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Stavros Korres

Publications and source records attributed to Stavros Korres.

18 recordsLinked to original sources
PubMed2007

Grommets in otitis media with effusion: the most frequent operation in children. But is it associated with significant complications?

INTRODUCTION: Otitis media with effusion is one of the most frequent diseases in children, and its management requires the attention of general practitioners, pediatricians and ear, nose and throat (ENT) surgeons. The main complications associated with tympanostomy tube insertion, are: (1) purulent otorrhea (10-26% of cases), in which local otic preparations might be effective, and biofilm-resistant tubes may decrease this complication in the future; (2) myringosclerosis (39-65% of operated ears), with usually no serious sequelae; (3) segmental atrophy (16-75% of cases); (4) atrophic scars and pars flaccida retraction pockets (28 and 21% of operated ears, respectively); (5) tympanic membrane perforations (3% of cases, although with T-tubes, the incidence may be as high as 24%); (6) cholesteatoma (1% of cases), although tympanostomy tubes may sometimes prevent, rather than contribute to its development; (7) granulation tissue (5-40% of instances), when the duration of tube retention is prolonged. CONCLUSION: It would appear that the complications associated with tympanostomy tube insertion are more frequent than anticipated, reaching 80% of operated ears under specific circumstances and in certain subgroups of children. These complications may resolve with conservative management, but in persistent cases surgical removal of the tubes is mandatory.

Child↗
PubMed2007

Juvenile recurrent respiratory papillomatosis: still a mystery disease with difficult management.

Juvenile recurrent respiratory papillomatosis (RRP) is the most common benign neoplastic disease of the larynx in children and adolescents and has a significant impact on patients and the health care system with a cost ranging from $60,000 to $470,000 per patient. The aim of this paper is to review the current literature on RRP and summarize the recent advances. RRP is caused by human papillomavirus (HPV; mainly by types 6 and 11). Patients suffer from wart-like growths in the aerodigestive tract. The course of the disease is unpredictable. Although spontaneous remission is possible, pulmonary spread and malignant transformation have been reported. Surgical excision, including new methods like the microdebrider, aims to secure an adequate airway and improve and maintain an acceptable voice. Repeated recurrences are common and thus overenthusiastic attempts to eradicate the disease may cause serious complications. When papillomas recur, old and new adjuvant methods may be tried. In addition, recent advances in immune system research may allow us to improve our treatment modalities and prevention strategies. A new vaccine is under trial to prevent HPV infection in women; the strongest risk factor for juvenile RRP is a maternal history of genital warts (transmitted from mother to child during delivery). Better understanding of the etiology of the disease and the knowledge of all available therapies is crucial for the best management of the affected patients.

Child↗
PubMed2007

Cochlear function in facioscapulohumeral muscular dystrophy.

OBJECTIVE: Facioscapulohumeral muscular dystrophy (FSHD) is commonly associated with high-frequency hearing impairment. Our objective was to evaluate a group of normally hearing patients with FSHD using otoacoustic emissions. STUDY DESIGN: Prospective, randomized clinical trial. SETTING: A tertiary University-based referral center in Athens, Greece. PATIENTS: The study group consisted of a consecutive sample of 24 patients diagnosed on clinical, histopathologic, and genetic grounds as having FSHD. All subjects were selected on the basis of normal to near normal audiometric pure tone thresholds. Controls consisted of 40 age-matched healthy volunteers. INTERVENTIONS: Transiently evoked otoacoustic emissions were performed. Whole reproducibility and total response were measured, as well as partial scores at the octave bands centered at 1, 2, 3, 4, and 5 kHz. MAIN OUTCOME MEASURES: Transiently evoked otoacoustic emission measurements were compared between the two groups. RESULTS: The audiometric findings were normal to near normal for both groups. Compared with controls, most patients had diminished scores in both whole and partial reproducibility scores and overall and partial response scores. CONCLUSION: Despite normal hearing, subclinical involvement of the cochlea is quite common in patients with FSHD. Our findings support the genetic homogeneity of this disorder and its association with cochlear damage. Otoacoustic emissions might provide a useful tool in the clinical workup and follow-up of these patients.

