[The anthropometric parameters of the external nose in a Kazakh population with particular reference to the planning of ethnic-specific rhinoplasty].

[The anthropometric parameters of the external nose in a Kazakh population with particular reference to the planning of ethnic-specific rhinoplasty].

Vestn Otorinolaringol. 2016;81(4):64-68

Authors: Rusetsky YY, Makhambetova EA, Reshetov IV, Makhambetova DE

Abstract
The objective of the present study was to determine the anthropometric parameters of the external nose in a Kazakh population for the subsequent elaboration of the algorithms of and approaches to the planning of ethnic-specific rhinoplasty. The study included 500 ethnic Kazakhs (197 women and 303 men) at the age varying from 16 to 25 (mean 20.6±3.5) years. The following parameters were calculated; the height and the width of the nose, nasal index, lobular index, nasolabial angle, nasal projection index, projection and rotation of the tip of the nose. It was found that the nasal index in male and female Kazakhs was 80.8±0.53 and 79.4±3.17 respectively which corresponds to mesorhinia and is more characteristic of the Europeoid race. The nasofrontalindex in men andwomen was 138.94±5.71 ad 130.1±8.25 degrees respectively. Rotation of the tip of the nose in men was 78.45±2.24 degrees in men and 73.92±4.32 degrees in women. Goode's nasal projection index was 57.25±4.36%. The nasal tip projection was estimated at 67.9±5.21 and 76.72±4.17 in men and women respectively. It is concluded based on the results of the present study that noses in Kazakh men and women have certain specific masculine and feminine anthropometric features making them different from the typical «Asiatic» noses because some of their proportions are more characteristic of the Europeoid race. The height of the nose in the Kazakhs is lowest among the three races. It indicates that the main concern as regards rhinoplasty in the Kazakh population is the dorsal augmentation. The present study provided the reference information on the parameters of the external nose in the Kazakh population that may be of value not only in terms of reconstructive and aesthetic rhinosurgery but also for the purpose of forensic medical and other expertises.

PMID: 27500583 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aCmHUC
via IFTTT

[Clinico-anamnestic diagnostics of chronic maxillary sinusitis associated with chlamydial infection].

[Clinico-anamnestic diagnostics of chronic maxillary sinusitis associated with chlamydial infection].

Vestn Otorinolaringol. 2016;81(4):60-63

Authors: Parilova OV, Kapustina TA, Markina AN

Abstract
The present study included 201 adult patients presenting with exacerbation of chronic maxillary sinusitis. The presence of Chlamydia trachomatis and Chl. pneumoniae was verified by the direct immunofluorescencetechnique and polymerase chain reaction. The study material consisted of swipes und swabs from the mucous membrane of the middle nasal passage. The information from the patients was collected with the use of a questionnaire specially elaborated for the purpose of this study. The correlation relationships were established by means of gamma-statistics. The method is based on the calculation of the integral index characterizing the risk of development of chlamydial infection using the scoring scale for the evaluation of the clinical and anamnestic characteristics of the patients. The assessment of the risk of chlamydial colonization by the anamnestic method makes it possible to enhance the effectiveness of clinical diagnostics of chlamydial infection and thereby provides a basis for the prescription of the adequate anti-chlamydial treatment facilitating reduction of the frequency of complications and preventing dissemination of the causative factor of the disease. Moreover, this approach creates the conditions for the targeted selection of the patients to be referred to the laboratory verification of Chlamydia. Highoperating performance and effectiveness characteristics of the clinic-anamnestic diagnostics make it a method of choice for the wide application in the clinical practice.

PMID: 27500582 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aOvl5T
via IFTTT

[The systemic approach to the rehabilitation of the patients presenting with laryngeal cancer after the resection of the organ and laryngectomy with tracheoesophageal by-pass and endoprosthetics].

[The systemic approach to the rehabilitation of the patients presenting with laryngeal cancer after the resection of the organ and laryngectomy with tracheoesophageal by-pass and endoprosthetics].

Vestn Otorinolaringol. 2016;81(4):54-59

Authors: Kryukov AI, Reshetov IV, Kozhanov LG, Sdvizhkov AM, Kozhanov AL

Abstract
The objective of the present study was to enhance the effectiveness of rehabilitation of the patients presenting with laryngeal cancer after the resection of the organ and laryngotomy with tracheoesophageal by-pass and endoprosthetics. Our experience in this field is based on the treatment of 102 patients. They were distributed by the nosological forms as follows: primary laryngeal cancer in 97 patients including T1NoMo - 8 (8.2%), T2NoMo - 63 (65%), T3NoMo - 18 (17.6%), T2N1Mo - 1 (0.9%), T4NoMo - 3 (2.9%), and T4N1M0 - 4 (3.9%), root of the tongue cancer spreading over the vestibular part of the larynx in one patient, laryngeal sarcoma in one patient, relapse of cancer following the full-dose radiotherapy and organ-sparing surgery in 3 patients. Laryngeal resection was performed in 83 patients; 19 patients underwent laryngectomy with tracheoesophageal by-pass and endoprosthetics using a domestically manufactured voice prosthesis. The systemic approach to the rehabilitation of the patients and the use of the proposed treatment algorithm made it possible to restore the function of the larynx by means of organ-sparing surgery in 79 (95.1%) of the 83 patients. The vocal function in the patients following laryngectomy with tracheoesophageal by-pass and endoprosthetics was restored in 18 (94.7%) of the 19 patients.

PMID: 27500581 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b5a2il
via IFTTT

[Differential diagnostics of the causes responsible for a cough in the pregnant women].

[Differential diagnostics of the causes responsible for a cough in the pregnant women].

Vestn Otorinolaringol. 2016;81(4):50-53

Authors: Ryabova MA, Shumilova NA, Lavrova OV, Pestakova LV, Fedotova YS

Abstract
The objective of the present study was to elucidate the causes responsible for a cough in the pregnant women. It involved 92 patients including 23 ones presenting with bronchial asthma and 69 having no manifestations of asthma in their medical histories but suffering from dry cough that started after the beginning of pregnancy. All the patients were given counseling by the otorhinolaryngology and pulmonology specialists. The degree of endoscopic manifestations of gastroesophageal reflux was estimated based on a scoring scale. The study revealed the correlation between cough duration and gestational age. The signs of reflux-induced changes in the larynx were documented in 91% cases among the patients with bronchial asthma and in 97% cases in the pregnant women having no bronchial pathology in their medical histories. The main cause behind the cough during pregnancy in women without bronchial pathology was sluggish bronchitis (7%), arising asthma (12%), gastroesophageal reflux (77%), and allergic rhinitis (4%). This conclusion was confirmed by the results of therapy.

PMID: 27500580 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bg3MRd
via IFTTT

[Local cytokine therapy of inflammation of the rhinosinusotubal area].

[Local cytokine therapy of inflammation of the rhinosinusotubal area].

Vestn Otorinolaringol. 2016;81(4):45-49

Authors: Katinas EB, Lavrenova GV, Glukhova EY, Kucherova LR

Abstract
The objective of the present work was to elaborate a scheme for the effective combined treatment ofinflammation of the rhinosinusotubal area including the local administration of roncoleukin and cyclopheron without antibiotics. The study included 82 patients (27 men and 55 women) at the age from 25 to 55 years presenting with acute inflammation ofroncoleukin and cycloferon. They were divided into two groups. Group 1 was comprised of 39 patients dominated by those with the clinical picture of sinusitis whereas group 2 contained 43 patients in whom symptoms of catarrhal otitis media prevailed. The patients of both groups were treated by the local application of roncoleukin in combination with cycloferon inhalation, intranasal administration of decongestants and mucomodifiers. All the patients underwent, before and after the treatment, the microbiological study of the contents of the sinuses, impedancobarometry, 3D computed tomography, and measurement of the IgA, IgM, IgG, IgE, SIgA, IL-8, TNF-alpha, and albumin levels in the blood sera and lavages. The study has demonstrated the difference between the local cytokine levels in the two groups of the patients. The clinical improvement was documented within 24 hours after the onset of therapy. 93.3% of the patients recovered by day 5. Three (3.7%) of them had to be prescribed antibiotic therapy for the lack of the desired effect of the cytokine treatment. It is concluded that the local application of ronkoleukin and cycloferon in combination with elimination therapy provides a tool for the efficient treatment of the patients suffering frominflammatory pathology of the rhinosinusotubalzone due to its stimulatory action on the immune system at the inflammation site mediated through the activation of the earlier formed targeted immune response, the promotion of the accelerated elimination of the causative factor, and the termination of the pathological process.

PMID: 27500579 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aCmroO
via IFTTT

[Endoscopic endonasal surgery of paranasal sinus osteomas].

[Endoscopic endonasal surgery of paranasal sinus osteomas].

Vestn Otorinolaringol. 2016;81(4):42-44

Authors: Karpishchenko SA, Bolozneva EV

Abstract
This article was designed to summarize the experience gained withendoscopic endonasal removal of paranasal sinus osteomas during the period from January 2013 till February 2016. In addition a review of the relevant literature is presented encompassing the publicationsthat provide information about etiology, pathogenesis, clinical picture, diagnostics, and treatment of bone tumours. The objective of the study was to enhance the effectiveness and safety of the surgical treatment of the patients presenting with paranasal sinus osteomas. A total of 81 cases of paranasal sinus osteoma were documented in the patients admitted to I.P. Pavlov Saint-Peterburg First State Medical Universityduring the period from January 2013 till February 2016. Forty nine of them were given the surgical endoscopic endonasal treatment with the removal of the neoplasm. The remaining 32 patients were included in the group for the further dynamic follow up. The authors report the data of morphological studies and the results of computed tomography performed in the pre- and postoperative periods with special reference to the potential for the use of the electromagnetic navigation station (an image-guidance system) that makes it possible to significantly reduce the risk of development of possible complications. In addition, the findings suggestive of the progressive tumour growth in the group of the patients under dynamic observation are discussed.

