"Iran J Otorhinolaryngol"[jour]; +24 new citations

24 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"Iran J Otorhinolaryngol"[jour]

These pubmed results were generated on 2016/01/21

PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1OK3ihC
via IFTTT

Isolated vocal tremor as a focal phenotype of essential tremor: a retrospective case review.

Related Articles

Isolated vocal tremor as a focal phenotype of essential tremor: a retrospective case review.

J Clin Mov Disord. 2015;2:4

Authors: Patel A, Frucht SJ

Abstract
BACKGROUND: Essential tremor (ET) is a common condition associated with significant physical and psychosocial disability. "Classic" ET is a clinical syndrome of action tremor in the upper limbs and less commonly the head, jaw, voice, trunk, or lower limbs. Current diagnostic criteria for ET exclude isolated vocal tremor (IVT). Failure to recognize IVT as a form of ET may contribute to misdiagnosis and missed opportunities for treatment.
METHODS: We conducted a retrospective review of cases referred for voice disturbance. Patients with a primary diagnosis of vocal tremor were included while those with a diagnosis of spasmodic dysphonia where excluded.
RESULTS: 19 cases of vocal tremor were identified, of which 17 patients (89%) were female. The average age of vocal symptom onset was 64 (SD 8.0) and patients had been symptomatic an average of 6 years (SD 4) at their initial visit. 8 patients had IVT while 11 also had evidence of subtle head or limb tremor. 8 patients (42%) had a family history of ET, with vocal tremor specifically identified in 5 of those cases (26%). 11 patients (58%) noted transient tremor improvement after alcohol consumption. Primidone and propranolol were the most common medications prescribed to these patients prior to consultation. 7 patients were given a trial of 1 gm of sodium oxybate in the office as part of a clinical trial, with at least mild improvement in vocal tremor noted by qualitative assessment.
CONCLUSIONS: ET may present as vocal tremor with little or no associated limb tremor. It may be a more common manifestation of ET in women. A family history of tremor and improvement in tremor after consuming alcohol can often be elicited on history. We propose that IVT may be part of the spectrum of ET.

PMID: 26788340 [PubMed]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1VarCNE
via IFTTT

p11 modulates L-DOPA therapeutic effects and dyskinesia via distinct cell types in experimental Parkinsonism.

Related Articles

p11 modulates L-DOPA therapeutic effects and dyskinesia via distinct cell types in experimental Parkinsonism.

Proc Natl Acad Sci U S A. 2016 Jan 19;

Authors: Schintu N, Zhang X, Alvarsson A, Marongiu R, Kaplitt MG, Greengard P, Svenningsson P

Abstract
The reduced movement repertoire of Parkinson's disease (PD) is mainly due to degeneration of nigrostriatal dopamine neurons. Restoration of dopamine transmission by levodopa (L-DOPA) relieves motor symptoms of PD but often causes disabling dyskinesias. Subchronic L-DOPA increases levels of adaptor protein p11 (S100A10) in dopaminoceptive neurons of the striatum. Using experimental mouse models of Parkinsonism, we report here that global p11 knockout (KO) mice develop fewer jaw tremors in response to tacrine. Following L-DOPA, global p11KO mice show reduced therapeutic responses on rotational motor sensitization, but also develop less dyskinetic side effects. Studies using conditional p11KO mice reveal that distinct cell populations mediate these therapeutic and side effects. Selective deletion of p11 in cholinergic acetyltransferase (ChAT) neurons reduces tacrine-induced tremor. Mice lacking p11 in dopamine D2R-containing neurons have a reduced response to L-DOPA on the therapeutic parameters, but develop dyskinetic side effects. In contrast, mice lacking p11 in dopamine D1R-containing neurons exhibit tremor and rotational responses toward L-DOPA, but develop less dyskinesia. Moreover, coadministration of rapamycin with L-DOPA counteracts L-DOPA-induced dyskinesias in wild-type mice, but not in mice lacking p11 in D1R-containing neurons. 6-OHDA lesioning causes an increase of evoked striatal glutamate release in wild type, but not in global p11KO mice, indicating that altered glutamate neurotransmission could contribute to the reduced L-DOPA responsivity. These data demonstrate that p11 located in ChAT or D2R-containing neurons is involved in regulating therapeutic actions in experimental PD, whereas p11 in D1R-containing neurons underlies the development of L-DOPA-induced dyskinesias.

