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Attempts to examine association between diabetes mellitus and hearing loss. Dependence of cochlear homeostasis on oxidative phosphorylation; Pathogenesis of diabetic neuropathy; Comparison of audiometric and temporal bone findings of several diabetics and controls; Periodic acid-Schiff positive thickening of the basement membrane; Latency of brainstem auditory evoked potential.

Mucociliary transport relies not only on co-ordinated ciliary activity but on mucus and its specific rheological properties. The rheological and viscoelastic properties of mucus are determined by its complex polymeric structure and degree of hydration. Mucus does not behave like a simple Newtonian fluid but is non-Newtonian, with heterogeneous viscoelastic properties. An alteration in mucus rheology can significantly affect the mechanical coupling of the cilia with the overlying mucus. The mucociliary apparatus has an important role in maintaining the integrity of the nasal airway and paranasal sinuses as well as that of the rest of the respiratory tract. The mucociliary clearance rate was first studied in the 18306.¹ Studies of the relationship between the properties of mucus and mucociliary clearance rate date from 1956 when Dalhamn described mucostasis following the inhalation of irritant gases in rats.² He concluded that the composition and quality of the secretions are important factors. Further studies looking at the rheology of mucus and mucociliary clearance rate together were done by Carson et al. in 1966³ using the cat trachea. Ewert[sup 4] reviewed the literature and concluded that one of the prerequisites for normal mucus flow is an intact blood and nerve supply to the mucosa. This implied that in-vivo studies are particularly important in the measurement of mucus flow rate. The ciliary beat has two components, the effective and the recovery stroke. The effective stroke occurs with the cilium perpendicular to the cell surface with its tip in contact with the mucus. The mucus layer acts as a coupler which transfers momentum from the tips of the cilia to the loads (Figure 1). When the cilia contact the mucus they tend to bend backwards and if this bend is too great because of excessive mucus viscosity the system does not work effectively. The cilia beat efficiently at 10.8 Hz (SD0.7)[sup 6]. If there is an inadequate quantity of mu... [ABSTRACT FROM AUTHOR]

Examines the effect of the nasal cycle on mucociliary clearance. Physiology of the nasal cycle; Ratios of clearance times from teh patent nostril when compared to the obstructed nostril; Marked effect of the nasal cycle on the mucociliary clearance patterns of the nose.

The clinician should suspect a disorder of mucociliary clearance in a patient who has both rhinosinusitis and bronchiectasis, an individual with purulent rhinosinusitis who repeatedly fails to respond to medical treatment, or if the nasal airway is filled with tenaceous secretions. This is a review of the various clinical tests which could be employed to assess mucociliary clearance. [ABSTRACT FROM AUTHOR]

The prevalence of hyperlipidaemia in the normal population means that hyperlipidaemia is often found in patients who have a hearing loss of unknown aetiology. We prospectively undertook a case-controlled study of 85 patients presenting consecutively with a sensorineural hearing loss of unknown aetiology to see if the prevalence of hyperlipidaemia differed between the group with an idiopathic sensorineural hearing loss and a control population. Control subjects were recruited from patients undergoing nasal surgery for structural abnormalities. Both the study and control groups were also compared with the National Study of Hearing data. Hyperlipidaemia was no more prevalent in a population with idiopathic sensorineural hearing loss than a control population. No consistent association between hyperlipidaemia and hearing loss was found. [ABSTRACT FROM AUTHOR]

Forty-four patients undergoing magnetic resonance imaging (MRI) head scans for non-nasal disease were asked to complete a questionnaire immediately after the scan. Subjective patency was scored for each nasal airway, patients were also asked about other nasal symptoms, hay fever, upper respiratory tract infections, medication and any history of nasal surgery or trauma. The following measurements from MRI scans were made: the cross-sectional area of the nasal airway at the anterior end of the middle turbinate, the horizontal width of the inferior turbinate and maximum septal mucosal thickness. In addition the presence of any septal deviation and the thickness or the mucosa of the paranasal sinuses was assessed. Correlation between subjective airway patency and the anatomical parameters studied was generally very weak. However, patients with sinus mucosal thickening on MRI scanning had significantly lower subjective patency scores (left P = 0.003, right P = 0.029) for both nasal airways. Assessment of the nasal airway on MRI correlates poorly with symptoms of nasal obstruction. However, patients with sinus mucosal thickening ( > 5 mm) had significantly more symptoms of nasal obstruction on both sides. [ABSTRACT FROM AUTHOR]