PMID: 27500578 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aOwzhq
via IFTTT

[The blockade of sphenopalatineganglionthrough the palatal approachin the present-day rhinological practice].

[The blockade of sphenopalatineganglionthrough the palatal approachin the present-day rhinological practice].

Vestn Otorinolaringol. 2016;81(4):38-41

Authors: Borodulin VG, Filimonov SV

Abstract
This article deals with the application of the sphenopalatine ganglion blockade in the present-day rhinological practice. The blockade is known to arrest the propagation of pain impulses from the nose and break the rhinocardiac reflex arc. Moreover, it is involved in bleeding control during nasal surgery. The method for the blockade via the palatal route using the modern equipment and imaging techniques is described. The objective of the present study was to evaluate the effectiveness and safety of the blockade of sphenopalatine ganglionthrough the palatal approach in the patients who had undergone septoplasty under general and local anesthesia. It included a total of 105 patients divided into two groups one of which was treated with the use ofblockade of sphenopalatineganglionin addition to conventional anesthesia while the patients of the other group were treated under traditional anesthesia alone. The results of the study confirm the effectiveness of blockade of sphenopalatineganglionthrough the palatal approach as a method for the treatment of postoperative syndrome, bleeding control during nasal surgery, and reduction of parasympathetic influence on the cardiac rhythm.

PMID: 27500577 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aCn9T5
via IFTTT

[The low-invasive treatment of laryngotrachealstenoses].

[The low-invasive treatment of laryngotrachealstenoses].

Vestn Otorinolaringol. 2016;81(4):34-37

Authors: Ulupov MY

Abstract
The objective of the present study was to evaluate the effectiveness and safety of balloonlaryngotracheoplasty for the treatment of laryngeal and tracheal stenosis We undertook the analysis of the case histories of the patients presenting withlaryngotracheal stenosis who had undergone balloonlaryngotracheoplasty during the period from October 2013 till February 2016. A total of 21 histories of the patients (6 men and 15 women) were available for the investigation. Most laryngotrachealstenoses that occurred in 18 (85.7%) patients were of the idiopathic, post-tracheotomy, and post-intubation types. Their most typical localization was the subfold part of the larynx and/or the upper third of the trachea (76.2%). The length of the stenotic lesions varied from 5 to 20 mm (76.2%) and corresponded to grade III if estimated based on the Cotton-Myer classification (81%). The number of the balloonlaryngotracheoplastic procedures ranged from 1 to 4 (a total of 36 operations). The interval between the consecutive interventions varied from 1.5 to 104 (mean 20) weeks. In 16 of the 36 cases, dilatation of the narrowed portion was followed by the 4 minute application of mitomycin C at a concentration of 0.4 mg/kg. No complications were documented during the surgical interventions and in the postoperative periods. The treatment was associated with a significant enhancement of the maximum expiratory flow rate from 2±1.13 l/s to 4.23±1.9 l/s (p=0.000). The duration of the follow up period varied from 1 to 105 (mean 36.2) weeks. Mitomycin C exerted nosignificant influence on the increment of the maximum expiratory flow rate (p=0.174).

PMID: 27500576 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b5arBe
via IFTTT

[The association of the severe clinical course of respiratory papillomatosis with certain HLA-DQ alleles].

[The association of the severe clinical course of respiratory papillomatosis with certain HLA-DQ alleles].

Vestn Otorinolaringol. 2016;81(4):31-33

Authors: Kolesnikova OM

Abstract
We undertook the analysis of genetic polymorphism of the HLADQA1 and DQB1 genes in the patients presenting with recurrent respiratory papillomatosis (n=21) with the use of the multiprimer polymerase chain reaction. The results of the study give evidence that the identification of DQ 2.5 and DQ 7.5 haplotypes encoded by the DQA1 *0501, DQB1 *0201, DQA1 *0505, and DQB1 *0301 alleles as well as the carriage of type 16 human papilloma virus (HPV) in combination with these haplotypes in the patients with recurrent respiratory papillomatosis can be used for the prognostication of the severity of this disease.

PMID: 27500575 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aOwqe0
via IFTTT

[Determination of the rational extent of laser-assisted resection for the treatment of paralytic laryngeal stenosis].

[Determination of the rational extent of laser-assisted resection for the treatment of paralytic laryngeal stenosis].

Vestn Otorinolaringol. 2016;81(4):27-30

Authors: Karpishchenko SA, Dolgov OI

Abstract
The objective of the present study was to improve the procedures for extended and restricted laser-assisted laryngoplasty in the patients presenting withparalytic laryngeal stenosis and to evaluate the outcome of the surgical interventionsdiffering in extent. The study included 51 patients (47 women and 4 men) at the age varying from 18 to 78 years. Twenty five of these patients had a tracheostoma. The examination was focused on the detection of the following characteristics: vocal fold angle, body mass index, age, specific anatomical and physiological features of the larynx, clinically significant concomitant pathologies, engagement in voice and speech professional activities as well as the influence of paramedical factors. The resulting total score was calculated. The data obtained were used to rationally plan the laser-assisted resection (either extended or restricted)of the posterior third of a vocal fold. The total score of 6 or higher always implied the necessity of extended resection whereas the overall score of 3 and less was regarded as an indication for the tissue-sparing surgery. The patients to whom the extended resection was prescribed had significantly higher physical health indices and the worse vocal function compared with the same parameters in the patients undergoing restricted resection. The spirometric characteristics of the patients in both groups were similar and either normal or slightly reduced. The characteristics of the psychic component of general health were not significantly different and corresponded to the internationally accepted normal values. It is concluded that the proposed treatment resulted in the favourable outcome in 49 of the 51 patients (96%).

PMID: 27500574 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bg4D4i
via IFTTT

[The rationale for the conservative treatment of chronic tonsillitis in the patients of the older age groups by the «soft» therapy methods].

[The rationale for the conservative treatment of chronic tonsillitis in the patients of the older age groups by the «soft» therapy methods].

Vestn Otorinolaringol. 2016;81(4):22-26

Authors: Lavrenova GV, Nesterova KI, Yaremenko KV, Nesterova AA

Abstract
The objective of the present study was to develop an efficient system for the treatment of chronic tonsillitis in the patients of advanced and middle age based on the application of polyvalent bacteriophages in the combination with the physical factors and herbal medicines. The study involved 65 patients (39 women and 276 men) at the age from 65 to 73 years presenting with chronic tonsillitis. The treatment included washing the tonsillar lacunae with herbal infusion consisting of a tetterwort (Choledoniummajus) extract. This procedure was followed by phonophoresiswith the use of the combined polyvalent bacteriophage preparation in the non-liquid formulation during 7-10 days. The effectiveness of such treatment was evaluated based on the results of clinical examination and the analysis of the subjective feelings reported by the patients. In addition, the rosette-forming function of lymphocytes was estimated and palatine tonsil microbiotas in different patients were compared. The effectiveness of therapy was estimated at 89.2%. The positive outcome of the proposed treatment was documented in 78.6% of the cases within 6 months after the onset of therapy. It is concluded that the treatment of chronic tonsillitis with bacteriophagal preparations and herbal infusions in combination with thetraditionallow-frequency ultrasound treatment is highly efficacious (favourable outcome in 78.6% of the patients of middle and advanced age) without the use of antibiotic medications.

PMID: 27500573 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aCmYaj
via IFTTT

[The damage to the trigeminal nerve associated with herpetic viral infection in otorhinolaryngology].

[The damage to the trigeminal nerve associated with herpetic viral infection in otorhinolaryngology].

Vestn Otorinolaringol. 2016;81(4):19-21

Authors: Nikitin KA, Alekseeva DA, Panikarovskaya MM

Abstract
Neurotropism of herpetic viral infection is attributable to a wide range of its clinical manifestations. Theobjective of the present study was to elucidate the specific features of the damage to the trigeminal nerve associated with this condition. A total of 36 patients presenting with trigeminal nerve neuropathycaused by type 1 herpes simplex infection and 21 patients with trigeminal nerve neuropathy due to Herpes zoster oticus infection were available for the examination and etiopathogenetic treatment. The traditional clinical methods used in the study were supplemented by virological diagnostics for the verification of herpetic infection and theelectroneurographic technique. The apparent clinical recovery was documented for 23 and 11 patients of the former and latter groups respectively.

PMID: 27500572 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aOwqdL
via IFTTT

[The choice of parameters for the laser application in ENT surgery].

[The choice of parameters for the laser application in ENT surgery].

