Explore the vast range of titles available.

In the published paper [...]

Objective: The aim of the study was to evaluate the validity, clinical applicability, and developmental sensitivity of the Romanian LEESPQ in children with cochlear implants (CIs), by analyzing its association with age at implantation, duration of auditory experience, and implantation laterality, and by comparing the developmental trajectory with that of normal-hearing (NH) children. Methods: The study assesses the validity, reliability, and clinical sensitivity of the LEESPQ in pediatric cochlear implant users. Furthermore, it investigates the associations between total questionnaire scores and key clinical variables, including implantation laterality (unilateral versus bilateral), age at device activation, and duration of implant use. Forty-seven children with CIs (26 boys, 21 girls) were included, with implantation ages ranging from 9 months to 5 years. Of these, 21 received unilateral implants and 26 bilateral implants. Responses were analyzed both in relation to clinical variables and in comparison with available normative data from NH children, in order to delineate potential differences in linguistic developmental trajectories. Results: Findings suggest that the LEESPQ is a reliable and clinically valuable instrument for monitoring post-implant linguistic progress. It provides relevant insights into early auditory access, the linguistic environment within the family, and the development of early verbal production. Scores were significantly influenced by age at implantation and duration of auditory experience, confirming the role of early stimulation and neural plasticity in shaping speech development after cochlear implantation. Conclusions: The LEESPQ demonstrates strong clinical utility as a sensitive tool for monitoring early preverbal and verbal development in children with CIs. By capturing score variations associated with age at implantation, auditory experience, and implantation laterality, the questionnaire provides meaningful insights into early post-implant outcomes and supports individualized rehabilitation planning. These findings highlight the value of the LEESPQ for early outcome assessment in pediatric cochlear implant users.

Background/Objectives: Addressing cochlear malformations in the context of cochlear implantation is particularly important because the dimensions of the cochlea can affect intraoperative surgical decisions and options as well as the postoperative outcomes of each patient. High-resolution computed tomography (CT) is routinely used to assess the dimensions of the cochlea and the presence of any structural malformations. The purpose of this paper is to evaluate the dimensions of the cochlea and its malformations by using imaging measurements and correlating the data obtained with certain types of medical devices used. Methods: A retrospective observational study was conducted, through the systematic analysis of computed tomography images, on 130 cochlear implants between 2014 and 2024 at the ENT Clinic in Târgu Mureș, Romania, analyzing 103 patients. Data related to the anatomical features of the cochlea and their dimensions were evaluated, with an emphasis on the volume of the malformed and non-malformed cochleas. The collected data were statistically analyzed, evaluating the volume of the cochlea in relation to the gender and age of the patients, as well as the presence of cochlear malformations related to the analyzed side—the right and left ear. Results: The age groups analyzed were 58% between 0 and 7 years, 14% between 8 and 17 years, and 28% between 17 and 68 years, with the minimum age for implantation being 10 months and the maximum age being 68 years. Analyzing the presence of malformations by gender, it was found that enlarged cochlear aperture occurs at a rate of 14.89% in females and 17.02% in males, while an enlarged vestibular aqueduct occurs at a rate of 4.26% in females and 8.51% in males. Incomplete partition types I and II have a frequency of 10.64% in women and 14.89% in men. Incomplete partition type I is equally present in 10.64% of women and men. Cochlear hypoplasia occurs at a low frequency of 2.13% in women and is not observed in men in our analysis. Conclusions: In this study, we analyzed cochlear volume variables between malformed and normal cochleae. Cochlear dimensions (width and height) did not show statistically significant variations between the right and left ears, both in malformed and non-malformed cochleae. The cochlear volume is consistent across the groups studied and is not influenced by malformations or the demographic variables analyzed. Cochlear malformations, according to our assessments, do not present contraindications for a cochlear implant, which nevertheless demonstrates that a preliminary imaging assessment is extremely useful for determining the type of implant that can be used.

