Eduardo Tanaka Massuda

Anatomical and functional evaluation of tympanoplasty using a transitory natural latex biomembrane implant from the rubber tree Hevea brasiliensis

PURPOSE To compare the role of transitory latex and sylastic® implants in tympanoplasty on the closure of tympanic perforations. METHODS A randomized double-blind prospective study was conducted on 107 patients with chronic otitis media submitted to underlay tympanoplasty and divided at random into three groups: control with no transitory implant, latex membrane group, and sylastic® membrane group. RESULTS Greater graft vascularization occurred in the latex membrane group (p<0.05). Good biocompatibility was obtained with the use of the latex and silicone implants, with no effect on the occurrence of infection, otorrhea or otorragy. CONCLUSION The use of a transitory latex implant induced greater graft vascularization, with a biocompatible interaction with the tissue of the human tympanic membrane.

A New Experimental Model of Acquired Cholesteatoma

Objective: Cholesteatoma is a recurrent disease that is difficult control by otologists. This study aims to develop an experimental model of cholesteatoma that is easy to reproduce, using latex to induce the inflammatory reaction and propylene glycol as the foreign body in the middle ear.

Biosilicate® Ototoxicity and Vestibulotoxicity evaluation in guinea-pigs

UNLABELLED Changes, destructions and interruptions in middle ear ossicular chain architecture may be caused by infection, trauma, tumors, congenital alterations or prior surgeries. Nonetheless, infectious and inflammatory processes, focal or generalized which affect the middle ear are the most prevalent, causing a great demand for ossiculoplasty. Biosilicato is a new material which can be used in the middle ear with the goal of reconstructing the ossicular chain. It is a bioactive type A vitroceramic, in other words, it binds to bone or soft tissue in a matter of a few hours, thanks to the formation of hydroxy-carbonateapatatie in its contact surface when in contact with body fluids. AIMS The goal of the present paper is to assess biosilicate ototoxicity and vestibular toxicity in experimental animals, for later use in humans. MATERIALS AND METHODS This a clinical and experimental study in which otoacoustic emissions were performed before and after the placement of Biosilicate in the middle ear of experimental animals and a scanning electron microscopy was carried out in the cochlea, saccule, utriculus and macula of the semicircular canals after 30 and 90 days to assess oto and vestibular toxicity. RESULTS There were no signs of oto or vestibular toxicity in any of the groups associated with biosilicate. CONCLUSION Biosilicate is a safe material to be used in ossiculoplasties.

Otogenic Spontaneous pneumocephalus: case report

PhD, Medicine (Professor, FMRP-USP).Send correspondence to: Miguel Angelo Hyppolito. Av. Bandeirantes, no 3900, 12o andar. Monte Alegre. Ribeirao Preto - SP. Brazil. CEP: 14048-900.Medical School of Ribeirao Preto - University of Sao Paulo - University Hospital (FMRP - USP).FAEPA - HCRP - FMRP-USP.Paper submitted to the BJORL-SGP (Publishing Management System - Brazilian Journal of Otorhinolaryngology) on September 29, 2005;and accepted on October 16, 2012. cod. 1460.

Case ReportOtogenic Spontaneous pneumocephalus: case report

PhD, Medicine (Professor, FMRP-USP).Send correspondence to: Miguel Angelo Hyppolito. Av. Bandeirantes, no 3900, 12o andar. Monte Alegre. Ribeirao Preto - SP. Brazil. CEP: 14048-900.Medical School of Ribeirao Preto - University of Sao Paulo - University Hospital (FMRP - USP).FAEPA - HCRP - FMRP-USP.Paper submitted to the BJORL-SGP (Publishing Management System - Brazilian Journal of Otorhinolaryngology) on September 29, 2005;and accepted on October 16, 2012. cod. 1460.

Rare case of neurinoma of the facial nerve

Paciente masculino, 28 anos, referia desvio de rima labial para a esquerda, desde a infância, evoluindo ha oito meses com paralisia do terco superior da face, percebido durante avaliacao medica. Apresentava hipoacusia e zumbido inter-mitente a esquerda ha aproximadamente dois anos.Exame otorrinolaringologico apresentava paralisia facial periferica Grau II de House-Brackmann (HB) a esquerda. RNM mostrando formacao expansiva na topografia do canal do nervo facial esquerdo, proxima ao gânglio geniculado, com hiposinal em T1 e hipersinal em T2, sugestiva de neuri -noma do nervo facial. Foram discutidas opcoes terapeuticas com o paciente, que decidiu por seguimento clinico.Evoluiu, apos dois anos de seguimento, com piora da pa-ralisia facial periferica, HB grau IV e RNM mostrando aumen -to volumetrico da lesao em relacao ao exame anterior, medindo 1,7 3 1,3 cm (fig. 1), comprimindo o giro temporal inferior.