Vestn Otorinolaringol. 2016;81(4):14-18

Authors: Karpishchenko SA, Ryabova MA, Ulupov MY, Shumilova NA, Portnov GV

Abstract
The authors present the results and describe the methods of the experimental studies aimed at the evaluation of the biological effects of laser-assisted treatment of ENT pathologies at the wavelengths of 810 nm, 980 nm, and 1470 nm in comparison with the results obtained with the use of a radiofrequency scalpel in biological tissues having different optical and mechanical properties.Special emphasis is placed on the peculiarities of the action of laser irradiation and healing of radiation-induced wounds depending on the treatment regimens, viz. contact, remote, pulsed and continuous ones. The results of the analysis of the experience gained during the study and of the experimental findings provided a basis on which the main principles of the choice of the optimal parameters of the laser radiation action on the biological tissues have been formulated.

PMID: 27500571 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aCmD7r
via IFTTT

[The potential of cone beam computed tomography of the temporal bones in the patients presenting with otosclerosis].

[The potential of cone beam computed tomography of the temporal bones in the patients presenting with otosclerosis].

Vestn Otorinolaringol. 2016;81(4):10-13

Authors: Karpishchenko SA, Zubareva AA, Filimonov VN, Shavgulidze MA, Azovtseva EA

Abstract
The objective of the present study was to analyze the potential of cone beam computed tomography of the temporal bones in the patients presenting with otosclerosis for the detection of surgically significant specific structural features of the labyrinth wall of the tympanic cavity. More than 400 tomograms of the temporal bones were obtained with the use of a cone beam tomographwere available for the investigation during the period from 2012 till 2016. The study was carried out in several steps, viz. the search for the optimal (for the given instrument) position of the patient, the experimental stage, the retrospective analysis of the tomograms and the comparison of the temporal bones of different types (pneumatic, mixed, and sclerotic) in individual patients, the comparison of the results of cone beam computed tomography (CBCT) with the intraoperative observations, and the modification of the algorithm for the analysis of temporal bone cone beam tomograms. The study included a total of 16 patients (15 women at the age from 32 to 56 years and one managed 58 years) presenting with the clinical diagnosis of otosclerosis. The results of the study were used to elaborate the algorithm for the analysis of cone beam tomograms of the temporal bones to be performed inthe stage by stage manner including the qualitative analysis of tomograms, evaluation of their quantitative parameters and additional characteristics to be taken into consideration when planning the surgical interventions on the labyrinth wall and the tympanic cavity as a preparation for the stapedoplastic treatment. The results of CBCT obtained in the present study were compared with the surgical observations. The diagnostic sensitivity and specificity of the method were estimated to be 100% and 83% respectively. It is concluded that cone beam computed tomography can be employed as a component of the diagnostic algorithm prior to the planning of surgical interventions onthe medial wall of the tympanic cavity and the assessment of dynamics of the clinical course of middle ear diseases.

PMID: 27500570 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aOx1vY
via IFTTT

[Department of Otorhinolaryngology of the I.P. Pavlov Saint-Peterburg First State Medical University].

[Department of Otorhinolaryngology of the I.P. Pavlov Saint-Peterburg First State Medical University].

Vestn Otorinolaringol. 2016;81(4):4-9

Authors: Karpishchenko SA

Abstract
This article is designed to report the results of the analysis ofacademic, scientific, and clinical activities of the Department of Otorhinolaryngology of the I.P. Pavlov Saint-Peterburg First State Medical University.

PMID: 27500569 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aCmC3w
via IFTTT

Mitochondrial calcium uptake underlies ROS generation during aminoglycoside-induced hair cell death.

Mitochondrial calcium uptake underlies ROS generation during aminoglycoside-induced hair cell death.

J Clin Invest. 2016 Aug 8;

Authors: Esterberg R, Linbo T, Pickett SB, Wu P, Ou HC, Rubel EW, Raible DW

Abstract
Exposure to aminoglycoside antibiotics can lead to the generation of toxic levels of reactive oxygen species (ROS) within mechanosensory hair cells of the inner ear that have been implicated in hearing and balance disorders. Better understanding of the origin of aminoglycoside-induced ROS could focus the development of therapies aimed at preventing this event. In this work, we used the zebrafish lateral line system to monitor the dynamic behavior of mitochondrial and cytoplasmic oxidation occurring within the same dying hair cell following exposure to aminoglycosides. The increased oxidation observed in both mitochondria and cytoplasm of dying hair cells was highly correlated with mitochondrial calcium uptake. Application of the mitochondrial uniporter inhibitor Ru360 reduced mitochondrial and cytoplasmic oxidation, suggesting that mitochondrial calcium drives ROS generation during aminoglycoside-induced hair cell death. Furthermore, targeting mitochondria with free radical scavengers conferred superior protection against aminoglycoside exposure compared with identical, untargeted scavengers. Our findings suggest that targeted therapies aimed at preventing mitochondrial oxidation have therapeutic potential to ameliorate the toxic effects of aminoglycoside exposure.

PMID: 27500493 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aHzeps
via IFTTT

Quality of life improvement after pressure equalization tube placement in Down syndrome: A prospective study.

Related Articles

Quality of life improvement after pressure equalization tube placement in Down syndrome: A prospective study.

Int J Pediatr Otorhinolaryngol. 2016 Sep;88:168-72

Authors: Labby A, Mace JC, Buncke M, MacArthur CJ

Abstract
OBJECTIVE: To evaluate quality-of-life changes after bilateral pressure equalization tube placement with or without adenoidectomy for the treatment of chronic otitis media with effusion or recurrent acute otitis media in a pediatric Down syndrome population compared to controls.
STUDY DESIGN: Prospective case-control observational study.
METHODS: The OM Outcome Survey (OMO-22) was administered to both patients with Down syndrome and controls before bilateral tube placement with or without adenoidectomy and at an average of 6-7 months postoperatively. Thirty-one patients with Down syndrome and 34 controls were recruited. Both pre-operative and post-operative between-group and within-group score comparisons were conducted for the Physical, Hearing/Balance, Speech, Emotional, and Social domains of the OMO-22.
RESULTS: Both groups experienced improvement of mean symptom scores post-operatively. Patients with Down syndrome reported significant post-operative improvement in mean Physical and Hearing domain item scores while control patients reported significant improvement in Physical, Hearing, and Emotional domain item scores. All four symptom scores in the Speech domain, both pre-operatively and post-operatively, were significantly worse for Down syndrome patients compared to controls (p ≤ 0.008).
CONCLUSIONS: Surgical placement of pressure equalizing tubes results in significant quality of life improvements in patients with Down syndrome and controls. Problems related to speech and balance are reported at a higher rate and persist despite intervention in the Down syndrome population. It is possible that longer follow up periods and/or more sensitive tools are required to measure speech improvements in the Down syndrome population after pressure equalizing tube placement ± adenoidectomy.

PMID: 27497407 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aIOiqb
via IFTTT

Tinnitus- related distress: evidence from fMRI of an emotional stroop task.

Tinnitus- related distress: evidence from fMRI of an emotional stroop task.

BMC Ear Nose Throat Disord. 2016;16:10

Authors: Golm D, Schmidt-Samoa C, Dechent P, Kröner-Herwig B

Abstract
BACKGROUND: Chronic tinnitus affects 5 % of the population, 17 % suffer under the condition. This distress seems mainly to be dependent on negative cognitive-emotional evaluation of the tinnitus and selective attention to the tinnitus. A well-established paradigm to examine selective attention and emotional processing is the Emotional Stroop Task (EST). Recent models of tinnitus distress propose limbic, frontal and parietal regions to be more active in highly distressed tinnitus patients. Only a few studies have compared high and low distressed tinnitus patients. Thus, this study aimed to explore neural correlates of tinnitus-related distress.
METHODS: Highly distressed tinnitus patients (HDT, n = 16), low distressed tinnitus patients (LDT, n = 16) and healthy controls (HC, n = 16) underwent functional magnetic resonance imaging (fMRI) during an EST, that used tinnitus-related words and neutral words as stimuli. A random effects analysis of the fMRI data was conducted on the basis of the general linear model. Furthermore correlational analyses between the blood oxygen level dependent response and tinnitus distress, loudness, depression, anxiety, vocabulary and hypersensitivity to sound were performed.
RESULTS: Contradictory to the hypothesis, highly distressed patients showed no Stroop effect in their reaction times. As hypothesized HDT and LDT differed in the activation of the right insula and the orbitofrontal cortex. There were no hypothesized differences between HDT and HC. Activation of the orbitofrontal cortex and the right insula were found to correlate with tinnitus distress.
CONCLUSIONS: The results are partially supported by earlier resting-state studies and corroborate the role of the insula and the orbitofrontal cortex in tinnitus distress.

PMID: 27499700 [PubMed]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aIIThu
via IFTTT

A dural arteriovenous fistula detected during the chronic phase of cerebral venous sinus thrombosis.

A dural arteriovenous fistula detected during the chronic phase of cerebral venous sinus thrombosis.

Rinsho Shinkeigaku. 2016 Aug 6;

Authors: Suzuki Y, Inatomi Y, Yonehara T

Abstract
A 47-year-old woman developed a headache and tinnitus in her right ear followed by sudden-onset left hemiparesis. She had no history of trauma or thrombophilia. Arteriography showed an occlusion of the superior sagittal sinus, and a stenosis of the right transverse sinus. She was treated with anticoagulants; thereafter her deficits and sinus thrombosis immediately improved. However, 7 months after the onset, she noticed tinnitus in her left ear. Arteriography showed a dural arteriovenous fistula extending from the left occipital artery to the left transverse and sigmoid sinus, but no recurrence of the cerebral venous sinus thrombosis. After manual compression of the left occipital artery was initiated, the tinnitus and dural arteriovenous fistula did not worsen. A dural arteriovenous fistula may be detected in patients with cerebral venous sinus thrombosis during the chronic phase.

