Quality of life and level of physical activity of individuals with temporomandibular disorders with and without otological symptoms: Secondary analysis of a cross-sectional study.

BACKGROUND AND PURPOSE: Otological symptoms (OS) are highly prevalent in individuals with temporomandibular disorders (TMD). Individuals with TMD and OS have more neck disability and decreased deep neck muscles endurance when compared to individuals without OS. However, no studies have evaluated whether OS is associated with lower Quality of Life (QoL) and worse levels of physical activity. This study aimed to evaluate the QoL and level of physical activity of individuals with TMD with and without OS. METHODS: In this cross-sectional study, 62 individuals with TMD were allocated into 2 groups: TMD with OS (n = 36) or TMD without OS (n = 26). Self-reported complaints of dizziness, vertigo, tinnitus, earache, ear fullness, or hypoacusis were considered as OS. QoL was assessed with the WHOQOL-Bref and physical activity with the IPAQ-SF. Independent t-test and chi-squared test were used for analysis between-groups. Effect sizes were reported using Cohen's d. A Pearson correlation was used to compare the number of OS and QoL scores. A significance level of p < 0.05% and 95% confidence intervals were considered statistically significant. RESULTS: The total generic scores for QoL were not different between-groups (p = 0.076), but individuals with TMD with OS had lower satisfaction (p = 0.015; d: 0.63) and physical domain (p = 0.015; d: 0.64) scores with a moderate effect size. In TMD with OS, 69.4% of individuals were irregularly active and 50% for the TMD without OS, with no statistical significance (p > 0.05). The number of OSs was inversely and weakly associated with the QoL total score. CONCLUSION: Individuals with TMD and OS are associated with worsened QoL (physical domain and satisfaction) when compared to individuals with TMD without OS. The higher the number of OS, the worse the QoL score. Individuals with TMD with and without OS had similar levels of physical activity, but a high prevalence of irregularly active and sedentary individuals within TMD diagnosed population was found.

Cuidado del oído y la audición en la atención primaria: manual de capacitación

El diagnóstico precoz de las enfermedades del oído y la pérdida auditiva es fundamental. Casi todas las personas que padecen enfermedades del oído o pérdida de audición se beneficiarían de adoptar medidas oportunas y adecuadas. Muchas de las causas comunes de enfermedades del oído y pérdida de audición, como por ejemplo infecciones de oído o sonidos y ruidos fuertes, se pueden prevenir. El tratamiento y la rehabilitación oportunos pueden beneficiar a todas las personas con enfermedades del oído y pérdida de audición. Los trabajadores de la salud, los médicos generales, los médicos de familia y los médicos que trabajan en atención primaria suelen ser el primer punto de contacto para que las personas reciban servicios de atención de salud. El cuidado del oído y la audición en la atención primaria: manual de capacitación es una guía práctica sobre cómo prevenir, identificar y controlar la pérdida auditiva y las enfermedades comunes del oído que conducen a la pérdida auditiva. Está destinado principalmente a trabajadores de la salud y médicos que trabajan en el nivel de atención primaria y brindan servicios a las personas, ya sea en establecimientos de salud o en comunidades. Está destinado a ser administrado por un formador/instructor familiarizado con los problemas del oído y la audición, su evaluación y tratamiento y va acompañado de un manual para el formador. El manual consta de una serie de módulos independientes. El manual fue desarrollado siguiendo un proceso de consulta basado en evidencia. Los procesos y pasos de diagnóstico y procesos de gestión/referencia descritos en el manual se basan en diversas fuentes de información.