Acoustic Stimulation↗
PubMed2006

Bilateral spontaneous hemotympanum: case report.

BACKGROUND: The most common causes of hemotympanum are therapeutic nasal packing, epistaxis, blood disorders and blunt trauma to the head. Hemotympanum is characterized as idiopathic, when it is detected in the presence of chronic otitis media. A rare case of spontaneous bilateral hemotympanum in a patient treated with anticoagulants is presented herein. CASE PRESENTATION: A 72-year-old male presented with acute deterioration of hearing. In the patient's medical history aortic valve replacement 1 year before presentation was reported. Since then he had been administered regularly coumarinic anticoagulants, with INR levels maintained between 3.4 and 4.0. Otoscopy revealed the presence of bilateral hemotympanum. The audiogram showed symmetrical moderately severe mixed hearing loss bilaterally, with the conductive component predominating. Tympanograms were flat bilaterally with absent acoustic reflexes. A computerized tomography scan showed the presence of fluid in the mastoid and middle ear bilaterally. Treatment was conservative and consisted of a 10-day course of antibiotics, anticongestants and temporary interruption of the anticoagulant therapy. After 3 weeks, normal tympanic membranes were found and hearing had returned to previous levels. CONCLUSION: Anticoagulant intake should be included in the differential diagnosis of hemotympanum, because its detection and appropriate treatment may lead to resolution of the disorder.

Aged↗
PubMed2006

Inverted papilloma of the sphenoid sinus: presentation of three cases.

INTRODUCTION: Inverted papilloma deriving originally from the sphenoid sinus is extremely rare. Three such cases are presented aiming to show the particularities and diagnostic clues of this clinical entity. CASE REPORTS: All three patients were male, and presented mainly with nasal symptoms. In all three cases imaging shows the sphenoid sinus was completely occupied by the tumor. Additionally the ethmoids and nasal cavities have been invaded in contiguity to the site of the initial appearance of the tumor. In particular one of the cases was of even more interest as a malignant transformation of the inverted papilloma of the sphenoid sinus was histologically observed. Endoscopic sinus surgery was the therapeutic approach chosen for all three cases, with very good results. Follow up 30 months after the operation has not revealed any signs of recurrence of the disease. CONCLUSION: Inverted papilloma of the sphenoid sinuses--and even more malignant transformation--although quite rare, may present occasionally. The ENT surgeon should be aware of this condition. Preoperative imaging with CT scan and MRI and the experience of the surgeon will dictate the appropriate surgical approach.

Adult↗
PubMed2005

Transient otoacoustic emissions in the detection of olivocochlear bundle maturation.

OBJECTIVE: The medial olivocochlear bundle, forms a neural pathway connecting the superior olivary complex to the outer hair cells of mainly the contralateral cochlea. Although the biological significance of the bundle remains ambiguous, it is clear that activation of medial olivocochlear fibers alters cochlear output and this can be experimentally evident through a series of changes on otoacoustic emissions, called otoacoustic emission suppression. The aim of this study is to observe the maturation of the medial olivocochlear bundle by measuring the suppression effects on transient otoacoustic emissions. METHODS: The study population consisted of 27 premature babies (53 ears) from the P&A Kyriakou Neonatal Intensive Care Unit (conceptional age: 31-36 weeks) and 43 fullterm babies (61 ears) (conceptional age: 37-42 weeks) from the same unit. The ILO-92 system is used to deliver both the linear clicks to the ear examined (producing the emissions) and the white noise to the contralateral ear. The mode used is based on the alternating on and off presence of the white noise in the contralateral ear. RESULTS: 12/53 (22%) ears of preterm babies presented suppression > or =1 dB. 32/61 (52.4%) ears of fullterm babies presented suppression > or =1 dB. The mean suppression for the ears of premature infants was 0.52 dB, (+/-0.1 S.E.M.). The mean suppression for the ears of fullterm infants was 0.90 dB, (+/-0.09 S.E.M.). At the second half of the time window, suppression of fullterms rises above 1 dB (a pattern similar to that of adults), whereas it remains below 1 dB for preterms. CONCLUSIONS: Suppression of otoacoustic emissions helps us to study the function of the medial olivocochlear bundle in different populations. It appears in premature babies but becomes stronger as the postconceptional age advances.