PMID: 26787846 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1ncCCPr
via IFTTT

Entraining with another person's speech rhythm: Evidence from healthy speakers and individuals with Parkinson's disease.

Related Articles

Entraining with another person's speech rhythm: Evidence from healthy speakers and individuals with Parkinson's disease.

Clin Linguist Phon. 2016 Jan 20;:1-18

Authors: Späth M, Aichert I, Ceballos-Baumann AO, Wagner-Sonntag E, Miller N, Ziegler W

Abstract
This study examines entrainment of speech timing and rhythm with a model speaker in healthy persons and individuals with Parkinson's. We asked whether participants coordinate their speech initiation and rhythm with the model speaker, and whether the regularity of metrical structure of sentences influences this behaviour. Ten native German speakers with hypokinetic dysarthria following Parkinson's and 10 healthy controls heard a sentence ('prime') and subsequently read aloud another sentence ('target'). Speech material comprised 32 metrically regular and irregular sentences, respectively. Turn-taking delays and alignment of speech rhythm were measured using speech wave analyses. Results showed that healthy participants initiated speech more closely in rhythm with the model speaker than patients. Metrically regular prime sentences induced anticipatory responses relative to metrically irregular primes. Entrainment of speech rhythm was greater in metrically regular targets, especially in individuals with Parkinson's. We conclude that individuals with Parkinson's may exploit metrically regular cues in speech.

PMID: 26786186 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1ncyKhf
via IFTTT

Robust contour tracking in ultrasound tongue image sequences.

Related Articles

Robust contour tracking in ultrasound tongue image sequences.

Clin Linguist Phon. 2016 Jan 20;:1-15

Authors: Xu K, Yang Y, Stone M, Jaumard-Hakoun A, Leboullenger C, Dreyfus G, Roussel P, Denby B

Abstract
A new contour-tracking algorithm is presented for ultrasound tongue image sequences, which can follow the motion of tongue contours over long durations with good robustness. To cope with missing segments caused by noise, or by the tongue midsagittal surface being parallel to the direction of ultrasound wave propagation, active contours with a contour-similarity constraint are introduced, which can be used to provide 'prior' shape information. Also, in order to address accumulation of tracking errors over long sequences, we present an automatic re-initialization technique, based on the complex wavelet image similarity index. Experiments on synthetic data and on real 60 frame per second (fps) data from different subjects demonstrate that the proposed method gives good contour tracking for ultrasound image sequences even over durations of minutes, which can be useful in applications such as speech recognition where very long sequences must be analyzed in their entirety.

PMID: 26786063 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1ZDUH5c
via IFTTT

Intra-Operative Lymphatic Mapping and Sentinel Node Biopsy in Laryngeal Carcinoma: Preliminary Results.

Intra-Operative Lymphatic Mapping and Sentinel Node Biopsy in Laryngeal Carcinoma: Preliminary Results.

Iran J Otorhinolaryngol. 2015 Jul;27(81):285-91

Authors: Khadivi E, Daghighi M, Khazaeni K, Dabbagh Kakhki VR, Zarifmahmoudi L, Sadeghi R

Abstract
INTRODUCTION: Sentinel node mapping has been used for laryngeal carcinoma in several studies, with excellent results thus far. In the current study, we report our preliminary results on sentinel node mapping in laryngeal carcinoma using intra-operative peri-tumoral injection of a radiotracer.
MATERIALS AND METHODS: Patients with biopsy-proven squamous cell carcinoma of the larynx were included in the study. Two mCi/0.4 cc Tc-99m-phytate in four aliquots was injected on the day of surgery, after induction of anesthesia, in the sub-mucosal peri-tumoral location using a suspension laryngoscopy. After waiting for 10 minutes, a portable gamma probe was used to search for sentinel nodes. All patients underwent laryngectomy and modified radical bilateral neck dissection. All sentinel nodes and removed non-sentinel nodes were examined by hematoxylin and eosin (H&E) staining.
RESULTS: Ten patients with laryngeal carcinoma were included. At least one sentinel node could be detected in five patients (bilateral nodes in four patients). One patient had pathologically involved sentinel and non-sentinel nodes (no false-negative cases).
CONCLUSION: Sentinel node mapping in laryngeal carcinoma is technically feasible using an intra-operative radiotracer injection. In order to evaluate the relationship of T-stage and the laterality of the tumor with accuracy, larger studies are needed.

