OtoRhinoLaryngology News: 06/22/16

Τετάρτη 22 Ιουνίου 2016

MAXIMUM PROTRUSIVE TONGUE FORCE IN HEALTHY YOUNG ADULTS.

MAXIMUM PROTRUSIVE TONGUE FORCE IN HEALTHY YOUNG ADULTS.

Int J Orofacial Myology. 2014 Nov;40:56-63

Authors: Berbert MC, Brito VG, Furlan RM, Perilo TV, Valentim AF, Barroso MF, De Las Casas EB, Motta AR

Abstract
In clinical speech-language pathology practice, tongue force is usually evaluated qualitatively. Perception and practical experience are used to classify this force. The Biomechanical Engineering Group from the Federal University of Minas Gerais developed an instrument to quantify tongue force. The purposes of this study were to quantify maximum tongue protrusion force in Brazilian subjects with normal tongue strength and to compare force values between gender groups. In total, 105 subjects, 43 men and 62 women, aged from 18 to 29 years, with normal tongue strength according to qualitative evaluation, underwent quantitative evaluation by using the instrument. The mean of the maximum tongue force values of all participants was 17.58 ± 7.95 N. There were significant differences in the median values for maximum tongue forces between the genders, with higher values observed for men. In intersubject comparisons, high variation coefficients were evident due to the variability among individuals. However, the study suggested that the instrument could be an interesting tool for intrasubject comparisons, especially during the follow-up.

PMID: 27295848 [PubMed - in process]

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THE ESSENTIAL ROLE OF THE COM IN THE MANAGEMENT OF SLEEP-DISORDERED BREATHING: A LITERATURE REVIEW AND DISCUSSION.

THE ESSENTIAL ROLE OF THE COM IN THE MANAGEMENT OF SLEEP-DISORDERED BREATHING: A LITERATURE REVIEW AND DISCUSSION.

Int J Orofacial Myology. 2014 Nov;40:42-55

Authors: Frey L, Green S, Fabbie P, Hockenbury D, Foran M, Elder K

Abstract
The origins of Orofacial Myofunctional Therapy began in the early 1960's by orthodontists who recognized the importance of functional nasal breathing, proper swallowing, and more ideal oral rest postures. Re-patterning these functions through myofunctional therapy assisted with better orthodontic outcomes and improved stability. Experts in orofacial myology have concluded that improper oral rest postures and tongue thrusting may be the result of hypertrophy of the lymphatic tissues in the upper airway. Orthodontists are aware of the deleterious effects these habits have on the developing face and dentition. Sleep disordered breathing is a major health concern that affects people from infancy into adulthood. Physicians who treat sleep disorders are now referring patients for orofacial myofunctional therapy. Researchers have concluded that removal of tonsils and adenoids, along with expansion orthodontics, may not fully resolve the upper airway issues that continue to plague patients' health. Sleep researchers report that the presence of mouth breathing, along with hypotonia of the orofacial muscular complex, has been a persistent problem in the treatment of sleep disordered breathing. Orofacial myofunctional disorders (OMDs) coexist in a large population of people with sleep disordered breathing and sleep apnea. Advances in 3D Cone Beam Computed Tomography (CBCT) imaging offer the dental and medical communities the opportunity to identify, assess, and treat patients with abnormal growth patterns. These undesirable changes in oral structures can involve the upper airway, as well as functional breathing, chewing and swallowing. Leading researchers have advocated a multidisciplinary team approach. Sleep physicians, otolaryngologists, dentists, myofunctional therapists, and other healthcare professionals are working together to achieve these goals. The authors have compiled research articles that support incorporating the necessary education on sleep disordered breathing for healthcare professionals seeking education in orofacial myology.

PMID: 27295847 [PubMed - in process]

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A REVIEW OF ELECTRICAL STIMULATION AND ITS EFFECT ON LINGUAL, LABIAL AND BUCCAL MUSCLE STRENGTH.

A REVIEW OF ELECTRICAL STIMULATION AND ITS EFFECT ON LINGUAL, LABIAL AND BUCCAL MUSCLE STRENGTH.

Int J Orofacial Myology. 2014 Nov;40:12-29

Authors: Safi MF, Wright-Harp W, Lucker JR, Payne JC, Harris O

Abstract
BACKGROUND: Lingual, labial and buccal weakness (LLBW) is a widespread consequence of several neurological insults. LLBW impact on oral motor functions such as speech production and swallowing is well documented in the literature. Therefore, it is important for the speech-language pathologists to have access to evidence-based approaches for treatment. Thus, it is imperative that the speech-language pathology field search for effective treatment approaches and explore new treatment modalities that can improve therapy outcomes. One relatively new modality in this field is neuromuscular electrical stimulation (NMES).
AIMS: The purpose of this paper is fivefold: (a) to provide an overview of the general effects of NMES on skeletal muscles; (b) to review the effect of NMES on orofacial musculature evaluating the potential appropriateness of NMES for use in strengthening lingual, labial and buccal muscles; (c) to identify future directions for research with consideration of its potential role in improving speech intelligibility and the oral preparatory phase of swallowing in patients with oral motor weakness; (d) to provide a brief anatomic and physiologic bases of LLBW; (e) to provide background information for orofacial myologists who may encounter individuals with LLBW.
MAIN CONTRIBUTION: NMES is a modality that is commonly used in physical therapy and occupational therapy fields that assists in treating several motor and sensory muscular disorders including muscular weakness. The literature reviewed demonstrate that very limited data related to the use of NMES on orofacial muscles exist despite the fact that these muscles can be easily accessed by electrical stimulation from the surface.
CONCLUSIONS: This review of the research using electrical stimulation of muscles highlights the need for experimental treatment studies that investigate the effect of NMES on orofacial weakness.

PMID: 27295845 [PubMed - in process]

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FORTIETH ANNIVERSARY ISSUE OF THE INTERNATIONAL JOURNAL OF OROFACIAL MYOLOGY (IJOM): THE FACE OF THE IAOM.

FORTIETH ANNIVERSARY ISSUE OF THE INTERNATIONAL JOURNAL OF OROFACIAL MYOLOGY (IJOM): THE FACE OF THE IAOM.

Int J Orofacial Myology. 2014 Nov;40:4-11

Authors: Mills CS

Abstract
This article presents an historical account of the International Journal of Orofacial Myology from its inception to the present. Highlights from individuals involved and perspectives are included.

PMID: 27295844 [PubMed - in process]

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Medical therapy versus sinus surgery by using balloon sinus dilation technology: A prospective multicenter study.

Medical therapy versus sinus surgery by using balloon sinus dilation technology: A prospective multicenter study.

Am J Rhinol Allergy. 2016 Jun 17;

Authors: Payne S, Stolovitzky P, Mehendale N, Brown W, Rieder A, Liepert D, Tseng E, Gould A, Powell S, Van Himbergen D, Karanfilov B, Harfe D, England L, Melroy C

Abstract
BACKGROUND: Although previous studies of sinus surgery that used balloon catheter dilation technology for the paranasal sinuses (balloon sinus dilation [BSD]) demonstrated safety and efficacy, data that compare BSD with continued medical management (MM) are lacking.
OBJECTIVE: To evaluate the outcomes of sinus surgery when using BSD instruments versus MM for patients with chronic rhinosinusitis for whom MM failed.
METHODS: Adult patients with chronic rhinosinusitis for whom a minimum of 3 weeks of oral antibiotics, 4 weeks of daily saline solution therapy, and 4 weeks of daily nasal corticosteroids failed were included. Qualifying participants were allowed to self-select sinus surgery with BSD (either an office or operating room setting) or continued MM. The primary end point was the comparison of change in the Chronic Sinusitis Survey score from baseline to 24 weeks. Secondary end points included comparisons of change for the Rhinosinusitis Disability Index (RSDI) and the Sino-Nasal Outcome Test (SNOT-20).
RESULTS: A total of 198 patients were enrolled (146 surgery and 52 MM). Of the patients who chose BSD, 72% (105/146) had their procedures completed in an office setting. Overall, BSD instruments were successful in dilating 97.6% of targeted sinuses (561/575). Patients who chose BSD showed a significantly greater improvement in the Chronic Sinusitis Survey score versus MM (42.0 versus 27.0, p < 0.001). Results from the RSDI and SNOT-20 surveys showed similar improvements for surgery versus MM (RSDI, 36.0 versus 18.1, p < 0.001; SNOT-20, 1.7 versus 1.0, p < 0.002).
CONCLUSION: Patients who selected sinus surgery in which BSD instruments were used on the peripheral sinuses demonstrated significantly greater improvements in quality of life compared with those who elected ongoing MM. These results were achieved through office-based procedures with the patient under local anesthesia in the majority of patients.

