[Binaural cochlear implant--good choice in the treatment of deep sensorinural hearing loss]. / Implantul cohlear binaural--optiune avantajoasa în tratamentul surditatii profunde neuro-senzoriale.

UNLABELLED: Nowadays. cochelar implant is the only choice of treatment in deep bilateral deafness. AIM: To evaluate the benefits of binaural implantation of a single receiver-stimulator device by using audiometric tests at 3 and 6 months intervals. MATERIAL AND METHODS: The study included 3 patients with bilateral sensorineural deafness of cochlear origin. Following implantation they were assessed by pure tone audiometry (PTA), speech audiometry (SA), and sound localization tests (LT). RESULTS: PTA showed a significant decrease in hearing thresholds level during the 6-month interval following implantation. As to the degree of speech discrimination in both quiet and noisy environment, SA showed evident progress at 6 months compared to the results at 3 month. The location tests revealed improved sound localization in both ears at 6 months compared to the results at 3 months. CONCLUSIONS: Compared to unilateral implant, the binaural cochlear implant has the advantage of stereophonic hearing, facilitating the communication through a better understanding of speech in both quiet and noisy environment, and improving the quality of life by the location of sounds similar to natural hearing.

[Peripheral vestibular syndrome intricated pathogenic issues. A case report]. / Sindromul vestibular--aspecte patogenice intricate. Prezentare de caz.

BACKGROUND: Ménière's syndrome appears to be the final common pathway of the mechanisms the inner ear responds to almost any injury. Although the autoimmune disease seems to play a major role, exposure to intense noise can also be a trigger in the appearance and/or aggravation of the disease. MATERIAL AND METHODS: The case of 41 years old musician with a history of ankylosing spondylitis, diagnosed with Ménière's syndrome 5 years ago, is presented. Recently the symptoms became more polymorphic, revealing the association between benign paroxysmal positional vertigo (BPPV), Ménière's syndrome and high frequency hearing loss in an autoimmune background. Besides general, neurological and ENT examination, the diagnostic workup comprised of tonal audiogram, brain stem auditory evoked potentials, computerized dynamic posturography and videonistagmography. RESULTS: The final diagnosis was acute noise trauma, Ménière's syndrome, left horizontal semicircular canal BPPV, bilateral sensorineural sudden aggravated hearing loss in high frequencies (above 9 kHz) and allegedly autoimmune inner ear disease. Treatment with an association of corticosteroids, vasodilators and vitamins combined with Vannucchi's maneuver were followed by a significant relief of the symptoms. CONCLUSION: Although no causal relationship was found between acoustic trauma and increased endolymphatic pressure, both literature data and the case presented show that intense and prolonged noise exposure may aggravate peripheral vestibular syndrome.

[Seven years of cochlear implant at the ENT Clinic of "Recuperare" Hospital Iasi]. / 7 ani de implant cochlear in Clinica ORL a Spitalului Clinic de Recuperare Iasi.

This paper presents our Cochlear Implant Departments results from the beginning until present time. Our implant list contains 161 candidates. The enlisted was made based on the criteria's for implant candidates' selection and we have implanted already 17 of them (11 children and 6 adults). Surgical interventions were done according to standard procedure - the approach being through mastoidectomy and posterior tympanotomy. We discuss the results obtained with cochlear implantation in each case. The outline idea is that the cochlear implant was a good choice in all our implanted cases and the patients had achieved at least the performances predicted before implantation for every particular situation.

[Laser Doppler vibrometry: a new tool for diagnosing hearing loss with an intact eardrum]. / Laser Doppler vibrometria: un nou instrument pentru diagnosticarea Hipoacuziei cu timpan închis.

The diagnosis of hearing loss with an intact eardrum frequently requires an entire battery of hearing tests, without the guarantee of an exact diagnosis. The techniques frequently provide only orientation for it, without establishing the site of the lesion and the etiology of the hearing loss. Laser Doppler vibrometry is a new technique, which has recently proved capable, of partially resolving this problem. The method is based on the study of the sound-induced vibration of the eardrum in humans in vivo, using a laser Doppler vibrometer. The method proved to be useful in the diagnosis of the pathology of the middle ear sound transmission system, avoiding the need for exploratory tympanotomy. Called "laser-audiometry", the method promises to become a new diagnostic tool for hearing impairment.

