Prevention of Postoperative Cerebrospinal Fluid Leaks After Translabyrinthine Tumor Resection With Resorbable Mesh Cranioplasty.

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Prevention of Postoperative Cerebrospinal Fluid Leaks After Translabyrinthine Tumor Resection With Resorbable Mesh Cranioplasty.

Otol Neurotol. 2015 Sep;36(9):1537-42

Authors: Hunter JB, Sweeney AD, Carlson ML, Wanna GB, Rivas A, Weaver KD, Chambless LB, Thompson RS, Haynes DS, Bennett ML

Abstract
OBJECTIVES: To evaluate the effectiveness of resorbable mesh cranioplasty at reducing postoperative cerebrospinal fluid (CSF) leak and pseudomeningocele formation after translabyrinthine tumor resection.
STUDY DESIGN: Case series with chart review.
SETTING: Tertiary academic referral center.
PATIENTS: Fifty-three consecutive cases using a resorbable mesh cranioplasty after translabyrinthine tumor resection were reviewed.
INTERVENTION: Temporal bone defects were repaired with a dural substitute, layered fat graft, and a resorbable mesh plate secured with screws.
MAIN OUTCOME MEASURES: Primary outcome measures included the incidence of postoperative CSF wound leak or rhinorrhea, pseudomeningocele formation, and surgical site infection.
RESULTS: Fifty-three cases (average age, 54.0 yr; range, 19.3-75.1 yr) were analyzed. The average body mass index was 30.8 kg/m2 (range, 17.9-48.3 kg/m2), and the average tumor size was 18.8 mm (range, 8-38 mm). One patient (1.9%) experienced CSF rhinorrhea on postoperative Day 16, which resolved after transmastoid middle ear and eustachian tube packing. One patient (1.9%) experienced a surgical site infection requiring surgical debridement and mesh removal 4 months after surgery. Compared with 1,441 prior translabyrinthine surgeries analyzed from our institution using a traditional fat graft closure without mesh, the rate of postoperative CSF leak was significantly less using the resorbable mesh cranioplasty technique (p = 0.0483).
CONCLUSION: Resorbable mesh cranioplasty is a safe and effective method to reduce postoperative CSF leak and pseudomeningocele formation after translabyrinthine craniotomy for tumor excision.

PMID: 26208128 [PubMed - indexed for MEDLINE]

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Jaw movement in people with Parkinson's Disease.

Jaw movement in people with Parkinson's Disease.

Codas. 2016 Apr;28(2):193-196

Authors: Albuquerque LC, Silva HJ

Abstract
This study aimed to characterize the amplitude and speed of isolated jaw movements and chewing using electrognathography in a volunteer and to compare these data with those of two other Parkinson Disease (PD) subjects, differentiated by the motor characteristics.
METHOD: The 3 participants were divided into three categories: one with 1 non-PD volunteer, a second category with 1 volunteer characterized by Parkinson's hypokinesia, and a third with 1 volunteer characterized by Parkinson's tremor.
RESULTS: There were differences among the three groups; however the most significant was between the non-PD and the PD-rigidity, in the amplitude and speed when performing the jaw movements and chewing. Factors related to the adaptive and compensatory processes derived from rigidity process seemed to better explain the observed changes among the PD groups.

PMID: 27191885 [PubMed - as supplied by publisher]

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Differences of brain electrical activity between moderate and severe obstructive sleep apneic patients: a LORETA study.

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Differences of brain electrical activity between moderate and severe obstructive sleep apneic patients: a LORETA study.

J Sleep Res. 2016 May 18;

