Changes in pressure waves after endoscopic intervention in patients with achalasia: A focus on peristaltic recovery of the esophageal body.

Changes in pressure waves after endoscopic intervention in patients with achalasia: A focus on peristaltic recovery of the esophageal body.

Turk J Gastroenterol. 2015 Dec 17;

Authors: Park SK, Hong SJ, Han JP, Goong HJ, Kim HS, Myung YS, Kim SH, Jung HJ, Lee TH, Lee JS, Lee MS

Abstract
BACKGROUND/AIMS: We conducted the present study to investigate the recovery of peristalsis of the esophageal body and evaluate the pressure changes observed on manometry before and after endoscopic intervention.
MATERIALS AND METHODS: Forty-five patients were diagnosed with achalasia, and 36 received endoscopic or surgical treatment. We collected the data of 24 patients who underwent manometry before and after treatment (pneumatic balloon dilatation, n=7; botulinum toxin injection, n=10; peroral endoscopic myotomy, n=7).
RESULTS: The lower esophageal sphincter (LES) resting pressure and nadir LES relaxation pressure decreased regardless of the achalasia subtype or type of endoscopic intervention following treatment (p<0.05). Among patients with a nadir LES relaxation pressure of <4 mmHg, 42.9% (6/14) exhibited partial esophageal peristaltic wave recovery. However, no patients with a nadir LES relaxation pressure of >4 mmHg exhibited peristaltic wave recovery (p=0.024). Of the six patients with peristaltic wave recovery, two had type I achalasia (15.4%), three had type II (33.3%), and one had type III (100.0%). The Eckardt score, symptom duration, and type of intervention were not associated with the recovery of peristaltic waves.
CONCLUSION: Our results suggest that normalization of the nadir LES relaxation pressure can be a predictive factor for the recovery of esophageal peristalsis.

PMID: 26674979 [PubMed - as supplied by publisher]

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Prognostic impact of lymph node micrometastasis in oral and oropharyngeal squamous cell carcinomas.

Prognostic impact of lymph node micrometastasis in oral and oropharyngeal squamous cell carcinomas.

Head Neck. 2015 Dec 17;

Authors: Cho JH, Lee YS, Sun DI, Kim MS, Cho KJ, Nam IC, Kim CS, Kim SY, Park YH, Joo YH

Abstract
BACKGROUND: The purpose of this study was to determine the role of lymph node micrometastasis in oral and oropharyngeal cancers.
METHODS: We investigated the presence of micrometastases by cytokeratin immunohistochemical staining in 54 patients with node-negative oral and oropharyngeal carcinomas.
RESULTS: The positive rate of cytokeratin expression was 13.0% (7 of 54 patients). The incidence of micrometastasis was significantly higher in patients with more invasive tumors (p < .001) and larger tumor size (p = .034). The 5-year disease-specific (DS) survival rate significantly correlated with micrometastasis, margin involvement, and depth of invasion in the univariate analyses. Multivariate Cox regression analysis confirmed a significant association between the 5-year DS survival rate and micrometastasis (hazard ratio [HR] = 7.89; 95% confidence interval [CI] = 1.09-57.14; p = .041) and margin involvement (HR = 11.68; 95% CI = 1.22-111.75; p = .033).
CONCLUSION: Micrometastasis was significantly correlated with the depth of invasion and tumor size in oral and oropharyngeal cancers. Furthermore, micrometastasis was associated with adverse outcomes. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26676645 [PubMed - as supplied by publisher]

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Sinonasal mucosal melanoma: A 12-year experience of 58 cases.

Sinonasal mucosal melanoma: A 12-year experience of 58 cases.