Background and Objectives: The Cochlear implant is the first approved cranial nerve stimulator that works by directly stimulating the cochlear nerve. Various attempts have been made to evaluate the dimensions of the cochlea related to cochlear implantation. The preoperative computed tomographic examination is essential not only in assessing the anatomical aspect of the cochlea, but also in determining its dimensions to choose an appropriate electrode and obtain the best possible audiological performance. Materials and Methods: In the present paper, we aimed to carry out an observational study regarding the role of cochlear measurements in the preoperative evaluation of patients proposed for cochlear implants. The purpose of the study was to measure the cochlea and establish the existence of a correlation between the size of the cochlea and the age and gender of the patients. Results: From the group of 35 examined patients, 54% (n = 19) were male and 46% (n = 16) were female. The average length of the cochlea in the age group 0–4 years is 7.82 mm in the left ear and 7.86 mm in the right ear; in the age group 4–7 years, it is 7.82 mm and 7.94 mm, respectively; for the age group 7–14 years, the dimensions increase to 8.48 mm and 8.77 mm, respectively; and after 14 years, these dimensions reach 9.12 mm and 9.18 mm, respectively. Comparative measurements of the length of the cochlea by age groups show an increase in length with the patient’s age, but this increase does not exceed 1.5 mm for both the right and left ears. The measurements of the width of the cochlea, by age group, start from 6.84 mm in the left ear and 6.81 mm in the right ear at 0–4 years, 6.94 mm and 6.97 mm, respectively, in the group 4–7 years, 7.71 mm and 7.55 mm at 7–14 years, and reaching 8.19 mm and 8.12 mm at the age of 14 years and over. Conclusions: From the study carried out, it can be concluded that the evaluation of the dimensions of the cochlea is important for cochlear implantation. The size variables, although small, are still an element to be considered in correlation with the age of the patient and the implanted ear. This increase is statistically insignificant, but it still exists, even if, from a theoretical point of view, it is considered that the dimensions of the cochlea remain constant.

Obstructive sleep apnea (OSA) is considered the silent killer pathology of the new millennium. This is due to increased risk factors such as obesity. Healthcare systems face an increasing burden from severe cases of OSA. We performed a study on a group of 152 Romanian patients with OSA recording data obtained through polysomnography and cephalometric variables, recorded in lateral plain X-rays. The results confirmed some of the data available from previous studies worldwide, but some of the variables presented a positive statistical correlation specific to our study group. For example, the apnea-hypopnea index (AHI) correlated with the uvula length but surprisingly did not correlate with body mass index (BMI) because obesity tends to become endemic in Romania. To our knowledge, this is one of the first studies focusing on cephalometric data in Romanian OSA patients. The results obtained through this study will be further analyzed in research on larger groups of Romanian OSA patients.

Background and Objectives: Head and neck squamous cell carcinomas (HNSCCs) vary significantly in terms of invasiveness, growth rate, and metastatic potential. This study aimed to investigate the expression of several prognostic biomarkers (Ki67, p53, EGFR, COX-2, Cx43, and p16) in HNSCC from various anatomical regions and to correlate these expressions with clinicopathological parameters. Materials and Methods: We performed immunohistochemistry on 91 histologically verified HNSCC cases from the County Emergency Hospital, Targu Mures. Biomarker expression for Ki67, COX-2, and Cx43 was assessed using a standard immunoexpression scoring system: S1: 0–10%, S2: 11–25%, S3: 26–50%, S4 > 50%; EGFR was scored based on membrane staining intensity: 0, 1+, 2+, 3+; we classified p16 as positive or negative; p53 was grouped into mutant and wild-type; and we compared these across histopathological types, tumor grades, anatomical locations, gender, and different age groups. We performed a comparative analysis of Cx43 expression levels in relation to the expression of the rest of the markers. Statistical analysis was conducted using GraphPad InStat 3 software, version 3.06 (GraphPad Software Inc., San Diego, USA). Results: The majority of tumors were in males (95.6%) aged 51–60 years. Mutant p53 expression was prevalent in most cases. Elevated Ki67 and EGFR expression were associated with more aggressive tumors. COX-2 levels varied, with a higher proportion of moderate and high immunoexpression (S3 + S4) observed in patients under 70 years old. Cx43 expression was generally low, especially in extralaryngeal tumors. Conclusions: HNSCC primarily affects older males, with the larynx being the most common site. High levels of Ki-67 and EGFR suggest more aggressive tumors, while low COX-2 levels reflect varying prognoses. Women may develop more aggressive tumors, and extralaryngeal tumors often present with more challenging prognoses. Low Cx43 expression may be more likely to coincide with higher Ki67 and COX-2 levels, possibly indicating a link with more aggressive tumor behavior.