PMID: 27325205 [PubMed - as supplied by publisher]

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Outcomes of Transmastoid Surgery for Superior Semicircular Canal Dehiscence Syndrome.

Outcomes of Transmastoid Surgery for Superior Semicircular Canal Dehiscence Syndrome.

Otol Neurotol. 2016 Jun 20;

Authors: Powell HR, Khalil SS, Saeed SR

Abstract
OBJECTIVE: To present the management strategy and outcomes for our series of superior semicircular canal dehiscence syndrome (SSCDS) patients.
STUDY DESIGN: Retrospective cross-sectional study.
SETTING: Tertiary referral center.
PATIENTS: Thirty-seven consecutive patients referred from June 2011 to January 2015. Diagnosis of SSCDS based on presence of classical symptoms, computerized tomography, and concordant reduction in cervical vestibular evoked myogenic potentials.
INTERVENTIONS: Transmastoid resurfacing or plugging.
MAIN OUTCOME MEASURES: Pre- and postoperative pure tone audiometry. Nine item questionnaire grading pre- and postoperative symptom severity. Results of a short semi-structured telephone survey.
RESULTS: Twenty surgical patients: 13 women and 7 men. Mean age 52 years 6 months. Eighteen patients underwent transmastoid resurfacing and two underwent transmastoid plugging. Three of those who initially had resurfacing but had ongoing SSCD symptoms, subsequently had transmastoid plugging with complete resolution of third window symptoms. From the questionnaire there was improvement in mean scores for 8 of 9 of the SSCD symptoms, with statistically significant improvement in 6 of 9.
CONCLUSIONS: Management strategies and surgical techniques continue to evolve for SSCDS. We currently offer transmastoid resurfacing having informed patients of a 25% possibility of incomplete symptom resolution, and explain that plugging can be performed as a "second stage," if necessary. However, as we accrue more experience and there is more evidence from the literature we are considering whether to offer transmastoid plugging as our primary surgical procedure. In our experience, patients with multiple vestibular pathologies or atypical vestibular symptoms are the ones for whom SSCD surgery has not been curative, although they do report improvement in their SSCD symptoms.

PMID: 27327868 [PubMed - as supplied by publisher]

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[Effects of aging on vestibular evoked myogenic potential].

[Effects of aging on vestibular evoked myogenic potential].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Nov;29(22):1992-4

Authors: Li F, Zhuang J, Chen Y, Zhou X

Abstract
OBJECTIVE: The purpose of this study is to assess the effects of aging on air-conducted sound elicited cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential(oVEMP) in normal people.
METHOD: Sixty normal subjects were recruited for the vestibular evoked myogenic potential examination. Among them, 20-40 year-old group was setted as the first group, 41-60 year-old group was setted as the second group, > 60-year-old group was setted as the third group. Each group included 20 normal subjects. SPSS 16.0 software was used to analyze the data.
RESULT: As the age growing, P1 latency prolonged, N1-P1 amplitude decreased, and amplitude asymmetric ratio increased in cVEMP; N1 latency prolonged, P1-N1 amplitude decreased, and amplitude asymmetric ratio increased in oVEMP.
CONCLUSION: With the age growing, the time of otolithic organ input pathways prolonged, the function of otolithic organ decreased and the decrease level may be asymeetrical on both sides.

PMID: 26911066 [PubMed - indexed for MEDLINE]

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[The roles of otolith organs in the recurrence primary benign paroxysmal positional vertigo].

[The roles of otolith organs in the recurrence primary benign paroxysmal positional vertigo].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Sep;29(18):1641-4

Authors: Zhou X, Yu Y, Wu Z, Liu X, Chen X

Abstract
OBJECTIVE: To explore the roles of otolith organs in the occurrence and recurrence of primary benign paroxysmal positional vertigo (BPPV) by vestibular evoked myogenic potential (VEMP) test.
METHOD: We enrolled 17 recurrent primary BPPV patients and 42 non-recurrent primary BPPV patients between September 2014 and November 2014. All patients underwent VEMP tests, including cervical vestibular evoked myogenic potential (cVEMP and ocular vestibular evoked myogenic potential (oVEMP) tests. The abnormal case was defined as non-elicitation or asymmetry rate between bilateral sides is larger than 29%.
RESULT: Significant difference was found in abnormal rate between cVEMP and oVEMP (P < 0.05 ) in BPPV patients. The abnormal rate of oVEMP was higher than that of cVEMP. Significant difference was found in abnormal rate in oVEMP test between recurrent and non-recurrent groups (P < 0.01) but not in cVEMP( P > 0.05). No significant difference was found in sex and age between recurrent and non-recurrent groups (P > 0.05).
CONCLUSION: The impairment of otolith organs, especially the utricle, is related to primary BPPV. Dysfunction of utricle may play a role in recurrence of BPPV. Recurrence of BPPV is not correlated with sex and age.

PMID: 26790267 [PubMed - indexed for MEDLINE]

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[Efficacy of quick repositioning maneuver for posterior semicircular canal benign paroxysmal positional vertigo in different age groups].

[Efficacy of quick repositioning maneuver for posterior semicircular canal benign paroxysmal positional vertigo in different age groups].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Dec;29(23):2053-6

Authors: Zhang H, Li J, Guo P, Tian S, Li K

Abstract
OBJECTIVE: To observe the short and long-term efficacy of quick repositioning maneuver for posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) in different age groups.
METHOD: The clinical data of 113 adult patients with single PC-BPPV who underwent quick repositioning maneuver from July 2009 to February 2015 were retrospectively analyzed. The quick repositioning maneuver was to roll the patient from involved side to healthy side in the coronal plane for 180° as quickly as possible. The patients were divided into 3 groups according to different ages: young group (< 45 years), middle-age group (45 ≤ age < 60 years) and old group (≥ 60 years). The short and long term outcomes of the three groups were observed.
RESULT: The left ear was involved in 58 cases (51.3%) and the right ear in 55 cases (48.7%). The short term improvement rates of the young, middle-age and the old groups were 92.5%, 93.6% and 92.3% respectively, and the long term improvement rate was 90.0%, 85.1% and 73.1% respectively. There was no significant difference among the three groups in short and long term outcomes (P > 0.05). The recurrence rate of the three groups was 5.0%, 6.4% and 15.4% respectively, also no significant difference (P > 0.05).
CONCLUSION: The quick repositioning maneuver along the coronal plane for PC-BPPV has a definite effect for every age groups. The method is simple, rapid and easy to master, and the patients are tolerated the maneuver well without evident side effect.

PMID: 27101677 [PubMed - indexed for MEDLINE]

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[Investigation of the relationship between chronic diseases and residual symptoms of benign paroxysmal positional vertigo].

[Investigation of the relationship between chronic diseases and residual symptoms of benign paroxysmal positional vertigo].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Sep;29(18):1627-9

Authors: Zhou F, Fu M, Zhang N, Xu Y, Ge Y

Abstract
OBJECTIVE: To investigate the prognosis-related influence factors of the residual symptoms after the canalith repositioning procedure (CRP) for the benign paroxysmal positional vertigo (BPPV) in the second affiliated hospital of dalian medical university.
METHOD: Among patients who were diagnosed with BPPV and treated by CRP, the one that still show residual symptoms were enrolled in our study, then make a follow-up irregularly about the tendency of their residual symptoms' self-healing,and respectively record in their gender, age and chronic diseases and so on. Single-factor analysis and multi-factors analysis was utilized to investigate the residual symptoms' related influencing factors.
RESULT: In this study, 149 cases of patients were in record, for the residual symptoms, 71 patients can go to self-healing, 78 patients can not; age is 23-88, 30 cases in the young group, 46 cases in the middle aged group, 47 cases in the young elderly group, 26 cases in the elderly group; patients suffering from high blood pressure are 76 cases, 76 cases had diabetes, 47 cases had hyperlipidemia, 110 cases had heart disease, 43 cases had ischemic encephalopathy.
CONCLUSION: The residual symptoms in the elderly females patients and patients suffering from the hypertension, diabetes, heart disease patients and ischemic encephalopathy are not easy to heal by itself, in which, the older and the fact suffering from the hypertension and diabetes are the risk factors influencing the prognosis of the residual symptoms.

PMID: 26790263 [PubMed - indexed for MEDLINE]

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Evaluating the Epley maneuver.

