OtoRhinoLaryngology News: 01/23/16

Σάββατο 23 Ιανουαρίου 2016

Relationship between smoking and otorhinolaryngological symptoms.

Relationship between smoking and otorhinolaryngological symptoms.

Kulak Burun Bogaz Ihtis Derg. 2016 Jan-Feb;26(1):28-33

Authors: Şanlı A, Bekmez E, Yıldız G, Erdoğan BA, Yılmaz HB, Altın G

Abstract
OBJECTIVES: This study aims to investigate the possible relationship between smoking and otorhinolaryngological symptoms in smokers, non-smokers and ex-smokers.
PATIENTS AND METHODS: Between March 01st, 2014 and March 31st, 2014, a total of 1,840 patients (823 males, 1,017 females) over 25 years of age who were admitted to the ear nose, and throat (ENT) outpatient clinic were included in the study. The patients who were smoking at least 10 cigarettes daily for at least five years were included in the smokers group (n=514). The patients who did not smoke for at least one year following at least five years of smoking were included in the ex-smokers group (n=268). The patients who never smoked were included in the non-smokers group (n=1,058). A form containing all ENT symptoms was given to all patients and the patients were asked to fill the form with their complaints following being informed by the same doctor.
RESULTS: Cough, shortness of breath, reflux, dryness of throat, irritation, taste disorder, bad breath, toothache, nasal congestion, smell disorders, snoring, and nasal discharge were found to be significantly higher in the smokers group, compared to the non-smokers group. Cough, sputum, hoarseness, dysphagia, reflux, sore throat, dryness of throat, irritation, stinging, oral aphthae, taste disorder, toothache, bleeding gums, and bad breath were significantly lower in the ex-smokers group. Nasal congestion, nosebleeds, sneezing, nasal discharge, smell disorders, headache, feeling of facial fullness, ear discharge, hearing loss, pain, fullness, dizziness, and tinnitus were statistically significantly lower in the ex-smokers group.
CONCLUSION: Our study results show that smoking causes symptoms particularly associated with upper respiratory tract and these symptoms may persist in ex-smokers.

PMID: 26794332 [PubMed - in process]

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The effects of dust storms on quality of life of allergic patients with or without asthma.

The effects of dust storms on quality of life of allergic patients with or without asthma.

Kulak Burun Bogaz Ihtis Derg. 2016 Jan-Feb;26(1):19-27

Authors: Soy FK, Yazıcı H, Kulduk E, Dündar R, Gülen ŞT, Doğan S, Can İH

Abstract
OBJECTIVES: This study aims to investigate the quality of life of allergic patients with or without asthma during dust storms.
PATIENTS AND METHODS: A total of 148 allergic patients (66 males, 82 females; mean age 35.7±15.5 years; range 18 to 65 years) were classified as those with (group 1, n=80) or without (group 2, n=68) concomitant asthma between January 2012 and January 2013. The quality of life [Short Form-36 (SF-36)] scores, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), nasal symptom and visual analog scale (VAS) scores at the time of diagnosis were obtained. The particulate matter (PM10) and sulfur dioxide (SO2) values of that day from the General Directorate of Meteorology were recorded. The day of dust storm and PM10 and SO2 measurements along with SF-36, RQLQ, nasal symptom and VAS scores were recorded again.
RESULTS: The absolute change in the RQLQ subparameters including eye and nasal symptoms, practical problems and global scores was statistically significant (p=0.022, p=0.036, p=0.026 and p=0.032, respectively). There were statistically significant changes in the SF-36 subgroups of general health, physical functioning, vitality, and mental health (p=0.026, p=0.042, p=0.008 and p=0.026, respectively). In the multivariate logistic regression model, specific and general quality of life was 4.6 times worse in RQLQ and 3.8 times in SF-36 after the dust storm in patients with asthma, while 2.1 times worse in RQLQ and 1.9 times in SF-36 in patients with pure allergic rhinitis. The attributable risk of asthma was found to be 2.5 times higher in RQLQ and 1.9 times higher in SF-36.
CONCLUSION: Dust storms may deteriorate the quality of life of patients with allergic rhinitis and asthma and lead to related personal and societal problems.

PMID: 26794331 [PubMed - in process]

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[The relationship between passive rhinomanometry measurements in sitting and supine position and obstructive sleep apnea syndrome].

[The relationship between passive rhinomanometry measurements in sitting and supine position and obstructive sleep apnea syndrome].

Kulak Burun Bogaz Ihtis Derg. 2016 Jan-Feb;26(1):12-8

Authors: Avcı S, Lakadamyalı H, Büyüklü F, Kansu L, Eyüpoğlu FÖ, Öğüş E

Abstract
OBJECTIVES: This study aims to investigate the possible relationship between passive rhinomanometry measurements in sitting and supine position and obstructive sleep apnea syndrome.
PATIENTS AND METHODS: Between January 2011 and December 2013, 88 male patients (mean age 46.8 years; range 18 to 79 years) underwent passive rhinomanometry in sitting and supine position following history, physical examination and fiberoptic endoscopic examination. 1.5 lt/sn air flow was pumped into the nose of each patient via a silicone nasal mask. Meanwhile, flow and pressure values were measured.
RESULTS: There was no correlation between the resistance values and apnea hypopnea index (AHI) scores and polysomnography and physical examination parameters (p>0.05). The differential resistance was correlated with AHI (r=0.325, p<0.05), body mass index (r=0.324, p<0.05), neck circumference (r=0.421, p<0.01), waist circumference (r=0.444, p<0.01), modified Mallampati score (r=0.356, p<0.05), and retropalatal grade (r=0.438, p<0.01).
CONCLUSION: The correlation between the differential resistance and physical examination parameters and AHI scores support the hypothesis that position-related retropalatal segment alterations can be measured by passive rhinomanometry while awake.

PMID: 26794330 [PubMed - in process]

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The impact of pregnancy on nasal resonance.

The impact of pregnancy on nasal resonance.

Kulak Burun Bogaz Ihtis Derg. 2016 Jan-Feb;26(1):7-11

Authors: Demirci Ş, Tüzüner A, Küçük Z, Açıkgöz C, Arslan N, Samim EE

Abstract
OBJECTIVES: This study aims to investigate the possible impact of hormonal changes on nasal resonance during pregnancy.
PATIENTS AND METHODS: Between January 2013 and June 2013, a total of 101 pregnant women (mean age 27.1±5.8 years; range 18 to 41 years) visiting obstetric clinics for routine antenatal checkups were included in the study. The control group was consisted of 99 patients (mean age 29.2±6.6 years; range 18 to 42 years) without any nasal complaints. Nasal symptoms were assessed using the Nasal Obstruction Symptom Evaluation (NOSE) Scale. Nasalance scores were calculated by nasometry. The results were compared between study and control groups.
RESULTS: The mean nasalance score in pregnant women (40.4±7.8) were statistically significantly lower than the control group (44.7±6.4) (p<0.001). The nasalance score was 43.2±7.0 for the first trimester, 41.1±6.6 for the second trimester, and 39.2±8.8 for the third trimester. There was no statistically significant difference in nasalance scores within three trimesters. The mean nasalance scores of the second and third trimesters were statistically significantly lower than the control group (p<0.001). The NOSE scores were found to be statistically significantly higher in the third trimester (2.9±2.6) than the second trimester (1.1±1.9) (p<0.001).
CONCLUSION: These findings indicate that nasalance scores fall in pregnancy, leading to the development of hyponasal voice.

PMID: 26794329 [PubMed - in process]

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[Validation and reliability of Turkish Singing Voice Handicap index].

[Validation and reliability of Turkish Singing Voice Handicap index].

Kulak Burun Bogaz Ihtis Derg. 2016 Jan-Feb;26(1):1-6

Authors: Denizoğlu İİ, Şahin M, Kazancıoğlu A, Dağdelen Z, Akdeniz S, Oğuz H, Kılıç MA, Yücedağ A, Öğüt MF

Abstract
OBJECTIVES: This study aims to constitute a valid and reliable Turkish version of the original Singing Voice Handicap Index.
PATIENTS AND METHODS: An authorized committee assessed the reliability and validity of the content, scope, and language of the original Singing Voice Handicap Index which underwent a back translation process. The Turkish version of the questionnaire was answered twice with a 7 to 10-day interval by two singing voice groups with or without singing voice problems. The reliability and validity analyses were performed based on these answers.
RESULTS: Of a total of 123 individuals (64 females, 59 males; mean age 26.2±7.3 years), 81 were without a voice pathology and 42 were with a voice pathology. The total Cronbach's alpha coefficient was 0.917. The item-total correlations ranged between 0.51 and 0.89. The weighted kappa values of test-retest correlation values of the items were 0.82-0.91. The Cronbach's alpha values of two part of the questionnaire based on the split-half method were 0.89 and 0.84. The mean total scale scores were 21.8±18.5 and 53.6±28.9 in normal and pathology groups, respectively and there was a statistically significant difference in scores between these two groups (p=0.000).
CONCLUSION: The Turkish version of the Singing Voice Handicap Index is a valid and reliable scale which can be used in the evaluation of voice problems of Turkish-speaking singing voice users.

