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Song M, Hoon SJ, Shin TM. An anti-barotrauma system for preventing barotrauma during hyperbaric oxygen therapy. Undersea Hyperb Med 2018; 45:19-25. [PMID: 29571228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In the present study, a tympanometry-based anti-barotrauma (ABT) device was designed using eardrum admittance measurements to develop an objective method of preventing barotrauma that occurs during hyperbaric oxygen (HBO₂) therapy. The middle ear space requires active equalization, and barotrauma of these tissues during HBO₂therapy constitutes the most common treatment-associated injury. Decongestant nasal sprays and nasal steroids are used, but their efficacy is questionable to prevent middle ear barotrauma (MEB) during HBO₂ treatment. Accordingly, a tympanometry-based ABT device was designed using eardrum admittance measurements to develop an objective method for preventing MEB, which causes pain and injury, and represents one of the principal reasons for patients to stop treatment. This study was conducted to test a novel technology that can be used to measure transmembrane pressures, and provide chamber attendants with real-time feedback regarding the patient's equalization status prior to the onset of pain or injury. Eardrum admittance values were measured according to pressure changes inside a hyperbaric oxygen chamber while the system was fitted to the subject. When the pressure increased to above 200 daPa, eardrum admittance decreased to 16.255% of prepressurization levels. After pressure equalization was achieved, eardrum admittance recovered to 95.595% of prepressurization levels. A one-way repeated measures analysis of variance contrast test was performed on eardrum admittance before pressurization versus during pressurization, and before pressurization versus after pressure equalization. The analysis revealed significant differences at all points during pressurization (P⟨0.001), but no significant difference after pressure equalization was achieved. This ABT device can provide objective feedback reflecting eardrum condition to the patient and the chamber operator during HBO₂ therapy.
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Affiliation(s)
- Moon Song
- Department of Biomedical Engineering, Yonsei University, Wonju, Korea
| | - Se Jeon Hoon
- Department of Biomedical Engineering, Yonsei University, Wonju, Korea
| | - Tae Min Shin
- Department of Biomedical Engineering, Yonsei University, Wonju, Korea
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Meng FC, Shen CH, Chu CM, Shih CP, Lin HC, Peng CK, Chang SC, Huang KL. Dried salted plum consumption ameliorates hyperbaric oxygen therapy-induced otalgia severity at the first chamber session: a prospective randomized controlled study. Undersea Hyperb Med 2017; 44:551-557. [PMID: 29281192 DOI: 10.22462/11.12.2017.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE One of the most common complications of hyperbaric oxygen (HBO₂) therapy is middle ear barotrauma (MEB), occasionally causing otalgia. The objective of this study was to evaluate the effect of dried salted plum consumption on MEB and otalgia associated with HBO₂ therapy. MATERIALS AND METHODS Patients undergoing the first chamber session of HBO₂ therapy were included in the present prospective randomized controlled trial. The Valsalva maneuver was administered to all patients before HBO₂. The patients were randomly divided into two groups: one that ate a dried salted plum during HBO₂ treatment and the other that did not. An otoscopic examination was performed after HBO₂ therapy. The MEB was graded according to Teed scores. The degree of otalgia was recorded using the Visual Analog Scale (VAS). RESULTS Ninety patients were enrolled. The overall incidence of MEB (Teed score grade 1~4) was 39.6% (21 of 53) for patients administered a dried salted plum versus 37.8% (14 of 37) for the control group (P=1.000). The incidence of mild MEB (Teed score grade 1~2) and severe MEB (Teed score Grade 3~4) between the two groups was not significantly different. Otalgia was present in 5.7% (3 of 53) of patients administered a dried salted plum versus 18.9% (7 of 37) for the control group (P=.085). No patients administered a dried salted plum had a VAS score ≥4 for otalgia versus 10.8% (4 of 37) for the control group (P=.026). CONCLUSIONS Dried salted plum consumption does not decrease the incidence of MEB, but may ameliorate the severity of first chamber session HBO₂-induced otalgia.
