Αρχειοθήκη ιστολογίου

Τετάρτη 7 Σεπτεμβρίου 2016

Assistant Professor Alyson Abel Featured On KPBS!

See the full article and hear the broadcast on KPBS!

See the full article and hear the broadcast on KPBS!

“Abel is an assistant professor in San Diego State University’s School of Speech, Language and Hearing Sciences. She runs a lab where she studies brain responses to get a better picture of how we go from hearing a new word to understanding what it means.

For the past four years, she’s done that by plotting kids’ neural activity as she teaches them made-up words like gouse.”

 

 

 

 



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Ear pruritus: a new otologic finding related to temporomandibular disorder.

Ear pruritus: a new otologic finding related to temporomandibular disorder.

Gen Dent. 2016 Sep-Oct;64(5):39-43

Authors: Vasconcelos BC, Barbosa LM, Barbalho JC, Araújo GM, Melo AR, Santos LA

Abstract
This prospective clinical study evaluated the correlation among temporomandibular disorder (TMD), otologic manifestations, and parafunctional habits in a sample of 100 patients with TMD. The subjects were evaluated by clinical examination, use of a simplified anamnestic questionnaire for TMD diagnosis, and the investigation of otologic manifestations and parafunctional habits of the stomatognathic system. The prevalence of TMD and correlations with otologic manifestations and parafunctional habits were calculated. Patients ranged in age from 13 to 70 years, and 79.0% of the patients were between the ages of 30 and 59 years. Women represented 88.0% of the sample. Otologic manifestations were found in 92.0% of patients with TMD. Sex showed a significant correlation with severity of TMD (P = 0.024). A significant correlation was observed between female patients and both otalgia (P = 0.036) and ear pruritus (P < 0.001). Otalgia showed a significant association with the symptoms of TMD (P = 0.003). Significant correlations between severe TMD and otalgia (P < 0.001), tinnitus (P = 0.010), ear pruritus (P < 0.001), and aural fullness (P = 0.014) were also observed. Ear pruritus, otalgia, and aural fullness are the most common otologic manifestations in patients with TMD, showing a significant correlation with the female sex, severity of TMD, and frequency of TMD symptoms.

PMID: 27599280 [PubMed - as supplied by publisher]



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Objective assessment of subjective tinnitus through contralateral suppression of otoacoustic emissions by white noise; suggested cut-off points.

Objective assessment of subjective tinnitus through contralateral suppression of otoacoustic emissions by white noise; suggested cut-off points.

Int J Audiol. 2016 Sep 6;:1-7

Authors: Riga M, Komis A, Maragkoudakis P, Korres G, Danielides V

Abstract
OBJECTIVE: Normative otoacoustic emission (OAE) suppression values are currently lacking and the role of cochlear efferent innervation in tinnitus is controversial. The aim of this study was to investigate the association between tinnitus and medial olivocochlear bundle (MOCB) malfunction. Potential suppression amplitude cut-off criteria that could differentiate participants with tinnitus from those without were sought.
DESIGN: Mean suppression amplitudes of transient evoked OAEs and distortion product OAEs by contralateral white noise (50 dBSL) were recorded. Six mean suppression amplitudes criteria were validated as possible cut-off points.
STUDY SAMPLE: The population consisted of normal hearing (n = 78) or presbycusic adults (n = 19) with tinnitus or without (n = 28 and 13, respectively) chronic tinnitus (in total, n = 138 78 females/60males, aged 49 ± 14 years).
RESULTS: Participants with mean suppression values lower than 0.5-1 dBSPL seem to present a high probability to report tinnitus (specificity 88-97%). On the other hand, participants with mean suppression values larger than 2-2.5dBSPL seem to present a high probability of the absence of tinnitus (sensitivity 87-99%). Correlations were stronger among participants with bilateral presence or absence of tinnitus.
CONCLUSIONS: This study seem to confirm an association between tinnitus and low suppression amplitudes (<1 dBSPL), which might evolve into an objective examination tool, supplementary to conventional audiological testing.

PMID: 27598848 [PubMed - as supplied by publisher]



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Transarterial embolization of peripheral arteriovenous malformations with ethylenevinyl alcohol copolymer - feasibility, technical outcomes, and clinical outcomes.

Transarterial embolization of peripheral arteriovenous malformations with ethylenevinyl alcohol copolymer - feasibility, technical outcomes, and clinical outcomes.

Vasa. 2016 Sep 6;:1-8

Authors: De Beule T, Vranckx J, Verhamme P, Labarque V, Morren MA, Fourneau I, Maleux G

Abstract
BACKGROUND: The technical and clinical outcomes of catheter-directed embolization for peripheral arteriovenous malformations (AVM) using Onyx® (ethylene-vinyl alcohol copolymer) are not well documented. The purpose of this study was to retrospectively assess the safety, technical outcomes and clinical outcomes of catheter-directed Onyx® embolisation for the treatment of symptomatic peripheral AVMs.
PATIENTS AND METHODS: Demographics, (pre-)interventional clinical and radiological data were assessed. Follow-up was based on hospital medical records and telephone calls to the patients' general practitioners. Radiological success was defined as complete angiographic eradication of the peripheral AVM nidus. Clinical success was defined as major clinical improvement or complete disappearance of the initial symptoms.
RESULTS: 25 procedures were performed in 22 patients. The principal indications for treatment were pain (n = 10), limb swelling (n = 6), recurrent bleeding (n = 2), tinnitus (n = 3), and exertional dyspnoea (n = 1). Complete radiological success was obtained in eight patients (36 %); near-complete eradication of the nidus was achieved in the remaining 14 patients. Adjunctive embolic agents were used in nine patients (41 %). Clinical success was observed in 18 patients (82%). Major complications were reported in two patients (9 %). During follow-up, seven patients (32 %) presented with symptom recurrence, which required additional therapy in three patients.
CONCLUSIONS: Catheter-directed embolisation of peripheral AVMs with Onyx® resulted in major clinical improvement or complete disappearance of symptoms in the vast majority of patients, although complete angiographic exclusion of the AVMs occurred in only a minority of patients.

PMID: 27598050 [PubMed - as supplied by publisher]



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Genetics of Tinnitus: An Emerging Area for Molecular Diagnosis and Drug Development.

Genetics of Tinnitus: An Emerging Area for Molecular Diagnosis and Drug Development.

Front Neurosci. 2016;10:377

Authors: Lopez-Escamez JA, Bibas T, Cima RF, Van de Heyning P, Knipper M, Mazurek B, Szczepek AJ, Cederroth CR

Abstract
Subjective tinnitus is the perception of sound in the absence of external or bodily-generated sounds. Chronic tinnitus is a highly prevalent condition affecting over 70 million people in Europe. A wide variety of comorbidities, including hearing loss, psychiatric disorders, neurodegenerative disorders, and temporomandibular joint (TMJ) dysfunction, have been suggested to contribute to the onset or progression of tinnitus; however, the precise molecular mechanisms of tinnitus are not well understood and the contribution of genetic and epigenetic factors remains unknown. Human genetic studies could enable the identification of novel molecular therapeutic targets, possibly leading to the development of novel pharmaceutical therapeutics. In this article, we briefly discuss the available evidence for a role of genetics in tinnitus and consider potential hurdles in designing genetic studies for tinnitus. Since multiple diseases have tinnitus as a symptom and the supporting genetic evidence is sparse, we propose various strategies to investigate the genetic underpinnings of tinnitus, first by showing evidence of heritability using concordance studies in twins, and second by improving patient selection according to phenotype and/or etiology in order to control potential biases and optimize genetic data output. The increased knowledge resulting from this endeavor could ultimately improve the drug development process and lead to the preventive or curative treatment of tinnitus.

PMID: 27594824 [PubMed]



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Theoretical Tinnitus Framework: A Neurofunctional Model.

Theoretical Tinnitus Framework: A Neurofunctional Model.

Front Neurosci. 2016;10:370

Authors: Ghodratitoostani I, Zana Y, Delbem AC, Sani SS, Ekhtiari H, Sanchez TG

Abstract
Subjective tinnitus is the conscious (attended) awareness perception of sound in the absence of an external source and can be classified as an auditory phantom perception. Earlier literature establishes three distinct states of conscious perception as unattended, attended, and attended awareness conscious perception. The current tinnitus development models depend on the role of external events congruently paired with the causal physical events that precipitate the phantom perception. We propose a novel Neurofunctional Tinnitus Model to indicate that the conscious (attended) awareness perception of phantom sound is essential in activating the cognitive-emotional value. The cognitive-emotional value plays a crucial role in governing attention allocation as well as developing annoyance within tinnitus clinical distress. Structurally, the Neurofunctional Tinnitus Model includes the peripheral auditory system, the thalamus, the limbic system, brainstem, basal ganglia, striatum, and the auditory along with prefrontal cortices. Functionally, we assume the model includes presence of continuous or intermittent abnormal signals at the peripheral auditory system or midbrain auditory paths. Depending on the availability of attentional resources, the signals may or may not be perceived. The cognitive valuation process strengthens the lateral-inhibition and noise canceling mechanisms in the mid-brain, which leads to the cessation of sound perception and renders the signal evaluation irrelevant. However, the "sourceless" sound is eventually perceived and can be cognitively interpreted as suspicious or an indication of a disease in which the cortical top-down processes weaken the noise canceling effects. This results in an increase in cognitive and emotional negative reactions such as depression and anxiety. The negative or positive cognitive-emotional feedbacks within the top-down approach may have no relation to the previous experience of the patients. They can also be associated with aversive stimuli similar to abnormal neural activity in generating the phantom sound. Cognitive and emotional reactions depend on general personality biases toward evaluative conditioning combined with a cognitive-emotional negative appraisal of stimuli such as the case of people with present hypochondria. We acknowledge that the projected Neurofunctional Tinnitus Model does not cover all tinnitus variations and patients. To support our model, we present evidence from several studies using neuroimaging, electrophysiology, brain lesion, and behavioral techniques.

