Inhaled Mannitol as a Laryngeal and Bronchial Provocation Test.

Inhaled Mannitol as a Laryngeal and Bronchial Provocation Test.

J Voice. 2016 Aug 23;

Authors: Tay TR, Hoy R, Richards AL, Paddle P, Hew M

Abstract
OBJECTIVES: Timely diagnosis of vocal cord dysfunction (VCD), more recently termed "inducible laryngeal obstruction," is important because VCD is often misdiagnosed as asthma, resulting in delayed diagnosis and inappropriate treatment. Visualization of paradoxical vocal cord movement on laryngoscopy is the gold standard for diagnosis, but is limited by poor test sensitivity. Provocation tests may improve the diagnosis of VCD, but the diagnostic performance of current tests is less than ideal. Alternative provocation tests are required. This pilot study demonstrates the feasibility of using inhaled mannitol for concurrent investigation of laryngeal and bronchial hyperresponsiveness.
METHODS: Consecutive patients with suspected VCD seen at our institution's asthma clinic underwent flexible laryngoscopy at baseline and following mannitol challenge. VCD was diagnosed on laryngoscopy based on inspiratory adduction, or >50% expiratory adduction of the vocal cords. Bronchial hyperresponsiveness after mannitol challenge was also assessed. We evaluated the interrater agreement of postmannitol laryngoscopy between respiratory specialists and laryngologists.
RESULTS: Fourteen patients with suspected VCD in the context of asthma evaluation were included in the study. Mannitol provocation demonstrated VCD in three of the seven patients with normal baseline laryngoscopy (42.9%). Only two patients had bronchial hyperresponsiveness. There was substantial interrater agreement between respiratory specialists and laryngologists, kappa = 0.696 (95% confidence interval: 0.324-1) (P = 0.006).
CONCLUSION: Inhaled mannitol can be used to induce VCD. It is well tolerated and can evaluate laryngeal and bronchial hyperresponsiveness at the same setting.

PMID: 27567392 [PubMed - as supplied by publisher]

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Translaryngeal percutaneous arytenoid lateralization technique in a canine cadaveric study.

Translaryngeal percutaneous arytenoid lateralization technique in a canine cadaveric study.

J Vet Emerg Crit Care (San Antonio). 2016 Aug 27;

Authors: Hardie RJ

Abstract
OBJECTIVE: To describe the technique for translaryngeal percutaneous arytenoid lateralization (TPAL) and the effect on rima glottidis cross-sectional area using a canine cadaveric model.
STUDY DESIGN: Ex vivo study.
ANIMALS: Canine cadavers (n = 9).
MATERIALS AND METHODS: With the aid of a laryngoscope, the larynx was visualized and a mattress suture (double-armed 2-0 polypropylene) was placed through the right arytenoid cartilage and exited the skin ventral to the jugular vein. The ends of the suture were passed through a button and tied on the skin to lateralize the right arytenoid cartilage. Digital images of the larynx were made before and after suture placement. Mean (±SD) rima glottidis cross-sectional area (mm(2) ) was calculated from the digital images and values before and after suture placement were compared using a paired t-test. A P value < 0.05 was considered significant. Change in cross-sectional area was expressed as percent increase.
RESULTS: Suture placement and the degree of arytenoid lateralization was relatively consistent in all dogs. Mean (±SD) cross-sectional area of the rima glottidis was 126.3 mm(2) (±7.74) before and 172.1 mm(2) (±24.7) after suture placement (P = 0.004). Mean percent increase in cross-sectional area was 25%.
CONCLUSION: The TPAL technique was effective at enlarging the rima glottidis in this canine cadaveric model. TPAL is rapid to perform and does not require specialized instrumentation. Results of this study support further investigation of the TPAL technique as an alternative to temporary tracheostomy for dogs in severe respiratory distress due to laryngeal paralysis.

PMID: 27566841 [PubMed - as supplied by publisher]

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Cancer patterns in Karachi (all districts), Pakistan: First results (2010-2015) from a Pathology based cancer registry of the largest government-run diagnostic and reference center of Karachi.

Cancer patterns in Karachi (all districts), Pakistan: First results (2010-2015) from a Pathology based cancer registry of the largest government-run diagnostic and reference center of Karachi.

Cancer Epidemiol. 2016 Aug 23;44:114-122

Authors: Qureshi MA, Mirza T, Khan S, Sikandar B, Zahid M, Aftab M, Mohsin S, Sharafat S, Avesi L, Hassan S

Abstract
National level population-based cancer data have never been published from Pakistan in seven decades since independence (1947). Therefore, generation of high-quality regional data becomes highly relevant. Cancer data for the period of 2010-2015 representing the population from all districts of Karachi (14.6 million) are presented herein. After institutional approval (Ref no. IRB-459/DUHS/-14), a Pathology based cancer registry was established at the largest government-run diagnostic and reference center of Karachi. During 2010-2015, a total of 13,508 cancers (including 686 non-melanoma-skin-cancers (NMSC)) were diagnosed. Of these, 5665 (41.9%) were in males while 7843 (58.1%) were in females. Incidence rates for all cancers (excluding NMSC) were 66.7 per 100,000 (crude) and 105.1 per 100,000 (ASR) for males and 112.0 per 100,000 (crude) and 175.8 per 100,000 (ASR) for females. In males, cancer of lip and oral cavity was the most frequently diagnosed cancer (30.8%, ASR 33.1), followed by NMSC (7.7%, ASR 9.5) and colorectum (7%, ASR 7.3). In females, breast cancer was the most frequently recorded malignancy (49.5%, ASR 87.9), followed by lip and oral cavity (11.2%, ASR 22.0) and oesophagus (5.6%, ASR 10.7). We report that Karachi has the highest incidence of cancers of breast, lip and oral cavity, oesophagus and larynx in females and cancer of lip and oral cavity and larynx (2nd only to Turkey) in males compared to any of the Asian populations. Notably, incidence of tobacco associated cancers is very high in Karachi, demanding urgent attention by relevant authorities to address the un-controlled and drastically high consumption of various forms of tobacco in the city.

