Search

Objective: The aim of the present study was to study patterns in the extended spectrum of the human hearing (0.125 to 20 kHz) in order to obtain reference thresholds. Then, we compare our values with existing results at extended high-frequencies (8 to 20 kHz) in an attempt to establish new standards for potential international adoption. Design: A prospective study in a group of otologically healthy subjects. Study sample: A total of 645 subjects aged between 5 and 90 years were recruited. Pure-tone thresholds were determined for conventional and extended high-frequencies. Results: There was an increase in the hearing thresholds as a function of frequency and age. For the 20 to 69 years old group, thresholds were lower in females than in males, especially at 12.5 and 16 kHz. Our threshold values are comparable to those presented in previous studies that used different instrumentation and populations. Conclusions: When comparing different studies the hearing thresholds were found to be similar. Therefore, it would be possible to establish international standard thresholds. [ABSTRACT FROM AUTHOR]

Since the McCabe report, growing indirect evidence has accumulated to indicate the implication of immune mechanisms in the pathogenesis of immune-mediated inner-ear disease (IMIED). A clinical study of a group of patients affected by this condition was performed in order to characterize the immune group, based on a recently reported profile, and compared with the vascular, viral and idiopathic aetiologies of sudden deafness. Patients affected by immune-mediated inner-ear disease had the best and the earliest recovery rate of hearing (p = 0.0028 and p = 0.017, respectively). However, this group of patients also had the higher rate of recurrence (p = 0.034), supporting the typical clinical course of the autoimmune disorders. On the basis of the results the criteria used in the diagnosis of the sudden presentation of the immune-mediated inner ear disease could be accepted leading to the characterization of this condition. Likewise, the role of the supporting cells in the pathogenesis of the IMIED is discussed. [ABSTRACT FROM AUTHOR]

High-performance thin film nanocomposite (TFN) hollow fiber (HF) membranes, with MIL-101(Cr) MOF nanoparticles (52 ± 13 nm) embedded, have been synthesized with the polyamide layer formed either on the outer or inner surface of a polysulfone HF (250 and 380 μm ID and OD, respectively). The TFN_out membrane was developed using the conventional interfacial polymerization method, typically applied to obtain TFN flat membranes (MOF particles added to the thin layer by deposition). This membrane gave a water permeance value of 1.0 ± 0.7 L·m -2 ·h -1 ·bar -1 and a rejection of 90.9 ± 1.2% of acridine orange (AO, 265 Da). In contrast, the TFN_in membrane was synthesized by microfluidic means and gave a significantly higher water permeance of 2.8 ± 0.2 L·m -2 ·h -1 ·bar -1 and a slightly lower rejection of 87.4 ± 2.5% of the same solute. This remarkable increase of flux obtained with small solute AO suggests that the HF membranes developed in this work would exhibit good performance with other typical solutes with higher molecular weight than AO. The differences between the performances of both TFN_in and TFN_out membranes lay on the distinct superficial physicochemical properties of the support, the synthesis method, and the different concentrations of MOF present in the polyamide films of both membranes. The TFN_in is more desirable due to its potential advantages, and more effortless scalability due to the microfluidic continuous synthesis. In addition, the TFN_in membrane needs much fewer quantities of reactants to be synthesized than the TFN_out or the flat membrane version.

The MOFs Cr carboxylate MIL-101(Cr) and Zn imidazolate ZIF-11 have different chemical and textural properties. These properties have been combined to prepare thin film nanocomposite (TFN) membranes for organic solvent nanofiltration (OSN) with the two MOFs simultaneously embedded in the same membrane. The TFN membrane containing only ZIF-11 permeated faster than that with only MIL-101(Cr) when filtering sunset yellow (SY) (4.9 L m -2 h -1 bar -1 ) and acridine orange (AO) (3.2 L m -2 h -1 bar -1 ), although MIL-101(Cr) alone gave rise in both cases to better rejections (above 90%). The combination of the two MOFs led to a versatile TFN membrane that showed an intermediate performance that improved the rejections given by the TFN membrane synthesized with ZIF-11 and the permeances corresponding to the TFN membrane synthesized with MIL-101(Cr). The effect of the temperature on the TFN membranes designed for this work has also been studied, obtaining apparent activation energies of 13.2 ± 2.1 and 8.3 ± 1.1 kJ mol -1 for the OSN of pure methanol and SY-methanol, respectively.

