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Vocal-fold vibration of patients with Reinke's edema observed using high-speed digital imaging.
Auris Nasus Larynx. 2016 Mar 11;
Authors: Watanabe T, Kaneko K, Sakaguchi K, Takahashi H
Abstract
OBJECTIVE: We aimed to assess the vocal-fold vibration of patients with moderate-to-severe Reinke's edema using high-speed digital imaging (HSDI) and videostroboscopy and to confirm HSDI usefulness in examining the vocal folds with Reinke's edema.
METHODS: We examined the vocal folds of seven patients (six severe and one moderate; six females and one male; aged 55-74 years; mean 64.7 years) with Reinke's edema using HSDI and videostroboscopy. The following characteristics were analyzed: glottic closure, mucosal-wave propagation, left-right asymmetry, phase shift, frequency difference, periodicity, and contact of the true vocal fold with the false vocal fold.
RESULTS: HSDI revealed complete glottic closure, anterior-posterior phase shift, and obvious contact of at least one side of the edematous true vocal fold with the ipsilateral false vocal fold in all patients. Mucosal-wave propagation increased in six patients and decreased in one. Left-right asymmetry was observed in six patients. Left-right phase shifts and left-right frequency differences were observed in four and two patients, respectively. The vibration was periodic in four patients, quasi-periodic in three, and aperiodic in none. Anterior-posterior frequency differences were not observed for any patient. The vocal-fold vibration always synchronized with strobolights in two patients, while the vibration occasionally and never synchronized in two and three patients, respectively. In one patient whose vibration occasionally synchronized, videostroboscopy could not reveal the slight left-right frequency difference of the vibration.
CONCLUSION: It was often difficult to observe vocal-fold vibration correctly in patients with severe Reinke's edema using videostroboscopy. However, HSDI was useful for examining these patients. Our results suggest that HSDI can be very useful for examining the vocal folds of patients with severe Reinke's edema.
PMID: 26976546 [PubMed - as supplied by publisher]
Double-Scope Peroral Endoscopic Myotomy (POEM) for Esophageal Achalasia: The First Trial of a New Double-Scope POEM.
Clin Endosc. 2016 Mar 15;
Authors: Hong HJ, Song GW, Ko WJ, Kim WH, Hahm KB, Hong SP, Cho JY
Abstract
With the accumulation of clinical trials demonstrating its efficacy and safety, peroral endoscopic myotomy (POEM) has emerged as a less invasive treatment option for esophageal achalasia compared with laparoscopic Heller myotomy. However, the difficulty in determining the exact extent of myotomy, a critical factor associated with the success and safety of the procedure, remains a limitation. Although the various endoscopic landmarks and ancillary techniques have been applied, none of these has been proven sufficient. As a solution for this limitation, the double-scope POEM technique with a second endoscope to assure the exact length of the submucosal tunnel has been applied since 2014. Before double-scope POEM was introduced, the second endoscope was applied only to confirm the accuracy of the procedure. In the present study, we performed double-scope POEM in the treatment of esophageal achalasia through a novel procedure of simultaneous application of the second endoscope to assist in the conventional POEM procedure.
PMID: 26975862 [PubMed - as supplied by publisher]
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Mortality trend and predictors of mortality in dysphagic stroke patients postpercutaneous endoscopic gastrostomy.
Chin Med J (Engl). 2015 May 20;128(10):1331-5
Authors: Jiang YL, Ruberu N, Liu XS, Xu YH, Zhang ST, Chan DK
Abstract
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) feeding is widely used in stroke patients suffering from persistent dysphagia; however, predicting the risks and benefits of PEG insertion in the individual patient is difficult. The aim of our study was to investigate if candidate risk factors could predict short-term mortality risk in poststroke patients who had PEG tube insertion for persistent dysphagia.
METHODS: This was a retrospective study of 3504 consecutive stroke patients admitted to two metropolitan hospitals during the period January 2005 to December 2013 and who also underwent PEG insertion for feeding due to persistent dysphagia.
RESULTS: A total of 102 patients were included in the study. There were 22 deaths in 6 months after insertion of PEG tubes and 20 deaths of those occurred within 3 months post PEG. Those who survived beyond 6 months showed significantly lower mean age (75.9 ± 9.0 years vs. 83.0 ± 4.9 years, P < 0.001), a lower mean American Society of Anesthesia (ASA) score (3.04 ± 0.63 vs. 3.64 ± 0.58, P < 0.001) compared to nonsurvivors. In multiple Logistic, age (P = 0.004, odds ratio [OR] = 1.144; 95% confidence interval [CI]: 1.044-1.255); ASA (P = 0.002, OR = 5.065; 95% CI: 1.815-14.133) and albumin level pre-PEG insertion (P = 0.033, OR = 0.869; 95% CI: 0.764-0.988) were the independent determinants of mortality respectively.
CONCLUSIONS: We propose that age, ASA score and albumin level pre-PEG insertion to be included as factors to assist in the selection of patients who are likely to survive more than 3 months post PEG insertion.
PMID: 25963353 [PubMed - indexed for MEDLINE]
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Gender typicality in children's speech: A comparison of boys with and without gender identity disorder.
J Acoust Soc Am. 2015 Apr;137(4):1995-2003
Authors: Munson B, Crocker L, Pierrehumbert JB, Owen-Anderson A, Zucker KJ
Abstract
This study examined whether boys with gender identity disorder (GID) produced less prototypically male speech than control boys without GID, a possibility that has been suggested by clinical observations. Two groups of listeners participated in tasks where they rated the gender typicality of single words (group 1) or sentences (group 2) produced by 15 5-13 year old boys with GID and 15 age-matched boys without GID. Detailed acoustic analyses of the stimuli were also conducted. Boys with GID were rated as less boy-like than boys without GID. In the experiment using sentence stimuli, these group differences were larger than in the experiment using single-word stimuli. Listeners' ratings were predicted by a variety of acoustic parameters, including ones that differ between the two groups and ones that are stereotypically associated with adult men's and women's speech. Future research should examine how these variants are acquired.
PMID: 25920850 [PubMed - indexed for MEDLINE]
[Perioperative Rehabilitation for Patients with Esophageal Cancer].
