This is an RSS newsfeed from BioMed Central It is intended to be used with an RSS reader. For more information about RSS newsfeeds from BioMed Central, visit http://www.biomedcentral.com/info/about/rss/ http://www.biomedcentral.com/bmcearnosethroatdisord/ The latest articles from BMC Ear, Nose and Throat Disorders (ISSN 1472-6815) published by BioMed Central Background: Tone-burst otoacoustic emissions (TBOAEs) have not been routinely studied in pediatric populations, although tone burst stimuli have greater frequency specificity compared with click sound stimuli. The present study aimed (1) to determine an appropriate stimulus level for neonatal TBOAE measurements when the stimulus center frequency was 1 kHz, (2) to explore the characteristics of 1 kHz TBOAEs in a neonatal population. Methods: A total of 395 normal neonates (745 ears) were recruited. The study consisted of two parts, reflecting the two study aims. Part I included 40 normal neonatal ears, and TBOAE measurement was performed at five stimulus levels in the range 60–80 dB peSPL, with 5 dB incremental steps. Part II investigated the characteristics of the 1 kHz TBOAE response in a large group of 705 neonatal ears, and provided clinical reference criteria based on these characteristics. Results: The study provided a series of reference parameters for 1 kHz TBOAE measurement in neonates. Based on the results, a suggested stimulus level and reference criteria for 1 kHz TBOAE measures with neonates were established. In addition, time-frequency analysis of the data gave new insight into the energy distribution of the neonatal TBOAE response. Conclusion: TBOAE measures may be a useful method for investigating cochlear function at specific frequency ranges in neonates. However, further studies of both TBOAE time-frequency analysis and measurements in newborns are needed. http://www.biomedcentral.com/1472-6815/8/3 Vicky Wei Zhang, Bradley McPherson and Zhi-Guo Zhang BMC Ear, Nose and Throat Disorders 2008, 8:3 2008-04-17 doi:10.1186/1472-6815-8-3 BMC Ear, Nose and Throat Disorders 1472-6815 8 3 2008-04-17 Background: The aim of the study was to examine the psychometric properties of the Vertigo symptom scale – short form (VSS-SF), a condition-specific measure of dizziness, following translation of the scale into Norwegian. Methods: A cross-sectional survey design was used to examine the factor structure, internal consistency and discriminative ability (sample I, n = 503). A cross-sectional pre-intervention design was used to examine the construct validity (sample II, n = 36) of the measure and a test-retest design was used to examine reliability (sub-sample of sample II, n = 28). Results: The scree plot indicated a two factor structure accounting respectively for 41% and 12% of the variance prior to rotation. The factors were related to vertigo-balance (VSS-V) and autonomic-anxiety (VSS-A). Twelve of the items loaded clearly on either of the two dimensions, while three items cross-loaded. Internal consistency of the VSS-SF was high (alpha = 0.90). Construct validity was indicated by correlation between path length registered by platform posturography and the VSS-V (r = 0.52), but not with the VSS-A. The ability to discriminate between dizzy and not dizzy patients was excellent for the VSS-SF and sub-dimension VSS-V (area under the curve 0.87 and 0.91, respectively), and acceptable for the sub-dimension VSS-A (area under the curve 0.77). High test-retest reliability was demonstrated (ICC VSS-SF: 0.88, VSS-V: 0.90, VSS-A: 0.90) and no systematic change was observed in the scores from test to retest after 2 days. Conclusion: Using a Norwegian translated version of the VSS-SF, this is the first study to provide evidence of the construct validity of this instrument demonstrating a stable two factor structure of the scale, and the identified sub-dimensions of dizziness were related to vertigo-balance and autonomic-anxiety, respectively. Evidence regarding a physical construct underlying the vertigo-balance sub-scale was provided. Satisfactory internal consistency was indicated, and the discriminative ability of the instruments was demonstrated. The instrument showed satisfactory test-retest reliability. http://www.biomedcentral.com/1472-6815/8/2 