Acetaldehyde effects in the brain

The effects of alcohol have been widely studied during the past century as alcohol abuse is a major health problem in Western society. In the last years, a growing body of evidence indicates that acetaldehyde, the first oxidation product of ethanol, is one of the mediators of peripheral and central effects of ethanol. Indeed, acetaldehyde has been recently taken into account as the mediator of the rewarding properties of alcohol. The role of acetaldehyde in ethanol-related properties has been proved by enzymatic manipulation studies in which the inactivation of acetaldehyde potentially synthesized in the brain produces the same results as blocking the formation of acetaldehyde by inhibiting…

Epidemiologia, aspetti genetici e clinici nei neonati con familiarità per ipoacusia: esperienza di un centro di terzo livello

INTRODUZIONE Rilievo frequente nei soggetti affetti da ipoacusia neurosensoriale (SNHL) è un' anamnesi familiare positiva per sordità, correlata a mutazioni genetiche, non sempre facilmente individuate, responsabili del deficit uditivo. L'eziologia genetica costituisce complessivamente il 50-60% di tutte le cause di sordità. Si distinguono forme sindromiche e non sindromiche, queste ultime classificabili secondo le differenti modalità di trasmissione. Nel 50-80% dei casi è riscontrabile una mutazione interessante il gene della connessina 26 (GJB2) localizzato sul cromosoma 13 che oramai è noto, codifica per una proteina chiamata in causa nei processi di trasduzione dello stimolo sonoro. La …

THE LINKAGE BETWEEN UPPER RESPIRATORY TRACT INFECTIONS AND OTITIS MEDIA: EVIDENCE OF THE 'UNITED AIRWAYS CONCEPT'

Upper respiratory tract infection (URTI) is a nonspecific term used to describe acute infections involving the nose, paranasal sinuses, pharynx and larynx and resulting from interplay between microbial load (viral and bacterial) and immune response. Infant and young children are prone to developing upper respiratory tract infections, which often result in bacterial complications especially acute otitis media because of the passage of bacteria (colonizing the nasopharynx) in the middle ear via Eustachian tube.

Profilo familiare ed individuale come fattore predittivo delle performances verbo-acustiche pre impianto cocleare: esperienza personale

RAZIONALE L’impianto cocleare è oramai il trattamento di scelta in tutti quei casi di sordità preverbale severa/profonda permettendo di ottenere a distanza di 12 mesi una soglia uditiva amplificata integralmente all’interno dello spettro acustico del parlato. Se ciò è dimostrato ampiamente dalla letteratura, è comunque vero che le aspettative familiari e le performances verbo/acustiche sono altamente variabili. Lo scopo del presente lavoro è quello di identificare tramite un accurato studio del profilo familiare ed individuale, tutte le possibili variabili in grado di influenzare i risultati. MATERIALI E METODI Le variabili oggetto del presente studio sono state suddivise in familiari ed in…

Psychopathologic disease in patients with tinnitus: a case control of an outpatient cohort

The goal of this work was to study if patients suffering from tinnitus, that affects 14.5% of Italian people, are more susceptible to psychological distress than those who are not affected by tinnitus; to evaluate the prevalence of psychopathological disorders among the cohort, their relationship with the severity of tinnitus and eventual correlation between the distress caused by tinnitus and age of patients. 191 cases and 237 controls were enrolled between 2009-2011. Cases were 80 females and 111 males with mean age of 48.06. Controls were 106 females and 131 males with mean age of 47.09. Overall subjects completed Symptom CheckList-90 R (SCL 90-R) and some brief questionnaire about audio…

FOLLOW-UP AFTER PEDIATRIC MYRINGOPLASTY: OUTCOME AT 5 YEARS

Aim. The aim of this paper was to evaluate anatomical and functional outcomes 5 years after myringoplasty in children affected by perforated eardrum. To analyze the main differences in the frequency of postoperative complications between patients under and over 9 years of age. Methods. One hundred and thirty-two children, aged from 4 to 15 years, who underwent myringoplasty with or without mastoidectomy, were followed for a five-year period after surgery. The cohort was divided in two groups: children from 4 to 9 years old (G1) and patients older than 9 years (G2); all subjects underwent a pre- and post-operatively clinical exam and were evaluated through audiometry and impedenzometry. Aden…