Head Neck. 2015 Dec 17;

Authors: Lombardi D, Bottazzoli M, Turri-Zanoni M, Raffetti E, Villaret AB, Morassi ML, Ungari M, Vermi W, Battaglia P, Castelnuovo P, Facco C, Sessa F, Donato F, Nicolai P

Abstract
BACKGROUND: Sinonasal mucosal melanoma is a rare malignancy with poor prognosis.
METHODS: Patients with sinonasal malignant melanoma who underwent surgery by different approaches were included in this study. Overall survival (OS) and event-free survival were calculated, and statistically significant variables by univariate analysis were entered in a multivariate Cox regression model.
RESULTS: Pathological staging was pT3, pT4a, and pT4b in 30 cases (51.7%), 17 cases (29.3%), and 11 cases (19.0%). At 3 and 5 years, OS was 43.5% and 29% and event-free survival was 23.6% and 12.4%, respectively. At univariate analysis, OS was significantly influenced by male sex, advanced pT classification, positive margins, and surgical approach; event-free survival was affected by positive margins. At multivariate analysis, the risk of death was independently associated with male sex (hazard ratio [HR] = 2.27; p = .04) and positive margins (HR = 2.32; p = .03).
CONCLUSION: Male sex and positive margins were negative prognostic factors. Endoscopic resection did not show an increased risk of death compared with more extensive surgical approaches. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26676523 [PubMed - as supplied by publisher]

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Use of propranolol for parotid hemangioma.

Use of propranolol for parotid hemangioma.

Head Neck. 2015 Dec 17;

Authors: Chang L, Jin Y, Lv D, Ying H, Wang T, Qiu Y, Ma G, Chen H, Yu W, Yang X, Lin X

Abstract
BACKGROUND: Few specific reports have addressed propranolol as a treatment for parotid hemangioma, and its mechanism remains unclear.
METHODS: Eighty-seven patients were recruited in this prospective study. Ten patients underwent detailed color Doppler examination. The depths, vessel densities, and resistant indices of 10 lesions were recorded and analyzed before treatment and at 1 and 3 months after treatment.
RESULTS: The overall responses were "bad" in 2 cases, "stable" in 4 cases, "good" in 53 cases, and "excellent" in 28 cases. Hemangioma regrowth was observed in 11 cases (12.6%). The parents of 18 patients (20.7%) complained that their children experienced minor discomfort during therapy. The lesion depths, vessel densities, and resistant indices were altered after propranolol treatment.
CONCLUSION: Propranolol can significantly reduce the sizes of parotid hemangiomas with minor side effects. Hemodynamic changes might play an important role in the course of propranolol treatment. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26676449 [PubMed - as supplied by publisher]

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External validation of sTWEAK as a prognostic noninvasive biomarker for head and neck squamous cell carcinoma.

External validation of sTWEAK as a prognostic noninvasive biomarker for head and neck squamous cell carcinoma.

Head Neck. 2015 Dec 17;

Authors: Terra X, Gómez D, García-Lorenzo J, Flores JC, Figuerola E, Mora J, Chacón MR, Quer M, Camacho M, León X, Avilés-Jurado FX

Abstract
BACKGROUND: The main purpose of this study was to validate the prognostic significance of tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) in head and neck squamous cell carcinoma (HNSCC) using an independent cohort.
METHODS: Data were evaluated from 153 patients with HNSCC in stages III to IV, who received radiotherapy (RT) or chemoradiotherapy. We quantified soluble TWEAK (sTWEAK) in pretreatment samples using enzyme-linked immunosorbent assay.
RESULTS: The classification tree revealed a cutoff value of 322 pg/mL for sTWEAK to be ideal for discriminating between patients' disease control. Kaplan-Meier curves indicate that the disease-free survival rate in patients with high sTWEAK was significantly higher than in patients with low levels (p = .006, log-rank test). An independent link was identified between low sTWEAK and poor clinical outcome in Cox regression multivariate analysis (hazard ratio = 1.866; 95% confidence interval [CI] = 1.114-3.125; p = .001).
CONCLUSION: Our study highlights the significance of this noninvasive biomarker in the discrimination according to the disease control achieved by patients who received a nonsurgical organ-preservation treatment. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26676381 [PubMed - as supplied by publisher]

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[Early recognition of cancerous lesions in the mouth and oropharynx : Automated evaluation of hyperspectral image stacks].

[Early recognition of cancerous lesions in the mouth and oropharynx : Automated evaluation of hyperspectral image stacks].

