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Atopy is associated with increased numbers of IgE+ and Fc(epsilon)RI+ cells in adenoids irrespective of whether the child has OME or AH.

ABSTRACT.Purpose: To present the results of orbital decompression in patients with thyroid-associated ophthalmopathy (TAO). Methods: Transantral orbital decompression was performed in 63 patients with TAO. In 40 patients (63%) the operation was made because of progressive ophthalmopathy not responding to medical therapy, and in 23 patients (37%) the operation was made for rehabilitative reasons. The long-term hypesthesia engaging the infraorbital nerve was assessed with a questionnaire using a Visual Analogue Scale (VAS). Results: The mean proptosis reduction was 3.2 mm (range 0-8 mm). Twentyone patients had impaired visual acuity preoperatively, and 20 improved. Altogether 30 patients (40%) had worsened ocular motility postoperatively. Fortythree patients did not have diplopia in the primary position preoperatively, and new diplopia developed in 22 of these (51%). Hypesthesia in the infraorbital nerve area was reported for half of the operated sides, but was a major cause of distress (VAS-scoring ±5) to eleven patients. Conclusions: Transantral orbital decompression is indicated in patients with progressive TAO or in patients with prominent exophthalmos, and results in a good proptosis reduction, but the risk of postoperative diplopia is significant. Postoperative hypesthesia is common but often not a major problem.

Otosclerosis is a common disorder that leads to conductive hearing loss. Most patients with otosclerosis also have tinnitus, and surgical treatment is known to improve hearing as well as tinnitus. Some patients however experience worsening of tinnitus after the operation, but there are no known factors that allow surgeons to predict who will be at risk. In this prospective observational study on 133 patients undergoing stapedotomy, we show that postoperative air conduction thresholds at very high stimulus frequencies predict improvement of tinnitus, as assessed with proportional odds logistic regression models. Young patients were significantly more likely to experience reduction of tinnitus and patients whose tinnitus became better were also more satisfied with the outcome of the operation. These findings have practical importance for patients and their surgeons. Young patients can be advised that surgery is likely to be beneficial for their tinnitus, but a less positive message should be conveyed to older patients.Otosclerosis is a common disorder 1,2 , where one of the ossicles in the middle ear, the stapes, gradually fuses with surrounding bone, producing conductive hearing loss. This hearing impairment can be treated surgically 3 , commonly by replacing the diseased stapes with a prosthesis that improves sound transmission through the middle ear to the sensory cells in the inner ear. The usual result is great enhancement of low-frequency hearing 4 . At frequencies below 1000 Hz, the average improvement is around 30 dB, which substantially enhances speech perception and frequently means patients no longer need hearing aids.Despite being a generally successful procedure that improves hearing in a large majority of patients, stapes surgery is associated with some risk. The risk for complete hearing loss on the operated ear is very low, on the order of 1% 5 . However, many studies have shown that the benefit from surgery declines with stimulus frequency and at 6 and 8 kHz, some loss of both air and bone conduction thresholds is commonly seen [6][7][8][9] . In two previous studies 10,11 , where the frequency range of audiometry was extended beyond the standard 8 kHz, a mean threshold loss ranging from 9 to 23 dB was evident across the frequencies 10-14 kHz, despite robust improvement of low-frequency hearing. The relevance of changes in hearing thresholds at these very high stimulus frequencies is unclear, although tinnitus patients often have elevated thresholds at 10 kHz and higher, which may correlate with the pitch of their tinnitus 12 .