Femoroacetabular Impingement Is Associated With Sports-Related Posterior Hip Instability in Adolescents: A Matched-Cohort Study.

Femoroacetabular Impingement Is Associated With Sports-Related Posterior Hip Instability in Adolescents: A Matched-Cohort Study.

Am J Sports Med. 2016 Jun 16;

Authors: Mayer SW, Abdo JC, Hill MK, Kestel LA, Pan Z, Novais EN

Abstract
BACKGROUND: Femoroacetabular impingement (FAI) deformity has been associated with posterior hip instability in adult athletes.
PURPOSE: To determine if FAI deformity is associated with posterior hip instability in adolescents, the femoral head-neck junction or acetabular structure in a cohort of adolescent patients who sustained a low-energy, sports-related posterior hip dislocation was compared with that in a group of healthy age- and sex-matched controls with no history of hip injury or pain.
STUDY DESIGN: Cross-sectional study; Level of evidence, 3.
METHODS: We identified 12 male patients (mean age, 13.9 years; range, 12-16 years) who sustained a sports-related posterior hip dislocation and underwent a computed tomography (CT) scan after closed reduction. For each patient, 3 age- and sex-matched healthy controls were identified. Femoral head-neck type was assessed by measurement of the alpha angle on the radially oriented CT images at the 12-, 1-, 2-, and 3-o'clock positions. Age, body mass index (BMI), alpha angle at each position, acetabular version, Tönnis angle, and lateral center-edge angle (LCEA) on the involved hip in the dislocation group were compared with those of the matched controls using a mixed-effects model. A logistic regression analysis using a generalized estimating equation was used to compare the percentage of subjects with cam-type FAI deformity (alpha angle >55°) in each group.
RESULTS: The dislocation and control groups were similar in age distribution and BMI (P > .05). The mean alpha angles were statistically significantly higher in the dislocation group compared with the control group at the superior (46.3° ± 1.1° vs 42.7° ± 0.6°; P = .0213), superior-anterior (55.5° ± 1.9° vs 46.0° ± 1.3°; P = .0005), and anterior-superior (54.9° ± 1.5° vs 48.9° ± 1.0°; P = .0045) regions. Cam deformity was present in a larger proportion of patients in the dislocation group than in the control group (P < .0035). An alpha angle greater than 55° was present in 16.7% of the dislocation group and 0% of the control group at the 12-o'clock position (P = .1213), 41.7% versus 0% at the 1-o'clock position (P = .0034), 58% versus 6% at the 2-o'clock position (P = .0004), and 25% versus 2.8% at the 3-o'clock position (P = .0929). Acetabular anteversion was lower in the dislocation group (9.6° ± 1.4°) compared with the control group (15.1° ± 0.8°) (P = .0068). Mean acetabular LCEA was within a normal range in both groups.
CONCLUSION: A significantly higher mean alpha angle from the superior to the anterior-superior regions of the femoral head-neck junction and lower acetabular version were found in adolescents who sustained low-energy, sports-related posterior hip dislocations.

PMID: 27311413 [PubMed - as supplied by publisher]

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Intraoperative and Early Postoperative Complications After Hip Arthroscopic Surgery: A Prospective Multicenter Trial Utilizing a Validated Grading Scheme.

Intraoperative and Early Postoperative Complications After Hip Arthroscopic Surgery: A Prospective Multicenter Trial Utilizing a Validated Grading Scheme.

Am J Sports Med. 2016 Jun 16;

Authors: Larson CM, Clohisy JC, Beaulé PE, Kelly BT, Giveans MR, Stone RM, Samuelson KM, ANCHOR Study Group

Abstract
BACKGROUND: There is limited literature looking at comprehensive complication rates after arthroscopic hip procedures.
PURPOSE: To prospectively report complication rates for a consecutive series of hips undergoing arthroscopic procedures.
STUDY DESIGN: Case series; Level of evidence, 4.
METHODS: Over a 29-month period, 1615 consecutive hips in patients with a mean age of 30.5 years underwent arthroscopic hip procedures at 4 institutions. The diagnosis, demographic information, and procedures were recorded, and a validated grading classification for complications of hip joint surgery was utilized prospectively. The cohort with complications was observed postoperatively for a mean of 36.7 months (range, 24-54 months).
RESULTS: There were 1487 primary hip arthroscopic procedures and 128 revision hip arthroscopic procedures. Arthroscopic femoroacetabular impingement correction was performed in 1505 hips (93.2%), and 1273 hips (78.8%) underwent a labral repair procedure. The most common event was postoperative lateral femoral cutaneous (LFC) nerve disturbance (16.5%), which persisted beyond 6 months in only 1.6%. The incidence of iatrogenic chondral injuries was 1.2%, iatrogenic labral punctures was 0.9%, superficial portal infections was 1.1%, sensory deficits about the foot was 0.8%, deep venous thrombosis was 0.1%, pulmonary embolism was 0.1%, perineal numbness (pudendal nerve) was 1.4%, heterotopic ossification was 0.8%, and femoral neck stress fractures was 0.1%. There was no iatrogenic instability, avascular necrosis, or extra-abdominal fluid extravasation identified in this cohort. The overall complication rate, not including temporary LFC periportal and thigh numbness (sequela), was 8.3% (134 hips). Overall, a grade 1 complication was seen in 7.2% (117 hips), grade 2 in 0.6% (10 hips), grade 3 in 0.4% (6 hips), and grade 4 in 0.1% (1 hip). There was a significantly higher rate of complications for longer surgical time and traction time (P < .01) and for female patients as compared with male patients (P = .017). Most notably, traction time longer than 60 minutes was associated with a significantly increased complication rate (P < .001). Hips with pudendal nerve neurapraxia had longer traction times than those without (61.5 vs 43.8 minutes, respectively; P < .001). No differences were found between primary versus revision cases (P = .123) or between labral repair versus debridement (P = .209), and body mass index had no effect on the complication rate (P = .103).
CONCLUSION: The overall complication rate after hip arthroscopic surgery at tertiary hip centers was 8.3%, with higher rates reported for longer traction times (>60 minutes) and for female patients. Compared with surgical hip dislocation using the same classification system, the overall rate of complications was similar, but the rate of higher grade complications was lower for arthroscopic hip procedures.

PMID: 27311412 [PubMed - as supplied by publisher]

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Decreasing expression of glucose-regulated protein GRP78/BiP as a significant prognostic predictor in patients with advanced laryngeal squamous cell carcinoma.

Decreasing expression of glucose-regulated protein GRP78/BiP as a significant prognostic predictor in patients with advanced laryngeal squamous cell carcinoma.

