Unilateral vocal fold paralysis: can laryngoscopy predict recovery? A prospective study.

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Unilateral vocal fold paralysis: can laryngoscopy predict recovery? A prospective study.

J Laryngol Otol. 2014 Dec;128(12):1095-104

Authors: Menon JK, Nair RM, Priyanka S

Abstract
OBJECTIVE: To determine the prognostic value of laryngoscopy in predicting the recovery of unilateral vocal fold paralysis.
METHOD: A prospective study was carried out of all patients with unilateral vocal fold paralysis without a progressive lesion or arytenoid dislocation.
RESULTS: Among the 66 candidates, 15 recovered. Patients with interarytenoid paralysis (p < 0.001) or posterolateral tilt of the arytenoid (p = 0.028) had less chance of recovery. Among 51 patients who did not recover, 25.49 per cent regained phonatory function by compensatory movement of the normal side; the rest required an intervention. Intervention requirement was significantly less for those patients who had isolated glottic level compensation. The paralysed vocal fold was at the same level in 32.35 per cent of patients, higher in 38.23 per cent and lower in 29.42 per cent. In those in whom vocal folds were in the abducted position (46.67 per cent), the affected vocal fold was at a lower position on phonation. Inter-observer reliability assessment revealed excellent to good agreement for all criteria.
CONCLUSION: Interarytenoid paralysis and posterolateral tilt of the arytenoid were predictors of poor recovery.

PMID: 25399681 [PubMed - indexed for MEDLINE]

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Targeted use of endoscopic CO2 laser cricopharyngeal myotomy for improving swallowing function following head and neck cancer treatment.

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Targeted use of endoscopic CO2 laser cricopharyngeal myotomy for improving swallowing function following head and neck cancer treatment.

J Laryngol Otol. 2014 Dec;128(12):1105-10

Authors: Dawe N, Patterson J, Hamilton D, Hartley C

Abstract
BACKGROUND: Cricopharyngeal dysfunction following head and neck cancer treatment may lead to a significant reduction in oral intake. Carbon dioxide laser is an established procedure for the treatment of non-malignant cricopharyngeal disorders. We report our experience of laser cricopharyngeal myotomy with objective swallowing outcome measures, before and after treatment.
METHODS: We identified 11 patients who had undergone carbon dioxide laser cricopharyngeal myotomy for dysphagia following radiotherapy, with or without chemotheraphy between January 2006 and July 2011. We analysed the swallowing outcomes following carbon dioxide laser cricopharyngeal myotomy by retrospective grading of pre- and post-procedure videofluoroscopic swallowing study of liquids, using the validated Modified Barium Swallow Impairment Profile.
RESULTS: The median Modified Barium Swallow Impairment Profile score was 13 pre-myotomy and 10 post-myotomy. This difference between scores was non-significant (p = 0.41). The median, cricopharyngeal-specific Modified Barium Swallow Impairment Profile variables (14 and 17) improved from 3 to 2, but were similarly non-significant (p = 0.16). We observed the improved Modified Barium Swallow Impairment Profile scores post-procedure in the majority of patients.
CONCLUSION: Endoscopic carbon dioxide laser cricopharyngeal myotomy remains a viable option in treatment-related cricopharyngeal dysfunction; its targeted role requires further prospective study. Objective analysis of the technique can be reported using the validated Modified Barium Swallow Impairment Profile.

PMID: 25385025 [PubMed - indexed for MEDLINE]

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New laryngoscope for endoscopic arytenoidectomies.

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New laryngoscope for endoscopic arytenoidectomies.

J Laryngol Otol. 2014 Nov;128(11):991-5

Authors: Yilmaz T, Süslü N, Bajin MD, Günaydin RÖ, Özer S, Atay G

Abstract
OBJECTIVE: During an endoscopic arytenoidectomy, an intubation tube must be elevated anteriorly with the laryngoscope to ensure an adequate surgical field. This paper describes a new laryngoscope that has a canal along the outer wall of the body and a ridge which runs along the canal.
METHOD: Ten patients underwent endoscopic total arytenoidectomy using this new laryngoscope and 10 patients underwent the same operation using a regular laryngoscope.
RESULTS: The duration of all operations ranged between 25 and 65 minutes, with a median duration of 42.5 minutes. The median duration with the new laryngoscope was 39 minutes, and that with the regular laryngoscope was 49 minutes; this difference was statistically significant (p < 0.05).
CONCLUSION: This new laryngoscope shortened the duration of the endoscopic arytenoidectomy and facilitated the procedure by enlarging the surgical field. This new laryngoscope may be a beneficial surgical instrument for posterior endoscopic laryngeal operations.

PMID: 25316106 [PubMed - indexed for MEDLINE]

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Visual impairment, but not hearing impairment, is independently associated with lower subjective well-being among individuals over 95 years of age: A population-based study.

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Visual impairment, but not hearing impairment, is independently associated with lower subjective well-being among individuals over 95 years of age: A population-based study.

