The effect of circadian rhythm on the perceived tinnitus severity: A preliminary study.

Related Articles

The effect of circadian rhythm on the perceived tinnitus severity: A preliminary study.

Int Tinnitus J. 2014;19(1):41-5

Authors: Zacharia T, James J, Prakash H, Mohan RT, Rajashekhar B

Abstract
INTRODUCTION: Hearing sound that does not originate in the world outside the body is an experience every human has at one time or another in life. Circadian rhythm is common for all living organisms and nearly all physiological functions, especially sleep-wake cycles, exhibit circadian rhythmicity. A short survey conducted in the study center revealed that majority of the tinnitus subjects reported a difference in tinnitus severity across the day. So the current study focused on finding out the influence of circadian rhythm on tinnitus severity.
MATERIALS & METHODS: Study was conducted on 20 tinnitus subjects irrespective of age, gender, hearing status and type of tinnitus. Kannada version of MEQ was given to all the subjects to classify them to various circadian types. A visual analog scale was also given to rate the severity of the tinnitus in the morning and evening.
RESULTS: The result of the current study states that, there was a significant difference in the tinnitus severity for moderate morning type individuals in the morning and evening and not for the intermediate group.
CONCLUSION: So we can conclude that, circadian rhythm has a strong association with the severity of the tinnitus.

PMID: 27186832 [PubMed - in process]

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Development and standardization of Morningness-Eveningness Questionnaire (MEQ) in the Indian language Kannada.

Related Articles

Development and standardization of Morningness-Eveningness Questionnaire (MEQ) in the Indian language Kannada.

Int Tinnitus J. 2014;19(1):36-40

Authors: Zacharia T, James J, Prakash H, Mohan RT, Rajashekhar B

Abstract
INTRODUCTION: A circadian rhythm is any biological process that displays an endogenous, entrainable, oscillation of about 24 hours; the rhythms driven by a circadian clock and sleep have been widely observed in plants, animals, fungi and cyanobacteria. The main aim of the current study was to translate and validate the Morningness-Eveningness Questionnaire (MEQ) to Kannada (MEQ-K).
MATERIALS AND METHODS: The English version of MEQ was translated to Kannada using translation-back-translation method. Further it was given to 30 native Kannada speakers for content validation. The final MEQ-Kannada version was then administered on 93 normal native Kannada speakers. Statistical analysis was carried out using SPSS 17.0 software. Statistics such as mean, standard deviation and variance and reliability statistics such as Cronbach's alpha score as well as item-total correlation were obtained.
RESULTS: RESULTS showed that, MEQ-K has a Cronbach's alpha score of 0.870 which is considered to be of good reliability. It was also observed that, even after deletion of any one item from the MEQ-K, the Cronbach's alpha score remained the same.
CONCLUSION: From the current results it can be stated that, MEQ-K is a reliable tool that can categorize Kannada speaking population into various circadian types.

PMID: 27186831 [PubMed - in process]

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Gastric peroral endoscopic pyloromyotomy (G-POEM) as a salvage therapy for refractory gastroparesis: a case series of different subtypes.

Gastric peroral endoscopic pyloromyotomy (G-POEM) as a salvage therapy for refractory gastroparesis: a case series of different subtypes.

Neurogastroenterol Motil. 2016 May 15;

Authors: Mekaroonkamol P, Li LY, Dacha S, Xu Y, Keilin SD, Willingham FF, Cai Q

Abstract
BACKGROUND: Gastroparesis is a poorly understood, chronic, debilitating motility disorder with very limited medical therapeutic options. Gastric peroral endoscopic pyloromyotomy (G-POEM) is an emerging novel endoscopic technique as an incisionless pyloroplasty for refractory cases. Effective information of G-POEM on different types of gastroparesis is sparse.
METHODS: Cases of G-POEM using selective circular myotomy as a salvage therapy for refractory symptoms were retrospective studied. The G-POEM procedures were performed by a single expert endoscopist under a certain protocol. Gastroparesis Cardinal Symptoms Index (GCSI) and gastric emptying scintigraphy (GES) were evaluated before and after the procedure. Procedures related adverse event were also recorded.
KEY RESULTS: All procedures were successfully completed without complications. Each case in this series was different in demography and etiology of gastroparesis, namely postsurgical, postinfectious, and idiopathic gastroparesis in an elderly male and two young female adults. All cases were refractory to conventional treatment but demonstrated obvious success after G-POEM as a salvage therapy both clinically and on GES.
CONCLUSIONS & INFERENCES: G-POEM as a salvage therapy improves symptoms and gastric emptying in patients with different types of refractory gastroparesis. Our cases are also the firsts to show success of G-POEM in postinfectious gastroparesis and in elderly male patient. More data are needed to determine which subgroup of patients would benefit most from this novel procedure.

PMID: 27197717 [PubMed - as supplied by publisher]

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Role of worry in patients with chronic tinnitus and sensorineural hearing loss: a preliminary study.

Role of worry in patients with chronic tinnitus and sensorineural hearing loss: a preliminary study.

Eur Arch Otorhinolaryngol. 2016 May 19;

Authors: Caldirola D, Teggi R, Daccò S, Sangiorgio E, Bussi M, Perna G

Abstract
Tinnitus-related distress appears to be more strongly associated with multiple psychological factors than with any perceptual properties of tinnitus. Prior studies have not investigated the role of worry in tinnitus sufferers. Worry is a dispositional cognitive trait that involves a pervasive, non-specific, future-oriented proneness to fretting, which can foster negative affective states and catastrophic thinking about a specific trouble when the trouble is actual and present. We examined the relationship between worry and self-perceived anxiety and depressive symptoms and handicap in 54 outpatients with chronic tinnitus and sensorineural hearing loss who had been previously recruited for a randomized double-blind study on the efficacy of transmeatal low-level laser therapy for tinnitus. We measured the current anxiety and depressive symptoms with the State-Trait Anxiety Inventory Form Y-1/Self-evaluation Depression Scale, the handicap with the Tinnitus Handicap Inventory, and the proneness to worry with the Penn State Worry Questionnaire. For the psychoacoustic tinnitus measures, we considered the loudness match and the minimum masking level. We found that tinnitus-related anxiety and depressive symptoms and handicap were significantly associated with proneness to worry (linear regression models, p < 0.01), whereas no associations were found with the psychoacoustic measures. This suggests the usefulness of worry assessment when managing chronic tinnitus in clinical practice. Early therapeutic interventions for reducing proneness to worry may facilitate better adaptation to tinnitus.

PMID: 27197727 [PubMed - as supplied by publisher]

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Authors' reply.

Authors' reply.

J Laryngol Otol. 2016 Feb;130(2):210

Authors: Larsen K

PMID: 27200446 [PubMed - indexed for MEDLINE]

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Optimal outcomes for hearing preservation in the management of small vestibular schwannomas.

Optimal outcomes for hearing preservation in the management of small vestibular schwannomas.

J Laryngol Otol. 2016 May 20;:1-5

Authors: Peng KA, Wilkinson EP

Abstract
OBJECTIVE: To undertake a systematic review of the role of microsurgery, in relation to observation and stereotactic radiation, in the management of small vestibular schwannomas with serviceable hearing.
METHODS: The Medline database was searched for publications that included the terms 'vestibular schwannoma' and/or 'acoustic neuroma', occurring in conjunction with 'hearing'. Articles were manually screened to identify those concerning vestibular schwannomas under 1.5 cm in greatest dimension. Thereafter, only publications discussing both pre-operative and post-operative hearing were considered.
RESULTS: Twenty-six papers were identified. Observation is an acceptable strategy for small tumours with slow growth where hearing preservation is not a consideration. In contrast, microsurgery, including the middle fossa approach, may provide excellent hearing outcomes, particularly when a small tumour has begun to cause hearing loss. Immediate post-operative hearing usually predicts long-term hearing. Recent data on stereotactic radiation suggest long-term deterioration of hearing following definitive therapy.
CONCLUSION: In patients under the age of 65 years with small vestibular schwannomas, microsurgery via the middle fossa approach offers durable preservation of hearing.

PMID: 27198728 [PubMed - as supplied by publisher]

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Letter to the Editor regarding squamoid pattern of anaplastic thyroid carcinoma, a poorly recognized entity.

Letter to the Editor regarding squamoid pattern of anaplastic thyroid carcinoma, a poorly recognized entity.

Head Neck. 2016 May 19;

Authors: Cabanillas ME, Williams MD

PMID: 27198734 [PubMed - as supplied by publisher]

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Reply to Letter to the Editor regarding anaplastic thyroid carcinoma.