PMID: 27594822 [PubMed]



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Pulsatile tinnitus associated with dehiscent internal carotid artery: An irremediable condition?

Pulsatile tinnitus associated with dehiscent internal carotid artery: An irremediable condition?

Auris Nasus Larynx. 2016 Sep 1;

Authors: Van Damme JP, Heylen G, Gilain C, Garin P

Abstract
Dehiscent internal carotid artery (ICA) in the middle ear is a rare condition, with conservative treatment primarily recommended. We report the case of a 63-year-old patient referred to the Ear, Nose, and Throat (ENT) ward for unbearable pulsatile tinnitus. Otoscopy revealed a normal right tympanic membrane, with pulsatile tinnitus but without hearing impairment. Based on imaging studies, including computed tomography (CT) and magnetic resonance imaging (MRI) of the temporal bone, as well as Doppler ultrasound of the internal carotid artery and sigmoid sinus, the diagnosis of ICA canal dehiscence into the tympanic cavity was established, thus excluding the diagnosis of aberrant ICA. Following the patient's own request, we undertook surgical correction, with the technique used described in the report. Immediately postoperatively, the pulsatile tinnitus had disappeared, with no surgical complications noted. At the 9-month follow-up, otoscopy revealed a healthy right tympanic membrane and the patient reported no remaining symptoms.

PMID: 27594410 [PubMed - as supplied by publisher]



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Deep brain stimulation of the inferior colliculus in the rodent suppresses tinnitus.

Related Articles

Deep brain stimulation of the inferior colliculus in the rodent suppresses tinnitus.

Brain Res. 2016 Aug 31;

Authors: Smit JV, Janssen ML, van Zwieten G, Jahanshahi A, Temel Y, Stokroos RJ

Abstract
In tinnitus models pathological neuronal activity has been demonstrated. Deep brain stimulation disrupts pathological neuronal activity and might therefore be a potential treatment for patients who suffer severely from tinnitus. In this study, the effect of DBS in the inferior colliculus is investigated in an animal model for tinnitus. The external cortex of the inferior colliculus was targeted because of the key position of the inferior colliculus within the auditory network and the relation of the external cortex with the limbic system. In this study we show the effect of DBS in the inferior colliculus on tinnitus using a within-subject experimental design. After noise trauma, rats showed a significant increase in gap:no gap ratio of the gap-induced prepulse inhibition at 16 and 20kHz (p<0.05), indicating the presence of tinnitus in these frequency bands. During DBS the gap:no gap ratio returned back to baseline (p<0.05). Hearing thresholds before and during DBS did not differ, indicating that hearing function is probably not impaired by electrical stimulation. In summary, this study shows that DBS of the inferior colliculi is effective in reducing behavioral signs of tinnitus in an animal model. Impaired hearing function could not be objectified as a side effect of stimulation.

PMID: 27592136 [PubMed - as supplied by publisher]



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Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus?

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Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus?

Man Ther. 2016 Aug 26;26:125-131

Authors: Michiels S, Van de Heyning P, Truijen S, Hallemans A, De Hertogh W

Abstract
BACKGROUND: Tinnitus can be related to many different aetiologies such as hearing loss or a noise trauma, but it can also be related to the somatosensory system of the cervical spine, called cervicogenic somatic tinnitus (CST). Case studies suggest a positive effect of cervical spine treatment on tinnitus complaints in patients with CST, but no experimental studies are available.
OBJECTIVE: To investigate the effect of a multimodal cervical physical therapy treatment on tinnitus complaints in patients with CST.
DESIGN: Randomized controlled trial.
PATIENTS: Patients with a combination of severe subjective tinnitus (Tinnitus Functional Index (TFI): 25-90 points) and neck complaints (Neck Bournemouth Questionnaire (NBQ) > 14 points).
INTERVENTION: All patients received cervical physical therapy for 6 weeks (12 sessions). Patients were randomized in an immediate-start therapy group (n = 19) and a 6-week delayed-start therapy group (n = 19).
MEASUREMENTS: TFI and NBQ-scores were documented at baseline, after the wait-and-see period in the delayed-start group, after treatment and after 6 weeks follow-up. The Global Perceived Effect (GPE) was documented at all measuring moments, except at baseline.
RESULTS: In all patients (n = 38) TFI and NBQ-scores decreased significantly after treatment (p = 0.04 and p < 0.001). NBQ-scores remained significantly lower after follow-up (p = 0.001). Immediately after treatment, 53% (n = 38) experienced substantial improvement of tinnitus. This effect was maintained in 24% of patients after follow-up at six weeks.
CONCLUSION: Cervical physical therapy can have a positive effect on subjective tinnitus complaints in patients with a combination of tinnitus and neck complaints. Larger studies, using more responsive outcome measures, are however necessary to prove this effect.
TRIAL REGISTRATION: NCT02016313.

PMID: 27592038 [PubMed - as supplied by publisher]



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A Case of Skull Base Osteomyelitis with Multiple Cerebral Infarction.

A Case of Skull Base Osteomyelitis with Multiple Cerebral Infarction.

Case Rep Otolaryngol. 2016;2016:9252361

Authors: Miyabe H, Uno A, Nakajima T, Morizane N, Enomoto K, Hirose M, Hazama T, Takenaka Y

Abstract
Skull base osteomyelitis is classically documented as an extension of malignant otitis externa. Initial presentation commonly includes aural symptoms and cranial nerve dysfunctions. Here we present a case that emerged with multiple infarctions in the right cerebrum. A male in his 70s with diabetes mellitus and chronic renal failure presented with left hemiparesis. Imaging studies showed that blood flow in the carotid artery remained at the day of onset but was totally occluded 7 days later. However, collateral blood supply prevented severe infarction. These findings suggest that artery-to-artery embolization from the petrous and/or cavernous portion of the carotid artery caused the multiple infarctions observed on initial presentation. Osteomyelitis of the central skull base was diagnosed on the basis of the following findings taken together: laboratory results showing high levels of inflammation, presence of Pseudomonas aeruginosa in the otorrhea and blood culture, multiple cranial nerve palsies that appeared later, the bony erosion observed on CT, and the mass lesion on MRI. Osteomyelitis was treated successfully by long-term antibiotic therapy; however, the patient experienced cefepime-induced neurotoxicity during therapy. The potential involvement of the internal carotid artery in this rare and life-threatening disease is of particular interest in this case.

PMID: 27597916 [PubMed]



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Craniometaphyseal dysplasia in a 14-month old: a case report and review of imaging differential diagnosis.

Craniometaphyseal dysplasia in a 14-month old: a case report and review of imaging differential diagnosis.

Radiol Case Rep. 2016 Sep;11(3):260-5

Authors: Singh S, Qin C, Medarametla S, Hegde SV

Abstract
We report a 14-month-old male with craniometaphyseal dysplasia (CMD). The patient presented with a history of diminishing vision and hearing loss. Cranial computed tomography scan showed diffuse calvarial and skull base hyperostosis with excessive bone narrowing the internal auditory canals and skull base foramina. A subsequent skeletal survey revealed other skeletal abnormalities, which led to the diagnosis of CMD. This was later confirmed by ANKH mutation. CMD is a rare genetic disorder that belongs to the group of craniotubular bone dysplasias. It is important to recognize this condition from other causes of craniotubular bone dysplasias to institute early treatment and explain prognosis.

PMID: 27594963 [PubMed]



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Endovascular Management of Iatrogenic Vascular Injury in Craniocervical Region.

Endovascular Management of Iatrogenic Vascular Injury in Craniocervical Region.

Turk Neurosurg. 2016 Jul 1;

Authors: Aydin E, Gök M, Esenkaya A, Çinar C, Oran İ

Abstract
AIM: We aimed to evaluate iatrogenic vascular injuries in craniocervical region and their endovascular management.
MATERIAL AND METHODS: Twenty-one patients (nine women, twelve men) with a mean age of 53.6 (range 16-87 years), who underwent endovascular embolization for iatrogenic vascular injury in craniocervical region between December 2000 and October 2015 were included in this retrospective study. Types of iatrogenic injuries, etiologies that caused these injuries and details of endovascular managements were reported.
RESULTS: The etiologies of the vascular injuries were as follows: transsphenoidal surgery (n=9), skull-base surgery (n=2), cholesteatoma surgery (n=1), tracheostomy (n=2), central venous catheterization (n=2), oropharyngial tumor operation (n=1), endovascular treatment of internal carotid artery (ICA) stenosis (n=1), suprasellar epidermoid tumor operation (n=1), sphenoid sinus tumor surgery (n=1), and speech prostehesis device placement (n=1). The types of vascular injuries diagnosed at the time of angiography were; 2 occlusions, 2 stenosis, 2 dissections, 1 carotid cavernous fistula, 8 artery rupture with extravasation, 9 pseudoaneurysms. Endovascular management of these vascular injuries were; parent artery occlusion (PAO) (n=15), aneurysm occlusion (n=3), covered stent (n=1) and conservative management (n=2). All patients except two, were successfully treated. All patients didn\'t have bleeding within 30-day period after angiography. Long-term follow-up was available in all patients without occurrence of re-bleeding. One patient died due to complications related to primary vascular injury.
CONCLUSION: Although iatrogenic vascular injuries are rare, early diagnosis and management may be lifesaving. The endovascular techniques are reliable and safe in most of the patients.

PMID: 27593845 [PubMed - as supplied by publisher]



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Severe Venous Air Embolism Related to Positioning in Posterior Cranial Fossa Surgery in Siriraj Hospital.

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Severe Venous Air Embolism Related to Positioning in Posterior Cranial Fossa Surgery in Siriraj Hospital.