Acoustic Stimulation↗
PubMed2005

The effect of impulse noise on distortion product otoacoustic emissions.

The aim of this study was the evaluation of distortion product otoacoustic emissions (DPOAEs) before and after noise exposure from shooting, and the comparison of DPOAEs with pure-tone audiometry. Thirteen young male police officers were exposed to impulse noise from shooting, without using earplugs. Standard pure-tone audiometry, tympanometry, and DPOAEs were performed before exposure and at one hour post- and 24 hour post-exposure. In the one hour post-exposure testing mean pure-tone thresholds were elevated in the 1-8 kHz frequency zone and DPOAE levels were reduced at several frequencies. DPOAEs were more affected at 3 kHz or lower, whereas pure-tone thresholds were more affected at higher frequencies. After the final examination, non-significant partial shifts at high frequencies on both tests remained. Pure-tone audiometry was overall more sensitive, but DPOAEs provided additional information about the cochlear status of certain ears. These data suggest that besides behavioral testing, DPOAEs may play a role as a fast, objective, and easy to perform test for monitoring subjects exposed to impulse noise.

Acoustic Stimulation↗
PubMed2004

Correlation of transiently evoked otoacoustic emission measures to auditory thresholds.

BACKGROUND: The presence of otoacoustic emissions is objective evidence of normal cochlear status. However, this test cannot be used to predict absolute auditory thresholds with accuracy. The criteria of normal otoacoustic emissions are not yet standardized and different measures of otoacoustic emissions have been used in various settings. In this study, the measures of reproducibility and otoacoustic emission amplitude are compared with regard to their correlation to pure-tone auditory (PTA) thresholds. MATERIAL/METHODS: One hundred and seventeen subjects with normal hearing were included in the study. Subjects with previous audiological, otolaryngologic, or vestibular disease were excluded. A complete ENT and audiological work-up was performed, including transiently evoked otoacoustic emissions (TEOAEs). The equipment used for TEOAE testing was a DP Echoport ILO 292 Otodynamics analyzer connected to a portable personal computer. A full 260 low-noise samples were averaged. Correlation between PTA thresholds and either overall TEOAE amplitude or whole reproducibility was estimated using multiple regression analysis. RESULTS: Correlation between acoustic thresholds at 250, 500, 1000, 2000, 4000 and 8000 Hz and either whole reproducibility or emission amplitude was highly significant for both measures. However, whole reproducibility was better correlated to acoustic thresholds at 250, 500, 1000, 2000, 4000 and 8000 Hz than was emission amplitude, and was more accurately predicted from multiple regression equations. CONCLUSIONS: Reproducibility measures performed better than TEOAE amplitude levels in the prediction of auditory thresholds.

Acoustic Stimulation↗
PubMed2003

Newborn hearing screening resources on the Internet.

Starting as a small military and academic network, the Internet has gradually evolved into a worldwide web, which connects most local networks as well as millions of personal computers from individual users. It is of interest to the medical practitioner, that ever more biomedical resources are becoming available on-line to assist in clinical medicine, research and education. In this paper a detailed list of the World Wide Web sites accessible through the Internet is provided, in which data about newborn hearing screening may be found. Web resources of medical equipment and suppliers and sites including otoacoustic emissions topics, are presented as well. This review is intended to present the wealth of the accessible information on the Internet and to promote further presentation on the web of any available hearing screening data from hospitals and Audiology Departments in which such programs are implemented.

Audiology↗
PubMed2003

Detection of pseudohypacusis: a prospective, randomized study of the use of otoacoustic emissions.

