E Ferekidis

Academisch Medisch Centrum Universiteit van Amsterdam, Amsterdamo, North Holland, Netherlands

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Publications (64)50.82 Total impact

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    ABSTRACT: To quantify the bystander-effect of 2.5G mobile telephones (2.5G-MTs) on the speech perception of digital hearing-aid (dHA) users. Differences in the susceptibility of behind-the-ear (BTE) compared to in-to-the-ear (ITE) dHAs were also assessed. Prospective-comparative study conducted at a tertiary referral centre (ENT Department) and a HA-fitting laboratory. Key-word recognition scores from open-sentence lists were calculated. Power-analysis determined that a minimum of 60 subjects with SNHL (30 in each group), using either BTE or ITE dHAs, were required for reliable study outcomes. Sixty-four adults were tested with a functioning 2.5G-MT at almost physical contact with their ear; thirty subjects used BTE and 34 ITE dHAs. Aided word recognition score differences between studied groups and within each group, while a 2.5G-MT was activated. Cut-off inclusion criterion regarding baseline aided word recognition score was 75%. Baseline aided word recognition scores for ITE dHAs were better compared to BTE ones (p < 0.01). Following the 2.5G-MT activation, this difference disappeared. No statistically significant difference in word recognition was observed between the examined groups, or within the BTE group, from the bystander-effect of the 2.5G-MT. ITE dHAs proved more susceptible to electromagnetic interference (p < 0.05). The bystander-effect of 2.5G-MTs on the speech perception of dHA users is either minimal, or not significant. The observed compatibility has a positive impact on the lives of millions of people worldwide. The long-standing theory of more interference in BTE compared to ITE HAs is not confirmed by the results of the present study. EBM level of evidence: 2c.
    B-ENT 01/2012; 8(2):95-101. · 0.08 Impact Factor
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    ABSTRACT: To investigate the role of smoking, alcohol, coffee consumption, demographic factors, toxic agents, and occupation in laryngeal carcinogenesis. A case-control study included 70 patients with histologically confirmed laryngeal cancer and 70 controls with non-neoplastic conditions unrelated to diet/smoking/alcohol. Relative risk, odds ratio (OR), and 95% confidence intervals were estimated using multiple logistic regression. Current smokers had 19.46 OR of laryngeal cancer compared to non-smokers (p = 0.006). The respective OR for alcohol consumption was 3.94 (p = 0.006). While the risk increased in heavy drinkers, there was no difference in duration of alcohol consumption. There was a strong and consistent relation between laryngeal cancer and the consumption of Greek/Turkish coffee cups/day (p = 0.002, OR = 1.77). Diesel exhaust fumes also seemed to increase the risk of laryngeal cancer, although the association was found to be no longer significant after analysis with logistic regression. The present study confirmed the relation of smoking and alcohol with laryngeal cancer. However, other factors such as coffee and diesel exhaust fumes may play an important role in laryngeal carcinogenesis.
    B-ENT 01/2012; 8(4):273-8. · 0.08 Impact Factor
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    ABSTRACT: To determine whether tympanostomy tube insertion has benefit, compared with simple myringotomy, in children with otitis media with effusion who receive concurrent adenoidectomy as treatment for obstructive sleep apnoea syndrome caused by adenoid hypertrophy. Fifty-two children older than three years with obstructive sleep apnoea syndrome were randomly assigned to receive either adenoidectomy plus tympanostomy tube insertion (group one, n = 25) or adenoidectomy plus myringotomy (group two, n = 27). Pre- and post-operative health-related quality of life was assessed using the otitis media-6 (OM-6) tool, and audiological outcomes were recorded six and 12 months post-operatively. Group one showed better quality of life scores six months post-operatively (score difference -0.38, confidence interval -0.65 to -0.10) but not 12 months post-operatively (score difference -0.23, confidence interval -0.76 to 0.11), compared with pre-operative values. Audiological outcomes did not differ significantly at either time point, compared with pre-operative values. Tympanostomy tube insertion confers a short term benefit, compared with simple myringotomy, in children older than three years with otitis media with effusion who receive concurrent adenoidectomy as treatment for obstructive sleep apnoea syndrome. Further studies are necessary to identify which of these children will receive long-lasting benefit from tympanostomy tube insertion.