Hearing loss in neonatal intensive care units (NICUS): Follow-up surveillance

Infants admitted to the neonatal intensive care unit (NICU), who represent the 4-8% of all births, present problems such as prematurity, low Apgar scores, infections, hyperbilirubinemia and hearing impairment. In particular significant hearing loss is the most common disorder at birth, occurring in 1 to 2 newborns per 1000 in the general population and 24% to 46% of newborns who are admitted to a NICU. This leads more difficulty to develope verbal skills (learning vocabulary, grammar, word order and idiomatic expressions), language, learning and speech. Hearing impairment influences also cognitive and affective development of infants making consequences in their interpersonal relationships.…

Extramedullary plasmacytoma of the tonsil: A new management

Introduction: Extramedullary plasmacytoma (EMP) is a rare tumor of all plasma cell neoplasms. The tumor is mainly localized in the head and neck region, but rarely involving the tonsil. Case presentation: The authors report the 5th case of EMP of the tonsil in the literature occurred in a 57-year-old Caucasian male. Conclusions: Through a review of the relevant literature, we consider adjuvant radiotherapy not necessary for EMP of tonsil because of an adequate resection achieved by surgery.

Guide to the management of complications in endoscopic sinus surgery (ESS)

Endoscopic sinus surgery (ESS) is one of the most commonly performed procedures in otolaryngology. ESS complications should be distinguished in minor and major based on the treatment they need and the permanent sequelae they can cause. Over the years it has gone from an incidence of complications in endoscopic surgery of 8% for the major and 21% for the minor to a percentage of 0-1.5% and 1.1-20.8%, respectively. This is due to the considerable diffusion of the technique with a progressive increase over the years of the surgical experience but their presence help to educate otolaryngologists and patients about complication rates in ESS in a modern context. A complication occurs when injurie…

Sudden sensorineural hearing loss

Sudden sensorineural hearing loss (SSNHL), is an important otological disorder that affects up to 5-20 in 100,000 people. It is characterized by a rapid loss of the hearing, usually unilateral, with a sensorineural hearing loss greater than 30 dB over three consecutive frequencies, in less than 72 hours and can be associated with tinnitus and vertigo. It is a real sensorineural emergency that can become a permanent handicap if not adequately treated. Because of patients recovering rapidly or seeking no medical attention, the true figure might be higher, even if delaying SHL diagnosis and treatment may decrease the effectiveness of treatment. Sudden Hearing Loss can occur at any age but usua…

Determinants of failure in the reconstruction of the tympanic membrane: A case-control study

Introduction: The recurrence rate after tympanoplasty is variable between 0% and 50%. The causes of failure may be different and frequently interrelated, making the surgical choice difficult and the prognosis not always favourable. In this study, we analysed recurrence rate and the possible causes of failure of tympanoplasty in the treatment of tympanic perforations. Materials and Methods: This prospective case-control study was carried out on patients undergoing tympanoplasty. The main outcome was closure of the tympanic membrane. Results: Among the studied 72 patients, the overall recurrence rate was 19.4%. The average follow-up was 28 months; no recurrence was observed over 12 months of …

Body balance and postural control in patients with dizziness

The ability to maintain body balance and postural control is regulated by a central integration process of afferent inputs received from peripheral sensory components such as the somatosensory, visual, and vestibular apparatus, which control the tonic postural system by modulating efferent information. It is widely recognized that stimuli from the visual and the vestibular systems provide information on the position of the head relative to the trunk and contribute to the orientation and the movement of the body in the environment. For these reasons, the vestibular system plays a key role in controlling body balance. Indeed, several studies have shown the presence of imbalance, postural inst…

Association between sleep-disordered breathing and hearing disorders: Clinical observation in Sicilian patients

Introduction: To examine the putative association between Sleep-Disordered breathing and hearing disorders Material and methods: 120 Sicilian subjects ranging from 14 to 85 years of age who were divided in 46 cases suffering from tinnitus (G1 group) and 74 controls (G2 group) were evaluated through STOP BANG screening questionnaire and Four-Variable Screening Tool; after Data collecting each subject underwent Audiological assessment by multi-frequency audiometry (PTA) and Transient-evoked otoacoustic emissions (TEOAE-diagnostic) for each ear. Results: Cases showed: PTA significantly severe than the control group (58.70% vs. 16.89% hearing loss; P<0.001), such as a lower signal-to-noise r…

