Quality standards for bone conduction implants.

Related Articles

Quality standards for bone conduction implants.

Acta Otolaryngol. 2015;135(12):1277-85

Authors: Gavilan J, Adunka O, Agrawal S, Atlas M, Baumgartner WD, Brill S, Bruce I, Buchman C, Caversaccio M, De Bodt MT, Dillon M, Godey B, Green K, Gstoettner W, Hagen R, Hagr A, Han D, Kameswaran M, Karltorp E, Kompis M, Kuzovkov V, Lassaletta L, Li Y, Lorens A, Martin J, Manoj M, Mertens G, Mlynski R, Mueller J, O'Driscoll M, Parnes L, Pulibalathingal S, Radeloff A, Raine CH, Rajan G, Rajeswaran R, Schmutzhard J, Skarzynski H, Skarzynski P, Sprinzl G, Staecker H, Stephan K, Sugarova S, Tavora D, Usami S, Yanov Y, Zernotti M, Zorowka P, de Heyning PV

Abstract
CONCLUSION: Bone conduction implants are useful in patients with conductive and mixed hearing loss for whom conventional surgery or hearing aids are no longer an option. They may also be used in patients affected by single-sided deafness.
OBJECTIVES: To establish a consensus on the quality standards required for centers willing to create a bone conduction implant program.
METHOD: To ensure a consistently high level of service and to provide patients with the best possible solution the members of the HEARRING network have established a set of quality standards for bone conduction implants. These standards constitute a realistic minimum attainable by all implant clinics and should be employed alongside current best practice guidelines.
RESULTS: Fifteen items are thoroughly analyzed. They include team structure, accommodation and clinical facilities, selection criteria, evaluation process, complete preoperative and surgical information, postoperative fitting and assessment, follow-up, device failure, clinical management, transfer of care and patient complaints.

PMID: 26223816 [PubMed - indexed for MEDLINE]

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Surgical Repair and Detection of Cerebrospinal Fluid Rhinorrhea using Magnetic Resonance Cisternography and Skull Base Coronal Thin-section Computed Tomography Scan.

Surgical Repair and Detection of Cerebrospinal Fluid Rhinorrhea using Magnetic Resonance Cisternography and Skull Base Coronal Thin-section Computed Tomography Scan.

Chin Med J (Engl). 2016 20th Aug;129(16):2005-2006

Authors: Du HS, Ma GS, Ma JJ

PMID: 27503029 [PubMed - as supplied by publisher]

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Structure of the lateral mass of the ethmoid by curved stacking of endoturbinal elements.

Structure of the lateral mass of the ethmoid by curved stacking of endoturbinal elements.

Eur Ann Otorhinolaryngol Head Neck Dis. 2016 Aug 5;

Authors: Jankowski R, Perrot C, Nguyen DT, Rumeau C

Abstract
CONTEXT: According to evo-devo theory, the embryonic development of the nasal organ mimics its phylontogenic formation: the lateral masses of the human ethmoid bone develop by curved "onion" stacking of the endoturbinals (the horizontal bone septa of the mammalian olfactory chamber) under the impact of facial and skull-base remodeling, rather than by pneumatization of cavities communicating via ostia.
OBJECTIVES: To assess the frequency of the onion structure on coronal CT.
MATERIAL AND METHODS: Three independent examiners performed a retrospective descriptive study of coronal CT scans taken ahead of septorhinoplasty between June 2010 and December 2012 in adult patients without history of sinonasal surgery.
RESULTS: Fifty patients were included. In the anterior right and left and posterior right ethmoid, an onion arrangement of the endoturbinals was systematically found on at least 1 view, and on 60% of views taking all ethmoid compartments together. Two endoturbinals were generally involved, but a rolling-up of 3 endoturbinals was also observed, significantly more frequently in the posterior compartments (P=0.004 on the right side, P=0.012 on the left).
CONCLUSION: The onion structure of the lateral masses of the ethmoid can be observed on coronal CT scans. This structure confirms evo-devo theory. The ethmoid thus appears fundamentally different from the paranasal sinuses, suggesting that the pathogenesis of nasal polyposis and ethmoidectomy techniques need to be reconsidered.

PMID: 27502821 [PubMed - as supplied by publisher]

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Maximum surgical resection and adjuvant intensity-modulated radiotherapy with simultaneous integrated boost for skull base chordoma.

Maximum surgical resection and adjuvant intensity-modulated radiotherapy with simultaneous integrated boost for skull base chordoma.

