Polish Journal of Otolaryngology最新文献

<b>Introduction:</b> Studies on the pathophysiology of chronic rhinosinusitis have shown an effect of IgE antibodies on the course of the disease, as well as the effectiveness of treatment. Steroid therapy remains the most prevailing method of CRS treatment. </br></br> <b>Aim: </b>The aim of our study was to determine the clinical response to systemic and local steroid therapy in patients with CRSsNP depending on the total IgE antibody serum concentration. </br></br> <b>Material and methods:</b> A total of 92 patients with CRSsNP took part in the study, where they were divided randomly into 2 groups. In group I, the patients received fluticasone propionate 800 mcg/day intranasally for 12 weeks. Patients in group II were treated with prednisone at a dose of 0.5 mg/kg/day, given orally, for 7 consecutive days and continued by another week with decreasing dosage. Both groups were evaluated prior to and following treatment using the TSS score of CRS clinical symptoms, the endoscopic Lund-Kennedy scale and the Lund-Mackay CT staging of chronic rhinosinusitis. Statistical analy-sis of the effectiveness of treatment was carried out in subgroups according to the total IgE serum concentrations obtained before treatment. </br></br> <b>Results:</b> Both groups of patients achieved statistically significant improvement in the TSS evaluation, as well as in endosco-pic and CT imaging findings. In patients with a total IgE serum concentration over 100 IU/ml systemic steroid therapy sho-wed significantly greater effect on the relief of CRS symptoms in the TSS score than intranasal steroid therapy. Analogous differences in the effectiveness of both methods were not found in patients with a normal total IgE serum concentration (<100 IU/ml). </br></br> <b>Conclusions:</b> A short course of systemic steroid therapy is more effective than local treatment in relieving of CRS symptoms in patients with CRSsNP with elevated serum concentration of IgE antibodies. Atopy may be considered a specific predictor of response to steroid therapy in the treatment of chronic rhinosinusitis.

In everyday otolaryngological and gastroenterological practice, the diagnosis and treatment of extraesophageal forms of gastroesophageal reflux disease are often challenging. It is sometimes the case that treatment ordered by other specialists proves ineffective or even worsens the symptoms. There is no golden standard of diagnosis for otolaryngological forms of GERD, and currently used tools (gastroscopy, laryngoscopy, impedance and pH testing) have low sensitivity and specificity. After finishing a course of successful treatment, the patients often come back to our offices with the very same symptoms. In order to improve the efficacy of treatment, a prokinetic agent can be added to the standard proton pump inhibitor therapy.

<b>Aim:</b> The aim was to compare hearing loss between men and women over 65 in pure tone audiometry and to evaluate the sensitivity of the abbreviated version of the Hearing Handicap Inventory (HHIE-S). This questionnaire highlights hearing handicaps in understanding speech. </br></br><b> Materials and Methods:</b> The data was collected in the years 2011-2015 from respondents above 18 years of age using a standar-dized HHIE-S questionnaire and specialized tests. The cohort was divided into groups based on the severity of hearing loss in the better ear according to the World Health Organization (WHO) as measured by tone threshold audiometry at 500 Hertz (Hz), 1000 Hz, 2000 Hz and 4000 Hz. </br></br> <b> Results:</b> Of the 7070 people (61.8% female and 38.2% male), 68.93% had hearing impairment. Most people had a slight he-aring loss. Based on HHIE-S, 56.94% reported impaired hearing. A statistically significant difference was found between the genders, but according to HHIE-S, females with impaired hearing were not statistically significantly more numerous than males. The diagnostic sensitivity of the HHIE-S was assessed in particular by its sensitivity (75.43%) and specificity (82.53%). The probability that a person has a hearing impairment when the HHIE-S test is positive is 90.21%. </br></br> <b> Conclusions:</b> The HHIE-S is fast, inexpensive and short, and can be included as a screening test for hearing impairment in ca-ring for the elderly. Even a minor hearing impairment can be a significant handicap in elderly patients by restricting not only social interactions but also weakening mental functioning.