Clinical Implication of the Threshold Equalizing Noise Test in Patients With Sudden Sensorineural Hearing Loss.

Clinical Implication of the Threshold Equalizing Noise Test in Patients With Sudden Sensorineural Hearing Loss.

Otol Neurotol. 2016 Sep 14;

Authors: Choi JE, Lee JJ, Chung WH, Cho YS, Hong SH, Moon IJ

Abstract
OBJECTIVE: The aims of the present study were to investigate the prevalence of cochlear dead regions (DRs) in patients with sudden sensorineural hearing loss (SSNHL) and compare the hearing outcome according to the presence of DRs.
STUDY DESIGN: Retrospective chart review.
SETTING: Tertiary referral center.
PATIENTS AND METHODS: The threshold-equalizing noise (HL) test was performed on a total of 112 ears diagnosed with SSNHL. Ears were divided into two groups based on the presence of DRs. Eighty-two ears belonged to the group without DRs and 30 ears belonged to the group with DRs. There was no difference between the two groups with respect to age, sex, side of affected ear, presence of bilateral SSNHL, presence of vertigo, history of treatment, and initial pure-tone thresholds. Pure-tone audiograms were gathered at the time of initial presentation and at 1, 3, and 6 months after onset of symptoms.
RESULTS: The prevalence of DRs was observed to be 29% and was found to be prevalent at 1k and 1.5k Hz in patients with SSNHL. When the hearing thresholds over times were compared between the two groups, subjects with DRs showed significantly poorer hearing outcome compared with those without DRs. The improvements in word recognition scores over times were also less in subject with DRs than those without DRs.
CONCLUSION: DRs are associated with worse hearing thresholds at follow-up audiogram and might be associated with unfavorable hearing outcome in patients with SSNHL.

PMID: 27631827 [PubMed - as supplied by publisher]

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Modified titration intratympanic gentamicin injection for unilateral intractable Ménière's disease.

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Modified titration intratympanic gentamicin injection for unilateral intractable Ménière's disease.

J Huazhong Univ Sci Technolog Med Sci. 2015 Oct;35(5):747-51

Authors: Liu B, Leng YM, Shi H, Zhou RH, Liu JJ, Zhang WJ, Zhang SL, Kong WJ

Abstract
This study looked into the efficacy of a modified titration protocol of intratympanic gentamicin injection (ITG) in the patients with unilateral intractable Ménière's disease (MD). Modified titration protocol of ITG at a low dose (20 mg/mL) was administered to 10 patients with definite unilateral intractable MD. After initial first two fixed ITGs on weekly basis, the patients might or might not be given any more injections, depending on the appearance of unilateral vestibular loss (UVL). ITG was terminated if the patients satisfied the criteria of UVL. All patients were followed-up for at least two years. The effects of ITG on the vertigo attack, functional level scores and postural balance were evaluated. Of the 10 cases, 8 showed the sign of UVL after receiving initial two ITGs and were not given any more intratympanic injections, and the other 2 patients were administered three ITGs. A two-year follow-up revealed that complete and substantial vertigo control was achieved in 9 cases, and limited vertigo control in 1 patient. Hearing level was lowered in 2 patients. The posture stability and functional level scores were improved. Our study showed that the modified titration protocol of ITG at a low dose could effectively control vertigo in patients with unilateral intractable MD.

PMID: 26489633 [PubMed - indexed for MEDLINE]

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[POSTERIOR LUMBAR INTERBODY FUSION FOR DOUBLE-SEGMENTAL BILATERAL ISTHMIC LUMBAR SPONDYLOLISTHESIS].

