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In reference to Spontaneous middle cranial fossa cerebrospinal fluid otorrhea in adults.
Laryngoscope. 2016 Jun 27;
Authors: Mokhtari TE, Ziai K, Djalilian HR, Djalilian HR
PMID: 27346371 [PubMed - as supplied by publisher]
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Variables associated with communicative participation in Parkinson's disease and its relationship to measures of health-related quality-of-life.
Int J Speech Lang Pathol. 2016 Jun 27;:1-11
Authors: McAuliffe MJ, Baylor CR, Yorkston KM
Abstract
PURPOSE: Communication disorders associated with Parkinson's disease (PD) often lead to restricted participation in life roles, yet there is a limited understanding of influencing factors and few quantitative measurement tools available. This study aimed to identify variables associated with communicative participation in PD and to examine the relationship between the Communicative Participation Item Bank (CPIB) and existing health-related quality-of-life (HRQoL) measures.
METHOD: Self-report data from 378 participants with PD from the US and New Zealand were analysed. Data included responses to the CPIB, PD Questionnaire-8, sub-scales of the Global Health instrument from the Patient Reported Outcomes Measurement Information System (PROMIS) and additional self-report instruments.
RESULT: Greater perceived speech disorder, lower levels of speech usage, fatigue, cognitive and emotional problems and swallowing difficulties were associated with lower levels of communicative participation. Participants' age significantly influenced findings, interacting with country of residence, sex and speech usage. Scores on the CPIB were moderately correlated with HRQoL measures.
CONCLUSION: Communicative participation in PD is complex and influenced by both demographic and disease-based variables, necessitating a broader view of the communicative experiences of those with PD. Measurement of communicative participation as a separate construct to existing HRQoL measures is recommended.
PMID: 27347713 [PubMed - as supplied by publisher]
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Variables associated with communicative participation in Parkinson's disease and its relationship to measures of health-related quality-of-life.
Int J Speech Lang Pathol. 2016 Jun 27;:1-11
Authors: McAuliffe MJ, Baylor CR, Yorkston KM
Abstract
PURPOSE: Communication disorders associated with Parkinson's disease (PD) often lead to restricted participation in life roles, yet there is a limited understanding of influencing factors and few quantitative measurement tools available. This study aimed to identify variables associated with communicative participation in PD and to examine the relationship between the Communicative Participation Item Bank (CPIB) and existing health-related quality-of-life (HRQoL) measures.
METHOD: Self-report data from 378 participants with PD from the US and New Zealand were analysed. Data included responses to the CPIB, PD Questionnaire-8, sub-scales of the Global Health instrument from the Patient Reported Outcomes Measurement Information System (PROMIS) and additional self-report instruments.
RESULT: Greater perceived speech disorder, lower levels of speech usage, fatigue, cognitive and emotional problems and swallowing difficulties were associated with lower levels of communicative participation. Participants' age significantly influenced findings, interacting with country of residence, sex and speech usage. Scores on the CPIB were moderately correlated with HRQoL measures.
CONCLUSION: Communicative participation in PD is complex and influenced by both demographic and disease-based variables, necessitating a broader view of the communicative experiences of those with PD. Measurement of communicative participation as a separate construct to existing HRQoL measures is recommended.
PMID: 27347713 [PubMed - as supplied by publisher]
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Association of High-Resolution Manometry Metrics with the Symptoms of Achalasia and the Symptomatic Outcomes of Peroral Esophageal Myotomy.
PLoS One. 2015;10(9):e0139385
Authors: Tang Y, Xie C, Wang M, Jiang L, Shi R, Lin L
Abstract
BACKGROUND: High-resolution manometry (HRM) has improved the accuracy of manometry in detecting achalasia and has helped distinguish between clinically relevant subtypes. This study investigated whether HRM metrics correlate with the achalasia symptoms and symptomatic outcomes of peroral esophageal myotomy (POEM).
METHODS: Of the 30 patients who were enrolled, 25 were treated with POEM, 12 of who underwent HRM after 3 months. All the patients completed the Eckardt score questionnaires, and those who underwent POEM were followed up for about 6 months. Pearson correlation was used to assess the relationship between the HRM metrics and symptoms and outcomes.
KEY RESULTS: The integrated relaxation pressure (IRP) score positively correlated with the total Eckardt score, regurgitation score and weight loss score in all the patients, and with the weight loss score in type I achalasia. In 25 patients (10 patients, type I; 15 patients, type II) who underwent POEM, the total Eckardt scores and individual symptom scores significantly decreased after surgery. Changes in the Eckardt scores were similar between type I and type II. Further, the Eckardt scores and weight loss score changes were positively correlated with baseline IRP. Twelve patients (4 patients, type I; 8 patients, type II) underwent HRM again after POEM. IRP changed significantly after POEM, as did the DEP in type II. The IRP changes after POEM were positively correlated with the Eckardt score changes.
