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Cervical necrotising fasciitis with descending mediastinitis.
Emerg Med J. 2015 Apr;32(4):339
Authors: Hsiao CY, Huang AP
PMID: 24317289 [PubMed - indexed for MEDLINE]
Management of chronic refractory cough.
BMJ. 2015;351:h5590
Authors: Gibson PG, Vertigan AE
Abstract
Chronic refractory cough (CRC) is defined as a cough that persists despite guideline based treatment. It is seen in 20-46% of patients presenting to specialist cough clinics and it has a substantial impact on quality of life and healthcare utilization. Several terms have been used to describe this condition, including the recently introduced term cough hypersensitivity syndrome. Key symptoms include a dry irritated cough localized around the laryngeal region. Symptoms are not restricted to cough and can include globus, dyspnea, and dysphonia. Chronic refractory cough has factors in common with laryngeal hypersensitivity syndromes and chronic pain syndromes, and these similarities help to shed light on the pathophysiology of the condition. Its pathophysiology is complex and includes cough reflex sensitivity, central sensitization, peripheral sensitization, and paradoxical vocal fold movement. Chronic refractory cough often occurs after a viral infection. The diagnosis is made once the main diseases that cause chronic cough have been excluded (or treated) and cough remains refractory to medical treatment. Several treatments have been developed over the past decade. These include speech pathology interventions using techniques adapted from the treatment of hyperfunctional voice disorders, as well as the use of centrally acting neuromodulators such as gabapentin and pregabalin. Potential new treatments in development also show promise.
PMID: 26666537 [PubMed - as supplied by publisher]
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Endoscopic endonasal transclival transodontoid approach for ventral decompression of the craniovertebral junction: operative technique and nuances.
Neurosurg Focus. 2015 Apr;38(4):E17
Authors: Liu JK, Patel J, Goldstein IM, Eloy JA
Abstract
The transoral approach is considered the gold-standard surgical route for performing anterior odontoidectomy and ventral decompression of the craniovertebral junction for pathological conditions that result in symptomatic cervicomedullary compression, including basilar invagination, rheumatoid pannus, platybasia with retroflexed odontoid processes, and neoplasms. Extended modifications to increase the operative corridor and exposure include the transmaxillary, extended "open-door" maxillotomy, transpalatal, and transmandibular approaches. With the advent of extended endoscopic endonasal skull base techniques, there has been increased interest in the last decade in the endoscopic endonasal transclival transodontoid approach to the craniovertebral junction. The endonasal route represents an attractive minimally invasive surgical alternative, especially in cases of irreducible basilar invagination in which the pathology is situated well above the palatine line. Angled endoscopes and instrumentation can also be used for lower-lying pathology. By avoiding the oral cavity and subsequently using a transoral retractor, the endonasal route has the advantages of avoiding complications related to tongue swelling, tracheal swelling, prolonged intubation, velopharyngeal insufficiency, dysphagia, and dysphonia. Postoperative recovery is quicker, and hospital stays are shorter. In this report, the authors describe and illustrate their method of purely endoscopic endonasal transclival odonotoidectomy for anterior decompression of the craniovertebral junction and describe various operative pearls and nuances of the technique for avoiding complications.
PMID: 25828493 [PubMed - indexed for MEDLINE]
Effect of postoperative use of diclofenac on pharyngocutaneous fistula development after primary total laryngopharyngectomy: Results of a single-center retrospective study.
Head Neck. 2015 Dec 15;
Authors: Parzefall T, Wolf A, Czeiger S, Frei K, Formanek M, Erovic BM
Abstract
BACKGROUND: Primary total laryngopharyngectomy is the treatment of choice in many cases of locally advanced hypopharyngeal and laryngeal cancer. Development of pharyngocutaneous fistulae is the most common postoperative complication. A recent Danish study showed significantly increased rates of anastomosal leakage after colorectal resection in patients receiving diclofenac treatment.
