OtoRhinoLaryngology News: 04/14/16

Πέμπτη 14 Απριλίου 2016

Acetyl-DL-leucine improves gait variability in patients with cerebellar ataxia-a case series.

Acetyl-DL-leucine improves gait variability in patients with cerebellar ataxia-a case series.

Cerebellum Ataxias. 2016;3:8

Authors: Schniepp R, Strupp M, Wuehr M, Jahn K, Dieterich M, Brandt T, Feil K

Abstract
Acetyl-DL-leucine is a modified amino acid that was observed to improve ataxic symptoms in patients with sporadic and hereditary forms of ataxia. Here, we investigated the effect of the treatment with Acetyl-DL-leucine on the walking stability of patients with cerebellar ataxia (10x SAOA, 2x MSA-C, 2x ADA, 1x CACNA-1A mutation, 2x SCA 2, 1x SCA 1). Treatment with Acetyl-DL-leucine (500 mg; 3-3-4) significantly improved the coefficient of variation of stride time in 14 out of 18 patients. Moreover, subjective ambulatory scores (FES-I and ABC) and the SARA scores were also improved under treatment. Further prospective studies are necessary to support these class III observational findings.

PMID: 27073690 [PubMed]

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The effect of intratympanic gentamicin for treatment of Ménière's disease on lower frequency hearing.

The effect of intratympanic gentamicin for treatment of Ménière's disease on lower frequency hearing.

Int J Clin Pharm. 2016 Apr 12;

Authors: Sam G, Chung DW, van der Hoeven R, Verweij S, Becker M

Abstract
Background The intratympanic application of the ototoxic aminoglycoside gentamicin has shown promising results as an ablative treatment for vertigo associated with Ménière's disease. Objective To evaluate the efficacy and safety of intratympanic gentamicin and to specifically analyse the effect of this treatment on high and low hearing frequencies in patients with unilateral definite Ménière's disease. Method Subjects were treated with intratympanic gentamicin and were evaluated on vertigo, tinnitus, mean pure tone audiometry threshold and speech discrimination score. Subjects were followed for evaluation for up to 2 years after treatment. Results The number of vertigo spells per month decreased and subjects experienced less tinnitus. During follow up there was an increase of hearing loss in the low (0.25-, 0.5-, 1-kHz) frequency range (13.3 dB; p = 0.03). There was no significant increase of hearing loss in the high (2-, 4-, 8-kHz) frequency range. A clinically significant change in speech discrimination score was found in 50 % of the subjects. Conclusion Our results indicate that intratympanic gentamicin especially affects the mean pure tone audiometry threshold in the low frequency range, which may have clinical implications. Though many of our results are (statistically) substantial the study was limited by the small cohort size.

PMID: 27073077 [PubMed - as supplied by publisher]

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[Rehabilitation of facial palsy and vertigo in patients with vestibular schwannoma].

[Rehabilitation of facial palsy and vertigo in patients with vestibular schwannoma].

HNO. 2016 Apr 12;

Authors: Müller B, Volk GF, Guntinas-Lichius O

Abstract
BACKGROUND: Facial palsy and vertigo, as symptoms of vestibular schwannoma (VS) or consequences of its therapy, have a significant impact on patients' quality of life.
OBJECTIVE: This review analyzed current literature on the topic and deduced recommendations for rehabilitation of facial palsy and vertigo.
METHODS: The present review describes a PubMed-based search of the literature of the past 10 years.
RESULTS: There is no evidence-based drug therapy for the treatment of acute facial palsy after VS surgery. Several surgical procedures for facial nerve reconstruction, muscle transfer, and static techniques have been established. Physiotherapeutic movement therapy, optimally with biofeedback, seems to improve facial function in patients with post-paralytic syndrome. Botulinum toxin injections are the method of choice for synkinesis treatment. For treatment of acute and chronic vertigo in patients with VS, the same antivertiginous drugs as for other vertigo patients are used. If the patient shows retained vestibular stimulation function, preoperative intratympanic gentamycin therapy followed by compensation training is a promising approach to decreasing postoperative vertigo. Good vestibular rehabilitation comprises intensive and regular movement training, preferably with real-time feedback and therapy control.
CONCLUSION: There are several conservative, surgical, or combined conservative-surgical treatment options for individualized facial nerve rehabilitation of VS patients, as confirmed by clinical studies. In cases of acute vertigo, standard antivertiginous pharmacotherapy is indicated. In cases of acute and also of chronic vertigo, intensive balance and movement training relieves complaints.

PMID: 27072637 [PubMed - as supplied by publisher]

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Refractory episodic vertigo: role of intratympanic gentamicin and vestibular evoked myogenic potentials.

Refractory episodic vertigo: role of intratympanic gentamicin and vestibular evoked myogenic potentials.

Braz J Otorhinolaryngol. 2016 Mar 28;

Authors: Celis-Aguilar E, Hinojosa-González R, Vales-Hidalgo O, Coutinho-Toledo H

Abstract
INTRODUCTION: Even today, the treatment of intractable vertigo remains a challenge. Vestibular ablation with intratympanic gentamicin stands as a good alternative in the management of refractory vertigo patients.
OBJECTIVE: To control intractable vertigo through complete saccular and horizontal canal vestibular ablation with intratympanic gentamicin treatment.
METHODS: Patients with refractory episodic vertigo were included. The inclusion criteria were: unilateral ear disease, moderate to profound sensorineural hearing loss, and failure to other treatments. Included patients underwent 0.5-0.8mL of gentamicin intratympanic application at a 30mg/mL concentration. Vestibular ablation was confirmed by the absence of response on cervical vestibular evoked myogenic potentials and no response on caloric tests. Audiometry, electronystagmography with iced water, and vestibular evoked myogenic potentials were performed in all patients.
RESULTS: Ten patients were included; nine patients with Meniere's disease and one patient with (late onset) delayed hydrops. Nine patients showed an absent response on vestibular evoked myogenic potentials and no response on caloric tests. The only patient with low amplitude on cervical vestibular evoked myogenic potentials had vertigo recurrence. Vertigo control was achieved in 90% of the patients. One patient developed hearing loss >30dB.
CONCLUSIONS: Cervical vestibular evoked myogenic potentials confirmed vestibular ablation in patients treated with intratympanic gentamicin. High-grade vertigo control was due to complete saccular and horizontal canal ablation (no response to iced water in electronystagmography and no response on cervical vestibular evoked myogenic potentials).

PMID: 27068887 [PubMed - as supplied by publisher]

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Developing and piloting a multifactorial intervention to address participation and quality of life in nursing home residents with joint contractures (JointConImprove): study protocol.

Developing and piloting a multifactorial intervention to address participation and quality of life in nursing home residents with joint contractures (JointConImprove): study protocol.