PMID: 26788477 [PubMed]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1Jk2NhC
via IFTTT

Spindle Cell Carcinoma of the Larynx: A Confusing Diagnosis for the Pathologist and Clinician.

Spindle Cell Carcinoma of the Larynx: A Confusing Diagnosis for the Pathologist and Clinician.

Case Rep Otolaryngol. 2015;2015:831835

Authors: Bostanci A, Ozbilim G, Turhan M

Abstract
Laryngeal spindle cell carcinoma (SpCC) is an uncommon subtype of squamous cell carcinoma which represents 0.5% of all laryngeal squamous cell carcinomas. It is a biphasic tumor consisting of the combination of a malignant mesenchymal spindle cell component and a squamous cell component that includes dysplasia, carcinoma in situ, or invasive carcinoma. Although it has aggressive biological features, the probability of making a diagnosis in the early stages is high as it often leads to obstructive symptoms in the early period. Due to its low incidence, there is no clear consensus on prognostic factors and optimal treatment strategies yet. In this paper, a 60-year-old laryngeal SpCC case that was effectively treated with wide local excision followed by adjuvant radiotherapy was presented with the literature.

PMID: 26788392 [PubMed]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1Jk2Nhv
via IFTTT

[Surgical management in metastatic squamous cell carcinoma of the larynx to the cavernous sinus. Case report].

[Surgical management in metastatic squamous cell carcinoma of the larynx to the cavernous sinus. Case report].

An Sist Sanit Navar. 2015 septiembre-diciembre;38(3):465-470

Authors: Torres-Bayona S, Bollar A, Undabeitia J, Samprón N, Najera E, Úrculo E

Abstract
The spread to the cavernous sinus in laryngeal cancer means the presence of a disseminated disease and short survival. The aim of this paper is to report a case of laryngeal squamous carcinoma of the larynx. A search was conducted in the databases of Medline and SciELO DOYMA using the words "cavernous sinus metas-tasis". We found 10 published cases of laryngeal squamous carcinoma with metastasis to the cavernous sinus. The average survival of the 10 cases reported in the literature was 4.1 months; in our case it was 9 months. Patients who received radiotherapy improved symptomatically. In some cases the diagnosis was confirmed only after necropsy. In this type of lesions, surgery is used for diagnosis rather than as a therapeutic tool.

PMID: 26786376 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1Jk2Lq2
via IFTTT

Survivorship care experiences, information, and support needs of patients with oral and oropharyngeal cancer.

Survivorship care experiences, information, and support needs of patients with oral and oropharyngeal cancer.

Head Neck. 2016 Jan 20;

Authors: Manne S, Hudson SV, Baredes S, Stroup A, Virtue SM, Paddock L, Kalyoussef E

Abstract
BACKGROUND: There is little research documenting the posttreatment experiences and needs of oral/oropharyngeal cancer survivors.
METHODS: In this cross-sectional study, 92 patients with oral/oropharyngeal cancer diagnosed between 2 and 5 years prior completed a survey about oral cancer information and support needs.
RESULTS: About half retrospectively reported that they did not receive a written treatment summary. The desire for more oral cancer information was common; one-third or more desired more information about long-term effects, recommended follow-up, and symptoms that should prompt contacting a doctor. Support needs were less common; only a lack of energy was rated as a significant support need. Patients who had a recurrence, did not drink alcohol, and had a greater recurrence fear desired more information. Smokers and more distressed patients reported more support needs.
CONCLUSION: Survivors reported the desire for more oral cancer information. A desire for assistance was less common. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 26788714 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1npjWwB
via IFTTT

Novel High-Fidelity Peritonsillar Abscess Simulator.

