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pubmed: 0165-5876

Maternal breastfeeding, parafunctional oral habits and malocclusion in adolescents: A multivariate analysis.
Thomaz EB, Cangussu MC, Assis AM Maternal breastfeeding, parafunctional oral habits and malocclusion in adolescents: A multivariate analysis. Int J Pediatr Otorhinolaryngol. 2012 Feb 4; Authors: Thomaz EB, Cangussu MC, Assis AM Abstract OBJECTIVE: Malocclusion may result in esthetic impairment and functional disorders such as bad chewing, speech and swallowing, with a negative impact on quality of life. There is uncertainty regarding the effects of breastfeeding on dentofacial malocclusions. The purpose of the study was to evaluate the relationship between maternal breastfeeding and dental malocclusions and facial characteristics in adolescents with permanent dentition. METHODS: Probabilistic sampling of 2060 12- to 15-year-old students in a cross-sectional study was used. Malocclusion, as defined by Angle, and facial characteristics were the dependent variables. The duration of breastfeeding was the main independent variable. Other covariates were tested as effect modifiers or confounders. The associations were estimated using the odds ratio (OR) in multinomial logistic regression analysis (α=5%). RESULTS: There was an association between a short duration of breastfeeding (less than 6 months) and Angle class II (OR=3.14; 95% CI: 1.28-7.66) and class III (OR=2.78; 95% CI: 1.21-6.36) malocclusion only in students with a prolonged history of bruxism. A higher occurrence of severe convex profile (OR=3.4; 95% CI: 0.63-18.26) and a lower occurrence of cancave profile (OR=0.43; 95% CI: 0.21-0.88) were also observed only among adolescents who had been breastfed for a short period and exposed to a long periods of mouth breathing. CONCLUSIONS: These findings support the hypothesis that breastfeeding alone seems not to be directly associated with malocclusions, but it may have a synergetic effect with parafunctional oral habits on the development of occlusofacial problems. It is recommended that deleterious oral habits be avoided, especially by children who were breast-fed for less than 6 months. PMID: 22310072 [PubMed - as supplied by publisher]
ABR-based newborn hearing screening with MB11 BERAphone(®) using an optimized chirp for acoustical stimulation.
Cebulla M, Shehata-Dieler W ABR-based newborn hearing screening with MB11 BERAphone(®) using an optimized chirp for acoustical stimulation. Int J Pediatr Otorhinolaryngol. 2012 Feb 4; Authors: Cebulla M, Shehata-Dieler W Abstract OBJECTIVE: At our center, the Maico MB11 BERAphone(®) device is used for newborn hearing screening based on Auditory Brainstem Responses (ABR). In 2006, an optimized chirp stimulus was implemented in the device to increase the reliability and quality of the screening method. In 2002, an automated response detection algorithm had been implemented. This study analyzes the screening results using the MB11 BERAphone(®) device with the implemented chirp stimulus and automated response detection method. METHODS: The data presented were collected in the well-baby nursery as part of the newborn hearing screening program following a two stage screening protocol. To focus the study on the typical routine screening, data from at-risk babies were not included. Overall, data from 6866 babies (3604 males and 3262 females) screened from March 2006 to April 2011 were analyzed in this study. RESULTS: Out of the 6866 babies screened, 6607 passed bilaterally prior to hospital discharge (defined as 1st stage in this hearing screening program). Therefore, the pre-discharge pass rate of the hearing screening with the MB11 BERAphone(®) device was 96.2%. The resulting referral rate was 3.8%. The median test time per ear (excluding time for preparation and data reporting) was 28s with a range of 15-112s (5-95th percentile). The number of infants referred for 2nd stage, post-discharge re-screening was 259. Of this group, 71 passed bilaterally and 188 failed the re-screening in one or both ears. Therefore, including both the pre-discharge and post-discharge screening results, the bilateral pass rate was 97.3% and 2.7% were referred for diagnostic evaluation. Diagnostic testing was performed on all of the 188 infants who were referred. Results showed that 47 of these babies had hearing loss. This equates to a positive predictive value for a refer result of 25%. The observed prevalence of hearing impairment in our population was 0.684%. Diagnostic results for 141 of the referred newborns proved that they had normal hearing. That is, 141 out of 6866 newborns had a false-positive result with the MB11 BERAphone(®) screening. Therefore, the device had a specificity of 97.9%. During the time period of this study, no baby who passed the hearing screening was later found to have hearing impairment, suggesting a sensitivity of 100%. However, due to the limited number of newborns and the short time period after screening for the more recently screened babies, a reliable estimate of the sensitivity cannot be yet made from our program statistics. The theoretical sensitivity of the MB 11 device is 99.9%. CONCLUSIONS: The Maico MB11 BERAphone(®) is a reliable device for auditory brainstem response newborn hearing screening and it provides results within a very short time. Due to the implemented method for automatic detection of ABR, the use of the device does not require an experienced examiner, allowing it to be used by trained technicians in locations outside the department of audiology such as the well-baby nursery. PMID: 22310071 [PubMed - as supplied by publisher]
Chronic rhinosinusitis in children-Bacteriological analysis in terms of cytological examination.
