Last Thursday (8/25/2016), SLHS welcomed the new Master’s students at the annual pizza party! Our new recruits for the MA education program in speech-language pathology are excited to join the school! They were able to mingle with the second year MA students, doctoral students, and faculty, and learn more about life in SLHS.
Welcome to the new recruits!
[See image gallery at slhs.sdsu.edu]
Dysphagia in Amyotrophic Lateral Sclerosis: Relationships between disease progression and Fiberoptic Endoscopic Evaluation of Swallowing.
Auris Nasus Larynx. 2016 Aug 25;
Authors: Fattori B, Siciliano G, Mancini V, Bastiani L, Bongioanni P, Caldarazzo Ienco E, Barillari MR, Romeo SO, Nacci A
Abstract
OBJECTIVE: Our aim was to evaluate the relationship between the disease severity of Amyotrophic Lateral Sclerosis (ALS) and the following parameters of Fiberoptic Endoscopic Evaluation of Swallowing (FEES): premature spillage, post-swallowing residue and aspiration.
METHODS: We studied 202 patients (95 women and 107 men) with ALS; of these, 136 had spinal and 66 had bulbar onset. They were analyzed according to the Amyotrophic Lateral Sclerosis Functioning Rating Scale (ALSFRS) and the b-ALSFRS subscale (bulbar scale). All subjects underwent FEES. Post-swallowing residue was classified into four classes (0-3); premature spillage and aspiration were considered either present or absent.
RESULTS: Spearman's correlation test showed a highly significant correlation (p<0.0001) between the value of ALSFRS and b-ALSFRS and the FEES parameters as the following: disease severity and dysphagia severity are closely related, both in spinal and bulbar onset, no matter what bolus texture was used. Spearman's Rho was more significant for post-swallowing residue, ≤-0.500 with all three consistencies (p<0.0001) in spinal onset and -0.520 only with liquid bolus (p<0.0001) in bulbar onset. Independent T-Test revealed a significant difference (p<0.0001) between the mean ALSFRS and b-ALSFRS scores and the presence/absence of aspiration. For the premature spillage in spinal onset (ALSFRS), we found a statistically significant difference for all three bolus textures (p<0.0001). Analysis of variance for the post-swallowing residue in spinal onset (ALSFRS) revealed a statistically significant difference (p<0.0001) for most of the comparisons between groups for all three textures. For the premature spillage in bulbar onset (b-ALSFRS), we found a statistically significant difference for all three textures (p<0.0001). Analysis of variance for the post-swallowing residue in bulbar onset (b-ALSFRS) showed a statistically significant difference (p<0.0001) for most of the comparisons between groups for all three textures. Kruskal-Wallis test showed a highly significant association between the classes of severity in bulbar forms and all the FEES parameters, no matter what type of bolus was administered (p<0.0001), whereas a significant correlation in spinal forms only for post-swallowing residue with solid (p=0.026) and semisolid (p=0.031) boluses.
CONCLUSION: There is a highly significant relationship as the following between the FEES parameters and the disease severity assessed via ALSFRS and b-ALSFRS: classes of greater severity entail a greater deterioration of FEES parameters. FEES can be considered a good indicator of the dysphagia severity and a useful test for the follow-up of dysphagia in patients with ALS, whether of spinal or bulbar onset.
PMID: 27569290 [PubMed - as supplied by publisher]
Recovery of endocochlear potential after severe damage to lateral wall fibrocytes following acute cochlear energy failure.
Neuroreport. 2016 Aug 26;
Authors: Kitao K, Mizutari K, Nakagawa S, Matsunaga T, Fukuda S, Fujii M
Abstract
Reduction of endocochlear potential (EP) is one of the main causes of sensorineural hearing loss. In this study, we investigated changes in the EP using a mouse model of acute cochlear energy failure, which comprised severe cochlear lateral wall damage induced by the local administration of 3-nitropropionic acid to the inner ear. We also analyzed the correlation between EP changes and histological findings in the cochlear lateral wall. We detected the recovery of the EP and hearing function at lower frequencies after severe damage of the cochlear lateral wall fibrocytes at the corresponding region. Remodeling of the cochlear lateral wall was associated with EP recovery, including the re-expression of ion transporters or gap junctions (i.e. Na/K/ATPase-β1 and connexin 26). These results indicate a mechanism for late-phase hearing recovery after severe deafness, which is frequently observed in clinical settings.
