Abstract Introduction Balloon eustachian tuboplasty (BET) allows the treatment of the main etiology of eustachian tube disfunction (ETD). Objective To eval uate the ef ficacy of isolated BET, through objective and subjective results, in the short and medium term, in patients with chronic obstructive ETD. Methods Adult patients diagnosed with chronic obstructive ETD who underwent BET between January 2018 and December 2020 were enrolled in the study. We performeda prospective observational study of BET efficacy, by comparing subjective data, based on the Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7), and objective data, obtained by tympanometry, objective Valsalva maneuver and tubomanometry, prior to BET with these outcome tools on postprocedure follow-up. Results In total, 30 BETs were performed and analyzed. There were no complications with the procedure. Analysis of BET efficacy was performed in the short-term (average of 7.5 weeks) and in the medium-term (average of 8 months). There was a significant reduction (p < 0.0001) in the total ETDQ-7 score from baseline to both follow-up periods. A normalization of the ETDQ-7 score was observed in 60 and 83.3% of the performed procedures, in the short- and medium-term, respectively. In tubomanometry, we verified a significant improvement (p < 0.0001) at all pressures, with a normalization of tubomanometry values in 53.3% and 43.3% of cases in the short-and medium-term, respectively. Tympanogram normalization occurred in 71.4% of patients with abnormal preoperative assessments. Conclusion As an isolated procedure, BET results in significant improvements in symptomatology and objective metric results. This, associated with its safety profile, currently makes BET the most indicated therapeutic option in refractory obstructive ETD. (BET . (ETD) term 201 202 data Questionnaire7 Questionnaire 7 Questionnaire- ETDQ7, ETDQ7 ETDQ , (ETDQ-7) tympanometry followup. followup follow up. up 3 analyzed procedure shortterm average 75 5 7. weeks mediumterm months. months months) p 0.0001 00001 0 0001 ETDQ- periods 6 833 83 83.3 procedures mediumterm, respectively pressures 533 53 53.3 433 43 43.3 shortand 714 71 4 71.4 assessments This profile (ETD 20 (ETDQ-7 0.000 0000 000 83. 53. 43. 71. 2 (ETDQ- 0.00 00 (ETDQ 0.0 0.

Abstract Introduction Tinnitus is experienced by a significant part of the patients suffering from otosclerosis. Objective To assess the prevalence of tinnitus in otosclerosis, its main features, and the impact on the daily life. Methods Patients diagnosed with otosclerosis in 2019 in a tertiary hospital were enrolled in the study. Demographic data were retrieved and, besides a regular audiometric evaluation, the patients underwent acuphenometry to assess the psychoacoustic measurements (pitch and loudness), and the Tinnitus Handicap Inventory (THI). Results In total, 66 patients fulfilled the inclusion criteria, with a female predominance (63.6%; n = 42), and a mean age of 48.7 years. The mean air-bone gap was of 26.3 dB. A total of 72.7% complained of tinnitus; it was mostly unilateral, identified in the low frequencies, namely 500 Hz, with median loudness of 7.5 dB. The median score on the THI score was of 37; most patients had a mild handicap (33.3%, n = 16), followed by those with a severe handicap (22.9%; n = 11). The female gender had a statistically significant association with the presence of tinnitus. The THI scores were higher in middle-aged patients (age groups: 40 to 49 and 50 to 59 years), which was statistically significant. No correlation was found between audiometry results and the prevalence of tinnitus or score on the THI. On the other hand, high-pitched tinnitus, compared to low pitched-tinnitus, was associated with larger air-bone gaps. Conclusion The prevalence of tinnitus in our population was in line with the prevalences reported in the literature. It caused a catastrophic handicap in 22.9% of the patients. High-pitched tinnitus was associated with higher handicap. Nonetheless, the existence of tinnitus and its severity were not associated with the degree of hearing loss.