Kyobu Geka. 2016 Jan;69(1):53-8
Authors: Hirose C, Takeuchi H, Ishikawa A, Kawakubo H, Tsuji T, Kitagawa Y
Abstract
Transthoracic esophagectomy for patients with esophageal cancer is one of the most invasive of all gastrointestinal surgery. Postoperative management and surgical techniques are improved. However, many patients are more elderly or suffering from comorbid diseases or in malnutrition status. In order to prevent for postoperative complications after esophagectomy, especially for respiratory complication and swallowing dysfunction, adequate rehabilitation approaches are necessary depending on the various conditions.
PMID: 26975644 [PubMed - in process]
Sarcopenia and Hearing Loss in Older Koreans: Findings from the Korea National Health and Nutrition Examination Survey (KNHANES) 2010.
PLoS One. 2016;11(3):e0150281
Authors: Lee J, Han K, Song JJ, Im GJ, Chae SW
Abstract
Age-related hearing impairment (ARHI) is becoming a more significant issue as geriatric population increases. Sarcopenia in older people is known to have a diverse health problem in various circumstances in recent studies. We assessed whether the decrease in muscle mass is related to ARHI. We used the 2010 data of the Korea National Health and Nutrition Examination Survey (KNHANES) to examine the associations between sarcopenia and ARHI. A total number of participants was 1,622 including 746 males and 876 females aged 60 years or older. Muscle mass was assessed as an appendicular skeletal muscle mass, and hearing loss was defined as the pure-tone averages (PTA) of test frequencies 0.5, 1, 2, 4 kHz at a threshold of 40 dB or higher in worse hearing side of the ear. Among 1,622 participants, 298 men and 256 women had hearing loss. Appendicular muscle mass (ASM), expressed as kg, was categorized in tertiles. In female population, after adjusting for age, smoking, drinking, amount of exercise, total body fat, education level, income level, and tinnitus, the odds ratio (OR) for hearing loss was 1.57 (95% confidence interval (CI) = 0.92-2.68) in the middle tertile and 1.79 (1.03-3.08) in the lowest tertile, compared with the highest tertile. P for trend in this model was 0.036. Controlling further for hypertension, diabetes mellitus, chronic kidney disease, and three types of noise exposure did not change the association. Larger muscle mass is associated with lower prevalence of hearing loss in elderly Korean females.
PMID: 26978776 [PubMed - as supplied by publisher]
Sensorineural Tinnitus: Its Pathology and Probable Therapies.
Int J Otolaryngol. 2016;2016:2830157
Authors: Møller AR
Abstract
Tinnitus is not a single disease but a group of different diseases with different pathologies and therefore different treatments. Regarding tinnitus as a single disease is hampering progress in understanding of the pathophysiology of tinnitus and perhaps, more importantly, it is a serious obstacle in development of effective treatments for tinnitus. Subjective tinnitus is a phantom sound that takes many different forms and has similarities with chronic neuropathic pain. The pathology may be in the cochlea, in the auditory nerve, or, most commonly, in the brain. Like chronic neuropathic pain tinnitus is not life threatening but influences many normal functions such as sleep and the ability to concentrate on work. Some forms of chronic tinnitus have two components, a (phantom) sound and a component that may best be described as suffering or distress. The pathology of these two components may be different and the treatment that is most effective may be different for these two components. The most common form of treatment of tinnitus is pharmacological agents and behavioral treatment combined with sound therapy. Less common treatments are hypnosis and acupuncture. Various forms of neuromodulation are becoming in use in an attempt to reverse maladaptive plastic changes in the brain.
PMID: 26977153 [PubMed]
Managing the female patient with hereditary angioedema.
Womens Health (Lond Engl). 2016 Mar 15;
Authors: Banerji A, Riedl M
Abstract
Hereditary angioedema (HAE) is a rare disorder resulting from decreased functional levels of C1-inhibitor (C1-INH), which manifests as periodic episodes of localized edema which can be extremely painful, debilitating and even fatal if the swelling affects the larynx. HAE can complicate many aspects of obstetric/gynecologic care, and an awareness of the disease is critical for clinicians involved in the care of women because of potential HAE-related complications pertaining to pregnancy, labor and delivery, and other women's health issues. This article provides a review of published literature specific to HAE and its management in female patients, including important concerns regarding obstetric/gynecologic care. A growing body of relevant experience is presented to help guide the care of women with HAE.
PMID: 26978558 [PubMed - as supplied by publisher]
[The state of the larynx in the patients presenting with chronic obstructive pulmonary disease].
Vestn Otorinolaringol. 2016;81(1):29-32
Authors: Gilifanov EA, Nevzorova VA, Artyushkin SA, Ivanets IV
Abstract
The objective of the present study was to evaluate the clinical state of the larynx and its microbial population in 49 patients examined at the stage of stable condition of chronic obstructive pulmonary disease. Examination of the larynxwas carried out with the use of a rigid laryngoscope having a visual angle of 70 degrees, videofibrolaryngoscopy, and stroboscopy using a «TelePac» videocomplex (Karl Storz, Germany). It was supplemented by the study of the bacteriological and mycological paysage. The acoustic analysis of the voice was performed with the help of the Specta PLUS computer program. It was shown that more than 70% of the examined patients presented with various forms of chronic laryngitis. Potentially pathogenic St. pyogenesand yeast-like fungi C. albicans were isolated from 59% and 29% of the patients respectively.
PMID: 26977564 [PubMed - as supplied by publisher]
Outcomes review of modern hearing preservation technique in cochlear implant.
Auris Nasus Larynx. 2016 Mar 11;
Authors: Nguyen S, Cloutier F, Philippon D, Côté M, Bussières R, Backous DD
Abstract
INTRODUCTION: Preservation of residual hearing in cochlear implantation is a main concern for patients and otologists. New electrode arrays as well as development of minimally invasive technique have allowed the expansion of indication criteria for cochlear implantation. The loss of residual low-frequency hearing is thought to be the result of many factors. Opinions differ in regards with the electrodes array characteristics, the surgical implantation technique and the pharmacological therapy used.
OBJECTIVE: The aim of this research is to analyze the available information pertaining to hearing preservation with cochlear implantation.