Authors: Toth M, Kondakor I, Faludi B

Abstract
The effects of initiation of continuous positive airway pressure (CPAP) therapy on electroencephalographic (EEG) background activity were investigated in patients exhibiting both moderate (n = 13) and severe (n = 12) obstructive sleep apnea syndromes in the testing of the potential differences of alterations of brain electrical activity caused by chronic hypoxia between these two groups. A normal control group (n = 14) was also examined. Two EEG examinations were achieved in each group: before and after first-time CPAP therapy. Low-resolution electromagnetic tomography (LORETA) was implemented towards localizing the generators of EEG activity in separate frequency bands. Prior to CPAP treatment, as a common direction of change, analysis with LORETA demonstrated increased activity in comparison with the patient and control groups. In the moderate group, significant changes were detected in the alpha2 band in the posterior cingulate cortex as well as in the beta1 band in the right posterior parietal cortex and the left supramarginal gyrus. In the severe group, significant changes were found in theta and alpha1 bands in the posterior cingulate cortex. Following CPAP treatment, these significant differences vanished in the severe group. In the moderate group, significantly decreased activity was seen in the beta3 band in the right fusiform gyrus. These findings potentially suggest a normalizing effect of CPAP therapy on EEG background activity in both groups of obstructive sleep apnea syndrome patients. Compensatory alterations of brain electrical activity in regions associated with influencing successful memory retrieval, emotional perception, default mode network, anorexia and fear network caused by chronic intermittent hypoxia could possibly be reversed with the use of CPAP therapy.

PMID: 27192694 [PubMed - as supplied by publisher]

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Use of a platelet-rich fibrin membrane to repair traumatic tympanic membrane perforations: a comparative study.

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Use of a platelet-rich fibrin membrane to repair traumatic tympanic membrane perforations: a comparative study.

Acta Otolaryngol. 2016 May 18;:1-7

Authors: Gür ÖE, Ensari N, Öztürk MT, Boztepe OF, Gün T, Selçuk ÖT, Renda L

Abstract
OBJECTIVES: (1) To evaluate the effects of a platelet-rich fibrin (PRF) membrane in the repair of traumatic tympanic membrane (TM) perforations; and (2) to compare the use of a PRF membrane with the paper patch technique with regard to recovery rates, healing time, and correction of the mean air-bone gap.
METHODS: A randomized, prospective analysis was performed for 60 patients who were treated for traumatic TM perforations using one of the two methods. Closure rate, speed of healing, and hearing gain were compared between the PRF (Group 1) and paper patch (Group 2) groups.
RESULTS: Closure was obtained in 28 (93%) perforations in Group 1 and 25 (83%) perforations in Group 2 (p > 0.05). On day 10, full closure of the TM was observed in 24 (80%) patients in Group 1 and 16 (53%) patients in Group 2 (p < 0.05). The improvement in the mean air-bone gap was 14.1 dB in Group 1 and 12.4 dB in Group 2 on post-operative day 45 (p < 0.05).
CONCLUSIONS: In comparison with the paper patch method, PRF, a new method, provided more rapid healing with more successful audiological results, and with no requirement for a second procedure.

PMID: 27192505 [PubMed - as supplied by publisher]

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Hearing impairment, cochlear morphology, and peroxynitrite (ONOO(-)) formation in adult and aging NOS II knockout mice.

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Hearing impairment, cochlear morphology, and peroxynitrite (ONOO(-)) formation in adult and aging NOS II knockout mice.

Acta Otolaryngol. 2016 May 18;:1-8

Authors: Labbé D, Bloch W, Schick B, Michel O

Abstract
CONCLUSION: Nitric oxide synthase (NOS) II induction is a protective mechanism against age-related degeneration of the cochlea.
OBJECTIVES: An induction of NOS II has been described in different inner ear pathologies. The objective was to examine the role of NOS II in age-related degeneration of the cochlea.
METHODS: The hearing ability in adult and aging NOS II knockout mice (KO) and their wildtype (WT) littermates was explored via auditory brainstem response (ABR) measurements. Inner ear morphological differences were studied with scanning electron microscopy (SEM). Immunohistochemistry was used to examine the induction of NOS II in the inner ear of aging WT mice. Expression of nitrotyrosin, a marker protein for the reactive oxygen species peroxynitrite, was compared between KO and WT mice using immunohistochemistry.
RESULTS: Adult KO mice exhibited a mild hearing impairment. WT mice showed an induction of NOS II after 6 months of age. Age-related hearing deterioration was accelerated in KO mice, which was accompanied by increased nitrotyrosin formation and outer hair cell loss.

PMID: 27192390 [PubMed - as supplied by publisher]

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Prognostic impact of perineural invasion in hypopharyngeal squamous cell carcinoma.

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Prognostic impact of perineural invasion in hypopharyngeal squamous cell carcinoma.

