Processing complex pseudo-words in mild cognitive impairment: The interaction of preserved morphological rule knowledge with compromised cognitive ability.

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Processing complex pseudo-words in mild cognitive impairment: The interaction of preserved morphological rule knowledge with compromised cognitive ability.

Clin Linguist Phon. 2015 Nov 20;:1-19

Authors: Manouilidou C, Dolenc B, Marvin T, Pirtošek Z

Abstract
Mild cognitive impairment (MCI) affects the cognitive performance of elderly adults. However, the level of severity is not high enough to be diagnosed with dementia. Previous research reports subtle language impairments in individuals with MCI specifically in domains related to lexical meaning. The present study used both off-line (grammaticality judgment) and on-line (lexical decision) tasks to examine aspects of lexical processing and how they are affected by MCI. 21 healthy older adults and 23 individuals with MCI saw complex pseudo-words that violated various principles of word formation in Slovenian and decided if each letter string was an actual word of their language. The pseudo-words ranged in their degree of violability. A task effect was found, with MCI performance to be similar to that of healthy controls in the off-line task but different in the on-line task. Overall, the MCI group responded slower than the elderly controls. No significant differences were observed in the off-line task, while the on-line task revealed a main effect of Violation type, a main effect of Group and a significant Violation × Group interaction reflecting a difficulty for the MCI group to process pseudo-words in real time. That is, while individuals with MCI seem to preserve morphological rule knowledge, they experience additional difficulties while processing complex pseudo-words. This was attributed to an executive dysfunction associated with MCI that delays the recognition of ungrammatical formations.

PMID: 26588013 [PubMed - as supplied by publisher]

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Methods for quantifying tongue shape and complexity using ultrasound imaging.

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Methods for quantifying tongue shape and complexity using ultrasound imaging.

Clin Linguist Phon. 2015 Nov 20;:1-17

Authors: Dawson KM, Tiede MK, Whalen DH

Abstract
Quantification of tongue shape is potentially useful for indexing articulatory strategies arising from intervention, therapy and development. Tongue shape complexity is a parameter that can be used to reflect regional functional independence of the tongue musculature. This paper considers three different shape quantification methods - based on Procrustes analysis, curvature inflections and Fourier coefficients - and uses a linear discriminant analysis to test how well each method is able to classify tongue shapes from different phonemes. Test data are taken from six native speakers of American English producing 15 phoneme types. Results classify tongue shapes accurately when combined across quantification methods. These methods hold promise for extending the use of ultrasound in clinical assessments of speech deficits.

PMID: 26587871 [PubMed - as supplied by publisher]

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Parapharyngeal space tumors: Fifty-one cases managed in a single tertiary care center.

Parapharyngeal space tumors: Fifty-one cases managed in a single tertiary care center.

Acta Otolaryngol. 2015 Nov 20;:1-6

Authors: Iglesias-Moreno MC, López-Salcedo MA, Gómez-Serrano M, Gimeno-Hernández J, Poch-Broto J

Abstract
CONCLUSIONS: Pre-operative planning for parapharyngeal tumors must include meticulous analysis. Factors such as tumor size, distance to cranial base, and relation to neurovascular structures must guide the selection of a surgical approach.
OBJECTIVE: To summarize experience in diagnosis and surgical management of parapharyngeal tumors, analyzing the frequencies of various tumoral types, clinical presentation, choice of surgical approach and outcomes. This study also compares the results with the most relevant case series in the literature.
METHODS: A retrospective review was performed of the records of 51 patients treated by the team, from 1984-2012. Only primary tumors were included, excluding invasion from adjacent spaces and metastatic disease. All patients underwent imaging studies and surgical resection of the neoplasm. Cytological analysis and arteriography were used on an individualized basis. Surgical excision was performed via different approaches, predominantly through a cervicoparotid route.
RESULTS: Benign neoplasms were predominant (80%), and the most frequent tumor was pleomorphic adenoma. FNAC had a 100% accuracy to differentiate benign vs malignant tumors. The most common post-operative sequel was compromise of a cranial nerve, and three patients presented local complications after surgery. After follow-up, only three of 41 patients with benign tumors had recurring disease.

PMID: 26588771 [PubMed - as supplied by publisher]

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A correlation analysis between HDAC1 over-expression and clinical features of laryngeal squamous cell carcinoma.

A correlation analysis between HDAC1 over-expression and clinical features of laryngeal squamous cell carcinoma.

Acta Otolaryngol. 2015 Nov 20;:1-5

Authors: Zhao R, Chen K, Cao J, Yu H, Tian L, Liu M

Abstract
CONCLUSION: HDAC1 may be a prognostic biomarker for LSCC malignant potency and a potent factor resulting in decreased sensitivity of LSCC in radiotherapy.
OBJECTIVE: The aim of this study was to evaluate the correlation between histone deacetylase 1 (HDAC1) over-expression and clinical features in laryngeal squamous cell carcinoma (LSCC).
METHODS: This study assessed the HDAC1 expressions in 90 formalin-fixed paraffin-embedded LSCC samples, 30 adjacent non-neoplastic tissues, and 30 laryngeal polyp tissues by immunohistochemistry (IHC). In addition, another 40 LSCC samples were collected that were divided into two groups after 3-month radiotherapy: the high radio-sensitive group (HRS) and low radio-sensitive group (LRS). Overall survival curves of all the LSCC patients were constructed by Kaplan-Meier method and long-rank test.
RESULTS: All ninety samples were positively immunostained for HDAC1. The expression of HDAC1 was up-regulated and significantly associated with T classification, lymph node metastases, tumor location and clinical stage. HDAC1 was mainly labeled in the epithelial cells of laryngeal polyp tissues and adjacent non-neoplastic tissues. In addition, the expression of HDAC1 was significantly higher in LRS than that in HRS. The positive rates for stage III-IV tumor were significantly higher than those for stage II. LSCC patients with HDAC1 over-expression and LRS presented a shorter 5-year overall survival rate.