J Med Assoc Thai. 2016 May;99(5):511-6

Authors: Rushatamukayanunt P, Seanho P, Muangman S, Raksakietisak M

Abstract
BACKGROUND: Posterior cranial fossa surgery is commonly performed under sitting and horizontal position in our institution. Venous air embolism is a potentially serious complication of neurosurgery especially in the sitting position.
OBJECTIVE: We aim to compare the incidence of severe venous air embolism and other complications of both positions.
MATERIAL AND METHOD: A retrospective analysis of medical record was performed in 192 patients undergoing posterior cranial fossa craniotomy from January 2010 to December 2013. Data collected from the records included demographic profile, patient position, hemodynamic changes, venous air embolism (VAE), blood loss/transfusion, duration of surgery, postoperative complications, duration of ICU stay, and postoperative discharge status. The definition of severe air embolism was identified as suspected VAE with decreased systolic blood pressure greater than 20%.
RESULTS: There were 92 patients in sitting position (SP) group and 100 patients in horizontal position (HP) group. The incidence of severe venous air embolism was signficantly higher in SP group compared with HP group (41.3% vs. 11.0%, p<0. 001). SP group had more complications than HP group in both central nervous system (71% vs. 34.0%, p = 0.001), and cardiovascular system (17% vs. 6%, p = 0.001). Although postoperative ventilator time in SP group was less than HP group (1.24 vs. 1.60 days, p = 0.029), ICU and hospital stay were not different in either group.
CONCLUSION: The incidence of severe venous air embolism detected by end tidal CO₂ was significantly higher in SP group. However, 11% of HP group were suspected of severe air embolism.

PMID: 27501605 [PubMed - indexed for MEDLINE]



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Neurologic involvement in patients with atypical Chediak-Higashi disease.

http:--highwire.stanford.edu-icons-exter Related Articles

Neurologic involvement in patients with atypical Chediak-Higashi disease.

Neurology. 2016 Apr 5;86(14):1320-8

Authors: Introne WJ, Westbroek W, Cullinane AR, Groden CA, Bhambhani V, Golas GA, Baker EH, Lehky TJ, Snow J, Ziegler SG, Adams DR, Dorward HM, Hess RA, Huizing M, Gahl WA, Toro C

Abstract
OBJECTIVE: To delineate the developmental and progressive neurodegenerative features in 9 young adults with the atypical form of Chediak-Higashi disease (CHD) enrolled in a natural history study.
METHODS: Patients with atypical clinical features, but diagnostically confirmed CHD by standard evaluation of blood smears and molecular genotyping, underwent complete neurologic evaluation, MRI of the brain, electrophysiologic examination, and neuropsychological testing. Fibroblasts were collected to investigate the cellular phenotype and correlation with the clinical presentation.
RESULTS: In 9 mildly affected patients with CHD, we documented learning and behavioral difficulties along with developmental structural abnormalities of the cerebellum and posterior fossa, which are apparent early in childhood. A range of progressive neurologic problems emerge in early adulthood, including cerebellar deficits, polyneuropathies, spasticity, cognitive decline, and parkinsonism.
CONCLUSIONS: Patients with undiagnosed atypical CHD manifesting some of these wide-ranging yet nonspecific neurologic complaints may reside in general and specialty neurology clinics. The absence of the typical bleeding or infectious diathesis in mildly affected patients with CHD renders them difficult to diagnose. Identification of these individuals is important not only for close surveillance of potential CHD-related systemic complications but also for a full understanding of the natural history of CHD and the potential role of the disease-causing protein, LYST, to the pathophysiology of other neurodevelopmental and neurodegenerative disorders.

PMID: 26944273 [PubMed - indexed for MEDLINE]



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An Extremely Rare Association of Posterior Fossa Arachnoid Cyst with Chiari I Malformation and Syringomyelia in a Child: A Short Report.

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An Extremely Rare Association of Posterior Fossa Arachnoid Cyst with Chiari I Malformation and Syringomyelia in a Child: A Short Report.

Pediatr Neurosurg. 2015;50(6):350-2

Authors: Prasad GL, Sinha S, Mahapatra AK

PMID: 26461066 [PubMed - indexed for MEDLINE]



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Preliminary application of intra-operative hearing monitoring by tone pip ABR via loudspeakers.

Preliminary application of intra-operative hearing monitoring by tone pip ABR via loudspeakers.

Acta Otolaryngol. 2016 Sep 6;:1-7

Authors: Ren W, Ji F, Zeng J, Hao Q, Liu R, Xu G, Yan Y, Zhang M, Zhao H, Yang S

Abstract
CONCLUSION: This method might be an effective intra-operative way to access hearing threshold under general anesthesia in the operating room.
OBJECTIVE: To develop an intra-operative hearing monitoring method for surgeons to access hearing threshold under general anesthesia in the operating room.
METHOD: System establishment and calibration was done firstly. Normal hearing (NH) and conductive hearing loss (CHL) participants were recruited. This study applied pure tone audiometry (PTA) to all subjects and tone pip ABR (tp-ABR) via loudspeakers in sound booth and operating room for NH and CHL subjects, respectively. For NH subjects, Bland Altman was conducted to compare 1k Hz PTA and tp-ABR threshold. For CHL participants, Paired t-test, Satterth waite t'-test, and linear correlation analysis were used to compare the two methods. p < .05 was considered statistically different.
RESULTS: (1) Bland Altman showed all plots were inside the 95% confidence interval, indicating that there was no difference between the two methods for NH subjects. (2) The two methods had a high correlation (Pearson's coefficient =0.872 > 0.6, p < .05) in assessing hearing threshold in the operating room. (3) Satterth waite t'-test showed the ossicular chain malfunction enlarged the deviation of threshold by the two methods (.01 < p < .025).

PMID: 27599303 [PubMed - as supplied by publisher]



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The neutrophil-to-lymphocyte ratio in children with sudden sensorineural hearing loss: a retrospective study.

The neutrophil-to-lymphocyte ratio in children with sudden sensorineural hearing loss: a retrospective study.

Acta Otolaryngol. 2016 Sep 6;:1-4

Authors: Lee JS, Hong SK, Kim DH, Lee JH, Lee HJ, Park B, Choi HG, Kong IG, Song HJ, Kim HJ

Abstract
CONCLUSION: The elevated neutrophil-to-lymphocyte ratio (NLR) value in children with sudden sensorineural hearing loss (SSNHL) would suggest the inflammatory etiology of pediatric SSNHL. The results of this study may suggest NLR value can be used as a useful indicator, which is associated with the disease severity in pediatric SSNHL.
OBJECTIVES: This study aimed to elucidate any clues of inflammatory etiology, which might be related with the development of pediatric SSNHL, using calculated NLR.
METHODS: Forty-six patients aged younger than 19 years, who were admitted to the hospital with the diagnosis of SSNHL, were included in the study. Forty-six healthy children were matched as control group according to their propensity score. The complete blood cell count, calculated NLR, platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) were compared. The relationship between NLR and the initial hearing level was also investigated.
RESULTS: The mean NLR value was 2.86 ± 2.58 in the SSNHL group, whereas the mean NLR value was 1.63 ± 0.87 in the control group. The mean NLR value of the SSNHL children was significantly higher than that of the control group (p = .023). There was a positive correlation between the NLR value and initial hearing level (r = .312, p = .037).

PMID: 27598228 [PubMed - as supplied by publisher]



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Notch1 regulates invasion and metastasis of head and neck squamous cell carcinoma by inducing EMT through c-Myc.

Notch1 regulates invasion and metastasis of head and neck squamous cell carcinoma by inducing EMT through c-Myc.

Auris Nasus Larynx. 2016 Aug 29;

Authors: Inamura N, Kimura T, Wang L, Yanagi H, Tsuda M, Tanino M, Nishihara H, Fukuda S, Tanaka S

Abstract
OBJECTIVE: As 50% of patients of head and neck squamous carcinoma (HNSCC) exhibit poor prognosis, the identification of new therapeutic targets is required. Recently, there have been several reports about the correlation between Notch1 and HNSCC, but the precise mechanism is still obscure. Therefore, in this study, we examined the involvement of Notch1 in HNSCC by using HNSCC cell lines and surgical specimens.
METHODS: To investigate the role of Notch1 in HNSCC, we examined the effect of Notch inhibitor DAPT on cell growth, invasion, and tumorigenicity using five HNSCC cell lines in vitro and in vivo. We further examined that the correlation with Notch expression and clinical prognostic factors was evaluated by using 101 HNSCC surgical specimens.
RESULTS: DAPT reduced the nuclear expression of Notch and c-Myc and repressed cell growth, EMT-dependent cell invasion in vitro, and tumorigenicity in vivo. An overexpression of Myc enhanced EMT with an increase of Snail and vimentin together with decreased levels of E-cadherin in HSC3 cells. Finally, we discovered that Notch expression was well correlated with MIB-1 index and lymph node metastases.
CONCLUSION: We discovered that Notch1 was strongly correlated with HNSCC growth, invasion, and metastases. Therefore, Notch1 might be a new therapeutic target and a predictive marker of proliferation and metastasis of HNSCC.

PMID: 27595504 [PubMed - as supplied by publisher]



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Mano-videoendoscopic assessment in the evaluation of the pharyngeal contraction and upper esophageal sphincter function in dysphagic patients.

Mano-videoendoscopic assessment in the evaluation of the pharyngeal contraction and upper esophageal sphincter function in dysphagic patients.

