Αρχειοθήκη ιστολογίου

Σάββατο 31 Οκτωβρίου 2015

Correlation of Otorhinolaryngologic Symptoms with Physical Findings in Behçet's Disease.

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Correlation of Otorhinolaryngologic Symptoms with Physical Findings in Behçet's Disease.

B-ENT. 2015;11(1):31-7

Authors: Meric A, Dogan R, Su O, Eren SB, Tugrul S, Ozturan O

Abstract
OBJECTIVE: Behçet's disease is a chronic systemic inflammatory disease of unknown etiology. We examined the correlation between otorhinolaryngologic symptoms and otorhinolaryngologic physical findings in patients with Behçet's disease, in search of strategies to reduce the morbidity rates.
METHODS: Seventy-two patients diagnosed with Behçet's disease were included. After giving a detailed history of oropharyngeal, nasal, laryngeal, and otic symptoms, patients were examined endoscopically by an otolaryngologist, and the findings were recorded.
RESULTS: Thirty-nine of the patients were male, and thirty-three were female. The mean age was 39.2 ± 3.4, and the mean disease duration was 8.24 ± 4.2 years. Statistically significant correlations were observed between ear lesions and ear symptoms (crusting and otic pain), nasal lesions and nasal symptoms (crusting and nasal pain), oropharyngeal lesions and oropharyngeal symptoms (pain and difficulty in swallowing), and laryngeal lesions and laryngeal symptoms (hoarseness, difficulty in swallowing, and pain).
CONCLUSION: The results demonstrated a positive correlation between symptoms and otorhinolaryngeal examination findings in Behçet's disease. Potential morbidities can be prevented by routine endoscopic otorhinolaryngeal examinations and symptom screening of patients with Behçet's disease and arranging the therapy accordingly.

PMID: 26513945 [PubMed - in process]



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The relationship between serum urea levels and outcome in acute epistaxis.

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The relationship between serum urea levels and outcome in acute epistaxis.

B-ENT. 2015;11(1):25-9

Authors: Fishpool SJ, Foley K, Bul S, Whittet H

Abstract
OBJECTIVES: To establish whether, for the patient presenting with epistaxis, there is a relationship between clinical outcome and serum urea levels measured on initial attendance at the accident and emergency (A&E) department.
METHODOLOGY: Records were reviewed from all patients attending a single teaching hospital A&E department between 1st January 2010 and 11st February 2011 with a diagnosis of epistaxis. Patients were analysed according to their admission serum urea and creatinine levels and then grouped according to clinical outcome.
RESULTS: We identified 278 patients (145 males, 133 females), 82 of which required hospital admission. Eleven required blood transfusion, and five required surgical arrest of the haemorrhage. No patients died. Serum urea and creatinine levels were measured in 119/278 patients. The mean serum urea level was significantly higher in patients admitted for further management of epistaxis than in patients who were discharged from the A&E department (9.35 mmol/l vs. 6.74 mmol/l, respectively; p = 0.003). There was no significant difference in mean serum urea levels between patients who were transfused and patients who were not, or between patients who went to the operating theatre and patients who did not.
CONCLUSIONS: Elevated serum urea levels on hospital admission are related to more severe clinical outcome in epistaxis.

PMID: 26513944 [PubMed - in process]



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Preoperative anxiety and postoperative pain in patients undergoing septoplasty.

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Preoperative anxiety and postoperative pain in patients undergoing septoplasty.

B-ENT. 2015;11(1):19-23

Authors: Ocalan R, Akin C, Disli ZK, Kilinc T, Ozlugedik S

Abstract
OBJECTIVE: The aim of the study was to determine whether psychological variables such as preoperative anxiety could serve as predictors of the postoperative pain response.
METHODS: Sixty consecutive patients with deviated nasal septum were evaluated in the pre- and postoperative periods. A questionnaire that included sociodemographic features was administered to patients. Preoperative anxiety was assessed by the Spielberger State-Trait Anxiety Index. The severity of pain was recorded with a ten-point Visual Analog Scale at the immediate postoperative period (baseline) and at postoperative hours 2, 4, 6, 12, and 24.
RESULTS: Sixty patients met the eligibility criteria for the study. Of the 60 patients (39 men and 21 women) whose charts were reviewed, the mean age was 30.9 ± 12.6 years for men and 32.8 ± 10.4 years for women. The mean State-Trait Anxiety Index score was 44.3 ± 7.5 (range 29-67). No significant relationship was found between the patients' self-reports of postoperative pain and sociodemographic variables such as age and educational status. Men and women showed significant differences with respect to pain in the immediate and late postoperative periods. Correlation tests identified a significant relationship between patients' preoperative anxiety and postoperative pain in both the immediate and late periods.
CONCLUSIONS: The results of this study suggest that early interventions to minimize the preoperative anxiety stress response may affect the postoperative pain response.

PMID: 26513943 [PubMed - in process]



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Rupatadine relieves allergic rhinitis: a prospective observational study.

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Rupatadine relieves allergic rhinitis: a prospective observational study.

B-ENT. 2015;11(1):11-8

Authors: Eloy P, Tobback L, Imschoot J

Abstract
BACKGROUND: Allergic rhinitis has reached epidemic levels for years in Belgium and substantially impacts the quality of life of patients. Observational, non-interventional studies can provide valuable data, supplementing findings from double-blind trials, on the true value of a drug therapy in daily practice. Rupatadine is a new, second-generation, selective oral H1-antihistamine. The primary objective of.this study was to evaluate the evolution of quality of life in patients treated with rupatadine in clinical practice. The impact of rupatadine on the severity of allergic rhinitis symptoms, the subject's evaluation of the treatment, and the safety of rupatadine were also evaluated.
METHODS: This prospective, non-interventional, observational, multicenter study included 2,838 adults aged over 18 years. The diagnosis of moderate to severe allergic rhinitis was confirmed. Patients were assessed with validated scales at baseline and after 6 weeks of treatment with rupatadine (10 mg, once daily).
RESULTS: All outcome parameters improved significantly: mini-rhinoconjunctivitis quality of life questionnaire (mini- RQLQ, p < 0.001), total 5-symptom score (T5SS) severity (p < 0.001), visual analog scale (VAS) of symptom severity (p < 0.001), and the allergic rhinitis and its impact on asthma (ARIA) severity classification (p < 0.001). Compliance was very good in 72.2% of patients, and only a few minor adverse effects were reported. The therapeutic responses, evaluated by the patients, were complete relief in 21% and strong relief in 62%.
CONCLUSION: This study, which included a wide cohort of allergic-rhinitis patients, confirmed the clinical benefit of rupatadine when prescribed in clinical practice, even for the most severe symptoms, including nasal congestion.

PMID: 26513942 [PubMed - in process]



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Recruitment and activation of circulating neutrophils after sinus surgery.

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Recruitment and activation of circulating neutrophils after sinus surgery.

B-ENT. 2015;11(1):1-10

Authors: Watelet JB, Chatelain B, Eloy P, Dogne JM, Mullier F

Abstract
OBJECTIVE: After failure of pharmacological treatment, sinus surgery is the recommended alternative treatment for chronic sinusitis with or without nasal polyps. During post-operative healing, adequate local neutrophil activation plays an important role in the repair process. This pilot study aimed to systematically explore the participation of circulating neutrophils in early-phase wound repair of the nasal and paranasal mucosa after sinus surgery, with a special focus on neutrophil recruitment and activation patterns.
METHODOLOGY: We conducted a single-center outcome study of patients undergoing sinus surgery. Whole blood samples were collected from eleven patients before surgery and at post-surgical time points of 1 hour and 1, 7, 14, and 30 days. Hematological analysis was conducted to count circulating neutrophils and evaluate their overall activation status. Using flow cytometry, neutrophil expression of membrane CD11b, CD11c, and CD15 was also measured, and oxidative burst analysis was performed.
RESULTS: After sinus surgery, neutrophilia increased by 1 hour after surgery, reached a maximum at Day 1, and showed a gradual return toward baseline by Day 30. The oxidative burst initially decreased during the first hours after surgery, increased at Day 14, and returned toward normal by Day 30. Lewis X factor and the expression of CD11b and CD11c exhibited a bimodal change over time, in an inverted phase compared to the oxidative reaction.
CONCLUSIONS: Circulating neutrophils are involved in the first phase of wound healing after sinus surgery as indicated by increased abundance, early membrane changes, and the modulation of their oxidative capacities.

PMID: 26513941 [PubMed - in process]



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[The research status of probiotic treatment of allergic rhinitis].

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[The research status of probiotic treatment of allergic rhinitis].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1140-2

Authors: Qiao W, Feng K, Luo Q

Abstract
Allergic rhinitis is nasal mucosa of immediate hypersensitivity, and the current treatment is not satisfied. With the increasing incidence in recent years, we pay more attention on the effective treatments. There are some published studies indicate the benefit of probiotic for allergic rhinitis. Refer to the related literature in recent years, the paper will discuss probiotic species, safety, route of administration, mechanism and efficacy, pointing out a new direction for the treatment of allergic rhinitis.

PMID: 26514016 [PubMed - in process]



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[One case of human nasal myiasis].

