Silvio Antonio Monteiro Marone

Multiprofessional committee on auditory health: COMUSA

Created in 2007, COMUSA is a multiprofessional committee comprising speech therapy, otology, otorhinolaryngology and pediatrics with the aim of debating and countersigning auditory health actions for neonatal, lactating, preschool and school children, adolescents, adults and elderly persons. COMUSA includes representatives of the Brazilian Audiology Academy (Academia Brasileira de Audiologia or ABA), the Brazilian Otorhinolaryngology and Cervicofacial Surgery Association (Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial or ABORL), the Brazilian Phonoaudiology Society (Sociedade Brasileira de Fonoaudiologia or SBFa), the Brazilian Otology Society (Sociedade Brasileira de Otologia or SBO), and the Brazilian Pediatrics Society (Sociedade Brasileira de Pediatria or SBP).

Avaliaçäo do processamento auditivo por meio do teste de reconhecimento de dissílabos em tarefa dicótica SSW em indivíduos com audiçäo normal e ausência do reflexo acústico contralateral

Introduction: The Acoustic Reflex (AR) is considered to be an important tool for diagnosing hearing disorders. Its threshold is normal when situated within the range of 70 to 90 dBNS. For the AR to occur, it is necessary to have the integrity of the peripheral and central auditory system, especially at the Brainstem level. Brainstem structures related with the AR are also responsible for the Auditory Processing (AP) with regard to the important auditory abilities. Aim: In this study, we have tried to verify the performance of individuals with normal peripheral hearing and absence of Contralateral AR in word recognition in dichotic listening by SSW, Portuguese version. Study design: Clinical prospective randomized. Material and Method: The case records consist of 100 individuals of both sexes and age ranging from 19 to 59. They have been equally divided into two groups, half of them forming a Control group and another half the Study group. The people in the Study group have normal peripheral hearing and absence of Contralateral AR in at least one frequency. Results: There is a statistically relevant difference between these groups as regards the absence of Contralateral and Ipsilateral AR in all bilaterally tested frequencies. As to the SSW Test results regarding normality, the difference has been statistically significant in the conditions of Competitive Right and Competitive Left and Auditory Effect, Order Effect and Type A response trend. During the comparison by the number of errors, the statistically relevant difference has been found in the situations of Competitive Right and Competitive Left. Conclusion: The results of this study reinforce the relevancy of the role of structures responsible for AR in AP, and suggest that the patients with normal peripheral hearing and AR alterations should undergo AP assessment.

Utilização do questionário ERG na avaliação do grau de satisfação dos pacientes submetidos à otoplastia em um serviço de residência médica de otorrinolaringologia

UNLABELLED The ear deformity surgery intervention impact on psychological and self-esteem aspects, in adults and children, is well documented. Recently, the studys are focused on patient satisfaction, funcional result and impact on quality of life. Any modification on patients quality of life has been a challenge. The use of valid and established questionnairies, like Glasgow Benefit Inventory (GBI), assists on data analyse, turning it consistent. AIM The aim of this study is to evaluate the impact on patients quality of life after otoplasty, through the GBI questionnaire. METHODS Retrospective study including patients underwent otoplasty, within july of 2009 to july of 2010. The data were collected through questionnaire applied by medical resident on 90 post-surgical return. RESULTS 36 patients answered the questionnaire. There was increase on patients quality of life demonstrated by positive mediana obtained through out questinnaire. There were no significantly differences between age and sex. CONCLUSION The patients are satisfied with post-surgical results. There was increase on patients quality of life conform positive results obtained. The use of GBI showed easy and elucidative.

Remote hearing aid fitting: Tele-audiology in the context of Brazilian Public Policy.

Summary Introduction: Currently, the Brazilian government has certificated nearly 140 specialized centers in hearing aid fittings through the Brazilian National Health System (SUS). Remote fitting through the Internet can allow a broader and more efficient coverage with a higher likelihood of success for patients covered by the SUS, as they can receive fittings from their own homes instead of going to the few and distant specialized centers. Aim: To describe a case of remote fitting between 2 cities, with revision of the literature. Method: Computer gears, a universal interface, and hearing aids were used. Case study: An audiologist located in a specialized center introduced a new hearing aid and its fitting procedure to a remote center (200 km away). The specialized center helped the remote center in fitting a hearing aid in 2 patients, and performed fitting in one of its own patients. The whole process was done through the Internet with audio and video in real time. Results: Three patients were fitted remotely. Three audiologists were remotely trained on how to fit the hearing aids. Conclusions: Remote fitting of hearing aids is possible through the Internet, as well as further supplying technical training to a remote center about the fitting procedures. Such a technological approach can help the government advance public policies on hearing rehabilitation, as patients can be motivated about maintaining their use of hearing aids with the option to ask for help in the comfort of their own homes.