    The Journal of Laryngology & Otology 03/2011; 125(3):274-8. · 0.68 Impact Factor
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    ABSTRACT: To study the effect of functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis (CRS) and nasal polyps (NP) with concomitant asthma. The study was designed to evaluate prospectively whether FESS can influence parameters of asthma in patients with CRS with nasal polyps. One hundred thirty seven patients were recruited from the ENT-Allergy and Panedoscopy Clinic of the ENT Department. All selected patients underwent medical therapy for CRS and NP for 12 weeks, and in case of no improvement, they proceeded to surgical treatment. They also underwent pre- and post-treatment subjective and objective measurements for CRS and asthma. In the study, 86 patients were finally evaluated who completed the protocol and were followed up for a period of 12 months. The patients showed statistically significant improvement of the objective measurements for asthma, from baseline to six and twelve months follow-up. No significant increase was found in the proportion of patients with well or very well overall asthma-control during the follow-up period. There was a clear improvement in the use of bronchodilators, oral steroids and need for hospitalization for asthma. Obviously, there is a link between CRS with NP and asthma. The data analysis of our study supports the hypothesis that FESS could have beneficial effect on both diseases improving objective and subjective measurements.
    Rhinology 09/2010; 48(3):331-8. · 1.72 Impact Factor
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    ABSTRACT: To validate a disease-specific health related quality of life (HRQOL) instrument for children with chronic suppurative otitis media with or without cholesteatoma. Caregivers of 45 children with chronic suppurative otitis media, who were offered an operation (tympanoplasty or radical mastoidectomy) in a tertiary children's hospital, were administered a 5-item quality of life survey (COM-5) The COM-5, which is a modified version of OM-6, was administered four times: few weeks and few days before operation and six months and one year postoperatively. Psychometric characteristics and more specifically test-retest reliability, internal consistency, construct validity, and responsiveness to clinical change of the COM-5 score were the main outcome measures. Median COM-5 score was 2.6 (1- to 7-point scale) with higher scores indicating poorer quality of life. Test-retest reliability was good (interclass correlation coefficient=0.73) Construct validity was demonstrated by significant correlations between COM-5 score and global ear-related quality of life (R=-0.485), between physical suffering and ear-related physician visits (R=0.41) and between caregiver concerns vs ear-related physician visits (R=0.44). The mean change in COM-5 score after successful tympanoplasty was 1.1 and correlated well with the change of global ear-related quality of life rating (R=-0.545) as well as with the degree of clinical change reported by the caregiver (R=0.494). The mean standardized response was 1.3 after tympanoplasty indicating the instrument's large responsiveness to clinical change after this procedure, but only 0.7 after radical mastoidectomy. The COM-5 is a valid, reliable and responsive instrument. Apart from its satisfactory psychometric characteristics, it can be easily administered in caregivers of children who require a tympanoplasty due to chronic suppurative otitis media.
    International journal of pediatric otorhinolaryngology 03/2009; 73(3):363-9. · 0.85 Impact Factor
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    ABSTRACT: Our objective was to investigate the prognostic significance of bcl-2 protein, p53 protein and HLA-DR antigen expression in a group of surgically treated parotid cancer patients. We studied bcl-2, p53 and HLA-DR immunohistochemical expression in paraffin-embedded surgically removed tissue specimens derived from 26 patients with parotid cancer and 9 patients with Warthin parotid tumors operated between 2000 and 2006 at the Hippokration Hospital of Athens. The staining results were correlated with the patients' clinicopathological characteristics and clinical outcome. Bcl-2 expression was associated with a significantly decreased survival in patients with advanced tumor stage (P = 0.04), high grade lesions (P = 0.02), or cervical node involvement (P = 0.03). Radiotherapy was associated with a significantly improved recurrence-free survival among patients with negative tumor staining for either bcl-2, or both HLA-DR and bcl-2 [HLA-DR(-)/Bcl-2(-)] (P = 0.04 for both comparisons). Classical clinicopathologic factors failed to show prognostic value both in the univariate and the multivariate analyses performed. Our results suggest that bcl-2 can be used to identify locally advanced or histologically aggressive tumors with a lower survival probability following the application of standard treatment modalities. Furthermore, bcl-2(+) patients should be considered for more aggressive adjuvant treatment protocols, since conventional radiotherapy often fails to decrease relapse rates in this setting of patients.