HNO. 2015 Dec 16;

Authors: Laffers W, Westermann S, Regeling B, Martin R, Thies B, Gerstner AO, Bootz F, Müller NA

Abstract
BACKGROUND: Early detection of cancerous lesions is still crucial for a patient's prognosis. Although diagnostic access to the oral cavity and oropharynx is comparably easy, the incidence of resulting disease remains high. This is due to the fact that in many cases, malignity is recognized too late on a purely visual basis. Previously, we discussed the application of hyperspectral imaging for early detection of precancerous and cancerous lesions of the larynx. This time, we evaluate the method in the oral cavity and oropharynx.
MATERIALS AND METHODS: In 85 patients scheduled for endoscopy, hyperspectral imaging was performed. We used a rigid 0-degree endoscope, a light-adjustable monochromator, and a hyperspectral camera. For evaluation of the method, 3 patients were chosen exemplarily. Training sites from physiological and cancerous tissues were marked. Hyperspectral data from 1 patient were used to train a classifier, which was then used for automatic detection of precancerous and cancerous lesions in another 2 patients.
RESULTS: Intraoperative hyperspectral imaging was performed without any problems. Classification showed sensitivities of 61 and 43 %, and a specificity of 100 %.
CONCLUSION: This proof-of-concept study underscores the high potential of hyperspectral imaging for early recognition of cancer in the mouth and oropharynx. Besides a better prognosis for cancer patients, this approach could lead to higher cost efficiency in the health system.

PMID: 26676521 [PubMed - as supplied by publisher]

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Anatomic and physiopathologic changes affecting the airway of the elderly patient: implications for geriatric-focused airway management.

Anatomic and physiopathologic changes affecting the airway of the elderly patient: implications for geriatric-focused airway management.

Clin Interv Aging. 2015;10:1925-1934

Authors: Johnson KN, Botros DB, Groban L, Bryan YF

Abstract
There are many anatomical, physiopathological, and cognitive changes that occur in the elderly that affect different components of airway management: intubation, ventilation, oxygenation, and risk of aspiration. Anatomical changes occur in different areas of the airway from the oral cavity to the larynx. Common changes to the airway include tooth decay, oropharyngeal tumors, and significant decreases in neck range of motion. These changes may make intubation challenging by making it difficult to visualize the vocal cords and/or place the endotracheal tube. Also, some of these changes, including but not limited to, atrophy of the muscles around the lips and an edentulous mouth, affect bag mask ventilation due to a difficult face-mask seal. Physiopathologic changes may impact airway management as well. Common pulmonary issues in the elderly (eg, obstructive sleep apnea and COPD) increase the risk of an oxygen desaturation event, while gastrointestinal issues (eg, achalasia and gastroesophageal reflux disease) increase the risk of aspiration. Finally, cognitive changes (eg, dementia) not often seen as related to airway management may affect patient cooperation, especially if an awake intubation is required. Overall, degradation of the airway along with other physiopathologic and cognitive changes makes the elderly population more prone to complications related to airway management. When deciding which airway devices and techniques to use for intubation, the clinician should also consider the difficulty associated with ventilating the patient, the patient's risk of oxygen desaturation, and/or aspiration. For patients who may be difficult to bag mask ventilate or who have a risk of aspiration, a specialized supralaryngeal device may be preferable over bag mask for ventilation. Patients with tumors or decreased neck range of motion may require a device with more finesse and maneuverability, such as a flexible fiberoptic broncho-scope. Overall, geriatric-focused airway management is necessary to decrease complications in this patient population.

PMID: 26673904 [PubMed - as supplied by publisher]

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Alterations of mucosa of the larynx and hypopharynx in patients with mucopolysaccharidoses.

Alterations of mucosa of the larynx and hypopharynx in patients with mucopolysaccharidoses.

J Laryngol Otol. 2015 Dec 17;:1-7

Authors: Keilmann A, Bendel F, Nospes S, Lampe C, Läßig AK

Abstract
OBJECTIVE: This study aimed to: assess the mucosal alterations of the larynx and hypopharynx typical for mucopolysaccharidoses, in a standardised manner; compare the severity in different subtypes of mucopolysaccharidoses; and monitor the effect of an enzyme replacement therapy.
METHODS: A classification for mucosal alterations of the larynx and hypopharynx was developed and utilised in 55 patients with mucopolysaccharidoses. Fifteen patients who started treatment with enzyme replacement therapy were followed longitudinally.
RESULTS: The most severe alterations were seen in the posterior region of the larynx and the arytenoids, and in the region of the false vocal folds. The alterations were most severe in patients with mucopolysaccharidosis II. No clear trend was observed in the patients who received enzyme replacement therapy.
CONCLUSION: Quantification of mucosal alterations of the hypopharynx and larynx in mucopolysaccharidoses patients can provide information about the disease's natural process and about the efficacy of enzyme replacement therapy.