Microbiologia dos seios maxilar e etmoidal em pacientes com rinossinusite crônica submetidos à cirurgia funcional endoscópica dos seios paranasais

Estudos da microbiologia da rinossinusite cronica mostram a presenca de microorganismos aerobicos, anaerobicos, fungos e virus e sua incidencia varia de acordo com cada estudo. Estes estudos nos guiam para a escolha do antimicrobiano mais adequado para eliminar o processo infeccioso, ajudando a restaurar a mucosa nasossinusal. FORMA DE ESTUDO: Clinico prospectivo. OBJETIVO: O objetivo deste trabalho foi estudar a microbiologia dos seios maxilar e/ou etmoidal de pacientes com rinossinusite cronica e com indicacao de cirurgia funcional endoscopica dos seios paranasais. MATERIAIS E METODOS: Durante a cirurgia coletamos, em 41 pacientes, secrecao e/ou fragmento de mucosa dos seios maxilar e/ou etmoidal para realizacao de bacterioscopia, pesquisa direta de fungos, cultura para microorganismos aerobios, anaerobios e fungos. RESULTADOS: Identificou-se a presenca de microorganismos aerobios em 21 pacientes (51,2%), anaerobios em 16 (39%) e fungos em 1 (2,4%). Na populacao estudada, apenas em 12 (29,2%) o microorganismo isolado foi considerado patogenico quando analisado junto a contagem semiquantitativa de leucocitos. O Staphylococcus coagulase-negativo e o Staphylococcus aureus foram os microorganismos mais frequentes, em 5 (12,1%) e em 4 pacientes (9,75%) respectivamente. CONCLUSAO: Este estudo revela que o Staphylococcus coagulase-negative e o Staphylococcus aureus foram os microorganismos mais frequentes isolados nos pacientes com rinossinusite cronica.

Inflammatory myofibroblastic tumor: a rare laryngeal case

The inflammatory myofibroblastic tumor (IMT) is more commonly found in the lungs. The paranasal sinuses and the orbit are the most affected areas in the head and neck; the laryngeal presentation is extremely rare, and only about 15 cases have been described in the literature. We report the clinical findings of a case of laryngeal IMT that was seen at the otorhinolaryngology unit of a university hospital.

Microbiology of the maxillary and ethmoid sinuses in patients with chronic rhinosinusitis submitted to functional endoscopic sinus surgery

UNLABELLED Chronic rhinosinusitis microbiology studies show the presence of aerobe and anaerobe microorganisms, fungus and virus and their incidence vary according to each study. These studies guide us on choosing the most adequate antimicrobial agent to eliminate the infectious process, thus, helping in restoring rhinosinusal mucosa. STUDY DESIGN Clinical prospective. AIM This work aimed at studying the microbiology of the maxillary and/or ethmoid sinuses of patients with chronic rhinosinusitis and with indication of functional endoscopic sinus surgery. MATERIALS AND METHODS During surgery, we collected secretion and/or fragments of maxillary and/or ethmoid sinus mucosa from 41 patients to perform Gram stain, fungus direct research, aerobe and anaerobe microorganism culture and fungus culture. RESULTS We identified the presence of aerobe microorganisms in 21 patients (51.2%), anaerobe microorganisms in 16 (39%) and fungus in 1 (2.4%). In the studied population, only 12 patients (29.2%) presented microorganisms considered pathogenic when analyzed together with the semi-quantitative leukocyte count. Staphylococcus coagulase-negative and Staphylococcus aureus were the most frequent microorganisms found, in 5 (12.18%) and in 4 (9.75%) patients respectively. CONCLUSION This study reveals that Staphylococcus coagulase-negative and Staphylococcus aureus were the most frequent microorganisms isolated from patients with chronic rhinosinusitis.

Emotional Stress Evaluation of Patients with Moderate and Severe Sleep Apnea Syndrome

Introduction The scientific literature has shown that the damage caused by sleep fragmentation in people affected by Obstructive Sleep Apnea (OSA) can reflect emotionally, generating not only physical symptoms such as drowsiness and tiredness, but also psychical symptoms, such as stress. Objective This study aimed at comparing symptoms of stress in patients with moderate or severe OSA, before and after two months of treatment (clinical or surgical). Method This isx an Individual, prospective, longitudinal, and interventional study. All patients underwent polysomnography before treatment. We collected data through the application of Stress Symptoms Inventory for Adults Lipp (ISSL) before and after two months of medical or surgical treatment for moderate or severe OSA. Results The sample consisted of 18 patients (72.2% male) with a mean age of 51.83 years. We found that 77.8% (n = 14) of patients had stress in the first evaluation. In the second evaluation (after treatment), this reduced to 16.7% (n = 3). The average stress symptoms decreased from the first to the second evaluation (M = 13.78 and M = 6.17, respectively), being statistically significant (z = -3.53; p < 0.000). Conclusions We found that moderate and severe apnea patients have significant stress index and that, after two months of medical or surgical treatment, there is a significant reduction of the symptom. In addition, the patients with severe OSA had a better outcome regarding the reduction of stress index than patients with moderate OSA.