PMID: 26794328 [PubMed - in process]

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Relationship between clinical and instrumental assessment of the tongue in healthy young adults.

Relationship between clinical and instrumental assessment of the tongue in healthy young adults.

Codas. 2015 May-Jun;27(3):260-6

Authors: Rezende BA, Furlan RM, Casas EB, Motta AR

Abstract
PURPOSE: To verify the association of tongue clinical evaluation aspects with quantitative evaluation of tongue force.
METHODS: A cross-sectional study was conducted with 48 healthy adults, 13 men and 35 women (ages 20-44 years; mean - M=24.8 years; standard deviation - SD=5.3 years). By clinical evaluation, the following aspects were checked: tongue force, alternate movements, snap, suction and vibration of the tongue. The evaluator also checked if the floor of the mouth elevated during tasks of tongue elevation and sucking tongue on palate and the occurrence of lingual tremor. Quantitative evaluation was accomplished using the FORLING instrument. It is composed of a piston/cylinder assembly attached to a mouthguard and to a drive shaft. The force applied by the tongue to the drive shaft is hydraulically transmitted to a pressure sensor. Mann-Whitney's test was used to verify whether there were differences in average and maximum forces according to the characteristics assessed. The test was performed at a 5% level of significance.
RESULTS: The aspects with the most frequent alteration were sucking tongue on palate and tongue vibration. Tremor had a higher occurrence during tongue movements. Elevation of the floor of the mouth in sucking tongue on palate was the only aspect associated with quantitative evaluation.
CONCLUSION: The association between elevation of the floor of the mouth during sucking tongue on palate and quantitative evaluation can provide insight into the higher participation of the suprahyoid muscles in some participants in both tasks.

PMID: 26222943 [PubMed - indexed for MEDLINE]

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[Osteoradionecrosis of the sternoclavicular joint].

[Osteoradionecrosis of the sternoclavicular joint].

HNO. 2016 Jan 21;

Authors: Schnurbein G, Wagner J, Todt I, Ernst A, Seidl RO

Abstract
BACKGROUND/OBJECTIVE: Osteoradionecrosis is a rare, but feared, late complication after radiotherapy of the head and neck region. Its localization to the sternoclavicular joint has rarely been described so far.
MATERIALS AND METHODS: Data are from a retrospective study that included all patients admitted to the authors' clinic with osteoradionecrosis of the sternoclavicular joint during the last 5 years. Therapy and outcome were evaluated and compared to the established literature.
RESULTS: Over the past 5 years, 2 patients have been treated for pronounced osteoradionecrosis of the sternoclavicular joint. Both patients had received postoperative radiotherapy for tumors of the neck and chest, and presented with lesions involving the clavicle and the sternum. After eliminating the suspicion of recurrent cancer, both radiologic imaging and histopathologic evaluation confirmed an infection. Aggressive debridement with partial claviculectomy, partial sternectomy, and reconstruction using a pectoralis flap lead to the patients' recovery.
CONCLUSION: Osteoradionecrosis does not only affect bone, but also the surrounding soft tissue. Due to the changes associated with previous radiotherapy, osteoradionecrosis should always be treated with radical debridement of the infected area, followed by flap reconstruction using unaffected tissue. The prognosis for the patient is then good.

PMID: 26795738 [PubMed - as supplied by publisher]

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Laryngeal Schwannoma: A Case Presentation and Review of the Mayo Clinic Experience.

Laryngeal Schwannoma: A Case Presentation and Review of the Mayo Clinic Experience.

J Voice. 2016 Jan 18;

Authors: Romak JJ, Neel HB, Ekbom DC

Abstract
OBJECTIVES: The aim of this study was to clarify the nature of laryngeal schwannomas through review of the experience of a single institution during a 104-year period.
STUDY DESIGN: This is a retrospective case series.
METHODS: The Mayo Clinic, Rochester, Minnesota clinical and surgical pathology database was reviewed for the years 1985-2011. Four cases of laryngeal schwannoma were identified. These cases were pooled with a previously published series of laryngeal schwannomas treated at our institution between 1907 and 1986. The characteristics of all 11 cases were studied, and relevant literature was reviewed.
RESULTS: A total of 11 cases of schwannoma of the larynx were identified. The mean age at presentation was 48 years (range 12-73 years). The most common presenting symptoms were dysphonia and dysphagia. The most frequently involved primary site was the false vocal fold (six patients), followed by the aryepiglottic fold (three), epiglottis (two), subglottis (two), ventricle (one), true vocal fold (one) and postcricoid region (one). The mean maximal tumor diameter was 2.5 cm. In all but one case, surgical excision was curative with no recurrence during recorded follow up ranging from 1 to 17 years.
CONCLUSIONS: Laryngeal schwannomas, although rare, should be considered in the differential diagnosis of laryngeal tumors. They occur most frequently in the false vocal fold and present most commonly with dysphonia and/or dysphagia. Surgical excision is the treatment of choice.

PMID: 26795969 [PubMed - as supplied by publisher]

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Prevalence and Voice Characteristics of Laryngeal Pathology in an Italian Voice Therapy-seeking Population.

Prevalence and Voice Characteristics of Laryngeal Pathology in an Italian Voice Therapy-seeking Population.

J Voice. 2016 Jan 18;

Authors: Mozzanica F, Ginocchio D, Barillari MR, Barozzi S, Maruzzi P, Ottaviani F, Schindler A, Atac M

Abstract
OBJECTIVES: The aim of this study was to determine the prevalence and clinical characteristics of voice disorders in a large group of patients seeking voice therapy.
STUDY DESIGN: This is a prospective prevalence study.
METHODS: A total of 821 patients were enrolled. Each patient was evaluated following a multidimensional protocol including videolaryngostroboscopy, perception, acoustics, aerodynamics, and self-rating by the patient. Data regarding age, gender, tobacco use, gastroesophageal reflux disease (GERD), and professional voice use were collected and analyzed.
RESULTS: Based on videolaryngoscopic findings, the sample group was divided into patients with functional dysphonia (n = 155), patients with organic dysphonia (n = 359), and patients with dysphonia due to movement disorders (n = 307). The most frequently detected pathologies were vocal fold paralysis, muscle tension dysphonia, and vocal fold edema. Children (n = 41) and adolescents (n = 43) represented a minority of the sample group. Dysphonia was significantly more common in women. Organic dysphonia was more common in children and adolescents. GERD was suspected in 382 patients and confirmed in 83 of them; 164 patients were smokers. Professional voice users composed the large majority of the working population and were more frequently affected by organic dysphonia. Patients with dysphonia due to movement disorders presented a worse voice quality and voice-related quality of life.
CONCLUSIONS: In patients seeking voice therapy, there are more females than males, children and adolescents represent a minority of the sample, professional voice users more commonly present organic dysphonia, and patients with dysphonia due to movement disorders show significantly worse voice quality.

PMID: 26795968 [PubMed - as supplied by publisher]

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Auditory-perceptual evaluation of the degree of vocal deviation: correlation between the Visual Analogue Scale and Numerical Scale.

Auditory-perceptual evaluation of the degree of vocal deviation: correlation between the Visual Analogue Scale and Numerical Scale.

Codas. 2015 May-Jun;27(3):279-84

Authors: Martins PC, Couto TE, Gama AC

Abstract
PURPOSE: To analyze the intra- and inter-rater agreement for visual analog scale and numerical scale in task of sustained vowel and to determine numerical cutoff points to visual analog scale corresponding to the degrees of the numeric scale.
METHODS: We selected 205 samples of the usual task of the sustained vowel /a/. Six voice specialists rated the overall degree of vocal deviation, first by visual analog scale and, after two days, by the numeric scale. The results obtained by both scales were compared and the intra- and inter-rater agreement, the correlation between the scales, and the estimated cutoff points using the intraclass correlation and concordance Kappa coefficients, the Spearman coefficient, and analysis of variance, and the values of sensitivity and specificity were analyzed.
RESULTS: A strong correlation was observed between the scales. The following numerical cutoff values were found for visual analog scale corresponding to the numerical scale: neutral (degree zero) - 0 to 34 mm; mild (degree one) - 34.1 to 51 mm; moderate (degree two) - 51.1 to 63.5 mm; intense (degree three) - 63.6 to 77.5 mm; and extreme (degree four) - above 77.5 mm.
CONCLUSION: The visual analog scale and numerical scale showed a strong correlation, being observed the greater intra- and inter-rater agreement in visual analog scale. Numerical cutoff values for visual analog scale were found. This correlation enables the comparison between the results found in the evaluation of the overall degree of vocal deviation by both scales, which are widely used in research and in the clinical speech therapy routine.

PMID: 26222946 [PubMed - indexed for MEDLINE]

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Comparison of dosimetry methods for panoramic radiography: thermoluminescent dosimeter measurement versus personal computer-based Monte Carlo method calculation.