PMID: 26672641 [PubMed - as supplied by publisher]

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[The clinical application of data mining in laryngeal cancer].

[The clinical application of data mining in laryngeal cancer].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jul;29(14):1272-5

Authors: Xu W, Zhang R, Qimin E, Liu J, Laing C

Abstract
OBJECTIVE: To provide a basis for the prediction and early diagnosis of laryngeal cancer through data mining and analysis.
METHOD: We constructed a laryngeal cancer data warehouse on Caché and combined IBM Cognos for on-line analytical processing. After building research data set, software Weka was used for feature selection and data mining.
RESULT: Data warehouse of laryngeal cancer was structured and Laryngeal cancer data were multidimensional presented. It is possible to find the high relevant and potential characteristics associated with laryngeal cancer by integration and 2-phase feature subset of data mining to extract the larynx.
CONCLUSION: Application of data mining technology could help clinicians to find potential clinical knowledge and make early diagnosis of laryngeal cancer.

PMID: 26672241 [PubMed - in process]

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Alterations of mucosa of the larynx and hypopharynx in patients with mucopolysaccharidoses.

Alterations of mucosa of the larynx and hypopharynx in patients with mucopolysaccharidoses.

J Laryngol Otol. 2015 Dec 17;:1-7

Authors: Keilmann A, Bendel F, Nospes S, Lampe C, Läßig AK

Abstract
OBJECTIVE: This study aimed to: assess the mucosal alterations of the larynx and hypopharynx typical for mucopolysaccharidoses, in a standardised manner; compare the severity in different subtypes of mucopolysaccharidoses; and monitor the effect of an enzyme replacement therapy.
METHODS: A classification for mucosal alterations of the larynx and hypopharynx was developed and utilised in 55 patients with mucopolysaccharidoses. Fifteen patients who started treatment with enzyme replacement therapy were followed longitudinally.
RESULTS: The most severe alterations were seen in the posterior region of the larynx and the arytenoids, and in the region of the false vocal folds. The alterations were most severe in patients with mucopolysaccharidosis II. No clear trend was observed in the patients who received enzyme replacement therapy.
CONCLUSION: Quantification of mucosal alterations of the hypopharynx and larynx in mucopolysaccharidoses patients can provide information about the disease's natural process and about the efficacy of enzyme replacement therapy.

PMID: 26672641 [PubMed - as supplied by publisher]

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Is age a limiting factor for adaptation to cochlear implant?

Is age a limiting factor for adaptation to cochlear implant?

Eur Arch Otorhinolaryngol. 2015 Dec 16;

Authors: Hiel AL, Gerard JM, Decat M, Deggouj N

Abstract
The influence of age on adaptation to cochlear implant (CI) is still being contested in the literature. The aim of this study was twofold. First, hearing outcomes in quiet conditions were compared between CI users implanted over and under the age of 70 years. Second, the effect of the duration of auditory deprivation was investigated. The study design is a retrospective review and the setting is in academic tertiary referral center. One hundred and twenty-one postlingually deafened implanted adults participated in this study. Hearing outcomes were compared between 121 postlingually deafened adults implanted under 40, between 40 and 70, and over 70 years of age. Speech audiometry measurements were taken at 1, 3, 6, 12, 24 and 60 months post-cochlear implantation (pCI), in quiet conditions only. Hearing outcomes were significantly better only at 1 year pCI in the youngest group compared to the two older groups. No significant difference was observed between the middle-aged and eldest subjects at any time. The influence of the severe-to-profound hearing loss (SPHL) duration was investigated and found to be equally distributed among the different age groups. Good hearing outcomes in elderly patients are not secondary to a difference in SPHL duration. Age should not be a limiting factor for cochlear implantation decision.

PMID: 26676874 [PubMed - as supplied by publisher]

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Intratemporal facial nerve schwannoma: clinical presentation and management.