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[One case of human nasal myiasis].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1138-9

Authors: Su H, Liu L, Zhao Y

Abstract
Human myiasis is caused by the parasitic maggots of flies. We report a case of nasal myiasis in a 37-year-old woman in Henan. The patient presented with nasal foreign-body sensation, nansal itching sneezing, snuffle and such allergic symptoms in nasal cavity. Based on maggots that were bowed from the right nasal cavity, a detailed endoscopic examination, sinus CT scan and identification of the maggot's species done by parapsychologists of the parasitology teaching and reseach section of the Zhengzhou University School of Medicine, the diagnosis of human nasal infestation by oestrus ovis was definited.

PMID: 26514015 [PubMed - in process]



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[Pyogenic granuloma of inferior turbinate: a case report].

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[Pyogenic granuloma of inferior turbinate: a case report].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1137-8

Authors: Zhang S, Liu Y, Jiang Z

Abstract
A case of pyogenic granuloma occurred in inferior turbinate was reported and the literatures were reviewed. A 32 years old male patient with left side progressive stuffy nose and repeated epistaxis. Nasal endoscopic examination showed a dark red neoplasm in left nasal cavity and blocked the anterior naris. Nasal cavity enhanced CT showed the neoplasm located in the front of left nasal cavity with marked enhancement. Bilateral sinuses were normal and there was no significant bone destruction. Nasal endoscopic surgery was performed under local anesthesia. Postoperative pathology report showed pyogenic granuloma (granulation tissue type of angioneoplasm).

PMID: 26514014 [PubMed - in process]



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[Digestive system carcinoma metastatic to the nasal cavity: two case report].

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[Digestive system carcinoma metastatic to the nasal cavity: two case report].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1134-6

Authors: Wang W, Ying L, Zhu Z

Abstract
Metastatic tumors to the nasal cavity and paranasal sinuses are far less common than primary cancer in this location. The digestive system malignant tumor metastasis to the nose is rarer. The clinical presentation of metastases is similar to that of primary tumors and common symptoms include recurrent epistaxis, nasal obstruction and facial pain. Metastases to the nose and paranasal sinuses usually respond poorly to treatment and have a poor prognosis.

PMID: 26514013 [PubMed - in process]



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[Nasopharynx pleomorphic adenoma report].

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[Nasopharynx pleomorphic adenoma report].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1133-4

Authors: Liu X, Zhang Q, She C

Abstract
The patient was a 42 years old female. And the reason why she was addmited to the hospital was progressive bilateral nasal congestion for one year, and bilateral nasal bleeding for one day. Physical examination showed no surgical contraindication so the patient got the nasal endoscope by plasma radiofrequency ablation surgery with general anesthesia on 3rd Dec. 2013. And the result of potholegical examination was nasopharynx pleomorphic adenoma.

PMID: 26514012 [PubMed - in process]



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[A case report of endoscopic assisted unilateral infraorbital nerve decompression].

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[A case report of endoscopic assisted unilateral infraorbital nerve decompression].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1131-2

Authors: Chen Y, An Y, Zhao C

Abstract
Patients of infraorbital nerve injury often appear in the sensory abnormalities of corresponding position, such as numbness or pain. We present a case with numbness of the left cheek because of the injury. The patient were treated by endoscopic assisted on the left infraorbital nerve decompression through the approach of the canine fossa. The symptom shows improvement after the operation. The patient feels numbness significantly ease on 4 months after the operation.

PMID: 26514011 [PubMed - in process]



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[Intranasal endoscopic coblation exairesis for nasal vestibular cyst].

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[Intranasal endoscopic coblation exairesis for nasal vestibular cyst].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1129-30

Authors: Wang X, Zhang H, Li Z

PMID: 26514010 [PubMed - in process]



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[The extraction of foreign body in nasal sinus and bases of skull: craniotomy or not?].

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[The extraction of foreign body in nasal sinus and bases of skull: craniotomy or not?].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1127-9

Authors: Fu Z, Wang S, Zhang Y

PMID: 26514009 [PubMed - in process]



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[The application of expandible and soluble chitosan sponge in patients with the disease of haematology nasal bleeding].

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[The application of expandible and soluble chitosan sponge in patients with the disease of haematology nasal bleeding].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1126-7

Authors: Liu T, Ren S, Zhu X

PMID: 26514008 [PubMed - in process]



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[Effect of dexamethasone on the expression of Tregs in allergic rhinitis mice].

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[Effect of dexamethasone on the expression of Tregs in allergic rhinitis mice].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1121-5

Authors: Jiang T, Wang W, Zhu Z, Zhu L, Ma Z

Abstract
OBJECTIVE: To investigate the effect of dxamethasone (DEX) on the expression of Tregs in allergic rhinitis (AR) mice, and explore the mechanism of glucocorticoid in the treatment of AR.
METHOD: AR murine model was established by sensitization and challenge with OVA, besides intervention treatment with DEX was carried out in AR model. The behavior observation was used to evaluate the improvement effect of DEX on AR symptoms. The morphological characteristics of nasal tissues were observed by HE staining after fixation and decalcification. The mononuclear cells were obtained by grinding spleens, and the total RNA was extracted for reverse transcriptase polymerase chain reaction to investigate the level of mRNA expression of Foxp3. The changes of CD4+ Foxp3+ Tcells in spleen of mice were analyzed by flow cytometry.
RESULT: BALB/c mice received OVA sensitization followed by OVA intranasal challenge, the frequencies of sneezing and nose-scratching increased significantly in AR group (44. 50 ± 5. 61 and 72. 94 ± 8. 76) compared with control group (12. 68 ± 1. 87 and 26. 76 ± .2. 89), P<0. 01; The frequencies decreased significantly in DEX group (26. 04 ± 3. 93 and 56. 79 ± 5. 64), P< 0. 05 compared with AR group. The continuity of nasal mucosa ciliated columnar epithelium in AR group was destroyed and appeared to be repaired in DEX group. Inflammatory cells infiltration was also markedly decreased by DEX treatment. The proportion of CD4+ Foxp3+ T cells in AR group (3. 89 ± 0. 39)% decreased, P<0. 01 vs control group (4. 63 ± 0. 15) %. DEX treatment induced production of Tregs (6. 89 ± 0. 49)%, P<0. 05 vs control group. DEX significantly increased the expression of Foxp3 mRNA (P<0. 05) compared with AR and control group.
CONCLUSION: DEX reduce upper airway allergic inflammation effectively, which may be mediated by promoting the expression of Foxp3 and inducing the amplification of Tregs in vivo.

PMID: 26514007 [PubMed - in process]



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[An in vitro study on substance P-stimulated neuro-immune mechanism of mast cell degranulation].

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[An in vitro study on substance P-stimulated neuro-immune mechanism of mast cell degranulation].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1118-20

Authors: Li Q, Zhao C

Abstract
OBJECTIVE: The goal of this study was to study the mechanism of substance P (SP)-mediated the neural control of mast cell (MC) degranulation.
METHOD: Bone marrow mast cells from mice were cultured with stem cell factor (SCF), IL-3 and IL-4 (group A) and SCF, IL-3 (group B) for four weeks. Then the cells were harvested and reserved for studies. Western Blot hybridization technique was used to detect the expression of FcεR I α and NK-1R on MCs from the two groups. Then such cells were activated with SP (0, 0. 01, 0. 10, 1. 00, 10. 00 µg/ml, respectively) for 30 min. The histamine released into the supernatant and stored in the protoplasm was quantified by enzyme linked immunosorbent assay (ELISA). And the percentage of histamine release was calculated as a percent of total histamine content.
RESULT: The expressions of FcεR I α and NK-1R on these mast cells in group A were statistically higher than in group B (P<0. 05). The MCs from two groups can be actived when stimulated by SP, but the level of MC degranulation in group A was higher than group B (P<0. 05).
CONCLUSION: Neuropeptide may stimulate MC degranulation through immunological and non-immunological pathways. In summary, the current study provides us with better understanding of the mechanism of neuropeptide-controlled MC deranulation, and this should be helpful for the further research involved in the mechanism and treatmemt of airway hyper-reactivity.

PMID: 26514006 [PubMed - in process]



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[The clinical characters and surgical management of nasopharyngeal teratoma in infants].

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[The clinical characters and surgical management of nasopharyngeal teratoma in infants].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1115-7

Authors: Xia F, Wang Z, Xu Z

Abstract
OBJECTIVE: To describe and analyze the clinical characteristics of nasopharyngeal teratoma in infants and improve the levels of diagnosis and treatment to reduce misdiagnosis.
METHOD: The clinical data of 11 cases of nasopharyngeal teratoma in infants were reviewed retrospectively and summarized the clinical features. After the preoperative examination of nasopharyngeal endoscopy and imaging (CT or MRI), all patients were under general anesthesia of nasopharyngeal teratoma surgical resection. Of them, 8 cases were used radiofrequency ablation, 3 cases used conventional power systems.
RESULT: Eleven cases with neoformation were completely removed, the operation time was 5-15 min, blood loss was 1-5 ml, patients had no significant nasal obstruction, bleeding, eating nasopharyngeal regurgitation, breathing difficulties or other complications. No recurrence was found after 10 months to 9 years followed up.
CONCLUSION: The nasopharyngeal mass must be kept in mind in the differential diagnosis of breathing difficulties in infants, especially when it exists together with upper airway obstruction symptoms; The low-temperature radiofrequency ablation with endoscopic had the advantages of short time, precise control, less bleeding, clear operative field, little injury and pain, low recurrence, providing a new clinical treatments.