Ger Med Sci. 2015;13:Doc13

Authors: Müller M, Bartoszek G, Beutner K, Klingshirn H, Saal S, Stephan AJ, Strobl R, Grill E, Meyer G

Abstract
BACKGROUND: Joint contractures are common problems in frail older people in nursing homes. Irrespective of the exact extent of older individuals in geriatric care settings living with joint contractures, they appear to be a relevant problem. Also, the new emphasis on the syndrome of joint contractures, e. g. by the German statutory long term care insurance, led to an increase in assessment and documentation efforts and preventive interventions in clinical care. However, more attention should be paid to the actual situation of older individuals in nursing homes with prevalent joint contractures, particularly their experience of related activity limitations and participation restrictions. Thus, the aim of this study is 1) to develop a tailored intervention to improve functioning, and especially participation and quality of life in older residents with joint contractures in nursing homes and 2) to test the feasibility of the intervention accompanied by a rigorous process evaluation.
METHODS: The complex intervention, which will be developed in this project follows the UK Medical Research Council (MRC) framework and integrates the perspectives of all potentially relevant user groups, from the affected individuals to clinicians and researchers. The development process will comprise a systematic literature review, reanalysis of existing data and the integration of the knowledge of the affected individuals and experts. The developed intervention including a comprehensive process evaluation will be pilot tested with residents with joint contractures in three nursing homes.
DISCUSSION: The projected study will provide a tailored intervention to improve functioning, participation and quality of life in older residents with joint contractures in nursing homes. With this focus, the intervention will support patient relevant outcomes. The pilot study including process evaluation will offer a first opportunity to indicate the size of the intervention's effect and prepare further studies.

PMID: 26195926 [PubMed - indexed for MEDLINE]

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Cochlear implant outcomes in patients with superior canal dehiscence.

Cochlear implant outcomes in patients with superior canal dehiscence.

Cochlear Implants Int. 2015 Jul;16(4):213-21

Authors: Puram SV, Roberts DS, Niesten ME, Dilger AE, Lee DJ

Abstract
OBJECTIVE: To determine whether adult cochlear implant (CI) users with superior canal dehiscence syndrome (SCDS) or asymptomatic superior semicircular canal dehiscence (SCD) have different surgical, vestibular, and audiologic outcomes when compared to CI users with normal temporal bone anatomy.
METHODS: A retrospective single institution review of CI users with either superior semicircular canal dehiscence syndrome or asymptomatic superior semicircular canal dehiscence identified eight post-lingually deafened adults with unilateral or bilateral cochlear implantation between 2006 and 2010. Preoperative and postoperative speech perception scores as well as medical and epidemiological data were recorded and analyzed.
RESULTS: One patient with superior canal dehiscence syndrome and seven patients with asymptomatic superior semicircular canal dehiscence were identified, representing 7% or 8/113 of CI patients that fulfilled selection criteria. Average dehiscence length was 3.3 mm ± 0.79 SEM. Three patients received bilateral implants and five patients received a unilateral implant. Among asymptomatic superior semicircular canal dehiscence patients, subjective rates of post-operative dizziness were similar to those seen in patients with normal temporal bone anatomy (12.5 % vs. 15.9%, respectively). Speech perception abilities after surgery were poorer in SCD patients compared to the non-SCD cohort (Consonant Nucleus Consonant 33.7 ± 7.78 SEM vs. 56.7 ± 2.15 SEM P = 0.011), although both groups improved substantially relative to pre-operative performance. We also completed detailed analyses of auditory and vestibular outcomes in one patient with SCDS who underwent CI surgery in the symptomatic ear, which demonstrated preservation of vestibular function post-operatively, improved quality-of-life measures, and reduced dizziness symptomatology.
CONCLUSIONS: Our data suggest that patients with asymptomatic superior canal dehiscence at the time of CI surgery have similar albeit decreased speech perception scores compared to non-SCD adult CI users. Subjective rate of dizziness or vertigo following CI surgery was similar in both asymptomatic SCD and non-SCD cohorts, with detailed analyses of a single symptomatic SCD patient revealing improved vestibular function and reduced SCD symptoms following CI.

PMID: 24074366 [PubMed - indexed for MEDLINE]

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Tongguan Liqiao acupuncture therapy improves dysphagia after brainstem stroke.

Tongguan Liqiao acupuncture therapy improves dysphagia after brainstem stroke.

Neural Regen Res. 2016 Feb;11(2):285-91

Authors: Zhang CH, Bian JL, Meng ZH, Meng LN, Ren XS, Wang ZL, Guo XY, Shi XM

Abstract
Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in patients with brainstem infarction. Sixty-four patients with dysphagia following brainstem infarction were recruited and divided into a medulla oblongata infarction group (n = 22), a midbrain and pons infarction group (n = 16), and a multiple cerebral infarction group (n = 26) according to their magnetic resonance imaging results. All patients received Tongguan Liqiao acupuncture for 28 days. The main acupoints were Neiguan (PC6), Renzhong (DU26), Sanyinjiao (SP6), Fengchi (GB20), Wangu (GB12), and Yifeng (SJ17). Furthermore, the posterior pharyngeal wall was pricked. Before and after treatment, patient swallowing functions were evaluated with the Kubota Water Test, Fujishima Ichiro Rating Scale, and the Standard Swallowing Assessment. The Barthel Index was also used to evaluate their quality of life. Results showed that after 28 days of treatment, scores on the Kubota Water Test and Standard Swallowing Assessment had decreased, but scores on the Fujishima Ichiro Rating Scale and Barthel Index had increased in each group. The total efficacy rate was 92.2% after treatment, and was most obvious in patients with medulla oblongata infarction (95.9%). These findings suggest that Tongguan Liqiao acupuncture therapy can repair the connection of upper motor neurons to the medulla oblongata motor nucleus, promote the recovery of brainstem infarction, and improve patient's swallowing ability and quality of life.

PMID: 27073382 [PubMed]

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Voice analysis before and after vocal rehabilitation in patients following open surgery on vocal cords.

Voice analysis before and after vocal rehabilitation in patients following open surgery on vocal cords.

Vojnosanit Pregl. 2016 Feb;73(2):165-8

Authors: Bunijevac M, Petrović-Lazić M, Jovanović-Simić N, Vuković M

Abstract
BACKGROUND/AIM: The major role of larynx in speech, respiration and swallowing makes carcinomas of this region and their treatment very influential for patients' life quality. The aim of this study was to assess the importance of voice therapy in patients after open surgery on vocal cords.
METHODS: This study included 21 male patients and the control group of 19 subjects. The vowel (A) was recorded and analyzed for each examinee. All the patients were recorded twice: firstly, when they contacted the clinic and secondly, after a three-month vocal therapy, which was held twiceper week on an outpatient basis. The voice analysis was carried out in the Ear, Nose and Throat (ENT) Clinic, Clinical Hospital Center "Zvezdara" in Belgrade.
RESULTS: The values of the acoustic parameters in the patients submitted to open surgery on the vocal cords before vocal rehabilitation and the control group subjects were significantly different in all specified parameters. These results suggest that the voice of the patients was damaged before vocal rehabilitation. The results of the acoustic parameters of the vowel (A) before and after vocal rehabilitation of the patients with open surgery on vocal cords were statistically significantly different. Among the parameters--Jitter (%), Shimmer (%)--the observed difference was highly statistically significant (p < 0.01). The voice turbulence index and the noise/harmonic ratio were also notably improved, and the observed difference was statistically significant (p < 0.05). The analysis of the tremor intensity index showed no significant improvement and the observed difference was not statistically significant (p > 0.05 ). CONCLUSION. There was a significant improvement of the acoustic parameters of the vowel (A) in the study subjects three months following vocal therapy. Only one out of five representative parameters showed no significant improvement.

