CLINICAL COMMENT ON THE SENSORY-NEURAL ACUITY LEVEL (SAL) TEST.
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BACKGROUND: In daily dental surgery practice, when it is not possible to obtain-enough autogenous bone graft to fill bone defects, bone substitutes can be useful for bone regeneration. MATERIALS AND METHODS: After a preliminary microscopic examination of histologic samples obtained from semithin sections of the tibias of rats showing no major differences in the results both for the single material and implant time, further studies on five different osteoconductive materials used in oral clinical practice were carried out with microradiography, SEM and X-ray microanalysis. In experimental animals (rats) bone defects 3 mm large were surgically induced in both tibias: one of the defects was filled by bone substitutes and on the other side the bone defect healed naturally. RESULTS AND CONCLUSIONS: The findings obtained were studied in depth, and allowed to conclude that the materials tested are suitable for the purpose for which they are marketed. Non-demineralized bovine bone showed the best results with a high degree of osteointegration. However, the results also show that not all the materials tested offer healing advantages over controls.
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Osteopetrosis is an inherited disorder characterized by bone sclerosis. One of the more predominant feature of the disease in the temporal bone is conductive hearing loss due to anomalous bone formation in the middle ear and to otitis media. A 55-year-old woman affected by the adult type of osteopetrosis was referred to our department with a long history of otitis media. CT study demonstrated a narrowing of Eustachian tube due to abnormal deposition of sclerotic bone; this condition was confirmed during surgery. Tubotomy was performed during tympanoplastic surgery and there were no relapse of otitis after 12 months of follow up. Timpanoplastic surgery should be considered in those cases where medical treatment has failed in dealing with otitis media. In our experience an enlargement of Eustachian tube shuld be performed in this kind of patients, thus helping the functional recovery and the potential well-being of the patient as we observed in our case.
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OBJECTIVE: To compare the function of bone anchored hearing aids (BAHA) with conventional air conduction hearing aids (ACHA) by means of objective audiometric tests focusing on temporal acuity and consonant discrimination in quiet and noise, as well as subjective quality-of-life questionnaires. SETTING: Tertiary referral center. STUDY DESIGN: Prospective. SUBJECTS: Patients using BAHAs because of profuse drainage from chronic suppurative otitis media, and a comparison group of healthy volunteers. MAIN OUTCOME MEASURES: Objective measures: sound field audiograms, duration discrimination, gap discrimination, and final and initial consonant discrimination in quiet and in noise. Subjective measures: Sanders' Profiles, MOS SF-36 questionnaire. RESULTS: Normal-hearing subjects always performed better than hearing-impaired patients in all tests. When the BAHA was compared with the ACHA, there were no significant differences in any of the measures. CONCLUSIONS: The BAHA and the ACHA provided similar audiometric functioning in audiometric tests. The BAHA, although using a nonphysiologic sound conduction route, did not sacrifice temporal processing ability or speech perception in noise, and should be considered for patients with profuse ear drainage.
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