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Acoustic rhinometry and rhinomanometry as objective tools for the assessment of nasal patency in nasal septal surgery

REFERENCES 1. Stewart M.G., Smith T.L., Weaver E.M., et al. - Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Head Neck Surg., 2004;130(3):283–290. 2. Gray L.P. - Deviated nasal septum. Incidence and etiology. Ann Otol Rhinol Laryngol Suppl., 1978;87(3 Pt 3Suppl 50):3-20. 3. Aziz T., Biron L.V., Ansari K., Flores-Mir C. - Measurement tools for the diagnosis of nasal septal deviation: a systematic review. J Otolaryngol Head Neck Surg., 2014;43:1-11. doi: 10

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The association of absolute eosinophil count, serum immunoglobulin E and spirometry with co-morbid bronchial asthma in patients with allergic rhinitis


OBJECTIVE. This study aimed to analyse the association of absolute eosinophil count (AEC), serum IgE and spirometry with co-morbid bronchial asthma in patients with allergic rhinitis.

MATERIAL AND METHODS. This study involved 50 patients with signs and symptoms of allergic rhinitis who underwent a clinical examination and various tests, including spirometry, and were followed up regularly. Patients found to have bronchial asthma or nasal polyposis were treated accordingly.

RESULTS. The study found the prevalence of bronchial asthma in patients with allergic rhinitis to be 58% and that the severity of bronchial asthma was reduced significantly, with lesser acute attacks and reduced hospitalizations with the effective treatment of allergic rhinitis (p=0.064).

CONCLUSION. This study showed that elevated AEC and serum IgE were significantly associated with co-existing allergic rhinitis and bronchial asthma and increased the chance of co-existence of these two pathologies. Spirometry is a useful tool for observing the response to treatment.

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Anatomic patterns of maxillary sinus drainage


Background. Functional endoscopic sinus surgery may be indicated when certain anatomic variations impede the normal drainage of the paranasal sinuses through the ostiomeatal complex. We aimed at studying the drainage system of the maxillary sinus which consists of the maxillary infundibulum, the main ostium of the maxillary sinus, the ethmoidal infundibulum and the hiatus semilunaris inferior.

Material and methods. The study was performed retrospectively on cone beam computed tomography (CBCT) scans of 60 subjects (N=120 maxillary sinuses). The anatomical pattern of the maxillary sinus drainage was studied on coronal scans.

Results. As related to different morphological possibilities in the supero-lateral limit of the maxillary sinus drainage system, five different patterns were defined: in type I (55%) there was no pneumatization in that situs, in type II (18%) there was an infraorbital recess of the maxillary sinus placed above the sinus ostium, in type III (14%) an ethmoidal recess of the maxillary sinus was expanded within the ethmoid bone, above the ethmoidal infundibulum, in type IV (3%) there were Haller cells above the sinus ostium, while in type V (10%) there were non-infraorbital ethmoid air cells above and draining into the ethmoidal infundibulum.

Conclusion. It appears that CBCT is a reliable tool to make an anatomical distinction of the variable pattern of pneumatization impeding a normal drainage of the maxillary sinus, between maxillary sinus- and ethmoid-derived air-filled spaces.

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Clinical application of laryngeal electromyography – a point of view


In recent years, the clinical importance of laryngeal electromyography (LEMG) has been recognized. This method of investigation proved itself to be a valuable and indispensable tool regarding voice disorder management and requires multidisciplinary approach.

In this article, we focus on the clinical usefulness of LEMG to assess inferior and superior motor neuron integrity by recording action potentials generated by muscle fibers of the larynx in the new field known as neurolaryngology. To facilitate the clinical application of this electrophysiologic test, we present a detailed description of LEMG techniques, which were applied for simultaneous bilateral recordings of the thyroarytenoid, cricothyroid and posterior cricoarytenoid muscles. Also, we analysed and measured the following electrophysiological parameters: 1) insertional activity; 2) spontaneous activity; 3) recruitment; 4) morphology of waveform.

From a practical point of view, in our country, LEMG performance is still not a routine procedure in ENT and Phoniatric Departments. The difficulty of practical use of LEMG in Romania consists in technical limitations and it depends on the physician’s experience regarding the examination technique and also the interpretation of electrophysiological results.

Our current clinical experience shows that the use of LEMG contributes especially to the diagnosis, prognosis and treatment of patients with neurolaryngological disorders.

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Variations of sphenoid pneumatization: a CBCT study


BACKGROUND. The pneumatization pattern of the sphenoid sinus seems rather unpredictable, as resulted from previous studies. It is however extremely important for endoscopic approaches to target structures of the middle cranial fossa, such as the pituitary gland.

