[Rhinosinusitis in cystic fibrosis].

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[Rhinosinusitis in cystic fibrosis].

HNO. 2015 Oct 22;

Authors: Mainz JG, Gerber A, Arnold C, Baumann J, Baumann I, Koitschev A

Abstract
In cystic fibrosis (CF) mucociliary clearance of the entire respiratory system is impaired. This allows pathogens, such as Pseudomonas aeruginosa to persist and proliferate, which by progressive pulmonary destruction causes 90 % of premature deaths due to this inherited disease. The dramatic improvement in life expectation of patients due to intensive therapy has resulted in the inevitable but variably expressed sinonasal involvement coming into the clinical and scientific focus. Thereby, almost all CF patients reveal sinonasal pathology and many suffer from chronic rhinosinusitis. Recently, the sinonasal niche has been recognized as a site of initial and persistent colonization by pathogens. This article presents the pathophysiological background of this multiorgan disease as well as general diagnostic and therapeutic standards. The focus of this article is on sinonasal involvement and conservative and surgical options for treatment. Prevention of pathogen acquisition is an essential issue in the otorhinolaryngological treatment of CF patients.

PMID: 26495450 [PubMed - as supplied by publisher]

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Influence of Voice Focus on Oral-Nasal Balance in Speech.

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Influence of Voice Focus on Oral-Nasal Balance in Speech.

J Voice. 2015 Oct 19;

Authors: de Boer G, Bressmann T

Abstract
OBJECTIVES: The concept of voice focus describes the relationship of the vocal tract length on the perceived brightness or darkness of the speaker's voice. The present study explored the impact of adjustments of the voice focus on oral-nasal balance. The vocal tract settings in question were backward focus (retracted tongue, wide pharynx, and lowered larynx) and forward focus (fronted tongue, constricted pharynx, and raised larynx). The backward focus condition was expected to decrease nasalance scores and the forward focus condition was expected to increase nasalance scores.
STUDY DESIGN: Experimental repeated-measures study.
METHODS: Sixteen females aged 23.78 (standard deviation 1.99) produced oral and nasal test sentences with a backward focus and a forward focus. Audio recordings and nasometry measurements were made. Nine of the participants completed the task successfully.
RESULTS: In a repeated-measures analysis of variance, the nasalance scores were compared across stimuli, speaking condition, and repetition. There was a main effect for stimuli (F = 109.37, P < 0.0001). In a follow-up analysis of variance we found a condition effect for the nasal stimulus (F = 17.91, P < 0.0001). For the nasal stimulus, the nasalance scores of the backward focus were lower, and the nasalance scores of the forward focus were higher than in the normal condition.
CONCLUSIONS: Changing the voice focus influenced oral-nasal balance more when the velopharyngeal port was open. Future studies should explore the possible treatment potential of voice focus for patients with hypernasality.

PMID: 26494180 [PubMed - as supplied by publisher]

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Head and neck adenoid cystic carcinoma: A prospective multicenter REFCOR study of 95 cases.

Related Articles

Head and neck adenoid cystic carcinoma: A prospective multicenter REFCOR study of 95 cases.

Eur Ann Otorhinolaryngol Head Neck Dis. 2015 Oct 19;

Authors: Meyers M, Granger B, Herman P, Janot F, Garrel R, Fakhry N, Poissonnet G, Baujat B, REFCOR members

Abstract
OBJECTIVES: To describe the clinical, histological and therapeutic characteristics of a prospective multicenter series of 95 head and neck adenoid cystic carcinoma patients, and to determine any prognostic factors for disease-free survival.
PATIENTS AND METHODS: Ninety-five patients with adenoid cystic carcinoma were included in the Réseau d'Expertise Français Des Cancers ORL Rares (REFCOR, French Rare Head and Neck Cancer Expert Network) database between 2009 and 2012. The primary site was the salivary glands in 39 cases, sinus cavities (including hard palate) in 36 cases, pharynx-larynx-trachea in 14 cases, and lips and oral cavity in 4 cases. The tumor was stage I in 15% of cases, stage II in 23%, stage III in 26% and stage IV in 36%. Nine patients had cervical lymph node involvement and 5 had metastases at diagnosis. Fifty-six percent of patients were managed by surgery with postoperative radiation therapy. During follow-up, 3 patients died, 9 developed metastases and 12 showed recurrence or local progression.
RESULTS: Mean follow-up was 18 months. On univariate analysis, disease-free survival correlated with T stage (P=0.05), N stage (P=0.003), resection margins (P=0.04), lymph node involvement on histology (P=0.01), and absence of chemotherapy (P=0.03). On multivariate analysis, disease-free survival correlated with T stage (P=0.01), N stage (P=0.09) and surgery (P=0.005).
CONCLUSION: The essential issue in adenoid cystic carcinoma is long-term control. The present results confirm that the reference attitude is radical surgical resection for optimal local control. Adjuvant radiation therapy did not emerge as a prognostic factor. This study also provides a starting-point for translational studies in pathology and genetics.