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[POSTERIOR LUMBAR INTERBODY FUSION FOR DOUBLE-SEGMENTAL BILATERAL ISTHMIC LUMBAR SPONDYLOLISTHESIS].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2015 Dec;29(12):1500-3

Authors: Xing W, Huo Hongjun, Yang X, Xiao Y, Zhao Y, Fu Y, Zhu Y, Li F, Xin D

Abstract
OBJECTIVE: To explore the effectiveness of posterior lumbar interbody fusion in the treatment of double-segmental bilateral isthmic lumbar spondylolisthesis.
METHODS: Between February 2008 and December 2013, 17 patients with double-segmental bilateral isthmic lumbar spondylolisthesis were treated with posterior lumbar interbody fusion. There were 12 males and 5 females, with an age ranged 48-69 years (mean, 55.4 years). The disease duration ranged from 11 months to 17 years (median, 22 months). According to the Meyerding classification, 30 vertebrea were rated as degree I, 3 as degree II, and 1 as degree III. L₄,₅ was involved in 14 cases and L₃,₄ in 3 cases. The preoperative visual analogue scale (VAS) score was 8.6 ± 3.2.
RESULTS: Cerebrospinal fluid leakage occurred in 2 cases because of intraoperative dural tear; primary healing of incision was obtained, with no operation related complication in the other patients. The patients were followed up 1-6 years (mean, 3.4 years). At last follow-up, VAS score was decreased significantly to 1.1 ± 0.4, showing significant difference when compared with preoperative score (t=7.652, P=0.008). X-ray films showed that slippage vertebral body obtained different degree of reduction, with a complete reduction rate of 85% (29/34) at 1 week after operation. All patients achieved bony union at 6-12 months (mean, 7.4 months). According to the Lenke classification, 13 cases were rated as grade A and 4 cases as grade B. No internal fixation loosening and fracture were observed during the follow-up. Intervertebral disc height was maintained, no loss of spondylolisthesis reduction was found.
CONCLUSION: It can obtain satisfactory clinical result to use spinal canal decompression by posterior approach, and screw fixation for posterior fusion in treatment of double-segmental bilateral isthmic lumbar spondylolisthesis. The key points to successful operation include accurate insertion of screw, effective decompression, distraction before reduction, rational use of pulling screws, and interbody fusion.

PMID: 27044218 [PubMed - indexed for MEDLINE]

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Early detection of hearing impairment in patients with diabetes mellitus with otoacoustic emission. A systematic review and meta-analysis.

Early detection of hearing impairment in patients with diabetes mellitus with otoacoustic emission. A systematic review and meta-analysis.

Acta Otolaryngol. 2016 Sep 15;:1-7

Authors: Hao J, Fu X, Zhang C, Zhang X, Zhao S, Li Y

Abstract
CONCLUSIONS: The distortion product otoacoustic emission (DPOAE) amplitudes in diabetics were significantly lower than those in controls when pure tone audiometry (PTA) was within normal limits, implying cochlear function impairment in the early stage of diabetes mellitus. Retrocochlear damage was suggested by elongated wave latencies and the wave interval of auditory brainstem response (ABR) in diabetics.
OBJECTIVES: This study aimed to systematically analyze the application of DPOAE in evaluation of the hearing function of diabetics.
DATA SOURCES AND REVIEW METHODS: Eligible articles were identified through searches of nine different electronic databases. Two investigators reviewed the original articles independently, with pre-defined inclusion and exclusion criteria. Meta-analyses were conducted by using Metan module.
RESULTS: There were seven articles eligible for the analysis. PTA thresholds were within normal limits in all diabetics at low-middle frequencies. The mean DPOAE amplitudes of diabetics were significantly lower than those of controls. The standardized mean difference (SMD) (95% CI) was -0.49 (-0.70, -0.27), -0.46 (-0.63, -0.30), and -0.60 (-0.77, -0.43) at 1, 2, and 4 kHz, respectively. The latencies of waves I, III, and V in diabetes were significantly longer than those of controls (0.43 (0.23, 0.64), 0.54 (0.33, 0.75), and 0.56 (0.35, 0.77), respectively). The wave interval I-V was significantly longer in diabetics (p < .001, 0.47 [0.24, 0.70]).

PMID: 27632340 [PubMed - as supplied by publisher]

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Clinical outcomes following ear reconstruction with adjuvant 3D template model.

Clinical outcomes following ear reconstruction with adjuvant 3D template model.