Cuidado del oído y la audición en la atención primaria: Manual de capacitación / Ear and hearing care in primary care: training manual

La presente publicación describe las pautas sobre cómo prevenir, identificar y controlar la pérdida auditiva y las enfermedades comunes del oído que conducen a la pérdida auditiva. Está destinado principalmente a trabajadores de la salud y médicos que trabajan en el nivel de atención primaria y brindan servicios a las personas, ya sea en establecimientos de salud o en comunidades. Está destinado a ser administrado por un formador/instructor familiarizado con los problemas del oído y la audición, su evaluación y tratamiento y va acompañado de un manual para el formador. El manual consta de una serie de módulos independientes. El manual fue desarrollado siguiendo un proceso de consulta basado en evidencia. Los procesos y pasos de diagnóstico y procesos de gestión/referencia descritos en el manual se basan en diversas fuentes de información

Estudo da ocorrência de otopatias em felinos domésticos no município de Fortaleza/CE / Study of the occurrence of otopathies in domestic felines in the municipality of Fortaleza/CE

Estima-se que as otites externas estão presentes em 2 a 10% dos atendimentos na clínica de felinos, correspondendo a uma afecção clinicamente desafiadora nessa espécie. Diante disso, este trabalho tem como objetivo realizar um levantamento retrospectivo da ocorrência de otopatias em felinos no município de Fortaleza/CE, em um período de três anos, contribuindo para o estabelecimento do perfil epidemiológico da região. O estudo foi realizado através da coparticipação de médicos-veterinários dermatólogos e clínicos de felinos, sendo elaborado de forma retrospectiva avaliando-se fichas clínicas de gatos com histórico de otopatias. Os dados demonstraram uma maior frequência de otites associadas às causas infecciosas, com 30% dos gatos acometidos pela levedura Malassezia spp., 17% por bactérias do tipo cocos e 1% pelo fungo dimórfico Sporothix schencki, seguido de origem parasitária pelos ácaros Otodectes cynotis e Notoedres cati com 18% e 2% dos animais estudados, respectivamente. Na associação entre os patógenos, a maior incidência correspondeu à infecção mista por fungos e bactérias (17%). Tratando-se de raças, os SRD obtiveram uma maior frequência geral no estudo e gatos machos foram mais acometidos em relação às fêmeas. Logo, ressalta-se a importância de estudos retrospectivos para a saúde única, a partir do estabelecimento do perfil epidemiológico da região e da identificação de potenciais agentes zoonóticos.

It is estimated that external otitis accounts for 2 to 10% of attendances at to the feline clinics, corresponding to a clinically challenging condition in this species. This work aims to carry out a retrospective survey of the occurrence of otopathies in cats in the city of Fortaleza/Ce in a period of 3 years, contributing to the establishment of the epidemiological profile of the region. The study was carried out through the co-participation of veterinarians, dermatologists and feline clinicians, and was elaborated retrospectively by evaluating clinical records of cats with a history of ear diseases. The data showed a higher frequency of otitis associated with infectious causes, with 30% of cats affected by the yeast Malassezia spp., 17% by coccus-type bacteria, and 1% by the dimorphic fungus Sporothix schencki, followed by otitis of parasitic origin caused by the mites Otodectes cynotis and Notoedres cati, corresponding to 18% and 2% of the studied animals, respectively. In the association between pathogens, the highest incidence corresponded to mixed infection by fungi and bacteria (17%). Regarding the breeds, SRD presented a higher overall frequency in the study, and male cats were more affected than females. Therefore, the importance of retrospective studies for single health is emphasized, based on the establishment of the epidemiological profile of the region and the identification of potential zoonotic agents.

Modified bilateral fasciaperichondrial flap for prominent ear correction.