CONCLUSIONS & INFERENCES: IRP is correlated with the symptoms and outcomes of achalasia patients. Thus, HRM is effective for assessing the severity of achalasia and can predict the efficacy of POEM.
PMID: 26421919 [PubMed - indexed for MEDLINE]
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Midline posterior glossectomy and lingual tonsillectomy in obese and nonobese children with down syndrome: Biomarkers for success.
Laryngoscope. 2016 Jun 27;
Authors: Propst EJ, Amin R, Talwar N, Zaman M, Zweerink A, Blaser S, Zaarour C, Luginbuehl I, Karsli C, Aziza A, Forrest C, Drake J, Narang I
Abstract
OBJECTIVES/HYPOTHESIS: To examine outcomes following midline posterior glossectomy (MPG) plus lingual tonsillectomy (LT) for the treatment of significant obstructive sleep apnea (OSA) in children with Down syndrome (DS).
METHODS: Patients with DS who had persistent OSA following tonsillectomy and adenoidectomy (TA) and were relatively intolerant of positive airway pressure (PAP) therapy were evaluated by physical examination and sleep/CINE magnetic resonance imaging to determine the etiology of upper airway obstruction. Patients with relative macroglossia underwent MPG plus LT if required. Successful surgical outcome was defined as the resolution of OSA or the ability to tolerate PAP.
RESULTS: Thirteen children (8 male, 5 female), mean (standard deviation) age 14.2 (4.0) years underwent MPG plus LT. Fifty-four percent of patients were obese (Body mass index [BMI] > 95th centile) and 8% were overweight (BMI 85th-95th centile) preoperatively. All patients underwent pre- and postoperative polysomnography. Postoperatively, the obstructive apnea-hypopnea index fell significantly from 47.0/hour to 5.6/hour (P <.05) in normal weight individuals who did not become obese, but not in obese patients or those who became obese postoperatively. Successful surgical outcome was seen in all (N = 6) children who were normal weight or overweight preoperatively compared with none who were obese preoperatively (N = 7).
CONCLUSION: Midline posterior glossectomy and LT are beneficial in normal weight and overweight children with DS who have persistent OSA following TA and are intolerant of PAP therapy. Obesity pre- or postoperatively portends a worse prognosis following MPG, suggesting that aggressive weight loss initiatives should be considered as an adjunct to surgery in this population.
LEVEL OF EVIDENCE: Level 4. Laryngoscope, 2016.
PMID: 27345007 [PubMed - as supplied by publisher]
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Central Sleep Apnea at High Altitude.
Adv Exp Med Biol. 2016;903:275-83
Authors: Burgess KR, Ainslie PN
Abstract
The discovery of central sleep apnea (CSA) at high altitude is usually attributed to Angelo Mosso who published in 1898. It can occur in susceptible individuals at altitude above 2000 m, but at very high altitude, say above 5000 m, it will occur in most subjects. Severity is correlated with ventilatory responsiveness, particularly to hypoxia. Theoretically, it should spontaneously improve with time and acclimatization. Although the time course of resolution is not well described, it appears to persist for more than a month at 5000 m.It occurs due to the interaction of hypocapnia with stages 1 and 2 NREM sleep, in the presence of increased loop-gain. The hypocapnia is secondary to hypoxic ventilatory drive. With acclimatization, one might expect that the increase in PaO2 and cerebral blood flow (CBF) would mitigate the CSA. However, over time, both the hypoxic and hypercapnic ventilatory responses increase, causing an increase in loop gain which is a counteracting force.The severity of the CSA can be reduced by descent, supplemental oxygen therapy, oral or intravenous acetazolamide. Recent studies suggest that acute further increases in cerebral blood flow will substantially, but temporarily, reduce central sleep apnea, without altering acid based balance. Very recently, bi-level noninvasive ventilation has also been shown to help (mechanism unknown). Sleep quality can be improved independent of the presence of CSA by the use of benzodiazepine sedation.
PMID: 27343103 [PubMed - in process]
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Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss.
Int J Audiol. 2016 Jun 27;:1-5
Authors: Park MJ, Lee JR, Yang CJ, Yoo MH, Jin IS, Choi CH, Park HJ
Abstract
OBJECTIVE: Transcutaneous devices have a disadvantage, the dampening effect by soft tissue between the bone and devices. We investigated hearing outcomes with percutaneous and transcutaneous devices using test-bands in an induced unilateral conductive hearing loss.
DESIGN: Comparison of hearing outcomes of two devices in the same individuals.
STUDY SAMPLE: The right ear was plugged in 30 subjects and a test-band with devices (Cochlear™ Baha® BP110 Power and Sophono® Alpha-2 MPO™) was applied on the right mastoid tip with the left ear masked. Sound-field thresholds, speech recognition thresholds (SRTs), and word recognition scores (WRSs) were compared.
RESULTS: Aided thresholds of Sophono were significantly better than those of Baha at most frequencies. Sophono WRSs (86 ± 12%) at 40 dB SPL and SRTs (14 ± 5 dB HL) were significantly better than those (73 ± 24% and 23 ± 8 dB HL) of Baha. However, Sophono WRSs (98 ± 3%) at 60 dB SPL did not differ from Baha WRSs (95 ± 12%).