Relationship between Speech Perception and Level of Satisfaction of Hearing Aid Users

Introduction Hearing difficulties can be minimized by the use of hearing aids. Objective The objective of this study is to assess the speech perception and satisfaction of hearing aids users before and after aid adaptation and to determine whether these measures are correlated. Methods The study was conducted on 65 individuals, 54% females and 46% males aged 63 years on average, after the systematic use of hearing aids for at least three months. We characterized subjectś personal identification data, the degree, and configuration of hearing loss, as well as aspects related to adaptation. We then applied a satisfaction questionnaire and a speech perception test (words and sentences), with and without the use of the hearing aids. Results Mean speech recognition with words and sentences was 69% and 79%, respectively, with hearing aids use; whereas, without hearing aids use the figures were 43% and 53%. Mean questionnaire score was 30.1 points. Regarding hearing loss characteristics, 78.5% of the subjects had a sensorineural loss, 20% a mixed loss, and 1.5% a conductive loss. Hearing loss of moderate degree was present in 60.5% of cases, loss of descending configuration in 47%, and plain loss in 37.5%. There was no correlation between individual satisfaction and the percentages of the speech perception tests applied. Conclusion Word and sentence recognition was significantly better with the use of the hearing aids. The users showed a high degree of satisfaction. In the present study, there was no correlation observed between the levels of speech perception and levels of user satisfaction measured with the questionnaire.

Cochlear implant revision surgeries in children

INTRODUCTION The surgery during which the cochlear implant internal device is implanted is not entirely free of risks and may produce problems that will require revision surgeries. OBJECTIVE To verify the indications for cochlear implantation revision surgery for the cochlear implant internal device, its effectiveness and its correlation with certain variables related to language and hearing. METHODS A retrospective study of patients under 18 years submitted to cochlear implant surgery from 2004 to 2015 in a public hospital in Brazil. Data collected were: age at the time of implantation, gender, etiology of the hearing loss, audiological and oral language characteristics of each patient before and after cochlear implant surgery and any need for surgical revision and the reason for it. RESULTS Two hundred and sixty-five surgeries were performed in 236 patients. Eight patients received a bilateral cochlear implant and 10 patients required revision surgery. Thirty-two surgeries were necessary for these 10 children (1 bilateral cochlear implant), of which 21 were revision surgeries. In 2 children, cochlear implant removal was necessary, without reimplantation, one with cochlear malformation due to incomplete partition type I and another due to trauma. With respect to the cause for revision surgery, of the 8 children who were successfully reimplanted, four had cochlear calcification following meningitis, one followed trauma, one exhibited a facial nerve malformation, one experienced a failure of the cochlear implant internal device and one revision surgery was necessary because the electrode was twisted. CONCLUSION The incidence of the cochlear implant revision surgery was 4.23%. The period following the revision surgeries revealed an improvement in the subjects hearing and language performance, indicating that these surgeries are valid in most cases.

Cross-cultural adaptation of the Amsterdam inventory for auditory disability and handicap to Brazilian Portuguese

INTRODUCTION Patient-reported outcome measures, inventory and or questionnaire, allow patients to present their perspective of the impact of their individual condition on a day-to-day basis, independent of the analysis of test results by the expert clinician. Outcome measures are recommended when there is evidence showing their reliability, validity and sensitivity. There are standardized patient-reported outcome measures for hearing in English language; however, other languages lack these instruments. OBJECTIVE Adapt the Amsterdam inventory for auditory disability and handicap to Brazilian Portuguese and analyze its validation measures. METHODS We conducted two studies. In Study 1, we translated and adapted the Amsterdam inventory for auditory disability and handicap to Brazilian Portuguese according to good practice guidelines; this included the pre-test stage. In Study 2, we administered the Portuguese version to adults with and without hearing loss (n=31 and 18, respectively) and analyzed the measures of instrument validation, reliability, and reproducibility. Moreover, we calculated the correlation between pure tone thresholds and scores on the questionnaire. RESULTS The results obtained in Study 1 demonstrated the feasibility of the translation process and the instruments cultural adaptation, as well as its applicability, resulting in the Portuguese version of the Amsterdam inventory for auditory disability and handicap. In Study 2, the results revealed construct values for the questions and domains, as well as for the total reliable score. The intra-interviewer test-retest condition showed excellent reproducibility (ICC=0.97). Finally, there was a strong positive correlation (r=0.83) between the mean pure tone threshold and the hearing difficulties values, as measured by the instruments scores. CONCLUSION The English version of the Amsterdam inventory for auditory disability and handicap could be translated and adapted to Brazilian Portuguese. An analyses of the validation process yielded reliable, consistent, and stable results.

Cochlear Implant in a Patient with Arnold-Chiari Syndrome

Objective: To verify the efficacy of cochlear implantation in a patient with Arnold-Chiari syndrome. Design: Review of a medical chart from a patient with Arnold-Chiari syndrome that underwent to cochlear implant surgery. Case report: A 6 year-old female, with meningomyelocele and congenital hydrocephalus, deaf in the past 3 years, after meningitis. At that time, she used oral language with adequate speech development. Tone audiometry revealed bilateral profound sensorineural hearing loss. The MRI was compatible with the Arnold-Chiari syndrome. Cochlear implantation was performed on the left ear with MED-EL? Implant (model SONATATi100). Currently, the child is 12 year-old, performs speech therapy three times a week, with good hearing and language development. Conclusion: Despite the presence of Arnold-Chiari syndrome (Chiari type II) with neurological disorders and with ventriculoperitoneal shunt, patient had good hearing results after cochlear implant surgery.