Arch Gerontol Geriatr. 2015 Nov 3;

Authors: Liu Z, Wu D, Huang J, Qian D, Chen F, Xu J, Li S, Jin L, Wang X

Abstract
BACKGROUND: Sensory impairment affects an increasing number of elderly adults, with a negative psychological impact. Our objective was to examine the associations of visual and hearing impairment with subjective well-being (SWB), an important psychological concept defined by life satisfaction [LS], positive affect [PA], negative affect [NA], and affect balance [AB] among long-lived individuals (LLIs) over 95 years of age.
METHODS: Data on 442 LLIs from the Rugao longevity cohort, a population-based study in Rugao, China, were analyzed. Graded classifications of visual and hearing impairment (none, mild, moderate, and severe) were constructed from self-reported items. Bivariate correlation and multiple regression analysis were performed to test the associations.
RESULTS: Approximately 66.1% and 87.3% of the subjects reported varying degrees of visual and hearing impairment. Following the degree of vision impairment, LS, PA, and AB decreased linearly, whereas NA increased linearly (all p for trend<0.05). Vision was significantly related to LS (r=0.238, p<0.001), PA (r=0.142, p<0.01), NA (r=-0.157, p<0.001), and AB (r=0.206, p<0.001). After adjustment for multiple variables including functional ability, an important factor of SWB, the associations of vision impairment with LS, NA, and AB, while diminished, still existed.
CONCLUSIONS: Visual impairment, but not hearing impairment, was independently associated with low SWB among LLIs, and functional ability may play a mediating role in the observed relationship. The findings indicate that rehabilitation targeted for those with reduced vision and functioning in long-lived populations may be important for promoting well-being and quality of life.

PMID: 26553484 [PubMed - as supplied by publisher]

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Esophagogastric junction distensibility measurements during Heller myotomy and POEM for achalasia predict postoperative symptomatic outcomes.

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Esophagogastric junction distensibility measurements during Heller myotomy and POEM for achalasia predict postoperative symptomatic outcomes.

Surg Endosc. 2015 Mar;29(3):522-8

Authors: Teitelbaum EN, Soper NJ, Pandolfino JE, Kahrilas PJ, Hirano I, Boris L, Nicodème F, Lin Z, Hungness ES

Abstract
BACKGROUND: The functional lumen imaging probe (FLIP) is a novel diagnostic tool that can be used to measure esophagogastric junction (EGJ) distensibility. In this study, we performed intraoperative FLIP measurements during laparoscopic Heller myotomy (LHM) and peroral esophageal myotomy (POEM) for treatment of achalasia and evaluated the relationship between EGJ distensibility and postoperative symptoms.
METHODS: Distensibility index (DI) (defined as the minimum cross-sectional area at the EGJ divided by distensive pressure) was measured with FLIP at two time points during LHM and POEM: (1) at baseline after induction of anesthesia, and (2) after operation completion.
RESULTS: Measurements were performed in 20 patients undergoing LHM and 36 undergoing POEM. Both operations resulted in an increase in DI, although this increase was larger with POEM (7 ± 3.1 vs. 5.1 ± 3.4 mm(2)/mmHg, p < .05). The two patients (both LHM) with the smallest increases in DI (1 and 1.6 mm(2)/mmHg) both had persistent symptoms postoperatively and, overall, LHM patients with larger increases in DI had lower postoperative Eckardt scores. In the POEM group, there was no correlation between change in DI and symptoms; however, all POEM patients experienced an increase in DI of >3 mm(2)/mmHg. When all patients were divided into thirds based on final DI, none in the lowest DI group (<6 mm(2)/mmHg) had symptoms suggestive of reflux (i.e., GerdQ score >7), as compared with 20 % in the middle third (6-9 mm(2)/mmHg) and 36 % in the highest third (>9 mm(2)/mmHg). Patients within an "ideal" final DI range (4.5-8.5 mm(2)/mmHg) had optimal symptomatic outcomes (i.e., Eckardt ≤ 1 and GerdQ ≤ 7) in 88 % of cases, compared with 47 % in those with a final DI above or below that range (p < .05).
CONCLUSIONS: Intraoperative EGJ distensibility measurements with FLIP were predictive of postoperative symptomatic outcomes. These results provide initial evidence that FLIP has the potential to act as a useful calibration tool during operations for achalasia.

PMID: 25055891 [PubMed - indexed for MEDLINE]

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Response to the Letter to the Editor regarding "Tympanic membrane perforation in children: Endoscopic type I tympanoplasty, a newly technique, is it worthwhile?" by Nassif et al. [Int. J. Pediatr. Otorhinolaryngol. 2015 (79) (11) 1860-1864].

Response to the Letter to the Editor regarding "Tympanic membrane perforation in children: Endoscopic type I tympanoplasty, a newly technique, is it worthwhile?" by Nassif et al. [Int. J. Pediatr. Otorhinolaryngol. 2015 (79) (11) 1860-1864].

Int J Pediatr Otorhinolaryngol. 2015 Oct 30;

Authors: Nassif N

PMID: 26553401 [PubMed - as supplied by publisher]

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Health-related quality of life among children with adenoid hypertrophy in Xi'an, China.

Health-related quality of life among children with adenoid hypertrophy in Xi'an, China.