Acta Neurochir (Wien). 2016 Aug 9;

Authors: Kim JW, Suh CO, Hong CK, Kim EH, Lee IJ, Cho J, Lee KS

Abstract
BACKGROUND: Local recurrence is common after surgical resection of clivus chordoma. We report the results of maximum surgical resection followed by intensity-modulated radiotherapy with simultaneous integrated boost (IMRT-SIB).
METHODS: We reviewed 14 consecutive clivus chordoma cases undergoing postoperative IMRT-SIB using the institutional protocol between 2005 and 2013. Total and near-total resections were achieved in 11 patients (78.6 %), partial in 2 patients (14.3 %), and 1 patient (7.1 %) received RT for recurrent tumor after total resection. Gross residual or the high-risk area defined the planning target volume (PTV)1; PTV2 was the postoperative tumor bed plus a 3-5-mm margin, and PTV3 was PTV2 plus a 5-10 mm margin. A moderate hypofractionation schedule was used: doses to PTV1, PTV2 and PTV3 were 3.9 Gy, 3.15 Gy and 2.8 Gy through 15 fractions for the first two patients, and the rest received 2.5 Gy, 2.2 Gy and 1.8 Gy through 25 fractions. The biologically equivalent dose in 2-Gy fractions (EQD2) was 65-68 Gy for PTV1, 52-56 Gy for PTV2, and 44.3-44.8 Gy for PTV3.
RESULTS: Median follow-up was 41 months. Eight patients were free of disease for median 42.5 months (range 23-91 months), four patients had stable disease for median 60.5 months (range 39-113 months), and 1 patient showed partial response for 38 months after RT. Local progression was seen in one patient who received EQD2 67.8 Gy after partial resection. Estimated 5-year progression-free and overall survival rates were 92.9 %. Surgery improved the neurologic deficit in six patients, and IMRT-SIB was well tolerated without lasting toxicity.
CONCLUSION: Our experience suggests that maximum resection and high-dose IMRT-SIB can achieve local control without significant morbidities.

PMID: 27502775 [PubMed - as supplied by publisher]

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Towards valid 'serious non-fatal injury' indicators for international comparisons based on probability of admission estimates.

Towards valid 'serious non-fatal injury' indicators for international comparisons based on probability of admission estimates.

Inj Prev. 2016 Aug 8;

Authors: Cryer C, Miller TR, Lyons RA, Macpherson AK, Pérez K, Petridou ET, Dessypris N, Davie GS, Gulliver PJ, Lauritsen J, Boufous S, Lawrence B, de Graaf B, Steiner CA

Abstract
BACKGROUND: Governments wish to compare their performance in preventing serious injury. International comparisons based on hospital inpatient records are typically contaminated by variations in health services utilisation. To reduce these effects, a serious injury case definition has been proposed based on diagnoses with a high probability of inpatient admission (PrA). The aim of this paper was to identify diagnoses with estimated high PrA for selected developed countries.
METHODS: The study population was injured persons of all ages who attended emergency department (ED) for their injury in regions of Canada, Denmark, Greece, Spain and the USA. International Classification of Diseases (ICD)-9 or ICD-10 4-digit/character injury diagnosis-specific ED attendance and inpatient admission counts were provided, based on a common protocol. Diagnosis-specific and region-specific PrAs with 95% CIs were calculated.
RESULTS: The results confirmed that femoral fractures have high PrA across all countries studied. Strong evidence for high PrA also exists for fracture of base of skull with cerebral laceration and contusion; intracranial haemorrhage; open fracture of radius, ulna, tibia and fibula; pneumohaemothorax and injury to the liver and spleen. Slightly weaker evidence exists for cerebellar or brain stem laceration; closed fracture of the tibia and fibula; open and closed fracture of the ankle; haemothorax and injury to the heart and lung.
CONCLUSIONS: Using a large study size, we identified injury diagnoses with high estimated PrAs. These diagnoses can be used as the basis for more valid international comparisons of life-threatening injury, based on hospital discharge data, for countries with well-developed healthcare and data collection systems.

PMID: 27501735 [PubMed - as supplied by publisher]

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Dogs died in studies of drug that killed man in French trial.

Related Articles

Dogs died in studies of drug that killed man in French trial.

BMJ. 2016;352:i1228

Authors: Hawkes N

PMID: 26925932 [PubMed - indexed for MEDLINE]

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Use of systemic therapy with definitive radiotherapy for elderly patients with head and neck cancer: A National Cancer Data Base analysis.

Use of systemic therapy with definitive radiotherapy for elderly patients with head and neck cancer: A National Cancer Data Base analysis.

