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The Effects of Type 2 Diabetes Mellitus on the Cochlear Structure in Human Temporal Bones
Scientific Posters
mutational or endocrine disorders, we choose to iniciate with phonoterapy and after its failure we indicated surgery. Conclusion: It is an efficient technique for the treatment of patients with a high-pitch voice associated with mutational voice disorder without affecting the voice intensity.
P092 The Effects of Type 2 Diabetes Mellitus on the Cochlear Structure in Human Temporal Bones Hisaki Fukushima, MD (presenter); Sebahattin Cureoglu, MD; Patricia Schachern, MD; Michael M Paparella, MD; Tamotsu Harada, MD St Anthony Village MN; Saint Paul MN; Minneapolis MN; Minneapolis MN; Kurashiki-Shi Japan
Objectives: Many authors agree that diabetes mellitus can lead to sensorineural hearing loss. Although there have been a few histopathologic reports of human temporal bones from patients with diabetes mellitus, they did not differentiate diabetes mellitus into types 1 and 2. Because they included elderly patients, it is also difficult to differentiate the effect of diabetes from that of presbycusis. We therefore include only patients with type 2 diabetes and excluded patients over 65 years of age. Methods: Temporal bones from 18 patients (age range, 44-65; mean age, 52.8 years) with type 2 diabetes mellitus and 26 age-matched controls were examined by light microscopy. Thickening of walls of cochlear vessels, area of the stria vascularis, percentage of cochlear hair cells and number of spiral ganglion cells were compared between groups. Results: In the diabetes group, walls of vessels of basilar membrane in all turns (P ⬍ 0.01) and the stria vascularis in the basal and apical (p ⬍ 0.01) and middle (P ⬍ 0.05) turns were significantly thicker than those of controls. Atrophy of the stria vascularis in the lower basal (p ⬍ 0.05), lower and upper middle (P ⬍ 0.01) and apical turns (P ⬍ 0.05) was significantly greater than in the control group. Loss of cochlear outer hair cells was significantly greater in the lower basal (P ⬍ 0.001), upper basal and lower middle turns (P ⬍ 0.05) in the diabetic group. There was no significant difference in the number of spiral ganglion cells. Conclusion: There was cochlear microangiopathy and degeneration of the stria vascularis and cochlear outer hair cells in patients with type 2 diabetes mellitus.
P093 Efficacy of Commonly Used Ear Drops in Clearing Middle Ear Ventilation Tubes Sandeep Uppal, MD FRCS (presenter); Shri K. Nadig, MD FRCS; Ravi Sharma, MD FRCS; Gary W. Back, MD; James England, MD FRCS; Andrew P Coatesworth, FRCS
Leeds United Kingdom; Northern Ireland United Kingdom; York United Kingdom; Leeds United Kingdom; Hull United Kingdom; York United Kingdom
Objectives: An in-vitro prospective double blind randomized controlled trial was performed to: 1. Assess the usefulness of eardrops in clearing ventilation tubes blocked with thick middle ear effusion fluid. 2. Compare the efficacy. Methods: A total of 473 Shephard middle ear ventilation tubes were blocked with freshly harvested un-pooled thick middle ear effusion fluid obtained from patients. Patency of the ventilation tubes before and 7 days after intervention was ascertained by tympanometry and close visual inspection. The usefulness and efficacy of 5% NaHCO3, 3% H2O2, Sofradex (Dexamethasone sodium metasulphobenzoate 0.05%, Framycetin sulphate 0.5%), gramicidin 0.005%), 0.33% Acetic acid and 0.9% NaCl eardrops were compared. Results: Data analysis shows that topical ear drops leads to a statistically significant increase in the number of ventilation tubes being cleared as compared to not using any drops (x2 ⫽ 14.3, df ⫽ 5, p ⫽ 0.006). Results of logistic regression showed the odds ratio to be 0.01(CI ⫽ 0 to 0.09) for no drops, 10.32(CI⫽1.35 to 79.10, p⫽0.024) for H2O2, 24.34 (CI ⫽3.35 to 176.65, p⫽ 0.002) for Sofradex , 28.66(CI⫽ 3.98 to 206, p⫽0.001) for 0.33% Acetic acid, 37.01(CI⫽ 5.16 to 265.36, p ⬍ 0.001) for 0.9% NaCl and 44.58(CI ⫽6.23 to 318.89, p ⬍ 0.001) for NaHCO3 ear drops. The numbers needed to treat were 2.82 for NaHCO3, 3.20 for 0.9% NaCl, 3.86 for 0.33% Acetic acid, 4.39 for Sofradex and 9.47 for H2O2 ear drops. Conclusion: Ear drops statistically and clinically significantly increase clearance of blocked ventilation tubes with thick fluid to not using any drops. 5% NaHCO3 ear drops are more effective. P094 Neuronavigated Transcranial Magnetic Stimulation Improves Chronic Tinnitus Tobias Kleinjung, MD (presenter); Peter Eichhammer, MD; Berthold Langguth, MD; Peter Jacob, MD; Joerg Marienhagen, MD; Goeran Hajak, MD; Juergen Strutz, MD PhD Regensburg Germany; Regensburg Germany; Regensburg Germany; Regensburg Germany; Regensburg Germany; Regensburg Germany; Regensburg Germany
Objectives: Neuroimaging and neurophysiological data suggest that chronic tinnitus is associated with focal brain activation of the primary auditory cortex. Low frequency repetitive transcranial magnetic stimulation (rTMS) has been proposed as an efficient method to reduce cortical hyperexcitability. Recent studies showed positive effects in patients with chronic tinnitus. Methods: Twenty-three patients suffering from chronic tinnitus underwent a FDG- PET investigation to detect areas of increased metabolic activity in the cortex. Fusioning of the
POSTERS
P228
Otolaryngology– Head and Neck Surgery August 2005
mutational or endocrine disorders, we choose to iniciate with phonoterapy and after its failure we indicated surgery. Conclusion: It is an efficient technique for the treatment of patients with a high-pitch voice associated with mutational voice disorder without affecting the voice intensity.