PMID: 27498817 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aCtiP3
via IFTTT

Different infusion durations for preventing platinum-induced hearing loss in children with cancer.

Different infusion durations for preventing platinum-induced hearing loss in children with cancer.

Cochrane Database Syst Rev. 2016 Aug 8;8:CD010885

Authors: van As JW, van den Berg H, van Dalen EC

Abstract
BACKGROUND: Platinum-based therapy, including cisplatin, carboplatin or oxaliplatin, or a combination of these, is used to treat a variety of paediatric malignancies. Unfortunately, one of the most important adverse effects is the occurrence of hearing loss or ototoxicity. In an effort to prevent this ototoxicity, different platinum infusion durations have been studied. This review is an update of a previously published Cochrane review.
OBJECTIVES: To assess the effects of different durations of platinum infusion to prevent hearing loss or tinnitus, or both, in children with cancer. Secondary objectives were to assess possible effects of these infusion durations on: a) anti-tumour efficacy of platinum-based therapy, b) adverse effects other than hearing loss or tinnitus, and c) quality of life.
SEARCH METHODS: We searched the electronic databases Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2016, Issue 4), MEDLINE (PubMed) (1945 to 18 May 2016) and EMBASE (Ovid) (1980 to 18 May 2016). In addition, we handsearched reference lists of relevant articles and we assessed the conference proceedings of the International Society for Paediatric Oncology (2009 up to and including 2015) and the American Society of Pediatric Hematology/Oncology (2014 and 2015). We scanned ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP; http://ift.tt/1VXDXYs) for ongoing trials (searched on 20 May 2016 and 24 May 2016 respectively).
SELECTION CRITERIA: Randomised controlled trials (RCTs) or controlled clinical trials (CCTs) comparing different platinum infusion durations in children with cancer. Only the platinum infusion duration could differ between the treatment groups.
DATA COLLECTION AND ANALYSIS: Two review authors independently performed the study selection, risk of bias assessment and GRADE assessment of included studies, and data extraction including adverse effects. Analyses were performed according to the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions.
MAIN RESULTS: We identified one RCT and no CCTs; in this update no additional studies were identified. The RCT (total number of children = 91) evaluated the use of a continuous cisplatin infusion (N = 43) versus a one-hour bolus cisplatin infusion (N = 48) in children with neuroblastoma. For the continuous infusion, cisplatin was administered on days 1 to 5 of the cycle but it is unclear if the infusion duration was a total of 5 days. Methodological limitations were present. Only results from shortly after induction therapy were provided. No clear evidence of a difference in hearing loss (defined as asymptomatic and symptomatic disease combined) between the different infusion durations was identified as results were imprecise (risk ratio (RR) 1.39, 95% confidence interval (CI) 0.47 to 4.13, low quality evidence). Although the numbers of children were not provided, it was stated that tumour response was equivalent in both treatment arms. With regard to adverse effects other than ototoxicity we were only able to assess toxic deaths. Again, the confidence interval of the estimated effect was too wide to exclude differences between the treatment groups (RR 1.12, 95% CI 0.07 to 17.31, low quality evidence). No data were available for the other outcomes of interest (i.e. tinnitus, overall survival, event-free survival and quality of life) or for other (combinations of) infusion durations or other platinum analogues.
AUTHORS' CONCLUSIONS: Since only one eligible RCT evaluating the use of a continuous cisplatin infusion versus a one-hour bolus cisplatin infusion was found, and that had methodological limitations, no definitive conclusions can be made. It should be noted that 'no evidence of effect', as identified in this review, is not the same as 'evidence of no effect'. For other (combinations of) infusion durations and other platinum analogues no eligible studies were identified. More high quality research is needed.

PMID: 27498707 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aOBP4H
via IFTTT

Pediatric sudden sensorineural hearing loss: Etiology, diagnosis and treatment in 20 children.

Related Articles

Pediatric sudden sensorineural hearing loss: Etiology, diagnosis and treatment in 20 children.

Int J Pediatr Otorhinolaryngol. 2016 Sep;88:208-12

Authors: Dedhia K, Chi DH

Abstract
OBJECTIVES: 1. To report our experience in children with sudden-onset sensorineural hearing loss (SSNHL). 2. To describe the etiology and management of children with SSNHL.
METHODS: Retrospective review of 20 children with SSNHL, from 2000 to 2013 at a tertiary pediatric facility. Patients had the following inclusion criteria: history of normal hearing, hearing loss occurring in less than 3 days, and audiogram documentation.
RESULTS: The average age of patients presenting with SSNHL is 11 years 3 months (22months-18years). Only 6 (30%) children presented prior to 2 weeks. Tinnitus (55%) was the most common associated symptoms followed by otalgia (25%), and vertigo (20%). Eight patients had bilateral hearing loss, 6 only right and 6 only left. Hearing loss severity ranged from profound (45%) being most common to mild. Etiology was unknown (30%), viral (25%), anatomic abnormality (25%), Meniere's disease (5%), autoimmune (5%), perilymphatic fistula (5%), and suppurative labyrinthitis (5%). Eight patients had initial treatment with oral steroids of which 50% had improvement on audiograms. Two patients underwent intratympanic injections, both showed improvement. Of the 12 patients with no treatment, only 1 had improved hearing.
CONCLUSIONS: The true incidence of pediatric SSNHL is not well established in our literature. Unique aspects of pediatric SSNHL are delayed presentation and higher percent of anatomic findings. In our study 70% presented more than 2 weeks after experiencing symptoms. Anatomic abnormalities are in 40% of patients. Hearing improvement occurred in 50% of children treated with oral steroids. Intratympanic steroid treatment is another option but may have practical limitation in the pediatric population.

PMID: 27497416 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aWnUsH
via IFTTT

How Commonly Is Stroke Found in Patients with Isolated Vertigo or Dizziness Attack?

Related Articles

How Commonly Is Stroke Found in Patients with Isolated Vertigo or Dizziness Attack?

J Stroke Cerebrovasc Dis. 2016 Aug 2;

Authors: Doijiri R, Uno H, Miyashita K, Ihara M, Nagatsuka K

Abstract
BACKGROUND: The sudden development of vertigo or dizziness without focal neurological symptoms is generally attributable to vestibular diseases such as benign paroxysmal positional vertigo. Isolated vertigo or dizziness attack needs more attention than vestibular diseases. This retrospective study was performed to elucidate the frequency of strokes in patients with isolated vertigo or dizziness attack.
SUBJECTS AND METHODS: We enrolled 221 patients (men, 119; women, 102; mean age, 68.4 ± 10.3 years) who were admitted to our hospital over the last 10 years because of sudden isolated vertigo or dizziness attack without other neurological symptoms except for nystagmus, deafness, or tinnitus. We investigated the clinical features, final diagnosis, neuroimaging findings, and short- or long-term outcome of these patients.
RESULTS: One hundred eighteen patients had vertigo whereas the other 103 had dizziness. Brain computed tomography or magnetic resonance imaging revealed recent stroke lesions in 25 patients (11.3%) (ischemic, 21; hemorrhagic, 4).The lesions were generally small and localized in the cerebellum (n = 21), pons (n = 1), medulla oblongata (n = 1), or corona radiata (n = 1). Of the 25 patients, 19 (76%) had dizzy-type spells; none had neurological dysfunction at the time of discharge. In the remaining 196 patients, no stroke was detected on computed tomography or magnetic resonance imaging.
CONCLUSIONS: Stroke was found in 11% of patients with isolated vertigo or dizziness attack. The posterior inferior cerebellar artery area was the most frequently implicated for isolated vertigo or dizziness.

PMID: 27495834 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aOBDCB
via IFTTT

CSF hypotension: A review of its manifestations, investigation and management.

CSF hypotension: A review of its manifestations, investigation and management.

J Clin Neurosci. 2016 Aug 4;

Authors: Pattichis AA, Slee M

Abstract
Intracranial cerebrospinal fluid (CSF) hypotension usually arises in the context of known or suspected leak of CSF. This can be spontaneous, or due to central nervous system trauma or dural defects created during lumbar puncture or epidural anaesthesia. Spontaneous intracranial hypotension (SIH) is increasingly being recognised as a cause for orthostatic headache or spontaneous subdural haematoma where no other obvious cause is found. We review CSF physiology, the mechanism of symptom generation in CSF hypotension and the investigation and management of the syndrome. Whilst commonly mild and self-limiting, CSF hypotension may result in life threatening complications and is most often treatable. When the syndrome is severe, prolonged or complicated, epidural blood patching (EBP) is the mainstay of treatment.

PMID: 27499119 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aICNin
via IFTTT

Risk factors associated with postcraniotomy meningitis: A retrospective study.

Related Articles

Risk factors associated with postcraniotomy meningitis: A retrospective study.