Novel High-Fidelity Peritonsillar Abscess Simulator.

Otolaryngol Head Neck Surg. 2016 Jan 19;

Authors: Scott GM, Fung K, Roth KE

Abstract
OBJECTIVE: To create and assess a novel high-fidelity peritonsillar abscess simulation task trainer with junior otolaryngology-head and neck surgery residents.
STUDY DESIGN: Prospective cohort study.
SETTING: Third annual Emergencies in Otolaryngology Head & Neck Surgery Bootcamp course at the Canadian Surgical Technologies & Advanced Robotics in London, Canada.
SUBJECTS AND METHODS: Fresh cadaveric material was obtained consisting of a head and neck. Abscess pockets were simulated with a finger of a latex glove containing vanilla pudding to represent pus, tied off with a silk suture. These abscess pockets were inserted into the peritonsillar space from the transected neck inferiorly, passing medial to the great vessels into the parapharyngeal space. Faculty members evaluated the models to test content validity. The primary outcome measure was a postbootcamp survey evaluation assessing specific domains: learning objectives, effectiveness of faculty, and the quality and realism of models.
RESULTS: When working with this model, learners were able to locate, visualize, and manipulate the abscess. The materials and positioning of the pockets created high-fidelity models that were realistic in appearance and haptics feedback.
CONCLUSIONS: A novel high-fidelity task trainer has been successfully developed to teach the technique of peritonsillar abscess incision and drainage. This task trainer is currently the highest-fidelity model reported in the literature. This model allows learners to practice a high-stakes emergency skill in a controlled environment, affording the opportunity to practice localization, visualization, and drainage of the abscess with a high level of realism.

PMID: 26786268 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1npjUor
via IFTTT

Laryngeal Manifestations of Neurofibromatosis.

Laryngeal Manifestations of Neurofibromatosis.

Otolaryngol Head Neck Surg. 2016 Jan 19;

Authors: Naunheim MR, Plotkin SR, Franco RA, Song PC

Abstract
OBJECTIVES: To describe the range of findings in patients with neurofibromatosis (NF) presenting to a laryngology clinic and to analyze the etiologic factors of vocal fold dysfunction in this cohort.
STUDY DESIGN: Case series with chart review.
SETTING: Tertiary laryngology practice.
SUBJECTS AND METHODS: All cases of NF presenting to an academic laryngology practice were retrospectively reviewed (August 2005 to May 2014), with a total of 34 cases. Demographic data, symptoms, and endoscopic examination findings were reviewed. Etiologic factors of laryngeal complaints were analyzed with reference to NF-associated pathologies and surgical history.
RESULTS: Thirty-four patients with NF-1 or NF-2 were evaluated, and 28 of these patients (6 NF-1 and 22 NF-2) had laryngeal pathology. The most common presenting symptoms were vocal weakness (n = 21), dysphagia (n = 5), and globus (n = 4). Three patients had NF-related vocal fold masses on examination, including 2 neurofibromas and 1 schwannoma. Unilateral vocal cord paralysis was seen in 17 patients; bilateral paralysis was observed in 5 patients. Of patients with unilateral or bilateral paralysis, 20 had intracranial masses (vestibular schwannoma, meningioma, or skull base tumors), and 16 had previously undergone surgery for these lesions. Of the patients with NF-associated intracranial tumors, 87.0% presented with vocal cord paralysis, whereas only 40.0% of those without intracranial masses had paralysis (P = .0560). Seven patients underwent medialization procedures.
CONCLUSION: Neurofibromatosis patients may present to laryngology clinic with primary laryngeal tumors or, more commonly, unilateral or bilateral paralysis. Otolaryngologists should be keenly aware of vocal fold paralysis caused by the NF-associated tumors, with particular attention to bilateral paralysis in NF-2.

