OtoRhinoLaryngology News: Οκτωβρίου 2016

Παρασκευή 7 Οκτωβρίου 2016

Surgical Strategy and Facial Nerve Outcomes in Petrous Bone Cholesteatoma.

Surgical Strategy and Facial Nerve Outcomes in Petrous Bone Cholesteatoma.

Audiol Neurootol. 2016 Oct 7;21(5):275-285

Authors: Prasad SC, Piras G, Piccirillo E, Taibah A, Russo A, He J, Sanna M

Abstract
OBJECTIVE: To review the classification and management of petrous bone cholesteatomas (PBCs) at our center and the outcomes of facial nerve (FN) management in these lesions.
METHODS: This was a retrospective study. The setting was a quaternary referral center for skull base pathology in Italy. A total of 200 patients with 201 PBCs were included in the study. All patients diagnosed radiologically with PBCs were classified according to the Sanna classification. All patients were surgically treated and followed up with radiology. The main outcome measures - classification of PBCs, the surgical approach used, disease control, and FN outcomes - were analyzed.
RESULTS: Supralabyrinthine PBCs were the most common type with 92 cases (45.8%) followed by the massive PBCs with 72 cases (35.8%). Preservation of preoperative FN function was highest in the infralabyrinthine (72.2%) and infralabyrinthine-apical (73.3%) types. The transotic approach was used in 66 cases (32.8%) in this series. The modified transcochlear approach type A was applied in 55 cases (27.3%). Active management of the nerve (rerouting, anastomosis, or grafting) was required in 53 cases (26.4%). Postoperatively, of the 116 cases with FN House-Brackmann grade I and II, 107 cases (92.2%) retained the same grade or improved. Recurrence was seen in 7 cases (3.5%). The mean duration of follow-up was 6.3 years.
CONCLUSIONS: Radical disease clearance must take precedence over hearing and FN preservation in PBCs. Active FN management, including rerouting, end-to-end anastomosis, and cable nerve grafting, routinely come to play in the surgical management of PBCs, and the postoperative FN results after such interventions can be satisfactory in most cases.

PMID: 27710980 [PubMed - as supplied by publisher]

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R2* Map by IDEAL IQ for Acute Cerebral Infarction: Compared with Susceptibility Vessel Sign on T2*-Weighted Imaging.

R2* Map by IDEAL IQ for Acute Cerebral Infarction: Compared with Susceptibility Vessel Sign on T2*-Weighted Imaging.

Yonago Acta Med. 2016 Sep;59(3):204-209

Authors: Shinohara Y, Kato A, Yamashita E, Ogawa T

Abstract
BACKGROUND: To evaluate the detectability of arterial acute thrombus on R2* map by iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) IQ compared with T2*-weighted imaging (T2*WI).
METHODS: Twenty-six patients with acute cerebral infarction who underwent R2* map and T2*WI were reviewed. We performed visual assessment of each sequence regarding the visibility of susceptibility effect reflecting acute thrombus and quantitative evaluation of the thrombus on R2* map.
RESULTS: Both R2* map and T2*WI showed susceptibility effect reflecting acute thrombi at the occluded site of magnetic resonance angiography (MRA) in 9 patients. R2* map revealed positive while T2*WI showed equivocal findings in 3 patients due to the surrounding vessel signal intensity. Acute thrombus at distal internal carotid artery (ICA) on R2* map was more clearly detected than that on T2*WI without any apparent susceptibility artifact from the skull base in 4 patients. Most of cardiogenic embolic infarction (CEI) and artery-to-artery embolic infarction (A-to-A) demonstrated positive and most of atherothrombotic infarction (ATI) revealed negative findings on R2* map, although quantitative R2* values of thrombi did not show significant differences between CEI (136.6 /msec) and A-to-A (189.9 /msec) (P = 0.332).
CONCLUSION: The detectability of acute thrombus on R2* map is comparable to that on T2*WI. Regarding thrombus at distal ICA, its detectability on R2* map is superior to that on T2*WI. R2* map provide additional information to distinguish between embolic and atherothrombotic infarctions.

PMID: 27708535 [PubMed - in process]

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Platelet-rich fibrin: a boon in regenerative endodontics.

Platelet-rich fibrin: a boon in regenerative endodontics.

Minerva Stomatol. 2016 Dec;65(6):385-392

Authors: Rebentish PD, Umashetty G, Kaur H, Doizode T, Kaslekar M, Chowdhury S

Abstract
Research into regenerative dentistry has contributed momentum to the field of molecular biology. Periapical surgery aims at removing periapical pathology to achieve complete wound healing and regeneration of bone and periodontal tissue. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. Platelet-rich fibrin (PRF) is a wonderful tissue-engineering product and has recently gained much popularity due its promising results in wound healing bone induction. The features of this product are an attribute of platelets which, after cellular interactions, release growth factors and have shown application in diverse disciplines of dentistry. This paper is intended to shed light onto the various prospects of PRF and to provide clinical insight into regenerative endodontic therapy.

PMID: 27711028 [PubMed - in process]

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Quantification of the amount of dental material removed by selective grinding in wax dentures with photogrammetric measurements.

Quantification of the amount of dental material removed by selective grinding in wax dentures with photogrammetric measurements.

Minerva Stomatol. 2016 Dec;65(6):335-342

Authors: Ravasini F, Fornari M, Bonanini M

Abstract
BACKGROUND: The use of photogrammetry may be a new method to quantify the amount of artificial dental material removed from the surface of each teeth during the grind procedure (SG). SG is necessary in each denture to reach a correct occlusion. It consists in a refine action on the prosthesis teeth's surface using milling machine tools, aimed to remove the interferences (pre-contacts) between upper and lower teeth during chewing. This measure is achieved after a comparison between pre and post-grinding 3D models. This new application could be of interest for both dentists and dental technicians because it could be used to evaluate, with a accurate numerical description, the action applied on teeth surfaces during the grinding process. Furthermore, results of the analysis could have some value for the dental industry, since the use of photogrammetry can improve the process, reducing costs during the design of artificial teeth and eventually this method could be used as a teaching tool both for dental and "dental technician" high school students. The purpose of this work is to measure the thickness of the artificial enamel removed during grinding phases. Usually, the dental technician adjusts the dental plate on the mount of the patient following the traditional method, without a quantitative evaluation of the material removed. The photogrammetric method (PM) proposed here allows to measure the amount of material removed during the grinding process. This measure is achieved after a comparison between pre and post-grinding 3D models.
METHODS: Under control of three teachers (experts of dentures performed according to the Gerber method) ten complete dentures arrangements (upper and inferior arches) performed by dental students at the Prosthodontic Department of the University of Parma, Italy were analyzed with PM before and after SG.
RESULTS: The average thickness variation between the pre and post-grinding dentures is within the range of 0.1÷0.4 mm. For the upper arches, the mean value of the SG process is 223 µm while for the inferior arches is 240 µm. Results show that the most important grind process in all models appear in correspondence of cusps, with values up to 1660 µm. On the other hand, in correspondence of the fossae the results show a moderate grind action: the value is around 200-300 µm. Conversely to guidelines thought to students: cusps undergo a greater grinding process than fossae, consequently cusps should be revisioned at least on their technical and morphological aspects. The average thickness variation between the pre and post-grinding dentures is within the range of 0.1÷0.4 mm, this mean an equal value loss of vertical dimension. Furthermore, the knowledge of the gauge material removed during the SG could be useful for dental industries, giving important information, that could be considered for project and design of artificial teeth.
CONCLUSIONS: The FM implemented in this article has given satisfactory preliminary results, showing good accuracy, low costs and high versatility. It is necessary to highlight that this is an experimental method and that the present analysis is a pilot study that needs further evaluation. Nevertheless results obtained could be of some value for medical companies, in order to improve the artificial teeth's design and project. Moreover, such a method may serve as educational tool for dental students.

PMID: 27711027 [PubMed - in process]

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Acoustic analysis of snoring sounds recorded with a smartphone according to obstruction site in OSAS patients.

Acoustic analysis of snoring sounds recorded with a smartphone according to obstruction site in OSAS patients.

Eur Arch Otorhinolaryngol. 2016 Oct 5;:

Authors: Koo SK, Kwon SB, Kim YJ, Moon JI, Kim YJ, Jung SH

Abstract
Snoring is a sign of increased upper airway resistance and is the most common symptom suggestive of obstructive sleep apnea. Acoustic analysis of snoring sounds is a non-invasive diagnostic technique and may provide a screening test that can determine the location of obstruction sites. We recorded snoring sounds according to obstruction level, measured by DISE, using a smartphone and focused on the analysis of formant frequencies. The study group comprised 32 male patients (mean age 42.9 years). The spectrogram pattern, intensity (dB), fundamental frequencies (F 0), and formant frequencies (F 1, F 2, and F 3) of the snoring sounds were analyzed for each subject. On spectrographic analysis, retropalatal level obstruction tended to produce sharp and regular peaks, while retrolingual level obstruction tended to show peaks with a gradual onset and decay. On formant frequency analysis, F 1 (retropalatal level vs. retrolingual level: 488.1 ± 125.8 vs. 634.7 ± 196.6 Hz) and F 2 (retropalatal level vs. retrolingual level: 1267.3 ± 306.6 vs. 1723.7 ± 550.0 Hz) of retrolingual level obstructions showed significantly higher values than retropalatal level obstruction (p < 0.05). This suggests that the upper airway is more severely obstructed with retrolingual level obstruction and that there is a greater change in tongue position. Acoustic analysis of snoring is a non-invasive diagnostic technique that can be easily applied at a relatively low cost. The analysis of formant frequencies will be a useful screening test for the prediction of occlusion sites. Moreover, smartphone can be effective for recording snoring sounds.

PMID: 27709292 [PubMed - as supplied by publisher]

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Antibiotic Prescribing by Physicians Versus Nurse Practitioners for Pediatric Upper Respiratory Infections.

