthesis. Results No inflammatory process differences were detected between the control and experimental groups at 3 days (p = 1), 7 days (p = 0.474), or 14 days (p = 303). Evaluation of types I and III collagen in the control group did not demonstrate healing benefits at 3 days (p = 0.436), 7 days (p = 0.853), or 14 days (p = 0.436); whereas in the experimental group there were increases in types I and III collagen at 3 and 14 days (p = 0.005). Immunohistochemical analysis confirmed the results of hematoxylin eosin staining, since there were no differences between subsets in terms of area of myofibroblasts, in the experimental (p = 0.4) or the control (p = 0.336) groups. Conclusions Administration of bismuth subgallate to skin wounds in rats did not result in any evidence of benefits to healing, i.e., no difference in fibroplasia was detected when experimental and control groups were compared.

Medical Devices; Ear, Nose, and Throat Devices; Classification of the Tympanic Membrane Contact Hearing Aid. Final order.

The Food and Drug Administration (FDA) is classifying the tympanic membrane contact hearing aid into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the tympanic membrane contact hearing aid's classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.

Medical Devices; Ear, Nose, and Throat Devices; Classification of the External Upper Esophageal Sphincter Compression Device. Final order.

The Food and Drug Administration (FDA) is classifying the external upper esophageal sphincter (UES) compression device into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the external UES compression device's classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.

The subspecialty of rhinology: a survey of otolaryngology chairmen.

BACKGROUND: The past decade has witnessed the emergence of rhinology as a distinct subspecialty within otolaryngology. A critical evaluation of this process is necessary to define the field and to determine the impact of subspecialization on residency education. METHODS: An Internet-based survey of otolaryngology residency chairmen was performed to query attitudes about the importance of various aspects of rhinologic education including didactics, presence of rhinology faculty, exposure to research, office-based rhinology, and various surgical procedures. A 7-point Likert scale was used to rate responses. RESULTS: A 30.2% response rate was noted for the chairmen survey. From the chairmen's perspective, overall high levels of importance were ascribed to rhinology education and surgical training in otolaryngology residency. Lower scores for importance were noted for basic science research, exposure to office-based allergy care, and advanced surgical procedures. High scores were noted for the importance of fellowship training in the professional development of a resident interested in pursuing a career in rhinology. CONCLUSION: Overall high levels of importance were ascribed by the participating chairmen to the importance of rhinology education in residency. As the subspecialty of rhinology continues to develop, the role of the various educational, research and clinical activities will require continued evaluation.

[Otoneurology (definition, brief historical note, classification)].

The authors consider otoneurology to be an integral constituent part of general otorhinolaryngology. They propose its definition, present a brief historical sketch of this scientific discipline, and describe the principles of classification of the pathological conditions encompassed by this branch of general otorhinolaryngology.

Semiología en otorrinolaringología / Semiology in otolaryngology

La patología otorrinolaringológica (ORL) es una de las principales causas de consulta en pediatría y su exploración semiológica exige una serie de habilidades en la técnica, además de paciencia por parte del explorador, con el fin que ésta no sea una experiencia negativa para el paciente. Se debe realizar la valoración de ORLcon el niño en brazos de la madre, recordando cada uno de los pasos en semiología. En la presente revisión, se evaluarán aspectos de la anamnesis en ORL, anatomía básica así como de la exploración física de la oreja, los oídos, la nariz, los senos paranasales, la boca, la faringe y el cuello.

Otolaryngology pathology (OTL) is one of the main causes of pediatric and semiologic exploration requires a range of skills in the art, as well as patience from the browser, so it is not a negative experience for the patient . PtÑ assessment should be conducted with the child in mother's arms, remembering every one of the steps in semiology. In the present review, we evaluated aspects of OTL history.

Oral and maxillofacial surgery - a case of mistaken identity?

There are international grumbles from those perturbed by an impending identity crisis within oral and maxillofacial surgery (OMFS). This unrest is further compounded by scattered suggestions that a name change may prove beneficial in raising the profile of OMFS. The purpose of this paper is to consider novel methods of increasing awareness of the specialty amongst the public, primary and secondary care colleagues by collecting a consensus of thoughts and opinions regarding the specialty's identity and the appropriate and holistic nomenclature of OMFS. Approximately 300 eight-point questionnaires were distributed internationally with a response rate, via both email and post, of approximately 25% (72). Thirty-two percent of respondents considered there to be an identity crisis within OMFS although just 18% felt that a specialty name change would be beneficial. The results suggest that the problem with identity relates more to incapacity to convey the message of OMFS rather than nomenclature.

Sleep medicine for surgeons.