CONCLUSION: Amplifications of the current transcutaneous device were not inferior to those of percutaneous devices with a test-band in subjects with normal bone-conduction thresholds. Since the percutaneous devices can increase the gain when fixed to the skull by eliminating the dampening effect, both devices are expected to provide sufficient hearing amplification.
PMID: 27347717 [PubMed - as supplied by publisher]
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Paediatric tinnitus: The unmet clinical need.
Int J Audiol. 2016 Jun 27;:1-2
Authors: Humphriss R, Hall A, Baguley D
PMID: 27347601 [PubMed - as supplied by publisher]
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Current concepts in the management of idiopathic sudden sensorineural hearing loss.
Curr Opin Otolaryngol Head Neck Surg. 2016 Jun 24;
Authors: O'Connell BP, Hunter JB, Haynes DS
Abstract
PURPOSE OF REVIEW: The purpose of this manuscript is to review the initial management strategies for idiopathic sudden sensorineural hearing loss, with an emphasis on the role that steroids play in treatment of this condition, and discuss options for auditory rehabilitation of persistent unilateral hearing loss.
RECENT FINDINGS: Recent data suggest that hearing improvement may be greater for patients initially treated with both systemic and intratympanic steroid when compared with those treated with systemic steroids alone. Salvage intratympanic steroids have been shown to confer hearing benefit if initial management fails. The ideal dosing regimen for intratympanic steroids has not been established, but evidence supports that higher dosing strategies are advantageous. Cochlear implantation has emerged as a strategy for auditory rehabilitation of persistent unilateral hearing loss. Recent studies have demonstrated high patient satisfaction, subjective improvement in tinnitus, and objective performance benefit after cochlear implantation for single-sided deafness.
SUMMARY: Patients can be offered steroid therapy in the initial management of idiopathic sudden sensorineural hearing loss, but should be counseled that the efficacy of steroids remains unclear. If patients fail to improve with initial management, salvage intratympanic steroid administration should be considered. If hearing loss persists long term, options for auditory rehabilitation should be discussed.
PMID: 27348351 [PubMed - as supplied by publisher]
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Paediatric tinnitus: The unmet clinical need.
Int J Audiol. 2016 Jun 27;:1-2
Authors: Humphriss R, Hall A, Baguley D
PMID: 27347601 [PubMed - as supplied by publisher]
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Cochlear implantation for single-sided deafness: A multicenter study.
Laryngoscope. 2016 Jun 27;
Authors: Sladen DP, Frisch CD, Carlson ML, Driscoll CL, Torres JH, Zeitler DM
Abstract
OBJECTIVES/HYPOTHESIS: To report the preliminary outcomes of patients with single-sided deafness and asymmetric hearing loss undergoing cochlear implantation at two centers.
STUDY DESIGN: Retrospective review and prospective data collection.
METHODS: Patients with single-sided deafness who underwent cochlear implantation at two centers were included. Pre- and postoperative measures included monosyllabic word and sentence recognition in quiet for the ear implanted, and sentence recognition in noise in the best-aided bilateral condition.
RESULTS: Average monosyllabic word recognition scores in quiet improved significantly from 11.3% (standard deviation [SD] 15.6%) preoperatively to 48.7% (SD 24.2%) at the 3-month postactivation interval, although they did not increase significantly between the 3-month and 6-month intervals. Sentence recognition scores in quiet increased significantly from 18.4% (SD 28.5%) preoperatively to 65.9% (SD 17.9%) at the 3-month postactivation interval, but not between the 3-month and 6-month intervals. Sentence recognition in noise in the best-aided bilateral condition increased from 59% (SD 16.3%) preoperatively to 72% (SD 16.0%) at 6-months postactivation, though the difference was not statistically significant. Thirteen of the participants reported tinnitus prior to surgery. Of those, 12 reported that tinnitus was improved after implantation, and one reported that tinnitus was unchanged.
CONCLUSION: Preliminary results suggest that speech recognition in a singly deafened ear is significantly improved after cochlear implantation, although speech recognition in noise measured in the bilateral condition remains the same at 6-months postactivation.
LEVEL OF EVIDENCE: 4. Laryngoscope, 2016.
PMID: 27346874 [PubMed - as supplied by publisher]
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Matrix Metalloproteinase Levels in Cervical and Intracranial Carotid Dolichoarteriopathies.
J Stroke Cerebrovasc Dis. 2016 Jun 23;
Authors: Arslan Y, Arslan İB, Pekçevik Y, Şener U, Köse Ş, Zorlu Y
Abstract
BACKGROUND: Matrix metalloproteinases (MMPs) are enzymes suggested as a possible candidate for pathogenesis of arterial dolichoarteriopathy (DA). We aimed to investigate the relationship between MMP levels and DA of intra- and extracranial carotid arteries.