PMID: 26588579 [PubMed - as supplied by publisher]

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The relationship between hearing loss and vestibular dysfunction in patients with sudden sensorineural hearing loss.

The relationship between hearing loss and vestibular dysfunction in patients with sudden sensorineural hearing loss.

Acta Otolaryngol. 2015 Nov 20;:1-7

Authors: Niu X, Zhang Y, Zhang Q, Xu X, Han P, Cheng Y, Gao Y, Zhang R, Yang Y, Chen Z, Hu J, Chen Y, Xu M

Abstract
OBJECTIVE: To investigate the relationship between hearing loss and vestibular dysfunction in patients with sudden sensorineural hearing loss (SSHL).
METHODS: Clinical data including the symptom of vertigo of 149 SSHL patients were investigated retrospectively. Pure tone audiometry, ocular vestibular-evoked myogenic potential (oVEMP) and cervical vestibular-evoked myogenic potential (cVEMP) evoked by air-conducted sound (ACS), and caloric test were employed for cochlear and vestibular function assessment. The relationship between hearing level and vestibular dysfunction was analyzed.
RESULTS: The pure tone averages (PTAs) (mean ± SD) of SSHL patients with and without vertigo were 88.81 ± 21.74 dB HL and 72.49 ± 21.88 dB HL (Z = -4.411, p = 0.000), respectively. The PTAs of SSHL patients with abnormal and normal caloric test were 84.71 ± 22.54 dB HL and 70.41 ± 24.07 dB HL (t = -2.665, p = 0.009), respectively. Conversely, vertigo and abnormal caloric results also happened more frequently in patients with profound hearing loss. However, no consistent tendency could be found among vestibular evoked myogenic potentials (VEMPs) responses or hearing loss.
CONCLUSIONS: SSHL patients with vertigo or abnormal caloric test displayed worse hearing loss; and vice versa, vertigo and abnormal caloric results happened more frequently in SSHL patients with profound hearing loss.

PMID: 26587580 [PubMed - as supplied by publisher]

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Reversible coma and Duret hemorrhage after intracranial hypotension from remote lumbar spine surgery: case report.

Reversible coma and Duret hemorrhage after intracranial hypotension from remote lumbar spine surgery: case report.

J Neurosurg Spine. 2015 Nov 20;:1-5

Authors: Bonow RH, Bales JW, Morton RP, Levitt MR, Zhang F

Abstract
Intracranial hypotension is a rare condition caused by spontaneous or iatrogenic CSF leaks that alter normal CSF dynamics. Symptoms range from mild headaches to transtentorial herniation, coma, and death. Duret hemorrhages have been reported to occur in some patients with this condition and are traditionally believed to be associated with a poor neurological outcome. A 73-year-old man with a remote history of spinal fusion presented with syncope and was found to have small subdural hematomas on head CT studies. He was managed nonoperatively and discharged with a Glasgow Coma Scale score of 15, only to return 3 days later with obtundation, fixed downward gaze, anisocoria, and absent cranial nerve reflexes. A CT scan showed Duret hemorrhages and subtle enlargement of the subdural hematomas, though the hematomas remained too small to account for his poor clinical condition. Magnetic resonance imaging of the spine revealed a large lumbar pseudomeningocele in the area of prior fusion. His condition dramatically improved when he was placed in the Trendelenburg position and underwent repair of the pseudomeningocele. He was kept flat for 7 days and was ultimately discharged in good condition. On long-term follow-up, his only identifiable deficit was diplopia due to an internuclear ophthalmoplegia. Intracranial hypotension is a rare condition that can cause profound morbidity, including tonsillar herniation and brainstem hemorrhage. With proper identification and treatment of the CSF leak, patients can make functional recoveries.

PMID: 26588496 [PubMed - as supplied by publisher]

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Cancer stem cells in laryngeal cancer: what we know.

Cancer stem cells in laryngeal cancer: what we know.

Eur Arch Otorhinolaryngol. 2015 Nov 19;

Authors: Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Pagliuca G, Martellucci S, Turchetta R, De Vincentiis M

Abstract
Cancer stem cells (CSCs) are a group of cells with eternal life or infinite self-renewal ability, which have high migrating, infiltrative, and metastatic abilities. Though CSCs only account for a small proportion in tumors, the high resistance to traditional therapy exempts them from therapy killing and thus they can reconstruct tumors. Previous studies found that heterogeneity of cancer cells extensively exists in head and neck cancers. Our current knowledge, about CSCs in the laryngeal cancer (LC), largely depends on head and neck studies. Given the lack of systematic data about CSCs in LC, we propose a review of the literature, reporting the evidences of CSCs in tumorigenesis of LC, with the purpose to provide new insights into the prevention and/or treatment of laryngeal carcinoma.

PMID: 26585332 [PubMed - as supplied by publisher]

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[Thyroidectomy performed under local anesthesia at the University Hospital of Antananarivo].

[Thyroidectomy performed under local anesthesia at the University Hospital of Antananarivo].

Pan Afr Med J. 2015;21:278

Authors: Razafindrakoto RM, Razafindranaivo MN, Valisoa HA, Schammirah MR, Randriamboavonjy R

PMID: 26587128 [PubMed - as supplied by publisher]

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Speech task effects on acoustic measure of fundamental frequency in Cantonese-speaking children.

Speech task effects on acoustic measure of fundamental frequency in Cantonese-speaking children.