Comparison of dosimetry methods for panoramic radiography: thermoluminescent dosimeter measurement versus personal computer-based Monte Carlo method calculation.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Nov 14;

Authors: Lee C, Lee SS, Kim JE, Huh KH, Yi WJ, Heo MS, Choi SC

Abstract
OBJECTIVE: The purpose of this study was to evaluate the patient radiation dose based on panoramic radiography and calculated with personal computer-based Monte Carlo (PCXMC) software compared with thermoluminescent dosimetry (TLD) measurement. We also proposed appropriate input values for dose-determining factors in PCXMC.
STUDY DESIGN: Tissue-absorbed doses and the effective dose based on panoramic radiography were measured with TLD and with PCXMC under various conditions. The calculated PCXMC doses were compared with those measured with TLD.
RESULTS: The effective doses calculated with PCXMC were higher by 9.55% to 51.24% compared with the doses measured with TLD. Reference points on the Y-axis and Z-axis were the sensitive factors when calculating the effective dose. The differences between the highest and the lowest organ doses were 0.32 and 0.10 mGy, respectively, for PCXMC calculation and TLD measurement.
CONCLUSIONS: The effective dose calculated with PCXMC was generally higher than the dose measured by using TLD, and the absorbed doses varied by organ more severely in the PCXMC calculations than in the TLD measurements. The effective dose obtained from PCXMC calculations was dependent on input values for dose-determining factors. Standard values for each dose-determining factor required for the application of PCXMC to panoramic radiography were suggested in this study.

PMID: 26795453 [PubMed - as supplied by publisher]

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Accuracy of magnetic resonance imaging-cone beam computed tomography rigid registration of the head: an in-vitro study.

Accuracy of magnetic resonance imaging-cone beam computed tomography rigid registration of the head: an in-vitro study.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Nov 14;

Authors: Al-Saleh MA, Punithakumar K, Jaremko JL, Alsufyani NA, Boulanger P, Major PW

Abstract
OBJECTIVE: To evaluate the performance of cross-modality image registration procedure between magnetic resonance imaging (MRI) and cone beam computed tomography (CBCT).
METHODS: In vitro diagnostic MRI and CBCT images of 5 cadaver swine heads were obtained prospectively. Five radiopaque fiducial markers were attached to each cadaver skull by using resin screws. Automatic MRI-CBCT rigid registrations were performed. The specimens were then scanned using a 3-dimensional (3-D) laser scanner. The 3-D coordinate points for the centroid of the attached fiducial markers from laser scan were identified and considered ground truth. The distances between marker centroids were measured with MRI, CBCT, and MRI-CBCT. Accuracy was calculated by using repeated measures analysis of variance and mean difference values. The registration method was repeated 10 times for each specimen in MRI to measure the average error.
RESULTS: There was no significant difference (P > .05) in mean distances of the markers between all images and the ground truth. The distances' mean difference between MRI, CBCT, and MRI-CBCT and the ground truth were 0.2 ± 1.1 mm, 0.3 ± 1.0 mm, 0.2 ± 1.2 mm, respectively. The detected method error ranged between 0.06 mm and 0.1 mm.
CONCLUSION: The cross-modality image registration algorithm is accurate for head MRI-CBCT registration.

PMID: 26795452 [PubMed - as supplied by publisher]

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Differences in human papillomavirus-positive and -negative head and neck cancers in Belgium: an 8-year retrospective, comparative study.

Differences in human papillomavirus-positive and -negative head and neck cancers in Belgium: an 8-year retrospective, comparative study.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Nov 17;

Authors: Grisar K, Dok R, Schoenaers J, Dormaar T, Hauben E, Jorissen M, Nuyts S, Politis C

Abstract
OBJECTIVES: This study investigated the prevalence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) and compared patient profiles and outcomes between HPV-positive and HPV-negative groups.
STUDY DESIGN: This retrospective study included all patients treated for OPSCC in the University Hospitals of Leuven between 2004 and 2012. Paraffin-embedded tumor tissue was available for all patients. Patient characteristics, treatment, and follow-up data were retrieved from medical files. HPV status was determined by immunohistochemical staining for the p16 epitope.
RESULTS: Among 94 patients, the prevalence of HPV-positive OPSCC was 22.34%. Compared with HPV-negative tumors, HPV-positive tumors were correlated with less smoking and alcohol consumption, tonsillar sublocalization (P < .05), and younger age. HPV-positive OPSCC was associated with better overall survival (62.2%) compared with HPV-negative OPSCC (42.5%; P = .0588).
CONCLUSIONS: Among patients with OPSCC, those with HPV exhibited profiles different from those without HPV. HPV-positive OPSCC was associated with better overall survival compared with HPV-negative OPSCC. HPV-positive OPSCC prevalence increased over time.

PMID: 26795451 [PubMed - as supplied by publisher]

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Surgical management of bisphosphonate-related osteonecrosis of the jaw stages II and III.

Surgical management of bisphosphonate-related osteonecrosis of the jaw stages II and III.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Dec 1;

Authors: Bodem JP, Schaal C, Kargus S, Saure D, Mertens C, Engel M, Hoffmann J, Freudlsperger C

Abstract
OBJECTIVE: The value of surgery in advanced stages of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is still controversial. Hence, we evaluated the effect of surgical therapy in BRONJ stages II and III in combination with a standardized perioperative adjuvant treatment.
STUDY DESIGN: We included 39 patients who presented with BRONJ in a total of 47 locations and stages II (n = 23) and III (n = 24). All patients had exclusively received a monthly intravenous application of zoledronic acid. Surgical therapy consisted of complete removal of the necrotic jaw, accompanied by a standardized perioperative adjuvant treatment including intravenous antibiotic prophylaxis, gastric feeding, and an antimicrobiologic mouth rinsing.
RESULTS: Overall, 35 (74.5%) of the 47 BRONJ sites were treated successfully, with success defined as complete mucosal healing of the exposed jaw (n = 24) or as relative healing when surgical therapy downscaled BRONJ II or III to asymptomatic BRONJ stage I (n = 11). Interestingly, perioperative adjuvant treatment or bisphosphonate therapy parameters showed no statistical effect on the treatment outcome.
CONCLUSIONS: The results of the present study prove the effectiveness of surgical therapy for BRONJ stage II or III.

PMID: 26795450 [PubMed - as supplied by publisher]

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Reduction of scatter-induced image noise in cone beam computed tomography: effect of field of view size and position.

Reduction of scatter-induced image noise in cone beam computed tomography: effect of field of view size and position.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Feb;121(2):188-95

Authors: Pauwels R, Jacobs R, Bogaerts R, Bosmans H, Panmekiate S

Abstract
OBJECTIVE: To measure the effect of field of view (FOV) size and position on scatter-induced image noise in cone beam computed tomography (CBCT).
STUDY DESIGN: A polymethyl methacrylate (PMMA) phantom containing air and aluminum underwent CBCT scanning, using seven FOVs ranging between 4 × 4 cm and 14 × 10 cm, positioned both centrally and according to a dental scan. Signal difference to noise ratio (SDNR) was measured on two-dimensional (2-D) projection images.
RESULTS: At a central position, SDNR decreased with increasing FOV size, ranging between 9.8 (14 × 10 cm) and 10.9 (4 × 4 cm). For dental FOV positions, SDNR values were between 6.3 (14 × 10 cm) and 9.5 (4 × 4 cm). To reach a constant SDNR, a dose reduction up to 76% was possible for small FOVs compared with the 14 × 10 cm FOV.
CONCLUSIONS: The use of small FOVs and peripheral FOV positioning decreases scatter at the detector, resulting in a considerable potential for reduction of radiation dose to the patient.

PMID: 26792756 [PubMed - in process]

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Oral medicine (stomatology) across the globe: birth, growth, and future.

Oral medicine (stomatology) across the globe: birth, growth, and future.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Feb;121(2):149-157.e5

Authors: Scully C, Miller CS, Aguirre Urizar JM, Alajbeg I, Almeida OP, Bagan JV, Birek C, Chen Q, Farah CS, Figueirido JP, Hasséus B, Jontell M, Kerr AR, Laskaris G, Lo Muzio L, Mosqueda-Taylor A, Nagesh KS, Nikitakis NG, Peterson D, Sciubba J, Thongprasom K, Tovaru Ş, Zadik Y

Abstract
Oral medicine (stomatology) is a recognized and increasingly important dental specialty in many parts of the world that recognizes and fosters the interplay between medical health and oral health. Its dental activities rely greatly on the underlying biology of disease and evidence-based outcomes. However, full recognition of the importance of oral medicine to patient care, research, and education is not yet totally universally acknowledged. To address these shortcomings, we outline the birth, growth, and future of oral medicine globally, and record identifiable past contributions to the development of the specialty, providing an accurate, unique, and valuable resource on oral medicine. Although it was challenging to gather the data, we present this information as a review that endeavors to summarize the salient points about oral medicine, based on MEDLINE, other internet searches, communication with oral medicine and stomatological societies across the world, the web page http://ift.tt/1KjW8gF, and discussions with a wide range of key senior persons in the specialty.

PMID: 26792755 [PubMed - in process]

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Evaluation of computer-assisted mandibular reconstruction with vascularized fibular flap compared to conventional surgery.