OBJECTIVE: Various techniques have been described in the literature for prominent ear correction. These cartilage-preserving or cartilage-shaping techniques have their own advantages and disadvantages. We aim to achieve aesthetic and stable results with low complication rates using combinations of these methods. Herein, we present our results of prominent ear surgery with a modified bilateral fasciaperichondrial flap in combination with concha-mastoid and concha-scaphal sutures. METHODS: Patients whose surgeries included a modified bilateral fasciaperichondrial flap for prominent ear deformities were included in the study. Patients' demographic data, pre- and postoperative Concha-Mastoid Angle (CMA) and upper-middle Helix-Mastoid Distances (HMD), follow-up time, complications, secondary operations, and postoperative Visual Analogue Scale (VAS) results were evaluated. With a postauricular fish-mouth incision, the bilateral fasciaperichondrial flap was planned into two: proximal- and distal-based. They were then elevated from the cartilage subperichondrially on the proximal side and supraperichondrially on the distal side. Concha-scaphal sutures were used to form an antihelical rim along with concha-mastoid sutures to reduce the concha-mastoid angle. Conchal cartilage resection was done if needed. Then, the bilateral fasciaperichondrial flaps were sutured together to cover the concha-mastoid and concha-scaphal sutures. RESULTS: Between May 2017 and May 2021, 32 ears of 17 patients were operated on due to prominent ear deformity. No hematoma or infection was observed in any patient, and there were no instances of recurrence, suture exposure, hypertrophic scars, or keloids. The satisfaction level of all patients was 8.2 ±â€¯0.9 points on average according to the VAS. In the anthropometric measurements, a statistically significant difference was found between preoperative and postoperative sixth month CMA and HMD values. CONCLUSION: A combination of suture techniques and a modified bilateral fasciaperichondrial flap may be used in prominent ear cases, with low recurrence rates and high patient satisfaction. LEVEL OF EVIDENCE: III.

Experimental cholesteatoma: a comparison between spontaneous and induced models.

OBJECTIVE: To compare the incidence and the histopathological aspect of spontaneous and two induced Mongolian gerbils' models of cholesteatoma: External Auditory Canal (EAC) obliteration model and the Auditory Tube (AT) cauterization model. METHODS: Fifty-four ears of 27 animals were divided into EAC obliteration, AT cauterization, and control groups and histologically assessed for cholesteatoma incidence and classification at intervals of 2, 4, 8, and 16 weeks. RESULTS: Cholesteatoma was diagnosed in 30 of the 53 ears evaluated with a significantly higher incidence in groups that received some type of intervention (p<0.0001). It was not possible to histologically distinguish cholesteatomas of the same stage between the study groups. CONCLUSION: Although we observed a significant increase in cholesteatoma incidence with the two methods used when compared to the control group, all developed cholesteatomas were apparently identical from a histological point of view.

Perforación timpánica y colesteatoma, una patología de niños y adultos / Tympanic perforation and cholesteatoma, a pathology of children and adults

INTRODUCCIÓN. La patología de oído es una enfermedad frecuente en nuestro medio, asociada a infecciones a repetición del oído, con la presencia de perforación timpánica y colesteatoma, que determinará la presencia de lesiones mucho más acentuadas en cuanto a la evolución auditiva o complicaciones locales o sistémicas. OBJETIVO. Determinar la asociación existente entre la presencia de colesteatoma y perforación timpánica en pacientes con otitis media crónica. MATERIALES Y MÉTODOS. Estudio epidemiológico analítico retrospectivo. Población de 4 733 y muestra de 75 pacientes para casos y 75 para controles basados en historias clínicas tomadas del sistema informático AS 400, que acudieron a la consulta externa de torrinolaringología del Hospital de Especialidades Carlos Andrade Marín en el periodo de enero de 2018 a diciembre de 2019; Criterios de inclusión para grupo de casos: Hombres y mujeres de 20 a 65 años de edad, diagnóstico de otitis media crónica, diagnóstico de colesteatoma ótico. Criterios de inclusión para grupo controles: Hombres y mujeres de 20 a 65 años de edad, no presentar diagnóstico de colesteatoma. RESULTADOS. Se observó una relación fuerte entre el poseer perforación timpánica y el desarrollo de colesteatoma con un valor de OR 33,14 con un IC al 95% de 31,94 ­ 34,34, con lo que se comprobó la hipótesis del estudio. Se determinó que la perforación timpánica es un factor de riesgo asociado con el desarrollo de colesteatoma en pacientes con otitis media crónica, la prevalencia de colesteatoma en relación a la edad estuvo en un 72% en pacientes de 41 a 65 años, con mayor predominancia en mujeres en un 57,3%. DISCUSIÓN. La presencia de perforación timpánica de acuerdo a lo observado es un factor de riesgo para el desarrollo de colesteatoma, ligado en su mayoría a cuadros de Otitis Media Crónica. CONCLUSIONES. Se confirmó que la perforación timpánica, es un factor de riesgo en el desarrollo del colesteatoma en los pacientes que tienen otitis media crónica, lo que demuestra la necesidad de manejo actualizado y continuo en pacientes con esta patología de oído. Se requieren estudios con muestras más amplias para determinar otros factores de riesgo como sexo, nivel de educación y edad que podrían influir en el desarrollo de colesteatoma.