Evaluating the Epley maneuver.

Can Fam Physician. 2015 Sep;61(9):779

Authors: Braschi E, Ross D, Korownyk C

PMID: 26371102 [PubMed - indexed for MEDLINE]

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Surfactant proteins of the human larynx.

Surfactant proteins of the human larynx.

Ann Anat. 2016 Jun 17;

Authors: Sheats M, Schröder H, Rausch F, Bohr C, Kißlinger F, de Tristan J, Iro H, Garreis F, Paulsen F, Schicht M, Bräuer L

Abstract
PURPOSE: Surfactant proteins (SPs) originally identified in lung tissue are important players in the innate immune system. Beyond this, they contribute to stability and rheology of gaseous or aqueous interphases. In the present study, we determined the expression and presence of SPs (A, B, C and D) in different areas of the human larynx.
METHODS: mRNA expression of SP-A, -B, -C and -D was analyzed by means of RT-PCR in healthy samples of epiglottis, vocal and vestibular folds, subglottis and trachea. Distribution and localization of all four SPs were analyzed by Western blot and immunohistochemistry in healthy human tissue samples.
RESULTS: All four SPs were detected at the mRNA- and protein level in the human larynx as well as by means of immunohistochemistry in the different tissue samples of the human larynx.
CONCLUSION: The results reveal that all four SPs are produced with different expression patterns within the human larynx. Based on the known functions, our results suggest that SPs might be involved in maintaining mucus rheology and subsequently they could be essential components for proper phonation. Moreover, the proteins seem to play a role in immune defense of the larynx.

PMID: 27328406 [PubMed - as supplied by publisher]

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Granular Cell Tumour of the Larynx.

Granular Cell Tumour of the Larynx.

Head Neck Pathol. 2016 Jun 20;

Authors: Sproat R, Wong G, Rubin J

Abstract
A 55-year-old lady with a 6 month history of hoarse voice presented to our ENT department. Endoscopic examination displayed a white left arytenoid lesion. Biopsy of this lesion displayed a nodule covered with non-keratinizing stratified squamous epithelium, with a central core of polygonal cells, positive for S-100 staining. This confirmed a granular cell tumour. CO2 laser was utilised to excise this benign tumour. Granular cell tumours of the head and neck are common, but are infrequently found in the larynx. This case report highlights the importance for the otolaryngologist to be aware of this differential diagnosis, particularly as histologically they may be confused with squamous cell carcinoma.

PMID: 27325237 [PubMed - as supplied by publisher]

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Expression and localization of GPR99 in human nasal mucosa.

Expression and localization of GPR99 in human nasal mucosa.

Auris Nasus Larynx. 2016 Jun 17;

Authors: Shirasaki H, Kanaizumi E, Himi T

Abstract
OBJECTIVE: The cysteinyl leukotrienes (CysLTs) are lipid mediators that have been implicated in the pathogenesis of allergic rhinitis. Pharmacological studies of CysLTs indicate that two classes of receptors, CysLT1R and CysLT2R exist. CysLT1R is a high affinity LTD4 receptor with lower affinity for LTC4, and a CysLT1R antagonist is currently used to treat asthma and allergic rhinitis. CysLT2R binds to LTC4 and LTD4 with equal affinity. GPR99 (also called GPR80), previously described as an oxoglutarate receptor (OXGR1), has recently emerged as a potential novel receptor with LTE4. The purpose of this study was to determine the expression and localization of GPR99 protein in the human nasal mucosa.
METHODS: Human turbinates were obtained after turbinectomy from 12 patients with nasal obstruction refractory to medical therapy. GPR99 protein expression was evaluated by western blotting, and the specific cells expressing GPR99 protein identified by immunostaining using a commercial anti-GPR99 (OXGR1) monoclonal antibody.
RESULTS: A 38-kDa band was detected in the western blots of human nasal samples by using the anti-GPR99 monoclonal antibody. We did not find any differences in GPR99 protein levels between allergic and non-allergic nasal mucosa. The immunohistochemical studies revealed that the anti-GPR99 monoclonal antibody mainly labeled vascular smooth muscle cells in the nasal mucosa.
CONCLUSION: These immunohistochemical results suggest that GPR99 may play some roles in the vascular response. Further functional studies will be necessary to clarify the biological significance of the GPR99 receptor in nasal vasculature.

PMID: 27324180 [PubMed - as supplied by publisher]

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[Laryngeal interarytenoid neurilemmoma excised via microlaryngeal endoscopy: two case reports].

[Laryngeal interarytenoid neurilemmoma excised via microlaryngeal endoscopy: two case reports].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Dec;29(23):2091-2

Authors: Shen Y, Cheng L, Tang M

Abstract
Laryngeal interarytenoid neurilemmomas (LIN) is a benign encapsulated tumor originating from the schwann cells lining nerve fibers. Even though LINs are extremely rare in incidence, they could present with potential threat to the airway and thus requiring prompt diagnosis and treatment. Here, we report two cases of LINs. Both patients underwent excision of the tumor via microlaryngeal endoscopic procedures and recovered well postoperatively without complications. No recurrence was observed postoperatively on routine follow-up after 14 months.

PMID: 27101688 [PubMed - indexed for MEDLINE]

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[The value of target biopsy using narrow band imaging endoscopy for diagnosis of laryngeal carcinoma].

[The value of target biopsy using narrow band imaging endoscopy for diagnosis of laryngeal carcinoma].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Dec;29(23):2078-82

Authors: Yang Y, Song F, Liu J

Abstract
OBJECTIVE: To estimate the clinical significance of target biopsy in clinical diagnosis, and accurate pathologic specimen acquisition of laryngeal lesion by using narrow band imaging (NBI) endoscopy.
METHOD: A total of 156 cases of patients with laryngeal lesions were collected from the department of Otolaryngology Head and Neck Surgery of Tianjin Union Medical Center from Aug 2012 to Dec 2014. All patients were randomly divided into regular biopsy group and NBI target biopsy group. Image data were recorded and the patients' samples were biopsied. The pathologic diagnosis was used to evaluate the accuracy of regular biopsy and target biopsy.
RESULT: Based on the pathologic diagnosis, the correct accurate pathologic specimen acquisition rates in NBI target pathology group at stage 0 (Tis), stage I and stage II laryngeal cancer diagnosis compliance rate were higher than those in regular biopsy group, stage 0 (Tis) (χ² = 22.00, P < 0.05), stage I (χ² = 8.33, P < 0.05) and stage II (χ² = 4.55, P < 0.05).
CONCLUSION: NBI endoscopy plays an important role in the clinical diagnosis and accurate pathologic specimen acquisition of laryngeal carcinoma and can be a regular means to detect laryngeal lesions in clinical.

PMID: 27101684 [PubMed - indexed for MEDLINE]

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[The treatment of pharyngeal and laryngeal hemangioma by injection with urea combined with pingyangmycin].

[The treatment of pharyngeal and laryngeal hemangioma by injection with urea combined with pingyangmycin].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Dec;29(24):2172-4

Authors: Fan F, Zang Y, Jia X

PMID: 27093823 [PubMed - indexed for MEDLINE]

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[Prognostic analysis of CO₂ laser surgery for early glottic cancer with anterior commissure involvement].

[Prognostic analysis of CO₂ laser surgery for early glottic cancer with anterior commissure involvement].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Dec;29(24):2121-5

Authors: She S, Wang B, Li Y, Gao W, Feng Y

Abstract
OBJECTIVE: To systematically analyze the local recurrence of CO₂ laser surgery for early glottic cancer and without anterior commissure involvement.
METHOD: By searching CBM, CNKI, wanfang, weipu, PubMed, Embase, OVID, and Springer database, the retrospective clinical studies were included according to inclusion and exclusion criteria. Meta analysis of extracted data was carried out by RevMan 5.0 software.
RESULT: By analyzing the 1900 cases from 14 retrospective studies using Meta analysis, it was indicated that local recurrence rate of AC+ group was significantly higher than that of AC- group [OR = 3.00, 95% CI (2.31, 3.89), P < 0.01] for early glottic cancer. Local recurrence rates between AC+ group and AC- group for glottic cancer of Tis and T₁b stage showed no statistically significant difference, while those for glottic cancer of T₁a and T₂ stage showed statistically significant difference.
CONCUSION: Local recurrence rate of CO₂laser surgery for early glottic cancer was related with anterior commissure involvement.

PMID: 27093809 [PubMed - indexed for MEDLINE]

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[Application of CO2 laser and self-made laryngeal dilator in the treatment of the laryngeal stenosis].