Reply to Letter to the Editor regarding anaplastic thyroid carcinoma.

Head Neck. 2016 May 19;

Authors: Ryan NA, Lazic D

PMID: 27198627 [PubMed - as supplied by publisher]

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Impact of parathyroidectomy for primary hyperparathyroidism on quality of life: A case-control study using Short Form Health Survey 36.

Impact of parathyroidectomy for primary hyperparathyroidism on quality of life: A case-control study using Short Form Health Survey 36.

Head Neck. 2016 May 20;

Authors: Dulfer R, Geilvoet W, Morks A, van Lieshout EM, Smit CP, Nieveen van Dijkum EJ, In't Hof K, van Dam F, van Eijck CH, de Graaf PW, van Ginhoven TM

Abstract
BACKGROUND: Physical and mental complaints are common in patients with primary hyperparathyroidism (PHPT) and negatively impact quality of life (QOL). Subjective symptoms in current guidelines are not considered an indication for surgery. The purpose of this study was to assess the effect of parathyroidectomy on QOL in patients with PHPT.
METHODS: This multicenter case-control study investigated preoperative and postoperative QOL scores in patients operated for PHPT, measured with the Short Form Health Survey-36 (SF-36) questionnaire. Results were compared with patients undergoing a hemithyroidectomy, the control group.
RESULTS: Fifty-two patients and 49 controls were included. Patients with PHPT had significantly lower QOL scores preoperatively and improved significantly after successful surgical treatment. Postoperatively, no differences were observed between the 2 groups.
CONCLUSION: QOL was significantly lower in patients with untreated PHPT. Surgical treatment was associated with a significant increase in QOL. Decreased QOL should also be considered as an indicator for surgical treatment in patients with PHPT. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27198205 [PubMed - as supplied by publisher]

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Severe laryngeal stenosis in newly born twins with 22q11.2 deletion syndrome: A case report.

Severe laryngeal stenosis in newly born twins with 22q11.2 deletion syndrome: A case report.

J Neonatal Perinatal Med. 2016 May 18;

Authors: Clive B, Corsten G, Penney LS, Van den Hof M, El-Naggar W

Abstract
Chromosome 22q11.2 deletion syndrome is common and presents with a range of clinical features from cardiac malformations to hypocalcemia. Laryngeal anomalies are not a common feature of this syndrome. We describe newly born twins who presented with unexpected severe birth depression secondary to severe type IV glottic webs requiring extensive resuscitation and emergency tracheostomy. They were diagnosed postnatally to have deletion of 22q11.2. The successful resuscitation of these infants at birth was only possible because they were born in a tertiary care hospital. This report shows the critical nature of prenatal diagnosis of 22q11.2 deletion syndrome.

PMID: 27197926 [PubMed - as supplied by publisher]

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Development of a bilayer ring system for achieving high strain in commercial rheometers.

Related Articles

Development of a bilayer ring system for achieving high strain in commercial rheometers.

J Biomech. 2015 Sep 18;48(12):3512-6

Authors: Christensen MB, Wolchok JC, Klemuk SA, Titze IR

Abstract
Mechanical stimulation of cell cultures has been shown be an effective means of enhancing ECM production. ECM produced from vocal fold fibroblast cultures has the potential for therapeutic use for vocal fold repair. However, current bioreactor designs generally fail to produce physiological relevant frequency and strain values. Here we present an approach for using commercial oscillatory rheometers and an elastic ring bilayer system to produce physiologically relevant strain values at frequencies in the range of 20-100 Hz. We demonstrate the ability to target specific strain and frequency values by manipulating system parameters, and also show that it is possible to maintain high oscillatory strains for extended periods of time. Such a system could be used to mechanically stimulate cell cultures contained within gel carrier systems and has the potential to be extended to other applications requiring high strains at low frequencies.

PMID: 26228712 [PubMed - indexed for MEDLINE]

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Cochlear Implant Impedance Fluctuation in Ménière's Disease: A Case Study.

Cochlear Implant Impedance Fluctuation in Ménière's Disease: A Case Study.

Otol Neurotol. 2016 May 19;

Authors: McNeill C, Eykamp K

Abstract
OBJECTIVE: To contribute to the understanding of hearing fluctuation in Ménière's disease (MD) by disseminating a case study of a cochlear implanted ear with ongoing fluctuation of electrode impedances with episodic tinnitus and no associated vestibular symptoms.
STUDY DESIGN: Retrospective case review.
SETTING: Tertiary referral audiology clinic.
PATIENT: Man, born in 1936, with a total hearing loss in the right ear because of Mumps at age 8 years and a fluctuating progressive hearing loss in the left ear because of Ménière's disease since age 63 years.
INTERVENTION: Sequential bilateral cochlear implantation right ear in August 2002 and left ear in March 2006.
MAIN OUTCOME MEASURE: Impedance measurements of implanted intracochlear electrodes via common ground stimulation using proprietor programming software.
RESULTS: Electrode impedances in the MD showed significant ongoing variation since implantation, whereas the contralateral non-MD ear remained stable over a period of 9 years.
CONCLUSION: Electrode impedances in the ear with MD showed a variation pattern similar to that found in the hearing fluctuation characteristic of the disease. These findings raise the possibility that the same physiological mechanisms of hearing fluctuation may be responsible for intracochlear electrode impedance changes. We hypothesize that impedance fluctuation is because of changes in the permeability of the blood-labyrinth barrier because of cyclic immune activity in the inner ear which alters the electrical resistance between scala tympani and blood.

PMID: 27203844 [PubMed - as supplied by publisher]

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Transient Hearing Loss and Objective Tinnitus Induced by Mouth Opening: A Rare Connection Between the Temporomandibular Joint and Middle Ear Space.

Transient Hearing Loss and Objective Tinnitus Induced by Mouth Opening: A Rare Connection Between the Temporomandibular Joint and Middle Ear Space.

Otol Neurotol. 2016 May 19;

Authors: Hidaka H, Tatewaki Y, Sakamoto M, Kobayashi T, Yuasa Y, Yuasa R, Nomura K, Yamauchi D, Katori Y

Abstract
OBJECTIVES: To describe objective tinnitus complicated with transient low-tone hearing loss coinciding with mouth opening, which was related to the connection between the mandibular fossa and middle ear space.
PATIENTS: A 41-year-old man presented with tinnitus, ear fullness, and hearing loss in the left ear on mouth opening.
MAIN OUTCOME MEASURES: Clinical case records, audiological data, and radiological analyses including computed tomography (CT) and magnetic resonance imaging.
RESULTS: Hearing thresholds on the affected side, which were evaluated with mouth opening, showed elevations of approximately 20 dB in the frequencies below 1000 Hz. Again, peak pressure on the tympanogram deviated negatively to -220 mmH2O under mouth opening without changing peak amplitude. CT showed a connection between the mandibular fossa and middle ear space, as revealed by a gas collection around the joint capsule evaluated in two phases (with and without mouth closing). Ear symptoms resolved after myringotomy.
CONCLUSIONS: Although an influence of temporomandibular disorder (TMD) on tinnitus perception has been debated, whether this association is causal or fortuitous has remained contentious. The present case showed a unique feature of tinnitus attributed to a connection between the mandibular fossa and middle ear space.

PMID: 27203846 [PubMed - as supplied by publisher]

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Cochlear Implant Impedance Fluctuation in Ménière's Disease: A Case Study.

Cochlear Implant Impedance Fluctuation in Ménière's Disease: A Case Study.

Otol Neurotol. 2016 May 19;

Authors: McNeill C, Eykamp K

Abstract
OBJECTIVE: To contribute to the understanding of hearing fluctuation in Ménière's disease (MD) by disseminating a case study of a cochlear implanted ear with ongoing fluctuation of electrode impedances with episodic tinnitus and no associated vestibular symptoms.
STUDY DESIGN: Retrospective case review.
SETTING: Tertiary referral audiology clinic.
PATIENT: Man, born in 1936, with a total hearing loss in the right ear because of Mumps at age 8 years and a fluctuating progressive hearing loss in the left ear because of Ménière's disease since age 63 years.
INTERVENTION: Sequential bilateral cochlear implantation right ear in August 2002 and left ear in March 2006.
MAIN OUTCOME MEASURE: Impedance measurements of implanted intracochlear electrodes via common ground stimulation using proprietor programming software.
RESULTS: Electrode impedances in the MD showed significant ongoing variation since implantation, whereas the contralateral non-MD ear remained stable over a period of 9 years.
CONCLUSION: Electrode impedances in the ear with MD showed a variation pattern similar to that found in the hearing fluctuation characteristic of the disease. These findings raise the possibility that the same physiological mechanisms of hearing fluctuation may be responsible for intracochlear electrode impedance changes. We hypothesize that impedance fluctuation is because of changes in the permeability of the blood-labyrinth barrier because of cyclic immune activity in the inner ear which alters the electrical resistance between scala tympani and blood.