METHODS: This study included 88 subjects admitted with headache, vertigo, or pulsatile tinnitus and those who underwent computed tomography angiography. The study group (n = 70) consisted of patients with kink-coiling (group I, n = 41) and patients with tortuosity (group II, n = 29). The control group (n = 18) had normal angiography results. The diameter, course, and geometry of the carotid artery were analyzed. Serum MMP-1, -2, -3, and -12 levels were measured in all subjects. Vascular risk factors for DA were also noted.
RESULTS: MMP-2 levels were significantly higher in the kink-coiling and tortuous groups than in the control group. In the study group (n = 70), MMP-12 levels were also significantly higher in patients with atheromatous plaques than in those without plaques. Diameters of arteries were meaningfully wider in the kink and tortuous groups than in the control group. Among vascular risk factors, hypertension and diabetes mellitus were more common in the kink group than in the control group, and there were significant differences between them.
CONCLUSIONS: MMP-2 plays a role in the etiology of DA, and MMP-12 levels increase in carotid atherosclerotic lesions and may lead to plaque formation. We demonstrated that dilatation and tortuosity occur together.
PMID: 27345464 [PubMed - as supplied by publisher]
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Comment on the publication of Hansson, Halling and Fangerau with the title 'The Nobel Prize and Otolaryngology: "Papa Gunnar's" promotion of his peers Gustav Killian and Themistocles Gluck'.
Acta Otolaryngol. 2016 Jun 27;:1
Authors: Folz BJ
PMID: 27348338 [PubMed - as supplied by publisher]
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The expression of cancerous inhibitor protein phosphatase 2A in chronic rhinosinusitis with nasal polyps.
Acta Otolaryngol. 2016 Jun 27;:1-7
Authors: Terna E, Luukkainen A, Seppälä M, Renkonen R, Huhtala H, Tommola S, Paavonen T, Kauppi P, Tynninen O, Jeskanen L, Toppila-Salmi S
Abstract
CONCLUSION: The study suggests that cancerous inhibitor of protein phosphatase 2A (CIP2A) expression and eosinophilia associate with chronic rhinosinusitis with nasal polyps with aspirin exacerbated respiratory disease (CRSwNP + AERD). Further studies with a larger sample size are needed to evaluate further the role of CIP2A and related pathways in CRSwNP + AERD.
OBJECTIVES: Low prostaglandin E2 levels putatively associate with CRSwNP + AERD and decreased c-Myc levels. The aim of this study was to evaluate the expression and revision-predictive role of oncoprotein CIP2A, another c-Myc modulator, in CRSwNP with/without AERD, and in antrochoanal polyps.
METHOD: Ninety retrospective archival objective glasses of nasal polyp tissue from CRSwNP or ACP patients were used for assessing mucosal eosinophilia. Of this population, 90 archival nasal polyp specimens were available for immunohistochemical staining with a polyclonal anti-CIP2A antibody, together with 19 control nasal mucosa specimens. CIP2A staining intensity and tissue eosinophilia were assessed by two blinded observers with a light microscope. Subject characteristics from 90 patients and 19 controls were obtained from patient records and additionally by a questionnaire from controls. The follow-up data was available from patient records of 84 patients and 16 controls.
RESULTS: The expression of epithelial CIP2A was detected both in control inferior turbinate mucosa and nasal polyps. The expression was significantly lower in the CRSwNP + AERD group compared to controls and CRSwNP without AERD (p < 0.01). High mucosal eosinophilia associated with CRSwNP (p < 0.01). Neither CIP2A nor eosinophilia predicted the need for revision surgery (p > 0.05), whereas previous surgery, allergic rhinitis, and use of corticosteroids did predict the need for revision surgery (p < 0.05).
PMID: 27348236 [PubMed - as supplied by publisher]
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Is dehydration test using isosorbide useful in Meniere's disease?
Acta Otolaryngol. 2016 Jun 27;:1-3
Authors: Lee JD, Kim HJ, Jung J, Kim SH, Kim BG, Kim KS
Abstract
CONCLUSION: The dehydration test using isosorbide is well tolerated when used to detect endolymphatic hydrops and may also be used to improve the sensitivity of ECoG performed on patients with MD, especially in poor hearing at low-frequency.
OBJECTIVE: This prospective study was to explore the diagnostic utility of a dehydration test, administering oral isosorbide, which has been used to treat Meniere's disease (MD).
METHOD: Electrocochleography (ECoG) and the dehydration test with isosorbide were performed on 32 patients diagnosed with definite diagnosed MD. Isosorbide (120 mL) was orally administered after baseline audiometric testing, and the testing was repeated 3 h later. The dehydration test was considered positive when improvements in hearing thresholds of 10 dB or more were evident at two or more frequencies, or the speech discrimination score increased by 12% or more. An abnormal ECoG finding was defined as an SP/AP (summating potential/action potential) ratio ≥0.4.