Int J Pediatr Otorhinolaryngol. 2015 Nov 3;

Authors: Ma EP, Lam NL

Abstract
OBJECTIVES: Speaking fundamental frequency (F0) is a voice measure frequently used to document changes in vocal performance over time. Knowing the intra-subject variability of speaking F0 has implications on its clinical usefulness. The present study examined the speaking F0 elicited from three speech tasks in Cantonese-speaking children. The study also compared the variability of speaking F0 elicited from different speech tasks.
METHODS: Fifty-six vocally healthy Cantonese-speaking children (31 boys and 25 girls) aged between 7.0 and 10.11 years participated. For each child, speaking F0 was elicited using speech tasks at three linguistic levels (sustained vowel /a/ prolongation, reading aloud a sentence and passage). Two types of variability, within-session (trial-to-trial) and across-session (test-retest) variability, were compared across speech tasks.
RESULTS AND CONCLUSIONS: Significant differences in mean speaking F0 values were found between speech tasks. Mean speaking F0 value elicited from sustained vowel phonations was significantly higher than those elicited from the connected speech tasks. The variability of speaking F0 was higher in sustained vowel prolongation than that in connected speech.

PMID: 26586246 [PubMed - as supplied by publisher]

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Polymorphic variants near 1p22 and 20q11.2 loci and the risk of non-syndromic cleft lip and palate in South Indian population.

Polymorphic variants near 1p22 and 20q11.2 loci and the risk of non-syndromic cleft lip and palate in South Indian population.

Int J Pediatr Otorhinolaryngol. 2015 Nov 4;

Authors: Babu Gurramkonda V, Hussain Syed A, Murthy J, Chaubey G, Bhaskar Lakkakula VK

Abstract
BACKGROUND: Recent genome-wide association studies (GWAS) have reported multiple genetic risk loci for non-syndromic orofacial clefts (NSOFCs) in many populations. However, the contribution of these loci to NSOFC in India, which comprises one-fifth of the global population, is completely lacking. Our aim was to replicate the association of the SNPs located on 1p22 chromosomal loci (rs540026, rs481931) and 20q11.2 (rs13041247, rs11696257) in the aetiology of NSOFCs, in South Indian populations.
METHODS: The SNPs were genotyped by using KBiosciences KASPar SNP genotyping chemistry in 173 cases and 176 controls for NSOFCs in South India. To estimate the association between these SNPs and NSOFCs, chi-square test was adopted. Odds ratios (OR) with 95% confidence intervals (CI) were also calculated in order to assess the risk.
RESULTS: Single nucleotide polymorphisms located at chromosomal region 1p22 are not found to be associated with cleft lip with or without non-syndromic cleft palate (NSCL/P) and non-syndromic cleft palate only (NSCPO) at either the genotype or allele levels. Further, there is no LD observed between these variants. The polymorphic variants near 20q11.2 (rs13041247, rs11696257) are in complete linkage disequilibrium (LD) and are significantly associated with only NSCL/P in genotypic (p=0.013) and allelic models (p=0.029). In the genotypic model significance persisted even after Bonferroni correction (p<0.016).
CONCLUSION: These results suggest that 20q11.2 SNPs could play a contributory role in the pathophysiology and risk of NSCL/P, while the variations in 1p22 do not underlie the pathophysiology of NSOFCs in South Indian populations.

PMID: 26586245 [PubMed - as supplied by publisher]

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Investigation of pepsin in tears of children with laryngopharyngeal reflux disease.

Investigation of pepsin in tears of children with laryngopharyngeal reflux disease.

Int J Pediatr Otorhinolaryngol. 2015 Oct 30;

Authors: Iannella G, Di Nardo G, Plateroti R, Rossi P, Plateroti AM, Mariani P, Magliulo G

Abstract
OBJECTIVES: Numerous investigations postulated that laryngopharyngeal reflux (LPR) is implicated in the pathogenesis of various upper airway inflammatory diseases as sinusitis or dacryostenosis. The presence of pepsin in tears might be confirmed the presuntive hypothesis of the arrival in the nasolacrimal ducts and precorneal tears film through the laryngopharyngeal reflux of either gastric acid or stomach secretions (pepsin) with inflammatory potentialities. The aim of this preliminary study was to identify the presence or absence of pepsin in the tears collected from children with a high suspicion of LPR who underwent 24-h pH (MII-pH) monitoring to confirm the disease.
METHODS: This study enrolled 20 patients suffering from symptoms of laryngopharyngeal reflux that underwent 24-h multichannel intraluminal impedance (MII)-pH monitoring to confirm the disease. The findings of the study group were compared with those of a control group of patients with negative pH monitoring. The quantitative analysis of human pepsin concentration in the tear samples was performed by ELISA method in both groups.
RESULTS: Four children (20%) of the study group showed pepsin in the tears. All of the subjects belonging to the control group were negative for its presence. No difference differences in the total number of reflux episodes and the number of weakly basic reflux in the pepsin positive patients vs. pepsin negative children were present.
CONCLUSIONS: 20% of the children with diagnosed LPR showed pepsin in the tears. Our specific investigation might provide information regarding sinusitis or dacryostenosis.

PMID: 26586244 [PubMed - as supplied by publisher]

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Rabbit model of tracheal stenosis induced by prolonged endotracheal intubation using a segmented tube.

Rabbit model of tracheal stenosis induced by prolonged endotracheal intubation using a segmented tube.

Int J Pediatr Otorhinolaryngol. 2015 Nov 3;

Authors: Lee HS, Kim SW, Oak C, Ahn YC, Kang HW, Chun BK, Lee KD

Abstract
OBJECTIVE: Animal model of tracheal stenosis based on pathophysiology of prolonged endotracheal intubation has been rarely reported. We sought to verify the feasibility of inducing an animal model of tracheal stenosis by segmented endotracheal tube insertion in the New Zealand white rabbit model.
METHODS: Tracheal stenosis was induced by inserting a segmented endotracheal tube of 1.5cm length which was wrapped with a commercialized absorbable hemostat in 15 New Zealand white rabbits, while sham surgery controls (n=3) underwent tracheotomy and direct closure of tracheal exposure. The tube was removed transorally, 1 week after tube insertion. All rabbits were evaluated endoscopically at 1 week, 2 weeks and 3 weeks after the tube insertion. The rabbits were sacrificed 3 weeks after the surgery, and the excised tissue of trachea was processed along with the procedure of standard hematoxylin eosin staining and observed under a microscope.
RESULTS: Tracheal stenosis was induced in all rabbits (range 32-84% stenosis) with no death of rabbits during the study. The histological features of tracheal stenosis demonstrated thickening and fibrosis of lamina propria and submucosa with relatively intact cartilage framework.
CONCLUSIONS: We developed a rabbit model of tracheal stenosis induced by endotracheal intubation using a segmented tracheal tube. Since the model is based on the physiologic condition of prolonged endotracheal intubation, it may be used in variable studies related to tracheal stenosis.

