Raluca Enache, Dorin Sarafoleanu and Codrut Sarafoleanu
BACKGROUND. Computerized dynamic posturography is the most important battery test designed to assess the ability to use visual, vestibular and proprioceptive cues in the maintenance of posture. Foam posturography reduces the availability of proprioceptive inputs, which makes more difficult the balance control.
OBJECTIVE. The objective of the study was to assess the clinical use of foam posturography in evaluating peripheral vestibular dysfunction.
MATERIAL AND METHODS. We evaluated 41 patients with vestibular disorders and 41 normal patients by using the sensory organization test in eyes opened, eyes closed and mislead vision conditions with and without the foam. We measured several parameters: the position of the center of pressure, the displacement in the center of pressure in anteroposterior and mediolateral planes and Romberg’s ratio on static and foam rubber.
RESULTS. The values of all parameters were significantly higher in patients with peripheral vestibular disorders than in the control group (p<0.05). Also. comparing the Romberg test results, the foam surface used by the patient was larger than the static one.
CONCLUSION. Foam posturography can be a reliable test in assessing patients with peripheral vestibulopathy, being also able to identify the visual and proprioceptive dependence levels.
Whiplash syndrome is a quite common pathology and can be defined as a neck injury produced by a sudden acceleration-deceleration, the consequence of which is a sudden forward and backward movement of the head and neck. The main production mechanism is a sudden acceleration-deceleration process that has as a consequence the sudden extension/flexion of the neck. Starting from the many structures involved, the whiplash syndrome is an interdisciplinary challenge (ENT specialist, neurologist, orthopedist, ophthalmologist, psychologist) and can be described by multiple signs and symptoms.
Whiplash syndrome is a complex pathology both through the mechanism of production and symptoms, and through the forensic implications that it has. The interdisciplinary medical collaboration, the implementation of stricter rules on wearing the seat belt and the development by car manufacturers of chairs and head restraints that protect the head and neck of passengers, would be the preventive step in the occurrence and especially the chronicization of these lesions.
Neck pathology in children involves many diseases with similar clinical expression. Different disorders in paediatric practice may be clinically manifested by a cervical tumefaction. The cervical tumefaction can be represented by adenopathies or tumors. Cervical adenopathies may be unilateral or bilateral; the cause of their occurrence may be infectious, inflammatory, tumoral or may be associated with rare diseases. Tumoral cervical tumefactions can be represented by: congenital cervical cysts and fistulae, cystic lymphangiomas, thyroid swellings, malformations and cervical tumors detected antenatally. A correct diagnosis is established after a complete clinical and paraclinical assessment. In this article the authors make a review of the types of cervical tumefactions in children, emphasising the diagnostic protocol.
Cough is a common symptom encountered in medical practice and can occur throughout the life of a person. From a physiological point of view, it represents a mechanism responsible for the elimination of secretions from the airways. At the same time, cough may be the first symptom of an illness. There are many causes that may lead to the emergence of a chronic cough syndrome, the most frequent being pulmonary diseases. Besides the bronchopulmonary pathology, there are a number of extrapulmonary disorders that may manifest with coughing. The first step in evaluating the patient with chronic cough is performing a correct and complete anamnesis, followed by the physical examination of the patient. The treatment of the chronic cough syndrome must address mainly the underlying disease but, in case of failure of the established treatment, the antitussive therapy is used.
The term monosymptomatic nasal obstruction does not refer to the isolated nasal obstruction, but to a nasal pathology in which nasal obstruction is the predominant symptom. Four nasal structures may be involved in the isolated monosymptomatic nasal obstruction: the inferior nasal turbinates, the nasal septum or the nasal valve. Since the phenomenon of nasal obstruction can be due to various diseases, correct assessment of the patient is very important. Correctly performed anamnesis and clinical and paraclinical evaluations can help determine the definite diagnosis and choose the therapeutic strategy indicated in each individual case.
In this review the authors present the proper therapeutic approach for each type of monosymtpomatic nasal obstruction, emphasizing the need of a preoperatory detailed and correct investigation and diagnosis.