Kjersti Wilhelmsen, Liv Inger Strand, Stein Helge G Nordahl, Geir Egil Eide and Anne Elisabeth Ljunggren BMC Ear, Nose and Throat Disorders 2008, 8:2 2008-03-27 doi:10.1186/1472-6815-8-2 BMC Ear, Nose and Throat Disorders 1472-6815 8 2 2008-03-27 Background: An acute complication of thyroidectomy is fatal hematoma, which can produce an upper airway obstruction needing immediate intubation or tracheostomy. After neck surgery, we usually apply a pressure dressing with a non-woven, adhesive fabric to reduce bleeding and fluid collection at the operative bed. We conducted a prospective, randomized, controlled study to evaluate a pressure vs. a non-pressure dressing after thyroid surgery by monitoring blood and serum in the operative bed. Methods: We studied 108 patients who underwent 116 thyroid surgeries at Srinagarind Hospital, Khon Kaen University, between December 2006 and September 2007. The patients were randomized to either the pressure dressing or non-pressure dressing group. Ultrasound of the neck was performed 24 ± 3 hours after surgery. The volume of fluid collection in the operative bed was calculated. All patients were observed for any post-operative respiratory distress, wound complications, tingling sensation or tetany. Results: The distributions of age, sex, surgical indications and approaches were similar between the two groups. There was no statistically significant difference in the volume of fluid collection in the operative bed (p = 0.150) and the collected drained content (p = 0.798). The average time a drain was retained was 3 days. One patient in the pressure dressing group suffered cutaneous bruising while one patient in the non-pressure dressing group developed immediate hemorrhage after the skin sutures. Conclusion: Pressure dressing after thyroidectomy does not have any significant impact on decreasing fluid collection at the operative bed. The use of pressure dressing after thyroidectomy may not therefore be justified.Trial RegistrationNCT00400465, ISRCTN52660978 http://www.biomedcentral.com/1472-6815/8/1 Patorn Piromchai, Patravoot Vatanasapt, Wisoot Reechaipichitkul, Warinthorn Phuttharak and Sanguansak Thanaviratananich BMC Ear, Nose and Throat Disorders 2008, 8:1 2008-03-20 doi:10.1186/1472-6815-8-1 BMC Ear, Nose and Throat Disorders 1472-6815 8 1 2008-03-20 Background: Multi-drug resistant tuberculosis has emerged as a significant problem with the resurfacing of tuberculosis and thus the need to use the second line drugs with the resultant increased incidence of adverse effects. We discuss the effect of second line aminoglycoside anti-tubercular drugs on the hearing status of MDR-TB patients. Methods: Sixty four patients were put on second line aminoglycoside anti-TB drugs. These were divided into three groups: group I, 34 patients using amikacin, group II, 26 patients using kanamycin and group III, 4 patients using capreomycin. Results: Of these, 18.75% of the patients developed sensorineural hearing loss involving higher frequencies while 6.25% had involvement of speech frequencies also. All patients were seen again approximately one year after aminoglycoside discontinuation and all hearing losses were permanent with no threshold improvement. Conclusion: Aminoglycosides used in MDR-TB patients may result in irreversible hearing loss involving higher frequencies and can become a hearing handicap as speech frequencies are also involved in some of the patients thus underlining the need for regular audiologic evaluation in patients of MDR-TB during the treatment. http://www.biomedcentral.com/1472-6815/7/5 Prahlad Duggal and Malay Sarkar BMC Ear, Nose and Throat Disorders 2007, 7:5 2007-11-12 doi:10.1186/1472-6815-7-5 BMC Ear, Nose and Throat Disorders 1472-6815 7 5 2007-11-12 Background: There is very little knowledge about alcohol-induced hearing loss. Alcohol consumption and tolerance to loud noise is a well observed phenomenon as seen in the Western world where parties get noisier by the hour as the evening matures. This leads to increase in the referrals to the "hearing aid clinic" and the diagnosis of "cocktail party deafness" which may not necessarily be only due to presbyacusis or noise-induced hearing