    Archives of Oto-Rhino-Laryngology 07/2008; 266(3):417-24. · 1.29 Impact Factor
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    ABSTRACT: Acute tonsillitis or pharyngitis may lead to suppurative thrombophlebitis of the internal jugular vein. This complication, also known as Lemierre's syndrome, remains, even nowadays, life threatening, due to dissemination of septic thromboemboli to various organs. Respiratory deficiency and renal impairment are often reported in patients suffering from Lemierre's syndrome. The unusual clinical manifestation of this case involves severe acute renal and respiratory deficiency in addition to microangiopathic consumption coagulopathy in a young patient treated with macrolides five days after the onset of acute tonsillitis. The usual causative pathogen, namely Fusobacterium necrophorum, shows a varying sensitivity to macrolides. As a result, the syndrome may present itself in a variety of clinical forms even in patients under treatment with macrolides. A high index of suspicion is therefore crucial for in time prevention of potentially life threatening complications.
    The Journal of Laryngology & Otology 06/2008; 122(5):527-30. · 0.68 Impact Factor
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    ABSTRACT: To study the development of the organ of Corti in the human cochlea, and to correlate our findings with the onset of auditory function. Step sections of 81 human fetal temporal bones were studied, from eight weeks of gestation to full term. By the end of the 10th week, the tectorial membrane primordium could be traced even in the most apical turns. Individual hair cells became identifiable at the basal turn at 14 weeks. At the same time, a small but well formed oval space was observed between the inner and outer hair cells in the basal turn. This does not correspond to the tunnel of Corti, as is erroneously quoted in the literature, as the individual pillar cells develop at later stages. Between 14 and 15 weeks, Hensen's cells were recognised for the first time. Individual pillar cells were identifiable at 17 weeks and the tunnel of Corti opened at 20 weeks. By 25 weeks, the cochlea had reached its adult size, but continued to develop until full term. A temporal coincidence of different developmental events is responsible for early fetal audition at 20 weeks, including growth of pillar cells, opening of the tunnel of Corti and regression of Kollicker's organ, with the subsequent formation of the inner spiral sulcus and then separation of the tectorial membrane. The fine structures of the organ of Corti continue to develop well after the 25th week, and this may well alter the mechanical properties of the vibrating parts of the cochlea, which may in turn account for the frequency shift observed in preterm infants. These changes will have to be taken into account in the development of prenatal hearing screening tests.
    The Journal of Laryngology & Otology 05/2008; 122(4):336-42. · 0.68 Impact Factor
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    ABSTRACT: The characteristics of otoacoustic emissions that make them ideally suited for universal newborn hearing loss screening could potentially be useful for the screening of older children. This study was performed in order to assess the role of otoacoustic emissions in a screening programme for middle-ear disorders and hearing loss in school-age children. Cross-sectional, preliminary screening study. Primary schools of Argolida municipality, south-east Greece, between December 2004 and March 2005. PATIENT SELECTION AND RECRUITMENT: All the primary school students of Argolida were invited, by press releases and individually by their teachers, to attend a session of otological and audiological screening. One hundred and ninety-six children were evaluated using transient evoked otoacoustic emissions. Twenty per cent failed in both ears, while in 32 per cent otoacoustic emissions could not be produced in at least one ear. Younger children had higher rates of absent transient evoked otoacoustic emissions. The absence of otoacoustic emissions was highly correlated with tympanic membrane changes seen on otoscopy and the presence of a type B tympanogram. As a single screening modality, otoacoustic emissions had a 100 per cent sensitivity in diagnosing hearing loss worse than 30 dB, and a 90 per cent sensitivity and 64 per cent specificity in diagnosing hearing loss worse than 25 dB, which did not improve by adding tympanometry to the screening protocol. These results strongly suggest the potential usefulness of otoacoustic emission testing in screening school-age children for hearing loss. Further studies, taking into account cost-effectiveness issues, are indicated.