Antibiotic Prescribing by Physicians Versus Nurse Practitioners for Pediatric Upper Respiratory Infections.

Ann Otol Rhinol Laryngol. 2016 Oct 5;:

Authors: Ference EH, Min JY, Chandra RK, Schroeder JW, Ciolino JD, Yang A, Holl J, Shintani Smith S

Abstract
BACKGROUND: This study investigates differences in antibiotic prescribing rates for pediatric upper respiratory infections (URIs) between physicians and nurse practitioners (NPs).
METHODS: Visits by children <18 years old diagnosed with URI to physicians or NPs between 2001 and 2010 were abstracted from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Care Survey. Logistic regression analyses examined variations in antibiotic prescribing rates.
RESULTS: Upper respiratory infections accounted for approximately 439 ± 21.5 million visits. Patients seen by NPs were more likely to have Medicaid, live in the lowest median household income quartile zip codes and micropolitan locations, and live in the South compared to patients seen by physicians. Nurse practitioners prescribed antibiotics 66.7% ± 4.2% of the time versus physicians at 52.8% ± 0.8% for URI visits (unadjusted P-value = .002). Adjusted by specialty, URI type, and chronic diseases, NPs had marginally significantly different odds of prescribing antibiotics (OR = 1.6, 95% CI, 1.0-2.6, P-value = .048), but the association with prescribing broad-spectrum antibiotics is not as strong (adjusted P-value = .063). Patient visits to a pediatric (OR = 0.54, 95% CI, 0.43-0.67) or ENT/surgery practice (OR = 0.11, 95% CI, 0.06-0.18) had lower odds of antibiotic prescribing compared to general/family medicine practices. Year (2001-2010) was not significantly associated with antibiotic or broad-spectrum antibiotic prescribing rates for physicians, but rates for NPs fell for otitis media (P-value = .007) from 90.2% ± 8.2% (2001-2002) to 74.8% ± 6.8% (2009-2010) of visits.
CONCLUSIONS: Nurse practitioners have higher rates of antibiotic prescribing compared to physicians for pediatric patients with URIs; however, this difference is less after adjusting for specialty. Examining comparative antibiotic prescribing is important to promote evidence-based practice and adoption of clinical guidelines.

PMID: 27707916 [PubMed - as supplied by publisher]

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Airway observations during upper endoscopy predicting obstructive sleep apnea.

Airway observations during upper endoscopy predicting obstructive sleep apnea.

Ann Gastroenterol. 2016 Oct-Dec;29(4):481-486

Authors: Harvin G, Ali E, Raina A, Leland W, Abid S, Vahora Z, Movahed H, Kachru S, Tee R

Abstract
BACKGROUND: This pilot study examined airway characteristics during upper endoscopy to determine who is at high risk for obstructive sleep apnea.
METHODS: Patients undergoing routine upper endoscopy were divided into 2 groups according to the Berlin Questionnaire (high and low risk for sleep disordered breathing). Patients underwent routine upper endoscopy using propofol sedation. The airway was then evaluated for no, partial, or complete collapse at the levels of the palate/uvula/tonsils, the tongue base, the hypopharynx, and the larynx. They were given a score of 0 for no collapse, 1 for partial collapse, and 2 for complete collapse. The score for each of these levels was added to give a total score or severity index. The larynx was also evaluated for lateral pharyngeal collapse (minimal, up to 50%, >50%, or 100%).
RESULTS: We found that patients with a partial obstruction at the level of the palate/uvula/tonsils, tongue base, hypopharynx, or larynx, or complete obstruction at any level more often had a positive Berlin questionnaire. Patients with a positive Berlin questionnaire were more often of increased weight (mean 197 vs 175 lbs, P=0.19), increased body mass index (31.2 vs 27.42 kg/m(2), P=0.11), increased neck circumference (36.7 vs 34.7 cm, P=0.23), and had a higher total airway score (2.61 vs 1.67, P=0.09).
CONCLUSIONS: The results of our pilot study represent preliminary data regarding the use of upper endoscopy as a potential tool to evaluate patients for obstructive sleep apnea.

PMID: 27708514 [PubMed - in process]

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Foreign Body Granuloma of the Epiglottic Vallecula Mimicking Malignancy on MRI and FDG PET/CT.

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Foreign Body Granuloma of the Epiglottic Vallecula Mimicking Malignancy on MRI and FDG PET/CT.

Clin Nucl Med. 2016 Mar;41(3):227-9

Authors: Dong A, Bai Y, Wang Y, Zuo C

Abstract
A 66-year-old man complained of foreign body sensation of the throat and progressive dysphagia without any trigger. Videolaryngoscopy showed a whitish lesion in the epiglottic vallecula. Neck enhanced MRI showed a lesion in epiglottic vallecula with remarkable enhancement. FDG PET/CT showed intense FDG uptake of the lesion with SUVmax of 28. Malignant tumor was suspected. The patient underwent microlaryngoscopic surgery. Histopathologic findings of the specimen were consistent with foreign body granuloma.

PMID: 26447384 [PubMed - indexed for MEDLINE]

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Vocal fold tear in an operatic tenor.

Vocal fold tear in an operatic tenor.

Ear Nose Throat J. 2014 Sep;93(9):E41-2

Authors: Portnoy JE, Sataloff RT

PMID: 25255360 [PubMed - indexed for MEDLINE]

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[Conjunctival impression cytology in patients with normal and impaired OSDI scores].

[Conjunctival impression cytology in patients with normal and impaired OSDI scores].

Arch Soc Esp Oftalmol. 2014 Oct;89(10):391-6

Authors: Zuazo F, López-Ponce D, Salinas-Toro D, Valenzuela F, Sans-Puroja J, Srur M, López-Solís RO, Traipe-Castro L

Abstract
PURPOSE: To describe goblet cell density and Nelson grading in different areas of the ocular surface using conjunctival impression cytology (CIC) among patients with normal and impaired Ocular Surface Disease Index (OSDI) scores.
MATERIAL AND METHODS: Patients (n=166) under assessment for dry eye were recruited between 2011 and 2012 and classified according to the OSDI score in 4 categories (normal and impaired). Cytological study (CIC plus Papanicolaou staining) using the Nelson grading system, with modifications in staging, and goblet cell counting were performed on the nasal, temporal, inferior, and superior bulbar conjunctival surfaces.
RESULTS: Nelson grading was significantly higher in patients with a severely impaired OSDI score (1.41±0.14) compared to normal patients (0.86±0.09) (P<.01). Goblet cell density was significantly reduced in patients with a severely impaired OSDI score (310.24±56.24 cells per sample) compared with normal subjects (497.31±50.07 cells per sample) (P<.001). Compared with the photoexposed bulbar conjunctiva, goblet cell density on the non-photoexposed conjunctiva was significantly higher both in patients with mild (P<.01) and moderate (P<.001) OSDI scores.
CONCLUSION: Patients with severely impaired OSDI scores have less goblet cells and a higher Nelson grade. Goblet cells are more abundant on the non-photoexposed conjunctiva.

PMID: 24993073 [PubMed - indexed for MEDLINE]

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Πέμπτη 6 Οκτωβρίου 2016

Improvement of the insertion axis for cochlear implantation with a robot-based system.

Improvement of the insertion axis for cochlear implantation with a robot-based system.

Eur Arch Otorhinolaryngol. 2016 Oct 4;:

Authors: Torres R, Kazmitcheff G, De Seta D, Ferrary E, Sterkers O, Nguyen Y

Abstract
It has previously reported that alignment of the insertion axis along the basal turn of the cochlea was depending on surgeon' experience. In this experimental study, we assessed technological assistances, such as navigation or a robot-based system, to improve the insertion axis during cochlear implantation. A preoperative cone beam CT and a mastoidectomy with a posterior tympanotomy were performed on four temporal bones. The optimal insertion axis was defined as the closest axis to the scala tympani centerline avoiding the facial nerve. A neuronavigation system, a robot assistance prototype, and software allowing a semi-automated alignment of the robot were used to align an insertion tool with an optimal insertion axis. Four procedures were performed and repeated three times in each temporal bone: manual, manual navigation-assisted, robot-based navigation-assisted, and robot-based semi-automated. The angle between the optimal and the insertion tool axis was measured in the four procedures. The error was 8.3° ± 2.82° for the manual procedure (n = 24), 8.6° ± 2.83° for the manual navigation-assisted procedure (n = 24), 5.4° ± 3.91° for the robot-based navigation-assisted procedure (n = 24), and 3.4° ± 1.56° for the robot-based semi-automated procedure (n = 12). A higher accuracy was observed with the semi-automated robot-based technique than manual and manual navigation-assisted (p < 0.01). Combination of a navigation system and a manual insertion does not improve the alignment accuracy due to the lack of friendly user interface. On the contrary, a semi-automated robot-based system reduces both the error and the variability of the alignment with a defined optimal axis.

PMID: 27704279 [PubMed - as supplied by publisher]

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Impact of gender and sleep position on relationships between anthropometric parameters and obstructive sleep apnea syndrome.

Impact of gender and sleep position on relationships between anthropometric parameters and obstructive sleep apnea syndrome.