Auris Nasus Larynx. 2016 Aug 29;

Authors: Karaho T, Nakajima J, Satoh T, Kawahara K, Nakayama T, Kohno N

Abstract
OBJECTIVE: Mano-videoendoscopy (MVE) is a manometry technique with endoscopic confirmation of the pressure catheter. This study aimed to investigate the possibility of replacing a videofluorographic swallowing study (VFSS) with MVE for the precise evaluation of the pharyngeal contraction and the upper esophageal sphincter (UES) function.
METHODS: The data from 69 patients with dysphagia were retrospectively reviewed. All of the patients underwent both MVE and a VFSS for the evaluation of dysphagia. Manometry was performed with a transnasally inserted catheter (2.6-mm outer diameter and 4 pressure sensors) under endoscopic observation. The sensors were kept at the tongue base, upper pyriform sinus, apex of the pyriform sinus, and UES. We evaluated the pharyngeal contraction and UES function fluorographically and statistically compared the manometric parameters.
RESULTS: The fluorographic pharyngeal contraction was diagnosed as good in 28 patients and poor in 41 patients. The UES opening was diagnosed as good in 44 patients and poor in 25 patients. The highest pressure values at the tongue base (sensor 1), upper pyriform sinus (sensor 2), and apex of the pyriform sinus (sensor 3) were significantly larger in the good contraction group than in the poor contraction group. A stepwise logistic regression test revealed that the peak pressure of sensor 2 (upper pyriform sinus) was a robust predictor of fluorographic pharyngeal contraction, and the cut-off level for good fluorographic pharyngeal contraction was >81.5mmHg (specificity, 0.929; sensitivity, 0.870; area under the curve, 0.923). The nadir pressure, pressure drop, and pressure rise in the UES were significantly correlated with the fluorographic UES opening. A stepwise logistic regression test revealed that the pressure drop-the gap between the resting pressure and the nadir of the UES pressure-was a robust predictor of fluorographic UES opening, and the cut-off level to anticipate good fluorographic opening was ≥33.5mmHg (specificity, 0.853; sensitivity, 0.759).
CONCLUSION: MVE can supplement the information obtained regarding the pharyngeal contraction and UES function, and overcomes the drawbacks of a videoendoscopic swallowing study (VESS).

PMID: 27595503 [PubMed - as supplied by publisher]



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Pulsatile tinnitus associated with dehiscent internal carotid artery: An irremediable condition?

Pulsatile tinnitus associated with dehiscent internal carotid artery: An irremediable condition?

Auris Nasus Larynx. 2016 Sep 1;

Authors: Van Damme JP, Heylen G, Gilain C, Garin P

Abstract
Dehiscent internal carotid artery (ICA) in the middle ear is a rare condition, with conservative treatment primarily recommended. We report the case of a 63-year-old patient referred to the Ear, Nose, and Throat (ENT) ward for unbearable pulsatile tinnitus. Otoscopy revealed a normal right tympanic membrane, with pulsatile tinnitus but without hearing impairment. Based on imaging studies, including computed tomography (CT) and magnetic resonance imaging (MRI) of the temporal bone, as well as Doppler ultrasound of the internal carotid artery and sigmoid sinus, the diagnosis of ICA canal dehiscence into the tympanic cavity was established, thus excluding the diagnosis of aberrant ICA. Following the patient's own request, we undertook surgical correction, with the technique used described in the report. Immediately postoperatively, the pulsatile tinnitus had disappeared, with no surgical complications noted. At the 9-month follow-up, otoscopy revealed a healthy right tympanic membrane and the patient reported no remaining symptoms.

PMID: 27594410 [PubMed - as supplied by publisher]



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Assessment of in vitro COPD models for tobacco regulatory science: Workshop proceedings, conclusions and paths forward for in vitro model use.

Related Articles

Assessment of in vitro COPD models for tobacco regulatory science: Workshop proceedings, conclusions and paths forward for in vitro model use.

Altern Lab Anim. 2016 May;44(2):129-66

Authors: Behrsing H, Raabe H, Manuppello J, Bombick B, Curren R, Sullivan K, Sethi S, Phipps R, Tesfaigzi Y, Yan S, D'Ruiz C, Tarran R, Constant S, Phillips G, Gaça M, Hayden P, Cao X, Mathis C, Hoeng J, Braun A, Hill E

Abstract
The Family Smoking Prevention and Tobacco Control Act of 2009 established the Food and Drug Administration Center for Tobacco Products (FDA-CTP), and gave it regulatory authority over the marketing, manufacture and distribution of tobacco products, including those termed 'modified risk'. On 8-10 December 2014, IIVS organised a workshop conference, entitled Assessment of In Vitro COPD Models for Tobacco Regulatory Science, to bring together stakeholders representing regulatory agencies, academia, industry and animal protection, to address the research priorities articulated by the FDA-CTP. Specific topics were covered to assess the status of current in vitro technologies as they are applied to understanding the adverse pulmonary events resulting from tobacco product exposure, and in particular, the progression of chronic obstructive pulmonary disease (COPD). The four topics covered were: a) Inflammation and Oxidative Stress; b) Ciliary Dysfunction and Ion Transport; c) Goblet Cell Hyperplasia and Mucus Production; and d) Parenchymal/Bronchial Tissue Destruction and Remodelling. The 2.5 day workshop included 18 expert speakers, plus poster sessions, networking and breakout sessions, which identified key findings and provided recommendations to advance the in vitro technologies and assays used to evaluate tobacco-induced disease etiologies. The workshop summary was reported at the 2015 Society of Toxicology Annual Meeting, and the recommendations led to an IIVS-organised technical workshop in June 2015, entitled Goblet Cell Hyperplasia, Mucus Production, and Ciliary Beating Assays, to assess these assays and to conduct a proof-of-principle multi-laboratory exercise to determine their suitability for standardisation. Here, we report on the proceedings, recommendations and outcomes of the December 2014 workshop, including paths forward to continue the development of non-animal methods to evaluate tissue responses that model the disease processes that may lead to COPD, a major cause of mortality worldwide.

PMID: 27256455 [PubMed - indexed for MEDLINE]



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Vascular ring "mimickring" asthma in a preschool girl with combined immunodeficiency: the benefits of lung function measurements at diagnosis and postoperative follow-up.

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Vascular ring "mimickring" asthma in a preschool girl with combined immunodeficiency: the benefits of lung function measurements at diagnosis and postoperative follow-up.

Ann Allergy Asthma Immunol. 2016 Apr;116(4):287-9

Authors: Navratil M

PMID: 26896881 [PubMed - indexed for MEDLINE]



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Prosthetic Rehabilitation of Patients After Surgical Treatment of Maxillary Tumors with Respect to Upper Airway Protection.

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Prosthetic Rehabilitation of Patients After Surgical Treatment of Maxillary Tumors with Respect to Upper Airway Protection.

Adv Exp Med Biol. 2016;885:83-8

Authors: Rolski D, Kostrzewa-Janicka J, Nieborak R, Przybyłowska D, Stopa Z, Mierzwińska-Nastalska E

Abstract
As a consequence of surgical treatment of maxillary tumors, a connection between oral and nasal cavities is formed, which leads to serious functional disorders, manifested by inability to normally ingest food, proper speech articulation, and to respiratory route disorders and upper airway inflammation. These morphological and functional disorders are intensified by adjunctive radio- or chemotherapy. The aim of this paper is to present different possible methods of rehabilitation, including application of interim obturators and individually planned prosthetic restorations to improve respiratory efficiency in patients after extensive maxillary resections. In the course of prosthetic treatment, cooperation with the laryngologist to consider every aspect of chronic paranasal sinusitis, accompanied by concurrent inflammation of oral, nasal, or laryngeal mucous membranes, was of paramount importance. Based on the quality of life questionnaire, used in this study, evident improvement in the masticatory efficiency, speech articulation, and respiration was observed. Particularly good effects were obtained in edentulous patients, in whom implant-prosthetic treatment was possible to apply. Comprehensive and multidisciplinary care of postoperative patients greatly contributes to their better quality of life and facilitates their return to prior living conditions, as well as to occupational and family lives.

PMID: 26820729 [PubMed - indexed for MEDLINE]



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IL-33 Signaling Protects from Murine Oxazolone Colitis by Supporting Intestinal Epithelial Function.

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IL-33 Signaling Protects from Murine Oxazolone Colitis by Supporting Intestinal Epithelial Function.

Inflamm Bowel Dis. 2015 Dec;21(12):2737-46

Authors: Waddell A, Vallance JE, Moore PD, Hummel AT, Wu D, Shanmukhappa SK, Fei L, Washington MK, Minar P, Coburn LA, Nakae S, Wilson KT, Denson LA, Hogan SP, Rosen MJ

Abstract
BACKGROUND: IL-33, a member of the IL-1 cytokine family that signals through ST2, is upregulated in ulcerative colitis (UC); however, the role of IL-33 in colitis remains unclear. IL-33 augments type 2 immune responses, which have been implicated in UC pathogenesis. We sought to determine the role of IL-33 signaling in oxazolone (OXA) colitis, a type 2 cytokine-mediated murine model of UC.
METHODS: Colon mucosal IL-33 expression was compared between pediatric and adult UC and non-IBD patients using immunohistochemistry and real-time PCR. OXA colitis was induced in WT, IL-33, and ST2 mice, and histopathology, cytokine levels, and goblet cells were assessed. Transepithelial resistance was measured across IL-33-treated T84 cell monolayers.
RESULTS: Colon mucosal IL-33 was increased in pediatric patients with active UC and in OXA colitis. IL-33 and ST2 OXA mice exhibited increased disease severity compared with WT OXA mice. OXA induced a mixed mucosal cytokine response, but few differences were observed between OXA WT and IL-33 or ST2 mice. Goblet cells were significantly decreased in IL-33 and ST2 OXA compared with WT OXA mice. IL-33 augmented transepithelial resistance in T84 cells, and this effect was blocked by the ERK1/2 inhibitor PD98,059.
CONCLUSIONS: OXA colitis is exacerbated in IL-33 and ST2 mice. Increased mucosal IL-33 in human UC and murine colitis may be a homeostatic response to limit inflammation, potentially through effects on epithelial barrier function. Further investigation of IL-33 protective mechanisms would inform the development of novel therapeutic approaches.

PMID: 26313694 [PubMed - indexed for MEDLINE]



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[Histopathological evaluation of the subtotal laryngectomy specimen].

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[Histopathological evaluation of the subtotal laryngectomy specimen].

