Volume 11 Issue 3 (2021)

Giuseppe Gradenigo was born in Venice in 1859, and he was a member of the noble Venetian family of the Gradenigo. After graduation in medicine in Padua, he went to Vienna where he deepened his studies in otology and embryology. He obtained, in 1888, the “libera docenza” in otology in Padua, and in 1889, he began to direct the section of otolaryngology of the polyclinic of Turin. After a brilliant career in 1917, he took over the chair of otolaryngology at the University of Naples. Gradenigo was a pioneer in otolaryngology and audiology and a reference figure in the clinical and scientific fields. In this paper, the most important aspects about his works and his biography will be discussed.

Objective: Hearing loss as a complication of diabetes is a debatable issue with a handful of contradictory studies. The objective of the present study was to evaluate the status of hearing in patients with type 2 diabetes mellitus and to correlate the severity of hearing loss with the duration of diabetes mellitus.

Methods: This is an observational cross-sectional study which was done at a tertiary care teaching hospital over a period of 12 months. Two hundred consecutive type 2 diabetic patients in the age group between 18 and 60 years were enrolled. Patients were subjected to blood sugar levels, glycosylated hemoglobin, and pure tone audiometry. Possible confounders for hearing loss were excluded. The chi-square test was applied and P < .05 was considered significant.

Results: The average age of the patients was 47.18±8.65 years with a male to female ratio of 1.19 : 1. The mean duration of diabetes was 5.60±4.15 years. Out of 200 patients, hearing loss was observed in 55%. The prevalence of sensorineural hearing loss was 50%. Higher frequencies (4 kHz-8 kHz) were most affected. The association of fasting blood sugar and HbA1c levels with hearing loss was significant while no association was observed between the duration of diabetes and hearing loss.

Conclusion: The study confirmed hearing loss in almost half of the diabetic patients while no association was observed between the duration of diabetes and hearing loss. It is recommended that the audiological screening must be included in the initial evaluation of the diabetic patient to detect and prevent further hearing loss.

Background: The Parents’ Evaluation of the Aural/Oral Performance of Children (PEACH) Rating Scale is a widely used instrument to evaluate adaptation, effectiveness of hearing aid and cochlear implant, and auditory rehabilitation outcomes in hearing-impaired children by parent observation in daily life listening situations. This study aimed to adapt the Parents’ Evaluation of the Aural/Oral Performance of Children to Turkish children, analyze, and verify the validity and the reliability. We also looked for scores in various clinical conditions (age, sex, HA, CI experience, unilateral vs. bilateral users).

Methods: The study composed of 120 children with hearing loss (hearing aid users n = 57; cochlear implant users n = 63) between 3 and 12 (mean: 7.51±2.84) years of age. First, Parents’ Evaluation of the Aural/Oral Performance of Children was adapted to Turkish children, and confirmatory factor analysis was used to evaluate the validity of the Turkish Parents’ Evaluation of the Aural/Oral Performance of Children. Then, correlations of Turkish Parents’ Evaluation of the Aural/Oral Performance of Children scores with age, hearing aid and cochlear implant experience, and group differences (male vs. female; hearing aid vs. cochlear implant users) were analyzed by using the proper statistical tests. Cronbach’s alpha coefficient was used to confirm internal consistency, and the test-retest method was performed to evaluate the reliability of the measurement.

Results: Turkish Parents’ Evaluation of the Aural/Oral Performance of Children has high internal consistency (Cronbach's alpha = 0.942) and test-retest reliability (r = 0.949, P < .001). Scores were increased in parallel to age, hearing aid, cochlear implant experience, and there was a significant difference in Turkish Parents’ Evaluation of the Aural/Oral Performance of Children scores between unilateral and bilateral cochlear implant users.

Conclusion: The Turkish Parents’ Evaluation of the Aural/Oral Performance of Children could be recommended as a convenient tool for children with hearing aid and cochlear implant to monitor functional, auditory, and communication skills.

Background: Submental muscles are vital for swallowing as they are responsible for hyolaryngeal elevation. This study aimed to determine the normative values of submental muscles in healthy children.

Methods: The thickness of the digastric muscle, the thickness of the mylohyoid muscle, and the thickness of the geniohyoid muscle were measured in 218 (124 boys and 94 girls) healthy children by the ultrasonography. Correlation analysis of the thickness of the digastric muscle, the thickness of the mylohyoid muscle, and the thickness of the geniohyoid muscle with gender, age, height, weight, and body mass index were performed, and median values were determined in preschool, school, and adolescent age groups.

Results: No significant differences were found in median height, weight, body mass index, the thickness of the digastric muscle, the thickness of the mylohyoid muscle, and the thickness of the geniohyoid muscle values of the males and females (P > .05). There were highly significant mild to moderate positive correlations of age, height, weight, and body mass index with the thickness of the digastric muscle, the thickness of the mylohyoid muscle, and the thickness of the geniohyoid muscle parameters (P = .001, r = 0.26-0.58). The thickness of the digastric muscle was 4.3 mm, 4.5 mm, and 5.4 mm in the preschool, school, and adolescent groups, respectively. In the preschool, school, and adolescent groups, the thickness of the geniohyoid muscle was 4.8 mm, 5.35 mm, and 6.25 mm, respectively. The thickness of the mylohyoid muscle was found as 1.6 mm, 1.9 mm, and 2.3 mm in preschool, school, and adolescent groups, respectively.