Acta Otolaryngol. 2016 Sep 15;:1-6

Authors: Zhu P, Chen S

Abstract
CONCLUSIONS: The use of the 3D template model in microtia surgery leads to satisfactory results, for its contribution to the engraving and localization of the microtia auricle in auricle reconstruction.
OBJECTIVES: The aim of the study was to create an anatomical correct 3D rapid prototyping model for patients with microtia, to assist with the accurate fabrication and localization of a coastal cartilage framework for auricular reconstruction, and patients, who had undergone rib-cartilage reconstruction to treat a congenital auricular defect, were evaluated for aesthetic outcomes following ear reconstruction with a different template model.
METHODS: Forty patients with unilateral congenital microtia were enrolled in this study during the last 2 years, they were divided into two groups randomly before surgery; 20 patients who had a 3D digital template made for clinical application and the other 20 who underwent ear reconstruction with a 2D template.
RESULTS: The patients who had undergone ear reconstruction with the 3D template model had a better result of the appearance and location of the constructed auricle, and a higher level of satisfaction with their clinical outcomes (p < .05).

PMID: 27632079 [PubMed - as supplied by publisher]

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86(th) Annual Meeting of the American Thyroid Association.

86(th) Annual Meeting of the American Thyroid Association.

Thyroid. 2016 Sep;26(S1):P1-A129

Authors:

PMID: 27628677 [PubMed - as supplied by publisher]

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Short Call Author Abstract Index.

Short Call Author Abstract Index.

Thyroid. 2016 Sep;26(S1):A164-A166

Authors:

PMID: 27628676 [PubMed - as supplied by publisher]

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Thyroid. 2016 Sep;26(S1):A138-A163 Authors: PMID: 27628675 [PubMed...

Thyroid. 2016 Sep;26(S1):A138-A163

Authors:

PMID: 27628675 [PubMed - as supplied by publisher]

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Abstract Author Index.

Abstract Author Index.

Thyroid. 2016 Sep;26(S1):A130-A137

Authors:

PMID: 27628674 [PubMed - as supplied by publisher]

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Language and speech outcomes of children with hearing loss and additional disabilities: identifying the variables that influence performance at five years of age.

Language and speech outcomes of children with hearing loss and additional disabilities: identifying the variables that influence performance at five years of age.

Int J Audiol. 2016 Sep 14;:1-12

Authors: Cupples L, Ching TY, Button L, Leigh G, Marnane V, Whitfield J, Gunnourie M, Martin L

Abstract
OBJECTIVE: This study examined language and speech outcomes in young children with hearing loss and additional disabilities.
DESIGN: Receptive and expressive language skills and speech output accuracy were evaluated using direct assessment and caregiver report. Results were analysed first for the entire participant cohort, and then to compare results for children with hearing aids (HAs) versus cochlear implants (CIs).
STUDY SAMPLE: A population-based cohort of 146 five-year-old children with hearing loss and additional disabilities took part.
RESULTS: Across all participants, multiple regressions showed that better language outcomes were associated with milder hearing loss, use of oral communication, higher levels of cognitive ability and maternal education, and earlier device fitting. Speech output accuracy was associated with use of oral communication only. Average outcomes were similar for children with HAs versus CIs, but their associations with demographic variables differed. For HA users, results resembled those for the whole cohort. For CI users, only use of oral communication and higher cognitive ability levels were significantly associated with better language outcomes.
CONCLUSIONS: The results underscore the importance of early device fitting for children with additional disabilities. Strong conclusions cannot be drawn for CI users given the small number of participants with complete data.

PMID: 27630013 [PubMed - as supplied by publisher]

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Tympanometric measurements in conscious sheep - a diagnostic tool for pre-clinical middle ear implant studies.

Tympanometric measurements in conscious sheep - a diagnostic tool for pre-clinical middle ear implant studies.