PMID: 27203844 [PubMed - as supplied by publisher]

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Microvascular decompression for tinnitus: systematic review.

Microvascular decompression for tinnitus: systematic review.

J Neurosurg. 2016 May 20;:1-10

Authors: Nash B, Carlson ML, Van Gompel JJ

Abstract
OBJECTIVE The objective of this study was to examine operative outcomes in cases of microvascular decompression (MVD) of cranial nerve (CN) VIII for tinnitus through a critical review of the literature. METHODS Forty-three English-language articles were gathered from PubMed and analyzed. In this review, two different case types were distinguished: 1) tinnitus-only symptomatology, which was defined as a patient with tinnitus with or without sensorineural hearing loss; and 2) mixed symptomatology, which was defined as tinnitus with symptoms of other CN dysfunction. This review reports outcomes of those with tinnitus-only symptoms. RESULTS Forty-three tinnitus-only cases were found in the literature with a 60% positive outcome rate following MVD. Analysis revealed a 5-year cutoff of preoperative symptom duration before which a good outcome can be predicted with 78.6% sensitivity, and after which a poor outcome can be predicted with 80% specificity. CONCLUSIONS As the 60% success rate is more promising than several other therapeutic options open to the chronic tinnitus sufferer, future research into this field is warranted.

PMID: 27203146 [PubMed - as supplied by publisher]

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Venous sinus stenting in patients without idiopathic intracranial hypertension.

Venous sinus stenting in patients without idiopathic intracranial hypertension.

J Neurointerv Surg. 2016 May 19;

Authors: Levitt MR, Albuquerque FC, Gross BA, Moon K, Jadhav AP, Ducruet AF, Crowley RW

Abstract
BACKGROUND: Venous sinus stenting is an effective treatment for patients with idiopathic intracranial hypertension (IIH) and venous sinus stenosis.
OBJECTIVE: To determine the usefulness of venous sinus stenting in the treatment of patients with symptomatic venous sinus stenosis without a diagnosis of IIH.
METHODS: We performed a retrospective review of a prospective multicenter database of patients undergoing venous sinus stenting between January 2008 and February 2016. Patients with acute dural venous sinus thrombosis, arteriovenous fistula or arteriovenous malformation, or IIH were excluded. Clinical, radiological, and ophthalmological information was recorded.
RESULTS: Nine patients met the inclusion criteria and underwent venous sinus stenting for symptomatic dural venous sinus stenosis. Reasons for treatment included isolated unilateral pulsatile tinnitus (n=1), congenital hydrocephalus (n=2), unilateral pulsatile tinnitus following prior venous sinus thrombosis (n=1), acquired hydrocephalus following dural sinus thrombosis (n=2), meningitis (n=2) and tumor invasion into the dural venous sinus (n=1). Six patients underwent lumbar puncture or shunt tap, and all of these patients had elevated intracranial pressure. All stenoses were located in the transverse sinus, transverse-sigmoid junction and/or jugular bulb, and all were treated with self-expanding bare-metal stents. At follow-up, clinical symptoms had resolved in all but two patients, both of whom had congenital hydrocephalus and pre-existing shunts. There was no significant in-stent stenosis, and patients with ophthalmological follow-up demonstrated improvement of papilledema.
CONCLUSIONS: Dural venous sinus stenting may be an effective treatment for patients with symptomatic venous sinus stenosis without IIH in carefully selected cases, but may not be effective in resolving the symptoms of congenital hydrocephalus.

PMID: 27199383 [PubMed - as supplied by publisher]

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Association Between Headaches and Tinnitus in Young Adults: Cross-Sectional Study.

Association Between Headaches and Tinnitus in Young Adults: Cross-Sectional Study.

Headache. 2016 May 20;

Authors: Guichard E, Montagni I, Tzourio C, Kurth T

Abstract
OBJECTIVE: To study the association between migraine and tinnitus in a large, cross-sectional study among students.
BACKGROUND: Tinnitus has been associated with various pain syndromes, including headaches. However, prior studies were mainly conducted among elderly adults.
METHODS: Cross-sectional study among 5729 participants of the French internet-based Students Health Research Enterprise (i-Share) cohort. Health, personal and lifestyle habits, and socio-demographics characteristics as well as headache/migraine symptoms and tinnitus, were recorded in a standardized questionnaire based on self-reports. Logistic regression models were used to evaluate the association between the students' headache status and tinnitus.
RESULTS: The 5729 participants had a mean age of 20.8 years (standard deviation 2.8 years), 75.4% were female, and 1645 reported migraine. An association was found between the students' headache status and tinnitus after adjustment for confounding variables. Tinnitus was reported by 8.9% of participants with migraine, 7.3% of patients with migraine without aura, and 10.8% of participants with migraine with aura. The adjusted odds ratios of tinnitus were 1.77 (95% confidence interval, 1.36-2.30) for migraine and 1.38 (0.98-1.92) for non-migraine headache. The association was stronger for students with migraine with aura (odds ratio = 2.10, 95% confidence interval 1.54-2.86) than for migraine without aura (odds ratio = 1.51, 95% confidence interval 1.09-2.07).
CONCLUSION: We found an association between migraine and tinnitus among young individuals, which was strongest for the subgroup migraine with aura.

PMID: 27197786 [PubMed - as supplied by publisher]

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Role of worry in patients with chronic tinnitus and sensorineural hearing loss: a preliminary study.

Role of worry in patients with chronic tinnitus and sensorineural hearing loss: a preliminary study.

Eur Arch Otorhinolaryngol. 2016 May 19;

Authors: Caldirola D, Teggi R, Daccò S, Sangiorgio E, Bussi M, Perna G

Abstract
Tinnitus-related distress appears to be more strongly associated with multiple psychological factors than with any perceptual properties of tinnitus. Prior studies have not investigated the role of worry in tinnitus sufferers. Worry is a dispositional cognitive trait that involves a pervasive, non-specific, future-oriented proneness to fretting, which can foster negative affective states and catastrophic thinking about a specific trouble when the trouble is actual and present. We examined the relationship between worry and self-perceived anxiety and depressive symptoms and handicap in 54 outpatients with chronic tinnitus and sensorineural hearing loss who had been previously recruited for a randomized double-blind study on the efficacy of transmeatal low-level laser therapy for tinnitus. We measured the current anxiety and depressive symptoms with the State-Trait Anxiety Inventory Form Y-1/Self-evaluation Depression Scale, the handicap with the Tinnitus Handicap Inventory, and the proneness to worry with the Penn State Worry Questionnaire. For the psychoacoustic tinnitus measures, we considered the loudness match and the minimum masking level. We found that tinnitus-related anxiety and depressive symptoms and handicap were significantly associated with proneness to worry (linear regression models, p < 0.01), whereas no associations were found with the psychoacoustic measures. This suggests the usefulness of worry assessment when managing chronic tinnitus in clinical practice. Early therapeutic interventions for reducing proneness to worry may facilitate better adaptation to tinnitus.

PMID: 27197727 [PubMed - as supplied by publisher]

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[Extramedullary relapse of acute lymphoblastic leukemia in the mastoid after allogeneic hematopoietic stem cell transplantation: a case report].

[Extramedullary relapse of acute lymphoblastic leukemia in the mastoid after allogeneic hematopoietic stem cell transplantation: a case report].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Jan;30(1):72-3

Authors: Dong F, Wang N, Liu R

Abstract
Extramedullary relapse of acute lymphoblastic leukemia (ALL) in the mastoid after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is rare. In this paper, we describe such an uncommon case of extramedullary relapse of ALL in the mastoid. The patient, who had been diagnosed as having ALL and underwent an allo-HSCT from his matched sibling donor. Eight months after allo-HSCT, he presented with ear-ache, tinnitus. The middle ear mastoid CT revealed otomastoiditis. The patient underwent operation. After pathological examination, the definited diagnosis was made that the patient was extramedullary relapse of ALL in the mastoid. We should pay more attention to the patients with hemopathy, which can help to improve early diagnosis.

PMID: 27197463 [PubMed - in process]

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[The progress of inner ear malformation in radiological research].