PMID: 26586243 [PubMed - as supplied by publisher]

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[On the Differential Diagnosis of Intractable Psychogenic Chronic Cough: Neuropathic Larynx Irritable - Gabapentin's Antitussive Action].

[On the Differential Diagnosis of Intractable Psychogenic Chronic Cough: Neuropathic Larynx Irritable - Gabapentin's Antitussive Action].

Fortschr Neurol Psychiatr. 2015 Oct;83(10):568-577

Authors: Bonnet U, Ossowski A, Schubert M, Gall H, Steinkamp I, Richter LE, Khalil-Boutros Y, Nefedev A, Kuhlmann R

Abstract
We present the case of a 76 year old female inpatient who suffered from a chronic intractable cough which arose simultaneously to a severe major depression and was secondary to an exorbitant psychological distress. Chronic cough had never been experienced before and was initially considered to have a mere psychogenic origin since a comprehensive and guideline-based diagnostic screening did not reveal any underlying somatic cause. However, several factors cast doubt on the solitary psychic genesis of the chronic cough: i) occurrence immediately after a penetrant cold, ii) embedding in other complaints of laryngeal hyperreagibility (larynx irritable), such as persistent globus pharyngeus sensation, throat clearing and episodic dysphonia, iii) first occurrence on old life, iv) erupting from sleep as well, v) persistence despite remission of the major depression, and v) no sustaining benefit from specific psychotherapy and speech therapy. Therefore, diagnostics were extended to apparative tools for objective evaluation of swallowing by using fiberoptic videoendoscopic (FEES) and videofluoroscopic (VFS) techniques, which revealed signs of laryngeal neuropathy but without evidence of penetration or aspiration. A co-existing small goiter and an impaired glucose tolerance along with a putative intracellular vitamin B12 or folate deficiency (as indirectly derived from an apparent hyperhomocysteinemia) were assumed to be responsible for the neuropathy and underwent specific treatments. The impaired glucose tolerance and putative vitamin deficit were compatible with a distal symmetric sensorimotoric, even subclinical polyneuropathy of the lower extremities. The larynx irritable improved under gabapentin being confirmed by drug removals several times, and finally calmed down almost completely under gabapentin, which was in line with the scant literature of this topic. Re-examination of the larynx per FEES nine months later showed no deficits any more under the well-tolerated treatment (gabapentin, levothyroxine, vitamin B12 and folic acid substitution, weight reduction and physical training). All in all, the larynx irritable as well as the chronic cough were most probably induced by a laryngeal neuropathy and were not solely of psychic origin. Due to good treatment options a larynx irritable should be regularly taken into consideration of the investigation of intractable chronic cough. Therefore, an apparative evaluation of deglutition is recommended in the diagnostic toolbox of chronic cough - even if embedded in a psychiatric disorder or distress - before diagnosing a sole psychic origin. An hypothetical scheme of the development of a larynx irritable caused by neuropathic and non-neuropathic ("nociceptive") conditions is proposed.

PMID: 26588720 [PubMed - as supplied by publisher]

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Familial Sulcus Vergeture: Further Evidence for Congenital Origin of Type 2 Sulcus.

Familial Sulcus Vergeture: Further Evidence for Congenital Origin of Type 2 Sulcus.

J Voice. 2015 Nov 13;

Authors: Husain S, Sulica L

Abstract
A 29-year-old otherwise healthy woman presented with a lifetime history of hoarseness because it had begun to interfere with her career. Examination of both the woman and her 60-year-old father revealed bilateral sulcus vergeture, without inflammation or lesions attributable to phonotrauma. The woman responded well to injection augmentation; the father declined treatment. Combined with existing descriptions of other family groupings, all with sulcus vergeture without signs of inflammation, clinical progression, and little or no apparent behavioral component, this report further suggests that sulcus vergeture (Ford type 2) and sulcus vocalis (Ford type 3) are entirely different entities, despite architectural similarity.

PMID: 26584518 [PubMed - as supplied by publisher]

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Pathology of Tinnitus and Hyperacusis-Clinical Implications.

Pathology of Tinnitus and Hyperacusis-Clinical Implications.

Biomed Res Int. 2015;2015:608437

Authors: Moller AR, Salvi R, De Ridder D, Kleinjung T, Vanneste S

PMID: 26587541 [PubMed - as supplied by publisher]

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Effects of Noise Exposure on Development of Tinnitus and Hyperacusis: Prevalence rates 12 months after exposure in Middle-Aged Rats.

Effects of Noise Exposure on Development of Tinnitus and Hyperacusis: Prevalence rates 12 months after exposure in Middle-Aged Rats.

Hear Res. 2015 Nov 13;

Authors: Turner JG, Larsen D

Abstract
Fischer Brown Norway (FBN) rats (n=233) were unilaterally exposed to 12 different combinations of noise intensity, duration, and spectrum, while 46 rats served as sham-exposed controls. Rats were behaviorally tested for tinnitus and hyperacusis using gap-induced inhibition of the acoustic startle reflex (Gap) and prepulse inhibition (PPI) using 60-dB SPL before noise-exposure and at regular intervals for 12 mo. 12-mo after noise exposure the middle-aged rats were then tested again for tinnitus and hyperacusis before collecting Auditory Brainstem Response (ABR) thresholds. Collapsing across all noise exposure conditions a significant tinnitus-like deficit in responding to silent gaps was observed, with the most likely tinnitus pitch around 16 kHz. Rates of tinnitus 12-mo after noise exposure were greatest in groups receiving the four least intense noise doses (110-dB for 30, 60 and 120 mins, and 116-dB for 30 min), while some of the greatest rates of hyperacusis occurred in groups receiving more intense or longer exposures. The results suggest that rates for developing tinnitus in animal models may not be easily predicted based upon noise exposure dose, but that low-to-moderate noise exposures may result in the greatest likelihood for producing tinnitus.