Cir Cir. 2015 Nov-Dec;83(6):537-42

Authors: García-Sánchez M, Romero-Durán E, Mantilla-Morales A, Gallegos-Hernández JF

Abstract
INTRODUCTION: The goal of conservative surgical treatment of laryngeal cancer is to obtain oncological control with preservation of laryngeal function. The concept of laryngeal function preservation should be understood as the preservation of the patient's ability to breathe normally with neither tracheostomy nor aspiration, and maintaining intelligible speech. This can be achieved by a balance between two fundamental aspects, proper patient selection (based on tumour extension and preoperative laryngeal function), and an adequate histopathological analysis of the surgical specimen. Supracricoid subtotal laryngectomy is the voice conservative surgical technique that offers the best possibility of control in patients with locally advanced laryngeal cancer. The proper histopathological analysis allows staging and selecting patients for adjuvant therapy, avoiding unnecessary ones as well as designing monitoring and surveillance programs based on risk factors.
OBJECTIVE: To highlight key points in the histopathological evaluation of the surgical specimen of a subtotal laryngectomy.
CONCLUSION: The proper communication between the surgeon and pathologist, offering complete information on preoperative clinical evaluation and the knowledge of the key points in the evaluation of the surgical specimen (sites of tumour leakage and surgical resection margins) are fundamental parameters to achieve a proper histopathological evaluation of the surgical specimen.

PMID: 26159367 [PubMed - indexed for MEDLINE]



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Laryngeal Tumor Detection and Classification in Endoscopic Video.

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Laryngeal Tumor Detection and Classification in Endoscopic Video.

IEEE J Biomed Health Inform. 2016 Jan;20(1):322-32

Authors: Barbalata C, Mattos LS

Abstract
The development of the narrow-band imaging (NBI) has been increasing the interest of medical specialists in the study of laryngeal microvascular network to establish diagnosis without biopsy and pathological examination. A possible solution to this challenging problem is presented in this paper, which proposes an automatic method based on anisotropic filtering and matched filter to extract the lesion area and segment blood vessels. Lesion classification is then performed based on a statistical analysis of the blood vessels' characteristics, such as thickness, tortuosity, and density. Here, the presented algorithm is applied to 50 NBI endoscopic images of laryngeal diseases and the segmentation and classification accuracies are investigated. The experimental results show the proposed algorithm provides reliable results, reaching an overall classification accuracy rating of 84.3%. This is a highly motivating preliminary result that proves the feasibility of the new method and supports the investment in further research and development to translate this study into clinical practice. Furthermore, to our best knowledge, this is the first time image processing is used to automatically classify laryngeal tumors in endoscopic videos based on tumor vascularization characteristics. Therefore, the introduced system represents an innovation in biomedical and health informatics.

PMID: 25438330 [PubMed - indexed for MEDLINE]



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Future Meetings.

Future Meetings.

Thyroid. 2016 Sep;26(9):1340-1341

Authors:

PMID: 27598650 [PubMed - as supplied by publisher]



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Peter M. Laurberg (June 14, 1945-June 20, 2016).

Peter M. Laurberg (June 14, 1945-June 20, 2016).

Thyroid. 2016 Sep;26(9):1149-1153

Authors:

PMID: 27598649 [PubMed - as supplied by publisher]



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Extrathyroidal Extension is Associated with Compromised Survival in Patients with Thyroid Cancer.

Extrathyroidal Extension is Associated with Compromised Survival in Patients with Thyroid Cancer.

Thyroid. 2016 Sep 5;

Authors: Youngwirth L, Abdelgadir Adam M, Scheri R, Roman S, Sosa JA

Abstract
Background Patients with thyroid cancer that have extrathyroidal extension (ETE) are considered to have more advanced tumors. However, data on the impact of ETE on patient outcomes remain limited. The purpose of this study was to evaluate the association between ETE and survival in patients with thyroid cancer. Methods The National Cancer Database (1998-2012) was queried for all adult patients with differentiated thyroid cancer and medullary thyroid cancer. Patients were divided into three groups: no ETE (T1 and T2 tumors), minimal ETE (T3 tumors <4 cm), and extensive ETE (T4 tumors <4 cm). Patient demographic, clinical, and pathologic factors were evaluated for all patients. A Cox proportional hazards model was developed for each histology to identify factors associated with survival. Results In total, 241,118 patients with differentiated thyroid cancer met inclusion criteria; 86.9% had no ETE, 9.1% minimal ETE, and 4.0% extensive ETE. Compared to patients with no ETE, patients with minimal and extensive ETE were more likely to have larger tumors (1.4 cm vs 1.8 cm and 2.0 cm, respectively), lymphovascular invasion (8.6% vs 28.0% and 35.1%), positive margins after thyroidectomy (6.1% vs 35.2% and 45.9%), and regional lymph node metastases (32.5% vs 67.0% and 74.6%) (all p<0.01), respectively. After adjustment, minimal ETE (HR=1.13; p<0.01) and extensive ETE (HR=1.74; p<0.01) were associated with compromised survival for patients with differentiated thyroid cancer. In total, 3,415 patients with medullary thyroid cancer met inclusion criteria; 87.9% had no ETE, 7.1% minimal ETE, and 5.0% extensive ETE. Compared to patients with no ETE, patients with minimal and extensive ETE were more likely to have larger tumors (1.7 cm vs 2.2 cm and 2.2 cm, respectively), lymphovascular invasion (19.2% vs 68.9% and 79.3%), positive margins after thyroidectomy (5.8% vs 44.1% and 51.9%), and regional lymph node metastases (39.0% vs 90.5% and 94.4%) (all p<0.01), respectively. After adjustment, extensive ETE (HR=1.63; p=0.01) was associated with compromised survival for patients with medullary thyroid cancer. Conclusion In patients with differentiated and medullary thyroid cancers, ETE is associated with compromised survival. Given these findings, ETE should be included in the thyroid cancer treatment guidelines.

PMID: 27597378 [PubMed - as supplied by publisher]



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Posterior fixation with C1 lateral mass screws and C2 pars screws for type II Odontoid Fracture in the elderly: Long Term Follow-Up.

Posterior fixation with C1 lateral mass screws and C2 pars screws for type II Odontoid Fracture in the elderly: Long Term Follow-Up.

World Neurosurg. 2016 Sep 1;

Authors: Dobran M, Nasi D, Esposito DP, Iacoangeli M

Abstract
OBJECTIVE: To evaluate the long term C1-C2 fusion rates, fracture healing and functional outcomes in geriatric patients with type II odontoid fracture treated with posterior fixation with polyaxial C1 lateral mass screws and C2 pars screws.
METHODS: Twenty-one consecutive patients between 2005 and 2011 with Anderson and D'Alonzo type II odontoid fracture underwent a posterior atlanto-axial fixation with polyaxial C1 lateral mass screws and C2 pars screws. A long-term clinical and radiological follow-up was achieved in all patients with a mean follow-up period of 53.28 ± 15.41 months (range 38-91 months).
RESULTS: All 21 patients had bilateral C1 lateral mass screws and bilateral C2 pars screws. Correct positioning of the C1 lateral mass screws and C2 pars screws was observed in all 42 placements by postoperative CT-scans. No vascular or neurological complication was noted. At the last follow-up, 20 patients (95.24 %) had a solid fusion (defined as Lenke fusion grade of A or B) while 1 patient (4.76 %) had a partial fusion (Lenke fusion grade of C). Overall no hardware failures occurred in any patient. Odontoid fracture healing was achieved in 18 patients out of 21 (85.71 %). The mean postoperative neck disability index (NDI) score was 12.73 % and neck motion was within normal physiologic limits at 12 months.
CONCLUSIONS: This study adds to the evidence that posterior atlantoaxial fixation with polyaxial C1 lateral mass screws and C2 pars screws is a safe and effective surgical option in the treatment of odontoid fractures including long-term stability.

PMID: 27593713 [PubMed - as supplied by publisher]



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[Spinal osteochondroma: diagnostic imaging and treatment. Case reports].

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[Spinal osteochondroma: diagnostic imaging and treatment. Case reports].

Cir Cir. 2015 Nov-Dec;83(6):496-500

Authors: García-Ramos CL, Buganza-Tepole M, Obil-Chavarría CA, Reyes-Sánchez AA

Abstract
BACKGROUND: Osteochondromas are benign bony tumours, with only 1 to 4% being located in the spine. It occurs more frequently in the cervical spine, with C2 being the vertebra most affected. The neurological presentation is slow due to the growth characteristics of the tumour. Computed axial tomography is the reference method for diagnosis. Surgical management is indicated for patients with neurological impairment or pain.
CLINICAL CASE: The first case presents a 21-year-old male with osteochondroma located in the spinous processes of L2, L3 and L4. The second case is a 20-year-old female with multiple osteochondromatosis with tumours at the right lateral mass of C1, with extension to C2 and tumours on the spinous processes of C5 and C7. Both patients presented with painful symptoms, which were resolved after surgical resection of the tumours.
CONCLUSIONS: The rarity of these conditions, relevance of a clinical-radiographic diagnosis, and considerations required for surgical treatment are discussed here.

PMID: 26362790 [PubMed - indexed for MEDLINE]



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Preliminary application of intra-operative hearing monitoring by tone pip ABR via loudspeakers.

Preliminary application of intra-operative hearing monitoring by tone pip ABR via loudspeakers.

