Impact of Costco Brand Name Hearing Aid Expansion on Otolaryngology Office Hearing Aid Revenue

Objectives: The objective of this study is to evaluate the impact of Costco’s expansion in the hearing aid market on the impact of hearing aid sales by otolaryngologists. Design: Revenue data was acquired for 34 practice locations for the years 2013 through 2017 and compared before and after 2015, when Costco expanded its options for hearing aid brands. Revenue growth was regressed on the distance between otolaryngology office and the nearest three Costco locations. Results: A univariate regression analysis shows that a 10-minute decrease in average travel time to Costco would result in an 8% increase in CAGR growth. Conclusion: This study shows the closer an otolaryngologist’s office is to a Costco, the greater the growth the office experienced after 2015, indicating that Costco proximity did not reduce hearing aid sales.

Follow the link for full article
https://medwinpublishers.com/OOAJ/OOAJ16000180.pdf 

An Unusual Cause of Upper Airway Obstruction in Newborn: Congenital Nasal Pyriform Aperture Stenosis

Congenital nasal pyriform aperture stenosis (CNAPS) is a rare cause of pediatric nasal airway obstruction that clinically mimics choanal atresia in a neonate. CNPAS is suspected clinically and confirmed with CT scanning. Early diagnosis and management is essential for this potentially life-threatening condition. Because of the association this anomaly has with other midline defects, such as holoprosencephaly, it is important to recognize it and pursue a thorough workup. Patients can be managed conservatively or surgically. Surgical treatment is usually reserved for those patients that fail conservative treatment. We present a case of CNPAS, to highlight the importance of recognizing the classic signs of CNPAS on cross-sectional imaging to prevent fatal outcome.

Follow the link for full article
https://medwinpublishers.com/OOAJ/OOAJ16000179.pdf

Is Tinnitus Retraining Therapy effective in managing Persistent Tinnitus after Middle Ear Surgery?

Introduction: Tinnitus, commonly referred to as "ringing in the ears," is phantom auditory perception which can be debilitating condition. Middle ear surgery can give rise to complications like development of Tinnitus in certain patients. This article evaluates patients with persistent Tinnitus managed by Tinnitus Retraining therapy. Materials and Methods: Prospective study was carried on patients operated for chronic middle ear disease presented with persistent Tinnitus post operatively at completion of 3 months of follow up during January 2016 to December 2017. Level of tinnitus was assessed using Tinnitus Handicap Inventory (THI) scale. These Patients were subjected to Tinnitus Retraining Therapy for 3 months. Results: Total of 29 patients presented with Persistent Tinnitus Post operatively of which 17 were male and 12 female in age group 21–50 years. Tinnitus was mild (13.79%), moderate (51.72%), severe (31.03%) and Catastrophic (3.44%) of patients. Frequency, Intensity match and type of noise of each patient for tinnitus retraining therapy was documented where unilateral Tinnitus was seen in 25 and bilateral in 4 patients. Overall improvement in tinnitus observed in 16 (55.17%) of patients. Patients with moderate tinnitus showed improvement in Catastrophic and Severe tinnitus. As perception of Tinnitus increased more improvement was observed following therapy and vice versa. Results of Tinnitus Retraining Therapy do not vary based on middle ear surgery performed, laterality of ear and type of noise used to suppress tinnitus. Discussion: Tinnitus retraining Therapy aims in reducing tinnitus perception by inducing habituation of tinnitus-induced reactions allowing patients to achieve control over tinnitus, live normal life.