PMID: 26584761 [PubMed - as supplied by publisher]

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Whole scalp resting state EEG of oscillatory brain activity shows no parametric relationship with psychoacoustic and psychosocial assessment of tinnitus: a repeated measures study.

Whole scalp resting state EEG of oscillatory brain activity shows no parametric relationship with psychoacoustic and psychosocial assessment of tinnitus: a repeated measures study.

Hear Res. 2015 Nov 13;

Authors: Pierzycki RH, McNamara AJ, Hoare DJ, Hall DA

Abstract
Tinnitus is a perception of sound that can occur in the absence of an external stimulus. A brief review of electroencephalography (EEG) and magnetoencephalography (MEG) literature demonstrates that there is no clear relationship between tinnitus presence and frequency band power in whole scalp or source oscillatory activity. Yet a preconception persists that such a relationship exists and that resting state EEG could be utilised as an outcome measure for clinical trials of tinnitus interventions, e.g. as a neurophysiological marker of therapeutic benefit. To address this issue, we first examined the test-retest correlation of EEG band power measures in tinnitus patients (n = 42). Second we examined the evidence for a parametric relationship between numerous commonly used tinnitus variables (psychoacoustic and psychosocial) and whole scalp EEG power spectra, directly and after applying factor reduction techniques. Test-retest correlation for both EEG band power measures and tinnitus variables were high. Yet we found no relationship between whole scalp EEG band powers and psychoacoustic or psychosocial variables. We conclude from these data that resting state whole scalp EEG should not be used as a biomarker for tinnitus and that greater caution should be exercised in regard to reporting of findings to avoid confirmation bias. The data was collected during a randomised controlled trial registered at ClinicalTrials.gov (Identifier: NCT01541969).

PMID: 26584760 [PubMed - as supplied by publisher]

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The impact of tinnitus characteristics and associated variables on tinnitus-related handicap.

The impact of tinnitus characteristics and associated variables on tinnitus-related handicap.

J Laryngol Otol. 2015 Nov 20;:1-7

Authors: Degeest S, Corthals P, Dhooge I, Keppler H

Abstract
OBJECTIVE: This study aimed to determine the characteristics of tinnitus and tinnitus-related variables and explore their possible relationship with tinnitus-related handicap.
METHODS: Eighty-one patients with chronic tinnitus were included. The study protocol measured hearing status, tinnitus pitch, loudness, maskability and loudness discomfort levels. All patients filled in the Tinnitus Sample Case History Questionnaire, the Hyperacusis Questionnaire and the Tinnitus Handicap Inventory. The relationship of each variable with the Tinnitus Handicap Inventory score was evaluated by univariate and multivariate analyses.
RESULTS: Five univariables were associated with the Tinnitus Handicap Inventory score: loudness discomfort level, subjective tinnitus loudness, tinnitus awareness, noise intolerance and Hyperacusis Questionnaire score. Multiple regression analysis showed that the Hyperacusis Questionnaire score and tinnitus awareness were independently associated with the Tinnitus Handicap Inventory score.
CONCLUSION: Hyperacusis and tinnitus awareness were independently associated with the Tinnitus Handicap Inventory score. Questionnaires on tinnitus and hyperacusis are especially suited to providing additional insight into tinnitus-related handicap and are therefore useful for evaluating tinnitus patients.

PMID: 26584711 [PubMed - as supplied by publisher]

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A Double-Blind Placebo-Controlled Trial of Liquid Thyroxine Ingested at Breakfast: Results of the TICO study.

A Double-Blind Placebo-Controlled Trial of Liquid Thyroxine Ingested at Breakfast: Results of the TICO study.

Thyroid. 2015 Nov 20;

Authors: Cappelli C, Pirola I, Daffini L, Formenti A, Iacobello C, Cristiano A, Gandossi E, Agabiti Rosei E, Castellano M

Abstract
BACKGROUND: Levothyroxine (L-T4) is the recommended treatment for millions of hypothyroid patients. Current guidelines recommend that L-T4 tablets be taken in a fasting state, but inability to adhere to this often leads to poor therapy compliance.
METHODS: We conducted a randomized, double-blind, placebo-controlled, crossover trial in previously untreated hypothyroid patients randomly assigned to receive an oral solution of L-T4 either at least 30 minutes before breakfast or directly at breakfast time. Each patient completed two 6-week treatment periods, with different timing of active L-T4 administration: placebo before breakfast and active L-T4 at breakfast, or vice versa. At the end of each period, TSH, fT4 and fT3 were measured. The primary endpoint was to verify any difference in serum TSH levels whether consuming liquid L-T4 at breakfast or 30 minutes prior to breakfast.
RESULTS: A total of 77 patients (64/13 female/male, median age 45.4 ±13.7) completed the study. No statistically significant difference of serum TSH, fT4 and fT3 levels was observed whether L-T4 was taken at breakfast or 30 minutes before, in a fasting state. No significant effect from the sequence of regimens, breakfast composition and/or concomitantly administered drugs was observed on the dose of L-T4 administered, or on the post-treatment serum TSH values.
CONCLUSIONS: The TICO study suggests that a liquid L-T4 formulation can be ingested directly at breakfast, thus potentially improving therapeutic compliance. This observation is of considerable clinical relevance, since non-adherence to L-T4therapy requirements is more likely to cause variability in serum TSH concentrations.

PMID: 26586610 [PubMed - as supplied by publisher]

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EFFECTS OF MATERNAL IODINE NUTRITION AND THYROID STATUS ON COGNITIVE DEVELOPMENT IN OFFSPRING: A PILOT STUDY.

