Critical Issues in the Management of Newborn Hearing Screening in the Time of COVID-19 in Umbria, Italy.

Hearing impairment is the most frequent of the sensorial defects in humans, and if not treated promptly, can severely impair cognitive and spoken language skills. For this reason, a universal newborn hearing screening (UNHS) has been established. The purpose of our study is to examine, by means of a retrospective analysis, the results of the UNHS program in the Umbria region during the spread of COVID-19 (2020-2021), comparing the same data from the years 2011-2012, to understand if the program has improved.

Long-Term Results of Tinnitus Retraining Therapy in Patients Who Failed to Complete the Program.

We aimed to evaluate the results of Tinnitus Retraining Therapy (TRT) in patients who did not complete the program. We divided 90 patients who failed to complete the TRT program were into 3 groups: 36 patients who only completed the first phase of the TRT program (Missing group; M), 34 patients who attended counselling for less than 6 months (Noncompliant group; NC) and 20 patients who attended counselling for more than 6 months but did not complete the TRT program (Compliant group; C). The Tinnitus Handicap Inventory (THI), tinnitus Visual Analogue Scales (VAS) and a questionnaire regarding the reasons for dropout were obtained through a telephone survey.

Sensorineural Hearing Loss in Newborns Hospitalized in Neonatal Intensive Care Unit: An Observational Study.

Children hospitalized in Neonatal Intensive Care Units (NICU) present an increased risk for Sensorineural Hearing Loss (SNHL) due to prematurity, hypoxia-ischemia, hyperventilation, low birth weight and the use of ototoxic drugs. The aim of this study was to assess the prevalence of SNHL in newborns hospitalized in a NICU using Transient Evoked Otoacoustic Emissions (TEOAE) and Automated Auditory Brainstem Responses (A-ABR) and analyze the associated risk factors. A sample of 153 newborns hospitalized in NICU underwent TEOAE, A-ABR and clinical ABR to evaluate the presence of hearing deficits.

Improving regional universal newborn hearing screening programmes in Italy.

The Universal Newborn Hearing Screening (UNHS) programme aims at achieving early detection of hearing impairment. Subsequent diagnosis and intervention should follow promptly. Within the framework of the Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for early Identification, Intervention and Care of Hearing Impaired Children", the limitations and strengths of current UNHS programs in Italy have been analysed by a group of professionals working in tertiary centres involved in regional UNHS programmes, using SWOT analysis and a subsequent TOWS matrix.

Universal newborn hearing screening in Umbria region, Italy.

Objective: In Italy, universal newborn hearing screening (UNHS) was first introduced in some regions from 1997. Umbria Region has launched a UNHS program in all hospitals, which has been implemented throughout the region since July 2010. Before UNHS implementation in Umbria region, the average age of identification of congenital hearing loss was around 32 months of age with an average age of initial amplification treatment at least 2 months later.

Impact of identifying factors which trigger bothersome tinnitus on the treatment outcome in tinnitus retraining therapy.

The aim of this work was to ascertain any differences in the effectiveness of rehabilitation therapy in relation to the presence or absence of a known negative reinforcement responsible for the tinnitus-related pathology. Between 1 January 2001 and 31 December 2008, we recruited 294 subjects suffering from incapacitating tinnitus and/or hyperacusis. The patients underwent tinnitus retraining therapy (TRT) according to the methods described by Jastreboff and Hazell [Tinnitus Retraining Therapy: Implementing the Neurophysiological Model.

Cochlear implantation in children with "CHARGE syndrome": surgical options and outcomes.

CHARGE syndrome is a rare, polymalformative disease, representing one of the major causes of associated blindness and deafness. Bilateral, severe-profound, sensorineural hearing loss is common in CHARGE children. Aim of this study is to present our results in children with "CHARGE syndrome" submitted to cochlear implantation (CI).

Personal experience with tinnitus retraining therapy.