PMID: 27566468 [PubMed - as supplied by publisher]

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Cancer cases attributable to alcohol consumption in Brazil.

Cancer cases attributable to alcohol consumption in Brazil.

Alcohol. 2016 Aug;54:23-6

Authors: Thuler LC, de Menezes RF, Bergmann A

Abstract
This is the first study specifically estimating the proportion of new cancer cases that could be attributable to alcohol consumption in the year 2012 in Brazil. The proportion of exposed cases and the association between alcohol and lip and oral cavity, nasopharynx, other pharynx, larynx, esophagus, colorectum, female breast, liver, and intrahepatic bile ducts cancers was based on data made available by the Integrator System of Hospital Cancer Registries. The cancer incidence was obtained from the estimates produced by GLOBOCAN. In 2012 there were 437,592 new cancer cases in Brazil, excluding non-melanoma skin cancers. Of these, alcohol consumption was responsible for 4.8% of all new cases. The alcohol-attributable fraction was higher for men (7.0%) than for women (2.6%). A total of 21,000 new cancer cases, 15,554 in men and 5,646 in women, could be attributable to alcohol consumption. In Brazil, a significant fraction of cancer cases can be attributed to alcohol consumption, and public health measures to prevent heavy alcohol use should be implemented.

PMID: 27565752 [PubMed - in process]

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Transforming growth factor-β1 activates ΔNp63/c-Myc to promote oral squamous cell carcinoma.

Transforming growth factor-β1 activates ΔNp63/c-Myc to promote oral squamous cell carcinoma.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Jun 8;

Authors: Hu L, Liu J, Li Z, Wang C, Nawshad A

Abstract
OBJECTIVE: During the development of oral squamous cell carcinoma (OSCC), the transformed epithelial cells undergo increased proliferation resulting in tumor growth and invasion. Interestingly, throughout all phases of differentiation and progression to OSCC, transforming growth factor-β1 (TGF)-β1 induces cell cycle arrest or apoptosis; however, the role of TGF-β1 in promoting cancer cell proliferation has not been explored in detail. The purpose of this study was to identify the effect of TGF-β1 on OSCC cell proliferation.
STUDY DESIGN: Using both human OSCC samples and cell lines (UMSCC38 and UMSCC11B), we assessed protein, mRNA, gene expression, and protein-DNA interactions during OSCC progression.
RESULTS: Our results showed that TGF-β1 increased OSCC cell proliferation by upregulating the expression of ΔNp63 and c-Myc oncogenes. Although the basal OSCC cell proliferation is sustained by activating ΔNp63, increased induction of c-Myc causes unregulated OSCC cell proliferation. Following induction of the cell cycle by ΔNp63 and c-Myc, cancer cells that halt c-Myc activity undergo epithelial mesenchymal transition or invasion while those that continue to express ΔNp63/c-Myc undergo unlimited progression through the cell cycle.
CONCLUSIONS: OSCC proliferation is manifested by the induction of c-Myc in response to TGF-β1 signaling, which is essential for OSCC growth. Our data highlight the potential role of TGF-β1 in the induction of cancer progression and invasion of OSCC.

PMID: 27567435 [PubMed - as supplied by publisher]

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Candidal carriage predicts candidiasis during topical immunosuppressive therapy: a preliminary retrospective cohort study.

Candidal carriage predicts candidiasis during topical immunosuppressive therapy: a preliminary retrospective cohort study.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Jun 29;

Authors: Tejani S, Sultan A, Stojanov I, Woo SB

Abstract
OBJECTIVES: To determine (1) the prevalence of candidal carriage in patients with oral mucosal disease to be treated with topical immunosuppressive therapy, and (2) the incidence of oral candidiasis among carriers and noncarriers after initiation of therapy to assess any correlation between carriage and the development of candidiasis.
STUDY DESIGN: Records of patients who underwent swab cultures for Candida between January 2009 and October 2014 at the Brigham and Women's Hospital in Boston, Massachusetts, were retrospectively reviewed. The prevalence of candidal carriage and incidence of candidiasis were determined by using descriptive statistics.
RESULTS: Of 99 evaluable patients, 20 (20.2%) were Candida positive and 79 (79.8%) were Candida negative. Of 44 patients with follow-up, 7 (15.9%) were Candida positive and 37 (84.1%) were Candida negative; five (11.4%) developed candidiasis. Four of seven (57.1%) Candida-positive patients developed candidiasis, whereas only one of 37 (2.7%) Candida-negative patients developed candidiasis (P = .0012).
CONCLUSIONS: The overall prevalence of candidal carriage was low (20.2%), and there was a significant difference in the incidence of candidiasis between carriers and noncarriers (P = .0012) after topical immunosuppressive therapy. Therefore, patients who are candidal carriers should be monitored closely for the development of secondary candidiasis and may be candidates for prophylactic antifungal therapy.

PMID: 27567434 [PubMed - as supplied by publisher]

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[Intraoperative navigation, with focus on the skull base].

[Intraoperative navigation, with focus on the skull base].