Acta Otolaryngol. 2016 Sep 6;:1-7

Authors: Ren W, Ji F, Zeng J, Hao Q, Liu R, Xu G, Yan Y, Zhang M, Zhao H, Yang S

Abstract
CONCLUSION: This method might be an effective intra-operative way to access hearing threshold under general anesthesia in the operating room.
OBJECTIVE: To develop an intra-operative hearing monitoring method for surgeons to access hearing threshold under general anesthesia in the operating room.
METHOD: System establishment and calibration was done firstly. Normal hearing (NH) and conductive hearing loss (CHL) participants were recruited. This study applied pure tone audiometry (PTA) to all subjects and tone pip ABR (tp-ABR) via loudspeakers in sound booth and operating room for NH and CHL subjects, respectively. For NH subjects, Bland Altman was conducted to compare 1k Hz PTA and tp-ABR threshold. For CHL participants, Paired t-test, Satterth waite t'-test, and linear correlation analysis were used to compare the two methods. p < .05 was considered statistically different.
RESULTS: (1) Bland Altman showed all plots were inside the 95% confidence interval, indicating that there was no difference between the two methods for NH subjects. (2) The two methods had a high correlation (Pearson's coefficient =0.872 > 0.6, p < .05) in assessing hearing threshold in the operating room. (3) Satterth waite t'-test showed the ossicular chain malfunction enlarged the deviation of threshold by the two methods (.01 < p < .025).

PMID: 27599303 [PubMed - as supplied by publisher]



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The neutrophil-to-lymphocyte ratio in children with sudden sensorineural hearing loss: a retrospective study.

The neutrophil-to-lymphocyte ratio in children with sudden sensorineural hearing loss: a retrospective study.

Acta Otolaryngol. 2016 Sep 6;:1-4

Authors: Lee JS, Hong SK, Kim DH, Lee JH, Lee HJ, Park B, Choi HG, Kong IG, Song HJ, Kim HJ

Abstract
CONCLUSION: The elevated neutrophil-to-lymphocyte ratio (NLR) value in children with sudden sensorineural hearing loss (SSNHL) would suggest the inflammatory etiology of pediatric SSNHL. The results of this study may suggest NLR value can be used as a useful indicator, which is associated with the disease severity in pediatric SSNHL.
OBJECTIVES: This study aimed to elucidate any clues of inflammatory etiology, which might be related with the development of pediatric SSNHL, using calculated NLR.
METHODS: Forty-six patients aged younger than 19 years, who were admitted to the hospital with the diagnosis of SSNHL, were included in the study. Forty-six healthy children were matched as control group according to their propensity score. The complete blood cell count, calculated NLR, platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) were compared. The relationship between NLR and the initial hearing level was also investigated.
RESULTS: The mean NLR value was 2.86 ± 2.58 in the SSNHL group, whereas the mean NLR value was 1.63 ± 0.87 in the control group. The mean NLR value of the SSNHL children was significantly higher than that of the control group (p = .023). There was a positive correlation between the NLR value and initial hearing level (r = .312, p = .037).

PMID: 27598228 [PubMed - as supplied by publisher]



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Rate of multilingual phonological acquisition: Evidence from a cross-sectional study of English-Mandarin-Malay.

Related Articles

Rate of multilingual phonological acquisition: Evidence from a cross-sectional study of English-Mandarin-Malay.

Clin Linguist Phon. 2015;29(11):793-811

Authors: Lim HW, Wells B, Howard S

Abstract
Early child multilingual acquisition is under-explored. Using a cross-sectional study approach, the present research investigates the rate of multilingual phonological acquisition of English-Mandarin-Malay by 64 ethnic Chinese children aged 2;06-4;05 in Malaysia--a multiracial-multilingual country of Asia. The aims of the study are to provide clinical norms for speech development in the multilingual children and to compare multilingual acquisition with monolingual and bilingual acquisition. An innovative multilingual phonological test which adopts well-defined scoring criteria drawing upon local accents of English, Mandarin and Malay is proposed and described in this article. This procedure has been neglected in the few existing Chinese bilingual phonological acquisition studies resulting in peculiar findings. The multilingual children show comparable phonological acquisition milestones to that of monolingual and bilingual peers acquiring the same languages. The implications of the present results are discussed. The present findings contribute to the development of models and theories of child multilingual acquisition.

PMID: 26237032 [PubMed - indexed for MEDLINE]



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EMBalance - validation of a decision support system in the early diagnostic evaluation and management plan formulation of balance disorders in primary care: study protocol of a feasibility randomised controlled trial.

EMBalance - validation of a decision support system in the early diagnostic evaluation and management plan formulation of balance disorders in primary care: study protocol of a feasibility randomised controlled trial.

Trials. 2016;17(1):435

Authors: Rammazzo L, Kikidis D, Anwer A, Macdonald N, Kyrodimos E, Maurer C, Wuyts F, Luxon L, Bibas A, Bamiou DE

Abstract
BACKGROUND: Balance problems are caused by multiple factors and often lead to falls and related fractures, bringing large socio-economic costs. The complexity of balance control mechanisms, the lack of medical expertise, and the absence of specialised equipment contribute to the delayed or incorrect diagnosis and management ofthese patients. Advances in computer science have allowed the development of computer systems that support clinical diagnosis and treatment decisions based on individualised patient data. The aim of the EMBalance decision support system (DSS) is to support doctors facing this clinical challenge, to make a definitive diagnosis and implement an effective management plan. The EMBalance study will determine the accuracy of this supportive tool when used by non-specialist doctors. This study is funded by the European Union's Seventh Framework Programme.
METHODS/DESIGN: EMBalance is a proof-of-concept study designed as a non-commercial, international, multi-centre, single-blind, parallel-group randomised controlled trial to be carried out at four clinical sites in the United Kingdom, Germany, Greece and Belgium. The study is comprised of three stages: internal pilot, phase I (diagnosis) and stage II (management). For this purpose, 200 patients presenting with persistent dizziness (>3 months' duration) to primary care services will be randomised to either the intervention group (diagnostic assessment with the DSS) or a control group (diagnostic assessment without the DSS). Patients allocated to the intervention group will be assessed by a doctor with the support of the EMBalance DSS, while patients allocated to the control group will receive a visit as per standard practice. Ultimately, all patients' diagnoses and management plans will be certified by a consultant in neuro-otology.
DISCUSSION: EMBalance is the first trial to test the accuracy of a DSS in both the diagnosis of and the management plan for vestibular disorders across the healthcare systems of four different countries. The EMBalance study is the result of a combined effort of engineers and physicians to develop an accurate tool to support non-specialist doctors, with no risk for the patient. This trial will provide reliable information about the benefits of implementing DSSs in primary care while supporting the feasibility of testing the EMBalance algorithms in further research.
TRIAL REGISTRATION: ClinicalTrials.gov NCT02704819 . Registered 29 February 2016.

PMID: 27596486 [PubMed - in process]



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Health-related quality of life and disability in patients with acute unilateral peripheral vestibular disorders.

Health-related quality of life and disability in patients with acute unilateral peripheral vestibular disorders.

Braz J Otorhinolaryngol. 2016 Aug 24;

Authors: Petri M, Chirilă M, Bolboacă SD, Cosgarea M

Abstract
INTRODUCTION: Health-related quality of life (HRQoL) is used to denote that portion of the quality of life that is influenced by the person's health.
OBJECTIVES: To compare the HRQoL of individuals with vestibular disorders of peripheral origin by analyzing functional, emotional and physical disabilities before and after vestibular treatment.
METHODS: A prospective, non randomized case-controlled study was conduced in the ENT Department, between January 2015 and December 2015. All patients were submitted to customize a 36 item of health survey on quality of life, short form 36 health survey questionnaire (SF-36) and the Dizziness Handicap Inventory (DHI) for assessing the disability. Individuals were diagnosed with acute unilateral vestibular peripheral disorders classified in 5 groups: vestibular neuritis, Ménière Disease (MD), Benign Paroxysmal Positional Vertigo (BPPV), cochlear-vestibular dysfunction (other than MD), or other type of acute peripheral vertigo (as vestibular migraine).
RESULTS: There was a statistical significant difference for each parameter of DHI score (the emotional, functional and physical) between the baseline and one month both in men and women, but with any statistical significant difference between 7 days and 14 days. It was found a statistical significant difference for all eight parameters of SF-36 score between the baseline and one month later both in men and women; the exception was the men mental health perception. The correlation between DHI and SF-36 scores according to diagnostics type pointed out that the Spearman's correlation coefficient was moderate correlated with the total scores of these instruments.
CONCLUSION: The DHI and the SF-36 are useful, proved practical and valid instruments for assessing the impact of dizziness on the quality of life of patients with unilateral peripheral vestibular disorders.

PMID: 27595924 [PubMed - as supplied by publisher]



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Responses of the Human Inner Ear to Low-Frequency Sound.

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Responses of the Human Inner Ear to Low-Frequency Sound.

Adv Exp Med Biol. 2016;894:275-84

Authors: Drexl M, Krause E, Gürkov R, Wiegrebe L

Abstract
The perceptual insensitivity to low frequency (LF) sound in humans has led to an underestimation of the physiological impact of LF exposure on the inner ear. It is known, however, that intense, LF sound causes cyclic changes of indicators of inner ear function after LF stimulus offset, for which the term "Bounce" phenomenon has been coined.Here, we show that the mechanical amplification of hair cells (OHCs) is significantly affected after the presentation of LF sound. First, we show the Bounce phenomenon in slow level changes of quadratic, but not cubic, distortion product otoacoustic emissions (DPOAEs). Second, Bouncing in response to LF sound is seen in slow, oscillating frequency and correlated level changes of spontaneous otoacoustic emissions (SOAEs). Surprisingly, LF sound can induce new SOAEs which can persist for tens of seconds. Further, we show that the Bounce persists under free-field conditions, i.e. without an in-ear probe occluding the auditory meatus. Finally, we show that the Bounce is affected by contralateral acoustic stimulation synchronised to the ipsilateral LF sound. These findings clearly demonstrate that the origin of the Bounce lies in the modulation of cochlear amplifier gain. We conclude that activity changes of OHCs are the source of the Bounce, most likely caused by a temporary disturbance of OHC calcium homeostasis. In the light of these findings, the effects of long-duration, anthropogenic LF sound on the human inner ear require further research.

PMID: 27080668 [PubMed - indexed for MEDLINE]



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Microvascular Decompression Surgery for Hemifacial Spasm.

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Microvascular Decompression Surgery for Hemifacial Spasm.