Cancer. 2016 Aug 9;

Authors: Ward MC, Reddy CA, Adelstein DJ, Koyfman SA

Abstract
BACKGROUND: The purpose of this study was to investigate the use of systemic therapy along with definitive radiotherapy for elderly patients with head and neck cancer.
METHODS: Patients who were 71 years old or older with stage III to IVB squamous cell carcinoma of the nasopharynx, oropharynx, larynx, or hypopharynx treated with definitive radiotherapy with or without systemic therapy were identified from the National Cancer Data Base. Patterns of systemic therapy use before or during definitive radiotherapy were investigated. The association between systemic therapy use and overall survival was investigated with a multivariate, inverse probability-weighted propensity score-adjusted Cox proportional hazards model.
RESULTS: Elderly patients treated between 2004 and 2012 (n = 4165) were identified, and 80.4% received systemic therapy. The median follow-up was 26 months (range, 1.8-125 months), and the 3-year overall survival rate was 51.6% (95% confidence interval, 50.0%-53.2%). During the study period, there was an increase in the frequency of systemic therapy use from 64% in 2004 to 86% in 2012. The use of systemic therapy was associated with improved overall survival in the multivariate model (hazard ratio, 1.456; 95% confidence interval, 1.308-1.620; P < .0001). A threshold age above which the use of systemic therapy was not associated with improved overall survival in select patients was not identified.
CONCLUSIONS: In contrast to the available prospective evidence, the majority of elderly patients with locoregionally advanced head and neck cancer treated with definitive radiotherapy also receive systemic therapy. The use of systemic therapy is associated with improved overall survival and should be a patient-specific decision in all age groups. Cancer 2016. © 2016 American Cancer Society.

PMID: 27504955 [PubMed - as supplied by publisher]

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Intensity-modulated radiotherapy for early glottic cancer: transition to a new standard of care?

Intensity-modulated radiotherapy for early glottic cancer: transition to a new standard of care?

Future Oncol. 2016 Aug 9;

Authors: Samuels MA, Freedman LM, Elsayyad N

Abstract
For decades, the standard of care for radiation treatment of early larynx cancers has been conventional treatment using opposed lateral fields encompassing the larynx and overlying neck structures, including the adjacent carotid arteries. While intensity-modulated radiotherapy (IMRT) has replaced conventional radiotherapy for all other head/neck cancer situations, the use of IMRT to treat early glottic cancers remains controversial. The article reviews the published experience with IMRT for this clinical situation and provides a detailed review of the literature on radiation-induced carotid toxicity and how it might apply to the controversy. Finally, we discuss whether the radiation oncology community should transition to IMRT as a new standard of care for the treatment of early glottic cancers.

PMID: 27502431 [PubMed - as supplied by publisher]

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Voice evaluation in asthma patients using inhaled corticosteroids.

Related Articles

Voice evaluation in asthma patients using inhaled corticosteroids.

Kulak Burun Bogaz Ihtis Derg. 2016;26(2):101-8

Authors: Hassen HE, Abo Hasseba AM

Abstract
OBJECTIVES: This study aims to assess voice changes and laryngeal abnormalities in asthmatic patients using inhaled corticosteroids (ICSs).
PATIENTS AND METHODS: This study included 30 patients (15 females; mean age 21.3±2.6 years; range, 17 to 26 years and 15 males; mean age 20.7±2.3 years; range, 16 to 27 years) with bronchial asthma treated with ICSs between May 2013 and December 2013. A speech sample from each patient was evaluated by two phoniatricians and the degrees of dysphonia were scored. Each patient's voice was acoustically analyzed using the multidimensional voice program software. Videolaryngoscopy was used to detect laryngeal abnormalities including the vocal folds.
RESULTS: A total of 53.3% of ICSs users had dysphonia; most of them had a mild degree dysphonia. Of patients, vocal folds erythema was present in 56.7%, interarytenoid thickening in 56.7%, vocal folds bowing in 5.3% and vocal fold atrophy in 5.5%. A total of 36.7% patients had manifestations of laryngopharyngeal reflux. The presence of vocal fold bowing and atrophy was significantly related to the duration of ICS use (p=0.048). Soft phonation index values were positively associated with the duration of the ICS use (p=0.013).
CONCLUSION: Inhaled corticosteroids have abnormally adverse effects both on the function and the structure of the vocal folds.

PMID: 26890712 [PubMed - indexed for MEDLINE]

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Management of subglottic hemangiomas with carbon dioxide laser: Our 25-year experience and comparison with the literature.

Related Articles

Management of subglottic hemangiomas with carbon dioxide laser: Our 25-year experience and comparison with the literature.