OBJECTIVES: This study was designed to evaluate the effectiveness of transient otoacoustic emissions in an audiological protocol used in the evaluation of patients suspicious of pseudohypacusis. DESIGN: This was a prospective study of 72 adult patients suspicious of pseudohypacusis on the grounds of case history and inconsistent audiometric results. The subjects were randomly assigned to a treatment group or control group. The treatment group consisted of 42 patients who underwent a four-stage protocol that included (1) standard speech and pure-tone audiometry, (2) transiently evoked otoacoustic emissions (TEOAEs) and tympanometry, (3) repeat modified pure-tone audiometry, and (4) auditory brain stem response (ABR) audiometry. The control group consisted of 30 patients, who underwent an identical protocol except that Stage 2 (TEOAEs and tympanometry) was omitted. The main outcome measure was the mean exaggeration level defined as the difference in mean pure tone average (PTA) between the initial and the repeat session (mean PTAinitial minus mean PTArepeat). RESULTS: The mean PTA (average threshold at 1, 2, 3, and 4 kHz) on repeat audiometry was significantly better than the mean PTA obtained on the initial evaluation for each group. However, the mean exaggeration level was significantly greater for the treatment group (35.2 dB HL) than for the control group (11.0 dB HL). In addition, there was no significant difference between the mean PTArepeat (32.7 dB HL) and the mean click-evoked ABR threshold (31.6 dB nHL) for the treatment group whereas the mean PTArepeat (52.9 dB HL) was significantly poorer than the click evoked ABR threshold (29.2 dB nHL) for the control group. CONCLUSIONS: The inclusion of TEOAEs and tympanometry in an audiological protocol used in the evaluation of patients suspicious of pseudohypacusis resulted in a significantly greater threshold improvement on repeat modified pure-tone audiometry when compared to the improvement observed for a control group in which these tests were not performed.

Acoustic Impedance Tests↗
PubMed2003

Otoacoustic emissions in patients with hypotension.

The aim of this study was to investigate the relation between hypotension and slowly developing hearing impairment, using otoacoustic emissions. A group of 42 patients was examined, with diastolic blood pressure < or = 60 mmHg and systolic blood pressure < or = 105 mmHg. The subjects underwent biochemical, cardiological, ENT and audiological examinations. Distortion product otoacoustic emissions (DPOAE) were recorded in the format of DP-gram. The results were compared to the data of 30 normal persons of similar age and sex, examined at the same laboratory. Audiometric results showed that 18 patients had mild or moderate symmetrical hearing loss in one or more frequencies, mainly in the lower frequency range. DPOAE of the patients had reduced amplitude as compared to controls or were even absent, in one or more frequencies. It may be concluded that a hypotensive condition could be a possible factor in the origin of cochlear damage and DPOAE may be useful in monitoring hypotensive patients.

Adult↗
PubMed2002

Occurrence of semicircular canal involvement in benign paroxysmal positional vertigo.

OBJECTIVES: To study the occurrence of each variant of benign paroxysmal positional vertigo (BPVV) and to present some specific clinical features and the results of their treatment by appropriate repositioning maneuvers. STUDY DESIGN: A retrospective review of the records of patients with BPPV. SETTING: Neurotology clinic of the ear, nose, and throat department of a general hospital. PATIENTS: One hundred twenty-two patients were included in the study, 54 male and 68 female, mean ages 61.8 and 59.6 years, respectively, ranging in age from 25 years to 86 years and with symptoms lasting for an average of 124 days. The diagnosis of each type of BPPV was based on the history of the patients and on the positive results of the appropriate provoking maneuver. METHODS: From all the patients, a comprehensive history was obtained, followed by clinical examination of the ears, nose, and throat and a complete audiologic and neurotologic examination, including electronystagmography. All patients were treated with an appropriate repositioning maneuver, depending on the type of BPPV. RESULTS: Of 122 patients, 110 had posterior canal involvement, 10 had horizontal canal involvement, and only 2 had the anterior canal variant. The canalith repositioning procedure was immediately successful in 106 patients and in 8 more patients proved successful after its repetition in a second session, resulting in a total success rate of 93.4%. CONCLUSIONS: All the BPPV variants shared the same clinical and demographic characteristics and responded equally well to treatment. However, differential diagnosis was necessary to apply the appropriate canalith repositioning procedure. Although data from clinical and histologic studies do not fully account for the observed relative occurrence of each variant of BPPV, a satisfactory explanation may be provided by the anatomic location of each semicircular canal and additionally by self-treatment of most cases of the horizontal and the anterior canal variety.

Adult↗
PubMedDate not supplied

Cochlear dysfunction in patients with mitochondrial myopathy.