Sleep Breath. 2016 Oct 5;:

Authors: Jeong JI, Gu S, Cho J, Hong SD, Kim SJ, Dhong HJ, Chung SK, Kim HY

Abstract
OBJECTIVE: Considering the mechanisms by which obesity affects obstructive sleep apnea syndrome (OSAS) and the differences of fat distribution depending on gender, associations between anthropometric parameters, and OSAS may differ depending on gender or sleep position. We analyzed the impact of gender and sleep position on the relationship between fat distribution and development of OSAS.
METHODS: One thousand thirty-two consecutive subjects were analyzed. Recorded anthropometric measurements and overnight polysomnographic data of the subjects were reviewed retrospectively. The presence of OSAS was defined by the respiratory disturbance index (RDI) ≥5 with documented symptoms of excessive daytime sleepiness.
RESULTS: Eight hundred fifty-eight males and 174 females were included. Male subjects had significantly higher body mass index (BMI), larger waist circumference (WC), and lower percent of overall body fat (P < 0.0001, P < 0.0001, and P < 0.0001, respectively). The severity of OSAS was significantly higher in male subjects (RDI 26.9 ± 22.4 in males vs. 10.2 ± 13.8 in females, P < 0.0001). In male subjects, BMI, WC, and overall body fat were significantly associated with severity of OSAS and had larger impacts on supine RDI than lateral RDI. Overall body fat was not associated with severity of OSAS in female subjects, and there were no significant differences of the associations between all anthropometric parameters and RDIs depending on sleep position.
CONCLUSIONS: Evaluation of the correlation of anthropometric data with severity of OSAS should consider sleep position as well as gender.

PMID: 27704328 [PubMed - as supplied by publisher]

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Improvement of the insertion axis for cochlear implantation with a robot-based system.

Improvement of the insertion axis for cochlear implantation with a robot-based system.

Eur Arch Otorhinolaryngol. 2016 Oct 4;:

Authors: Torres R, Kazmitcheff G, De Seta D, Ferrary E, Sterkers O, Nguyen Y

PMID: 27704279 [PubMed - as supplied by publisher]

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A systematic review of resonant voice therapy.

A systematic review of resonant voice therapy.

Int J Speech Lang Pathol. 2016 Oct 5;:1-13

Authors: Yiu EM, Lo MC, Barrett EA

Abstract
PURPOSE: The purpose of this study is to systematically review the literature on resonant voice therapy and to evaluate the level of evidence on the effectiveness of using resonant voice therapy in treating dysphonia.
METHOD: Refereed journal papers from 1974 to 2014 were retrieved and reviewed by two independent reviewers using the keywords "Humming, Resonance, Resonant Voice, Semi-occluded or closed tube phonation" using available database systems. Quality of evidence was evaluated by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).
RESULT: Thirteen papers met the search criteria. Nine papers were selected by the two reviewers. Two of the papers were randomised-controlled studies and the other seven were observational studies. At least four types of resonant voice therapies were described. They included the Lessac-Madsen Resonant Voice Therapy, Y-Buzz, Resonance Therapy and Humming. The overall level of quality of evidence was graded as "moderate".
CONCLUSION: There were limited studies that investigated the effectiveness of resonant voice therapy. Most studies were small-scale uncontrolled observational studies with the inclusion of only small samples or specific populations. There is clearly a need for more large-scale randomised controlled studies with a wider range of populations to provide further evidence on the effectiveness of resonant voice training for different populations.

PMID: 27705008 [PubMed - as supplied by publisher]

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Extracapsular dissection versus superficial parotidectomy in benign parotid gland tumors: The Vienna Medical School experience.

Extracapsular dissection versus superficial parotidectomy in benign parotid gland tumors: The Vienna Medical School experience.

Head Neck. 2016 Oct 5;:

Authors: Kadletz L, Grasl S, Grasl MC, Perisanidis C, Erovic BM

Abstract
BACKGROUND: The purpose of this study was to evaluate the clinical outcome in patients with benign parotid gland tumors after extracapsular dissection or superficial parotidectomy (SP).
METHODS: Eight hundred ninety-four patients with primary pleomorphic adenoma or Warthin's tumor were included from this study. Type and length of surgery, tumor size, resection margins, and complication rates were assessed.
RESULTS: Three hundred ninety-five (44.2%) extracapsular dissections and 499 SPs (55.8%) were performed. The rate of positive margins was significantly higher in the extracapsular dissection compared to the SP group (29.4% vs 10.2%; p < .0001). Recurrent disease (extracapsular dissection = 7.2% vs SP = 2.2%; p = .0003) and permanent facial palsy were significantly more frequent after extracapsular dissection than SP (2.2% vs 0.6%; p = .0396). Significant prolonged surgery time was observed after SP (146 vs 94 minutes; p < .0001).
CONCLUSION: Because extracapsular dissection led to a significantly higher percentage of permanent facial palsy, recurrent disease, and positive resection margins compared to SP, we recommend SP for treating benign parotid gland tumors. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704717 [PubMed - as supplied by publisher]

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Weight loss after head and neck cancer: A dynamic relationship with depressive symptoms.

Weight loss after head and neck cancer: A dynamic relationship with depressive symptoms.

Head Neck. 2016 Oct 5;:

Authors: Van Liew JR, Brock RL, Christensen AJ, Karnell LH, Pagedar NA, Funk GF

Abstract
BACKGROUND: Weight loss and depressive symptoms are critical head and neck cancer outcomes, yet their relation over the illness course is unclear.
METHODS: Associations between self-reported depressive symptoms and objective weight loss across the year after head and neck cancer diagnosis were examined using growth curve modeling techniques (n = 564).
RESULTS: A reciprocal covariation pattern emerged-changes in depressive symptoms over time were associated with same-month changes in weight loss (t [1148] = 2.05; p = .041), and changes in weight loss were associated with same-month changes in depressive symptoms (t [556] = 2.43; p = .015). To the extent that depressive symptoms increased, patients lost incrementally more weight than was lost due to the passage of time and vice versa. Results also suggested that pain and eating-related quality of life might explain the reciprocal association between depressive symptoms and weight loss.
CONCLUSION: In head and neck cancer, a transactional interplay between depressive symptoms and weight loss unfolds over time. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704695 [PubMed - as supplied by publisher]

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Versatility of the facial artery myomucosal island flap in neopharyngeal reconstruction.

Versatility of the facial artery myomucosal island flap in neopharyngeal reconstruction.

Head Neck. 2016 Oct 5;:

Authors: Frisch T

Abstract
BACKGROUND: The facial artery myomucosal (FAMM) island flap is a cheek flap, pedicled on the facial artery and suitable for small to medium-sized reconstructions of the oral cavity and neighboring areas. A novel transposition of the flap to the hypopharynx after laryngectomy is presented in this report.
METHODS: A 58-year-old man, previously irradiated, was laryngopharyngectomized because of a new supraglottic carcinoma. An unexpected need for a flap was solved by tunneling a FAMM island flap lateral to the mandible. The reach and size of the flap were sufficient to close the defect.
RESULTS: Vitality of the flap was ascertained by fiber endoscopy. No donor-site morbidity was seen. Postoperatively, the patient had a minor stomal fistula with spontaneous healing.
CONCLUSION: The pedicled FAMM island flap may be considered for smaller reconstructions of the upper hypopharynx. Accessibility, low donor-site morbidity, and recipient tissue similarity count among the advantages. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704666 [PubMed - as supplied by publisher]

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Efficacy of ultrasound-guided fine-needle aspiration performed by surgeons newly trained in thyroid ultrasound.

Efficacy of ultrasound-guided fine-needle aspiration performed by surgeons newly trained in thyroid ultrasound.

Head Neck. 2016 Oct 5;:

Authors: Graciano AJ, Fischer CA, Chone CT, Bublitz GS, Sonagli M, Filho CA

Abstract
BACKGROUND: There are a growing number of thyroid ultrasound courses to train endocrinologists, pathologists, and surgeons to perform ultrasound-guided fine-needle aspiration (FNA). However, there are limited data to support the efficacy of ultrasound-guided FNA performed by nonradiologists.
METHODS: We compared the efficacy of ultrasound-guided FNA performed by surgeons newly trained in thyroid ultrasound with that of the same technique performed by 1 experienced radiologist. The ratio of nondiagnostic examinations was used to compare the 2 groups.
RESULTS: A total of 197 ultrasound-guided FNAs were performed on 172 women (95.53%) and 8 men (4.47%) over a 12-month period. The efficacy of ultrasound-guided FNA did not differ between groups. A nondiagnostic report was found in 23% and 25.7% of the examinations performed by the radiologist and surgeons, respectively.
CONCLUSION: The efficacy of ultrasound-guided FNAs performed by our 2 surgeons was similar to that of our radiologist. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704660 [PubMed - as supplied by publisher]

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High-dose intravenous steroid regimen for radiation-induced hypoglossal nerve palsy.

High-dose intravenous steroid regimen for radiation-induced hypoglossal nerve palsy.

Head Neck. 2016 Oct 5;:

Authors: McDowell LJ, Jacobson MC, Levin W

Abstract
BACKGROUND: Hypoglossal nerve palsies are infrequent complications of head and neck radiotherapy. Treatments focus on maintaining function and prevention of abnormal airway-related swallowing events.
METHODS: A patient with longstanding cranial neuropathies, including bilateral hypoglossal involvement, secondary to chemoradiotherapy for nasopharyngeal carcinoma, experienced repeated episodes of life-threatening complications. Initially, 2 courses of 2 weekly 24-hour intravenous methylprednisolone (IVMP) infusions were administered 2 years apart. We report the results of a third course comprising 5 weekly cycles.
RESULTS: Patient-reported outcomes revealed significant improvement in swallowing function, speech, and psychosocial status. Airway invasion during swallowing and pharyngeal retention were assessed videofluoroscopically and evaluated using the Penetration-Aspiration Scale (PAS) and a residue rating scale, respectively. PAS ratings after infusions 2 and 5, improved dramatically from baseline and were maintained at 1-year follow-up.
CONCLUSION: High doses of IVMP may improve radiation-induced neuropathies. Further testing in similar patients is needed to prove reproducibility. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704653 [PubMed - as supplied by publisher]

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Supratracheal partial laryngectomy with tracheohyoidoepiglottopexy (open partial horizontal laryngectomy type IIIa + cricoarytenoid unit): Surgical technique illustrated in the anatomy laboratory.