Int J Pediatr Otorhinolaryngol. 2015 Oct 30;

Authors: Jiang X, Ren X, Liu H, Tian J, Du C, Luo H, Cheng Y, Shang L

Abstract
OBJECTIVE: The aim of this study was to investigate the health-related quality of life (HRQOL) in 5-7-year-old children diagnosed with adenoid hypertrophy and the impact of adenoid hypertrophy on affected families.
METHODS: This is a cross-sectional case-control study evaluating 5-7-year-old children with adenoid hypertrophy (n=195), 5-7-year-old healthy children (n=156), and associated caregivers (parents and/or grandparents). A Chinese version of the PedsQL™ 4.0 Generic Core Scale was used to assess childhood HRQOL, and a Chinese version of the Family Impact Module (FIM) was used to assess the impact of adenoid hypertrophy on family members. HRQOL scores were compared between the children with adenoid hypertrophy and healthy children. In addition, a multiple step-wise regression with demographic variables of children and their caregivers, family economic status, and caregiver's HRQOL as independent variables were referenced to determine the factors that may influence HRQOL in children with adenoid hypertrophy.
RESULTS: Children with adenoid hypertrophy showed significantly lower physical, emotional, social, and school functioning scores than healthy children (p<0.001 in all these dimensions). Caregivers for children with adenoid hypertrophy also scored significantly lower than caregivers for healthy children on physical, emotional, social, cognitive, and communication functioning (p<0.001 in all these dimensions). Caregivers for adenoid hypertrophy-affected children also exhibited significantly higher levels of worry than healthy children (p<0.001). Multivariate analyses demonstrated that children's age, children's relation with caregivers, caregiver's educational level, caregiver's own HRQOL, and the size of adenoid may all influence the HRQOL in children with adenoid hypertrophy (p<0.05).
CONCLUSIONS: The current data suggested that adenoid hypertrophy were associated with lower HRQOL in both children and their caregivers, and may negatively influence family functioning. In addition, caregivers' social characteristics may also significantly affect the HRQOL in children with adenoid hypertrophy.

PMID: 26553400 [PubMed - as supplied by publisher]

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Two novel compound heterozygous families with a trimutation in the GJB2 gene causing sensorineural hearing loss.

Two novel compound heterozygous families with a trimutation in the GJB2 gene causing sensorineural hearing loss.

Int J Pediatr Otorhinolaryngol. 2015 Oct 28;

Authors: Mirna MS, María Del Refugio RV, María GL, Héctor UC, Jaime TL, Pedro BV, Sergio CC

Abstract
BACKGROUND: Sensorineural hearing loss (SNHL) is a genetically heterogeneous disease. GJB2 gene mutations seem to be the most frequent cause of hereditary hearing impairment in several populations. There is variability in the mutations in the GJB2 gene worldwide; this remarks the influence of ethnic background in SNHL.
OBJECTIVE: To describe the presence of two trimutations in the GJB2 gene in two Mexican families with hereditary SNHL.
MATERIALS AND METHODS: Two unrelated Mexican families with prelingual SNHL were included in the study. Analysis of the GJB2 gene through PCR and DNA direct sequencing analysis was performed in all members of the families and in 100 normal controls.
RESULTS: Affected member of the family 1 showed the trimutation p.S19R/p.R32S/p.E47*, whereas affected members of the family 2 showed the trimutation p.F31I/p.W44*/p.V84M. Parents of both families were heterozygous with normal audition.
CONCLUSION: We found a novel mutation in the GJB2 gene and two trimutations with SNHL not previously reported. This remarks the complexity in the pattern of mutations in the GJB2 gene in SNHL and enriches the spectrum of the type of molecular defects in the GJB2 gene.

PMID: 26553399 [PubMed - as supplied by publisher]

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A high-fat diet is associated with otitis media with effusion.

A high-fat diet is associated with otitis media with effusion.

Int J Pediatr Otorhinolaryngol. 2015 Oct 30;

Authors: Choi HG, Sim S, Kim SY, Lee HJ

Abstract
OBJECTIVE: An association between obesity and otitis media with effusion (OME) has been previously reported. The aim of this study was to evaluate the association between dietary intake and OME when adjusting obesity.
METHODS: We analyzed the differences in dietary intake between children with/without OME who were 4 through 13 years of age using data from a large population-based survey - the Korea National Health and Nutrition Examination Survey - from 2008 through 2012. Data from 4359 participants were analyzed using simple and multiple logistic regression analyses with complex sampling.
RESULTS: The BMI category, the proportion of total calorie intake, protein intake, water intake, and Na intake (intake/recommendation), and the distribution of carbohydrate intake were not associated with OME. The distribution of fat intake was associated with OME (each 10% increase of fat calories/total calories: unadjusted odds ratio [OR]=1.331, 95% confidence interval [CI]=1.016-1.744, P=0.038; age- and sex-adjusted OR=1.359, 95% CI=1.028-1.797, P=0.031; adjusted for age, sex and other factors OR=1.392, 95% CI=1.054-1.839, P=0.020). Based on BMI subgroup analysis, the distribution of fat intake was associated with OME in the healthy weight group (each 10% increase of fat calories/total calories: unadjusted OR=1.393, 95% CI=1.017-1.909, P=0.039; adjusted OR=1.470, 95% CI=1.051-2.055, P=0.024) but not in the obese group.
CONCLUSIONS: A high-fat diet was associated with OME and may represent a confounding factor between obesity and OME.