METHODS: We retrospectively analyzed 67 patients after primary total laryngopharyngectomy to determine whether diclofenac increases the risk for development of pharyngocutaneous fistula analogously to leakage in the colorectal area.
RESULTS: The fistula rate in the total study population (n = 67) was 19.4%. In the group receiving diclofenac postoperatively (n = 31), the fistula rate was 25.8%. In the patient group not receiving diclofenac (n = 36), the fistula rate was 13.9% (p = .219).
CONCLUSION: Our results suggest that cyclooxygenase-2 (COX-2) selective nonsteroidal anti-inflammatory drugs (NSAIDs) should be administered with caution after laryngopharyngectomy. Additional studies on larger cohorts are required to further evaluate our findings. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.
PMID: 26669822 [PubMed - as supplied by publisher]
Risk factors for locoregional relapse after transoral robotic surgery for human papillomavirus-related oropharyngeal squamous cell carcinoma.
Head Neck. 2015 Dec 15;
Authors: Funk RK, Moore EJ, García JJ, Harmsen WS, Stoddard DG, Vencio EF, Foote RL, Price KA, Ma DJ
Abstract
BACKGROUND: Factors predicting locoregional relapse after surgery for oropharyngeal squamous cell carcinoma (SCC) were identified in the pre-human papillomavirus (HPV) era. We examined whether traditional indications for adjuvant radiotherapy (RT) or adjuvant chemoradiotherapy (CRT) still correlate with locoregional relapse in HPV-positive patients after transoral robotic surgery (TORS).
METHODS: Retrospective review of oropharyngeal SCC cases identified patients with HPV-positive tumors who did not receive adjuvant therapy after TORS despite intermediate or high-risk features.
RESULTS: Median follow-up was 26.7 months (range, 4.9-73.1 months). Five of 25 eligible patients (20%) relapsed at a median 4.8 months (range, 3.2-7.8 months). Two of 18 (11%) intermediate and 3 of 7 (43%) high-risk patients relapsed. Kaplan-Meier 2-year locoregional relapse-free survival estimates for intermediate and high-risk patients were 88% and 57% (p = .078), respectively.
CONCLUSION: Traditional indications for adjuvant RT or CRT were associated with high risk of locoregional relapse in HPV-positive patients treated with TORS alone. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.
PMID: 26667985 [PubMed - as supplied by publisher]
Cell-free Epstein-Barr virus-DNA in patients with nasopharyngeal carcinoma: Plasma versus urine.
Head Neck. 2015 Dec 15;
Authors: Sengar M, Chorghe S, Jadhav K, Singh S, Laskar SG, Pai P, Aggarwal JP, D'Cruz A, Chaturvedi P, Deshpande M, Chaukar D, Budrukkar A, Gupta T, Murthy V, Kane S, Thakur M, Rangarajan V, Kannan S, Shet T, Kode J
Abstract
BACKGROUND: The purpose of this study was to explore urinary Epstein-Barr virus (EBV)-DNA as a potential biomarker in patients with nasopharyngeal carcinoma (NPC).
METHODS: EBV-DNA copies were estimated in plasma/urine of patients with NPC (n = 76) by real-time polymerase chain reaction (PCR) at baseline, during therapy, and at follow-up. Their correlation with EBV-RNA expression in tissues (n = 53) was used to assess sensitivity and specificity of plasma/urine EBV-DNA. Correlation of urine and plasma EBV-DNA with each other and with radiological response was evaluated.
RESULTS: This study demonstrated that urine EBV-DNA has high sensitivity (96%) at diagnosis and it correlates well with plasma EBV-DNA at baseline and after neoadjuvant chemotherapy. The EBV-DNA copies reduced significantly with therapy (plasma: p < .001; urine: p = .011). Patients with low EBV-DNA copies demonstrated improved survival (plasma: p = .023; urine: p = .083).
CONCLUSION: Plasma EBV-DNA is a good prognostic marker, whereas further study on a larger cohort may help in developing urine EBV-DNA as a surrogate prognostic marker for patients with NPC. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.