Supratracheal partial laryngectomy with tracheohyoidoepiglottopexy (open partial horizontal laryngectomy type IIIa + cricoarytenoid unit): Surgical technique illustrated in the anatomy laboratory.

Head Neck. 2016 Oct 5;:

Authors: Succo G, Crosetti E, Bertolin A, Lucioni M, Rizzotto G

Abstract
The first supratracheal partial laryngectomy (STPL) with tracheohyoidoepiglottopexy was performed in 1972. This procedure entailed preservation of the suprahyoid epiglottis as well as a pexy of the hyoid bone and residual epiglottis to the first tracheal ring; however, this technique was abandoned by the same author in the early 1980s because of poor functional outcomes. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704651 [PubMed - as supplied by publisher]

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Core-needle biopsy versus repeat fine-needle aspiration for thyroid nodules initially read as atypia/follicular lesion of undetermined significance.

Core-needle biopsy versus repeat fine-needle aspiration for thyroid nodules initially read as atypia/follicular lesion of undetermined significance.

Head Neck. 2016 Oct 5;:

Authors: Choi YJ, Baek JH, Suh CH, Shim WH, Jeong B, Kim JK, Song DE, Kim TY, Chung KW, Lee JH

Abstract
BACKGROUND: The purpose of this study was to evaluate the role of core-needle biopsy (CNB) by comparing the results of CNB and repeat fine-needle aspiration (FNA) for thyroid nodules that are initially read as atypia/follicular lesion of undetermined significance (AUS/FLUS) on FNA.
METHODS: Among 2631 initial AUS/FLUS FNA results, 505 consecutive nodules (295 repeat FNAs and 210 CNBs) were retrospectively analyzed. The primary outcome was inconclusive (ie, nondiagnostic or AUS/FLUS). The secondary outcomes included inconclusive results of the subcategory, risk factors for inconclusive results, and diagnostic performance.
RESULTS: CNB demonstrated significantly fewer inconclusive results than repeat FNA for the overall nodules (40.9% vs 63%; p < .001). Repeat FNA and group FLUS were significant risk factors for inconclusive results (odds ratio = 1.92; p =.001 and odds ratio = 2.08; p <.001, respectively). All diagnostic performances using CNB were higher than repeat FNAs.
CONCLUSION: CNB is more useful than repeat FNAs for reducing inconclusive results and improving the diagnostic performance of thyroid nodules with initial AUS/FLUS FNA results. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704650 [PubMed - as supplied by publisher]

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Predicting lymph node metastasis in patients with papillary thyroid carcinoma by vascular index on power Doppler ultrasound.

Predicting lymph node metastasis in patients with papillary thyroid carcinoma by vascular index on power Doppler ultrasound.

Head Neck. 2016 Oct 5;:

Authors: Lee JH, Shin HJ, Yoon JH, Kim EK, Moon HJ, Lee HS, Kwon HJ, Kwak JY

Abstract
BACKGROUND: For patients with papillary thyroid carcinoma (PTC), lymph node metastasis is associated with an increased recurrence rate. The purpose of this study was to investigate whether the vascular endothelial growth factor (VEGF), microvessel density (MVD), and vascular index (VI) can predict lymph node metastasis in patients with PTC.
METHODS: From January 2011 to October 2011, 202 patients with PTCs underwent preoperative staging ultrasound evaluation. To evaluate vascularity, we measured the VI, VEGF expression, and MVD.
RESULTS: The VI was significantly correlated with MVD (p = .009). On multivariate analysis, young age showed a significant correlation with lymph node metastasis (p < .001; p < .001; p < .001). However, the other clinicopathologic features, VEGF, MVD, and VI failed to show any significant correlations with lymph node metastasis.
CONCLUSION: Although the VI showed significant correlation with MVD, it was not significantly correlated to lymph node metastasis. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704649 [PubMed - as supplied by publisher]

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Intonation patterns in older children with cerebral palsy before and after speech intervention.

Intonation patterns in older children with cerebral palsy before and after speech intervention.

Int J Speech Lang Pathol. 2016 Oct 5;:1-11

Authors: Kuschmann A, Miller N, Lowit A, Pennington L

Abstract
PURPOSE: This paper examined the production of intonation patterns in children with developmental dysarthria associated with cerebral palsy (CP) prior to and after speech intervention focussing on respiration and phonation. The study further sought to establish whether intonation performance might be related to changes in speech intelligibility.
METHOD: Intonation patterns were examined using connected speech samples of 15 older children with moderate to severe developmental dysarthria due to CP (9 females; age range: 11-18). Recordings were made prior to and after speech intervention based on a systems approach. Analyses are focussed on the use of intonation patterns, pitch accentuation and phrasing.
RESULT: Group analyses showed a significant increase in the use of rising intonation patterns after intervention. There were also some indications that this increase might have been related to gains in speech intelligibility for some of the children. No changes were observed regarding pitch accentuation and phrasing following intervention.
CONCLUSION: The findings highlight that changes can occur in the use of intonation patterns in children with dysarthria and CP following speech systems intervention. It is hypothesised that the emergence of the rising pattern in some of the children's intonational inventories possibly reflected improved breath support and control of laryngeal muscles.

PMID: 27705032 [PubMed - as supplied by publisher]

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Therapeutic effects of intensive voice treatment (LSVT LOUD) for children with spastic cerebral palsy and dysarthria: A phase I treatment validation study.

Therapeutic effects of intensive voice treatment (LSVT LOUD) for children with spastic cerebral palsy and dysarthria: A phase I treatment validation study.

Int J Speech Lang Pathol. 2016 Oct 5;:1-15

Authors: Boliek CA, Fox CM

Abstract
PURPOSE: The aim of the present study was to validate and extend the evaluation of treatment outcomes following LSVT LOUD® in children with dysarthria secondary to cerebral palsy (CP).
METHOD: Seven children (5 females, 6-10 years) with spastic quadriplegia and dysarthria received LSVT LOUD. Outcomes included: (a) quantitative and qualitative indices of communication and social functioning representing therapeutic effects and (b) features of the acoustic signal representing physiological effects on the speech mechanism. A matched group of typically developing children served as controls. Testing occurred just prior to (PRE), immediately following (POST), and at 12 weeks post-treatment (FUP).
RESULT: Expert listeners preferred voice quality and articulatory precision of children with CP at FUP as compared to PRE. Acoustic data indicated improvements on select measures of vocal functioning at POST with some maintenance at FUP. Single word intelligibility improved immediately POST, but was not maintained at FUP. Parents rated positive changes in characteristics of voice and speech and qualitative changes in communication at both POST and FUP.
CONCLUSION: The present study validated some of the previous LSVT LOUD outcomes in children with dysarthria and CP and extended our understanding of therapeutic effects through qualitative data obtained from extensive parent interviews.

PMID: 27705010 [PubMed - as supplied by publisher]

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A systematic review of resonant voice therapy.

A systematic review of resonant voice therapy.

Int J Speech Lang Pathol. 2016 Oct 5;:1-13

Authors: Yiu EM, Lo MC, Barrett EA

PMID: 27705008 [PubMed - as supplied by publisher]

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Speech and nonspeech: What are we talking about?

Speech and nonspeech: What are we talking about?

Int J Speech Lang Pathol. 2016 Oct 5;:1-15

Authors: Maas E

Abstract
Understanding of the behavioural, cognitive and neural underpinnings of speech production is of interest theoretically, and is important for understanding disorders of speech production and how to assess and treat such disorders in the clinic. This paper addresses two claims about the neuromotor control of speech production: (1) speech is subserved by a distinct, specialised motor control system and (2) speech is holistic and cannot be decomposed into smaller primitives. Both claims have gained traction in recent literature, and are central to a task-dependent model of speech motor control. The purpose of this paper is to stimulate thinking about speech production, its disorders and the clinical implications of these claims. The paper poses several conceptual and empirical challenges for these claims - including the critical importance of defining speech. The emerging conclusion is that a task-dependent model is called into question as its two central claims are founded on ill-defined and inconsistently applied concepts. The paper concludes with discussion of methodological and clinical implications, including the potential utility of diadochokinetic (DDK) tasks in assessment of motor speech disorders and the contraindication of nonspeech oral motor exercises to improve speech function.

PMID: 27701907 [PubMed - as supplied by publisher]

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Responses made by late talkers and typically developing toddlers during speech assessments.

Responses made by late talkers and typically developing toddlers during speech assessments.

Int J Speech Lang Pathol. 2016 Oct 5;:1-14

Authors: Hodges R, Baker E, Munro N, Mcgregor KK

Abstract
PURPOSE: Assessing toddlers' speech is challenging. We explored responses made by late talkers and their typically developing peers in structured speech sampling contexts and determined if late talker subgroups could be identified.
METHOD: Twenty-six late talkers and 26 age-matched typically developing toddlers participated in an expressive phonology assessment and an elicited non-word imitation test. We quantified the breadth of toddler responses used in a subset of monosyllabic stimuli from the toddler phonology assessment and in the non-word imitation test. Correlational and cluster analyses were conducted.
RESULT: There were six response types: no response, protoword response, different verbal response, correct phoneme, common and uncommon phonological errors. Toddlers' use of most of the response types correlated across the two sampling contexts. Use of the response types also correlated with several direct and parent-report assessments. There were significant group differences in the use of several response types in both sampling contexts. Five late talker subgroups were identified that presented with differing profiles of responses.
CONCLUSION: Toddlers respond in a variety of ways during structured speech sampling contexts. Responses made by late talkers offer insights about the nature of late talking and their heterogeneity. Implications for research and clinical management of late talkers are discussed.

PMID: 27701903 [PubMed - as supplied by publisher]

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Speech-language pathology research in the Philippines in retrospect: Perspectives from a developing country.

Speech-language pathology research in the Philippines in retrospect: Perspectives from a developing country.