Int J Audiol. 2016 Sep 14;:1-9

Authors: Pohl F, Paasche G, Lenarz T, Schuon R

Abstract
OBJECTIVE: To investigate and establish the use of tympanometry in conscious sheep to provide a means of objective assessment of tympanic membrane integrity, middle ear ventilation and functioning of the Eustachian tube (ET).
DESIGN: After conditioning the sheep for four weeks, tympanometric measurements at 226 Hz were carried out weekly for 13 weeks. Before measurements, the external ear canal had been cleaned. Resultant curves were classified according to human reference values.
STUDY SAMPLE: Tests were performed on 12 female blackface sheep.
RESULTS: After cleaning of the external ear canal under otoscopic control, tympanic membranes were intact with no evidence of acute or chronic middle ear inflammation, middle ear effusion or retraction. Cleaning ensured valid, objective and reproducible measurements. As the majority of normal tympanograms were notched without the appearance of any malformation, an additional tympanogram type (AN) was introduced. The notched appearance can most likely be explained by the anatomy of the middle ear of the sheep and the test frequency that was used.
CONCLUSION: The current study demonstrated how tympanometry can be used to evaluate treatment modalities for middle ear and ET function in conscious sheep. This provided a large animal model for further human research in otology.

PMID: 27627838 [PubMed - as supplied by publisher]

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Corrigendum.

Related Articles

Corrigendum.

Otolaryngol Head Neck Surg. 2014 Jul;151(1):185

Authors:

Abstract
Shah RK, Boss EF, Brereton J, Roberson DW. Errors in otolaryngology revisited. Otolaryngol Head Neck Surg 2014;150:779-784. (Original doi: 10.1177/0194599814521985).

PMID: 27626283 [PubMed - in process]

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Proposal for a New Exercise Method for Dysphagia with Velopharyngeal Inadequacy: A Case of Bickerstaff's Brainstem Encephalitis.

Proposal for a New Exercise Method for Dysphagia with Velopharyngeal Inadequacy: A Case of Bickerstaff's Brainstem Encephalitis.

Tokai J Exp Clin Med. 2016;41(3):143-146

Authors: Koyama Y, Nitta K, Tochikura M, Kasahara T, Kametsu Y, Toyokura M, Masakado Y

Abstract
Bickerstaff's brainstem encephalitis is an autoimmune disease with the primary lesion situated in the brainstem and three cardinal signs: ophthalmoplegia; ataxia; and impaired consciousness. A 68-year-old man was started on rehabilitation exercise 3 months after onset of Bickerstaff's brainstem encephalitis, due to remnant dysarthria and dysphagia (Functional Oral Intake Scale, level 5) after the cardinal signs of Bickerstaff's brainstem encephalitis resolved. Exercise involved using a straw in the anterior midline between the dorsal tongue and hard palate. While the patient was inhaling through the straw, the straw was blocked. After strengthening suction as much as possible, the patient was asked to immediately dry swallow at the same time that suction was stopped. Effects of exercise were examined using videofluorographic swallowing studies before and after 6 weeks of training to compare posterior and superior velar displacements and the presence of nasopharyngeal reflux. No adverse effects of exercise were encountered, and Functional Oral Intake Scale improved to level 7, with significant increases in posterior and superior velar displacement during swallowing compared with before training. In addition, nasopharyngeal reflux that had consistently been seen on swallowing before training was absent after 6 weeks of exercise. This exercise method may prove useful.

PMID: 27628607 [PubMed - as supplied by publisher]

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Nonspeech Oral Movements and Oral Motor Disorders: A Narrative Review.

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Nonspeech Oral Movements and Oral Motor Disorders: A Narrative Review.

