Objectives: 1] To describe a case of an embryonal rhabdomyosarcoma presenting as al radiolucent mandibular mass in a 3-year-old child. 2] To review existing literature on the clinical picture and pathophysiology of intraosseous rhabdomyosarcoma. 3] To identify learning points in the diagnosis of intraosseous rhabdomyosarcoma. Design: Case report. Setting: A tertiary referral hospital. Patients: One (1) Results: A case of a 3-year-old child with a radiolucent mandibular mass is described. Thel final histopathologic report turned out to be embryonal rhabdomyosarcoma. Intraosseous rhabdomyosarcomas are rare occurrences (3.5 percent in one review), and clinically present in younger age groups, with a non-tender, enlarging, firm-hard mass over a specific area. A review of the available literature on intraosseous rhabdomyosarcomas, and its proposed pathogenesis, is presented. Conclusion: A case of a radiolucent mandibular mass in a 3-year-old child is presented. Intraosseous rhabdomyosarcomas of the mandible are rare occurrences that pose challenges to the otorhinolaryngologist. Taken separately, the presentation, patient characteristics, clinical course, ancillary laboratories and imaging modalities may lead even the most astute otorhinolaryngologist astray. The whole clinical picture should be taken together so that the correct diagnosis will not be missed despite the rare presentation. (Author)
RHABDOMYOSARCOMA RHABDOMYOSARCOMA ; EMBRYONAL

Objectives: To identify the bacterial pathogens associated with chronic suppurative otitis media and their antimicrobial sensitivity and resistance. Study Design: Cross-sectional survey. Setting: The study was carried out from July 2004-July 2005 at the outpatient clinic of a government tertiary hospital. Number of subjects: A total of 32 patients (54 ears) with unilateral or bilateral active chronic suppurative otitis media. Results: Bacterial pathogens of 54 ear discharge samples from CSOM were studied. Among them, 42 (78 percent) were pure cultures and 9 (16.7 percent) were mixed, only 3 (5.6 percent) of the submitted samples had no growth. There were 42 pure isolates, the most common of which was Staphylococcus aureus 21 (50 percent), followed by Pseudomonas aeruginosa 14 (33.3 percent). Drug sensitivity pattern of Staphylococcus aureus showed that 61.9 percent were resistant to Penicillin while more than 90 percent were sensitive to Aminoglycosides and Clindamycin. Pseudomonas aeruginosa was resistant to penicillin in 64.3 percent of cases and Ciprofloxacin was active against pseudomonas in 85.7 percent. Conclusion: The most common bacterial pathogens from CSOM include Staphylococcus aureu and Pseudomonas aeruginosa. Majority of the isolates of Staphylococcus aureus were resistant to penicillin. Aminoglycosides, macrolides and quinolones were effective against most of the isolates of Staphylococcus aureus. (Author)
OTITIS MEDIA OTITIS MEDIA ; SUPPURATIVE TYMPANIC-MEMBRANE MASTOIDITIS CROSS-SECTIONAL STUDIES

p style=text-align: justify;strongOBJECTIVE:/strong 1) To describe patterns of Filipino Voice Handicap Index (VHI) scores in relation to the demographic data of dysphonic patients; 2) To describe patterns of Filipino VHI scores in relation to the different pathologies of dysphonia as determined by videostroboscopy.br /br /strongMETHODS: br /Design:/strong Cross-sectional study br /strongSetting:/strong Tertiary Government Hospitalbr /strongPopulation:/strong Adult patients (? 18 years olrd), proficient in Filipinobr /br /A group of 124 dysphonic patients seen at the Videostroboscopy Unit completed the Filipino VHI. Demographic data were collected Videostroboscopy diagnoses were classified into six goups: normal, mass, lesions, inflammatory, mucosal irregularities, functional and neurogenic. The T-test was used to determine differences in scores among the demographic parameters and the pathology groups. ANOVA one-way factor was used to determine difference of subscaleo scres within each pathology group, and to determine difference of pathology scores in each subscale. Differences were considered statistically significant if plt;0.05. RESULTS: /strongStatistical analyses showed that Fiipino VHI scores were affected by age, gender, educational status and occupation. Younger patients significantly scored higher than patientsgt;40 years old. Females had significantly higher scores than males in the functional, physical and total subscales. Patients with lower educational status scored higher compared to college graduates. Voice professionals significantly scored higher than the non-voice professionals. Dysphonic patients significantly scored higher than normal volunteers. Among the pathological groups, neurogenic lesions had the highest scores. Physical subscale scores were significantly higher in all lesions except in functional lesions.br /br /strongCONCLUSION:/strong The Filipino VHI is comparable to the other versions of the VHI, with patterns similar to other versions. It gives the clinician a measure of a dysphonic patient's handicap, and is an invaluable tool in quantifying severity of dysphonia./p
Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; Voice Disorders ; Dysphonia ; VOICE