Acta Otolaryngol. 2016 May 18;:1-5

Authors: Joo YH, Cho KJ, Lee YS, Kim SY, Kim MS

Abstract
OBJECTIVES: The aim of this study was to evaluate the role of PNI in HPSCC.
METHODS: The medical records of 105 patients who underwent surgery-based treatment for HPSCC were reviewed. Clinicopathologic parameters including disease-specific survival were correlated with PNI.
RESULTS: PNI was identified in 27 of the 105 (25.7%) cases of HPSCC. Correlation analysis demonstrated that PNI in HPSCC was significantly correlated with pN classification (10.3% in N0/N1 vs 34.8% in N2/N3, p = 0.006). Patients with PNI had decreased 5-year disease-specific survival with borderline significance (p = 0.065). In a sub-set of 31 patients who did not receive post-operative radiotherapy, PNI was determined to be a significant prognostic predictor (p = 0.033). In multivariate analysis, extracapsular invasion was the only independent prognostic factor for disease-specific survival (p = 0.001).
CONCLUSION: Perineural invasion (PNI) should be considered an independent predictor for cervical lymph node involvement. PNI status in primary hypopharyngeal squamous cell carcinoma (HPSCC) specimens should be considered in decisions concerning adjuvant radiotherapy.

PMID: 27192156 [PubMed - as supplied by publisher]

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The effectiveness of the head-turn-plus-chin-down maneuver for eliminating vallecular residue.

The effectiveness of the head-turn-plus-chin-down maneuver for eliminating vallecular residue.

Codas. 2016 Apr;28(2):113-117

Authors: Nagy A, Peladeau-Pigeon M, Valenzano TJ, Namasivayam AM, Steele CM

Abstract
Purpose When swallowing efficiency is impaired, residue accumulates in the pharynx. Cued or spontaneous swallows in the head neutral position do not always successfully clear residue. We investigated the impact of a novel maneuver on residue clearance by combining a head turn with the chin down posture. Methods Data were collected from 26 participants who demonstrated persistent vallecular residue after an initial head neutral clearance swallow in videofluoroscopy. Participants were cued to perform a head-turn-plus-chin-down swallow, with the direction of head turn randomized. Pixel-based measures of residue in the vallecular space before and after the maneuver were made on still frame lateral images using ImageJ software. Measures of % full and the Normalized Residue Ratio Scale (NRRS) were extracted. Univariate analyses of variance were used to detect significant reductions in residue. Results On average, pre-maneuver measures showed residue filling 56-73% of the valleculae, depending on stimulus consistency (NRRS scores: 0.2-0.4). More than 80% of pre-swallow measures displayed NRRS ratios > 0.06, a threshold previously linked to increased risk of post-swallow aspiration. Conclusion The head-turn-plus-chin-down maneuver achieved significant reductions in residue for thin and nectar-thick fluids, suggesting that this maneuver can be effective in reducing persistent vallecular residue with these consistencies.

PMID: 27191873 [PubMed - as supplied by publisher]

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Which Patients With Ossifying Fibroma of the Jaws Would Be Suitable for Radical Ablative Surgery?

Which Patients With Ossifying Fibroma of the Jaws Would Be Suitable for Radical Ablative Surgery?

J Craniofac Surg. 2016 May 17;

Authors: Lv M, Shen Y, Li J, Gvetadze SR, Sun J

Abstract
OBJECTIVE: The aim of authors' study was to present their 10-year experience in the treatment of giant ossifying fibroma (GOF), and to prove if GOF can be totally excised preventing recurrence. The authors' secondary goal was to study the aesthetic and functional outcomes after radical resection of GOF followed by immediate reconstruction.
METHODS: Eighteen patients who underwent radical ablative surgery of GOF of the jaw followed by immediate reconstruction with vascularized fibula flap or ilium flap between May 2003 and May 2013 were taken. Recurrence rate was statistically observed and 2-year postoperative aesthetic and functional outcomes were evaluated.
RESULTS: The average length of follow-up was 4.5 years. There was no residual tumor or tumor recurrence observed in any patient during the mean follow-up of 4.5 years, and good cosmesis and functional outcome was noted after ablative surgery of GOF followed by computer-assisted reconstruction.
CONCLUSIONS: For giant OF, if it is mainly located in the jaws without invasion of the skull base and/or pterygoid process, radical surgical treatment should be performed for prevention of tumor recurrence. And good aesthetic and functional results can be achieved by immediate computer-assisted reconstruction and dental rehabilitation.

