Objectives: West Nile virus (WNV) has been spreading over the last 20 years. Human infection is asymptomatic in most cases. When the disease becomes clinically manifest, it may involve a range of issues, from a mild infection with flu-like symptoms to a neuroinvasive disease. Albeit rarely, WNV-associated sensorineural hearing loss (SNHL) has also been reported. Here we describe two new cases of SNHL and balance impairment caused by WNV infection. Methods: The patients were investigated with repeated audiometric tests and, for the first time, videonystagmography was also used. Results: Unlike findings in the few other published cases, an improvement in audiometric thresholds and vestibular function was documented in both of our patients. Conclusions: In the light of our findings, a prospective study would be warranted on a large series of patients with WNV infection in order: (i) to better define the epidemiology of the related cochlear-vestibular involvement; and (ii) to elucidate the virus-related changes to peripheral and central auditory and vestibular functions.
When is a multidisciplinary surgical approach required in sinonasal tumours with cranial involvement?Quando è indicato un approccio chirurgico multidisciplinare nei tumori naso-sinusali con estensione cranica?
Air pollution (AP) represents one of the main environmental threats to public health and exposure to AP has been connected to upper airway (UA) disease. We evaluated the relationships between the ENT urgent referrals recorded at the Hospital of Padua and the daily levels of particulate matter (PM) as well as other environmental factors in a single year. Patients with UA disorders were included in the study group while those referred for facial trauma or foreign body inhalation formed the control group. Daily PM concentrations, meteorological data and the concentrations of the commonest aeroallergens were obtained. 6368 patients formed the study group and 910 the control one. The concentration of compositae allergens showed a positive effect on the total number of admissions (p = 0.001). PM10 did not demonstrate an effect on the total number of admissions or either the study or control groups admissions (p = 0.25). Alternaria positively influenced admissions of patients in the study group (p = 0.005). Significant relationships were found between the following: PM10 measured on the seventh day before A&E admission and rhinosinusitis (p = 0.007), PM10 on the fifth day and laryngitis (p = 0.01), PM10 on the second day and otitis media (p = 0.03), PM10 on the admission day and epistaxis (p = 0.0198). Our study confirms the causal relationship between aeroallergen concentration and ENT admissions. The levels of PM10 at specific days preceding A&E admission correlated with certain UA disorders. This study strongly points towards the harmful effects of pollution and climate change on UA disease.
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