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Augusto Pietro Casani,1 Elena Navari,1 Roberto Albera,2 Giuseppe Agus,3 Giacinto Asprella Libonati,4 Giuseppe Chiarella,5 Nicola Lombardo,6 Vincenzo Marcelli,7 Giovanni Ralli,8 Leonardo Scotto di Santillo,9 Roberto Teggi,10 Pasquale Viola,5 Luigi Califano111Department of Medical and Surgical Pathology, Otorhinolaryngology Section, Pisa University, Pisa, Italy; 2Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin School of Medicine, Turin, Italy; 3Otorhinolaryngology, Private Practice, Cagliari, Italy; 4Ear, Nose and Throat Department, Unit of Audiology, Vestibology and Phoniatry, Madonna delle Grazie Hospital, Matera, Italy; 5Department of Experimental and Clinical Medicine, Unit of Audiology and Phoniatrics, Magna Græcia University, Catanzaro, Italy; 6Otorhinolaryngology Section, Mater Domini University, Catanzaro, Italy; 7Department of Neuroscience, Vestibular and Audiology Unit, University of Naples “Federico II”, Naples, Italy; 8Department of Sense Organs, Sapienza University of Rome, Rome, Italy; 9Vestibology and Vestibular Rehabilitation Unit, Antero Micone Hospital, Genoa, Italy; 10Ear, Nose and Throat Department, San Raffaele Scientific Hospital, Milan, Italy; 11Audiovestibology Unit, G. Rummo Hospital, Benevento, ItalyPurpose: To assess if a polyphenol compound supplementation (Vertigoval®) could improve residual dizziness earlier after benign paroxysmal positional vertigo (BPPV) and relieve patients from this disabling symptomatology.Methods: In this prospective, multicentric study, 127 patients were randomized in the treatment group (TG), who received a 60-day supplementation, while 131 patients were randomized in the control group (CG), who did not receive any medication. The dizziness handicap inventory (DHI) score, static posturography, and the visual analog scale (VAS) for both dizziness (D-VAS) and nausea/vomit (N/V-VAS) were used as measures of outcome at baseline and after 30 and 60 days. Patients were asked about efficacy and tolerance to the treatment. Side effects were examined.Results: A statistically significant greater decrease was established in the TG for DHI, D-VAS, and N/V-VAS compared to the CG. On the other hand, static posturography did not show statistical differences between the two groups, though a better clinical improvement after 60-day supplementation was shown in the TG in comparison to the CG. We counted mild side effects in only 2 patients. Most patients reported an excellent or good efficacy and tolerance to the treatment.Conclusion: Residual dizziness is a frequent condition of unknown origin that manifests as persistent disabling imbalance after successful repositioning maneuvers for BPPV. The decreasing postural control can affect the quality of life, contributing to falling and psychological problems. The supplementation with the polyphenol compound used in our study is safe, manageable, and appeared to be able to reduce subjective symptoms and improve instability earlier, decreasing the risk of potential complications.Keywords: residual dizziness, benign, paroxysmal positional vertigo, BPPV, Vertigoval®