Head Neck. 2016 Jun 17;

Authors: Kaira K, Toyoda M, Shimizu A, Imai H, Sakakura K, Nikkuni O, Suzuki M, Iijima M, Asao T, Chikamatsu K

Abstract
BACKGROUND: The immunoglobulin heavy chain binding protein (BiP)/glucose-regulated protein 78 (GRP78) is important in the endoplasmic reticulum stress, and is highly expressed in various human cancers. The clinical and pathological features of GRP78/BiP are unclear in patients with advanced laryngeal squamous cell carcinoma (SCC). The purpose of this study was to investigate the clinicopathological significance of GRP78/BiP as a prognostic marker for laryngeal SCC.
METHODS: A total of 59 patients with advanced laryngeal SCC (stage III/IV) were analyzed, and tumor specimens were stained by immunohistochemistry for GRP78/BiP and Ki-67. Microvessel density was determined by immunohistochemical staining for CD34 and p53.
RESULTS: Expression of GRP78/BiP was confirmed in 87% of cases. Decreased expression of GRP78/BiP was highly associated with positive expression of p53. Decreased GRP78/BiP expression was identified on multivariate analysis as an independent factor of decreased progression-free survival (PFS).
CONCLUSION: GRP78/BiP was found to be commonly expressed in laryngeal SCC, whereas its downregulation was found to serve a significant prognostic role for predicting poor survival in patients with laryngeal SCC with advanced disease. GRP78/BiP may be a potentially attractive target for the treatment of various human neoplasms. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27312568 [PubMed - as supplied by publisher]

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Investigation of the ototoxicity of gadoteridol (ProHance) and gadodiamide (Omniscan) in mice.

Investigation of the ototoxicity of gadoteridol (ProHance) and gadodiamide (Omniscan) in mice.

Acta Otolaryngol. 2016 Jun 17;:1-6

Authors: Nonoyama H, Tanigawa T, Shibata R, Tanaka H, Katahira N, Horibe Y, Takemura K, Murotani K, Ozeki N, Ueda H

Abstract
CONCLUSION: In the mouse, when a tympanic perforation is present, gadoteridol does not seem to cause ototoxicity. Gadodiamide may cause mild ototoxicity other than toxicity to the outer hair cells of the cochlea.
OBJECTIVES: Endolymphatic hydrops have been visualized through intra-tympanic injection of gadolinium-based contrast agents (GBCAs) and three-dimensional fluid-attenuated inversion recovery (3-D FLAIR) magnetic resonance imaging. However, reports on the safety of GBCAs are limited. This study aimed to assess ototoxicity of gadoteridol and gadodiamide.
METHOD: In a prospective, randomized, controlled trial, myringotomies in the left ear were performed in 20 male C57 BL/6 mice. After testing the baseline auditory brainstem response (ABR) (range = 8-32 kHz), the test solution (gadoteridol, gadodiamide, saline, or cisplatin) was injected into the left ear. ABR testing was repeated 14 days after test solution application. In morphological experiments, images of post-mortem surface preparations were assessed for cochlear hair cell status.
RESULTS: At 14 days following gadoteridol application, there was no significant change in ABR thresholds at 8, 16, or 32 kHz. Gadodiamide application caused a significant change in the ABR threshold at 8 kHz. Apparent cochlear hair cell loss was not observed in the surface preparation after gadoteridol or gadodiamide application.

PMID: 27315460 [PubMed - as supplied by publisher]

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The Use Of Anterolateral Thigh Flap (ALTF) For Functional Tongue Reconstruction With Postoperative Quality Of Live Evaluation.

Related Articles

The Use Of Anterolateral Thigh Flap (ALTF) For Functional Tongue Reconstruction With Postoperative Quality Of Live Evaluation.

Pol Przegl Chir. 2015 Aug;87(8):384-8

Authors: Krakowczyk Ł, Maciejewski A, Szymczyk C, Wierzgoń J, Półtorak S

Abstract
UNLABELLED: The use of microsurgery for oral reconstruction of cancer patients, has become standard treatment in restoring oral function. The free anterolateral thigh flap is one of the most preferred options in reconstruction after total, subtotal or hemiresection of the tonque due to squamous cell cancer. The aim of the study was to present the reconstructive method using anterolateral thigh free flap with evaluation of quality of live.
MATERIAL AND METHODS: Clinical material includes 46 consecutive patients with tongue cancer, who underwent complex surgical treatment between 2009 and 2011. There were 36 males and 10 females and the M: F ratio was 3.6: 1. All of them were reconstructed using the anterolateral thigh free flap. The quality of life was evaluated 6 months after completing the treatment, based on postoperative functional and aesthetic status.
RESULTS: The overall flap survival rate was 96%. Surgical complications were observed in 8 patients (17%). Donor site was closed primarly in 42 cases and in remaining 4 skin graft was required. In all 46 cases understandable speech and return to unrestricted diet mastication and swallowing were achieved. The mean follow-up period after treatment was 32 months. Analysis of aesthetic effects evaluated in 23 cases and shows generally very good results. According to average transformed scores the QOL can be characterized as excellent for >90, very good for 76-90, good for 51-75, moderate for 25-50 and bad for <25 points.
CONCLUSIONS: Anterolateral thigh flap, with its versatility in design, long pedicle with a suitable vessel diameter, low donor site morbidity, and very good aesthetic effects, could be the ideal flap for functional tongue reconstruction.

PMID: 26495913 [PubMed - indexed for MEDLINE]

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Petroclival meningiomas: Magnetic resonance imaging factors predict tumor resectability and clinical outcome.

Petroclival meningiomas: Magnetic resonance imaging factors predict tumor resectability and clinical outcome.

Clin Neurol Neurosurg. 2016 Jun 2;147:90-97

Authors: Pirayesh A, Petrakakis I, Raab P, Polemikos M, Krauss JK, Nakamura M

Abstract
OBJECTIVE: Despite advances in skull base surgery, surgical removal of petroclival meningiomas (PCM) still poses a considerable neurosurgical challenge with regard to postoperative morbidity and the patients' long-term outcome. Knowledge of imaging features for PCM that might help to predict common risk factors encountered with tumor resection preoperatively is limited. The aim of this study was to clarify whether MRI features of PCM might predict tumor resectability and clinical outcome.
METHODS: A retrospective analysis of 18 cases of PCM treated surgically in our department between 2007 and 2013 was performed. Following radiological tumor features were compared to the extent of tumor resection and the patients' outcome: a) tumor diameter, b) calcification, c) tumor margin towards the brainstem, d) presence of an arachnoidal cleavage plane, e) brainstem edema, f) brainstem compression and g) tumor signal intensity on T2WI.
RESULTS: There was an excellent correlation between tumor resectability and preoperative findings with regard to the presence or absence of an arachnoidal cleavage plane and an irregular tumor margin towards the brainstem. Additionally, the presence of brainstem edema was significantly related to surgical morbidity, whereas a high tumor intensity on T2WI correlated significantly with soft tumor consistency and/or vascularity encountered during surgery.
CONCLUSION: As demonstrated in our series, PCM with an irregular tumor margin and absence of an arachnoidal plane towards the brainstem should be considered a high-risk group. In these cases, especially when additional brainstem edema is present, limited resection of tumor may be aspired to avoid postoperative morbidity.