Brożek-Mądry E, Chmielik LP, Gałązka A, Rogulska J, Frąckiewicz M, Biejat A Chronic rhinosinusitis in children-Bacteriological analysis in terms of cytological examination. Int J Pediatr Otorhinolaryngol. 2012 Feb 1; Authors: Brożek-Mądry E, Chmielik LP, Gałązka A, Rogulska J, Frąckiewicz M, Biejat A Abstract INTRODUCTION: The mechanisms of inflammatory response occurring in chronic rhinosinusitis in children are multifactorial. Besides the history and a physical examination, amongst diagnostic tools there are cytological and bacteriological examinations. OBJECTIVES: MATERIALS AND METHODS: The study group included 64 patients with chronic rhinosinusitis without polyps. The control group included 30 randomly chosen children. Diagnostic tests performed in both groups were: middle meatal culture and cytological examination from the inferior nasal concha and middle meatus. Statistical analysis was accomplished with Statistica 8.0. RESULTS: CONCLUSIONS: Damage to the respiratory epithelial surface is understood as damage to the innate immune barrier, and repeated antibiotic therapy with the subsequent repopulation of the epithelium accidentally by various bacteria can become responsible for the pathogenic effect of bacteria in chronic rhinosinusitis. PMID: 22305689 [PubMed - as supplied by publisher]
Probiotics and otitis media in children.
Niittynen L, Pitkäranta A, Korpela R Probiotics and otitis media in children. Int J Pediatr Otorhinolaryngol. 2012 Feb 1; Authors: Niittynen L, Pitkäranta A, Korpela R Abstract OBJECTIVE: An alternative option in the prophylaxis and the management of infectious diseases is the use of probiotics, which are known to stabilize gut microbiota and stimulate immune function. Otitis media (OM) is the most common bacterial infection in childhood. The aim of this review is to present the current knowledge of the effects of probiotics on OM. METHODS: A PUBMED search was made to review the relevant literature, and publications on probiotics and otitis media in children were included. Additional studies were obtained from the references of the selected articles. RESULTS: Only a few studies using different probiotic strains and study populations have investigated the effects of probiotics on OM. Five studies investigating the effects of oral probiotics, and three studies investigating the effect of probiotic nasal spray treatment were included in this review. Oral probiotics have reduced the incidence of OM in healthy children in one of two studies (days with OM: probiotic 0.5 vs. control 1.0; p=0.003) and in newborns in one of two studies (incidence of OM: probiotic 22%, placebo 50%; p=0.014), but has had no effect on OM in one study in otitis prone children. Nasal spray treatment containing α streptococci has led to clinical improvement in children with recurrent or secretory OM in two of three studies (cured: probiotic 42% vs. placebo 22%, p=0.02; recovery: probiotic 7/19 patients vs. placebo 1/17, p<0.05). CONCLUSIONS: Although there are some promising results, the lack of confirmative studies makes it difficult to draw any conclusions. More studies are needed to identify the most promising probiotic strains and study populations, and to evaluate the mechanisms behind the possible effects of probiotics on OM. PMID: 22305688 [PubMed - as supplied by publisher]
Lipoteichoic acid from Staphylococcus aureus induced expression of MMP-9 in human middle ear epithelial cells.