Am J Speech Lang Pathol. 2015 Nov;24(4):763-89

Authors: Kent RD

Abstract
PURPOSE: Speech and other oral functions such as swallowing have been compared and contrasted with oral behaviors variously labeled quasispeech, paraspeech, speechlike, and nonspeech, all of which overlap to some degree in neural control, muscles deployed, and movements performed. Efforts to understand the relationships among these behaviors are hindered by the lack of explicit and widely accepted definitions. This review article offers definitions and taxonomies for nonspeech oral movements and for diverse speaking tasks, both overt and covert.
METHOD: Review of the literature included searches of Medline, Google Scholar, HighWire Press, and various online sources. Search terms pertained to speech, quasispeech, paraspeech, speechlike, and nonspeech oral movements. Searches also were carried out for associated terms in oral biology, craniofacial physiology, and motor control.
RESULTS AND CONCLUSIONS: Nonspeech movements have a broad spectrum of clinical applications, including developmental speech and language disorders, motor speech disorders, feeding and swallowing difficulties, obstructive sleep apnea syndrome, trismus, and tardive stereotypies. The role and benefit of nonspeech oral movements are controversial in many oral motor disorders. It is argued that the clinical value of these movements can be elucidated through careful definitions and task descriptions such as those proposed in this review article.

PMID: 26126128 [PubMed - indexed for MEDLINE]

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Efficacy of CDP and ENG in Detecting Balance Impairment Associated With Cerebral White Matter Changes.

Efficacy of CDP and ENG in Detecting Balance Impairment Associated With Cerebral White Matter Changes.

Otol Neurotol. 2016 Sep 14;

Authors: Urban MJ, Sataloff RT

Abstract
OBJECTIVE: To examine the relationship between white matter changes (WMCs) and abnormal balance test results on computerized dynamic posturography (CDP) and electronystagmography (ENG). Also, to compare the utility of CDP with ENG for this purpose.
STUDY DESIGN: Retrospective case review.
SETTING: Tertiary care referral center.
PATIENTS: A retrospective review of 137 subjects was conducted. The CDP and ENG results were compared between patients with (80) and without (57) WMCs as detected byT2/fluid attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI).
MAIN OUTCOME MEASURES: CDP analysis consisted of both sensory organization test (SOT) and motor control test (MCT) results, and ENG analysis included positional, oculomotor, and bithermal caloric testing. Multivariate logistic regression was performed to control for age and hearing loss discrepancies between the two groups.
RESULTS: Ninety three percent of patients with WMCs had an abnormal CDP result, as compared with 44% of patients lacking WMCs (p < 0.001). Eighty six percent of patients with WMCs had an abnormal ENG, as did 81% of patients without WMCs (p = 0.435). Multivariate regression analysis maintained that an abnormal CDP result was significantly associated with WMCs when controlling for age and hearing loss (p < 0.001).
CONCLUSION: These findings suggest that patients with cerebral small-vessel ischemic changes are significantly more likely to have an abnormal balance result as detected by CDP, than by ENG. Hence, CDP may be a better study to identify and document patients who have balance dysfunction associated with this central finding. Such identification will permit additional evaluation and treatment based on objective confirmation of balance dysfunction, in this group of balance-impaired subjects who may have normal ENG's.

PMID: 27631826 [PubMed - as supplied by publisher]

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The use of narrow band imaging for the detection of benign lesions of the larynx.

The use of narrow band imaging for the detection of benign lesions of the larynx.

Eur Arch Otorhinolaryngol. 2016 Sep 8;

Authors: Dippold S, Nusseck M, Richter B, Echternach M

Abstract
In the cases of uncertainty, even if the patient has no complaints about his voice quality, sometimes, benign vocal fold mass lesions are removed to exclude malignancy with the risk of resultant dysphonia. Narrow Band Imaging (NBI) enables a specific visualization of vessel structures in the superficial tissue. Benign lesions of the larynx are frequently characterized by abnormal vessel configuration or an absence of vessels in the area of the lesion. It was hypothesized that, in the primary diagnosis of patients with these benign lesions, the combination of white light and NBI endoscopy enables a better detection compared with white light endoscopy alone. Twenty-nine patients (eight patients with a cyst on a vocal fold, eight with a polyp, seven with a Reinke´s edema, two with a leukoplakia, one with a carcinoma, one with a granuloma, and two without any pathologic finding) were examined with normal white light and NBI endoscopy. 87 video sequences (29 white, 29 NBI, and 29 white/NBI) were generated and randomized and presented to 20 otolaryngologists who rated the videos in terms of the suspected diagnosis. Results were compared with the histopathologic findings of microlaryngoscopy. The probability of detecting benign lesions of the vocal folds was higher using NBI in combination with white light endoscopy compared with white light endoscopy alone. For vocal fold cysts, this difference was statistically significant. NBI endoscopy in combination with normal white light endoscopy improves the detection rate of benign lesions of the larynx, especially of vocal fold cysts.