J Craniofac Surg. 2016 Jan;27(1):124-7

Authors: Qi H, Zhang W, Zhang X, Zhao C

Abstract
OBJECTIVE: This study aims to investigate the operative efficacy, surgical complication rate, and surgical strategy of microvascular decompression (MVD) for hemifacial spasm (HFS).
METHODS: Clinical data of 46 patients with HFS who underwent MVD were retrospectively analyzed.
RESULTS: During surgery, it was found that the facial nerve root exit zone was compressed by the following arterial vessels: anterior inferior cerebellar artery in 24 patients (52.17%); posterior inferior cerebellar artery in 14 patients (30.43%); vertebral artery and a small artery in 7 patients (15.22%); and vertebral artery in 1 patient (2.18%). Symptoms of 38 patients were immediately remitted completely after surgery and symptoms of 8 patients were significantly reduced. Main complications included dizziness and tinnitus in 9 patients, hearing loss in 5 patients, cerebrospinal fluid leakage in 1 patient, and infection in 2 patients. No patient died during surgery.
CONCLUSIONS: MVD is the preferred choice for treating idiopathic hemifacial spasm, and hearing impairment is the main complication. Skilled microsurgical techniques, as well as identifying and completely decompressing offending vessels, are the key to ensuring a successful microvascular decompression.

PMID: 26703065 [PubMed - indexed for MEDLINE]



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Endovascular treatment of wide necked ruptured saccular aneurysms with flow- diverter stent.

Endovascular treatment of wide necked ruptured saccular aneurysms with flow- diverter stent.

Turk Neurosurg. 2015 Dec 28;

Authors: Duman E, Çöven İ, Yildirim E, Yilmaz C, Pinar U

Abstract
AIM: Flow diverter (FD) stents have been used in the treatment of unruptured intracranial aneurysms. There are a few studies that report the use of these devices in ruptured blister-like aneurysms. We present 5 consecutive patients, who have ruptured intracranial wide necked or side branch close to the neck of saccular aneurysms, have no other treatment options, treated with FD stents and coil embolization.
MATERIAL AND METHODS: Between September 2012 and April 2015, 139 ruptured aneurysms of 133 consequent patients were treated. Of these, 48 were surgically treated aneurysms. Five of remaining 85 aneurysms treated with FD stents. Three aneurysms were posterior communicant artery, and 2 were supraclinoid ICA. Partial coil embolization performed in three patients additional to FD stents. All patients were treated in first 3 day after bleeding.
RESULTS: Technical success was 100%. Inappropriate deployment of silk stent and partial thrombus formation was occurred in one patient due to the jailed microcatheter. Inappropriate apposition of stent was corrected with a balloon, and thrombus resolved with tirofiban , tPA injections. No other complication or death occurred related to the procedure. One patient who has giant ICA aneurysm and Fisher grade 4 bleeding was died due to vasospasm, cerebral edema and sepsis on postoperative 13th day. The other patients were followed-up with CTA at 6th month and DSA at 12th month uneventfully.
CONCLUSION: FD stents can be used in the treatment of ruptured large wide necked or side branch close to the neck of saccular aneurysms when other treatment options cannot be performed.

PMID: 27593785 [PubMed - as supplied by publisher]



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Massive Cerebrospinal Fluid Leak of the Temporal Bone.

Massive Cerebrospinal Fluid Leak of the Temporal Bone.

Case Rep Otolaryngol. 2016;2016:7521798

Authors: Iannella G, Manno A, Pasqualitto E, Ciofalo A, Angeletti D, Pasquariello B, Magliulo G

Abstract
Cerebrospinal fluid (CSF) leakage of the temporal bone region is defined as abnormal communications between the subarachnoidal space and the air-containing spaces of the temporal bone. CSF leak remains one of the most frequent complications after VS surgery. Radiotherapy is considered a predisposing factor for development of temporal bone CSF leak because it may impair dural repair mechanisms, thus causing inadequate dural sealing. The authors describe the case of a 47-year-old man with a massive effusion of CSF which extended from the posterior and lateral skull base to the first cervical vertebrae; this complication appeared after a partial enucleation of a vestibular schwannoma (VS) with subsequent radiation treatment and second operation with total VS resection.

PMID: 27597915 [PubMed]



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Does shunt selection affect the rate of early shunt complications in neonatal myelomeningocele-associated hydrocephalus? -a multi-center report.

Does shunt selection affect the rate of early shunt complications in neonatal myelomeningocele-associated hydrocephalus? -a multi-center report.

Turk Neurosurg. 2016 Jul 28;

Authors: Kahilogullari G, Etus V, Tugba Morali G, Hakan K, Agahan U

Abstract
AIM: To evaluate the effect of shunt selection on the rate of shunt revision due to early shunt com-plications in neonatal myelomeningocele-associated hydrocephalus.
MATERIAL AND METHODS: The data of a total of 157 neonatal myelomeningocele cases in three pediatric neurosurgery centers (Ankara University, Kocaeli University, Selcuk University) who underwent shunt surgery at the time of myelomeningocele repair between 2000 and 2014 were retrospectively analyzed. Clinical features of the patients shunt types used, and early shunt complications within the first three months were recorded. The patients were classified according to several features of the shunt systems used, such as the valve type, valve size/contour and catheter type.
RESULTS: Of all patients, 71 (45.2%) underwent early shunt revision surgery due to various complications. Mechanical complications were the most frequent cause of shunt failure, followed by infection. There was no significant difference among valve types. Also, no significant difference was observed among the catheter types. Only preferred valve contour/size (contoured regular /ultra-small / burr-hole / cylindrical / neonatal) seemed to significantly affect the rate of early complications. The patients with neonatal-design valves or ultra-small valves had significantly less problems, such as poor wound-healing, wound-dehiscence, cerebrospinal fluid leak or an exposed-shunt. The infection rate due to such problems was found to be lower.
CONCLUSION: myelomeningocele patients with prominent hydrocephalus frequently have a friable skin, due to reduced macrocrania-related subcutaneous tissues. Our study findings suggest that using small-sized (neonatal-design or ultra-small) valves may significantly reduce the early shunt complication rate in this patient population.

PMID: 27593850 [PubMed - as supplied by publisher]



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Endoscopic Vascular Decompression in trigeminal Neuralgia.

Endoscopic Vascular Decompression in trigeminal Neuralgia.

Turk Neurosurg. 2016 May 25;

Authors: Kher Y, Yadav N, Yadav YR, Parihar V, Ratre S, Bajaj J

Abstract
AIM: Microscope may fail to detect culprit vessel at the root entry zone or distally especially when suprameatal tubercle is prominent and when compressing vessel is lying anteriorly to trigeminal nerve without using significant brain retraction. Endoscopic techniques allow better visualization of nerve and vascular conflict.
MATERIAL AND METHODS: A retrospective study of 178 patients of endoscopic vascular decompression without use of microscope was done. The follow-up period ranged from 12 to 108 months (average 58 months).
RESULTS: Age ranged from 32 to 75 years. Neuralgia was in maxillary, mandibular and both (maxillary and mandibular) divisions in 89, 72 and 16 patients respectively. Duration of operation and hospital stay ranged from 85 -160 minutes and 2 to 10 days (average 2.7 days) respectively. Offending vessels could be identified in 174 patients. Superior cerebellar artery, anterior inferior cerebellar artery, single vessel, double vessels conflicts and vessel anterior to nerve were seen in 136, 76, 133, 41 and 31 patients respectively. The pain was relieved in 167 patients (93.8 %). Temporary complications included trigeminal dysesthesias (3.9%), cerebrospinal fluid leak (2.8%), facial paresis (3.9%), decreased hearing (1.7%) and vertigo (3.3%) patients. Permanent hearing loss, recurrence of pain and re-surgery was observed in 1, 7 and 3 patients respectively.
CONCLUSION: Endoscopic vascular decompression is safe, effective technique for vascular decompression with advantages of better visualization of entire course of nerve and vascular conflict without brain retraction. It also helps in better detection of completeness of surgery.

PMID: 27593827 [PubMed - as supplied by publisher]



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Microvascular Decompression Surgery for Hemifacial Spasm.

http:--pt.wkhealth.com-pt-pt-core-templa Related Articles

Microvascular Decompression Surgery for Hemifacial Spasm.

J Craniofac Surg. 2016 Jan;27(1):124-7

Authors: Qi H, Zhang W, Zhang X, Zhao C

Abstract
OBJECTIVE: This study aims to investigate the operative efficacy, surgical complication rate, and surgical strategy of microvascular decompression (MVD) for hemifacial spasm (HFS).
METHODS: Clinical data of 46 patients with HFS who underwent MVD were retrospectively analyzed.
RESULTS: During surgery, it was found that the facial nerve root exit zone was compressed by the following arterial vessels: anterior inferior cerebellar artery in 24 patients (52.17%); posterior inferior cerebellar artery in 14 patients (30.43%); vertebral artery and a small artery in 7 patients (15.22%); and vertebral artery in 1 patient (2.18%). Symptoms of 38 patients were immediately remitted completely after surgery and symptoms of 8 patients were significantly reduced. Main complications included dizziness and tinnitus in 9 patients, hearing loss in 5 patients, cerebrospinal fluid leakage in 1 patient, and infection in 2 patients. No patient died during surgery.
CONCLUSIONS: MVD is the preferred choice for treating idiopathic hemifacial spasm, and hearing impairment is the main complication. Skilled microsurgical techniques, as well as identifying and completely decompressing offending vessels, are the key to ensuring a successful microvascular decompression.

PMID: 26703065 [PubMed - indexed for MEDLINE]



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Management of swallowing and communication difficulties in Down syndrome: A survey of speech-language pathologists.

Management of swallowing and communication difficulties in Down syndrome: A survey of speech-language pathologists.