PMID: 26667883 [PubMed - as supplied by publisher]
Management of invasive well-differentiated thyroid cancer: An American Head and Neck Society Consensus Statement.
Head Neck. 2015 Dec 15;
Authors: Varvares MA, Walker RJ
PMID: 26667782 [PubMed - as supplied by publisher]
[Experience of Fusion image guided system in endonasal endoscopic surgery].
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Aug;29(16):1431-4
Authors: Wen J, Zhen H, Shi L, Cao P, Cui Y
Abstract
OBJECTIVE: To review endonasal endoscopic surgeries aided by Fusion image guided system, and to explore the application value of Fusion image guided system in endonasal endoscopic surgeries.
METHOD: Retrospective research. Sixty cases of endonasal endoscopic surgeries aided by Fusion image guided system were analysed including chronic rhinosinusitis with polyp (n = 10), fungus sinusitis (n = 5), endoscopic optic nerve decompression (n = 16), inverted papilloma of the paranasal sinus (n = 9), ossifying fibroma of sphenoid bone (n = 1), malignance of the paranasal sinus (n = 9), cerebrospinal fluid leak (n = 5), hemangioma of orbital apex (n = 2) and orbital reconstruction (n = 3).
RESULT: Sixty cases of endonasal endoscopic surgeries completed successfully without any complications. Fusion image guided system can help to identify the ostium of paranasal sinus, lamina papyracea and skull base. Fused CT-CTA images, or fused MR-MRA images can help to localize the optic nerve or internal carotid arteiy . Fused CT-MR images can help to detect the range of the tumor. It spent (7.13 ± 1.358) minutes for image guided system to do preoperative preparation and the surgical navigation accuracy reached less than 1mm after proficient. There was no device localization problem because of block or head set loosed.
CONCLUSION: Fusion image guided system make endonasal endoscopic surgery to be a true microinvasive and exact surgery. It spends less preoperative preparation time, has high surgical navigation accuracy, improves the surgical safety and reduces the surgical complications.
PMID: 26665449 [PubMed - in process]
Dermoid Cyst of the Lateral Neck Included Within the Submandibular Gland.
J Craniofac Surg. 2015 Dec 10;
Authors: Kusuyama Y, Takeuchi N, Wakabayashi K, Yura Y
Abstract
Dermoid cysts are benign lesions of congenital origin, and those in the head and neck region are usually present as a midline neck mass. They rarely appear in the lateral neck. This article describes the clinical presentation and histopathologic features of an extremely rare case of lateral dermoid cyst included within the submandibular gland in a 58-year-old man. The etiology of the cyst is also discussed.
PMID: 26669652 [PubMed - as supplied by publisher]
Pleomorphic adenoma of the frontal sinus masquerading as a mucocele.
Ear Nose Throat J. 2015 Dec;94(12):E4-E6
Authors: Chew YK, Brito-Mutunayagam S, Chong AW, Prepageran N, Chandran PA, Khairuzzana B, Lingham OR
Abstract
Pleomorphic adenoma is the most common type of benign salivary gland tumor. It can also be found in the larynx, ear, neck, and nasal septum. It is rarely found in the maxillary sinus, and it has never been reported in the frontal sinus. We report a case of pleomorphic adenoma of the frontal sinus that masqueraded as a mucocele. We discuss the clinical presentation, diagnosis, and treatment of this patient, and we review the literature.
PMID: 26670764 [PubMed - as supplied by publisher]
[(18)F]-FDG PET/CT imaging for detection of nodal metastases in patients with squamous cell carcinoma of the pharynx and larynx: comparison with CT.
Jpn J Radiol. 2015 Dec 15;
Authors: Suenaga Y, Kitajima K, Kanda T, Otsuki N, Nibu KI, Sasaki R, Itoh T, Sugimura K
Abstract
PURPOSE: Our aim was to investigate the diagnostic accuracy of fluorine-18-labeled fluorodeoxyglucose positron emission tomography computed tomography (FDG-PET/CT) relative to CT for detecting neck lymph node metastases in patients with squamous cell carcinoma (SCC) of the hypopharynx, oropharynx, and larynx.