Evaluation of computer-assisted mandibular reconstruction with vascularized fibular flap compared to conventional surgery.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Feb;121(2):139-48

Authors: Zhang L, Liu Z, Li B, Yu H, Shen SG, Wang X

Abstract
OBJECTIVE: The purpose of this study was to evaluate the accuracy of computer-assisted mandibular reconstruction with a vascularized fibular flap and compare it with conventional surgery.
STUDY DESIGN: In this retrospective study conducted between February 2009 and December 2012, 8 patients underwent computer-assisted mandibular reconstruction, and 14 patients underwent conventional surgery. The accuracy of virtual surgical planning was determined, and the outcomes in the two groups were compared.
RESULTS: In the computer-assisted group, the deviation in fibula segment length was 1.34 ± 1.09 mm, the angular deviation was 2.29 ± 1.19°, and the mean 3-D deviation was 0.53 ± 0.06 mm. Mean differences in intercondylar distance, intergonial angle distance, anteroposterior distance, gonial angle, and duration of ischemia were all improved in the computer-assisted group compared with the conventional surgery group.
CONCLUSIONS: Computer-assisted surgery, including preoperative virtual surgical planning, intraoperative cutting and reconstructive guides, and postoperative analysis is highly accurate in fibular flap mandibular reconstruction.

PMID: 26792754 [PubMed - in process]

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Predicting the future.

Predicting the future.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Feb;121(2):113-4

Authors: Miller CS

PMID: 26792753 [PubMed - in process]

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The impact of topical and systemic enoxaparin sodium use on traumatic tympanic membrane perforation and myringosclerosis.

The impact of topical and systemic enoxaparin sodium use on traumatic tympanic membrane perforation and myringosclerosis.

Eur Arch Otorhinolaryngol. 2016 Jan 21;

Authors: Bilge A, Gunes A, Dagli M, Koybasioglu FF, Guvey A

Abstract
The objective of this study is to investigate the effect of topical and systemic enoxaparin sodium on the healing pattern of experimentally induced tympanic membrane perforation and formation of myringosclerosis. A total of 24 Wistar-Albino strain rats were included in the study. Standard myringotomies were performed on each rat. In the first group, isotonic serum physiologic was dropped on external ear canal (control group). Topical enoxaparin was dropped on external ear canal and daily topical doses of enoxaparin were dropped on external ear canal of the rats for 14 days (topical treatment group). Third group received subcutaneous injections of enoxaparin for 14 days (systemic treatment group). Five micrometer thick sections of the bullae of the rats were stained with H&E. Inflammation, edema and sclerotic lesions and neovascularization observed in the lamina propria layer of the tympanic membrane, and total thickness of the tympanic membrane were evaluated. In intergroup comparisons, significant difference in the distribution pattern of severity of inflammation in all three groups was not observed (p = 0.784, p > 0.05). Total TM thickness differed among all three groups (p = 0.028, p < 0.05). A statistically significant difference was observed between the systemic enoxaparin and the control groups (p = 0.022, p < 0.05). A statistically significant difference was observed between the topical enoxaparin and the control groups (p = 0.037, p < 0.05). However, comparison between the topical and systemic treatment groups could not reveal any statistically significant intergroup difference (p = 0.682, p > 0.05). A significant difference was not observed among three groups as for the distribution of myringosclerotic plaques, severity of edema and neovascularization in the lamina propria (p = 0.539, p > 0.05), (p = 0.063, p > 0.05), (p = 0.152, p > 0.05). Topical and systemic enoxaparin treatment did not prevent formation of sclerotic plaques; however, it decreased TM thickness significantly in comparison with the control group.

PMID: 26796878 [PubMed - as supplied by publisher]

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Treatment of ameloblastoma and ameloblastic carcinoma with radiotherapy.

Treatment of ameloblastoma and ameloblastic carcinoma with radiotherapy.

Eur Arch Otorhinolaryngol. 2016 Jan 21;

Authors: Kennedy WR, Werning JW, Kaye FJ, Mendenhall WM

Abstract
The purpose of this study is to report our institutional experience using radiotherapy in the treatment of ameloblastoma and ameloblastic carcinoma. Three patients with ameloblastoma and 3 patients with ameloblastic carcinoma were treated with radiotherapy alone (2 patients) or surgery and postoperative radiotherapy (4 patients) at the University of Florida between 1973 and 2007. Follow-up ranged from 4.0 to 13.1 years with a median of 7.8 years. Radiotherapy complications were scored using the Common Terminology Criteria for Adverse Events, version 4.0. Local control was achieved in 4 of the 6 patients. One patient treated with RT alone for an unresectable ameloblastoma developed a local recurrence and metastases in both the cervical lymph nodes and lungs, but had excellent response to dual BRAF/MEK inhibition with dabrafenib and trametinib. Another patient treated with surgery and postoperative radiotherapy for an ameloblastic carcinoma recurred locally without metastasis, but was not salvaged. No significant treatment-related complications were observed. For patients with local recurrence or inadequate margins after surgery, adjuvant radiotherapy provides the potential for disease control. In the setting of metastatic disease, targeted therapies may provide an additional opportunity for salvage.

PMID: 26796877 [PubMed - as supplied by publisher]

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[Computational fluid dynamic application in diagnosis and treatment of OSAHS].

[Computational fluid dynamic application in diagnosis and treatment of OSAHS].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Sep;29(18):1666-70

Authors: Wang J, Li S, Jiang Z

Abstract
To apply more precise upper airway modeling and computer fluid dynamic technology, and simulate the upper airways of the fluid velocity, flow field distribution and pressure changes on 1 case of OSAHS patients before and after surgery. At home and abroad, computer fluid dynamic has been applied to research on human airway and predict curative effect before and after operation, but the study of the whole upper airway fluid physics parameter is less within normal people and sick people, more the lack of large sample research. The application of this technology can lay the foundation to establish normal people and sick people upper airways database, formulate normative operation and research process, the quantitative domestic normal population and pathological airway blocking criteria of each plane, develop a handling the precision of simulation software and the curative effect of surgical or medical treatment evaluation system, and open up the new train of thought of OSAHS patients diagnosis and treatment.

PMID: 26790277 [PubMed - in process]

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[Report of one case Kimura's disease].

[Report of one case Kimura's disease].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Sep;29(18):1664-5

Authors: Li S, Gao S, Xu K

Abstract
A 48-year-old middle aged male presented swelling lymph nodes and mass in neck for 5 years. Physical examination shows swollen mass in head and neck regions. The masses could be touched in bilateral parotids and neck with a little movement and moderate tenderness. The level of IgG was normal, but Eosinophi count was high. The function of heart liver and kidney was normal. The result of B-mode ultrasonography reveals bilateral parotids and subcutaneous near parotids were widely swollen and several swollen lymph nodes in neck. pathological examination displays features of a large number of lymph follicles hyperplasia, acidophilic granulocyte infiltration, capillary hyperplasia and fibrosis of different level. The disease were eventually diagnosed by pathological examination. Method of treatment includes glucocorticoid drug therapy, surgical resection and local radiotherapy. The last treatment of patients with Kimura's disease should be combined with the clinical manifestation of them to determine the individualized treatment, so as to improve the quality of life of patients.

PMID: 26790276 [PubMed - in process]

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[Clinical diagnose and significance of congenital sensorineural hearing loss combined with BPES].

[Clinical diagnose and significance of congenital sensorineural hearing loss combined with BPES].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Sep;29(18):1660-3

Authors: Ao L, Liu Y

Abstract
To analyze congenital sensorineural hearing loss combined with blepharophimosis-ptosis-epicanthus inversus syndrome (BPES). For the case of cochlear implantation to child with congenital sensorineural deafness combined BPES, accomplish routine examination and assessment, combining with literature to analyze the clinical diagnosis of this disease and its significance. Sensorineural hearing loss is a common congenital diseases with neonatal incidence of 1 per thousand - 3 per thousand, 50%-70% of deafness is associated with genetic factors, the incidence of congenital sensorineural hearing loss combined with eye disease is about 40%-60%, mainly reflected in ametropia and retinopathy. BPES's main clinical manifestations is blepharophimosis, ptosis, epicanthus inversus, and telecanthus. BPES is a rare autosomal dominant disease caused by FOXL 2 gene mutation, sometimes associated with retarded growth, delayed development, congenital heart disease, and microcephaly. Suffering from both sensorineural hearing loss and BPES is rare in reported literature. This case is diagnosed by clinical examination, without visual impairment. Facial nerve dysplasia has been found during the surgery. For congenital deafness patients with eye disease or other diseases, timely and correct diagnosis has important clinical significance, which can improve the diagnostic rate and make it coming true to early intervention, and then, effectively improve the quality of the patients. There are few literature reports, of patients with two kinds of genetic diseases. Our inference is that the cases are rare or the patients has visited different departments and ignored the other systems' signs. Therefore, in such doubtful cases, we should do the professional comprehensive examination in daily clinical work in order to avoid missed diagnosis or delayed treatment and intervention. By analyzing this case, the patient may also suffer from facial nerve dysplasia. Preoperatively viewing CT scan and operatively facial nerve monitor being used can avoid the occurrence of surgical complications.

PMID: 26790275 [PubMed - in process]

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Regarding ACR Appropriateness Criteria® aggressive nonmelanomatous skin cancer of the head and neck.