Medicine (Baltimore). 2016 Aug;95(31):e4329

Authors: Chen CH, Chang CY, Lin LJ, Chen WL, Chang YJ, Wang SH, Cheng CY, Yen HC

Abstract
Postcraniotomy meningitis (PCM) is a major challenge in neurosurgery, and changing patterns of infectious agents in PCM have been noted. The limited epidemiological data and urgent clinical needs motivated this research. We conducted this study to determine a risk assessment for PCM and the current pattern of infectious agents.We performed a retrospective case-control study of significant cases of postcraniotomy meningitis in the Changhua Christian Hospital System between January 1, 2008, and December 31, 2012. Postcraniotomy meningitis was diagnosed in 22 out of 4392 surgical patients; this data was reviewed for risk assessment.This study assessed the risk factors for postcraniotomy meningitis and found that it was more frequently seen in patients who were elderly (OR = 1.57, 95% CI = 1.32-2.98, P = 0.013), underwent emergency procedures (OR = 4.82, 95% CI = 1.50-14.53, P = 0.008), had leak of cerebrospinal fluid (OR = 4.62, 95% CI = 2.03-10.50, P = 0.012), had external ventricular drainage (OR = 4.68, 95% CI = 2.46-8.87, P = 0.006), were admitted to the intensive care unit (OR = 2.41, 95% CI = 1.53-8.08, P = 0.012), had used drain placement >72 hours (OR = 2.66, 95% CI = 1.04-4.29, P = 0.007), had surgery >4.5 hours (OR = 2.38, 95% CI = 1.39-4.05, P = 0.005), had repeat operations (OR = 2.74, 95% CI = 1.31-5.73, P = 0.018), endured trauma (OR = 5.97, 95% CI = 1.57-17.61, P = 0.007), or had 30-days mortality (OR = 5.07, 95% CI = 2.20-11.48, P = 0.001). The predominant pathogens isolated from cerebrospinal fluid were Staphylococcus aureus in 8 patients (36.7%) and Acinetobacter baumannii in 7 patients (31.8%). In our study, the mortality rate was 5.1% among all postcraniotomy patients.Accurate risk assessment, early diagnosis, and choice of appropriate antibiotics in accordance with epidemiologic information are the cornerstones of reducing mortality and morbidity in PCM. The changing pattern of infectious agents in PCM over time suggests the necessity of further studies to provide the most up-to-date insight to physicians.

PMID: 27495035 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aHsp7r
via IFTTT

Vestibular-dependent inter-stimulus interval effects on sound evoked potentials of central origin.

Related Articles

Vestibular-dependent inter-stimulus interval effects on sound evoked potentials of central origin.

Hear Res. 2016 Aug 3;

Authors: Todd NP, Govender S, Colebatch JG

Abstract
Todd et al. (2014ab) have recently demonstrated the presence of vestibular-dependent contributions to auditory evoked potentials (AEPs) when passing through the vestibular threshold as determined by vestibular evoked myogenic potentials (VEMPs), including a particular deflection labeled as an N42/P52 prior to the long-latency AEPs N1 and P2. In this paper we report the results of an experiment to determine the effect of inter-stimulus interval (ISI) and regularity on potentials recorded above and below VEMP threshold. Five healthy, right-handed subjects were recruited and evoked potentials were recorded to binaurally presented sound stimulation, above and below vestibular threshold, at seven stimulus rates with ISIs of 212, 300, 424, 600, 848, 1200 and 1696 ms. The inner five intervals, i.e. 300, 424, 600, 848, 1200 ms, were presented twice in both regular and irregular conditions. ANOVA on the global field power (GFP) were conducted for each of four waves, N42, P52, N1 and P2 with factors of intensity, ISI and regularity. Both N42 and P52 waves showed significant ANOVA effects of intensity but no other main effects or interactions. In contrast both N1 and P2 showed additional effects of ISI, as well as intensity, and evidence of non-linear interactions between ISI and intensity. A source analysis was carried out consistent with prior work suggesting that when above vestibular threshold, in addition to bilateral superior temporal cortex, ocular, cerebellar and cingulate sources are recruited. Further statistical analysis of the source currents indicated that the origin of the interactions with intensity may be the ISI sensitivity of the vestibular-dependent sources. This in turn may reflect a specific vestibular preference for stimulus rates associated with locomotion, i.e. rates close to 2 Hz, or ISIs close to 500 ms, where saccular afferents show increased gain and the corresponding reflexes are most sensitive.

PMID: 27498399 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aOvDJV
via IFTTT

Vestibular, Visual Acuity, and Balance Outcomes in Children With Cochlear Implants: A Preliminary Report.

Related Articles

Vestibular, Visual Acuity, and Balance Outcomes in Children With Cochlear Implants: A Preliminary Report.

Ear Hear. 2015 Nov-Dec;36(6):e364-72

Authors: Janky KL, Givens D

Abstract
OBJECTIVES: There is a high incidence of vestibular loss in children with cochlear implants (CCI). However, the relationship between vestibular loss and various outcomes is unknown in children. The objectives of this study are to (1) determine whether age-related changes in peripheral vestibular tests occur; (2) quantify peripheral vestibular function in children with normal hearing and CCI; and (3) determine whether amount of vestibular loss predicts visual acuity and balance performance.
DESIGN: Eleven CCI and 12 children with normal hearing completed the following tests of vestibular function: ocular and cervical vestibular-evoked myogenic potential to assess utricle and saccule function and the video head impulse test to assess semicircular canal function. The relationship between amount of vestibular loss and the following balance and visual acuity outcomes was assessed: dynamic gait index, single-leg stance, the sensory organization test, and tests of visual acuity, including dynamic visual acuity and the gaze stabilization test.
RESULTS: (1) There were no significant age-related changes in peripheral vestibular testing with the exception of the n23 cervical vestibular-evoked myogenic potential latency, which was moderately correlated with age. (2) CCI had significantly higher rates of vestibular loss for each test of canal and otolith function. (3) Amount of vestibular loss predicted performance on single-leg stance, the dynamic gait index, some conditions of the sensory organization test, and the dynamic visual acuity test. Age was also a contributing factor for predicting the performance of almost all outcomes.
CONCLUSIONS: Preliminarily, children with vestibular loss do not recover naturally to levels of their healthy peers, particularly with activities that utilize vestibular input; they have poorer visual acuity and balance function.

PMID: 26182202 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aOvCFU
via IFTTT

Pretreatment factors associated with functional oral intake and feeding tube use at 1 and 6 months post-radiotherapy (+/- chemotherapy) for head and neck cancer.

Related Articles

Pretreatment factors associated with functional oral intake and feeding tube use at 1 and 6 months post-radiotherapy (+/- chemotherapy) for head and neck cancer.

Eur Arch Otorhinolaryngol. 2016 Aug 6;

Authors: Barnhart MK, Ward EC, Cartmill B, Robinson RA, Simms VA, Chandler SJ, Wurth ET, Smee RI

Abstract
A proportion of patients with head and neck cancer (HNC) experience significant swallowing difficulty during and post-radiotherapy/chemoradiotherapy (RT/CRT). Identifying patients during the pretreatment period who are anticipated to have compromised oral intake would allow for early and accurate patient education, and prioritisation of their management. Ascertaining a clear set of pretreatment predictors from the literature is challenging due to heterogeneity in study designs and patient cohorts, with minimal prospective data available (especially at 1-month post-treatment). The objectives of this study were to investigate which pretreatment factors predicted compromised oral intake and feeding tube use at 1 and 6 months post-RT/CRT. Prospective data were collected on 80 consecutive HNC patients receiving RT/CRT from 2011 to 2014. The primary outcome was to identify predictors of a modified diet at 1 and 6 months post-RT/CRT. Secondary outcomes were to identify predictors of feeding tube use at these time intervals, and <6 vs. >6 week duration of feeding tube use. Multivariate analysis revealed bilateral neck radiotherapy treatment was a strong predictor of modified diets at 1 month (p < 0.001), and T-stages T3/T4 a predictor of modified diets at 6 months (p = 0.03). Patients treated with concurrent CRT (p = 0.02) and bilateral neck treatment (p = 0.02) predicted feeding tube use at 1 month, and concurrent CRT predicted feeding tube use for >6 weeks (p = 0.04). Therefore, patients receiving bilateral neck treatment and/or CRT are at greatest risk of requiring modified diets and feeding tube use early post-treatment, and should be prioritised for intervention and ongoing support.

PMID: 27498203 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bbquNh
via IFTTT

Management of locoregional recurrence in cutaneous squamous cell carcinoma of the head and neck.

Related Articles

Management of locoregional recurrence in cutaneous squamous cell carcinoma of the head and neck.

Eur Arch Otorhinolaryngol. 2016 Aug 6;

Authors: Strassen U, Hofauer B, Jacobi C, Knopf A

Abstract
Cutaneous squamous cell carcinomas often affect elderly patients. Follow-up monitoring is difficult in these patients due to their multi-morbidity and reduced compliance. Tumour recurrence is consequently diagnosed in advanced tumour stages. Surgical therapy with curative intention often requires extended resections. The study at hand should determine whether surgical concepts are warranted in this collective. Sixty-seven patients who underwent surgical procedure due to recurrent disease of cutaneous head and neck squamous cell carcinoma were included. The cohort was divided in patients with/without adjuvant therapeutic regimens. Data were assessed retrospectively. Complete tumour resection was achieved in 85 % of our patients. Patients with adjuvant treatment demonstrated a favorable 5-year-recurrence-free interval (78 vs 30 %) and overall survival (79 vs 46 %). Complete surgical resection of advanced recurrent head and neck cutaneous squamous cell carcinomas is possible and yields favorable results in terms of survival, especially if combined with adjuvant treatment.

PMID: 27498202 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b5bbXc
via IFTTT

Transaxillary gasless endoscopic thyroidectomy versus conventional open thyroidectomy: a randomized study.

