Negative prognostic factors for psychological conditions in patients with audiovestibular diseases.

Negative prognostic factors for psychological conditions in patients with audiovestibular diseases.

Auris Nasus Larynx. 2016 Feb 24;

Authors: Sakagami M, Kitahara T, Okayasu T, Yamashita A, Hasukawa A, Ota I, Yamanaka T

Abstract
OBJECTIVE: To examine the backgrounds of patients with audiovestibular disease regarding what influences their psychological state.
METHODS: During a 12-year period, 375 successive patients with audiovestibular diseases were enrolled in this study. Diseases included unilateral (n=174) and bilateral (n=51) Menière's disease, sudden deafness with vertigo (n=70), and vestibular neuritis (n=80). Diagnosis, sex, age, duration of disease, vertigo frequency, persistent nystagmus, and ipsilateral/contralateral hearing levels were recorded. Cornell Medical Index (domains III-IV=neurosis) and Self-Rating Depression Scale (score>40=depression) were applied during acute vertigo remissions in all patients.
RESULTS: Neurosis and depression, respectively, were diagnosed in 62.7% and 82.4% of bilateral Menière's, 32.7% and 48.9% of unilateral Menière's, 15.7% and 38.6% of sudden deafness/vertigo, and 12.7% and 31.3% of vestibular neuritis patients. Multivariable logistic regression analysis showed that Menière's disease with longer disease duration (Oz 1.212; P=0.021) and worse hearing in the secondary affected ear (Oz 1.131; P=0.042); sudden deafness/vertigo with persistent nystagmus (Oz 1.895; P=0.005); and vestibular neuritis with longer disease duration (Oz 1.422; P=0.019) and persistent nystagmus (Oz 1.950; P=0.0003) had mental illness significantly more often than those with shorter-duration disease, better hearing and no persistent nystagmus.
CONCLUSION: Mental disorder increased in accordance with solo vertigo, vertigo/hearing loss, repeated symptoms, and bilateral lesions. Treatment strategies should be carefully constructed for patients with persistent nystagmus, long disease duration, and hearing loss in the secondary affected ear to avoid psychological disorders.

PMID: 26922128 [PubMed - as supplied by publisher]

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Tinnitus prevalence in New Zealand.

Tinnitus prevalence in New Zealand.

N Z Med J. 2015;128(1424):24-34

Authors: Wu BP, Searchfield G, Exeter DJ, Lee A

Abstract
AIM: There is a lack of consensus in the international literature pertaining to the prevalence of tinnitus for the overall population, as well as sex and age sub-groups, suggesting the need for country-specific prevalence estimates. We aim to find prevalence estimates of tinnitus that are representative of the New Zealand population.
METHOD: We obtained data from random-digit dialled telephone surveys of households, conducted by Roy Morgan Research Limited between August, 2007, and July, 2013, for people aged ≥14 years in New Zealand (n=69,976). As part of the survey, participants were asked whether they have had tinnitus in the last 12 months. The response options were "yes" or "no". Estimates were standardised to the New Zealand population structure based on the 2013 national census. Sex, age and ethnic differences were explored.
RESULTS: The overall weighted prevalence for any tinnitus was 6.0% in the total New Zealand population age ≥14 years. Tinnitus was higher among males (6.5%) compared to females (5.5%). Males were 55% more likely to report tinnitus compared to females among young adults aged 14 to 24 years, while males were 32% more likely to report tinnitus compared to females among adults aged 50 to 64 years. Tinnitus prevalence increased with age, peaking at 13.5% for older adults aged ≥65 years. Adults aged ≥65 years are three times more likely to report tinnitus than people aged below 65 years. Tinnitus prevalence was highest among people identifying as European (7.05%) and lowest among people identifying as Asian (1.00%).
CONCLUSION: This is the first nationally representative study of tinnitus prevalence in New Zealand and largest study sample internationally for tinnitus prevalence to date. Tinnitus is a public health problem affecting approximately 207,000 people in the New Zealand population aged ≥14 years. This study has highlighted the importance of sex and age in defining a high-risk tinnitus population, but our knowledge falls short of profiling their ethnic and social-economic characteristics.

PMID: 26922445 [PubMed - as supplied by publisher]

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Investigation of the calcification at the petroclival region through Multi-slice Computed Tomography of the skull base.

Investigation of the calcification at the petroclival region through Multi-slice Computed Tomography of the skull base.