INTRODUCTION. Ear pathology is a frequent disease in our environment, associated with repeated ear infections, with the presence of tympanic perforation and cholesteatoma, which will determine the presence of much more accentuated lesions in terms of auditory evolution or local or systemic complications. OBJECTIVE. To determine the association between the presence of cholesteatoma and tympanic perforation in patients with chronic otitis media. MATERIALS AND METHODS. Retrospective analytical epidemiological study. Population of 4 733 and sample of 75 patients for cases and 75 for controls based on clinical histories taken from the AS 400 computer system, who attended the Otorhinolaryngology outpatient clinic of the Carlos Andrade Marín Specialties Hospital in the period from January 2018 to December 2019; Inclusion criteria for case group: Men and women aged 20 to 65 years, diagnosis of chronic otitis media, diagnosis of otic cholesteatoma. Inclusion criteria for controls group: men and women aged 20 to 65 years, no diagnosis of cholesteatoma. RESULTS. A strong relationship was observed between having tympanic perforation and the development of cholesteatoma with an OR value of 33,14 with a 95% CI of 31,94 - 34,34, thus proving the study hypothesis. It was determined that tympanic perforation is a risk factor associated with the development of cholesteatoma in patients with chronic otitis media, the prevalence of cholesteatoma in relation to age was 72% in patients aged 41 to 65 years, with greater predominance in women in 57,3%. DISCUSSION. The presence of tympanic perforation according to what was observed is a risk factor for the development of cholesteatoma, mostly linked to Chronic Otitis Media. CONCLUSIONS. It was confirmed that tympanic perforation is a risk factor in the development of cholesteatoma in patients with chronic otitis media, which demonstrates the need for updated and continuous management in patients with this ear pathology. Studies with larger samples are required to determine other risk factors such as sex, education level and age that could influence the development of cholesteatoma.

Quiste epidermoide en conducto auditivo externo: reporte de caso / Epidermoid cysts of the external auditory canal: case report

Resumen El quiste epidérmico es una lesión benigna y común de la piel. Se desarrolla por un bloqueo de la unidad pilosebácea, con la consecuente proliferación de células epiteliales y secuestro de queratina. El 7% se desarrollan en cabeza y cuello, sin embargo, son infrecuentes en canal auditivo externo. Su patrón de crecimiento es lento y progresivo durante años, siendo asintomáticos. Al aumentar de tamaño causan sintomatología variable, acorde a su localización; en el canal auditivo tienen un comportamiento obstructivo que genera síntomas como otalgia e hipoacusia. Se presenta caso de una paciente de 69 años, con acúfeno e hipoacusia progresiva derecha. Durante la otoscopia se observó una neoformación obstructiva del 100% de la luz del conducto. Se realizaron estudios de imagen que reportaron tumoración de características quísticas de conducto auditivo derecho, bien circunscrita, sin erosión ósea. Para el diagnóstico definitivo, se realizó resección quirúrgica y biopsia reportando quiste epidérmico. Durante el seguimiento posoperatorio sin hallazgos de recidiva.

