Superior semicircular canal dehiscence: prevalence in a population with clinical suspected otosclerosis-type hearing loss.

Superior semicircular canal dehiscence (SSCD) can present with a variety of symptoms that can be predominantly auditory, predominantly vestibular or both. It can mimic a wide range of otological disorders, in particular otosclerosis-like stapes fixation. Our study revealed that, in 5.3% of our patients with clinically suspected otosclerosis, SSCD was detected in high-resolution multi-detector computed tomography (HRMDCT) of the temporal bone. We therefore emphasise the value of HRMDCT with reconstructions in the plane of the superior semicircular canal and perpendicular to the superior semicircular canal in the diagnostic work-up of each patient with a tentative diagnosis of otosclerosis-type stapes fixation. Where there are doubts, VEMP testing should be performed. We believe that a number of unexplained complications after an uneventful stapedotomy procedure might be explained by a pre-operatively undetected dehiscent superior semicircular canal and therefore unwarranted surgery. The typical feature of the conductive hearing loss due to SSCD compared to otosclerosis is an air-bone gap which is much more prominent at low frequencies than at high frequencies.

Montelukast does not prevent reactive airway disease in young children hospitalized for RSV bronchiolitis.

AIM: To evaluate the long-term effect of montelukast on symptoms of cough and wheeze following RSV bronchiolitis. METHODS: Fifty eight patients (aged < or = 24 months) hospitalized with a first episode of RSV bronchiolitis were enrolled in this double blind prospective randomized trial comparing montelukast (n = 31) vs placebo (n = 27). RESULTS: During the 3-month treatment period, there were no statistical significant differences between the two groups for symptom-free days and nights (48.5 [interquartile range 33.0.0-66.0] for montelukast vs 57.0 [29.0-71.0] for placebo p = 0.415) nor disease-free days and nights (44.5 days [26.0-54.0] vs 53.0 [22.3-71.0]; p = 0.266). During the 1 year follow-up, there were 41 exacerbations in the montelukast group vs 54 exacerbations in the placebo group (p = 0.57). Time to first exacerbation was not different. Number of unscheduled visits and need to start inhaled steroids were comparable in the two groups. CONCLUSION: Treatment with montelukast after hospital admission for RSV bronchiolitis in children younger than 2 years of age did not reduce symptoms of cough and wheeze. We cannot exclude that a subgroup of children may, however, benefit from this treatment.

Exposure to pets and the association with sensitization and allergic disease in Belgian schoolchildren.

Prolonged domestic exposure, from birth on, to dog allergen may protect against sensitization.

Body mass index in Belgian schoolchildren and its relationship with sensitization and allergic symptoms.

Results of studies of the influence of body mass index (BMI) on the allergic status are controversial. As a part of the Aalst Allergy Study, we assessed the prevalence of the different BMI categories (underweight, normal weight, overweight, and obesity) and a possible association between BMI and atopy in 1576 unselected Belgian schoolchildren, aged from 3.4 to 14.8 yr. BMI was used to determine weight status. Skin prick testing with the most common aeroallergens was performed. A parental questionnaire documented data on respiratory and allergic disorders, demographic characteristics and other potential risk factors for sensitization. Among the total children, 4.1% of the children were underweight, 14.5% were overweight, and 7.4% were obese. More girls than boys were overweight (p = 0.015). In the group of children older than 12 yr, we found more overweight (p = 0.03) and obese (p = 0.004) girls, and more obese boys (p = 0.004) than in the younger age groups. In contrast with reports in the literature, an increased prevalence of allergic sensitization in underweight girls only [adjusted odd ratio (OR(adj)) = 2.9, 95% confidence interval (CI): 1.3-6.4] was documented. A strong association between obesity and exercise-induced respiratory symptoms was found in both boys (OR(adj) = 14.5, 95% CI: 2.9-73.3) and girls (OR(adj) = 4.9, 95% CI: 1.3-17.4). No correlations with allergic respiratory symptoms, eczema, or rhinoconjunctivitis could be documented.

The influence of bedroom environment on sensitization and allergic symptoms in schoolchildren.

BACKGROUND: Bedroom conditions have been associated with an increased risk of allergy. OBJECTIVE: The aim of this study was to evaluate the relationship between sleeping environment and sensitization and allergic symptoms in schoolchildren. METHODS: A cross-sectional study, the Aalst Allergy Study, was performed in an unbiased community population of 2021 Belgian schoolchildren, aged 3.4 to 14.8 years. Skin prick testing was performed with the most common aeroallergens and bedroom conditions (presence of stuffed toys, type of flooring, and bedding material) were documented through a parental questionnaire. RESULTS: The presence of stuffed toys in the bedroom was associated with a lower prevalence of overall sensitization and a lower prevalence of conjunctivitis and allergic respiratory symptoms. That effect was almost exclusively present in children with a positive family history of atopy and was more pronounced as the number of stuffed toys increased. A significantly lower prevalence of overall sensitization, sensitization to house dust mite, and wheezing was documented in children with nonsynthetic bedding materials. That effect was exclusive to children with a positive family history of atopy. Type of flooring was not associated with sensitization or allergic symptoms. CONCLUSION: Our data suggest that bedroom exposure to stuffed toys and nonsynthetic bedding materials may have a protective effect against sensitization and allergic symptoms in genetically predisposed children. Confirmation of these findings will require further prospective studies that include measurement of levels of mite allergens and endotoxins and assessment of the time, degree, and duration of the exposure.