Self-reported hearing status and audiometric thresholds among college students using headphones

Purpose: The study aims to investigate headphone listening habits of college-going students and for those using headphones, correlate self-reported hearing status with average audiometric hearing thresholds. Method: Headphone listening habits and awareness of adverse effects of the same was profiled in college-going students using a questionnaire distributed through online platform. Hearing thresholds were then compared for those with and without self-report of hearing difficulty. 341 responses were obtained from students between 17 and 23 years of age. For the second part of the study, a convenience sample of 30 willing students from among these 341 was selected. Pure tone thresholds were obtained for various frequencies with a high frequency audiometer. PTA (average of 500, 1000, 2000 Hz) and HFPTA (average of 4000, 6000, 8000, 10000 Hz) were calculated for both the ears and compared for those with and without reported hearing difficulty. Results: 78% students reported headphone usage for less than 3 hours per day, while 22% reported usage for more than 3 hours per day. 77% respondents were aware that listening to loud sounds can alter hearing sensitivity, but many (54.83%) did not have awareness about the minimum safe hours of listening. There was a weak positive correlation between self-reported hearing difficulty and poor ear HFPTA (r = 0.2304). Conclusion: Majority of students used insert earphones even after knowing the adverse effect of the same. There was a weak correlation found between the self-reported hearing problems and audiometric hearing thresholds. Implication: More awareness is needed about the ill effects of headphone usage amongst the young teenage population. Proper counseling and management strategies are required for people who report difficulty in hearing.

Effect of probiotics on total salivary antioxidant level and physical properties of saliva: An ex-vivo study

Background: Role of oxidative stress in pathophysiology of various diseases has already been established. Antioxidants act as free radical scavenger and prevent damage to cell, at the same time affects the metabolism of several pathogenic microbes. With increasing incidence of antibiotic resistance, alternative therapeutic treatment options are coming into picture. WHO claims probiotics to be the next most important immune defence system following antibiotic resistance. Even though there are several studies emphasising on the positive outcome of probiotics on diseases, their exact mechanism of action still remains debatable. The present study tried to unveil the antioxidant property of probiotics in saliva along with its effect on salivary pH and buffering capacity. Methods: Unstimulated saliva from 10 individuals were analysed for total antioxidant level, pH and buffering capacity using spectrophotometer, pH paper and buffering strips respectively, before and after probiotic intake for 2 weeks. Results: Probiotic intake led to increase in total salivary antioxidant level with no significant changes in pH and buffering capacity. Results obtained were statistically analysed using “paired t-test”. Conclusions: Probiotics are effective in increasing antioxidant level thereby minimizing cellular damage and hence can be used for prevention of several diseases. Also increase in antioxidant level can be easily assessed in saliva, thus, saliva can be used as a routine diagnostic tool.

Outcome comparison between radiochemotherapy and surgery in the management of locally advanced non-metastatic laryngeal cancer a single institution experience

he treatment of locally advanced non-metastatic laryngeal squamous cell carcinoma is very controversial. Total laryngectomy associated with lymph node dissection and adjuvant radiotherapy with or without chemotherapy is considered the gold standard treatment. The functional impairment on voice and breathing that result from this approach called for discussion of preservation of this organ. Since the publication of the Veterans' Study in 1991 on laryngeal cancer and the confirmation by subsequent randomized trials of an equivalent survival, treatment strategies for advanced laryngeal carcinoma have shown significant changes in favour of an organ-sparing approach by chemoradiotherapy. Purpose: We aim to assess the outcome of locally advanced non-metastatic laryngeal cancer classified as (T3NxM0 -T4NxM0) by comparing the carcinological results and the survival at one and three years between two cohorts of patients, one treated by surgery and the other by organ preservation protocols. Between the two series, we will analyze the carcinological outcomes, local control, local and lymph node recurrence, distant metastases, overall survival, and recurrence-free survival, lymph Node-free survival, and metastatic evolution. Results: 106 patients were treated for locally advanced squamous cell laryngeal carcinoma of the ENT department and radiation Oncology department of Mohamed VI University hospital between January 2014 and December 2018; Sixty-three patients in surgery group I and forty-three patients in group II went on organ sparing approach by radiochemotherapy. The two groups were compared according to local tumor control, local recurrence, lymph node recurrence, and distant metastasis. Early deaths and patients who were lost to follow-up were excluded from this analysis. The average age was 61 years in the surgery group versus 60 years in the RCC. The male predominance was marked in both treatment groups, 102 were male (96.23%) and only 4 female (3.77 %.).88.7% were smokers with an average consumption of 26.4 package-years. Only 15% of our smoking patients reported a withdrawal period estimated at two months on average. Alcohol-smoking synergy was observed in 19% of cases. In the surgery group, 47 patients or 83.9% had local tumor control compared to 12 patients or 41.4% in the radio-chemotherapy group with a statistically significant difference p<0.0001. Local recurrence was observed in 8 patients (14.5%) in the surgery group against 6 patients (46.2%) in the radio-chemotherapy cohort with a p= 0.02. We noted that there was a large number of missing data (30 patients) in the radio-chemotherapy group due to the large number of patients who were lost to follow-up, early deaths, and patients who did not progress well after treatment. There was no statistically significant difference between the two groups in terms of lymph node recurrence and metastatic progression. At 1 year, Overall survival was 87.9% of patients were alive (n=51 out of 58) in the surgery arm versus 60.6% (n=20 out of 33) in the radio-chemotherapy arm. At 3 years overall survival was 77.5% for surgery versus 48.4% for radiotherapy (p= 0.005).Lymph node free recurrence and metastatic free progression at 1 year was 94.5% in the surgery group compared with 84.6% for radio-chemotherapy. Survival at 3 years was 85.4% versus 53.8% respectively (p=0.05).In the chemoradiation therapy group, there were 30 missing data due to a large number of deaths and loss of the follow-up during the first year without any indication of the presence or absence of recurrence, compared to 8 missing data for the radio-chemotherapy group. Conclusion: The optimal treatment for advanced squamous cell carcinoma of the larynx is highly controversial. Total laryngectomy associated with cervical lymph node dissection remains the gold standard of treatment but organ-sparing protocols are as effective as surgical therapy. However, in our study, total laryngectomy plus lymph node dissection showed better survival outcomes in terms of locoregional control and significantly increased overall survival and recurrence-free survival. This makes surgery the treatment of choice in the management of locally advanced non-metastatic laryngeal cancer in our single institutional Moroccan setting. Possible reasons for these results may be poor patient selection, inadequate follow-up, incomplete treatment, and interrupted treatment sessions but also the long delay in consultation. Patients and professionals should be made aware of the small but significant disadvantage of the non-surgical therapy approach as part of the shared decision-making process when selecting treatment. Both surgery and radio-chemotherapy can be effective if the treatment indications are well directed. These indications depend on several many several parameters and should be considered at the multidisciplinary consultation meetings and adapted on a case-by-case basis.