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Affiliation(s)
- Fan-Chun Meng
- Hyperbaric Oxygen Therapy Center, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Hao Shen
- Hyperbaric Oxygen Therapy Center, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Ming Chu
- Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Cheng-Ping Shih
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hung-Che Lin
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Kan Peng
- Hyperbaric Oxygen Therapy Center, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shun Cheng Chang
- Division of Plastic Surgery, Department of Surgery, Hyperbaric Oxygen Therapy Center, Shuang-Ho Hospital, New Taipei City, Taiwan
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kun-Lun Huang
- Hyperbaric Oxygen Therapy Center, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan
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Wright T. Middle-ear pain and trauma during air travel. BMJ Clin Evid 2015; 2015:0501. [PMID: 25599243 PMCID: PMC4298289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Changes in air pressure during flying can cause ear-drum pain and perforation, vertigo, and hearing loss. It has been estimated that 10% of adults and 22% of children might have changes to the ear drum after a flight, although perforation is rare. Symptoms usually resolve spontaneously. METHODS AND OUTCOMES We conducted a systematic review and aimed to answer the following clinical question: What are the effects of interventions to prevent middle-ear pain during air travel? We searched: Medline, Embase, The Cochrane Library and other important databases up to July 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS We found three studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS In this systematic review we present information relating to the effectiveness and safety of the following interventions: nasal balloon inflation, nasal decongestants (topical), and oral pseudoephedrine.
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Affiliation(s)
- Tony Wright
- Emeritus Professor of Otolaryngology, UCL Ear Institute, London, UK
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Don't let flying make you sick. Consum Rep 2008; 73:8. [PMID: 19125495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Abstract
Frequent flyer business travelers experience recurrent ear problems. Common causes and prevention are discussed.
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Affiliation(s)
- Olga Tompkins
- Occidental Oil and Gas Corporation, Houston, TX, USA
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Zodpe P, Cho JG, Kang HJ, Hwang SJ, Lee HM. Efficacy of sucralfate in the postoperative management of uvulopalatopharyngoplasty: a double-blind, randomized, controlled study. ACTA ACUST UNITED AC 2006; 132:1082-5. [PMID: 17043255 DOI: 10.1001/archotol.132.10.1082] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of sucralfate in influencing throat pain, otalgia, analgesic requirement, bleeding, mucosal recovery, and incidence of postoperative bleeding in patients undergoing uvulopalatopharyngoplasty. DESIGN A prospective double-blind randomized study. SETTING University-affiliated tertiary referral hospital. PARTICIPANTS Eighty adult patients with obstructive sleep apnea syndrome requiring uvulopalatopharyngoplasty were recruited and randomly allocated into either a sucralfate treatment group or a control group. INTERVENTIONS All patients underwent uvulopalatopharyngoplasty. Patients enrolled in the sucralfate group (n=40) were instructed to gargle the sucralfate suspension and then to swallow. Patients enrolled in the control group (n=40) were instructed to gargle placebo suspension at the same doses and schedule. MAIN OUTCOME MEASURES Postoperative throat pain, otalgia, amount of analgesic required, degree of strength (defined as patients' general well-being and return to regular daily activities), percentage of mucosal covering, and postoperative bleeding. RESULTS Throat pain and otalgia occurred significantly less often in sucralfate group, with less analgesic requirement and with rapid mucosal healing and early return to regular daily activities. There was no significant difference in episodes of postoperative bleeding between the 2 groups (P=.37). CONCLUSIONS Although sucralfate therapy may not provide complete analgesia after uvulopalatopharyngoplasty, it may reduce the amount of analgesic required, thus preventing dose-related adverse effects from the analgesic agent. It can also significantly reduce the total number of days needed to return to normal daily activities (P=.41).