Int J Pediatr Otorhinolaryngol. 2015 Dec;79(12):2003-7

Authors: Clarós A, Fokouo JV, Roqueta C, Clarós P

Abstract
INTRODUCTION: Subglottic hemangiomas (SGH) are rare tumors of infancy arising between the perichondrium and the mucosa of the subglottic space. It is a potential life-threatening condition. Many therapeutic options exist for this disease, including lasers.
OBJECTIVE: To report our 25-year experience of laser treatment of SGH.
MATERIAL AND METHODS: Retrospective review of charts.
SETTING: Clarós' Otolaryngology and Head and Neck Surgery Clinic in Barcelona, Spain.
RESULTS: We recruited a total of 97 patients of whom 89 were treated with CO2 laser. Mean age at first contact was 2.1 months (range: 1.5-6.5). Sex ratio was 10 girls for 1 boy. Eighty percent of patients presented with stridor and 30.3% with recurrent acute laryngitis. Forty percent had associated cutaneous hemangiomas. They received an average of 1.85 laser session (range: 1-4) and 78.5% were healed after a maximum of 2. We had a 100% success rate and 1.1% complication rate (subglottic stenosis).
CONCLUSION: CO2 laser is a very effective and recommendable tool against subglottic hemangiomas. To achieve good results traditional laser safety measures should be respected besides some useful surgical tips.

PMID: 26614224 [PubMed - indexed for MEDLINE]

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Evaluation of glottic view through Air-Q Intubating Laryngeal Airway in the supine and lateral position and assessing it as a conduit for blind endotracheal intubation in children in the supine position.

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Evaluation of glottic view through Air-Q Intubating Laryngeal Airway in the supine and lateral position and assessing it as a conduit for blind endotracheal intubation in children in the supine position.

Paediatr Anaesth. 2015 Dec;25(12):1241-7

Authors: Pandey RK, Subramanium RK, Darlong V, Lekha C, Garg R, Punj J, Rewari V, Bajpai M

Abstract
INTRODUCTION: We assessed the feasibility of blind orotracheal intubation in children using the Air-QILA as a conduit in supine position and the glottic view grading by fiberoptic bronchoscope (FOB) through it both in supine and lateral positions.
METHODS: After ethical approval and consent, 60 children were enrolled in the study. In the operating room, after attaching standard monitors to all children, anesthesia was induced with sevoflurane (2-8%) in oxygen (100%). Once the children became sedated, an i.v. access was established and injection glycopyrrolate (10 μg · kg(-1)), fentanyl (2 μg · kg(-1)), and atracurium (0.5 mg · kg(-1)) were administered. After 3 min, the Air-QILA was placed in supine position and glottic view was assessed by using FOB, in supine and right lateral decubitus position. In all children, gradings of glottic view in two different positions were noted. After that all children were turned supine, and orotracheal intubation was done blindly through the Air-QILA. The success rate, insertion time of the Air-QILA, and endotracheal intubation were noted.
RESULTS: The Air-QILA placement was successful in 57 children in first attempt and three children required second attempt. However, blind endotracheal intubations through the Air-QILA were successful in 38 children in first attempt and 12 children required second attempt. In the remaining 10 children, where blind endotracheal intubation through the Air-QILA remained unsuccessful, conventional laryngoscopy was performed. In supine and lateral positions, Grade 1 glottic view was seen in 41 and 38 of total 60 patients, respectively. Turning of all children from supine to lateral decubitus position resulted in the deterioration of grading of glottic view in eight children and improvement in two children (P = 0.001).
CONCLUSION: The Air-QILA is an easy to place supraglottic airway device with excellent airway seal and low airway morbidity. It may be useful as a conduit for blind orotracheal intubation in supine position and can be used as an effective alternative to FOB in low resource settings.

PMID: 26417722 [PubMed - indexed for MEDLINE]

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Efficiency and durability of hyaluronic acid of different particle sizes as an injectable material for VF augmentation.

Related Articles

Efficiency and durability of hyaluronic acid of different particle sizes as an injectable material for VF augmentation.

Acta Otolaryngol. 2015;135(12):1311-8

Authors: Kim YS, Choi JW, Park JK, Kim YS, Kim HJ, Shin YS, Kim CH

Abstract
CONCLUSION: The results of the present investigation suggest that modification of HA could improve efficiency and durability in augmentation laryngoplasty.
OBJECTIVES: Injection laryngoplasty (IL) is one of the most suitable options for treatment of glottic insufficiency, which is caused by vocal fold (VF) paralysis, atrophy, or scarring. Hyaluronic acid (HA) is a widely used material for VF injection. This study was intended to evaluate the durability and efficiency of HA of different particle sizes for VF augmentation.
METHODS: Three types of HA, Restylane®, monophasic low-viscosity, and unequal particle-sized middle-viscosity HA were injected into the left VF of three groups with eight rabbits each.
RESULTS: After 6 and 10 weeks, the injected site was evaluated endoscopically, histologically, radiologically, and functionally. None of the 24 rabbits showed any signs of respiratory distress. Computed tomography (CT) images and endoscopic evaluation revealed sufficient augmented volume of the injected VF in all treated groups 6 weeks after the injection. Histological data at week 10 showed that unequal particle-sized HA did not migrate from its original injection site, while other HAs migrated to the periphery of the arytenoid cartilage. Videokymographic analysis showed more favorable vibrations of unequal particle-sized HA injected VF mucosa 10 weeks post-injection, compared to the other treatment groups.