BACKGROUND. Sleep-breathing disorders are increasingly common in the general population, affecting the quality of life from many points of view. Patients with sleep-disordered breathing have a series of comorbidities, including arterial hypertension, which affects the quality of life also through the collateral manifestations of daytime sleepiness.MATERIAL AND METHODS. A descriptive study was conducted on a group of 134 patients who underwent investigations to determine the degree of obstructive sleep apnea syndrome (OSAS) by respiratory polygraphic and polysomnographic investigations. This group was also investigated from the point of view of blood pressure values as well as the degree of daytime sleepiness, an important element for the quality of life.RESULTS. The average age of the evaluated patients was 42.18±12.70 years, and the body mass index was 31.20±5.74 kg/m2. The assessment of systemic blood pressure indicated an increased value above its standard normal value in most subjects: 58 patients (43.9%) were included in stage I hypertension, 9.8% in stage II, 1.5% of the subjects were diagnosed with stage III hypertension. To describe the relationship between OSAS and quality of life assessed by the degree of daytime sleepiness, we performed the regression and correlation analysis. The dependence between the values of the apnea-hypopnea index (AHI) and the ESS (the degree of daytime sleepiness) was positive; an increase in the AHI implies an increase in the ESS, thus a decrease in the quality of life.CONCLUSION. We can conclude that the severity of OSAS is directly involved in establishing the degree of arterial hypertension. Moreover, early detection is essential in order to decrease the degree of daytime sleepiness and implicitly increase the quality of life.

Introductions: The global prevalence of obstructive sleep apnea shows that this disease appears in 1 billion people, with the prevalence exceeding 50% in some countries. Treatment is necessary to minimize negative health impacts. Obstructive sleep apnea (OSA) is defined as a cause of daytime sleepiness, as well as a clinical manifestation of sleep-disordered breathing. In the literature, there are numerous controversial studies regarding the etiology of this condition, but it is universally accepted that reduced activity in the upper airway muscles plays a significant role in its onset. Additionally, OSA has been associated with a series of comorbidities, such as type II diabetes, metabolic syndrome, and cardiovascular and pulmonary conditions, as well as head and neck tumors, especially oropharyngeal and laryngeal tumors. This is a review of the subject of OSA that considers several aspects: an analysis of the comorbidities associated with OSA, the involvement of tumor pathology in the onset of OSA, and the association of OSA with various types of laryngeal cancers. Additionally, it includes an evaluation of postoperative and medical outcomes for patients with OSA and laryngeal tumors treated surgically and medically, including chemotherapy. Relevant Sections: By taking into consideration the stated objective, a systematic analysis of the available literature was conducted, encompassing the PubMed, Medline, and Scopus databases. The evaluation was based on several keywords, including head and neck cancer, diabetes, diabetic, overlap syndrome, cardiovascular conditions, laryngeal neoplasm, radiotherapy, and chemotherapy, as well as the concept of quality of life in laryngectomized patients and patients with OSA. Discussions: The review evaluates the involvement of OSA in the presence of comorbidities, as well as the increased incidence of OSA in patients with laryngeal cancer. It is important to note that surgical and post-surgical treatment can play a significant role in triggering OSA in these patients. Conclusions: The studies regarding the correlations between OSA, comorbidities, and head and neck tumors indicate a significantly increased risk of OSA in association with conditions such as diabetes, metabolic syndrome, cardiovascular diseases, and head and neck tumors, particularly laryngeal tumors. This association has a physio-pathological basis. The various surgical methods followed by radiation and chemotherapy for tumor treatment do not exclude an increased risk of developing OSA after treatment. This significantly influences the quality of life of patients who survive these types of tumors. Future directions: Due to the multiple comorbidities associated with OSA, the extension of polysomnography associated with investigations during sleep, such as drug-induced sleep endoscopy, represents a tendency for the early diagnosis of this pathology, which affects the quality of life of these patients. Patients with head and neck cancer are at high risk of developing obstructive sleep apnea; this is why it is necessary to expand the polysomnographic investigation of these patients after surgical procedures or after radiotherapy and chemotherapy.