loss. Methods: 30 healthy volunteers were recruited for this trial which took place in a controlled acoustic environment. Each of the individuals was required to consume a pre-set amount of alcohol and the hearing was tested (using full pure tone audiogram) pre- and post- alcohol consumption over a broad range of 6 frequencies. Volunteers who achieve a minimum breath alcohol threshold level of 30 u/l had to have second audiogram testing. All the volunteers underwent timed psychometric and visuo-spatial skills tests to detect the effect of alcohol on the decision-making and psychomotor co-ordination. Results: Our results showed that there was a positive association between increasing breath alcohol concentration and the magnitude of the increase in hearing threshold for most hearing frequencies. This was calculated by using the Pearson Regression Coefficient Ratio which was up to 0.6 for hearing at 1000 Hz. Over 90% of subjects had raised auditory thresholds in three or more frequencies; this was more marked in the lower frequencies. Conclusion: Alcohol specifically blunts lower frequencies affecting the mostly 1000 Hz, which is the most crucial frequency for speech discrimination. In conclusion alcohol does appear to affect auditory thresholds with some frequencies being more affected than others. http://www.biomedcentral.com/1472-6815/7/4 Tahwinder Upile, Fabian Sipaul, Waseem Jerjes, Sandeep Singh, Seyed Ahmad Reza Nouraei, Mohammed El Maaytah, Peter Andrews, John Graham, Colin Hopper and Anthony Wright BMC Ear, Nose and Throat Disorders 2007, 7:4 2007-09-18 doi:10.1186/1472-6815-7-4 BMC Ear, Nose and Throat Disorders 1472-6815 7 4 2007-09-18 Although he was listed as an author in the original submission of an article published in BMC Ear, Nose and Throat Disorders (Cetik F, Yazici D, Uguz A: A thyroid tumor extending to the parapharyngeal space. BMC Ear, Nose and Throat Disorders 2006, 6:3), Dr Ramazan Gun was not included in the author list of the published version. The authors agree that Dr Gun meets the criteria for authorship, and should be considered to be an author of Cetik et al. 2006. http://www.biomedcentral.com/1472-6815/7/3 Fikret Cetik, Demet Yazici, Ramazan Gun and Aysun Uguz BMC Ear, Nose and Throat Disorders 2007, 7:3 2007-05-21 doi:10.1186/1472-6815-7-3 BMC Ear, Nose and Throat Disorders 1472-6815 7 3 2007-05-21 Background: Reusable nasal-spray devices are frequently used in otolaryngologic examinations, and there is an increasing concern about the risk of cross-contamination from these devices. The aim of our study was to determine, by means of microbiologic analysis, the safety of a positive-displacement or pump-type atomizer after multiple uses. Methods: A reusable nasal spray bottle, pump, and tips were used in the nasal physical examination of 282 patients admitted to a tertiary otolaryngology clinic. The effectiveness of 2 different methods of prophylaxis against microbiologic contamination (the use of protective punched caps or rinsing the bottle tip with alcohol) was compared with that of a control procedure. Results: Although there was no statistically significant difference in positive culture rates among the types of nasal spray bottles tested, methicillin-resistant coagulase-negative staphylococci were isolated in 4 of 198 cultures. Conclusion: Given these findings, we concluded that additional precautions (such as the use of an autoclave between sprays, disposable tips, or disposable devices) are warranted to avoid interpatient cross-contamination from a reusable nasal spray device. http://www.biomedcentral.com/1472-6815/7/2 Erdinc Aydin, Evren Hizal, Babur Akkuzu and Ozlem Azap BMC Ear, Nose and Throat Disorders 2007, 7:2 2007-03-13 doi:10.1186/1472-6815-7-2 BMC Ear, Nose and Throat Disorders 1472-6815 7 2 2007-03-13 Background: Septal perforation is an uncommon but very bothersome illness and treatment is difficult particularly with large perforations. We wanted to establish the etiology and size of nasal septal perforations in an attempt to implement preventive measures. Methods: This is an open, prospective clinical study of patients seen at our hospital from 1981 to 2005. The clinical data of size, gender and etiology have been recorded