    The Journal of Laryngology & Otology 05/2008; 122(12):1299-304. · 0.68 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate hearing in a population of industrial workers exposed to occupational noise by using both conventional and extended high-frequency (EHF) audiometry, and to compare our results with the findings from a control group. A total of 139 industry workers exposed to noise were examined over a period of two years and 32 healthy subjects were used as controls. Conventional audiometry in the frequency range 0.25-8 kHz and EHF audiometry in the frequency range 9-20 kHz were performed. Thresholds in the noise-exposed group were higher than in the control group for both standard and extended high frequencies, but variability was greater in EHF. Larger differences were found in the 4,000-18,000 Hz frequency region, and especially in the 12,500-18,000 frequency zone. A statistically significant correlation between the elevation of puretone thresholds and time of exposure was found across all frequencies (from 250 to 20,000 Hz), with the exception of 10,000 Hz. EHF audiometry is a useful adjunct to conventional audiometry in the audiological assessment of subjects exposed to occupational noise. This test performs well in the frequency range 12,500-18,000 Hz, but there is greater variability in the results compared with conventional audiometry.
    B-ENT 02/2008; 4(3):147-55. · 0.08 Impact Factor
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    ABSTRACT: The treatment of acute lymphoblastic leukemia (ALL) often combines a neurotoxic chemotherapeutic protocol such as Berlin-Frankfurt-Munster-95 (BFM-95) with gentamicin, an antibiotic known to have an early and quickly reversed impact on olivocochlear reflex in animal studies. This study investigates whether this combination has any long-term side effects on the medial olivocochlear bundle (MOCB). In all 47 children of the study suppression of distortion product otoacoustic emissions (DPOAEs) by contralateral application of white noise (WN) was used to assess the function of the MOCB. The population was divided into three groups depending on the time interval between the end of therapy and examination. The group examined shortly after chemotherapy included 12 children who had received low gentamicin doses (less than 13 days). The group evaluated 2 years after therapy involved another 12 children who had required medium gentamicin doses (more than 13, less than 23 days). The group examined 3 years after therapy included a subgroup of 12 children to whom low gentamicin doses were infused and another 11 children with high gentamicin doses (more than 23 days). Three years after therapy the olivocochlear reflex was efficiently produced in both subgroups of low and high gentamicin doses. Two years after therapy, contralateral WN induced increase of DPOAEs at 4 of the 12 examined frequencies. Shortly after therapy, WN increased, instead of suppressing, DPOAEs at five frequencies. This abnormal result of contralateral noise application perceived as impaired cochlear efferent innervation may indicate that ALL-BFM-95 exerts a toxic effect on the MOCB, which is slowly reversed within the first 3 years after chemotherapy and does not seem to be affected in the long term by different cumulative doses of gentamicin.
    International Journal of Pediatric Otorhinolaryngology 12/2007; 71(11):1767-73. · 1.35 Impact Factor
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    ABSTRACT: Meningoencephaloceles are herniations of brain tissue through dehiscences of the skull base. These skull defects are either acquired (otologic infection, trauma, surgery, neoplasia) or spontaneous. Spontaneous temporal bone meningoencephaloceles are quite rare conditions, usually congenital in origin presenting during childhood, and only occasionally idiopathic presenting during adulthood. We present a case of temporal bone meningoencephalocele of adult onset. The patient was treated with exploratory mastoidectomy, amputation of the herniated cele and closure of the defect with temporalis fascia and an inferiorly based pedicled muscular flap. No reconstruction of the bony defect was performed, as the layered closure was considered adequate. Twelve months' follow-up revealed no relapse of the condition or postoperative complications.