[Application of CO2 laser and self-made laryngeal dilator in the treatment of the laryngeal stenosis].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Oct;29(19):1708-10

Authors: Zhong G, Xiong X

Abstract
OBJECTIVE: To study the treatment effect of CO2 laser and self-made laryngeal dilator on the laryngeal stenosis.
METHOD: Twenty-five patients with laryngeal stenosis were treated with CO2 laser and self-made laryngeal dilator. The laryngeal cavity scar was resected as much as possible by using CO2 laser and the laryngeal cavity was exposed by placing laryngeal dilator under general anesthesia.
RESULT: The 24 cases of all were successfully decanulated 1 to 12 months after operation and could breathe freely. One case had second operation and was successfully decanulated 9 months after operation. The follow-up for 1 to 2 years showed all cases speaking well and 3 cases recurrence.
CONCLUSION: The method for treating laryngeal stenosis using CO2 laser and self-mande laryngeal dilator is effective, fewer complication, less invasive, and faster recovery. The laryngeal dilator is made simply and conveniently.

PMID: 26999842 [PubMed - indexed for MEDLINE]

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[Intubation treatment of acute laryngeal obstruction: a case report].

[Intubation treatment of acute laryngeal obstruction: a case report].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Nov;29(22):2014

Authors: Guo X, Liu S, Li H

Abstract
Acute laryngeal obstruction is one of the most common diseases in Department of ENT, and it can cause suffocation without prompt treatment. Methods by using Nasopharyngofiberoscope guided tracheal intubation treatment of a case of acute laryngeal obstruction patients in a timely manner. This method is well tolerated, less trauma, high success rate, in the shortest time to improve the patient's ventilation, for the next step of the treatment to win the time.

PMID: 26911075 [PubMed - indexed for MEDLINE]

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[Expressions and correlations of Survivin, Ki67 and p53 in laryngeal squmous cell carcinoma].

[Expressions and correlations of Survivin, Ki67 and p53 in laryngeal squmous cell carcinoma].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Sep;29(17):1545-8

Authors: Wang J, Yang B, Pei S, Wang X, Zhang Q, Qu F, Zhang H

Abstract
OBJECTIVE: To investigate the expression of Survivin, p53 and Ki67 in laryngeal carcinoma and the relation with clinical data.
METHOD: Immunohistochemical staining (SP) was used to detect expression of Survivin, p53 and Ki67 of 64 cases with laryngeal carcinoma, 26 cases with precancerosis, 34 cases with vocal polyps.
RESULT: The positive expression rates of Survivin, p53 and Ki67 were 59.4%, 68.8%, 65.6% respectively in laryngeal carcinoma, which were significantly higher than those in precancerosis and vocal polyps (P < 0.01). The expression of Survivin, p53 and Ki67 in laryngeal carcinoma were significantly statistical different in TNM stage and lymph node metastasis (P < 0.05), but were not correlated with patients' ages, the pathological grades, 3 years and 5 years surviving rates (P > 0.05). The expression of Survivin, Ki-67 and p53 was positively correlated (r = 0.607, 0.541, 0.648, P < 0.01) in laryngeal carcinoma.
CONCLUSION: Survivin, p53 and Ki-67 may play an important role in the carcinogenesis and progress of laryngeal carcinoma. They may play synergetic roles in the process of carcinogenesis of laryngeal carcinoma.

PMID: 26647541 [PubMed - indexed for MEDLINE]

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[Correlation of osteopontin expression and laryngeal squamous cell carcinoma infiltration and metastasis].

[Correlation of osteopontin expression and laryngeal squamous cell carcinoma infiltration and metastasis].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Sep;29(17):1530-3

Authors: Zhao Hongchun, Wang Yanfei, Zheng Tihua, Che Juan, Cao Ruijuan, Wang Xia

Abstract
OBJECTIVE: To investigate osteopontin (OPN) expression in plasma and tissue of patients with layngeal squamous cell carcinoma and analyze its role in invasion, metastasis, and clinical significance in laryngeal quamous cell carcinoma.
METHOD: Enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry were used to detect expression of OPN in plasma and tissue of 60 cases of laryngeal squamous cell carcinoma, 20 cases of adjacent normal laryngeal tissue and 20 cases of plasma from healthy subjects.
RESULT: The expression of plasma OPN was closely correlated with clinical stage and cervical lymphatic metastasis in laryngeal squamous cell carcinoma (P < 0.05), but no significant correlation with the tumor location, pathological grade, gender and age (P > 0.05). The expression of OPN increased in plasma during cancer development: laryngeal squamous cell carcinoma (38.089 ± 9.225) ng/ml, healthy subjects (18.563 ± 9.308) ng/ml. There was a significant difference between the groups (P < 0.05). The expression of OPN in tissue was closely correlated with clinical stage (P < 0.05), pathological grade (P < 0.05) and cervical lymphatic metastasis (P < 0.05) in laryngeal squamous cell carcinoma adjacent atypical hyperplastic epithelium and carcinoma. The expression of OPN increased in tissue during cancer development: laryngeal squamous cell carcinoma (56.67%), adjacent normal laryngeal tissue (15.00%). There was a significant difference between the groups (P < 0.05). Elevated expression of plasma OPN is positively correlated with the expression of OPN in tissue in laryngeal squamous cell carcinoma patients (r = 0. 871, P < 0.05).
CONCLUSION: OPN plays an important role in the infiltration, metastasis and carcinogenesis in laryngeal squamous cell carcinoma. Combination of serum OPN, tissue OPN detection can be used as diagnostic and surveillance indicators for laryngeal squamous cell carcinoma infiltration and metastasis.

PMID: 26647537 [PubMed - indexed for MEDLINE]

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[The related factors analysis of difficult laryngeal exposure under retaining laryngoscope].

[The related factors analysis of difficult laryngeal exposure under retaining laryngoscope].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Sep;29(17):1519-21

Authors: Wang J, Hu Y, Wang D, Zhao G, Li X, Li Y

Abstract
OBJECTIVE: To analyze the related factors of difficult laryngeal exposure under retaining laryngoscope.
METHOD: We did a retrospective analysis of 287 retaining laryngoscope surgery patients' clinical datas to observe the relationship between difficult glottis exposure and patients' gender, degree of mouth opening, BMI, neck circumference, head and neck flexion, TMD, HMD and SMD.
RESULT: By ROC curve analysis, we determine the optimal threshold for TMD was 7.35 cm, HMD was 6.33 cm, SMD was 14.75 cm. Univariate analysis showed that gender, and glottis exposure had no significant correlation with difficult laryngeal exposure under retaining laryngoscope. Degree of mouth opening, BMI, neck circumference, head and neck flexion, TMD, HMD and SMD had correlation with difficult laryngeal exposure. Multivariate analysis showed that neck circumference, head and neck flexion, TMD, SMD were independent factors of difficult laryngeal exposure under retaining laryngoscope.
CONCLUSION: Measurement of neck circumference, head and neck flexion, TMD, SMD before the operation is important for the prediction of difficult laryngeal exposure under retaining laryngoscope.

PMID: 26647534 [PubMed - indexed for MEDLINE]

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Vocal fold myofibroblast profile of scarring.

http:--media.wiley.com-assets-7315-19-Wi

Vocal fold myofibroblast profile of scarring.

Laryngoscope. 2016 Mar;126(3):E110-7

Authors: Branco A, Bartley SM, King SN, Jetté ME, Thibeault SL

Abstract
OBJECTIVES/HYPOTHESIS: Vocal fold fibroblasts (VFF) are responsible for extracellular matrix synthesis supporting lamina propria in normal and diseased conditions. When tissue is injured, VFF become activated and differentiate into myofibroblasts to facilitate wound healing response. We investigated if vocal fold myofibroblasts can be utilized as surrogate cells for scarred VFF.
STUDY DESIGN: In vitro.
METHODS: Normal VFF cell lines from a 21-year-old male (N21), 59-year-old female (N59), and a scar VFF cell line from a 56-year-old female (S56) were used in this study. 10 ng/mL of transforming growth factor (TGFβ1) was applied for 5 days to normal VFF. Myofibroblast differentiation was determined with immunocytochemistry and western blot, measuring alpha smooth muscle actin (α-SMA). Cell growth, proliferation, contractile properties, and gene expression profiles were evaluated.
RESULTS: N21, N59, and S56 VFF presented elongated configuration. N21+ and N21- VFF demonstrated significantly greater proliferation compared to N59+, N59-, and S56 VFF at 6 days. α-SMA was expressed in all cells. Fibronectin, alpha smooth actin, connective tissue growth factor, and metallopeptidase inhibitor were the highest genes expression in VFF treated with transforming growth factor β1 (TGFβ1). At 24 hours, S56 VFF showed lower contraction compared to N21+ and N59+ VFF, but at 60 hours S56 VFF had lower collagen contraction compared to all cell groups. Highest collagen contraction matrices were measured with VFF treated with TGFβ1 at 24 hours and N59- VFF at 60 hours.
CONCLUSION: VFF treated with TGFβ1 (myofibroblasts) appear to have similar phenotypic characteristics but different genotypic behavior compared to scar VFF.
LEVEL OF EVIDENCE: N/A. Laryngoscope, 126:E110-E117, 2016.