Deceiving & deceptive growth in the ear canal in an elderly female

Malignant neoplasms of the external auditory canal, middle and inner ear are rare. Squamous cell carcinoma (SCC) is the most common neoplasm to occur in this region. As such primary neoplasms of the external auditory canal and temporal bone are uncommon, as these structures more frequently are involved by the cutaneous squamous cell carcinoma (cSCC) of pinna or metastatic cSCC involving parotid gland or post auricular lymph nodes.

Hearing, listening and deep neural networks in hearing aids

Hearing aids have undergone vast changes in the last 30 years from basic analog sound processing techniques, to advanced digital technology, to Deep Neural Networks (DNNs) “on-the-chip” providing real-time sound processing. In addition to making sounds audible, advanced hearing aids with DNN on-the-chip are better able to provide clearer understanding of speech in noise, improve recall, maintain interaural loudness and timing differences, and improve the wearer’s ability to selectively attend to the speaker of choice in challenging listening situations. These improvements are delivered without acoustic feedback and with very high sound quality.

Spontaneous temporal cerebrospinal fluid leak

Spontaneous cerebrospinal fluid leaks of the temporal bone are uncommon conditions, but with increasing incidence in the last years. They represent the osteodural defect of the middle and posterior fossae floor with consequent communication between the subarachnoid space and the middle ear and mastoid cells, not associated with a history of trauma, chronic infections, tumors, surgery or irradiation. Physiopathogenesis is not well defined, being associated with the faulty development of the temporal bone and/or the presence of aberrant arachnoid granulations, in addition to being favored by idiopathic intracranial hypertension, obstructive sleep apnea and obesity. It has the potential for serious neurological complications, which is why surgical treatment is recommended. The main approaches involve transmastoid access and craniotomy access through the middle fossa, or a combination of both. This paper reports on a case attended at Grupo Santa Casa BH and performs a literature review and on aspects related to the clinical presentation and management of the condition.

Rehabilitation strategies and results in patients treated with chemoradiotherapy/radiotherapy for head and neck cancer: Institutional experience

Oncologic treatments, such as Radio- therapy and Chemo-radiation, for head and neck cancer can cause long-term swallowing impairments (dysphagia) that negatively impact the Quality of life. Radiation-induced dysphagia consists of a broad spectrum of structural, mechanical, and neurologic deficits. The goal of this study is to understand the importance of Onco Rehabilitation during Radiation and Chemo-Radiation to minimize the incidence of Dysphagia during the Treatment, which ultimately causes delay in Overall Treatment Time (OTT).

Unilateral tonsillar swelling: role and urgency of tonsillectomy

Unilateral tonsillar swelling is a fairly common presenting complaint in an Ear, Nose and Throat (ENT) department. It may or may not be associated with any other symptoms. Most of the time, the tonsil asymmetry is secondary to previous history of tonsillitis, quinsy, and tonsil stones. Other benign lesions to cause tonsil swelling may include a mucus retention cyst, lipoma, polyp or papilloma. Sometimes, it is the site of primary malignancy but in these situations, it is often associated with red flag symptoms like pain in the mouth, dysphagia, odynophagia, referred otalgia, weight loss, night sweating, haemoptysis, haematemesis, hoarseness or neck nodes. Most of the patients with suspected tonsillar malignancy have underlying risk factors like smoking and excessive alcohol intake. However, lately, the tonsil squamous cell carcinoma can be found in younger patients with no history of smoking or drinking as there is rising incidence of human papilloma virus related oropharyngeal malignancy. Sometimes, lymphoma may manifest as a tonsil enlargement. If, after detailed history and examination, there remains any doubt about the underlying cause of unilateral tonsil swelling then tonsillectomy should be considered for histological analysis. it is our practice to perform bilateral tonsillectomy in such cases. We present a case of unilateral tonsillar swelling and discuss its management.

A rare basal cell adenoma (BCA) of the parotid gland ina male patient

Basal cell adenoma (BCA) is an uncommon, benign salivary tumor comprising 1-3% of salivary tumors. These tumors occur more commonly in women and patients older than 50 years of age. Patients typically present with a slow growing, well circumscribed mass. Overall BCA has a good prognosis with low rates of recurrence and malignant transformation. However, BCA membranous subtype undergoes malignant transformation at increased rates compared with the solid, tubular and trabecular forms. We present a rare case of a basal cell adenoma in a 57 year old male as well as a literature review.