RESULTS: The dehydration test using isosorbide was positive in 10 of 32 patients (31.3%). The test was not associated with development of any serious side-effect. Abnormal ECoG findings were noted in 14 of 32 patients (43.8%). When endolymphatic hydrops was defined as an abnormal ECoG or a positive dehydration test, the condition was detected in 21 of 32 patients (65.6%). The positive result in dehydration test was significantly higher in patients with above moderate hearing loss at low-frequency.
PMID: 27348133 [PubMed - as supplied by publisher]
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Pragmatic language impairment in children with Noonan syndrome.
Clin Linguist Phon. 2016 Jun 27;:1-12
Authors: Selås M, Helland WA
Abstract
Noonan syndrome (NS) is a disorder causing symptoms like short stature, characteristic facial features, congenital heart disease, possible mental retardation and pragmatic difficulties. This study describes the pragmatic skills in NS and discusses the linguistic profile of 17 informants aged 6-15 years, by comparing the participants' scores on the Children's Communication Checklist, 2nd Edition (CCC-2) (Bishop, 2011), with a group of typically developing children of matching age and gender. Language impairments were common in the NS group. The results show that children and adolescents with NS do not have one coherent pragmatic profile. However, 76.5% of the participants displayed communication impairments, and pragmatic skills were significantly lower than in the control group.
PMID: 27348294 [PubMed - as supplied by publisher]
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'How to stop a nosebleed': an assessment of the quality of epistaxis treatment advice on YouTube.
J Laryngol Otol. 2016 Jun 27;:1-6
Authors: Haymes AT, Harries V
Abstract
OBJECTIVE: Video hosting websites are increasingly being used to disseminate health education messages. This study aimed to assess the quality of advice contained within YouTube videos on the conservative management of epistaxis.
METHOD: YouTube.com was searched using the phrase 'how to stop a nosebleed'. The first 50 videos were screened. Objective advice scores and subjective production quality scores were attributed by independent raters.
RESULTS: Forty-five videos were analysed. The mean advice score was 2.0 out of 8 and the mean production quality score was 1.6 out of 3. There were no correlations between a video's advice score and its search results rank (ρ = -0.28, p = 0.068), its view count (ρ = 0.20, p = 0.19) or its number of 'likes' (ρ = 0.21, p = 0.18).
CONCLUSION: The quality of information on conservative epistaxis management within YouTube videos is extremely variable. A high search rank is no indication of video quality. Many videos proffer inappropriate and dangerous 'alternative' advice. We do not recommend YouTube as a source for patient information.
PMID: 27345303 [PubMed - as supplied by publisher]
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Gender and laterality in semicircular canal dehiscence syndrome.
J Laryngol Otol. 2016 Jun 27;:1-5
Authors: Karimnejad K, Czerny MS, Lookabaugh S, Lee DJ, Mikulec AA
Abstract
OBJECTIVE: To determine if there is gender or laterality predilection in patients with semicircular canal dehiscence syndrome.
METHODS: A multi-institutional chart review was performed to identify patients diagnosed with semicircular canal dehiscence between 2000 and 2015. A systematic literature search was conducted using PubMed to further identify patients with semicircular canal dehiscence. Age, gender and laterality data were collected. Statistical analysis was performed to evaluate for gender or laterality preponderance.
RESULTS: A total of 682 patients with semicircular canal dehiscence were identified by literature and chart review. Mean age of diagnosis was 49.75 years (standard deviation = 15.33). Semicircular canal dehiscence was associated with a statistically significant female predominance (chi-square = 7.185, p = 0.007); the female-to-male ratio was 1.2 to 1. Left-sided semicircular canal dehiscence was most common, followed by right-sided then bilateral (chi-square = 23.457, p < 0.001).
CONCLUSION: Semicircular canal dehiscence syndrome is most commonly left-sided and exhibits a female predominance. This may be secondary to morphological cerebral hemisphere asymmetries in both sexes and a predilection of women to seek more medical care than men.
PMID: 27345153 [PubMed - as supplied by publisher]
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Comment on the publication of Hansson, Halling and Fangerau with the title 'The Nobel Prize and Otolaryngology: "Papa Gunnar's" promotion of his peers Gustav Killian and Themistocles Gluck'.
Acta Otolaryngol. 2016 Jun 27;:1
Authors: Folz BJ
PMID: 27348338 [PubMed - as supplied by publisher]
| Related Articles |
The expression of cancerous inhibitor protein phosphatase 2A in chronic rhinosinusitis with nasal polyps.
Acta Otolaryngol. 2016 Jun 27;:1-7
Authors: Terna E, Luukkainen A, Seppälä M, Renkonen R, Huhtala H, Tommola S, Paavonen T, Kauppi P, Tynninen O, Jeskanen L, Toppila-Salmi S
Abstract
CONCLUSION: The study suggests that cancerous inhibitor of protein phosphatase 2A (CIP2A) expression and eosinophilia associate with chronic rhinosinusitis with nasal polyps with aspirin exacerbated respiratory disease (CRSwNP + AERD). Further studies with a larger sample size are needed to evaluate further the role of CIP2A and related pathways in CRSwNP + AERD.
