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Conclusion: Patients with upper airway narrowing at the soft palate level and partial upper airway obstruction during sleep seem to benefit from laser-assisted uvulopalatoplasty (LUPP) in terms of decreased velopharyngeal collapsibility and improved nocturnal breathing. Objectives: The current operative treatments for obstructive sleep apnea syndrome (OSAS) are not very effective compared with continuous positive airway pressure (CPAP). It has been suggested that active treatment should be performed earlier, when sleep apnea is present in a milder form. The main problem is identifying progressive sleep apnea. The present study assessed the efficacy of LUPP in patients with partial upper airway obstruction during sleep diagnosed by means of a static charge-sensitive bed (SCSB) combined with oxyhemoglobin desaturation recording and digital fluoroscopy-based collapsibility estimation. Methods: LUPP was carried out in 27 patients under local anesthesia as day surgery. Digital fluoroscopy and SCSB were recorded preoperatively and 6 months after LUPP. Results: Partial upper airway obstruction events and arterial oxyhemoglobin desaturations during sleep decreased significantly. Digital fluoroscopy revealed that the minimal anteroposterior dimension increased and collapsibility decreased at the level where velopharyngeal obstruction occurred, the soft palate. [ABSTRACT FROM AUTHOR]

Sudden sensorineural hearing loss (S-SNHL) is a common problem with a high recovery rate. However, little is known of the long-term prognosis of affected patients. The purpose of this follow-up study was to evaluate the long-term hearing results of S-SNHL patients. The sample consisted of 168 patients with S-SNHL treated with carbogen inhalation and or anticoagulant therapy during the period 1982-89. A questionnaire was sent to these patients, and audiological investigations were carried out in a selection of these patients in 1997. Comparison of the different treatment methods showed that the difference observed in improvement of hearing was statistically significant between the carbogen inhalation and anticoagulant treatment groups. The hearing improvement achieved was stable for, on average, 8 years of follow-up. During the follow-up period, Ménière's disease was diagnosed in only 1 of the 116 patients who answered the questionnaire and no cases of acoustic neurinoma were diagnosed, indicating that establishment of a careful patient history and clinical and audiological investigations are sufficient for the diagnosis of S-SNHL. In general, the hearing improvement achieved in S-SNHL patients is stable during long-term follow-up. [ABSTRACT FROM AUTHOR]

The effects of timolol maleate on the secretion and composition of human saliva were studied in vivo. Eight healthy volunteers received orally 10 mg timolol maleate. Stimulated parotid saliva samples, resting whole saliva samples, and blood samples were collected immediately before and four times after the drug intake at intervals of 1 h. The levels of total protein, lysozyme, IgA, IgG and IgM, salivary peroxidase, myeloperoxidase, lactoferrin, amylase, thiocyanate (SCN-), and hypothiocyanite (OSCN-) were analyzed from saliva samples. Drug levels were measured both from parotid saliva and blood samples. Results were compared to the analyses of the samples collected in a similar way but without administration of any drugs. Decreased levels of total protein, lactoferrin, amylase, and salivary peroxidase were observed in parotid saliva after a single oral dose of timolol maleate. No such decrease was found in lysozyme, myeloperoxidase, SCN-, OSCN-, or immunoglobulins. Salivary flow rate was not significantly changed after drug intake. The results suggest that the β-blocking drug may cause qualitative changes in the composition of saliva by inhibiting the synthesis and/or release of acinar proteins. [ABSTRACT FROM AUTHOR]

presbyacusisPure tone audiograms from 68 dentists with a minimum of 10 yr in dental practice were taken in 1973 and a follow-up was carried out in 1988. The aim was to study whether the dental occupation carried a risk for hearing handicap or not. Allowance for age and sex was made by using the presbyacusis values of SPOOR as the reference. At the speech range of frequencies dentists did not differ from the reference. At higher frequencies of 4, 6, and 8 kHz dentists tended to have higher hearing thresholds than expected. At 6 kHz, both male and female dentists had highly significantly greater hearing thresholds than expected by the corresponding references in both the studies. This difference remained essentially similar over the follow-up period, indicating that dental drill noise was insufficient to cause continuous loss of hearing. While mild NIHL was very common and tended to appear earlier in male than in female dentists, there was in the long run no continuous toss of hearing in either sex other than that attributable to the natural development of presbyacusis. [ABSTRACT FROM AUTHOR]