[Experience of the ENT clinic--rehabilitation hospital of Iasi in the diagnosis of hearing loss in children between 1 and 5 years of age]. / Experienta clinicii orl--spitalul clinic de recuperare Iasi in diagnosticarea surditatii la copilul de 1-5 ani. Studiu pe anul 2005.

The aim of this study is to asses the average age of diagnosis of congenital hearing loss in children up to 5 years old. A group of 48 children aged between 1-5 years old were admitted in our clinic in 2005 because of hearing impairment, noticed in most cases by their parents. All cases were investigated in our clinic by transient evoked oto-acoustic emission test, threshold auditory brainstem response, impedance-metry and, whenever possible, audiometry. Sensori-neural hearing loss of variable gravity was diagnosed in 30 cases, most of them in the 2-3 yrs group of age (9 cases). The etiology of hearing loss could be established in 9 cases only. 19 patients (63%) were hearing aided, but follow-up was not possible. The average age of congenital hearing loss diagnosis may be reduced by applying universal neonatal hearing screening and a well established modality of confirmation of deafness in infants identified by the universal screening.

[Thrombophlebitis of left cavernous sinus secondary to acute right sphenoid sinusitis]. / Tromboflebita sinusului cavernos stâng secundara sinuzitei sfenoidale drepte acute izolate prezentare de caz.

Isolated sphenoid sinusitis is a rare, potentially destructive entity. Presenting symptoms are often vague and non-specific therefore the diagnosis is made late when complications have had already occurred. The most frequent complications of sinusitis are the neurological ones--being serious life--threatening conditions. We report a case of isolate right sphenoid sinusitis with concurrent thrombophlebitis of left cavernous sinus. Accordingly, we review the salient clinical features of this illness, with emphasis on the importance of a high index of suspicion, the potentially rapid and fatal course of the disease process and the aspects of the diagnosis and treatment. We also reviewed the predisposing factors of complications of sphenoid sinusitis.

Malignant tumors of the nose and paranasal sinuses: a retrospective review of 291 cases.

Malignant neoplasms of the nose and paranasal sinuses are not common among the general population. We present a retrospective study of 291 cases of malignant tumors of the nose and paranasal sinuses that were diagnosed in a northern Romanian population over a period of 35 years. We review the etiology, diagnosis, prognosis, and treatment of these tumors.

[The technic for the reoptimization of laryngeal cannulae by recoating them with a silicone material]. / La technologie de reoptimisation des canules laryngiennes par recouvrement d'un materiau siliconique.

In the laryngeal surgical pathology area, the application of a cannula with temporary or long term indications is necessary for ensuring the respiratory function troubled by various causes (inflammatory, tumor or traumatic) that obstruction the respiratory tract. The most frequently used standard cannula is rigid and does not show proper adaptation for every clinical situation, thus leading to local troubles. In this paper, the realization technique of a rigid/flexible and individual cannula applied after the tracheotomy is presented. In order to carry out the cannula, a rigid material is utilized (acrylic resin) for maintaining the shape and dimensions of the laryngeal stoma. It is also utilized an elastically material (acrylic resin with a retard plug--Simpa) that ensures the optimal adaptation, tight close and tissue protection around the stoma. In co-operation with the ORL Clinic--Recuperation Hospital, these cannulae were applied to fifteen patients pursuing their evolution in time.

[Cervical lymph node metastases of unknown origin]. / Metastaze ganglionare cervicale cu punct de plecare necunoscut.

In this paper we present a three-year prospective study (1991-1993) about the cervical lymph node metastases of unknown origin. 370 patients with lymphatic carcinomatous metastases in the were admitted in "Sf. Spiridon" Hospital--ENT Clinic. No primary tumor was located in 33 patients (8.9%). The diagnostic strategy for cervical metastases of an unknown primary was reviewed. The probability of locating the primary tumor depend on diagnostic phase.

[Launois Besaude lipomatosis]. / La lipomatosis Launois Bensaude.

We report two new cases of Launois Bensaude syndrome. Diagnostic and therapeutic aspects are discussed.