Related Articles

Transaxillary gasless endoscopic thyroidectomy versus conventional open thyroidectomy: a randomized study.

Eur Arch Otorhinolaryngol. 2016 Aug 5;

Authors: Jantharapattana K, Maethasith J

Abstract
The objective of this study is to compare the outcomes of transaxillary gasless endoscopic thyroidectomy (TGET) and conventional open thyroidectomy (COT). Thirty-three patients with thyroid nodule were enrolled. All patients were randomized into two different groups. Sixteen patients underwent TGET and 17 patients underwent COT. We analyzed the patients' characteristics, wound satisfaction, the intraoperative phase, hospitalization, pain, and costs. The operative time for the TGET group was significantly longer than in the COT group. The estimated blood loss, the hospitalized days, and pain between the two groups were not significantly different. The drainage content was significantly more in the TGET group. The patients' wound satisfaction and mean total cost per case were significantly greater in the TGET group. The TGET provided better cosmetic outcomes and was comparable regarding the estimated blood loss, pain, complication, and hospitalization. However, the TGET required a longer operative time which determines the higher costs.

PMID: 27496209 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aYLD9U
via IFTTT

Polypropylene mesh for nasal septal perforation repair: an experimental study.

Related Articles

Polypropylene mesh for nasal septal perforation repair: an experimental study.

Eur Arch Otorhinolaryngol. 2016 Aug 5;

Authors: Yücebaş K, Taşkın Ü, Oktay MF, Tansuker HD, Erdil M, Altınay S, Kozanoğlu E, Kuvat SV

Abstract
The aim of this study is to determine the effectiveness and biocompatibility of polypropylene mesh for the repair of nasal septal perforations in an animal model on rabbits. A full-thickness nasal septal perforation with a diameter of nearly 10 × 10 mm was created on 12 rabbits, and then the perforation was reconstructed with two different methods. We used mucosal flaps and polypropylene mesh as an interpositional graft in group 1. Only mucosal flaps were used for reconstruction and are identified as group 2. After 4 weeks, we removed the nasal septum of the rabbits and performed histopathological examinations for acute rejection, infection, inflammatory response, fibrosis, and granuloma formation. We found perforation closure rates of 75 and 25 % in groups 1 and 2, respectively. Inflammatory response was seen in all specimens of group 1 (100 %). The inflammatory response was +1 in five of the specimens (62.5 %), +2 in one specimen (12.5 %), and +3 in two specimens (25 %). Mild fibrosis around the mesh was detected in four specimens (50 %), medium-level fibrosis was detected in one (12.5 %), and no fibrosis was detected in three (37.5 %). Severe fibrosis was not seen in any specimens. The foreign-body reaction was limited to a few giant cells, and granuloma formation was seen in two specimens (25 %). The propylene mesh showed excellent biocompatibility with the septal mucosa, and it can, therefore, be used for the repair of septal perforation as an interpositional graft safely.

PMID: 27496208 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b36hsh
via IFTTT

Extended lateral thoracic fasciocutaneous biosynthetic flap for reconstruction of full-thickness partial external ear defects: an experimental study.

Related Articles

Extended lateral thoracic fasciocutaneous biosynthetic flap for reconstruction of full-thickness partial external ear defects: an experimental study.

Eur Arch Otorhinolaryngol. 2016 Aug 5;

Authors: Kuvat SV, Taşkın Ü, Yücebaş K, Tansuker HD, Oktay MF, Kozanoğlu E, Aydın S

Abstract
External ear reconstruction is a controversial topic in reconstructive plastic surgery. Here, we prepared a pedicled biosynthetic flap for full-thickness, partial ear defects in rabbits. We operated on six adult female New Zealand rabbits weighing 3-4 kg. The dimensions of the lateral thoracic fasciocutaneous flap were 7 × 6 cm. The flap was elevated based on one of the bilaterally located internal thoracic arteries, which were dissected proximally. The pedicled flap was folded in two, and polypropylene mesh was sandwiched in the middle. The flap was adapted to a defect of 3.5 × 3 cm in diameter. In fact, the defect was created before elevation of the flap. Rabbits were followed up for 4 weeks, at the end of which they were killed and their ears were evaluated histopathologically. The survival rate of the rabbits was 100 %. All pedicled biosynthetic flaps were viable, but one showed partial (20 %) necrosis (1/6) and one was partially detached (1/6). Macroscopic (color, thickness, texture) and histological (polymorphonuclear leukocyte invasion in the skin, subcutaneous tissue, and at the junction between the polypropylene mesh and the flap) features of the flap were compared to the ipsilateral ear. A new technique was developed for partial external ear reconstruction with sufficient inner skeletal support and outer skin lining. Level of evidence Level NA.

PMID: 27496207 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b36j3f
via IFTTT

Modified partial maxillary swing approach for myxofibrosarcoma in pterygopalatine fossa.

Modified partial maxillary swing approach for myxofibrosarcoma in pterygopalatine fossa.

Head Neck. 2016 Aug 8;

Authors: Shimoda H, Yonezawa K, Shinomiya H, Otsuki N, Hashikawa K, Sasaki R, Komura E, Nibu KI

Abstract
BACKGROUND: Extirpation of tumors arising in the pterygopalatine fossa is challenging because of its anatomic complexity.
METHODS AND RESULTS: A 67-year-old man was referred to our department with a diagnosis of a tumor in his left pterygoid fossa. An incisional biopsy through the canine fossa was diagnosed as myxofibrosarcoma. The upper part of the maxilla was swung laterally to remove the tumor while the hard plate was preserved. The defect was reconstructed using rectus abdominis musculocutaneous free and ipsilateral temporal. The postoperative course was uneventful, without facial palsy or mastication disorders.
CONCLUSION: Our experience with this case suggests that the modified partial maxillary swing approach with preservation of the hard palate and orbital floor in combination with infratemporal and cervical approaches is useful for lesions in the pterygoid process without causing severe complications. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27501198 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bg59zh
via IFTTT

Endoscopic management of congenital anterior glottic stenosis.

Related Articles

Endoscopic management of congenital anterior glottic stenosis.

Int J Pediatr Otorhinolaryngol. 2015 Dec;79(12):2056-8

Authors: Yoo MJ, Roy S, Smith LP

Abstract
INTRODUCTION: Congenital anterior glottic stenosis (web) is a rare condition usually presenting with airway obstruction, stridor or dysphonia. Symptomatic infants may require tracheotomy to bridge the neonatal period. Early open surgical reconstruction may have significant risks and failure may still result in tracheotomy. We introduce an endoscopic surgical approach with balloon dilation for primary management of congenital anterior glottic stenosis.
METHODS: We present three cases of congenital anterior glottic stenosis in children 7, 14, and 90 days old presenting with stridor, dyspnea, and dysphonia. The larynx was exposed by suspension microlaryngoscopy. The glottic stenosis was incised from a posterior to anterior direction using a laryngeal sickle knife. Subsequently, an airway balloon was guided through the stenotic lumen. Once the balloon was inflated, the balloon pressure was maintained for 30s or until the patient's oxygen saturation dropped below 92%. The dilation was repeated two or three times. The patients were kept intubated with an uncuffed endotracheal tube and monitored in the pediatric intensive care unit following surgery.
RESULTS: All three patients were extubated within 72h without complications. One patient failed the first extubation attempt and was reintubated and successfully extubated 24h later. Patients were re-evaluated with direct microlaryngoscopy within two weeks. All patients had symptomatic relief and did not require further surgical intervention.
CONCLUSION: Endoscopic balloon dilation laryngoplasty may be a safe and effective primary procedure for pediatric patients with congenital anterior glottic stenosis. It is technically simple and obviates the potential morbidities associated with an open surgical procedure or tracheotomy.

PMID: 26412460 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2aIDCYL
via IFTTT

[Mini-orbitozygomatic craniotomy in surgery for supratentorial aneurysms and tumors of the anterior and middle cranial fossae].

[Mini-orbitozygomatic craniotomy in surgery for supratentorial aneurysms and tumors of the anterior and middle cranial fossae].

Zh Vopr Neirokhir Im N N Burdenko. 2016;80(4):40-47

Authors: Dzhindzhikhadze RS, Dreval' ON, Lazarev VA, Kambiev RL

Abstract
Progress in microneurosurgical techniques, neuroanesthesiology, and intraoperative imaging enables surgery using small incisions and craniotomy, in accordance with the keyhole surgery concept. Supraorbital craniotomy is the most widespread minimally invasive approach. There are a number of supraorbital craniotomy modifications, regarding different soft tissue incisions and the extent of craniotomy. We present the first results of using mini-orbitozygomatic craniotomy for aneurysms of the anterior circle of Willis and space-occupying lesions of the anterior and middle cranial fossae performed through an eyebrow incision.
MATERIAL AND METHODS: Forty five patients were operated on using mini-orbitozygomatic (MOZ) craniotomy in the period between March 2014 and December 2015. Fifteen supratentorial aneurysms were clipped, and 30 space-occupying lesions were resected. Most patients had unruptured aneurysms (10 patients). Five patients had a history of SAH. The aneurysm localization was as follows: 8 anterior communicating artery aneurysms, 4 aneurysms of the internal carotid artery in the area of the posterior communicating artery orifice, and 3 ophthalmic aneurysms. The Hunt-Hess scale was used to evaluate the patients' condition, and the Fisher scale was used to quantify SAH volume. Surgery was performed 14 days after SAH, on average. Contrast-enhanced MRI of the brain was the diagnostic method of choice in a group of patients with space-occupying lesions within the anterior and middle cranial fossae. In some cases, patients underwent CT with reconstruction for assessment of the skull base bone structures. The mean age of patients was 58.3 years.
RESULTS: All aneurysms were completely excluded from the cerebral blood flow. No serious complications and deaths in a group of aneurysm patients occurred. Complete tumor removal was performed in 28 patients. Two patients having pituitary macroadenomas with supra- and parasellar spread underwent subtotal resection due to adenoma invasion into the cavernous sinus. Mortality in this group was 3.3% (1 patient). Postoperative complications were evaluated after 2 weeks and 6 months. The postoperative cosmetic result after 3 and 6 months after surgery was assessed by patients as excellent.
CONCLUSION: Mini-orbitozygomatic craniotomy is an alternative to classic approaches and can be assistive in surgery for skull base aneurysms and tumors. Selection of candidates for this keyhole surgery should be based on their critical assessment.