HNO. 2016 Aug 26;

Authors: Wirtz CR

Abstract
Intraoperative navigation systems are widely used in ENT, oral and maxillofacial, and neurosurgery. The benefits of such systems have been demonstrated in various applications, including intracranial and skull base surgery. Intraoperative shift, "brain shift" and changes in anatomy caused by the surgical procedure itself impair the accuracy of navigation and represent factors limiting its application, particularly in glioma and metastatic brain surgery. For this reason, intraoperative imaging was incorporated into neurosurgery. A specific application of navigation is thus skull base surgery, where shifts are often negligible due to the bony structures in which pathologies are embedded. Development of new systems with seamless integration into the operative workflow propagated routine use of navigation in neuro- and ENT surgery. Navigation proved especially helpful in interdisciplinary surgery with pathologies located in anatomic regions where competences of different surgical disciplines overlap, as in the skull base. While this increased radicality in tumour resection, there was a high risk of morbidity. The integration of electrophysiological function monitoring served to preserve function and reduce morbidity, and has led to less invasive and radical strategies in skull base surgery. New radiosurgical methods to adjuvantly treat possible tumour remnants have also supported this development. Systems allowing resection borders to be marked in the navigational coordinates would enable direct linking of these data to radiotherapy planning and better interpretation of follow-up imaging. Navigation is thus a valuable tool supporting interdisciplinary cooperation in skull base surgery for the benefit of patients.

PMID: 27566369 [PubMed - as supplied by publisher]

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Endoscopic Techniques in Tympanoplasty.

Endoscopic Techniques in Tympanoplasty.

Otolaryngol Clin North Am. 2016 Oct;49(5):1253-64

Authors: Anzola JF, Nogueira JF

Abstract
The endoscope has transformed the way we observe, understand, and treat chronic ear disease. Improved view, exclusive transcanal techniques, assessment of ventilation routes and mastoid tissue preservation have led to decreased morbidity and functional enhancement of minimally invasive reconstruction of the middle ear. The philosophical identity of endoscopic ear surgery is evolving; new research, long-term results, and widespread acknowledgement of its postulates will undoubtedly define its role in otology.

PMID: 27565390 [PubMed - in process]

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Endoscopic-Assisted Repair of Superior Canal Dehiscence.

Endoscopic-Assisted Repair of Superior Canal Dehiscence.

Otolaryngol Clin North Am. 2016 Oct;49(5):1189-204

Authors: Cheng YS, Kozin ED, Lee DJ

Abstract
Superior canal dehiscence (SCD) is a bony defect of the superior canal that can cause vestibular and/or auditory symptoms. Surgical repair of SCD provides effective relief from symptoms, and the middle fossa craniotomy approach with binocular microscopy offers direct visualization and surgical access to the arcuate eminence. However, for SCDs located along the downsloping tegmen medial to the peak of the arcuate eminence, a direct light of sight may be obscured, rendering visualization with traditional microscopy difficult. The endoscope is the ideal adjunct in middle fossa craniotomy approach SCD surgery and offers a safe, effective means to identify and repair arcuate eminence defects hidden from microscopic view.

PMID: 27565386 [PubMed - in process]

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Endoscopic Anatomy of the Protympanum.

Endoscopic Anatomy of the Protympanum.

Otolaryngol Clin North Am. 2016 Oct;49(5):1107-19

Authors: Jufas N, Marchioni D, Tarabichi M, Patel N

Abstract
The protympanum, a final common pathway between the tympanic cavity and external environment, is gaining relevance due to the ease and completeness of visualization with angled endoscopes. Two primary conformations are described, quadrangular and triangular, and new anatomic structures such as the protiniculum, subtensor recess, and protympanic spine are defined. Surgical relevance of the protympanum is described with respect to ventilation, cholesteatoma, cerebrospinal fluid leak, otic neuralgia, and surgical access to the eustachian tube.

PMID: 27565384 [PubMed - in process]

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Functional outcome after one-stage flap reconstruction of the hypopharynx following tumor ablation.

Functional outcome after one-stage flap reconstruction of the hypopharynx following tumor ablation.

Eur Arch Otorhinolaryngol. 2016 Aug 26;

Authors: van Brederode TD, Halmos GB, Stenekes MW

Abstract
The main objective of this study was to evaluate functional outcome in terms of food passage of the three different reconstruction techniques that are currently most often used for hypopharyngeal reconstruction in our institution. A retrospective observational database research was conducted of all patients that underwent hypopharyngeal reconstruction for carcinoma of the hypopharynx or larynx from 1992 until 2014 in the University Medical Center Groningen. The following techniques were most commonly used and therefore analyzed: the pedicled pectoralis major flap, the radial forearm free flap and the anterolateral thigh free flap. Our primary outcome food passage was measured after 1 year and classified in gastric tube fed, fluids, semisolid or solid. Complications were registered according to the Clavien Dindo classification in five different grades. Comorbidity was scored using the Adult Comorbidity Evaluation Index. 58 patients were included. 51 patients survived one year follow up, 25 % returned to a solid diet, 40 % returned to a semi-solid diet and 20 % remained feeding tube dependent. Overall flap success rate was 88 and 35 % developed a pharyngocutaneous fistula. Multivariable ordinal regression showed that reconstruction with free flaps, a near-circumferential surgical defect, a higher body mass index and no comorbidity showed significantly better functional outcomes in the food passage. For recipient site complications, both free flaps and a shorter surgery time resulted in less severe complications. This study shows that the use of free flaps is superior to the use of the pectoralis major flap, and that it should therefore be reserved as a second choice.

PMID: 27565158 [PubMed - as supplied by publisher]

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Cortical and subcortical processing of short duration speech stimuli in trained rock musicians: a pilot study.

Cortical and subcortical processing of short duration speech stimuli in trained rock musicians: a pilot study.