PMID: 26493113 [PubMed - as supplied by publisher]

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The use of laryngeal mask airway Supreme™ in rescue airway situation in the critical care unit.

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The use of laryngeal mask airway Supreme™ in rescue airway situation in the critical care unit.

Singapore Med J. 2014 Dec;55(12):e205-6

Authors: Siddiqui S, Seet E, Chan WY

Abstract
We herein report a witnessed cardiopulmonary collapse of a patient with difficult mask ventilation and near-impossible laryngoscopy-cum-intubation in the critical care unit. The airway was successfully rescued with a laryngeal mask airway Supreme™, followed by an open, crash tracheostomy by the otolaryngologist.

PMID: 25630328 [PubMed - indexed for MEDLINE]

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Which ear should we choose for cochlear implantation in the elderly: The poorer or the better? Audiometric outcomes, quality of sound, and quality-of-life results.

Related Articles

Which ear should we choose for cochlear implantation in the elderly: The poorer or the better? Audiometric outcomes, quality of sound, and quality-of-life results.

Acta Otolaryngol. 2015 Dec;135(12):1268-76

Authors: Lassaletta L, Calvino M, Sánchez-Cuadrado I, Pérez-Mora RM, Gavilán J

Abstract
CONCLUSIONS: Cochlear implantation in the poorer ear of an elderly patient does not predict poorer post-operative audiological, quality-of-life (QoL), and quality of sound results.
OBJECTIVES: To determine whether choosing the 'better' or the 'poorer' ear for cochlear implantation impacts performance outcome in an elderly population.
METHODS: Forty-two out of 73 elderly (≥ 60 years) cochlear implant users with some residual hearing in at least one ear were selected. Three criteria were used to group the patients as 'better' or 'poorer' ear implanted; (C1) based on previous use of hearing aid, (C2) pre-operative PTA, and (C3) pre-operative speech discrimination. The Glasgow Benefit Inventory (GBI) and the Hearing Implant Sound Quality Index (HISQUI) were used to measure QoL and quality of sound, respectively.
RESULTS: The mean post-operative PTA was 38.7 ± 7.2 dBHL. In quiet, the mean disyllabic SDS at 65dBSPL was 75.4 ± 18.5, whereas the discrimination of sentences was 95.0% ± 6.9. The mean total GBI score was 30.9 ± 21.8, 92.9% of patients reporting a positive score. The mean HISQUI score was 111.3 ± 36.0, which corresponds to 'moderate' sound quality. No significant differences were found between both groups in terms of audiological outcomes, HISQUI scores or GBI scores when considering each of the three criteria.

PMID: 26493303 [PubMed - in process]

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A retrospective study on post-operative hearing of middle ear cholesteatoma patients with labyrinthine fistula.

Related Articles

A retrospective study on post-operative hearing of middle ear cholesteatoma patients with labyrinthine fistula.