BACKGROUND. Children’s communication with the family and the environmental surroundings begins immediately after birth and development continues throughout life. Impairment of hearing due to the presence of congenital hypoacusis results in severe language development disorders. The purpose of the study was to identify the main factors involved in the auditory-verbal rehabilitation process of children with hearing impairment.MATERIAL AND METHODS. A descriptive, observational study was conducted on a group of 35 carers of hearing-impaired children proposed for auditory-verbal rehabilitation through cochlear implantation. The study carried out was based on the parents’ statements, analyzing the essential factors that can influence the quality of life of parents with hearing-impaired children: the child’s age at the time of the positive diagnosis, the child’s communication skills before implantation, the time elapsed from the intervention to implant activation, participation in auditory-verbal rehabilitation sessions with a speech therapist, parental commitment during the immediate pre- and post-implant period, the parent’s level of education.RESULTS. The dominance of the female gender can be noted - 91.43%. 60% of adult participants were college graduates, 20% discontinued their education after completing high school, 17.14% graduated from a post-secondary school. 57.14% of the parents reported being employed in some form of work during the period before and immediately after the cochlear implantation of their children. 82.85% reported the diagnosis of their child’s hypoacusis in the pre-kindergarten group. Out of the total number of children, 68.57% were recipients of bilateral cochlear implants, 31.43% had unilateral implants. The periods during which children benefited from post-implantation speech therapy were between 1 and 6 months (5.71%), 1 and 2 years (2.86%), >2 years (17.14%). In 71.43% of cases, families were in the rehabilitation phase with speech therapy at the time of filling out the form.CONCLUSION. In the auditory-verbal rehabilitation process of a hearing-impaired child, there are a number of factors and conditions that must be considered in a specific manner for each individual patient.

BACKGROUND. The COVID-19 pandemic had a devastating impact in terms of both somatic and mental morbidity. The most vulnerable group of patients is represented by the elderly, due to their global fragility. During the COVID-19 pandemic, research have stated that age and related comorbidities are associated with the outcome and evolution of the coronavirus infection.MATERIAL AND METHODS. We performed a prospective observational study by applying a specific unsystematized questionnaire containing 21 questions, including patients admitted between 01.10.2021-16.03.2022 in the Internal Medicine Clinic and the Infectious Diseases Clinic COVID-19. Two hundred patients were included in the study of which the most important group was represented by the elderly. The current study aimed to demonstrate the clinical complexity of the patients hospitalized with SARS-CoV-2 and the importance of a multidisciplinary approach.RESULTS. Among those patients who complained of cardiovascular symptoms such as tachycardia, palpitations, chest pains, 59.6% had no cardiac pathology, therefore they required psychiatric examination and specific anxiolytic and/or antidepressant treatment. Despite the fact that alarmingly low rates of vaccination were observed, we noticed a statistically significant association between the presence of insomnia and vaccination status: half of the vaccinated stated that they sleep as well as usual, compared to only 22.8% of the unvaccinated. We also found a statistically significant association between the presence of insomnia and peripheric oxygen saturations below 93%.CONCLUSION. The results of our study highlight the importance of a multidisciplinary management of the SARS-CoV-2 infection, especially targeting the elderly and fragile patients.