PMID: 27315034 [PubMed - as supplied by publisher]

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Letter to the Editor: Endoscopic endonasal approach for clip ligation of cerebral aneurysms.

Letter to the Editor: Endoscopic endonasal approach for clip ligation of cerebral aneurysms.

J Neurosurg. 2016 Jun 17;:1-3

Authors: Tayebi Meybodi A, Benet A

PMID: 27315023 [PubMed - as supplied by publisher]

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Required Reading: The most impactful articles in endoscopic endonasal skull base surgery.

Required Reading: The most impactful articles in endoscopic endonasal skull base surgery.

World Neurosurg. 2016 Jun 13;

Authors: Zhang M, Singh H, Almodovar-Mercado GJ, Anand VK, Schwartz TH

Abstract
OBJECTIVE: Endoscopic endonasal skull base surgery has become a widely accepted field in neurosurgery and otolaryngology over the last 15 years. However, there has yet to be a formal curation of the most impactful articles for an introductory curriculum to its technical evolution.
METHODS: The Science Citation Index Expanded was used to generate a citation rank list (October 2015) on articles relevant to endoscopic skull base surgery. The top 35 cited articles overall, as well as the top 15 since 2009, were identified. Journal, year, author, study population, article format, and level of evidence were compiled. Additional surgeon-experts were polled and made recommendations for significant contributions to the literature.
RESULTS: The top 35 publications ranged from 98 to 467 citations and were published in 10 different journals. Four articles had over 250 citations. A period of frequent contribution occurred between 2005-2009, when 21/35 reports were published. 18/35 articles were case series, and 13/35 were technical reports. There were 11/35 articles focused primarily on pituitary surgery, and 10/35 on extra-sellar lesions. The top 15 articles since 2009 had 8/15 articles focus on extra-sellar lesions. Polled surgeons consistently identified the most prominently cited articles, and their recommendations drew attention to CSF-leak as well as extra-sellar management.
CONCLUSIONS: Identification of the most cited works within endoscopic endonasal skull base surgery demonstrates greater anatomical access and safety over the last two decades. These articles can serve as an educational tool for novices or mid-level practitioners wishing to obtain a greater understanding of the field.

PMID: 27312387 [PubMed - as supplied by publisher]

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Radiotherapy in late elderly (aged 75 or older) patients with paranasal sinus carcinoma: a single institution experience.

Radiotherapy in late elderly (aged 75 or older) patients with paranasal sinus carcinoma: a single institution experience.

Eur Arch Otorhinolaryngol. 2016 Jun 17;

Authors: Doi H, Kitajima K, Tanooka M, Terada T, Noguchi K, Takada Y, Fujiwara M, Ishikura R, Kamikonya N, Hirota S

Abstract
The purpose of our study was to assess the feasibility of radiotherapy (RT) for locally advanced paranasal sinus carcinomas in late elderly patients (aged ≥75 years) from a single institution in Japan. From 2000 to 2015, we retrospectively analyzed 14 patients (11 maxillary and 3 ethmoid sinus carcinoma patients) who underwent RT for pathologically confirmed paranasal sinus carcinomas. RT was performed without unexpected cessations. Two patients, however, developed Grade 3 mucositis. The median follow-up duration was 13 months (range 2-54 months). The 1- and 2-year overall survival (OS) rates were 81.8 and 54.5 %, respectively. The local response rate after the initial treatment was 85.7 %. The 1- and 2-year progression-free survival (PFS) rates were 46.2 and 24.8 %, respectively. Univariate analysis of different clinicopathological parameters was conducted to identify associations with OS and PFS. We demonstrated that intensity modulated radiation therapy (IMRT) of >60 Gy with concomitant intra-arterial (cisplatin-based) infusion chemoradiotherapy led to improved OS and PFS rates, although no statistical significance was observed. Moreover, none of the squamous cell carcinoma (SCC) patients who received 33 fractions of 66 Gy in IMRT died during the median follow-up period of 13 months (range 12-25 months). In conclusion, RT with concomitant intra-arterial (cisplatin-based) infusion chemoradiotherapy can be considered an effective, well-tolerated, and feasible treatment option for late elderly patients with paranasal sinus carcinomas. In addition, >60 Gy of RT in IMRT led to improved survival outcomes in elderly paranasal sinus carcinoma patients.

PMID: 27314860 [PubMed - as supplied by publisher]

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Clinical comparison of two subtypes of cystic vestibular schwannoma: surgical considerations and outcomes.

Clinical comparison of two subtypes of cystic vestibular schwannoma: surgical considerations and outcomes.

Eur Arch Otorhinolaryngol. 2016 Jun 16;

Authors: Huo Z, Zhang Z, Huang Q, Yang J, Wang Z, Jia H, Wu H

Abstract
Cystic vestibular schwannoma (CVS) is classified as Type A and Type B based on the overall cyst location and cyst wall thickness in magnetic resonance imaging. A retrospective analysis was performed to compare surgical considerations and outcomes between Type A and Type B groups of CVS. We selected 188 patients diagnostic for CVS with surgical resection, and divided them into Type A and Type B groups. General information, preoperative symptoms, the result of neuroimaging, and audiological tests were recorded. Surgical approach, completeness of tumor resection, and intraoperative facial nerve (FN) integrity were taken down. After operation, the short-term and long-term FN functions, complications, and recurrence rate were evaluated. The total tumor removal rate in Type A group was higher than that in Type B group (86.1 vs 72.5 %, p = 0.021). Anatomical FN integrity was preserved in 173 patients (92.0 %), with no significant differences between Type A and Type B. FN function was better in Type A group at hospital discharge. Besides, a good FN function rate was inversely proportional to the tumor size. The long-term FN function and all of the complications had no significant differences between the two groups. Patients in the Type B group are prone to have a lower total tumor removal rate and transient FN dysfunction. The long-term FN function was similar in both groups. Tumor size is another important indication of FN function. All postoperative complications occurred in patients with a tumor larger than grade 3, regardless of the subtypes of CVS.

PMID: 27312994 [PubMed - as supplied by publisher]

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Reply to the letter to the editor concerning: "An absorbable thread suture technique to treat snoring".

Reply to the letter to the editor concerning: "An absorbable thread suture technique to treat snoring".

Eur Arch Otorhinolaryngol. 2016 Jun 16;

Authors: Kwon JW, Park DJ

PMID: 27312993 [PubMed - as supplied by publisher]

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A meta-analysis for the role of proton pump inhibitor therapy in patients with laryngopharyngeal reflux.

A meta-analysis for the role of proton pump inhibitor therapy in patients with laryngopharyngeal reflux.