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Affiliation(s)
- Prakash Zodpe
- Department of Otorhinolaryngology-Head and Neck Surgery, Communication Disorder Institute of Medical Science Research Center, Korea University College of Medicine, Seoul, South Korea
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Basu A. Middle ear pain and trauma during air travel. Clin Evid 2005:666-8. [PMID: 16620427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Affiliation(s)
- Arin Basu
- Guru Tegh Bahadur Medical Center, West Bengal, India
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Abstract
BACKGROUND First line antibiotic treatment of uncomplicated acute otitis media has been questioned. PATIENTS AND METHODS In an prospective, open, controlled study, 390 children aged 1-10 years were treated either conventionally (free combinations of decongestant nose drops, mucolytics, analgesics and antibiotics) or alternatively with Otovowen, supplemented by conventional medications when considered necessary. RESULTS Patients treated conventionally took more antibiotics (80.5% vs 14.4%) and analgesics (66.8% vs 53.2%). The time to recovery (5.3 vs 5.1 days) and absence from school or pre-school nursery (both 1.7 days) were not significantly different between groups. Pain resolution was slightly better with conventional treatment (-5.8 vs -5.2 score points). The alternative treatment was judged both by doctors, and parents, to be significantly better tolerated. CONCLUSION In uncomplicated acute otitis media of childhood, an alternative treatment strategy with the natural medicine Otovowen may substantially reduce the use of antibiotics without disadvantage to the clinical outcome.
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Kahan E, Gross S, Cohen HA. Exclusion of ill children from child-care centers in Israel. Patient Educ Couns 2005; 56:93-97. [PMID: 15590228 DOI: 10.1016/j.pec.2003.12.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2003] [Revised: 12/14/2003] [Accepted: 12/28/2003] [Indexed: 05/24/2023]
Abstract
The aim of the study was to examine criteria for ill children in child-care centers. A questionnaire on practices of exclusion/return of children according to specific signs and symptoms was mailed to the directors of care centers in central Israel. Thirty-six of the 60 questionnaires (60%) were returned by mail and the reminded were completed in personal visits to the CCCs achieving a response rate of 100%. About half (51.7%) used "common sense" and "personal feelings" to exclude children and to allow their return, and 29 (48.3%) used the guidelines of the Ministries of Education and Health or other authorities. The percentage of centers excluding children by signs/symptoms was as follows: high fever (>38 degrees C), 100%; low-grade fever, 76.7%; asthma exacerbation, 80.0%; heavy cough, 75.0%; eye discharge or conjunctivitis, 83.3%; diarrhea and vomiting more than twice per day, 100%; rash, 72.3%; otalgia, 46.7%; and infected skin lesion, 66.7%. Only four centers excluded children with head lice. Most centers required a physician's note on return of a child after high fever (76.7%), eye discharge or conjunctivitis (48.3%), and from 75 to 80%, respectively, for frequent vomiting and bloody or mucinous diarrhea. The results show that exclusion practices among child-care centers (CCCs) vary widely, suggesting the need for the establishment of a uniform exclusion and return policy in Israel, with distribution of clear, up-to-date guidelines on the prevention and control of communicable diseases to all day-care centers. In a simple way, this study identified attitudes concerning the exclusion/return of sick children in CCCs and was useful for the discussion of the related policy with CCCs responsible and national health and educational authorities.
