OtoRhinoLaryngology News: 05/12/16

Πέμπτη 12 Μαΐου 2016

Histological identification of nasopharyngeal mechanoreceptors.

Histological identification of nasopharyngeal mechanoreceptors.

Eur Arch Otorhinolaryngol. 2016 May 10;

Authors: Salburgo F, Garcia S, Lagier A, Estève D, Lavieille JP, Montava M

Abstract
The auditory tube plays a fundamental role in regulating middle ear pressure. A "system" sensitive to a pressure gradient between the middle ear and the ambient environment is necessary. The presence of mechanoreceptors in the middle ear and the tympanic membrane has been studied, but the presence of these receptors in the nasopharyngeal region remains unclear. The aim of this study is to confirm the presence of pressure sensitive corpuscles in the nasopharynx. An experimental study was conducted on five fresh and unembalded human cadavers. The pharyngeal ostium of the auditory tube and its periphery was removed in one piece by video-assisted endonasal endoscopy. Samples were fixed in formaldehyde solution, embedded in paraffin, and cut. Slides were analyzed by HES (Hematoxyline Eosine Safran) coloration, by S100 protein and neurofilament protein immunostaining. Encapsulated nerve endings were researched and identified by slides analysis. Eight samples were included in our study. On seven samples, Ruffini corpuscles were identified in the mucosa of the posterior area of the pharyngeal ostium, with a higher concentration in the pharyngeal recess and in the posterior nasopharyngeal wall. Our study identified nasopharyngeal mechanoreceptors that could detect the nasopharyngeal pressure and, by extension, the atmospheric pressure. These findings support the theory of the neuronal reflex arc of isobaric system of the middle ear, based on the existence of a "system" sensitive to a pressure gradient between the middle ear and the ambient environment. Understanding of this system has been helpful in the diagnosis and management of middle ear diseases.

PMID: 27164946 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1NrrxGQ
via IFTTT

Necrotizing sialometaplasia: Manifestation of a localized unclassified vasculitis.

Necrotizing sialometaplasia: Manifestation of a localized unclassified vasculitis.

Indian J Pathol Microbiol. 2016 Apr-Jun;59(2):232-234

Authors: Senapati S, Samal SC, Kumar R, Patra S

Abstract
Necrotizing sialometaplasia is a rare benign and self-limiting disease, which commonly affects the minor salivary glands. Typically, it involves the seromucinous glands located at palate, buccal mucosa, tongue, tonsil, nasal cavity, trachea, larynx, maxillary sinus, and retromolar trigone. We report two such cases of necrotizing sialometaplasia to create awareness among the pathologists and surgeons because of its close morphological and clinical resemblance to squamous cell carcinoma. We have also documented that, the ischemic necrosis of salivary gland is the result of a vasculitic process.

PMID: 27166051 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1XmFZSw
via IFTTT

Functional Outcomes after Salvage Transoral Laser Microsurgery for Laryngeal Squamous Cell Carcinoma.

Functional Outcomes after Salvage Transoral Laser Microsurgery for Laryngeal Squamous Cell Carcinoma.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: Fink DS, Sibley H, Kunduk M, Schexnaildre M, Sutton C, Kakade-Pawar A, McWhorter AJ

Abstract
OBJECTIVES: Transoral laser microsurgery (TLM) has been increasingly used in lieu of total laryngectomy to treat malignancy after definitive radiation. There are few data in the literature regarding functional outcomes. We retrospectively reviewed voice and swallowing outcomes in patients who underwent TLM for recurrent laryngeal carcinoma.
STUDY DESIGN: Case series with chart review.
SETTING: Tertiary care center.
SUBJECTS AND METHODS: Forty-two patients were identified with recurrent squamous cell carcinoma of the larynx after definitive radiation therapy from 2001 to 2013: 28 patients with glottic recurrence and 14 with supraglottic recurrence. Swallowing outcomes were evaluated by gastrostomy tube dependence, the MD Anderson Dysphagia Inventory, and the Functional Oral Intake Scale. Voice outcomes were evaluated by the Voice Handicap Index and observer-rated perceptual analysis.
RESULTS: No significant difference was noted between mean pre- and postoperative MD Anderson Dysphagia Inventory scores: 78.25 and 74.9, respectively (P = .118, t = 1.6955). Mean Functional Oral Intake Scale scores after TLM for supraglottic and glottic recurrences were 6.4 and 6.6, respectively. Of 42 patients, 17 (40.5%) required a gastrostomy tube either during radiation or in conjunction with the salvage procedure. Of 17 patients, 15 resumed sufficient oral diet for tube removal. Patients' mean Voice Handicap Index score did increase from 34.3 to 51.5 (P = .047), and their mean perceptual score did decrease from 60.0 to 45.3 (P = .005). However, at 1-year follow-up, there was no significant difference in perceptual score: 61.1 to 57.1 (P = .722).
CONCLUSIONS: TLM is a successful surgical option for recurrent laryngeal cancer with acceptable functional outcomes.

PMID: 27165684 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1XmFZC6
via IFTTT

Trends in Incidence of Common Cancers in Iran.

Trends in Incidence of Common Cancers in Iran.

Asian Pac J Cancer Prev. 2016;17 Spec No.:39-42

Authors: Enayatrad M, Mirzaei M, Salehiniya H, Karimirad MR, Vaziri S, Mansouri F, Moudi A

Abstract
Cancer is a major public health problem in Iran. The aim of this study was to evaluate trends in incidence of ten common cancers in Iran, based on the national cancer registry reports from 2004 to 2009. This epidemiological study was carried out based on existing age-standardized estimate cancer data from the national report on cancer registry/Ministry of Health in Iran. The obtained data were analyzed by test for linear trend and P ≥ 0.05 was taken as the significant level. Totals of 41,169 and 32,898 cases of cancer were registered in men and females, respectively, during these years. Overall age-standard incidence rates (ASRs) per 100,000 population according to primary site weres 125.6 and 113.4 in males and females, respectively. Between 2004 and 2009, the ten most common cancers (excluding skin cancer) were stomach (16.2), bladder (12.6), prostate (11), colon-rectum (10.14), hematopoeitic system (7.1), lung (6.1), esophagus (6.4), brain (3.2), lymph node (3.8) and larynx (3.4) in males; and in females were breast (27.4), colon-rectum (9.3), stomach (7.6), esophagus (6.4), hematopoeitic system (4.9), thyroid (3.9), ovary (3.6), corpus uteri (2.9), bladder (3.2) and lung (2.6). Moreover, results showed that skin cancer was estimated as the most common cancer in both sexes. The lowest and the highest incidence in females and males were reported respectively in 2004 and 2009. Over this period, the incidence of cancer in both sexes has been significantly increasing (p<0.01). Like other less developed and epidemiologically transitioning countries, the trend of age-standardized incidence rate of cancer in Iran is rising. Due to the increasing trends, the future burden of cancer in the Iran is going to be acute with the expected increases in aging populations. Determining and controlling potential risk factors of cancer should hopefully lead to decrease in its burden.

PMID: 27165205 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1TH2ls2
via IFTTT

Effect of Anterior Cervical Discectomy and Fusion on Patients with Atypical Symptoms Related to Cervical Spondylosis.

Effect of Anterior Cervical Discectomy and Fusion on Patients with Atypical Symptoms Related to Cervical Spondylosis.