PMID: 27192645 [PubMed - as supplied by publisher]

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Combined External-Endoscopic Endonasal Assisted Removal of a Nail Gun.

Combined External-Endoscopic Endonasal Assisted Removal of a Nail Gun.

J Craniofac Surg. 2016 May 17;

Authors: Dehgani Mobaraki P, Longari F, Lapenna R, Ricci G

Abstract
Management of penetrating trauma to the paranasal sinuses with retained foreign bodies represents a challenge due to the proximity to vital neurovascular structures. The authors report the successful treatment of a patient with a work-related nail gun injury, carried out by means of a combined endoscopic endonasal external assisted procedure.A transnasal endoscopic approach was planned to minimize inadvertent movements of the nail during surgery and in case necessary to repair the orbit or skull base. No major bleeding or neurovascular complication was observed after surgery and a computed tomography scan was performed after surgery confirming the complete removal of the nail and with no damage of the orbit nor the skull base.

PMID: 27192640 [PubMed - as supplied by publisher]

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Applying Craniofacial Principles to Neurosurgical Exposures in Cerebrovascular Aneurysm Repair.

Applying Craniofacial Principles to Neurosurgical Exposures in Cerebrovascular Aneurysm Repair.

J Craniofac Surg. 2016 May 17;

Authors: Alperovich M, Frey JD, Potts MB, Riina HA, Staffenberg DA

Abstract
The subspecialty of craniofacial surgery emphasizes skeletal exposure, preservation of critical structures, and provision of a superior cosmetic result. In recent decades, an emphasis on minimally invasive neurosurgical exposure has paved the way for increased collaboration between neurosurgeons and craniofacial surgeons.The 1990s saw the growing popularity of an eyebrow incision for orbital roof craniotomies in neurosurgery to address lesions in the anterior skull base. Disadvantages of this approach included conspicuous scarring above the brow skin, risk of injury to the frontal branch of the facial nerve, and numbness from supraorbital or supratrochlear nerve transection.A transpalpebral approach was first described in 2008 in the neurosurgical literature. An approach familiar to the craniofacial surgeon, transpalpebral exposure is used for zygomaticomaxillary complex fractures as well as aesthetic brow and periorbital surgery.In conjunction with neurosurgery, the authors have applied craniofacial principles to address the major pitfalls of the transpalpebral craniotomy. The authors present their patient series experience. Hopefully, in the future, other institutions will have increased collaboration between craniofacial surgeons and neurosurgeons.

PMID: 27192638 [PubMed - as supplied by publisher]

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Innate Immune Response of the Pig Laryngeal Mucosa to Endotracheal Intubation.

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Innate Immune Response of the Pig Laryngeal Mucosa to Endotracheal Intubation.

Otolaryngol Head Neck Surg. 2016 Jan;154(1):138-43

Authors: Hughes OR, Ayling SM, Birchall MA

Abstract
OBJECTIVE: The aim of this study was to measure the effects of endotracheal intubation on innate immune response within the pig laryngeal mucosa.
STUDY DESIGN: Prospective controlled basic science study.
SETTING: The animal experiments and analyses were conducted at the University of Bristol.
SAMPLES AND METHODS: Eighteen pigs, matched at the major histocompatibility complex (MHC), were used in the study. The pigs were divided into 9 pairs. One of each pair (9 pigs in total) was intubated with an endotracheal tube under general anesthesia for 90 minutes. Two days later, pinch biopsies were taken from the supraglottis (specifically the false cords) and subglottis of both pigs. The experiment was repeated 8 more times. Based on quantitative immunohistochemistry, percentage areas of positive staining for CD172a, CD163, MHC class II, CD14, and CD16 were calculated separately for the epithelium and lamina propria of each biopsy.
RESULTS: Total areas of laryngeal mucosa (epithelium and lamina propria) expressing CD172a and coexpressing CD163 and CD172a were significantly reduced at 2 days following endotracheal intubation (P = .039 and P = .037, respectively). MHC class II expression and MHC class II coexpression with CD172a were similarly reduced following intubation (P = .003 and P = .005, respectively). In the supraglottis, MHC class II coexpression with CD16 and CD14 was also reduced following endotracheal intubation (P = .037).
CONCLUSIONS: Our results indicate that endotracheal intubation reduces the number of innate immune cells within the upper airway mucosa. This may be an important first step in a cascade leading to chronic wound and scar formation causing airway stenosis.