Eur Arch Otorhinolaryngol. 2016 Aug 26;

Authors: Kumar P, Anil SP, Grover V, Sanju HK, Sinha S

Abstract
Most trained musicians are actively involved in rigorous practice from several years to achieve a high level of proficiency. Therefore, musicians are best group to research changes or modification in brain structures and functions across several information processing systems. This study aimed to investigate cortical and subcortical processing of short duration speech stimuli in trained rock musicians and non-musicians. Two groups of participant (experimental and control groups) in the age range of 18-25 years were selected for the study. Experimental group includes 15 rock musicians who had minimum professional training of 5 years of rock music, and each member had to be a regular performer of rock music for at least 15 h a week. Further age-matched 15 participants who were not having any formal training of any music served as non-musicians, in the control group. The speech-evoked ABR (S-ABR) and speech-evoked ALLR (S-LLR) with short duration speech 'synthetic /da/' was elicited in both groups. Different measures were analyzed for S-ABR and S-LLR. For S-ABR, MANOVA revealed significant main effect of groups on latencies of wave V, wave A, and amplitude of wave V/A slope. Similarly, Kruskal-Wallis test showed significantly higher F 0 amplitude in rock musicians compared with non-musicians. For S-LLR, MANOVA showed statistically significant differences observed for latencies of wave P2 and N2 and amplitude measures of P2-N2 amplitude. This study indicated better neural processing of short duration speech stimuli at subcortical as well as cortical level among rock musicians when compared with non-musicians.

PMID: 27565157 [PubMed - as supplied by publisher]

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Stereocilia morphogenesis and maintenance through regulation of actin stability.

Stereocilia morphogenesis and maintenance through regulation of actin stability.

Semin Cell Dev Biol. 2016 Aug 23;

Authors: McGrath J, Roy P, Perrin BJ

Abstract
Stereocilia are actin-based protrusions on auditory and vestibular sensory cells that are required for hearing and balance. They convert physical force from sound, head movement or gravity into an electrical signal, a process that is called mechanoelectrical transduction. This function depends on the ability of sensory cells to grow stereocilia of defined lengths. These protrusions form a bundle with a highly precise geometry that is required to detect nanoscale movements encountered in the inner ear. Congenital or progressive stereocilia degeneration causes hearing loss. Thus, understanding stereocilia hair bundle structure, development, and maintenance is pivotal to understanding the pathogenesis of deafness. Stereocilia cores are made from a tightly packed array of parallel, crosslinked actin filaments, the length and stability of which are regulated in part by myosin motors, actin crosslinkers and capping proteins. This review aims to describe stereocilia actin regulation in the context of an emerging "tip turnover" model where actin assembles and disassembles at stereocilia tips while the remainder of the core is exceptionally stable.

PMID: 27565685 [PubMed - as supplied by publisher]

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Ménière's disease and biographical disruption: Where family transitions collide.

Ménière's disease and biographical disruption: Where family transitions collide.

Soc Sci Med. 2016 Aug 18;166:177-185

Authors: Bell SL, Tyrrell J, Phoenix C

Abstract
People's lived experiences of chronic illness have garnered increasing research interest over the last 30-40 years, with studies recognising the disruptive influence of illness onset and progression, both to people's everyday lives and to their biographical selves. We extend this body of work, drawing on the experiences of people living with Ménière's disease; a long-term progressive vestibular disorder characterised by unpredictable episodes of debilitating vertigo, tinnitus and permanent sensorineural hearing loss. In response to calls for more critical examination of the wider biographical contexts in which chronic illnesses are encountered, we draw on 28 in-depth narrative interviews with Ménière's patients and their family members to discuss how personal chronic illness experiences may be closely entwined with, and deeply shaped by, the life transitions (illness-related and otherwise) of 'linked others'. Interviews were conducted in south west England from January to June 2015. Focusing on intersecting transitions of parenthood, caregiving and retirement, we explore how and why familial relationships can both facilitate and hinder adaptation to a lifetime of chronically disrupted normalities, contributing to fluctuating experiences of 'cherished time', 'anomalous time' and 'turbulent time'. In so doing, we suggest that the onset and progression of chronic illness could usefully be re-conceptualised as one of many 'biographical oscillations' encountered during the life course that serve to re-route us between continually shifting life trajectories. In recognising life's dynamism and challenging the identity-limiting and self-damaging nature of entrenched cultural life course constructions, we suggest value in recognising alternative ways of 'living well' when negotiating the wide-ranging biographical maps that life can follow.

PMID: 27566047 [PubMed - as supplied by publisher]

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High-level language ability in healthy individuals and its relationship with verbal working memory.

High-level language ability in healthy individuals and its relationship with verbal working memory.

Clin Linguist Phon. 2016 Aug 24;:1-15

Authors: Antonsson M, Longoni F, Einald C, Hallberg L, Kurt G, Larsson K, Nilsson T, Hartelius L

Abstract
The aims of the study were to investigate healthy subjects' performance on a clinical test of high-level language (HLL) and how it is related to demographic characteristics and verbal working memory (VWM). One hundred healthy subjects (20-79 years old) were assessed with the Swedish BeSS test (Laakso, Brunnegård, Hartelius, & Ahlsén, 2000) and two digit span tasks. Relationships between the demographic variables, VWM and BeSS were investigated both with bivariate correlations and multiple regression analysis. The results present the norms for BeSS. The correlations and multiple regression analysis show that demographic variables had limited influence on test performance. Measures of VWM were moderately related to total BeSS score and weakly to moderately correlated with five of the seven subtests. To conclude, education has an influence on the test as a whole but measures of VWM stood out as the most robust predictor of HLL.

PMID: 27557807 [PubMed - as supplied by publisher]

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Lexical tone recognition in noise in normal-hearing children and prelingually deafened children with cochlear implants.

Lexical tone recognition in noise in normal-hearing children and prelingually deafened children with cochlear implants.