J Neurol Surg A Cent Eur Neurosurg. 2016 May 11;

Authors: Muheremu A, Sun Y, Yan K, Yu J, Zheng S, Tian W

Abstract
Background A considerable number of patients with cervical spondylosis complain about one or multiple atypical symptoms such as vertigo, palpitations, headache, blurred vision, hypomnesia, and/or nausea. It remains unclear whether surgical intervention for cervical spondylosis can also effectively alleviate those symptoms. The current study was performed to see if anterior cervical diskectomy and fusion (ACDF) offers such an extra benefit for patients with cervical spondylosis. Objective To investigate if patients who received ACDF for the treatment of cervical spondylotic myelopathy and/or radiculopathy can also achieve alleviation of certain atypical symptoms associated with cervical spondylosis after the surgery in the long run. Methods Sixty-seven patients who underwent ACDF for the treatment of cervical spondylotic myelopathy and/or radiculopathy were involved in this study. All these patients also complained about various associated atypical symptoms. They were followed up for 26 to 145 months after the surgery. Severity and frequency scores of the atypical symptoms before the surgery and at last follow-up were compared by paired t tests. Results Most patients reported significantly alleviated symptoms at the last follow-up compared with before the surgery. The severity of vertigo, headache, nausea, and palpitations were significantly alleviated at the last follow-up (with p values of p < 0.001, p = 0.001, p = 0.022, p = 0.004, respectively). There were no significant changes in the severity of tinnitus (p = 0.182), blurred vision (p = 0.260), and hypomnesia (p = 0.821). Conclusion ACDF can significantly alleviate vertigo, headache, nausea, and palpitations in most patients with cervical spondylotic myelopathy and/or radiculopathy, but it is not effective in alleviating symptoms such as tinnitus, blurred vision, and hypomnesia. It can be considered for alleviating atypical symptoms when other treatment options prove ineffective.

PMID: 27168319 [PubMed - as supplied by publisher]

from Hearing and Balance via ola Kala on Inoreader http://ift.tt/1X3vgfg
via IFTTT

[Geriatrics - an interdisciplinary challenge].

[Geriatrics - an interdisciplinary challenge].

Nervenarzt. 2016 May 11;

Authors: Nau R, Djukic M, Wappler M

Abstract
The care of elderly patients will continue to challenge the healthcare system over the next decades. As a rule geriatric patients suffer from multimorbidities with complex disease patterns, and the ability to cope with everyday life is severely reduced. Treatment is provided by a multiprofessional geriatric team, and the primary goal is improvement of functional status, quality of life in the social environment and autonomy by employing a holistic approach. In Germany geriatric care is provided by physicians from various medical specialties (e.g. general practitioners, internists, neurologists and psychiatrists). In the training for the subspecialty clinical geriatrics, these specialties enjoy equal rights. Recent efforts to establish a qualification as physician for internal medicine and geriatrics have initiated a discussion to make the suitability for qualification as a geriatrician dependent on the medical specialty. Geriatric patients benefit from multidisciplinary cooperation. Neurologists possess great expertise in the treatment of patients with dementia, depression, delirium, consequences of degenerative spinal cord diseases and vertebral bone fractures, stroke, Parkinson's syndrome, epileptic seizures, vertigo and dizziness, neuropathies, lesions of peripheral nerves and in the multimodal therapy of pain. To function in a position of responsibility in a geriatric department, neurologists need skills in general internal medicine. These are acquired either on a geriatric ward or during specialization as a neurologist by full time secondment to large neurological or interdisciplinary intensive care units.

PMID: 27167886 [PubMed - as supplied by publisher]

from Hearing and Balance via ola Kala on Inoreader http://ift.tt/1X3zTpG
via IFTTT

Extension and Application of High-Speed Digital Imaging Analysis Via Spatiotemporal Correlation and Eigenmode Analysis of Vocal Fold Vibration Before and After Polyp Excision.

Extension and Application of High-Speed Digital Imaging Analysis Via Spatiotemporal Correlation and Eigenmode Analysis of Vocal Fold Vibration Before and After Polyp Excision.

Ann Otol Rhinol Laryngol. 2016 May 10;

Authors: Wang JS, Olszewski E, Devine EE, Hoffman MR, Zhang Y, Shao J, Jiang JJ

Abstract
OBJECTIVES/HYPOTHESIS: To evaluate the spatiotemporal correlation of vocal fold vibration using eigenmode analysis before and after polyp removal and explore the potential clinical relevance of spatiotemporal analysis of correlation length and entropy as quantitative voice parameters. We hypothesized that increased order in the vibrating signal after surgical intervention would decrease the eigenmode-based entropy and increase correlation length.
STUDY DESIGN: Prospective case series.
METHODS: Forty subjects (23 males, 17 females) with unilateral (n = 24) or bilateral (n = 16) polyps underwent polyp removal. High-speed videoendoscopy was performed preoperatively and 2 weeks postoperatively. Spatiotemporal analysis was performed to determine entropy, quantification of signal disorder, correlation length, size, and spatially ordered structure of vocal fold vibration in comparison to full spatial consistency. The signal analyzed consists of the vibratory pattern in space and time derived from the high-speed video glottal area contour.
RESULTS: Entropy decreased (Z = -3.871, P < .001) and correlation length increased (t = -8.913, P < .001) following polyp excision. The intraclass correlation coefficients (ICC) for correlation length and entropy were 0.84 and 0.93.
CONCLUSION: Correlation length and entropy are sensitive to mass lesions. These parameters could potentially be used to augment subjective visualization after polyp excision when evaluating procedural efficacy.

PMID: 27164969 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/24RghuX
via IFTTT

The Role of Electrode Placement in Bilateral Simultaneously Cochlear-Implanted Adult Patients.

The Role of Electrode Placement in Bilateral Simultaneously Cochlear-Implanted Adult Patients.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: De Seta D, Nguyen Y, Bonnard D, Ferrary E, Godey B, Bakhos D, Mondain M, Deguine O, Sterkers O, Bernardeschi D, Mosnier I

Abstract
OBJECTIVE: To evaluate the influence of the electrode placement on hearing performance in adult patients who were simultaneously and bilaterally cochlear implanted.
STUDY DESIGN: Case series with planned data collection.
SETTING: Tertiary referral university centers.
SUBJECTS AND METHODS: The postoperative computed tomography scan was studied for 19 patients who were simultaneously and bilaterally implanted with a long straight electrode array. The size of the cochlea was measured in consideration of the major cochlear diameter and cochlear height. The electrode-to-modiolus distance for the electrodes positioned at 180 and 360 degrees and the angular depth of insertion of the array were also measured. Speech perception was assessed at 1 and 5 years postimplantation with disyllabic word lists in quiet and in noise, with the speech coming from the front and a background noise (cocktail party) coming from 5 loudspeakers.
RESULTS: At 1 year postimplantation, the electrode-to-modiolus distance at 180 degrees was correlated with the speech perception scores in both quiet and noise. In patients with a full electrode insertion, no correlation was found between the angular depth of insertion and hearing performance. The speech perception scores in noise gradually declined as a function of the number of inserted and active electrodes. No relationship between electrode position and speech perception scores was found at 5 years postimplantation.
CONCLUSION: In adult patients who were simultaneously and bilaterally implanted, the use of a long straight array, the full electrode array insertion, and the proximity to the modiolus might be determining factors to obtain the best speech performance at 1 year, without influence on the speech perception scores after long-term use.