Abstract The epidermal cyst is a common and benign lesion of the skin. It develops due to a blockage of the pilosebaceous unit, with the consequent proliferation of epithelial cells and keratin sequestration. Seven percent develop in the head and neck; however, they are infrequent in the external auditory canal. Its growth pattern is slow and progressive over the years, being asymptomatic. As they increase in size, they cause variable symptoms, according to their location. In the ear canal they have an obstructive behavior that generates symptoms such as earache and hearing loss. A case of a 69-year-old female with tinnitus and progressive right hearing loss is presented. At otoscopy, a 100% obstructive neoformation of the canal lumen was observed. Imaging studies showed a well circumscribed, cystic tumor of the right ear canal, without bone erosion. For the definitive diagnosis, a resection and biopsy were performed, reporting an epidermal cyst. During follow up there was no recurrence of tumor.

Dépistage auditif: considérations sur la mise en œuvre

Le présent manuel est l’aboutissement d’un processus de consultation mené par l’Organisation mondiale de la Santé. Il s’adresse à toutes les personnes qui prévoient d’instaurer un programme de dépistage auditif à l’échelon national ou infranational : coordinateurs de soins de l’oreille et de l’audition ou points focaux au sein des ministères de la Santé, planificateurs en santé publique, organisations non gouvernementales ou entités de la société civile qui prodiguent des soins de l’oreille et de l’audition. Cet ouvrage contient des informations pratiques visant à faciliter le dépistage des pertes auditives et des maladies connexes de l’oreille ainsi que l’intervention précoce chez les nouveau-nés et les nourrissons, les enfants d’âge préscolaire et scolaire ainsi que les personnes âgées. Ce manuel contient aussi des conseils sur des facteurs importants à prendre en compte lors de l’élaboration d’un programme de dépistage auditif : sujets devant faire l’objet du dépistage, objectif du programme, fréquence du dépistage, outils à employer, etc.

Ressecção de pólipo nasofaríngeo inflamatório em conduto auditivo de felino doméstico: relato de caso / Resection of inflammatory nasopharyngeal polyp in ear canal of domestic feline: case report

Uma fêmea de felino doméstico foi encaminhada a um hospital veterinário particular da cidade de Guarujá (SP), Brasil, com a queixa de um aumento de volume em região de pavilhão auricular. Durante a inspeção, foi constatado que a formação peduncular tinha origem no interior da orelha, que somado ao histórico da paciente, suspeitou-se de um pólipo nasofaríngeo inflamatório. Foi feita a excisão e envio do material para exames patológicos que confirmaram a suspeita.(AU)

A female domestic cat was referred to a private veterinary hospital in the city of Guarujá-SP, Brazil, with the complaint of an increase in volume in the region of the ear. During inspection, it was found that the peduncular formation originated inside the ear, which added to the patient's history, suspected an inflammatory nasopharyngeal polyp. Excision was performed and the material was sent for pathological examinations that confirmed the suspicion.(AU)

New locus underlying auriculocondylar syndrome (ARCND): 430 kb duplication involving TWIST1 regulatory elements.

BACKGROUND: Auriculocondylar syndrome (ARCND) is a rare genetic disease that affects structures derived from the first and second pharyngeal arches, mainly resulting in micrognathia and auricular malformations. To date, pathogenic variants have been identified in three genes involved in the EDN1-DLX5/6 pathway (PLCB4, GNAI3 and EDN1) and some cases remain unsolved. Here we studied a large unsolved four-generation family. METHODS: We performed linkage analysis, resequencing and Capture-C to investigate the causative variant of this family. To test the pathogenicity of the CNV found, we modelled the disease in patient craniofacial progenitor cells, including induced pluripotent cell (iPSC)-derived neural crest and mesenchymal cells. RESULTS: This study highlights a fourth locus causative of ARCND, represented by a tandem duplication of 430 kb in a candidate region on chromosome 7 defined by linkage analysis. This duplication segregates with the disease in the family (LOD score=2.88) and includes HDAC9, which is located over 200 kb telomeric to the top candidate gene TWIST1. Notably, Capture-C analysis revealed multiple cis interactions between the TWIST1 promoter and possible regulatory elements within the duplicated region. Modelling of the disease revealed an increased expression of HDAC9 and its neighbouring gene, TWIST1, in neural crest cells. We also identified decreased migration of iPSC-derived neural crest cells together with dysregulation of osteogenic differentiation in iPSC-affected mesenchymal stem cells. CONCLUSION: Our findings support the hypothesis that the 430 kb duplication is causative of the ARCND phenotype in this family and that deregulation of TWIST1 expression during craniofacial development can contribute to the phenotype.

