Zika Virus Infection during Pregnancy and Sensorineural Hearing Loss among Children at 3 and 24 Months Post-Partum.

OBJECTIVE: The objectives of this study were to describe the findings of the auditory screening in children of mothers with ZIKV during pregnancy or suspicious of congenital ZIKV, and to determine whether hearing loss was in the first 2 years in life, regardless of whether microcephaly was also present. METHODS: This is a cases report. The information was collected and recorded in a database between January 2016 and April 2018. We perform two auditory tests to 3 and 24 months of life. The study was developed in Aguachica (Cesar, Colombia). It is considered a high-risk area for ZIKV infection. Participants included children of mothers with confirmed ZIKV during pregnancy or suspicious of congenital ZIKV exposure of ZIKV infection during an epidemic period in a tropical area. We defined a positive case according to the epidemiological definition and clinical criteria based on maternal symptoms. However, other children of mothers without clinical signs of Zika were evaluated at the same time. The main outcome was the presence of sensorineural hearing loss. RESULTS: The median age in the study group (n = 43) was 3.5 months (rank: 0-6) and the comparison group (n: 23, children of mothers without clinical signs of ZIKV) was 3 months (rank: 0-12). Screening hearing test was done using distortion product otoacustic emissions. At 3 months follow-up, children were evaluated using distortion product otoacustic emissions and automatized auditory brainstem response. None of the patients evaluated in this study were found to have sensorineural hearing loss. CONCLUSIONS: We did not find hearing loss during the first 2 years in the children whose mother showed Zika during pregnancy. We recommend these children must be assessed to closed because there is a high risk the hearing loss as it usually may occur with CMV.

La nariz a tension: manejo de la deformidad mediante rinoplastia abordaje cerrado / The tension nose: Handling the deformity by close rhinoplasty approach

El objetivo de este artículo es analizar y entender la patología de la nariz a tensión desde su semiología.Se describe detalladamente la técnica quirúrgica, así como los procedimientos complementarios que son de gran utilidad en algunos casos. Mostraremos algunos determinantes quirúrgicos que consideramos básicos para definir una vía de abordaje abierta o cerradaEl manejo cerrado de la nariz a tensión, nos proporciona una fácil y más cómoda corrección de las alteraciones anatómicas a nivel de septum caudal y del dorso nasal, con un manejo más conservador de la punta nasal, así como un mejor manejo de la “columnela colgante”, que la mayoría de las veces se presenta en esta patología.