Hyperlipidaemia has been reported as an aetiological factor in sensorineural hearing loss. Reports on this subject have been retrospective, lacked adequate controls, or have been based on a series of cases which may represent incidental findings as hyperlipidaemia is prevalent in the normal population. The published evidence that hyperlipidaemia causes hearing problems is contradictory and warrants further controlled trials. A prospective case-controlled study was conducted of 197 men between 50 and 60 years old selected at random from a population at risk from ischaemic heart disease or hyperlipidaemia. Hearing thresholds, relevant variables and–on two occasions–their fasting cholesterol levels, were recorded. The control subjects were recruited from patients undergoing nasal surgery for either internal or external structural abnormalities. All study and control groups were also compared with the National Study of Hearing (NSH) data. When hearing thresholds were grouped together as 0.5, 1, 2 and 4 kHz, 0.5, 1, 2 kHz or 4, 6 and 8 kHz there were no statistically significant differences except at 4, 6 and 8 kHz in the worse hearing ear where the at risk group had better hearing thresholds, P = 0.0475. However, the differences which existed became reduced across all frequencies when the subgroup with fasting lipids > 6.5 mmol/l was compared with the at risk group as a whole against the NSH data. [ABSTRACT FROM AUTHOR]

Presents abstract of a paper entitled 'Changes in quality of life following dacryocystorhinostomy: external and endoscopic-laser techniques compared,' by A.S. Carneyi, S.A. Bakri, K.L Robinson, R.J. Downes and N.S. Jones, which was featured at the April 1998 meeting of the Otorhinolaryngology Research Society in Leicester, England. Utilization of Glasgow Benefit Inventory; Improvement in orbital symptoms.

The aim of the study was to determine the incidence of olfactory disorders before and following nasal and paranasal sinus surgery. It was a prospective observational study. Over a 6-month period, all patients who had been listed for nasal and paranasal sinus surgery underwent preoperative and postoperative evaluation of their sense of smell. A questionnaire and the ‘Smell Diskettes Test’ were used to assess olfaction. One hundred and eighty-four patients were studied. Preoperatively, 19 patients (10.3%) had an impaired sense of smell (8.1% before septoplasty, 6.1% before rhinoplasty and 17.1% before endoscopic sinus surgery). Only 16 (84%) of these patients were aware of their impaired sense of smell. Following surgery, four patients (2.5%) who were normal preoperatively developed impaired olfaction on questioning, and this was supported by testing it. In the subgroup that had a septoplasty, no patient developed hyposmia compared to one patient (2.6%) after rhinoplasty and one patient (3%) after endoscopic sinus surgery. No patient developed anosmia. Preoperatively, 10.3% of patients had an altered sense of smell, making it desirable that this is documented in order to avoid postoperative claims that this was caused by surgery. It also helps to audit the results of surgery. [ABSTRACT FROM AUTHOR]

The nasal delivery of drugs, both for systemic and local use, is an expanding field with many drugs being delivered by this route. It is known that changes in pH can affect drug absorption but there is no data regarding intranasal pH over time. We present the results of 24-h ambulatory nasal pH monitoring in four subjects, each of whom had monitoring on two separate occasions. The apparatus consisted of a pH monitor with two electrodes, thus enabling us to take readings from 1 and 4 cm behind the anterior end of the inferior turbinate. Measurements were recorded every 6 s by the posterior electrode and every 30 s by the anterior electrode. The recording apparatus was worn around the subjects waist. Analysis of the results showed that there was no diurnal variation and no significant differences between the subjects. The mean pH from the anterior electrode was higher than that from the posterior (7.1 versus 6.6). The pH did not fluctuate with daily activities such as eating, drinking or sleeping. The results are interesting and may be of importance with regard to the design of formulations for nasal drug delivery systems. [ABSTRACT FROM AUTHOR]

Betamethasone topical nasal drops may have systemic corticosteroid activity and cause suppression of the hypothalamo-pituitary-adrenal (HPA) axis and impairment of bone turnover. The aim of this study was to assess the effect of a standard 6-week regime of betamethasone topical nasal drops on the HPA axis (using a physiological dose (1 μg) ACTH test) and on bone turnover (using markers of bone turnover, urinary deoxypyridinoline and serum bone specific alkaline phosphatase). Eleven patients with nasal polyposis were included in a prospective cohort study. Plasma cortisol was lower after betamethasone treatment at all time intervals (P < 0.0001). There was no change in urinary deoxypyridinoline corrected for creatinine or bone specific alkaline phosphatase. Six weeks’ treatment with recommended doses of betamethasone suppresses the HPA axis, but has no significant effect upon markers of bone turnover. Topical betamethasone in subjects with nasal polyps should be viewed as systemic corticosteroid administration and the long and short-term sequelae should be borne in mind. [ABSTRACT FROM AUTHOR]