Tamizaje auditivo: Consideraciones para su implementación / Hearing screening: Considerations for its implementation

La presente publicación describe una orientación técnica para el establecimiento de los programas basados ​​en la evidencia para el tamizaje auditivo en diferentes grupos de edad y con el objetivo de facilitar las intervenciones tempranas para las enfermedades del oído y la pérdida auditiva en: los recién nacidos y lactantes; la población infantil, en especial en el entorno preescolar y escolar; las personas mayores, y las personas expuestas al ruido, a sustancias químicas ototóxicas y a medicamentos ototóxicos, factores que aumentan el riesgo de sufrir pérdida de audición

Tamizaje auditivo: consideraciones para su implementación

En el Informe mundial sobre la audición, la Organización Mundial de la Salud (OMS) ha estimado que en el 2050 casi 2.500 millones de personas tendrán algún grado de pérdida auditiva, de las cuales al menos 700 millones necesitarán servicios de rehabilitación. El Informe mundial sobre la audición recomienda que los Estados Miembros de la OMS adopten medidas políticas urgentes y basadas en pruebas para prevenir, identificar y rehabilitar la pérdida auditiva. La detección de la pérdida auditiva y enfermedades del oído en momentos específicos hace parte importante de esta estrategia. En esta publicación, el Tamizaje auditivo: consideraciones para su implementación se basa en las recomendaciones formuladas en el Informe mundial sobre la audición. Su objetivo es proporcionar a los Estados Miembros una orientación técnica para el establecimiento de los programas basados ​​en la evidencia para el tamizaje auditivo en diferentes grupos de edad y con el objetivo de facilitar las intervenciones tempranas para las enfermedades del oído y la pérdida auditiva en: los recién nacidos y lactantes; la población infantil, en especial en el entorno preescolar y escolar; las personas mayores, y las personas expuestas al ruido, a sustancias químicas ototóxicas y a medicamentos ototóxicos, factores que aumentan el riesgo de sufrir pérdida de audición.

Production and Characterization of Chitooligosaccharides: Evaluation of Acute Toxicity, Healing, and Anti-Inflammatory Actions.

The search for promising biomolecules such as chitooligosaccharides (COS) has increased due to the need for healing products that act efficiently, avoiding complications resulting from exacerbated inflammation. Therefore, this study aimed to produce COS in two stages of hydrolysis using chitosanases derived from Bacillus toyonensis. Additionally, this study aimed to structurally characterize the COS via mass spectrometry, to analyze their biocompatibility in acute toxicity models in vivo, to evaluate their healing action in a cell migration model in vitro, to analyze the anti-inflammatory activity in in vivo models of xylol-induced ear edema and zymosan-induced air pouch, and to assess the wound repair action in vivo. The structural characterization process pointed out the presence of hexamers. The in vitro and in vivo biocompatibility of COS was reaffirmed. The COS stimulated the fibroblast migration. In the in vivo inflammatory assays, COS showed an antiedematogenic response and significant reductions in leukocyte migration, cytokine release, and protein exudate. The COS healing effect in vivo was confirmed by the significant wound reduction after seven days of the experiment. These results indicated that the presence of hexamers influences the COS biological properties, which have potential uses in the pharmaceutical field due to their healing and anti-inflammatory action.