PMID: 27631509 [PubMed - as supplied by publisher]

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Measuring the nose in septorhinoplasty patients: ultrasonographic standard values and clinical correlations.

Measuring the nose in septorhinoplasty patients: ultrasonographic standard values and clinical correlations.

Eur Arch Otorhinolaryngol. 2016 Sep 15;

Authors: Stenner M, Koopmann M, Rudack C

Abstract
Although septorhinoplasty is the most commonly performed operation in plastic surgery, and the surgical plan as well as its outcome is directly related to the configuration of the anatomical structures in the nose, these are not routinely assessed preoperatively. The aim of our study was to evaluate the nasal soft tissue and cartilaginous structures by means of high-resolution ultrasonography to set up clinical correlations and standard values. We examined 44 patients before septorhinoplasty by high-resolution ultrasonography in noncontact mode. All pictures were quantitatively evaluated by measuring 13 lengths and 4 ratios. All patients underwent a rhinomanometry measuring the nasal air flow. Besides others, men as well as older patients have a significantly thicker alar cartilage. Patients with thinner alar cartilages have a significantly smaller interdomal distance as well as significantly thinner upper lateral cartilages. The soft tissue above the bony dorsum was significantly thicker in older patients. Younger patients have significantly thicker soft tissue in relation to their cartilage. Patients with thicker soft tissue and thinner cartilage have a smaller tip. The interdomal distance and the thickness of the cartilaginous septum significantly correlated with the nasal air flow. We set up standard values of nasal structures in septorhinoplasty patients which can be used as reference values. By judging cartilage and soft tissue characteristics preoperatively, relevant factors for distinct procedures could be analyzed and the surgical steps can be better planned. Visualization by ultrasonography enables the surgeon to achieve treatment goals in a more predictable fashion.

PMID: 27628964 [PubMed - as supplied by publisher]

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Risk of Peripheral Artery Occlusive Disease in Patients with Vertigo, Tinnitus, or Sudden Deafness: A Secondary Case-Control Analysis of a Nationwide, Population-Based Health Claims Database.

Risk of Peripheral Artery Occlusive Disease in Patients with Vertigo, Tinnitus, or Sudden Deafness: A Secondary Case-Control Analysis of a Nationwide, Population-Based Health Claims Database.

PLoS One. 2016;11(9):e0162629

Authors: Koo M, Chen JC, Hwang JH

Abstract
BACKGROUND: Cochleovestibular symptoms, such as vertigo, tinnitus, and sudden deafness, are common manifestations of microvascular diseases. However, it is unclear whether these symptoms occurred preceding the diagnosis of peripheral artery occlusive disease (PAOD). Therefore, the aim of this case-control study was to investigate the risk of PAOD among patients with vertigo, tinnitus, and sudden deafness using a nationwide, population-based health claim database in Taiwan.
METHODS: We identified 5,340 adult patients with PAOD diagnosed between January 1, 2006 and December 31, 2010 and 16,020 controls, frequency matched on age interval, sex, and year of index date, from the Taiwan National Health Insurance Research Database. Risks of PAOD in patients with vertigo, tinnitus, or sudden deafness were separately evaluated with multivariate logistic regression analyses.
RESULTS: Of the 5,340 patients with PAOD, 12.7%, 6.7%, and 0.3% were diagnosed with vertigo, tinnitus, and sudden deafness, respectively. In the controls, 10.6%, 6.1%, and 0.3% were diagnosed with vertigo (P < 0.001), tinnitus (P = 0.161), and sudden deafness (P = 0.774), respectively. Results from the multivariate logistic regression analyses showed that the risk of PAOD was significantly increased in patients with vertigo (adjusted odds ratio = 1.12, P = 0.027) but not in those with tinnitus or sudden deafness.
CONCLUSIONS: A modest increase in the risk of PAOD was observed among Taiwanese patients with vertigo, after adjustment for comorbidities.