OBJECTIVES: Low prostaglandin E2 levels putatively associate with CRSwNP + AERD and decreased c-Myc levels. The aim of this study was to evaluate the expression and revision-predictive role of oncoprotein CIP2A, another c-Myc modulator, in CRSwNP with/without AERD, and in antrochoanal polyps.
METHOD: Ninety retrospective archival objective glasses of nasal polyp tissue from CRSwNP or ACP patients were used for assessing mucosal eosinophilia. Of this population, 90 archival nasal polyp specimens were available for immunohistochemical staining with a polyclonal anti-CIP2A antibody, together with 19 control nasal mucosa specimens. CIP2A staining intensity and tissue eosinophilia were assessed by two blinded observers with a light microscope. Subject characteristics from 90 patients and 19 controls were obtained from patient records and additionally by a questionnaire from controls. The follow-up data was available from patient records of 84 patients and 16 controls.
RESULTS: The expression of epithelial CIP2A was detected both in control inferior turbinate mucosa and nasal polyps. The expression was significantly lower in the CRSwNP + AERD group compared to controls and CRSwNP without AERD (p < 0.01). High mucosal eosinophilia associated with CRSwNP (p < 0.01). Neither CIP2A nor eosinophilia predicted the need for revision surgery (p > 0.05), whereas previous surgery, allergic rhinitis, and use of corticosteroids did predict the need for revision surgery (p < 0.05).
PMID: 27348236 [PubMed - as supplied by publisher]
| Related Articles |
Is dehydration test using isosorbide useful in Meniere's disease?
Acta Otolaryngol. 2016 Jun 27;:1-3
Authors: Lee JD, Kim HJ, Jung J, Kim SH, Kim BG, Kim KS
Abstract
CONCLUSION: The dehydration test using isosorbide is well tolerated when used to detect endolymphatic hydrops and may also be used to improve the sensitivity of ECoG performed on patients with MD, especially in poor hearing at low-frequency.
OBJECTIVE: This prospective study was to explore the diagnostic utility of a dehydration test, administering oral isosorbide, which has been used to treat Meniere's disease (MD).
METHOD: Electrocochleography (ECoG) and the dehydration test with isosorbide were performed on 32 patients diagnosed with definite diagnosed MD. Isosorbide (120 mL) was orally administered after baseline audiometric testing, and the testing was repeated 3 h later. The dehydration test was considered positive when improvements in hearing thresholds of 10 dB or more were evident at two or more frequencies, or the speech discrimination score increased by 12% or more. An abnormal ECoG finding was defined as an SP/AP (summating potential/action potential) ratio ≥0.4.
RESULTS: The dehydration test using isosorbide was positive in 10 of 32 patients (31.3%). The test was not associated with development of any serious side-effect. Abnormal ECoG findings were noted in 14 of 32 patients (43.8%). When endolymphatic hydrops was defined as an abnormal ECoG or a positive dehydration test, the condition was detected in 21 of 32 patients (65.6%). The positive result in dehydration test was significantly higher in patients with above moderate hearing loss at low-frequency.
PMID: 27348133 [PubMed - as supplied by publisher]
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Singing voice outcomes following singing voice therapy.
Laryngoscope. 2016 Jun 27;
Authors: Dastolfo-Hromack C, Thomas TL, Rosen CA, Gartner-Schmidt J
Abstract
OBJECTIVES/HYPOTHESIS: The objectives of this study were to describe singing voice therapy (SVT), describe referred patient characteristics, and document the outcomes of SVT.
STUDY DESIGN: Retrospective.
METHODS: Records of patients receiving SVT between June 2008 and June 2013 were reviewed (n = 51). All diagnoses were included. Demographic information, number of SVT sessions, and symptom severity were retrieved from the medical record. Symptom severity was measured via the 10-item Singing Voice Handicap Index (SVHI-10). Treatment outcome was analyzed by diagnosis, history of previous training, and SVHI-10.
RESULTS: SVHI-10 scores decreased following SVT (mean change = 11, 40% decrease) (P < .001). Approximately 18% (n = 9) of patient SVHI-10 scores decreased to normal range. The average number of sessions attended was three (± 2); patients who concurrently attended singing lessons (n = 10) also completed an average of three SVT sessions. Primary muscle tension dysphonia (MTD1) and benign vocal fold lesion (lesion) were the most common diagnoses. Most patients (60%) had previous vocal training. SVHI-10 decrease was not significantly different between MTD and lesion.
CONCLUSIONS: This is the first outcome-based study of SVT in a disordered population. Diagnosis of MTD or lesion did not influence treatment outcomes. Duration of SVT was short (approximately three sessions). Voice care providers are encouraged to partner with a singing voice therapist to provide optimal care for the singing voice. This study supports the use of SVT as a tool for the treatment of singing voice disorders.
LEVEL OF EVIDENCE: 4 Laryngoscope, 2016.