Sleep medicine is an important component of current head and neck surgery practices. Furthermore, obstructive sleep apnea is an anatomic disease of the upper respiratory tract, a region of anatomy best known to head and neck surgeons. If head and neck surgeons choose to participate in the surgical treatment of sleep apnea, they must develop expertise in the evaluation and home sleep testing aspects of sleep apnea. Because positive airway pressure remains the front line treatment, they must also develop expertise in the prescription of positive airway pressure therapy.

How we do it: Changes in thyroid and salivary gland surgery since 1989: who's doing it and what are they doing?

Keypoints * The aim of this study was to identify changes in the provision of parotid, submandibular and thyroid gland surgery between surgical specialties since 1989, as well as changes in surgical practice. * Data from the Department of Health's Hospital Episode Statistics (HES) was extracted from 1989/1990 and 2003/2004 records by operation and surgical specialty in England. * The data reveals a considerable decline in the amount of parotid and submandibular surgery performed by General surgeons; with the majority of this surgery currently being performed by ENT surgeons, and to a lesser extent, Oral and Maxillo-Facial surgeons. * Thyroid surgery has undergone less radical change, with General surgeons continuing to perform the majority of cases; however, an increasing proportion is now provided by ENT surgeons. * There also seems to be changes in the types of thyroid operation being performed; with large increases in total thyroidectomy and reductions in subtotal thyroidectomies.

Patología ORL ambulatoria / No disponible

Realizamos un estudio descriptivo de las consultas ORL ambulatorias durante un periodo de tres meses. Estudiamos1261 pacientes (568 hombres y 693 mujeres)con una media de edad de 40.41 años. Analizamos la edad, sexo, motivos de consulta, exploraciones complementarias y diagnósticos. Los síntomas más frecuentemente observados fueron hipoacusia (17.66%), insuficiencia respiratoria nasal obstrucción nasal (15.66%) y otalgia (9.95%). El43.74% de las consultas fueron por patología óptica. Los diagnósticos más frecuentes fueron faringitis crónica (9.14%), tapón de cerumen (8.85%) y rinitis alérgica(7.37%).Las exploraciones complementarias más frecuentes fueron las radiografías simples (35.50%), estudios audiométricos (33.38%) y analíticos (19.49%).Los resultados son similares a los de otras series revisadas

A descriptive study of ambulatory ENT consultations wasmade over a three months period. We studied 1261patients (568 mens and 693 womens) with an overall average age of 40.41 years. We analized age, sex, symptons of consultations, complementary studies anddiagnosis. The most frequently observed symptons were loss of hearing (17,66%), nasal respiratory insufficiency-nasal obstruction (15,66%) and otalgia (9,95%). Otic pathology were the 43,74% of consultations. The most frequents diagnosis were chronic pharyngitis (9,14%), ceruminoma(8,85%) and allergic rhinitis (7,37%).The most frequents complementary studies were radiograph findings (35,50%), audiometric studies (33,38%)and analytic studies (19,49%).The results were similars to the others rewievs series

Nearest neighbour classification of otoneurological data.

We studied the nearest neighbour classification of patient cases with benign positional vertigo, Meniere's disease, sudden deafness, traumatic vertigo, vestibular neuritis, and vestibular schwannoma. The classification results were compared to the inference results obtained by an otoneurological expert system ONE whose inference mechanism somewhat resembles the classical nearest neighbour method. With respect to the predictive accuracy, the classification results of these two systems agreed. The best predictive accuracy for the expert system ONE was 79.7% and for the nearest neighbour method 80.5%. However, differences in the true positive rates for sudden deafness, traumatic vertigo, vestibular neuritis, and vestibular schwannoma were found. The nearest neighbour classification results will be used in the refinement of ONE's knowledge base.

Pontenciales evocados auditivos de tallo cerabral y emisiones otoacusticas en la evaluación de la audición de recien nacidos sanos / Brain stem auditory evored and emision otoacustic in the evaluation of the hearing of neonatals

Se presentan los resultados de potenciales evocados auditivos de tallo cerebral y emisiones otoacústicas en 35 recién nacidos sanos en edades de 8-120 días de nacidos. Se concluye que los potenciales evocados auditivos de tallo cerebral y las emisiones otoacústicas son procedimientos diagnósticos confiables en al determinación de función auditiva en la población neonatal

The Ear, Nose, and Throat Devices Classification Panel of the Food And Drug Administration.

The passage into law in 1976 of the Medical Device Amendments authorized the FDA to regulate the safety and efficacy of medical devices. The effects of this regulation are contrasted with the mode of entry of medical devices onto the market prior to 1976. The structure and operation of Ear, Nose, and Throat Devices Classification Panel is described briefly. Continued input from otolaryngologists and allied professionals is encouraged.