PMID: 26567047 [PubMed - indexed for MEDLINE]

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Triticeous Cartilage CT Imaging Characteristics, Prevalence, Extent, and Distribution of Ossification.

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Triticeous Cartilage CT Imaging Characteristics, Prevalence, Extent, and Distribution of Ossification.

Otolaryngol Head Neck Surg. 2016 Jan;154(1):131-7

Authors: Alqahtani E, Marrero DE, Champion WL, Alawaji A, Kousoubris PD, Small JE

Abstract
OBJECTIVE: The triticeous cartilage is a small ovoid cartilaginous structure variably present as a component of the laryngeal skeleton. This structure has received scant attention in the literature and has yet to be described adequately on cross-sectional imaging.
STUDY DESIGN AND SETTING: Retrospective study in a tertiary medical center.
SUBJECTS AND METHODS: We investigated triticeous cartilage prevalence in a large population utilizing computed tomography images. The cases of all patients with computed tomography angiography images of the neck from October 1, 2013, to September 31, 2014, were examined. A total of 663 patients were included in this study (age: range, 18-97 years; mean ± SD, 65 ± 15 years), 58.4% men and 41.6% women. The presence of a triticeal cartilage and its site, number, and degree of ossification were recorded.
RESULTS: A total of 53.1% of patients had at least 1 triticeous cartilage (352 of 663). Prevalence was 57.4% (222 of 387) among men and 47.1% (130 of 276) among women. The presence of bilateral triticeous cartilages was more common than unilateral (63.1%, 222 of 352). A minority of patients (4.5%, 16 of 352) had a cartilaginous triticeous with no appreciable ossification, and more than half (54.0%, 190 of 352) had mild triticeal ossification. Moderate ossification was found in 34.9% of patients (123 of 352) and marked ossification in 6.5% (23 of 352).
CONCLUSION: The presence of a triticeous cartilage is common and of variable appearance. As the clinical and surgical significance of this anatomic structure may be misinterpreted, it is important for imaging interpreters to be familiar with this seldom-recognized anatomic structure and recognize its variable appearance on cross-sectional imaging to avoid a misdiagnosis.

PMID: 26556461 [PubMed - indexed for MEDLINE]

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Delayed Onset Intracranial Subdural Hematoma Following Spinal Surgery.

Delayed Onset Intracranial Subdural Hematoma Following Spinal Surgery.

J Craniofac Surg. 2016 May 12;

Authors: Işik S, Yilmaz B, Ekşi MŞ, Özcan-Ekşi EE, Akakin A, Toktaş ZO, Demir MK, Konya D

Abstract
In this case-based review, the authors analyzed relevant literature with an illustrative patient of theirs about subdural hematoma secondary to dural tear at spinal surgery. Intracranial hypotension is a condition of decreased cerebrospinal fluid volume and pressure. Even though intracranial hypotension is temporary and can be managed conservatively, it may progress and result in subdural fluid collections, hematoma formations, "brain sagging or slumping" states, syringohydromyelia, encephalopathy, coma, and even death. The authors present an 81-year-old man admitted with subdural hematoma 50 days following previous spinal surgery for lumbar spinal stenosis. In his previous spinal surgery he had had dural tear, which had been closed primarily. To the literature, only 21 patients have been reported to develop subdural hematoma following spinal surgery. In patients with subdural hematoma following spinal surgery, the female:male ratio was 3:4 and the median age was 55 years. Surgical diagnoses for previous spinal surgeries were intervertebral disc herniation (5), spinal canal stenosis and spondylolisthesis (6), failed back syndrome (2), tethered cord syndrome and myelodysplastic spine (2), spinal cord tumor, spinal epidural hematoma, vertebral dislocation, vertebral fracture, vertebral tumor, and inflammatory spine. Patients presented with signs and symptoms of subdural hematoma within 6 hours to 50 days following the spinal surgery. Source of cerebrospinal fluid leak was most commonly from lumbar region (13 patients, 62%). Ten of 21 (48%) patients were treated conservatively. Late-onset neurological findings should not prevent the evaluation of cranial vault with computed tomography and magnetic resonance imaging. Spinal dural tear should be more aggressively treated instead of suture alone approach, when recognized in older patients during the spinal surgery.