Regarding ACR Appropriateness Criteria® aggressive nonmelanomatous skin cancer of the head and neck.

Head Neck. 2016 Feb;38(2):183

Authors: Weber RS

PMID: 26791006 [PubMed - in process]

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ACR Appropriateness Criteria(®) Aggressive Nonmelanomatous Skin Cancer of the Head and Neck.

ACR Appropriateness Criteria(®) Aggressive Nonmelanomatous Skin Cancer of the Head and Neck.

Head Neck. 2016 Feb;38(2):175-82

Authors: Koyfman SA, Cooper JS, Beitler JJ, Busse PM, Jones CU, McDonald MW, Quon H, Ridge JA, Saba NF, Salama JK, Siddiqui F, Smith RV, Worden F, Yao M, Yom SS

Abstract
BACKGROUND: Aggressive nonmelanomatous skin cancer (NMSC) of the head and neck presents an increasingly common therapeutic challenge for which prospective clinical trials are lacking.
METHODS: The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
RESULTS: The American College of Radiology Expert Panel on Radiation Oncology - Head and Neck Cancer developed consensus recommendations for guiding management of aggressive NMSC.
CONCLUSION: Multidisciplinary assessment is vital to guiding the ideal use of surgery, radiation, and systemic therapy in this disease. © 2016 Wiley Periodicals, Inc. Head Neck 38: 175-182, 2016.

PMID: 26791005 [PubMed - in process]

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Issue Information - TOC.

Issue Information - TOC.

Head Neck. 2016 Feb;38(2):161-4

Authors:

PMID: 26791004 [PubMed - in process]

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Temporary dumping syndrome after gastric peroral endoscopic myotomy: should we control the glycemia?

Temporary dumping syndrome after gastric peroral endoscopic myotomy: should we control the glycemia?

Endoscopy. 2016 0;48(S 01):E10-E11

Authors: Louazon T, Rivory J, Roman S, Mion F, Ponchon T, Pioche M

PMID: 26800191 [PubMed - as supplied by publisher]

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Posterior inferior cerebellar artery reimplantation: buffer lengths, perforator anatomy, and technical limitations.

Posterior inferior cerebellar artery reimplantation: buffer lengths, perforator anatomy, and technical limitations.

J Neurosurg. 2016 Jan 22;:1-6

Authors: Tayebi Meybodi A, Lawton MT, Feng X, Benet A

Abstract
OBJECTIVE Reimplantation of the posterior inferior cerebellar artery (PICA) to the vertebral artery (VA) is a safe and effective bypass option after deliberate PICA sacrifice during the treatment of nonsaccular and dissecting aneurysms at this location. However, the anatomy and limitations of this technique have not been studied. The goal of this study was to define the surgical anatomy and buffer lengths specific to the proximal segment of the PICA related to 2 variations of PICA reimplantation: 1) reimplantation "along-VA" (simulating a dissecting VA aneurysm), and 2) reimplantation "across-VA" (simulating a nonclippable, proximal PICA aneurysm). METHODS Ten cadaver heads (20 sides) were prepared for surgical simulation. Twenty far-lateral approaches were performed. The PICA was mobilized and reimplanted onto the VA according to 2 different paradigms: 1) transposition along the axis of the VA (along-VA) to simulate a dissecting VA, and 2) transposition perpendicular to the axis of the VA (across-VA) to simulate a nonclippable, proximal PICA aneurysm. The buffer lengths provided by mobilization of the artery in each paradigm were measured and the anatomy of perforator branching on the proximal PICAs was analyzed. RESULTS The PICA was reimplanted in all surgical simulations. The most common perforating artery on the P1 and P2 segments was the short circumflex type. No direct perforator was found on the P1 segment. The mean buffer length with reimplantation along the VA axis was 13.43 ± 4.61 mm, and it was 6.97 ± 4.04 mm with reimplantation across the VA. The PICA was less maneuverable when it was reimplanted across the VA, due to perforator branches of the PICA (P3 segment). CONCLUSIONS The buffer lengths measured in this study describe the limitations of PICA reimplantation as a revascularization procedure for nonsaccular aneurysms in this location. PICA reimplantation is a revascularization option for dissecting VA aneurysms incorporating the PICA origin that are < 13 mm in length, and for nonsaccular proximal PICA aneurysms that are < 6 mm in diameter. The final decision to reimplant the PICA depends on careful inspection of perforator anatomy that is not visible preoperatively on angiography, as well as an assessment of technical difficulty intraoperatively.

PMID: 26799299 [PubMed - as supplied by publisher]

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Outcomes after surgical treatment of meningioma-associated proptosis.

Outcomes after surgical treatment of meningioma-associated proptosis.

J Neurosurg. 2016 Jan 22;:1-7

Authors: Bowers CA, Sorour M, Patel BC, Couldwell WT

Abstract
OBJECTIVE Meningioma-associated proptosis (MAP) can be cosmetically and functionally debilitating for patients with sphenoorbital and other skull base meningiomas, and there is limited information on the quantitative improvement in proptosis after surgery. Because less extensive removals of tumor involving the orbit fail to reduce proptosis, the senior author has adopted an aggressive surgical approach to the removal of tumor involving the periorbita and orbit. The authors of this study retrospectively reviewed outcomes of this surgical approach. METHODS All surgeries for MAP performed by a single surgeon between January 1, 2002, and May 1, 2015, were reviewed. Age, sex, visual symptoms, number and types of surgical treatments, cavernous sinus involvement, complications, duration of follow-up, residual tumor, use of adjuvant radiation therapy, and extent of proptosis resolution as measured by the exophthalmos index (EI) pre- and postoperatively and at the final follow-up were recorded. RESULTS Thirty-three patients (24 female [73%]) with an average age of 51.6 years were treated for MAP. Of the 22 patients with additional visual symptoms (for example, loss of visual acuity, field cut, or diplopia), 15 had improved vision and 7 had stable vision. No patients had worse proptosis after treatment. The average preoperative EI was 1.39, the average immediate postoperative EI was 1.23, and the average final EI at the most recent follow-up was 1.13. Thus, average overall EI improvement was 0.26, but the average immediate EI reduction was 0.16, demonstrating that proptosis progressively improved during the postoperative period. Residual cavernous sinus involvement was present in 17 of 18 patients who had had preoperative cavernous sinus meningioma involvement. Only 2 patients in the series had recurrent tumor at the orbital region, and their proptosis improved again after reoperation. One case of delayed vasospasm and 2 cases of postoperative trigeminal numbness (V2) were recorded. The average follow-up was 4.5 years (53.8 months). CONCLUSIONS In this series, all patients experienced proptosis improvement and none had worse visual symptoms at the final follow-up, although proptosis resolution occurred over time. Only 2 patients had tumor recurrence at the orbit that required surgery. Surgical complications were uncommon. Study results suggest that aggressive resection of MAP is well tolerated and offers superior proptosis elimination with infrequent recurrence at the orbit. Importantly, no cases of enophthalmos were noted despite the lack of formal reconstruction of the orbit.

PMID: 26799293 [PubMed - as supplied by publisher]

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Magnetic resonance neurography in the management of peripheral trigeminal neuropathy: experience in a tertiary care centre.

Magnetic resonance neurography in the management of peripheral trigeminal neuropathy: experience in a tertiary care centre.

Eur Radiol. 2016 Jan 21;

Authors: Cox B, Zuniga JR, Panchal N, Cheng J, Chhabra A

Abstract
OBJECTIVE: This tertiary care experience examines the utility of magnetic resonance neurography (MRN) in the management of peripheral trigeminal neuropathies.
MATERIALS AND METHODS: Seventeen patients with clinically suspected peripheral trigeminal neuropathies (inferior alveolar nerve and lingual nerve) were imaged uniformly with 1.5-T examinations. MRN results were correlated with clinical and surgical findings in operated patients and the impact on clinical management was assessed.
RESULTS: Clinical findings included pain (14/17), sensory changes (15/17), motor changes (2/17) and palpable masses (3/17). Inciting events included prior dental surgery (12/17), trauma (1/17) and idiopathic incidents (4/17). Non-affected side nerves and trigeminal nerves in the intracranial and skull base course were normal in all cases. Final diagnoses on affected sides were nerve inflammation (4/17), neuroma in continuity (2/17), LN transection (1/17), scar entrapment (3/17), infectious granuloma (1/17), low-grade injuries (3/17) and no abnormality (3/17). Associated submandibular gland and sublingual gland oedema-like changes were seen in 3/17 cases because of parasympathetic effects. Moderate-to-excellent MRN-surgical correlation was seen in operated (8/17) patients, and neuroma and nerve transection were prospectively identified in all cases.
CONCLUSION: MRN is useful for the diagnostic work-up of suspected peripheral trigeminal neuropathy patients with significant impact on clinical management and moderate-to-excellent correlation with intra-operative findings.
KEY POINTS: • MRN substantially impacts diagnostic thinking and management in peripheral trigeminal neuropathy. • MRN has moderate-to-excellent correlation with intra-operative findings. • MRN should be considered in pre-surgical planning of peripheral trigeminal neuropathy subjects.