PMID: 26248614 [PubMed - indexed for MEDLINE]

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Clinical outcomes of tracheoesophageal diversion and laryngotracheal separation for aspiration in patients with severe motor and intellectual disability.

Related Articles

Clinical outcomes of tracheoesophageal diversion and laryngotracheal separation for aspiration in patients with severe motor and intellectual disability.

Acta Otolaryngol. 2015;135(12):1304-10

Authors: Takano K, Kurose M, Mitsuzawa H, Nagaya T, Himi T

Abstract
CONCLUSIONS: Tracheoesophageal diversion (TED) and laryngotracheal separation (LTS) can prevent aspiration pneumonia and improve the morbidity of patients with severe motor and intellectual disability (SMID). By improving hospitalization rates and care needs, the quality-of-life can be improved for the patients and their parents.
OBJECTIVES: This study evaluated the clinical outcomes of TED and LTS in patients with intractable aspiration and SMID.
METHODS: This study retrospectively reviewed patients with SMID and intractable aspiration pneumonia who underwent TED or LTS at the institution between January 2008 and January 2015. It assessed the frequency of sputum suctioning, the number of pre-operative and post-operative hospitalizations, the operative time, and complications.
RESULTS: Forty patients were identified during the study period. After surgery, there were significant reductions in the frequency of secretion suctioning (from 165.0 times/day to 33.0 times/day) and the number of hospitalizations because of aspiration pneumonia (from 5.4 times/year to 0.2 times/year). A tracheocutaneous fistula occurred in one (2.5%) patient, and two (5.4%) patients developed tracheoinnominate artery fistulas. In the latter group, the innominate arteries were successfully ligated and endovascular embolization was performed.

PMID: 26211394 [PubMed - indexed for MEDLINE]

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Autologous fat augmentation of the vocal fold with basic fibroblast growth factor: Computed tomographic assessment of fat tissue survival after augmentation.

Related Articles

Autologous fat augmentation of the vocal fold with basic fibroblast growth factor: Computed tomographic assessment of fat tissue survival after augmentation.

Acta Otolaryngol. 2015;135(11):1163-7

Authors: Tamura E, Tabata Y, Yamada C, Okada S, Iida M

Abstract
CONCLUSION: The volume of fat tissue loss after vocal fold augmentation can be decreased when augmentation is performed with addition of basic fibroblast growth factor (b-FGF).
OBJECTIVES: The effectiveness of augmentation is easily decreased due to absorption. Canine experiments have confirmed that the decreased effectiveness caused by absorption after augmentation can be reduced by administering low-concentration b-FGF. Clinical application was trialed after acquiring approval from the institutional clinical review committee.
METHOD: Autologous fat tissue with b-FGF was injected into the vocal folds in cases of unilateral vocal cord paralysis. This study compared fat tissue survival after injection by assessing images from computed tomography (CT).
RESULTS: Assessments using CT revealed that the decrease in volume of injected fat tissue was smaller in cases treated using b-FGF than in cases using the conventional method. No severe complications were encountered using this method.

PMID: 26143653 [PubMed - indexed for MEDLINE]

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Structure of the lateral mass of the ethmoid by curved stacking of endoturbinal elements.

Structure of the lateral mass of the ethmoid by curved stacking of endoturbinal elements.

Eur Ann Otorhinolaryngol Head Neck Dis. 2016 Aug 5;