[The progress of inner ear malformation in radiological research].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Jan;30(1):88-90

Authors: Kong D, Fu K, Zhao H

Abstract
Inner ear malformations are anomalies linking to development insults at different periods of embryogenesis,which are common causes of congenital sensorineural hearing loss. The evaluation of pediatric sensorineural hearing loss mostly depends on high-resolution computed tomography and magnetic resonance imaging, which can excellently depict the temporal bones and inner ear malformations.

PMID: 27197469 [PubMed - in process]

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[The review on voice disorders and rehabilitation in teachers of primary and secondary school].

[The review on voice disorders and rehabilitation in teachers of primary and secondary school].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Jan;30(1):84-8

Authors: Tang J, Wan P, Chen X

Abstract
Nowadays, various voice disorders are sprung out towards teachers of primary and secondary school, affecting their personal life and social work. Through literature review, the author aims at clearing up series of assessments and methods of voice training which are suitable for the teachers of primary and secondary school, such as establishing a right way of respiratory, phonation and resonance, avoiding occupational risk factors such as vocal abuse or misuse to regain healthy voice. Review of the several relevant literature and commentary about voice disorders of the teachers in primary and secondary school. Although various methods of voice training were reported from time to time to guide us SLP to carry out voice therapy, however, deviations of the clinical data from scholars' different points of view are waiting for our further support through case-control study.

PMID: 27197468 [PubMed - in process]

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[Research progress on the management of no packing after septoplasty].

[Research progress on the management of no packing after septoplasty].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Jan;30(1):80-3

Authors: Lu S, Zhang L, Li J

Abstract
Packing the nose after septoplasty is common practice. The use of postoperative packing has been proposed to reduce the dead space between the subperichondrial flaps and minimize postoperative complications such as hemorrhage, septal hematoma, and formation of synechiae. Additionally, postoperative packing is thought to stabilize the remaining cartilaginous septum and minimize persistence or recurrence of septal deviation. Despite these theoretic advantages, evidence to support the use of postoperative packing is lacking. Additionally, nasal packing is not an innocuous procedure. The use of nasal packing actually cause these complications such as postop- erative pain, mucosal injury, bleeding, worsening of breathing due to sleep disorders, and postoperative infections. Routine use of anterior nasal packing after septoplasty should be challenged for not presenting proven benefit. As alternatives to traditional packing, septal suturing, septal stapler and fibrin glue have been used recently. The purpose of this article is to summarize the progress of traditional packing to no packing after septoplasty.

PMID: 27197467 [PubMed - in process]

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[Supernumerary nasal tooth a case report].

[Supernumerary nasal tooth a case report].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Jan;30(1):78-9

Authors: Li S, Wu J

Abstract
This case report describes a male patient, 5 years old, with recurrent nose congestion and fetid discharge from the right nasal cavity. The suspected clinical diagnosis of a supernumerary nasal tooth was confirmed by computed tomography (CT). Laboratory examination showed normal. After endoscopic removal in general anesthesia, the tooth was examined by pathological examination. A literature search identified 22 supernumerary nasal teeth in 21 patients.

PMID: 27197466 [PubMed - in process]

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[Pleomorphic adenoma of the nasal septum: a case report].

[Pleomorphic adenoma of the nasal septum: a case report].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Jan;30(1):76-7

Authors: Li J, Bian D, Wang J

Abstract
We report a rare case of pleomorphic adenoma arising from the nasal septum. A 37-year-old woman presented with a 1-year-history of right-sided occasional epistaxis. Computed tomographic scans revealed an oval mass in the right nasal cavity. The tumor was removed endoscopically with endonasal approach. The microscopic finding showed numbers of myoepithelial cells and duct-like structures consisting of loose myxoid stroma. This lesion had histological characteristics of a pleomorphic adenoma, and this was confirmed by immunohistochemical expression of cytokeratin, S-100 protein and SMA. Her post-operative course was uneventful, and she is currently free from the disease 1.5 years after surgery.

PMID: 27197465 [PubMed - in process]

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[Distant metastases to maxillary sinus from an unknown lung adenocarcinoma: a cases report].

[Distant metastases to maxillary sinus from an unknown lung adenocarcinoma: a cases report].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Jan;30(1):74-5

Authors: Liang W, Li Q, Zhang T

Abstract
A 59-year-old man was admitted to the Department of Ear, Nose and Throat with a complaint of six-month history of left facial numbness and toothache. There was no special previous medical history in addition to smoking. No obvious abnormality in routine electrocardiogram, chest X-ray, abdominal B ultrasound were found. (1) CT scans showed heterogeneous shadows in maxillary sinus with the lesions on the left max- illary bone and evidently destruction of alveolar bone. The histopathological examination revealed bone tissue which was partly covered by an intact adenocarcinoma cell. (2) Immunohistochemical staining foe CK7, CD117, thyroid transcription factor-1, and novel aspartic proteinase A were positive and thus compatible with metastatic lung adenocarcinoma. (3) Chest CT scans showed a 1 cm x 2 cm mass on the superior lobe of the left lung, with destruction of sternum and rib, confirming that the lesions in the paranasal sinuses were lung cancer metastases. Therefore, this patient conclusively diagnosed as lung adenocarcinoma with multiple bone metastases.

PMID: 27197464 [PubMed - in process]

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[Extramedullary relapse of acute lymphoblastic leukemia in the mastoid after allogeneic hematopoietic stem cell transplantation: a case report].

[Extramedullary relapse of acute lymphoblastic leukemia in the mastoid after allogeneic hematopoietic stem cell transplantation: a case report].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Jan;30(1):72-3

Authors: Dong F, Wang N, Liu R

Abstract
Extramedullary relapse of acute lymphoblastic leukemia (ALL) in the mastoid after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is rare. In this paper, we describe such an uncommon case of extramedullary relapse of ALL in the mastoid. The patient, who had been diagnosed as having ALL and underwent an allo-HSCT from his matched sibling donor. Eight months after allo-HSCT, he presented with ear-ache, tinnitus. The middle ear mastoid CT revealed otomastoiditis. The patient underwent operation. After pathological examination, the definited diagnosis was made that the patient was extramedullary relapse of ALL in the mastoid. We should pay more attention to the patients with hemopathy, which can help to improve early diagnosis.

PMID: 27197463 [PubMed - in process]

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[Hypofibrinogenemia caused by hemocoagulase after endoscopic sinus surgery: a case report].

[Hypofibrinogenemia caused by hemocoagulase after endoscopic sinus surgery: a case report].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Jan;30(1):70-1

Authors: Zhang C, Liu Y, Liu G

Abstract
A 61 year-old male patient, plasma fibrinogen level was 2.98 g/L, endoscopic sinus surgery was performed under general anesthesia for polypoid of uncinate process with mycotic maxillary sinusitis. Hemocoagulase were given in pre- and post-operative for treatment. The patient was found postoperative drain blood continuously since 3 days after surgery, when the dose of hemocoagulase reach 26 KU, and fibrinogen determined in Plasma was 0.48 g/L. Coagulation returned to normal and nasal bleeding stopped after discontinuation of the hemocoagulase and supplement with fibrinogen.

PMID: 27197462 [PubMed - in process]

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[Diagnosis and treatment of laryngeal carcinosarcoma (attached one case report)].

[Diagnosis and treatment of laryngeal carcinosarcoma (attached one case report)].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Jan;30(1):67-9

Authors: Gong W, Liu Y, Li X

PMID: 27197461 [PubMed - in process]

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[3.0 T MRI observe the ears and sinus damage degree of patients with acute carbon onoxide poisoning].

[3.0 T MRI observe the ears and sinus damage degree of patients with acute carbon onoxide poisoning].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Jan;30(1):64-6

Authors: Jia L, Du Y, Gao F, Li Y, Fan X

Abstract
OBJECTIVE: Through 3.0 T MRI study the ear and sinus lesions of patients with acute carbon monoxide poisoning.
METHOD: From 2012 to 2015 collected the MRI images of the 45 patients with acute carbon monoxide poisoning, observe their changes of middle ear and mastoid and sinus imaging.
RESULT: The middle ear injury of mastoid 41 cases (91.1%), 22 cases (48.9%) of maxillary sinus injury, ethmoid sinus injury in 20 cases (44.4%), sphenoid sinus 9 cases (20.0%), 5 cases (11.1%) of frontal sinus injury. Carbon monoxide poisoning patients according to clinical symptoms can be divided into light, medium and heavy 3 groups, observing the ear sinus damage degree for comparison between groups, found to have significant differences (P < 0.05).
CONCLUSION: The patients with acute carbon monoxide poisoning ear and sinus injury should cause the attention of the medical staff, MRI can reflect people's ears from the details and the damage degree of the sinuses.