EFFECTS OF MATERNAL IODINE NUTRITION AND THYROID STATUS ON COGNITIVE DEVELOPMENT IN OFFSPRING: A PILOT STUDY.

Thyroid. 2015 Nov 20;

Authors: Moleti M, Trimarchi F, Tortorella G, Candia Longo A, Giorgianni GM, Sturniolo G, Alibrandi A, Vermiglio F

Abstract
BACKGROUND AND OBJECTIVE: Maternal iodine nutrition and thyroid status may influence neurocognitive development in offspring. This study investigated the effects on the Intelligence Quotient (IQ) of children born to mothers with different levels of iodine supplementation, with or without the administration of levothyroxine (LT4), prior to and during pregnancy .
PATIENTS AND METHODS: This pilot, prospective, observational study included four study groups, each comprising 15 mother-child pairs, identified on the basis of maternal histories of iodized salt consumption and LT4 treatment prior to and during pregnancy. The groups were labeled as follows: iodine (I), no-iodine (no-I), iodine+LT4 (I+T4), and no-iodine+LT4 (no-I+T4). IQ tests were administered to children at age 6-12 years with the Wechsler Intelligence Scale for Children-3rd-Edition (WISC-III) and full-scale IQ (FSIQ), verbal IQ (VIQ), and performance IQ (PIQ) being evaluated.
RESULTS: Children of I and I+T4 mothers had similar verbal, performance, and FSIQs, which were 14, 10, and 13 points higher, respectively, than children born to no-I and no I+T4 mothers. A positive association was found between VIQ and maternal urinary iodine [() = 1.023, 95% CI 1.003-1.043; p = 0.028], but not with maternal free -thyroxine (FT4) concentrations at any stage of pregnancy. Overall, the prevalence of borderline or defective cognitive function was more than 3-fold higher in the children of unsupplemented mothers than of supplemented mothers (76.9% vs. 23.1%, OR 7.667, 95%CI 2.365-24.856, χ2 = 12.65; p = 0.0001).
CONCLUSIONS: Neuro-intellectual outcomes in children appear to be more dependent on their mothers' nutritional iodine status than on maternal thyroid function. These results support the growing body of evidence that prenatal, mild-to-moderate iodine deficiency adversely affects cognitive development later in life, with a seemingly greater impact on verbal abilities.

PMID: 26586553 [PubMed - as supplied by publisher]

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[Caloric irrigation of the vestibular organ using near infrared: A device for use in clinical practice].

[Caloric irrigation of the vestibular organ using near infrared: A device for use in clinical practice].

Laryngorhinootologie. 2015 Nov;94(11):735-737

Authors: Walther LE

PMID: 26587672 [PubMed - as supplied by publisher]

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Natural and surgical history of Chiari malformation Type I in the pediatric population.

Natural and surgical history of Chiari malformation Type I in the pediatric population.

J Neurosurg Pediatr. 2015 Nov 20;:1-10

Authors: Pomeraniec IJ, Ksendzovsky A, Awad AJ, Fezeu F, Jane JA

Abstract
OBJECT The natural and surgical history of Chiari malformation Type I (CM-I) in pediatric patients is currently not well described. In this study the authors discuss the clinical and radiological presentation and outcomes in a large cohort of pediatric CM-I patients treated with either conservative or surgical management. METHODS The authors retrospectively reviewed 95 cases involving pediatric patients with CM-I who presented between 2004 and 2013. The patients ranged in age from 9 months to 18 years (mean 8 years) at presentation. The cohort was evenly split between the sexes. Twenty-five patients underwent posterior fossa decompression (PFD) with either dural splitting or duraplasty. Seventy patients were managed without surgery. Patients were followed radiologically (mean 44.8 months, range 1.2-196.6 months) and clinically (mean 66.3 months, range 1.2-106.5 months). RESULTS Seventy patients were treated conservatively and followed with serial outpatient neurological and radiological examinations, whereas 25 patients were treated with PFD. Of these 25 surgical patients, 11 were treated with duraplasty (complete dural opening) and 14 were treated with a dura-splitting technique (incomplete dural opening). Surgical intervention was associated with better clinical resolution of symptoms and radiological resolution of tonsillar ectopia and syringomyelia (p = 0.0392). Over the course of follow-up, 20 (41.7%) of 48 nonsurgical patients who were symptomatic at presentation experienced improvement in symptoms and 18 (75%) of 24 symptomatic surgical patients showed clinical improvement (p = 0.0117). There was no statistically significant difference in resolution of symptoms between duraplasty and dura-splitting techniques (p = 0.3572) or between patients who underwent tonsillectomy and tonsillopexy (p = 0.1667). Neither of the 2 patients in the conservative group with syrinx at presentation showed radiological evidence of resolution of the syrinx, whereas 14 (87.5%) of 16 patients treated with surgery showed improvement or complete resolution of syringomyelia (p = 0.0392). In the nonsurgical cohort, 3 patients (4.3%) developed new or increased syrinx. CONCLUSIONS The overwhelming majority of CM-I patients (92.9%) managed conservatively do not experience clinical or radiological progression, and a sizeable minority (41.7%) of those who present with symptoms improve. However, appropriately selected symptomatic patients (sleep apnea and dysphagia) and those presenting with syringomyelia should be considered surgical candidates because of the high rates of clinical (75%) and radiological improvement (87.5%).

PMID: 26588459 [PubMed - as supplied by publisher]

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Conceiving a national head and neck cancer screening programme.

Conceiving a national head and neck cancer screening programme.