PMID: 27071284 [PubMed - in process]

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Ebi, a Drosophila homologue of TBL1, regulates the balance between cellular defense responses and neuronal survival.

Ebi, a Drosophila homologue of TBL1, regulates the balance between cellular defense responses and neuronal survival.

Am J Neurodegener Dis. 2016;5(1):62-8

Authors: Lim YM, Tsuda L

Abstract
Transducin β-like 1 (TBL1), a transcriptional co-repressor complex, is a causative factor for late-onset hearing impairments. Transcriptional co-repressor complexes play pivotal roles in gene expression by making a complex with divergent transcription factors. However, it remained to be clarified how co-repressor complex regulates cellular survival. We herein demonstrated that ebi, a Drosophila homologue of TBL1, suppressed photoreceptor cell degeneration in the presence of excessive innate immune signaling. We also showed that the balance between NF-κB and AP-1 is a key component of cellular survival under stress conditions. Given that Ebi plays an important role in innate immune responses by regulating NF-κB activity and inhibition of apoptosis induced by associating with AP-1, it may be involved in the regulation of photoreceptor cell survival by modulating cross-talk between NF-κB and AP-1.

PMID: 27073743 [PubMed]

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Clinical outcome and patient satisfaction using biodegradable (NasoPore) and non-biodegradable packing, a double-blind, prospective, randomized study.

Clinical outcome and patient satisfaction using biodegradable (NasoPore) and non-biodegradable packing, a double-blind, prospective, randomized study.

Braz J Otorhinolaryngol. 2016 Mar 28;

Authors: Burduk PK, Wierzchowska M, Grześkowiak B, Kaźmierczak W, Wawrzyniak K

Abstract
INTRODUCTION: Nasal packing after endoscopic sinus surgery is used as a standard procedure. The optimum solution to minimize or eliminate all disadvantages of this procedure may be accomplished using biodegradable packs.
OBJECTIVE: The aim of this study was to compare patient satisfaction and clinical outcome associated with absorbable and non-absorbable packing after FESS.
METHODS: In total, 50 patients were included in a prospective, double-blind, randomized trial. One side was packed with polyurethane foam, while the opposite side was packed with gauze packing. On the 2nd, 10th, and 30th postoperative day, the patients were questioned with the aid of a visual analog scale. The standardized questionnaires for bleeding, nasal breathing, feeling of pressure, and headache were used. The presence of synechiae, infection, or granulation was noted and recorded with the video-endoscopy.
RESULTS: A significant difference according to lower pressure was found in the NasoPore group compared to the controls on day ten after surgery. The NasoPore packing had lower scores with respect to postoperative nose blockage on the 2nd and 10th days. Mucosal healing was better for the NasoPore group, both at day ten and 30 compared with the control group.
CONCLUSION: The overall patient comfort is higher when using NasoPore compared to non-resorbable traditional impregnated gauze packing. Intensive saline douches applied three to four times per day are mandatory after the operation to prevent synechiae formation and fluid resorption by the packing.

PMID: 27068885 [PubMed - as supplied by publisher]

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Expression of estrogen and progesterone receptors in angioleiomyoma of the nasal cavity of six patients.

Expression of estrogen and progesterone receptors in angioleiomyoma of the nasal cavity of six patients.

Oncol Lett. 2016 Apr;11(4):2359-2364

Authors: Zhu G, Xiao D, Sun P

Abstract
Angioleiomyoma of the nasal cavity is extremely rare. There are only a small number of studies in the literature that demonstrate that the estrogen receptor (ER) and progesterone receptor (PR) are expressed in angioleiomyoma, and the results from these studies are inconsistent. The present study identified 6 patients with nasal angioleiomyoma that were treated between 2004 and 2013. All patients underwent endoscopic surgery and were followed-up for 1-10 years. Resected tumors were investigated for the presence of ER and PR using immunoperoxidase staining. Of the 6 patients, 4 were men and 2 were woman. The mean age of the patients was 60.5 years. The tumors of the 6 patients were identified in the nasal septum, middle turbinate, inferior turbinate, lateral wall of the nasal cavity and nasal vestibule. The clinical manifestations reported by the patients consisted of a painless mass, recurrent epistaxis and nasal obstruction. There were no specific features observed in any of the patients using computed tomography or magnetic resonance imaging. All the patients underwent tumor dissection visualized with a nasal endoscope and recovered without recurrence or malignancy of the tumor post-surgery. Hematoxylin and eosin and immunoperoxidase staining confirmed the diagnosis of angioleiomyoma in all patients. In 5 patients the nuclei of the smooth muscle tumor cells markedly expressed ER and PR. To the best of our knowledge, the present study is the first to demonstrate that ER and PR are clearly expressed in nasal angioleiomyoma. The present study suggests that the sex hormones are possibly associated with the growth of angioleiomyoma.

PMID: 27073480 [PubMed - as supplied by publisher]

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Papillary Thyroid Cancer in a Child with Progressive Transformation of Germinal Centers.

Papillary Thyroid Cancer in a Child with Progressive Transformation of Germinal Centers.

Case Rep Otolaryngol. 2016;2016:6469073

Authors: Mohan S, DeNardo B, Stachurski D, Greene Welch J, Groblewski JC

Abstract
Objectives. To describe the presentation and management of a child with Progressive Transformation of Germinal Centers (PTGC), an uncommon condition characterized by significant persistent lymphadenopathy, who developed papillary thyroid carcinoma and to explore and review potential links between PTGC and neoplastic processes in the head and neck. Methods. Case presentation and literature review are used. Results. A 10-year-old female presented with a right parotid mass and cervical lymphadenopathy. Multiple biopsies revealed PTGC without malignancy. Two years later, she developed fatigue and weight gain, and a thyroid nodule was found. Fine needle aspiration was strongly suggestive of papillary thyroid carcinoma. The patient underwent total thyroidectomy and central neck dissection without surgical management of the longstanding right lateral neck lymphadenopathy. Final pathology confirmed papillary thyroid carcinoma. She was treated with radioactive iodine therapy postoperatively and remains free of disease at three years of follow-up. Conclusions. PTGC is considered a benign condition but has previously been associated with Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL). This is the first reported case of papillary thyroid cancer in a child with preexisting cervical PTGC and no defined risk factors for thyroid malignancy. No link has been established with thyroid carcinoma, but patients with PTGC may have a defect in immune surveillance that predisposes them to malignancy.

PMID: 27069706 [PubMed]

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Computer-assisted navigation: its role in intraoperatively accurate mandibular reconstruction.