PMID: 27165685 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1ZIlajb
via IFTTT

Treatment outcome of ion beam therapy in eight patients with head and neck cancers.

Treatment outcome of ion beam therapy in eight patients with head and neck cancers.

Eur Arch Otorhinolaryngol. 2016 May 11;

Authors: Ohkubo JI, Hohchi N, Takeuchi S, Ikezaki S, Kise Y, Koizumi H, Suzuki H

Abstract
Ion beam therapy has enabled us to treat formerly untreatable malignant tumors. The aim of the present study was to investigate the long-term follow-up course of patients with head and neck cancers who received ion beam therapy. The subjects were 8 patients (3 men and 5 women aged 43-78 years) with head and neck cancers who visited our department from 2006 to 2015 and received ion beam therapy. Six patients received carbon ion beam therapy, and the other two patients received proton beam therapy. The medical records of the patients were retrospectively analyzed. The primary site was the nasal and paranasal sinuses in six cases, nasopharynx in one case, and external auditory canal in one case. The histological type was olfactory neuroblastoma, malignant melanoma, and adenoid cystic carcinoma in two cases each, and chondrosarcoma and squamous cell carcinoma in one case each. The exposure dose ranged from 64 to 70.4 GyE. The average follow-up period was 42.0 months. Early adverse events were generally mild, and complete therapeutic response was obtained in all cases. However, five patients developed severe late complications including craniospinal dissemination, osteoradionecrosis of the maxilla and skull base, brain necrosis, and loss of eyesight. Three patients died of distant metastasis, local recurrence and/or brain necrosis within 2 years, and four patients have been surviving with distant metastasis or severe late complications. Ion beam therapy exhibits outstanding antitumor effects, but the severe late complications of the therapy must also be recognized.

PMID: 27168403 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1TcoVLX
via IFTTT

Cochlear implantation in deaf patients with eosinophilic otitis media using subtotal petrosectomy and mastoid obliteration.

Cochlear implantation in deaf patients with eosinophilic otitis media using subtotal petrosectomy and mastoid obliteration.

Eur Arch Otorhinolaryngol. 2016 May 11;

Authors: Sugimoto H, Hatano M, Noda M, Hasegawa H, Yoshizaki T

Abstract
We investigated the usefulness and safety of our cochlear implantation method for two deaf patients with eosinophilic otitis media. The surgical approach was a subtotal petrosectomy to remove the theater of eosinophilic infiltration and to prevent leaching of foreign substances and entry of stimuli that are the cause of eosinophilic inflammations. The operative cavity was obliterated with abdominal fat. There were no complications or recurrent inflammation following surgery in the cases of both patients. It was confirmed by CT scan that the eustachian tube was closed and the operative cavity remained obliterated with abdominal fat. Following the procedure, the hearing threshold results of the two patients were 30 and 34 dB. Cochlear implantation procedures in this report for deaf patients resulting from eosinophilic otitis media may be effective and safe. Using steroids before surgery may be the better option. To further confirm the efficacy and safety of our surgical concept, we need to administer this treatment concept for a large number of cases in a future study.

PMID: 27168402 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/24Rbael
via IFTTT

Application of xenogenic acellular dermal matrix in reconstruction of oncological hypopharyngeal defects.

Application of xenogenic acellular dermal matrix in reconstruction of oncological hypopharyngeal defects.

Eur Arch Otorhinolaryngol. 2016 May 10;

Authors: Li P, Li S, Yang X, Tang Q, He X, Wang S

Abstract
Acellular dermal matrix (ADM) can be used as a new membrane substitute for repairing mucosal defects. The objective of this study is to explore the effectiveness of xenogenic acellular dermal matrix (xeno-ADM) in hypopharynx reconstruction. A total of 40 patients were treated with this surgical method to reconstruct hypopharynx in our department between February 2011 and October 2012. Patients were diagnosed had hypopharyngeal cancer located at lateral and/or postpharyngeal wall. The mucosal defect size after hypopharyngeal resection was 3 × 4 cm-6 × 7 cm, and was repaired by xeno-ADM. Patients were followed up for 11-36 months. 4 patients got infected, and two developed into pharyngeal fistula. Patients regained eating function 2-5 weeks after surgery. No membrane was removed; no severe stenosis of hypopharynx was observed. All patients were successfully decannulated. The overall 3-year survival rate is 67.5 %; the 3-year disease-free rate is 47.5 %. Reconstruction of hypopharynx by xeno-ADM is proved to be a simple, safe and effective method with fewer complications.

PMID: 27164947 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1OoZJxB
via IFTTT

Histological identification of nasopharyngeal mechanoreceptors.

Histological identification of nasopharyngeal mechanoreceptors.

Eur Arch Otorhinolaryngol. 2016 May 10;

Authors: Salburgo F, Garcia S, Lagier A, Estève D, Lavieille JP, Montava M

PMID: 27164946 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1NrrxGQ
via IFTTT

Vascular leiomyoma of the nasal cavity: case report and literature review.

Vascular leiomyoma of the nasal cavity: case report and literature review.

Eur Arch Otorhinolaryngol. 2016 May 10;

Authors: Mathieu T, Verbruggen A, Goovaerts G, Declau F

Abstract
We report a case of a 54-year-old man with an angioleiomyoma originating from the right nasal floor. Nasal vascular leiomyomas are extremely rare tumours. A review of the literature revealed a limited number of cases of vascular leiomyoma in the nasal cavity. Clinically, they are characterised by nasal obstruction, epistaxis or pain as the primary symptom. Up to our knowledge, this is the first case in which a 3D CT scan was performed preoperatively. 3D CT scan reconstructions can show the delineation of the tumour very accurately helping to establish the therapeutic plan for removal. The definite diagnosis can only be confirmed by histopathology. Histopathologically, a vascular leiomyoma demonstrates proliferation of smooth muscle cells intermingled with dilated venous vessels.

PMID: 27164945 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1OoZJxz
via IFTTT

Drug-induced sleep endoscopy in the obstructive sleep apnea: comparison between NOHL and VOTE classifications.

Drug-induced sleep endoscopy in the obstructive sleep apnea: comparison between NOHL and VOTE classifications.

Eur Arch Otorhinolaryngol. 2016 May 10;

Authors: da Cunha Viana A, Mendes DL, de Andrade Lemes LN, Thuler LC, Neves DD, de Araújo-Melo MH

Abstract
Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete collapse of the pharynx that result in a decrease in oxyhemoglobin saturation. Nasofibrolaryngoscopy under induced sleep is a promising alternative for identifying sites of upper airway obstruction in patients with OSA. This study aimed to compare the obstruction sites screened by drug-induced sleep endoscopy (DISE) using the Nose oropharynx hypopharynx and larynx (NOHL) and Velum oropharynx tongue base epiglottis (VOTE) classifications. We also determined the relationship between OSA severity and the number of obstruction sites and compared the minimum SaO2 levels between DISE and polysomnography (PSG). This was a prospective study in 45 patients with moderate and severe OSA using DISE with target-controlled infusion of propofol bispectral index (BIS) monitoring. The retropalatal region was the most frequent obstruction site, followed by the retrolingual region. Forty-two percent of patients had obstruction in the epiglottis. Concentrically shaped obstructions were more prevalent in both ratings. The relationship between OSA severity and number of obstruction sites was significant for the VOTE classification. Similar minimum SaO2 values were observed in DISE and PSG. The VOTE classification was more comprehensive in the analysis of the epiglottis and pharynx by DISE and the relationship between OSA severity and number of affected sites was also established by VOTE. The use of BIS associated with DISE is a reliable tool for the assessment of OSA patients.

