<b>Introduction:</b> Upon hearing that the “little” patient has trouble with hearing, we are mostly interested in the level of his hearing threshold. When the child is in the first year of life, results can only be achieved by means of ABR test. Subsequent control tests, especially in children from the hearing loss risk groups selected in this study, show that the obtained outcomes are subject to fluctuations. Their fluctuating nature is manifested by the instability of wave V threshold in subsequent diagnostic periods. Such variability often delays the implementation of the appropriate proceeding. Knowledge of the dissimilarity of behavior of the wave V threshold occurring in individual groups at risk of hearing loss allows for the correct interpretation of the obtained results, and thus, effective therapeutic measures. <br><b>Aim:</b> The aim of the paper is to analyze the stability of wave V threshold during the first year of life in children from selected risk groups for congenital hearing disorders. <br><b>Material and methods:</b> From the patient population of 2,114 individuals examined in 2015–2016 at a reference center participating in the Universal Neonatal Hearing Screening Program in 2015–2016, the results of 250 children were subjected to retrospective analysis. Furthermore, 4 groups of little patients were formed (children with Down syndrome; children with other diseases or damage to the nervous system; children with cleft palate or cleft lip and cleft palate; children with congenital cytomegaly) in whom diagnostic practice revealed variable results of the wave V threshold. We analyzed the results of tests obtained during the first year of the child’s life divided into 4 diagnostic periods. <br><b>Results:</b> The highest percentage of instability in the established threshold of wave V between individual diagnostic periods occurred in the group of children with cleft palate or cleft lip and cleft palate. In the group of children with Down syndrome, it was observed that the instability of the ABR test results decreased over time. In the group of children with other diseases or damage of the nervous system, the highest percentage of the lack of stable ABR wave V thresholds was observed between the 1st and 2nd as well the 1st and 4th diagnostic periods. On the other hand, in the group of children with congenital CMV, there was a relatively low percentage of instability of results. <br><b>Conclusions:</b> (1) Although the ABR test is a diagnostic standard, in particular groups of patients the study is burdened with high variability of measurement results in subsequent diagnostic periods. Such a group of patients are children with cleft palate or cleft lip and cleft palate; therefore, it must receive particular attention in treatment planning; (2) in selected groups at risk of hearing loss, due to the high percentage of children with hearing impairment (70%), the validity of performing newborn hearing screening tests was confirmed.
Cel: Celem badania było wykazanie roli BMI jako czynnika ryzyka krtaniowej manifestacji choroby refluksowej przełyku z uwzględnieniem nowatorskich i nieinwazyjnych form diagnostyki GERD na przykładzie laryngografii. Materiał i metoda: W okresie od stycznia do marca 2017 roku w II Katedrze Chirurgii Ogólnej UJ CM w Krakowie wybrano 32 pacjentów ze zdiagnozowanym GERD i objawami pozakrtaniowymi. Pacjenci zostali skierowani do Katedry i Kliniki Otolaryngologii UJ CM w Krakowie celem poszerzenia diagnostyki w kierunku refluksu krtaniowo-gardłowego LPR. Na podstawie obliczonego BMI i wyników badań laryngologicznych wybrano 20 pacjentów z objawami LPR oraz BMI >24,9. Pacjenci zostali następnie skierowani do Instytutu Techniki Uniwersytetu Pedagogicznego im. KEN w Krakowie celem wykonania badania laryngograficznego i analizy statystycznej. Po badaniu pacjentów zakwalifikowano do leczenia farmakologicznego lub operacyjnego. Każdy pacjent po trzecim etapie badania był zobowiązany do przestrzegania diety antyrefluksowej oraz zwiększenia dotychczasowej aktywności ruchowej. Po 6 tygodniach od zakończenia leczenia wykonano badania kontrolne w Katedrze i Klinice Otolaryngologii UJ CM (badanie laryngologiczne i wideostroboskopowe) oraz w Instytucie Techniki Uniwersytetu Pedagogicznego w Krakowie (badanie laryngograficzne). Wyniki: Badanie laryngograficzne wykazało podwyższone wartości SDFx oraz SDQx. Wzrost tych wartości wskazuje na dysfunkcję krtani i zaostrzenie GERD/LPR. Podczas badań kontrolnych po 6 tygodniach od zakończenia leczenia zaobserwowano poprawę funkcji krtani w postaci spadku wartości SDFx i SDQx. Badanie wideolaryngostroboskopowe wykazało zmniejszenie objawów zapalenia błony śluzowej krtani u pacjentów w porównaniu z obrazem przed leczeniem. Wnioski: Wysokie BMI jest czynnikiem ryzyka krtaniowej manifestacji choroby refluksowej przełyku LPR. Potwierdzono rolę laryngografii jako efektywnej i nieinwazyjnej formy diagnostyki funkcji fałdów głosowych.
BackgroundThe Eustachian tube is a complex and inaccessible structure, which is responsible for the ventilation of the middle ear. The aim of the study was the assessment of an impact of chronic sinusitis on the auditory tube function. MethodsThe prospective analysis of 84 surgically treated chronic sinusitis patients was carried out. This study is based on preoperative results of impedance audiometry in correlation with the data from the medical history of chronic sinusitis, symptoms reported by the patients, results of Computered Tomography (CT) and the stage of inflammatory changes according to Lund and Mackay score. ResultsThe significant majority of patients of our study (65) had advanced auditory tube symptoms, while 4 patients suffered from symptoms significantly impacting daily life. In patients with chronic sinusitis the analysis demonstrated that tympanometry type B (12.67) and C (12.4) occured with significantly higher number of points of Lund-Mackay score than type A (9.2). In allergy sufferers type B of tympanometry was more often observed with characteristically bilaterally located inflammatory changes in maxillary and anterior ethmoid sinuses.ConclusionThe profile of chronic sinusitis patient in whom Eustachian Tube Dysfunction is more often observed, is as follows: Lund and Mackay score above 12pathological changes are bilaterally observed in maxillary and frontal ethmoid sinuses decrease of nasal patency nad postnasal dripAllergyoverusing alcohol and cigarettes, at least alcoholWorse result of Lund and Mackay score and the age of patients are 2 factors favoring the dysfunction of the Eustachian Tube
• Early implementation of treatment and/or rehabilitation in children with hearing disorders is crucial to prevent depression of speech and psychological development. I t is important in children with cleft palate or both cleft palate and lip even if surgical correction is discussed. • The highest proportion of children with the implemented course of proceedings, was in groups with children with congenital CMV. This children should be observed despite of right results of hearing tests. • In children with nervous system disorders 1 year period of observation is too short to exclude problems with hearing.
The place of residence (in or out of the industrial area) and exacerbations of chronic laryngitis are highly correlated. Air pollution seems to be the main factor influencing on the condition of upper respiratory tract. In our local conditions of Lesser Poland Voivodeship subterraneotherapy may be an interesting, non-invasive method preventing from exacerbations of upper respiratory tract diseases.
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