PMID: 27631630 [PubMed - as supplied by publisher]

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Reactive Neurogenesis and Down-Regulation of the Potassium-Chloride Cotransporter KCC2 in the Cochlear Nuclei after Cochlear Deafferentation.

Reactive Neurogenesis and Down-Regulation of the Potassium-Chloride Cotransporter KCC2 in the Cochlear Nuclei after Cochlear Deafferentation.

Front Pharmacol. 2016;7:281

Authors: Tighilet B, Dutheil S, Siponen MI, Noreña AJ

Abstract
While many studies have been devoted to investigating the homeostatic plasticity triggered by cochlear hearing loss, the cellular and molecular mechanisms involved in these central changes remain elusive. In the present study, we investigated the possibility of reactive neurogenesis after unilateral cochlear nerve section in the cochlear nucleus (CN) of cats. We found a strong cell proliferation in all the CN sub-divisions ipsilateral to the lesion. Most of the newly generated cells survive up to 1 month after cochlear deafferentation in all cochlear nuclei (except the dorsal CN) and give rise to a variety of cell types, i.e., microglial cells, astrocytes, and neurons. Interestingly, many of the newborn neurons had an inhibitory (GABAergic) phenotype. This result is intriguing since sensory deafferentation is usually accompanied by enhanced excitation, consistent with a reduction in central inhibition. The membrane potential effect of GABA depends, however, on the intra-cellular chloride concentration, which is maintained at low levels in adults by the potassium chloride co-transporter KCC2. The KCC2 density on the plasma membrane of neurons was then assessed after cochlear deafferentation in the cochlear nuclei ipsilateral and contralateral to the lesion. Cochlear deafferentation is accompanied by a strong down-regulation of KCC2 ipsilateral to the lesion at 3 and 30 days post-lesion. This study suggests that reactive neurogenesis and down-regulation of KCC2 is part of the vast repertoire involved in homeostatic plasticity triggered by hearing loss. These central changes may also play a role in the generation of tinnitus and hyperacusis.

PMID: 27630564 [PubMed - as supplied by publisher]

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CBCT Evaluation of the tridimensional relationship between impacted lower third molar and the inferior alveolar nerve position.

CBCT Evaluation of the tridimensional relationship between impacted lower third molar and the inferior alveolar nerve position.

Minerva Stomatol. 2016 Sep 15;

Authors: Borgonovo AE, Rigaldo F, Maiorana C, Grossi GB, Augusti D, Re D

Abstract
BACKGROUND: The aim of this study is to evaluate if the statistical significant relations between the measures taken exists or not and to show how the 3D reconstruction could be help the oral surgeon in all those instances in which it may have a direct impact on the planning of the surgical steps.
METHODS: Thanks to use of NobelClinicianTM Software it was possible to analyze 200 mandibular tomography computerized, random selected, and create a 3D reconstruction of mandibular bone, point out dental structure of wisdom tooth and the way of IAN. Statistical analysis was performed using the Statistical Package for Social Sciences. One way ANOVA test was used to measure the association between each independent variable and the outcome variable, followed by the post-hoc least significant difference (LSD) test for intergroup differences.
RESULTS: Two independent variables were significant predictors for risk to have the distance 0 mm from IAN to apex: "Ramus relationship/space available" and "depth".
CONCLUSIONS: The 3D reconstruction software provide surgeons with an additional planning tool, offering: immediate and neat visualization of the noble structures that have to be respected and their localization in the three spatial planes; the exact morphology of the relevant root apex; a 360° view of the relationship between the IAN and the third molar and the exact point in which the root is in relationship with the canal.

PMID: 27627858 [PubMed - as supplied by publisher]

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Labels, identity and narratives in children with primary speech and language impairments.