RESULTS: Both cochleostomy and round window approaches are adequate, but should rely on the anatomic position of the round window membrane. No electrode design had a higher rate of hearing preservation, either a standard or shorter length was used, or a straight or contoured array. The speed of insertion has a significant impact on hearing preservation and vestibular function. A slow insertion should be used for all cochlear implant insertion, hearing preservation or not. However, the optimal speed of insertion is still unclear. Moreover, the use of steroids regardless of the route or the timing, along with intraoperative topical steroids, had a positive impact on hearing preservation.
CONCLUSION: Classic atraumatic insertion maneuvers, very slow and delicate insertion and the use of intraoperative corticosteroids improve hearing outcomes. Whichever the surgeon's preferences, all surgical modifications are aimed at the same goal: protection of the delicate intracochlear structures with preservation of residual low-frequency hearing to improve speech perception abilities.
PMID: 26976547 [PubMed - as supplied by publisher]
Vocal-fold vibration of patients with Reinke's edema observed using high-speed digital imaging.
Auris Nasus Larynx. 2016 Mar 11;
Authors: Watanabe T, Kaneko K, Sakaguchi K, Takahashi H
Abstract
OBJECTIVE: We aimed to assess the vocal-fold vibration of patients with moderate-to-severe Reinke's edema using high-speed digital imaging (HSDI) and videostroboscopy and to confirm HSDI usefulness in examining the vocal folds with Reinke's edema.
METHODS: We examined the vocal folds of seven patients (six severe and one moderate; six females and one male; aged 55-74 years; mean 64.7 years) with Reinke's edema using HSDI and videostroboscopy. The following characteristics were analyzed: glottic closure, mucosal-wave propagation, left-right asymmetry, phase shift, frequency difference, periodicity, and contact of the true vocal fold with the false vocal fold.
RESULTS: HSDI revealed complete glottic closure, anterior-posterior phase shift, and obvious contact of at least one side of the edematous true vocal fold with the ipsilateral false vocal fold in all patients. Mucosal-wave propagation increased in six patients and decreased in one. Left-right asymmetry was observed in six patients. Left-right phase shifts and left-right frequency differences were observed in four and two patients, respectively. The vibration was periodic in four patients, quasi-periodic in three, and aperiodic in none. Anterior-posterior frequency differences were not observed for any patient. The vocal-fold vibration always synchronized with strobolights in two patients, while the vibration occasionally and never synchronized in two and three patients, respectively. In one patient whose vibration occasionally synchronized, videostroboscopy could not reveal the slight left-right frequency difference of the vibration.
CONCLUSION: It was often difficult to observe vocal-fold vibration correctly in patients with severe Reinke's edema using videostroboscopy. However, HSDI was useful for examining these patients. Our results suggest that HSDI can be very useful for examining the vocal folds of patients with severe Reinke's edema.
PMID: 26976546 [PubMed - as supplied by publisher]
Metastases of Melanoma to Head and Neck Mucosa: A Report of Short Series.
Clin Exp Otorhinolaryngol. 2016 Mar;9(1):80-4
Authors: Santos RS, Andrade MF, Alves Fde A, Kowalski LP, Perez DE
Abstract
OBJECTIVES: Metastasis of melanoma to the head and neck mucosa is a very unusual condition. The aim of this study was to report four cases of patients with metastatic melanoma in the head and neck mucosa treated at a single institution.
METHODS: Clinical data were obtained from the medical records. All cases were histologically reviewed to confirm the diagnosis, and immunohistochemical reactions were performed in the cases submitted to biopsy.
RESULTS: All patients were males and the mean age was 40.5 years old. The sites of the metastatic tumors were gingival mucosa, floor of the mouth, oropharynx, and larynx. Two tumors appeared as submucosal nodules with normal color; one lesion was a blackish nodular lesion, and one was shown to be an ulcerated lesion. The size of tumors ranged from 2.0 to 4.0 cm. All patients had developed systemic disease at time of diagnosis of metastatic tumor in the head and neck mucosa. Survival rates ranged from 2 to 19 months after the diagnosis of the metastatic mucosal melanoma in the head and neck region.
CONCLUSION: Although rare, patients with melanoma must be closely and regularly followed up, with careful routine examination of head and neck, because metastatic tumors in this region seem to be part of a lethal widespread metastatic disease.
PMID: 26976032 [PubMed]
Granulomatosis With Polyangiitis in Otolaryngologist Practice: A Review of Current Knowledge.
Clin Exp Otorhinolaryngol. 2016 Mar;9(1):8-13
Authors: Wojciechowska J, Krajewski W, Krajewski P, Kręcicki T
Abstract
Granulomatosis with polyangiitis (GPA) is an idiopathic vasculitis of medium and small arteries, characterized by necrotizing granulomatous inflammation. GPA typically affects upper and lower respiratory tract with coexisting glomerulonephritis. This disease is generally characterized by antineutrophil cytoplasm antibodies (ANCA), nevertheless, there are rare cases with negative ANCA. GPA affects people at any age, with predominance of the sixth and seventh decade of life. In 80%-95% of the patients the first symptoms of GPA are otorhinolaryngological manifestations of head and neck including nose/sinuses, ears, eyes, larynx/trachea, oral cavity, and salivary glands. Diagnosis of GPA is based on Criteria of the American College of Rheumatology. In clinical practice diagnosis, the presence of distinctive ANCA antibodies and biopsy of affected organ are crucial. GPA must be differentiated from neoplastic, infectious or inflammatory ulcerative lesions of the head and neck. The standard treatment procedure is divided into two essential phases, induction and maintenance. The induction phase is based on combination of systemic corticosteroid and immunosuppressant therapy, whereas the maintenance phase comprises corticosteroids and azathioprine/methotrexate supplementation. Surgical treatment ought to be considered for patients who are not responding to pharmacotherapy.
PMID: 26976020 [PubMed]
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Speech Articulatory Characteristics of Individuals With Dentofacial Deformity.
J Craniofac Surg. 2015 Sep;26(6):1835-9
Authors: de Almeida Prado DG, Filho HN, Berretin-Felix G, Brasolotto AG
Abstract
PURPOSE: To analyze the speech articulatory characteristics of individuals with dentofacial deformities (DFD) and assess differences compared to individuals with dentofacial balance.
METHODS: Sixty individuals participated, being 30 presenting DFD (19 with class III and 11 class II skeletal malocclusion, 18 women and 12 men, age group 18-40 years) and 30 individuals from a control group matched for gender and age. The assessment of the diadochokinesis (DDK) was evaluated using the emissions /pa/, /ta/, /ka/, /pataka/, and /i/.