PMID: 26344050 [PubMed - indexed for MEDLINE]

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[Not Available].

[Not Available].

Laryngorhinootologie. 2015 Jul;94(7):432-3

Authors: Frenzel H, Müller A

PMID: 26334070 [PubMed - indexed for MEDLINE]

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Quality of Life and Hearing Eight Years After Sudden Sensorineural Hearing Loss.

Quality of Life and Hearing Eight Years After Sudden Sensorineural Hearing Loss.

Laryngoscope. 2016 Jun 21;

Authors: Härkönen K, Kivekäs I, Rautiainen M, Kotti V, Vasama JP

Abstract
OBJECTIVES/HYPOTHESIS: To explore long-term hearing results, quality of life (QoL), quality of hearing (QoH), work-related stress, tinnitus, and balance problems after idiopathic sudden sensorineural hearing loss (ISSNHL).
STUDY DESIGN: Cross-sectional study.
METHODS: We reviewed the audiograms of 680 patients with unilateral ISSNHL on average 8 years after the hearing impairment, and then divided the patients into two study groups based on whether their ISSNHL had recovered to normal (pure tone average [PTA] ≤ 30 dB) or not (PTA > 30 dB). The inclusion criteria were a hearing threshold decrease of 30 dB or more in at least three contiguous frequencies occurring within 72 hours in the affected ear and normal hearing in the contralateral ear. Audiograms of 217 patients fulfilled the criteria. We reviewed their medical records; measured present QoL, QoH, and work-related stress with specific questionnaires; and updated the hearing status.
RESULTS: Poor hearing outcome after ISSNHL was correlated with age, severity of hearing loss, and vertigo together with ISSNHL. Quality of life and QoH were statistically significantly better in patients with recovered hearing, and the patients had statistically significantly less tinnitus and balance problems. During the 8-year follow-up, the PTA of the affected ear deteriorated on average 7 dB, and healthy ear deteriorated 6 dB.
CONCLUSION: Idiopathic sudden sensorineural hearing loss that failed to recover had a negative impact on long-term QoL and QoH. The hearing deteriorated as a function of age similarly both in the affected and the healthy ear, and there were no differences between the groups. The cumulative recurrence rate for ISSNHL was 3.5%.
LEVEL OF EVIDENCE: 4 Laryngoscope, 2016.

PMID: 27328455 [PubMed - as supplied by publisher]

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Composite Vascular Pedicled Middle Turbinate Flap for Reconstruction of Sellar Defects.

Composite Vascular Pedicled Middle Turbinate Flap for Reconstruction of Sellar Defects.

Ann Otol Rhinol Laryngol. 2016 Jun 19;

Authors: Amin SM, Fawzy TO, Hegazy AA

Abstract
OBJECTIVES: Herein, we describe our experience in simple harvest of the vascular pedicled middle turbinate flap (MTF) sufficient for sellar defect reconstruction.
METHODS: An anatomical feasibility study is done in 10 sides of 5 preserved injected cadaveric heads. The middle turbinate is separated from the skull base and the basal lamella with or without retrograde dissection of its tail as a composite flap based on the middle turbinate and posterolateral nasal arteries. The technique was applied in 25 cases of cerebrospinal fluid (CSF) leak after endoscopic transsphenoidal surgery.
RESULTS: The mean area of MTF with and without medial mucosal dissection was 9.53 cm(2) and 7.6 cm(2), respectively. The mean length between anterior end of MT and basal lamella and the latter and the sella was 3.67 cm and 2.33 cm, respectively. The mean area of sella was 2.2 cm(2). The MTF covered the sella, planum, and tuberculum sella corridors in 10 head sides. Partial dissection of MT medial mucosa was needed in 3 head sides to cover sella, planum, and tuberculum sella. Follow-up for 26 to 37 month revealed control of CSF leak in 24 cases.
CONCLUSION: Composite MTF is a simple rapid reproducible option for sellar defects reconstruction.

PMID: 27323957 [PubMed - as supplied by publisher]

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Impact of thyroid cancer on the incidence and survival of adolescents and young adults with cancer.

Impact of thyroid cancer on the incidence and survival of adolescents and young adults with cancer.

Thyroid. 2016 Jun 21;

Authors: Brito JP, Bleyer A

PMID: 27324868 [PubMed - as supplied by publisher]

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Follicular and Diffuse Sclerosing Variant Papillary Thyroid Carcinomas as Independent Predictive Factors of Loco-regional Recurrence: A Comparison Study Using Propensity Score Matching.

Follicular and Diffuse Sclerosing Variant Papillary Thyroid Carcinomas as Independent Predictive Factors of Loco-regional Recurrence: A Comparison Study Using Propensity Score Matching.

Thyroid. 2016 Jun 21;

Authors: Kim SK, Park I, Woo JW, Lee JH, Choe JH, Kim JH, Kim JS

Abstract
BACKGROUND: Only about half of papillary thyroid carcinoma (PTC) cases are classified as conventional PTC (CV-PTC), whereas various histologic variants constitute the remaining cases. Since controversies about the clinical behavior and outcomes of PTC variants continue, the purpose of this study was to compare the outcomes of patients with PTC variants who were treated at a large tertiary referral center in Korea.
METHODS: The medical records for 15,598 CV-PTCs, 435 follicular variants of PTC (FV-PTCs), and 66 diffuse sclerosing variants of PTC (DSV-PTCs) were retrospectively reviewed. Loco-regional recurrences (LRR) among PTC variants were compared using propensity score matching.
RESULTS: Analysis I compared CV-PTC with FV-PTC. After rigorous matching, 367 pairs were established. Recurrence-free survival (RFS) rates in CV-PTC were 96.1% at 5 years, 92.2% at 10 years, and 92.2% at 15 years, while those for FV-PTC were 98.8% at 5 years, 98.8% at 10 years, and 98.8% at 15 years (p = 0.026). Analysis II compared CV-PTC with DSV-PTC. Rigorous matching yielded 56 pairs. RFS rates for CV-PTC were 87.4% at 5 years, 87.4% at 10 years, and 87.4% at 15 years, while those for DSV-PTC were 68.9% at 5 years, 57.5% at 10 years, and were not available at 15 years (p = 0.013).
CONCLUSIONS: Compared with CV-PTC, FV-PTC showed less aggressive behaviors and more favorable outcomes. However, DSV-PTC showed more aggressive behaviors than CV-PTC and less favorable outcome. Therefore, the management strategy and follow-up plan for PTC should be differentiated according to the histologic variant.

PMID: 27324748 [PubMed - as supplied by publisher]

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Hypermetabolism on 18F-FDG PET scan does not influence the interpretation of thyroid cytopathology and nodules with SUVmax

Hypermetabolism on 18F-FDG PET scan does not influence the interpretation of thyroid cytopathology and nodules with SUVmax <2.5 are not at increased risk for malignancy.

Thyroid. 2016 Jun 21;

Authors: Valderrabano P, Montilla Soler J, Mifsud MJ, Leon ME, Centeno BA, Khazai L, Padhya T, McCaffrey TV, Russell JS, McIver B, Otto KJ

Abstract
BACKGROUND: Hypermetabolism of thyroid nodules on 18F-fluorodeoxyglucose positron emission tomography (PET) is associated with higher prevalence of malignancy. However, the definition of hypermetabolism and its impact on cytological interpretation are unclear.
METHODS: Medical records of all patients with thyroid nodules that had undergone cytological evaluation at Moffitt Cancer Center between October 2008 and May 2014 were retrospectively reviewed. Those with a PET scan performed within 1 year of the cytology composed the study group, and the rest were used as controls. The distribution of the cytological categories, percentage of resection and prevalence of malignancy among each Bethesda category was compared between both groups.
RESULTS: Fifteen percent (436) of all thyroid nodules with cytological evaluation were in the study group. Maximum standardized uptake (SUVmax) values were directly associated with the probability of having a malignant or a follicular neoplasm cytological diagnosis; and inversely associated with the probability of having a benign cytological diagnosis. However, the prevalence of cancer within each Bethesda category was not associated with SUVmax values. We found that the prevalence of malignant cytology increased above 5% with SUVmax values ≥2.5. SUVmax values were significantly higher in malignant than in benign nodules on histology (mean values 10.8 vs. 5) but with significant overlap between both groups for either the whole cohort or nodules with indeterminate cytology only limiting its use for differential diagnosis.
CONCLUSIONS: The prevalence of malignancy in thyroid nodules with SUVmax <2.5 is similar to the general population and management should not be modified in those patients. The increased prevalence of malignancy among hypermetabolic thyroid nodules (SUVmax ≥2.5) is well characterized by cytology and does not impact the interpretation of cytological categories. Therefore, SUVmax value does not add relevant information once cytology is available.