Acta Otolaryngol. 2015 Oct 23;:1-4

Authors: Bo Y, Yang Y, Xiaodong C, Xi W, Keyong T, Yu Z, Ye W, Kun L, Zheng Y, Yang C, Jianhua Q

Abstract
CONCLUSIONS: There is no significant change in bone conduction threshold after operation, so the tympanoplasty can be done to maintain hearing when conditions allow.
OBJECTIVE: To study the impact of surgical treatment on hearing of cholesteatoma patients with labyrinthine fistula.
METHODS: The clinical data of 35 patients (35 ears) with labyrinthine fistula, which were caused by cholesteatoma, were analyzed retrospectively. The hearing of 21 patients was followed up.
RESULTS: Three months to 5 years follow-up of 21 patients were accomplished by pure tone audiometry and other details. There was no recurrent cholesteatoma in the patients. Compared with pre-operative average bone conduction at 0.5, 1, 2, 4, and 8 kHz, 12 cases had a difference less than 5 dB, three patients' hearing improved (more than 10 dB), and five cases declined (more than 10 dB). One patient received cochlear implantation 3 months after the surgery. The average bone and air conduction thresholds at 0.5, 1, 2, 4, and 8 kHz had no obvious change (p > 0.05) in 11 patients managed by a canal wall down mastoidectomy with tympanoplasty.

PMID: 26493192 [PubMed - as supplied by publisher]

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Round window application of an active middle ear implant (AMEI) system in congenital oval window atresia.

Related Articles

Round window application of an active middle ear implant (AMEI) system in congenital oval window atresia.

Acta Otolaryngol. 2015 Oct 23;:1-11

Authors: Zhao S, Gong S, Han D, Zhang H, Ma X, Li Y, Chen X, Ren R, Li Y

Abstract
CONCLUSION: Application of the Vibrant Soundbridge to the round window (RW) membrane can be utilized as an efficient therapy for congenital oval window (OW) atresia.
OBJECTIVE: To report the surgical technique and auditory outcome of an active middle ear implant (AMEI) system used in patients with congenital OW atresia.
METHODS: Nine subjects with congenital OW atresia (six males and three females, ranging in age from 5.5 to 25 years, average 12.5 years) were implanted with an AMEI (Vibrant Soundbridge) at the round window (RW-Vibroplasty). Five cases were diagnosed as having isolated congenital OW atresia while four patients presented with combined external/middle ear malformation.
RESULTS: An improvement of 30 dB in average pure-tone air conduction thresholds (0.5-4 kHz) was achieved, with the high frequencies showing greater results. The subjects achieved postoperative speech recognition scores of 80-100% on the Computerized Mandarin Speech Test System (CMSTS) sentence test. Bone conduction thresholds were confirmed as stable in all subjects postoperatively. Decline in auditory benefit was noticed in two subjects, who then underwent revision surgery. One of these revision surgery patients then experienced stable hearing recovery, while the other patient's hearing declined.

PMID: 26493073 [PubMed - as supplied by publisher]

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Analysis of factors in successful nasal endoscopic resection of nasopharyngeal angiofibroma.

Related Articles

Analysis of factors in successful nasal endoscopic resection of nasopharyngeal angiofibroma.

Acta Otolaryngol. 2015 Oct 23;:1-9

Authors: Ye D, Shen Z, Wang G, Deng H, Qiu S, Zhang Y

Abstract
CONCLUSIONS: Endoscopic resection of nasopharyngeal angiofibroma is less traumatic, causes less bleeding, and provides a good curative effect. Using pre-operative embolization and controlled hypotension, reasonable surgical strategies and techniques lead to successful resection tumors of a maximum Andrews-Fisch classification stage of III.
OBJECTIVE: To investigate surgical indications, methods, surgical technique, and curative effects of transnasal endoscopic resection of nasopharyngeal angiofibroma, this study evaluated factors that improve diagnosis and treatment, prevent large intra-operative blood loss and residual tumor, and increase the cure rate.
METHODS: A retrospective analysis was performed of the clinical data and treatment programs of 23 patients with nasopharyngeal angiofibroma who underwent endoscopic resection with pre-operative embolization and controlled hypotension. The surgical method applied was based on the size of tumor and extent of invasion. Curative effects were observed.
RESULTS: No intra-operative or perioperative complications were observed in 22 patients. Upon removal of nasal packing material 3-7 days post-operatively, one patient experienced heavy bleeding of the nasopharyngeal wound, which was treated compression hemostasis using post-nasal packing. Twenty-three patients were followed up for 6-60 months. Twenty-two patients experienced cure; one patient experienced recurrence 10 months post-operatively, and repeat nasal endoscopic surgery was performed and resulted in cure.

PMID: 26492972 [PubMed - as supplied by publisher]

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Endoscopic butterfly cartilage myringoplasty.