P092 The Effects of Type 2 Diabetes Mellitus on the Cochlear Structure in Human Temporal Bones Hisaki Fukushima, MD (presenter); Sebahattin Cureoglu, MD; Patricia Schachern, MD; Michael M Paparella, MD; Tamotsu Harada, MD St Anthony Village MN; Saint Paul MN; Minneapolis MN; Minneapolis MN; Kurashiki-Shi Japan
Objectives: Many authors agree that diabetes mellitus can lead to sensorineural hearing loss. Although there have been a few histopathologic reports of human temporal bones from patients with diabetes mellitus, they did not differentiate diabetes mellitus into types 1 and 2. Because they included elderly patients, it is also difficult to differentiate the effect of diabetes from that of presbycusis. We therefore include only patients with type 2 diabetes and excluded patients over 65 years of age. Methods: Temporal bones from 18 patients (age range, 44-65; mean age, 52.8 years) with type 2 diabetes mellitus and 26 age-matched controls were examined by light microscopy. Thickening of walls of cochlear vessels, area of the stria vascularis, percentage of cochlear hair cells and number of spiral ganglion cells were compared between groups. Results: In the diabetes group, walls of vessels of basilar membrane in all turns (P ⬍ 0.01) and the stria vascularis in the basal and apical (p ⬍ 0.01) and middle (P ⬍ 0.05) turns were significantly thicker than those of controls. Atrophy of the stria vascularis in the lower basal (p ⬍ 0.05), lower and upper middle (P ⬍ 0.01) and apical turns (P ⬍ 0.05) was significantly greater than in the control group. Loss of cochlear outer hair cells was significantly greater in the lower basal (P ⬍ 0.001), upper basal and lower middle turns (P ⬍ 0.05) in the diabetic group. There was no significant difference in the number of spiral ganglion cells. Conclusion: There was cochlear microangiopathy and degeneration of the stria vascularis and cochlear outer hair cells in patients with type 2 diabetes mellitus.
P093 Efficacy of Commonly Used Ear Drops in Clearing Middle Ear Ventilation Tubes Sandeep Uppal, MD FRCS (presenter); Shri K. Nadig, MD FRCS; Ravi Sharma, MD FRCS; Gary W. Back, MD; James England, MD FRCS; Andrew P Coatesworth, FRCS
Leeds United Kingdom; Northern Ireland United Kingdom; York United Kingdom; Leeds United Kingdom; Hull United Kingdom; York United Kingdom
Objectives: An in-vitro prospective double blind randomized controlled trial was performed to: 1. Assess the usefulness of eardrops in clearing ventilation tubes blocked with thick middle ear effusion fluid. 2. Compare the efficacy. Methods: A total of 473 Shephard middle ear ventilation tubes were blocked with freshly harvested un-pooled thick middle ear effusion fluid obtained from patients. Patency of the ventilation tubes before and 7 days after intervention was ascertained by tympanometry and close visual inspection. The usefulness and efficacy of 5% NaHCO3, 3% H2O2, Sofradex (Dexamethasone sodium metasulphobenzoate 0.05%, Framycetin sulphate 0.5%), gramicidin 0.005%), 0.33% Acetic acid and 0.9% NaCl eardrops were compared. Results: Data analysis shows that topical ear drops leads to a statistically significant increase in the number of ventilation tubes being cleared as compared to not using any drops (x2 ⫽ 14.3, df ⫽ 5, p ⫽ 0.006). Results of logistic regression showed the odds ratio to be 0.01(CI ⫽ 0 to 0.09) for no drops, 10.32(CI⫽1.35 to 79.10, p⫽0.024) for H2O2, 24.34 (CI ⫽3.35 to 176.65, p⫽ 0.002) for Sofradex , 28.66(CI⫽ 3.98 to 206, p⫽0.001) for 0.33% Acetic acid, 37.01(CI⫽ 5.16 to 265.36, p ⬍ 0.001) for 0.9% NaCl and 44.58(CI ⫽6.23 to 318.89, p ⬍ 0.001) for NaHCO3 ear drops. The numbers needed to treat were 2.82 for NaHCO3, 3.20 for 0.9% NaCl, 3.86 for 0.33% Acetic acid, 4.39 for Sofradex and 9.47 for H2O2 ear drops. Conclusion: Ear drops statistically and clinically significantly increase clearance of blocked ventilation tubes with thick fluid to not using any drops. 5% NaHCO3 ear drops are more effective. P094 Neuronavigated Transcranial Magnetic Stimulation Improves Chronic Tinnitus Tobias Kleinjung, MD (presenter); Peter Eichhammer, MD; Berthold Langguth, MD; Peter Jacob, MD; Joerg Marienhagen, MD; Goeran Hajak, MD; Juergen Strutz, MD PhD Regensburg Germany; Regensburg Germany; Regensburg Germany; Regensburg Germany; Regensburg Germany; Regensburg Germany; Regensburg Germany
Objectives: Neuroimaging and neurophysiological data suggest that chronic tinnitus is associated with focal brain activation of the primary auditory cortex. Low frequency repetitive transcranial magnetic stimulation (rTMS) has been proposed as an efficient method to reduce cortical hyperexcitability. Recent studies showed positive effects in patients with chronic tinnitus. Methods: Twenty-three patients suffering from chronic tinnitus underwent a FDG- PET investigation to detect areas of increased metabolic activity in the cortex. Fusioning of the
POSTERS
P228
Otolaryngology– Head and Neck Surgery August 2005