We present the results of tinnitus retraining therapy (TRT) in a group of patients suffering from tinnitus and/or hyperacusia. Based on the scores from a specific questionnaire and the Tinnitus Handicap Inventory (THI), the patients were classified into five categories and began therapy according to Jastreboff's criteria. Depending on the individual case, therapy envisaged counselling sessions, ambient sound enrichment, sound generators and hearing aids.

Paroxysmal positional vertigo: the role of age as a prognostic factor.

Aim of this study was to examine possible relationships between several clinical aspects of paroxysmal positional vertigo and factors better defined as "intrinsic" to the patient, above all age. The disorder can affect essentially all age groups; nevertheless, the onset of age-linked degenerative processes, such as vascular damage, can have a negative influence--at least in theory--on the pathogenic mechanisms of cupulolithiasis or canalolithiasis. The study was based on the review of 566 patients with the typical form of paroxysmal positional vertigo.

Determining subjective visual vertical: dynamic versus static testing.

Objective: Comparative evaluation of two tests that, as a visual reference, respectively use a static light source (static testing) and a dynamic one (dynamic testing) to analyze subjective visual vertical in patients with unilateral vestibular dysfunction.

Study Design: Prospective study.

Setting: Otolaryngology and Cervicofacial Surgery Division, Department of Medical-Surgical Specialization, University of Perugia, Italy.

Study of vestibular evoked myogenic potentials in unilateral vestibulopathy: Otolithic versus canal function testing.

Objective: The study provides a qualitative evaluation of unilateral vestibulopathy by comparing otolithic and canal function, to establish possible relationships between the type of dysfunction observed and the evolving clinical pictures associated with it.

Study Design: Retrospective study of a series of cases.

Setting: Department of Medical-Surgical Specialization, Otolaryngology and Cervicofacial Surgery Division, University of Perugia, Perugia, Italy.

Aortic dilatation in patients with bicuspid aortic valve.

The association of a bicuspid aortic valve (BAV) with abnormalities of the proximal thoracic aorta, including dilatation, aneurysm and dissection, has been previously described, leading to the hypothesis of a common underlying developmental defect involving the aortic valve and the aortic wall. Consequently, any patient with BAV should receive a careful assessment not only of the valve function, but also of the aortic root and the ascending aorta. Dilatation of the proximal thoracic aorta is a common finding in patients with BAV and is believed to be related to aortic rupture and dissection.

Balance disorders in headache patients: evaluation by computerized static stabilometry.

Objectives: The aim of the study was to investigate the occurrence of equilibrium disturbances in headache patients, during the interictal period, by computerized static stabilometry.

Materials And Methods: Sixty-seven patients were studied: 35 with migraine without aura (MwoA), 12 with tension-type headache (TTH) in the episodic form (ETTH) + MwoA, and 20 with only TTH [10 ETTH + 10 chronic (CTTH)]. The stabilometric parameters considered were: statokinesigram length (L) and surface (S) in open (EO) and closed (EC) eyes conditions with/without occlusal bite, EC with head retroflexion (ECR), and optokinetic stimulation (OKN).

Treatment of severe epistaxis by superselective embolization: a review of 22 cases.

Objectives: Epistaxis represents one of the most common ENT emergencies. In this paper, the authors report their experience in treating some cases of severe epistaxis by super-selective embolization of the afferent vessels of the nasal fossae.

Patients And Methods: A retrospective study of 22 patients with severe recurrent epistaxis (1 anterior and 21 posterior).

Identifying congenital hearing impairment. Personal experience based on selective hearing screening.

If all degrees of permanent uni- or bilateral hypoacusis are taken into consideration, hearing impairment is the most common congenital disease. Early detection of permanent infantile hearing impairment has become extremely important in preventive medicine, since steps can be taken with hearing aids and rehabilitation to ensure better development of language and higher cognitive functions. Aim of this study is to provide a critical review of the time of diagnosis of hypoacusis at our audiology laboratory, where two methods were used to screen hearing of children with/without risk indicators.

Retrospective study on precancerous laryngeal lesions: long-term follow-up.