PMID: 27571432 [PubMed - as supplied by publisher]
Management of advanced hypopharyngeal and laryngeal cancer with and without cartilage invasion.
Auris Nasus Larynx. 2016 Aug 25;
Authors: Scherl C, Mantsopoulos K, Semrau S, Fietkau R, Kapsreiter M, Koch M, Traxdorf M, Grundtner P, Iro H
Abstract
OBJECTIVE: To compare efficacy, in terms of disease control/survival in advanced hypopharyngeal and laryngeal lesions, according to treatment strategy (primary surgery, PS or primary chemoradiotherapy, CRT) and invasion pattern (cartilage, CAI or soft tissue involvement, STI).
METHODS: Records from 463 patients with T3 and T4a carcinoma with CAI (n=221) or STI (n=242) treated at a university clinic over 18 years were retrospectively reviewed.
RESULTS: Disease-specific survival (DSS) for the CAI group was 70.1% (PS) and 38.4% (CRT), and 76.6% and 46% for the STI group, respectively. Overall survival (OS) for STI was 56.4% (PS) and 30.6% (CRT), and for CAI 51.1% (PS) and 28.5% (CRT) respectively. Positive resection margins and regional neck metastases reduced survival. T3 lesions treated non-operatively still had significantly improved survival versus T4a by >20%.
CONCLUSION: Surgery remains an indispensable part of treatment in local advanced hypopharyngeal and laryngeal cancer with high survival results. It should be part of a concept that includes adjuvant (C)RT. For T3 lesions, primary CRT is also acceptable and CAI is not a contraindication for primary CRT. Regional disease is a strong prognostic factor. In spite of adjuvant treatment, DSS deteriorates by about 20% in cases with positive resection margins.
PMID: 27569289 [PubMed - as supplied by publisher]
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Novel Anatomic Characteristics of the Laryngeal Framework: A Computed Tomography Evaluation.
Otolaryngol Head Neck Surg. 2016 Apr;154(4):674-8
Authors: Sagiv D, Eyal A, Mansour J, Nakache G, Wolf M, Primov-Fever A
Abstract
OBJECTIVE: The thyroid cartilage (TC) in men has a more prominent thyroid notch and a narrower interlaminae angle (ILA) as compared with women. Anatomy textbooks classically stipulate that the ILA is 90° in men and 120° in women. Our observation, based on thyroid chondroplasty operations, of a much narrower angle led to the current investigation.
STUDY DESIGN: Cohort imaging study.
SETTING: Tertiary academic referral center.
SUBJECTS AND METHODS: Computed tomography angiography neck images of adult patients were studied. The ILA was measured on 2 axial planes: at the level of the vocal processes (and the upper portion of thyroarytenoid muscles) and 5 mm superior and parallel to the former. The anterior projection of the TC and the vertical dimensions of the midline cricothyroid membrane (CTM) were also measured.
RESULTS: A total of 126 patients were included in the study. The average ILAs were 63.5°±20.6° and 93.3°±16.6° for men and women, respectively (P < 10(-14)), and were significantly narrower at the upper level in comparison with the vocal process level (P < 10(-7) for men, P = .004 for women). The anterior projection of the TC in men was more prominent as compared with women (P = .0003) and significantly correlated with the ILA (P = .0159). The length of the midline CTM was 11.1±2.3 mm in men and 10.3±1.7 mm in women (P = .0355).
CONCLUSIONS: The ILA is narrower than that reported in the classic anatomy textbooks. In male patients, the upper part of the TC becomes narrower and projects anteriorly like a "jug's spout." The mean vertical dimension of the midline CTM was 10 to 11 mm.