Introduction: Malignant tumors of the parotid gland account scarcely for 5% of all head and neck tumors. Most of these neoplasms have a high tendency for recurrence, local infiltration, perineural extension, and metastasis. Although uncommon, these malignant tumors require complex surgical treatment sometimes involving a total parotidectomy including a complete facial nerve resection. Severe functional and aesthetic facial defects are the result of a complete sacrifice or injury to isolated branches becoming an uncomfortable distress for patients and a major challenge for reconstructive surgeons., Case Report: A case of a 54-year-old, systemically healthy male patient with a 4 month complaint of pain and swelling on the right side of the face is presented. The patient reported a rapid increase in the size of the lesion over the past 2 months. Imaging tests and histopathological analysis reported an adenoid cystic carcinoma. A complete parotidectomy was carried out with an intraoperative notice of facial nerve infiltration requiring a second intervention for nerve and defect reconstruction. A free ALT flap with vascularized nerve grafts was the surgical choice. A 6 month follow-up showed partial facial movement recovery and the facial defect mended., Conclusion: It is of critical importance to restore function to patients with facial nerve injury. Vascularized nerve grafts, in many clinical and experimental studies, have shown to result in better nerve regeneration than conventional non-vascularized nerve grafts. Nevertheless, there are factors that may affect the degree, speed and regeneration rate regarding the free fasciocutaneous flap. In complex head and neck defects following a total parotidectomy, the extended free fasciocutaneous ALT (anterior-lateral thigh) flap with a vascularized nerve graft is ideally suited for the reconstruction of the injured site. Donor-site morbidity is low and additional surgical time is minimal compared with the time of a single ALT flap transfer.

Introduction: Many presbycusic patients have difficulty in understanding certain words. This could be justified because certain sounds in Spanish are more difficult to perceive, particularly the sounds with energy in the high frequencies. We propose to use a sentence as a tool to check this theory., Materials and Method: All the Spanish sounds were analyzed, measuring the degree of acoustic energy in all the frequencies. The conclusions drawn from the comparison of the results allowed the design of the tool that is proposed here., Results: We established a gradient of perception difficulty, occlusive consonants being the least perceptible, followed by fricative, and finally all those segments with harmony and a clear formant structure. The Spanish sentence "Ana vio ese coche rojizo fino" is proposed as the tool for this study. This sentence has some as it comprises certain peculiarities that makes it particularly useful for this purpose. It will allow us to check whether understanding deteriorates as we move from beginning to end, helping evaluate the importance of high frequencies for intelligibility., Conclusions: A positive result could help in the design of amplification systems to improve speech intelligibility. In addition, the exploratory tool could allow neuro-acoustic exploration, useful in the central auditory pathology studies.

Introduction and Objectives: Voice alteration is a common event following endotracheal intubation. The objective of this study is to describe strobolaryngoscopic and spectrogram changes after endotracheal intubation, and attempt to identify a relationship between these changes and also with anaesthetic variables., Material and Method: Thirty-eight patients who underwent endotracheal intubation for otological surgery were studied prospectively. None of these subjects had a history of voice problems or prior cervical surgery, and they did not consume alcohol or tobacco. The patients were studied prior to the operation and 3 hours, 24 hours, and 7 days after surgery. Laryngeal morphology was explored by strobolaryngoscopy. The vocal output was examined by means of the GRABS scale, acoustic analysis and spectrogram., Results: Strobolaryngoscopy was normal 24 hours after surgery in all but 2 subjects, in whom it later returned to normal. Spectrography, acoustic analysis (jitter and shimmer), and GRABS scale all showed an initial worsening of voice production after surgery when compared to pre-operative values, followed by a recovery of normal values 1 week after surgery. No statistical correlation was found between voice output and anaesthetic variables., Conclusions: Although there are temporary voice changes in subjects undergoing endotracheal intubation during the early post-operative period, these recover to normal parameters within 7 days after surgery. These changes occur even in the absence of strobolaryngoscopic changes.

Syphilis is a well established cause of hearing loss. Sensorineural hearing loss may develop in the congenital or acquired form. The clinical course of the early acquired and late congenital forms are similar: sudden or rapidly progressive bilateral sensorineural hearing loss with mild vestibular symptoms. Cochleovestibular involvement in early acquired syphilis has been related to a basilar meningitis with lymphocytic infiltration of the labyrinth and VIIIth nerve. However, neurosyphilis and inner ear syphilis are not the same disease. Prompt diagnosis and treatment with corticosteroids and penicillin are mandatory to reduce the immune response and fibrosis of the labyrinth and the endolymphatic sac. Unfortunately, early acquired syphilis is frequently overlooked in the differential diagnosis of other forms of sensorineural hearing loss, particularly autoimmune inner ear disease. Given the increasing number of luetic infection cases, especially in immunocompromised patients, this condition should be considered in any sexually active patients affected by sudden hearing loss. Cases of inner ear syphilis are presented. Immunopathology of luetic inner ear infection is discussed and compared with immune disorders of the inner ear.

