Arquivos Internacionais de Otorrinolaringologia 2011; 15(02): 203-207
DOI: 10.1590/S1809-48722011000200013
Original Article
Thieme Publicações Ltda Rio de Janeiro, Brazil

Audiologic Evaluation of Patients with Mucopolysaccharidosis at a Pediatric Hospital

Avaliação Audiológica de Pacientes com Mucopolissacaridose em um Hospital Pediátrico
Ariana Braga Gomes
*   Otorhinolaryngologist Doctor. Fellow at Pequeno Príncipe Hospital's Pediatric Otorhinolaryngology Department.
,
Rodrigo Guimarães Pereira
**   Pediatric Otorhinolaryngologist. Fellowship Coordinator at Pequeno Príncipe Hospital's Pediatric Otorhinolaryngology Department.
,
Tríssia Maria Farah Vassoler
***   Otorhinolaryngologist Doctor. Pediatric Otorhinolaryngologist at Pequeno Príncipe Hospital.
,
Lauro João Lobo Alcantara
***   Assistant Professor of Otorhinolaryngology of UFPR's Medical School (Head of Pequeno Príncipe Hospital's Pediatric Otorhinolaryngology Department).
,
Elise Zimmermann
***   Otorhinolaryngologist Doctor. Pediatric Otorhinolaryngologist at Pequeno Príncipe Hospital.
,
Mara Lúcia Schmitz Ferreira Santos
*****   Neuropediatrician at Pequeno Príncipe Hospital. Coordinator at the Emergency Department of Inborn Error of Metabolism at Pequeno Príncipe Hospital.
› Author Affiliations
Further Information

Publication History

16 January 2011

09 March 2011

Publication Date:
12 February 2014 (online)

Summary

Introduction: Mucopolysaccharidosis are characterized by the deficit of lysosomal enzymes corrupting the glycosaminoglycans. Accumulating these metabolites causes several alterations, such as otologic alterations.

Objective: To evaluate a number of patients with mucopolysaccharidosis at Pequeno Principe Hospital, emphasizing their audiologic alterations and establish a permanent evaluation protocol for these patients.

Method: A backward-looking study of audiologic evaluation by using records of 18 patients diagnosed with mucopolysaccharidosis and attended at Pequeno Principe Hospital between January 2005 and November 2010.

Results: 7 records were selected, out of which only one did not have a hearing loss, and most of them presented conductive or mixed hearing loss, and only one had an exclusively sensorineural loss. Six of these patients had also been submitted to at least one otorhinolaryngological procedure.

Conclusion: Mucopolysaccharidosis patients require a permanent care and a multidisciplinary follow-up. The pediatric otorhinolaryngologist plays an important role when performing the otologic and audiologic evaluation and managing the airways, since almost all the patients evaluated presented some kind of hearing loss and an indication of otorhinolaryngologic procedure. The pattern determined in our service was at least an initial consultation when there is a suspicion and/or diagnosis of MPS and sequential consultations that were at least twice a year or more frequent, if necessary.

Resumo

Introdução: Mucopolissacaridoses são caracterizadas pela deficiência de enzimas lisossomais que degradam glicosaminoglicanos. O acúmulo destes metabólitos causa alterações variadas, entre elas, alterações otológicas.

Objetivo: Avaliar uma série de pacientes com mucopolissacaridose no Hospital Pequeno Príncipe, enfatizando suas alterações audiológicas e estabelecer um protocolo permanente de avaliação desses pacientes.

Método: Estudo retrospectivo da avaliação audiológica através de 18 prontuários de pacientes com diagnóstico de mucopolissacaridose atendidos no Hospital Pequeno Príncipe entre janeiro de 2005 e novembro de 2010.

Resultados: Foram selecionados sete prontuários, destes, apenas um não apresentava perda auditiva, sendo que a maioria apresentava perda do tipo condutiva ou mista e apenas um perda exclusivamente neurossensorial. Seis destes pacientes também haviam sido submetidos a pelo menos um procedimento otorrinolaringológico.

Conclusão: Os pacientes com mucopolissacaridose requerem cuidados permanentes e acompanhamento multidisciplinar. O otorrinolaringologista pediátrico ocupa importante papel tanto na avaliação otológica e audiológica quanto no manejo das vias aéreas, já que quase a totalidade dos pacientes avaliados apresentavam algum tipo de perda auditiva e indicação de procedimentos otorrinolaringológicos. O padrão definido em nosso serviço foi de ao menos uma consulta inicial quando houver suspeita e/ou diagnóstico da MPS e consultas sequenciais, no mínimo semestrais, ou mais frequentes conforme necessidade.

 
  • Bibliographical References

  • 1 Yeung AH, Cowan MJ, Horn B, Rosbe KW. Airway Management in Children With Mucopolysaccharidoses. Arch Otolaryngol Head Neck Surg 2009; 135 (1) 73-79
  • 2 Simmons MA, Bruce IA, Penney S, Wraith E, Rothera MP. Otorhinolaryngological manifestations of the Mucopolysaccharidoses. Int J Pediatr Otorhinolaryngol 2005; 69: 589-595
  • 3 Pinto LLC. Um estudo sobre a história natural da mucopolissacaridose tipo II (Síndrome de Hunter) em pacientes brasileiros. [dissertação] Porto Alegre (RS). UFRS, 2005.
  • 4 Wold SM, Derkay CS, Darrow DH, Proud V. Role of the pediatric otolaryngologist in diagnosis and management of children with mucopolysaccharidoses. Intl J Pediatr Otorhinolaryngol 2010; 74: 27-31
  • 5 Meikle PJ, Hopwood JJ, Clague AE, Carey WF. Prevalence of lysosomal storage disorders. J Am Med Assoc 1999; 281 (3) 249-254
  • 6 Shinhar SY, Zablocki H, Madgy DN. Airway management in mucopolysaccharide storage disorders. Arch Otolaryngol Head Neck Surg 2004; 130: 233-237
  • 7 Friedmann I, Spellacy E, Crow J, Watts RW. Histopathological studies of the temporal bones in Hurler's disease (mucopolysaccharidosis IH). J Laryngol Otol 1985; 99: 29-41
  • 8 Walker RWM, Colovic V, Robinson DN, Dearlove OR. Postobstructive pulmonary oedema during anaesthesia in children with mucopolysaccharidoses. Paediatr Anaesth 2002; 12: 1-7
  • 9 Belani KG, Krivit W, Carpenter BL, Braunlin E, Buckley JJ, Liao JC , et al. Children with mucopolysaccharidoses: perioperative care, morbidity, mortality, and new findings. J Pediatr Surg 1993; 28 (3) 408-410
  • 10 Papsin BC, Vellodi A, Bailey CM, Ratcliffe PC, Leighton SE. Otologic and laryngologic manifestations of mucopolysaccharidoses after bone marrow transplantation. Otolaryngol Head Neck Surg 1998; 118 (1) 30-36