Tinnitus and Associated Handicaps in the French Mountain Artillery: Assessment by the Tinnitus Handicap Inventory.

INTRODUCTION: Tinnitus and associated handicap related to acoustic trauma sequelae have never been assessed in the French artillery. Although impulsive noise exposure to firearms and canons are thought to increase prevalence of tinnitus among soldiers, recent studies demonstrating this fact are missing. MATERIALS AND METHODS: Here, a representative sample of 389 soldiers from an operational mountain artillery regiment was surveyed. Soldiers personally concerned by tinnitus were invited to fill in a questionnaire. We assessed tinnitus and the associated handicap using a French translation of the Tinnitus Handicap Inventory (THI). Questions about attention/concentration problems, impaired speech hearing and understanding, sleep disorders, social and familial tension, irritability, depression, and tiredness as linked to tinnitus were the core of the questionnaire. RESULTS: Soldiers that completed the THI (n = 73, 19%) had a mean THI score of 18 ± 17, this mean score corresponded to a mild handicap. At this grade, tinnitus should be easily masked and should not interfere with daily activities. The percentage of soldiers concerned by tinnitus was slightly higher in the older age class, but there was no significant difference of THI scores between the different age classes. The most reported handicaps were attention/concentration problems, impaired speech hearing, and understanding. Among the THI fillers, eight soldiers (11%) had THI scores >36, indicating a moderate to severe handicap. CONCLUSION: Despite a mild tinnitus handicap, the percentage of people concerned by tinnitus in this regiment is higher (19%) than that in the estimated percentage of general population of European countries (about 10%). It should be of interest to replicate this type of study from other regiments and from other countries. Education and good fitting of hearing protection for prevention of acoustic trauma sequelae should still be encouraged.

Determination of success by objective scintigraphic criteria after laparoscopic pyeloplasty.

BACKGROUND AND PURPOSE: Laparoscopic pyeloplasty (LP) is a minimally invasive technique with high success rates that match open procedures. There are a variety of success definitions. We have defined and reported our success rate by objective renal scintigraphic criteria. We also compare our scintigraphic success with clinical success defined by absence of pain. PATIENTS AND METHODS: We reviewed retrospectively 111 adult cases of laparoscopic pyeloplasties. The Anderson-Hynes technique was used in 98% of cases. nonprimary pyeloplasties represented 12 cases of our series. Renal scintigraphic success rates were defined as: strict (T(1/2) <10 min), nonobstructive (T(1/2) <20 min), and technical success (improved T(1/2)). Of our patients, 83% had renal scintigraphy before and after surgery. RESULTS: Average operative time was 128 +/- 45 minutes, blood loss was 52 +/- 168 mL, and median postoperative hospital stay was 3 days. After surgery, T(1/2) was decreased by 26 minutes for a median time of 13 minutes. Strict success was achieved in 61% of cases, while nonobstructive success and technical success were achieved in 86% and 93%, respectively. No difference in success was observed between primary and nonprimary cases. Clinical success (absence of symptoms) was achieved in 95% of LPs. We also show that 75% of patients who had obstruction after LP based on scintigraphic criteria were asymptomatic, showing a poor correlation between symptoms and obstruction. CONCLUSIONS: By defining success with renal scintigraphic criteria, we still obtain a high success rate. When using strict criteria, however, the success decreases and might identify patients at risk of late recurrence.