The classification and the most appropriate treatment of dysplastic lesions of the larynx continue to be controversial issues. Aim of present study was to evaluate the incidence of precancerous lesions of larynx, their potential to evolve in relation to grade of dysplasia, and the most appropriate treatment. The study is based on the review of a series of 207 patients (157 (75.

Silent embolism of a large pedunculated left atrial thrombus.

Patients with a left atrial thrombus are considered as being at high risk for thromboembolic events. Although embolization may be asymptomatic, embolic events related to large thrombi are usually clinically manifest and tend to be associated with a worse prognosis. We describe the very unusual case of a patient with atrial fibrillation in whom two-dimensional echocardiography revealed a large, pedunculated, highly mobile left atrial thrombus attached by a thin stalk to the interatrial septum.

"Linear" and "derived" otoacoustic emissions in newborns: a comparative study.

Objective: To investigate the effects of a specific aspect of the acquisition procedure, the averaging technique, on the evaluation of click-evoked otoacoustic emissions (CEOAEs) in newborns.

Design: CEOAEs were recorded by an Otodynamic ILO88 system from 89 full-term newborns at the third day after delivery. For each ear and in the same test session, CEOAEs were evoked by 75 to 85 dB pSPL acoustic clicks and averaged according to two different modes: the "linear" (classic average) and the "derived" mode, which allows the cancellation of linear behaving components (such as acoustic artifacts).

[Postoperative follow-up of type A aortic dissectionexperience with 67 patients].

Background: The surgical treatment of type A aortic dissection is usually palliative and most surviving patients remain at considerable risk to develop late postoperative complications; consequently, there is the need for careful long-term follow-up. The present study reports on our experience in the postoperative follow-up of a consecutive series of patients with type A aortic dissection.

Methods: Between January 1986 and December 1996, 89 patients underwent emergency surgery for type A acute aortic dissection; the overall hospital mortality rate was 22% (20/89).

[Evaluation of hearing by studying acoustic distortion products in noise-induced hearing loss].

In this work, the Authors want to verify the possibility of an objective method of cochlear function evaluation in subjects affected by chronic acoustic trauma, through the study of the acoustic distortion products. Undertaking 46 subjects, the researchers have demonstrated a direct correlation between the tonal acoustic threshold and that of the distortion products. This method was able to show the useful indications of an objective evaluation of acoustic capacity in non collaborating subject.

[Sudden idiopathic hearing loss. Case reports in the course of ten years].

The authors present a retrospective case study of 132 subjects with sudden-onset hearing loss who had been observed during the course of 10 years. The results were compared with those available in the literature. These patients were divided into two subgroups based on age: over or under 40.

[Otoacoustic distortion products in infants and adults: a comparative study].

Distortion Products (DP) are otoacoustic emissions evoked by emitting two pure tones. The principle advantage of this method vs. transient evoked otoacoustic emissions is the specificness of frequency.

[Results and considerations regarding auditory neonatal screening based on the use of transient evoked otoacoustic emission].

The authors present a 5-year clinical experience in audiological screening performed at the neonatal center of the Policlinico of Perugia, Italy. The study was performed using an IL088 Otodynamics unit produced by Bray & Kemp. A total of 1328 newborns (2656 ears) were tested on the 4th day of life and during spontaneous sleep.

[Otoacoustic distortion products in sensorineural hearing loss in the cochlea].

The purpose of the present work was to assess distortion-product otoacoustic emissions (DPOAE) in cochlear hearing loss and in its various morphologies. A total of 19 patients (30 ears) were selected for the study. They showed various pictures of neurosensorial hearing loss which were localized within the frequency range normally examined during audiometric tonal threshold testing.

[Products of acoustic distortion in the examination of deafness in an infant].

Distortion-product otoacoustic emissions (DPOAEs) are otoacoustic emissions evoked by two pure tones. The greatest advantage of DPOAEs is their frequency specificity with respect to the eliciting bitonal stimuli. The purpose of this study was to compare DPOAEs in two populations.