consecutively. Results: One hundred and ninety seven patients (100 male, 97 female) were evaluated. Between 1981 and 1995 nasal septal perforation was caused by surgery in 40 of 102 (39.2 %). In the period 1995 to and inclusive of 2005 this percentage decreased as septal resection has been replaced by septo/septorhinoplasty. The latter was the cause for septal perforation in 14.7% in the last period. Nasal steroid and decongestive sprays have emerged as an important cause (28.4 %) during the last ten years particularly in females. In the first period 44 (43.1 %) and in the last 53 (55.7 %) patients were females. There was a noticeable reduction in the number of septal perforations 15 mm or larger in the last period. Conclusion: Nasal steroid and decongestive sprays are now important causes for septal perforation. Information about this complication should be given with an advice to immediately report increasing and bothersome crusting and bleeding. Warning of the simultaneous use of nasal steroid and decongestive sprays should be addressed particularly to females. All patients with symptoms of septal perforation should promptly be referred to otolaryngologists for treatment. http://www.biomedcentral.com/1472-6815/7/1 Liv Kari Døsen and Rolf Haye BMC Ear, Nose and Throat Disorders 2007, 7:1 2007-03-07 doi:10.1186/1472-6815-7-1 BMC Ear, Nose and Throat Disorders 1472-6815 7 1 2007-03-07 Background: To evaluate symptoms, clinical findings, and etiological factors in external ear canal cholesteatoma (EECC).MethodRetrospective evaluation of clinical records of all consecutive patients with EECC in the period 1979 to 2005 in a tertiary referral centre. Main outcome measures were incidence rates, classification according to causes, symptoms, extensions in the ear canal including adjacent structures, and possible etiological factors. Results: Forty-five patients were identified with 48 EECC. Overall incidence rate was 0.30 cases per year per 100,000 inhabitants. Twenty-five cases were primary, while 23 cases were secondary: postoperative (n = 9), postinflammatory (n = 5), postirradiatory (n = 7), and posttraumatic (n = 2). Primary EECC showed a right/left ratio of 12/13 and presented with otalgia (n = 15), itching (n = 5), occlusion (n = 4), hearing loss (n = 3), fullness (n = 2), and otorrhea (n = 1). Similar symptoms were found in secondary EECC, but less pronounced. In total the temporomandibular joint was exposed in 11 cases, while the mastoid and middle ear was invaded in six and three cases, respectively. In one primary case the facial nerve was exposed and in a posttraumatic case the atticus and antrum were invaded. In primary EECC 48% of cases reported mechanical trauma. Conclusion: EECC is a rare condition with inconsistent and silent symptoms, whereas the extent of destruction may be pronounced. Otalgia was the predominant symptom and often related to extension into nearby structures. Whereas the aetiology of secondary EECC can be explained, the origin of primary EECC remains uncertain; smoking and minor trauma of the ear canal may predispose. http://www.biomedcentral.com/1472-6815/6/16 Hanne H Owen, Jørn Rosborg and Michael Gaihede BMC Ear, Nose and Throat Disorders 2006, 6:16 2006-12-23 doi:10.1186/1472-6815-6-16 BMC Ear, Nose and Throat Disorders 1472-6815 6 16 2006-12-23 Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia, and it increases in prevalence with advancing age to about 5% in people older than 65 years.Case presentationWe present a rare case of atrial fibrillation secondary to a mega-oesophagus occurring in an 84-years-old Caucasian woman. The patient had a history of progressive dysphagia and the accumulation of food debris lead to mega-oesophagus. Conclusion: The diagnosis was made by barium swallow and electrocardiogram; evacuations of 300 ml of the food debris lead to complete resolution of the arrhythmia. The possible aetiology leading to this AF is discussed. http://www.biomedcentral.com/1472-6815/6/15 Tahwinder Upile, Waseem Jerjes, Mohammed El Maaytah, Sandeep Singh, Colin Hopper and Jaspal Mahil BMC Ear, Nose and Throat Disorders 2006, 6:15 2006-12-13 doi:10.1186/1472-6815-6-15 BMC Ear, Nose and Throat Disorders 1472-6815 6 15 2006-12-13