Int J Audiol. 2016 Aug 26;:1-8

Authors: Mao Y, Xu L

Abstract
OBJECTIVE: The purpose of the present study was to investigate Mandarin tone recognition in background noise in children with cochlear implants (CIs), and to examine the potential factors contributing to their performance.
DESIGN: Tone recognition was tested using a two-alternative forced-choice paradigm in various signal-to-noise ratio (SNR) conditions (i.e. quiet, +12, +6, 0, and -6 dB). Linear correlation analysis was performed to examine possible relationships between the tone-recognition performance of the CI children and the demographic factors.
STUDY SAMPLE: Sixty-six prelingually deafened children with CIs and 52 normal-hearing (NH) children as controls participated in the study.
RESULTS: Children with CIs showed an overall poorer tone-recognition performance and were more susceptible to noise than their NH peers. Tone confusions between Mandarin tone 2 and tone 3 were most prominent in both CI and NH children except for in the poorest SNR conditions. Age at implantation was significantly correlated with tone-recognition performance of the CI children in noise.
CONCLUSIONS: There is a marked deficit in tone recognition in prelingually deafened children with CIs, particularly in noise listening conditions. While factors that contribute to the large individual differences are still elusive, early implantation could be beneficial to tone development in pediatric CI users.

PMID: 27564095 [PubMed - as supplied by publisher]

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Corrigendum.

Corrigendum.

Int J Audiol. 2016 Aug 26;:1

Authors:

PMID: 27561903 [PubMed - as supplied by publisher]

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Development of a murine model of traumatic benign paroxysmal positional vertigo: a preliminary study.

Related Articles

Development of a murine model of traumatic benign paroxysmal positional vertigo: a preliminary study.

Acta Otolaryngol. 2016 Aug 26;:1-6

Authors: Yang CJ, Lee JW, Kim SJ, Lee CW, Park HJ

Abstract
CONCLUSION: The results showed a gradual detachment of otoconia in the utricle after a single event of head vibration, possibly explaining the frequent recurrence of BPPV attacks and persistent dizziness after trauma.
OBJECTIVES: This study developed a murine model of traumatic BPPV and observed the changes in otoconia detachment over time.
METHODS: Six-week-old CBA mice were used in this study. Otoconia detachment was induced by vibrating the head for 2 min. Utricles of mice were harvested from different groups: before the head vibration and 1 day, 1 week, 1 month, and 3 months after vibration application. Using scanning electron microscopy and ImageJ software, the percentage of the intact area of otoconia in the utricle was calculated. Hearing thresholds were compared among the groups.
RESULTS: The mean (± SD) percentages of the intact area of otoconia in the utricle were 98.1% ± 1.7% before the vibration and 93.6% ± 1.7%, 88.9% ± 5.3%, 78.2% ± 20.9%, and 38.9% ± 24.1% at 1 day, 1 week, 1 month, and 3 months after the vibration, respectively. The percentage decreased significantly over time after the vibration (p < .001). The hearing thresholds were not different among the groups.

PMID: 27564837 [PubMed - as supplied by publisher]

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Endolymphatic hydrops in patients with unilateral and bilateral Meniere's disease.

Related Articles

Endolymphatic hydrops in patients with unilateral and bilateral Meniere's disease.

Acta Otolaryngol. 2016 Aug 26;:1-6

Authors: Morimoto K, Yoshida T, Sugiura S, Kato M, Kato K, Teranishi M, Naganawa S, Nakashima T, Sone M

Abstract
CONCLUSION: All definite Meniere's disease (MD) had endolymphatic hydrops (EH) at least in the cochlea or the vestibule. Symptoms of MD may appear after formation of EH. It is assumed that the probability of immediate progression to bilateral MD from unilateral MD is very low in patients without EH on the non-affected side.
OBJECTIVE: To evaluate the EH on both sides in patients with unilateral and bilateral MD, and to investigate factors with progression to bilateral MD including the degree of EH, hearing level, and the duration of MD.
PATIENTS AND METHODS: The study included 29 patients with unilateral definite MD and 12 patients with bilateral definite MD. The endolymphatic space size was visualized by using 3-Tesla magnetic resonance imaging.
RESULTS: All patients with unilateral and bilateral MD had significant or mild EH at least in the cochlea or the vestibule on the affected side. On the non-affected side, EH was not observed at all in eight patients, but asymptomatic EH was observed in the cochlea in 14 patients and in the vestibule in 16 patients. There was no relationship between the EH on the non-affected side and the duration of MD.

PMID: 27564645 [PubMed - as supplied by publisher]

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Diagnostic criteria of barotraumatic perilymph fistula based on clinical manifestations.

Related Articles

Diagnostic criteria of barotraumatic perilymph fistula based on clinical manifestations.

Acta Otolaryngol. 2016 Aug 26;:1-7

Authors: Choi JE, Moon IJ, Kim H, Lee K, Cho YS, Chung WH

Abstract
CONCLUSIONS: Patients with sudden hearing loss and dizziness after barotrauma should be suspected of barotraumatic perilymph fistula (PLF). Early surgical repair of PLF showed better hearing outcomes. Therefore, diagnostic criteria should help surgical indications of barotraumatic PLF.
OBJECTIVES: The aim of this study was to establish diagnostic criteria for barotraumatic PLF.
METHODS: Twenty-four patients (26 ears) underwent surgery on suspicion of barotraumatic PLF. The causes of barotrauma and clinical symptoms were analyzed by surgical findings. Diagnostic criteria of PLF were proposed according to its clinical manifestations.
RESULTS: Definite PLF (17 subjects) was confirmed by any evidence of perilymph leak through oval and round windows. For the other seven subjects (probable PLF), even though there was no evidence of perilymph leak, their clinical manifestations were similar to definite PLF. High frequency hearing loss occurred as an early symptom after barotrauma. Positional dizziness occurred a few hours after auditory symptoms (67%). Positional nystagmus was observed in 10 cases. The characteristics of positional nystagmus were multi-directional, longer in duration, smaller in amplitude, no reversibility, and no response to repositioning maneuver. Regarding the surgical outcomes, hearing was significantly improved in the early repaired PFL group, and dizziness was improved in 96% of patients.