PMID: 26514005 [PubMed - in process]



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[Study on the factors impacting on early cochlear implantation between the eastern and western region of China].

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[Study on the factors impacting on early cochlear implantation between the eastern and western region of China].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1111-4

Authors: Xiao H, Li W, Ma R, Gong Z, Shi H, Li H, Chen B, Jiang Y, Dai C

Abstract
OBJECTIVE: To describe tne regional different factors which impact on early cochlear implantation in prelingual deaf children between eastern and western regions of China.
METHOD: The charts of 113 children who received the cochlear implantation after 24 months old were reviewed and analyzed. Forty-five of them came from the eastern region (Jiangsu, Zhejiang or Shanghai) while 68 of them came from the western region (Ningxia or Guizhou). Parental interviews were conducted to collect information regarding the factors that impact on early cochlear implantation. Result:Based on the univariate logistic regression analysis, the odds ratio (OR) value of universal newborn hearing screening (UNHS) was 5. 481, which indicated the correlation of UNHS with early cochlear implantation is significant. There was statistical difference between the 2 groups (P<0. 01). For the financial burden, the OR value was 3. 521(strong correlation) and there was statistical difference between the 2 groups (P<0. 01). For the communication barriers and community location, the OR value was 0. 566 and 1. 128 respectively, and there was no statistical difference between the 2 groups (P>0. 05). The multivariate analysis indicated that the UNHS and financial burden are statistically different between the eastern and western regions (P=0. 00 and 0. 040 respectively).
CONCLUSION: The UNHS and financial burden are statistically different between the eastern reinforced in the western region. In addition, the government and society should provide powerful policy and more financial support in the western region of China. The innovation of management system is also helpful to the early cochlear implantation.

PMID: 26514004 [PubMed - in process]



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[The long-term clinical efficacy of endoscopic surgery of primary sinonasal malignant neoplasms].

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[The long-term clinical efficacy of endoscopic surgery of primary sinonasal malignant neoplasms].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1105-10

Authors: Ye Y, Qiu Q, Zhang S, Huang Y, Zhan J, Xu M

Abstract
OBJECTIVE: To assess the long-term clinical efficacy of endoscopic surgery of primary sinonasal malignant neoplasms and find out the potential postoperative prognostic factors.
METHOD: Forty-three clinical cases of primary sinonasal malignant neoplasms treated under endoscopy were analyzed retrospectively.
RESULT: Fifteen patients died. The 1-year, 2-year, 3-year and 5-year survival rates were 83. 7% (36/43), 74. 4% (32/43), 69. 8% (30/43) and 65. 1% (28/43), respectively. Kaplan-Meier single-variable analysis showed that gender, T grade, TNM stage and pathological types of olfactory neuroblastoma were statistically significant prognostic factors (P< 0. 05). COX Pro-Portional hazard models showed that TNM stage was an independent prognostic factors.
CONCLUSION: Endoscopic surgery for primary sinonasal malignant neoplasms is a safe and effective minimally invasive surgical treatment, and it is an important supplement to the traditional surgery. Gender, T grade, TNM stage and pathological types of olfactory neuroblastoma might be significant prognostic factors.

PMID: 26514003 [PubMed - in process]



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[Study on the correlation between chronic sinusitis with nasal septum deviation].

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[Study on the correlation between chronic sinusitis with nasal septum deviation].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1103-4

Authors: Ji X, Fu H, Song A

Abstract
OBJECTIVE: Study on the correlation between chronic sinusitis with nasal septum deviation.
METHOD: Randomly selected 722 patients with coronal sinuses CT, statistics the number of cases of nasal septum deviation, cases of nasal septum deviation with chronic sinusitis, the wide and narrow side cases of nasal septum deviation complicated with sinusitis. The number of sinusitis without deviation, and paired test.
RESULT: The incidence of sinusitis between deviation of nasal septum and non deviation were 54. 13% and 44. 66%, the difference between two groups was statistically significant (P<. 05), the incidence of sinusitis with nasal septum deviation of wide and narrow side were 31. 65% and 32. 12%, no significant difference between the two groups (P>0. 01). The incidence of sinusitis high deviation and non high deviation were 59. 54% and 46. 97%, the difference between the two groups was statistically significant (P<0. 05). The number of wide side of upper nasal septum deviation with sinusitis was 54, the narrow side was 66, there is no significant difference between the two groups (P>0. 05).
CONCLUSION: The deviation of nasal septum is associated with the formation of chronic sinusitis, the high deviation is more prone to sinusitis, The incidence of sinusitis and nasal septum deviation on both sides was no different.

PMID: 26514002 [PubMed - in process]



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[The influence of Xuanfeijiedu granules on trace elements, IgE, ECP of allergic rhinitis].

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[The influence of Xuanfeijiedu granules on trace elements, IgE, ECP of allergic rhinitis].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1101-3

Authors: Liu Y

Abstract
OBJECTIVE: To study the influence of Xuanfeijiedu granules on trace elements, immunoglobulin E (IgE), eosinophil cationic protein (ECP) of allergic rhinitis.
METHOD: One hundred and ten cases of allergic rhinitis ere randomly divided into two groups, 55 cases of the observation group were treated with budesonide, 55 cases of the control group were treated with Xuanfeijiedu granules, the treatment efficacy and serum trace elements, IgE, ECP level were observed.
RESULT: The total effective rate of observation group and control group were 92. 7% and 96. 4%, there was no significant difference between two groups (P>0. 05). Before treatment, the serum zinc (Zn), copper (Cu), manganese (Mn) and IgE, ECP levels of two groups were compared, there was no significant difference (P>0. 05); after treatment, the serum Zn level was significantly increased, the serum Cu, Mn, IgE, ECP levels were significantly reduced, and the observation group changed more significantly, there were significant differences between two groups (P<. 05).
CONCLUSION: Xuanfeijiedu granules in the treatment of allergic rhinitis can significantly improve the patient's serum trace elements and IgE, ECP levels, improve the state of patient's disease, and promote the rehabilitation of patients.

PMID: 26514001 [PubMed - in process]



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[Relationship between allergic factors and eosinophilic nasal polyps].

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[Relationship between allergic factors and eosinophilic nasal polyps].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1098-100

Authors: Zhang G, Zhang J, Shi W, Sun P, Lin P

Abstract
OBJECTIVE: To explore the effects of allergic factores in eosinophilic nasal polyps.
METHOD: Clinical characters of 67 eosinophilic nasal polyps patients and 26 lymphocyte nasal polyps patients were restrospeetively analyzed. Allergic factors, allergens and nasal anatomic variations were compared between two groups.
RESULT: Allergic factors are proned to present in eosinophilic nasal polyps group compared with lymphocyte nasal polyps group; The positive rates of allergen skin test between eosinophilic nasal polyps group and lymphocyte nasal polyps group showed significant difference; Allergens in eosinophilic nasal polyps group are different from lymphocyte nasal polyps group; Nasal anatomic variations are different between two groups.
CONCLUSION: Different pathogenesis maybe exist in different pathological type nasal polyps. Allergic factors are closely relative to eosinophilic nasal polyps and nasal anatomic variations play a more important role in the formation of lymhocyte nasal polyps.

PMID: 26514000 [PubMed - in process]



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[Efficacy of sublingual immunotherapy with Dermatophagoides farina drops in monosensitized and polysensitized patients with allergic rhinitis].

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[Efficacy of sublingual immunotherapy with Dermatophagoides farina drops in monosensitized and polysensitized patients with allergic rhinitis].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1094-7

Authors: Cui L, Xia Z, Wang Z, Xu Z

Abstract
OBJECTIVE: To evaluate the efficacy of sublingual immunotherapy (SLIT) with standardized Dermatophagoides farina drops in monosensitized and polysensitized patients with allergic rhinitis.
METHOD: The clinical data of 162 patients treated with standardized Dermatophagoides farina drops were analyzed retrospectively. These patients were divided into the monoallergen sensitized group and polyallergen sensitized group according to the results of skin prick tests. The total nasal symptoms score (TNSS), the total medication score (TMS) and adverse effects (AEs) were evaluated before treatment, 2 year after SLIT treatment and 3 year after drug discontinuance. Result:After SLIT treatment for 2 years and drug discontinuance for 3 years, the TNSS (3. 14[2. 47; 3. 65], 3. 45 [2. 76; 3. 92], respectively) and TMS (0. 42[0. 36; 0. 57],0. 35[0. 26; 0. 44], respectively) in the monoallergen sensitized group were lower than that before the treatment (TNSS: 9. 00 [8. 00; 10. 00], TMS: 2. 16 [1. 88; 2. 37]), which have showed a statistically significant difference(P<0. 05). Similarly, after SLIT treatment for 2 years and drug discontinuance for 3 years, the TNSS (3. 14[2. 46; 3. 63], 4. 23[3. 65; 4. 96], respectively) and TMS (0. 42[0. 36; 0. 58], 0. 50[0. 34; 0. 72], respectively) in the polyallergen sensitized group were lower than that before the treatment (TNSS: 9. 00[8. 00; 10. 00], TMS: 2. 18[1. 95; 2. 37]), which have showed a statistically significant difference(P<0. 05). No statistically significant finding could be observed in monoallergen and polyallergen sensitized group before the treatment and 2 years after treatment, respectively. However, a statistically significant finding could be observed between two groups in the drug discontinuance for 3 years (P<0. 05). Eleven patients suffered local adverse effects, and the incidence of adverse effects showed no significantly difference (P>0. 05).
CONCLUSION: SLIT with standardized Dermatophagoides farina drops has a long-term efficacy in monosensitized and polysensitized patients with allergic rhinitis. Moreover, a longer SLIT treatment (>2 years) may be necessary to consolidate its efficacy.