RESULTS: The individuals with DFD produced fewer emissions per second: at syllable "ka" and sequence "pataka" for the total of individuals; syllable "pa" and sequence "pataka" for women, individuals with class II and class III malocclusion. The parameters related to the irregularity of the cycles were higher for the group with DFD than for the control, as well as emission of the syllable "pa" for the total of individuals, group of class III malocclusion and women, during production of the syllables "ta" and "ka" for all individuals and group of class III and during emission of the vowel "ï" for women.
CONCLUSIONS: Differences regarding speed and stability of oral and laryngeal DDK were found among individuals with DFD compared with the control group.
PMID: 26355970 [PubMed - indexed for MEDLINE]
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Cytotoxic Effects of Intranasal Midazolam on Nasal Mucosal Tissue.
J Craniofac Surg. 2015 Sep;26(6):2008-12
Authors: Ozbay I, Kucur C, Değer A, Ital I, Kasim CM, Oghan F
Abstract
The aim of this experimental study was to investigate the cytotoxic effects of intranasal midazolam on nasal mucosal tissue in rats. Forty healthy rats were randomly divided into 5 groups. Group 1 (n = 8) was the control group, group 2 (n = 8) received intranasal saline, group 3 (n = 8) received intranasal midazolam, group 4 (n = 8) received intraperitoneal saline, and group 5 received intraperitoneal midazolam (n = 8). Midazolam and saline were administered via intraperitoneal and intranasal routes at doses of 200 μg/kg. Nasal septal mucosal stripe tissues were removed at the 6th hour. All materials were evaluated according to Ki67 and p53 staining to evaluate proliferation and apoptosis, respectively, and hemotoxylin and eosin staining was performed for histopathology evaluation. Ki67 values and inflammation in group 3 were statistically higher compared to group 1, group 2, and group 4. P53 values in group 3 were statistically higher compared to group 1. Assessment of subepithelial edema between group 3 and the other groups revealed no statistically significant differences. Assessment of cilia loss between group 3 and group 1, group 2, and group 4 revealed no statistically significant difference. The evaluation of goblet cell loss between group 3 and group 1 revealed a statistically significant difference. Intranasal midazolam had adverse effects on nasal mucosa. However, intranasal midazolam is as safe as systemic midazolam administration with respect to nasal mucosa.
PMID: 26221857 [PubMed - indexed for MEDLINE]
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Effects of Quercetin in a Mouse Model of Experimental Dry Eye.
Cornea. 2015 Sep;34(9):1130-6
Authors: Oh HN, Kim CE, Lee JH, Yang JW
Abstract
PURPOSE: To evaluate the effect of treatment with quercetin in a mouse model of dry eye.
METHODS: 0.5% quercetin eye drops were prepared and an experimental dry eye model was induced in NOD.B10.H2(b) mice through desiccation stress. The mice were divided into 3 groups according to the treatment regimen: the DS 10D group (desiccation stress for 10 days), the phosphate buffered saline (PBS) group, and the quercetin group. Tear volumes and corneal irregularity scores were measured at 3, 5, 7, and 10 days after treatment. Hematoxylin and eosin staining, periodic acid-Schiff staining, and immunohistochemistry were performed at the end of the experiment.
RESULTS: The quercetin group had increased tear volumes (0.2 ± 0.03 μm, P < 0.05) and decreased corneal irregularity scores (0.7 ± 0.6, P < 0.05) compared with those of the PBS group. On histological examination, the quercetin group exhibited restored smooth corneal surfaces without detaching corneal epithelial cells and had significantly increased goblet cell density (13.8 ± 0.8 cells/0.1 mm², P < 0.05) compared with the PBS group. The quercetin group also exhibited significant declines of MMP-2 (5.1-fold of control, P < 0.01), MMP-9 (2.5-fold of control, P < 0.01), ICAM-1 (2.2-fold of control, P < 0.01), and VCAM-1 (2.3-fold of control, P < 0.01) levels in the lacrimal gland than did the PBS group.
CONCLUSIONS: Topical application of quercetin can help to improve ocular surface disorders of dry eye not only by decreasing the corneal surface irregularity but also by increasing the tear volume and goblet cell density. Moreover, quercetin has the potential for use in eye drops as a treatment for dry eye disease with antiinflammatory effects on the lacrimal functional unit.
PMID: 26203745 [PubMed - indexed for MEDLINE]
Direct fascia lata reconstruction to reduce donor site morbidity in endoscopic endonasal extended surgery: a pilot study.
Clin Neurol Neurosurg. 2016 Mar 7;144:59-63
Authors: Vitali M, Canevari FR, Cattalani A, Grasso V, Somma T, Barbanera A
Abstract
OBJECTIVE: Fascia lata is a validated source of autologous grafts, adopted by many surgical figures throughout different types of reconstructive procedures. Postoperative pain and muscle prolapse are frequent complications after harvesting fascia lata; donor site morbidity causes delayed mobilization and increased lenght of hospital stay. In our department fascia lata is used as autologous graft in reconstruction of skull base after extended endoscopic transsphenoidal surgery (EETS) and the thigh defect is usually repaired with allograft to restore tissue continuity and avoid muscle prolapse. Our aim was to evaluate the post-operative pain and muscle prolapse in a group of patients who underwent EETS with fascia lata reconstruction with allograft.
METHODS: We retrospectively analyzed clinical data of 11 patients who underwent harvesting and reconstruction of fascia lata during EETS, collected in our department of Neurosurgery between January 2012 and September 2015. "Pain on rest" and "pain on walking" data were collected daily according to the Numerical Rating Scale (NRS) system, during hospital stay until sutures removal and 1 month after surgery. Furthermore, the degree of muscle prolapse was analyzed at the time of sutures removal and 1 month following surgery.