Francesco Di Pierro,1 Guido Donato,2 Federico Fomia,3 Teresa Adami,4 Domenico Careddu,5 Claudia Cassandro,6 Roberto Albera61Scientific Department, Velleja Research, Milano, 2ASL 1, Cuneo, 3ASL 3, Brescia, 4Infective Diseases, Verona, 5ASL 13, Novara, 6Surgical Science Department, Università degli Studi, Torino, ItalyBackground: The oral probiotic Streptococcus salivarius K12 has been shown clearly to antagonize the growth of Streptococcus pyogenes, the most important bacterial cause of pharyngeal infections in humans, by releasing two bacteriocins named salivaricin A2 and salivaricin B. Unpublished observations indicate that it can also antagonize the growth of other bacteria involved in acute otitis media. Because of its ability to colonize the oral cavity and its safety profile, we have tested its efficacy in reducing the incidence of streptococcal pharyngitis and/or tonsillitis and episodes of acute otitis media.Methods: We enrolled 82 children, including 65 with and 17 without a recent diagnosis of recurrent oral streptococcal pathology. Of those with recurrent pathology, 45 were treated daily for 90 days with an oral slow-release tablet containing five billion colony-forming units of S. salivarius K12 (Bactoblis®), and the remaining 20 served as an untreated control group. The 17 children without a recent diagnosis of recurrent oral pathology were used as an additional control group. After 90 days of treatment, a 6-month follow-up period without treatment was included to evaluate a possible persistent protective role for the previously administered product.Results: The 41 children who completed the 90-day course of Bactoblis showed a reduction in their episodes of streptococcal pharyngeal infection (about 90%) and/or acute otitis media (about 40%), calculated by comparing infection rates in the previous year. The 90-day treatment also reduced the reported incidence of pharyngeal and ear infections by about 65% in the 6-month follow-up period during which the product was not administered. Subjects tolerated the product well, with no side effects or dropouts reported.Conclusion: Prophylactic administration of S. salivarius K12 to children with a history of recurrent oral streptococcal pathology reduced episodes of streptococcal pharyngeal infections and/or tonsillitis as well as episodes of acute otitis media.Keywords: BLIS K12, bacteriocin-like inhibitory substance K12, Streptococcus salivarius K12, Bactoblis®, pharyngitis, tonsillitis, acute otitis media

Aims Few studies have analysed the presence of hearing abnormalities in diabetes. We assessed the presence of subclinical auditory alterations and their possible association with early vascular and neurological dysfunction in young adults with Type 1 diabetes of long duration. Methods Thirty-one patients with Type 1 diabetes (mean age 33 ± 2.3 years, disease duration 25.7 ± 4.2 years) and 10 healthy controls underwent pure tone audiometry ( PTA), distortion product otoacoustic emission ( DPOAE) and auditory brainstem response ( ABR) analyses. Associations with metabolic variables and chronic complications were explored. Results Compared with healthy controls, patients with diabetes had significantly higher mean hearing thresholds, although still within the normoacusic range. DPOAE intensities at medium frequencies (2.8-4 kHz) were significantly lower in patients with diabetes. In ABR, in addition to waves I, III and V, we observed the appearance of a visible wave IV in patients with diabetes compared with controls (prevalence 61% vs. 10%, P < 0.05), and its appearance was related to a prolonged I-V interval (4.40 ± 0.62 ms vs. 4.19 ± 0.58 ms, P < 0.05). Diastolic blood pressure was higher in people with abnormal DPOAE ( P < 0.05), whereas systolic blood pressure correlated with wave V and interpeak I-V interval latencies. A trend towards an association between evidence of wave IV and the presence of somatic neuropathy or abnormal cardiovascular autonomic tests was observed. Conclusions Young adults with long-term Type 1 diabetes have subclinical abnormalities in qualitative auditory perception, despite normal hearing thresholds, which might reflect neuropathic and/or vascular alterations. [ABSTRACT FROM AUTHOR]

Noise-induced hearing loss (NIHL) is the cause of subjective problems that could be classified as auditory disability (AD) and auditory handicap (AH). The aim of the study was to determine the relationship between the degree of hearing loss due to NIHL and AD-AH by means of an 11-item questionnaire. The study group consisted of 750 males affected by NIHL and 891 normally hearing males. Each subject was submitted to pure-tone audiometry (PTA) and to a questionnaire that explored AD and AH. Results showed that only 60% of NIHL subjects reported AD and 50% reported AH. The most common AD complaint was reduced speech comprehension in noise. Changes in social relations were rarely reported among the AH items. A correlation was found between both AD and AH and PTA threshold. The severity of AD seems more related to PTA threshold rather than to age. [ABSTRACT FROM AUTHOR]