PMID: 26513999 [PubMed - in process]



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[The effect research of specific immunotherapy of allergic rhinitis and allergic rhinitis combined bronchial asthma].

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[The effect research of specific immunotherapy of allergic rhinitis and allergic rhinitis combined bronchial asthma].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1090-3

Authors: Deng B, Zhao Y, You Y

Abstract
OBJECTIVE: To study the therapeutic effects of the specific immunotherapy (SIT) on allergic rhinitis and allergic rhinitis combined bronchial asthma. METHED: All patients were classified into allergic rhinitis group (AR group) with 32 patients and allergic rhinitis combined bronchial asthma group (AR+BA group) with 32 patients. Another health control group with 32 cases was designed as well. The allergens,symptom scores and therapeutic effects of the former two-group patients were analysis, and the serums of all three-group cases were extracted to evaluate the specific Immunoglobin E(sIgE), Interleukin-4 (IL-4). The SPSS13. 0 package was applied to conduct t-test and chi-square test, and the difference of P<0. 05 was regarded as statistical significance.
RESULT: The main allergens of 64 patients were dermatophagoides farinae and dermatophagoides pteronyssinus. The improvement of symptom scores before and after SIT was statistical significant with P<0. 05. Although total effective rate reached 100% , AR group was superior than AR+BA group in term of the efficacy comparison, and P<0. 05 indicated the statistical significance. The serum sIgE, IL-4 values of three groups were brought into comparison, and P<0. 05 indicated the statistical significance of the difference.
CONCLUSION: The SIT on the AR, AR+BA is a safe and effective treatment, but different disease responds diversely. The long-term treatment course is recommended.

PMID: 26513998 [PubMed - in process]



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[Expression level and significance of IL-17 and IL-23 in serum and nasal secretion of patients with allergic rhinitis and non-allergrie rhinitis].

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[Expression level and significance of IL-17 and IL-23 in serum and nasal secretion of patients with allergic rhinitis and non-allergrie rhinitis].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1086-90

Authors: Yang G, Zheng G, Zhang L, Zhu K, Xin W, Wei J

Abstract
OBJECTIVE: To investigate the effect of IL-17 and IL-23 in the pathogenesis of allergic rhinitis(AR) and non. allergic rhinitis(NAR).
METHOD: Selected 156 cases of patients with allergic rhinitis (AR group) and 59 cases of patients with non-allergic rhinitis (NAR group), 60 cases of healthy people (control group). All cases in AR group and NAR groups were evaluated by a visual analog scale (VAS) score of nasal symptoms. Collected peripheral blood and nasal secretions in all cases and then detected IL-17 and IL-23 expression levels.
RESULT: There was no significant difference in VAS score of AR group and NAR group (P>0. 05). IL-17 and IL-23 levels of serum and nasal secretions in AR group and NAR group were both higher than control group, with a highly significant difference (P <0. 05). The research showed a clear correlation between expression of IL-17 and IL-23 both in serum and nasal secretions of AR group and NAR(P<0. 05).
CONCLUSION: IL-17 and IL-23 may be important cytokines and IL-23/IL-17 pathway may play a significant role in the pathogenesis of allergic rhinitis and non-allergic rhinitis.

PMID: 26513997 [PubMed - in process]



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Pure-tone audiometry outside a sound booth using earphone attentuation, integrated noise monitoring, and automation.

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Pure-tone audiometry outside a sound booth using earphone attentuation, integrated noise monitoring, and automation.

Int J Audiol. 2015 Nov;54(11):777-85

Authors: Swanepoel de W, Matthysen C, Eikelboom RH, Clark JL, Hall JW

Abstract
OBJECTIVE: Accessibility of audiometry is hindered by the cost of sound booths and shortage of hearing health personnel. This study investigated the validity of an automated mobile diagnostic audiometer with increased attenuation and real-time noise monitoring for clinical testing outside a sound booth.
DESIGN: Attenuation characteristics and reference ambient noise levels for the computer-based audiometer (KUDUwave) was evaluated alongside the validity of environmental noise monitoring. Clinical validity was determined by comparing air- and bone-conduction thresholds obtained inside and outside the sound booth (23 subjects).
STUDY SAMPLE: Twenty-three normal-hearing subjects (age range, 20-75 years; average age 35.5) and a sub group of 11 subjects to establish test-retest reliability.
RESULTS: Improved passive attenuation and valid environmental noise monitoring was demonstrated. Clinically, air-conduction thresholds inside and outside the sound booth, corresponded within 5 dB or less > 90% of instances (mean absolute difference 3.3 ± 3.2 SD). Bone conduction thresholds corresponded within 5 dB or less in 80% of comparisons between test environments, with a mean absolute difference of 4.6 dB (3.7 SD). Threshold differences were not statistically significant. Mean absolute test-retest differences outside the sound booth was similar to those in the booth.
CONCLUSION: Diagnostic pure-tone audiometry outside a sound booth, using automated testing, improved passive attenuation, and real-time environmental noise monitoring demonstrated reliable hearing assessments.

PMID: 26514954 [PubMed - in process]



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CKMT1 and NCOA1 expression as a predictor of clinical outcome in patients with advanced-stage head and neck squamous cell carcinoma.

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CKMT1 and NCOA1 expression as a predictor of clinical outcome in patients with advanced-stage head and neck squamous cell carcinoma.

Head Neck. 2015 Oct 30;

Authors: Pavón MA, Parreño M, Téllez-Gabriel M, León X, Arroyo-Solera I, López M, Céspedes MV, Casanova I, Gallardo A, López-Pousa A, Mangues MA, Quer M, Barnadas A, Mangues R

Abstract
BACKGROUND: We studied the association between the expression of a subset of previously identified genes and clinical outcome in patients with head and neck cancer.
METHODS: We analyzed by reverse transcriptase-polymerase chain reaction (RT-PCR) the expression of 89 genes in tumor biopsies from stage III to IVa/b chemotherapy treated patients (n = 46). Two additional cohorts analyzed by RNAseq (The Cancer Genome Atlas [TCGA] project; n = 371) or immunohistochemistry (IHC; n = 73) were used to validate results.
RESULTS: Thirty genes were associated with local-recurrence or progression-free survival. The best multi-gene decision-tree model to predict local recurrence included nuclear receptor coactivator 1 (NCOA1) and serum-amyloid A2 (SAA2) expression, whereas the best model to predict disease recurrence included creatine kinase mitochondrial 1 (CKMT1) and metal-regulatory transcription factor 1 (MTF1). Both models were associated with cancer-specific survival. Results were confirmed analyzing the RNAseq data included in the TCGA project. CKMT1 and NCOA1 were identified as independent risk factors for survival in an independent cohort analyzed by immunohistochemistry.
CONCLUSION: CKMT1 and NCOA1 expression has prognostic significance in advanced-stage head and neck carcinoma. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26516695 [PubMed - as supplied by publisher]



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Comparison of outcomes for open versus endoscopic approaches for olfactory neuroblastoma: A systematic review and individual participant data meta-analysis.

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Comparison of outcomes for open versus endoscopic approaches for olfactory neuroblastoma: A systematic review and individual participant data meta-analysis.

Head Neck. 2015 Oct 30;

Authors: Fu TS, Monteiro E, Muhanna N, Goldstein DP, de Almeida JR

Abstract
BACKGROUND: Endoscopic approaches have been adopted as an alternative to craniofacial resection in the surgical management of olfactory neuroblastoma.
METHODS: We conducted a systematic review and meta-analysis using MEDLINE, EMBASE, Cochrane, and CINAHL (2000-2014) to compare outcomes for open versus endoscopic approaches.
RESULTS: Thirty-six studies containing 609 patients were included. Meta-analysis of (a) all patients, (b) Kadish C/D only, and (c) Hyams III/IV only, failed to show a difference in locoregional control and metastasis-free survival between approaches. However, endoscopic approaches were associated with improved overall survival (OS) for all 3 groups (p = .001, .04, and .001, respectively), and higher disease-specific survival (DSS) for all patients (p = .004) and Hyams III/IV only (p = .002).
CONCLUSION: The current study suggests that endoscopic approaches have comparable control rates to open approaches for olfactory neuroblastoma. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26514662 [PubMed - as supplied by publisher]



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Sentinel lymph node biopsy in cN0 squamous cell carcinoma of the lip: A retrospective study.