    Skull Base Surgery 10/2007; 17(5):311-6. · 0.72 Impact Factor
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    ABSTRACT: Aim of this study was to investigate the clinical characteristics, management and prognosis of non-Hodgkin lymphomas of the nasal cavity and paranasal sinuses. Overall 12 patients with non-Hodgkin malignant lymphoma, at our Institute, were studied over an eight-year period from 1997 to 2005. Patients' data collected were age, sex, presenting signs and symptoms, histology, treatment, complications, and outcome. Also available were computerised tomography findings, and paraffin-embedded tissue bocks. Mean age was 62 years (range: 42-81), with a male dominance (male to female ratio: 7:5). Most patients had not presented any specific symptoms, such as nasal obstruction, headaches, epistaxis and facial swelling. Using immunocytochemistry on paraffin-embedded tissue sections, the predominance of large B-cell subtype was detected. Treatment administered: only radiotherapy (stage IEA) or in combination with chemotherapy (IIE-IVE). Of these patients, 5 died from the disease, 4 survived without disease, 2 survived with the disease, and one died of non-related causes. Non-Hodgkin's lymphomas are relatively rare. Early diagnosis, based mainly on tissue biopsy and computerised tomography, is essential in the management of non-Hodgkin lymphoma.
    Acta otorhinolaryngologica Italica: organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale 03/2007; 27(1):6-9. · 0.79 Impact Factor
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    ABSTRACT: The case of a hydatid cyst located in the duct of Wharton of a 56-year-old farmer is reported not only because of the unusual location of the disease, but also because the clinical manifestations and surgical findings of the hydatid cyst strongly resembled those of a salivary calculus in the duct of Wharton. The patient presented with a non-painful swelling of the right submandibular region. The mass, which appeared 5 years before seeking medical advice, augmented progressively during the first year after its onset and remained stable during the next 4 years. The subsequent surgical excision of the mass was uneventful and a round mass, which was palpated intraoperatively in the duct of Wharton was assumed to be a sialolith. The diagnosis for a hydatid cyst of the duct of Wharton was made by histological examination. Although salivary calculus is the most common finding in cases of obliteration of the duct of Wharton, histological examination of the surgically excised submandibular gland may reveal benign tumours. In extremely rare cases where hydatid cysts are located in the cervicofacial area, a detailed further diagnostic procedure is required in order to diagnose possible involvement of other organs.
    International Journal of Oral and Maxillofacial Surgery 03/2007; 36(2):177-9. · 1.52 Impact Factor
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    ABSTRACT: Vincristine is a well known neurotoxic chemotherapeutic agent. Dose dependent and cumulative peripheral neuropathy is the main dose limiting side effect of chemotherapy with vincristine. The mechanisms responsible for the neurotoxic effects of vincristine have not yet been fully understood. This prospective study was directed at determining whether vincristine treatment interferes with the function of the medial olivocochlear bundle. Fifteen children suffering from leukemia were subjected to tympanogram, stapedial muscle reflex, pure tone audiometry and transient evoked otoacoustic emissions (TEOAEs) in the absence and presence of contralateral white noise on day 1 and on day 22 of treatment with vincristine. The function of the medial olivocochlear bundle was assessed by the phenomenon of suppression of otoacoustic emissions by contralateral application of white noise. The study revealed a statistically significant decrease of contralateral suppression amplitudes in all cases after three sessions of chemotherapy with vincristine. On the contrary no alterations were observed in pure tone audiometry thresholds. A non-significant decrease of the mean TEOAEs' amplitudes was also noted. When analyzed by frequency, however, this decrease reached the level of statistical significance at two frequencies. Vincristine treatment seems to exert a neurotoxic effect on the efferent olivocochlear system, which takes place early in the course of chemotherapy. This is a new aspect to be added to the possible mechanisms underlying the toxicity of vincristine in the auditory periphery. Whether changes in efferent function might contribute to understanding the mechanisms of neurotoxicity caused by vincristine, or find any clinical application as a predictor or early detector of neurological side effects of vincristine still remains to be seen.