DNA ploidy and cell-cycle distribution were determined by flow cytometry in fresh tumor tissue of 27 epithelial head and neck carcinomas. Epithelial cells were labeled with a fluorescein-isothiocyanate-conjugated cytokeratin antibody to study the possible influence of contaminating stromal and inflammatory cells on the results of cell-cycle analysis of tumor cells. The patient sample included 26 men and 1 women with a mean age of 60 years. Without cytokeratin gating, 11/27 tumors (40.74%) were aneuploid. After selecting the cytokeratin population, 10 more aneuploid tumors were found that had not been detected when considering the total population. Therefore, aneuploid tumors increased from 40.74% to 77.74%. The remaining 6/27 (22.26%) tumors were diploid. In the tumors that were either aneuploid without cytokeratin gating or diploid, the S-phase and G2M phase were significantly higher after cytokeratin staining, specially in diploid tumors (24.2% versus 10% and 6.8% versus 3.2%, respectively, p < 0.01). Therefore, in head and neck tumors cytokeratin staining optimizes both the determination of DNA ploidy and cell-cycle analysis, which is advantageous for tumor staging and prognosis assessment in these patients.

Surgery, alone or in combination with other therapeutic measures, is one of the main approaches to curing laryngeal cancer. The risk of complications is implicit in any surgical procedure. We describe our experience with general and local complications in surgery for laryngeal cancer and examine their relation to tumor extension and surgical technique. A review was made of a series of 431 patients who underwent surgery for laryngeal cancer over a 10-year period (1982-1991). Twenty-two patients (5.1%) had systemic complications, including upper gastrointestinal hemorrhage (n = 5), massive cervical hemorrhage (n = 5), and four renal failure. Minor complications were recorded in 77 cases (17.8%), predominantly pharyngocutaneous salivary fistula, which developed in 55 patients (13.8%). The incidence of local complications was significantly greater in patients with extensive local spread (T4). There were no differences among patients with regional spread. The surgical technique and type of pharyngoesophageal reconstruction played no role in the development of complications. Preoperative radiotherapy did not influence on the development of salivary fistulas.

The treatment of early-stage laryngeal cancer using either partial surgical techniques or irradiation still is controversial. The performance of rescue surgical procedures after irradiation is related to increased postsurgical complications and lower survival rates. We made a retrospective study of 73 patients who underwent rescue surgery after failure of radiotherapy in our department in the last 10 years. A statistical analysis was made of the complications and survival rate of these patients in accordance with tumor location and clinicopathological stage compared with patients who underwent surgery alone (n = 435). More rescue surgery was performed for glottic carcinomas (52/73) than for supraglottic carcinomas (21/73). No significant differences were found in the complication rate (23.6%) compared with the control group (19.6%). There was a significant reduction in survival in patients who underwent previous irradiation of supraglottic tumors compared with glottic tumors and the control group. In view of these results, we conclude that irradiation is not a good option as an initial treatment for supraglottic tumors and that the procedure of choice should be surgical.

There are two types of rapidly progressive sensorineural hearing loss: sudden hearing loss, which is generally unilateral and develops in less than 72 hours, and rapidly progressive sensorineural hearing loss, which develops over days or months. The origin of sudden deafness is difficult to establish. Several etiopathogenic factors have been postulated, such as viral infection, autoimmune origin, vascular and metabolic disease, rupture of the labyrinthine membrane, and, recently, immune-mediated inner ear disease. We made a retrospective study of 40 patients seen in our department. Patients were given a combined treatment with steroids, nimodipine, heparin, and oxygen. Patients were divided into two groups by intravenous or oral treatment.

Imaging analysis has been applied to study typical cases of nasosinusal diseases, in an attempt to determine its capabilities for CT scan interpretations. Thus, polyps with sinusitis, cerebrospinal fluid occupying sinuses, cysts and bone tumors may be compared in order to obtain objective results that may help in the differential diagnosis in these conditions.

The present report reviews the problem of depression in children by means of an interview made by a pediatric to two paidopsychiatrists: concept, incidence, etiology and clinic, emphasizing un those features of interest and related to the pediatric and based on a bibliographic revision and the own experience of the authors, referring fifty cases of recent study. It is also showed the main exploratory and diagnosis methods: psychological, clinical and biological, as the evolution, treatment and some aspects of suicide in children.