Authors: Jankowski R, Perrot C, Nguyen DT, Rumeau C

Abstract
CONTEXT: According to evo-devo theory, the embryonic development of the nasal organ mimics its phylontogenic formation: the lateral masses of the human ethmoid bone develop by curved "onion" stacking of the endoturbinals (the horizontal bone septa of the mammalian olfactory chamber) under the impact of facial and skull-base remodeling, rather than by pneumatization of cavities communicating via ostia.
OBJECTIVES: To assess the frequency of the onion structure on coronal CT.
MATERIAL AND METHODS: Three independent examiners performed a retrospective descriptive study of coronal CT scans taken ahead of septorhinoplasty between June 2010 and December 2012 in adult patients without history of sinonasal surgery.
RESULTS: Fifty patients were included. In the anterior right and left and posterior right ethmoid, an onion arrangement of the endoturbinals was systematically found on at least 1 view, and on 60% of views taking all ethmoid compartments together. Two endoturbinals were generally involved, but a rolling-up of 3 endoturbinals was also observed, significantly more frequently in the posterior compartments (P=0.004 on the right side, P=0.012 on the left).
CONCLUSION: The onion structure of the lateral masses of the ethmoid can be observed on coronal CT scans. This structure confirms evo-devo theory. The ethmoid thus appears fundamentally different from the paranasal sinuses, suggesting that the pathogenesis of nasal polyposis and ethmoidectomy techniques need to be reconsidered.

PMID: 27502821 [PubMed - as supplied by publisher]

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Voice in Friedreich Ataxia.

Voice in Friedreich Ataxia.

J Voice. 2016 Aug 5;

Authors: Vogel AP, Wardrop MI, Folker JE, Synofzik M, Corben LA, Delatycki MB, Awan SN

Abstract
BACKGROUND: Friedreich Ataxia (FRDA) is the most common hereditary ataxia, with dysarthria as one of its key clinical signs.
OBJECTIVE: To describe the voice profile of individuals with FRDA to inform outcome marker development and goals of speech therapy.
METHODS: Thirty-six individuals with FRDA and 30 age-matched controls provided sustained vowel and connected speech samples. Speech and voice samples were analyzed acoustically using the Analysis of Dysphonia in Speech and Voice program and perceptually using the Consensus Auditory-Perceptual Evaluation of Voice form. Correlations between dysphonia and overall dysarthria severity, demographic, clinical, and genetic information were explored.
RESULTS: Individuals with FRDA presented with mild dysphonia characterized by hoarseness (combined roughness and breathiness), increased strain, and altered pitch variability (increased in vowel productions; slightly decreased on reading samples). Acoustically, individuals with FRDA had significantly higher scores on the Cepstral Spectral Index of Dysphonia during vowel production. A combination of perceptual and acoustic measures of dysphonia used in this study was quite effective in categorizing the FRDA versus control participants, with >80% overall accuracy.
CONCLUSIONS: Although dysphonia severity in FRDA did not correlate significantly with overall disease severity, speaking rate and syllabic duration significantly correlated with age at disease onset and disease duration, and also have an effect on listener perception of dysphonia. The relationship between dysphonia and dysarthria in FRDA suggests that reducing overall dysphonia severity via therapeutic techniques that improve phonatory stability and increase speaking rate is a viable target for speech therapy.

PMID: 27501923 [PubMed - as supplied by publisher]

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Voice evaluation in asthma patients using inhaled corticosteroids.

Related Articles

Voice evaluation in asthma patients using inhaled corticosteroids.

Kulak Burun Bogaz Ihtis Derg. 2016;26(2):101-8

Authors: Hassen HE, Abo Hasseba AM

Abstract
OBJECTIVES: This study aims to assess voice changes and laryngeal abnormalities in asthmatic patients using inhaled corticosteroids (ICSs).
PATIENTS AND METHODS: This study included 30 patients (15 females; mean age 21.3±2.6 years; range, 17 to 26 years and 15 males; mean age 20.7±2.3 years; range, 16 to 27 years) with bronchial asthma treated with ICSs between May 2013 and December 2013. A speech sample from each patient was evaluated by two phoniatricians and the degrees of dysphonia were scored. Each patient's voice was acoustically analyzed using the multidimensional voice program software. Videolaryngoscopy was used to detect laryngeal abnormalities including the vocal folds.
RESULTS: A total of 53.3% of ICSs users had dysphonia; most of them had a mild degree dysphonia. Of patients, vocal folds erythema was present in 56.7%, interarytenoid thickening in 56.7%, vocal folds bowing in 5.3% and vocal fold atrophy in 5.5%. A total of 36.7% patients had manifestations of laryngopharyngeal reflux. The presence of vocal fold bowing and atrophy was significantly related to the duration of ICS use (p=0.048). Soft phonation index values were positively associated with the duration of the ICS use (p=0.013).
CONCLUSION: Inhaled corticosteroids have abnormally adverse effects both on the function and the structure of the vocal folds.

PMID: 26890712 [PubMed - indexed for MEDLINE]

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Veranstaltungen.

Veranstaltungen.

Laryngorhinootologie. 2016 Aug;95(8):591-594

Authors:

PMID: 27504735 [PubMed - as supplied by publisher]

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Schädelbasischirurgie.

Schädelbasischirurgie.