Computer-assisted navigation: its role in intraoperatively accurate mandibular reconstruction.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Feb 13;

Authors: Wu J, Sun J, Shen SG, Xu B, Li J, Zhang S

Abstract
OBJECTIVE: This article presents our experiences of computer-assisted navigation in mandibular reconstruction and evaluates its effectiveness.
STUDY DESIGN: Eight patients who underwent navigation-guided mandibular reconstruction with a fibula free flap were reviewed. Under intraoperative navigation, the ideal positions of the mandibular angles and condyles were confirmed by the navigation probe. The surgical results were evaluated through postoperative panoramic radiographs, coronal computed tomography scans, and image fusion.
RESULTS: Navigation-guided mandibular reconstructions were successfully completed on the basis of preoperative planning and simulation. The surgical discrepancy in the mandibular angle between the actual surgical results and the preoperative designs was 1.92 ± 0.97 mm. Panoramic radiographs and coronal computed tomography scans illustrated that all the condyles fitted into their glenoid fossae. All patients were satisfied with their functional and aesthetic outcomes.
CONCLUSIONS: Computer-assisted navigation is a viable technology for improving surgical outcomes in mandibular reconstruction, which can assist the surgeons by providing real-time three-dimensional surgical references during the operation.

PMID: 27068681 [PubMed - as supplied by publisher]

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The use of immunohistochemistry in detection of perineural invasion in mucoepidermoid carcinoma.

The use of immunohistochemistry in detection of perineural invasion in mucoepidermoid carcinoma.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Feb 13;

Authors: Lanzel E, Robinson RA, Zimmerman MB, Pourian A, Hellstein JW

Abstract
OBJECTIVES: To retrospectively study the prevalence of perineural invasion (PNI) in cases of mucoepidermoid carcinoma (MEC). The study evaluated if previously assessed PNI would be increased by re-review of the original hematoxylin and eosin-stained (H&E) slides and also review of slides reacted immunohistochemically with S100 to enhance nerve visualization and whether this is associated with clinical outcome.
STUDY DESIGN: Thirty-one cases were reviewed for PNI with H&E-stained slides as well as S-100-reacted slides. These results were compared with the original pathology report's PNI status when available (13 of 31). Subject demographic characteristics and clinical outcome were collected from electronic medical records.
RESULTS: PNI was identified in 23% (3 of 13) of tumors in the original reports, 13% (4 of 31) of the authors' re-review of the slides, and 29% (9 of 31) by immunohistochemical assessment for S100. PNI and larger-diameter nerve involvement were significantly associated with death at 5-year follow-up.
CONCLUSIONS: Immunohistochemical assessment for S100 improves the accuracy of PNI determination. PNI is a significant factor in the survival outcome of cases of MEC.

PMID: 27068680 [PubMed - as supplied by publisher]

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Establishing a targeted plan for prophylactic dental extractions in patients with laryngeal cancer receiving adjuvant radiotherapy.

Establishing a targeted plan for prophylactic dental extractions in patients with laryngeal cancer receiving adjuvant radiotherapy.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Feb 13;

Authors: Hentz C, Diaz AZ, Borrowdale RW, Emami B, Kase M, Choi M

Abstract
OBJECTIVE: The purpose of this study was to determine dose delivered to individual mandibular tooth-bearing regions during adjuvant intensity-modulated radiotherapy for laryngeal cancers.
STUDY DESIGN: Twenty patients with laryngeal cancer treated with intensity-modulated radiotherapy were included. Individual mandibular tooth-borne areas were manually contoured. Average doses were calculated for individual teeth.
RESULTS: Doses to individual teeth increased with more posterior location. Highest dose was observed for third molar (M3) (43.1 Gy; P < .001). Doses to molars and premolars correlated with T- and N-stage (P = .007; P < .001, respectively). For ipsilateral nodal disease, there was no difference between the doses to ipsilateral teeth and contralateral teeth. Only in N2 c tumors, dose was above our threshold for extraction for M3 only (51.5 Gy).
CONCLUSIONS: T- and N-stage drive dose to individual mandibular tooth-borne areas. With the exception of the posterior molars, particularly in node-positive patients, radiation exposure falls below the threshold reported for pre-RT tooth extractions (50 Gy). We concluded that a more conservative approach to prophylactic tooth extraction with a greater emphasis on dental management may be warranted for the prevention of osteoradionecrosis in patients with laryngeal cancer receiving adjuvant RT.

PMID: 27068679 [PubMed - as supplied by publisher]

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Microvascular stent anastomosis using N-fibroin stents: feasibility, ischemia time, and complications.

Microvascular stent anastomosis using N-fibroin stents: feasibility, ischemia time, and complications.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):e97-e103

Authors: Smeets R, Vorwig O, Wöltje M, Gaudin R, Luebke AM, Beck-Broichsitter B, Rheinnecker M, Heiland M, Grupp K, Gröbe A, Hanken H

Abstract
OBJECTIVE: To evaluate a novel microvascular anastomosis technique using N-fibroin stents.
STUDY DESIGN: Cylinder stents of 1 mm diameter and 5 mm length were fabricated using N-fibroin from silkworms. In 22 rats, aortas were dissected, and the stent was inserted into the two ends of the aorta and fixed using methylmethacrylate.
RESULTS: Stent anastomosis was successful in 21 (96%) rats. The mean ischemia time was 7.4 minutes, significantly shorter than the 15.9 minutes in the control group with conventional sutures (P < .0001). After 4 months, anastomosis was functionally patent in all cases. However, elastic fibers remained interrupted in all stent anastomosis cases, and marked host rejection was evident at the stent anastomosis sites. Around the stents, thrombi were frequent (52%).
CONCLUSIONS: Our study demonstrated the basic feasibility of stent anastomosis using N-fibroin stents and reduced ischemia time. However, thrombus formation, frequent and severe abdominal infections, and heavy host rejection remain critical issues.

PMID: 27068318 [PubMed - in process]

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Comparison of the performance of intraoral X-ray sensors using objective image quality assessment.

Comparison of the performance of intraoral X-ray sensors using objective image quality assessment.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):e129-37

Authors: Hellén-Halme K, Johansson C, Nilsson M

Abstract
OBJECTIVES: The main aim of this study was to evaluate the performance of 10 individual sensors of the same make, using objective measures of key image quality parameters. A further aim was to compare 8 brands of sensors.
STUDY DESIGN: Ten new sensors of 8 different models from 6 manufacturers (i.e., 80 sensors) were included in the study. All sensors were exposed in a standardized way using an X-ray tube voltage of 60 kVp and different exposure times. Sensor response, noise, low-contrast resolution, spatial resolution and uniformity were measured.
RESULTS: Individual differences between sensors of the same brand were surprisingly large in some cases. There were clear differences in the characteristics of the different brands of sensors. The largest variations were found for individual sensor response for some of the brands studied. Also, noise level and low contrast resolution showed large variations between brands.
CONCLUSIONS: Sensors, even of the same brand, vary significantly in their quality. It is thus valuable to establish action levels for the acceptance of newly delivered sensors and to use objective image quality control for commissioning purposes and periodic checks to ensure high performance of individual digital sensors.

PMID: 27068317 [PubMed - in process]

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Gnathodiaphyseal dysplasia: report of a family with a novel mutation of the ANO5 gene.