Park HY, Song JW, Hong SP, In SM, Kim HJ Lipoteichoic acid from Staphylococcus aureus induced expression of MMP-9 in human middle ear epithelial cells. Int J Pediatr Otorhinolaryngol. 2012 Feb 1; Authors: Park HY, Song JW, Hong SP, In SM, Kim HJ Abstract OBJECTIVE: Change in matrix metalloproteinases (MMPs) and regulation of their tissue inhibitors of metalloproteinases (TIMPs) could play certain role in the pathogenesis of otitis media. This study was designed to evaluate the modulation of MMPs and TIMPs in middle ear epithelium by lipoteichoic acid (LTA) isolated from Staphylococcus aureus. METHODS: Human middle ear epithelial (HMEE) cells were treated with LTA. MMP activities were examined by PCR, ELISA and zymography, and levels of TIMPs were measured by PCR and ELISA. RESULTS: LTA isolated from S. aureus increased MMP-9 mRNA expression and secretion in HMEE cells, whereas no effect on the expressions of MMP-1, -2, -3, -7 and TIMP-1, -2 was observed. CONCLUSIONS: LTA increased the activity of MMP-9, not TIMPs in middle ear epithelia, suggesting that disturbed balance between MMP-9 and TIMPs could play an active role in LTA-induced otitis media. PMID: 22305687 [PubMed - as supplied by publisher]
Endoscopic endonasal multilayer repair of traumatic ethmoidal roof cerebrospinal fluid rhinorrhea in children.
Ibrahim AA, Magdy EA, Eid M Endoscopic endonasal multilayer repair of traumatic ethmoidal roof cerebrospinal fluid rhinorrhea in children. Int J Pediatr Otorhinolaryngol. 2012 Feb 1; Authors: Ibrahim AA, Magdy EA, Eid M Abstract OBJECTIVE: Pediatric traumatic cerebrospinal fluid (CSF) leak is a challenging problem in diagnosis and management. Posttraumatic leaks frequently present by intermittent rhinorrhea or by recurrent attacks of meningitis, which can be the only presenting symptom. The objective of this study is to present our experience in management of pediatric traumatic ethmoidal roof CSF leaks using a multilayer repair technique via an endoscopic approach. METHODS: Ten pediatric patients (aged 4-14 years, six males and four females) presenting with posttraumatic ethmoidal roof CSF rhinorrhea were operated upon between January 2007 and December 2010, using an endoscopic endonasal multilayer repair technique. Preoperative radiological evaluation included both multidetector computed tomography (MDCT) with ultra-thin 1mm cuts, and magnetic resonance imaging (MRI) high resolution coronal T2-weighted sequence. Intraoperatively, the GE InstaTrak™ 3500 electromagnetic navigation system was used in all cases. Postoperative follow-up was done clinically by regular endoscopic examinations and radiologically by MRI assessment using the same preoperative protocol. RESULTS: Clinically all patients presented with unilateral intermittent watery rhinorrhea with periods ranging from 5 to 24 months before operation. Seven cases had a history of recurrent meningitis. Defects were confined to ethmoidal roof in all 10 cases (right side in seven and left side in three), and ranged in size from 2 to 7mm(2) (mean 3.9±1.5mm(2)). Two cases had more than one defect on the same side. All defects were identified preoperatively using our radiological protocol. One case was associated with a meningocele with no brain herniation and another case was associated with a small meningoencephalocele. Mean postoperative hospitalization was 6 days (range 4-8 days). None of our patients developed any intra or postoperative complications or required revision surgery with a 100% success rate after a mean follow-up duration of 29.4±14.4 months (range 12-52 months). CONCLUSIONS: Pediatric posttraumatic CSF leaks involving the ethmoidal roof can be successfully managed via the endonasal endoscopic route using a multilayer repair technique, thus limiting complications associated with external approaches. Preoperative imaging including MDCT and high resolution MRI is of paramount importance for detecting the defect site and for planning surgery. PMID: 22305686 [PubMed - as supplied by publisher]

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