The role of explorative tympanotomy in patients with sudden sensorineural hearing loss with and without perilymphatic fistula.

PURPOSE: The purpose of this study was to describe the role of explorative tympanotomy in patients with Profound Sudden Sensorineural Hearing Loss (SSNHL) without clinical evidence of perilymphatic or labyrinthine fistula and to compare intraoperative findings with the postoperative hearing outcome. STUDY DESIGN: Retrospective study of all patients diagnosed with SSNHL who underwent explorative tympanotomy between 2002 and 2005. SETTINGS: Tertiary care university-affiliated hospital. SUBJECTS AND METHODS: Eighty-two patients were diagnosed with unilateral profound SSNHL and underwent tympanotomy with sealing of the round and oval windows. Values of pure tone audiograms and percentage hearing loss of patients with and without intraoperative diagnosed perilymphatic fistula (PLF) were compared and analyzed. RESULTS: PLF was diagnosed in 28% cases intraoperatively. In most cases, hearing improved significantly after surgery. Interestingly, patients with PLF had a 2.4 times greater decrease of percentage hearing loss compared to patients without PLF. CONCLUSIONS: Explorative tympanotomy seems to be useful in patients with profound SSNHL. Patients with PLF benefit more from the surgical procedure and have better outcome than patients without PLF.

A comparison between amylase levels from peritonsillar, dental and neck abscesses.

OBJECTIVES: Pus of peritonsillar abscess (PTA) contains very high amylase levels in some patients. The objective of this study was to further test this finding and to check whether high amylase levels in peritonsillar abscess originate from contamination by saliva during aspiration. STUDY DESIGN: Prospective study. SETTING: Tertiary care university hospital. PARTICIPANTS: The study includes 64 patients with PTA, 8 patients with a neck abscess and 12 patients with a dental abscess. MAIN OUTCOME MEASURE: Amylase levels of pus and serum were compared between the groups. Clinical data regarding hospitalisation length, recurrence rate and previous antibiotic treatment were also collected. RESULTS: Mean amylase levels in the pus of the PTA group were 3045 U/L (median 59 U/L), 13 U/L in the neck abscess group (P = 0.001) and 22 U/L in the dental abscess group (P = 0.001). Mean serum amylase was higher in the PTA group; PTA - 50 U/L, neck abscess - 37 U/L (P = 0.002) and dental abscess - 26 U/L (P < 0.002). All of the patients with amylase levels above 65 U/L had a first episode of PTA. In contrast, 40% of patients with amylase lower than 65 U/L had recurrent PTA (P = 0.003). CONCLUSION: A clear association is seen between minor salivary glands and peritonsillar abscess. The high amylase level in peritonsillar pus is not from contamination with saliva.

Monitoring of pesticide residues in human milk, soil, water, and food samples collected from Kafr El-Zayat Governorate.

Pesticide residues in human milk and environmental samples from Kafr El-Zayat Governorate in Egypt were analyzed. This governorate is located near one of the biggest pesticide factories in Egypt. Organochlorine and organophosphorus pesticides were monitored, including those that have been prohibited from use in Egypt. Human milk samples (31 samples) from Kafr El-Zayat were compared with 11 samples collected from Cairo. Data were compared with results from studies performed in 1987 and 1990. The present study showed that aldrin and dieldrin, heptachlor and heptachlor epoxide, and endrin residues have been eliminated from human milk. Estimated daily intakes (EDIs) of DDT complex and gamma-HCH by breast-fed infants in Kafr El-Zayat were 85.96 and 3.1% of the respective acceptable daily intakes (ADIs). beta-HCH residues showed an increasing pattern, especially in human milk samples from Cairo. DDT complex and HCH isomers in orange, spinach, lettuce, potatoes, and clover samples ranged from undetectable to very low concentrations. Higher levels of DDT and HCH were detected, but aldrin, dieldrin, endrin, and the heptachlors were not detected in food of animal origin. Residues in fish samples were below maximum residue limits established by some developed countries. Those in animal milk samples approached the extraneous residue limits of the Codex Committee on Pesticide Residues. HCH residues in soil were negligible, but DDT residues in soil were somewhat higher. Among water samples, groundwater samples had the highest residues of HCHs and DDTs, followed by Nile River water and then tap water. However, the organochlorine pesticide residues were found at concentrations below the maximum allowable limits set by the World Health Organization for drinking water. Among 12 organophosphorus pesticides monitored as parent compounds, dimethoate, malathion, methamidophos, and chlorpyrifos residues were detected in low concentrations in soil samples from a pesticide factory. No organophosphorus pesticide residues were found in plant samples, except for very low residues of dimethoate in an orange sample. Water samples were devoid of organophosphorus residues as parent compounds.