Gnathodiaphyseal dysplasia: report of a family with a novel mutation of the ANO5 gene.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):e123-8

Authors: Duong HA, Le KT, Soulema AL, Yueh RH, Scheuner MT, Holick MF, Christensen R, Tajima TL, Leung AM, Mallya SM

Abstract
Gnathodiaphyseal dysplasia (GDD) is a rare autosomal dominant disorder characterized by florid osseous dysplasia of the jaws, bone fragility, and diaphyseal cortical thickening and bowing of long bones. We present a family with previously undiagnosed GDD. The disorder was identified by the characteristic gnathic and skeletal manifestations in the father. Clinical and radiologic examination of the patient's son also revealed the characteristic features of GDD. Gene sequencing revealed a novel mutation (c. 1067 G>A, p. Cys356 Tyr) in the ANO5 gene, which is causative for GDD. This mutation was predicted to be detrimental by computational analyses and by structural modeling of the protein. The implications for recognition and management of this disease are discussed.

PMID: 27068316 [PubMed - in process]

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WhatsApp: a telemedicine platform for facilitating remote oral medicine consultation and improving clinical examinations-a commentary.

WhatsApp: a telemedicine platform for facilitating remote oral medicine consultation and improving clinical examinations-a commentary.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):573

Authors: Pentapati KC, Smriti K, Gadicherla S

PMID: 27068315 [PubMed - in process]

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Morphometric features of the mandibular condyle and association with disk abnormalities.

Morphometric features of the mandibular condyle and association with disk abnormalities.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):566-72

Authors: Torres MG, Crusoé-Rebello IM, Rosário M, Albuquerque MC, Campos PS

Abstract
OBJECTIVE: The aim of this study was to evaluate the relationship between the morphometric characteristics of the condyle and temporomandibular joint (TMJ) disk displacement.
STUDY DESIGN: One hundred and nine individuals who underwent magnetic resonance imaging of the TMJ were evaluated. Linear (D1: condyle width; D2: condyle thickness) and angular (A1: horizontal condylar angle; A2: anterior condylar angle; A3: medial condylar angle) measurements were made. These measurements were associated with articular disk displacement, with and without reduction.
RESULTS: There was statistically significant association between limited D1 and D2 and between A1 above and A1 below the mean and displacement of the joint disk. There was statistically significant association between A2 and anterior displacement of the disk. Furthermore, thicker condyles and/or condyles with smaller horizontal angles and/or with smaller medial angles were associated with articular disk reduction.
CONCLUSIONS: The morphometric characteristics of the bony components of the TMJ are related to articular disk displacement and with its reduction or nonreduction.

PMID: 27068314 [PubMed - in process]

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Objective and subjective image evaluation of maxillary alveolar bone based on cone beam computed tomography exposure parameters.

Objective and subjective image evaluation of maxillary alveolar bone based on cone beam computed tomography exposure parameters.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):557-65

Authors: de Moura PM, Hallac RR, Seaward JR, Kane AA, Aguiar M, Raggio R, Gutfilen B

Abstract
OBJECTIVES: The purpose of this study was to optimize the exposure parameters for cone beam computed tomography (CBCT) for performing diagnostic imaging of maxillary alveolar bone.
STUDY DESIGN: CBCT (Promax 3 D Max) was performed on a frozen human cadaver head. Image homogeneity and the degree of alveolar bone contrast were determined by objective assessment using ImageJ software and subjective assessment by orthodontists and oral radiologists. Kruskal-Wallis tests and interrater agreement were used to compare results across groups.
RESULTS: Image homogeneity and degree of alveolar bone contrast differed significantly among all exposure protocols (P < .001). Intraclass correlation values ranged from 0.681 to 0.779, with orthodontists having higher values compared with oral radiologists. Average of image quality scores between protocols were statistically significant (P < .001) and ranged from "fair" to "good."
CONCLUSIONS: There is great potential to reduce CBCT radiation doses for maxillary alveolar bone while maintaining adequate image quality for diagnosis.

PMID: 27068313 [PubMed - in process]

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Efficacy of a cone beam computed tomography metal artifact reduction algorithm for the detection of peri-implant fenestrations and dehiscences.

Efficacy of a cone beam computed tomography metal artifact reduction algorithm for the detection of peri-implant fenestrations and dehiscences.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):550-6

Authors: de-Azevedo-Vaz SL, Peyneau PD, Ramirez-Sotelo LR, Vasconcelos Kde F, Campos PS, Haiter-Neto F

Abstract
OBJECTIVE: To determine whether the use of a metal artifact reduction (MAR) algorithm improves the detection of peri-implant fenestrations and dehiscences on cone beam computed tomography scans.
STUDY DESIGN: One hundred titanium fixtures were implanted into bovine ribs after the creation of defects simulating fenestrations and dehiscences. Images were acquired using four different protocols, namely, A2 (MAR on, voxel 0.2 mm), A3 (MAR on, voxel 0.3 mm), B2 (MAR off, voxel 0.2 mm), and B3 (MAR off, voxel 0.3 mm). For all protocols, receiver operating characteristic (ROC) curves were determined. Values for the areas under the ROC curves (Az) were subjected to analysis of variance.
RESULTS: Az values were not statistically different among protocols regardless of the defect type (P > .05).
CONCLUSIONS: The MAR algorithm tested by us did not improve the diagnosis of peri-implant fenestrations and dehiscences with use of either the 0.2 mm or the 0.3 mm voxel sizes.

PMID: 27068312 [PubMed - in process]

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Diagnostic and prognostic utility of Mastermind-like 2 (MAML2) gene rearrangement detection by fluorescent in situ hybridization (FISH) in mucoepidermoid carcinoma of the salivary glands.

Diagnostic and prognostic utility of Mastermind-like 2 (MAML2) gene rearrangement detection by fluorescent in situ hybridization (FISH) in mucoepidermoid carcinoma of the salivary glands.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):530-41

Authors: Luk PP, Wykes J, Selinger CI, Ekmejian R, Tay J, Gao K, Eviston TJ, Lum T, O'Toole SA, Clark JR, Gupta R

Abstract
OBJECTIVE: Mucoepidermoid carcinoma (MEC) is the most common salivary gland malignancy, with a proportion harboring MAML2 rearrangement. This study evaluates the diagnostic and prognostic utility of MAML2 rearrangement in MEC.
STUDY DESIGN: Salivary gland malignancies at a single institution (1989-2014) were reviewed to identify MECs. Histopathologic evaluation, immunohistochemistry, and fluorescent in situ hybridization (FISH) were performed.
RESULTS: Forty-one cases of MEC were identified, with mean age of 47 years and mean tumor size of 21 mm. Seven locoregional recurrences and five MEC-related deaths were seen over a 22-year follow-up period. Thirty-eight cases were suitable for FISH, and 31 (82%) cases were positive for MAML2 rearrangement, including the oncocytic and clear cell variants of MEC. FISH was negative in the morphologic mimics of MEC. MAML2 rearrangement was significantly associated with longer survival.
CONCLUSIONS: MAML2 rearrangement is common and specific for MEC, which makes it a useful diagnostic tool. MAML2 rearrangement also predicts a favorable prognosis.

PMID: 27068311 [PubMed - in process]

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Possible alternative therapies for oral lichen planus cases refractory to steroid therapies.