Int J Speech Lang Pathol. 2016 Oct 5;:1-9

Authors: Bondoc IP, Mabag V, Dacanay CA, Macapagal ND

Abstract
PURPOSE: There is a need for speech-language pathology (SLP) research in the Philippines, in order to fill in knowledge gaps relevant to the local context. Information about the local SLP research status remains inadequate. This study describes local SLP research done over the almost past four decades.
METHOD: Using a descriptive retrospective design, a search was made for all empirical research articles completed by Filipino SLPs from 1978 to 2015.
RESULT: A total of 250 research articles were identified and described along several parameters. A predominant number were authored by the SLPs in the academe (97.20%). There was a focus on language (27.60%) and the nature of communication/swallowing disorders (20.80%). More than half utilised quantitative exploratory research designs (69.20%). Several used survey forms to generate data (38.41%). Nearly all were unpublished (93.60%) and were unfunded (94.80%).
CONCLUSION: The current study revealed a dearth of research studies, limited diversity of research articles, limited research dissemination and funding concerns. It is suggested that the results of the current study can serve as a reference point to restructure research systems in the Philippines and in other developing countries, and offer data that can be used to develop a research agenda for the profession.

PMID: 27701895 [PubMed - as supplied by publisher]

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Speech recognition outcomes in Mandarin-speaking cochlear implant users with fine structure processing.

Speech recognition outcomes in Mandarin-speaking cochlear implant users with fine structure processing.

Acta Otolaryngol. 2016 Oct 5;:1-7

Authors: Qi B, Liu Z, Gu X, Liu B

Abstract
CONCLUSION: Mandarin-speaking adults can use the Fine Structure Processing (FSP) coding strategy as well as the Continuous Interleaved Sampling (CIS+) coding strategy. No loss in performance was observed after switch-over. Tone identification improves over time with the FSP coding strategy, which is of benefit to tonal-language users. After some time, fine structure was preferred.
OBJECTIVE: This study aimed to determine speech perception, tone perception, and the subjective preferences of Mandarin-speaking adults who received the FSP coding strategy, at upgrade from the CIS + coding strategy.
METHODS: Thirteen Mandarin-speaking subjects were tested at switch-over from CIS + to the FSP coding strategy ∼1-month after switch-over, 2-months after switch-over, and 3-months after switch-over with the Mandarin Hearing in Noise Test (M-HINT), the Mandarin Tone Identification in Noise Test (M-TINT), and a visual analogue scale assessing Sound and Speech Assessment (SSA).
RESULTS: There were no significant differences in the M-HINT between presentation levels (62 dB SPL vs 65 dB SPL), over time, nor when compared to the CIS + coding strategy. Tone perception improved significantly over time with the FSP coding strategy. Subjects rated the FSP coding strategy with the OPUS 2 as significantly more 'full' and 'rich' than with the CIS + coding strategy after 3-months.

PMID: 27701966 [PubMed - as supplied by publisher]

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Racial and Ethnic Disparities in Nasopharyngeal Cancer Survival in the United States: A SEER Study.

Racial and Ethnic Disparities in Nasopharyngeal Cancer Survival in the United States: A SEER Study.

Otolaryngol Head Neck Surg. 2016 Oct 4;:

Authors: Patel VJ, Chen NW, Resto VA

Abstract
OBJECTIVE: To determine whether patient race and ethnicity affect nasopharyngeal cancer survival.
STUDY DESIGN: Retrospective database analysis.
SETTING: National Cancer Institute's SEER database (Surveillance, Epidemiology, and End Results), 1988-2010.
SUBJECTS AND METHODS: Nasopharyngeal carcinoma cases were extracted according to site codes and histology recode-broad groupings. The cohort of 5427 patients was used to calculate disease-specific survival in regard to race and ethnicity. Extracted data were further analyzed through direct comparisons and multivariable Cox regression models controlling for patient, tumor, and treatment characteristics.
RESULTS: Unadjusted survival curves for all nasopharyngeal carcinomas considered together showed a statistically significant better disease-specific survival for the African American race (P = .02) and Asian ethnicity (P = .01) relative to Caucasian patients. The survival advantage for both these groups was eliminated after controlling for the age and sex of the patients.
CONCLUSION: African American and Asian patients with nasopharyngeal cancer have better disease-specific survival as compared with Caucasian patients, while Hispanic ethnicity has no effect relative to Caucasians. This disparity is accounted for by diagnosis at an older age in Caucasian patients but remains poorly explained in regard to Hispanic patients.

PMID: 27703094 [PubMed - as supplied by publisher]

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Prevalence and Surgical Implications of Dural Enhancement at the Porus Acusticus in Vestibular Schwannomas.

Prevalence and Surgical Implications of Dural Enhancement at the Porus Acusticus in Vestibular Schwannomas.

Otolaryngol Head Neck Surg. 2016 Oct 4;:

Authors: Patel NS, Van Abel KM, Link MJ, Driscoll CL, Van Gompel JJ, Neff BA, Lane JI, Carlson ML

Abstract
OBJECTIVE: Demonstrate the association of radiographic dural enhancement with increased tumor adherence at the porus acusticus, which may influence completeness of resection and facial nerve outcome.
STUDY DESIGN: Case series with chart review.
SETTING: Academic referral center.
SUBJECTS AND METHODS: A total of 205 consecutive patients with histopathologically confirmed vestibular schwannoma (VS) were evaluated. Patients with tumors exhibiting dural enhancement on postgadolinium T1-weighted magnetic resonance imaging were identified and compared with matched controls. Completeness of resection, intraoperative details, and facial nerve outcomes were analyzed.
RESULTS: Excluding strictly intracanalicular tumors (n = 32, 16%) and those with NF2 (n = 10, 4.9%), the presence of dural enhancement was radiographically confirmed in 16 (9.8%) cases. Paired analysis did not reveal significant baseline differences between cases and controls. Subtotal resection was performed in 5 (31%) of the 16 patients with tumors exhibiting dural enhancement, in contrast to 1 (3%) of the matched controls (P = .01). Four (25%) demonstrated increased tumor adherence at the porus acusticus intraoperatively, compared with 1 control (3%, P = .04). Long-term facial nerve function was similar between cases and controls (81% vs 84% House-Brackmann I-II function, P = 1.00).
CONCLUSION: Dural enhancement is present in approximately 10% of extracanalicular VS. Dural enhancement at the porus acusticus may represent hypervascularity, dural reaction, or infiltration, and portends increased tumor adherence and greater likelihood of subtotal resection to preserve facial nerve function. To our knowledge, this is the first series that reports the prevalence of this phenomenon in VS and the potential surgical implications. Recognition preoperatively may be valuable toward patient counseling.

PMID: 27703093 [PubMed - as supplied by publisher]

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Survival Outcomes for Combined Modality Therapy for Sinonasal Undifferentiated Carcinoma.

Survival Outcomes for Combined Modality Therapy for Sinonasal Undifferentiated Carcinoma.

Otolaryngol Head Neck Surg. 2016 Oct 4;:

Authors: Kuo P, Manes RP, Schwam ZG, Judson BL

Abstract
OBJECTIVE: Sinonasal undifferentiated carcinoma is a rare and aggressive malignancy of the nasal cavity and paranasal sinuses. Multi-institutional studies examining outcomes of combined modality treatment versus other treatment modalities have not been performed. The objective of our study was to present outcomes for multimodality therapy through use of the National Cancer Database.
STUDY DESIGN: Retrospective cohort study.
SETTING: National Cancer Database.
METHODS: A total of 435 cases of SNUC diagnosed between 2004 and 2012 were identified. Kaplan-Meier analyses were performed to find 5-year cumulative survival rates. Multivariate Cox regression evaluated overall survival based on treatment when adjusting for other prognostic factors (age, primary site, sex, race, comorbidity, insurance, and TNM stage). Within the surgery + chemoradiotherapy group, survival analysis was also performed to compare outcomes for induction and adjuvant chemotherapy.
RESULTS: The cumulative 5-year survival rate was 41.5%, and 36.1% of patients received surgery with chemoradiotherapy. In multivariate analysis, surgery + chemoradiotherapy was associated with significantly improved overall survival versus surgery + radiotherapy and radiotherapy but not significantly different from chemoradiotherapy. Within the surgery + chemoradiotherapy group, induction and adjuvant chemotherapy groups did not have associated differences in survival.
CONCLUSION: Combined modality therapy (chemoradiotherapy or surgery + chemoradiotherapy) is associated with improved survival outcomes versus other treatment modalities in patients with sinonasal undifferentiated carcinoma.

PMID: 27703092 [PubMed - as supplied by publisher]

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Selenium supplementation significantly reduces thyroid autoantibody levels in patients with chronic autoimmune thyroiditis: A systematic review and meta-analysis.

Selenium supplementation significantly reduces thyroid autoantibody levels in patients with chronic autoimmune thyroiditis: A systematic review and meta-analysis.