PMID: 27564530 [PubMed - as supplied by publisher]

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Semantic Processing in Deaf and Hard-of-Hearing Children: Large N400 Mismatch Effects in Brain Responses, Despite Poor Semantic Ability.

Semantic Processing in Deaf and Hard-of-Hearing Children: Large N400 Mismatch Effects in Brain Responses, Despite Poor Semantic Ability.

Front Psychol. 2016;7:1146

Authors: Kallioinen P, Olofsson J, Nakeva von Mentzer C, Lindgren M, Ors M, Sahlén BS, Lyxell B, Engström E, Uhlén I

Abstract
Difficulties in auditory and phonological processing affect semantic processing in speech comprehension for deaf and hard-of-hearing (DHH) children. However, little is known about brain responses related to semantic processing in this group. We investigated event-related potentials (ERPs) in DHH children with cochlear implants (CIs) and/or hearing aids (HAs), and in normally hearing controls (NH). We used a semantic priming task with spoken word primes followed by picture targets. In both DHH children and controls, cortical response differences between matching and mismatching targets revealed a typical N400 effect associated with semantic processing. Children with CI had the largest mismatch response despite poor semantic abilities overall; Children with CI also had the largest ERP differentiation between mismatch types, with small effects in within-category mismatch trials (target from same category as prime) and large effects in between-category mismatch trials (where target is from a different category than prime), compared to matching trials. Children with NH and HA had similar responses to both mismatch types. While the large and differentiated ERP responses in the CI group were unexpected and should be interpreted with caution, the results could reflect less precision in semantic processing among children with CI, or a stronger reliance on predictive processing.

PMID: 27559320 [PubMed]

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"Ear Nose Throat J"[jour]; +19 new citations

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"Ear Nose Throat J"[jour]

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Lexical tone recognition in noise in normal-hearing children and prelingually deafened children with cochlear implants.

Lexical tone recognition in noise in normal-hearing children and prelingually deafened children with cochlear implants.

Int J Audiol. 2016 Aug 26;:1-8

Authors: Mao Y, Xu L

Abstract
OBJECTIVE: The purpose of the present study was to investigate Mandarin tone recognition in background noise in children with cochlear implants (CIs), and to examine the potential factors contributing to their performance.
DESIGN: Tone recognition was tested using a two-alternative forced-choice paradigm in various signal-to-noise ratio (SNR) conditions (i.e. quiet, +12, +6, 0, and -6 dB). Linear correlation analysis was performed to examine possible relationships between the tone-recognition performance of the CI children and the demographic factors.
STUDY SAMPLE: Sixty-six prelingually deafened children with CIs and 52 normal-hearing (NH) children as controls participated in the study.
RESULTS: Children with CIs showed an overall poorer tone-recognition performance and were more susceptible to noise than their NH peers. Tone confusions between Mandarin tone 2 and tone 3 were most prominent in both CI and NH children except for in the poorest SNR conditions. Age at implantation was significantly correlated with tone-recognition performance of the CI children in noise.
CONCLUSIONS: There is a marked deficit in tone recognition in prelingually deafened children with CIs, particularly in noise listening conditions. While factors that contribute to the large individual differences are still elusive, early implantation could be beneficial to tone development in pediatric CI users.

PMID: 27564095 [PubMed - as supplied by publisher]

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Corrigendum.

Corrigendum.

Int J Audiol. 2016 Aug 26;:1

Authors:

PMID: 27561903 [PubMed - as supplied by publisher]

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Motivational Interviewing as an Adjunct to Hearing Rehabilitation for Patients with Tinnitus: A Randomized Controlled Pilot Trial.

Motivational Interviewing as an Adjunct to Hearing Rehabilitation for Patients with Tinnitus: A Randomized Controlled Pilot Trial.

J Am Acad Audiol. 2016 Sep;27(8):669-676

Authors: Zarenoe R, Söderlund LL, Andersson G, Ledin T

Abstract
PURPOSE: To test the effects of a brief motivational interviewing (MI) program as an adjunct to hearing aid rehabilitation for patients with tinnitus and sensorineural hearing loss.
RESEARCH DESIGN: This was a pilot randomized controlled trial.
STUDY SAMPLE: The sample consisted of 50 patients aged between 40 and 82 yr with both tinnitus and sensorineural hearing loss and a pure-tone average (0.5, 1, 2, and 4 kHz) < 70 dB HL. All patients were first-time hearing aid users.
INTERVENTION: A brief MI program was used during hearing aid fitting in 25 patients, whereas the remainder received standard practice (SP), with conventional hearing rehabilitation.
DATA COLLECTION AND ANALYSIS: A total of 46 patients (N = 23 + 23) with tinnitus were included for further analysis. The Tinnitus Handicap Inventory (THI) and the International Outcome Inventory for Hearing Aids (IOI-HA) were administered before and after rehabilitation. THI was used to investigate changes in tinnitus annoyance, and the IOI-HA was used to determine the effect of hearing aid treatment.
RESULTS: Self-reported tinnitus disability (THI) decreased significantly in the MI group (p < 0.001) and in the SP group (p < 0.006). However, there was greater improvement in the MI group (p < 0.013). Furthermore, the findings showed a significant improvement in patients' satisfaction concerning the hearing aids (IOI-HA, within both groups; MI group, p < 0.038; and SP group, p < 0.026), with no difference between the groups (p < 0.99).
CONCLUSION: Tinnitus handicap scores decrease to a greater extent following brief MI than following SP. Future research on the value of incorporating MI into audiological rehabilitation using randomized controlled designs is required.