PMID: 26553398 [PubMed - as supplied by publisher]

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Impact of beta thalassemia on maxillary sinuses and sino-nasal passages: A case control study.

Impact of beta thalassemia on maxillary sinuses and sino-nasal passages: A case control study.

Int J Pediatr Otorhinolaryngol. 2015 Oct 24;

Authors: Ragab A, Ragab SM, Shawki M

Abstract
OBJECTIVES: Skeletal changes among beta (β) thalassemia children are well documented, but without available data regarding sino-nasal passages alterations. The authors investigated the maxillary sinuses and sino-nasal passages changes in β-thalassemia children and correlated such changes with the amount of transfused red cells and the erythroid marrow activity.
METHODS: Clinical analyses including otorhinolaryngical examination (ORL) were obtained in twenty β-thalassemia children and 20 matched healthy controls. Hemoglobin (Hb), serum ferritin, soluble transferrin receptor (sTfR) levels and bone mineral density of the lumbar spine (BMD ls) were assayed. The two groups were analyzed for the CT image parameters: bone thickness, anterior and posterior choanae diameters, extramedullary hematopoiesis and chronic rhinosinusitis (CRS) RESULTS: Nasal congestion/obstruction was identified in 14 (70%) children. Eight patients (40%) had criteria of chronic rhinosinusitis. In comparison with the normal controls, the increase in the roof, floor, medial, anterior, lateral and posterior maxillary bony walls thickness was significantly higher (1.26, 2.46, 2.6, 2.9, 3.23 and 5.34-folds, respectively). The mean posterior choanae horizontal, vertical diameters and their surface area were significantly reduced in the patients compared to the controls. The mean anterior maxillary wall bone thickness directly correlated with sTfR (P=0.047) while that of the posterior wall correlated inversely with Hb level (P=0.013). The mean vertical posterior choanae diameter had positive correlation with the amount of transfused red cells (P=0.001) and negative correlation with sTfR (P=0.001). The Hounsfield unit of maxillary sinus wall had direct relation with BMDls (P=0.003) CONCLUSIONS: Thalassemia children are at risk of different folds increase of maxillary sinuses walls thicknesses utmost at posterior and lateral walls. Other sino-nasal morbidities include diminished posterior choanal diameter, nasal obstruction and CRS. Certain morbidities had relations to the erythroid marrow activity and the transfusion adequacy.

PMID: 26553397 [PubMed - as supplied by publisher]

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[Frontal cephalgia and obstruction of nasal breathing : A rare differential diagnosis of rhinosinusitis].

[Frontal cephalgia and obstruction of nasal breathing : A rare differential diagnosis of rhinosinusitis].

HNO. 2015 Nov 9;

Authors: Holtmann L, Baba H, Lang S, Dominas N

PMID: 26553042 [PubMed - as supplied by publisher]

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Response.

Response.

J Neurosurg. 2015 Sep;123(3):823-4

Authors: Effendi ST, Duckworth EA

PMID: 26554097 [PubMed - indexed for MEDLINE]

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Variations of the posterior cerebral artery diagnosed by MR angiography at 3 tesla.

Variations of the posterior cerebral artery diagnosed by MR angiography at 3 tesla.

Neuroradiology. 2015 Nov 9;

Authors: Uchino A, Saito N, Takahashi M, Okano N, Tanisaka M

Abstract
INTRODUCTION: Fenestration, early bifurcation, and duplication of the posterior cerebral artery (PCA) and the so-called hyperplastic anterior choroidal artery (AChA), considered a variation of the PCA, are rare. We evaluated the prevalence and characteristic features of these PCA variations on magnetic resonance (MR) angiography.
METHODS: We reviewed intracranial MR angiographic images of 2402 patients examined using a 3-tesla scanner. Images from the skull base to the intracranial region were obtained using the standard time-of-flight technique. We excluded images of 52 patients with insufficient image quality or occlusion of the PCA(s) and retrospectively evaluated the images of 2350 patients using a picture archiving and communication system.
RESULTS: We observed PCA fenestration in eight (0.34 %) patients, most at the P1 segment and P1-P2 junction and all small in size, early bifurcation at the P1-P2 junction or proximal P2A segment in eight (0.34 %) patients, complete duplication in one patient, and hyperplastic AChA in 13 (0.55 %) patients. Eleven of the 13 hyperplastic AChAs supplied only the territory of the temporal branch of the PCA, and the remaining two supplied the entire territory of the PCA.
CONCLUSION: We observed PCA variations in 30 (1.28 %) patients. We believe the name "hyperplastic AChA" inaccurately describes variations of the PCA in which the AChA supplies part of or all of the territory of the PCA and propose "accessory PCA" to describe an AChA that supplies part of the territory of the PCA or "replaced PCA" to describe that vessel that supplies the territory all branches of the PCA.

PMID: 26553301 [PubMed - as supplied by publisher]

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Parapharyngeal Metastasis of Papillary Thyroid Carcinoma.

