ORL

Acute viral bronchiolitis is a leading cause of admission to pediatric intensive care units, but research on the care of these critically ill infants has been limited. Pathology of viral bronchiolitis revealed respiratory obstruction due to intraluminal debris and edema of the airways and vasculature. This and clinical evidence suggest that airway clearance interventions such as hypertonic saline nebulizers and pulmonary toilet devices may be of benefit, particularly in situations of atelectasis associated with bronchiolitis...

The deviated nasal dorsum veers off the ideal straight vertical orientation at midline. Deviations in the dorsum lead to functional and aesthetic consequences that frequently prompt the patient to seek consultation with a rhinoplasty surgeon. Inability to breathe through the nose and self-image perception significantly detracts from the patient's quality of life. Correction of the deviated nasal dorsum represents a challenge for the rhinoplasty surgeon. Anatomic correction of deviations is the goal. Straightening a deviated nasal dorsum will require maneuvers to realign the nose distinct from traditional aesthetic rhinoplasty techniques...

BACKGROUND: Despite the occurrence of the nasal cycle being well documented, the functional purpose of this phenomenon is not well understood. This investigation seeks to better understand the physiological objective of the nasal cycle in terms of airway health through the use of a computational nasal air-conditioning model. METHOD: A new state-variable heat and water mass transfer model is developed to predict airway surface liquid (ASL) hydration status within each nasal airway...

This review describes the phenomenon of the nasal cycle, which consists of periodic congestion and decongestion of the nasal venous sinusoids. The hypothesis is put forward that the nasal venous sinusoids participate in respiratory defence by generation of plasma exudate. This hypothesis is based on recent studies, which have shown that the nasal venous sinusoids have a fenestrated endothelium and that the nasal cycle is increased during periods of nasal infection; and also on a series of older observations in the literature, which link the generation of nasal fluid to the decongestion of nasal venous sinusoids...

PURPOSE OF REVIEW: Tinnitus is the sensation of hearing a sound when no external auditory stimulus is present. Most individuals experience tinnitus for brief, unobtrusive periods. However, chronic sensation of tinnitus affects approximately 17% (44 million people) of the general US population. Tinnitus, usually a benign symptom, can be constant, loud and annoying to the point that it causes significant emotional distress, poor sleep, less efficient activities of daily living, anxiety, depression and suicidal ideation/attempts...

OBJECTIVE: Tinnitus is the perception of sound without an external source. More than 50 million people in the United States have reported experiencing tinnitus, resulting in an estimated prevalence of 10% to 15% in adults. Despite the high prevalence of tinnitus and its potential significant effect on quality of life, there are no evidence-based, multidisciplinary clinical practice guidelines to assist clinicians with management. The focus of this guideline is on tinnitus that is both bothersome and persistent (lasting 6 months or longer), which often negatively affects the patient's quality of life...

BACKGROUND: Tinnitus is an often disabling condition for which there is no effective therapy. Current research suggests that tinnitus may develop due to maladaptive plastic changes and altered activity in the auditory and prefrontal cortex. Transcranial direct current stimulation (tDCS) modulates brain activity and has been shown to transiently suppress tinnitus in trials. OBJECTIVE: To investigate the efficacy and safety of tDCS in the treatment of chronic subjective tinnitus...

BACKGROUND: The aim of this randomized controlled trial was to investigate the effects of conventional face-to-face group cognitive behavioral therapy (GCBT) and an Internet-delivered guided self-help treatment (Internet-based CBT, ICBT) on tinnitus distress. METHODS: A total of 128 adults with at least mild levels of chronic tinnitus distress were randomly assigned to GCBT (n = 43), ICBT (n = 41), or a web-based discussion forum (DF) that served as a control condition (n = 44)...

In this paper, we review studies that have investigated brain morphology in chronic tinnitus in order to better understand the underlying pathophysiology of the disorder. Current consensus is that tinnitus is a disorder involving a distributed network of peripheral and central pathways in the nervous system. However, the precise mechanism remains elusive and it is unclear which structures are involved. Given that brain structure and function are highly related, identification of anatomical differences may shed light upon the mechanism of tinnitus generation and maintenance...

The prevalence of hearing problems in the Western world has, due to aging of the population, doubled over the past 30 years. Thereby, noise-induced hearing loss is an important factor that worsens over time in addition to age-related hearing loss. Hearing loss is usually measured as an elevation of a person's hearing thresholds, expressed in decibel (dB). However, recent animal studies have unraveled a type of permanent cochlear damage, without an elevation of hearing thresholds. This subtle damage is linked to a permanent and progressive degeneration of auditory fibers that occurs in association with damage of the inner hair cell synapse...