PMID: 26786267 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1Vas7Hs
via IFTTT

Does Type of Pharyngeal Packing during Sinonasal Surgery Have an Effect on PONV and Throat Pain?

Does Type of Pharyngeal Packing during Sinonasal Surgery Have an Effect on PONV and Throat Pain?

Otolaryngol Head Neck Surg. 2016 Jan 19;

Authors: Meco BC, Ozcelik M, Yildirim Guclu C, Beton S, Islamoglu Y, Turgay A, Meco C, Batislam Y

Abstract
OBJECTIVE: Postoperative nausea and vomiting (PONV) is a common problem that affects up to 30% of all surgical patients after general anaesthesia, which increases in sinonasal surgery due the very potent emetic effect of ingested blood that is swallowed during the procedures. Therefore, a hypo/oropharyngeal packing is commonly placed in an effort to prevent blood ingestion. The primary aim of this study was to compare the efficacy of 3 packing types in preventing PONV and to compare the results with patients who received no packing. The secondary aim was to compare the postoperative throat pain in all 4 groups.
STUDY DESIGN: A prospective double-blind randomized controlled study.
SETTING: A university hospital.
SUBJECTS AND METHODS: After Institutional Review Board approval and informed consent, 201 adult patients scheduled for sinonasal surgery were randomized to 4 groups to have dry packing (n = 52), packing soaked with water (n = 48), packing soaked with chlorhexidine gluconate and benzydamine hydrochloride (n = 51), or no packing (n = 50). Postoperative PONV and throat pain were assessed.
RESULTS: Demographic data, procedural characteristics, and PONV risk scores were similar among groups. The PONV incidences, throat pain scores, and analgesic use were comparable in all 4 groups.
CONCLUSION: Despite commonly used practices, usage of different types of pharyngeal packing did not affect incidence of PONV and throat pain, nor did usage of no packing.

PMID: 26786266 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/20gvFeI
via IFTTT

Endoscopic Salivary Stone Fragmentation with Pneumatic Lithotripsy in a Simulation Model.

Endoscopic Salivary Stone Fragmentation with Pneumatic Lithotripsy in a Simulation Model.

Otolaryngol Head Neck Surg. 2016 Jan 19;

Authors: Hoffman HT, Walvekar RR, Tracy CR, Kolenda J, Pagedar N

Abstract
OBJECTIVE: To evaluate the endoscopic fragmentation and removal of human salivary stones by employing intracorporeal pneumatic lithotripsy in a clinical simulation model of the submandibular gland.
STUDY DESIGN: Simulation model evaluating endoscopic management of human salivary stones.
SETTING: Laboratory.
SUBJECTS AND METHODS: A flexible nitinol contact probe adapted to a CO2-driven handheld salivary pneumatic lithotripter was deployed through a sialendoscope to disrupt parotid (n = 1) and submandibular (n = 8) stones embedded in separate 3-dimensionally printed plastic models of the mouth and submandibular glands. Simulation included endoscopic removal of small stone fragments by standard basket retrieval supplement by irrigation and suction through a salivary duct introducer system. Correlations were made between stone volume and density with the duration of the procedures and number of pneumatic pulses required to disrupt and remove stone fragments.
RESULTS: Among the 8 stones fragmented sufficiently to permit either full endoscopic removal (n = 7) or removal of the central portion leaving an adherent rind to the duct (n = 1), the average procedure time (32 minutes) and the average number of pneumatic pulses (98) correlated with stone density (range, 0.4-1.5 g/mL) and stone volume (range, 0.05-0.4 mL). One stone was sufficiently resistant to fragmentation as to prevent successful removal.
CONCLUSIONS: Modification to the evolving technology of intracorporeal pneumatic management of nephrolithiasis was successfully applied in an ex vivo model to simulate management of sialolithiasis.

PMID: 26786265 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1npjvlT
via IFTTT

Educational Value of a Medical Student-Led Head and Neck Cancer Screening Event.

Educational Value of a Medical Student-Led Head and Neck Cancer Screening Event.