Parapharyngeal Metastasis of Papillary Thyroid Carcinoma.

World J Surg. 2015 Nov 9;

Authors: Moritani S

Abstract
BACKGROUND: Nodal involvement of papillary thyroid carcinoma (PTC) commonly occurs in the paratracheal region and the internal jugular chain. Lymph node metastasis in the parapharyngeal space (PPS) is rare. In this report, we describe our experience and surgical outcomes of patients with PPS metastasis of PTC.
METHODS: Clinical data of patients with PTC who underwent surgery at our institution between January 2006 and December 2013 were retrospectively reviewed, and 22 patients with PPS metastasis were enrolled.
RESULTS: There were 2 primary and 20 secondary cases of PPS metastasis. Involvement of the jugular nodes was noted before or at the time of PPS metastasis detection in all cases. A transcervical surgical approach with partial resection of the mandibular angle was performed in 21 patients, while 1 patient underwent extirpation of the PPS metastasis via a transoral approach. Although curative resection was performed in 21 patients, the PPS metastasis was not removable in 1 patient owing to an invaded internal carotid artery at the skull base. Twelve and 6 patients had locoregional and distant recurrence, respectively. Of the 12 patients with locoregional recurrence, isolated locoregional recurrence in the PPS occurred in 1. Eight patients died of distant or locoregional recurrence, with a median survival time of 91.7 months.
CONCLUSIONS: For patients who experience recurrence after thyroid surgery, the possibility of PPS metastasis should be considered. In this series, all patients with PPS metastasis also had previous unilateral or bilateral cervical metastasis. Despite curative attempt, most patients experienced local or distant recurrence.

PMID: 26552910 [PubMed - as supplied by publisher]

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Letter to the Editor: The transbasal approach: historical observation.

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Letter to the Editor: The transbasal approach: historical observation.

J Neurosurg. 2015 Sep;123(3):823

Authors: Pompili A

PMID: 26140491 [PubMed - indexed for MEDLINE]

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Clinical and dosimetric implications of intensity-modulated radiotherapy for early-stage glottic carcinoma.

Clinical and dosimetric implications of intensity-modulated radiotherapy for early-stage glottic carcinoma.

Med Dosim. 2015 Nov 6;

Authors: Ward MC, Pham YD, Kotecha R, Zakem SJ, Murray E, Greskovich JF

Abstract
Conventional parallel-opposed radiotherapy (PORT) is the established standard technique for early-stage glottic carcinoma. However, case reports have reported the utility of intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) with or without image guidance (image-guided radiotherapy, IGRT) in select patients. The proposed advantages of IMRT/VMAT include sparing of the carotid artery, thyroid gland, and the remaining functional larynx, although these benefits remain unclear. The following case study presents a patient with multiple vascular comorbidities treated with VMAT for early-stage glottic carcinoma. A detailed explanation of the corresponding treatment details, dose-volume histogram (DVH) analysis, and a review of the relevant literature are provided. Conventional PORT remains the standard of care for early-stage glottic carcinoma. IMRT or VMAT may be beneficial for select patients, although great care is necessary to avoid a geographical miss. Clinical data supporting the benefit of CRT are lacking. Therefore, these techniques should be used with caution and only in selected patients.

PMID: 26553472 [PubMed - as supplied by publisher]

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Ambient PM2.5 exposure exacerbates severity of allergic asthma in previously sensitized mice.

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Ambient PM2.5 exposure exacerbates severity of allergic asthma in previously sensitized mice.

J Asthma. 2015 Oct;52(8):785-94

Authors: Zhang X, Zhong W, Meng Q, Lin Q, Fang C, Huang X, Li C, Huang Y, Tan J

Abstract
OBJECTIVE: Epidemiological studies have shown that elevated concentrations of ambient particulate matter (aerodynamic diameter ≤2.5 μm; PM2.5) correlates with increased incidence of asthma. The aim of this study was to determine whether PM2.5 participates in the exacerbation of asthma.
METHODS: Effects of 1, 10 and 100 μg PM2.5 instilled intratracheally in ovalbumin (OVA)-sensitized or asthmatic mice were compared.
RESULTS: PM2.5 exposure in the OVA-sensitized and especially asthmatic groups increased Mch responsiveness in a dose-dependent manner. In OVA-sensitized groups, exposure to 1 μg of PM2.5 caused no detectable lung inflammation, while 10 and 100 μg of PM2.5 resulted in a slightly increased trend in numbers of neutrophils and macrophages. Compared with the asthmatic control group, both 10 and 100 μg of PM2.5 provoked a significant increase in eosnophils and neutrophils whereas only 100 μg of PM2.5 noticeably enhanced lymphocytes. In asthmatic groups, administration of 100 μg of PM2.5 greatly increased levels of the pro-inflammatory cytokine TNF-α and Th2-related cytokines IL-4 and IL-10 in bronchoalveolar lavage fluid, but it decreased Th1-related INF-γ. In addition, 10 and 100 μg of PM2.5 exacerbated inflammatory infiltration, goblet cell metaplasia and lung ultrastructure lesions in asthmatic mice.
CONCLUSIONS: Our results suggested that acute exposure of PM2.5 could synergize with allergens in the subsequent challenge to aggravate the severity of asthma in sensitized mice, possibly by promoting a Th2-biased immune response.