METHODS: Thirty-four patients with SCC of the hypopharynx (n = 20), oropharynx (n = 5), and larynx (n = 9) who underwent neck dissection (29 bilateral, 5 unilateral; a total of 355 nodal levels) were assessed. Two observers determined the long-axis diameter and maximum standardized uptake value (SUVmax) of all visible neck nodes. Results of FDG-PET/CT were compared with those of corresponding histopathologic examinations according to the neck-level system.
RESULTS: Histopathology revealed metastases in 70 of 355 nodal levels. Using a best discriminative SUVmax cutoff of 3.65, sensitivity, specificity, and accuracy of FDG-PET/CT on a level-by-level basis were 72.9, 96.8, and 92.1 %; those for CT were 52.9, 98.6, and 89.6 %. Differences in sensitivity and accuracy were significant (p < 0.01). The best cutoff SUVmax on the ipsilateral side was 4.61, with corresponding figures of 81.6, 100, and 94.7 %; that on the contralateral side was 2.41, with figures of 60, 88.4, and 85.4 %.
CONCLUSION: FDG-PET/CT with SUVmax is useful for preoperative evaluation of neck-node metastasis from SCC of the pharynx and larynx, especially on the ipsilateral side.
PMID: 26670594 [PubMed - as supplied by publisher]
Co-existent breast and renal cancer.
Ulus Cerrahi Derg. 2015;31(4):238-40
Authors: Üreyen O, Dadalı E, Akdeniz F, Şahin T, Tekeli MT, Eliyatkın N, Postacı H, İlhan E
Abstract
The concomitant presence of breast cancer with one or more other types of cancer such as colon, vulva, lung, larynx, liver, uterus and kidneys has been presented in the literature. However, synchronous breast and renal cancer is very uncommon. Herein we present a woman with synchronous breast and renal cancer, and review the literature. A 77-year-old post-menopausal woman was admitted to our clinic complaining of left sided breast mass. On physical examination, there was a 3 cm palpable mass in the upper outer quadrant of the left breast along with a conglomerate of lymph nodes in the left axilla. Ultrasonography and mammography showed a 3 cm solid, hypoechoic mass in the upper outer quadrant and left axillary lymphadenopathy. The tru-cut biopsy of the lesion revealed invasive ductal carcinoma. The bone scintigraphy, thoracic and cranial computerized tomographies were normal. The abdominal computerized tomography identified a 3×3 cm solid renal mass with heterogeneous contrast enhancement in the posterior segment of the lower pole, which was suspicious for renal cell carcinoma. Breast conserving surgery and axillary lymph node dissection was performed, and the pathology specimen demonstrated invasive ductal carcinoma. The patient was discharged on postoperative day 5. Three weeks later partial nephrectomy was performed by urology department for the solid renal mass, and the pathology result showed clear cell-renal carcinoma with Fuhrman grade 3. The patient is being followed-up for renal carcinoma, and underwent radiotherapy for breast cancer. Hormonotherapy for breast cancer is still continuing.
PMID: 26668534 [PubMed]
[Optical diagnostic methods for early tumour diagnosis in the upper aerodigestive tract : Quo vadis?]
HNO. 2015 Dec 14;
Authors: Betz CS, Kraft M, Arens C, Schuster M, Pfeffer C, Rühm A, Stepp H, Englhard A, Volgger V
Abstract
BACKGROUND: Optical diagnostic methods may simplify and improve the early diagnosis of tumours of the upper aerodigestive tract; however, these have not yet found their way into clinical routine.
OBJECTIVE: This article aims to define the problems that have prevented routine use of optical diagnostic methods so far, as well as listing and also explaining potential trendsetting approaches to overcome these difficulties.