PMID: 27324615 [PubMed - as supplied by publisher]

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Pioglitazone, a PPARγ agonist, upregulates the expression of caveolin-1 and catalase, essential for thyroid cell homeostasis. A clue to the pathogenesis of Hashimoto's thyroiditis.

Pioglitazone, a PPARγ agonist, upregulates the expression of caveolin-1 and catalase, essential for thyroid cell homeostasis. A clue to the pathogenesis of Hashimoto's thyroiditis.

Thyroid. 2016 Jun 20;

Authors: Werion A, Joris V, Hepp M, Papasokrati L, Marique L, de Ville de Goyet C, Van Regemorter V, Mourad M, Lengelé B, Daumerie C, Marbaix E, Brichard S, Many MC, Craps J

Abstract
CONTEXT: Peroxisome proliferator-activated receptor γ (PPARγ) is a transcriptional factor that regulates the expression of multiple target genes involved in several metabolic pathways as well as in inflammation. The expression and cell localization of caveolin-1 (Cav-1), thyroid peroxidase (TPO), and dual oxidase (DUOX), involved in the extracellular iodination, is modulated by Th1 cytokines in human normal thyroid cells and in Hashimoto's thyroiditis (HT).
OBJECTIVES: 1) To analyze the PPARγ expression at the follicular level in HT versus controls in correlation with the one of Cav-1, 2) to study the effects of Th1 cytokines on PPARγ and catalase expression in human thyrocytes primary cultures, 3) to study the effects of pioglitazone, a PPAR γ agonist, on thyroxisome's components (Cav-1, TPO, DUOX) and on antioxidant defenses (catalase).
RESULTS: Although the global expression of PPARγ in the whole Hashimoto's glands was not modified as compared to controls, there was a great heterogeneity among glands and among follicles in a same gland. Besides normal type 1 follicles, there were, around inflammatory zones, hyperactive type 2 follicles with high PPARγ and Cav-1 expression and inactive type 3 follicles unable to form T4, which did not express PPARγ nor Cav-1. In human thyrocytes in primary cultures, Th1 cytokines decreased PPARγ and catalase expression; pioglitazone increased Cav-1, TPO and catalase expression.
CONCLUSION: PPARγ plays a central role in normal thyroid physiology by upregulating Cav-1, essential for the thyroxisome's organization and the extracellular iodination. By upregulating catalase, PPARγ also maintains the cell homeostasis. The inhibitory effect of Th1 cytokines on PPARγ expression may be considered as a new pathogenetic mechanism for Hashimoto's thyroiditis and the use of PPARγ agonists could open a new therapeutic approach.

PMID: 27324467 [PubMed - as supplied by publisher]

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Endoscopic endonasal skull base surgery for vascular lesions: a systematic review.

Endoscopic endonasal skull base surgery for vascular lesions: a systematic review.

J Neurosurg Sci. 2016 Jun 21;

Authors: Vaz-Guimaraes F, Gardner PA, Fernandez-Miranda JC, Wang EW, Snyderman CH

Abstract
Endoscopic endonasal skull base surgery for vascular lesions is a controversial topic in neurosurgical practice. Concerns regarding the ability to effectively work through the relatively narrow and deep endonasal corridor and manage serious hemorrhagic complications such as inadvertent internal carotid artery (ICA) injury during endoscopic endoscopic surgery (EES) are relevant sources of disagreement between neurosurgeons. Nevertheless, following careful preoperative evaluation, EES may be indicated for rare, well- selected cases, including medially-projecting paraclinoid aneurysms and cavernous malformations (CMs) located next to the ventral surface of the brainstem. To date, only small retrospective case series and case reports, attesting the safety, feasibility and technical aspects of the EES for aneurysm clipping, CM resection and arterio-venous malformations (AVMs), have been published in the literature. In this manuscript, we conducted a systematic review of the literature applying the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) guidelines on EES for treatment of intracranial vascular lesions. We also report two new cases (one frontal lobe cavernoma and one dural arterio-venous fistula successfully resected via EES). We discuss the indications, advantages, limitations and technical aspects of EES for vascular lesions. Although rarely indicated, EES may be considered as an alternative treatment and part of the armamentarium of cerebrovascular neurosurgeons dealing with these challenging lesions.

PMID: 27327518 [PubMed - as supplied by publisher]

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An olfactory groove schwannoma with a pseudocyst compressing the basal ganglia, internal capsule and optic tracts.

An olfactory groove schwannoma with a pseudocyst compressing the basal ganglia, internal capsule and optic tracts.

Childs Nerv Syst. 2016 Jun 21;

Authors: Liby P, Zamecnik J, Kyncl M, Tichy M

Abstract
INTRODUCTION: Olfactory groove schwannomas (OGSs) are extremely rare tumours, particularly in the paediatric population.
CASE REPORT: A 13-year-old girl presented with two epileptic seizures, papilloedema and incomplete binasal quadrantanopia. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a large heterogeneously enhancing tumour of the anterior skull base with a prominent dorsal pseudocyst. Interestingly, the pseudocyst embraced the right ICA bifurcation and displaced the optic tracts, optic chiasm and optic nerves and the ipsilateral basal ganglia. The patient underwent surgery via the frontolateral approach, and the tumour was completely removed. The pseudocyst was opened, and its wall was partially resected. It subsequently resolved completely. Histopathological examination yielded the rare diagnosis of schwannoma of the anterior skull base.
CONCLUSION: Although extremely rare, olfactory groove schwannomas can be seen in paediatric patients. Our patient is the youngest ever reported with this histopathological diagnosis along with the formation of a large pseudocyst.

PMID: 27325302 [PubMed - as supplied by publisher]

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Management of Skull Base Tumor-Associated Facial Pain.

Management of Skull Base Tumor-Associated Facial Pain.

Neurosurg Clin N Am. 2016 Jul;27(3):337-44

Authors: Reddy GD, Wagner K, Phan J, DeMonte F, Raza SM

Abstract
Cancer-associated facial pain can be caused by a variety of pathologic conditions. Here the authors describe the symptoms and incidence of facial pain secondary to three separate anatomic subcategories of cancer. The authors subsequently discuss the effectiveness and drawbacks of the most common methods of treatment.

PMID: 27325000 [PubMed - in process]

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Endoscopic and Microscopic Microvascular Decompression.

Endoscopic and Microscopic Microvascular Decompression.

Neurosurg Clin N Am. 2016 Jul;27(3):305-13

Authors: Piazza M, Lee JY

Abstract
The introduction of the endoscope into the neurosurgeon's armamentarium has revolutionized ventral and anterior skull-base surgery and, more recently, has been used in the surgical treatment of cerebellopontine angle (CPA) pathology. The utilization of the endoscope in microvascular decompression (MVD) for trigeminal neuralgia and other associated cranial nerve hyperactivity syndromes allows for unparalleled panoramic views and illumination of the neurovascular structures within the CPA and identification of vessel-nerve contact traditionally unseen using the microscope. In this article, the technical advantages and challenges of using the endoscope for MVD, operative technique, and patient outcomes of endoscopic MVD are discussed.

PMID: 27324997 [PubMed - in process]

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Overview and History of Trigeminal Neuralgia.

Overview and History of Trigeminal Neuralgia.

Neurosurg Clin N Am. 2016 Jul;27(3):265-76

Authors: Patel SK, Liu JK

Abstract
Although the symptoms associated with trigeminal neuralgia have been well documented, the root cause of this disease initially eluded most surgeons. Although early remedies were haphazard because of a lack of understanding about the condition, near the 20th century both medical and procedural therapies were established for the treatment of trigeminal neuralgia. These treatments include a variety of medications, chemoneurolysis, radiofrequency lesioning, percutaneous ablative procedures, stereotactic radiosurgery, and open rhizotomy and microvascular decompression. This report recounts the history of trigeminal neuralgia, from its earliest descriptions to the historical evolution of nonsurgical and surgical therapies.