Conclusion: Submental muscles that perform hyolaryngeal elevation can be easily evaluated with the ultrasonography. Knowing the normative thickness values of submental muscles according to age groups in children will contribute to the diagnosis of atrophy or hypertrophy in these muscles. It can also be used in the follow-up of dysphagia treatment.

Background: The present work intended to analyze the prechiasmatic sulcus types in adults via cone-beam computed tomographic images.

Methods: Four hundred randomly selected adult patient files registered in the electronic system of Gaziantep University Faculty of Dentistry were investigated retrospectively. The morphological features of the prechiasmatic sulcus including its size, angulation, and classification were revealed.

Results: The planum length was measured as 11.82±3.12 mm (4.70-20.72 mm), the sulcal length as 5.61±1.50 mm (1.82-11.20 mm), the sulcal angle (SA) as 18.66±9.90˚ (0-50.60˚), and the interoptic distance as 17.65±2.14 mm (8.60-24.52 mm). The interoptic distance was greater in male samples compared to females (P < .001); however, the sulcal angle (P = .834), sulcal length (P = .658), and planum length (P = .326) were similar in genders. Considering the average groove length and angle, the narrow steep sulcus was observed as 22.25% (89 cases), the narrow flat sulcus as 26.75% (107 cases), the wide steep sulcus as 25.5% (102 cases), and the wide flat sulcus as 25.5% (102 cases).

Conclusions: The findings of this radiologic study may be helpful for neurosurgeons, neuroradiologists, and otorhinolaryngologists in selection of patients suitable for surgical approach (e.g., endonasal or transcranial), by providing categorization of the prechiasmatic sulcus during resection of sulcus-related pathological entities.

Diphtheria is an acute, potentially fatal, and highly communicable bacterial infection caused by Corynebacterium diphtheriae. In India and the developing world, 100% immunisation is claimed against diphtheria through diphtheria, pertussis, and tetanus (DPT) vaccination. Only a negligible number of cases are seen in the western world. In India, a few outbreaks of diphtheria has been reported among children. But it is rarely diagnosed in Indian adults. Diphtheria has high morbidity due to nerve damage and high mortality because of respiratory obstruction or myocardial complications. PubMed data base was searched for case reports in last 10 years for respiratory diphtheria in adults. Here we are presenting our case and a review on laryngopharyngeal diphtheria in adults.

Objective: The aim of this research was to investigate the effects of hypoxia, observed in patients with obstructive sleep apnea (OSA) syndrome, on vestibular functions through the application of video head impulse test (v-HIT).

Methods: Patients with sleep apnea/snoring complaints and who had undergone polysomnography (PSG) between January 10, 2019, and January 10, 2020, received a full otorhinolaryngological examination and v-HIT in this prospective cohort study. Polysomnography findings of 83 patients with appropriate criteria for the study (age, sex, body mass index (BMI), apnea-hypopnea index (AHI), and mean oxygen saturation)
and v-HIT findings were compared.

Results: Patients included in the study were divided into 4 groups according to the AHI scores. When age, gender, BMI, AHI, and mean oxygen saturation data were examined, only AHI scores showed statistically significant differences (P = .000). There was no statistically significant difference present between the groups in terms of mean vestibulo-ocular reflex (VOR) gains, mean asymmetry, overt and covert saccades in the right ear, and overt saccades in the left ear. There was a statistically significant difference between the groups in the covert saccade in the left ear (P = .014). Of all patients included in the study, 72 patients (86.5%) had pathological VOR gains and/or at least 1 overt/covert saccade.

Conclusion: Our study with v-HIT concluded that the vestibular system is affected just as other systems in patients diagnosed with OSA syndrome. The literature review has proved that similar results were achieved in studies evaluating the vestibular system.

Objective: To analyze postoperative morbidity and quality of life of surgically treated patients for vagal paraganglioma.

Methods: Preoperative symptoms and findings, presence of cranial nerve paralysis,
radiological findings, surgical techniques, perioperative, and postoperative complications were analyzed retrospectively. Washington University Quality of Life Questionnaire (UW-QOL) was used to evaluate the quality of life of the patients.

Results: Of the 11 patients, 8 were women and 3 were men with an age distribution of 22-70 (mean age, 49.9 years). Two patients had vocal cord paralysis and 1 patient had
hypoglossal nerve paresis preoperatively. In 5 patients, the vagus nerve was partially resected; vocal cord movements recovered within 6 months in 2 out of 5 (40%). Thecontinuity of the nerve could not be preserved in the remaining 6 patients, Ishiki type 1 medialization thyroplasty was performed in 4 (44.4%). In 3 patients, the hypoglossalnerve was invaded by the tumor and was sacrificed. Temporary facial paresis occurred in 3 patients who were operated on with transcervical-transparotid approach. Complete recovery was achieved in all within 3 months. In a patient with an extensively large tumor, carotid bypass surgery was performed with the saphenous vein. Except for one patient, the mean scores of all patients were above 90 with UW-QOL.

Conclusion: Surgery, which is the only curative treatment method, may not cause a significant change in the postoperative quality of life in well-selected cases. Trying to protect the vagus nerve by dissecting it as much as possible and rehabilitation with Isshiki type 1 thyroplasty in case of aspiration are key points.

Orbital compartment syndrome (OCS) is an urgent condition which requires immediate treatment to avoid permanent vision loss. If the associated increased intraorbital pressure causes optical nerve and disc compression, emergency treatment to reduce the pressure is required. Here, we report the initially conservative management of a minimally displaced medial orbital fracture after blunt maxillofacial trauma and the late but sudden development of pneumo-orbit and OCS.