PMID: 27500773 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2ax54tO
via IFTTT

Pediatric sudden sensorineural hearing loss: Etiology, diagnosis and treatment in 20 children.

Related Articles

Pediatric sudden sensorineural hearing loss: Etiology, diagnosis and treatment in 20 children.

Int J Pediatr Otorhinolaryngol. 2016 Sep;88:208-12

Authors: Dedhia K, Chi DH

Abstract
OBJECTIVES: 1. To report our experience in children with sudden-onset sensorineural hearing loss (SSNHL). 2. To describe the etiology and management of children with SSNHL.
METHODS: Retrospective review of 20 children with SSNHL, from 2000 to 2013 at a tertiary pediatric facility. Patients had the following inclusion criteria: history of normal hearing, hearing loss occurring in less than 3 days, and audiogram documentation.
RESULTS: The average age of patients presenting with SSNHL is 11 years 3 months (22months-18years). Only 6 (30%) children presented prior to 2 weeks. Tinnitus (55%) was the most common associated symptoms followed by otalgia (25%), and vertigo (20%). Eight patients had bilateral hearing loss, 6 only right and 6 only left. Hearing loss severity ranged from profound (45%) being most common to mild. Etiology was unknown (30%), viral (25%), anatomic abnormality (25%), Meniere's disease (5%), autoimmune (5%), perilymphatic fistula (5%), and suppurative labyrinthitis (5%). Eight patients had initial treatment with oral steroids of which 50% had improvement on audiograms. Two patients underwent intratympanic injections, both showed improvement. Of the 12 patients with no treatment, only 1 had improved hearing.
CONCLUSIONS: The true incidence of pediatric SSNHL is not well established in our literature. Unique aspects of pediatric SSNHL are delayed presentation and higher percent of anatomic findings. In our study 70% presented more than 2 weeks after experiencing symptoms. Anatomic abnormalities are in 40% of patients. Hearing improvement occurred in 50% of children treated with oral steroids. Intratympanic steroid treatment is another option but may have practical limitation in the pediatric population.

PMID: 27497416 [PubMed - in process]

from Hearing and Balance via ola Kala on Inoreader http://ift.tt/2aWnUsH
via IFTTT

Real-time computer-based visual feedback improves visual acuity in downbeat nystagmus - a pilot study.

Related Articles

Real-time computer-based visual feedback improves visual acuity in downbeat nystagmus - a pilot study.

J Neuroeng Rehabil. 2016;13:1

Authors: Teufel J, Bardins S, Spiegel R, Kremmyda O, Schneider E, Strupp M, Kalla R

Abstract
BACKGROUND: Patients with downbeat nystagmus syndrome suffer from oscillopsia, which leads to an unstable visual perception and therefore impaired visual acuity. The aim of this study was to use real-time computer-based visual feedback to compensate for the destabilizing slow phase eye movements.
METHODS: The patients were sitting in front of a computer screen with the head fixed on a chin rest. The eye movements were recorded by an eye tracking system (EyeSeeCam®). We tested the visual acuity with a fixed Landolt C (static) and during real-time feedback driven condition (dynamic) in gaze straight ahead and (20°) sideward gaze. In the dynamic condition, the Landolt C moved according to the slow phase eye velocity of the downbeat nystagmus. The Shapiro-Wilk test was used to test for normal distribution and one-way ANOVA for comparison.
RESULTS: Ten patients with downbeat nystagmus were included in the study. Median age was 76 years and the median duration of symptoms was 6.3 years (SD +/- 3.1y). The mean slow phase velocity was moderate during gaze straight ahead (1.44°/s, SD +/- 1.18°/s) and increased significantly in sideward gaze (mean left 3.36°/s; right 3.58°/s). In gaze straight ahead, we found no difference between the static and feedback driven condition. In sideward gaze, visual acuity improved in five out of ten subjects during the feedback-driven condition (p = 0.043).
CONCLUSIONS: This study provides proof of concept that non-invasive real-time computer-based visual feedback compensates for the SPV in DBN. Therefore, real-time visual feedback may be a promising aid for patients suffering from oscillopsia and impaired text reading on screen. Recent technological advances in the area of virtual reality displays might soon render this approach feasible in fully mobile settings.

PMID: 26728632 [PubMed - indexed for MEDLINE]

from Hearing and Balance via ola Kala on Inoreader http://ift.tt/1OzHbOn
via IFTTT

Recent advances in orthostatic hypotension presenting orthostatic dizziness or vertigo.

Related Articles

Recent advances in orthostatic hypotension presenting orthostatic dizziness or vertigo.

Neurol Sci. 2015 Nov;36(11):1995-2002

Authors: Kim HA, Yi HA, Lee H

Abstract
Orthostatic hypotension (OH), a proxy for sympathetic adrenergic failure, is the most incapacitating sign of autonomic failure. Orthostatic dizziness (OD) is known to be the most common symptom of OH. However, recent studies have demonstrated that 30-39 % of patients with OH experienced rotatory vertigo during upright posture (i.e., orthostatic vertigo, OV), which challenges the dogma that OH induces dizziness and not vertigo. A recent population-based study on spontaneously occurring OD across a wide age range showed that the one-year and lifetime prevalence of OD was 10.9 and 12.5 %, respectively. Approximately 83 % of patients with OD had at least one abnormal autonomic function test result. So far, 11 subtypes of OD have been proposed according to the pattern of autonomic dysfunction, and generalized autonomic failure of sympathetic adrenergic and parasympathetic cardiovagal functions was the most common type. Four different patterns of OH, such as classic, delayed, early, and transient type have been found in patients with OD. The head-up tilt test and Valsalva maneuver should be performed for a comprehensive evaluation of sympathetic adrenergic failure in patients with OD/OV. This review summarizes current advances in OH presenting OD/OV, with a particular focus on the autonomic dysfunction associated with OD.

PMID: 26292788 [PubMed - indexed for MEDLINE]

from Hearing and Balance via ola Kala on Inoreader http://ift.tt/2b33wY2
via IFTTT

Opsoclonus-myoclonus syndrome associated with non-small cell lung cancer.

Related Articles

Opsoclonus-myoclonus syndrome associated with non-small cell lung cancer.

Asian Cardiovasc Thorac Ann. 2015 Nov;23(9):1113-5

Authors: Karasaki T, Tanaka M

Abstract
A 68-year-old man developed progressive vertigo, saccadic eye movements, and tremors. Computed tomography showed multiple lung nodules. Surgery was performed and the pathological diagnosis was large cell neuroendocrine carcinoma in the left upper lobe with ipsilobar metastases, and adenocarcinoma in the left lower lobe. The neurological symptoms resolved dramatically after complete resection of the tumors. Opsoclonus-myoclonus syndrome associated with non-small-cell lung carcinoma is extremely rare. Surgery should not be delayed if a complete resection is expected.

PMID: 26038602 [PubMed - indexed for MEDLINE]

from Hearing and Balance via ola Kala on Inoreader http://ift.tt/2aWo6bk
via IFTTT

Stress hormonal changes in the brain and plasma after acute noise exposure in mice.

Related Articles

Stress hormonal changes in the brain and plasma after acute noise exposure in mice.

Auris Nasus Larynx. 2016 Aug 2;

Authors: Jin SG, Kim MJ, Park SY, Park SN

Abstract
OBJECTIVE: To investigate the effects of acute noise stress on two amine stress hormones, norepinephrine (NE) and 5-hydroxyindoleacetic acid (5-HIAA) in the brain and plasma of mice after noise exposure.
METHODS: Mice were grouped into the control and noise groups. Mice in the noise group were exposed to white noise of 110dB sound pressure level for 60min. Auditory brainstem response thresholds, distortion product otoacoustic emissions, the organ of Corti grading scores, western blots of NE/5-HIAA in the whole brain and hippocampus, and the plasma levels of NE/5-HIAA were compared between the two groups.
RESULTS: Significant hearing loss and cochlear damage were demonstrated in the noise group. NE and 5-HIAA in the hippocampus were elevated in the noise group (p=0.019/0.022 for NE/5-HIAA vs. the control). Plasma levels of NE and 5-HIAA were not statistically different between the groups (p=0.052/0.671 for NE/5-HIAA).
CONCLUSION: Hearing loss with outer hair cell dysfunction and morphological changes of the organ of Corti after noise exposure in C57BL/6 mice proved the reliability of our animal model as an acute noise stress model. NE and 5-HIAA are suggested to be the potential biomarkers for acute noise stress in the hippocampus.