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Sentinel lymph node biopsy in cN0 squamous cell carcinoma of the lip: A retrospective study.

Head Neck. 2015 Oct 30;

Authors: Sollamo EM, Ilmonen SK, Virolainen MS, Suominen SH

Abstract
BACKGROUND: The purpose of this study was to assess the use of sentinel lymph node biopsy (SLNB) in clinically lymph node-negative (cN0) squamous cell carcinoma (SCC) of the lip deemed high risk for occult nodal metastasis.
METHODS: Twenty-six patients with cT1 to T2 cN0 with SCC of the lip underwent SLNB at a tertiary referral center between January 2001 and March 2012. Initial staging methods were clinical examination only (65.4%), ultrasound (23.1%), or CT (11.5%). Operations were performed with the patients under local anesthesia with sedation (50%) or general anesthesia (50%).
RESULTS: The mean follow-up time was 53 months. Three patients (11.5%) had a positive sentinel node and were upstaged. One SLNB-related complication was observed. Regional recurrence occurred in 2 patients (7.7%). The relationship between regional status and both tumor diameter and tumor thickness was statistically significant (p < .05).
CONCLUSION: SLNB can be a viable staging technique in SCC of the lip. Tumor diameter of ≥ 20 mm and increasing tumor thickness seem to delineate higher risk for regional disease in our study. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26514547 [PubMed - as supplied by publisher]



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Clinical parameters predicting development of pulmonary malignancies in patients treated for head and neck squamous cell carcinoma.

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Clinical parameters predicting development of pulmonary malignancies in patients treated for head and neck squamous cell carcinoma.

Head Neck. 2015 Oct 30;

Authors: Madana J, Morand GB, Alrasheed A, Gabra N, Laliberté F, Barona-Lleó L, Yolmo D, Black MJ, Sultanem K, Hier MP

Abstract
BACKGROUND: As the locoregional control rates in head and neck squamous cell carcinoma (HNSCC) have increased, these patients may suffer distant metastasis in a higher proportion of cases. Clinicopathological characteristics allowing prediction of high-risk profile would allow adapting posttreatment surveillance to individual risk.
METHODS: A retrospective review of all patients with HNSCC treated at the Jewish General Hospital, McGill University, Montreal, Quebec, Canada, between 1999 and 2008 was conducted for this study.
RESULTS: The study included 428 patients with a mean follow-up of 65 months (±SEM 1.7). Eighty patients (18.6%) developed pulmonary malignancy during follow-up. In multivariate Cox-regression analysis, locoregional failure and current smoking were associated with higher risk of pulmonary malignancy (p < .001 and p = .008, respectively).
CONCLUSION: Locoregional failure and smoking persistence are predictors of pulmonary malignancy in patients with HNSCC. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26514270 [PubMed - as supplied by publisher]



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Influence of extracapsular nodal spread extent on prognosis of oral squamous cell carcinoma.

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Influence of extracapsular nodal spread extent on prognosis of oral squamous cell carcinoma.

Head Neck. 2015 Oct 30;

Authors: Wreesmann VB, Katabi N, Palmer FL, Montero PH, Migliacci JC, Gönen M, Carlson D, Ganly I, Shah JP, Ghossein R, Patel SG

Abstract
BACKGROUND: An objective definition of clinically relevant extracapsular nodal spread (ECS) in head and neck squamous cell carcinoma (SCC) is unavailable.
METHODS: Pathologic review of 245 pathologically positive oral cavity SCC neck dissection specimens was performed. The presence/absence of ECS, its extent (in millimeters), and multiple nodal and primary tumor risk factors were related to disease-specific survival (DSS) at a follow-up of 73 months.
RESULTS: ECS was detected in 109 patients (44%). DSS was significantly better for patients without ECS than patients with ECS. Time-dependent receiver operator curve (ROC) analysis identified a prognostic cutoff for ECS extent at 1.7 mm. In multivariate analyses, DSS was significantly lower for patients with major ECS compared with patients with minor ECS, but not significantly different between patients with minor ECS and patients without ECS.
CONCLUSION: ECS is clinically relevant in oral cavity SCC when it has extended more than 1.7 mm beyond the nodal capsule. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26514096 [PubMed - as supplied by publisher]



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A checklist for endonasal transsphenoidal anterior skull base surgery.

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A checklist for endonasal transsphenoidal anterior skull base surgery.

J Neurosurg. 2015 Oct 30;:1-6

Authors: Laws ER, Wong JM, Smith TR, de Los Reyes K, Aglio LS, Thorne AJ, Cote DJ, Esposito F, Cappabianca P, Gawande A

Abstract
OBJECT Approximately 250 million surgical procedures are performed annually worldwide, and data suggest that major complications occur in 3%-17% of them. Many of these complications can be classified as avoidable, and previous studies have demonstrated that preoperative checklists improve operating room teamwork and decrease complication rates. Although the authors' institution has instituted a general preoperative "time-out" designed to streamline communication, flatten vertical authority gradients, and decrease procedural errors, there is no specific checklist for transnasal transsphenoidal anterior skull base surgery, with or without endoscopy. Such minimally invasive cranial surgery uses a completely different conceptual approach, set-up, instrumentation, and operative procedure. Therefore, it can be associated with different types of complications as compared with open cranial surgery. The authors hypothesized that a detailed, procedure-specific, preoperative checklist would be useful to reduce errors, improve outcomes, decrease delays, and maximize both teambuilding and operational efficiency. Thus, the object of this study was to develop such a checklist for endonasal transsphenoidal anterior skull base surgery. METHODS An expert panel was convened that consisted of all members of the typical surgical team for transsphenoidal endoscopic cases: neurosurgeons, anesthesiologists, circulating nurses, scrub technicians, surgical operations managers, and technical assistants. Beginning with a general checklist, procedure-specific items were added and categorized into 4 pauses: Anesthesia Pause, Surgical Pause, Equipment Pause, and Closure Pause. RESULTS The final endonasal transsphenoidal anterior skull base surgery checklist is composed of the following 4 pauses. The Anesthesia Pause consists of patient identification, diagnosis, pertinent laboratory studies, medications, surgical preparation, patient positioning, intravenous/arterial access, fluid management, monitoring, and other special considerations (e.g., Valsalva, jugular compression, lumbar drain, and so on). The Surgical Pause is composed of personnel introductions, planned procedural elements, estimation of duration of surgery, anticipated blood loss and fluid management, imaging, specimen collection, and questions of a surgical nature. The Equipment Pause assures proper function and availability of the microscope, endoscope, cameras and recorders, guidance systems, special instruments, ultrasonic microdoppler, microdebrider, drills, and other adjunctive supplies (e.g., Avitene, cotton balls, nasal packs, and so on). The Closure Pause is dedicated to issues of immediate postoperative patient disposition, orders, and management. CONCLUSIONS Surgical complications are a considerable cause of death and disability worldwide. Checklists have been shown to be an effective tool for reducing preventable errors surrounding surgery and decreasing associated complications. Although general checklists are already in place in most institutions, a specific checklist for endonasal transsphenoidal anterior skull base surgery was developed to help safeguard patients, improve outcomes, and enhance teambuilding.

PMID: 26517770 [PubMed - as supplied by publisher]



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Intraoperative neurophysiological monitoring during endoscopic endonasal surgery for pediatric skull base tumors.

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Intraoperative neurophysiological monitoring during endoscopic endonasal surgery for pediatric skull base tumors.

J Neurosurg Pediatr. 2015 Oct 30;:1-9

Authors: Elangovan C, Singh SP, Gardner P, Snyderman C, Tyler-Kabara EC, Habeych M, Crammond D, Balzer J, Thirumala PD

Abstract
OBJECT The aim of this study was to evaluate the value of intraoperative neurophysiological monitoring (IONM) using electromyography (EMG), brainstem auditory evoked potentials (BAEPs), and somatosensory evoked potentials (SSEPs) to predict and/or prevent postoperative neurological deficits in pediatric patients undergoing endoscopic endonasal surgery (EES) for skull base tumors. METHODS All consecutive pediatric patients with skull base tumors who underwent EES with at least 1 modality of IONM (BAEP, SSEP, and/or EMG) at our institution between 1999 and 2013 were retrospectively reviewed. Staged procedures and repeat procedures were identified and analyzed separately. To evaluate the diagnostic accuracy of significant free-run EMG activity, the prevalence of cranial nerve (CN) deficits and the sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS A total of 129 patients underwent 159 procedures; 6 patients had a total of 9 CN deficits. The incidences of CN deficits based on the total number of nerves monitored in the groups with and without significant free-run EMG activity were 9% and 1.5%, respectively. The incidences of CN deficits in the groups with 1 staged and more than 1 staged EES were 1.5% and 29%, respectively. The sensitivity, specificity, and negative predictive values (with 95% confidence intervals) of significant EMG to detect CN deficits in repeat procedures were 0.55 (0.22-0.84), 0.86 (0.79-0.9), and 0.97 (0.92-0.99), respectively. Two patients had significant changes in their BAEPs that were reversible with an increase in mean arterial pressure. CONCLUSIONS IONM can be applied effectively and reliably during EES in children. EMG monitoring is specific for detecting CN deficits and can be an effective guide for dissecting these procedures. Triggered EMG should be elicited intraoperatively to check the integrity of the CNs during and after tumor resection. Given the anatomical complexity of pediatric EES and the unique challenges encountered, multimodal IONM can be a valuable adjunct to these procedures.