Intratemporal facial nerve schwannoma: clinical presentation and management.

Eur Arch Otorhinolaryngol. 2015 Dec 16;

Authors: Lahlou G, Nguyen Y, Russo FY, Ferrary E, Sterkers O, Bernardeschi D

Abstract
Facial nerve schwannoma is the most common facial nerve tumor, but its therapeutic strategy remains debated. The aim of this study is to analyze the facial nerve function and the hearing outcomes after surgery or wait-and-scan policy in a facial nerve schwannoma series. A monocentric retrospective review of medical charts of patients followed for an intratemporal facial nerve schwannoma between 1988 and 2013 was performed. Twenty-two patients were included. Data were extracted pertaining to the following variables: patient demographics, tumor localization, clinical and imaging features, facial nerve function and hearing levels, and details of surgical intervention. The majority of tumors were located at the geniculate ganglion. Initial symptoms were mainly facial palsy and hearing loss. The average follow-up was 4.8 ± 4.5 years. Nineteen patients underwent surgery, and three patients were observed. After surgery, 11 patients had a stable or improved facial nerve function (57.9 %), and 8 patients had a worsened facial nerve function (42.1 %). Facial nerve function was in the majority of cases a HB grade III, depending on surgical strategy. No patient presented a postoperative HB grade V or VI. Regarding the hearing, it remained stable after surgery in 52.6 % of cases, and improved in 10.5 % of cases. Among monitored patients, facial nerve function and hearing remained stable. Surgery for facial nerve schwannoma is a safe and effective option in the treatment of these tumors.

PMID: 26676873 [PubMed - as supplied by publisher]

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[Early recognition of cancerous lesions in the mouth and oropharynx : Automated evaluation of hyperspectral image stacks].

[Early recognition of cancerous lesions in the mouth and oropharynx : Automated evaluation of hyperspectral image stacks].

HNO. 2015 Dec 16;

Authors: Laffers W, Westermann S, Regeling B, Martin R, Thies B, Gerstner AO, Bootz F, Müller NA

Abstract
BACKGROUND: Early detection of cancerous lesions is still crucial for a patient's prognosis. Although diagnostic access to the oral cavity and oropharynx is comparably easy, the incidence of resulting disease remains high. This is due to the fact that in many cases, malignity is recognized too late on a purely visual basis. Previously, we discussed the application of hyperspectral imaging for early detection of precancerous and cancerous lesions of the larynx. This time, we evaluate the method in the oral cavity and oropharynx.
MATERIALS AND METHODS: In 85 patients scheduled for endoscopy, hyperspectral imaging was performed. We used a rigid 0-degree endoscope, a light-adjustable monochromator, and a hyperspectral camera. For evaluation of the method, 3 patients were chosen exemplarily. Training sites from physiological and cancerous tissues were marked. Hyperspectral data from 1 patient were used to train a classifier, which was then used for automatic detection of precancerous and cancerous lesions in another 2 patients.
RESULTS: Intraoperative hyperspectral imaging was performed without any problems. Classification showed sensitivities of 61 and 43 %, and a specificity of 100 %.
CONCLUSION: This proof-of-concept study underscores the high potential of hyperspectral imaging for early recognition of cancer in the mouth and oropharynx. Besides a better prognosis for cancer patients, this approach could lead to higher cost efficiency in the health system.

PMID: 26676521 [PubMed - as supplied by publisher]

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[Headache : Otorhinolaryngological aspects].

[Headache : Otorhinolaryngological aspects].

HNO. 2015 Dec 16;

Authors: Michel O

Abstract
Headache is the main symptom in a wide variety of diseases of which ear, nose and throat (ENT) entities are only a small fraction but are not reflected in the number of patients. Comprehensive knowledge of the clinical signs of the most common primary headaches, e. g. migraine, is therefore essential for the ENT specialist because the few patients with secondary headache from ENT-related causes must be identified. Reasons for confusing primary headache with e. g. sinusitis are mostly symptoms mediated by the trigeminal nerve, such as nasal obstruction and rhinorrhea because branches of the trigeminal nerve also innervate the meninges. The ENT-specific origin of headaches is characterized by clinical findings of physical organ disease; therefore, from an ENT perspective imaging should be part of the diagnostic procedure as normal imaging findings are indicative of primary headache, which would not normally be treated by an ENT specialist.