Eur Arch Otorhinolaryngol. 2016 Jun 16;

Authors: Wei C

Abstract
We aimed to systematically review the randomized controlled trials (RCTs) regarding the therapeutic efficiency of proton pump inhibitor (PPI) therapy for laryngopharyngeal reflux (LPR). Randomized and placebo-controlled trials regarding the therapeutic efficacy of PPIs on LPR patients were systematically searched from MEDLINE, Cochrane Library, and EMBASE. Data were extracted from eligible studies meeting the inclusion criteria. Heterogeneity among these eligible studies was evaluated by the Q-statistic and I (2) test, based on which a fixed- or random-effects model was performed to pooled relative risks (RRs) for the response rate and standardized mean differences (SMDs) for reflux symptom index (RSI) and the reflux finding score (RFS). Potential publication bias was evaluated by trim and fill method. Totally, 13 RCTs including 831 LPR patients were eligible for this meta-analysis. Pooled results demonstrated that the total RSI significantly improved for patients who received PPI therapy by comparing with those receiving placebo (SMD = 3.65; 95 % CI 1.56-5.75), though no significant difference was found in response rate (RR = 0.04, 95 % CI -0.06 to 0.14) and RFS (SMD = 0.91; 95 % CI -0.53 to 2.35) between these two groups of patients. No publication bias was found among eligible studies. PPI treatment could significantly improve reflux symptoms in LPR patients and, therefore, should be taken into consideration for LPR management with other strategies, such as lifestyle modification.

PMID: 27312992 [PubMed - as supplied by publisher]

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Investigation of the ototoxicity of gadoteridol (ProHance) and gadodiamide (Omniscan) in mice.

Investigation of the ototoxicity of gadoteridol (ProHance) and gadodiamide (Omniscan) in mice.

Acta Otolaryngol. 2016 Jun 17;:1-6

Authors: Nonoyama H, Tanigawa T, Shibata R, Tanaka H, Katahira N, Horibe Y, Takemura K, Murotani K, Ozeki N, Ueda H

Abstract
CONCLUSION: In the mouse, when a tympanic perforation is present, gadoteridol does not seem to cause ototoxicity. Gadodiamide may cause mild ototoxicity other than toxicity to the outer hair cells of the cochlea.
OBJECTIVES: Endolymphatic hydrops have been visualized through intra-tympanic injection of gadolinium-based contrast agents (GBCAs) and three-dimensional fluid-attenuated inversion recovery (3-D FLAIR) magnetic resonance imaging. However, reports on the safety of GBCAs are limited. This study aimed to assess ototoxicity of gadoteridol and gadodiamide.
METHOD: In a prospective, randomized, controlled trial, myringotomies in the left ear were performed in 20 male C57 BL/6 mice. After testing the baseline auditory brainstem response (ABR) (range = 8-32 kHz), the test solution (gadoteridol, gadodiamide, saline, or cisplatin) was injected into the left ear. ABR testing was repeated 14 days after test solution application. In morphological experiments, images of post-mortem surface preparations were assessed for cochlear hair cell status.
RESULTS: At 14 days following gadoteridol application, there was no significant change in ABR thresholds at 8, 16, or 32 kHz. Gadodiamide application caused a significant change in the ABR threshold at 8 kHz. Apparent cochlear hair cell loss was not observed in the surface preparation after gadoteridol or gadodiamide application.

PMID: 27315460 [PubMed - as supplied by publisher]

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Expanding Hematoma's Life-Threatening Neck and Face Emergency Management.

Expanding Hematoma's Life-Threatening Neck and Face Emergency Management.

J Craniofac Surg. 2016 Jun 16;

Authors: Shuker ST

Abstract
This article aims to bring attention to the morbidity and fatality of hemorrhage, how expanding hematoma and air compromise neck/face N/F injuries and present challenges. Large neck vessel ballistic injuries may lead to hemorrhage and expanding hematoma, resulting in airway compromise, due to injuries to the internal and/or external carotid arteries, internal jugular veins "internal carotid artery, external carotid artery, internal jugular vein," and the external carotid artery deep branches. This also leads to injuries to the cervical fascial layers (barriers of deep spaces) that facilitate pooling blood and hematoma into compartmental and large potential space which effects the pharynx, larynx, esophagus, and trachea.The expanding hematomas distort neck anatomical landmarks so "no neck zones" classifications are applicable. As the spectrum of injuries continues to evolve, the clinical characterization needs a new categorization based on compartmental hematoma and potential space anatomical location like retropharyngeal, parapharyngeal, sublingual, submandibular spaces, retrobulbar, and cheek compartment space hematomas.Presence of symptoms and location of the hematoma generally dictate what type of procedure is needed and how urgently it needs to be appropriately performed.Two unusual patients of pseudoaneurysms facial artery injuries with extravasation of blood producing a pulsating hematoma are referred to. Another patient considers large internal carotid artery injuries pseudoaneurysms revealed in angiography.The immediate management of life-saving patients requires aggressive airway maintenance at the scene, conscious victim will often obtain a posture that clears his airway and the semiconscious or unconscious put him in prone position. Air compromise may need emergency intubation, large bore cannula cricothyroidotomy, cricothyrotomy and at medical facilities tracheostomy.

PMID: 27315316 [PubMed - as supplied by publisher]

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Ewing Sarcoma of the External Ear Canal.

Ewing Sarcoma of the External Ear Canal.

Case Rep Otolaryngol. 2016;2016:6925234

Authors: Binnetoglu A, Baglam T, Tokuc G, Kecelioglu Binnetoglu K, Gerin F, Sari M

Abstract
Background. Ewing sarcoma (ES) is a high-grade malignant tumor that has skeletal and extraskeletal forms and consists of small round cells. In the head and neck region, reported localization of extraskeletal ES includes the larynx, thyroid gland, submandibular gland, nasal fossa, pharynx, skin, and parotid gland, but not the external ear canal. Methods. We present the unique case of a 2-year-old boy with extraskeletal ES arising from the external ear canal, mimicking auricular hematoma. Results. Surgery was performed and a VAC/IE (vincristine, adriamycin, cyclophosphamide alternating with ifosfamide, and etoposide) regimen was used for adjuvant chemotherapy for 12 months. Conclusion. The clinician should consider extraskeletal ES when diagnosing tumors localized in the head and neck region because it may be manifested by a nonspecific clinical picture mimicking common otorhinolaryngologic disorders.

PMID: 27313930 [PubMed]

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Nucleolar localization of Small G protein RhoA is associated with active RNA synthesis in human carcinoma HEp-2 cells.

Nucleolar localization of Small G protein RhoA is associated with active RNA synthesis in human carcinoma HEp-2 cells.