Laryngorhinootologie. 2016 Aug;95(8):585-589

Authors:

PMID: 27504734 [PubMed - as supplied by publisher]

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A tangible head model showing semicircular canals for demonstrating the physical treatment for BPPV.

Related Articles

A tangible head model showing semicircular canals for demonstrating the physical treatment for BPPV.

Acta Otolaryngol. 2015;135(12):1212-8

Authors: Fujisaka M, Akaogi K, Shojaku H

Abstract
CONCLUSIONS: It was shown that practicing with a tangible head model with semicircular canals is a useful educational tool for learning the physical treatment for BPPV.
OBJECTIVES: To assess the efficacy of using a tangible head model with semicircular canals to teach the physical treatment for BPPV.
METHODS: This study compared the number of canalith particles in the posterior semicircular canal that 20 participants could move from the ampulla to the utricle, before and after practicing with the tangible model.
RESULTS: Before practicing with the model, they could move 2.5 (mean value) of 10 canalith particles. However, after practicing, they could move 6.6 (mean value) of 10 canalith particles. There was a statistical difference (p < 0.01) between the two trials.

PMID: 26271968 [PubMed - indexed for MEDLINE]

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Angiotensin-converting enzyme inhibitor-associated angioedema treated with c1-esterase inhibitor: A case report and review of the literature.

Angiotensin-converting enzyme inhibitor-associated angioedema treated with c1-esterase inhibitor: A case report and review of the literature.

Allergy Rhinol (Providence). 2016 Aug 5;

Authors: Erickson DL, Coop CA

Abstract
CASE REPORT: A 59-year old man currently on >5 years of angiotensin-converting enzyme inhibitor (ACEI) therapy presented to the emergency department with angioedema of the tongue and difficulty swallowing. After receiving conventional therapy of antihistamine, steroids, and epinephrine, the patient's condition continued to deteriorate, with imminent intubation. The patient was treated with a C1-esterase inhibitor (C1-INH) and experienced rapid resolution of symptoms, which avoided airway complications.
DISCUSSION: Although no therapy has been approved for the treatment of ACEI-associated angioedema (AAE), the conventional therapy (antihistamine, steroids, and epinephrine) often proves ineffective in this bradykinin-mediated angioedema. There are drugs approved and used for hereditary angioedema that may be effective in the acute phase of ACEI-AAE that may prevent the need for further interventions, such as intubation and tracheotomy. These drugs include icatibant, ecallantide, fresh frozen plasma, and C1-INH.
CONCLUSION: The literature and clinical evidence indicate C1-INH can be effectively used in the treatment of ACEI-AAE to halt the progression of the condition, prevent airway compromise and the need for intervention, and lead to rapid resolution of symptoms.

PMID: 27502825 [PubMed - as supplied by publisher]

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A systematic review of the effects of low-frequency repetitive transcranial magnetic stimulation on cognition.

A systematic review of the effects of low-frequency repetitive transcranial magnetic stimulation on cognition.

J Neural Transm (Vienna). 2016 Aug 8;

Authors: Lage C, Wiles K, Shergill SS, Tracy DK

Abstract
rTMS is increasingly used for a variety of neuropsychiatric conditions. There are data to support 'fast' rTMS (≥10 Hz) having some positive effects on cognitive functioning, but a dearth of research looking at any such effects of 'slow' rTMS. This question is important as cognitive dysfunction accompanies many neuropsychiatric conditions and neuromodulation that potentially enhances or hinders such functioning has important clinical consequences. To determine cognitive effects of slow (≤1 Hz) rTMS, a systematic review of randomized control trials assayed cognition in neurological, psychiatric, and healthy volunteer ≤1 Hz rTMS paradigms. Both active (fast rTMS) and placebo comparators were included. 497 Records were initially obtained; 20 met inclusion criteria for evaluation. Four major categories emerged: mood disorders; psychotic disorders; cerebrovascular accidents; and 'other' (PTSD, OCD, epilepsy, anxiety, and tinnitus). Cognitive effects were measured across several domains: attention, executive functioning, learning, and psychomotor speed. Variability of study paradigms and reporting precluded meta-analytical analysis. No statistically significant improvement or deterioration was consistently found in any cognitive domain or illness category. These data support the overall safety of rTMS in not adversely affecting cognitive functioning. There are some data indicating that rTMS might have cognitive enhancing potential, but these are too limited at this time to make any firm conclusions, and the literature is marked by considerable heterogeneity in study parameters that hinder interpretation. Greater consensus is required in future studies in cognitive markers, and particularly in reporting of protocols. Future work should evaluate the effects of rTMS on cognitive training.