PMID: 26795500 [PubMed - as supplied by publisher]

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Safety and efficacy of medium-sized particle embolisation for skull-base meningioma.

Safety and efficacy of medium-sized particle embolisation for skull-base meningioma.

Clin Radiol. 2016 Jan 11;

Authors: Jo KI, Kim B, Cha MJ, Choi JH, Jeon P, Kim KH

Abstract
AIM: To determine the effectiveness and safety of preoperative tumour embolisation for skull-base meningiomas via external carotid artery (ECA) feeders using medium-sized (150-250 μm) polyvinyl alcohol (PVA) particles.
MATERIALS AND METHODS: This study included 114 consecutive patients with skull-base meningiomas who underwent preoperative tumour embolisation using medium-sized PVA particles from January 2004 to December 2013. Tumours were categorised according to feeding artery as follows: type 1, tumour staining at ECA angiography only; type 2, tumour staining at both the ECA and internal carotid artery (ICA) angiography; or type 3, little or no tumour staining at ECA angiography. The effectiveness was based on the percent reduction in the enhanced area: >75% was considered effective, 25-75% was considered partially effective, and <25% was considered ineffective.
RESULTS: Tumour embolisation was performed in patients with dominant feeding vessels originating from the ECA. Procedural-related complications occurred in two (1.8%) patients. Post-procedural MRI images were available for 51 patients, which revealed effective embolisation in only 13 (25.5%) patients. Identification of an ICA feeding vessel was associated with ineffective embolisation (p=0.011). Effective embolisation was associated with low estimated blood loss during surgery.
CONCLUSION: ECA embolisation using medium-sized PVA is ineffective in patients in whom a definitive ICA feeding vessel was identified, even if preprocedural angiography showed that the dominant feeder originated from the ECA. When the risks of surgical morbidity and mortality are expected to be high, ICA feeder embolisation should also be considered.

PMID: 26791376 [PubMed - as supplied by publisher]

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Otolaryngology-head and neck surgery at Johns Hopkins: The first 100 years (1914-2014).

http:--media.wiley.com-assets-7315-19-Wi

Otolaryngology-head and neck surgery at Johns Hopkins: The first 100 years (1914-2014).

Laryngoscope. 2015 Nov;125 Suppl 9:S1-35

Authors: Francis HW, Papel I, Lina I, Koch W, Tunkel D, Fuchs P, Lin S, Kennedy D, Ruben R, Linthicum F, Marsh B, Best S, Carey J, Lane A, Byrne P, Flint P, Eisele DW

PMID: 26297867 [PubMed - indexed for MEDLINE]

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Evaluation of 3-dimensional superimposition techniques on various skeletal structures of the head using surface models.

Evaluation of 3-dimensional superimposition techniques on various skeletal structures of the head using surface models.

PLoS One. 2015;10(2):e0118810

Authors: Gkantidis N, Schauseil M, Pazera P, Zorkun B, Katsaros C, Ludwig B

Abstract
OBJECTIVES: To test the applicability, accuracy, precision, and reproducibility of various 3D superimposition techniques for radiographic data, transformed to triangulated surface data.
METHODS: Five superimposition techniques (3P: three-point registration; AC: anterior cranial base; AC + F: anterior cranial base + foramen magnum; BZ: both zygomatic arches; 1Z: one zygomatic arch) were tested using eight pairs of pre-existing CT data (pre- and post-treatment). These were obtained from non-growing orthodontic patients treated with rapid maxillary expansion. All datasets were superimposed by three operators independently, who repeated the whole procedure one month later. Accuracy was assessed by the distance (D) between superimposed datasets on three form-stable anatomical areas, located on the anterior cranial base and the foramen magnum. Precision and reproducibility were assessed using the distances between models at four specific landmarks. Non parametric multivariate models and Bland-Altman difference plots were used for analyses.
RESULTS: There was no difference among operators or between time points on the accuracy of each superimposition technique (p>0.05). The AC + F technique was the most accurate (D<0.17 mm), as expected, followed by AC and BZ superimpositions that presented similar level of accuracy (D<0.5 mm). 3P and 1Z were the least accurate superimpositions (0.79<D<1.76 mm, p<0.005). Although there was no difference among operators or between time points on the precision of each superimposition technique (p>0.05), the detected structural changes differed significantly between different techniques (p<0.05). Bland-Altman difference plots showed that BZ superimposition was comparable to AC, though it presented slightly higher random error.
CONCLUSIONS: Superimposition of 3D datasets using surface models created from voxel data can provide accurate, precise, and reproducible results, offering also high efficiency and increased post-processing capabilities. In the present study population, the BZ superimposition was comparable to AC, with the added advantage of being applicable to scans with a smaller field of view.

PMID: 25706151 [PubMed - indexed for MEDLINE]

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Swallowing Training Combined with Game-Based Biofeedback in Post-Stroke Dysphagia.

Swallowing Training Combined with Game-Based Biofeedback in Post-Stroke Dysphagia.

PM R. 2016 Jan 11;

Authors: Li CM, Wang TG, Lee HY, Wang HP, Hsieh SH, Chou M, Chen JJ

Abstract
BACKGROUND: For patients with dysphagia due to stroke, in addition to compensatory strategies, exercises are utilized to help improve motor function. Biofeedback is utilized in neuromuscular training, and is promising for swallowing training.
OBJECTIVE: To evaluate the functional value of game-based biofeedback in swallowing therapy for patients with post-stroke dysphagia.
DESIGN: A case control study SETTING: Academic tertiary hospital PARTICIPANTS: Subjects with post-stroke dysphagia (N=20) were individually matched to two separate groups, game-based biofeedback (N=10) or control (N=10), for age, sex, duration of dysphagia and dysphagia grades.
INTERVENTIONS: Each participant underwent 1-hour sessions three times a week for a total of 16 treatment sessions. Each session included a 30-minute session of traditional swallow treatment and a 30-minute session of laryngeal elevation exercises. In the experimental group, laryngeal elevation exercises were combined with additional game-based biofeedback.
MAIN OUTCOME MEASURES: Outcomes assessed before and after interventions included hyoid bone displacement, Functional Oral Intake Scale (FOIS) scores, and nasogastric (NG) tube removal rate.
RESULTS: Intergroup analyses showed larger differences in hyoid bone displacement and FOIS scores (before and after treatment) in the experimental group than in the control group, with statistical significance (p=.007 and p=.014, respectively). Intergroup analyses showed that the hyoid bone displacement change and FOIS scores before and after treatment, showed statistically significant improvement only in the experimental group (p=.002 and .004, respectively). Eight (80%) of 10 patients in the experimental group and 2 (20%) of 10 control patients discontinued nasogastric tube insertion after therapy. Participation in the experimental group was associated with an increased probability of tube removal (OR=6.00; 95% CI, 1.08-33.27, p=.009).
CONCLUSIONS: Laryngeal elevation training combined with game-based biofeedback augments the change in hyoid bone displacement, FOIS scores, and increases NG tube removal rate in patients with post-stroke dysphagia.

PMID: 26791426 [PubMed - as supplied by publisher]

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[Editor's Comment].

[Editor's Comment].

Laryngorhinootologie. 2016 Jan;95(1):1

Authors: Guntinas-Lichius O

PMID: 26797905 [PubMed - in process]

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Smartphone threshold audiometry in underserved primary health-care contexts.

Smartphone threshold audiometry in underserved primary health-care contexts.

Int J Audiol. 2016 Jan 21;:1-7

Authors: Sandström J, Swanepoel W, Carel Myburgh H, Laurent C

Abstract
OBJECTIVE: To validate a calibrated smartphone-based hearing test in a sound booth environment and in primary health-care clinics.
DESIGN: A repeated-measure within-subject study design was employed whereby air-conduction hearing thresholds determined by smartphone-based audiometry was compared to conventional audiometry in a sound booth and a primary health-care clinic environment.
STUDY SAMPLE: A total of 94 subjects (mean age 41 years ± 17.6 SD and range 18-88; 64% female) were assessed of whom 64 were tested in the sound booth and 30 within primary health-care clinics without a booth.
RESULTS: In the sound booth 63.4% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dB HL corresponded to smartphone thresholds within ≤10 dB in 80.6% of cases with an average threshold difference of -1.6 dB ± 9.9 SD. In primary health-care clinics 13.7% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dBHL corresponded to smartphone thresholds within ≤10 dB in 92.9% of cases with an average threshold difference of -1.0 dB ± 7.1 SD.
CONCLUSIONS: Accurate air-conduction audiometry can be conducted in a sound booth and without a sound booth in an underserved community health-care clinic using a smartphone.

PMID: 26795898 [PubMed - as supplied by publisher]

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Adaptation of the STARR test for adult Italian population: A speech test for a realistic estimate in real-life listening conditions.

Adaptation of the STARR test for adult Italian population: A speech test for a realistic estimate in real-life listening conditions.