The present study investigates cochlear function in a group of 11 patients suffering from mitochondrial myopathy with normal or near normal audiometric pure tone thresholds, in most of whom diagnosis was histologically confirmed. A complete ENT, neurologic and audiological work-up, including transiently evoked otoacoustic emissions, was performed in all patients in order to estimate cochlear function. Compared to control subjects, most patients had absent otoacoustic emissions (OAE) in spite of normal hearing, indicating cochlear dysfunction. These findings suggest that subclinical involvement of the cochlea is quite common in patients with mitochondrial myopathy. Damage of the cochlea can be explained on the grounds of its increased metabolic rate, resulting in failure of the stria vascularis and the outer hair cells. Otoacoustic emissions might provide a useful tool in the clinical work-up and follow-up of these patients.

Adult↗
PubMedDate not supplied

Otoacoustic emissions in universal hearing screening: which day after birth should we examine the newborns?

Transiently evoked otoacoustic emissions (TEOAEs) have been widely used in universal newborn hearing screening programs. Although there is consensus with regard to the avoidance of early screening, especially during the first hours after birth, the optimum testing day is not yet unanimously accepted. The aim of the present study was to compare the 'pass-refer' results between 4 groups of newborns tested during the 4 postbirth days and determine the most appropriate day for assessing newborn hearing. Our results suggest that, although TEOAEs can be recorded in very high rates from the first 24 h of life, 'refer' scores are lower on the third and fourth days after birth. It may be thus concluded that the optimum time of assessing newborn hearing in universal hearing screening programs seems to be the third or fourth postbirth day, provided that other social or financial reasons do not suggest an earlier discharge from the hospital.

Female↗
PubMedDate not supplied

Influence of vagus nerve stimulation on vestibulo-ocular reflex.

Vagus nerve stimulation (VNS), as used for the treatment of intractable epilepsy, may interfere with signals from viscera and modify the integration of autonomic afferent fibers in the brainstem. In order to detect an influence of VNS on vestibular function, the vestibulo-ocular reflex (VOR) of 5 patients was examined before and during VNS. Nonsignificant alterations of the maximum slow-phase velocity of the VOR were found. A significant clinical alteration of the VOR during VNS was not observed.

Adult↗
PubMedDate not supplied

The effect of different 'pass-fail' criteria on the results of a newborn hearing screening program.

'Pass' criteria in newborn hearing screening programs are important, since they affect the operating characteristics of the programs. In the present study, we intended to compare the results of two screening procedures, using different 'pass' criteria, in two samples from the same pool of screened newborns. The subjects were divided into two study groups, screened consecutively during 6 months. Testing and all procedures were exactly the same in both groups, differing only in the 'pass' criteria. In the first group a signal-to-noise ratio of at least 3 dB in the frequency bands of 1-2, 2-3 and 3-4 kHz was considered necessary for a 'pass', whereas a signal-to-noise ratio > or =6 dB was used in the second group, at the same frequency bands. During the period of the study, no other minor or major modification of the protocol was applied. The comparison of the screening predischarge results between the two groups showed no statistically significant differences in the 'pass-refer' results. Thus, it appears that the 3-dB signal-to-noise ratio is as valid as the 6-dB criterion, and it may be confidently used, especially in settings where rescreening is not available.

Evoked Potentials, Auditory↗
PubMedDate not supplied

Overcoming difficulties in implementing a universal newborn hearing screening program.

The aim of this paper was to present our experience with a universal newborn hearing screening program, including the specific problems and difficulties faced since its beginning, along with the measures used to overcome them and to improve its efficiency. We analyzed data from 22,195 newborns screened by transiently evoked otoacoustic emissions (TEOAE) performed during the first days after birth. 84.8% of the newborns passed on the first test and another 12.15% passed on rescreening before hospital discharge. This produced a "not pass" rate (false-positive and true positive) of 3.05%. The rate of newborns who did not undergo screening and the rate of "lost to follow-up" newborns were reduced in time, due to various applied modifications to the protocol. It may be thus concluded that our protocol proved to be successful in attaining low refer rates for follow-up screening. A major problem that remains unresolved is the absence of effective follow-up.

Audiometry, Evoked Response↗