PMID: 27503083 [PubMed - as supplied by publisher]

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The Role of Trace Elements in Tinnitus.

The Role of Trace Elements in Tinnitus.

Biol Trace Elem Res. 2016 Aug 8;

Authors: Yaşar M, Şahin Mİ, Karakükçü Ç, Güneri E, Doğan M, Sağıt M

Abstract
In this study, we aimed to investigate the role of three trace elements, namely, zinc, copper, and lead, in tinnitus by analyzing the serum level of copper and lead and both the serum and tissue level of zinc. Eighty patients, who applied to outpatient otolaryngology clinic with the complaints of having tinnitus, and 28 healthy volunteers were included. High-frequency audiometry was performed, and participants who had hearing loss according to the pure tone average were excluded; tinnitus frequency and loudness were determined and tinnitus reaction questionnaire scores were obtained from the patients. Of all the participants, serum zinc, copper, and lead values were measured; moreover, zinc levels were examined in hair samples. The levels of trace elements were compared between tinnitus and control groups. The level of copper was found to be significantly lower in the tinnitus group (p = 0.02), but there was no significant difference between the groups in terms of the levels of zinc, neither in serum nor in hair, and lead in serum (p > 0.05). The lack of trace elements, especially that of "zinc," have been doubted for the etiopathogenesis of tinnitus in the literature; however, we only found copper levels to be low in patients having tinnitus.

PMID: 27502826 [PubMed - as supplied by publisher]

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Unilateral sudden hearing loss: a rare symptom of Moyamoya disease.

Related Articles

Unilateral sudden hearing loss: a rare symptom of Moyamoya disease.

Kulak Burun Bogaz Ihtis Derg. 2016;26(2):114-7

Authors: Gül F, Berçin S, Müderris T, Yalçıner G, Ünal Ö, Kırış M

Abstract
A 38-year-old female patient experienced a sudden onset of unilateral sensorineural hearing loss due to Moyamoya disease. A detailed summary of audiological and neurological findings indicated that the sudden hearing loss might be due to Moyamoya disease resulting in occlusion of posterior and middle cerebral arteries. Intravenous prednisolone and trimetazidine dihydrochloride may improve hearing thresholds and speech understanding. To our knowledge, this is the first article in the literature reporting a case of sudden hearing loss as the first manifestation of Moyamoya disease in a young adult.

PMID: 26890714 [PubMed - indexed for MEDLINE]

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Erratum to: Comparison of acyclovir and famciclovir for the treatment of Bell's palsy.

Erratum to: Comparison of acyclovir and famciclovir for the treatment of Bell's palsy.

Eur Arch Otorhinolaryngol. 2016 Aug 8;

Authors: Kim HJ, Kim SH, Jung J, Kim SS, Byun JY, Park MS, Yeo SG

PMID: 27501992 [PubMed - as supplied by publisher]

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Computer-assisted versus traditional freehand technique in fibular free flap mandibular reconstruction: a morphological comparative study.

Computer-assisted versus traditional freehand technique in fibular free flap mandibular reconstruction: a morphological comparative study.

Eur Arch Otorhinolaryngol. 2016 Aug 8;

Authors: De Maesschalck T, Courvoisier DS, Scolozzi P

Abstract
The purpose of the study was to compare the accuracy of computer-assisted surgery (CAS) and the traditional freehand technique for fibular free flap mandibular reconstruction as well as to evaluate the accuracy of the CAS planning. The medical records of 18 patients who underwent mandibular reconstruction with fibular free flap were reviewed. The CAS group (n = 7) benefited from virtual surgical planning and custom patient-specific plates and surgical cutting guides. The Control group (n = 11) was treated by conventional surgery. Morphometric comparison was done by calculating the differences in specific linear and angular parameters on pre- and postoperative CT-scans for both groups by using ProPlan CMF(®) software. Symmetry was also assessed by calculating the ratio of the affected versus the nonaffected side. In the CAS group, planned and postoperative CT-scans were compared to evaluate accuracy. The morphometric comparison showed no statistically significant differences between the groups except for the axial angle on the nonaffected side (mean difference 1.0° in the CAS group versus 2.9° in the Control group; p = 0.03). Ratios of the affected side over the nonaffected side showed no differences between the two groups. In the CAS group, the accuracy assessment showed a mean distance deviation of 2.3 mm for mandibular osteotomies and 1.9 mm for fibular osteotomies. Our results indicated that CAS and the conventional freehand techniques were comparable in their ability to provide a satisfactory morphological fibular free flap mandibular reconstruction. Moreover, the accuracy of the CAS technique was within the range reported in the literature.

PMID: 27501991 [PubMed - as supplied by publisher]

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