PMID: 27192649 [PubMed - as supplied by publisher]

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Surgical outcomes of the endoscopic endonasal transsphenoidal approach for large and giant pituitary adenomas: institutional experience with special attention to approach-related complications.

Surgical outcomes of the endoscopic endonasal transsphenoidal approach for large and giant pituitary adenomas: institutional experience with special attention to approach-related complications.

Arq Neuropsiquiatr. 2016 May;74(5):388-395

Authors: Constantino ER, Leal R, Ferreira CC, Acioly MA, Landeiro JA

Abstract
Objective In this study, we investigate our institutional experience of patients who underwent endoscopic endonasal transsphenoidal approach for treatment of large and giant pituitary adenomas emphasizing the surgical results and approach-related complications. Method The authors reviewed 28 consecutive patients who underwent surgery between March, 2010 and March, 2014. Results The mean preoperative tumor diameter was 4.6 cm. Gross-total resection was achieved in 14.3%, near-total in 10.7%, subtotal in 39.3%, and partial in 35.7%. Nine patients experienced improvement in visual acuity, while one patient worsened. The most common complications were transient diabetes insipidus (53%), new pituitary deficit (35.7%), endonasal adhesions (21.4%), and cerebrospinal fluid leak (17.8%). Surgical mortality was 7.1%. Conclusions Endoscopic endonasal transsphenoidal surgery is a valuable treatment option for large or giant pituitary adenomas, which results in high rates of surgical decompression of cerebrovascular structures.

PMID: 27191235 [PubMed - as supplied by publisher]

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Use of a platelet-rich fibrin membrane to repair traumatic tympanic membrane perforations: a comparative study.

Use of a platelet-rich fibrin membrane to repair traumatic tympanic membrane perforations: a comparative study.

Acta Otolaryngol. 2016 May 18;:1-7

Authors: Gür ÖE, Ensari N, Öztürk MT, Boztepe OF, Gün T, Selçuk ÖT, Renda L

Abstract
OBJECTIVES: (1) To evaluate the effects of a platelet-rich fibrin (PRF) membrane in the repair of traumatic tympanic membrane (TM) perforations; and (2) to compare the use of a PRF membrane with the paper patch technique with regard to recovery rates, healing time, and correction of the mean air-bone gap.
METHODS: A randomized, prospective analysis was performed for 60 patients who were treated for traumatic TM perforations using one of the two methods. Closure rate, speed of healing, and hearing gain were compared between the PRF (Group 1) and paper patch (Group 2) groups.
RESULTS: Closure was obtained in 28 (93%) perforations in Group 1 and 25 (83%) perforations in Group 2 (p > 0.05). On day 10, full closure of the TM was observed in 24 (80%) patients in Group 1 and 16 (53%) patients in Group 2 (p < 0.05). The improvement in the mean air-bone gap was 14.1 dB in Group 1 and 12.4 dB in Group 2 on post-operative day 45 (p < 0.05).
CONCLUSIONS: In comparison with the paper patch method, PRF, a new method, provided more rapid healing with more successful audiological results, and with no requirement for a second procedure.

PMID: 27192505 [PubMed - as supplied by publisher]

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Hearing impairment, cochlear morphology, and peroxynitrite (ONOO(-)) formation in adult and aging NOS II knockout mice.

Hearing impairment, cochlear morphology, and peroxynitrite (ONOO(-)) formation in adult and aging NOS II knockout mice.

Acta Otolaryngol. 2016 May 18;:1-8

Authors: Labbé D, Bloch W, Schick B, Michel O

Abstract
CONCLUSION: Nitric oxide synthase (NOS) II induction is a protective mechanism against age-related degeneration of the cochlea.
OBJECTIVES: An induction of NOS II has been described in different inner ear pathologies. The objective was to examine the role of NOS II in age-related degeneration of the cochlea.
METHODS: The hearing ability in adult and aging NOS II knockout mice (KO) and their wildtype (WT) littermates was explored via auditory brainstem response (ABR) measurements. Inner ear morphological differences were studied with scanning electron microscopy (SEM). Immunohistochemistry was used to examine the induction of NOS II in the inner ear of aging WT mice. Expression of nitrotyrosin, a marker protein for the reactive oxygen species peroxynitrite, was compared between KO and WT mice using immunohistochemistry.
RESULTS: Adult KO mice exhibited a mild hearing impairment. WT mice showed an induction of NOS II after 6 months of age. Age-related hearing deterioration was accelerated in KO mice, which was accompanied by increased nitrotyrosin formation and outer hair cell loss.