    International Journal of Pediatric Otorhinolaryngology 02/2007; 71(1):63-9. · 1.35 Impact Factor
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    ABSTRACT: The effect of very low birth weight on otoacoustic emissions. The aim of this study was to examine the effect of very low birth weight (VLBW) on the measurement of transiently evoked otoacoustic emissions (TEOAEs) in newborns. TEOAEs were recorded in all VLBW newborns (birth weight < 1500 g) who were admitted in the Neonatal Intensive Care Unit of the Iaso Maternity Hospital, during a period of 1 year. Twenty-four VLBW newborns were included in the study. Their mean birth weight was 1283 g and they had mean gestational age 31.3 weeks. Forty full-term newborns with absence of any risk factor for hearing impairment were used as controls. TEOAEs were present in 97.5% of controls, but only in 79.2% of the VLBW group. Statistically significant differences were found between VLBW newborns and controls in most TEOAE measures. Increased rate of initial 'fail' in hearing screening, in conjunction with statistically confirmed lower TEOAE measures in VLBW newborns, justifies special care and long term follow-up for this group of newborns.
    B-ENT 01/2007; 3(1):15-20. · 0.08 Impact Factor
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    ABSTRACT: Sudden sensorineural hearing loss (SSHL) remains a challenge for the clinician. In the majority of cases, no definite cause can be found and the prognosis is variable. The present study assessed 114 patients suffering from idiopathic SSHL, with regard to the prognostic value of demographic, epidemiologic, neurotologic and audiometric factors. In addition, the relationship between the identification of wave V in auditory brainstem responses and the final hearing outcome was investigated. All patients received 75 mg/day intravenous prednisolone, divided into three daily doses, for 10 days, with gradual tapering of the dose over the next 10 days. The results (after one year follow up) revealed the following factors to be related to a better hearing outcome: younger age; male sex; less time elapsed between the onset of hearing loss and the beginning of treatment; and an upward-sloping or cupeloid audiogram contour. The detection of wave V early in recovery and within the first month of medical treatment might also constitute a significant favourable factor in respect to hearing recovery. The present study revealed that there are certain factors that affect prognosis in idiopathic SSHL. This is very important in counselling patients and may affect current clinical practice.
    The Journal of Laryngology & Otology 10/2006; 120(9):718-24. · 0.68 Impact Factor
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    ABSTRACT: A discharging ear is a very common condition for the general practitioner and the ENT surgeon. Oral and intravenous antibiotics have potential complications, are costly, and exhibit increasing resistance. This study explores the advantages and disadvantages of all common otic preparations and compares effectiveness, safety, cost and complication rates. In chronic otitis media (chronic discharging ears), topical antibiotics seem to be the treatment of choice by comparison with oral or intravenous antibiotics. Cultures and antibiograms do not correspond directly to clinical efficacy, as laboratory determination of resistance does not take into account the high concentration of antibiotics in local preparations. It is safer to use quinolone drops as a first-line treatment, but it is still possible to use short courses of other drops if quinolones are either unavailable or contraindicated (e.g. allergy), or when bacteria are resistant to them. However, in such a situation, a round window membrane involved in an established inflammatory process and therefore less permeable to the passage of topical preparations is the preferred setting, as ototoxicity is a potential complication, especially in the case of gentamicin, in which case patients should be warned accordingly.
