Radiotherapy and Local Laryngeal Defense..?
A not-too-recent study from Japan (Nakashima T et al, J Laryngol Otol. 2005 Dec;119(12):976-80.)studied the influence of neck irradiation for laryngeal cancer and observed that local defense function of the larynx may be impaired by radiotherapy

Abstract: To elucidate the influence of radiation therapy on the larynx in patients who receive radiotherapy to the neck, we observed the changes in the distribution of the laryngeal glands. Human adult larynges from patients with either laryngeal or hypopharyngeal cancer were histopathologically examined, and the changes in the glandular distribution as well as in the ratio of serous or mucous type cells were surveyed using an image analysis system. The mean ratio of the area occupied by glandular acini in the subglottic larynx was 0.182 in the non-radiation group and 0.098 in the radiation group (p < 0.001). Although no statistical difference was observed, the average density of the glands decreased and the average ratio of serous-type/mucous-type glandular cells decreased in the irradiated larynx. The glandular acini are often replaced with fibrous connective tissue and the ratio of serous-type glandular cells decreases. These results indicate that not only the voice function but also the local defence function of the larynx might be impaired after radiotherapy.
 

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Coming Events of Importance to Otolaryngologists in Africa...
 

1. 8th International Otology Course of the Jean Causse Ear Clinic
   June 22-24, 2006; Béziers, France
2. 110th American Academy of ORL,Head & Neck Surgery Annual Meeting & OTO EXPO
   September 17-20, 2006;
   Toronto, Canada.
3. 42nd South African ENT Congress joint meeting with the British Association of Otolaryngology - Head & Neck Surgery
   October 29-November 1, 2006;
   Cape Town, South Africa.

         For more Worldwide otolaryngological events and conferences....Click Here

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CAP in Older Person - What is the Odd.....?       

The dysfunction in the auditory component of the CNS, dubbed central auditory processing (CAP) disorder, is often elicited using central auditory test battery which includes both both dichotic and speech-in-noise measure. Yet known potential risk markers for CAP in older persons include cardiovascular disease, smoking, cognitive decline, hypertension, among others. Golding, Taylor, Cupples & Mitchell in a recent publication (Ear and Hearing, Volume 27(2), April 2006, pp 129-138) determine the odds of demonstrating CAP abnormality for the average older person, based on performance outcomes from a number of measures of CAP abnormality together with a number of potential risk markers and measures of perceived handicap and observed that this combination increases the odds of demonstrating CAP in older persons.

Abstract: Objective: To determine, for the average older adult, the odds of demonstrating an auditory processing abnormality for each of seven speech-based measures of auditory processing and how these odds vary based on a number of independent subject variables. Design: Using a cross-sectional design, 1576 adults aged 55 years and older were assessed with speech measures of central auditory processing and questionnaires pertaining to health status, cognitive and perceived auditory function. The speech-based measures from which abnormal/normal outcomes were derived were (a) right ear Macquarie Synthetic Sentence Identification (MSSI) test maximum performance score (Rt MSSImax), (b) left ear MSSI test maximum performance score (Lt MSSImax), (c) right ear Macquarie Dichotic Sentence Identification (MDSI) test score (Rt MDSI), (d) left ear MDSI test score (Lt MDSI), (e) difference score for the right and left ear MDSI test (MDSI Diff score), (f) right ear MSSI test maximum performance score subtracted from the maximum performance score for monosyllabic word list materials in the same ear (Rt PB-MSSImax), and (g) left ear MSSI test maximum performance score subtracted from the maximum performance score for monosyllabic word list materials in the same ear (Lt PB-MSSImax). Results: The odds of demonstrating auditory processing abnormality for average older participants, increased by 4 to 9% per year of age. Men were approximately twice as likely as women to demonstrate this abnormality, but the gender difference was only evident with dichotic measures. With increasing hearing handicap, the odds of demonstrating auditory processing abnormality increased, but this was only evident for speech-in-noise measures. With subtle cognitive decline, the odds of demonstrating auditory processing abnormality also increased. Conclusions: This population-based study provides evidence of a link between perceived hearing handicap and outcomes on speech-in-noise measures as well as evidence of a gender difference that became apparent using dichotic tests. The contribution of central auditory processing abnormality to hearing health should therefore not be overlooked in the provision of auditory rehabilitation programs to older adults

What is the diagnosis?

• Parting Shot...
  If you have an interesting case to discuss or share with other Otolaryngologists all over Africa, feel free to email Me or at best go to otolaryngology in Africa blogsite and post your case
• Also, if you are among those who requested for a copy of DODA at the last ORLSON Meeting @ Port Harcourt, please take time to view the DODA - FAQ page, you should have received your copy by now. If you have difficulty on using the program, please text +2348032472069.
• An online video demonstration of doda is available at http://www.otolaryngologyinafrica.net/doda_video.htm  This video takes about 30 - 45 minutes to fully load on a broad band network the first time, but once fully loaded could be viewed over and over again
• If you have anything you want to communicate with other Otolaryngologists - news, request, etc, feel free to email your communication to orl-mailer@ otolaryngologyinafrica.net. Your request will appear in member's page soon to be created.
• Reviewers wanted for otolaryngology news journals watch page. If you are an Otolaryngologist in Africa and will like to be our journal reviewer, please feel free to email orl-mailer@otolaryngologyinafrica.net
• DODA 2006, capable of advanced hearing measure, and also paediatric hearing assessment is being developed. If you requested for and got a free copy of DODA, you may also look out for this latest version dubbed DODA 2006, as well as for an additional page on outcome of hearing assessment using DODA.

Till Next Week,

Biodun

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