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Affiliation(s)
- Ernesto Kahan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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I often get discomfort, even pain, in my ears when I fly. Is there a way to prevent this? Johns Hopkins Med Lett Health After 50 2004; 17:8. [PMID: 15199890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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Janvrin S. Middle ear pain and trauma during air travel. Clin Evid 2004:673-6. [PMID: 15652028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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High-flying health tips. Safeguard your health in the air with advance knowledge and preparation. Harv Womens Health Watch 2004; 11:4-5. [PMID: 15153381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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Janvrin S. Middle ear pain and trauma during air travel. Clin Evid 2003:574-6. [PMID: 15366154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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Bjorne A, Agerberg G. Symptom relief after treatment of temporomandibular and cervical spine disorders in patients with Meniere's disease: a three-year follow-up. Cranio 2003; 21:50-60. [PMID: 12555932 DOI: 10.1080/08869634.2003.11746232] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study describes the coordinated treatment of temporomandibular disorders (TMD) and cervical spine disorders in patients diagnosed with Meniere's disease. The aim was to follow up treatment outcomes for three years with regular follow-up examinations every six months. Of the 31 patients with Meniere's disease who participated in a controlled comparative study on the signs and symptoms of TMD, 24 participated in a subsequent controlled comparative study on the signs and symptoms of cervical spine disorders (CSD). These 24 Meniere's disease patients (ten males and 14 females) agreed to participate in this longitudinal study. At each follow-up, their symptoms were evaluated using self-administered questionnaires and visual analog scales (VAS). The results of the coordinated treatment showed simultaneous decreases in the intensities of vertigo, nonwhirling dizziness, tinnitus, feeling of fullness in the ear, pain in the face and jaws, pain in the neck and shoulders, and headache that were both longitudinal and highly significant. Significant longitudinal reductions in the frequencies of vertigo, nonwhirling dizziness, and headache were also reported by the patients as well as a complete disappearance of pain located in the vertex area. A significant relief of TMD symptoms and a decrease in nervousness was also achieved. The results showed that a coordinated treatment of TMD and CSD in patients with Meniere's disease is an effective therapy for symptoms of this disease. The results also suggested that Meniere's disease has a clear association with TMD and CSD and that these three ailments appeared to be caused by the same stress, nervousness, and muscular tension.
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Affiliation(s)
- Assar Bjorne
- Vertigo Tinnitus, and Pain Unit, Ystad Hospital, Public Dental Service, County of Skåne, Sweden.
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Janvrin S. Middle ear pain and trauma during air travel. Clin Evid 2002:466-8. [PMID: 12230671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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Zenian J. Pillow otalgia. Arch Otolaryngol Head Neck Surg 2001; 127:1288. [PMID: 11587620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Ishiyama A. Why does air travel cause earache? West J Med 1999; 171:106. [PMID: 10510656 PMCID: PMC1305770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- A Ishiyama
- Department of Surgery, University of California at Los Angeles 90095, USA.
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Abstract
BACKGROUND Young children often appear bothered by ear pain during ascent and descent while traveling on commercial airplanes. While pseudoephedrine hydrochloride is effective in decreasing the risk for earache in adults with recurrent air travel-associated ear pain, such use in children has not been studied. OBJECTIVE To assess the efficacy and side effects of prophylactic pseudoephedrine in children traveling by air. DESIGN A placebo-controlled, double-blind clinical trial. SUBJECTS AND METHODS Children aged 6 months to 6 years were included in this study. Pseudoephedrine hydrochloride (1 mg/kg body weight) or placebo was administered 30 to 60 minutes prior to departure on commercial air flights. Caregivers noted historical details and the degree of apparent ear pain, drowsiness, and excitability with ascent and descent. RESULTS Ninety-one flights involving 50 children were studied, with ear pain being reported in 13 (14%) of flights. Ear pain was not associated with a history of air travel-associated ear pain, recent ear infection, or recent upper airway symptoms. Pseudoephedrine use was not associated with a decrease in ear pain during either ascent (4% with pseudoephedrine vs 5% with placebo; P approximately 1.00) or descent (12% with pseudoephedrine vs. 13% with placebo; P approximately 1.00). Pseudoephedrine use was, however, linked to drowsiness at takeoff (60% with pseudoephedrine vs. 27% with placebo; P = .003) but not at landing (P = .39). Treatment was not associated with excitability at takeoff (P = .09) or landing (P approximately 1.00). CONCLUSIONS Ear pain is not uncommon in children traveling by commercial aircraft. The predeparture use of pseudoephedrine does not decrease the risk for in-flight ear pain in children but is associated with drowsiness.