Otolaryngol Head Neck Surg. 2016 Jan 19;

Authors: Freiser ME, Desai DD, Azcarate PM, Szczupak M, Cohen ER, Raffa FN, George JS, Lo K, Nayak CS, Weed DT, Sargi ZB

Abstract
OBJECTIVE: To evaluate improvement of medical student knowledge of head and neck cancer (HNC) through participation in HNC screening fairs run by medical students.
STUDY DESIGN: Prospective cohort study of surveys assessing medical students' knowledge of HNC before and after volunteering at screening fairs.
SETTING: Four screening fairs held at the University of Miami Miller School of Medicine during Oral, Head and Neck Cancer Awareness Week.
SUBJECTS: Medical student screening fair volunteers.
METHODS: Four HNC screening fairs were organized by medical student volunteers. All students completed a preevent survey assessing baseline knowledge and participated in an otolaryngologist-led training session about HNC and the screening examination. During the screening events, students educated guests about HNC and performed physician-guided history and physical examinations. Finally, students completed identical surveys 1 week and 3 months after the event.
RESULTS: Thirty-four (n = 34) students completed the preevent surveys. At baseline, 59%, 44%, and 24% named tobacco, alcohol, and human papilloma virus as risk factors, compared with 84%, 81%, and 69% on 3 month follow-up, respectively. Out of 6 analyzed questions, the median total number of correctly answered questions improved from 2 on pretest to 5 at 3 months (P < .0001).
CONCLUSION: Volunteer participation in a HNC screening program improves medical students' knowledge of HNC risk factors and symptoms. This innovative approach to students' education via participation and organization of screening events is a useful method of improving their HNC knowledge.

PMID: 26786264 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1NmmrEl
via IFTTT

Profiles of orofacial dysfunction in different diagnostic groups using the Nordic Orofacial Test (NOT-S)--a review.

Related Articles

Profiles of orofacial dysfunction in different diagnostic groups using the Nordic Orofacial Test (NOT-S)--a review.

Acta Odontol Scand. 2014 Nov;72(8):578-84

Authors: Bergendal B, Bakke M, McAllister A, Sjögreen L, Åsten P

Abstract
OBJECTIVE: The Nordic Orofacial Test-Screening (NOT-S) was developed as a comprehensive method to assess orofacial function. Results from the screening protocol have been presented in 11 international publications to date. This study reviewed these publications in order to compile NOT-S screening data and create profiles of orofacial dysfunction that characterize various age groups and disorders.
MATERIALS AND METHODS: NOT-S results of nine reports meeting the inclusion criteria were reviewed. Seven of these studies not only provided data on the mean and range of total NOT-S scores, but also on the most common domains of orofacial dysfunction (highest rate of individuals with dysfunction scores), allowing the construction of orofacial dysfunction profiles based on the prevalence of dysfunction in each domain of NOT-S.
RESULTS: The compiled data comprised 669 individuals, which included healthy control subjects (n = 333) and various patient groups (n = 336). All studies reported differences between individuals with diagnosed disorders and healthy control subjects. The NOT-S data could measure treatment effects and provided dysfunction profiles characterizing the patterns of orofacial dysfunction in various diagnoses.
CONCLUSIONS: This review corroborates previous results that the NOT-S differentiates well between patients and healthy controls and can also show changes in individuals after treatment. NOT-S could be used as a standard instrument to assess orofacial dysfunction, evaluate the outcomes of oral habilitation and rehabilitation and improve comparability in clinical practice and research.

PMID: 25155559 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1VaqQQK
via IFTTT

Isolated vocal tremor as a focal phenotype of essential tremor: a retrospective case review.

Isolated vocal tremor as a focal phenotype of essential tremor: a retrospective case review.