PMID: 27564444 [PubMed - as supplied by publisher]

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Manganese and Lipoflavonoid Plus(®) to Treat Tinnitus: A Randomized Controlled Trial.

Manganese and Lipoflavonoid Plus(®) to Treat Tinnitus: A Randomized Controlled Trial.

J Am Acad Audiol. 2016 Sep;27(8):661-668

Authors: Rojas-Roncancio E, Tyler R, Jun HJ, Wang TC, Ji H, Coelho C, Witt S, Hansen MR, Gantz BJ

Abstract
BACKGROUND: Several tinnitus sufferers suggest that manganese has been helpful with their tinnitus.
PURPOSE: We tested this in a controlled experiment where participants were committed to taking manganese and Lipoflavonoid Plus(®) to treat their tinnitus.
RESEARCH DESIGN: Randomized controlled trial.
STUDY SAMPLE: 40 participants were randomized to receive both manganese and Lipoflavonoid Plus(®) for 6 months, or Lipoflavonoid Plus(®) only (as the control).
DATA COLLECTION AND ANALYSIS: Pre- and postmeasures were obtained with the Tinnitus Handicap Questionnaire, Tinnitus Primary Functions Questionnaire, and tinnitus loudness and annoyance ratings. An audiologist performed the audiogram, the tinnitus loudness match, and minimal masking level.
RESULTS: Twelve participants were dropped out of the study because of the side effects or were lost to follow-up. In the manganese group, 1 participant (out of 12) showed a decrease in the questionnaires, and another showed a decrease in the loudness and annoyance ratings. No participants from the control group (total 16) showed a decrease in the questionnaires ratings. Two participants in the control group reported a loudness decrement and one reported an annoyance decrement.
CONCLUSIONS: We were not able to conclude that either manganese or Lipoflavonoid Plus(®) is an effective treatment for tinnitus.

PMID: 27564443 [PubMed - as supplied by publisher]

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Compensating Artificial Airway Resistance via Active Expiration Assistance.

Compensating Artificial Airway Resistance via Active Expiration Assistance.

Respir Care. 2016 Aug 23;

Authors: Wirth S, Seywert L, Spaeth J, Schumann S

Abstract
BACKGROUND: Artificial airway resistance as provided by small-lumen tracheal tubes or catheters increases the risk of intrinsic PEEP (PEEPi). We hypothesized that by active expiration assistance, larger minute volumes could be generated without causing PEEPi compared with conventional mechanical ventilation when using small-lumen tracheal tubes or a cricothyrotomy catheter.
METHODS: We investigated the active expiration assistance in a physical model of the respiratory system and estimated its hypothetical performance in terms of maximal flow generated with endotracheal tubes ranging from 3.0 to 8.0 mm inner diameter (ID); with microlaryngeal tubes of 4.0, 5.0, and 6.0 mm ID; and with a cricothyrotomy catheter. Furthermore, we determined the minute volumes that could be achieved without generating PEEPi by ventilating a physical lung model using conventional mechanical ventilation or using active expiration assistance.
RESULTS: The inspiratory and expiratory flow during active expiration assistance increased with increasing supply flow and decreased with decreasing ID of the connected endotracheal tubes (both P < .001). With small-lumen tracheal tubes, the active expiration assistance generated similar or higher minute volumes than conventional ventilation. Conventional mechanical ventilation with PEEPi <1 cm H2O was not achievable via a microlaryngeal tube of 4.0 mm ID and smaller lumen tubes.
CONCLUSIONS: For mechanical ventilation via small-lumen tubes or thin catheters, active compensation of airway resistance might be a necessary means to generate adequate minute ventilation without causing PEEPi. Active expiration assistance can generate reasonable respiratory minute volumes via small-lumen tubes or thin catheters.

PMID: 27555619 [PubMed - as supplied by publisher]

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[Surgery of benign vocal fold lesions].

Related Articles

[Surgery of benign vocal fold lesions].

HNO. 2016 Aug 23;

Authors: Olthoff A

Abstract
Surgical treatment of benign vocal fold lesions can be indicated for clinical or functional reasons. The principles of phonosurgery have to be maintained in either case. The appropriate phonosurgical technique depends on the type of vocal fold lesion. Depending on the findings, phonosurgery aims to maintain or improve voice quality. The evaluation of clinical and functional results includes indirect laryngoscopy, videostroboscopy, and voice analysis.

PMID: 27552826 [PubMed - as supplied by publisher]

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Anaplastic Lymphoma Kinase-Negative Anaplastic Large Cell Lymphoma Manifesting as a Scalp Hematoma After an Acute Head Injury-a Case Report and Literature Review.

Related Articles

Anaplastic Lymphoma Kinase-Negative Anaplastic Large Cell Lymphoma Manifesting as a Scalp Hematoma After an Acute Head Injury-a Case Report and Literature Review.