MATERIALS AND METHODS: The study is based on a combined analysis of publically accessible databases (PubMed MEDLINE, Thompson Reuters Web of Science, SPIE. Digital Library; full time period available; search strings: "oral cavity", "pharynx", "larnyx", "optical diagnosis", "optical biopsy", "optical coherence tomography", "confocal endomicroscopy", "fluorescence endoscopy", "narrow band imaging", "non-linear imaging", "fluorescence lifetime imaging"), as well as personal experiences.
RESULTS: Both conceptual and methodical problems were determined, and possible solutions based on current developments are discussed.
CONCLUSION: Optical diagnostic methods have the potential to revolutionise early diagnosis of upper aerodigestive tract malignancies, providing the different hurdles listed in this review can be overcome.
PMID: 26666558 [PubMed - as supplied by publisher]
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Modified Sistrunk operation: New concept for management of thyroglossal duct cyst.
Int J Pediatr Otorhinolaryngol. 2015 Jun;79(6):812-6
Authors: Ryu YJ, Kim DW, Jeon HW, Chang H, Sung MW, Hah JH
Abstract
OBJECTIVE: To describe a method of hyoid cartilage division during Sistrunk operation for management of thyroglossal duct cyst (TGDC) and compare postoperative outcomes with those of conventional hyoid bone cutting.
METHODS: Fifty-nine patients who received operative treatment for TGDC from January 2005 to July 2013 were enrolled. The degree of fusion in the cartilaginous portion of the hyoid was evaluated by preoperative neck computed tomography and classified into (1) non-fusion, (2) partial fusion, and (3) complete fusion. Techniques of hyoid management, division of the cartilaginous portion of the hyoid or conventional hyoid bone cutting, during Sistrunk operation were analyzed according to the fusion classification.
RESULTS: Of the 59 patients, 27 were pediatric patients and 32 were adults. In 32 adults undergoing TGDC, there were 13 cases (41%) of complete hyoid fusion and 7 (22%) of non-fusion. A total of 20 adult patients (63%) were treated with the cartilage division. Among the pediatric patients, 96% of cases were classified as non-fusion of the hyoid, and all of these were treated with the cartilage division. Patients who were treated with the cartilage division showed better postoperative results. However, there were no statistical differences.
CONCLUSIONS: Our cartilage division technique at Sistrunk operation for TGDC is feasible and comparable to conventional hyoid cutting with regard to postoperative results.
PMID: 25829321 [PubMed - indexed for MEDLINE]
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The Ethics of Using the Recently Deceased to Instruct Residents in Cricothyrotomy.
Ann Emerg Med. 2015 Oct;66(4):403-8
Authors: Makowski AL
Abstract
Cricothyrotomy is a rare but crucial procedure in the armamentarium of the emergency physician. The infrequency with which it is performed has led to a reliance on models, simulators, and animals in resident education, but each of these methods has unique drawbacks. Using recently deceased patients as teaching tools has a long history in medicine, though controversy surrounds whether, how, and from whom consent ought to be obtained. Recent studies have shown that families expect to be asked for permission and often will grant it, even for invasive procedures such as cricothyrotomy. Obtaining consent maintains the integrity of the relationship among the physician, the deceased, the family, and the community and need not prohibit performing procedures on the newly dead for the purpose of resident education. Thus, a balanced approach to resident instruction that incorporates the use of the deceased in addition to other methods of instruction seems both prudent and feasible.
PMID: 25599943 [PubMed - indexed for MEDLINE]
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Otitis media in sperm-associated antigen 6 (Spag6)-deficient mice.