PMID: 27197460 [PubMed - in process]

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The potential role of epigenetic modulations in BPPV maneuver exercises.

The potential role of epigenetic modulations in BPPV maneuver exercises.

Oncotarget. 2016 May 18;

Authors: Tsai KL, Wang CT, Kuo CH, Cheng YY, Ma HI, Hung CH, Tsai YJ, Kao CL

Abstract
Benign paroxysmal positional vertigo (BPPV) is one of the most common complaints encountered in clinics and is strongly correlated with advanced age or, possibly, degeneration. Redistribution exercises are the most effective approaches to treat BPPV, and canalith repositioning procedure (CRP) cure most BPPV cases. However, the mechanisms through which the treatment modulates systemic molecules in BPPV patients remain largely unknown. In this study, we report that the miR-34a and Sirtuin 1 (SIRT1) genes correlated with the treatment effects of CRP in BPPV subjects. We found that miR-34a expression was largely inhibited and SIRT1 expression was significantly reversed after BPPV maneuver treatment. We also confirmed that the PPAR-γ, PGC-1 and FoxO gene expressions were decreased immediately after canalith repositioning procedure (CRP) for BPPV, and were largely increased after a complete cure of BPPV. Moreover, we observed that after a complete recovery of BPPV, the ROS concentrations, pro-inflammatory cytokine concentrations and p53 expression levels were attenuated. We conclude that BPPV treatment might involve some epigenetic regulations through the mediation of miR-34a, SIRT1 functions and repression of redox status.

PMID: 27203679 [PubMed - as supplied by publisher]

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[Efficacy comparison between endolymphatic sac surgery and semicircular canal occlusion in the treatment of stage 4 Ménière disease].

[Efficacy comparison between endolymphatic sac surgery and semicircular canal occlusion in the treatment of stage 4 Ménière disease].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Jan;30(1):12-4

Authors: Han L, Si F, Yu L, Xia R, Zheng H, Jing Y, Ma X

Abstract
OBJECTIVE: To compare the vertigo controlling situation between the endolymphatic sac decompression(ELSD) and semicircular canal occlusion (SCO) in stage 4 Ménière disease.
METHOD: Fourteen patients who underwent endolymphatic sac decompression and 9 patients who underwent semicircular canal occlusion from 2009 to 2013 were followed. All patients has complete preoperative examination and postoperative follow-up.
RESULT: The vetigo control of the patients underwent endolymphatic sac decompression: completely control 35.7%; basic control 28.6%; partly control 14.3%; the vetigo control of the patients underwent semicircular canal occlusion: completely control 88.9%; basic control 11.1%.
CONCLUSION: ELSD and SCO are alternative methods for the patients of stage 4. SCO has a much highter complete vertigo control rate. For the patients without practical listening, SCO is a better choice.

PMID: 27197446 [PubMed - in process]

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The Appropriate Surgical Approach to a Greater Petrosal Nerve Schwannoma in the Setting of Temporal Lobe Edema.

Related Articles

The Appropriate Surgical Approach to a Greater Petrosal Nerve Schwannoma in the Setting of Temporal Lobe Edema.

World Neurosurg. 2016 Jan;85:364.e5-10

Authors: Kusumi M, Oka H, Aliabadi H, Sato S, Kumabe T

Abstract
BACKGROUND: Facial nerve schwannomas are rare lesions that constitute only 0.8% of all intrapetrous mass lesions. The least frequent lesions are tumors originating in the greater petrosal nerve (GPN). We present a case of a GPN schwannoma with temporal lobe edema in which the patient was operated on using an extradural and intradural approach to prevent complications.
CASE DESCRIPTION: A 66-year-old woman with vertigo and abnormal magnetic resonance imaging findings was referred to our department. Computed tomography scan revealed an isodense subtemporal mass with partial rim calcification and petrosal bone apex erosion. Magnetic resonance imaging confirmed a 22-mm left middle fossa lesion with heterogeneous enhancement and edema of the temporal lobe. A left temporal craniotomy to the middle fossa was performed. The initial extradural exploration revealed the tumor to be in the Glasscock triangle, mainly involving the location of the GPN. The tumor was removed through an intradural approach in piecemeal fashion. Finally, using an extradural and intradural middle fossa approach, the tumor was totally removed, leaving the capsule on the middle fossa floor with continuous facial nerve monitoring. The postoperative course was uneventful without complications of xerophthalmia and facial palsy.
CONCLUSIONS: GPN schwannomas are very rare lesions. The extradural and intradural middle fossa approach was used to preserve the tumor capsule around the GPN. Using this technique, one can safely protect the geniculate ganglion and the GPN.

PMID: 26341443 [PubMed - indexed for MEDLINE]

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Mirror Meningioma at Foramen Magnum: A Management Challenge.

Related Articles

Mirror Meningioma at Foramen Magnum: A Management Challenge.

World Neurosurg. 2016 Jan;85:364.e1-4

Authors: Konar S, Bir SC, Maiti TK, Kalakoti P, Nanda A

Abstract
BACKGROUND: Meningiomas of the foramen magnum are among the most challenging of all skull base lesions. Controversies continue regarding the most appropriate approach to this critical anatomic region. The authors report a first case in English literature about twin meningiomas arising from both sides of the ventrolateral dura at the foramen magnum.
CASE DESCRIPTION: Preoperative imaging showed a solitary mass engulfing the lower medulla. However, intraoperatively a twin mass was discovered. It encased the right side vertebral artery (VA) and abutted the left side. The unilateral far lateral transcondylar approach is not enough to resect both tumors at the same time. However, the far lateral transcondylar approach in both sides may compromise the stability and increase the risk of injury to either side of the neurovascular structures.
CONCLUSIONS: We suggest that resection can be safely achieved via the unilateral far lateral transcondylar approach followed by Gamma Knife radiosurgery (GKRS) or a staged bilateral approach.

PMID: 26283489 [PubMed - indexed for MEDLINE]

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Dosimetric comparisons of carbon ion treatment plans for 1D and 2D ripple filters with variable thicknesses.

Dosimetric comparisons of carbon ion treatment plans for 1D and 2D ripple filters with variable thicknesses.

Phys Med Biol. 2016 Jun 7;61(11):4327-4341

Authors: Ringbæk TP, Weber U, Santiago A, Simeonov Y, Fritz P, Krämer M, Wittig A, Bassler N, Engenhart-Cabillic R, Zink K

Abstract
A ripple filter (RiFi)-also called mini-ridge filter-is a passive energy modulator used in particle beam treatments that broadens the Bragg peak (BP) as a function of its maximum thickness. The number of different energies requested from the accelerator can thus be reduced, which significantly reduces the treatment time. A new second generation RiFi with 2D groove shapes was developed using rapid prototyping, which optimizes the beam-modulating material and enables RiFi thicknesses of up to 6 mm. Carbon ion treatment plans were calculated using the standard 1D 3 mm thick RiFi and the new 4 and 6 mm 2D RiFis for spherical planning target volumes (PTVs) in water, eight stage I non-small cell lung cancer cases, four skull base chordoma cases and three prostate cancer cases. TRiP98 was used for treatment planning with facility-specific base data calculated with the Monte Carlo code SHIELD-HIT12A. Dose-volume-histograms, spatial dose distributions and dosimetric indexes were used for plan evaluation. Plan homogeneity and conformity of thinner RiFis were slightly superior to thicker RiFis but satisfactory results were obtained for all RiFis investigated. For the 6 mm RiFi, fine structures in the dose distribution caused by the larger energy steps were observed at the PTV edges, in particular for superficial and/or very small PTVs but performances for all RiFis increased with penetration depth due to straggling and scattering effects. Plans with the new RiFi design yielded for the studied cases comparable dosimetric results to the standard RiFi while the 4 and 6 mm RiFis lowered the irradiation time by 25-30% and 45-49%, respectively.

PMID: 27203127 [PubMed - as supplied by publisher]

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A rare case of atypical skull base meningioma with perineural spread.

A rare case of atypical skull base meningioma with perineural spread.

J Radiol Case Rep. 2015 Dec;9(12):1-14

Authors: Walton H, Morley S, Alegre-Abarrategui J

Abstract
Atypical meningioma is a rare cause of perineural tumour spread. In this report, we present the case of a 46-year-old female with an atypical meningioma of the skull base demonstrating perineural tumour spread. We describe the imaging features of this condition and its distinguishing features from other tumours exhibiting perineural spread.

PMID: 27200171 [PubMed - in process]

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[Extensive cranioplasty for sagittal synostosis in young children by preserving multiple cranial bone flaps adhered to the dura mater: experience with 63 cases].