PMID: 27345762 [PubMed - as supplied by publisher]
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Use of Biological Tissue Matrix in Postneurosurgical Posterior Trunk Reconstruction Is Associated with Higher Wound Complication Rates.
Plast Reconstr Surg. 2016 Jul;138(1):104e-110e
Authors: Coon D, Calotta NA, Broyles JM, Sacks JM
Abstract
BACKGROUND: Patients undergoing neurosurgical spine surgery for spinal tumors are increasingly undergoing soft-tissue reconstruction involving the use of biological tissue matrices. There are limited data available on the safety of these devices in posterior trunk reconstruction.
METHODS: A cohort study of patients undergoing oncologic spine surgery with subsequent plastic surgery soft-tissue reconstruction from 2002 to 2014 was conducted. Demographic, medical, and surgical variables were recorded. The primary outcome variable was development of a postoperative wound complication. Secondary outcome variables were specific complications, including infection, seroma, hematoma, dehiscence, and cerebrospinal fluid leak. The predictor variable was the presence or absence of biological matrix at the reconstruction site.
RESULTS: A total of 293 cases in 260 patients were included in this study. The cohorts were similar with regard to demographic, medical, and surgical variables. The incidence of all-cause wound complications in patients receiving biological matrix for reconstruction was 49.2 percent, whereas the all-cause complication rate for patients not receiving the matrix was 31.7 percent (p = 0.010). The rates of infection (34.9 percent versus 20.9 percent) and seroma (19.0 percent versus 10.0 percent) were also increased in patients receiving biological matrix. In multivariate analysis, biological matrix use remained a predictor of wound complications (p = 0.045), infection (p = 0.011), and seroma (p = 0.047).
CONCLUSIONS: The authors identified an increased risk of infection and seroma with the use of biological tissue matrix in posterior trunk reconstruction. Careful consideration of the risks and benefits of using these devices in this patient population is warranted.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
PMID: 27348672 [PubMed - as supplied by publisher]
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Detection of cerebrospinal fluid leakage by specific measurement of transferrin glycoforms.
Electrophoresis. 2015 Oct;36(19):2425-32
Authors: Kwon SJ, Zhang F, Dordick JS, Sonstein WJ, Linhardt RJ
Abstract
A simple and rapid detection of cerebrospinal fluid (CSF) leakage would benefit spine surgeons making critical postoperative decisions on patient care. We have assessed novel approaches to selectively determine CSF β2-transferrin (β2TF), an asialo-transferrin (aTF) biomarker, without interference from serum sialo-transferrin (sTF) in test samples. First, we performed mild periodate oxidation to selectively generate aldehyde groups in sTF for capture with magnetic hydrazide microparticles, and selective removal with a magnetic separator. Using this protocol sTF was selectively removed from mixtures of CSF and serum containing CSF aTF (β2TF) and serum sTF, respectively. Second, a two-step enzymatic method was developed with neuraminidase and galactose oxidase for generating aldehyde groups in sTF present in CSF and serum mixtures for magnetic hydrazide microparticle capture. After selectively removing sTF from mixtures of CSF and serum, ELISA could detect significant TF signal only in CSF, while the TF signal in serum was negligible. The new approach for selective removal of only sTF in test samples will be promising for the required intervention by a spine surgeon.
PMID: 26084971 [PubMed - indexed for MEDLINE]
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Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss.
Int J Audiol. 2016 Jun 27;:1-5
Authors: Park MJ, Lee JR, Yang CJ, Yoo MH, Jin IS, Choi CH, Park HJ
Abstract
OBJECTIVE: Transcutaneous devices have a disadvantage, the dampening effect by soft tissue between the bone and devices. We investigated hearing outcomes with percutaneous and transcutaneous devices using test-bands in an induced unilateral conductive hearing loss.
DESIGN: Comparison of hearing outcomes of two devices in the same individuals.
STUDY SAMPLE: The right ear was plugged in 30 subjects and a test-band with devices (Cochlear™ Baha® BP110 Power and Sophono® Alpha-2 MPO™) was applied on the right mastoid tip with the left ear masked. Sound-field thresholds, speech recognition thresholds (SRTs), and word recognition scores (WRSs) were compared.
RESULTS: Aided thresholds of Sophono were significantly better than those of Baha at most frequencies. Sophono WRSs (86 ± 12%) at 40 dB SPL and SRTs (14 ± 5 dB HL) were significantly better than those (73 ± 24% and 23 ± 8 dB HL) of Baha. However, Sophono WRSs (98 ± 3%) at 60 dB SPL did not differ from Baha WRSs (95 ± 12%).
CONCLUSION: Amplifications of the current transcutaneous device were not inferior to those of percutaneous devices with a test-band in subjects with normal bone-conduction thresholds. Since the percutaneous devices can increase the gain when fixed to the skull by eliminating the dampening effect, both devices are expected to provide sufficient hearing amplification.
PMID: 27347717 [PubMed - as supplied by publisher]
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Paediatric tinnitus: The unmet clinical need.