Related Articles

Endoscopic butterfly cartilage myringoplasty.

Acta Otolaryngol. 2015 Oct 23;:1-5

Authors: Özgür A, Dursun E, Terzi S, Erdivanlı ÖÇ, Coşkun ZÖ, Oğurlu M, Demirci M

Abstract
CONCLUSION: Based on the results of this study, it is believed that, in appropriate patients with tympanic membrane perforation, the endoscopic butterfly cartilage myringoplasty can be applied, with a shorter operation time, high graft success rate, and low risk of complications.
OBJECTIVE: The aim of this study was to evaluate the results of the endoscopic butterfly cartilage myringoplasty in terms of the graft success rate and hearing gain.
METHODS: Forty-five ears of the 42 patients who were subjected to endoscopic butterfly cartilage myringoplasty surgery between January 2013 and December 2014 were included in this study. The archival records of the patients were reviewed retrospectively, evaluating the pre-operative and post-operative hearing results and post-operative graft success rates in the early and late periods.
RESULTS: The graft success rates were 97.8% (44/45 ears) and 95.6% (43/45 ears) at the post-operative 1- and 6-month follow-ups, respectively. When the post-operative air conduction hearing thresholds were compared, significant improvement was seen at post-operative 1- and 6-month follow-ups in the hearing thresholds, when compared to the pre-operative levels (p < 0.001).

PMID: 26492853 [PubMed - as supplied by publisher]

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Epidemiology and Clinical Presentation of Medullary Thyroid Carcinoma.

Related Articles

Epidemiology and Clinical Presentation of Medullary Thyroid Carcinoma.

Recent Results Cancer Res. 2015;204:61-90

Authors: Raue F, Frank-Raue K

Abstract
Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor originating from the thyroid C cells producing mainly calcitonin (CTN) used as tumor marker. MTC occurs either sporadic (75 %) or in a hereditary form (multiple endocrine neoplasia type 2, MEN2), due to germline mutations in the RET proto-oncogene. The discovery of an MTC in a patient has several diagnostic implications involving a specific strategy: preoperative evaluation of the tumor marker CTN and the extent of the disease, classification of MTC as sporadic or hereditary by DNA testing, and screening for associated endocrinopathies in hereditary MTC. Elevated CTN is a highly sensitive and specific tumor marker for diagnosis and follow-up of MTC. CTN is directly related to the tumor mass. In patients with nodular thyroid disease, diagnosis of MTC could be made by CTN determination as an indicator of tumor burden in conjunction with fine-needle aspiration. Patients with confirmed sporadic or hereditary MTC should have a total thyroidectomy and depending on the preoperative CTN value and the extent of disease additional dissection of the lymph nodes in the central and lateral neck compartment. In MEN 2 patients diagnosed by screening, the time of prophylactic thyroidectomy depends on RET mutation and CTN level.

PMID: 26494384 [PubMed - as supplied by publisher]

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Which ear should we choose for cochlear implantation in the elderly: The poorer or the better? Audiometric outcomes, quality of sound, and quality-of-life results.

Related Articles

Which ear should we choose for cochlear implantation in the elderly: The poorer or the better? Audiometric outcomes, quality of sound, and quality-of-life results.

Acta Otolaryngol. 2015 Dec;135(12):1268-76

Authors: Lassaletta L, Calvino M, Sánchez-Cuadrado I, Pérez-Mora RM, Gavilán J

Abstract
CONCLUSIONS: Cochlear implantation in the poorer ear of an elderly patient does not predict poorer post-operative audiological, quality-of-life (QoL), and quality of sound results.
OBJECTIVES: To determine whether choosing the 'better' or the 'poorer' ear for cochlear implantation impacts performance outcome in an elderly population.
METHODS: Forty-two out of 73 elderly (≥ 60 years) cochlear implant users with some residual hearing in at least one ear were selected. Three criteria were used to group the patients as 'better' or 'poorer' ear implanted; (C1) based on previous use of hearing aid, (C2) pre-operative PTA, and (C3) pre-operative speech discrimination. The Glasgow Benefit Inventory (GBI) and the Hearing Implant Sound Quality Index (HISQUI) were used to measure QoL and quality of sound, respectively.
RESULTS: The mean post-operative PTA was 38.7 ± 7.2 dBHL. In quiet, the mean disyllabic SDS at 65dBSPL was 75.4 ± 18.5, whereas the discrimination of sentences was 95.0% ± 6.9. The mean total GBI score was 30.9 ± 21.8, 92.9% of patients reporting a positive score. The mean HISQUI score was 111.3 ± 36.0, which corresponds to 'moderate' sound quality. No significant differences were found between both groups in terms of audiological outcomes, HISQUI scores or GBI scores when considering each of the three criteria.