Possible alternative therapies for oral lichen planus cases refractory to steroid therapies.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):496-509

Authors: Yang H, Wu Y, Ma H, Jiang L, Zeng X, Dan H, Zhou Y, Chen Q

Abstract
Oral lichen planus (OLP) is a chronic inflammatory disorder with a multifactorial etiopathogenesis. Immune dysregulation plays a critical role in the development and progression of this disease. Patients' lives may be affected by pain caused by atrophic-erosive lesions. Given the obscure etiology, treatment is usually symptomatic. Topical steroids remain the mainstay of management. However, their therapeutic benefits are not always evident. There are substantial data on the possible therapeutic strategies that are effective in OLP cases refractory to steroids. This review provides an overview of the current approaches for the management of steroid-refractory OLP. The miscellaneous treatment regimens include tacrolimus, pimecrolimus, thalidomide, low-level laser therapy, photodynamic therapy, and surgical excision. Some results obtained from these studies were promising. However, further studies, especially randomized controlled trials with strict inclusion and exclusion criteria and larger sample sizes, are required for the evaluation of the long-term safety and efficacy of these therapies.

PMID: 27068310 [PubMed - in process]

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Oral surgery in liver transplant candidates: a retrospective study on delayed bleeding and other complications.

Oral surgery in liver transplant candidates: a retrospective study on delayed bleeding and other complications.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):490-5

Authors: Helenius-Hietala J, Åberg F, Meurman JH, Nordin A, Isoniemi H

Abstract
OBJECTIVE: Untreated dental infections pose a threat for immunocompromised liver transplant (LT) recipients. Therefore, pretransplant dental evaluations are recommended. However, risk of bleeding should be considered among patients with end-stage liver disease, and prophylactic blood transfusions may be used to prevent bleeding. We performed a retrospective study of the incidence of and risk factors for oral surgery-related bleeding in candidates for LT and hypothesized that complications may occur despite preoperative and perioperative hemostatic actions.
STUDY DESIGN: One hundred thirty-four patients who had tooth extractions performed by oral and maxillofacial surgeons before LT were studied. The primary endpoint was bleeding between 24 hours and 2 weeks after extraction. Bleeding risk was analyzed by preoperative platelet (PLT) count and international normalized ratio (INR). Invasiveness of procedures, severity of liver disease, PLT, INR, prophylactic transfusions of PLT, fresh frozen plasma, and tranexamic acid (TA) were included in univariate and multivariate logistic regression analyses to further assess risk.
RESULTS: Twelve patients exhibited minor bleeding; four despite PLT >100 × 10(9)/L and INR <1.5. Increased bleeding associated with INR and prophylactic transfusions by univariate analysis; by multivariate analyses, prophylactic TA (odds ratio [OR] = 8.0; 95% confidence interval [CI] 1.7-37.0), and PLT (OR = 8.3; 95% CI 1.1-62.7) remained significant.
CONCLUSIONS: Most extractions were safe, but prophylactic transfusions did not ensure adequate hemostasis. Local hemostatic measures and close follow-up are warranted.

PMID: 27068309 [PubMed - in process]

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Risk factors of distant metastasis in patients with squamous cell carcinoma of the oral cavity.

Risk factors of distant metastasis in patients with squamous cell carcinoma of the oral cavity.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):474-80

Authors: Sakamoto Y, Matsushita Y, Yamada S, Yanamoto S, Shiraishi T, Asahina I, Umeda M

Abstract
OBJECTIVE: Although the locoregional control rate of oral cancer has improved recently, the number of patients developing distant metastasis (DM) has increased. The aim of this study is to investigate the clinicopathologic factors related to DM in patients with oral cancer undergoing surgery.
STUDY DESIGN: This was a retrospective study of 252 patients who underwent surgery for squamous cell carcinoma of the oral cavity. Various clinicopathologic factors were examined to determine their relationship to the development of DM.
RESULTS: DM occurred in 21 patients. Univariate analysis showed that perineural invasion, pathologically positive lymph nodes (pN+), neck metastasis level, extracapsular spread, local recurrence, neck recurrence, locoregional control, and postoperative radiotherapy were related to the occurrence of DM. According to multiple logistic analyses, pN+, involvement of neck levels 4 and 5, and local recurrence were independent risk factors for DM.
CONCLUSIONS: pN+, metastasis to the lower neck, and local recurrence were risk factors for DM in patients with oral cancer.

PMID: 27068308 [PubMed - in process]

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Infinite cornucopia: The future of education and training in oral and maxillofacial surgery.

Infinite cornucopia: The future of education and training in oral and maxillofacial surgery.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):447-9

Authors: Bell RB

PMID: 27068307 [PubMed - in process]

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Acute Hemorrhagic Apoplectic Pituitary Adenoma: Endoscopic Management, Surgical Outcomes, and Complications.

http:--pt.wkhealth.com-pt-pt-core-templa

Acute Hemorrhagic Apoplectic Pituitary Adenoma: Endoscopic Management, Surgical Outcomes, and Complications.

J Craniofac Surg. 2015 Sep;26(6):e510-5

Authors: Zhan R, Zhao Y, Wiebe TM, Li X

Abstract
OBJECTIVE: To assess safety and effectiveness of endoscopic transsphenoidal surgery (ETS) for acute hemorrhagic apoplectic pituitary adenoma.
METHODS: Eighty nine patients with hemorrhagic apoplectic pituitary tumor undergoing endoscopic transsphenoidal surgery were included into a retrospective chart of this study. Charts were reviewed for patient age, sex, presentation, lesion size, surgical procedure, extent of resection, clinical outcome, and surgical complications.
RESULTS: Seventy eight (87.7%) patients achieved total resection, 9 (10.1%) had subtotal resection, and 2 (2.2%) patients had partial resection; no patient experienced insufficient resection. After surgery, 65 (90.3%) of 72 patients who had visual acuity deterioration preoperatively normalized and improved significantly; the rate for remission of visual field was 87.7%. All other acute symptoms, such as severe headache, nausea, vomiting, alteration of mental status, and loss of consciousness, vanished postoperatively. Twenty eight (90.4%) of 31 patients with active secreting adenoma had hormonal remission based on endocrinological evaluation. Three (3.4%) patients incurred CSF leakage which was managed with lumbar drainage. Nine (10.1%) patients incurred transient DI postoperatively, and 2 (2.2%) of them developed permanent DI. Seven (7.9%) patients developed hypopituitarism which was treated with replacement therapy of hormone. One (1.1%) experienced craniotomy for intracranial hemorrhage and died from severe surgical complications postoperatively. There were no patients of meningitis or carotid artery injury.
CONCLUSION: Early detection and emergent endoscopic transsphenoidal surgery provided a safe and effective surgical option for hemorrhagic apoplectic pituitary tumor with a low morbidity and mortality.

PMID: 26335327 [PubMed - indexed for MEDLINE]

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Immediate effect of laryngeal manual therapy in dysphonic individuals.

Immediate effect of laryngeal manual therapy in dysphonic individuals.