PMID: 27192390 [PubMed - as supplied by publisher]

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Prognostic impact of perineural invasion in hypopharyngeal squamous cell carcinoma.

Prognostic impact of perineural invasion in hypopharyngeal squamous cell carcinoma.

Acta Otolaryngol. 2016 May 18;:1-5

Authors: Joo YH, Cho KJ, Lee YS, Kim SY, Kim MS

Abstract
OBJECTIVES: The aim of this study was to evaluate the role of PNI in HPSCC.
METHODS: The medical records of 105 patients who underwent surgery-based treatment for HPSCC were reviewed. Clinicopathologic parameters including disease-specific survival were correlated with PNI.
RESULTS: PNI was identified in 27 of the 105 (25.7%) cases of HPSCC. Correlation analysis demonstrated that PNI in HPSCC was significantly correlated with pN classification (10.3% in N0/N1 vs 34.8% in N2/N3, p = 0.006). Patients with PNI had decreased 5-year disease-specific survival with borderline significance (p = 0.065). In a sub-set of 31 patients who did not receive post-operative radiotherapy, PNI was determined to be a significant prognostic predictor (p = 0.033). In multivariate analysis, extracapsular invasion was the only independent prognostic factor for disease-specific survival (p = 0.001).
CONCLUSION: Perineural invasion (PNI) should be considered an independent predictor for cervical lymph node involvement. PNI status in primary hypopharyngeal squamous cell carcinoma (HPSCC) specimens should be considered in decisions concerning adjuvant radiotherapy.

PMID: 27192156 [PubMed - as supplied by publisher]

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Prevention of Postoperative Cerebrospinal Fluid Leaks After Translabyrinthine Tumor Resection With Resorbable Mesh Cranioplasty.

Related Articles

Prevention of Postoperative Cerebrospinal Fluid Leaks After Translabyrinthine Tumor Resection With Resorbable Mesh Cranioplasty.

Otol Neurotol. 2015 Sep;36(9):1537-42

Authors: Hunter JB, Sweeney AD, Carlson ML, Wanna GB, Rivas A, Weaver KD, Chambless LB, Thompson RS, Haynes DS, Bennett ML

Abstract
OBJECTIVES: To evaluate the effectiveness of resorbable mesh cranioplasty at reducing postoperative cerebrospinal fluid (CSF) leak and pseudomeningocele formation after translabyrinthine tumor resection.
STUDY DESIGN: Case series with chart review.
SETTING: Tertiary academic referral center.
PATIENTS: Fifty-three consecutive cases using a resorbable mesh cranioplasty after translabyrinthine tumor resection were reviewed.
INTERVENTION: Temporal bone defects were repaired with a dural substitute, layered fat graft, and a resorbable mesh plate secured with screws.
MAIN OUTCOME MEASURES: Primary outcome measures included the incidence of postoperative CSF wound leak or rhinorrhea, pseudomeningocele formation, and surgical site infection.
RESULTS: Fifty-three cases (average age, 54.0 yr; range, 19.3-75.1 yr) were analyzed. The average body mass index was 30.8 kg/m2 (range, 17.9-48.3 kg/m2), and the average tumor size was 18.8 mm (range, 8-38 mm). One patient (1.9%) experienced CSF rhinorrhea on postoperative Day 16, which resolved after transmastoid middle ear and eustachian tube packing. One patient (1.9%) experienced a surgical site infection requiring surgical debridement and mesh removal 4 months after surgery. Compared with 1,441 prior translabyrinthine surgeries analyzed from our institution using a traditional fat graft closure without mesh, the rate of postoperative CSF leak was significantly less using the resorbable mesh cranioplasty technique (p = 0.0483).
CONCLUSION: Resorbable mesh cranioplasty is a safe and effective method to reduce postoperative CSF leak and pseudomeningocele formation after translabyrinthine craniotomy for tumor excision.

PMID: 26208128 [PubMed - indexed for MEDLINE]

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