PMID: 27164944 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1NrrA5r
via IFTTT

Intraoperative Endovascular Embolization of Middle Meningeal Artery and a Pseudoaneurysm by Using N-Butyl 2-Cyanoacrylate for Hemostasis during Operation of Acute Epidural Hemorrhage.

Intraoperative Endovascular Embolization of Middle Meningeal Artery and a Pseudoaneurysm by Using N-Butyl 2-Cyanoacrylate for Hemostasis during Operation of Acute Epidural Hemorrhage.

Korean J Neurotrauma. 2015 Oct;11(2):167-169

Authors: Kim DH, Lee JY, Jeon HJ, Cho BM, Park SH, Oh SM

Abstract
A 21-year-old female presented with acute epidural hemorrhage (EDH) on the left temporal region associated with skull fracture after traffic accident. She was neurologically deteriorated at four-hour after an admission, and follow-up computed tomography revealed increased amount of EDH. Under the general anesthesia, emergency craniotomy was performed. During the surgery, massive bleeding from the base of middle cranial fossa was observed. However, we could not identify an origin of bleeding and foramen spinosum due to brain swelling and obscured surgical field. Consequently, her systolic blood pressure was dropped to 60 mm Hg with >110 beat/min of heart rate. Therefore, we decided to perform an intraoperative angiography after gauze packing into the middle cranial fossa. Intraoperative angiography showed a large pseudoaneurysm with massive contrast leakage of the middle meningeal artery (MMA). Intraoperative endovascular embolization of the pseudoaneurysm and MMA by using n-butyl-2-cyanoacrylate was done. After that, her vital sign became stable, and we could complete the operation after the achievement of adequate hemostasis. Intraoperative angiography and endovascular embolization of MMA was effective in achieving adequate hemostasis in case with brisk bleeding from the middle cranial fossa could not be controlled in an open surgical field.

PMID: 27169087 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1X3q6jr
via IFTTT

The orbitozygomatic stich: A technical modification of the lateral supraorbital approach.

The orbitozygomatic stich: A technical modification of the lateral supraorbital approach.

Surg Neurol Int. 2016;7:46

Authors: Lazukova M, Andrade-Barazarte H, Makhamov M, Kivelev J, Goehre F, Jahromi BR, Ibrahim TF, Araujo R, Lehto H, Hernesniemi JA

Abstract
BACKGROUND: The lateral supraorbital approach (LSO) provides access to a variety of pathologies including anterior and some posterior circulation aneurysms, sellar and suprasellar lesions, and anterior fossa tumors. Technical modifications of LSO improve the surgical exposure of the skull base.
METHODS: We retrospectively analyzed 73 consecutive patients treated by the senior author (Juha A. Hernesniemi), at the Department of Neurosurgery, Helsinki University Hospital in Helsinki, Finland from May 2013 to October 2013. This study cohort underwent a modified LSO to access anterior circulation aneurysms, sellar and suprasellar tumors, and anterior fossa tumors. The studied population comprised 30 men and 43 women, with a mean age at treatment of 54 years (9-83 years).
RESULTS: LSO was successfully used to access anterior circulation aneurysms in 59 (81%) patients, 10 (14%) patients with anterior cranial fossa tumors, and 4 (5%) patients with suprasellar tumors. The skull base drilling provided a mean of 6.8 mm (1.7-22 mm) in increased exposure.
CONCLUSION: LSO provides adequate access to vascular and neoplastic lesions of the anterior cranial fossa, by drilling approximately 6.8 mm (1.7-22 mm) of the lateral orbital wall and sphenoid wing. This enhances surgical exposure and trajectory. An additional trick while performing an LSO is to place a single or multiple stiches (orbitozygomatic stich) at the base of the dura once opened, eliminating the dead space between the dura and anterior skull base.

PMID: 27168949 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/23JPo6i
via IFTTT

Notch signaling is active in normal mouse middle ear epithelial cells.

Notch signaling is active in normal mouse middle ear epithelial cells.

Exp Ther Med. 2016 May;11(5):1661-1667

Authors: Liu X, Sheng HB, Ma R, Yang JM, Luo WW, Yang XY, Ren DD, Chi FL

Abstract
Mucous cell metaplasia/hyperplasia in the middle ear epithelium is associated with the occurrence of otitis media with effusion during infections. However, the mechanism by which Notch signaling regulates cell fate in the middle ear epithelium is unclear. The aim of the present study was to elucidate this mechanism by investigating the localization of Notch receptors, such as Notch1 and Notch2, and Notch ligands, such as Jagged1, in the normal mouse middle ear epithelium (NMMEE) using immunoﬂuorescence. Furthermore, the mRNA expression levels of Notch receptors and ligands were evaluated using reverse transcription polymerase chain reaction (PCR). The effects of the γ-secretase inhibitor N-[N-(3,5-difluorophenacetyl)-L-alanyl]-S-phenylglycine tert-butyl ester (DAPT) on epithelial cell proliferation were determined using 5-ethynyl-2'-deoxyuridine (EdU) staining and immunofluorescence staining of the apoptosis marker caspase-3 and the epithelial proliferation marker pan-cytokeratine. In addition, the differentiation of the NMMEE cells was characterized by evaluating the mRNA expression levels of the mucous cell-associated genes Arg2, Muc2, Spdef, Spink4 and Tff1 using quantitative PCR. Notch1, Notch2 and Jagged1 were observed to be co-localized throughout the mouse middle ear epithelium. Furthermore, Notch1-4, Jagged1, Jagged2, Dll1 and Dll4 mRNAs were expressed in the NMMEE cells. The inhibition of Notch by DAPT resulted in fewer EdU-positive cells and the upregulation of the expression levels of various mucous cell-associated genes. The results indicate that DAPT suppresses the proliferation of NMMEE cells while promoting their differentiation into mucous cells. Therefore, DAPT may provide a specific therapeutic strategy for the reversal of multiple pathological processes that are associated with epithelium thickening in the middle ear.

PMID: 27168786 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1X3q6jp
via IFTTT

Epiglottic cysts in clinical practice.

Epiglottic cysts in clinical practice.

Cleve Clin J Med. 2016 May;83(5):338-339

Authors: Vourexakis Z

PMID: 27168507 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/23JPnQ2
via IFTTT

Treatment outcome of ion beam therapy in eight patients with head and neck cancers.

Treatment outcome of ion beam therapy in eight patients with head and neck cancers.

Eur Arch Otorhinolaryngol. 2016 May 11;

Authors: Ohkubo JI, Hohchi N, Takeuchi S, Ikezaki S, Kise Y, Koizumi H, Suzuki H

PMID: 27168403 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1TcoVLX
via IFTTT

Primary Lymphomas of the Skull Base from a Neurosurgical Perspective: Review of the Literature and Personal Experience.