J Clin Mov Disord. 2015;2:4

Authors: Patel A, Frucht SJ

Abstract
BACKGROUND: Essential tremor (ET) is a common condition associated with significant physical and psychosocial disability. "Classic" ET is a clinical syndrome of action tremor in the upper limbs and less commonly the head, jaw, voice, trunk, or lower limbs. Current diagnostic criteria for ET exclude isolated vocal tremor (IVT). Failure to recognize IVT as a form of ET may contribute to misdiagnosis and missed opportunities for treatment.
METHODS: We conducted a retrospective review of cases referred for voice disturbance. Patients with a primary diagnosis of vocal tremor were included while those with a diagnosis of spasmodic dysphonia where excluded.
RESULTS: 19 cases of vocal tremor were identified, of which 17 patients (89%) were female. The average age of vocal symptom onset was 64 (SD 8.0) and patients had been symptomatic an average of 6 years (SD 4) at their initial visit. 8 patients had IVT while 11 also had evidence of subtle head or limb tremor. 8 patients (42%) had a family history of ET, with vocal tremor specifically identified in 5 of those cases (26%). 11 patients (58%) noted transient tremor improvement after alcohol consumption. Primidone and propranolol were the most common medications prescribed to these patients prior to consultation. 7 patients were given a trial of 1 gm of sodium oxybate in the office as part of a clinical trial, with at least mild improvement in vocal tremor noted by qualitative assessment.
CONCLUSIONS: ET may present as vocal tremor with little or no associated limb tremor. It may be a more common manifestation of ET in women. A family history of tremor and improvement in tremor after consuming alcohol can often be elicited on history. We propose that IVT may be part of the spectrum of ET.

PMID: 26788340 [PubMed]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1VarCNE
via IFTTT

Scintigraphy in laryngopharyngeal and gastroesophageal reflux disease: a definitive diagnostic test?

Related Articles

Scintigraphy in laryngopharyngeal and gastroesophageal reflux disease: a definitive diagnostic test?

World J Gastroenterol. 2015 Mar 28;21(12):3619-27

Authors: Falk GL, Beattie J, Ing A, Falk SE, Magee M, Burton L, Van der Wall H

Abstract
AIM: To investigate the utility of scintigraphic studies in predicting response to laparoscopic fundoplication (LF) for chronic laryngopharyngeal reflux symptoms.
METHODS: Patients with upper aero-digestive symptoms that remained undiagnosed after a period of 2 mo were studied with conventional pH and manometric studies. Patients mainly complained of cough, sore throat, dysphonia and globus. These patients were imaged after ingestion of 99m-technetium diethylene triamine pentaacetic acid. Studies were quantified with time activity curves over the pharynx, upper and lower oesophagus and background. Late studies of the lungs were obtained for aspiration. Patients underwent LF with post-operative review at 3 mo after surgery.
RESULTS: Thirty four patients (20 F, 14 M) with an average age of 57 years and average duration of symptoms of 4.8 years were studied. Twenty four hour pH and manometry studies were abnormal in all patients. On scintigraphy, 27/34 patients demonstrated pharyngeal contamination and a rising or flat pharyngeal curve. Lung aspiration was evident in 50% of patients. There was evidence of pulmonary aspiration in 17 of 34 patients in the delayed study (50%). Pharyngeal contamination was found in 27 patients. All patients with aspiration showed pharyngeal contamination. In the 17 patients with aspiration, graphical time activity curve showed rising activity in the pharynx in 9 patients and a flat curve in 8 patients. In those 17 patients without pulmonary aspiration, 29% (5 patients) had either a rising or flat pharyngeal graph. A rising or flat curve predicted aspiration with a positive predictive value of 77% and a negative predictive value of 100%. Over 90% of patients reported a satisfactory symptomatic response to LF with an acceptable side-effect profile.
CONCLUSION: Scintigraphic reflux studies offer a good screening tool for pharyngeal contamination and aspiration in patients with gastroesophageal reflux disease.

PMID: 25834329 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1P7Gs7j
via IFTTT

Randomized comparison of the i-gel(TM) with the LMA Supreme (TM) in anesthetized adult patients.

Related Articles

Randomized comparison of the i-gel(TM) with the LMA Supreme (TM) in anesthetized adult patients.