PMID: 26861235 [PubMed - indexed for MEDLINE]
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Barrett's Esophagus: A Comprehensive and Contemporary Review for Pathologists.
Am J Surg Pathol. 2016 May;40(5):e45-66
Authors: Naini BV, Souza RF, Odze RD
Abstract
This review provides a summary of our current understanding of, and the controversies surrounding, the diagnosis, pathogenesis, histopathology, and molecular biology of Barrett's esophagus (BE) and associated neoplasia. BE is defined as columnar metaplasia of the esophagus. There is worldwide controversy regarding the diagnostic criteria of BE, mainly with regard to the requirement to histologically identify goblet cells in biopsies. Patients with BE are at increased risk for adenocarcinoma, which develops in a metaplasia-dysplasia-carcinoma sequence. Surveillance of patients with BE relies heavily on the presence and grade of dysplasia. However, there are significant pathologic limitations and diagnostic variability in evaluating dysplasia, particularly with regard to the more recently recognized unconventional variants. Identification of non-morphology-based biomarkers may help risk stratification of BE patients, and this is a subject of ongoing research. Because of recent achievements in endoscopic therapy, there has been a major shift in the treatment of BE patients with dysplasia or intramucosal cancer away from esophagectomy and toward endoscopic mucosal resection and ablation. The pathologic issues related to treatment and its complications are also discussed in this review article.
PMID: 26813745 [PubMed - indexed for MEDLINE]
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A Fast Semiautomatic Algorithm for Centerline-Based Vocal Tract Segmentation.
Biomed Res Int. 2015;2015:906356
Authors: Poznyakovskiy AA, Mainka A, Platzek I, Mürbe D
Abstract
Vocal tract morphology is an important factor in voice production. Its analysis has potential implications for educational matters as well as medical issues like voice therapy. The knowledge of the complex adjustments in the spatial geometry of the vocal tract during phonation is still limited. For a major part, this is due to difficulties in acquiring geometry data of the vocal tract in the process of voice production. In this study, a centerline-based segmentation method using active contours was introduced to extract the geometry data of the vocal tract obtained with MRI during sustained vowel phonation. The applied semiautomatic algorithm was found to be time- and interaction-efficient and allowed performing various three-dimensional measurements on the resulting model. The method is suitable for an improved detailed analysis of the vocal tract morphology during speech or singing which might give some insights into the underlying mechanical processes.
PMID: 26557710 [PubMed - indexed for MEDLINE]
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Treatment of Hemorrhagic Vocal Polyps by Pulsed Dye Laser-Assisted Laryngomicrosurgery.
Biomed Res Int. 2015;2015:820654
Authors: Byeon HK, Han JH, Choi BI, Hwang HJ, Kim JH, Choi HS
Abstract
OBJECTIVE: Conventional surgical techniques of laryngomicrosurgery (LMS) on hemorrhagic vocal polyps are often difficult due to obscuration of the surgical field by inadvertent bleeding from the lesion, and there are often significant amounts of mucosal epithelium loss. Here, we introduce our surgical technique using pulsed dye laser (PDL), which can effectively resect the polyp with vocal fold mucosa preservation.
METHODS: Patients who were diagnosed with hemorrhagic vocal polyp and who were surgically managed using PDL from March 2013 to October 2014 were retrospectively reviewed. Preoperative and postoperative clinical outcomes and surgical findings were evaluated.
RESULTS: A total of 39 patients were treated with PDL-assisted enucleation LMS. The average age was 43.7 years (range 20-73), and there were 20 males and 19 females (17 professional voice users). In all cases, the hemorrhagic polyp was successfully enucleated after application of PDL, thereby preserving the overlying epithelium. Postoperative voice outcomes were favorable with clear preservation of the vocal fold mucosal wave.
CONCLUSION: PDL-assisted enucleation LMS for the treatment of hemorrhagic vocal polyps can be a safe and effective surgical technique. It can be considered a promising treatment option for hemorrhagic vocal polyps.
