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OBJECTIVE: It has been estimated that about 5 million people of those affected with otitis media have cholesteatoma, however, its pathophysiology is unclear. In this study we aimed to detect Helicobacter pylori via polymerase chain reaction and real-time polymerase chain reaction in young patients with chronic otitis media. METHODS: Patients included in our prospective cross-sectional study had middle-ear/mastoid inflammation and underwent surgical procedures. Middle-ear mucosa samples were collected, and genomic DNA was extracted for H pylori detection by polymerase chain reaction and real-time polymerase chain reaction analyses. Sociodemographic data and gastroesophageal reflux symptoms were analysed. RESULTS: We included 49 patients with mean age of 12.7 ± 3.8 years. Twenty per cent of the patients were diagnosed with cholesteatoma. No increase in H pylori-amplified fluorescence was observed, indicating absence of H pylori. CONCLUSION: Due to the absence of amplification for H pylori and the fact that albumin was amplified in all samples, we conclude that H pylori does not appear to be a causal factor.
ABSTRACT
Objective: We describe the first-year implementation experience of an Instrumented Sensory Integration Therapy Program in Audiological & Balance Center patients. Design: This is a retrospective descriptive study. Participants included Seventy-three adults with diagnoses of acute, episodic, or chronic vestibular syndromes. They were classified into the following two groups: group 1 included 46 individuals treated with ISIT plus VRT, and group 2 included 27 individuals treated only with ISIT. Results: The Sensory Organization Test (SOT) for both groups showed a statistical significance for all three sensory inputs; visual systems (G1: p = 0.0003; G2: p = 0.0337), vestibular system (G1: p < 0.0001; G2: p = 0.0003), and balance as demonstrated by compound balance score (G1: p < 0.0001; G2: p = 0.0035), and balance percentage deficit (G1: p < 0.0001; G2: p = 0.0078). Conclusions: The severity and complexity of functional neurological disorders in the context of vestibular syndromes seem to require between 10 and 20 therapy sessions, and combined ISIT plus VRT appears to be more effective than ISIT as a monotherapy.
ABSTRACT
En el mundo se reportan más de 600 millones de personas que experimentan tinnitus. Aproximadamente 20% de las personas con tinnitus subjetivo permanente presentan incomodidad significativa, interviniendo negativamente en su calidad de vida, con inducción de estados depresivos. Existen diferentes estrategias de intervención para el manejo del tinnitus, entre ellas la estimulación acústica. El objetivo de este estudio fue evaluar el impacto de la estimulación acústica pasiva en la severidad del tinnitus y en la calidad de vida de los pacientes con tinnitus subjetivo crónico mediante la Escala Visual Análoga(VAS)y el Inventario de Discapacidad del Tinnitus(THI). Estudio descriptivo de cohorte histórico que incluyó a pacientes >18 años con tinnitus subjetivo crónico que recibieron manejo con estimulación acústica pasiva entre 2017-2018. A los pacientes se les aplicó la VAS y el THI antes, durante y después del tratamiento. Se evidenciaron cambios significativos (p<0,05) entre las medianas en dos de los tres dominios del VAS y en todos los dominios pre y post tratamiento del THI. En las pruebas post hoc se encontraron diferencias (p<0.05) entre las medianas de los puntajes al inicio y a los tres meses y entre los puntajes al inicio y a los seis meses en todos los dominios y en el puntaje total de la escala THI. La estimulación acústica pasiva generó cambios en la discapacidad generada por el tinnitus. Se sugiere complementar los abordajes de tratamiento con estrategias que favorezcan también los mecanismos de memoria, atención y conciencia para aumentar la efectividad de las intervenciones
More than 600 million people worldwide are reported to experience tinnitus. Approximately 20% of people with permanent subjective tinnitus present significant discomfort, interfering negatively in their quality of life, inducing depressive states. There are different intervention strategies for the management of tinnitus, including acoustic stimulation. The aim of this study was to evaluate the impact of passive acoustic stimulation on tinnitus severity and quality of life in patients with chronic subjective tinnitus using the Visual Analogue Scale (VAS) and the Tinnitus Disability Inventory (THI). Descriptive historical cohort study including patients >18 years with chronic subjective tinnitus who received management with passive acoustic stimulation between 2017-2018. Patients were administered VAS and THI before, during and after treatment. Significant changes (p<0.05) between medians were evident in two of the three VAS domains and in all pre and post-treatment domains of THI. In post hoc tests, differences (p<0.05) were found between the medians of scores at baseline and at three months and between scores at baseline and at six months in all of the domains and in the total THI scale score. Passive acoustic stimulation generated changes in tinnitus-generated disability. It is suggested to complement treatment approaches with strategies that also favor memory, attention and awareness mechanisms to increase the effectiveness of the inter ventions