PMID: 27324994 [PubMed - in process]

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Radiographic characterization of the retroantral ethmoid cell.

Radiographic characterization of the retroantral ethmoid cell.

Int Forum Allergy Rhinol. 2016 Jun 21;

Authors: Chapurin N, Honeybrook A, Johnson S, Wang C, Jang DW

Abstract
BACKGROUND: The retroantral ethmoid cell (RAEC) is defined as a posterior ethmoid cell that pneumatizes inferolaterally behind the posterior wall of the maxillary sinus. The RAEC can present a challenge to otolaryngologists during endoscopic ethmoidectomy due to its concealed location. It is also encountered during the endoscopic transpterygoid approach to the skull base, which requires dissection behind the posterior wall of the maxillary sinus. Because the RAEC is not described in the literature, this study aims to better characterize this anatomic variant.
METHODS: This is a retrospective review of 58 consecutive patients who underwent revision functional endoscopic sinus surgery (FESS) within a 2-year period at a tertiary referral center. Sinus computed tomography (CT) scans for this cohort (116 sides total) were reviewed independently by 3 authors to determine the incidence of the RAEC and the degree of surgical dissection during prior surgery.
RESULTS: Of the 116 sides included in the study, RAEC was identified in 19 (16%). Furthermore, 14 of 19 (74%) cells were diseased with evidence mucosal thickening or neo-osteogenesis. Of the 12 sides with RAEC that had evidence of previous posterior ethmoidectomy, 4 (33%) cells were not opened, 6 (50%) were partially opened, and only 2 (17%) were completely opened.
CONCLUSION: This study demonstrates the relatively high prevalence of the RAEC in our patient population. The majority of RAECs showed both evidence of disease and that they were not completely opened during previous surgery. Recognition of this anatomic entity may allow for more thorough ethmoidectomy.

PMID: 27324069 [PubMed - as supplied by publisher]

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Composite Vascular Pedicled Middle Turbinate Flap for Reconstruction of Sellar Defects.

Composite Vascular Pedicled Middle Turbinate Flap for Reconstruction of Sellar Defects.

Ann Otol Rhinol Laryngol. 2016 Jun 19;

Authors: Amin SM, Fawzy TO, Hegazy AA

PMID: 27323957 [PubMed - as supplied by publisher]

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I-gel Laryngeal Mask Airway Combined with Tracheal Intubation Attenuate Systemic Stress Response in Patients Undergoing Posterior Fossa Surgery.

http:--images.hindawi.com-linkout-hindaw

I-gel Laryngeal Mask Airway Combined with Tracheal Intubation Attenuate Systemic Stress Response in Patients Undergoing Posterior Fossa Surgery.

Mediators Inflamm. 2015;2015:965925

Authors: Tang C, Chai X, Kang F, Huang X, Hou T, Tang F, Li J

Abstract
BACKGROUND: The adverse events induced by intubation and extubation may cause intracranial hemorrhage and increase of intracranial pressure, especially in posterior fossa surgery patients. In this study, we proposed that I-gel combined with tracheal intubation could reduce the stress response of posterior fossa surgery patients.
METHODS: Sixty-six posterior fossa surgery patients were randomly allocated to receive either tracheal tube intubation (Group TT) or I-gel facilitated endotracheal tube intubation (Group TI). Hemodynamic and respiratory variables, stress and inflammatory response, oxidative stress, anesthesia recovery parameters, and adverse events during emergence were compared.
RESULTS: Mean arterial pressure and heart rate were lower in Group TI during intubation and extubation (P < 0.05 versus Group TT). Respiratory variables including peak airway pressure and end-tidal carbon dioxide tension were similar intraoperative, while plasma β-endorphin, cortisol, interleukin-6, tumor necrosis factor-alpha, malondialdehyde concentrations, and blood glucose were significantly lower in Group TI during emergence relative to Group TT. Postoperative bucking and serious hypertensions were seen in Group TT but not in Group TI.
CONCLUSION: Utilization of I-gel combined with endotracheal tube in posterior fossa surgery patients is safe which can yield more stable hemodynamic profile during intubation and emergence and lower inflammatory and oxidative response, leading to uneventful recovery.

PMID: 26273146 [PubMed - indexed for MEDLINE]

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CT findings of the temporal bone in CHARGE syndrome: aspects of importance in cochlear implant surgery.

CT findings of the temporal bone in CHARGE syndrome: aspects of importance in cochlear implant surgery.

Eur Arch Otorhinolaryngol. 2016 Jun 20;

Authors: Vesseur AC, Verbist BM, Westerlaan HE, Kloostra FJ, Admiraal RJ, van Ravenswaaij-Arts CM, Free RH, Mylanus EA

Abstract
To provide an overview of anomalies of the temporal bone in CHARGE syndrome relevant to cochlear implantation (CI), anatomical structures of the temporal bone and the respective genotypes were analysed. In this retrospective study, 42 CTs of the temporal bone of 42 patients with CHARGE syndrome were reviewed in consensus by two head-and-neck radiologists and two otological surgeons. Anatomical structures of the temporal bone were evaluated and correlated with genetic data. Abnormalities that might affect CI surgery were seen, such as a vascular structure, a petrosquamosal sinus (13 %), an underdeveloped mastoid (8 %) and an aberrant course of the facial nerve crossing the round window (9 %) and/or the promontory (18 %). The appearance of the inner ear varied widely: in 77 % of patients all semicircular canals were absent and the cochlea varied from normal to hypoplastic. A stenotic cochlear aperture was observed in 37 %. The middle ear was often affected with a stenotic round (14 %) or oval window (71 %). More anomalies were observed in patients with truncating mutations than with non-truncating mutations. Temporal bone findings in CHARGE syndrome vary widely. Vascular variants, aberrant route of the facial nerve, an underdeveloped mastoid, aplasia of the semicircular canals, and stenotic round window may complicate cochlear implantation.

PMID: 27324890 [PubMed - as supplied by publisher]

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Cranial tonsillotomy for peritonsillar abscess: what a relief!

Cranial tonsillotomy for peritonsillar abscess: what a relief!

Eur Arch Otorhinolaryngol. 2016 Jun 20;

Authors: Windfuhr JP, Nematian M, Ziogou S

Abstract
Peritonsillar abscess (PTA) is a common infection of the oropharynx resulting in painful swallowing, sometimes associated with fever, trismus and a typical voice alteration. Several draining methods have been suggested, including needle aspiration (NA), incision and drainage (ID), or abscesstonsillectomy. However, a gold standard of surgical therapy still does not exist. The aim of this study was to evaluate the outcome in patients who had undergone ID supplemented by cranial tonsillotomy (IDTT) as first-line treatment. A retrospective chart review of all patients who had undergone IDTT at our department in 2015 was performed. Demographic data, clinical findings, pain intensity on a 10-point visual analog scale, operation time and routine bloods before and after IDTT were collected. In addition, a 10-point visual analog scale (VAS) was utilized to measure personal satisfaction 2 weeks and 2 months after surgery. A total of 104 procedures were performed in 65 male and 38 female patients (median age 35 years), including one patient with a contralateral PTA 2 weeks after IDTT. Three patients had experienced abscess formation after admittance for antibiotic treatment of acute tonsillitis. 57.7 % of all patients denied intake of antibiotic therapy in their history at initial presentation. Patients were hospitalized for 3 days (median). The median pain intensity (VAS) within the first three postoperative days was 2, 1 and 1, respectively. Two weeks and 2 months after surgery patients were highly satisfied with the procedure (median value 10). Bleeding complications did not occur. IDTT is a novel surgical concept and associated with great patient comfort. It is safe, easy to learn and associated with an early return to normal diet and physical activity. These findings are supported by a rapid normalization of white blood cell count and C-reactive protein. IDTT eliminates the necessity of painful re-draining of the wound cavity and is free of bleeding complications. In contrast to ID and NA, histological examination of tonsillar tissue is feasible to disclose a previously undetected malign disease. Further analysis is warranted to verify the success rate in the long-term.

PMID: 27324889 [PubMed - as supplied by publisher]

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The protective effects of different treatments on rat salivary glands after radiotherapy.

The protective effects of different treatments on rat salivary glands after radiotherapy.