PMID: 26194420 [PubMed - indexed for MEDLINE]

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Samsoeum water extract attenuates allergic airway inflammation via modulation of Th1/Th2 cytokines and decrease of iNOS expression in asthmatic mice.

Related Articles

Samsoeum water extract attenuates allergic airway inflammation via modulation of Th1/Th2 cytokines and decrease of iNOS expression in asthmatic mice.

BMC Complement Altern Med. 2015;15:47

Authors: Jeon WY, Shin IS, Shin HK, Lee MY

Abstract
BACKGROUND: Samsoeum has long been used in Korea and other Asian countries as a traditional medicine to treat various diseases. In the present study, we investigated the antiasthma effect of the herbal medicine Samsoeum water extract (SSEW) using an in vivo ovalbumin (OVA)-induced asthmatic model.
METHODS: Female BALB/c mice were sensitized by an intraperitoneal injection of OVA and subsequently challenged with nebulized OVA. We investigated the number of inflammatory cells, the production of Th1/Th2 cytokines and chemokine in bronchoalveolar lavage fluid (BALF), histological changes in lung tissue, the infiltration of inflammatory cells and hyperplasia of goblet cells in lung tissue, the levels of immunoglobulin E (IgE) in BALF and plasma, and the expression of inducible nitric oxide synthase (iNOS) in lung tissue.
RESULTS: Our findings indicated that SSEW decreased the accumulation of inflammatory cells (particularly, eosinophil and neutrophil) and regulated the balance in the production of Th1/Th2 cytokines and chemokine in BALF. Moreover, SSEW suppressed the level of IgE in BALF and plasma, and inhibited the infiltration of inflammatory cells, hyperplasia of goblet cells, and the expression of iNOS in lung tissue.
CONCLUSIONS: Collectively, these results suggest that, because of its anti-inflammatory and antiasthma properties, SSEW may be useful in reducing airway inflammation in the treatment of allergic asthma.

PMID: 25886760 [PubMed - indexed for MEDLINE]

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Unilateral vocal fold paralysis: can laryngoscopy predict recovery? A prospective study.

Related Articles

Unilateral vocal fold paralysis: can laryngoscopy predict recovery? A prospective study.

J Laryngol Otol. 2014 Dec;128(12):1095-104

Authors: Menon JK, Nair RM, Priyanka S

Abstract
OBJECTIVE: To determine the prognostic value of laryngoscopy in predicting the recovery of unilateral vocal fold paralysis.
METHOD: A prospective study was carried out of all patients with unilateral vocal fold paralysis without a progressive lesion or arytenoid dislocation.
RESULTS: Among the 66 candidates, 15 recovered. Patients with interarytenoid paralysis (p < 0.001) or posterolateral tilt of the arytenoid (p = 0.028) had less chance of recovery. Among 51 patients who did not recover, 25.49 per cent regained phonatory function by compensatory movement of the normal side; the rest required an intervention. Intervention requirement was significantly less for those patients who had isolated glottic level compensation. The paralysed vocal fold was at the same level in 32.35 per cent of patients, higher in 38.23 per cent and lower in 29.42 per cent. In those in whom vocal folds were in the abducted position (46.67 per cent), the affected vocal fold was at a lower position on phonation. Inter-observer reliability assessment revealed excellent to good agreement for all criteria.
CONCLUSION: Interarytenoid paralysis and posterolateral tilt of the arytenoid were predictors of poor recovery.

PMID: 25399681 [PubMed - indexed for MEDLINE]

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Targeted use of endoscopic CO2 laser cricopharyngeal myotomy for improving swallowing function following head and neck cancer treatment.

Related Articles

Targeted use of endoscopic CO2 laser cricopharyngeal myotomy for improving swallowing function following head and neck cancer treatment.

J Laryngol Otol. 2014 Dec;128(12):1105-10

Authors: Dawe N, Patterson J, Hamilton D, Hartley C

Abstract
BACKGROUND: Cricopharyngeal dysfunction following head and neck cancer treatment may lead to a significant reduction in oral intake. Carbon dioxide laser is an established procedure for the treatment of non-malignant cricopharyngeal disorders. We report our experience of laser cricopharyngeal myotomy with objective swallowing outcome measures, before and after treatment.
METHODS: We identified 11 patients who had undergone carbon dioxide laser cricopharyngeal myotomy for dysphagia following radiotherapy, with or without chemotheraphy between January 2006 and July 2011. We analysed the swallowing outcomes following carbon dioxide laser cricopharyngeal myotomy by retrospective grading of pre- and post-procedure videofluoroscopic swallowing study of liquids, using the validated Modified Barium Swallow Impairment Profile.
RESULTS: The median Modified Barium Swallow Impairment Profile score was 13 pre-myotomy and 10 post-myotomy. This difference between scores was non-significant (p = 0.41). The median, cricopharyngeal-specific Modified Barium Swallow Impairment Profile variables (14 and 17) improved from 3 to 2, but were similarly non-significant (p = 0.16). We observed the improved Modified Barium Swallow Impairment Profile scores post-procedure in the majority of patients.
CONCLUSION: Endoscopic carbon dioxide laser cricopharyngeal myotomy remains a viable option in treatment-related cricopharyngeal dysfunction; its targeted role requires further prospective study. Objective analysis of the technique can be reported using the validated Modified Barium Swallow Impairment Profile.