Thyroid. 2016 Oct 5;:

Authors: Wichman J, Winther KH, Bonnema SJ, Hegedus L

Abstract
BACKGROUND: Selenium supplementation may decrease circulating thyroid autoantibodies in patients with chronic autoimmune thyroiditis (AIT), but the previous trials are heterogenous. Here, we expand and critically reappraise the knowledge on this topic.
METHODS: A literature search identified 3366 records. Controlled trials in adults (≥ 18 years) with AIT, comparing selenium with or without levothyroxine (LT4), versus placebo and/or LT4, were eligible. Assessed outcomes were serum thyroid peroxidase (TPO-Ab), thyroglobulin (Tg-Ab) autoantibody levels, and immunomodulatory effects. After screening and full-text assessment, sixteen controlled trials were included in the systematic review. Random effects meta-analyses in weighted mean difference (WMD) were performed for three, six, and twelve months of supplementation in two different populations: one receiving LT4-therapy and one newly diagnosed and untreated. Heterogeneity was estimated using I2 and quality of evidence was assessed per outcome, using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines.
RESULTS: In LT4-treated populations, the selenium group had significantly lower TPO-Ab levels after three months (seven studies, WMD: -271, 95% CI: -366 to -175, p<0.0001, I2 = 45.4%), which was consistent at six months (three studies) and twelve months (one study). Tg-Ab decreased at twelve months but not at three or six months. In untreated populations, the selenium group showed a decrease of TPO-Ab levels after three months (three studies, WMD: -512, 95% CI: -626 to -398, p <0.0001, I2 = 0.0%), but not after six or twelve months. Tg-Ab decreased at three months, but neither at six nor at twelve months. Quality of evidence was generally assessed as low. Study participants receiving selenium had a significantly higher risk than controls of reporting adverse effects (p = 0.036).
CONCLUSIONS: Selenium supplementation reduced serum TPO-Ab levels after three, six and twelve months in an LT4-treated AIT population and after three months in an untreated AIT population. Whether these effects correlate with clinically relevant measures remains to be demonstrated.

PMID: 27702392 [PubMed - as supplied by publisher]

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Speech recognition outcomes in Mandarin-speaking cochlear implant users with fine structure processing.

Speech recognition outcomes in Mandarin-speaking cochlear implant users with fine structure processing.

Acta Otolaryngol. 2016 Oct 5;:1-7

Authors: Qi B, Liu Z, Gu X, Liu B

PMID: 27701966 [PubMed - as supplied by publisher]

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Development of Tinnitus at a Low Dose of Sertraline: Clinical Course and Proposed Mechanisms.

Development of Tinnitus at a Low Dose of Sertraline: Clinical Course and Proposed Mechanisms.

Case Rep Psychiatry. 2016;2016:1790692

Authors: Miller CW

Abstract
Introduction. Serotonin is involved in filtering of auditory stimuli. Cochlear input is processed through complex interactions between serotonergic, glutamatergic, and GABAergic neurotransmitter systems. Options for treatment of tinnitus include selective serotonin reuptake inhibitors (SSRIs); however in rare instances this symptom may occur as a side effect of this class of medications. Case Presentation. A 50-year-old woman developed bilateral tinnitus after several weeks of being treated with sertraline 50 mg. She had been on a long-standing daily dose of aspirin 325 mg which had been discontinued shortly before starting sertraline. Medical work-up was negative for her symptom. Shortly after discontinuation of the medication, her tinnitus subsided completely. Discussion. Tinnitus is a rare side effect of sertraline and may be related to particular distribution of serotonin receptor subtypes within the auditory system, and serotonergic agents may reinforce or desensitize the activity of different receptors. Also, there may be a priming effect of salicylate agents on the auditory system, predisposing particular patients to be more sensitive to how auditory stimuli are processed.

PMID: 27703829 [PubMed - in process]

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Acute high-intensity noise induces rapid Arc protein expression but fails to rapidly change GAD expression in amygdala and hippocampus of rats: Effects of treatment with D-cycloserine.

Acute high-intensity noise induces rapid Arc protein expression but fails to rapidly change GAD expression in amygdala and hippocampus of rats: Effects of treatment with D-cycloserine.

Hear Res. 2016 Oct 1;:

Authors: Kapolowicz MR, Thompson LT

Abstract
Tinnitus is a devastating auditory disorder impacting a growing number of people each year. The aims of the current experiment were to assess neuronal mechanisms involved in the initial plasticity after traumatic noise exposure that could contribute to the emergence of tinnitus and to test a potential pharmacological treatment to alter this early neural plasticity. Specifically, this study addressed rapid effects of acute noise trauma on amygdalo-hippocampal circuitry, characterizing biomarkers of both excitation and inhibition in these limbic regions, and compared them to expression of these same markers in primary auditory cortex shortly after acute noise trauma. To assess excitatory plasticity, activity-regulated cytoskeleton-associated (Arc) protein expression was evaluated in male rats 45 min after bilateral exposure to acute high-intensity noise (16 kHz, 115 dB SPL, for 1 h), sufficient to cause acute cochlear trauma, a common cause of tinnitus in humans and previously shown sufficient to induce tinnitus in rat models of this auditory neuropathology. Western blot analyses confirmed that up-regulation of amygdalo-hippocampal Arc expression occurred rapidly post-noise trauma, corroborating several lines of evidence from our own and other laboratories indicating that limbic brain structures, i.e. outside of the classical auditory pathways, exhibit plasticity early in the initiation of tinnitus. Western blot analyses revealed no noise-induced changes in amygdalo-hippocampal expression of glutamate decarboxylase (GAD), the biosynthetic enzyme required for GABAergic inhibition. No changes in either Arc or GAD protein expression were observed in primary auditory cortex in this immediate post-noise exposure period, confirming other reports that auditory cortical plasticity may not occur until later in the development of tinnitus. As a further control, our experiments compared Arc protein expression between groups exposed to the quiet background of a sound-proof chamber to those exposed not only to the traumatic noise described above, but also to an intermediate, non-traumatic noise level (70 dB SPL) for the same duration in each of these three brain regions. We found that non-traumatic noise did not up-regulate Arc protein expression in these brain regions. To see if changes in Arc expression due to acute traumatic noise exposure were stress-related, we compared circulating serum corticosterone in controls and rats exposed to traumatic noise at the time when changes in Arc were observed, and found no significant differences in this stress hormone in our experimental conditions. Finally, the ability of D-cycloserine (DCS; an NMDA-receptor NR1 partial agonist) to reduce or prevent the noise trauma-related plastic changes in the biomarker, Arc, was tested. D-cycloserine prevented traumatic noise-induced up-regulation of Arc protein expression in amygdala but not in hippocampus, suggesting that DCS alone is not fully effective in eliminating regionally-specific early plastic changes after traumatic noise exposure.

PMID: 27702572 [PubMed - as supplied by publisher]

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A typical but seldom recognized foreign body in the esophagus of a laryngectomized patient.

A typical but seldom recognized foreign body in the esophagus of a laryngectomized patient.

Rev Esp Enferm Dig. 2016 Oct;108(10):660-661

Authors: Rodrigues JP, Pinho R, Carvalho J

Abstract
A 57-year-old man with a past medical history of total laryngectomy for squamous cell carcinoma of the larynx was admitted to our institution 5 months after the procedure, for surgical resection of a local recurrence of the tumor. In the postoperative period, endoscopically guided placement of a nasogastric tube was scheduled, after previous failed attempts. Upper gastrointestinal endoscopy revealed an anastomotic dehiscence, 13 cm distal to the incisors, and a foreign body penetrating through the esophageal wall, 20cm distal to the incisors. We were unable to identify the foreign body with certainty but, after consulting with the assistant otorhinolaryngologist, we realized that it was a voice prosthesis.

PMID: 27701887 [PubMed - in process]

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Changing head model extent affects finite element predictions of transcranial direct current stimulation distributions.

Changing head model extent affects finite element predictions of transcranial direct current stimulation distributions.

J Neural Eng. 2016 Oct 05;13(6):066006

Authors: Indahlastari A, Chauhan M, Schwartz B, Sadleir RJ

Abstract
OBJECTIVE: In this study, we determined efficient head model sizes relative to predicted current densities in transcranial direct current stimulation (tDCS).
APPROACH: Efficiency measures were defined based on a finite element (FE) simulations performed using nine human head models derived from a single MRI data set, having extents varying from 60%-100% of the original axial range. Eleven tissue types, including anisotropic white matter, and three electrode montages (T7-T8, F3-right supraorbital, Cz-Oz) were used in the models.
MAIN RESULTS: Reducing head volume extent from 100% to 60%, that is, varying the model's axial range from between the apex and C3 vertebra to one encompassing only apex to the superior cerebellum, was found to decrease the total modeling time by up to half. Differences between current density predictions in each model were quantified by using a relative difference measure (RDM). Our simulation results showed that [Formula: see text] was the least affected (a maximum of 10% error) for head volumes modeled from the apex to the base of the skull (60%-75% volume).
SIGNIFICANCE: This finding suggested that the bone could act as a bioelectricity boundary and thus performing FE simulations of tDCS on the human head with models extending beyond the inferior skull may not be necessary in most cases to obtain reasonable precision in current density results.

PMID: 27705955 [PubMed - as supplied by publisher]

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Short stature Revealing a Pycnodysostosis: A Case Report.

Short stature Revealing a Pycnodysostosis: A Case Report.

J Orthop Case Rep. 2016 Apr-Jun;6(2):43-45

Authors: Aynaou H, Skiker I, Latrech H

Abstract
INTRODUCTION: Pycnodysostosis is a rare genetic disease characterized by osteosclerosis and bone fragility. The clinical aspects are varied including short stature, acro-osteolysis of distal phalanges, and dysplasia of the clavicles. Oral and maxillofacial manifestations of this disease are very clear. The head is usually large, a beaked nose, obtuse mandibular angle, and both maxilla and mandible are hypoplastic. Dental abnormalities are common. We report a case with the typical clinical and radiological characteristics of the Pycnodysostosis associated with a conductive hearing loss, an association rarely reported.
CASE PRESENTATION: A 12-year-female was admitted in our institute for short stature with a dysmorphic facies for evaluation. The patient reported a history of multiple fractures of the long bones after a trivial fall. On physical examination, she had the following features: short stature, limited mouth opening, short hands and feet with dysplastic nails; frontal and occipital bossing; and hypoplasia of the maxilla and mandible. Examination of the mouth: grooved palate, caries of the teeth, impacted and malposed teeth, persistent deciduous teeth and missing teeth. Laboratory investigations were normal. The radiographic examination showed a generalized increase in the bone density, slight condensation of the skull base and a very open mandibular angle. X-rays showed tapered phalanges with acro-osteolysis of the distal phalanges. A symptomatic treatment was proposed based on fracture prevention, oral hygiene, frequent dental visits and psychiatric support.
CONCLUSION: The clinical and radiological features are the bases for the diagnosis of this disease. It is important to make the diagnosis as early as possible in order to plan the treatment and to provide a better life quality to the patients.