Follow the link for full article
https://medwinpublishers.com/OOAJ/OOAJ16000178.pdf

Upper Eyelid Fistula Secondary to a Frontal Sinusitis: A Case Report and Review of the Literature

Introduction: Sinus disease may occur in individuals who are not otherwise aware that they have problems (occult sinusitis). An upper eyelid fistula is one of the complications of the frontal sinusitis. It can happen as a result of the obstruction of the frontal sinus ostia. Case report: In this article, we reported a case of a 64 years old female patient admitted to our department with a 2 years’ history of an upper eyelid fistula secondary to a frontal sinusitis. A paranasal sinus computed tomography (CT) concluded to a frontal and ethmoidal sinusitis associated to a frontal osteitis. The patient underwent a functional endoscopic sinus surgery to establish drainage of the affected sinuses and direct excision of the fistular tract. Conclusion: The development of a sinocutaneous fistula secondary to a frontal sinusitis is rare, but still occurs in the modern antibiotic era. Definitive management of this disease process requires a frontal drainage of the affected sinus with fistula excision and multilayer closure.

Follow the link for full article
https://medwinpublishers.com/OOAJ/OOAJ16000177.pdf

Tinnitus and Deafness in the Musicians

Music is the art of sound, with this concept begin all the texts of Musical Education in Schools of all levels. Even though it is rarely considered and considered as a noise, it presents, like all other sound sources, an acoustic phenomenon, which may present auditory disturbances depending on the intensity level and exposure times. Orchestral musicians play almost 5-6 hours a day almost daily.

Follow the link for full article
https://medwinpublishers.com/OOAJ/OOAJ16000176.pdf

Sinonasal Symptoms and Outcomes in Aircrew

Background: This study was performed to determine the effect of extended flying time on the Sino-Nasal Outcome Test (SNOT-22) scores of aircrew. Methodology: A cross-sectional questionnaire was administered to 172 randomly selected aircrew employees (pilots and flight attendants) of Saudi based airlines, collecting demographic data, smoking habit, flying hours, job effects, SNOT22 score, and nasal surgery history. Data were analyzed using SPSS. Results: When flying time exceeded 12 hours weekly, job performance was affected for 45.4% of the aircrew. Some (24.8%) cancelled their flights because symptoms were intolerable. This was reflected on the SNOT-22 instrument: respondents indicated nasal discharge (p = 0.012), ear fullness (p = 0.03), or a nasal block (p = 0.004). Conclusion: Flying time of more than 12 hours weekly presents a significant risk for developing many sinonasal symptoms.

Follow the link for full article
https://medwinpublishers.com/OOAJ/OOAJ16000175.pdf 

SNHL of Childhood New Diagnostic Criteria. An Upgraded Clinical Approach to a ‘Failed’ BERA Test

Medical literature is replete with articles about the benefits of BERA, not merely as an auditory test, but also an aid for evaluating the CNS function represented by the brainstem activity in several clinical conditions, such as in comatose patients, bipolar disorders, attention deficit disorder, synapse dysfunctions and hydrocephalus. Irreversible sensorineural hearing loss (SNHL) in infants, identified by a failed BERA, in addition to its being one of major clinical features of intrinsic ear diseases, is also a sign of inborn disorders of white matter. Thus, a new dimension is attached unto the benefits of a failed-BERA. We will high lighten the way towards identifying the exact etiology of irreversible SNHL of non-intrinsicear-disease, in condition that other clinical features appear in conjunction with SNHL. To achieve this, we reviewed all the diseases, syndromes and triads, at which a failed-BERA is one of their major components of the clinical picture. We brought here a case report of an infant suffering from SNHL. Irreversible SNHL in childhood is one of the major features in certain neurologic disorders, but not necessarily the first to appear. It is a main marker for the diagnosis of Leukodystrophies, as well as Multiple Sclerosis. Otolaryngologists and clinicians in general should be conscious while following-up certain infants who have irreversible SNHL of non-intrinsic-ear-disease. The appearance of pendular nystagmus, truncal hypotonia, or intentional tremor with a staccato speech, in parallel with hyperreflexia, and spastic paraplegia is the core of our upgraded flow chart of SNHL clinical approach.

Follow the link for full article
https://medwinpublishers.com/OOAJ/OOAJ16000174.pdf