ABSTRACT
OBJECTIVES: Hearing loss has long been known to be a complication of Paget's disease of bone. The aim of this study was to investigate Paget's disease of the temporal bone with special attention to hearing loss. METHODS: Twenty-five patients with skull involvement were treated with either pamidronate or tiludronate. Imaging included radiography, quantitative bone scintigraphy (QBS), single photon emission computed tomography (SPECT) and high-resolution computed tomographic (HRCT) scanning. Audiometric assessment was also performed. RESULTS: Twenty-three of the 25 patients with skull involvement suffered from hearing loss. Bisphosphonate treatment resulted in a decreased serum total alkaline phosphatase (serum tAP) level and QBS ratio, and also seemed to improve the complaints of the patients. HRCT demonstrated involvement of the middle ear ossicles (n = 7), involvement of the petrous pyramids (n = 14), demineralization of the otic capsule (n = 10), porosis pericochlearis (n = 8), narrowing of the external auditory meatus (n = 12), mastoid process thickening (n = 5) and stapedial footplate thickening (n = 4). The audiometric examination did not show any significant changes 1 yr after bisphosphonate treatment. CONCLUSIONS: HRCT imaging is a well suited tool for demonstrating the complication of Paget's disease. QBS and measurement of serum tAP level may also be regarded as useful techniques for monitoring treatment. However, hearing may remain impaired in spite of the improved scintigraphy and laboratory parameters, therefore, audiometric assessment is also important in pagetic patients with skull involvement.
Subject(s)
Diphosphonates/therapeutic use , Osteitis Deformans/drug therapy , Temporal Bone , Aged , Aged, 80 and over , Audiometry , Female , Follow-Up Studies , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/drug therapy , Hearing Loss, Sensorineural/etiology , Humans , Male , Middle Aged , Osteitis Deformans/complications , Osteitis Deformans/diagnostic imaging , Pamidronate , Statistics, Nonparametric , Temporal Bone/diagnostic imaging , Tomography, Emission-Computed, Single-Photon , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
The place of histamine among primary mediators in allergic rhinitis and the mechanism of action of antihistamines have been discussed. The use of Loderix was tried in 40 chronic rhinitis patients by the open method. According to the observations the second generation Loderix may be successfully used in allergic rhinitis and "eosinophil" type vasomotor rhinitis cases. The side-effects of Loderix did not differ from those of the other antihistamine products.