PMID: 27703936 [PubMed - in process]

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Prevalence and Surgical Implications of Dural Enhancement at the Porus Acusticus in Vestibular Schwannomas.

Prevalence and Surgical Implications of Dural Enhancement at the Porus Acusticus in Vestibular Schwannomas.

Otolaryngol Head Neck Surg. 2016 Oct 4;:

Authors: Patel NS, Van Abel KM, Link MJ, Driscoll CL, Van Gompel JJ, Neff BA, Lane JI, Carlson ML

PMID: 27703093 [PubMed - as supplied by publisher]

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Rhabdomyosarcoma of Cervix: A Case Report.

Rhabdomyosarcoma of Cervix: A Case Report.

Iran J Cancer Prev. 2016 Jun;9(3):e4383

Authors: Hosseini MS, Ashrafganjoei T, Sourati A, Tabatabeifar M, Mohamadianamiri M

Abstract
INTRODUCTION: Rhabdomyosarcoma has known as a highly malignant soft tissue sarcoma. It has been the most common soft tissue sarcoma in childhood, accounting for about 3 to 4 % of all cases of childhood cancer. Rhabdomyosarcoma was rare in adults, accounting for 3% of all soft-tissue sarcomas. embryonal rhabdomyosarcoma of female genital tract including uterine cervix in an adult was rare.
CASE PRESENTATION: This study has reported a 33-year-old woman presented with abnormal vaginal discharge. Gynecologic examination revealed a cervical mass with grape- like feature protruding into vagina with posterior- superior vaginal wall involvement. Biopsy has performed and pathologic examination was consistent with embryonal botryoid type rhabdomyosarcoma. She has undergone the staging work up measurements including thoracic computed tomography (CT) scan, abdominopelvic magnetic resonance imaging (MRI), bone scan and bone marrow examination. In exception of abdominopelvic MRI, with 2 suspicious pelvic lymph nodes in addition of cervical mass, all others were normal. Radical hysterectomy with lymph node debulking and ovarian preservation has performed. Final results have shown embryonal botryoid type rhabdomyosarcoma of cervix. ovaries, endometrium, parametrium, and follopian tubes were unremarkable. Pelvic lymph nodes pathology and intraabdominal fluid cytology were negative for malignancy. Lymphovascular invasion was identified. She has advised for adjuvant chemotherapy.
CONCLUSIONS: This case has reminded that embryonal rhabdomyosarcoma could occur in uncommon site and older female. Longer follow up of these cases has required due to lack of survival data for embryonal rhabdomyosarcoma of this site and age group.

PMID: 27703644 [PubMed - in process]

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Τετάρτη 5 Οκτωβρίου 2016

Central skull base osteomyelitis involving cavernous sinus and meninges of the skull base: Successful treatment with antibiotic and antifungal combination therapy.

Central skull base osteomyelitis involving cavernous sinus and meninges of the skull base: Successful treatment with antibiotic and antifungal combination therapy.

Clin Neurol Neurosurg. 2016 Sep 29;150:190-193

Authors: Ueno T, Nishijima H, Haga R, Tomiyama M

PMID: 27701039 [PubMed - as supplied by publisher]

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Effect of day-case unilateral cochlear implantation in adults on general and disease-specific quality of life, postoperative complications and hearing results, tinnitus, vertigo and cost-effectiveness: protocol for a randomised controlled trial.

Effect of day-case unilateral cochlear implantation in adults on general and disease-specific quality of life, postoperative complications and hearing results, tinnitus, vertigo and cost-effectiveness: protocol for a randomised controlled trial.

BMJ Open. 2016 Oct 3;6(10):e012219

Authors: Derks LS, Wegner I, Smit AL, Thomeer HG, Topsakal V, Grolman W

Abstract
INTRODUCTION: Cochlear implantation is an increasingly common procedure in the treatment of severe to profound sensorineural hearing loss (SNHL) in children and adults. It is often performed as a day-case procedure. The major drive towards day-case surgery has been from a logistical, economical and societal perspective, but we also speculate that the patient's quality of life (QoL) is at least equal to inpatient surgery if not increased as a result of rapid discharge and rehabilitation. Even though cochlear implantation seems well suited to a day-case approach and this even seems to be common practice in some countries, evidence is scarce and of low quality to guide us towards the preferred treatment option.
METHODS AND ANALYSIS: A single-centre, non-blinded, randomised, controlled trial was designed to (primarily) investigate the effect on general QoL of day-case cochlear implantation compared to inpatient cochlear implantation and (secondarily) the effect of both methods on (subjective) hearing improvement, disease-specific QoL, tinnitus, vertigo and cost-effectiveness. 30 adult patients with severe to profound bilateral postlingual SNHL who are eligible for unilateral cochlear implantation will be randomly assigned to either the day-case or inpatient treatment group. The outcome measures will be assessed using auditory evaluations, questionnaires (preoperatively, at 1-week, 3-week, 3-month and 1-year follow-up) and costs diaries (weekly during the first month postoperatively, after which once in a month until 1-year follow-up). Preoperative and postoperative outcomes will be compared. The difference in costs and benefit will be represented using the incremental cost utility/effectiveness ratio. The analyses will be carried out on an intention-to-treat basis.
ETHICS AND DISSEMINATION: This research protocol was approved by the Institutional Review Board of the UMC Utrecht (NL45590.041.13; V.5, November 2015). The trial results will be disseminated through peer-reviewed medical journals and presented at scientific conferences.
TRIAL REGISTRATION NUMBER: NTR4464; Pre-results.

PMID: 27697874 [PubMed - in process]

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Time-Varying Distortions of Binaural Information by Bilateral Hearing Aids: Effects of Nonlinear Frequency Compression.

Time-Varying Distortions of Binaural Information by Bilateral Hearing Aids: Effects of Nonlinear Frequency Compression.

Trends Hear. 2016 Oct 3;20:

Authors: Brown AD, Rodriguez FA, Portnuff CD, Goupell MJ, Tollin DJ

Abstract
In patients with bilateral hearing loss, the use of two hearing aids (HAs) offers the potential to restore the benefits of binaural hearing, including sound source localization and segregation. However, existing evidence suggests that bilateral HA users' access to binaural information, namely interaural time and level differences (ITDs and ILDs), can be compromised by device processing. Our objective was to characterize the nature and magnitude of binaural distortions caused by modern digital behind-the-ear HAs using a variety of stimuli and HA program settings. Of particular interest was a common frequency-lowering algorithm known as nonlinear frequency compression, which has not previously been assessed for its effects on binaural information. A binaural beamforming algorithm was also assessed. Wide dynamic range compression was enabled in all programs. HAs were placed on a binaural manikin, and stimuli were presented from an arc of loudspeakers inside an anechoic chamber. Stimuli were broadband noise bursts, 10-Hz sinusoidally amplitude-modulated noise bursts, or consonant-vowel-consonant speech tokens. Binaural information was analyzed in terms of ITDs, ILDs, and interaural coherence, both for whole stimuli and in a time-varying sense (i.e., within a running temporal window) across four different frequency bands (1, 2, 4, and 6 kHz). Key findings were: (a) Nonlinear frequency compression caused distortions of high-frequency envelope ITDs and significantly reduced interaural coherence. (b) For modulated stimuli, all programs caused time-varying distortion of ILDs. (c) HAs altered the relationship between ITDs and ILDs, introducing large ITD-ILD conflicts in some cases. Potential perceptual consequences of measured distortions are discussed.

PMID: 27698258 [PubMed - in process]

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A tool for assessing case history and feedback skills in audiology students working with simulated patients.

A tool for assessing case history and feedback skills in audiology students working with simulated patients.

Int J Audiol. 2016 Dec;55(12):765-774

Authors: Hughes J, Wilson WJ, MacBean N, Hill AE

Abstract
OBJECTIVE: To develop a tool for assessing audiology students taking a case history and giving feedback with simulated patients (SP).
DESIGN: Single observation, single group design.
STUDY SAMPLE: Twenty-four first-year audiology students, five simulated patients, two clinical educators, and three evaluators.
RESULTS: The Audiology Simulated Patient Interview Rating Scale (ASPIRS) was developed consisting of six items assessing specific clinical skills, non-verbal communication, verbal communication, interpersonal skills, interviewing skills, and professional practice skills. These items are applied once for taking a case history and again for giving feedback. The ASPIRS showed very high internal consistency (α = 0.91-0.97; mean inter-item r = 0.64-0.85) and fair-to-moderate agreement between evaluators (29.2-54.2% exact and 79.2-100% near agreement; κweighted up to 0.60). It also showed fair-to-moderate absolute agreement amongst evaluators for single evaluator scores (intraclass correlation coefficient [ICC] r = 0.35-0.59) and substantial consistency of agreement amongst evaluators for three-evaluator averaged scores (ICC r = 0.62-0.81). Factor analysis showed the ASPIRS' 12 items fell into two components, one containing all feedback items and one containing all case history items.
CONCLUSION: The ASPIRS shows promise as the first published tool for assessing audiology students taking a case history and giving feedback with an SP.

PMID: 27696974 [PubMed - in process]

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Collaboration, trouble and repair in multiparty interactions involving couples with dementia or aphasia.

Collaboration, trouble and repair in multiparty interactions involving couples with dementia or aphasia.