Codas. 2016 Feb;28(1):59-65

Authors: Reimann AP, Siqueira LT, Rondon AV, Brasolotto AG, Silverio KC

Abstract
PURPOSES: To investigate the immediate effect of Laryngeal Manual Therapy (LMT) in musculoskeletal pain, in voice and sensations referred to individuals with behavioral dysphonia and individuals without it.
METHODS: 30 individuals ranging from 18 to 45 years old were selected and sorted into two groups: the dysphonic group (DG) - 15 individuals with functional or organofunctional dysphonia, and the control group (CG) - 15 individuals without vocal complaints and with non-impaired voices. The individuals answered a pain questionnaire and their voices were subsequently registered. The initial evaluation was repeated after the LMT. The LMT was applied for 20 minutes. After the LMT, the individuals were self-evaluated in terms of sensations in their voices, larynxes, articulations and respiration.
RESULTS: After the application of LMT, the DG reported significant improvement of pain in the following areas: temporal, larynx, posterior neck, wrists/hands/fingers, upper and lower back, hip/thigh, which did not occur in CG. The perceptual analysis of the vowel /a/ revealed no significant difference in any parameter in both groups after the LMT. The analysis of the speech showed that there was an increase of the roughness parameter after the application of LMT just in the DG. The DG individuals reported better sensations in the larynx and articulations after the submission to LMT, which did not occur in CG.
CONCLUSION: this study clarified that TML immediately reduces the intensity of corporal pain in dysphonic individuals, which did not occur in individuals without any vocal impairments. Although the perceptual analysis reveals an increase of the roughness in the quality of the voice, positive sensation in the larynx and articulation were reported by dysphonic individuals after the application of TML.

PMID: 27074191 [PubMed - as supplied by publisher]

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Signs and symptoms of temporomandibular disorders in women and men.

Signs and symptoms of temporomandibular disorders in women and men.

Codas. 2016 Feb;28(1):17-21

Authors: Ferreira CL, Silva MA, Felício CM

Abstract
INTRODUCTION: Women are more likely to present temporomandibular disorders (TMD); however, studies comparing genders in Brazilian samples are rare.
PURPOSE: To analyze the proportion of men and women, as well as the association between gender and age, problem duration, and TMD symptoms in patients admitted to an university clinic for treatment.
METHODS: Interview and assessment data of protocols from 1,000 patients diagnosed with TMD were collected and analyzed and then divided into two groups, male (n = 177) and female (n = 823). The exploratory analysis was based on contingency tables and χ2 test was carried out. Subsequently, the logistic regression model was used and the odds ratios (OR) concerning the evaluated comparisons were calculated.
RESULTS: Females were more prevalent in the sample, and mean ages and TMD duration were similar between the groups, with higher occurrence in young adults (19 to 40 years old). The OR values showed an association between the female gender and the signs/symptoms of pain in the temporomandibular joint, pain in the facial muscles, neck and shoulders, headache, fatigue in the muscles of mastication, otologic symptoms, and dysphonia. Women had two times higher chances of presenting these symptoms than men.
CONCLUSION: In the sample of Brazilian patients with TMD, the number of women who presented a higher prevalence of painful symptoms was greater, followed by otologic symptoms and complaints of dysphonia. The prevalence of joint noise was similar in both studied groups.

PMID: 27074184 [PubMed - as supplied by publisher]

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Dysphonia risk screening protocol.

Dysphonia risk screening protocol.

Clinics (Sao Paulo). 2016 Mar;71(3):114-127

Authors: Nemr K, Simões-Zenari M, Duarte JM, Lobrigate KE, Bagatini FA

Abstract
OBJECTIVE: To propose and test the applicability of a dysphonia risk screening protocol with score calculation in individuals with and without dysphonia.
METHOD: This descriptive cross-sectional study included 365 individuals (41 children, 142 adult women, 91 adult men and 91 seniors) divided into a dysphonic group and a non-dysphonic group. The protocol consisted of 18 questions and a score was calculated using a 10-cm visual analog scale. The measured value on the visual analog scale was added to the overall score, along with other partial scores. Speech samples allowed for analysis/assessment of the overall degree of vocal deviation and initial definition of the respective groups and after six months, the separation of the groups was confirmed using an acoustic analysis.
RESULTS: The mean total scores were different between the groups in all samples. Values ranged between 37.0 and 57.85 in the dysphonic group and between 12.95 and 19.28 in the non-dysphonic group, with overall means of 46.09 and 15.55, respectively. High sensitivity and specificity were demonstrated when discriminating between the groups with the following cut-off points: 22.50 (children), 29.25 (adult women), 22.75 (adult men), and 27.10 (seniors).
CONCLUSION: The protocol demonstrated high sensitivity and specificity in differentiating groups of individuals with and without dysphonia in different sample groups and is thus an effective instrument for use in voice clinics.

PMID: 27074171 [PubMed - as supplied by publisher]

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Solitary fibrous tumour of the supraglottic larynx.

Solitary fibrous tumour of the supraglottic larynx.

Acta Otorhinolaryngol Ital. 2015 Dec 29;

Authors: Grammatica G, Bolzoni Villaret A, Ravanelli M, Nicolai P

Abstract
Solitary fibrous tumour (SFT) is a rare, benign, mesenchymal neoplasm that usually arises in the pleura, but rarely involves other sites outside the serosal space (mediastinum, lung, liver, thyroid gland); larynx involvement is very rare with only sporadic cases reported in the literature. We report a case of SFT in a 41-year-old woman with supraglottic laryngeal invovlement; symptoms included dysphonia and mild odynophagia lasting 2 years, and fibre-optic laryngeal evaluation showed a sub-mucosal mass involving the left supraglottis and medial wall of the pyriform sinus. MRI represents the gold standard tool for differential diagnosis (with schwannoma, paraganglioma and haemangioma) and correct staging, while immunohistochemical and cytomorphologic analysis (bcl-2 and CD34 positivity in 90% of cases) is needed for definitive diagnosis. Surgery is the main treatment (endoscopic and open conservative technique), and its goal is a balance between safe oncological resection and good preservation of laryngeal functions; in this particular case an open laryngeal approach was scheduled due to the size of the tumour. Prognosis is good and in only a few cases (especially in pleural SFT) does the biological behaviour take a malignant course.

PMID: 27070539 [PubMed - as supplied by publisher]

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Auditory training program in subjects with tinnitus.

Auditory training program in subjects with tinnitus.

Codas. 2016 Feb;28(1):27-33

Authors: Tugumia D, Samelli AG, Matas CG, Magliaro FC, Rabelo CM

Abstract
Tinnitus may be defined as the conscious perception of sound or noise, without the presence of external acoustic stimulation. Given the damage caused by tinnitus and the lack of effective treatment, alternatives are necessary to rehabilitate subjects with tinnitus. There is an assumption that auditory training (AT) could lead to a plastic reorganization of this system, thus promoting an improvement of the symptom.
OBJECTIVE: To verify the effect of an AT program in subjects with tinnitus in the perception of this symptom.
METHODS: Twelve subjects with tinnitus were included in the study and divided into two groups: Study Group (SG) and Control Group (CG). All of them underwent audiometric and electrophysiological assessments; acuphenometry; Tinnitus Handicap Inventory and auditory processing assessment (GIN - Gaps in Noise, Frequency Pattern Test and Speech-in-Noise). Afterward, trainings began and the SG was submitted to the formal AT, and the CG to the visual training.
RESULTS: In the characterization of the groups, no statistically significant difference was found for the variables such as age, pitch, and loudness of tinnitus, or for hearing thresholds in conventional audiometry and high frequencies. Comparisons were performed between the groups, before and after the trainings, regarding electrophysiological, behavioral, and Tinnitus Handicap Inventory tests, and no statistically significant differences were found between them for any of the evaluations.
CONCLUSION: Findings showed no statistically significant differences between groups in the comparison between the moments pre- and post-trainings (auditory or visual), nor for the electrophysiological findings or behavioral assessment of the auditory processing and for the Tinnitus Handicap Inventory, although some specific differences in the individual analysis have occurred.