    International Journal of Clinical Practice 10/2006; 60(9):1115-9. · 2.43 Impact Factor
  • S Korres, D G Balatsouras, E Ferekidis
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    ABSTRACT: To evaluate the prognostic factors in benign paroxysmal positional vertigo (BPPV) treated with canalith repositioning procedures (CRPs). Retrospective study of consecutive BPPV cases diagnosed over three years. All patients underwent a complete otolaryngologic, audiologic and neurotologic evaluation. The appropriate CRP was performed, depending on the type of BPPV. Prognostic factors studied included age, sex, aetiology, duration of disease, abnormal electronystagmographic findings, canal involvement, improper performance of manoeuvres, response on first or repeat treatment, and presence of recurrences. One hundred and fifty-five patients were studied, 66 men and 89 women, with mean ages of 58.7 and 60.4 years, respectively. Age and the involvement of two canals or bilateral disease had an effect on initial treatment outcome and were correlated to increased recurrences but not to repeat treatment outcome. Secondary BPPV, abnormal electronystagmographic findings and improper performance of manoeuvres had a significant effect both on initial and repeat treatment, but not on recurrences. Sex and duration of symptoms had no effect. Canalith repositioning procedures provide fast and long-lasting treatment of BPPV in most patients. However, in a small subgroup of patients, failures may be noticed that may be attributed to various prognostic factors.
    The Journal of Laryngology & Otology 08/2006; 120(7):528-33. · 0.68 Impact Factor
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    ABSTRACT: Although systemic steroids in sudden sensorineural hearing loss (SSHL) appears to be the most effective and the most widely accepted treatment today, a significant number of patients do not respond to steroid treatment or they cannot receive steroids for medical reasons. Intratympanic (IT) administration of steroids appears to be an alternative or additional method of management without the side effects of intravenous steroids. The aim of this study is to investigate the effectiveness and safeness of IT administration of steroids in patients who had not responded to IV treatment and to compare treatment efficacy with controls. Our study consisted of 37 patients with SSHL who, at the end of 10 days of therapy with intravenous steroids as a 1st line treatment, had pure-tone 4-frequency (0.5, 1, 2, and 4 kHz) average (PTA) of worse than 30 dB or worse than 10 dB from the contralateral ear (defined as failed intravenous treatment). They were randomized into 2 groups, treatment and control. The 19 patients of the treatment group received approximately 0.5 mL sterile aqueous suspension of methylprednisolone acetate in a concentration of 80 mg/2 mL by direct injection. The procedure was carried out 4 times within a 15-day period. An audiogram was performed before each injection and approximately 1.5 months after the last session. All patients tolerated the procedure well. No perforation or infection was noticed in any of the patients at their last visit. With regard to the 19 patients who received intratympanic treatment, in 9 patients, the PTA threshold improved more than 10 db, in 10 patients there was no change greater than 10 db, and no patients deteriorated more than 10 db. In the control group, none of the patients showed any change greater than 10 db. The difference was statistically significant (P = 0.002). The treatment group showed an improvement in mean PTA of 14.9 dB, whereas the control group showed a deterioration of 0.8 dB, and this difference also was statistically significant (P = 0.0005). IT treatment (P = 0.0001), better post-IV PTA (P = 0.0008), and absence of vertigo (P = 0.02) were good predictors of the outcome. In contrast, sex, age, affected ear, days to admission, and pattern of the initial audiogram showed no significant influence on the outcome. IT steroid administration after failed intravenous steroids is a safe and effective treatment in sudden sensorineural hearing loss.
    Otolaryngology Head and Neck Surgery 07/2006; 134(6):940-5. · 1.73 Impact Factor

Publication Stats

291 Citations
50.82 Total Impact Points

Institutions

  • 2008
    • Academisch Medisch Centrum Universiteit van Amsterdam
      Amsterdamo, North Holland, Netherlands
    • National and Kapodistrian University of Athens
      • Division of Anatomy
      Athínai, Attica, Greece
  • 1997–2008
    • Hippokration General Hospital, Athens
      Athínai, Attica, Greece
  • 1994–2008
    • Athens State University
      Athens, Alabama, United States
  • 1996–2007
    • Aglaia Kyriakou Children's Hospital
      Athínai, Attica, Greece
  • 2005
    • Tzaneio General Hospital of Piraeus
      Le Pirée, Attica, Greece