Eur Arch Otorhinolaryngol. 2016 Jun 20;

Authors: Konak M, Cincik H, Erkul E, Kucukodaci Z, Gungor A, Ozdemir S, Cekin E, Arisan V, Mutluoglu M, Salihoglu M

Abstract
This study was aimed to evaluate the efficacy of treatment modalities for minimizing salivary gland damage caused by radiotherapy. Forty rats were divided into five groups. Group 1 had no irradiation or any treatment. Group 2 underwent only 15 Gy single dose radiotherapy. N-acetylcysteine, dexamethasone, hyperbaric oxygen treatment were given, respectively to the group 3, 4 and 5 for 5 days. 15 Gy single dose radiotherapy was applied to the group 3, 4 and 5 on the second day. Pyknosis, lysis, and vacuolization were examined in ductal cells and pyknosis, lysis, vacuolization, inflammation and collective duct damage in acinar cells. Dexamethasone and hyperbaric oxygen did not prove to have a positive effect on acinar and ductal cell. N-acetylcysteine-applied group had statistically significantly lower amount of damage. We determined that the decrease of ductal and acinar cell damage in parotid glands of N-acetylcysteine-applied rats was more distinct and statistically.

PMID: 27324888 [PubMed - as supplied by publisher]

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Quality of Life and Hearing Eight Years After Sudden Sensorineural Hearing Loss.

Quality of Life and Hearing Eight Years After Sudden Sensorineural Hearing Loss.

Laryngoscope. 2016 Jun 21;

Authors: Härkönen K, Kivekäs I, Rautiainen M, Kotti V, Vasama JP

PMID: 27328455 [PubMed - as supplied by publisher]

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[From the Expert's Office: Noise Induced Hearing Loss by Dog-barking?].

[From the Expert's Office: Noise Induced Hearing Loss by Dog-barking?].

Laryngorhinootologie. 2015 Jul;94(7):464-6

Authors: Brusis T, Meister EF

PMID: 26125292 [PubMed - indexed for MEDLINE]

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The ageing voice and voice therapy in geriatrics.

The ageing voice and voice therapy in geriatrics.

Aging Clin Exp Res. 2016 Jun 20;

Authors: Çiyiltepe M, Şenkal ÖA

Abstract
BACKGROUND: Although voice therapy is commonly used as an initial treatment for geriatric dysphonia, its role in the treatment for different organic voice disorder is less defined.
AIMS: The goal of this study was to investigate dysphonia and therapy modalities in this cohort.
METHODS: This study analyzes the demographics, Voice Handicap Index questionnaires, and acoustic voice measures including fundamental frequency, jitter and shimmer by using Kay Elemetrics Computerized Speech Lab Multidimensional voice program which were obtained in all patients before and after treatment. A total of 91 (55 men and 36 women) patients with voice complaints, age ranging from 50 to 91 years (mean 64.11 ± 7.2) diagnosed of any vocal fold pathology were made via strobovideolaryngoscopy.
RESULTS: Vocal nodules in 23.9 % (N = 22) was the most common diagnosis associated with the voice complaints, followed by laryngopharyngeal reflux in 10.8 % (N = 10) and paresis in 9.78 % (N = 9). VHI scores varied greatly, ranging from 4 to 92, with an average score of 42.7. Multidimensional voice program scores showed that fundamental frequency (F0) tends to rise as a function of age in men (mean 283.66 ± 23.7).
DISCUSSION: Fundamental frequency perturbation may be affected in ageing, both genders same values detected. Of these patients, 80 % received hygienic voice therapy and % 20 symptomatic voice therapies. This study identified fundamental frequency alteration for ageing voice and dysphonia in all elderly patients presenting with voice complaints.
CONCLUSION: Additional research is needed to determine normative values for multidimensional voice program scores and other assessments in the elderly population.

PMID: 27324692 [PubMed - as supplied by publisher]

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Articulatory-acoustic vowel space: Associations between acoustic and perceptual measures of clear speech.

Articulatory-acoustic vowel space: Associations between acoustic and perceptual measures of clear speech.

Int J Speech Lang Pathol. 2016 Jun 21;:1-11

Authors: Whitfield JA, Goberman AM

Abstract
PURPOSE: The current investigation examined the relationship between perceptual ratings of speech clarity and acoustic measures of speech production. Included among the acoustic measures was the Articulatory-Acoustic Vowel Space (AAVS), which provides a measure of working formant space derived from continuously sampled formant trajectories in connected speech.
METHOD: Acoustic measures of articulation and listener ratings of speech clarity were obtained from habitual and clear speech samples produced by 10 neurologically healthy adults. Perceptual ratings of speech clarity were obtained from visual-analogue scale ratings and acoustic measures included the AAVS measure, articulation rate and percentage pause.
RESULT: Clear speech was characterised by a higher perceptual clarity rating, slower articulation rate, greater percentage pause and larger AAVS compared to habitual speech. Additionally, correlation analysis revealed a significant relationship between the perceptual clear speech effect and the relative clarity-related change in the AAVS and articulation rate measures.
CONCLUSION: The current findings suggest that, along with speech rate measures, the recently introduced AAVS is sensitive to changes in speech clarity.

PMID: 27328115 [PubMed - as supplied by publisher]

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Saliva management options for difficult-to-wean people with tracheostomy following severe acquired brain injury (ABI): A review of the literature.

Saliva management options for difficult-to-wean people with tracheostomy following severe acquired brain injury (ABI): A review of the literature.

Brain Inj. 2015;29(1):1-10

Authors: Checklin M, Etty-Leal M, Iseli TA, Potter N, Fisher S, Chapman L

Abstract
PRIMARY OBJECTIVE: To evaluate the evidence on saliva management options in those people who have a tracheostomy in situ following an acquired brain injury and to ascertain whether any of these treatments may facilitate tracheostomy decannulation.
METHODS: The search was conducted on Medline, Embase, Cinahl and Central databases since 1990 and the evidence has been critiqued and summarized. Saliva management options were identified and analysed to see whether they had evidence or clinical support for the population.
MAIN OUTCOMES AND RESULTS: There is a paucity of evidence in this area and clinical decision-making requires evidence from other populations. Saliva management issues in this population are most likely to be related to dysphagia. Treatment options include behavioural/compensatory therapies which should be tried in all cases, with adjunct pharmaceutical therapies or surgical options to reduce saliva volume as clinically appropriate. CONCLUSION AND FUTURE DIRECTIONS: This group of people is complex and requires a multi-disciplinary team to guide decision-making. High quality control studies looking at the effectiveness of dysphagia therapy and guidelines regarding botulinum toxin injections are recommended.

PMID: 25313955 [PubMed - indexed for MEDLINE]

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Optimal contrast enhancement liquid for dynamic MRI of swallowing.

Optimal contrast enhancement liquid for dynamic MRI of swallowing.

J Oral Rehabil. 2016 Jun 21;

Authors: Ohkubo M, Higaki T, Nishikawa K, Otonari-Yamamoto M, Sugiyama T, Ishida R, Wakoh M

Abstract
Several dynamic magnetic resonance imaging (MRI) techniques to observe swallowing and their parameters have been reported. Although these studies used several contrast enhancement liquids, no studies were conducted to investigate the most suitable liquids. The purpose of this study was to identify the optimal contrast enhancement liquid for dynamic MRI of swallowing. MRI was performed using a new sequence consisting of true fast imaging with steady-state precession, generalised auto-calibrating partially parallel acquisition and a keyhole imaging technique. Seven liquids were studied, including pure distilled water, distilled water with thickener at 10, 20 and 30 mg mL(-1) concentrations and oral MRI contrast medium at 1, 2 or 3 mg mL(-1) . Distilled water showed the highest signal intensity. There were statistically significant differences among the following contrast media: distilled water with thickener at 20 mg mL(-1) and the oral MRI contrast medium at 2 mg mL(-1) and 1 mg mL(-1) . It can be concluded that the optimal liquid for dynamic MRI of swallowing is a water-based substance that allows variations in viscosity.

PMID: 27328011 [PubMed - as supplied by publisher]

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Composite Vascular Pedicled Middle Turbinate Flap for Reconstruction of Sellar Defects.

Composite Vascular Pedicled Middle Turbinate Flap for Reconstruction of Sellar Defects.

Ann Otol Rhinol Laryngol. 2016 Jun 19;

Authors: Amin SM, Fawzy TO, Hegazy AA

PMID: 27323957 [PubMed - as supplied by publisher]

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Αρχειοθήκη ιστολογίου

Τετάρτη 22 Ιουνίου 2016