Int J Speech Lang Pathol. 2016 Sep 6;:1-12

Authors: Meyer C, Theodoros D, Hickson L

Abstract
PURPOSE: To explore speech pathology services for people with Down syndrome across the lifespan.
METHOD: Speech-language pathologists (SLPs) working in Australia were invited to complete an online survey, which enquired about the speech pathology services they had provided to client/s with Down syndrome in the past 12 months. The data were analysed using descriptive statistics.
RESULT: A total of 390 SLPs completed the survey; 62% reported seeing a client with Down syndrome in the past 12 months. Most commonly, SLPs provided assessment and individual intervention for communication with varying levels of family involvement. The areas of dysphagia and/or communication addressed by SLPs, or in need of more services differed according to the age of the person with Down syndrome. SLPs reported a number of reasons why services were restricted.
CONCLUSION: There is a need to re-assess the way that SLPs currently provide services to people with Down syndrome. More research is needed to develop and evaluate treatment approaches that can be used to better address the needs of this population.

PMID: 27598658 [PubMed - as supplied by publisher]



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Phonological awareness development in children with and without spoken language difficulties: A 12-month longitudinal study of German-speaking pre-school children.

Phonological awareness development in children with and without spoken language difficulties: A 12-month longitudinal study of German-speaking pre-school children.

Int J Speech Lang Pathol. 2016 Sep 6;:1-11

Authors: Schaefer B, Stackhouse J, Wells B

Abstract
PURPOSE: There is strong empirical evidence that English-speaking children with spoken language difficulties (SLD) often have phonological awareness (PA) deficits. The aim of this study was to explore longitudinally if this is also true of pre-school children speaking German, a language that makes extensive use of derivational morphemes which may impact on the acquisition of different PA levels.
METHOD: Thirty 4-year-old children with SLD were assessed on 11 PA subtests at three points over a 12-month period and compared with 97 four-year-old typically developing (TD) children.
RESULT: The TD-group had a mean percentage correct of over 50% for the majority of tasks (including phoneme tasks) and their PA skills developed significantly over time. In contrast, the SLD-group improved their PA performance over time on syllable and rhyme, but not on phoneme level tasks. Group comparisons revealed that children with SLD had weaker PA skills, particularly on phoneme level tasks.
CONCLUSION: The study contributes a longitudinal perspective on PA development before school entry. In line with their English-speaking peers, German-speaking children with SLD showed poorer PA skills than TD peers, indicating that the relationship between SLD and PA is similar across these two related but different languages.

PMID: 27598520 [PubMed - as supplied by publisher]



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Parental involvement in the care and intervention of children with hearing loss.

Parental involvement in the care and intervention of children with hearing loss.

Int J Audiol. 2016 Sep 6;:1-12

Authors: Erbasi E, Scarinci N, Hickson L, Ching TY

Abstract
OBJECTIVE: The present study aimed to explore the nature of parental involvement in the intervention of children with hearing loss, as experienced by parents.
DESIGN: A qualitative descriptive methodology was adopted to conduct semi-structured in-depth interviews with a purposive sample of parents who have a child with hearing loss.
STUDY SAMPLE: Seventeen parents of 11 children aged 6-9 years participated in this study.
RESULTS: The overarching theme of parents taking the central role was identified using thematic analysis. This overarching theme connected five themes which described the nature of parental involvement: (1) parents work behind the scenes; (2) parents act as 'case managers'; (3) parents always have their child's language development in mind; (4) parents' role extends to advocacy for all children with hearing loss; and (5) parents serve a number of roles, but at the end of the day, they are parents.
CONCLUSIONS: The results indicate that parental involvement in the intervention of children with hearing loss is multifaceted in nature and incorporates a broad range of behaviours and practices. These findings have important implications for the provision of family-centred practices.

PMID: 27599106 [PubMed - as supplied by publisher]



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Modifications of the MUlti stimulus test with Hidden Reference and Anchor (MUSHRA) for use in audiology.

Modifications of the MUlti stimulus test with Hidden Reference and Anchor (MUSHRA) for use in audiology.

Int J Audiol. 2016 Sep 6;:1-13

Authors: Völker C, Bisitz T, Huber R, Kollmeier B, Ernst SM

Abstract
OBJECTIVE: Two modifications of the standardised MUlti Stimulus test with Hidden Reference and Anchor (MUSHRA), namely MUSHRA simple and MUSHRA drag&drop, were implemented and evaluated together with the original test method. The modifications were designed to maximise the accessibility of MUSHRA for elderly and technically non-experienced listeners, who constitute the typical target group in hearing aid evaluation.
DESIGN: Three MUSHRA variants were assessed based on subjective and objective measures, e.g. test-retest reliability, discrimination ability, time exposure and overall preference. With each method, participants repeated the task to rate the quality of several hearing aid algorithms four times.
STUDY SAMPLE: Fifty listeners grouped into five subject classes were tested, including elderly and technically non-experienced participants with normal and impaired hearing. Normal-hearing, technically experienced students served as controls.
RESULTS: Both modifications can be used to obtain compatible rating results. Both were preferred over the classical MUSHRA procedure. Technically experienced listeners performed best with the modification MUSHRA drag&drop.
CONCLUSIONS: The comprehensive comparison of the MUSHRA variants demonstrates that the intuitive modification MUSHRA drag&drop can be generally recommended. However, considering e.g. specific evaluation demands, we suggest a differentiated and careful application of listening test methods.

PMID: 27598985 [PubMed - as supplied by publisher]



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Objective assessment of subjective tinnitus through contralateral suppression of otoacoustic emissions by white noise; suggested cut-off points.

Objective assessment of subjective tinnitus through contralateral suppression of otoacoustic emissions by white noise; suggested cut-off points.

Int J Audiol. 2016 Sep 6;:1-7

Authors: Riga M, Komis A, Maragkoudakis P, Korres G, Danielides V

Abstract
OBJECTIVE: Normative otoacoustic emission (OAE) suppression values are currently lacking and the role of cochlear efferent innervation in tinnitus is controversial. The aim of this study was to investigate the association between tinnitus and medial olivocochlear bundle (MOCB) malfunction. Potential suppression amplitude cut-off criteria that could differentiate participants with tinnitus from those without were sought.
DESIGN: Mean suppression amplitudes of transient evoked OAEs and distortion product OAEs by contralateral white noise (50 dBSL) were recorded. Six mean suppression amplitudes criteria were validated as possible cut-off points.
STUDY SAMPLE: The population consisted of normal hearing (n = 78) or presbycusic adults (n = 19) with tinnitus or without (n = 28 and 13, respectively) chronic tinnitus (in total, n = 138 78 females/60males, aged 49 ± 14 years).
RESULTS: Participants with mean suppression values lower than 0.5-1 dBSPL seem to present a high probability to report tinnitus (specificity 88-97%). On the other hand, participants with mean suppression values larger than 2-2.5dBSPL seem to present a high probability of the absence of tinnitus (sensitivity 87-99%). Correlations were stronger among participants with bilateral presence or absence of tinnitus.
CONCLUSIONS: This study seem to confirm an association between tinnitus and low suppression amplitudes (<1 dBSPL), which might evolve into an objective examination tool, supplementary to conventional audiological testing.

PMID: 27598848 [PubMed - as supplied by publisher]



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Provision, perception and use of trainable hearing aids in Australia: a survey of clinicians and hearing impaired adults.

Provision, perception and use of trainable hearing aids in Australia: a survey of clinicians and hearing impaired adults.

Int J Audiol. 2016 Sep 6;:1-9

Authors: Walravens E, Keidser G, Hickson L

Abstract
OBJECTIVE: This study set out to obtain information on the impact of trainable hearing aids among clinicians and hearing aid users and candidates.
DESIGN: Two online adaptive surveys were developed to evaluate provision, uptake and experience or expectation of trainable hearing aids.
STUDY SAMPLE: Responses from 259 clinicians, 81 hearing aid users and 23 candidates for hearing aids were included.
RESULTS: Over half of the clinicians surveyed activated trainable features in hearing aids. Most of these clinicians activated trainable features for selected users and reported positive findings. Most commonly trainable features were not activated because the hearing aid controls had already been disabled for management or client preference. One-third reported that they had no access to trainable aids or they were unsure about the presence or activation of trainable features. The remaining clinicians never activated trainable features. One in five users reported having used trainable aids and 93% would train again. Over 85% of the remaining hearing-impaired adults were interested in trainable aids.
CONCLUSIONS: Positive reports from most providers and users who had experience with the trainable feature support the provision of trainable aids to selected clients, pending more evidence-based data to support the clinical management of such devices.

PMID: 27598724 [PubMed - as supplied by publisher]



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Economic evaluation of long-term impacts of universal newborn hearing screening.

Economic evaluation of long-term impacts of universal newborn hearing screening.

Int J Audiol. 2016 Sep 6;:1-7

Authors: Chiou ST, Lung HL, Chen LS, Yen AM, Fann JC, Chiu SY, Chen HH

Abstract
OBJECTIVE: Little is known about the long-term efficacious and economic impacts of universal newborn hearing screening (UNHS).
DESIGN: An analytical Markov decision model was framed with two screening strategies: UNHS with transient evoked otoacoustic emission (TEOAE) test and automatic acoustic brainstem response (aABR) test against no screening. By estimating intervention and long-term costs on treatment and productivity losses and the utility of life years determined by the status of hearing loss, we computed base-case estimates of the incremental cost-utility ratios (ICURs). The scattered plot of ICUR and acceptability curve was used to assess the economic results of aABR versus TEOAE or both versus no screening.
STUDY SAMPLE: A hypothetical cohort of 200,000 Taiwanese newborns.
RESULTS: TEOAE and aABR dominated over no screening strategy (ICUR = $-4800.89 and $-4111.23, indicating less cost and more utility). Given $20,000 of willingness to pay (WTP), the probability of being cost-effective of aABR against TEOAE was up to 90%.
CONCLUSIONS: UNHS for hearing loss with aABR is the most economic option and supported by economically evidence-based evaluation from societal perspective.

PMID: 27598544 [PubMed - as supplied by publisher]



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