Labels, identity and narratives in children with primary speech and language impairments.

Int J Speech Lang Pathol. 2016 Sep 15;:1-16

Authors: Lyons R, Roulstone S

Abstract
PURPOSE: There has been debate about labels in relation to speech and language impairments. However, children's views are missing from this debate, which is risky considering that labels with negative associations may result in stigma. The aim of this study was to explore the range of identities which children with primary speech and language impairments presented in their narratives and to investigate their evaluations of these identities with a view to understanding the values they attach to labels.
METHOD: Eleven children aged 9-12 years with primary speech and language impairments were recruited to the study. Fifty nine semi-structured interviews were conducted with the aim of generating storied accounts of everyday experiences. The data were analysed using thematic analysis. Two themes were identified in the data: desired identities and undesired identities.
RESULT: The findings suggest that the children were actively involved in identity construction and wanted to be seen in positive ways. They disliked labels assigned by others, which they considered portrayed them in negative ways.
CONCLUSION: The debate about labels could be progressed by consulting with children themselves asking for their ideas in relation to labels in specialist education, and speech and language pathology.

PMID: 27631150 [PubMed - as supplied by publisher]

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"Gan To Kagaku Ryoho"[jour]; +20 new citations

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Middle Cranial Fossa (MCF) Approach Without the Use of Lumbar Drain for the Management of Spontaneous Cerebral Spinal Fluid (CSF) Leaks.

Middle Cranial Fossa (MCF) Approach Without the Use of Lumbar Drain for the Management of Spontaneous Cerebral Spinal Fluid (CSF) Leaks.

Otol Neurotol. 2016 Sep 14;

Authors: Nelson RF, Roche JP, Gantz BJ, Hansen MR

Abstract
OBJECTIVE: To determine the efficacy and morbidity of repairing spontaneous cerebrospinal fluid (CSF) leaks with the middle cranial fossa (MCF) approach without the use of a lumbar drain (LD), as perioperative use of LD remains controversial.
STUDY DESIGN: Retrospective review from 2003 to 2015.
SETTING: University of Iowa Hospitals and Clinics and Indiana University Health Center.
PATIENTS: Those with a confirmed lateral skull base spontaneous CSF leaks and/or encephaloceles.
INTERVENTION: MCF approach for repair of spontaneous CSF leak and/or encephalocele without the use of lumbar drain. Assessment of patient age, sex, body mass index (BMI), and medical comorbidities.
MAIN OUTCOME MEASURE: Spontaneous CSF leak patient characteristics (age, sex, BMI, obstructive sleep apnea) were collected. Length of stay (LOS), hospital costs, postoperative complications, CSF leak rate, and need for LD were calculated.
RESULTS: Sixty-five operative MCF repairs were performed for spontaneous CSF leaks on 60 patients (five had bilateral CSF leaks). CSF diversion with LD was used in 15 of 60 patients, mostly before 2010. After 2010, only three of 44 patients (6.7%) had postoperative otorrhea requiring LD. The use of LD resulted in significantly longer LOS (3.6 ± 1.6 versus 8.7 ± 2.9 d) and hospital costs ($29,621). There were no postoperative complications in 77% (50 of 65) of cases. Three cases required return to the operating room for complications including frontal subdural hematoma (1), subdural CSF collection (1), and tension pneumocephalus (1). No patients experienced long-term neurologic sequelae or long-term CSF leak recurrence with an average length of follow-up of 19.5 months (range 3-137 mo). The average patient BMI was 37.5 ± 8.6 kg/m. The average age was 57.5 ± 11.4 years and 68% were female. Obstructive sleep apnea was present in 43.3% (26 of 60) of patients.
CONCLUSION: The morbidity of the MCF craniotomy for repair of spontaneous CSF leaks is low and the long-term efficacy of repair is high. Universal use of perioperative lumbar drain is not indicated and significantly increases length of stay and hospital costs. Obesity and obstructive sleep apnea are highly associated with spontaneous CSF leaks.

PMID: 27631830 [PubMed - as supplied by publisher]

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