Int J Audiol. 2016 Jan 21;:1-6

Authors: Dincer D'Alessandro H, Ballantyne D, De Seta E, Musacchio A, Mancini P

Abstract
OBJECTIVES: To introduce the Italian adaptation of the STARR test based on a roving-level adaptive method to mimic challenging real-life listening conditions for use in people with auditory prostheses.
DESIGN: Normative data were collected and interlist-variability, as well as learning effects, were investigated using a within-subject design with repeated measures.
STUDY SAMPLE: A group of 32 normal-hearing (NH) adults participated in the study.
RESULTS: The average speech reception threshold (SRT) for NH subjects was -8.4 dB SNR. The variability of mean SRTs across test lists was relatively small (≤1 dB for all test lists). The statistically significant differences between lists were eliminated after applying correction factors. On the basis of variability for the corrected SRTs within each subject, a difference of 2.8 dB in SRT was meaningful for outcome comparisons using one test list per condition and 2 dB using two lists per condition. Statistical analysis did not show any significant learning effects.
CONCLUSIONS: Findings in NH listeners suggested that the Italian STARR test could be a promising supplement to existing speech assessment tools. Further studies in populations with hearing impairment could contribute to cross-language studies.

PMID: 26795710 [PubMed - as supplied by publisher]

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Assessment of low-frequency hearing with narrow-band chirp-evoked 40-Hz sinusoidal auditory steady-state response.

Assessment of low-frequency hearing with narrow-band chirp-evoked 40-Hz sinusoidal auditory steady-state response.

Int J Audiol. 2016 Jan 21;:1-9

Authors: Wilson US, Kaf WA, Danesh AA, Lichtenhan JT

Abstract
Objective To determine the clinical utility of narrow-band chirp-evoked 40-Hz sinusoidal auditory steady state responses (s-ASSR) in the assessment of low-frequency hearing in noisy participants. Design Tone bursts and narrow-band chirps were used to respectively evoke auditory brainstem responses (tb-ABR) and 40-Hz s-ASSR thresholds with the Kalman-weighted filtering technique and were compared to behavioral thresholds at 500, 2000, and 4000 Hz. A repeated measure ANOVA and post-hoc t-tests, and simple regression analyses were performed for each of the three stimulus frequencies. Study sample Thirty young adults aged 18-25 with normal hearing participated in this study. Results When 4000 equivalent response averages were used, the range of mean s-ASSR thresholds from 500, 2000, and 4000 Hz were 17-22 dB lower (better) than when 2000 averages were used. The range of mean tb-ABR thresholds were lower by 11-15 dB for 2000 and 4000 Hz when twice as many equivalent response averages were used, while mean tb-ABR thresholds for 500 Hz were indistinguishable regardless of additional response averaging. Conclusion Narrow-band chirp-evoked 40-Hz s-ASSR requires a ∼15 dB smaller correction factor than tb-ABR for estimating low-frequency auditory threshold in noisy participants when adequate response averaging is used.

PMID: 26795555 [PubMed - as supplied by publisher]

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Knowledge, attitudes, behaviors, and noise exposure of baristas.

Knowledge, attitudes, behaviors, and noise exposure of baristas.

Int J Audiol. 2016 Jan 21;:1-5

Authors: Pursley AJ, Saunders GH

Abstract
OBJECTIVE: To examine the daily noise exposure of baristas working in cafés, and to measure their knowledge, attitudes, and behaviors regarding hearing conservation and perceptions of noise in their work environment.
DESIGN: Fifteen baristas from six cafés in Portland completed the Knowledge, Attitudes and Behaviors questionnaire, a sound disturbance survey, and a structured interview to document perceptions of noise in the work environment. To measure daily noise exposure, a subset of eight participants wore a personal dosimeter for three different work shifts.
STUDY SAMPLE: A total of 11 females and four males, aged between 19 and 36 years old (mean: 26.3, SD: 4.6) recruited from independently owned cafés in the Portland metro area.
RESULTS: Dosimetry measurements revealed Leq measurements between 71 and 83 dBA, with noise doses ranging from 4% to 74%, indicating that baristas are not exposed to sound levels above the regulatory criterion. Questionnaire results indicated that baristas have low awareness about the hazards of noise, are not opposed to hearing conservation, and rarely use hearing protection when engaged in noisy activities.
CONCLUSIONS: Baristas here lacked the pertinent education and motivation to commit to invaluable hearing conservation practices.

PMID: 26795371 [PubMed - as supplied by publisher]

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Attentional Bias in Patients with Decompensated Tinnitus: Prima Facie Evidence from Event-Related Potentials.

Attentional Bias in Patients with Decompensated Tinnitus: Prima Facie Evidence from Event-Related Potentials.

Audiol Neurootol. 2016 Jan 23;21(1):38-44

Authors: Li Z, Gu R, Zeng X, Zhong W, Qi M, Cen J

Abstract
Tinnitus refers to the auditory perception of sound in the absence of external sound or electric stimuli. The influence of tinnitus on cognitive processing is at the cutting edge of ongoing tinnitus research. In this study, we adopted an objective indicator of attentional processing, i.e. the mismatch negativity (MMN), to assess the attentional bias in patients with decompensated tinnitus. Three kinds of pure tones, D1 (8,000 Hz), S (8,500 Hz) and D2 (9,000 Hz), were used to induce event-related potentials (ERPs) in the normal ear. Employing the oddball paradigm, the task was divided into two blocks in which D1 and D2 were set as deviation stimuli, respectively. Only D2 induced a significant MMN in the tinnitus group, while neither D1 nor D2 was able to induce MMN in the control group. In addition, the ERPs in the left hemisphere, which were recorded within the time window of 90-150 ms (ERP90-150 ms), were significantly higher than those in the right hemisphere in the tinnitus group, while no significant difference was observed in the control group. Lastly, the amplitude of ERP90-150 ms in the tinnitus group was significantly higher than that in the control group. These findings suggest that patients with decompensated tinnitus showed automatic processing of acoustic stimuli, thereby indicating that these patients allocated more cognitive resources to acoustic stimulus processing. We suggest that the difficulty in disengaging or facilitated attention of patients might underlie this phenomenon. The limitations of the current study are discussed.

PMID: 26800229 [PubMed - as supplied by publisher]

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Gamma Knife surgery for tumor-related trigeminal neuralgia: targeting both the tumor and the trigeminal root exit zone in a single session.

Gamma Knife surgery for tumor-related trigeminal neuralgia: targeting both the tumor and the trigeminal root exit zone in a single session.

J Neurosurg. 2016 Jan 22;:1-7

Authors: Kim SK, Kim DG, Se YB, Kim JW, Kim YH, Chung HT, Paek SH

Abstract
OBJECTIVE Gamma Knife surgery (GKS) represents an alternative treatment for patients with tumor-related trigeminal neuralgia (TRTN). However, in previous studies, the primary GKS target was limited to mass lesions. The authors evaluated whether GKS could target both the tumor and the trigeminal root exit zone (REZ) in a single session while providing durable pain relief and minimizing radiation dose-related complications for TRTN patients. METHODS The authors' institutional review board approved the retrospective analysis of data from 15 consecutive patients (6 men and 9 women, median age 67 years, range 45-79 years) with TRTN who had undergone GKS. In all cases, the radiation was delivered in a single session targeting both the tumor and trigeminal REZ. The authors assessed the clinical outcomes, including the extent of pain relief, durability of the treatment response, and complications. Radiation doses to organs at risk (OARs), including the brainstem and the cranial nerve VII-VIII complex, were analyzed as doses received by 2% or 50% of the tissue volume and the tissue volume covered by a dose of 12 Gy (V12Gy). RESULTS The median length of clinical follow-up was 38 months (range 12-78 months). Pain relief with GKS was initially achieved in 14 patients (93.3%) and at the last follow-up in 13 patients (86.7%). The actuarial recurrence-free survival rates were 93%, 83%, and 69% at 1, 3, and 5 years after GKS, respectively. Persistent facial numbness was observed in 3 patients (20.0%). There were no complications such as facial weakness, altered taste function, hearing impairment, and balance difficulties indicating impaired function of the cranial nerve VII-VIII complex. The V12Gy in the brainstem was less than or equal to 0.24 cm(3) in all patients. There were no significant differences in any OAR values in the brainstem between patients with and without facial numbness after GKS. CONCLUSIONS The strategy of performing GKS for both tumor and trigeminal REZ in a single session is a safe and effective radiosurgical approach that achieves durable pain control for TRTN patients.

PMID: 26799302 [PubMed - as supplied by publisher]

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Nocardia asteroides sinusitis in a pediatric patient: Case report with 20 year follow-up and review of the literature.

http:--linkinghub.elsevier.com-ihub-imag

Nocardia asteroides sinusitis in a pediatric patient: Case report with 20 year follow-up and review of the literature.

Int J Pediatr Otorhinolaryngol. 2015 Jul;79(7):1152-4

Authors: Sorichetti B, Westerberg BD, Tan R, Kozak FK

Abstract
Nocardia Asteroides infection in a non-immunocompromised pediatric patient is extremely rare. We present a case of ethmoid sinusitis and orbital subperiosteal abscess caused by N. asteroides with a 20 year follow up and a review of the literature. N. asteroides was grown from intraoperative cultures for mycobacteria following surgical incision and drainage of the abscess. Postoperatively, the patient received a seven month course of trimethoprim-sulfamethozaxole and had no subsequent sequelae. Nocardia infections are common in immunocompromised patients. We present what we believe to be the first case of pediatric Nocardia sinusitis with 20-year follow up.

