HPV genotype is a prognosticator for recurrence of respiratory papillomatosis in children.

OBJECTIVES: This study aimed to compare the prognosis according to age, genotype or human papillomavirus (HPV) variant in patients with recurrent respiratory papillomatosis (RRP). DESIGN: Non-concurrent cohort. PARTICIPANTS: Forty one patients with RRP. SETTING: Tertiary referral hospital. MAIN OUTCOME MEASURES: Disease severity was defined by the number of surgeries performed, and Derkay score at surgeries, obtained from medical records. HPV was detected and genotyped, and HPV-6 variants were also assessed. RESULTS: Fifteen (36.58%) individuals belonged to the juvenile RRP group (JoRRP, less than 18 years), while 26 patients (63.41%) were allocated at the adult group (AoRRP, equal or more than 18 years). JoRRP patients needed, in average, a higher number of surgeries to control the disease than AoRRP patients (mean difference: 3.36). Also, JoRRP patients showed a higher Derkay score at each surgery (mean difference: 3.76). There was no significant difference in the number of surgeries when we compared patients infected with HPV-6 or HPV-11, neither in accordance to HPV-6 variants. Patients with HPV-11 presented a higher mean Derkay score at surgery than those with HPV-6 (mean difference: 4.39); when co-variated by age, we observed that this difference occurred only among JoRRP patients (mean difference: 6.15). CONCLUSIONS: Age of onset of RRP has an important impact on number of surgeries to control disease. Patients with JoRRP and HPV-11 tend to present worse Derkay score at each surgery. HPV genotype among adults and HPV-6 variants had no impact on the outcome of the disease.

Is there a best side for cochlear implants in post-lingual patients?

INTRODUCTION: Cochlear Implant is a sensory prosthesis capable of restoring hearing in patients with severe or profound bilateral sensorineural hearing loss. OBJECTIVE: To evaluate if there is a better side to be implanted in post-lingual patients. METHODS: Retrospective longitudinal study. Participants were 40 subjects, of both sex, mean age of 47 years, with post-lingual hearing loss, users of unilateral cochlear implant for more than 12 months and less than 24 months, with asymmetric auditor reserve between the ears (difference of 10dBNA, In at least one of the frequencies with a response, between the ears), divided into two groups. Group A was composed of individuals with cochlear implant in the ear with better auditory reserve and Group B with auditory reserve lower in relation to the contralateral side. RESULTS: There was no statistical difference for the tonal auditory threshold before and after cochlear implant. A better speech perception in pre-cochlear implant tests was present in B (20%), but the final results are similar in both groups. CONCLUSION: The cochlear implant in the ear with the worst auditory residue favors a bimodal hearing, which would allow the binaural summation, without compromising the improvement of the audiometric threshold and the speech perception.

Is there a best side for cochlear implants in post-lingual patients? / Existe um lado melhor para implantes cocleares em pacientes pós-linguais?

Abstract Introduction: Cochlear Implant is a sensory prosthesis capable of restoring hearing in patients with severe or profound bilateral sensorineural hearing loss. Objective: To evaluate if there is a better side to be implanted in post-lingual patients. Methods: Retrospective longitudinal study. Participants were 40 subjects, of both sex, mean age of 47 years, with post-lingual hearing loss, users of unilateral cochlear implant for more than 12 months and less than 24 months, with asymmetric auditor reserve between the ears (difference of 10 dBNA, In at least one of the frequencies with a response, between the ears), divided into two groups. Group A was composed of individuals with cochlear implant in the ear with better auditory reserve and Group B with auditory reserve lower in relation to the contralateral side. Results: There was no statistical difference for the tonal auditory threshold before and after cochlear implant. A better speech perception in pre-cochlear implant tests was present in B (20%), but the final results are similar in both groups. Conclusion: The cochlear implant in the ear with the worst auditory residue favors a bimodal hearing, which would allow the binaural summation, without compromising the improvement of the audiometric threshold and the speech perception.

Resumo Introdução: O implante coclear é uma prótese sensorial capaz de restaurar a audição em pacientes com perda auditiva neurossensorial bilateral severa ou profunda. Objetivo: Avaliar se há um melhor lado para o implante coclear em pacientes pós-linguais. Método: Estudo longitudinal retrospectivo; incluiu 40 indivíduos, de ambos os sexos, média de 47 anos, com perda auditiva pós-lingual, usuários de implante coclear unilateral por mais de 12 meses e menos de 24 meses, com perda auditiva assimétrica entre as orelhas (diferença de 10 dBNA, em pelo menos uma das frequências), divididos em dois grupos. O Grupo A foi composto por indivíduos com implante coclear na orelha com melhor audição residual e Grupo B com menor audição residual em relação ao lado contralateral. Resultados: Não houve diferença estatística entre o limiar auditivo tonal antes e depois do implante coclear. Uma melhor percepção da fala nos testes pré-implante coclear foi observada no grupo B (20%), mas os resultados finais foram semelhantes em ambos os grupos. Conclusão: O implante coclear na orelha com pior audição residual favorece uma audição bimodal, o que possibilitaria a somação binaural, sem comprometer a melhora do limiar audiométrico e a percepção da fala.