PCA Defect and Sudden Deafness..?
A recent open access study (Tsushima, Taketomi-Takahashi & Endo, BMC Ear, Nose and Throat Disorders 2006, 6:5) designed to investigate the link between sudden deafness and defect of posterior communicating artery (PCA) failed to observe statistically significant link between the two.

Abstract: Background A strong association was suggested between a non-functioning posterior communicating artery (Pcom) of the circle of Willis and sudden deafness (SD). The purpose of this study was to determine the rate of depiction of the posterior communicating artery (Pcom) on magnetic resonance angiography (MRA) in patients with SD. Methods Sixteen patients with SD (47.7 +/- 13.3 years; range, 24 - 76 years; nine males) were evaluated with intracranial MRA as well as magnetic resonance imaging (MRI) of the head. The depiction of Pcom on MRA was correlated with the laterality of SD. One hundred twenty-eight controls (49.1 +/- 8.4 years; range, 22 - 66 years; 87 male) were selected from neurologically normal subjects who underwent MR examinations as a part of an annual medical check-up in our hospital. Results Four (25%) of 16 SD patients had bilateral Pcom on MRA, four patients had unilateral Pcom and eight patients had bilaterally absent Pcom These results were not significantly different from the controls (p=0.96). In 6 (37.5 %) of 16 SD patients, the ipsilateral Pcom was present on MRA, and 104 (40.6%) of 256 Pcom were present in 128 normal controls (p=0.81). Conclusions Since there was no link between the occurrence of SD and the absence of the ipsilateral Pcom, our results cannot support the hypothesis that the absence of Pcom may be a risk factor for the occurrence of SD.

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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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Dextran 40 & SD in Pregnancy....?       

The recognized risks of  iv Dextran therapy (coagulopathy, renal failure and non-cardiogenic pulmonary oedema) as well as  the known riskt of steroid therapy on the pregnant female as well as the fetus puts the otolaryngologist at a crossroad when faced with management of sudden deafness (SD) in pregnancy. A new study from Taiwan (Yen-Ping Wang & Yi-Ho Young, Acta Oto-Laryngologica, 2006; 126: 271 -276) reported significant benefit of Dextran 40 in pregnant women with SD without adverse effect of the mother or fetus

Abstract: Conclusion. Excluding the possibility of acoustic neuroma, therapeutic benefits from dextran 40 can be anticipated in a pregnant woman with sudden deafness, leading to significant hearing improvement, without detrimental effect on the mother or fetus. Objective. The aim of this study was to present our experience in the treatment of pregnant women with sudden deafness during the past decade. Methods. From January 1994 to December 2003, 12 pregnant women with sudden deafness were consecutively encountered at the authors’ clinic. With the exception of one patient with acoustic neuroma who underwent craniotomy, six patients were treated with dextran 40 only, while the other five patients preferred no medication, and served as a control group. Each patient underwent audiometry before treatment and at 1 year postpartum. Results. In the dextran group, five (83%) of six patients had hearing improvement 1 year postpartum, compared with one (20%) of five patients in the control group showing hearing improvement; both groups revealed a significant difference. Those receiving intravenous dextran treatment had significant hearing improvement at the frequencies of 1000, 2000, and 4000 Hz, at 1 year postpartum. In contrast, in those who followed a natural course without medication no significant difference existed in the mean hearing level of each frequency, at 1 year after delivery.

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.
• Watch out for otolaryngological.net Journal Club Page!

Till Next Week,

Biodun

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