Newborn hearing screening in Sicily: Lesson learned

The motor development of preterm infants after the neonatal intensive care unit

The extra uterine environment is a hostile environment, due to noises, lights and different biological activities compared to intra uterine environment for infants born preterm or underweight. Stress and painful experiences may also impact developmental outcomes. In addition, developmental delay risks increase with the decrease in gestational age. Thus, those born with immature developed systems may need neonatal intensive care units (NICU) in order to allow a correct growth and body maturation. In general, infants that need NICUs suffer from a slower development compared to their full-term peers. This may translate in a delay in oral, tactile, kinesthetic, vestibular, auditory, olfactory, …

The role of Leptin in laryngeal squamous cell carcinoma

Leptin is a peptide produced by peptidergic cells or those able to process and secrete peptides. Originally, this function was considered proper and exclusive of certain neurons of the magnocellular and parvicellular hypothalamus. These cells originated from a common precursor, namely neural crest cells, which have the ability to produce hormonal neuropeptides. From this primitive neuroectodermal site, cells migrate to other organs: the gastro-entero-pancreatic system (GEP), the lung, heart, reproductive and urinary systems. Leptin is considered the typical neuropeptide with an anorexic function, and is also called the “satiety hormone” because it plays a key role in the control of ener…

Emerging pharmacological treatments of tinnitus

Tinnitus is not a disease, but rather a symptom or condition characterized by a conscious perception of an unreal sound in the absence of external auditory stimulus. This ontological condition can modify everyday life in different ways: causing distress and annoyance, sleep disruption, anxiety and depression. The World Health Organization (WHO) describes tinnitus as a symptom of hearing disorder characterized by the sensation of buzzing, ringing, clicking, pulsations, grinding, hissing, roaring or other noises in the ear. Even if different treatments exist for “tinnitus-related abnormalities” such as cognitive behavioural therapy and/or sound therapy, no effective pharmacological approa…

Effects of tinnitus on postural control and stabilization: A pilot study

Introduction: The aim of this study was to evaluate the tinnitus's impacts on postural control. Material and methods: Sixty-six subjects (age: 46,71 ± 15,12 years, height 166,32 ± 8,88 cm, weight 64,85 ± 12,57 kg) with idiopathic tinnitus were recruited for the study and were tested. Each subject underwent to ‘Romberg test’, ‘Static balance’ and ‘posture analysis’. Static balance and posture analysis were performed two times, with open and close eyes, and were measured through the FreeMed posturography system. Results: showed that subjects had worse Baropodometric performances respect to benchmarks; moreover according to literature the results show that these patients had significant differ…

Pharmacological treatment of sensorineural hearing loss

Sudden sensorineural hearing loss is a common and alarming symptom of about 360 million people that suffer from hearing impairment worldwide. The sudden sensorineural hearing loss usually arises unilaterally and it is habitually described as greater than 30dB hearing reduction, attributable to lesions of the cochlea, cranial nerve VIII, brainstem and temporal lobe. There are many factor that promote the onset of this lesions such us infections, circulatory diseases, inner ear neoplasia and neurological disorders. This pathology is characterized by primary symptoms such as the impairment of the comprehension of spoken language and the struggling to listen to music. Subsequently, secondary sy…

TREATMENT OF TINNITUS AND DIZZINESS ASSOCIATED VERTEBROBASILAR INSUFFICIENCY WITH A FIXED COMBINATION OF CINNARIZINE AND DIMENHYDRINATE

Seventy-eight consecutive subjects, 43 males and 35 females, ranging from 43 to 87 years of age suffering from dizziness and/or tinnitus due to vertebrobasilar insufficiency without other central nervous system diseases were treated with fixed combination of cinnarizine and dimenhydrinate two times a day and for two months. Data were collected considering the following parameters: age, sex, vestibular symptoms (unsteadiness, staggering, tendency to fall, swaying, vertigo due to change of position, bowing, walking, eye movements), headache, tinnitus, impaired hearing and aural fullness. Patients evaluated their vertigo symptoms and/or tinnitus intensities using a graded 3- point visual analo…

Role of cannabinoids in the treatment of tinnitus

Tinnitus is a frequent symptom in audiological clinical practice characterized by an abnormal noise perceived in one or both ears or in the head, in which a patient has a conscious hearing percept in absence of external sound. Tinnitus might be caused by a homeostatic response of central dorsal cochlear nucleus auditory neurons that makes them hyperactive in compensation to auditory input loss. One hypothesis suggests that tinnitus is a sensory form of epilepsy that involves the cochlear nucleus and the inferior colliculus, which display impairment in the electrical activity in the auditory system. This alteration determines a synaptic plasticity in the dorsal cochlear nucleus that becomes …

TINNITUS PATIENTS: ETIOLOGIC, AUDIOLOGIC AND PSYCHOLOGICAL PROFILE

Tinnitus represents one of the most frequent symptoms observed in the general population in association with different pathologies, although often its etiology remains unclear. Objective of this work is to evidence the main aspects concerning epidemiology, causes, audiological characteristics and psychological consequences of tinnitus.

