The middle ear pressure does not change after adenotonsillectomy in children younger than 10 years old.

OBJECTIVE. In children aged less than 10 years, to assess whether adenotonsillectomy has some permanent or transitory effect on middle ear pressure. MATERIAL AND METHODS. 20 children aged 4 to 9 years old (13 girls and 7 boys) participated in the study. The day before surgery and on days 1, 7, 14 and 21 after adenotonsillectomy both tympanometry and pure tone audiometry were performed. During surgery, medication consisted in dexamethasone, atropine, propofol and sevoflurane. RESULTS. Before surgery, the middle ear pressure was within the range of 0 ± 99 daPa. On day 1 of the followup study, the average right and left middle ear pressure decreased less than -99 daPa in 6 patients aged 4 to 9 years old (2 girls and 4 boys), with a body mass index from 11.9 to 16.6. At day 7 of follow-up, the middle ear pressure increased and none of the patients showed a pressure less than -99 daPa. Before surgery and during the 21 days of follow-up, hearing thresholds were always ≤ 20 dB nHL. No significant difference was observed between children with or without an average middle ear pressure lower than -99 daPa on their age, weight, height, body mass index or duration of the surgery. CONCLUSIONS. After adenotonsillectomy, children aged 4 to 9 years old who received dexamethasone, atropine and sevoflurane might develop negative middle ear pressure with no hearing loss, which may resolve in 1 week. After adenotonsillectomy, in patients with otalgia or risk factors for middle ear disease, closer evaluation of middle ear pressure may be advisable.

Influence of Tobacco Smoke Exposure on the Protein Expression of α7 and α4 Nicotinic Acetylcholine Receptors in Squamous Cell Carcinoma Tumors of the Upper Aerodigestive Tract (Out of the Larynx).

PURPOSE: To assess protein expression of α7 and α4 nicotinic acetylcholine receptors (nAChR) subtypes in squamous cell carcinoma of the upper aerodigestive track (out of the larynx) according to tobacco smoke exposure, considering the general characteristics of the patients. METHODS: The α7 and α4 nAChR subtypes were assessed by immunohistochemistry in tumor samples from 33 patients with novel diagnosis of squamous cell carcinoma of the upper aerodigestive tract (out of the larynx). RESULTS: Current smokers were middle-age men with alcohol consumption, whereas elderly women with no alcohol consumption prevailed among nonsmokers. Expression of α4 nAChR was high in all groups, with an influence of alcohol use, although expression of α7 nAChR was low in current smokers with alcohol use. Expression of α4 with no expression of α7 nAChR was associated with advanced disease. CONCLUSIONS: Squamous cell carcinoma tumors of the upper aerodigestive tract (out of the larynx) may show desensitization of α4 nAChR. Advanced disease at diagnosis might be associated with desensitization of α4 with decrease in α7 nAChR.