PMID: 26517056 [PubMed - as supplied by publisher]



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Comments on "Endoscopic Transpterygoid Approach and Skull Base Repair After Sphenoid Meningoencephalocele Resection".

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Comments on "Endoscopic Transpterygoid Approach and Skull Base Repair After Sphenoid Meningoencephalocele Resection".

Acta Otorrinolaringol Esp. 2015 Oct 26;

Authors: Reeve N, Woodworth BA

PMID: 26514068 [PubMed - as supplied by publisher]



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[The anatomy study of the frontal beak approach of Draf II b frontal sinusotomy].

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[The anatomy study of the frontal beak approach of Draf II b frontal sinusotomy].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(12):1078-81

Authors: Liu Z, Li X, Zhao H, Wang P, Wu Y, Li X, Ma S

Abstract
OBJECTIVE: To investigate the possibility and anatomy landmark of the frontal beak approach of endoscopic frontal sinusotomy to the frontal sinus lesions.
METHOD: (1)Twenty cases of frozen cadaveric head underwent spiral computed tomography scans. Then data were transferred into the Mimics image workstation to reorganize CT images in the coronal, sagittal, and axial planes. The anatomic parameters related to surgical approach points were measured, such as the distance between vertical plate of the middle turbinate and lamina papyracea and the thickness of the frontal beak. (2) 3D visual model of the frontal cell and the drainage way of the frontal sinus was produced with the application of Sinuses Trachea I software. (3)The endoscopic frontal sinus surgery were performed on 20 cases of subjects (objects)to find out the anatomy landmarks of the frontal beak approach, measure the parameters such as the distance between middle turbinate and lamina papyracea, and evaluate the potential surgical complications during operation.
RESULT: (1)The frontal beak is a white bony arcs located at the attachment point of middle turbinate front inserted to the skull base. Its position was relatively constant, before frontal sinus above. (2)The distance between the middle turbinate vertical plate and lamina papyracea was (7. 61 ± 1. 34) mm. The thickness of the frontal beak in surgical approach was (3. 27 ± 0. 91) mm. (3) 3D visual structure of the frontal sinus and its ventilation pathway: the shape of unilateral frontal sinus looked like the cone, which was transited by the drainage pathway of the frontal sinus. The front part of the frontal sinus ostium is surrounded by the frontal beak. The upper part the frontal beak connected to the floor of the frontal sinus. (4) Frontal beak can be used as an landmark of frontal beak approach in the endoscopic frontal sinus surgery. But the lateral view of frontal sinus still was limited in the operation.
CONCLUSION: The endoscopic frontal sinus surgery with the approach of the frontal beak is easy to operate and learn. In this area between the double "L", the operation is safe.

PMID: 26513995 [PubMed - in process]



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Costello syndrome: Analysis of the posterior cranial fossa in children with posterior fossa crowding.

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Costello syndrome: Analysis of the posterior cranial fossa in children with posterior fossa crowding.

Neuroradiol J. 2015 Jun;28(3):254-8

Authors: Calandrelli R, D'Apolito G, Marco P, Zampino G, Tartaglione T, Colosimo C

Abstract
This study aimed to assess changes in the posterior cranial fossa (PCF) to shed light on the mechanism of cerebellar herniation in children with Costello syndrome (CS) and posterior fossa crowding. We performed a morphovolumetric PCF analysis on brain magnetic resonance imaging (MRI) in seven children with CS (mean age 31 ± 16 months) comparing the MRI scans with those of seven age-matched healthy subjects.PCF volume (PCFV), PCF brain volume (PCFBV) and cerebellar volume (CeV) were assessed on axial T2-weighted MRI. Morphometric parameters (diameters of the foramen magnum, tentorial angle, basiocciput, supraocciput, basisphenoid and exocciput lengths) were measured on sagittal T1-weighted MRI. The volume of the cerebrospinal fluid (CSF) spaces was calculated as PCFV minus PCFBV.Five out of seven CS children showed tonsillar herniation in the upper cervical canal; no child had hydrocephalus but three out of seven children showed ventriculomegaly. In addition, the PCFV/PCFBV ratio, PCFV, CSF spaces volume, basiocciput, basisphenoid and exocciput lengths and latero-lateral and antero-posterior diameters of the foramen magnum were significantly reduced, whereas no significant changes were found in supraocciput length, PCFBV, CeV or hindbrain volume. The volumetric reduction of the PCF due to bony posterior fossa hypoplasia is a predisposing factor for developing cerebellar tonsillar herniation through the foramen magnum in children with CS. The altered anatomy of the foramen magnum and upward expansion of the PCF secondary to an increased tentorial slope serves to explain the possible mechanism of cerebellar herniation in patients with CS.

PMID: 26246091 [PubMed - indexed for MEDLINE]



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Congenital basis of posterior fossa anomalies.

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Congenital basis of posterior fossa anomalies.

Neuroradiol J. 2015 Jun;28(3):238-53

Authors: Cotes C, Bonfante E, Lazor J, Jadhav S, Caldas M, Swischuk L, Riascos R

Abstract
The classification of posterior fossa congenital anomalies has been a controversial topic. Advances in genetics and imaging have allowed a better understanding of the embryologic development of these abnormalities. A new classification schema correlates the embryologic, morphologic, and genetic bases of these anomalies in order to better distinguish and describe them. Although they provide a better understanding of the clinical aspects and genetics of these disorders, it is crucial for the radiologist to be able to diagnose the congenital posterior fossa anomalies based on their morphology, since neuroimaging is usually the initial step when these disorders are suspected. We divide the most common posterior fossa congenital anomalies into two groups: 1) hindbrain malformations, including diseases with cerebellar or vermian agenesis, aplasia or hypoplasia and cystic posterior fossa anomalies; and 2) cranial vault malformations. In addition, we will review the embryologic development of the posterior fossa and, from the perspective of embryonic development, will describe the imaging appearance of congenital posterior fossa anomalies. Knowledge of the developmental bases of these malformations facilitates detection of the morphological changes identified on imaging, allowing accurate differentiation and diagnosis of congenital posterior fossa anomalies.

PMID: 26246090 [PubMed - indexed for MEDLINE]



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Forensic age estimation by spheno-occipital synchondrosis fusion degree: computed tomography analysis.

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

Forensic age estimation by spheno-occipital synchondrosis fusion degree: computed tomography analysis.

J Craniofac Surg. 2014 Jul;25(4):1212-6

Authors: Can IO, Ekizoglu O, Hocaoglu E, Inci E, Sayin I, Kaya KH

Abstract
The analysis of ossification points plays a considerable role in forensic age estimation. Although traditional methods are still in use, researchers are working on different age estimation procedures especially within the development of radiologic methods. One of these methods is to define spheno-occipital synchondrosis fusion degree. Spheno-occipital synchondrosis, an important growth point on cranial base, provides noteworthy information about age estimation through its late stage ossification nature. This study aimed to investigate spheno-occipital synchondrosis fusion degree for age estimation in the Turkish population. In our study, 1-mm-sectioned computed tomography images of 638 (399 men and 139 women) subjects within the age of 10 to 25 years were retrospectively examined. It is stated in our study that spheno-occipital syncondrosis fusion begins superiorly and progresses inferiorly until it is completed. Spheno-occipital syncondrosis is known to be totally open at the mean (SD) age of 11.5 (1.5) years in men and 10.7 (0.8) years in women. In addition, fusion degree is known to be increased with age. Fusion starts approximately 2 years earlier in women than in men, and the process of fusion completes at the age of 17 years in both sexes. An analysis of fusion degree between sex groups showed significance at the age of 11 to 15 years, and Spearman rank correlations indicate a significant positive relationship between age and degree of spheno-occipital fusion (P < 0.001; men, ρ = 0.714; women, ρ = 0.698). Consequently, 5-staged analysis of spheno-occipital synchondrosis fusion degree in use with 1-mm computed tomography images will be helpful for age estimation between 11 and 17 years.

PMID: 25006899 [PubMed - indexed for MEDLINE]



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Pure-tone audiometry outside a sound booth using earphone attentuation, integrated noise monitoring, and automation.

Related Articles

Pure-tone audiometry outside a sound booth using earphone attentuation, integrated noise monitoring, and automation.