PMID: 26557700 [PubMed - indexed for MEDLINE]
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Stem Cell Therapy in Injured Vocal Folds: A Three-Month Xenograft Analysis of Human Embryonic Stem Cells.
Biomed Res Int. 2015;2015:754876
Authors: Svensson B, Nagubothu SR, Nord C, Cedervall J, Hultman I, Ährlund-Richter L, Tolf A, Hertegård S
Abstract
We have previously shown that human embryonic stem cell (hESC) therapy to injured rabbit vocal folds (VFs) induces human tissue generation with regained VF vibratory capacity. The aims of this study were to test the sustainability of such effect and to what extent derivatives of the transplanted hESCs are propagated in the VFs. The VFs of 14 New Zealand rabbits were injured by a localized resection. HESCs were transplanted to 22 VFs which were analyzed for persistence of hESCs after six weeks and after three months. At three months, the VFs were also analyzed for viscoelasticity, measured as dynamic viscosity and elastic modulus, for the lamina propria (Lp) thickness and relative content of collagen type I. Three months after hESC cell therapy, the dynamic viscosity and elastic modulus of the hESC treated VFs were similar to normal controls and lower than untreated VFs (p ≤ 0.011). A normalized VF architecture, reduction in collagen type I, and Lp thickness were found compared with untreated VFs (p ≤ 0.031). At three months, no derivatives of hESCs were detected. HESCs transplanted to injured rabbit VFs restored the vibratory characteristics of the VFs, with maintained restored function for three months without remaining hESCs or derivatives.
PMID: 26557696 [PubMed - indexed for MEDLINE]
Characterization of tinnitus in different age groups: A retrospective review.
Noise Health. 2016 Jul-Aug;18(83):214-9
Authors: Al-Swiahb J, Park SN
Abstract
OBJECTIVES: The aim of this study was to characterize tinnitus in affected patients.
METHODS: A retrospective review of medical records from 470 consecutive patients who visited a tertiary care hospital for evaluation of chronic subjective tinnitus between January 2009 and June 2010 was performed. Patients were divided into three subgroups based on age. Clinical, audiological, and psychological characteristics of each subgroup were analyzed.
RESULTS: Of the 470 patients evaluated, 85 were less than 40, 217 between 40 and 60, and 168 above 60 years of age. Most patients were men and complained of unilateral, acute high-pitched tinnitus. Most patients above the age of 40 years complained of loud and annoying tinnitus and had worse stress and severity scores.
CONCLUSIONS: Chronic tinnitus in older adults is subjectively louder, more annoying, and more distressing than that found in younger patients. We recommend considering age in the patient management plan.
PMID: 27569409 [PubMed - in process]
Characteristics of hyperacusis in the general population.
Noise Health. 2016 Jul-Aug;18(83):178-84
Authors: Paulin J, Andersson L, Nordin S
Abstract
There is a need for better understanding of various characteristics in hyperacusis in the general population. The objectives of the present study were to investigate individuals in the general population with hyperacusis regarding demographics, lifestyle, perceived general health and hearing ability, hyperacusis-specific characteristics and behavior, and comorbidity. Using data from a large-scale population-based questionnaire study, we investigated individuals with physician-diagnosed (n = 66) and self-reported (n = 313) hyperacusis in comparison to individuals without hyperacusis (n = 2995). High age, female sex, and high education were associated with hyperacusis, and that trying to avoid sound sources, being able to affect the sound environment, and having sough medical attention were common reactions and behaviors. Posttraumatic stress disorder, chronic fatigue syndrome, generalized anxiety disorder, depression, exhaustion, fibromyalgia, irritable bowel syndrome, migraine, hearing impairment, tinnitus, and back/joint/muscle disorders were comorbid with hyperacusis. The results provide ground for future study of these characteristic features being risk factors for development of hyperacusis and/or consequences of hyperacusis.
PMID: 27569405 [PubMed - in process]
Systematic Review of Trends in the Incidence Rates of Thyroid Cancer.