Primary Lymphomas of the Skull Base from a Neurosurgical Perspective: Review of the Literature and Personal Experience.

J Neurol Surg A Cent Eur Neurosurg. 2016 May 11;

Authors: Pesce A, Acqui M, Cimatti M, Caruso R, Wierzbicki V, Raco A

Abstract
Primary lymphomas of the skull base are exceedingly rare and thus not commonly dealt with in everyday clinical practice. Primary diffuse large B cell lymphoma is the most commonly found (30-40% of primary non-Hodgkin lymphomas of the bone). This article reports a case of primary lymphoma of the skull base and reviews all the relevant literature in the PubMed, National Institutes of Health Library, and Google Scholar databases to outline the clinical, diagnostic, and surgical traits of this yet widely unexplored pathology. The incidence of cases peaks between 60 and 70 years of age; those affected tend to be mostly male. The clinical presentation of this pathology is usually abrupt with headache and acute deficit of cranial nerves that improves dramatically with intravenous corticosteroid therapy. The abducens nerve is most commonly involved. Imaging can be unclear because corticosteroid medications can significantly alter magnetic resonance imaging findings, at least in the early stages of the disease, similarly to what happens for primary brain lymphomas ("the ghost tumor"). Cavernous sinus, parasellar region, upper clivus, and Meckel cave are usually found to be already affected by the time a diagnosis can be made. The intracavernous internal carotid artery is usually encased by the lesion rather than displaced. Because of the anatomical pattern of primary lymphomas of the skull base and their well-known chemosensitivity, surgery is usually only used for diagnosis. Surgical approaches for primary lymphoma of the skull base include transcranial and transnasal-transsphenoidal endoscopy and microsurgery as well as other minimally invasive techniques. Due to the rarity of this neoplasm, there are no definitive data regarding the overall survival rate among patients.

PMID: 27168320 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1sgj4gd
via IFTTT

Efficacy of Elective Neck Dissection in T1/T2N0M0 Oral Tongue Squamous Cell Carcinoma: A Population-Based Analysis.

Efficacy of Elective Neck Dissection in T1/T2N0M0 Oral Tongue Squamous Cell Carcinoma: A Population-Based Analysis.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: Patel TD, Vázquez A, Marchiano E, Sanghvi S, Eloy JA, Baredes S, Park RC

Abstract
OBJECTIVE/HYPOTHESIS: The aim of this population-based study is to analyze the survival benefits of elective neck dissection (END) over neck observation in T1/T2N0M0 oral tongue squamous cell carcinoma (OT-SCC) cases.
STUDY DESIGN: Retrospective administrative database analysis.
SUBJECTS AND METHODS: The SEER database (Surveillance, Epidemiology, and End Results) was queried for patients diagnosed with T1/T2N0M0 OT-SCC from 1998 to 2011. Data included patient demographics, initial treatment, and survival outcomes. The Kaplan-Meier model and the Cox proportional hazards model were utilized for survival analysis.
RESULTS: Out of 7010 T1/T2N0M0 cases, END was performed in 1770 T1 and 950 T2 cases, and the neck was observed in 3278 T1 and 1001 T2 cases. Significantly poorer 5-year disease-specific survival (DSS) rates were noted for the neck observation group when compared with the END group for tumors with moderately differentiated (72.1% vs 86%, P < .0001) and poorly differentiated or undifferentiated (55.6% vs 71.5%, P = .0001) histologic grades. No significant survival benefit was seen between the END group and the neck observation group when tumor size was <1 cm, regardless of histology grade. However, those with tumors >1 cm had a significantly better 5-year DSS with END, except for the well-differentiated tumor cohort, which showed improved survival only when the tumors were >2 cm (5-year DSS: END vs neck observation, 83.5% vs 65.7%, P = .0002).
CONCLUSION: END improves DSS versus neck observation in T1/T2N0M0 OT-SCC patients with moderately differentiated, poorly differentiated, or undifferentiated histologic grade tumors >1 cm. Those with well-differentiated tumors benefited from END only when tumor size was >2 cm.

PMID: 27165672 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1TcoWQ7
via IFTTT

Closure of endoscopic third ventriculostomy after surgery for posterior cranial fossa tumor: The "snow globe effect".

Closure of endoscopic third ventriculostomy after surgery for posterior cranial fossa tumor: The "snow globe effect".

Br J Neurosurg. 2015 Jun;29(3):386-9

Authors: Tamburrini G, Frassanito P, Bianchi F, Massimi L, Di Rocco C, Caldarelli M

Abstract
The management of obstructive hydrocephalus associated to posterior cranial fossa tumor remains a controversial issue. In this context, the role of endoscopic third ventriculostomy (ETV) performed before tumor removal (the so-called preoperative ETV) is debated and its success rate is reported as being largely variable in the literature. We describe two children who experienced the closure of a preoperatively performed ETV after the surgical resection of their posterior fossa tumor. In both cases tumor removal was performed in the prone position. Radiological investigations and intraoperative evidence documented that the failure of the ETV was due to a blood clot which directly occluded the stoma. We speculate that the prone position favored the migration of blood, through the aqueduct, thereafter, clotting on the most declivous part of the third ventricle once the patient assumed the upright position, with the consequent occlusion of the stoma. Based on a gravitational hypothesis, we named this mechanism the "snow globe effect."

PMID: 25470245 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1X3q631
via IFTTT

Effect of Vocal Fold Medialization on Dysphagia in Patients with Unilateral Vocal Fold Immobility.

Effect of Vocal Fold Medialization on Dysphagia in Patients with Unilateral Vocal Fold Immobility.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: Cates DJ, Venkatesan NN, Strong B, Kuhn MA, Belafsky PC

Abstract
OBJECTIVE: The effect of vocal fold medialization (VFM) on vocal improvement in persons with unilateral vocal fold immobility (UVFI) is well established. The effect of VFM on the symptom of dysphagia is uncertain. The purpose of this study is to evaluate dysphagia symptoms in patients with UVFI pre- and post-VFM.
STUDY DESIGN: Case series with chart review.
SETTING: Academic tertiary care medical center.
SUBJECTS AND METHODS: The charts of 44 persons with UVFI who underwent VFM between June 1, 2013, and December 31, 2014, were abstracted from a prospectively maintained database at the University of California, Davis, Voice and Swallowing Center. Patient demographics, indications, and type of surgical procedure were recorded. Self-reported swallowing impairment was assessed with the validated 10-item Eating Assessment Tool (EAT-10) before and after surgery. A paired samples t test was used to compare pre- and postmedialization EAT-10 scores.
RESULTS: Forty-four patients met criteria and underwent either vocal fold injection (73%) or thyroplasty (27%). Etiologies of vocal fold paralysis were iatrogenic (55%), idiopathic (29%), benign or malignant neoplastic (9%), traumatic (5%), or related to the late effects of radiation (2%). EAT-10 (mean ± SD) scores improved from 12.2 ± 11.1 to 7.7 ± 7.2 after medialization (P < .01) with a follow-up of 119 ± 65 days.
CONCLUSION: Patients with UVFI suffer from dysphagia and report significant improvement in swallowing symptoms following VFM. The symptomatic improvement appears to be durable over time.

PMID: 27165683 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1rZRvqL
via IFTTT

Median maxillary alveolar osteolytic lesion in a 50-year-old female.