Oncol Lett. 2016 Jun;11(6):3605-3610

Authors: Li Y, Hu Y, Che L, Jia J, Chen M

Abstract
Previous studies have demonstrated that the nuclear localization of ras homolog family member A (RhoA), with prominent concentration in the nucleolus, is a common feature in human cancer tissues and cancer cell lines. Although a previous study has demonstrated that the nuclear translocation of RhoA occurs via active transport, a process that occurs through importin α in a nuclear factor-κB-dependent manner, the mechanism, biological function and pathological meaning of the nucleolar residency of RhoA remain to be elucidated. As the cell nucleolus is the site of ribosome biosynthesis, the aim of the present study was to investigate the association between RNA synthesis and the nucleolar localization of RhoA, as well as the molecular mechanisms underlying the residency of RhoA in the nucleolus of HEp-2 (human larynx epithelial carcinoma) cells. Indirect immunofluorescence microscopy was used to evaluate the subcellular distribution of nuclear RhoA, and immunoblotting analysis was used to determine the total cellular protein level of RhoA. Consistent with the results of previous studies, untreated HEp-2 cells exhibited bright nucleolar staining, indicating an increased concentration of RhoA in the nucleoli. Treatment with actinomycin D for the inhibition of RNA synthesis caused a redistribution of RhoA from the nucleoli to the nucleoplasm with a speckled staining pattern. Immunoblotting revealed that neither the total cellular amount of RhoA nor the integrity of RhoA was affected by treatment with actinomycin D. In cells that were treated at a decreased concentration (0.05 mg/l) of actinomycin D, the redistribution of RhoA was reversible following the removal of the drug from the culture medium. However, this reversal was not observed at an increased drug concentration (1 mg/l). Overall, to the best of our knowledge, the results of the present study provide the first in situ evidence that the inhibition of RNA synthesis induces a redistribution of nucleolar RhoA to the nucleoplasm, and additionally suggest that the nucleolar residency of RhoA in HEp-2 cells may be associated with active RNA synthesis.

PMID: 27313679 [PubMed - as supplied by publisher]

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Prevention of anterior glottis web with hyaluronic acid derivatives in rabbit model.

Prevention of anterior glottis web with hyaluronic acid derivatives in rabbit model.

Laryngoscope. 2016 Jun 16;

Authors: Kwon SK, Ryu YJ, Kim DW, Chang H, Kim SY, Sung MW, Hah JH

Abstract
OBJECTIVES/HYPOTHESIS: Validating an antiadhesive strategy to prevent anterior glottic web (AGW) development.
STUDY DESIGN: Prospective animal study in rabbits.
METHODS: Fifteen New Zealand white rabbits were randomly divided into three equal groups (five rabbits each), applying either HyFence (HF: 0.1 g/vocal fold), an antiadhesive test agent; mitomycin-C (MMC: 1 mg/ml, 4 min) as reference therapy; or saline (control group) to AGWs induced by laryngofissure technique (previously reported by us). At week 8, the extent of AGW was measured to assess preventive effects of HF and MMC, and laryngeal specimens were sampled for high-speed recording and histologic analysis.
RESULTS: AGW induction was successful in all five (100%) control rabbits, each demonstrating fibroconnective tissue and collagen fibers at anterior commissure, with AGW ratio averaging 0.57 ± 0.052. An AGW was seen in 100% of the rabbits survived in the MMC group (n = 2) with the 60% (n = 3) of the MMC rabbits expired due to postprocedure infections. The average AGW ratio was 0.28 ± 0.070 in the MMC group. AGW formation rate was 50% in HF group with one rabbit expired from infection. Mean AGW ratio was lowest in the HF group (0.23 ± 0.10; P = 0.013). Microscopically, AGW induction sites in HF-treated rabbits displayed significantly fewer collagen fibers (P = 0.009) by comparison.
CONCLUSION: This is the first reported use of a cross-linked hyaluronic acid gel that may prevent AGW formation.
LEVEL OF EVIDENCE: N/A. Laryngoscope, 2016.

PMID: 27313151 [PubMed - as supplied by publisher]

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Sulfated glycosaminoglycans in human vocal fold lamina propria.

Sulfated glycosaminoglycans in human vocal fold lamina propria.

Braz J Otorhinolaryngol. 2016 Jun 2;

Authors: Park SW, Korn GP, Kobayashi EY, Martins JR, De Biase NG

Abstract
INTRODUCTION: The distribution, concentration and function of glycosaminoglycans in the various vocal fold tissues are still unclear.
OBJECTIVE: To evaluate the distribution and concentration of sulfated glycosaminoglycans in different layers of the human vocal fold according to gender and age.
METHODS: We used 11 vocal folds obtained from cadavers (7 men and 4 women) with no laryngeal lesion, less than 12h after death, and aged between 35 and 98 years. The folds underwent glycosaminoglycans extraction from the cover and ligament, and post-electrophoresis analysis. Data were compared according to the layer, age and gender.
RESULTS: The concentration of dermatan sulfate was significantly higher in all layers. No differences were observed in the total concentrations of glycosaminoglycans in layers studied according to gender. It is significantly lower in the cover of individuals aged below 60 years.
CONCLUSION: Dermatan sulfate, chondroitin sulfate, and heparan sulfate were observed in the human vocal folds cover and ligament of both genders, with the concentration of dermatan sulfate being significantly higher in all layers. glycosaminoglycans concentration on the cover is significantly lower in individuals below 60 years compared with elderly.

PMID: 27312227 [PubMed - as supplied by publisher]

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Prenatal features of Pena-Shokeir sequence with atypical response to acoustic stimulation.

Prenatal features of Pena-Shokeir sequence with atypical response to acoustic stimulation.

J Clin Ultrasound. 2016 Jun 17;

Authors: Pittyanont S, Jatavan P, Suwansirikul S, Tongsong T

Abstract
A fetal sonographic screening examination performed at 23 weeks showed polyhydramnios, micrognathia, fixed postures of all long bones, but no movement and no breathing. The fetus showed fetal heart rate acceleration but no movement when acoustic stimulation was applied with artificial larynx. All these findings persisted on serial examinations. The neonate was stillborn at 37 weeks and a final diagnosis of Pena-Shokeir sequence was made. In addition to typical sonographic features of Pena-Shokeir sequence, fetal heart rate accelerations with no movement in response to acoustic stimulation suggests that peripheral myopathy may possibly play an important role in the pathogenesis of the disease. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound, 2016.

PMID: 27312123 [PubMed - as supplied by publisher]

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Efficacy of microsurgical tumor removal for treatment of patients with intracanalicular vestibular schwannoma presenting with disabling vestibular symptoms.

Efficacy of microsurgical tumor removal for treatment of patients with intracanalicular vestibular schwannoma presenting with disabling vestibular symptoms.

