No abstract

Background Various grafting materials and different techniques have been used for myringoplasty. The aim of the study was to compare the result of tympanoplasty in patients with safe-type chronic suppurative otitis media using periosteum versus tragal cartilage with perichondrium grafts through pre- and postoperative clinical and audiological evaluation. Results There was statistically significant difference for mean air-bone gap for group A (23.4 dB ± 0.03 SD) when compared to group B (19.4 dB ± 4.2 SD) with P value 0.103. Also, there was statistically significant difference in the hearing gain in group A after 6 months (25.53 dB ± 6.26 SD) when compared to group B (19.63 dB ± 9.76 SD) and the P value was 0.003. Graft taken was superior in the periosteal group (95%), compared to the cartilage grafts (90%). Conclusion Tympanoplasty with periosteal graft showed better hearing results and high rates of graft taken than tragal cartilage grafts.

Background: Combined hearing and vestibular loss in children pose potentially significant problems. Children and infants with vestibular problems are faced with motor problems that could limit their normal development. Objectives: the aim of the study is to assess the relationship between the vestibular disorders and the delayed motor development in hearing impaired children as well as to assess the integrity of the vestibular system through clinical testing and radiological imaging in those children with delayed motor development. Methods: Thirty hearing impaired children with history of delayed motor milestones, and a control group of 10 hearing impaired children with normal motor development were included with variable degree of hearing loss. Each child was subjected to careful history taking, general examination, otoscopic examination, motor and balance questionnaires were answered by the parents or caregivers, audiological evaluation either through conditioned play audiometry or conventional audiometry, speech audiometry and Immittancemetry. Vestibular evaluation through cVEMP and caloric tests and finally the radiological studies through CT and MRI of the petrous bone. Results: There were variable degrees of hearing loss among both groups. In the control group (10 HI children, 20 ears), 18 ears (90%) had VEMP response, while two ears (10%) had absent VEMP, while in the study group (30 HI children, 60 ears), 48 ears (80%) had VEMP response, while 12 ears (20%) had absent VEMP. All children in the control group had normal caloric response, while in the study group, 23 children (77%) had normal response, and seven children (23%) had abnormal caloric response, 4 children had bilateral weakness and 3 had unilateral weakness. CT and MRI study of petrous bone was done for the control group and revealed normal radiology, while in the study group, 21 children had normal imaging (70%) and the last 9 children (30%) had abnormal findings, the most common abnormalities was enlarged vestibular aqueduct (13%), followed by common cavity (7%). Conclusion: Children with hearing loss, irrespective of the degree of hearing loss, the vestibular system should be screened, assessed as it may be responsible for co-morbidities in fine and gross motor difficulties. Early intervention and effective therapy will be the proper way to get good outcome.

Background Psoriasis is a multisystem, immune disorder driven by inflammatory processes, characterized by skin and joint manifestations, and may be associated with hearing loss. Aim To assess the hearing function in patients with psoriasis and if psoriasis could cause sensorineural hearing loss (SNHL). Patients and methods A total of 50 patients with psoriasis and 50 apparently healthy controls matched for age and sex were included in a cross-sectional comparative study between May 2017 and April 2018. Medical history of patients was taken. Demographics, type of psoriasis, and disease severity evaluated by PASI score were assessed. All patients who were included in this study provided a complete history and audiological history. All patients underwent otoscopic examination, pure tone audiometry, speech audiometry, and immittancemetry including tympanometry and acoustic reflexes. Results There was no statistically significant difference in age or sex for patients with psoriasis and the control group. Eight patients with psoriasis showed impaired hearing function with significant longer duration with psoriasis and older age more than 20 years old in comparison with the rest of the patient. Conclusion Psoriasis is a chronic inflammatory immune-mediated skin disease with estimated prevalence in Upper Egypt at a rate of 0.19% of skin diseases. There were eight (16%) patients who had SNHL in psoriatic group in comparison with three (6%) cases in nonpsoriatic group. There was a statistically significant difference for the age and the duration of psoriasis in relation to hearing loss. SNHL increased with age in psoriatic patients much more than in healthy controls.

Background: At the end of 2019 the world was attacked by coronavirus disease 19 caused by severe acute respiratory syndrome coronavirus, there is a direct association between COVID-19 and SSNHL. Corticosteroids are widely used as a first-line treatment option for SSNHL. Our objective was to evaluate and compare between the efficacy of both known treatments of SSNHL, which are oral steroid versus intratympanic steroid injection in post COVID 19 hearing loss. Patients and methods: Twenty patients with confirmed COVID-19 reported SSNHL were included in this study with different degrees of hearing loss ranged from mild to profound hearing loss. Different approach of steroid therapy including intratympanic steroid injection, high dose oral steroid and both systemic steroid with intratympanic injection. Results: There were no statistically significant differences in the mean of each frequency pre and post treatment audiogram, but there was significant difference in overall change in frequencies which means general improvement. In the other hand there was significant difference between the mean of post treatment low and high frequencies thresholds with more improvement in low than high frequencies. Compering the three groups, there was statistically significant difference in median of all frequencies between the group receiving systemic steroid and the other two groups. Conclusion: COV-SARS-2 virus infection seems to induce SSNHL, Early treatment for sudden hearing loss induced by COVID-19 with high dose of systemic steroid is the most probable option of treatment, and intratympanic injection can be used as a salvage treatment.