PLoS One. 2014;9(11):e112879
Authors: Li X, Xu L, Li J, Li B, Bai X, Strauss JF, Zhang Z, Wang H
Abstract
Mammalian SPAG6 protein is localized to the axoneme central apparatus, and it is required for normal flagella and cilia motility. Recent studies demonstrated that the protein also regulates ciliogenesis and cilia polarity in the epithelial cells of brain ventricles and trachea. Motile cilia are also present in the epithelial cells of the middle ear and Eustachian tubes, where the ciliary system participates in the movement of serous fluid and mucus in the middle ear. Cilia defects are associated with otitis media (OM), presumably due to an inability to efficiently transport fluid, mucus and particles including microorganisms. We investigated the potential role of SPAG6 in the middle ear and Eustachian tubes by studying mice with a targeted mutation in the Spag6 gene. SPAG6 is expressed in the ciliated cells of middle ear epithelial cells. The orientation of the ciliary basal feet was random in the middle ear epithelial cells of Spag6-deficient mice, and there was an associated disrupted localization of the planar cell polarity (PCP) protein, FZD6. These features are associated with disordered cilia orientation, confirmed by scanning electron microscopy, which leads to uncoordinated cilia beating. The Spag6 mutant mice were also prone to develop OM. However, there were no significant differences in bacterial populations, epithelial goblet cell density, mucin expression and Eustachian tube angle between the mutant and wild-type mice, suggesting that OM was due to accumulation of fluid and mucus secondary to the ciliary dysfunction. Our studies demonstrate a role for Spag6 in the pathogenesis of OM in mice, possibly through its role in the regulation of cilia/basal body polarity through the PCP-dependent mechanisms in the middle ear and Eustachian tubes.
PMID: 25393619 [PubMed - indexed for MEDLINE]
Correlation of the VEMP score, ambulation and upper extremity function in clinically isolated syndrome.
J Neurol Sci. 2015 Dec 15;359(1-2):197-201
Authors: Crnošija L, Krbot Skorić M, Gabelić T, Adamec I, Brinar V, Habek M
Abstract
OBJECTIVE: To investigate the correlation of the vestibular evoked myogenic potential (VEMP) score with Timed 25-Foot Walk (T25FW), 9-Hole Peg Test (9HPT), Paced Auditory Serial Addition Test (PASAT) and EDSS in patients with multiple sclerosis (MS).
METHODS: This prospective, cross sectional study included 52 patients with clinically isolated syndrome (CIS). Cervical VEMP (cVEMP) and ocular VEMP (oVEMP), analyzed in the form of the cVEMP, oVEMP and VEMP scores, T25FW, 9HPT, PASAT and Expanded Disability Status Scale (EDSS) were performed.
RESULTS: The only predictor of walking impairment in this study was general disability as measured by the EDSS, after controlling for age, gender, PASAT and EDSS the effect of VEMP score was non-significant (p=0.419). 9HPT of the dominant hand did not correlate with the oVEMP score (rs=0.258, p=0.065), however after controlling for age, gender, PASAT and EDSS, the effect of the oVEMP score on 9HPT of the dominant hand was statistically significant (p=0.017). After controlling for age, gender and oVEMP score, the effect of the PASAT on 9HPT variable for the non-dominant hand was statistically significant (p=0.001).
CONCLUSION: We found possible effects of brainstem dysfunction on walking impairment, however they were not seen after correction for EDSS and cognitive dysfunction. On the other hand, dominant hand function seems to be influenced by upper brainstem dysfunction measured with oVEMP, while cognitive dysfunction is related to non-dominant hand function.
PMID: 26671112 [PubMed - as supplied by publisher]
[Save the post-market cancer clinical trials in Japan--their benefit to society must not be forgotten].
Gan To Kagaku Ryoho. 2015 Oct;42(10):1179-82
Authors: Saji S
PMID: 26665418 [PubMed - in process]
[III. Repeat pancreatectomy for recurrent pancreatic cancer].
Gan To Kagaku Ryoho. 2015 Oct;42(10):1173-7
Authors: Yoshitomi H, Shimizu H, Ohtsuka M, Kato A, Furukawa K, Takayashiki T, Kuboki S, Takano S, Suzuki D, Sakai N, Kagawa S, Nojima H, Miyazaki M
PMID: 26665417 [PubMed - in process]
[II. Liver resection for recurrence of metastatic liver tumor following primary intervention with special reference to colorectal liver metastasis].
Gan To Kagaku Ryoho. 2015 Oct;42(10):1169-72
Authors: Kawaguchi Y, Hasegawa K, Kokudo N
PMID: 26665416 [PubMed - in process]
[I. Repeat hepatectomy for recurrent hepatocellular carcinoma--review of literature].