Anaesthesist. 2015 Apr;64(4):271-6

Authors: Beleña JM, Núñez M, Vidal A, Gasco C, Alcojor A, Lee P, Pérez JL

Abstract
BACKGROUND: The LMA Supreme(TM) (LMA-S) and i-gel(TM) are two of the most commonly used supraglottic airway devices (SADs) with an inbuilt drain channel. These devices are particularly indicated for performing certain procedures accompanied by high peak airway pressure, such as laparoscopy. This study compared the devices regarding efficacy, safety, ease of use and incidence of adverse events, focusing on the postoperative rate of sore throat, dysphagia or dysphonia and development with time, in patients undergoing laparoscopic cholecystectomy procedures under general anesthesia.
METHODS: This was a prospective, randomized, controlled clinical study including 140 patients randomized into 2 groups undergoing elective laparoscopic cholecystectomy to use either i-gel or LMA-S. After the general anesthesia procedure, the speed of insertion, success rates, ease of insertion of the drain tube, leak pressure and tidal volume achieved by the devices were evaluated. The postoperative oropharyngeal discomfort (POPD) during the period of stay of the patients in the recovery room was also recorded.
RESULTS: The mean leak pressure was comparable between the two groups (i-gel 28.18 ± 3.90 cmH2O and LMA-S 27.50 ± 4 cmH2O, p = 0.09), as well as maximum expiratory tidal volume provided (i-gel 559.60 ± 45.25 ml and LMA-S 548.95 ± 56.18 ml, p = 0.12). Insertion times were lower for the i-gel (10 ± 1.62 s) compared with the LMA-S (11.31 ± 2.85 s, p = 0.008). Insertion success rate at the first attempt was higher for the LMA-S (95 % compared with i-gel 79 %, p = 0.007). Drain tubes were easier to insert in the LMA-S group (p < 0.001). No differences were found between groups relating to intraoperative complications. Frequency of coughing and visible blood on removal of the device were low and comparable in both groups (p = 0.860 and p = 0.623, respectively). There were no differences relating to the incidence of sore throat, dysphagia or hoarseness at 10 min postoperatively between groups (p = 0.088). The i-gel group complained about a higher sore throat score at 2 h postoperatively (p = 0.009), specifically patients receiving i-gel suffered more from sore throats with 0.24 more points on the visual analog scale (VAS) than patients from the LMA-S group. The i-gel group also reported a lower POPD drop during the first 2 h (p < 0.001).
CONCLUSION: No differences were found between i-gel and LMA-S regarding leak pressure in the groups of anesthetized patients undergoing laparoscopic cholecystectomy. The LMA-S was easier to insert than the i-gel (based on its better first time success rate) and this device showed better ease of drain tube insertion, although the i-gel was quicker to insert than the LMA-S. The i-gel resulted in higher sore throat scores at 2 h postoperatively and lower POPD reduction during the 2 h period studied in the recovery room was reported.

PMID: 25801488 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1P7Gv2Y
via IFTTT

Case 226: Oval Window Atresia.

Case 226: Oval Window Atresia.

Radiology. 2016 Feb;278(2):626-631

Authors: Hughes A, Danehy A, Adil E

Abstract
History A 6-year-old girl presented with bilateral hearing loss. Her otologic, birth, and family histories were limited, given that she was adopted, but her parents reported that she had had difficulty hearing and speaking ever since they adopted her at 2 years of age. Her parents denied a history of acute otitis media, otorrhea, otalgia, vertigo, autophony, or tinnitus since her adoption. At 2.5 years of age, a diagnosis of hearing loss was made, and she was given hearing aids. Her parents believed that she had been doing well with both receptive and expressive language since she had received the hearing aids. At examination, she had small bilateral preauricular skin tags and normal pinna. Her external auditory canals were of a normal caliber bilaterally, with no otorrhea or lesions. The tympanic membranes were translucent and mobile at pneumatic otoscopy. There was no evidence of a middle ear lesion, nor was there a Schwartz sign. She had no nystagmus or vertigo at pneumatic otoscopy. Audiometry was performed and revealed moderate to severe conductive hearing loss bilaterally, with a mixed component present at 2000 KHz. She had normal bilateral middle ear pressure at tympanometry. Thin-section computed tomography (CT) of the temporal bone was performed.

PMID: 26789605 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1QnUL8C
via IFTTT