PMID: 25943955 [PubMed - indexed for MEDLINE]

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Attentional Bias in Patients with Decompensated Tinnitus: Prima Facie Evidence from Event-Related Potentials.

Attentional Bias in Patients with Decompensated Tinnitus: Prima Facie Evidence from Event-Related Potentials.

Audiol Neurootol. 2016 Jan 23;21(1):38-44

Authors: Li Z, Gu R, Zeng X, Zhong W, Qi M, Cen J

PMID: 26800229 [PubMed - as supplied by publisher]

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Breathing-related changes of respiratory resistance in vocal cord dysfunction.

Breathing-related changes of respiratory resistance in vocal cord dysfunction.

Respirology. 2016 Jan 22;

Authors: Ioan I, Marchal F, Coffinet L, Coutier L, Bonabel C, Demoulin B, Clisson R, Schweitzer C, Varechova S

Abstract
Vocal cord dysfunction induced by exercise in children with uncontrolled asthma was identified by laryngoscopy. The paradoxical adduction of the vocal cords was also indicated by the breathing-related changes of the forced oscillation respiratory resistance showing prominent increase during inspiration and a large positive difference between inspiration and expiration. The breathing-related changes of respiratory resistance offer thus a useful first-line technique to diagnose vocal cord dysfunction.

PMID: 26799544 [PubMed - as supplied by publisher]

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Effect of visual biofeedback to acquire supraglottic swallow in healthy individuals: a randomized-controlled trial.

Effect of visual biofeedback to acquire supraglottic swallow in healthy individuals: a randomized-controlled trial.

Int J Rehabil Res. 2016 Jan 19;

Authors: Imada M, Kagaya H, Ishiguro Y, Kato M, Inamoto Y, Tanaka T, Shibata S, Saitoh E

Abstract
The aim of this study is to evaluate the effect of visual biofeedback therapy in acquiring supraglottic swallow (SGS) in a randomized-controlled trial with healthy individuals. Eighteen individuals (mean age, 26 years) who could not close or keep closed the vocal folds before and during the swallow in SGS were allocated randomly to either a visual biofeedback group (eight individuals) or a nonbiofeedback group (10 individuals). A videoendoscope was inserted intranasally and an SGS exercise, using 4 ml of green-colored water, was performed 30 times per day up to 5 days. When the participant failed to perform SGS, the result was provided only to the participants in the visual biofeedback group. The median length of time until acquiring SGS was 1.5 days in the visual biofeedback group and 3.5 days in the nonbiofeedback group (P=0.040). We concluded that visual biofeedback effectively enabled participants to acquire SGS earlier.

PMID: 26795716 [PubMed - as supplied by publisher]

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Effects of aging and sarcopenia on tongue pressure and jaw-opening force.

Effects of aging and sarcopenia on tongue pressure and jaw-opening force.

Geriatr Gerontol Int. 2016 Jan 22;

Authors: Machida N, Tohara H, Hara K, Kumakura A, Wakasugi Y, Nakane A, Minakuchi S

Abstract
AIM: Aging and sarcopenia reduce not only body strength, but also the strength of swallowing muscles. We examined how aging and sarcopenia affect tongue pressure and jaw-opening force.
METHODS: A total of 97 older adults (97 men, mean age 78.5 ± 6.6 years; 100 women, mean age 77.8 ± 6.2 years) were enrolled. Classification of sarcopenia was based on the Criteria of Asian Working Group for Sarcopenia. To investigate which variable between aging and sarcopenia was a significant independent variable on tongue pressure and jaw-opening force, multivariate linear regression analysis was carried out.
RESULTS: The mean tongue pressure was 26.3 ± 7.8 kPa in men and 24.6 ± 7.2 kPa in women. The mean jaw-opening force was 6.3 ± 1.6 kg in men and 5.2 ± 1.3 kg in women. Tongue pressure in men, aging and sarcopenia were significant independent variables, whereas only sarcopenia was a significant independent variable in women. Jaw-opening force in men and sarcopenia were significant independent variables, whereas neither aging nor sarcopenia were significant independent variables in women.
CONCLUSIONS: We found different characteristics in the effects of aging and sarcopenia based on site and sex. We suggested that aging decreased tongue pressure more than jaw-opening force, and affected men more than women. Sarcopenia affected tongue pressure and jaw-opening force, with the exception of jaw-opening force in women. Considering these characteristics is useful to predict the decline of swallowing function, and provide appropriate interventions preventing dysphagia. Geriatr Gerontol Int 2016; ●●: ●●-●●.

PMID: 26800427 [PubMed - as supplied by publisher]

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Multicentered epidemiological study of factors associated with total bacterial count in the saliva of older people requiring nursing care.

Multicentered epidemiological study of factors associated with total bacterial count in the saliva of older people requiring nursing care.

Geriatr Gerontol Int. 2016 Jan 22;

Authors: Tohara T, Kikutani T, Tamura F, Yoshida M, Kuboki T

Abstract
AIM: To clarify whether the number of present teeth, independent of other well-known factors, was associated with the total bacterial count in the saliva of older people requiring care at nursing homes in a multicentered epidemiological survey.
METHOD: The participants were 618 older people (mean age 86.8 ± 6.9 years; 122 men, 496 women) residing in 14 nursing homes across Japan. The dependent variable was the participant's salivary bacterial count, and the independent variables were basic demographic data, oral conditions and activity of daily living (measured by Barthel Index). Statistical analysis was first carried out by Student's t-test, Pearson's correlation coefficient analysis and Spearman's rank correlation coefficient analysis. Independent variables found to have a significant relationship to their salivary bacterial count by the univariate analyses were further examined by stepwise multivariate analysis.
RESULTS: The independent variables shown by univariate analysis to have a significant positive relationship with higher salivary bacterial count were presence of food residue (P = 0.001), absence of mouth dryness (P = 0.001), need of oral care assistance (P = 0.001), inability to keep the mouth opened (P = 0.009), inability to gargle (P = 0.002), denture use (P = 0.004), higher number of present teeth (P = 0.006) and lower Barthel Index (P = 0.001). Subsequent multivariate analysis identified presence of food residue (P = 0.031), higher number of present teeth (P = 0.043) and lower Barthel Index (P = 0.001) as independent associated factors for higher salivary bacterial count.
CONCLUSIONS: The present study found that presence of food residue, higher number of present teeth and decreased activity of daily living were significantly related to higher bacterial count in the saliva of older people requiring care. Geriatr Gerontol Int 2016; ●●: ●●-●●.

PMID: 26800022 [PubMed - as supplied by publisher]

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High Resolution Manometry Analysis of a Patient With Dysphagia After Occiput-C3/4 Posterior Fusion Operation.

High Resolution Manometry Analysis of a Patient With Dysphagia After Occiput-C3/4 Posterior Fusion Operation.

Ann Rehabil Med. 2015 Dec;39(6):1028-32

Authors: Oh Y, Lee ST, Ryu JS

Abstract
Many reports of changes in cervical alignment after posterior occipitocervical (O-C) fusion causing dysphagia are available. The clinical course can range from mild discomfort to severe aspiration. However, the underlying pathogenesis is not well known. We report an 80-year-old female with videofluoroscopic swallowing study evidence of aspiration that developed after occiput-C3/4 posterior fusion. Pharyngeal pressure was analyzed using high resolution manometry (HRM). Impaired upper esophageal sphincter opening along with diminished peristalsis and pharyngeal pressure gradient were revealed by HRM to be the main characteristics in such patients. The patient fully recovered after a revision operation for cervical angle correction. Distinct pressure patterns behind reversible dysphagia caused by a change in cervical alignment were confirmed using HRM analysis.

PMID: 26798619 [PubMed]

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Practical Assessment of Dysphagia in Stroke Patients.

Practical Assessment of Dysphagia in Stroke Patients.

Ann Rehabil Med. 2015 Dec;39(6):1018-27

Authors: Lee KM, Kim HJ

Abstract
OBJECTIVE: To develop a quantitative and organ-specific practical test for the diagnosis and treatment of dysphagia based on assessment of stroke patients.
METHODS: An initial test composed of 24 items was designed to evaluate the function of the organs involved in swallowing. The grading system of the initial test was based on the analysis of 50 normal adults. The initial test was performed in 52 stroke patients with clinical symptoms of dysphagia. Aspiration was measured via a videofluoroscopic swallowing study (VFSS). The odds ratio was obtained to evaluate the correlation between each item in the initial test and the VFSS. A polychotomous linear logistic model was used to select the final test items.
RESULTS: Eighteen of 24 initial items were selected as significant for the final tests. These 18 showed high initial validity and reliability. The Spearman correlation coefficient for the total score of the test and functional dysphagia scale was 0.96 (p<0.001), indicating a statistically significant positive correlation.
CONCLUSION: This study was carried out to design a quantitative and organ-specific test that assesses the causes of dysphagia in stroke patients; therefore, this test is considered very useful and highly applicable to the diagnosis and treatment of dysphagia.

PMID: 26798618 [PubMed]

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