PMID: 27496010 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b5a21E
via IFTTT

Primary combined small cell carcinoma and squamous cell carcinoma of the oropharynx with special reference to EGFR status of small cell carcinoma component: Case report and review of the literature.

Related Articles

Primary combined small cell carcinoma and squamous cell carcinoma of the oropharynx with special reference to EGFR status of small cell carcinoma component: Case report and review of the literature.

Auris Nasus Larynx. 2016 Aug 2;

Authors: Nakano T, Motoshita J, Tanaka R, Okabe M, Tamae A, Shiratsuchi H, Yasumatsu R, Nakashima T, Nakagawa T

Abstract
Combined small cell carcinoma (SCC) and squamous cell carcinoma (SqCC) of the oropharynx is extremely rare and shows an aggressive clinical course. There are only 5 reported cases of combined SCC and SqCC in the English language literature. Here, we report a 59-year-old male presenting with a right tonsillar mass. The mass was biopsied, and the histological findings showed a proliferation of small-sized tumor cells with scant cytoplasm. Immunohistochemically, the tumor cells were positive for neuroendocrine markers (synaptophysin, chromogranin A, and CD56). Our first diagnosis was tonsillar small cell carcinoma. We treated the patient with concurrent chemoradiotherapy together with cisplatin followed by surgery. The resected tonsillar specimen showed a residual tumor composed of SCC and SqCC, and lymph nodes showed metastatic tumor cells of the SCC component. Immunohistochemically, the SCC component was positive for all neuroendocrine markers and p16; on the other hand, the SqCC component was positive for p40, p63, p16, and EGFR. Fluorescence in situ hybridization revealed that neither component showed any EGFR gene copy number gain. The patient was treated with adjuvant chemotherapy consisting of irinotecan and cisplatin. Liver and bone metastases developed, resulting in the death of the patient. We discuss the present case and review similar cases. Most cases of combined SCC and SqCC occur regardless of p16 status, and a therapeutic strategy has yet to be determined. Further examination of this kind of combined tumor is necessary.

PMID: 27496009 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b5apJC
via IFTTT

Sentinel node biopsy for oral cancer: A prospective multicenter Phase II trial.

Related Articles

Sentinel node biopsy for oral cancer: A prospective multicenter Phase II trial.

Auris Nasus Larynx. 2016 Aug 2;

Authors: Miura K, Hirakawa H, Uemura H, Yoshimoto S, Shiotani A, Sugasawa M, Homma A, Yokoyama J, Tsukahara K, Yoshizaki T, Yatabe Y, Matsuo K, Ohkura Y, Kosuda S, Hasegawa Y

Abstract
OBJECTIVE: A recent study identified a survival benefit with prophylactic neck dissection (ND) at the time of primary surgery as compared with watchful waiting followed by therapeutic neck dissection for nodal relapse, in patients with cN0 oral squamous cell carcinoma (OSCC). Alternative management of cN0 neck cancer is recommended to minimize the adverse effects of ND, indicating the need for sentinel node biopsy (SNB) and limited neck dissection. We conducted a multicenter Phase II study to examine the feasibility of SNB for clinically N0 OSCC.
METHODS: Previously untreated N0 OSCC patients (n=57) with clinical late-T2 or T3 tumors were enrolled across 10 institutions. SNB navigated with multislice frozen section analysis of sentinel nodes (SNs) and SNB supported sentinel node lymphatic basin dissection (SN basin dissection) were performed in a one-stage procedure. The endpoint was to investigate the rate of false-negative metastases after SN basin dissection and SNB alone.
RESULTS: Most tumors were late-T2 lesions (n=50; 87.7%). SNs were identified in all patients. A total of 196 SNs were detected. Among these SNs, 35 (17.8%) were positive for metastasis (9 in level I, 12 in level II, 12 in level III, 1 in level V and 2 in the contralateral region of the neck). The false-negative rate of SNB supported by SN basin dissection and SNB alone was 4.5% and 9.1%, respectively. The concordance of the SN status in intraoperative frozen sections with the permanent histopathology was 97.4% (191/196). The sensitivity and specificity of intraoperative pathological evaluation were 85.7% (30/35) and 100% (30/30), respectively. The 3-year overall survival (OS) and disease-free survival was 89.5% and 82.5%, respectively. The OS of SN-negative patients was significantly longer than that of SN-positive patients (P=0.047).
CONCLUSION: The current study verified that SN basin dissection was a useful back-up procedure for SNB performed as a one-stage procedure, showing a low false-negative rate. SNB alone is an appropriate staging method for patients with clinical N0 staging, and a reliable procedure to determine the appropriate levels for neck dissection.

PMID: 27496008 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2ax1hgh
via IFTTT

A case of vertebral artery aneurysm presenting with dysphagia.

Related Articles

A case of vertebral artery aneurysm presenting with dysphagia.

Auris Nasus Larynx. 2016 Aug 2;

Authors: Morishita H, Nakamura S, Toma N, Nakatsuka Y, Takeuchi K

Abstract
Here, we report a case of vertebral artery aneurysm causing dysphagia in a 56-year-old man who had no remarkable past history. Two months before the first visit, he developed posterior neck pain followed by difficulty swallowing 1 month later. He was referred to our clinic because of gradually worsening dysphagia. Physical examination showed paralysis of cranial nerves IX, X, and XII; therefore, he was hospitalized. Because enhanced CT and MRI showed a partially thrombosed right vertebral artery aneurysm, he was transferred to the care of the Department of Neurosurgery. Parent artery occlusion of the right vertebral artery aneurysm was performed and it improved his symptoms. After regaining his ability to take in liquid food, he was transferred to another hospital for further rehabilitation. In this case, we attributed the dysphagia to aneurysmal compression of the roots of cranial nerves IX, X, and XII. A partially thrombosed cerebral artery aneurysm may often rupture and cause worsening of neurologic symptoms. The prognosis is generally poor because the rupture rate is extremely high especially with large or giant aneurysms. However, this case had a good clinical course owing to treatment by parent artery occlusion.

PMID: 27496007 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bg5thp
via IFTTT

Endoscopic-modified medial maxillectomy and its limitation for a solitary fibrous tumor of the lacrimal sac and nasolacrimal duct.

Related Articles

Endoscopic-modified medial maxillectomy and its limitation for a solitary fibrous tumor of the lacrimal sac and nasolacrimal duct.

Auris Nasus Larynx. 2016 Aug 2;

Authors: Moriyama M, Kodama S, Hirano T, Suzuki M

Abstract
Solitary fibrous tumor (SFT) is an uncommon neoplasm that usually arises from the pleura. Recently, SFTs have been reported in the head and neck region located in subsites such as the orbit. SFTs of the lacrimal sac are extremely rare, with only six cases reported in the English literature. We describe a SFT arising from the right lacrimal sac and extending along the nasolacrimal duct into the nasal cavity. Although, the tumor could not be removed by endoscopic-modified medial maxillectomy (EMMM) alone, combined approach with EMMM and a small external incision achieved the complete removal of the tumor. The patient has remained disease-free 24 months after surgery.

PMID: 27496006 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bg4nlO
via IFTTT

Mast Cell Deficiency Limits the Development of Chronic Rhinosinusitis in Mice.

Related Articles

Mast Cell Deficiency Limits the Development of Chronic Rhinosinusitis in Mice.

Ann Otol Rhinol Laryngol. 2016 Apr;125(4):290-6

Authors: Hua X, Naselsky WC, Jania CM, Chason KD, Huang JJ, Doerschuk CM, Graham SM, Senior BA, Tilley SL

Abstract
BACKGROUND: Chronic rhinosinusitis (CRS) is one of the most common chronic diseases in adults in both developing and developed countries. The etiology and pathogenesis of CRS remain poorly understood, and the disease is refractory to therapy in many patients. Mast cell activation has been demonstrated in the sinonasal mucosa of patients with CRS; however, the specific contribution of mast cells to the development and pathogenesis of this disease has not been established.
OBJECTIVE: The objective of this study was to investigate the role of mast cells in the development of CRS.
METHODS: C57BL/6 wild-type and C57BL/6-Kit(W-sh/W-sh) mast cell-deficient mice were immunized by intraperitoneal allergen injection and subsequent chronic low dose intranasal allergen challenges. The sinonasal phenotypes of these groups were then evaluated and compared to saline-treated controls using radiologic, histologic, and immunologic methods.
RESULTS: Wild-type mice exposed to chronic intranasal allergen developed many features seen in human CRS, including mucosal thickening, cystic changes, polyp development, eosinophilia, goblet cell hyperplasia, and mast cell activation. In contrast, sinonasal pathology was significantly attenuated in mast cell-deficient mice subjected to the same chronic allergen protocol. Specifically, tissue eosinophilia and goblet cell hyperplasia were reduced by approximately 50% compared to wild-type levels. Surprisingly, none of the mast cell-deficient mice subjected to chronic allergen challenge developed cystic changes or polypoid changes in the nose or sinuses.
CONCLUSIONS: These data identify a critical role for mast cells in the development of many features of a mouse model of eosinophilic CRS, suggesting that therapeutic strategies targeting mast cells be examined in humans afflicted with this disease.

PMID: 26681624 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1J0kJgI
via IFTTT