PMID: 26493303 [PubMed - in process]

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A retrospective study on post-operative hearing of middle ear cholesteatoma patients with labyrinthine fistula.

Related Articles

A retrospective study on post-operative hearing of middle ear cholesteatoma patients with labyrinthine fistula.

Acta Otolaryngol. 2015 Oct 23;:1-4

Authors: Bo Y, Yang Y, Xiaodong C, Xi W, Keyong T, Yu Z, Ye W, Kun L, Zheng Y, Yang C, Jianhua Q

Abstract
CONCLUSIONS: There is no significant change in bone conduction threshold after operation, so the tympanoplasty can be done to maintain hearing when conditions allow.
OBJECTIVE: To study the impact of surgical treatment on hearing of cholesteatoma patients with labyrinthine fistula.
METHODS: The clinical data of 35 patients (35 ears) with labyrinthine fistula, which were caused by cholesteatoma, were analyzed retrospectively. The hearing of 21 patients was followed up.
RESULTS: Three months to 5 years follow-up of 21 patients were accomplished by pure tone audiometry and other details. There was no recurrent cholesteatoma in the patients. Compared with pre-operative average bone conduction at 0.5, 1, 2, 4, and 8 kHz, 12 cases had a difference less than 5 dB, three patients' hearing improved (more than 10 dB), and five cases declined (more than 10 dB). One patient received cochlear implantation 3 months after the surgery. The average bone and air conduction thresholds at 0.5, 1, 2, 4, and 8 kHz had no obvious change (p > 0.05) in 11 patients managed by a canal wall down mastoidectomy with tympanoplasty.

PMID: 26493192 [PubMed - as supplied by publisher]

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Round window application of an active middle ear implant (AMEI) system in congenital oval window atresia.

Related Articles

Round window application of an active middle ear implant (AMEI) system in congenital oval window atresia.

Acta Otolaryngol. 2015 Oct 23;:1-11

Authors: Zhao S, Gong S, Han D, Zhang H, Ma X, Li Y, Chen X, Ren R, Li Y

Abstract
CONCLUSION: Application of the Vibrant Soundbridge to the round window (RW) membrane can be utilized as an efficient therapy for congenital oval window (OW) atresia.
OBJECTIVE: To report the surgical technique and auditory outcome of an active middle ear implant (AMEI) system used in patients with congenital OW atresia.
METHODS: Nine subjects with congenital OW atresia (six males and three females, ranging in age from 5.5 to 25 years, average 12.5 years) were implanted with an AMEI (Vibrant Soundbridge) at the round window (RW-Vibroplasty). Five cases were diagnosed as having isolated congenital OW atresia while four patients presented with combined external/middle ear malformation.
RESULTS: An improvement of 30 dB in average pure-tone air conduction thresholds (0.5-4 kHz) was achieved, with the high frequencies showing greater results. The subjects achieved postoperative speech recognition scores of 80-100% on the Computerized Mandarin Speech Test System (CMSTS) sentence test. Bone conduction thresholds were confirmed as stable in all subjects postoperatively. Decline in auditory benefit was noticed in two subjects, who then underwent revision surgery. One of these revision surgery patients then experienced stable hearing recovery, while the other patient's hearing declined.

PMID: 26493073 [PubMed - as supplied by publisher]

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Analysis of factors in successful nasal endoscopic resection of nasopharyngeal angiofibroma.

Related Articles

Analysis of factors in successful nasal endoscopic resection of nasopharyngeal angiofibroma.