Int J Audiol. 2016 Jun 27;:1-2
Authors: Humphriss R, Hall A, Baguley D
PMID: 27347601 [PubMed - as supplied by publisher]
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Voice Quality After a Semi-Occluded Vocal Tract Exercise With a Ventilation Mask in Contemporary Commercial Singers: Acoustic Analysis and Self-Assessments.
J Voice. 2016 Jun 23;
Authors: Fantini M, Succo G, Crosetti E, Borragán Torre A, Demo R, Fussi F
Abstract
OBJECTIVE: The current study aimed at investigating the immediate effects of a semi-occluded vocal tract exercise with a ventilation mask in a group of contemporary commercial singers.
STUDY DESIGN: A randomized controlled study was carried out.
METHODS: Thirty professional or semi-professional singers with no voice complaints were randomly divided into two groups on recruitment: an experimental group and a control group. The same warm-up exercise was performed by the experimental group with an occluded ventilation mask placed over the nose and the mouth and by the control group without the ventilation mask. Voice was recorded before and after the exercise. Acoustic and self-assessment analysis were accomplished. The acoustic parameters of the voice samples recorded before and after training were compared, as well as the parameters' variations between the experimental and the control group. Self-assessment results of the experimental and the control group were compared too.
RESULTS: Significant changes after the warm-up exercise included jitter, shimmer, and singing power ratio (SPR) in the experimental group. No significant changes were recorded in the control group. Significant differences between the experimental and the control group were found for ΔShimmer and ΔSPR. Self-assessment analysis confirmed a significantly higher phonatory comfort and voice quality perception for the experimental group.
CONCLUSIONS: The results of the present study support the immediate advantageous effects on singing voice of a semi-occluded vocal tract exercise with a ventilation mask in terms of acoustic quality, phonatory comfort, and voice quality perception in contemporary commercial singers. Long-term effects still remain to be studied.
PMID: 27346393 [PubMed - as supplied by publisher]
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The resected area of the posterior wall of the external auditory canal during transcanal endoscopic ear surgery for cholesteatoma.
Auris Nasus Larynx. 2016 Jun 23;
Authors: Imai T, Nishiike S, Oshima K, Tanaka H, Tsuruta Y, Tomiyama Y
Abstract
OBJECTIVE: The aim of this study was to evaluate part of the area of the posterior wall of the external auditory canal (EAC) that is resected during transcanal endoscopic ear surgery (TEES) for cholesteatomas that extend to the mastoid cavity, and to determine whether TEES is a minimally invasive surgical procedure for cholesteatoma.
METHODS: This was a retrospective study involving 25 patients with cholesteatoma that extended to the mastoid cavity, and who underwent surgery between October 2014 and October 2015. The patients' cholesteatomas were removed using TEES. In this procedure, the superoposterior wall of the EAC was resected in order to access the deepest part of the cholesteatoma. We made a paper template by tracing the shape of the resected EAC and then reconstructed the resultant defect with a piece of cartilage, the size of which was based on the size of the template. We evaluated the size and greatest dimension of the resected part of the EAC by measuring the template. Preoperatively, we also evaluated the volume of each cholesteatoma on computed tomography (CT) images.
RESULTS: The median size of the resected region was 37.3 (14.7-68.4)mm(2). The median length of the greatest dimension of the resected area was 8.7 (5.1-15.9)mm. The median cholesteatoma volume was 417 (43-1399)mm(3). The correlation coefficient (R(2)) obtained using a two-thirds order approximation curve for the relationship between the resected tissue area and the cholesteatoma volume (0.617) was higher than that obtained by linear approximation (0.387).
CONCLUSION: These results suggest that the resected area was minimal and of an appropriate size relative to the volume of the cholesteatoma.
PMID: 27346682 [PubMed - as supplied by publisher]
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Sinus venosus atrial septal defect presenting with brain abscesses in a 77-year-old immunocompetent patient.
BMJ Case Rep. 2015;2015
Authors: Alhamshari YS, Punjabi C, Pressman GS, Govil A
Abstract
We present a case of 77-year-old immunocompetent patient who initially presented with vertigo, nausea and vomiting, with symptoms later progressing to headaches and increased lethargy. Brain MRI revealed ring-enhancing lesions typical of abscesses in the right cerebellum. Transoesophageal echocardiogram (TEE) was performed to look for the source of his abscesses, and uncovered a sinus venosus type atrial septal defect. Cardiac CT was carried out; the patient was found to have a sinus venosus atrial septal defect with partial anomalous pulmonary venous return. Moreover, dental examination showed multiple dental caries with poor oral hygiene. The patient was started on intravenous empiric antibiotics and steroids. Subsequent brain imaging showed almost complete resolution of the abscesses. The patient's symptoms started to improve, and he was eventually sent to an intensive rehabilitation centre with future plans to surgically correct his congenital heart disease to prevent further complications.
PMID: 26475881 [PubMed - indexed for MEDLINE]