INTRODUCTION: Dacryocystorhinostomy (DCR), a popular surgical procedure, has been performed using an endoscopic approach over recent years. Excellent anatomical knowledge is required for this endoscopic surgical approach. This study was performed in order to better evaluate the anatomical features of the lacrimal apparatus from cadavers in the Isfahan forensic center as a sample of the Iranian population. MATERIALS AND METHODS: DCR was performed using a standard method on 26 cadaver eyes from the forensic center of Isfahan...

INTRODUCTION: Techniques for inferior turbinate reduction vary from complete turbinectomy to limited cauterization. Surgical methods differ on the degree of tissue reduction and reliance on surgical tissue removal versus tissue ablation. METHOD: The technique and surgical steps of our preferred method of turbinate reduction are presented. RESULTS: Critical steps include proper design of the medial flap and removal of turbinate bone and lateral mucosa to allow lateral positioning of the medial flap...

BACKGROUND: Otitis media with effusion is a common problem that lacks an evidence-based nonsurgical treatment option. We assessed the clinical effectiveness of treatment with a nasal balloon device in a primary care setting. METHODS: We conducted an open, pragmatic randomized controlled trial set in 43 family practices in the United Kingdom. Children aged 4-11 years with a recent history of ear symptoms and otitis media with effusion in 1 or both ears, confirmed by tympanometry, were allocated to receive either autoinflation 3 times daily for 1-3 months plus usual care or usual care alone...

The current scientific research is continuously aiming at identifying new therapeutic targets with the purpose of modifying the immune response to allergens. The evolution in immunological methods has led to the identification of immunoglobulin E (IgE) as both a diagnostic biomarker and potential therapeutic target in allergic diseases, such as allergic rhinitis. Allergen immunotherapy has been used for more than 100 years to treat allergic diseases and it is today considered the only disease-modifying treatment capable of inducing a long-lasting immunological and clinical tolerance toward the causal allergen...

Tinnitus is the perception of sound in the absence of an acoustic external stimulus. It affects 10-17% of the world's population and it a complex symptom with multiple causes, which is influenced by pathways other than the auditory one. Recently, it has been observed that tinnitus may be provoked or modulated by stimulation arising from the somatosensorial system, as well as from the somatomotor and visual-motor systems. This specific subgroup -somatosensory tinnitus - is present in 65% of cases, even though it tends to be underdiagnosed...

PURPOSE OF REVIEW: Tinnitus is a debilitating condition that affects a broad range of patients. Despite thorough and extensive research, the cause of tinnitus has yet to be determined. Also, there has never been a single intervention identified that can consistently eliminate the symptoms of tinnitus. However, despite our inability to 'cure' tinnitus, there are many medical and behavioral strategies that may result in symptomatic relief. The purpose of this article is to review some of the previous information on tinnitus and to examine the recent research on the etiology and management of this condition...

Over the past decade, there has been a burgeoning of scientific interest in the neurobiological origins of tinnitus. During this period, numerous behavioral and physiological animal models have been developed which have yielded major clues concerning the likely neural correlates of acute and chronic forms of tinnitus and the processes leading to their induction. The data increasingly converge on the view that tinnitus is a systemic problem stemming from imbalances in the excitatory and inhibitory inputs to auditory neurons...

Tinnitus is a phantom sound (ringing of the ears) that affects quality of life for millions around the world and is associated in most cases with hearing impairment. This symposium will consider evidence that deafferentation of tonotopically organized central auditory structures leads to increased neuron spontaneous firing rates and neural synchrony in the hearing loss region. This region covers the frequency spectrum of tinnitus sounds, which are optimally suppressed following exposure to band-limited noise covering the same frequencies...

CONCLUSION: The reciprocal nature of the nasal cycle declined with age in keeping with other published data, suggesting that studies of the nasal cycle may be a useful measure of central nervous system (CNS) disease and aging. OBJECTIVES: The aim of this study was to investigate changes in the nasal cycle with age. METHODS: In one male subject changes in nasal airflow were measured by anterior rhinomanometry to determine the reciprocal nature of the 'nasal cycle' at age 28 and again at age 66 years...

CONCLUSION: By consulting an ENT-doctor, patients with chronic rhinosinusitis (CRS), in the general population, receive disease information and adjustment of treatment which can improve disease-specific Quality-of-Life and may improve objective measurements. OBJECTIVES: This study aims to follow persons with clinical diagnosed CRS from the general population, to evaluate their benefit from consultation with an ENT-doctor in terms of severity of symptoms and Quality-of-Life...