Acta Otolaryngol. 2015 Oct 23;:1-9

Authors: Ye D, Shen Z, Wang G, Deng H, Qiu S, Zhang Y

Abstract
CONCLUSIONS: Endoscopic resection of nasopharyngeal angiofibroma is less traumatic, causes less bleeding, and provides a good curative effect. Using pre-operative embolization and controlled hypotension, reasonable surgical strategies and techniques lead to successful resection tumors of a maximum Andrews-Fisch classification stage of III.
OBJECTIVE: To investigate surgical indications, methods, surgical technique, and curative effects of transnasal endoscopic resection of nasopharyngeal angiofibroma, this study evaluated factors that improve diagnosis and treatment, prevent large intra-operative blood loss and residual tumor, and increase the cure rate.
METHODS: A retrospective analysis was performed of the clinical data and treatment programs of 23 patients with nasopharyngeal angiofibroma who underwent endoscopic resection with pre-operative embolization and controlled hypotension. The surgical method applied was based on the size of tumor and extent of invasion. Curative effects were observed.
RESULTS: No intra-operative or perioperative complications were observed in 22 patients. Upon removal of nasal packing material 3-7 days post-operatively, one patient experienced heavy bleeding of the nasopharyngeal wound, which was treated compression hemostasis using post-nasal packing. Twenty-three patients were followed up for 6-60 months. Twenty-two patients experienced cure; one patient experienced recurrence 10 months post-operatively, and repeat nasal endoscopic surgery was performed and resulted in cure.

PMID: 26492972 [PubMed - as supplied by publisher]

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Endoscopic butterfly cartilage myringoplasty.

Related Articles

Endoscopic butterfly cartilage myringoplasty.

Acta Otolaryngol. 2015 Oct 23;:1-5

Authors: Özgür A, Dursun E, Terzi S, Erdivanlı ÖÇ, Coşkun ZÖ, Oğurlu M, Demirci M

Abstract
CONCLUSION: Based on the results of this study, it is believed that, in appropriate patients with tympanic membrane perforation, the endoscopic butterfly cartilage myringoplasty can be applied, with a shorter operation time, high graft success rate, and low risk of complications.
OBJECTIVE: The aim of this study was to evaluate the results of the endoscopic butterfly cartilage myringoplasty in terms of the graft success rate and hearing gain.
METHODS: Forty-five ears of the 42 patients who were subjected to endoscopic butterfly cartilage myringoplasty surgery between January 2013 and December 2014 were included in this study. The archival records of the patients were reviewed retrospectively, evaluating the pre-operative and post-operative hearing results and post-operative graft success rates in the early and late periods.
RESULTS: The graft success rates were 97.8% (44/45 ears) and 95.6% (43/45 ears) at the post-operative 1- and 6-month follow-ups, respectively. When the post-operative air conduction hearing thresholds were compared, significant improvement was seen at post-operative 1- and 6-month follow-ups in the hearing thresholds, when compared to the pre-operative levels (p < 0.001).

PMID: 26492853 [PubMed - as supplied by publisher]

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Complications of Pediatric Otitis Media.

Related Articles

Complications of Pediatric Otitis Media.

Otolaryngol Head Neck Surg. 2015 Oct 22;

Authors: Lavin JM, Rusher T, Shah RK

Abstract
OBJECTIVE: Otitis media (OM) is a common diagnosis in the pediatric population that is usually managed on an outpatient basis. A small proportion of children are admitted due to a complex disease course. The aim of this study was to investigate the demographics of those patients and the resources utilized during their admissions.
STUDY DESIGN: Retrospective review based on the 2009 Kids' Inpatient Database.
SETTING: Nationwide administrative database.
SUBJECTS AND METHODS: A review based on the 2009 Kids' Inpatient Database was conducted. Inclusion criteria were clinical modification codes for OM (ICD-9 code 382). Data recorded included patient demographics, concurrent discharge diagnosis codes, length of stay, total charges, and frequency of procedures performed.
RESULTS: There were 61,783 (92,548 nationally weighted) admissions with OM, which were analyzed. The average age (SD) for the patients was 2.18 (3.49) years, and the average length of stay was 2.88 days. The majority (80.75%) of patients did not have to undergo a procedure during admission, whereas a small proportion (5.4%) underwent a major operating room procedure. There were 21 deaths recorded (0.03%). A diagnosis of mastoiditis, meningitis, venous sinus thrombosis, or intracranial abscess was associated with significantly increased length of stay, incidence of procedures, and total cost of admission.
CONCLUSIONS: Complicated pediatric OM remains of concern requiring prompt and thorough management. Major complications include mastoiditis and meningitis, and unfortunately, fatalities still occur in patients with OM. An understanding of resource utilization and socioeconomic implications can identify and drive opportunities for targeted quality improvement.