MATERIAL AND METHODS. We aimed at documenting by Cone Beam Computed Tomography (CBCT) the possibilities of anatomic variation of the sphenoid sinus. 25 randomly selected patients were retrospectively analyzed.

RESULTS. In 56%, the left and right sphenoidal sinuses were bilaterally symmetrical with respect to the sagittal pneumatization type: four patients had sellar types, one had presellar type and in nine cases the sphenoidal sinuses were reaching posteriorly to the sella turcica. Only in 8% of cases were found conchal types of pneumatization, but they were part of anatomical pictures including Onodi air cells. Such an Onodi cell presented a posterior (sphenoidal) recess reaching posteriorly and superiorly to the pterygopalatine fossa. The recesses of the sphenoid sinus were also documented: anterior or septal, ethmoidal, maxillary, clinoidal and lateral. In 32% was found a lateral recess only engaged between the vidian and maxillary nerve canals.

CONCLUSION. It appears that CBCT is a reliable tool for accurate anatomic identification of the sphenoid sinus pneumatization pattern, on a case-by-case basis.

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The role of ultrasound in the diagnosis of obstructive sleep apnea

REFERENCES 1. Lahav Y, Rosenzweig E, Heyman Z, Doljansky J, Green A, Dagan Y. Tongue base ultrasound: a diagnostic tool for predicting obstructive sleep apnea. Ann Otol Rhinol Laryngol. 2009;118(3):179-84. 2. Chen JW, Huang CC, Weng CK, Chang CH, Wang SJ. Simultaneous recording of ultrasound and polysomnography during natural sleep in patients with obstructive sleep apnea: a pilot study. J Sleep Res. 2017;26(4):481-6. DOI: 10.1111/jsr.12515. Epub 2017 Mar 17. 3. Shu CC, Lee P, Lin JW, Huang CT, Chang YC, Yu CJ, et al. The Use of Sub

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Evolution of sinonasal radiological findings in a case of granulomatosis with polyangiitis

, Lobatto S, Wiik A, Permin H, van Es LA, et al. Autoantibodies against neutrophils and monocytes: tool for diagnosis and marker of disease activity in Wegener’s granulomatosis. Lancet. 1985;1(8426):425–9. 8. Helmberger RC, Mancuso AA. Wegener granulomatosis of the eustachian tube and skull base mimicking a malignant tumor. AJNR Am J Neuroradiol. 1996;17(9):1785-90. 9. D’Anza B, Langford CA, Sindwani R. Sinonasal imaging findings in granulomatosis with polyangiitis (Wegener granulomatosis): A systematic review. Am J Rhinol Allergy. 2017;31(1):16–21. DOI: 10

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Outcomes of mucociliary clearance and rhinomanometrical changes in nasal pathology

., Kljajić V., Pilija V. - Correlation between subjective and objective nasal breathing assessments in examinees with nasal septum deformities. Vojnosanit Pregl., 2013;70(4):380-385. 8. Aziz T., Biron V.L., Ansari K., Flores-Mir C. - Measurement tools for the diagnosis of nasal septal deviation: a systematic review. J Otolaryngol Head Neck Surg., 2014;43:11. doi: 10.1186/1916-0216-43-11. 9. Bercin S., Ural A., Kutluhan A. - Effects of topical drops and sprays on mucociliary transport time and nasal air flow. Acta Otolaryngol., 2009;129(11):125712-61. doi: 10

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Pulmonary tuberculosis with rhinosinusal and otic manifestations - diagnostic challenge

. Tuberc Respir Dis (Seoul). 2015;78(2):64–71. DOI: 10.4046/trd.2015.78.2.64. 13. World Health Organization. Early detection of tuberculosis: an overview of approaches, guidelines and tools [Internet]. Geneva: World Health Organization; 2011. Available from: . 14. Wilson ML. Recent advances in the laboratory detection of Mycobacterium tuberculosis complex and drug resistance. Clin Infect Dis. 2011;52(11):1350–5. DOI: 10.1093/cid/cir146. 15. Iseri M, Topdag M, Ulubil SA, Kuru FD. Bilateral facial paralysis

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Olfactometric assessment - where do we stand today?

References 1. Scadding G., Hellings P., Alobid I., et al. - Diagnostic tools in Rhinology EAACI position paper. Clin Transl Allergy., 2011;29(2):289-292. doi: 10.1186/2045-7022-1-2. 2. Croy I., Buschhüter D., Seo H.S., Negoias S., Hummel T. - Individual significance of olfaction: development of a questionnaire. Eur Arch Otorhinolaryngol., 2010;267(1):67-71. doi: 10.1007/s00405-009-1054-0. 3. Doty R.L. - Olfactory dysfunction and its measurement in the clinic and workplace. Int Arch Occup Environ Health, 2006

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