Objective The purpose of this study was to analyze the anatomical and functional results in 167 tympanoplasties performed in children. Methods A retrospective study of the anatomical and functional results of 167 tympanoplasties in children was performed. 91 ears had full records and were included in the study. Age, gender, size and site of perforation, status of operated and contralateral ear, underlying cause of the perforations, surgical technique, preoperative and postoperative hearing levels, postoperative follow-up time, and postoperative complications were recorded. Hearing results were reported using a 5-frequency (500,1,000, 2,000, 3,000, 4000 Hz) pure-tone average air-bone gap. Results Anatomical success was achieved in 85% of cases. 71% of the reperforations occurred during the first year of follow-up. The anatomical and functional success was 76% after a mean follow-up of 26.4 ± 16.2 months. The mean postoperative air conduction threshold significantly improved in the successful cases, with a mean audiological improvement of 12.54 ±7.3dB (p<0.05). The maximum mean postoperative gain was seen at 500 Hz 14.9 ±10.1 dB (P<.05). No postoperative sensorineural hearing loss was observed. 18% of minor postoperative complications were seen. Surgeon experience, intact and mobile ossicular chain, dry ear, and follow-up longer than 12 months (p<0.05) improves functional outcome. Conclusions We conclude that tympanoplasty in children is safe with anatomical and functional results comparable to that reported for adults. Dry ear over 6 months, surgeon experience, intact and mobile ossicular chain and follow-up >12 months significantly improves functional outcome.

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Objectives Many diseases with great prevalence in the population occur with disorders of smell funtction. However, assessment of olfactory function in patients with disorders of smell is frequently neglected in the otolaryngology routine consultation. One of the effects of tobacco consumption is a change in the nasal mucosa. It has been hypothesized that tobacco smoke consumption modifies olfactory levels of these people. Methods Prospective clinical study with 56 consecutive healthy volunteers, submitted to a previously validated protocol of olfactometry composed by a quantitative and a threshold test. Our population was constituted of an equal number of tobacco smokers and controls, between 16 and 78 years old (average 38,3 years), age and sex paired. Results The substance more frequently identified was naphthalene (94%), followed by menthol (88%), while the least times correctly identified had been the cinnamon and talcum (65%). The test of butanol showed a statistically significant difference (3.73±0.50 in smokers vs 4.34±1.00 in nonsmoking, p=0.02). This test presented a significant correlation with the smoking habit (r=-0.59, p< 0.01). The supraliminary test showed no significant differences between the 2 groups. There was no significant difference between genders. Conclusions We observed a significant statistical correlation between the tobacco smoking and the test of butanol, which confirms the subjective sense of former smokers when experiencing again the aromas that have been altered. Our study showed the quantitative difference imposed by tobacco smoking. Smokers presented lower olfaction levels than non-smokers, keeping, however, a similar discriminative ability.

METHODS: Some 38 consecutive tinnitus patients were enrolled from May to September 2004 (22 female; mean age 55.9 years). In a test situation, they performed 9 maneuvers of head and neck muscle contraction, each one for 5 seconds. Except for the first maneuver, all were performed with moderate counter-resistance applied by the patients themselves: 1. forced mandible occlusion; 2. counter-resistance to the pressure of the occipit; 3. counter-resistance to the pressure on forehead; 4. counter-resistance to the pressure on vertex; 5. counter-resistance to the mandible pressure; 6. counter-resistance to right temporal pressure; 7. counter-resistance to left temporal pressure; 8. head rotation to the right with resistance over the right zygoma; and 9. head rotation to the left with resistance over the left zygoma. Retest was applied 7 days later by the same professional. RESULTS: In the test situation, 57.9% experienced tinnitus modulation during at least one muscle contraction (77.3% worsened, 18.2% improved and 4.5% improved on one side and worsened on the other). During the retest, 63.2% patients reported tinnitus modulation after at least one maneuver (58.3% worsened, 29.2% improved and 12.5% improved on one side and worsened on the other). CONCLUSIONS: There was an agreement between test and retest of tinnitus modulation using head and neck muscle contraction maneuvers, which shows the reliability of this tool.

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