J Neurosurg. 2016 Jun 17;:1-6

Authors: Samii M, Metwali H, Gerganov V

Abstract
OBJECTIVE The aim of this study was to analyze the efficacy and risks of microsurgery via the hearing-preserving retrosigmoid approach in patients with intracanalicular vestibular schwannoma (VS) suffering from disabling vestibular symptoms, with special attention to vertigo. METHODS This is a retrospective analysis of 19 patients with intracanalicular VS and disabling vestibular dysfunction as the main or only symptom (Group A). All of the patients reported having had disabling vertigo attacks. Subjective evaluation of the impairment of patients was performed before surgery, 3 weeks after surgery, 3 months after surgery, and 1 year after surgery, using the Dizziness Handicap Inventory (DHI). The main outcome measures were improvement in quality of life as measured using the DHI, and general and functional outcomes, in particular facial function and hearing. Patient age, preoperative tumor size, preoperative DHI score, and preservation of the nontumorous vestibular nerve were tested using a multivariate regression analysis to determine factors affecting the postoperative DHI score. The Mann-Whitney U-test was used to compare the postoperative DHI score at 3 weeks, 3 months, and 1 year after surgery with a control group of 19 randomly selected patients with intracanalicular VSs, who presented without vestibular symptoms (Group B). The occurrence of early postoperative discrete vertigo attacks was also compared between groups. RESULTS The preoperative DHI score was ≥ 54 in all patients. All patients reported having had disabling rotational vertigo before surgery. The only significant factor to affect the DHI outcome 3 weeks and 3 months after surgery was the preoperative DHI score. The DHI outcome after 1 year was not affected by the preoperative DHI score. Compared with the control group, the DHI score at 3 weeks and 3 months after surgery was significantly worse. There was no significant difference between the groups after 1 year. Vertigo was improved in all patients and completely resolved after 1 year in 17 patients. CONCLUSIONS Disabling vestibular dysfunction that affects quality of life should be considered an indication for surgery, even in otherwise asymptomatic patients with intracanalicular VS. Surgical removal of the tumor is safe and very effective in regard to symptom relief. All patients had excellent facial nerve function within 1 year after surgery, with a very good chance of hearing preservation.

PMID: 27315031 [PubMed - as supplied by publisher]

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Outcomes among patients discharged from the emergency department with a diagnosis of peripheral vertigo.

Related Articles

Outcomes among patients discharged from the emergency department with a diagnosis of peripheral vertigo.

Ann Neurol. 2016 Jan;79(1):32-41

Authors: Atzema CL, Grewal K, Lu H, Kapral MK, Kulkarni G, Austin PC

Abstract
OBJECTIVE: We aimed to determine the risk of short- and long-term stroke, as well as accidental injury, in patients discharged from an emergency department who were given a diagnosis of a peripheral vestibular disorder.
METHODS: In this population-based, retrospective, cohort study, we identified all adult patients who were discharged from an emergency department in Ontario, Canada, between 2006 and 2011, with a primary diagnosis of a peripheral vestibular disorder. We assessed hospitalized strokes at 7, 30, 90, and 365 days, as well as subsequent falls, motor vehicle accidents, fractures, and burns. To provide context, we assessed the same outcomes in propensity score-matched discharged emergency department patients with renal colic.
RESULTS: Among 41,794 qualifying patients, 76 (0.18%) had a stroke within 30 days. Accidental injury at 30 days ranged from 0.01% (falls) to 0.15% (fractures). The relative risk (RR) of 30-day stroke was 9.3 (95% confidence interval [CI]: 4.3-20.3) times higher than among matched renal colic controls. The RR was highest at 7 days (50.0; 95% CI, 6.9-362.0) and diminished with duration from the emergency department visit: RR 6.1 (95% CI, 3.5-10.7) at 90 days and 2.5 (95% CI, 1.8-3.5) at 1 year. There was no difference in the risk of accidental injury.
INTERPRETATION: The frequency of early stroke after discharge from an emergency department with a diagnosis of a peripheral vestibular disorder was extremely low. However, the relative risk was markedly higher than in matched patients with renal colic, suggesting that some strokes, or sentinel events for strokes, are being misdiagnosed as peripheral vestibular disorders.

PMID: 26385410 [PubMed - indexed for MEDLINE]

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Image-Guided Placement of Osseointegrated Implants for Challenging Auricular, Orbital, and Rhinectomy Defects.

Image-Guided Placement of Osseointegrated Implants for Challenging Auricular, Orbital, and Rhinectomy Defects.

Ann Otol Rhinol Laryngol. 2016 Jun 15;

Authors: Choi KJ, Sajisevi MB, McClennen J, Kaylie DM

Abstract
OBJECTIVES: Prosthetic reconstruction can restore the preoperative form and function after surgery for head and neck malignancies. We demonstrate the use of preoperative planning and intraoperative image guidance for placement of osseointegrated implants to restore craniofacial defects.
METHODS: A retrospective review of patients with craniofacial defects treated with image-guided placement of osseointegrated prosthetic implants was performed.
RESULTS: Case 1: 55-year-old male who underwent total auriculectomy with anterolateral thigh reconstruction. Case 2: 64-year-old male who required orbital exenteration and total auriculectomy with latissimus dorsi reconstruction. Case 3: 74-year-old male presented after a total rhinectomy. Cases 1 and 3 received adjuvant radiation prior to implantation. Case 2 underwent simultaneous placement of osseointegrated hearing and prosthetic implants. Computed tomography scans were used to perform preoperative planning to determine the optimal implant trajectories and sites. Complications included tissue overgrowth, delayed nonunion of implant, wound infection, and dehiscence.
CONCLUSIONS: Defects following oncologic resection of head and neck malignancies can be difficult to achieve with native tissue alone. Osseointegrated implants offer an excellent means for reconstruction but can be challenging due to limited bone stock and anatomic landmarks. This can be overcome using intraoperative image guidance techniques for prosthetic reconstruction.

PMID: 27307422 [PubMed - as supplied by publisher]

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[Comparison between stapled and traditional suture closure total laryngectomy].

Related Articles

[Comparison between stapled and traditional suture closure total laryngectomy].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(11):963-6

Authors: Wang L, Wang W, Lou W

Abstract
OBJECTIVE: To compare the clinical results between stapled and traditional suture closure total laryngectomy.
METHOD: Fifty-three cases of laryngeal cancer with total laryngectomy were divided into 2 groups: 32 cases with traditional suture closure total laryngectomy (group A) and 21 cases with stapled total laryngectomy group (group B). Compare two groups in pharyngeal fistula, postoperative bleeding, dysphagia, and nasal regurgitation.
RESULT: There was no difference of postoperative pharyngeal fistula between group A and B (P>0. 05). The incidence of dysphagia, nasal regurgitation, and postoperative bleeding in group B were 23. 8%, 14. 3% and 14. 3% respectively, which were obviously higher than that in group A (P<0. 05).
CONCLUSION: Stapled total laryngectomy has the advantages of reducing the operative time and simplifying the operation with some disadvantages such as higher standards of operation indications, higher incidence of dysphagia, higher nasal regurgitation, higher postoperative bleeding, and poor medical economic profit. Traditional suture closure total laryngectomy is recommended in clinical practice.

PMID: 26536692 [PubMed - indexed for MEDLINE]

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Perception of Small Frequency Differences in Children with Auditory Processing Disorder or Specific Language Impairment.

Perception of Small Frequency Differences in Children with Auditory Processing Disorder or Specific Language Impairment.