A neurootologist examined 233 successive cases of acute disabling vertigo from the Clinic of Neurology of Turku University Central Hospital. On magnetic resonance imaging (MRI), 24 patients had evidence of acute cerebral or cerebellar brain infarction. The examination scheme included a case history analysis, clinical neurootological examination and electronystagmography (ENG). The audiological examination included pure-tone thresholds and speech audiometry. The ENG analyses were done by two neurootologists who had no information about the aetiology of the diseases. A central disturbance in ENG was observed in 59% (10/17) of the patients with cerebral brain infarction and 71% (5/7) of the patients with cerebellar brain infarction. ENG is not valid as a screening method for the central aetiology of vertigo; imaging of the central nervous system is needed. [ABSTRACT FROM AUTHOR]

A number of clinical disorders of free vascularized flap are presumed to reflect insufficient blood flow (BF) or an inadequate range of vascular responsiveness. We compared the changes in BF in a pedicled and free epigastric flap, directly after and 90 min after performing microsurgical artery anastomoses. We used the clamping method and laser Doppler flowmetry in six Sprague-Dawley rats. The BF response curves shortly after re-anastomosing of the artery differ markedly from those in a pedicled flap model and curves registered 90 min after performing the anastomosis. We conclude that the clamping method is reliable and reproducible when studying the short-term autoregulatory BF patterns of epigastric pedicled and free flaps. [ABSTRACT FROM AUTHOR]

The purpose of the investigation was to study the symptoms that may provide clues to the early diagnosis of vestibular schwannoma (VS). The symptoms associated with VS in 41 patients were compared with the tumour locations detected by magnetic resonance imaging (MRI). There were 9 (22%) mainly intracanalicular and 32 (78%) mainly extracanalicular tumours. MRI visualized the enhancement of the intracanalicular nerve in 27 of 32 extracanalicular schwannomas. Hearing impairment was found as an initial symptom equally frequently in patients with intra- or extracanalicular VS. Tinnitus was reported as the first symptom more often in patients with extracanalicular VS and dizziness more often in patients with intracanalicular tumours. At the time of diagnosis, unilateral hearing loss was present in 98% of patients, independent of tumour location. Likewise, dizziness was found equally frequently in both patient groups. Instead, tinnitus was found almost significantly more frequently in patients with intracanalicular VS (p=0.07). Although statistically insignificantly so, neurological symptoms were more common in patients with extracanalicular VS (p=0.45). [ABSTRACT FROM AUTHOR]

The use of electrocochleography (EcoG) is considered to be of clinical value in otological diagnosis. Non-invasive ear canal (EC) and tympanic membrane (TM) EcoG recording techniques, and invasive transtympanic (TT) technique are the methods used for objective assessment of cochlear function. In this study, eight adults (16 ears) with suspected Meniere's disease were examined using a newly designed, disposable tympanic electrode and a traditional, thin transtympanic needle. The amplitudes of the TT electrode responses were 4-6-fold larger than those produced by the TM electrode. The morphology of the waveforms for the two recording techniques was nearly identical. The mean amplitudes of the action potential (AP) obtained with the TM electrode were 2.39-3.73 μV, and with the TT electrode 14.08-19.60 μV, depending on the stimulus intensity. For the summating potential (SP), the TM and TT electrodes had mean amplitudes of 0.82-1.60 μV and 3.53-5.81 μV, respectively. The SP/AP ratios were larger with the TM electrode than with the TT electrode. They were inconsistent in four ears (25%) when measured with the TM and TT electrodes. All patients were more satisfied with the TT examination, since it was quite painless, unlike the TM examination. The authors recommend the use of the TT recording technique as a painless examination in which the electrode is close to the inner ear, allowing a good signal-to-noise ratio and large amplitudes. Diagnostic interpretations are easier and more reliable with the TT electrode than with the TM electrode. [ABSTRACT FROM AUTHOR]