Introdução: A Consulta da Primeira Infância do Departamento de Pedopsiquiatria do Centro Hospitalar do Porto foi criada em 2007. Pretendemos caracterizar as crianças observadas em primeiras consultas entre Junho de 2012 e Junho de 2013. Métodos: Consulta de processos e recolha de dados sociodemográficos e clínicos; avaliação diagnóstica através da Diagnostic Classification of Mental Health and Development Disorders of Infancy and Early Childhood: Revised Edition; análise estatística com SPSS v.19.0. Resultados e Discussão: Foram avaliadas 222 crianças, a maioria do sexo masculino (63,1%). As crianças observadas ao abrigo dos protocolos institucionais - sem sintomatologia específica (SSE) (43,7%) e as que apresentavam alterações de linguagem (12,6%), foram os principais motivos de consulta. Quarenta e nove (22,1%) apresentavam psicopatologia, destacando-se: Perturbação da Regulação do Processamento Sensorial (38,8%), Perturbação do Afeto (24,5%) e Perturbação da Relação e da Comunicação (22,4%). Em 57 casos (33,0%) verificaram-se alterações somente a nível relacional, maioritariamente com características de subenvolvimento (16,2%). Oitenta e oito (39,6%) revelaram Atraso Global do Desenvolvimento, sendo a escala da audição/linguagem a mais afetada (54,1%). Comparativamente com a casuística anterior, a média de idades de referenciação foi inferior, o que pode ser indicativo de uma maior sensibilização profissional e comunitária. Observámos menos crianças com diagnóstico no Eixo I mas um número equivalente com dificuldades relacionais. Conclusão: A maioria das crianças referenciadas tinha menos de três anos de idade e apresentava alterações a nível de saúde mental. Nos últimos anos, a saúde mental da primeira infância tem sido uma área de investimento crescente, nomeadamente na identificação de grupos de risco e de sinais de alerta de psicopatologia infantil, possibilitando a intervenção precoce.

Introduction: The Infancy and Early Childhood Psychiatric Outpatient Clinic at the Oporto Hospital Centre’s Department of Child and Adolescent Psychiatry opened in 2007. Our aim is to characterize the first consultations between June 2012 and June 2013. Methods: Review of clinical files and collection of demographic and medical data; diagnostic evaluation according to the Diagnostic Classification of Mental Health and Development Disorders of Infancy and Early Childhood: Revised Edition; statistical analysis using SPSS v.19.0. Results and Discussion: Two hundred and twenty-two children were evaluated and 63.1% were male. The main reasons for referral to consultation were children with no specific symptoms included in institutional protocols (43.7%) and language disorders (12.6%). Forty-nine (22.1%) had psychopathology, namely: Regulation Disorder of Sensory Processing (38.8%), Disorder of Affect (24.5%) and Disorder of Relating and Communicating (22.4%). In 57 cases (33.0%) there were alterations solely at the relational level, mostly underinvolved (16.2%). Eighty-eight (39.6%) showed Global Developmental Delay, and the scale of hearing / language was the most affected (54.1%). Compared to the previous study, the average age of referral was lower, which may be indicative of greater professional and community awareness. We observed fewer children with Axis I diagnosis but an equivalent number of those with relational difficulties. Conclusion: Most children referred were under the age of three and presented clinical indicators of mental suffering. In the last years, mental health in early childhood has been an area of growing investment, namely in the early identification of risk groups and signs of mental suffering, allowing mental carers to intervene preemptively.

Introdução: A laryngotracheobronchitis (LTB) vírica constitui a causa mais comum de estridor nas crianças que recorrem ao Serviço de Urgência. Na ausência de resposta ao tratamento com corticóide e adrenalina nebulizada, a traqueíte bacteriana deve ser considerada. Caso Clínico: Criança de seis anos de idade observada no Serviço de Urgência por estridor, sinais de dificuldade respiratória e febre com resposta parcial à terapêutica com adrenalina nebulizada; por suspeita de LTB com sobreinfeção bacteriana iniciou terapêutica empírica com ceftriaxone. Apesar da terapêutica, desenvolveu celulite cervical com posterior evolução para abcesso retrofaríngeo e mediastinite. Boa evolução após terapêutica com ceftriaxone, clindamicina e vancomicina. Discussão/Conclusões: Os autores descrevem um caso de traqueíte bacteriana complicada de abcesso retrofaríngeo e mediastinite, até agora não descrito na literatura. Pretendem elucidar que a traqueíte bacteriana é uma doença potencialmente ameaçadora à vida e que requer alto índice de suspeição para diagnóstico célere.

Introduction: Viral croup is the most common cause of stridor in children seen at emergency room. In the absence of response to treatment with corticosteroids and nebulized adrenaline, bacterial tracheitis should be considered. Case Report: A six year-old child, was admitted in emergency room with stridor, respiratory distress and fever, with partial response to therapy with nebulized epinephrine. Ceftriaxone was prescribed for suspected bacterial laryngotracheobronchitis. Despite therapy, developed cervical cellulitis with progression to retropharyngeal abscess and mediastinitis. Good outcome after therapy with ceftriaxone, clindamycin and vancomycin. Discussion/Conclusion: The authors describe an original case of a bacterial tracheitis complicated with retropharyngeal abcess and mediastinitis, emphasizing that bacterial tracheitis is potentially life threatening, requiring a high index of suspicion for early diagnosis.