PMID: 26676520 [PubMed - as supplied by publisher]

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[Muenster Parental Programme - Feedback from Parents : How do parents evaluate an early intervention programme for improving the communication with their baby or toddler with hearing impairment?]

[Muenster Parental Programme - Feedback from Parents : How do parents evaluate an early intervention programme for improving the communication with their baby or toddler with hearing impairment?]

HNO. 2015 Dec 16;

Authors: Glanemann R, Reichmuth K, Am Zehnhoff-Dinnesen A

Abstract
BACKGROUND: With the implementation of the UNHS, early educational services' existing concepts of early intervention have to be adapted to the situation and needs of families with a preverbal child who is deaf or hard of hearing. The Muenster Parental Programme (MPP), a module in early family-centered intervention, fulfils this requirement.
OBJECTIVE: We report feedback from participating parents regarding processes and outcomes of the MPP. The self-developed questionnaire was checked for its suitability as feedback instrument for measuring parental satisfaction with the MPP.
METHOD: 29 parents who participated in the MPP assessed the programme by using the standardised FBB and the self-developed questionnaire FB-MEP, which is specific to the MPP.
RESULTS: Using the FBB, 96 % of parents judged the MPP to be good or very good. With the FB-MEP, parents rated setting, contents and didactics as highly as they did using the FBB (r = 0.7, p < 0.01). In particular, parents judged both the contact and exchange with other affected parents, and the specific individual support for communicating with their child (including video feedback) as especially helpful.
CONCLUSIONS: The results reflect parents' high level of satisfaction with the setting, content, didactics and individual benefit gained by their child and themselves from the MPP. The parents are aware of the efficacy of the MPP, which was shown in the controlled intervention study. The self-developed questionnaire FB-MEP was shown to be a suitable instrument for quality assurance measurements of the MPP.

PMID: 26676519 [PubMed - as supplied by publisher]

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[An unusual combination of two rare tumors].

[An unusual combination of two rare tumors].

HNO. 2015 Dec 16;

Authors: Gärtner H, Schick B

PMID: 26676518 [PubMed - as supplied by publisher]

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Dopamine Modulates the Activity of Sensory Hair Cells.

Dopamine Modulates the Activity of Sensory Hair Cells.

J Neurosci. 2015 Dec 16;35(50):16494-16503

Authors: Toro C, Trapani JG, Pacentine I, Maeda R, Sheets L, Mo W, Nicolson T

Abstract
The senses of hearing and balance are subject to modulation by efferent signaling, including the release of dopamine (DA). How DA influences the activity of the auditory and vestibular systems and its site of action are not well understood. Here we show that dopaminergic efferent fibers innervate the acousticolateralis epithelium of the zebrafish during development but do not directly form synapses with hair cells. However, a member of the D1-like receptor family, D1b, tightly localizes to ribbon synapses in inner ear and lateral-line hair cells. To assess modulation of hair-cell activity, we reversibly activated or inhibited D1-like receptors (D1Rs) in lateral-line hair cells. In extracellular recordings from hair cells, we observed that D1R agonist SKF-38393 increased microphonic potentials, whereas D1R antagonist SCH-23390 decreased microphonic potentials. Using ratiometric calcium imaging, we found that increased D1R activity resulted in larger calcium transients in hair cells. The increase of intracellular calcium requires Cav1.3a channels, as a Cav1 calcium channel antagonist, isradipine, blocked the increase in calcium transients elicited by the agonist SKF-38393. Collectively, our results suggest that DA is released in a paracrine fashion and acts at ribbon synapses, likely enhancing the activity of presynaptic Cav1.3a channels and thereby increasing neurotransmission.
SIGNIFICANCE STATEMENT: The neurotransmitter dopamine acts in a paracrine fashion (diffusion over a short distance) in several tissues and bodily organs, influencing and regulating their activity. The cellular target and mechanism of the action of dopamine in mechanosensory organs, such as the inner ear and lateral-line organ, is not clearly understood. Here we demonstrate that dopamine receptors are present in sensory hair cells at synaptic sites that are required for signaling to the brain. When nearby neurons release dopamine, activation of the dopamine receptors increases the activity of these mechanosensitive cells. The mechanism of dopamine activation requires voltage-gated calcium channels that are also present at hair-cell synapses.