RESULTS: 11 patients were studied between January 2012 and September 2015: 4 men and 7 women (1:1.75). Mean age 53.6±11.1years. During the post-operative stay, "pain on rest" and "pain on walking" values of all patients did not exceed grade 4 of NRS. While removing sutures, "pain on rest" resulted grade 1 of NRS in 27.3% (3/11) patients, while "pain on walking" was grade 1 of NRS in 18.2% (2/11) and grade 2 in 9.1% (1/11). After a month of surgery "pain on rest" reduced to NRS grade 1 in 9.1% (1/11), while patients NRS results for "pain on walking" were the same as the previous evaluation. Mean duration of hospital stay was 5.7±2.28 days. 10 patients were discharged home, only 1 patient was transferred to a rehabilitation ward. No visible nor palpable muscle prolapse was found in our group of patients during the entire assessment.
CONCLUSION: Findings show how fascia lata reconstruction with allograft reduced post-operative discomfort and muscle prolapse in our serie; it also permitted their early mobilization and discharge. These are promising results. However further studies are needed to see this technique approved.
PMID: 26978684 [PubMed - as supplied by publisher]
[Apical petrositis, osteomyelitis of the base of the skull bones and of the first cervical vertebra in a 5 year-old children following chicken pox].
Vestn Otorinolaringol. 2016;81(1):61-63
Authors: Bogomil'sky MR, Polunin MM, Zelikovich EI, Soldatsky YL, Burova OV
Abstract
This publication was designed to describe a rare case of development of apicalpetrositis in a child presenting with acute otitis mediafollowing chicken pox experienced in the preceding period. We carried out the study with the use of computed tomography (CT) that demonstrated destruction of the temporal bone, bones of the base of the skull and of the first cervical vertebra. The treatment strategy chosen for the management of this condition that included antibiotic therapy and expectant observation proved justified and can be recommended as an algorithm of choice taking into consideration the difficulty of surgical approach to the apex of the petrous pyramid. However, this approach is associated with the high risk of disability arising from the potential injury to the craniocerebral nerves.
PMID: 26977573 [PubMed - as supplied by publisher]
Endoscopic Resection of Giant Ethmoid Osteomas with the Assistance of an Image-guidance System.
Anticancer Res. 2016 Mar;36(3):1325-30
Authors: Wang Y, Li D, Jiang A, Zhang H, Sun Y, Liu Z, Song X
Abstract
AIM: To investigate the minimally invasive ablation of giant osteoma of the ethmoid sinuses endonasally with the assistance of an image-guidance system.
PATIENTS AND METHODS: A retrospective analysis was carried out on 12 patients with osteomas of ethmoid sinuses treated by endoscopic surgery with the help of a navigation system from April 2005 to October 2013.
RESULTS: Osteomas in all 12 patients were giant and connected extensively with the anterior skull base, lamina papyracea, or orbital apex, and were removed successfully with the help of an endoscope and image navigation system under general anaesthesia. In two cases (one through superciliary arch incision and the other one through labiogingival incision), the procedure was combined with an external procedure to remove osteomas. All patients were followed-up for 8 to 64 months. No recurrences were found. All symptoms gradually vanished or reduced dramatically after surgery. One case of frontal mucocele was observed and was successfully removed 5 years after removal of the osteoma. Anosmia occurred in both patients who underwent crista galli resection, and no recovery was noted 9 and 26 months later. Cerebrospinal fluid rhinorrhea was found in one case during surgery and was repaired with mucosa of inferior nasal concha immediately, and primary healing was successful.
CONCLUSION: Endoscopic ablation of giant osteomas of the ethmoid sinuses with the guidance of a navigation system is an accurate, secure, minimally invasive procedure. A careful study of the preoperative computed tomographic scan is necessary for the success of the operation. If the lesion extensively affects the frontal sinus and maxillary sinus, a combination of superciliary arch incision and labiogingval groove incision is a simple, easy and elegant option.
PMID: 26977033 [PubMed - in process]
Outcomes review of modern hearing preservation technique in cochlear implant.
Auris Nasus Larynx. 2016 Mar 11;
Authors: Nguyen S, Cloutier F, Philippon D, Côté M, Bussières R, Backous DD
Abstract
INTRODUCTION: Preservation of residual hearing in cochlear implantation is a main concern for patients and otologists. New electrode arrays as well as development of minimally invasive technique have allowed the expansion of indication criteria for cochlear implantation. The loss of residual low-frequency hearing is thought to be the result of many factors. Opinions differ in regards with the electrodes array characteristics, the surgical implantation technique and the pharmacological therapy used.
OBJECTIVE: The aim of this research is to analyze the available information pertaining to hearing preservation with cochlear implantation.
RESULTS: Both cochleostomy and round window approaches are adequate, but should rely on the anatomic position of the round window membrane. No electrode design had a higher rate of hearing preservation, either a standard or shorter length was used, or a straight or contoured array. The speed of insertion has a significant impact on hearing preservation and vestibular function. A slow insertion should be used for all cochlear implant insertion, hearing preservation or not. However, the optimal speed of insertion is still unclear. Moreover, the use of steroids regardless of the route or the timing, along with intraoperative topical steroids, had a positive impact on hearing preservation.
CONCLUSION: Classic atraumatic insertion maneuvers, very slow and delicate insertion and the use of intraoperative corticosteroids improve hearing outcomes. Whichever the surgeon's preferences, all surgical modifications are aimed at the same goal: protection of the delicate intracochlear structures with preservation of residual low-frequency hearing to improve speech perception abilities.
PMID: 26976547 [PubMed - as supplied by publisher]
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A Geometric Classification of Jaw Deformities.
J Oral Maxillofac Surg. 2015 Dec;73(12 Suppl):S26-31
Authors: Gateno J, Alfi D, Xia JJ, Teichgraeber JF
PMID: 26608152 [PubMed - indexed for MEDLINE]
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Foreign Body Reaction After Cochlear Implantation: A Case Report.
Chin Med J (Engl). 2015 Aug 5;128(15):2124-5
Authors: Xin Y, Yuan YS, Chi FL, Wang J, Yang JM
PMID: 26228231 [PubMed - indexed for MEDLINE]
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Modification of Blair Approach With a Modified Endaural Component to Access the Parotid Region.
J Craniofac Surg. 2015 Sep;26(6):1972-4
Authors: Fernández Olarte H, Gómez-Delgado A, Rivera-Guzmán A
Abstract
OBJECTIVE: The aim of this study is to present our experience with a modification of the Blair approach to the parotid area, by means of a modified endaural component, which provides both excellent exposure and optimal functional and esthetic results, mainly over the preauricular area.