[Extensive cranioplasty for sagittal synostosis in young children by preserving multiple cranial bone flaps adhered to the dura mater: experience with 63 cases].

Zhonghua Zheng Xing Wai Ke Za Zhi. 2016 Jan;32(1):9-13

Authors: Bao Nan, Chu Jun, Wang Xue, Yang B, Song Y, Cai J

Abstract
OBJECTIVE: This study aimed to evaluate the effort of applying frontal and occipital bones in extensive cranioplasty and preserving multiple cranial bone flaps adhered to the dura mater in the treatment of sagittal synostosis.
METHODS: From April 2008 to June 2013, sixty-three children with sagittal synostosis, aged 5 months to 3 years, were included in the study. The frontal bone flap was removed using an air drill. The occipital and bilateral temporal bone flaps were cut open but not detached from the dura mater or fixed to produce floating bone flaps. The skull bone was cut into palisade-like structures. Brain compression from both sides and the base of the skull was released and the brain expanded bilaterally through the enlarged space. Only a long strip-shaped bone bridge remained in the central parietal bone. Subsequently, the frontal bone flaps and occipital bone flap were pushed towards the midline and fixed with the parietal bone bridge to shorten the anteroposterior diameter of the cranial cavity and allow the brain to expand bilaterally to correct scaphocephaly. The CT images showed that both sides of the parietal bone of artificial sagittal groove gradually merged postoperative 1 year, and skull almost completely normal healing after operation 2 or 3 years, without deformity recurrence within 5 years. Among them all, 61 children's intelligence is normal and 2 children's lagged behind normal level, no further improvement.
RESULTS: Patients were followed up 1 - 5 years (an average of 43 months). Skull growth was excellent in all patients, the anteroposterior diameter was shortened by 14.6 mm averagely, the transverse diameter was increased by 12.3 mm averagely, the prominent forehead was corrected, and scaphocephaly improved significantly. There were no complications such as death and skull necrosis.
CONCLUSIONS: The application of frontal and occipital bones in extensive cranioplasty and preserving multiple cranial bone flaps adhered to the dura mater can be used in the treatment of sagittal synostosis. Surgery without removing bone flaps is less traumatic and results in no massive bleeding. It can effectively relieve brain compression and promotes transversal expansion of the brain during surgery and subsequent normal brain development.

PMID: 27197472 [PubMed - in process]

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Morphometric study of the medial orbital wall emphasizing the ethmoidal foramina.

Related Articles

Morphometric study of the medial orbital wall emphasizing the ethmoidal foramina.

Surg Radiol Anat. 2015 Sep;37(7):809-13

Authors: Vadgaonkar R, Rai R, Prabhu LV, Rai AR, Tonse M, Vani PC

Abstract
PURPOSE: Ethmoidal foramina on the medial orbital wall show a higher incidence of variation. Surgeons performing endonasal, anterior cranial fossa and medial orbital wall surgeries must be aware of these variations as they are a source of hemorrhage and also serve as landmark in proximity to the orbital apex.
AIM: The present study aims to describe the morphometric distances of various ethmoidal foramina between anterior lacrimal crest to optic canal in south Indian dry human skulls.
MATERIALS AND METHOD: The study was done on 44 adult dry human skulls. The occurrence of Ethmoidal foramina was noted by direct inspection. The distance of Ethmoidal foramina from anterior lacrimal crest to optic canal was measured with the help of ruler, probe and magnifying glass.
RESULTS: The Posterior ethmoidal foramina were found in all 44 skulls bilaterally. Middle ethmoidal foramen was present in 12 and 13 skulls on right and left, respectively. Anterior ethmoidal foramen was found in 38 and 37 skulls on right and left, respectively. The distance between anterior lacrimal crest (ALC) and posterior lacrimal crest (PLC) was in the range of 3-8 mm and that of ALC to anterior ethmoidal foramen was in the range of 24-30 mm. The range of distance between anterior ethmoidal foramen to posterior ethmoidal foramen was 9-17 mm and that between posterior ethmoidal foramen to optic canal was 5-13 mm.
CONCLUSION: These observations would help to predict the anatomical variations in the position of ethmoidal foramina with respect to anterior and posterior lacrimal crest and ensure the safe and precise performance of medial orbital wall surgeries to avoid injuries to the important neurovascular bundles passing through various foramina and fissures.

PMID: 25563482 [PubMed - indexed for MEDLINE]

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Pigmented villonodular synovitis of the temporomandibular joint with intracranial extension: A case series and systematic review.

Related Articles

Pigmented villonodular synovitis of the temporomandibular joint with intracranial extension: A case series and systematic review.

Head Neck. 2015 Aug;37(8):1213-24

Authors: Safaee M, Oh T, Sun MZ, Parsa AT, McDermott MW, El-Sayed IH, Bloch O

Abstract
BACKGROUND: Pigmented villonodular synovitis (PVNS) is a rare proliferative disorder of the synovial membrane. PVNS generally affects large joints but occasionally involves the temporomandibular joint (TMJ), with occasional extension into the middle cranial fossa. The purpose of this study was to report our experience with PVNS along with a focused literature review.
METHODS: Patients with PVNS of the TMJ treated at the University of California - San Francisco from 2007 to 2013 were reviewed. A PubMed search was performed to identify additional cases.
RESULTS: Five patients underwent surgical resection, with 1 recurrence at 61 months. A literature review identified 58 patients, 19 of which had intracranial involvement. Interestingly, intracranial extension was more common in men. Intracranial extension was not associated with an increased rate of recurrence.
CONCLUSION: PVNS of the TMJ is a rare entity associated with excellent outcomes, even with intracranial extension. Management should consist of maximal resection, with radiotherapy reserved for extensive or recurrent lesions.

PMID: 24764167 [PubMed - indexed for MEDLINE]

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[Difference of cervical vestibular evoked myogenic potentials in different audition stage of Ménière disease].

[Difference of cervical vestibular evoked myogenic potentials in different audition stage of Ménière disease].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Jan;30(1):9-12

Authors: Li F, Zhuang J, Chen Y, Gao B, Gu H, Zhou X

Abstract
OBJECTIVE: Our goal was to find whether inreversible function damage of saccule was exist and correlated in Meniere's patients with different audition.
METHOD: Senenty-nine patients with unilateral Meniere's disease, who visited the Dizziness Diagnosis and Treatment Centre of the Second Military Medical University from January to July in 2015 were included. They were grouped as slightly audition damage group (41 cases), mildly-severely audition damage group(38 cases). Meanwhile 20 normal controls underwent the research. The cervical vestibular evoked myogenic potentials were conducted in symptom free period.
RESULT: There was no significant difference of the C-VEMP inducing rate between slightly audition damage group and normal control group. While a statistically difference showed between mildly-severely audition damage group and normal control group or slightly audition damage group. P1, N1 latency had no statistically difference between three groups. The P1-N1 amplitude and asymmetric ratio had no difference between slightly audition damage group and normal control group, but had a statistically difference between mildly-severely audition damage group and slightly audition damage group, normal control group.
CONCLUSION: The function of saccule in Meniere's patients decreased with the aggravation of audition damage.

PMID: 27197445 [PubMed - in process]

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Traumatic intra-sphenoidal pseudoaneurysm lodged inside the fractured sphenoidal sinus.

Traumatic intra-sphenoidal pseudoaneurysm lodged inside the fractured sphenoidal sinus.

Acta Otorhinolaryngol Ital. 2016 Apr;36(2):149-152

Authors: Pelliccia P, Bartolomeo M, Iannetti G, Bonafé A, Makeieff M

Abstract
We describe a case of traumatic intra-sphenoidal right internal carotid artery pseudoaneurysm lodged inside the fractured sphenoidal sinus that developed in a patient with a previous history of frontal and skull base fractures involving the sphenoid sinus and walls of the carotid canal, but with normal intracranial findings at early CT angiography. The patient presented two episodes of massive life-threatening delayed epistaxis before successful endovascular treatment combining the use of coils and an uncovered stent was instituted. This case report highlights that patients with head trauma who present sphenoid sinus fractures with or without massive epistaxis should be evaluated for the development of traumatic internal carotid artery pseudoaneurysm as soon as possible. If the first angiographic evaluation reveals normal findings, repeated epistaxis should prompt a second angiographic evaluation because psudoaneurysm takes time to develop. Early treatment with uncovered stent of the aneurysm can be a life-saving therapeutic approach.

PMID: 27196081 [PubMed - as supplied by publisher]

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Endonasal endoscopic resection of ossifying fibroma involving the ethmoid sinus, orbit and anterior skull base: case report and literature review.