PMID: 25385025 [PubMed - indexed for MEDLINE]

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Neoadjuvant treatment combined with planned surgery in laryngeal function preservation for locally advanced pyriform sinus carcinoma.

Related Articles

Neoadjuvant treatment combined with planned surgery in laryngeal function preservation for locally advanced pyriform sinus carcinoma.

J Craniofac Surg. 2014 Nov;25(6):1975-9

Authors: Yu Y, Wang X, Xu Z, Fan C, Tu G

Abstract
OBJECTIVES: This study aimed to determine the efficacy and feasibility of preoperative radiotherapy with or without chemotherapy (XRT) followed by surgery of locally advanced pyriform sinus carcinoma.
MATERIALS AND METHODS: We performed a retrospective study of 482 patients with T3 and T4 pyriform sinus carcinoma treated with curative intent between 1979 and 2008. The patients were divided into 4 groups according to different treatment patterns.
RESULTS: The 5-year disease-special survival rate was 32%. Survival was best for the patients treated with surgery followed by XRT (41.1%) and with neoadjuvant XRT followed by surgery (39.4%), but it was worse with surgery only (27.1%) and XRT alone (23%). The disease-special survival was significantly different between the patients who accepted multidisciplinary therapy and those who accepted single therapy (P<0.001). The 5-year laryngeal function preservation survival rate of the patients with XRT followed by surgery was 13.6%, which was similar to those with XRT alone (16.2%), and superior to those who accepted surgery followed by XRT (3.8%) and surgery alone (0). Multivariate analysis results revealed that treatment pattern is an independent predictor of both overall and laryngeal function preservation survival rates (P < 0.001; hazard ratio, 0.56; 95% confidence interval, 0.44-0.71). Perioperative wound complications were not different among the patients in the 3 groups who accepted surgical treatment (P > 0.05).
CONCLUSIONS: The results suggested that neoadjuvant XRT followed by planned surgery was feasible with satisfactory oncological and functional outcomes.

PMID: 25377955 [PubMed - indexed for MEDLINE]

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New laryngoscope for endoscopic arytenoidectomies.

Related Articles

New laryngoscope for endoscopic arytenoidectomies.

J Laryngol Otol. 2014 Nov;128(11):991-5

Authors: Yilmaz T, Süslü N, Bajin MD, Günaydin RÖ, Özer S, Atay G

Abstract
OBJECTIVE: During an endoscopic arytenoidectomy, an intubation tube must be elevated anteriorly with the laryngoscope to ensure an adequate surgical field. This paper describes a new laryngoscope that has a canal along the outer wall of the body and a ridge which runs along the canal.
METHOD: Ten patients underwent endoscopic total arytenoidectomy using this new laryngoscope and 10 patients underwent the same operation using a regular laryngoscope.
RESULTS: The duration of all operations ranged between 25 and 65 minutes, with a median duration of 42.5 minutes. The median duration with the new laryngoscope was 39 minutes, and that with the regular laryngoscope was 49 minutes; this difference was statistically significant (p < 0.05).
CONCLUSION: This new laryngoscope shortened the duration of the endoscopic arytenoidectomy and facilitated the procedure by enlarging the surgical field. This new laryngoscope may be a beneficial surgical instrument for posterior endoscopic laryngeal operations.

PMID: 25316106 [PubMed - indexed for MEDLINE]

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Recovery time for inflamed middle ear mucosa in chronic otitis media.

Recovery time for inflamed middle ear mucosa in chronic otitis media.

Acta Otolaryngol. 2015 Nov 9;:1-4

Authors: Pakır O, Dinç AE, Damar M, Akyıldız İ, Eliçora SŞ, Erdem D

Abstract
CONCLUSION: The present study shows that 2-3 weeks after medical treatment the status of middle ear mucosa in draining ears is similar to that of dry ears for at least 3 months.
OBJECTIVE: To measure the time required for an inflamed middle ear mucosa to return into optimal state after appropriate medical treatment in chronic suppurative otitis media (CSOM). To assess optimal timing for elective surgical treatment of draining ears in uncomplicated CSOM.
METHODS: In this prospective study, the Eustachian tube (ET) mucociliary clearance time (MCT) was used as the method to demonstrate the status of middle ear mucosa. In group 1 (28 patients) ET-MCT was measured in ears that were free of drainage for at least 3 months. In Group 2 (21 patients), ET-MCT was measured in draining ears, who responded to 10-14 days medical treatment, at presentation, after 10 days and 1 month.
RESULTS: The ET-MCT was 8.63 ± 1.32 min in group 1 and 28.96 ± 8.19 min in group 2 at presentation; and the difference was statistically significant (p < 0.001). The ET-MCT was 14.76 ± 5.11 min after 10 days and 9.31 ± 2.33 min after 1 month in group 2. The ET-MCT was indifferent between groups 1 and 2 after 1 month (p = 0.235).