Int J Audiol. 2015 Nov;54(11):777-85

Authors: Swanepoel de W, Matthysen C, Eikelboom RH, Clark JL, Hall JW

Abstract
OBJECTIVE: Accessibility of audiometry is hindered by the cost of sound booths and shortage of hearing health personnel. This study investigated the validity of an automated mobile diagnostic audiometer with increased attenuation and real-time noise monitoring for clinical testing outside a sound booth.
DESIGN: Attenuation characteristics and reference ambient noise levels for the computer-based audiometer (KUDUwave) was evaluated alongside the validity of environmental noise monitoring. Clinical validity was determined by comparing air- and bone-conduction thresholds obtained inside and outside the sound booth (23 subjects).
STUDY SAMPLE: Twenty-three normal-hearing subjects (age range, 20-75 years; average age 35.5) and a sub group of 11 subjects to establish test-retest reliability.
RESULTS: Improved passive attenuation and valid environmental noise monitoring was demonstrated. Clinically, air-conduction thresholds inside and outside the sound booth, corresponded within 5 dB or less > 90% of instances (mean absolute difference 3.3 ± 3.2 SD). Bone conduction thresholds corresponded within 5 dB or less in 80% of comparisons between test environments, with a mean absolute difference of 4.6 dB (3.7 SD). Threshold differences were not statistically significant. Mean absolute test-retest differences outside the sound booth was similar to those in the booth.
CONCLUSION: Diagnostic pure-tone audiometry outside a sound booth, using automated testing, improved passive attenuation, and real-time environmental noise monitoring demonstrated reliable hearing assessments.

PMID: 26514954 [PubMed - in process]



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Current Status of the Application of Intracranial Venous Sinus Stenting.

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Current Status of the Application of Intracranial Venous Sinus Stenting.

Int J Med Sci. 2015;12(10):780-9

Authors: Xu K, Yu T, Yuan Y, Yu J

Abstract
The intracranial venous sinus is an important component of vascular disease. Many diseases involve the venous sinus and are accompanied by venous sinus stenosis (VSS), which leads to increased venous pressure and high intracranial pressure. Recent research has focused on stenting as a treatment for VSS related to these diseases. However, a systematic understanding of venous sinus stenting (VS-Stenting) is lacking. Herein, the literature on idiopathic intracranial hypertension (IIH), venous pulsatile tinnitus, sinus thrombosis, high draining venous pressure in dural arteriovenous fistula (AVF) and arteriovenous malformation (AVM), and tumor-caused VSS was reviewed and analyzed to summarize experiences with VS-Stenting as a treatment. The literature review showed that satisfactory therapeutic effects can be achieved through stent angioplasty. Thus, the present study suggests that selective stent release in the venous sinus can effectively treat these diseases and provide new possibilities for treating intracranial vascular disease.

PMID: 26516306 [PubMed - in process]



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Effects of azelastine nasal spray on nasal and nasopharyngeal microflora.

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Effects of azelastine nasal spray on nasal and nasopharyngeal microflora.

J Laryngol Otol. 2015 Oct 30;:1-5

Authors: Aksoy F, Senturk E, Doğan R, Veyseller B, Ozturan O, Gönüllü N, Yilmaz F

Abstract
OBJECTIVE: Azelastine nasal spray is a topical antihistaminic drug for the symptomatic treatment of allergic rhinitis. This study aimed to investigate the effects of azelastine on nasal and nasopharyngeal microflora.
METHODS: Swab samples from 25 patients prescribed azelastine nasal spray monotherapy were collected just before treatment and after 1 month of treatment. After incubation of inoculates, the number of bacteria present in cultures was measured (in colony-forming units per millilitre).
RESULTS: Evaluation of the number of microflora revealed increased bacterial reproduction after treatment, but this difference was not statistically significant. The use of azelastine nasal spray decreased the reproduction of three potentially pathogenic bacteria; however, it did not affect the reproduction of other potentially pathogenic bacteria.
CONCLUSION: The use of azelastine nasal spray for one month did not have a statistically significant effect on the numbers of nasal and nasopharyngeal microflora; it is therefore safe from a microbiological viewpoint.

PMID: 26515526 [PubMed - as supplied by publisher]



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Ex vivo ovine model for pediatric flexible endoscopy training.

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Ex vivo ovine model for pediatric flexible endoscopy training.

Int J Pediatr Otorhinolaryngol. 2015 Oct 23;

Authors: Isaacson G, Ianacone DC, Wolfson MR

Abstract
OBJECTIVES: Medical students and residents in training have limited opportunities to develop pediatric endoscopy skills and would benefit from a realistic simulation model. We sought to develop such a model for flexible endoscopy using fresh head and neck tissue from young sheep.
METHODS: Tissue was collected from pre-pubescent sheep (n=5; mean age: 4 months; mean mass: 28kg) following humane euthanasia at the end of an in vivo protocol. No live animals were used in this study. The head and neck of the sheep were disarticulated 4-6cm above the sternal notch and stored at 5°C for 1-5 days. With the preparation was supported in supine position, flexible nasopharyngolaryngoscopy and transnasal endoscopic intubation were performed with video recording.
RESULTS: Five sheep were studied. Endoscopy was performed by a medical student under direct supervision by a pediatric otolaryngologist. Differences between ovine and human pediatric airway anatomy were defined.
CONCLUSIONS: Despite variations in proportion and structure, the experience of passing a flexible nasopharyngoscope through a sheep's airway is remarkably similar to pediatric endoscopy. The nasal anatomy is elongated, but very much like a child's in terms of anatomy, color and texture. The tactile feedback is nearly identical. Annoying secretions and their associated "whiteout" phenomena nicely simulate these challenges in pediatric endoscopy. When performing transnasal intubation, navigating to the larynx and advancing an endotracheal tube under guidance have the look and feel of the pediatric procedure. Issues of cost, availability, risk of zoonotic infection, and ethics are discussed.

PMID: 26514929 [PubMed - as supplied by publisher]



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Can Head and Neck Cancers Be Detected with Mean Platelet Volume?

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Can Head and Neck Cancers Be Detected with Mean Platelet Volume?

Asian Pac J Cancer Prev. 2015;16(16):7045-7

Authors: Eryilmaz A, Basal Y, Omurlu IK

Abstract
BACKGROUND: Mean platelet volume (MPV) is a marker which has been investigated in many cancers but data for head and neck lesions are limited. We aimed to study the MPV levels in head and neck cancers as a diagnostic marker.
MATERIALS AND METHODS: A total of 96 head and neck cancer patients and 31 control patients who did not meet exclusion criteria were enrolled in the study. The cancer locations, the platelet and MPV levels at the first diagnosis time were collected.
RESULTS: The head and neck cancer location distribution between these patients was 2 (2.1%) buccal, 9 (9.4%) tongue, 6 (6.3) lip, 1 (1%) gingiva, 1 (1%) hypopharynx, 1 (1%) ear, 58 (60.4%) larynx, 2 (2.1%) maxilla, 2 (2.1%) nasal, 1 (1%) nasopharynx, 2 (2.1%) palatal, 3 (3.1%) primary unknown, 1 (1%) retromolar, 1 (1%) thyroid, 2 (2.1%) tonsil, and 4 (4.2%) salivary gland. MPV levels were significantly different between cancer and control group (p=0.002). The cut-off point for MPV predicting head and neck cancer is >10 fL (sensitivity=55.21, specificity=87.10).
CONCLUSIONS: MPV level increase, a readily assessable parameter which does not bring extra costs can warn us regarding head and neck cancer risk.

PMID: 26514488 [PubMed - in process]



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[Diagnosis and surgery for dysphagia].

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[Diagnosis and surgery for dysphagia].

Nihon Jibiinkoka Gakkai Kaiho. 2015 Jan;118(1):74-7

Authors: Umeno H

PMID: 26506629 [PubMed - indexed for MEDLINE]



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[Comparison of Seven Intubation Devices in Difficult Airway Model].

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[Comparison of Seven Intubation Devices in Difficult Airway Model].

Masui. 2015 Apr;64(4):352-6

Authors: Taguchi A, Asai T, Hashimoto Y, Saito T, Arai T, Okuda Y

Abstract
BACKGROUND: The efficacy in tracheal intubation may differ between different video-optical devices, in particular in patients with difficult airways. The purpose of this study was to evaluate the efficacy of video-laryngoscopes and fiberoptic bronchoscope (FOB) in tracheal intubation on a mannequin with several difficult airways, including limited mouth opening, cervical spine rigidity and tongue edema.
METHODS: Residents performed tracheal intubation on a mannequin using Macintosh laryngoscope (Mac), rigid indirect-optical intubation devices and FOB. The laryngeal view, the success rate of tracheal intubation, and the time to intubate trachea were recorded.
RESULTS: With limited mouth opening and cervical spine rigidity, video-optical intubation devices showed a significantly higher success rate of tracheal intubation than the Mac or FOB. In contrast, with tongue edema, the success rate of tracheal intubation was lower when Mac-type videolaryngoscopes were used.
CONCLUSIONS: Videolaryngoscopes can generally be useful in patients with all difficult airways, but may be difficult in some circumstances (such as tongue edema). The FOB provided good laryngeal view in all cases, but the success rate of tracheal intubation was low and the time to intubate trachea was long.

PMID: 26419094 [PubMed - indexed for MEDLINE]



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Eagle's syndrome - A report of two cases.

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Eagle's syndrome - A report of two cases.