Endonasal endoscopic resection of ossifying fibroma involving the ethmoid sinus, orbit and anterior skull base: case report and literature review.

Acta Otorhinolaryngol Ital. 2016 Apr;36(2):144-148

Authors: Jurlina M, Skitarelić N, Passali D, Passali FM, Mladina R

Abstract
Ossifying fibroma is a benign fibro-osseous tumour that rarely involves the ethmoid sinuses and orbit. It is classified as a benign fibroosseous lesion, a term that is synonymous with a variety of lesions reported in the literature. Recurrence rate with deleterious effects in cases of extramandibular ossifying fibroma is the impetus for open en bloc resection of the tumour. Continuously evolving techniques in endonasal endoscopic sinus surgery has rendered resection of large benign sinonasal and cephalonasal tumours possible. The authors report a case of ossifying fibroma involving the ethmoid sinus, orbit and anterior skull base in a 65-year-old previously healthy woman completely resected by endonasal endoscopic sinus surgery. The patient was free from postoperative complications and was dismissed from hospital on the sixth postoperative day. At present, the patient is disease-free at a regular five-year postoperative follow-up. Endonasal endoscopic resection of sinonasal ossifying fibromas is an excellent therapeutic option when performed by a surgeon experienced in endoscopic sinonasal surgery. The advantages of an endonasal endoscopic approach include direct visualization, enhanced visibility and magnification resulting in decreased intraoperative and postoperative morbidity. Aesthetic outcome is excellent in the absence of facial scars.

PMID: 27196080 [PubMed - as supplied by publisher]

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Oral cavity reconstruction with the masseter flap.

Oral cavity reconstruction with the masseter flap.

Acta Otorhinolaryngol Ital. 2016 Apr;36(2):139-143

Authors: Mahieu R, Russo S, Gualtieri T, Colletti G, Deganello A

Abstract
The purpose of this report is to highlight how an unusual, outdated, unpopular and overlooked reconstructive method such as the masseter flap can be a reliable, straightforward and effective solution for oral reconstruction in selected cases. We report the transposition of the masseter crossover flap in two previously pre-treated patients presenting a second primary oral squamous cell carcinoma; excellent functional results with satisfactory cosmetic appearance were obtained in both cases. In the literature, only 60 cases of oral cavity and oropharyngeal reconstructions using the masseter flap have been reported. The possible clinical utility of this flap, even in modern head and neck reconstructive surgery, is presented and discussed. We believe that the masseter flap should enter in the armamentarium of every head and neck surgeon and be kept in mind as a possible solution since it provides an elegant and extremely simple procedure in suboptimal cases for microvascular reconstruction.

PMID: 27196079 [PubMed - as supplied by publisher]

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Can the learning curve in stapes surgery predict future functional outcome?

Can the learning curve in stapes surgery predict future functional outcome?

Acta Otorhinolaryngol Ital. 2016 Apr;36(2):135-138

Authors: Sergi B, Paludetti G

Abstract
Over the last 20 years, the number of stapes operations performed has decreased steadily. This inadequate exposure to stapes surgery poses problems for both trainees and trainers. We retrospectively reviewed the outcomes of stapedotomy performed by a young physician at the ENT Clinic of the "A. Gemelli" Hospital of Rome. We used the technique of "one-shot" CO2 Laser stapedotomy using a titanium-Teflon piston. For data analysis, we considered the audiograms obtained 24 hours preoperatively and at the last follow-up examination (mean 45 months). Air conduction (AC) and bone conduction (BC) PTA were calculated for 0.25, 0.5, 1, 2 and 4 kHz thresholds. Air bone gap (ABG) were obtained from ACPTA and BCPTA. Postoperative hearing gain was calculated from the ABG before the operation minus the ABG at late follow-up examination. Analysis of outcomes did not show a clear endpoint for the learning curve; complete closure of the ABG was obtained in a large number of patients at the beginning followed by patients who showed a higher ABG. Fortunately, we did not observed any "dead ear". The study supports a learning curve in stapes surgery, but the results can vary widely among surgeries with excellent results followed by others that are not fully satisfactory. Stapes surgery should not be one of the first ear surgeries performed by a young otologist due to the functional outcome expected by patients and the lack of necessary surgical skills.

PMID: 27196078 [PubMed - as supplied by publisher]

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Early and late surgical site infections in ear surgery.

Early and late surgical site infections in ear surgery.

Acta Otorhinolaryngol Ital. 2016 Apr;36(2):127-134

Authors: Bastier PL, Leroyer C, Lashéras A, Rogues AM, Darrouzet V, Franco-Vidal V

Abstract
A retroauricular approach is routinely used for treating chronic otitis media. The incidence of surgical site infections after ear surgery is around 10% in contaminated or dirty procedures. This observational prospective study describes surgical site infections after chronic otitis media surgery with the retroauricular approach and investigated their potential predictive factors. This observational prospective study included patients suffering from chronic otitis media and eligible for therapeutic surgery with a retroauricular approach. During follow-up, surgical site infections were defined as "early" if occurring within 30 days after surgery or as "late" if occurring thereafter. The data of 102 patients were analysed. Concerning early surgical site infections, four cases were diagnosed (3.9%) and a significant association was found with preoperative antibiotic therapy, wet ear at pre-operative examination, class III (contaminated) in the surgical wound classification, NNIS (National Nosocomial Infection Surveillance) index > 1, and oral post-operative antibiotic use. Seven late surgical site infections were diagnosed (7.1%) between 90 and 160 days after surgery and were significantly correlated to otorrhoea during the 6 months before surgery, surgery duration ≤60 minutes, canal wall down technique and use of fibrin glue. Surgical site infections after chronic otitis media surgery seem to be associated with factors related to the inflammatory state of the middle ear at the time of surgery in early infections and with chronic inflammation in late infections.

PMID: 27196077 [PubMed - as supplied by publisher]

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Idiopathic sensorineural hearing loss in the only hearing ear.

Idiopathic sensorineural hearing loss in the only hearing ear.

Acta Otorhinolaryngol Ital. 2016 Apr;36(2):119-126

Authors: Berrettini S, De Vito A, Bruschini L, Fortunato S, Forli F

Abstract
A retrospective chart review was used for 31 patients with sudden, progressive or fluctuating sensorineural hearing loss (SHL) in the only hearing ear who had been consecutively evaluated at the ENT, Audiology and Phoniatrics Unit of the University of Pisa. The group of patients was evaluated with a complete history review, clinical evaluation, imaging exam (MRI, CT), audiologic tests (tone and speech audiometry, tympanometry, study of stapedial reflexes, ABR and otoacoustic emission) evaluation. In order to exclude genetic causes, patients were screened for CX 26 and CX30 mutations and for mitochondrial DNA mutation A1555G. Patients with sudden or rapidly progressive SHL in the only hearing ear were treated with osmotic diuretics and corticosteroids. In patients who did not respond to intravenous therapy we performed intratympanic injections of corticosteroid. Hearing aids were fitted when indicated and patients who developed severe to profound SHL were scheduled for cochlear implant surgery. The aim of this study is to report and discuss the epidemiology, aetiopathogenesis, therapy and clinical characteristic of patients affected by SHL in the only hearing hear and to discuss the issues related to the cochlear implant procedure in some of these patients, with regard to indications, choice of the ear to implant and results.

PMID: 27196076 [PubMed - as supplied by publisher]

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Endoscopic endonasal approach to the craniocervical junction: the importance of anterior C1 arch preservation or its reconstruction.

Endoscopic endonasal approach to the craniocervical junction: the importance of anterior C1 arch preservation or its reconstruction.

Acta Otorhinolaryngol Ital. 2016 Apr;36(2):107-118

Authors: Re M, Iacoangeli M, Di Somma L, Alvaro L, Nasi D, Magliulo G, Gioacchini FM, Fradeani D, Scerrati M

Abstract
We report our experience with the endoscopic endonasal approaches (EEA) for different craniocervical junction (CCJ) disorders to analyse outcomes and demonstrate the importance and feasibility of anterior C1 arch preservation or its reconstruction. Between January 2009 and December 2013, 10 patients underwent an endoscopic endonasal approach for different CCJ pathologies at our Institution. In 8 patients we were able to preserve the anterior C1 arch, while in 2 post-traumatic cases we reconstructed it. The CCJ disorders included 4 cases of irreducible anterior bulbo-medullary compression secondary to rheumatoid arthritis or CCJ anomalies, 4 cases of inveterate fractures of C1 and/or C2 and 2 tumours. Pre- and postoperative neuroradiological evaluation was always obtained by magnetic resonance imaging (MRI), computed tomographic (CT) scanning and dynamic cranio-vertebral junction x-ray. Pre- and postoperative neurologic disability assessment was obtained by Ranawat classification for patients with rheumatoid arthritis and by Nurick classification for the others. At a mean follow-up of 31 months (range: 14-73 months), an improvement of at least one Ranawat or Nurick classification level was observed in 6 patients, while in another 4 patients neurological conditions were stable. Radiological follow-up revealed an adequate bulbo-medullary decompression in all patients and a regular bone fusion in cases of C1 and/or C2 fractures. In all patients spinal stability was preserved and none required subsequent posterior fixation. The endoscopic endonasal surgery provided adequate exposure and a low morbidity minimally invasive approach to the antero-medial located lesions of the CCJ, resulting in a safe, effective and well-tolerated procedure. This approach allowed preservation of the anterior C1 arch and the avoidance of a posterior fixation in all patients of this series, thus preserving the rotational movement at C0-C2 segment and reducing the risk of a subaxial instability development.