Median maxillary alveolar osteolytic lesion in a 50-year-old female.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Apr 16;

Authors: Elo JA, Sun HB, Kang SY

PMID: 27165482 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/24Rc9va
via IFTTT

The Role of Electrode Placement in Bilateral Simultaneously Cochlear-Implanted Adult Patients.

The Role of Electrode Placement in Bilateral Simultaneously Cochlear-Implanted Adult Patients.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: De Seta D, Nguyen Y, Bonnard D, Ferrary E, Godey B, Bakhos D, Mondain M, Deguine O, Sterkers O, Bernardeschi D, Mosnier I

PMID: 27165685 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1ZIlajb
via IFTTT

Functional Outcomes after Salvage Transoral Laser Microsurgery for Laryngeal Squamous Cell Carcinoma.

Functional Outcomes after Salvage Transoral Laser Microsurgery for Laryngeal Squamous Cell Carcinoma.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: Fink DS, Sibley H, Kunduk M, Schexnaildre M, Sutton C, Kakade-Pawar A, McWhorter AJ

PMID: 27165684 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1XmFZC6
via IFTTT

Racial Differences of Pigmentation in the Human Vestibular Organs.

Racial Differences of Pigmentation in the Human Vestibular Organs.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: Erbele ID, Lin FR, Agrawal Y, Francis HW, Carey JP, Chien WW

Abstract
OBJECTIVES: Melanin pigmentation is present in the human inner ear. In this study, we quantify the melanin pigmentation in the vestibular system and examine racial differences of vestibular melanin pigmentation using human cadaveric temporal bone specimens.
STUDY DESIGN: Basic research.
SETTING: Laboratory.
SUBJECTS AND METHODS: Light microscopy was used to examine specimens from 40 left temporal bones from the Johns Hopkins Human Temporal Bone Collection. Color images of (1) ampulla of the horizontal canal, (2) utricular wall, (3) endolymphatic duct, and (4) posterior ampullary nerve as it enters the posterior canal were acquired with a digital camera attached to the microscope and image acquisition software. Acquired images of each anatomic area of interest were processed offline through ImageJ. Melanin content was then compared according to ethnicity, age, sex, and location.
RESULTS: Fifteen African American and 25 Caucasian specimens were analyzed. Mean age was 68.8 years. African American specimens had a significantly greater amount of pigment at all 4 sampled locations as compared with Caucasian specimens (P < .01). Between sexes, there was a statistically significant difference (P < .05) at the posterior ampullary nerve, with males having more than females. Melanin content was not associated with age.
CONCLUSIONS: There is greater melanin pigmentation within the vestibular system of African Americans than in Caucasians, similar to what has been described in the cochlea. Racial differences in vestibular physiologic function have been observed in the literature and may be explained by differences in melanin pigmentation.

PMID: 27165682 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/24Rbda8
via IFTTT

MERS versus Standard Surgical Approaches for Porcine Vocal Fold Scarring with Adipose Stem Cell Constructs.

MERS versus Standard Surgical Approaches for Porcine Vocal Fold Scarring with Adipose Stem Cell Constructs.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: Woo JH, King SN, Hoffman H, Dailey S, Wang S, Christensen MB, Thibeault SL

Abstract
OBJECTIVE: Cells, scaffold, and surgical approaches are important for regeneration of the lamina propria of the scarred vocal fold (VF). Microendoscopy of Reinke's space (MERS) is a surgical approach used to access the lamina propria. The present study evaluated MERS in the treatment of VF scarring as compared with standardized approaches for the treatment of VF scarring with adipose stem cell constructs.
STUDY DESIGN: Animal study.
SETTING: Academic center.
SUBJECTS AND METHODS: VF injury was performed bilaterally to induce scarring in 20 pigs. Eight weeks after injury, pigs were classified into no treatment, minithyrotomy, VF injection, VF incision/dissection, and MERS. All groups (except control) were implanted with adipose stem cell and hyaluronan. Four weeks after treatment, histology for collagen, hyaluronan, and fibronectin; mRNA expression for α-smooth muscle actin, tumor growth factor β1, collagen 1α1, collagen 3α1, matrix metalloproteinase 2, basic fibroblast growth factor, and hepatocyte growth factor; and tissue rheology were evaluated.
RESULTS: Differences were measured among surgical approaches for protein levels of collagen, hyaluronan, and fibronectin (P = .0133, P < .0001, and P = .0025, respectively). Fibroblast growth factor, collagen 1α1, and matrix metalloproteinase 2 transcript levels were different among treatment groups (P = .003, P = .0086, and P = .014, respectively), while no differences were measured for α-smooth muscle actin, tumor growth factor β1, hepatocyte growth factor, and collagen 3α1. Rheologically, significant differences were not measured between groups.
CONCLUSION: MERS is a promising surgical approach for the treatment of VF scarring, optimizing the placement of implanted biomaterials.

PMID: 27165681 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1ZIlaj7
via IFTTT

Surgical Timing of the Orbital "Blowout" Fracture: A Systematic Review and Meta-analysis.

Surgical Timing of the Orbital "Blowout" Fracture: A Systematic Review and Meta-analysis.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: Damgaard OE, Larsen CG, Felding UA, Toft PB, von Buchwald C

Abstract
OBJECTIVE: The orbital blowout fracture is a common facial injury, carrying with it a risk of visual impairment and undesirable cosmetic results unless treated properly. Optimal timing of the surgical treatment is still a matter of debate. We set out to determine whether a meta-analysis would bring us closer to an answer to this question.
DATA SOURCES: PubMed, EMBASE, Web of Science, and the Cochrane Library were searched from January 1980 to August 2014. We applied the following inclusion criteria: isolated blowout fractures, presenting early and late surgery groups (<14 and >14 days). Patients were evaluated for diplopia and enophthalmos.
REVIEW METHODS: We followed the statements of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Pooled odds ratios were estimated with the fixed effects method of Mantel-Haenszel.
RESULTS: We identified 5 studies with available outcome data (N = 442). Patients in the late group showed an odds ratio of 3.3 (P = .027) for persistent postoperative diplopia as compared with the early group. We found no significant difference between the groups when assessing postoperative enophthalmos as an isolated symptom.
CONCLUSION: We found a significantly increased risk of persistent diplopia in patients who were operated >14 days after the trauma.

PMID: 27165680 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/24Rbda2
via IFTTT

Hemodynamic Parameters during Laryngoscopic Procedures in the Office and in the Operating Room.

Hemodynamic Parameters during Laryngoscopic Procedures in the Office and in the Operating Room.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: Tierney WS, Chota RL, Benninger MS, Nowacki AS, Bryson PC

Abstract
OBJECTIVE: Previous research has shown that office-based laryngoscopic procedures can induce hemodynamic changes, including tachycardia and severe hypertension, calling into question the safety of these procedures. However, comparison between office and operating room (OR) procedures has not been carried out. Therefore, we prospectively measured hemodynamic variables in both settings to compare hemodynamic changes between office and OR procedures.
STUDY DESIGN: Prospective cohort study.
SETTING: Single academic center.
SUBJECTS AND METHODS: Subjects undergoing office and OR laryngoscopic procedures were prospectively identified, and 92 OR and 70 office subjects were included. Heart rate and blood pressure were measured at established time points before, during, and after the procedures. Descriptive and comparative statistical analyses were conducted.
RESULTS: Severe hemodynamic events, either tachycardia or severe hypertension (blood pressure >180 mm Hg systolic or >110 mm Hg diastolic), occurred significantly more frequently in OR than office procedures (41% vs 20%; P = .006). OR severe hemodynamic events occurred more commonly than previously reported rates in the office (41% vs 28%; P = .012). Regression analyses showed that the odds of having a severe hemodynamic event were 3.66 times higher in OR versus office procedures.
CONCLUSION: Severe hemodynamic events are more likely to occur in the OR than in the office during laryngologic procedures. While larger studies will be required to establish rates of dangerous cardiovascular events in laryngoscopic procedures, hemodynamic parameters indicate that office-based procedures have a safety benefit for procedures that can be conducted in either setting.