Vojnosanit Pregl. 2015 May;72(5):458-62

Authors: Kiralj A, Illić M, Pejaković B, Markov B, Mijatov S, Mijatov I

Abstract
INTRODUCTION: Eagle's syndrome is defined as elongation of the styloid process or the stylohyoid ligament mineralization complex which consist of styloid process, stylohyoid ligament and lesser horn of hyoid bone. It is a rare entity, is not commonly suspected in clinical practice. It is characterized by recurrent facial and throat pain, dysphagia, odynophagia, parapharingeal foreign body sensation, otalgia and neck pain. Eagle's syndrome can be treated conservatively (lacing local anesthetic into the styloid process and stylomandibular ligament attachment) or surgically. Its pathogenesis and threatment modalities are still being debated while different theories have been presented.
CASE REPORT: The two traditional surgical approaches to styloidectomy (removal of the elongated portion of the styloid process) were presented the intraoral approach and the extraoral approach. We presented two cases (49 years and 34 years old males), with bilateral and unilateral elongated styloid process. The surgical treatment included unilateral right side stiloidectomy by intraoral approach in the first case and right styloidectomy by extraoral approach in the second case. In both eases post-operative course passed regularly with no complaints at regular postoperative control.
CONCLUSION: Surgical techniques for treatment of Eagle's syndrome have many advantages and disadvantages. We believe that the length of the styloid process or the calcified ligament is a decisive parameter for the selection of techniques and approach.

PMID: 26165056 [PubMed - indexed for MEDLINE]



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Nasal saline irrigation with or without systemic antibiotics in treatment of children with acute rhinosinusitis.

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Nasal saline irrigation with or without systemic antibiotics in treatment of children with acute rhinosinusitis.

Int J Pediatr Otorhinolaryngol. 2015 Oct 22;

Authors: Ragab A, Farahat T, Al-Hendawy G, Samaka R, Ragab S, El-Ghobashy A

Abstract
OBJECTIVES: Acute rhinosinusitis (ARS) is a common pediatric problem. Our aim was to determine the efficacy of normal nasal saline irrigation (NSI) with or without amoxicillin in treatment of acute rhinosinusitis (ARS) in children.
METHODS: It is a prospective randomized, blind placebo-controlled trial. Children with uncomplicated ARS were recruited. One group received (amoxacillin 100mg/kg/day) and 0.9% NSI. The second group received placebo and 0.9% NSI. The primary outcome was the effect of treatment on clinical response. Secondary outcomes included: Rating of Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ), middle meatus (MM) bacteriological and cytological cellular responses and adverse effects.
RESULTS: Sixty two patients with ARS were eligible for the study. In amoxicillin group (31 patients); clinical cure was observed in 26 (83.9%) in comparison to 22 (71%) patients in NSI without antibiotics group (31 patients) (p=0.22). No differences between both groups in the reported nasal symptom scores and total symptoms scores improvements at day 7 (p=0.09 and 0.65) and day 14 (p=0.29 and 0.14), respectively. The mean total PRQLQ values had no differences between both groups after the 2 weeks of treatment (p=0.06). At day 7, MM neutrophils reduced significantly in amoxicillin group in comparison to placebo group (p=0.004). At day 14, the MM cytological content had no differences between both groups (p=0.07). Normal NSI with placebo has less reported adverse effects than amoxicillin and nasal saline irrigations (p=0.005).
CONCLUSIONS: NSI can be used alone with the same clinical, bacteriological and cytological cellular changes efficacy and with higher safety profile than amoxicillin after 14 days of treatment in uncomplicated clinically diagnosed ARS in children.

PMID: 26514931 [PubMed - as supplied by publisher]



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Early identification: Language skills and social functioning in deaf and hard of hearing preschool children.

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Early identification: Language skills and social functioning in deaf and hard of hearing preschool children.

Int J Pediatr Otorhinolaryngol. 2015 Oct 19;

Authors: Netten AP, Rieffe C, Theunissen SC, Soede W, Dirks E, Korver AM, Konings S, Oudesluys-Murphy AM, Dekker FW, Frijns JH, DECIBEL Collaborative study group

Abstract
OBJECTIVE: Permanent childhood hearing impairment often results in speech and language problems that are already apparent in early childhood. Past studies show a clear link between language skills and the child's social-emotional functioning. The aim of this study was to examine the level of language and communication skills after the introduction of early identification services and their relation with social functioning and behavioral problems in deaf and hard of hearing children.
STUDY DESIGN: Nationwide cross-sectional observation of a cohort of 85 early identified deaf and hard of hearing preschool children (aged 30-66 months).
METHODS: Parents reported on their child's communicative abilities (MacArthur-Bates Communicative Development Inventory III), social functioning and appearance of behavioral problems (Strengths and Difficulties Questionnaire). Receptive and expressive language skills were measured using the Reynell Developmental Language Scale and the Schlichting Expressive Language Test, derived from the child's medical records.
RESULTS: Language and communicative abilities of early identified deaf and hard of hearing children are not on a par with hearing peers. Compared to normative scores from hearing children, parents of deaf and hard of hearing children reported lower social functioning and more behavioral problems. Higher communicative abilities were related to better social functioning and less behavioral problems. No relation was found between the degree of hearing loss, age at amplification, uni- or bilateral amplification, mode of communication and social functioning and behavioral problems.
CONCLUSION: These results suggest that improving the communicative abilities of deaf and hard of hearing children could improve their social-emotional functioning.

PMID: 26514930 [PubMed - as supplied by publisher]



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Ex vivo ovine model for pediatric flexible endoscopy training.

Related Articles

Ex vivo ovine model for pediatric flexible endoscopy training.

Int J Pediatr Otorhinolaryngol. 2015 Oct 23;

Authors: Isaacson G, Ianacone DC, Wolfson MR

Abstract
OBJECTIVES: Medical students and residents in training have limited opportunities to develop pediatric endoscopy skills and would benefit from a realistic simulation model. We sought to develop such a model for flexible endoscopy using fresh head and neck tissue from young sheep.
METHODS: Tissue was collected from pre-pubescent sheep (n=5; mean age: 4 months; mean mass: 28kg) following humane euthanasia at the end of an in vivo protocol. No live animals were used in this study. The head and neck of the sheep were disarticulated 4-6cm above the sternal notch and stored at 5°C for 1-5 days. With the preparation was supported in supine position, flexible nasopharyngolaryngoscopy and transnasal endoscopic intubation were performed with video recording.
RESULTS: Five sheep were studied. Endoscopy was performed by a medical student under direct supervision by a pediatric otolaryngologist. Differences between ovine and human pediatric airway anatomy were defined.
CONCLUSIONS: Despite variations in proportion and structure, the experience of passing a flexible nasopharyngoscope through a sheep's airway is remarkably similar to pediatric endoscopy. The nasal anatomy is elongated, but very much like a child's in terms of anatomy, color and texture. The tactile feedback is nearly identical. Annoying secretions and their associated "whiteout" phenomena nicely simulate these challenges in pediatric endoscopy. When performing transnasal intubation, navigating to the larynx and advancing an endotracheal tube under guidance have the look and feel of the pediatric procedure. Issues of cost, availability, risk of zoonotic infection, and ethics are discussed.

PMID: 26514929 [PubMed - as supplied by publisher]



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Behavioral techniques to optimize success of in-office pediatric tympanostomy tube placement without sedation.

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Behavioral techniques to optimize success of in-office pediatric tympanostomy tube placement without sedation.

Int J Pediatr Otorhinolaryngol. 2015 Oct 8;

Authors: Cohen LL, Martin SR, Gamwell KL, McCarty C, Shih SW

Abstract
OBJECTIVE: Tympanostomy tube insertion is the most common pediatric surgery, but it typically requires general anesthesia. To facilitate in-office tube placement without general anesthesia, two complementary technologies have recently been developed comprising an iontophoresis system for delivering local anesthesia and an integrated tube delivery system. The purpose of this study was to evaluate behavioral support techniques used during a clinical study of the new technology for pediatric in-office tube placement without general anesthesia or physical restraints.
METHODS: As part of an IRB-approved, prospective, nine-center clinical study, pediatric patients requiring tube insertion underwent in-office treatment using the new procedure. The behavior management techniques included preparation, distraction, coaching, and reinforcement for cooperation. The entire procedure was videotaped and two independent coders used the validated FLACC (Face, Legs, Activity, Cry, Consolability) scale to code behavioral distress across five procedural phases.
RESULTS: Seventy pediatric patients aged 8 months to 17 years (M=7.0 years; 51% female) were enrolled in the study and 68 had video recordings available for analysis. Of the 68 recordings analyzed, 63 patients completed the procedure and had tubes placed without sedation. Mean FLACC scores ranged from 0.05 to 2.38 (M=1.25, SD=0.82) and median FLACC scores ranged from 0 to 1 (Mdn=0, IQR=0.05), which indicate "mild" distress. During iontophoresis, eardrum tap (anesthesia assessment), and tube delivery, older children displayed lower distress and girls had higher FLACC scores during the eardrum tap procedural phase.
CONCLUSION: When combined with the evidence-based behavioral techniques, office-based local anesthesia and tube delivery resulted in minimal distress, suggesting that the new procedure may be a viable method of conducting tympanostomy tube placement in children without having to use general anesthesia. Clinicaltrials.gov identifier: NCT01496287.

PMID: 26514928 [PubMed - as supplied by publisher]



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