PMID: 27196075 [PubMed - as supplied by publisher]

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In vivo tissue response and durability of five novel synthetic polymers in a rabbit model.

In vivo tissue response and durability of five novel synthetic polymers in a rabbit model.

Acta Otorhinolaryngol Ital. 2016 Apr;36(2):101-106

Authors: Sahin E, Cingi C, Eskiizmir G, Altintoprak N, Calli A, Calli C, Yilgör I, Yilgör E

Abstract
Alloplastic materials are frequently used in facial plastic surgeries such as rhinoplasty and nasal reconstruction. Unfortunately, the ideal alloplastic material has not been found. This experimental study evaluates the tissue response and durability of five novel polymers developed as an alloplastic material. In this experimental study involving a tertiary university hospital, six subcuticular pockets were formed at the back of 10 rabbits for the implantation of each polymer and sham group. Each pocket was excised with its adjacent tissue after three months, and collected for histopathological examination. Semi-quantitative examination including neovascularisation, inflammation, fibrosis, abscess formation, multinucleated foreign body giant cells was performed, and integrity of polymer was evaluated. A statistical comparison was performed. No statically significant difference was detected in neovascularisation, inflammation, fibrosis, abscess formation and multinucleated foreign body giant cells when a paired comparison between sham and polymer II, III and IV groups was performed individually. Nevertheless, the degree of fibrosis was less than sham group in polymer I (p = .027) and V (p = .018), although the other variables were almost similar. The integrity of polymers III (9 intact, 1 fragmented) and IV (8 intact, 2 absent) was better than the other polymers. These novel synthetic polymers could be considered as good candidates for clinical applicability. All polymers provided satisfactory results in terms of tissue response; however, fibrovascular integration was higher in polymers II, III and IV. In addition, the durability of polymer III and IV was better than the others.

PMID: 27196074 [PubMed - as supplied by publisher]

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The effects of inferior turbinoplasty on nasal airflow during cosmetic rhinoplasty.

The effects of inferior turbinoplasty on nasal airflow during cosmetic rhinoplasty.

Acta Otorhinolaryngol Ital. 2016 Apr;36(2):97-100

Authors: Zojaji R, Keshavarzmanesh M, Bakhshaee M, Behdani R, Esmaeelzadeh S, MazloumFarsiBaf M

Abstract
Rhinoplasty is one of the most common and challenging cosmetic procedures. One of the complications of rhinoplasty associated with dissatisfaction is nasal obstruction, which is often due to narrowing of the nasal valve area. Application of certain procedures such as turbinoplasty can prevent and correct this problem. This study aim was to investigate the effect of inferior turbinoplasty in reduction of airflow resistance and nasal obstruction. Using active anterior rhinomanometry, nasal airflow was measured in 50 patients who underwent cosmetic rhinoplasty and bilateral turbinoplasty before and 6 months after surgery. None of the patients subjectively complained of nasal obstruction before or after surgery. According to rhinomanometry results, improvement in nasal airflow was seen both in inspiration and expiration, although only expiration was significant (p = 0.034). Airflow changes in males and females and in different age groups was not significant (p > 0.05). It appears that rhinoplasty does not adversely affect nasal airflow when it is accompanied by simple adjuvant procedure inferior turbinoplasty.

PMID: 27196073 [PubMed - as supplied by publisher]

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Post-operative pain management in head and neck cancer patients: predictive factors and efficacy of therapy.

Post-operative pain management in head and neck cancer patients: predictive factors and efficacy of therapy.

Acta Otorhinolaryngol Ital. 2016 Apr;36(2):91-96

Authors: Bianchini C, Malagò M, Crema L, Aimoni C, Matarazzo T, Bortolazzi S, Ciorba A, Pelucchi S, Pastore A

Abstract
There is increasing interest about all aspects of pain sensation for patients undergoing head and neck surgery, and efforts have been made to better assess, monitor and reduce the occurrence of pain. The aetiology of pain is considered to be "multifactorial", as it is defined by several features such as personal experience, quality perception, location, intensity and emotional impact. The aim of this paper is: (i) to evaluate the efficacy of analgesic treatment in patients with head and neck cancer treated by surgery, and (ii) to study the variables and predictive factors that can influence the occurrence of pain. A total of 164 patients, affected by head and neck cancer and surgically treated, between December 2009 and December 2013, were included in this study. Data collected include age, gender, assessment of anaesthetic risk, tumour localisation, pathological cancer stage, TNM stage, type of surgery performed, complexity and duration of surgery, post-operative complications, postoperative days of hospital stay and pain evaluation on days 0, 1, 3 and 5 post-surgery. We studied the appropriateness of analgesic therapy in terms of incidence and prevalence of post-operative pain; we also related pain to patient characteristics, disease and surgical treatment to determine possible predictive factors. The population studied received adequate pain control through analgesic therapy immediately post-surgery and in the following days. No associations between gender, age and post-operative pain were found, whereas pathological cancer stage, complexity of surgery and tumour site were significantly associated with the risk of post-operative pain. Adequate pain control is essential in oncological patients, and particularly in head and neck cancer patients as the prevalence of pain in this localisation is reported to be higher than in other anatomical sites. Improved comprehension of the biological and psychological factors that characterise pain perception will help to enhance its control in the future.

PMID: 27196072 [PubMed - as supplied by publisher]

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Intraoperative radiation therapy as adjuvant treatment in locally advanced stage tumours involving the middle ear: a hypothesis-generating retrospective study.

Intraoperative radiation therapy as adjuvant treatment in locally advanced stage tumours involving the middle ear: a hypothesis-generating retrospective study.

Acta Otorhinolaryngol Ital. 2016 Apr;36(2):85-90

Authors: Cristalli G, Mercante G, Marucci L, Soriani A, Telera S, Spriano G

Abstract
The objective of this study was to evaluate the safety, effectiveness and functional outcomes of intraoperative radiotherapy (IORT) followed by intensity-modulated radiation therapy (IMRT) in locally advanced stage tumours involving the middle ear. Data on 13 consecutive patients treated for malignant tumor of external auditory canal involving the middle ear were retrospectively reviewed. Median follow-up was 33 months (range 6-133). Five (38%) patients were stage III and 8 (62%) were Stage IV according to the University of Pittsburgh staging system. Lateral temporal bone resection (LTBR) was performed in all cases. LTBR was associated with parotidectomy in 5 (38%) cases, and with neck dissection and parotidectomy in 6 (46%) cases. No patients had gross residual tumour. Surgical treatment was followed by IORT (12 Gy) and IMRT (50 Gy). Adjuvant chemotherapy was used in 4 (30%) cases. Preoperative and postoperative audiometric tests were performed to assess hearing loss. 5-year local-control (LC), 5-year distant-metastasis (DM), 5-year disease-free-survival (DFS) and 5-year overall-survival (OS) were calculated with Kaplan-Meyer method. Significant changes in bone conduction were reported after treatment. Partial flap necrosis was the only early complication observed in three (23%) cases, while meningeal fistula was seen in one (7.6%) case as a late complication. The 5-year LC-rate was 68%. The 5-year DM-rate was 90%. The 5-year DFS-rate was 61%. The 5-year OS-rate was 69%. IORT followed by IMRT for the treatment of advanced external auditory canal and middle ear tumours seems to be safe. No intraoperative death was reported. IORT may reduce the postoperative irradiation of remnant tissue obtaining the same full dose on the tumour bed. No complications of the residual external ear were observed. Detriment of neurosensory hearing may be expected. Future studies are required to confirm the benefit of this procedure in the ear.

PMID: 27196071 [PubMed - as supplied by publisher]

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