PATIENTS AND METHODS: A retrospective case series study was performed. It included surgical cases of patients who were operated on the parotid region in which the mentioned approach was indicated. The information was collected from the database available at the Universidad El Bosque Oral and Maxillofacial Surgery Department in Bogota, Colombia from 2008 to 2013.
RESULTS: The sample consisted of 12 patients, with ages ranging from 23 to 56 years and a mean age of 38 years. A total of 8 patients were women and 4 patients were men. Parotid pathologies included salivary gland tumor (10 patients) and cranial base tumor (2 patients). Procedures executed were: superficial lobe and total parotidectomy resection, pharynx extended and cranial base tumor resections.
CONCLUSIONS: This investigation presents our experience with a modified approach to the parotid region. This approach gives an extended and safe exposure to the region with excellent cosmetic outcomes.
PMID: 26192031 [PubMed - indexed for MEDLINE]
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Pterygoid Plate Fractures: Not Limited to Le Fort Fractures.
J Craniofac Surg. 2015 Sep;26(6):1823-5
Authors: Garg RK, Alsheik NH, Afifi AM, Gentry LR
Abstract
Pterygoid plate fractures are often described in the setting of Le Fort fractures. The goal of this study was to define other craniofacial fracture patterns causing injury to the pterygoid plates. A retrospective review of computed tomography (CT) scans obtained on craniofacial trauma patients over a 5-year period revealed 209 patients with pterygoid plate fractures. Pterygoid plate fractures in 78 patients (37.3%) were unrelated to Le Fort fractures. Common causes included sphenotemporal buttress fractures in 26 patients (33.3%), temporal bone fractures in 18 patients (23.1%), zygomaticomaxillary complex fractures in 17 patients (21.8%), and displaced mandible fractures in 14 patients (17.9%). These findings indicate that approximately one third of pterygoid plate fractures do not result from Le Fort pattern injuries and that the craniofacial surgeon should have a broad differential for causes of pterygoid plate fractures when reviewing trauma imaging.
PMID: 26147022 [PubMed - indexed for MEDLINE]
Future Meetings.
Thyroid. 2016 Mar;26(3):476-477
Authors:
PMID: 26978322 [PubMed - as supplied by publisher]
Diminished Quality of Life and Increased Brain Functional Connectivity in Patients with Hypothyroidism after Total Thyroidectomy.
Thyroid. 2016 Mar 15;
Authors: Shin YW, Choi YM, Kim HS, Kim DJ, Jo HJ, O'Donnell BF, Jang EK, Kim TY, Shong Y, Hong JP, Kim WB
Abstract
BACKGROUND: Acute hypothyroidism induced by thyroid hormone withdrawal (THW) in patients with thyroid cancer after total thyroidectomy can affect mood and quality of life (QoL). While loss or dysregulation of thyroid hormone (TH) has these well-known behavioral consequences, the effects of TH alterations on brain function are not well understood. Resting state functional connectivity (FC) measured by functional magnetic resonance imaging (fMRI) allows non-invasive evaluation of human brain function. We therefore examined whether THW affects resting state FC and whether changes in FC correlate with the mood or QoL of the patients with THW status.
METHODS: Twenty-one patients who had undergone total thyroidectomy for thyroid cancer were recruited. Resting state functional MRI scanning of brain, thyroid function tests, the 12-Item Short Form Health Survey (SF-12) and Patient Health Questionnaire-9 (PHQ-9) were performed before and after 2 weeks of THW. Regional homogeneity (ReHo), one of the measures of resting state FC, was calculated and each voxel was compared between before and after THW in 19 patients. The ReHo values were extracted from the regions of interest (ROIs) showing within-group differences in ReHo values after THW, and correlations of ReHo values with thyroid-stimulating hormone (TSH) levels, total score of PHQ-9, and composite scores of SF-12 were statistically evaluated.
RESULTS: Higher ReHo was observed after THW in the brain cortical regions across primary motor and sensory, visual, and association cortices. Among the regions, the ReHo values in the bilateral pre- and postcentral gyri, bilateral middle occipito-temporal cortices, the left precuneus, and the left lingual gyrus showed positive correlations with serum TSH levels after THW. Higher ReHo values in the bilateral pre- and postcentral gyri, the left middle temporo-occipital cortices, and the left ligual gyrus correlated with the lower mental component summary score from the SF-12, while higher ReHo values in the bilateral pre- and postcentral gyri correlated with higher total scores in PHQ-9.
CONCLUSIONS: Local brain FC is increased in the acute hypothyroid state. Higher FC correlates with a poorer mental QoL and increased depression in the hypothyroid state.
PMID: 26976233 [PubMed - as supplied by publisher]
[The specific clinical features of acute sensorineural loss of hearing associated with vertigo].
Vestn Otorinolaringol. 2016;81(1):8-12
Authors: Pal'chun VT, Guseva AL, Levina YV, Chistov SD
Abstract
The objective of the present study was to estimate the prevalence of vertigo and to determine the type of the lesion of the vestibular analyzer in the patients presenting with acute sensorineural loss of hearing (ASNLH). The secondary objective wasto evaluate the possibility of the restoration of the auditory thresholds. The results of the examination and treatment of 94 patients suffering from ASNLH are presented. It was shown that the development of acute sensorineural loss of hearingwas accompanied by unilateral peripheral vestibulopathy in 22.3% of the patients. In 5.3% of these cases, dizziness could be attributed to benign paroxysmal positional vertigo and canalolythiasis of the posterior semicircular canal on the side of hearing impairment. It is concluded that the presence of the clinical signs of lesions of the vestibular analyzer and peripheral vestibular dysfunction in the form of latent spontaneous nystagmus without gaze fixation and/or asymmetric nystagmus with unilateral weakness in the caloric test is a negative prognostic factor for the restoration of the auditory thresholds in the patients presenting with acute sensorineural loss of hearing.
PMID: 26977560 [PubMed - as supplied by publisher]
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Related Articles |
Silicone impression material foreign body in the middle ear: Two case reports and literature review.