J Laryngol Otol. 2015 Nov 20;:1-7

Authors: Gogarty DS, Shuman A, O'Sullivan EM, Sheahan P, Kinsella J, Timon C, O'Neill JP

Abstract
BACKGROUND: This study was undertaken to determine the optimum approach to screening for head and neck cancer based on international experiences.
OBJECTIVE: To determine whether or not head and neck cancer is suitable for screening, and, if so, what the ideal approach should be.
METHODS: An electronic search of online databases up to and including May 2014 was conducted. Key search terms included 'head and neck', 'cancer', 'screening', 'larynx', 'oropharynx' and 'oral'.
RESULTS: Subset analysis of high-risk cohorts showed statistically significant improvements in early detection of head and neck cancer via screening.
CONCLUSION: Current levels of public awareness regarding head and neck cancers are suboptimal, despite increased incidence and mortality. Scheduled and opportunistic screening, coupled with efforts to enhance education and health behaviour modification, are highly recommended for pre-defined, high-risk, targeted populations. This can enable early detection and therefore improve morbidity and mortality.

PMID: 26585180 [PubMed - as supplied by publisher]

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Top-cited articles of the last 30 years (1985-2014) in otolaryngology - head and neck surgery.

Top-cited articles of the last 30 years (1985-2014) in otolaryngology - head and neck surgery.

J Laryngol Otol. 2015 Nov 20;:1-7

Authors: Lenzi R, Fortunato S, Muscatello L

Abstract
BACKGROUND: The frequency with which a scientific article is cited by other studies is one way to measure its academic influence.
METHODS: A comprehensive search was performed to identify journal articles in the otorhinolaryngology subject category of the 2013 Journal Citation Report Science Edition over the last 30 years (1985-2014). The 100 most cited articles were reviewed and basic information including the publication year, country of origin, source journal, article type and research field was collected.
RESULTS: The 100 most cited articles were published in 15 of the 44 otorhinolaryngology journals. The number of citations per article ranged between 208 and 1559. The leading research field was otology and neurotology (n = 50), followed by rhinology (n = 23) and head and neck surgery (n = 11). Most papers originated in the USA (n = 64).
CONCLUSION: The possibility of an article being cited is influenced by the publication language, country of origin and source journal.

PMID: 26584956 [PubMed - as supplied by publisher]

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The great mimicker: a rare case of head and neck inflammatory pseudotumour in the presence of human immunodeficiency virus.

The great mimicker: a rare case of head and neck inflammatory pseudotumour in the presence of human immunodeficiency virus.

J Laryngol Otol. 2015 Nov 20;:1-4

Authors: Ramotar H, Cheung L, Pitkin L

Abstract
BACKGROUND: Inflammatory pseudotumours of the head and neck are rare. A connection has been made between inflammatory pseudotumours and human immunodeficiency virus positivity.
CASE REPORT: This paper reports a case of an inflammatory pseudotumour presenting with a lesion in the left tonsil and left cervical lymph node in a 49-year-old human immunodeficiency virus positive patient. A histological diagnosis was obtained after biopsy and serial radiological imaging.
CONCLUSION: Diagnostic uncertainties can lead to unnecessary surgery. It is important to recognise the clinical, radiological and histological indicators of an inflammatory pseudotumour to enable a timely diagnosis and arrange appropriate treatment. In patients with co-morbidities causing immunocompromise, the potential diagnosis of an inflammatory pseudotumour should be considered. This is especially the case in human immunodeficiency virus patients, as inflammatory pseudotumours have been associated with immune reconstitution inflammatory syndrome, which can manifest up to several years after the initiation of, or change in, antiretroviral therapies.

PMID: 26584834 [PubMed - as supplied by publisher]

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The impact of tinnitus characteristics and associated variables on tinnitus-related handicap.

The impact of tinnitus characteristics and associated variables on tinnitus-related handicap.

J Laryngol Otol. 2015 Nov 20;:1-7

Authors: Degeest S, Corthals P, Dhooge I, Keppler H

Abstract
OBJECTIVE: This study aimed to determine the characteristics of tinnitus and tinnitus-related variables and explore their possible relationship with tinnitus-related handicap.
METHODS: Eighty-one patients with chronic tinnitus were included. The study protocol measured hearing status, tinnitus pitch, loudness, maskability and loudness discomfort levels. All patients filled in the Tinnitus Sample Case History Questionnaire, the Hyperacusis Questionnaire and the Tinnitus Handicap Inventory. The relationship of each variable with the Tinnitus Handicap Inventory score was evaluated by univariate and multivariate analyses.
RESULTS: Five univariables were associated with the Tinnitus Handicap Inventory score: loudness discomfort level, subjective tinnitus loudness, tinnitus awareness, noise intolerance and Hyperacusis Questionnaire score. Multiple regression analysis showed that the Hyperacusis Questionnaire score and tinnitus awareness were independently associated with the Tinnitus Handicap Inventory score.
CONCLUSION: Hyperacusis and tinnitus awareness were independently associated with the Tinnitus Handicap Inventory score. Questionnaires on tinnitus and hyperacusis are especially suited to providing additional insight into tinnitus-related handicap and are therefore useful for evaluating tinnitus patients.

PMID: 26584711 [PubMed - as supplied by publisher]

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[On the Differential Diagnosis of Intractable Psychogenic Chronic Cough: Neuropathic Larynx Irritable - Gabapentin's Antitussive Action].

[On the Differential Diagnosis of Intractable Psychogenic Chronic Cough: Neuropathic Larynx Irritable - Gabapentin's Antitussive Action].