PMID: 26494054 [PubMed - as supplied by publisher]

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Surgical Visual Reference for Auditory Brainstem Implantation in Children with Cochlear Nerve Deficiency.

Related Articles

Surgical Visual Reference for Auditory Brainstem Implantation in Children with Cochlear Nerve Deficiency.

Otolaryngol Head Neck Surg. 2015 Oct 22;

Authors: Colletti G, Mandalà M, Colletti L, Colletti V

PMID: 26494053 [PubMed - as supplied by publisher]

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Surgical Visual Reference for Auditory Brainstem Implantation in Children with Cochlear Nerve Deficiency.

Related Articles

Surgical Visual Reference for Auditory Brainstem Implantation in Children with Cochlear Nerve Deficiency.

Otolaryngol Head Neck Surg. 2015 Oct 22;

Authors: Colletti G, Mandalà M, Colletti L, Colletti V

PMID: 26494053 [PubMed - as supplied by publisher]

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Evaluation of atlas-based attenuation correction for integrated PET/MR in human brain - application of a head atlas and comparison to true CT-based attenuation correction.

Related Articles

Evaluation of atlas-based attenuation correction for integrated PET/MR in human brain - application of a head atlas and comparison to true CT-based attenuation correction.

J Nucl Med. 2015 Oct 22;

Authors: Sekine T, Buck A, Delso G, Ter Voert E, Huellner M, Veit-Haibach P, Warnock G

Abstract
INTRODUCTION: Attenuation correction (AC) for integrated PET/MRI in human brain is still an open problem. In this study, we evaluated a simplified atlas-based AC (Atlas-AC) by comparing FDG PET data corrected using either Atlas-AC or true CT data (CT-AC).
METHODS: We enrolled 8 patients (median age 63). All patients underwent a clinically indicated whole body (18)F-FDG-PET/CT (GE Healthcare Discovery 690 PET/CT) for staging, re-staging or follow-up of malignant disease. All patients volunteered for an additional PET/MR of the head (GE Healthcare SIGNA PET/MR). For each patient, 2 AC-maps were generated: an Atlas-AC map registered to a patient-specific LAVA-Flex MR sequence and using a vendor-provided head atlas generated from multiple CT head images, and a CT-based AC map. For comparative AC, the CT-AC map generated from PET/CT was superimposed on the Atlas-AC map. Using each AC map, PET images were reconstructed from the list-mode raw data from the PET/MRI scanner. All PET images were normalized to a brain template and FDG accumulation was quantified in 67 volumes-of-interest (VOIs; automated anatomical labeling atlas) using PMOD. Relative difference (%diff) between images based on Atlas-AC and CT-AC was calculated, and averaged difference images were generated. FDG uptake in all VOIs was compared using Bland-Altman analysis.
RESULTS: The range of error in all 536 VOIs was < 10% [range; -3.0% ~ 7.3%]. Whole brain FDG uptake based on Atlas-AC was slightly underestimated (%diff= 2.19±1.40%). The underestimation was most pronounced in the regions below the anterior/posterior commissure line, such as cerebellum, temporal lobe and central structures (%diff=3.69±1.43%, 3.25±1.42%, 3.05±1.18%). This suggests that Atlas-AC tends to underestimate the attenuation values of the skull base bone.
CONCLUSION: The simplified Atlas-AC proved robust and was comparable to the gold-standard CT-AC, although there was a minor underestimation of tracer uptake values close to the base of the skull.

PMID: 26493207 [PubMed - as supplied by publisher]

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Unusual outer ear swelling: Childhood auricular rhabdomyosarcoma.

Related Articles

Unusual outer ear swelling: Childhood auricular rhabdomyosarcoma.