PMID: 27165679 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1ZIlaj3
via IFTTT

Predictors of Failed and Delayed Decannulation after Head and Neck Surgery.

Predictors of Failed and Delayed Decannulation after Head and Neck Surgery.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: Isaac A, Zhang H, Varshney S, Hamilton S, Harris JR, O'Connell DA, Biron VL, Seikaly H

Abstract
OBJECTIVE: To determine the variables that are predictive of failed decannulation (FD), delayed decannulation (DD), and days to decannulation in patients who underwent head and neck cancer resection with free tissue transfer reconstruction for head and neck squamous cell carcinoma.
DESIGN: Case series with chart review.
SETTING: Tertiary care otolaryngology-head and neck surgery referral center.
SUBJECT AND METHODS: Patients (N = 108) were included who underwent head and neck cancer resection with free tissue transfer reconstruction and tracheostomy between 2011 and June 2014. Patients with laryngectomy, previous tracheostomy, and other airway pathology necessitating tracheotomy were excluded. Preoperative patient variables and cancer site/staging variables were analyzed, as well as extent of structures resected and type of reconstruction. Univariate and multivariate binary logistic and Cox regression analyses were used to determine predictors of FD and DD. Cox regression analysis was used to determine predictors of days to decannulation.
RESULTS: Of the 108 included patients, 16 had FD, and 26 had DD. Univariate analysis demonstrated that advanced stage (r = 0.233, P = .021), total glossectomy (r = 0.924, P < .001), anterolateral thigh flap reconstruction (r = 0.906, P < .001), smoking at time of surgery (r = 0.319, P = .002), and pack years (r = 0.322, P = .001) were associated with FD. Cox regression analysis showed that total glossectomy, exp(B) = 15.837 (95% confidence interval [95% CI]: 1.949-128.679); anterolateral thigh flap reconstruction, exp(B) = 8.439 (95% CI: 2.435-29.620); and smoking status, exp(B) = 2.970 (95% CI: 1.617-5.456) were independent predictors of days to decannulation and FD.
CONCLUSIONS: Patients with total glossectomy defects and those who continue to smoke are at increased risk for FD and DD. Aggressive smoking cessation programs may decrease the risk of FD and DD. Patients should be counseled about their risk profiles.

PMID: 27165678 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1TcoWQe
via IFTTT

Pathologic Changes of the Peripheral Vestibular System Secondary to Chronic Otitis Media.

Pathologic Changes of the Peripheral Vestibular System Secondary to Chronic Otitis Media.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: da Costa Monsanto R, Erdil M, Pauna HF, Kwon G, Schachern PA, Tsuprun V, Paparella MM, Cureoglu S

Abstract
OBJECTIVE: To evaluate the histopathologic changes of dark, transitional, and hair cells of the vestibular system in human temporal bones from patients with chronic otitis media.
STUDY DESIGN: Comparative human temporal bone study.
SETTING: Otopathology laboratory.
SUBJECTS AND METHODS: To compare the density of vestibular dark, transitional, and hair cells in temporal bones with and without chronic otitis media, we used differential interference contrast microscopy.
RESULTS: In the chronic otitis media group (as compared with the age-matched control group), the density of type I and type II hair cells was significantly decreased in the lateral semicircular canal, saccule, and utricle (P < .05). The density of type I cells was also significantly decreased in the chronic otitis media group in the posterior semicircular canal (P = .005), but that of type II cells was not (P = .168). The mean number of dark cells was significantly decreased in the chronic otitis media group in the lateral semicircular canal (P = .014) and in the posterior semicircular canal (P = .002). We observed no statistically significant difference in the density of transitional cells between the 2 groups (P > .1).
CONCLUSION: The findings of our study suggest that the decrease in the number of vestibular sensory cells and dark cells could be the cause of the clinical symptoms of imbalance of some patients with chronic otitis media.

PMID: 27165677 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/24RbauL
via IFTTT

Endoscopic Resection of Sinonasal Malignancy: A Systematic Review and Meta-analysis.

Endoscopic Resection of Sinonasal Malignancy: A Systematic Review and Meta-analysis.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: Rawal RB, Farzal Z, Federspiel JJ, Sreenath SB, Thorp BD, Zanation AM

Abstract
OBJECTIVES: The use of endoscopic approaches for sinonasal malignancy resection has increased, but survival data are limited secondary to disease rarity and new surgical technique. Here we present a systematic review and meta-analysis of endoscopic endonasal resection of sinonasal malignancy.
DATA SOURCES: MEDLINE, PubMed Central, NCBI Bookshelf, Cochrane Library, clinicaltrials.gov, National Guideline Clearinghouse.
REVIEW METHODS: PRISMA/MOOSE guidelines were followed. MeSH terms were "endoscopic" AND ("esthesioneuroblastoma" OR "sinonasal adenocarcinoma" OR "squamous cell carcinoma" OR "sinonasal undifferentiated carcinoma"). For studies in which individual-level data were available, results were obtained by direct pooling. For studies in which only summary Kaplan-Meier curves were available, numerical data were extracted, traced, and aggregated by fitting a Weibull model.
RESULTS: Of 320 studies identified, 35 case series were included (n = 952 patients), with 15 studies analyzed via aggregate modeling and 20 studies analyzed via direct pooling. Two- and 5-year survival rates for patients in aggregate modeling were 87.5% and 72.3%, respectively (mean follow-up: 32.9 months). Two- and 5-year survival for patients in direct pooling were 85.8% and 83.5%, respectively (mean follow-up: 43.0 ± 19.5 months). Significant overall survival difference was found between low- and high-grade cancers (P = .015) but not between low- and high-stage cancers (P = .79).
CONCLUSION: Overall 2- and 5-year survival rates are comparable and sometimes greater than those from open craniofacial resection. Survival rates significantly differ by cancer grade but not stage. Journals and investigators should be encouraged to publish retrospective and prospective case series with staged survival updates based on established guidelines.

PMID: 27165676 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1XmFZC0
via IFTTT

Pretreatment Hematologic Findings as Novel Predictive Markers for Facial Palsy Prognosis.

