The association of metabolic syndrome status with sensorineural hearing loss in pediatric obese patients.

OBJECTIVES: The prevalences of pediatric obesity and its associated comorbidities such as metabolic syndrome (metS) are rising. The aim of this study was to evaluate the association of metS status with sensorineural hearing loss in pediatric obese patients. METHODS: A two-center observationalprospective study was designed. In this study, 252 consecutive treatment-naive pediatric obese patients aged 5.8-17.8 yr in a tertiary pediatric Endocrinology outpatient clinic were prospectively enrolled. Following standard clinical and biochemical evaluations, the obese patients were diagnosed as having metabolic syndrome (metS) or not according to Internetional Diabetes Federation Criteria. All the patients were evaluated with tympanometry and pure tone audiometry tests after otomicroscopic examination. Comparative analyses of audiometric evaluations were performed between metS+ and metS- subgroups of the obese patients. RESULTS: The median age of the patients was 12.5 yr (range: 6.0-17.8 yr) and 56.3% of the patients were male. Metabolic syndrome was diagnosed in 82 (32.5%) patients. Age, gender distribution, history of the ventilation tube, and pubertal stage of the metS + patients and metS- counterparts were not statistically different (p > 0.05 for all). Pure tone hearing thresholds at all frequencies (125, 250, 500, 1k, 2k, 4k, 8k) were significantly higher in the metS + group then the metS- group (p˂0.05 for all). The tympanometry results were not statistically different between the two groups (p˃0.05). Abdominal obesity, hypertension, fasting hyperglycemia and dyslipidemia were not associated with increased hearing thresholds in metS + patients (p˃0.05 for all). CONCLUSION: Metabolic syndrome was associated with increased rates of subclinical hearing loss in our cohort. None of the investigated metS components emerged as a positive association with hearing loss in our cohort. Longitudinal follow-up of our cohort may help probe the causality of the association we found.

Imaging Modalities in the Etiologic Evaluation of Unilateral Vocal Fold Paralysis.

OBJECTIVE: This study aimed to investigate the roles of computed tomography (CT) and neck ultrasonography (US) in evaluating unilateral vocal fold paralysis (UVFP) of unknown etiology and to compare our results with those of other studies to assess the differences in etiology of UVFP. METHODS: We investigated the medical records of 202 eligible patients with UVFP. In total, 168 underwent chest CT, 118 underwent neck CT, and 108 underwent head CT. One hundred and three patients were also evaluated with high-resolution neck US. The etiologic causes of UVFP were also determined. RESULTS: Of the 202 eligible patients, the occult cause of the UVFP was determined in 96 patients (47.5%). Idiopathic causes were the most common etiologies (n = 106). In occult causes group, chest lesions were the most common diseases causing paralysis (52 cases) and included lung cancer (n = 28) and mediastinal malignancy (n = 8). More than half of the neck lesions were of thyroid origin. Of the 18 thyroid lesions, 12 were thyroid malignancies. Chest CT had an intermediate yield of 30.9% (52 of 168). Neck US had a diagnostic yield close to that of neck CT (26.2%). CONCLUSION: UVFP may result mainly from idiopathic, lung cancer, mediastinal, and thyroid malignancies. The initial use of neck US as an alternative to CT may be advocated for the determination of diseases resulting in UVFP.