Subject(s)
Humans , Quality of Life , Tinnitus , Acoustic Stimulation , Patients , Attention , Therapeutics , Aftercare , Equipment and Supplies , Gender IdentityABSTRACT
Introducción: Los tumores primarios que afectan el hueso temporal son raros, representan el 0,2% de todos los cánceres de la cabeza y el cuello; adicionalmente, se ha descrito como sitio de metástasis de melanoma aunque es inusual y los melanomas primarios intracraneales son aún más infrecuentes. Objetivo: Presentar el caso de una paciente de 54 años con diagnóstico histopatológico de melanoma maligno del hueso temporal con infiltración ósea. Diseño: Reporte de caso. Materiales y métodos: Presentamos el caso de una paciente de 54 años con parálisis facial derecha y otorrea ocasional de un año de evolución y una semana de otorragia fétida, edema retroauricular, ilusión rotatoria constante, otalgia derecha y presencia de masa retroauricular derecha; con escanografía cerebral simple que mostró masa en oído medio que infiltra y destruye mastoides y parte del hueso temporal. Se consideró patología maligna; se realiza biopsia; presenta como complicación hematoma epidural agudo el cual es drenado y se realiza tumorectomía por servicio de neurocirugía. Resultados: Paciente evoluciona hacia la mejoría por 72 horas, posteriormente presenta trastorno metabólico y respiratorio y fallece cuatro días después. El resultado histopatológico mostró lesión neoplásica maligna de origen melanocítico. No se encontró otro foco o metástasis. Conclusiones: La escisión quirúrgica es el tratamiento primario para el melanoma. En este momento, se están realizando múltiples estudios en el mundo para definir los márgenes quirúrgicos óptimos, sin embargo, dada su poca frecuencia estamos aún lejanos de resolverlo.
Introduction: Primary tumors involving the temporal bone are rare, accounting for 0.2% of all head and neck cancers; additionally, it has been described as melanoma metastases site but it is unusual and the primary intracranial melanomas are even rarer. Objective: To present the case of a 54 year old patient with diagnosis of malignant melanoma of the temporal bone marrow infiltration. Design: Case report. Materials and methods: We report a 54-year old woman with a year of evolution of right facial paralysis and occasional otorrhea and a week of fetid otorrhagia, retroauricular edema, constant rotating illusion, right otalgia and presence of a right retroauricular mass; with brain scenography which showed a middle ear single mass that infiltrates and destroys mastoid and part of the temporal bone. Malignancy was considered; a biopsy is performed; she presented an acute epidural hematoma as a complication which was drained and tumorectomy was performed by neurosurgery department. Results: Patient was improving for 72 hours, then presented metabolic and respiratory disorder and died four days later. Histopathological results showed neoplastic lesion of melanocytic origin. No other focus or metastasis was found. Conclusions: Surgical excision is the primary treatment for melanoma. At this time, are being conducted multiple studies in the world to define optimal surgical margins, however, given its rarity it is still far to solve.
Subject(s)
Humans , Melanoma , Temporal Bone , Head and Neck NeoplasmsABSTRACT
La timpanoplastia secundaria es un reto quirúrgico debido a que varios factores intervienen para obtener un resultado satisfactorio. Múltiples materiales han sido descritos para el cierre de las perforaciones timpánicas secundarias con tasas de éxito que oscilan en promedio del 93 por ciento. Los autores de este estudio describen una técnica quirúrgica que ha sido de gran utilidad en el Hospital Universitario del Valle, Cali, Colombia, para el cierre de perforaciones timpánicas secundarias con tejido areolar laxo. Este injerto posee una citoarquitectura ideal para integrarse al oído. Se reporta en esta serie una tasa de cierre de la perforación del 97 por ciento y una mejoría audiológica promedio de 21dB. Se considera que el mayor aporte vascular que se logra a través de la disección del ánulus posterior, colgajos meatales y timpánicos contribuyen de manera significativa a la viabilidad del injerto.
Secondary timpanoplasty is a surgical challenge since various factors contribute to obtain a satisfactory result. Multiples materials have been described for perforation closure in secondary timpanoplasty with a mean success rate around 93 percent. The authors describe a surgical technique that has proved to be of great help at the Hospital Universitario del Valle in Cali, Colombia with areolar tissue. The histological properties of areolar tissue makes it ideal for tympanic membrane repair. We report a closure rate of the 97 percent and a fair audiological results with a PTA less than 21 dB for the described series. The authors believe that a bigger blood supply that is achieved by posterior annulus dissection, meatal and timpanal flaps contribute significantly to the survival of the graft.