Hyperbilirubinemia, Auditory Neuropathy and Prelingually Deafness: Evidence Linking

Diagnosis and follow-up of complex congenital malformations/mental retardation (MRA/MR)

Complex congenital malformations, associated in 30% of cases with mental retardation, recognize different etiologies: environmental causes, mendelian disease, chromosomal abnormalities, imprinted anomalies. Frequently complex congenital disorders are rare diseases. Rare diseases are infrequent pathological conditions (prevalence in the general population of less than 1/2.000 live births1), and often poorly understood. Because of their rarity these morbid conditions often either go undiagnosed or are diagnosed late with a negative impact for both the affected person and the family. The birth prevalence is high (2-4% of all births). The diagnosis is essential to program complex and integrated…

The role of temporomandibular disorders in the genesis of tinnitus

Temporomandibular disorders (TMD) are musculoskeletal pain conditions characterized by pain in the temporomandibular joint (TMJ) and/or mastication muscles. Patients with TMD are frequently affected by otolaryngological symptoms like tinnitus, with a prevalence ranging from 2% to 59% of cases. There is still a debate in the scientific community about the relationship between tinnitus and TMD and actually the causal connection between them is not well understood. A possible explanation could be found in the ontogenetic development and in the mechanical and neuronal connections of the masticatory system and the middle ear. Additionally a potential role of TMD in tinnitus onset is suggested by…

Pharmacological therapy of newborn babies admitted to the neonatal intensive care unit

Newborn babies who need intensive medical care are often sheltered into a special area of the hospital called Neonatal Intensive Care Unit (NICU). In this structure, babies are regularly subject to conditions that would be considered harmful by older children and adults. In the last years, many clinical researches have paid particular attention to effectiveness of various pharmacological therapies, regularly used in neonatal intensive care that have sharply reduced mortality of newborn and preterm infants. Although there are many classes of drugs used for the treatment of different diseases (sepsis, pain, seizures, pulmonary hypertension and infection), the fledgling population is more diff…

Postural disorders in patients with dizziness: From postural analysis to vestibular rehabilitation programs

Postural control is regulated by a feedback and feedforward mechanism in which the central nervous system integrates several afferent information and constantly modulates the tone of the tonic postural system through efferent inputs. However, in pathological conditions, this mechanism is altered due to the non-physiological afferent inputs coming from the aberrant sensory organ. In particular, because of the vestibular system provides information regards sense of position and perception of movement of the head in the space, it represents a fundamental postural receptor in order to maintain static and dynamic body balance. Therefore, in vestibular disorders such as in patients suffering from…

Upper respiratory tract infections in children: From case history to management

Respiratory tract infections are the most common diseases in childhood. The respiratory tract, widely branched system of ducts, is particularly exposed to the action of microorganisms transmitted by air from here the high frequency of infections they face especially in the first years of life. It is usual distinguish: upper respiratory tract infections (URTI) and lower respiratory tract infections (LRTI). In particular, in infections of the upper airways, the inflammatory process, result of the interaction between microbes and the immune response, can be localized to the mucosa of the nose or sinuses (common cold and sinusitis), or the pharynx or larynx (pharyngotonsillitis and laryngitis) …

The minimally invasive sinus surgery technique

The minimally invasive sinus technique, (MIST) is different from minimally invasive sinus surgery. MIST implies a treatment philosophy and surgical model that is quite different from functional endoscopic sinus surgery (FESS). The goals of this article are to discuss the origins of functional sinus surgery as it relates to the evolution of FESS and MIST, define MIST as a philosophy and surgical model, discuss treatment of surgical sinus disease, and challenge the rationale for our departure from Messerklinger's "functional" concepts into what will be referred to as "contemporary FESS. " Many authors address the reduced revision rate (compared with FESS) following initial intervention with M…