PMID: 27074186 [PubMed - as supplied by publisher]

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The effect of intratympanic gentamicin for treatment of Ménière's disease on lower frequency hearing.

The effect of intratympanic gentamicin for treatment of Ménière's disease on lower frequency hearing.

Int J Clin Pharm. 2016 Apr 12;

Authors: Sam G, Chung DW, van der Hoeven R, Verweij S, Becker M

PMID: 27073077 [PubMed - as supplied by publisher]

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Cochlear implantation in delayed sudden hearing loss after conservative vestibular schwannoma surgery.

Cochlear implantation in delayed sudden hearing loss after conservative vestibular schwannoma surgery.

Acta Otorhinolaryngol Ital. 2015 Dec 29;

Authors: Dagna F, Murri A, Albera R, Cuda D

Abstract
This is a case of successful cochlear implantation in a 50-year-old man who experienced sudden hearing loss and developed ipsilateral severe tinnitus at three years following conservative stage 1 vestibular schwannoma retrosigmoid surgery. After cochlear implantation, tinnitus improved from THI grade 4 to 2. Localisation skills improved. Hearing in noise (S/N + 7 dB) with target signal from the operated side improved from 38 to 100% of correct answers. A significant improvement of spatial and speech items of the "speech, spatial and qualities of sounds" questionnaire was also measured. In conclusion, cochlear implantation is a feasible and effective solution after conservative vestibular schwannoma surgery should delayed hearing loss occur.

PMID: 27070537 [PubMed - as supplied by publisher]

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Effects of long-term salicylate administration on synaptic ultrastructure and metabolic activity in the rat CNS.

Effects of long-term salicylate administration on synaptic ultrastructure and metabolic activity in the rat CNS.

Sci Rep. 2016;6:24428

Authors: Yi B, Hu S, Zuo C, Jiao F, Lv J, Chen D, Ma Y, Chen J, Mei L, Wang X, Huang Z, Wu H

Abstract
Tinnitus is associated with neural hyperactivity in the central nervous system (CNS). Salicylate is a well-known ototoxic drug, and we induced tinnitus in rats using a model of long-term salicylate administration. The gap pre-pulse inhibition of acoustic startle test was used to infer tinnitus perception, and only rats in the chronic salicylate-treatment (14 days) group showed evidence of experiencing tinnitus. After small animal positron emission tomography scans were performed, we found that the metabolic activity of the inferior colliculus (IC), the auditory cortex (AC), and the hippocampus (HP) were significantly higher in the chronic treatment group compared with saline group (treated for 14 days), which was further supported by ultrastructural changes at the synapses. The alterations all returned to baseline 14 days after the cessation of salicylate-treatment (wash-out group), indicating that these changes were reversible. These findings indicate that long-term salicylate administration induces tinnitus, enhanced neural activity and synaptic ultrastructural changes in the IC, AC, and HP of rats due to neuroplasticity. Thus, an increased metabolic rate and synaptic transmission in specific areas of the CNS may contribute to the development of tinnitus.

PMID: 27068004 [PubMed - in process]

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Change in tinnitus after acoustic neuroma removal using a translabyrinthine approach. A Prospective study.

Change in tinnitus after acoustic neuroma removal using a translabyrinthine approach. A Prospective study.

Acta Otorrinolaringol Esp. 2016 Apr 8;

Authors: Alvarez L, Ugarte A, Goiburu M, Urreta Barallobre I, Altuna X

Abstract
INTRODUCTION: Tinnitus is one of the primary symptoms of vestibular schwannoma (VS) and the effect of surgery is unpredictable.
MATERIALS AND METHODS: We conducted a prospective study of the patients who underwent a translabyrinthine approach for the treatment of their VS (2009-2013) at our Hospital. Patients answered the Tinnitus Handicap Inventory (THI) questionnaire pre- and postoperatively. The clinical charts provided data such as age, gender, tumour size, preoperative audiometry and postoperative facial function.
RESULTS: The study included 39 patients. Of these, 71.8% suffered from tinnitus: 50% grade I, 17.9% grade II, 10.7% grade III, 21.4% grade IV and 0% grade V. We found no statistical association between tinnitus and the different variables measured preoperatively. Postoperatively, 48.7% of the patients suffered from tinnitus: 31.6% grade I, 36.8% grade II, 10.5% grade III, 15.8% grade IV and 5.3% grade V. The difference between mean pre- and postoperative THI was statistically significant (P=.011); this difference was greater in younger patients. We have found a significant negative correlation (r=-0.335; P=.037) between preoperative audiometry and postoperative THI.
CONCLUSIONS: We did not find any significant association between tinnitus and age, gender, tumour size and postoperative facial function. Translabyrinthine surgical removal of VS in these patients led to better THI results, with the younger patients having better outcomes. The patients with poorest preoperative audition were the ones that had the best results in the postoperative THI questionnaire.

PMID: 27067182 [PubMed - as supplied by publisher]

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Temporoparietal fascia flap and total temporomandibular joint replacement for the management of patent foramen of Huschke.

Temporoparietal fascia flap and total temporomandibular joint replacement for the management of patent foramen of Huschke.

Int J Oral Maxillofac Surg. 2016 Apr 8;

Authors: Shapiro MC, Osborn T

Abstract
Spontaneous herniation of the condylar head into the external auditory canal (EAC) through the foramen of Huschke is extremely rare, with approximately 30 cases reported in the international literature. The typical presentation is a constellation of non-specific symptoms including otalgia, temporomandibular joint (TMJ) pain, malocclusion, otorrhea, tinnitus while chewing, and hearing loss. Clinical examination may reveal pain, granulation tissue in the EAC, or the exposed mandibular condyle with the mouth closed. With mouth opening, the tissue or exposed bone retracts anteriorly leaving an often normal-appearing EAC. Having the patient open and close the mouth while performing otoscopy will show the displacement of tissue, which is critical for diagnosis of the condition. Radiographic examination with a computed tomography scan typically reveals a discontinuous anterior wall of the EAC with visible soft tissue in the protruding in the EAC. A case of spontaneous TMJ herniation into the EAC in a 54-year-old male patient with a history of otalgia and malocclusion is reported here. Total joint replacement therapy for the treatment of this rare condition is reported, and its importance in providing a posterior mechanical stop to prevent joint relapse is discussed.

PMID: 27066740 [PubMed - as supplied by publisher]

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"Int J Speech Lang Pathol"[jour]; +31 new citations

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Αρχειοθήκη ιστολογίου

Πέμπτη 14 Απριλίου 2016