PMID: 26674873 [PubMed - as supplied by publisher]

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[The diagnosis applying effects of ocular vestibular evoked myogenic potentials in BBPV disease].

[The diagnosis applying effects of ocular vestibular evoked myogenic potentials in BBPV disease].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jul;29(14):1256-9

Authors: Lu B, Yu W, Wu Z, Lian R, Lu Z, Yang J

Abstract
OBJECTIVE: To investigate the diagnosis applying effects of ocular vestibular evoked myogenic potentials(oVEMP) in peripheral BPPV disease.
METHOD: During September 2012 to January 2015, we selected 80 healthy people in our hospital medical center as the control group, choose the same period of primary benign paroxysmal positional vertigo as the observation group of 80 patients. Two groups were carried out fully functional auditory evoked potential analysis, determination of oVEMP and cervical vestibular evoked myogenic potentials (cVEMP) anomaly amplitude threshold, P1 latencies, N1 incubation period.
RESULT: The cVEMP abnormal rate in the observation group was 28.8%, the oVEMP abnormal rate was 38.8%, while cVEMP and oVEMP abnormal rates in the control group was 1.3% and 2.5% respectively that compared to significant differences between the two groups (P < 0.05). The oVEMP test amplitude in the observation group was (5.98 ± 2.15) µv, the N1 incubation period was (10.03 ± 0.76)ms, while the control group were (4.09 ± 2.11)µv and (11.67 ± 0.78) ms that compared difference were statistically significant (P < 0.05). The cVEMP test amplitude in the observation group was (154.8 ± 43.9)2 µv, while the control group was (180.49 ± 45.34)µv, compared the difference was statistically significant (P < 0.05).
CONCLUSION: Paroxysmal positional vertigo patients ocular vestibular evoked myogenic potentials abnormal rate is relatively high, the utricle dysfunction for more severe than the balloon can be the subject of an objective function of the ear stone judgment, judgment in favor of the disease.

PMID: 26672237 [PubMed - in process]

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[EAST/SeSAME syndrome and functional expression of inward rectifier potassium channel Kir4.1 in the inner ear].

[EAST/SeSAME syndrome and functional expression of inward rectifier potassium channel Kir4.1 in the inner ear].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jul;29(14):1318-22

Authors: Chen J, Zhao H

Abstract
Inwardly rectifying potassium (Kir) channels exhibit an asymmetrical conductance at hyperpolarization (high conductance) compared to depolarization (low conductance). The KCNJ10 gene which encodes an inwardly rectifying K+ channel Kir4.1 subunit plays an essential role in the inner ear and hearing. Mutations or deficiency of KCNJ10 can cause hearing loss with epilepsy, ataxia, sensorineural deafness, and renal tubulopathy (EAST) or SeSAME (seizures, sensorineural deafness, ataxia, mental retardation, and electrolyte imbalance) syndromes. In this review, we mainly focus on the expression and function of Kir4.1 channels in the inner ear and mutation-induced EAST/SeSAME syndromes to provide insight for understanding the pathogenesis of deafness induced by KCNJ10 deficiency.

PMID: 26672256 [PubMed - in process]

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[Gastroesophageal reflux and otitis media with effusion].

[Gastroesophageal reflux and otitis media with effusion].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jul;29(14):1315-8

Authors: Tian X, Liu Y, Liu H

Abstract
Otitis media with effusion (OME), a kind of inflammatory disease of the middle ear, is characterized by the retention of middle ear effusions and hearing loss. There are many factors involved in the development of OME including bacterial infection, formation of bacterial biofilms, eustachian tube dysfunction, adenoid hypertrophy, immune system disorders. Recently, some studies showed that gastroesophageal reflux has correlation with OME.

PMID: 26672255 [PubMed - in process]

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Intratemporal facial nerve schwannoma: clinical presentation and management.

Intratemporal facial nerve schwannoma: clinical presentation and management.