Thyroid. 2016 Aug 29;
Authors: Wiltshire JJ, Drake TM, Uttley L, Balasubramanian SP
Abstract
BACKGROUND: A large proportion of global increase in thyroid cancer (TC) incidence has been attributed to increased detection of papillary thyroid cancer (PTC). Nonetheless, some reports support a real increase in incidence. We aimed to perform a systematic review to evaluate the changing trends in thyroid cancer incidence and summarise potential risk factors predisposing to this trend.
METHODS: English language literature published between 1980 and August 2014 was searched via PubMed (MEDLINE) and OvidSP (EMBASE). Original studies on changes in thyroid cancer incidence in defined geographic areas that described clear methods of case selection and population estimates were included. Data on incidence rates and risk factors were collected.
RESULTS: Of 4719 manuscripts, 60 studies were included; 31 from Europe, 13 from North America and the rest from Asia (9), Oceania (4) and South America (3). 53 articles reported a significant increase in incidence (highest was a 10 fold increase in South Korea), 6 reported stable rates and 1 noted a decrease. PTC was the commonest type reported to have increased in incidence (in 10 studies with relevant data). Follicular thyroid cancer (FTC) increased in incidence (in 4 studies); albeit at a lower rate compared to PTC. Data on risk factors was sparse; factors discussed included ionising radiation, iodine deficiency and supplementation.
CONCLUSION: This systematic review strongly supports a widespread and persistent increase in thyroid cancer incidence. Evidence for over-detection of PTC as the predominant influence includes increased numbers of smaller size tumours and improved or unchanged survival.
PMID: 27571228 [PubMed - as supplied by publisher]
The maxillary artery as a recipient vessel option for complex midface and anterior skull base microsurgical repair: A cadaveric study.
Microsurgery. 2016 Aug 29;
Authors: Assam JH, Quinn TH, Militsakh ON
Abstract
INTRODUCTION: Variations in the operative situation for complex head and neck defect reconstructions resulting from mechanisms such as trauma, oncologic resection, and prior radiation exposure can result in situations of a vessel-depleted neck. This requires an awareness of alternate, innovative options for use in reconstructive repairs. The purpose of this study was to provide characterization of the third segment of the maxillary artery necessary to consider its use as a recipient vessel in free flap repair of complex midface defects.
MATERIALS AND METHODS: Seventeen cadaver hemifaces were used for anatomic demonstration of the maxillary artery third segment by a transmaxillary approach to obtain descriptive measures for statistical analysis.
RESULTS: The average artery intraluminal cross-section diameter was obtained for the sphenopalatine (1.39 ± 0.12 mm) descending palatine (0.94 ± 0.10 mm), and terminal maxillary (1.68 ± 0.17 mm) arterial vessels. The mean transmaxillary depth with was (43 ± 1.2 mm). Mean mobilizable lengths for sphenopalatine, descending palatine, and terminal maxillary arteries were (30 ± 2 mm), (29 ± 2 mm), and (20 ± 2 mm), accordingly. Vessel patterns were characterized using Morton and Kahn classification for sphenopalatine-descending palatine bifurcation as well as the Kwak classification for maxillary artery third segment morphology.
CONCLUSIONS: In situations where primary recipient vessel sites are unavailable, the maxillary artery represents an innovative option to be considered with suitable recipient artery characteristics.
PMID: 27571583 [PubMed - as supplied by publisher]
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Carcinoma cervix presenting with clivus metastasis.
J Cancer Res Ther. 2015 Jul-Sep;11(3):662
Authors: Rao AS, Nandennavar M, Narayanan GS
Abstract
We present an unusual case of a large metastatic lesion from carcinoma cervix located in the clivus. Patient presented with severe headache and vomiting, mimicking an intracranial pathology. Radiological imaging suggested metastatic origin of the lesion and later on investigations revealed primary in the uterine cervix. The anatomic importance of extradural neural axis component in the process of metastasis of carcinoma cervix to the clivus is highlighted in this case report.
PMID: 26458683 [PubMed - indexed for MEDLINE]