Fortschr Neurol Psychiatr. 2015 Oct;83(10):568-577

Authors: Bonnet U, Ossowski A, Schubert M, Gall H, Steinkamp I, Richter LE, Khalil-Boutros Y, Nefedev A, Kuhlmann R

Abstract
We present the case of a 76 year old female inpatient who suffered from a chronic intractable cough which arose simultaneously to a severe major depression and was secondary to an exorbitant psychological distress. Chronic cough had never been experienced before and was initially considered to have a mere psychogenic origin since a comprehensive and guideline-based diagnostic screening did not reveal any underlying somatic cause. However, several factors cast doubt on the solitary psychic genesis of the chronic cough: i) occurrence immediately after a penetrant cold, ii) embedding in other complaints of laryngeal hyperreagibility (larynx irritable), such as persistent globus pharyngeus sensation, throat clearing and episodic dysphonia, iii) first occurrence on old life, iv) erupting from sleep as well, v) persistence despite remission of the major depression, and v) no sustaining benefit from specific psychotherapy and speech therapy. Therefore, diagnostics were extended to apparative tools for objective evaluation of swallowing by using fiberoptic videoendoscopic (FEES) and videofluoroscopic (VFS) techniques, which revealed signs of laryngeal neuropathy but without evidence of penetration or aspiration. A co-existing small goiter and an impaired glucose tolerance along with a putative intracellular vitamin B12 or folate deficiency (as indirectly derived from an apparent hyperhomocysteinemia) were assumed to be responsible for the neuropathy and underwent specific treatments. The impaired glucose tolerance and putative vitamin deficit were compatible with a distal symmetric sensorimotoric, even subclinical polyneuropathy of the lower extremities. The larynx irritable improved under gabapentin being confirmed by drug removals several times, and finally calmed down almost completely under gabapentin, which was in line with the scant literature of this topic. Re-examination of the larynx per FEES nine months later showed no deficits any more under the well-tolerated treatment (gabapentin, levothyroxine, vitamin B12 and folic acid substitution, weight reduction and physical training). All in all, the larynx irritable as well as the chronic cough were most probably induced by a laryngeal neuropathy and were not solely of psychic origin. Due to good treatment options a larynx irritable should be regularly taken into consideration of the investigation of intractable chronic cough. Therefore, an apparative evaluation of deglutition is recommended in the diagnostic toolbox of chronic cough - even if embedded in a psychiatric disorder or distress - before diagnosing a sole psychic origin. An hypothetical scheme of the development of a larynx irritable caused by neuropathic and non-neuropathic ("nociceptive") conditions is proposed.

PMID: 26588720 [PubMed - as supplied by publisher]

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Conceiving a national head and neck cancer screening programme.

Conceiving a national head and neck cancer screening programme.

J Laryngol Otol. 2015 Nov 20;:1-7

Authors: Gogarty DS, Shuman A, O'Sullivan EM, Sheahan P, Kinsella J, Timon C, O'Neill JP

Abstract
BACKGROUND: This study was undertaken to determine the optimum approach to screening for head and neck cancer based on international experiences.
OBJECTIVE: To determine whether or not head and neck cancer is suitable for screening, and, if so, what the ideal approach should be.
METHODS: An electronic search of online databases up to and including May 2014 was conducted. Key search terms included 'head and neck', 'cancer', 'screening', 'larynx', 'oropharynx' and 'oral'.
RESULTS: Subset analysis of high-risk cohorts showed statistically significant improvements in early detection of head and neck cancer via screening.
CONCLUSION: Current levels of public awareness regarding head and neck cancers are suboptimal, despite increased incidence and mortality. Scheduled and opportunistic screening, coupled with efforts to enhance education and health behaviour modification, are highly recommended for pre-defined, high-risk, targeted populations. This can enable early detection and therefore improve morbidity and mortality.

PMID: 26585180 [PubMed - as supplied by publisher]

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Familial Sulcus Vergeture: Further Evidence for Congenital Origin of Type 2 Sulcus.

Familial Sulcus Vergeture: Further Evidence for Congenital Origin of Type 2 Sulcus.

J Voice. 2015 Nov 13;

Authors: Husain S, Sulica L

Abstract
A 29-year-old otherwise healthy woman presented with a lifetime history of hoarseness because it had begun to interfere with her career. Examination of both the woman and her 60-year-old father revealed bilateral sulcus vergeture, without inflammation or lesions attributable to phonotrauma. The woman responded well to injection augmentation; the father declined treatment. Combined with existing descriptions of other family groupings, all with sulcus vergeture without signs of inflammation, clinical progression, and little or no apparent behavioral component, this report further suggests that sulcus vergeture (Ford type 2) and sulcus vocalis (Ford type 3) are entirely different entities, despite architectural similarity.

PMID: 26584518 [PubMed - as supplied by publisher]

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The relationship between hearing loss and vestibular dysfunction in patients with sudden sensorineural hearing loss.

The relationship between hearing loss and vestibular dysfunction in patients with sudden sensorineural hearing loss.

Acta Otolaryngol. 2015 Nov 20;:1-7

Authors: Niu X, Zhang Y, Zhang Q, Xu X, Han P, Cheng Y, Gao Y, Zhang R, Yang Y, Chen Z, Hu J, Chen Y, Xu M

Abstract
OBJECTIVE: To investigate the relationship between hearing loss and vestibular dysfunction in patients with sudden sensorineural hearing loss (SSHL).
METHODS: Clinical data including the symptom of vertigo of 149 SSHL patients were investigated retrospectively. Pure tone audiometry, ocular vestibular-evoked myogenic potential (oVEMP) and cervical vestibular-evoked myogenic potential (cVEMP) evoked by air-conducted sound (ACS), and caloric test were employed for cochlear and vestibular function assessment. The relationship between hearing level and vestibular dysfunction was analyzed.
RESULTS: The pure tone averages (PTAs) (mean ± SD) of SSHL patients with and without vertigo were 88.81 ± 21.74 dB HL and 72.49 ± 21.88 dB HL (Z = -4.411, p = 0.000), respectively. The PTAs of SSHL patients with abnormal and normal caloric test were 84.71 ± 22.54 dB HL and 70.41 ± 24.07 dB HL (t = -2.665, p = 0.009), respectively. Conversely, vertigo and abnormal caloric results also happened more frequently in patients with profound hearing loss. However, no consistent tendency could be found among vestibular evoked myogenic potentials (VEMPs) responses or hearing loss.
CONCLUSIONS: SSHL patients with vertigo or abnormal caloric test displayed worse hearing loss; and vice versa, vertigo and abnormal caloric results happened more frequently in SSHL patients with profound hearing loss.

PMID: 26587580 [PubMed - as supplied by publisher]

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