Auris Nasus Larynx. 2015 Oct;42(5):419-23
Authors: Suzuki N, Okamura K, Yano T, Moteki H, Kitoh R, Takumi Y, Usami S
Abstract
We report two cases of impression material foreign body in the middle ear. The first case had been affected with chronic otitis media. The silicone flowed into the middle ear through a tympanic membrane perforation during the process of making an ear mold. About 4 years and 8 months after, the patient had severe vertigo and deafness. We found bone erosion of the prominence of the lateral semicircular canal and diagnosed labyrinthitis caused by silicone impression material. In the second case silicone flowed into the canal wall down mastoid cavity. Both cases required surgery to remove the foreign body. The clinical courses in such cases are variable and timing of surgery is sometimes difficult. In addition to reporting these two cases, we present here a review of the literature regarding impression material foreign bodies.
PMID: 25956272 [PubMed - indexed for MEDLINE]
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Endonasal Endoscopic Transsphenoidal Approach to Lesions of the Sellar Region in Pediatric Patients.
J Craniofac Surg. 2015 Sep;26(6):1818-22
Authors: Zhan R, Xin T, Li X, Li W, Li X
Abstract
OBJECTIVE: Endoscopic endonasal (transnasal) transsphenoidal approach (EETA) for management of sellar lesions has gained popularity as a reliable and atraumatic method. Most reported studies of EETA have focused on surgical outcome in adult patients; and there are few reports to describe outcome in pediatric patients. The authors report our early experience of 11 patients aged 14 to 18 years managed with EETA to evaluate the safety and effectiveness of EETA in the pediatric.
METHODS: Retrospective review of hospital records of 11 pediatric patients who underwent endonasal endoscopic transsphenoidal approach for resection of sellar region lesion over 2 years. Age, sex, symptoms, tumor size, extent of tumor resection, clinical outcome, and surgical complications were reviewed.
RESULTS: Total resection was achieved in 9 (81.8%) patients, subtotal resection in 2 (18.2%), and no patient had partial or insufficient resection. All (100%) patients achieved visual remission, 7 (87.5%) of 8 patients with hyperhormone preoperative had endocrinological remission. Two (18.2%) patients incurred temporary diabetes insipidus (DI) postoperatively. One (9.1%) patient incurred postoperative cerebrospinal fluid (CSF) leakage which resolved following lumbar drainage. Three (27.3%) patients developed hypopituitarism needed hormone replacement therapy. There were no cases of meningitis, intracranial hematoma, or death.
CONCLUSIONS: Endoscopic endonasal (transnasal) transsphenoidal approach (EETA) provides a safe and effective surgical option with low morbidity and mortality in pediatric patients.
PMID: 26352366 [PubMed - indexed for MEDLINE]
Visual afference mediates head and trunk stability in vestibular hypofunction.
J Clin Neurosci. 2016 Mar 11;
Authors: Wei SH, Chen PY, Chen HJ, Kao CL, Schubert MC
Abstract
Humans must maintain head and trunk stability while walking. The purpose of this study was to compare the kinematics of healthy controls and patients with vestibular hypofunction (VH) when walking and making head rotations of different frequencies in both light and dark conditions. We recruited eight individuals with VH and nine healthy control subjects to perform four tasks at their preferred gait speed, being normal walk, walking and making yaw head rotations at 1.5Hz and 2Hz, and walking in the dark and making yaw head rotations at 1.5Hz. Linear kinematics as well as head, trunk, and pelvis angular velocities were captured using the Vicon motion analysis system (Vicon Motion Systems, Oxford, UK). We found no difference in walking velocities for any of the four walking conditions across groups. The lateral displacement of the center of mass was increased in VH patients. In the dark, patients had more head instability in pitch (larger amplitudes and velocities) even though they were walking and making active yaw head rotations. Patients also had a smaller relative phase angle (mean 3.50±standard deviation 2.13°) than controls (mean 10.31±standard deviation 2.70°) (p<0.01). Our data suggest that patients with VH have difficulty walking with a straight trajectory when turning their head. Additionally, patients with VH have an abnormal excursion of spontaneous pitch head rotation while walking and making active yaw head turns, which is dependent on vision. Rehabilitation for these patients should consider applying unique head rotation frequencies when training gait with head turns as well as alternating their exposure to light.
PMID: 26976344 [PubMed - as supplied by publisher]
Aetiology and pathology of otitis media with effusion in adult life.
J Laryngol Otol. 2016 Mar 15;:1-7
Authors: Mills R, Hathorn I
Abstract
OBJECTIVES: To gather and analyse information concerning the aetiology and pathology of otitis media with effusion in adults.
METHOD: A review of the English language literature from 1970 to the present was conducted.
RESULTS: The available evidence suggests that otitis media with effusion in adult life is best viewed as a syndrome with a number of causes, including: infiltration of the eustachian tube by nasopharyngeal carcinoma and other local malignancies; changes in the middle ear and eustachian tube induced by radiotherapy; and systemic disease.
CONCLUSION: There is now a body of evidence specifically related to the aetiology and pathology of otitis media with effusion in adult life. However, further research is required to fill in the gaps in our knowledge and understanding of this condition.
PMID: 26976514 [PubMed - as supplied by publisher]
Outcomes of synchronous pulmonary nodules detected on computed tomography in head and neck cancer patients: 12-year retrospective review of a consecutive cohort.
J Laryngol Otol. 2016 Mar 15;:1-6
Authors: Zammit-Maempel I, Kurien R, Paleri V
Abstract
OBJECTIVE: To investigate the long-term outcomes of pulmonary nodules detected on chest computed tomography in a consecutive cohort of patients with newly diagnosed or recurrent head and neck squamous cell cancer staged between 2001 and 2003.
RESULTS: The study included 222 patients, 148 patients with newly diagnosed head and neck cancer (group 1) and 74 patients with recurrent cancer (group 2). Abnormalities were identified in 101 patients (45.4 per cent); these were predominantly benign in group 1 (61.7 per cent) as compared to predominantly malignant in group 2 (64.3 per cent) (Fisher's exact test; p = 0.0009). Only four patients (7.4 per cent) with an initially benign-looking pulmonary nodule went on to develop malignancy over time, conferring a negative predictive value of 93 per cent for the whole cohort.
CONCLUSION: Chest computed tomography abnormalities in patients with recurrent head and neck cancer are statistically more likely to be malignant. Very few patients with an initially benign-appearing nodule develop chest malignancy over time.
PMID: 26976351 [PubMed - as supplied by publisher]
Temporomandibular joint involvement as a positive clinical prognostic factor in necrotising external otitis.