Int J Speech Lang Pathol. 2016 Oct 4;:1-11

Authors: Samuelsson C, HydéN LC

Abstract
PURPOSE: The aim of the present study was to identify problems with communication with persons with aphasia and persons with dementia in a collaborative interview setting with their significant others. In particular, to compare interactional practices used in order to resolve problems caused by specific symptoms.
METHOD: Five persons with aphasia and five persons with dementia and their spouses participated in the study. Interviews were carried out couple by couple, and the interviews had a task-oriented character. The interviews were video and audio recorded. All interviews were transcribed. From the transcriptions categorisations according to previous literature were made.
RESULT: The results demonstrated that repair sequences were frequent in interaction involving people with aphasia (PWA), and even more so in interaction involving persons with dementia (PWD). In general, it was the PWA/PWD that initiated the repair sequence more often than the spouse, thus keeping the general rule of a preference for self-initiated repair compared to other-initiated repair.
CONCLUSION: The active involvement of the conversational partners in trouble solving sequences in interaction with PWA/PWD demonstrated in the present study indicates that the interactional style of the conversational partner to PWA/PWD important. This implies that conversation partner training programmes would be useful both for PWA and for PWD.

PMID: 27696901 [PubMed - as supplied by publisher]

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Τρίτη 4 Οκτωβρίου 2016

Cancer and orofacial pain.

Cancer and orofacial pain.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Romero-Reyes M, Salvemini D

Abstract
BACKGROUND: Cancer pain is a devastating condition. Pain in the orofacial region, may be present as the single symptom of cancer or as a symptom of cancer in its later stages. This manuscript revises in a comprehensive manner the content of the conference entitled "Orofacial Pain and Cancer" (Dolor Orofacial y Cancer) given at the VI Simposio International "Advances in Oral Cancer" on the 22 July, 2016 in San Sebastioan-Donostia._Material and Methods: We have reviewed (pubmed-medline) from the most relevant literature including reviews, systematic reviews and clinical cases, the significant and evidence-based mechanisms and mediators of cancer-associated facial pain, the diverse types of cancers that can be present in the craniofacial region locally or from distant sites that can refer to the orofacial region, cancer therapy that may induce pain in the orofacial region as well as discussed some of the new advancements in cancer pain therapy. _Results: There is still a lack of understanding of cancer pain pathophysiology since depends of the intrinsic heterogeneity, type and anatomic location that the cancer may present, making more challenging the creation of better therapeutic options. Orofacial pain can arise from regional or distant tumor effects or as a consequence of cancer therapy. _Conclusions: The clinician needs to be aware that the pain may present the characteristics of any other orofacial pain disorder so a careful differential diagnosis needs to be given. Cancer pain diagnosis is made by exclusion and only can be reached after a thorough medical history, and all the common etiologies have been carefully investigated and ruled out. The current management tools are not optimal but there is hope for new, safer and effective therapies coming in the next years.

PMID: 27694791 [PubMed - as supplied by publisher]

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Distance of the alveolar antral artery from the alveolar crest. Related factors and surgical considerations in sinus floor elevation.

Distance of the alveolar antral artery from the alveolar crest. Related factors and surgical considerations in sinus floor elevation.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Varela-Centelles P, Loira-Gago M, Gonzalez-Mosquera A, Seoane-Romero JM, Garcia-Martin JM, Seoane J

Abstract
BACKGROUND: In a variable proportion of maxillary sinuses alveolar antral artery is located close to the residual ridge, increasing the chances for haemorrhagic complications during sinus floor elevation procedures. _Material and Methods: Retrospective observational study of CBCT explorations performed for implant-treatment planning. The upper first molar area was selected for this study. The relative uncertainty (standard deviation of the measurement divided by its mean and expressed as a percentage from 0% to 100%) was chosen for determining the observational errors. For modeling the chances of AAA detection, the generalized additive models (GAM) approach was chosen._Results: A total of 240 maxillary sinuses were studied (46.25% males) whose median median age was 58 years old (IQR: 52-66). Univariate models showed that the chances for an AAA-alvelar crest distance ≤15mm increase in wider sinuses with lower, subsinusally edentulous crests. When distance is considered as a continuous variable, the best mutivariate model showed an explained deviance of 67% and included AAA diameter, distance AAA-sinus floor, sinus width, and shape, height and width of the residual ridge. Thinner AAAs are found closer to the crest (within the ≤15mm safe distance)._Conclusions: Bearing in mind the inclusion criteria and the limitations of this investigation, it is concluded that there is a high proportion of maxillary sinuses where AAA describes a course close to the alveolar crest (≤15mm), which was classically considered a safe distance for SFE. This position is related to the presence of atrophic crests (depressed ridge form) and wide maxillary sinuses where the distance of the vessel to the floor of the sinus is small. This information may permit a better surgical planning of SFE procedures.

PMID: 27694790 [PubMed - as supplied by publisher]

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Surgical complications in zygomatic implants: A systematic review.

Surgical complications in zygomatic implants: A systematic review.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Molinero-Mourelle P, Baca-Gonzalez L, Gao B, Saez-Alcaide L, Helm A, Lopez-Quiles J

Abstract
BACKGROUND: The use of zygomatic implants in the prosthetic rehabilitation of the patient with severe maxillary bone atrophy is another therapeutic alternative, not exempt from complications. The main objective of this review is to analyze and describe the most frequent surgical complications associated with the use of zygomatic implants._Material and Methods: An electronic database search on PubMed, along with a manual search, without taking into account date nor language, was undertaken by two observers, selecting studies that comprised a study period from 6 to 12 months, any type of clinical trial, and series that included a follow-up and/or review period during the aforementioned margin, that mentioned at least two types of complications._Results: Out of the initial search that yielded 455 studies, 67 were considered potentially relevant for the present study, out of which 14 were finally selected. Out of the most frequent surgical complications, sinusitis (3,9%) and failure in osseointegration (2,44%) are highlighted. _Conclusions: The analysis of the results shows that the most frequent complications are sinusitis and failure in osseointegration of the zygomatic implant. However, a standardised data collection system for the data on complications is needed.

PMID: 27694789 [PubMed - as supplied by publisher]

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Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Guarnieri R, Cavallini C, Vernucci R, Vichi M, Leonardi R, Barbato E

Abstract
BACKGROUND: The prevalence of impacted maxillary canine is reported to be between 1% and 3%._The lack of monitoring and the delay in the treatment of the impacted canine can cause different complications such as: displacement of adjacent teeth, loss of vitality of neighbouring teeth, shortening of the dental arch, follicular cysts, canine ankylosis, recurrent infections, recurrent pain, internal resorption of the canine and the adjacent teeth, external resorption of the canine and the adjacent teeth, combination of these factors._An appropriate diagnosis, accurate predictive analysis and early intervention are likely to prevent such undesirable effects. The objective is to evaluate, by means of a retrospective observational study, the possibility of carrying out a predictive analysis of root resorption adjacent to the impacted canines by means of orthopantomographs, so as to limit the prescription of additional 3D radiography._Material and Methods: 120 subjects with unilateral or bilateral maxillary impacted canine were examined and 50 patients with 69 impacted maxillary canine (22 male, 28 female; mean age: 11.7 years) satisfied the inclusion criteria of the study. These patients were subjected to a basic clinical and radiographic investigation (orthopantomographs and computerized tomography). All panoramic films were viewed under standardized conditions for the evaluation of two main variables: maxillary canine angulations (a, b, g angles) and the overlapping between the impacted teeth and the lateral incisor (Analysis of Lindauer). Binary logistic regression was used to estimate the likelihood of resorbed lateral incisors depending on sector location and angle measurements._Results: Results indicated that b angle has the greatest influence on the prediction of root resorption (predictive value of b angle = 76%). If β angle <18° and Lindauer = I, the probability of resorption is 0.06_Conclusions: Evaluation of b angle and superimposition lateral incisor/impacted canine analysed on orthopantomographs could be one of the evaluation criteria for prescribing second level examination (CT and CTCB) and for detecting root resorption of impacted maxillary canine adjacent teeth.

PMID: 27694788 [PubMed - as supplied by publisher]

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Oral health and quality of life in the municipal senior citizen's social clubs for people over 65 of Valencia, Spain.

Oral health and quality of life in the municipal senior citizen's social clubs for people over 65 of Valencia, Spain.

Med Oral Patol Oral Cir Bucal. 2016 Oct 1;:0

Authors: Sáez-Prado B, Haya-Fernández MC, Sanz-García MT

Abstract
BACKGROUND: The world population is aging considerably. The state of elderly's dentition is poor. Many authors agree that the oral health status influence the elderly's quality of life.The objective of our study was to analyze the relation between the oral health status and the general health status through the quality of life of elderly people aged 65 years or more in Valencia, Spain._Material and Methods: A cross-sectional oral health survey and an oral examination have been designed to study an elderly population.
SUBJECTS: 202 adults (103 men and 99 women). Age: 65 years of age and over.
SETTING: Randomly selected senior citizen's social clubs. The Oral Health Impact Profile (OHIP-14) has been used to obtain the health survey. Moreover, the EuroQol-5d and a Visual Analogue Scale (VAS) have been the tools to obtain the general health status. Finally, sociodemographic and oral health questions have been needed._Results: Descriptive and inferential results have been done and the main results are the following, the mean additive score of the OHIP-14 was 8.88, the mean value of the EuroQol-5d was 0.58 and of the VAS, 72.90. The OHIP-14 was consistently and significantly correlated with the index EuroQol-5d and with variables such as number of teeth, missing teeth, DMFT, dental status (being or not edentulous) and occupation. The EuroQol-5d was related to dental habits, sex, income, systemic pathologies and filled teeth._Conclusions: The oral health has a high impact on quality of life. The oral health and the general health are closely related. The oral hygiene and getting toothless influence negatively on the quality of life of elderly people.

PMID: 27694787 [PubMed - as supplied by publisher]

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Αρχειοθήκη ιστολογίου

Παρασκευή 7 Οκτωβρίου 2016

Πέμπτη 6 Οκτωβρίου 2016

Τετάρτη 5 Οκτωβρίου 2016

Τρίτη 4 Οκτωβρίου 2016