Eur Ann Otorhinolaryngol Head Neck Dis. 2015 Oct 19;

Authors: Chirat M, Dainese L, Fasola S, Couloigner V, Denoyelle F, Garabedian EN, Leboulanger N

Abstract
INTRODUCTION: Rhabdomyosarcoma (RMS) is the most frequent soft-tissue sarcoma in children and makes up 5% of all pediatric malignant tumors. The main head and neck locations are the base of the skull, nasopharynx, nasal cavity and orbit. An outer ear location is considered extremely rare. We present 3 cases of children, aged 6 to 14 years, presenting with auricular RMS.
CASE REPORTS: The first child, aged 6, was managed by 4 chemotherapy cycles followed by surgical resection of the tumor bed, completed by 5 further cycles of chemotherapy. The second, aged 14, was managed by 4 chemotherapy cycles followed by external radiation therapy of the tumor bed and lymph node areas, completed by 5 further cycles of chemotherapy. The third, aged 13, was managed by 4 chemotherapy cycles followed by surgery, completed by 5 further cycles of chemotherapy.
DISCUSSION: In these 3 patients, the treatment program achieved complete disease control. Prognosis was good, thanks to good surgical access. Diagnosis should be considered in case of unusual progressive swelling in the outer ear.

PMID: 26493114 [PubMed - as supplied by publisher]

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Recent advances in natural orifice transluminal endoscopic surgery†.

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Recent advances in natural orifice transluminal endoscopic surgery†.

Eur J Cardiothorac Surg. 2015 Oct 22;

Authors: Yip HC, Chiu PW

Abstract
Natural orifice transluminal endoscopic surgery (NOTES) has emerged as one of the most exciting areas in the field of minimally invasive surgery during the last decade. NOTES comprises a wide spectrum of procedures from various natural accesses such as transgastric or transvaginal routes, and different direct-target or distant-target organs. Since polypectomy was first performed in 1955, major advances in technology and refinement of endoscopic technique have allowed endoscopic surgeons to perform complex endoscopic interventions such as endoscopic submucosal dissection. Recognizing the safety and feasibility of submucosal tunnelling and mucosal closure, endoscopic resection beyond the level of mucosa has been increasingly reported. One of these procedures, peroral endoscopic myotomy for achalasia, has gained much popularity and excellent results have been published comparable with that of traditional Heller's cardiomyotomy. Submucosal tunnelling endoscopic resection has also been reported for tumours situated in the muscular layer of the gastrointestinal tract. To overcome the difficulty of intestinal closure after NOTES, researchers have collaborated with the industry in developing different endoscopic suturing devices such as the Eagle Claw (Olympus Medical Systems, Tokyo, Japan) and Overstitch™ (Apollo Endosurgery, Austin TX, USA). These devices allow precise and secure suture application with the ordinary flexible endoscope, achieving tissue approximation similar to open surgical suturing. To further expand the potential of NOTES, investigators had also developed multitasking platforms enabling the performance of surgical procedures of even higher complexity. Recently, a novel endoscopic robotic system 'Master and Slave Transluminal Endoscopic Robot' (MASTER) has been developed. Early results of endoscopic resection utilizing this system have been encouraging, allowing both experts and novices in endoscopy to perform difficult endoscopic resection with a high degree of flexibility.

PMID: 26494866 [PubMed - as supplied by publisher]

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[Rhinosinusitis in cystic fibrosis].

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[Rhinosinusitis in cystic fibrosis].

HNO. 2015 Oct 22;

Authors: Mainz JG, Gerber A, Arnold C, Baumann J, Baumann I, Koitschev A

Abstract
In cystic fibrosis (CF) mucociliary clearance of the entire respiratory system is impaired. This allows pathogens, such as Pseudomonas aeruginosa to persist and proliferate, which by progressive pulmonary destruction causes 90 % of premature deaths due to this inherited disease. The dramatic improvement in life expectation of patients due to intensive therapy has resulted in the inevitable but variably expressed sinonasal involvement coming into the clinical and scientific focus. Thereby, almost all CF patients reveal sinonasal pathology and many suffer from chronic rhinosinusitis. Recently, the sinonasal niche has been recognized as a site of initial and persistent colonization by pathogens. This article presents the pathophysiological background of this multiorgan disease as well as general diagnostic and therapeutic standards. The focus of this article is on sinonasal involvement and conservative and surgical options for treatment. Prevention of pathogen acquisition is an essential issue in the otorhinolaryngological treatment of CF patients.

PMID: 26495450 [PubMed - as supplied by publisher]

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