J Am Acad Audiol. 2016 Jun;27(6):489-497

Authors: Rota-Donahue C, Schwartz RG, Shafer V, Sussman ES

Abstract
BACKGROUND: Frequency discrimination is often impaired in children developing language atypically. However, findings in the detection of small frequency changes in these children are conflicting. Previous studies on children's auditory perceptual abilities usually involved establishing differential sensitivity thresholds in sample populations who were not tested for auditory deficits. To date, there are no data comparing suprathreshold frequency discrimination ability in children tested for both auditory processing and language skills.
PURPOSE: : This study examined the perception of small frequency differences (∆ƒ) in children with auditory processing disorder (APD) and/or specific language impairment (SLI). The aim was to determine whether children with APD and children with SLI showed differences in their behavioral responses to frequency changes. Results were expected to identify different degrees of impairment and shed some light on the auditory perceptual overlap between pediatric APD and SLI.
RESEARCH DESIGN: An experimental group design using a two-alternative forced-choice procedure was used to determine frequency discrimination ability for three magnitudes of ∆ƒ from the 1000-Hz base frequency.
STUDY SAMPLE: Thirty children between 10 years of age and 12 years, 11 months of age: 17 children with APD and/or SLI, and 13 typically developing (TD) peers participated. The clinical groups included four children with APD only, four children with SLI only, and nine children with both APD and SLI.
DATA COLLECTION AND ANALYSIS: Behavioral data collected using headphone delivery were analyzed using the sensitivity index d', calculated for three ∆ƒ was 2%, 5%, and 15% of the base frequency or 20, 50, and 150 Hz. Correlations between the dependent variable d' and the independent variables measuring auditory processing and language skills were also obtained. A stepwise regression analysis was then performed.
RESULTS: TD children and children with APD and/or SLI differed in the detection of small-tone ∆ƒ. In addition, APD or SLI status affected behavioral results differently. Comparisons between auditory processing test scores or language test scores and the sensitivity index d' showed different strengths of correlation based on the magnitudes of the ∆ƒ. Auditory processing scores showed stronger correlation to the sensitivity index d' for the small ∆ƒ, while language scores showed stronger correlation to the sensitivity index d' for the large ∆ƒ.
CONCLUSION: Although children with APD and/or SLI have difficulty with behavioral frequency discrimination, this difficulty may stem from two different levels: a basic auditory level for children with APD and a higher language processing level for children with SLI; the frequency discrimination performance seemed to be affected by the labeling demands of the same versus different frequency discrimination task for the children with SLI.

PMID: 27310407 [PubMed - as supplied by publisher]

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Factors Affecting Speech Discrimination in Children with Cochlear Implants: Evidence from Early-Implanted Infants.

Factors Affecting Speech Discrimination in Children with Cochlear Implants: Evidence from Early-Implanted Infants.

J Am Acad Audiol. 2016 Jun;27(6):480-488

Authors: Phan J, Houston DM, Ruffin C, Ting J, Holt RF

Abstract
BACKGROUND: To learn words and acquire language, children must be able to discriminate and correctly perceive phonemes. Although there has been much research on the general language outcomes of children with cochlear implants (CIs), little is known about the development of speech perception with regard to specific speech processes, such as speech discrimination.
PURPOSE: The purpose of this study was to investigate the development of speech discrimination in infants with CIs and identify factors that might correlate with speech discrimination skills.
RESEARCH DESIGN: Using a Hybrid Visual Habituation procedure, we tested infants with CIs on their ability to discriminate the vowel contrast /i/-/u/. We also gathered demographic and audiological information about each infant.
STUDY SAMPLE: Children who had received CIs before 2 yr of age served as participants. We tested the children at two post cochlear implantation intervals: 2-4 weeks post CI stimulation (N = 17) and 6-9 mo post CI stimulation (N = 10).
DATA COLLECTION AND ANALYSIS: The infants' mean looking times during the novel versus old trials of the experiment were measured. A linear regression model was used to evaluate the relationship between the normalized looking time difference and the following variables: chronological age, age at CI stimulation, gender, communication mode, and best unaided pure-tone average.
RESULTS: We found that the best unaided pure-tone average predicted speech discrimination at the early interval. In contrast to some previous speech perception studies that included children implanted before 3 yr of age, age at CI stimulation did not predict speech discrimination performance.
CONCLUSIONS: The results suggest that residual acoustic hearing before implantation might facilitate speech discrimination during the early period post cochlear implantation; with more hearing experience, communication mode might have a greater influence on the ability to discriminate speech. This and other studies on age at cochlear implantation suggest that earlier implantation might not have as large an effect on speech perception as it does on other language skills.

PMID: 27310406 [PubMed - as supplied by publisher]

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Investigating the Interaction between Dichotic Deficits and Cognitive Abilities Using the Dichotic Digits difference Test (DDdT) Part 2.

Investigating the Interaction between Dichotic Deficits and Cognitive Abilities Using the Dichotic Digits difference Test (DDdT) Part 2.

J Am Acad Audiol. 2016 Jun;27(6):470-479

Authors: Cameron S, Glyde H, Dillon H, Whitfield J

Abstract
BACKGROUND: The Dichotic Digits difference Test (DDdT) was developed to investigate the relationship between dichotic processing and cognitive abilities and, through the use of differential test scores, to provide professionals with a clinical tool that could aid in differentiation of clients with genuine dichotic deficits from those where cognitive disorders affect test performance. The DDdT consists of four subtests: dichotic free recall (FR), dichotic directed left ear, dichotic directed right ear, and diotic. Scores are calculated for six conditions: FR left ear (LE), right ear (RE), and total, as well as the directed left ear, directed right ear, and diotic, and four difference measures: dichotic advantage, RE advantage FR, RE advantage directed, and attention advantage.
PURPOSE: To investigate the role of cognitive abilities on DDdT test performance.
RESEARCH DESIGN: Correlational analysis between the various DDdT conditions and difference measures, as well as between dichotic, diotic, and cognitive factors (memory, intelligence, and attention).
STUDY SAMPLE: Fifty typically developing children (aged 7 yr 0 mo to 12 yr 1 mo, mean = 9 yr 2 mo) and ten children recruited from the Australian Hearing CAPD Service who were diagnosed with a memory or dichotic deficit (aged 7 yr 0 mo to 15 yr 0 mo, mean = 9 yr 5 mo) took part in the study.
DATA COLLECTION AND ANALYSIS: The Pearson product moment correlations were used to determine the strength of relationships between DDdT conditions as well as relationships between scores on these conditions and performance on the various cognitive assessment tools, which included the number memory forward and reversed subtests of the Test of Auditory Processing Skills - Third Edition, IVA + Plus Continuous Performance Test, and the Test of Non-Verbal Intelligence-4 (TONI-4). A parent questionnaire (Fisher's Auditory Checklist) and a participant questionnaire (Listening Inventory for Education) were also administered.
RESULTS: Diotic performance was significantly correlated with performance on all the DDdT dichotic FR conditions (r = 0.6-0.8; p < 0.00001). Further, significant correlations were found between the FR LE, total, and diotic conditions, and the cognitive measures of attention and memory, with r ranging from 0.4 to 0.5 (p < 0.01-0.001). Right-ear performance was not significantly correlated to any cognitive measure, except for FR RE and number memory forward (r = 0.35; p = 0.006). The DDdT dichotic advantage measure was investigated in a subset of clinical children and found to aid in differentiating true dichotic from spurious results.
CONCLUSIONS: As found in the DDdT normative data study that precedes in the companion paper (DDdT Study Part 1; Cameron et al, 2016), the high correlation between dichotic and diotic performances by the clinical and typically developing participants suggests that factors other than dichotic performance play a substantial role in a child's ability to perform a dichotic listening task. Indeed, 61% of the variance in FR total scores for the children in this study was accounted for by factors that do not involve the perception of dichotic stimuli. This view is supported by the correlations between measures of attention and memory and dichotic scores. This result has wide-spread implications in respect to interpretation of central auditory processing disorder test results and further investigation of the use of the DDdT in a clinical population is warranted.