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Affiliation(s)
- B J Buchanan
- Department of Pediatrics, University of California, Davis, USA
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Abstract
OBJECTIVE To determine the most effective method of short-term middle ear aeration in patients unable to tolerate hyperbaric oxygen (HBO) therapy. STUDY DESIGN Prospective study comparing two methods of short-term tympanostomy in each patient. METHODS Seventeen adult patients were referred for management of barotitis and inability to tolerate hyperbaric oxygen therapy (HBO). Each patient underwent CO2 laser tympanostomy on the right ear and tympanostomy with T-tube placement in the left ear. The tube was removed on completion of HBO. Patients were asked to rate pain and their satisfaction with each method of tympanostomy using a visual analog scale. Otorrhea, persistent perforation, recurrent barotitis, hearing loss, and otalgia occurring during the study period were documented. RESULTS Laser tympanostomy was associated with a significantly lower incidence of otorrhea but was attended by recurrent barotitis in four of 16 patients. Laser tympanostomy was perceived as being less painful and was rated higher in overall satisfaction. CONCLUSIONS Laser tympanostomy is an effective method for management of barotitis in patients unable to tolerate HBO. Otorrhea is significantly reduced, although a risk of recurrent barotitis exists if the laser perforation closes prior to completion of HBO. Both methods of short-term tympanostomy reduce complications when compared with a retrospective cohort.
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Affiliation(s)
- J T Vrabec
- Department of Otolaryngology, University of Texas Medical Branch, Galveston, USA
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Karjalainen M, Le Bell Y, Jämsä T, Karjalainen S. Prevention of temporomandibular disorder-related signs and symptoms in orthodontically treated adolescents. A 3-year follow-up of a prospective randomized trial. Acta Odontol Scand 1997; 55:319-24. [PMID: 9370031 DOI: 10.3109/00016359709114971] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Recommendations about the need for occlusal adjustment after malocclusion therapy are inconclusive. A total of 123 orthodontically treated healthy adolescents (88 girls, 35 boys; 14.8 +/- 1.7 years old) agreed to participate in the present study. The subjects were interviewed and examined for signs and symptoms related to temporomandibular disorder (TMD) and were randomly allocated to intervention (n = 63) and control (n = 60) groups. At base line, occlusal adjustment was carried out for the intervention group and repeated every 6 months thereafter as needed. Mock adjustments were performed for the control group. At the end of the 3rd year 118 subjects (96%) turned up for re-examination. The number of subjects with palpatory pain of the masticatory muscles, and with occlusal centric slides decreased significantly in the intervention group but not in the control group (P < 0.001). In conclusion, occlusal adjustment therapy may prevent the occurrence of TMD signs in orthodontically treated healthy adolescents.
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Abstract
The rising numbers of legal cases relating to delay in the diagnosis of acoustic neuroma, combined with the increasing availability of magnetic resonance, is increasing pressure on otologists to make an early definitive diagnosis of cerebellopontine angle tumours. Unilateral or asymmetrical otologic symptoms not explained by external or middle ear disease are elicited in 16.6% of 500 consecutive attenders to an otolaryngology clinic. An agreed policy of risk stratification of patients with unexplained asymmetric otological symptoms is required if expense is to be limited and litigation minimized.
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Affiliation(s)
- E W Fisher
- Royal National Throat, Nose and Ear Hospital, London, UK
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Byers PH. Infant crying during aircraft descent. Nurs Res 1986; 35:260-2. [PMID: 3638605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The phenomenon of infant crying during aircraft descent is described, based on in-flight observations of 37 infant-mother pairs and mother interviews. The hallmark was crying during descent that was not alleviated by mothers' strategies that had been effective prior to descent. A significant relationship was found between bottle feeding and crying during descent; 18 (78%) of nonfeeding infants cried, compared with 4 (29%) of the bottle feeders. All infants with colds cried during descent, and descent crying always occurred more than 9 minutes after adults perceived the need to clear their ears. Only 4 of the 22 mothers (18%) with crying infants attributed the crying to ear pain, yet the findings support the explanation of otalgia due to inadequate middle ear ventilation. Developmental factors that put airborne infants at risk for otic barotrauma, educational implications, and directions for future research are discussed.
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