Gan To Kagaku Ryoho. 2015 Oct;42(10):1164-8
Authors: Ariizumi S, Katagiri S, Yamamoto M
PMID: 26665415 [PubMed - in process]
[Re-surgical resection for the recurrence after initial surgical resection in HPB malignancies].
Gan To Kagaku Ryoho. 2015 Oct;42(10):1162-3
Authors: Miyazaki M
PMID: 26665414 [PubMed - in process]
[Definition of inflammatory subtypes of chronic rhinosinusitis with nasal polyp and asthma].
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Aug;29(16):1495-500
Authors: Wu D, Zhang M, Song Q
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma is a common clinical refractory airway disease. Comprehensive treatment of nasal endoscopic surgery including nasal endoscopic surgery and medication, which can significantly improve nose-pulmonary symptoms and make sinusitis and asthma easier to be controlled by medication, has certain superiority. But the existence of disease heterogeneity of CRSwNP with asthma causes different reactions to the current treatment, which manifests as parts of polyps and asthma easy to recur and difficult to control. According to the research recently, the study of the heterogeneity of airway diseases, for example endotype, is a hot area of research. Endotype is a subtype of a condition, which is defined by a distinct functional or pathobiological mechanism. This is distinct from a phenotype, which is any observable characteristic or trait of a disease. Different Inflammatory subtypes often represent different pathophysiology and even different pathogenesis. The concept of inflammatory subtypes of airway diseases provides a new perspective for studies of airway diseases of endotype and the mechanism of combined airway diseases. This review summarizes recent advances in the clinical characterization and treatment of the CRSwNP with asthma. On this basis, we analyze and summarize the heterogeneity of CRSwNP and asthma separately from the perspective of inflammatory subtypes. Then according to the concept of the combined airway diseases and the common pathogenesis, we put forward the definition of inflammatory subtypes of the CRSwNP with asthma and preliminarily discuss the method of the definition.
PMID: 26665469 [PubMed - in process]
[Nasal cavity supernumerary tooth and maxillary sinusitis: one case reported].
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Aug;29(16):1494-5
Authors: Guo G, Hu L, Lu Y
Abstract
Supernumerary tooth is a rare case. This report described a case of nasal cavity supernumerary tooth association with maxillary sinusitis. A 28-year-old male patient reported with the chief complaint of nasal obstruction, headache and purulent secretion for the past three months. Clinic examination and CT examination showed that there was a supernumerary tooth in the right nasal bottom, and maxillary sinus was infected in the same side. This patient was performed supernumerary tooth removing and given antibiotics for 3 days. Ten days after the operation, there was no clinical symptoms, and nasal bottom mucosa was normal. After 3 months of follow-up, reexamination of coronal CT scan appeared normal.
PMID: 26665468 [PubMed - in process]
[Giant ossifying fibroma of nasal cavity and nasal sinuses: one case report].
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Aug;29(16):1492-3
Authors: Tu X, Chen J, Jiang H
Abstract
A 39 years old male patient was admitted with the right of facial abnormalities and gradually protruding in right eye more than 30 years. CT shows high mixed density, clear boundary, and the right eye was crowded to the right. Giant tumor had completely been excised, and the result was fine. The outline figure and function of patients were obviously improved. The pathological examination after resection showed ossifying fibroma.
PMID: 26665467 [PubMed - in process]
Enhancing Rehabilitative Therapies with Vagus Nerve Stimulation.