PMID: 26552944 [PubMed - as supplied by publisher]

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Early Cellular Response to Radiation in Human Vocal Fold Fibroblasts.

Early Cellular Response to Radiation in Human Vocal Fold Fibroblasts.

Ann Otol Rhinol Laryngol. 2015 Nov 8;

Authors: Erickson-DiRenzo E, Enos G, Thibeault SL

Abstract
OBJECTIVES: Radiation therapy is a common treatment strategy for laryngeal carcinoma. However, radiation is not without adverse side effects, especially toward healthy vocal fold tissue, which can lead to long-term impairments in vocal function. The objective of this preliminary study was to investigate early responses of healthy human vocal fold fibroblasts (VFF) to radiation.
METHODS: VFF were exposed to a single or fractionated dose radiation scheme. Nonradiated VFF served as controls. Morphology of radiated and control VFF was subjectively examined. Quantitative polymerase chain reaction was used to evaluate the effect of radiation on extracellular matrix and inflammatory-related genes. VFF viability was investigated using a LIVE/DEAD and clonogenic assay.
RESULTS: Single or fractioned dose radiated VFF were morphologically indistinguishable from control VFF. No significant differences in gene expression were observed following either radiation scheme and as compared to controls. Clonogenic assay revealed reduced VFF viability following the fractionated but not single dose scheme. No changes in viability were detected using the LIVE/DEAD assay.
CONCLUSIONS: We present one of the first investigations to evaluate early responses of healthy VFF to radiation. Findings will contribute to a growing body of literature seeking to elucidate the biological mechanisms underlying voice changes following radiation therapy for laryngeal carcinoma.

PMID: 26553661 [PubMed - as supplied by publisher]

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Outcomes of Laryngeal Reinnervation for Unilateral Vocal Fold Paralysis in Children: Associations With Age and Time Since Injury.

Outcomes of Laryngeal Reinnervation for Unilateral Vocal Fold Paralysis in Children: Associations With Age and Time Since Injury.

Ann Otol Rhinol Laryngol. 2015 Nov 8;

Authors: Smith ME, Houtz DR

Abstract
OBJECTIVE: Outcomes of laryngeal reinnervation with ansa-cervicalis for unilateral vocal fold paralysis (UVFP) may be influenced by age of the patient and time interval between laryngeal nerve injury and reinnervation, suggesting less favorable outcomes in older patients and greater than 2-year time interval after injury. This study examines these issues in the pediatric population.
METHOD: Review of prospectively collected data set of 35 children and adolescents (1-21 years) that underwent ansa-recurrent laryngeal nerve (RLN) laryngeal reinnervation for UVFP.
RESULTS: The time from RLN injury to reinnervation averaged 5.0 years (range, 0.8-15.2 years). No correlation was found between age at reinnervation (r = 0.15) and patient- or parent-reported global percentage voice outcome or perceptual ratings. There was slight negative correlation in duration between RLN injury and reinnervation and voice outcomes (r = -0.31). Postoperative voice self/surrogate global percentage rating average was 80.5% (range, 50%-100%), and perceptual rating GRBAS sum score average was 2.9 (range, 0-7).
CONCLUSION: In pediatric ansa-RLN reinnervation for UVFP, no correlation between age at surgery and postoperative outcome was found. Denervation duration showed slight negative correlation, similar to what has been reported in adults, though voice improvement was seen in all patients.

PMID: 26553660 [PubMed - as supplied by publisher]

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Recovery time for inflamed middle ear mucosa in chronic otitis media.

Recovery time for inflamed middle ear mucosa in chronic otitis media.

Acta Otolaryngol. 2015 Nov 9;:1-4

Authors: Pakır O, Dinç AE, Damar M, Akyıldız İ, Eliçora SŞ, Erdem D

Abstract
CONCLUSION: The present study shows that 2-3 weeks after medical treatment the status of middle ear mucosa in draining ears is similar to that of dry ears for at least 3 months.
OBJECTIVE: To measure the time required for an inflamed middle ear mucosa to return into optimal state after appropriate medical treatment in chronic suppurative otitis media (CSOM). To assess optimal timing for elective surgical treatment of draining ears in uncomplicated CSOM.
METHODS: In this prospective study, the Eustachian tube (ET) mucociliary clearance time (MCT) was used as the method to demonstrate the status of middle ear mucosa. In group 1 (28 patients) ET-MCT was measured in ears that were free of drainage for at least 3 months. In Group 2 (21 patients), ET-MCT was measured in draining ears, who responded to 10-14 days medical treatment, at presentation, after 10 days and 1 month.
RESULTS: The ET-MCT was 8.63 ± 1.32 min in group 1 and 28.96 ± 8.19 min in group 2 at presentation; and the difference was statistically significant (p < 0.001). The ET-MCT was 14.76 ± 5.11 min after 10 days and 9.31 ± 2.33 min after 1 month in group 2. The ET-MCT was indifferent between groups 1 and 2 after 1 month (p = 0.235).

PMID: 26552944 [PubMed - as supplied by publisher]

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