J Laryngol Otol. 2016 Mar 15;:1-5
Authors: Yeheskeli E, Eta RA, Gavriel H, Kleid S, Eviatar E
Abstract
OBJECTIVE: Necrotising otitis externa is associated with high morbidity and mortality rates. This study investigated whether temporomandibular joint involvement had any prognostic effect on the course of necrotising otitis externa in patients who had undergone hyperbaric oxygen therapy after failed medical and sometimes surgical therapy.
METHODS: A retrospective case series was conducted of patients in whom antibiotic treatment and surgery had failed, who had been hospitalised for further treatment and hyperbaric oxygen therapy.
RESULTS: Twenty-three patients with necrotising otitis externa were identified. The temporomandibular joint was involved in four patients (17 per cent); these patients showed a constant gradual improvement in C-reactive protein and were eventually discharged free of disease, except one patient who was lost to follow up. Four patients (16 per cent) without temporomandibular joint involvement died within 90 days of discharge, while all patients with temporomandibular joint involvement were alive. Three patients (13 per cent) without temporomandibular joint involvement needed recurrent hospitalisation including further hyperbaric oxygen therapy; no patients with temporomandibular joint involvement required such treatment.
CONCLUSION: Patients with temporomandibular joint involvement had lower rates of recurrent disease and no mortality. Therefore, we suggest considering temporomandibular joint involvement as a positive prognostic factor in necrotising otitis externa management.
PMID: 26976229 [PubMed - as supplied by publisher]
Hypothyroidism in patients treated with radiotherapy for head and neck carcinoma: standardised long-term follow-up study.
J Laryngol Otol. 2016 Mar 15;:1-4
Authors: Alba JR, Basterra J, Ferrer JC, Santonja F, Zapater E
Abstract
OBJECTIVE: Hypothyroidism is a common complication when radiotherapy is part of the treatment for head and neck tumours. This study aimed to show the incidence of hypothyroidism and possible risk factors in these patients.
METHODS: Factors related to the population, tumour, treatment and occurrence of hypothyroidism were analysed in 241 patients diagnosed with head and neck carcinoma.
RESULTS: Approximately 53 per cent of patients were diagnosed with radiation-induced hypothyroidism. Its occurrence was related to: tumour location, laryngeal surgery type, neck dissection type, post-operative complications, cervical radiotherapy and radiotherapy unit type (linear particle accelerator or telecobalt therapy technology).
CONCLUSION: Control of thyroid function should be standardised for several years after treatment, particularly in patients with risk factors, such as those treated with telecobalt therapy, those with post-operative complications and for whom the thyroid parenchyma is included in the irradiated area (laryngeal or pharyngeal location and bilateral cervical radiation).
PMID: 26975210 [PubMed - as supplied by publisher]
The influence of frequency-dependent hearing loss to unaided APHAB scores.
Eur Arch Otorhinolaryngol. 2016 Mar 14;
Authors: Löhler J, Akcicek B, Wollenberg B, Kappe T, Schlattmann P, Schönweiler R
Abstract
Hearing loss can be measured by pure-tone and speech audiometry. The subjective hearing impairment can be assessed using questionnaires. The APHAB determines this for four typical hearing situations. It has not been researched previously whether a particular frequency-specific hearing loss leads to a particular unaided APHAB score in one of the subscales or not. Clarification could be helpful using the unaided APHAB as an instrument for primary diagnostics of hearing loss independently of whether hearing aids were subsequently fitted or not. A total of 4546 records from a database were analysed; the average age of the subjects was 69.3 years. Using a multivariant mixed linear model, a possible correlation was examined between a frequency-specific hearing loss (0.5-8.0 kHz) and particular unaided APHAB scores for its subscales. Furthermore, it was determined whether the subject's gender has a corresponding impact. There was no evidence of gender-specific dependence of the unaided APHAB scores. For the EC scale frequencies above 0.5 kHz, for the RV scale all frequencies and for the AV scale the frequencies at 1.0 and 2.0 kHz showed a significant correlation between hearing loss and the APHAB score. For each decibel of hearing loss there was an average rise in the APHAB score for the EC and RV scale of approximately 0.2 percentage points and an average decrease in the AV scale of 0.1 percentage points for each frequency. For the BN scale there was no evidence of this kind of correlation. The very varied possibility between individuals compensating for hearing loss in situations with background noises could be that there is no correlation between frequency-specific hearing loss and an associated unaided APHAB score. The described frequency-specific influence of hearing loss to the EC and RV score could be explained by fewer compensating possibilities for the patients in these specific hearing situations than for the BN scale described. Using the unaided APHAB form in primary diagnostics of hearing impairment is helpful for understanding individual problems.
PMID: 26975446 [PubMed - as supplied by publisher]
Prevalence and pattern of humoral immunodeficiency in chronic refractory sinusitis.
Eur Arch Otorhinolaryngol. 2016 Mar 14;
Authors: Odat H, Alqudah M
Abstract
The purpose of this study is to readdress the issue of primary humoral immunodeficiency frequency and pattern in medically resistant chronic rhinosinusitis (CRS) based on the new guidelines for CRS diagnosis and management. Two hundred and fifty-seven consecutive patients with refractory CRS were included in this study. The results of their IgA, IgM, IgG, and IgG subclasses were analyzed and compared with 75 age- and gender-matched control groups. The average age of CRS patients was 34 years (SD ± 13). In the refractory CRS group, there was no significant difference between patients with or without humoral immunodeficiency based on age, gender and status of allergy, polyps and revision. Low level of one of the major immunoglobulin isotypes was found in 15 patients (6 %). Six patients had low IgG, two had low IgA, and seven had low IgM. IgG subclasses were low in 37 patients (14 %), and IgG4 was the most common deficient subclass. Multiple immunoglobulins deficiencies were found in eight patients. Compared with the control group, CRS patients had a significant higher prevalence of major immunoglobulins as well as total major immunoglobulins and IgG subclasses deficiency. Because of high prevalence of subtle humoral immunodeficiency in medically resistant CRS and inability to find unique clinical and demographic characteristic of these patients, we recommend routine screening of major immunoglobulins and IgG subclasses on the group of CRS patients who failed medical treatment.
PMID: 26975445 [PubMed - as supplied by publisher]