Eur Arch Otorhinolaryngol. 2015 Dec 16;

Authors: Lahlou G, Nguyen Y, Russo FY, Ferrary E, Sterkers O, Bernardeschi D

Abstract
Facial nerve schwannoma is the most common facial nerve tumor, but its therapeutic strategy remains debated. The aim of this study is to analyze the facial nerve function and the hearing outcomes after surgery or wait-and-scan policy in a facial nerve schwannoma series. A monocentric retrospective review of medical charts of patients followed for an intratemporal facial nerve schwannoma between 1988 and 2013 was performed. Twenty-two patients were included. Data were extracted pertaining to the following variables: patient demographics, tumor localization, clinical and imaging features, facial nerve function and hearing levels, and details of surgical intervention. The majority of tumors were located at the geniculate ganglion. Initial symptoms were mainly facial palsy and hearing loss. The average follow-up was 4.8 ± 4.5 years. Nineteen patients underwent surgery, and three patients were observed. After surgery, 11 patients had a stable or improved facial nerve function (57.9 %), and 8 patients had a worsened facial nerve function (42.1 %). Facial nerve function was in the majority of cases a HB grade III, depending on surgical strategy. No patient presented a postoperative HB grade V or VI. Regarding the hearing, it remained stable after surgery in 52.6 % of cases, and improved in 10.5 % of cases. Among monitored patients, facial nerve function and hearing remained stable. Surgery for facial nerve schwannoma is a safe and effective option in the treatment of these tumors.

PMID: 26676873 [PubMed - as supplied by publisher]

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Surgical Correction of an Extensive Skull Base Defect as a Result of Pneumocele.

Surgical Correction of an Extensive Skull Base Defect as a Result of Pneumocele.

J Craniofac Surg. 2015 Dec 10;

Authors: Ramprasad VH, Woodard CR, Jang DW

Abstract
Pneumocele is a condition involving the pathologic expansion of paranasal sinuses with corresponding bony erosion of the skull base. Extensive pneumocele can lead to pneumocephalus, especially in patients with long-term cerebrospinal fluid shunts. Here, the authors present a case of pneumocele in an adult with a history of congenital hydrocephalus managed with a ventriculoperitoneal shunt. The patient underwent reconstruction of a posterior table defect with a pericranial flap followed by frontal sinus obliteration with abdominal fat.

PMID: 26674910 [PubMed - as supplied by publisher]

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Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study.

Multimodal navigated skull base tumor resection using image-based vascular and cranial nerve segmentation: A prospective pilot study.

Surg Neurol Int. 2015;6:172

Authors: Dolati P, Gokoglu A, Eichberg D, Zamani A, Golby A, Al-Mefty O

Abstract
BACKGROUND: Skull base tumors frequently encase or invade adjacent normal neurovascular structures. For this reason, optimal tumor resection with incomplete knowledge of patient anatomy remains a challenge.
METHODS: To determine the accuracy and utility of image-based preoperative segmentation in skull base tumor resections, we performed a prospective study. Ten patients with skull base tumors underwent preoperative 3T magnetic resonance imaging, which included thin section three-dimensional (3D) space T2, 3D time of flight, and magnetization-prepared rapid acquisition gradient echo sequences. Imaging sequences were loaded in the neuronavigation system for segmentation and preoperative planning. Five different neurovascular landmarks were identified in each case and measured for accuracy using the neuronavigation system. Each segmented neurovascular element was validated by manual placement of the navigation probe, and errors of localization were measured.
RESULTS: Strong correspondence between image-based segmentation and microscopic view was found at the surface of the tumor and tumor-normal brain interfaces in all cases. The accuracy of the measurements was 0.45 ± 0.21 mm (mean ± standard deviation). This information reassured the surgeon and prevented vascular injury intraoperatively. Preoperative segmentation of the related cranial nerves was possible in 80% of cases and helped the surgeon localize involved cranial nerves in all cases.
CONCLUSION: Image-based preoperative vascular and neural element segmentation with 3D reconstruction is highly informative preoperatively and could increase the vigilance of neurosurgeons for preventing neurovascular injury during skull base surgeries. Additionally, the accuracy found in this study is superior to previously reported measurements. This novel preliminary study is encouraging for future validation with larger numbers of patients.

PMID: 26674155 [PubMed - as supplied by publisher]

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