PMID: 27310405 [PubMed - as supplied by publisher]

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The Dichotic Digits difference Test (DDdT): Development, Normative Data, and Test-Retest Reliability Studies Part 1.

The Dichotic Digits difference Test (DDdT): Development, Normative Data, and Test-Retest Reliability Studies Part 1.

J Am Acad Audiol. 2016 Jun;27(6):458-469

Authors: Cameron S, Glyde H, Dillon H, Whitfield J, Seymour J

Abstract
BACKGROUND: The dichotic digits test is one of the most widely used assessment tools for central auditory processing disorder. However, questions remain concerning the impact of cognitive factors on test results.
PURPOSE: To develop the Dichotic Digits difference Test (DDdT), an assessment tool that could differentiate children with cognitive deficits from children with genuine dichotic deficits based on differential test results. The DDdT consists of four subtests: dichotic free recall (FR), dichotic directed left ear (DLE), dichotic directed right ear (DRE), and diotic. Scores for six conditions are calculated (FR left ear [LE], FR right ear [RE], and FR total, as well as DLE, DRE, and diotic). Scores for four difference measures are also calculated: dichotic advantage, right-ear advantage (REA) FR, REA directed, and attention advantage.
RESEARCH DESIGN: Experiment 1 involved development of the DDdT, including error rate analysis. Experiment 2 involved collection of normative and test-retest reliability data.
STUDY SAMPLE: Twenty adults (aged 25 yr 10 mo to 50 yr 7 mo, mean 36 yr 4 mo) took part in the development study; 62 normal-hearing, typically developing, primary-school children (aged 7 yr 1 mo to 11 yr 11 mo, mean 9 yr 4 mo) and 10 adults (aged 25 yr 0 mo to 51 yr 6 mo, mean 34 yr 10 mo) took part in the normative and test-retest reliability study.
DATA COLLECTION AND ANALYSIS: In Experiment 1, error rate analysis was conducted on the 36 digit-pair combinations of the DDdT. Normative data collected in Experiment 2 were arcsine transformed to achieve a distribution that was closer to a normal distribution and z-scores calculated. Pearson product-moment correlations were used to determine the strength of relationships between DDdT conditions.
RESULTS: The development study revealed no significant differences in the adult population between test and retest on any DDdT condition. Error rates on 36 digit pairs ranged from 1.5% to 16.7%. The most and the least error-prone digits were removed before commencement of the normative data study, leaving 25 unique digit pairs. Average z-scores calculated from the arcsine-transformed data collected from the 62 children who took part in the normative data study revealed that FR dichotic processing (LE, RE, and total) was highly correlated with diotic processing (r ranging from 0.5 to 0.6; p < 0.0001). Significant improvements in performance on retest occurred for the FR LE, RE, total, and diotic conditions (p ranging from 0.05 to 0.0004), the conditions that would be expected to improve with practice if the participant's response strategies are better the second time around.
CONCLUSIONS: The addition of a diotic control task-that shares many response demands with the usual dichotic tasks-opens up the possibility of differentiating children who perform below expectations because of poor dichotic processing skills from those who perform poorly because of impaired attention, memory, or other cognitive abilities. The high correlation between dichotic and diotic performance suggests that factors other than dichotic performance play a substantial role in a child's ability to perform a dichotic listening task. This hypothesis is investigated further in the cognitive correlation study that follows in the companion paper (DDdT Study Part 2; Cameron et al, 2016).

PMID: 27310404 [PubMed - as supplied by publisher]

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Perceptions Toward Internet-Based Delivery of Hearing Aids among Older Hearing-Impaired Adults.

Perceptions Toward Internet-Based Delivery of Hearing Aids among Older Hearing-Impaired Adults.

J Am Acad Audiol. 2016 Jun;27(6):441-457

Authors: Chandra N, Searchfield GD

Abstract
BACKGROUND: Despite evidence that hearing aids can improve the social and psychological functioning of older hearing-impaired adults, hearing aid uptake is low. High cost of hearing aids and poor access to audiology services in rural areas are potential barriers to hearing aid acquisition. Methods of hearing aid delivery deviating from the traditional clinician-based model have been available to consumers for many years. One such method is Internet hearing aid sales. However, research exploring Internet-based hearing aid delivery, as a method to improve hearing aid uptake in this population, is limited.
PURPOSE: The purpose of this study was to explore the perceptions of older hearing aid users (aged ≥65 yr) toward Internet-based hearing aid delivery.
RESEARCH DESIGN: A qualitative approach was adopted to investigate older adults' perceptions of buying hearing aids online.
STUDY SAMPLE: The sample consisted of 18 participants aged between 64 and 81 yr. Fourteen men and four women participated in this study. Participants were all experienced hearing aid users.
DATA COLLECTION AND ANALYSIS: Face-to-face semistructured interviews were conducted. An interview schedule guided the interview. Interviews were recorded with a voice recorder and transcribed verbatim. Thematic analysis of the data was carried out.
RESULTS: Seven main themes emerged from the data. A general lack of awareness, but willingness to learn more about Internet hearing aid sales, was found. Two perceived benefits of Internet-based hearing aid delivery were identified: lower cost of hearing aids and greater convenience or physical accessibility. Numerous concerns and limitations were communicated. Concerns regarding the availability of clinical procedures, such as hearing tests, obtaining the correct-sized earmolds, and fine-tuning of hearing aids, were expressed. Participants conveyed distrust in online retailers. However, trust in and a preference for audiologists' expertise, which was not perceived to be available online, was found. Participants further conveyed a preference for face-to-face contact. Finally, in this sample, a general lack of familiarity and confidence in using the Internet was communicated.
CONCLUSIONS: Internet sales of hearing aids is a controversial topic in audiology. Although Internet-based delivery of hearing aids was perceived by older adults to be potentially beneficial, several shortcomings and concerns were conveyed. Irrespective of opinion of the role of Internet sales, audiologists should consider the opinions of the elderly as to how different service models may improve hearing aid uptake.

PMID: 27310403 [PubMed - as supplied by publisher]

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