Pretreatment Hematologic Findings as Novel Predictive Markers for Facial Palsy Prognosis.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: Wasano K, Kawasaki T, Yamamoto S, Tomisato S, Shinden S, Ishikawa T, Minami S, Wakabayashi T, Ogawa K

Abstract
OBJECTIVE: To examine the relationship between prognosis of 2 different facial palsies and pretreatment hematologic laboratory values.
STUDY DESIGN: Multicenter case series with chart review.
SETTING: Three tertiary care hospitals.
SUBJECTS AND METHODS: We examined the clinical records of 468 facial palsy patients who were treated with an antiviral drug in combination with either oral or intravenous corticosteroids in participating hospitals between 2010 and 2014. Patients were divided into a Bell's palsy group or a Hunt's palsy group. We used the Yanagihara facial nerve grading system to grade the severity of facial palsy. "Recovery" from facial palsy was defined as achieving a Yanagihara score ≥36 points within 6 months of onset and having no accompanying facial contracture or synkinesis. We collected information about pretreatment hematologic findings, demographic data, and electrophysiologic test results of the Bell and Hunt group patients who recovered and those who did not. We then compared these data across the 2 palsy groups.
RESULTS: In the Bell's palsy group, recovered and unrecovered patients differed significantly in age, sex, electroneuronography score, stapedial muscle reflex, neutrophil rate, lymphocyte rate, neutrophil-to-lymphocyte ratio, and initial Yanagihara score. In the Hunt's palsy group, recovered and unrecovered patients differed in age, electroneuronography score, stapedial muscle reflex, monocyte rate, platelet count, mean corpuscular volume, and initial Yanagihara score.
CONCLUSIONS: Pretreatment hematologic findings, which reflect the severity of inflammation and bone marrow dysfunction caused by a virus infection, are useful for predicting the prognosis of facial palsy.

PMID: 27165675 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1ZIl7UC
via IFTTT

Spatial Mapping in the Rat Olfactory Bulb by Odor and Direct Electrical Stimulation.

Spatial Mapping in the Rat Olfactory Bulb by Odor and Direct Electrical Stimulation.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: Coelho DH, Costanzo RM

Abstract
OBJECTIVES: To directly measure the spatial mapping in the olfactory bulb by odor presentation and by direct electrical stimulation.
STUDY DESIGN: Experimental (animal).
SETTING: University research laboratory.
SUBJECTS AND METHODS: Odor (n = 8) and electrical stimulation (n = 4) of the olfactory bulb in rats were used to demonstrate the spatial mapping of neural responses in the olfactory bulb. Both multiunit responses to odor stimulation and evoked potential responses to localized electrical stimulation were measured in different regions of the olfactory bulb.
RESULTS: Responses that were recorded simultaneously from an array of 32 electrodes positioned at different locations within the olfactory bulb were mapped. Results show different spatial patterns of neural activity for different odors (odor maps). Direct stimulation of the olfactory bulb with electrical current pulses from electrodes positioned at different locations was also effective in generating spatial patterns of neural activity.
CONCLUSION: These data suggest that by programming an array of stimulating electrodes, it should be possible to selectively activate different regions of the olfactory bulb, generating unique patterns of neural activity as seen in normal smell.

PMID: 27165674 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/24Rbaev
via IFTTT

Impact of Middle versus Inferior Total Turbinectomy on Nasal Aerodynamics.

Impact of Middle versus Inferior Total Turbinectomy on Nasal Aerodynamics.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: Dayal A, Rhee JS, Garcia GJ

Abstract
OBJECTIVES: This computational study aims to (1) use virtual surgery to theoretically investigate the maximum possible change in nasal aerodynamics after turbinate surgery, (2) quantify the relative contributions of the middle and inferior turbinates to nasal resistance and air conditioning, and (3) quantify to what extent total turbinectomy impairs the nasal air-conditioning capacity.
STUDY DESIGN: Virtual surgery and computational fluid dynamics.
SETTING: Academic tertiary medical center.
SUBJECTS AND METHODS: Ten patients with inferior turbinate hypertrophy were studied. Three-dimensional models of their nasal anatomies were built according to presurgery computed tomography scans. Virtual surgery was applied to create models representing either total inferior turbinectomy (TIT) or total middle turbinectomy (TMT). Airflow, heat transfer, and humidity transport were simulated at a steady-state inhalation rate of 15 L/min. The surface area stimulated by mucosal cooling was defined as the area where heat fluxes exceed 50 W/m(2).
RESULTS: In both virtual total turbinectomy models, nasal resistance decreased and airflow increased. However, the surface area where heat fluxes exceed 50 W/m(2) either decreased (TIT) or did not change significantly (TMT), suggesting that total turbinectomy may reduce the stimulation of cold receptors by inspired air. Nasal heating and humidification efficiencies decreased significantly after both TIT and TMT. All changes were greater in the TIT models than in the TMT models.
CONCLUSION: TIT yields greater increases in nasal airflow but also impairs the nasal air-conditioning capacity to a greater extent than TMT. Radical resection of the turbinates may decrease the surface area stimulated by mucosal cooling.

PMID: 27165673 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1ZIl7Uz
via IFTTT

Efficacy of Elective Neck Dissection in T1/T2N0M0 Oral Tongue Squamous Cell Carcinoma: A Population-Based Analysis.

Efficacy of Elective Neck Dissection in T1/T2N0M0 Oral Tongue Squamous Cell Carcinoma: A Population-Based Analysis.

Otolaryngol Head Neck Surg. 2016 May 10;

Authors: Patel TD, Vázquez A, Marchiano E, Sanghvi S, Eloy JA, Baredes S, Park RC

PMID: 27165672 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1TcoWQ7
via IFTTT

Predictors of survival in parotid adenocarcinoma not otherwise specified: a National Cancer Database study of 3155 patients.

Predictors of survival in parotid adenocarcinoma not otherwise specified: a National Cancer Database study of 3155 patients.

Head Neck. 2016 May 10;

Authors: Zhan KY, Huang AT, Khaja SF, Bell D, Day TA

Abstract
BACKGROUND: Parotid adenocarcinoma not otherwise specified (PANOS) is a common parotid cancer, but studies specifically on this subject are limited.
METHODS: We conducted a retrospective review of the National Cancer Database.
RESULTS: Ten percent of all parotid cancers were PANOS (n = 3155). Median age was 67 years. Most patients were men (62.8%) with high-grade histology (67.2%). Regional metastasis was common (35.9%), whereas occult nodal metastasis (20.2% overall) was less frequent in non-high-grade lesions (8.5% vs 31.6%; p < .001). Distant metastasis was rare (7.9%). Five-year overall survival (OS) was 47%. In multivariate analysis, age, regional metastasis, distant metastasis, high-grade, and T classification were predictors of lower survival. Patients with stage III to IV disease receiving surgery and radiotherapy had a better OS than those receiving surgery alone (51% vs 41%; p < .001).
CONCLUSION: PANOS is an aggressive disease with frequent regional metastasis and low survival. Numerous variables are associated with worse survival. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27166875 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1UVb5A6
via IFTTT

Erratum.

Erratum.

Head Neck. 2016 Jun;38(6):939

Authors: Prisman E, Haerle SK, Irish JC, Daly M, Miles B, Chan HH

PMID: 27166754 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1TRjH8p
via IFTTT

Head & Neck Special online-only issue, April 2016 Volume 38/Number S1.

Head & Neck Special online-only issue, April 2016 Volume 38/Number S1.

Head Neck. 2016 Jun;38(6):807-809

Authors:

PMID: 27166753 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1UVb5zW
via IFTTT

Αρχειοθήκη ιστολογίου

Πέμπτη 12 Μαΐου 2016