World Neurosurg. 2016 Apr;88:688.e13-6

Authors: Yeung CY, Hong KT, Chiang CP, Chen YH, Ma HI, Tsai TH

Abstract
BACKGROUND: Anaplastic large cell lymphoma (ALCL) is a malignant non-Hodgkin lymphoma, typically associated with anaplastic lymphoma kinase (ALK) expression. In some cases, lack of ALK translocation correlated with a more unfavorable prognosis.
CASE DESCRIPTION: We describe a case of ALK(-) ALCL that manifested as a progressive, enlarged, swollen mass on the scalp after an acute head injury in an 84-year-old man. Neither palpable lymph nodes nor any B symptoms were noted on admission. Brain computed tomography showed a hematoma in the right posterior occipital region of the scalp as the only remarkable finding. Débridement and biopsy were performed. Histologic and immunohistochemical analysis of the specimen revealed an ALK(-) ALCL of the scalp. The lymphoma was resistant to bendamustine-containing chemotherapies, ultimately leading to the patient's death within 2 months.
CONCLUSIONS: This case report highlights the importance of recognizing the possibility of an ALCL manifesting as a focal inflammatory swelling mass on the scalp.

PMID: 26615790 [PubMed - indexed for MEDLINE]

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A Safe Method for Middle Colic Dissection and Ligation at its Origin in a Laparoscopic Extended Right Hemicolectomy.

A Safe Method for Middle Colic Dissection and Ligation at its Origin in a Laparoscopic Extended Right Hemicolectomy.

Ann Surg Oncol. 2016 Aug 22;

Authors: Koh FH, Tan KK

Abstract
BACKGROUND: Laparoscopic extended right hemicolectomy is regarded as one of the more difficult procedures in colorectal surgery due to the complexity of the dissection around the pancreatic neck to identify the origin of the middle colic artery.1 Proper identification and ligation of the middle colic artery at its origin is paramount to achieve complete mesocolic excision.2 (,) 3 We describe our technique of middle colic vessels dissection in a laparoscopic extended right hemicolectomy.
METHODS: Our patient was a 58-year-old female with a stenosing transverse colon adenocarcinoma. The video highlights the key steps of a laparoscopic extended right hemicolectomy with special attention to the dissection and identification of the origin of the middle colic vessels at the pancreatic neck. We utilized a posterior-to-anterior approach for the dissection around the superior mesenteric pedicle.
RESULTS: By carefully skeletonizing the pancreas from the body to the neck, the superior mesentery pedicle is isolated and skeletonized to identify the origin of the middle colic vessels. A posterior-to-anterior approach is used to complete the skeletonisation before ligation of the middle colic vessels at its origin. Operative time was 288 min with an estimated blood loss of 40 ml. The patient recovered well without complications of pancreatitis and was discharged on postoperative day 5. Histology revealed a 4-cm moderately differentiated adenocarcinoma with 10 of 34 lymph nodes involved-pT3N2b.
CONCLUSIONS: With the increasing popularity of laparoscopic surgery, meticulous laparoscopic dissection of the middle colic vessels is feasible and safe and may potentially help to optimize oncological outcomes for laparoscopic extended right hemicolectomy.

PMID: 27550618 [PubMed - as supplied by publisher]

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Bilateral vocal fold paralysis and dysphagia secondary to diffuse idiopathic skeletal hyperostosis.

Related Articles

Bilateral vocal fold paralysis and dysphagia secondary to diffuse idiopathic skeletal hyperostosis.

Head Neck. 2016 Aug 24;

Authors: Allensworth JJ, O'Dell KD, Schindler JS

Abstract
BACKGROUND: Diffuse idiopathic skeletal hyperostosis (DISH) is an idiopathic spinal disease common in the elderly and characterized by flowing ossification and osteophyte formation along the spinal column. Cervical hyperostosis is capable of producing dysphagia, stridor, and airway obstruction; however, there are no extant reports of true paralysis of bilateral vocal folds in patients fulfilling the criteria for DISH.
METHODS AND RESULTS: We report a case of a 61-year-old man presenting with dysphagia and dyspnea. Flexible laryngoscopy revealed bilateral true vocal fold paralysis. Cervical radiograph showed flowing ossification of the anterior longitudinal ligament with preservation of intervertebral disc height. Tracheotomy and cervical osteophytectomy were performed, after which the patient showed improved swallowing and speaking ability and was decannulated without complication.
CONCLUSION: In the case presented, cervical osteophytectomy dramatically reversed bilateral vocal fold paralysis and dysphagia secondary to hyperostosis, thus negating the need for prolonged tracheostomy and feeding tube dependence. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27557480 [PubMed - as supplied by publisher]

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Cost-benefit analysis of the intraoperative parathyroid hormone assay in primary hyperparathyroidism.

Related Articles

Cost-benefit analysis of the intraoperative parathyroid hormone assay in primary hyperparathyroidism.

Head Neck. 2016 Aug 24;

Authors: Badii B, Staderini F, Foppa C, Tofani L, Skalamera I, Fiorenza G, Qirici E, Cianchi F, Perigli G

Abstract
BACKGROUND: The purpose of this study was to evaluate the usefulness of the routine intraoperative intact parathyroid hormone (IOPTH) assay, the role of unilateral and bilateral cervical exploration and of preoperative imaging, and to do a cost-benefit analysis in parathyroidectomy for primary hyperparathyroidism.
METHODS: Two hundred sixty-four patients who underwent operations between January 2000 and March 2015 were retrospectively divided into 2 groups.
RESULTS: Group A (IOPTH) was composed of 64 patients. Ultrasonography and technetium-99m-sestamibi (MIBI) identified the adenoma in 38 cases. Bilateral exploration was performed in 43 patients; of which 2 failures occurred. The IOPTH false-negative rate was 18.4%. The average cost was €1297.30. Group B (without IOPTH) was composed of 200 patients. Ultrasonography and MIBI identified the adenoma in 113 cases. Bilateral exploration was performed in 129 patients; of which 2 failures occurred. The average cost was €618.75.
CONCLUSION: The IOPTH assay should be used only in few selected cases because of its high cost. The experience of the team is essential to obtain a high cure rate. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27557453 [PubMed - as supplied by publisher]

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