BACKGROUND AND AIMS: Acute otitis media (AOM) seems to be a significant public health problem, but national data on its prevalence is lacking. This study aims to determine the prevalence of acute otitis media in the Philippines and characterize this population.
METHODS: A cross-sectional survey of children 0-12 years old in community health centers and schools was performed, utilizing a multi-stage cluster sampling design.
RESULTS: Thirteen areas were included in the survey with 26 household and school clusters, surveying a total of 2,277 children. There were 218 children with clinically diagnosed acute otitis media, with an overall prevalence rate of 9.6%. Among the children with AOM, 108 (10%) were male while 110 (9.2%) were female. There were 32 (14.6%) cases of AOM in the 0-2 year olds, 56 (9.5%) in the 3-6 year olds, and 117 (8.4%) in the 7-12 year old children.
CONCLUSIONS: The overall prevalence of clinically diagnosed acute otitis media in the Philippines is 9.6%, with a variables area-specific prevalence. There is no gender predilection, with the 0-2 age group having the most prevalent cases of AOM in the sample.

Human ; Male ; Female ; Child ; Child Preschool ; Infant ; Infant Newborn ; Otitis Media ; Inflammation ; Ear ; Prevalence ; Diagnosis ; Acute Disease ; Community Health Centers

OBJECTIVES:To determine the agreement between 1) ear examination findings of the otorhinolaryngologist using an otoscope and trained elementary school nurses using a penlight, 2) hearing screening findings of the otorhinolaryngologist and elementary school nurses, both using the Philippine National Ear Institute (PNEI) Method of 512 Hz Tuning Fork Test (TFT) and 3) PNEI Method of 512 Hz TFT findings and screening audiometry findings.
METHODS:In this continuing study, nurses residing in the venue of the study, and previously trained in ear examination using a penlight and hearing screening using the PNEI 512 Hz TFT, conducted these in school children who attended the hearing screening and medical mission. Otoscopy, PNEI Method of 512 Hz TFT, and screening audiometry were then conducted on the children by the otolaryngologist. The nurses and the otolaryngologist performed independent and blinded assessments.
RESULTS:Eighteen nurses and ninety children participated in the study. Data subjected to Kappa statistics showed good agreement between nurses and otorhinolaryngologist's findings in the examination of the external canal and tympanic membrane and in PNEI Method of 512 Hz TFTs, and between the PNEI Method of 512 Hz TFT and screening audiometry.
CONCLUSION:PNEI methods of penlight ear examination and 512 Hz TFT may be effective tools for early detection of common ear conditions and hearing screening in Filipino school children. These may be conducted in the school setting not only by otorhinolaryngologists but also by adequately trained school nurses.

Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Child ; Child Preschool ; Diagnosis ; Nurses ; Hearing ; Audiometry ; Child ; Ear Diseases ; Early Diagnosis ; Humans ; Otolaryngologists ; Otoscopes ; Otoscopy ; Philippines ; Religious Missions ; Schools ; Tympanic Membrane ; Hearing Tests

OBJECTIVE: To explore the effects of pesticide exposure on the auditory system, specifically on hearing status based on auditory brainstem responses.

METHODS: A cohort of pregnant women was identified in several communities in a rural area from April 2002 to February 2003 and followed up until delivery. Mother-infant dyads were assessed for exposure to pesticides. Maternal and fetal exposures to environmental toxic products were determined by measuring levels in maternal hair and blood, and infant cord blood, hair, and meconium, respectively. Hearing status was measured using otoacoustic emissions (OAE) and confirmed by diagnostic auditory brainstem responses (ABR) measured at 80, 60, and 40 decibels. Waves I, III, V were identified and absolute latencies measured, including inter-peak latencies from waves 11III, I-V, and III-V. Pesticide exposure was then correlated with latencies of Waves I, III, V, and interpeak latencies of waves I-III, IIV, and III-V. Hearing loss and pesticide exposures were correlated with Griffiths Mental Development Scores (GMDS).

RESULTS: Significant delays in the ABR wave latencies were noted in the group with exposure to pesticides. Propoxur was the most common toxic product detected in infants and meconium the best substrate for its detection. There was a 1.4% risk of hearing loss with exposure to propoxur (RR=0.52 (0.12-2.30), p = 0.06), a 6.25% risk with cypermethrin exposure (RR= 4.53 (0.61133.64), P = 0.10) and 6.25% risk with pretilachlor exposure (3.13 (0.44-22.30), p = 0.07). Griffith's Mental Developmental Scale scores (GMDS- hearing and speech subscale and general quotient scores) were not significantly different between exposed and unexposed groups. However, three infants with positive exposures and hearing loss had below average, or low to average scores using this scale.

CONCLUSION: Maternal exposure to environmental toxic products may affect the auditory pathway in infants at birth. Pregnant women should limit their exposure to such toxic products in order to avoid neurodevelopmental effects particularly on hearing because this is very important in the critical stage of language and speech development.

Human ; Male ; Female ; Infant Newborn ; Auditory Pathways ; Maternal Exposure ; Meconium ; Speech ; Otoacoustic Emissions, Spontaneous ; Hearing Loss ; Deafness ; Hearing Tests ; Acetanilides ; Pesticides ; Hair