Neurotherapeutics. 2015 Dec 15;
Authors: Hays SA
Abstract
Pathological neural activity could be treated by directing specific plasticity to renormalize circuits and restore function. Rehabilitative therapies aim to promote adaptive circuit changes after neurological disease or injury, but insufficient or maladaptive plasticity often prevents a full recovery. The development of adjunctive strategies that broadly support plasticity to facilitate the benefits of rehabilitative interventions has the potential to improve treatment of a wide range of neurological disorders. Recently, stimulation of the vagus nerve in conjunction with rehabilitation has emerged as one such potential targeted plasticity therapy. Vagus nerve stimulation (VNS) drives activation of neuromodulatory nuclei that are associated with plasticity, including the cholinergic basal forebrain and the noradrenergic locus coeruleus. Repeatedly pairing brief bursts of VNS sensory or motor events drives robust, event-specific plasticity in neural circuits. Animal models of chronic tinnitus, ischemic stroke, intracerebral hemorrhage, traumatic brain injury, and post-traumatic stress disorder benefit from delivery of VNS paired with successful trials during rehabilitative training. Moreover, mounting evidence from pilot clinical trials provides an initial indication that VNS-based targeted plasticity therapies may be effective in patients with neurological diseases and injuries. Here, I provide a discussion of the current uses and potential future applications of VNS-based targeted plasticity therapies in animal models and patients, and outline challenges for clinical implementation.
PMID: 26671658 [PubMed - as supplied by publisher]
Sudden onset unilateral sensorineural hearing loss after rabies vaccination.
BMJ Case Rep. 2015;2015
Authors: Okhovat S, Fox R, Magill J, Narula A
Abstract
A 33-year-old man developed profound sudden onset right-sided hearing loss with tinnitus and vertigo, within 24 h of pretravel rabies vaccination. There was no history of upper respiratory tract infection, systemic illness, ototoxic medication or trauma, and normal otoscopic examination. Pure tone audiograms (PTA) demonstrated right-sided sensorineural hearing loss (thresholds 90-100 dB) and normal left-sided hearing. MRI internal acoustic meatus, viral serology (hepatitis B, C, HIV and cytomegalovirus) and syphilis screen were normal. Positive Epstein-Barr virus IgG, viral capsid IgG and anticochlear antibodies (anti-HSP-70) were noted. Initial treatment involved a course of high-dose oral prednisolone and acyclovir. Repeat PTAs after 12 days of treatment showed a small improvement in hearing thresholds. Salvage intratympanic steroid injections were attempted but failed to improve hearing further. Sudden onset sensorineural hearing loss (SSNHL) is an uncommon but frightening experience for patients. This is the first report of SSNHL following rabies immunisation in an adult.
PMID: 26670892 [PubMed - as supplied by publisher]
Combined rTMS treatment targeting the Anterior Cingulate and the Temporal Cortex for the Treatment of Chronic Tinnitus.
Sci Rep. 2015;5:18028
Authors: Kreuzer PM, Lehner A, Schlee W, Vielsmeier V, Schecklmann M, Poeppl TB, Landgrebe M, Rupprecht R, Langguth B
Abstract
Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a tinnitus treatment option. Promising results have been obtained by consecutive stimulation of lateral frontal and auditory brain regions. We investigated a combined stimulation paradigm targeting the anterior cingulate cortex (ACC) with double cone coil rTMS, followed by stimulation of the temporo-parietal junction area with a figure-of-eight coil. The study was conducted as a randomized, double-blind pilot trial in 40 patients suffering from chronic tinnitus. We compared mediofrontal stimulation with double-cone-coil, (2000 stimuli, 10 Hz) followed by left temporo-parietal stimulation with figure-of-eight-coil (2000 stimuli, 1 Hz) to left dorsolateral-prefrontal-cortex stimulation with figure-of-eight-coil (2000 stimuli, 10 Hz) followed by temporo-parietal stimulation with figure-of-eight-coil (2000 stimuli, 1 Hz). The stimulation was feasible with comparable dropout rates in both study arms; no severe adverse events were registered. Responder rates did not differ in both study arms. There was a significant main effect of time for the change in the TQ score, but no significant time x group interaction. This pilot study demonstrated the feasibility of combined mediofrontal/temporoparietal-rTMS-stimulation with double cone coil in tinnitus patients but failed to show better outcome compared to an actively rTMS treated control group.
PMID: 26667790 [PubMed - as supplied by publisher]
