Tinnitus and hearing loss, both reversible and irreversible, are associated both with acute intoxication and long term administration of a large range of drugs. The mechanism causing drug-induced ototoxicity is unclear, but may involve biochemical and consequent electrophysiological changes in the inner ear and eighth cranial nerve impulse transmission. Over 130 drugs and chemicals have been reported to be potentially ototoxic. The major classes are the aminoglycosides and other antimicrobials, anti-inflammatory agents, diuretics, antimalarial drugs, antineoplastic agents and some topically administered agents. Prevention of drug-induced ototoxicity is generally based upon consideration and avoidance of appropriate risk factors, as well as on monitoring of renal function, serum drug concentrations, and cochlear and auditory functions before and during drug therapy. Ototoxicity, although not life-threatening, may cause considerable discomfort to patients taking ototoxic drugs, and in some cases drug discontinuation may be necessary to prevent permanent damage. Much research has been performed to investigate the causes and mechanisms of ototoxicity, to try to prevent this complication. Despite these efforts, ototoxicity still occurs, and there is much work to be done in order to understand the mechanism of ototoxicity of different drugs and to prevent hearing loss and tinnitus in the future.
BACKGROUND The objective of this study is to compare and evaluate the results of Bilateral Inferior Turbinectomy (BIT) and Submucosal Diathermy (SMD) in case of bilateral hypertrophied inferior turbinates with nasal obstruction.
Auditory Brainstem Evoked Potentials (ABEP) were recorded from 29 adults and children, accidentally exposed to lead through food until approximately a year prior to this study. ABEP were recorded in response to 75 dBHL click presented at rates of 10/sec. and 55/sec. Average values were calculated for peak latency and for interpeak latency differences. Average values of the effect of increasing stimulus rate were calculated as well. Similar values were calculated for normative child and adult control groups.IPLD (I-III) showed the most significant and recurring results, with longer intervals in lead-exposed children compared with their control group. Increasing stimulus rate, on the other hand, affected the adult lead-exposed subjects more than the children. These results may imply an impairment of the auditory system with azonal and myelin involvement. ABEP is suggested as a sensitive detector of subclinical lead exposure effects on the nervous system.
Auditory Brainstem Evoked Potentials (ABEP) were recorded from 33 insulin-dependent diabetes mellitus (IDDM) patients (17 with diabetic peripheral neuropathy and 16 without) as well as from 20 normals. Pure-tone audiometry, speech reception threshold and discrimination were also evaluated. Sub-clinical pure-tone threshold elevation was observed for IDDM patients with neuropathy. Pure-tone thresholds of IDDM patients without neuropathy were not significantly different from those of normals. ABEP abnormality (at 10/sec click rate) was observed in 31% of IDDM patients with neuropathy, rising to 44% when 55/sec click rate measures were included. Abnormalities included bilateral and symmetrical peak-latency prolongations for all waves, greater for the later waves, and prolongation of V-I and V-III interpeak latency differences, all at 10/sec, and only prolonged peak latency for I at increased rate. Abnormalities coincided with microangiopathy and peripheral neuropathy. The incidence of ABEP abnormality for IDDM patients without neuropathy was only 12%, unilateral and sporadic in nature. As a group, IDDM patients with neuropathy had significantly prolonged IV and V peak-latencies, compared with the normals, or with the IDDM patients without peripheral neuropathy. In contrast, IDDM patients without neuropathy resembled the normals in all respects. ABEP have proven useful in understanding the variety of pathologies underlying the clinical manifestation of diabetes.
Four cases of hyoid bone fracture with laceration of the pharynx are presented. The emergency treatment must aim at an exploration of the neck in an attempt to suture the lacerations of the pharyngeal musosa.The fractured hyoid bone may be left untouched in most cases.The most common causes of fractures of the hyoid bone were previously considered to be violent strangulation and hanging.In the last two decades however, road accidents seem to have become the most important cause in patients who survive the initial impact of collision.The biodynamics of injury to the pharynx and larynx in road accidents hava been adequately described by Nahum and siegel(1967). They concluded that the driver was the most commonly collides.It is very easy to miss a fractured hyoid bone duing the urgent admission of a patient injured in a accident, since the more dramatic injures in a traffic in a traffic accident, since the more dramatic injuries are treated first and and a tracheostomy is often often perfomed to provide an airway.
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