J Craniomaxillofac Surg. 2016 Feb 3;

Authors: Inal M, Muluk NB, Burulday V, Akgül MH, Ozveren MF, Çelebi UO, Şimşek G, Daphan BÜ

Abstract
OBJECTIVES: The aim of this paper was a retrospective investigation of calcification at the petroclival region using Multi-slice Computed Tomography (MSCT).
METHODS: One hundred thirty skull bases were reviewed. The images were acquired with a 64 slice CT (MSCT). At first images were taken at the axial plane; and then coronal and sagittal reconstructions of raw data were performed. Later investigations were carried out on these 3-dimensional images (3-D imaging). Petrosphenoidal ligament (PSL) (Gruber's ligament) and posterior petroclinoid ligament (PPCL) calcifications were evaluated as "none, partial or complete calcification" for the right and left sides.
RESULTS: In the right PSL, there were partial calcifications in 9.8% and complete calcifications in 2.3%. Calcification ratio was 9.8% partial and 2.9% complete in the left PSL. In the right side, there were 26.6% partial and 5.2% complete calcifications of PPCL. In the left side, there were 29.5% partial and 4.6% complete PPCL calcifications. PPCL calcification was detected more in males compared to females in the right and left sides. In older patients, left PSL; right and left PPCL calcification were detected more.
CONCLUSION: PPCL calcifications cannot be differentiated from PSL calcifications in MSCT slices. The distinction can be easily done in 3-D views. The presence of ossified ligaments may make surgeries in this region difficult, and special care has to be taken to avoid injuries to structures which pass under these ossified ligaments. Particularly in elderly patients, the appropriate surgical instrument for the PSL calcifications should be prepared preoperatively. If PSL is calcified, 6th cranial nerve palsy may not occur even though increased intracranial pressure syndrome is present. Whereas, in lateral trans-tentorial herniations, 3rd cranial nerve palsy occurs in earlier periods when PSL is calcified. Moreover, in subtemporal and transtentorial petrosal approaches, knowing the PSL calcification preoperatively is important to avoid damaging the 6th cranial nerve during surgery.

PMID: 26922483 [PubMed - as supplied by publisher]

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Acute toxicity in comprehensive head and neck radiation for nasopharynx and paranasal sinus cancers: cohort comparison of 3D conformal proton therapy and intensity modulated radiation therapy.

Acute toxicity in comprehensive head and neck radiation for nasopharynx and paranasal sinus cancers: cohort comparison of 3D conformal proton therapy and intensity modulated radiation therapy.

Radiat Oncol. 2016;11(1):32

Authors: McDonald MW, Liu Y, Moore MG, Johnstone PA

Abstract
BACKGROUND: To evaluate acute toxicity endpoints in a cohort of patients receiving head and neck radiation with proton therapy or intensity modulated radiation therapy (IMRT).
METHODS: Forty patients received comprehensive head and neck radiation including bilateral cervical nodal radiation, given with or without chemotherapy, for tumors of the nasopharynx, nasal cavity or paranasal sinuses, any T stage, N0-2. Fourteen received comprehensive treatment with proton therapy, and 26 were treated with IMRT, either comprehensively or matched to proton therapy delivered to the primary tumor site. Toxicity endpoints assessed included g-tube dependence at the completion of radiation and at 3 months after radiation, opioid pain medication requirement compared to pretreatment normalized as equivalent morphine dose (EMD) at completion of treatment, and at 1 and 3 months after radiation.
RESULTS: In a multivariable model including confounding variables of concurrent chemotherapy and involved nodal disease, comprehensive head and neck radiation therapy using proton therapy was associated with a lower opioid pain requirement at the completion of radiation and a lower rate of gastrostomy tube dependence by the completion of radiation therapy and at 3 months after radiation compared to IMRT. Proton therapy was associated with statistically significant lower mean doses to the oral cavity, esophagus, larynx, and parotid glands. In subgroup analysis of 32 patients receiving concurrent chemotherapy, there was a statistically significant correlation with a greater opioid pain medication requirement at the completion of radiation and both increasing mean dose to the oral cavity and to the esophagus.
CONCLUSIONS: Proton therapy was associated with significantly reduced radiation dose to assessed non-target normal tissues and a reduced rate of gastrostomy tube dependence and opioid pain medication requirements. This warrants further evaluation in larger studies, ideally with patient-reported toxicity outcomes and quality of life endpoints.

PMID: 26922239 [PubMed - as supplied by publisher]

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Negative prognostic factors for psychological conditions in patients with audiovestibular diseases.

Negative prognostic factors for psychological conditions in patients with audiovestibular diseases.

Auris Nasus Larynx. 2016 Feb 24;

Authors: Sakagami M, Kitahara T, Okayasu T, Yamashita A, Hasukawa A, Ota I, Yamanaka T

Abstract
OBJECTIVE: To examine the backgrounds of patients with audiovestibular disease regarding what influences their psychological state.
METHODS: During a 12-year period, 375 successive patients with audiovestibular diseases were enrolled in this study. Diseases included unilateral (n=174) and bilateral (n=51) Menière's disease, sudden deafness with vertigo (n=70), and vestibular neuritis (n=80). Diagnosis, sex, age, duration of disease, vertigo frequency, persistent nystagmus, and ipsilateral/contralateral hearing levels were recorded. Cornell Medical Index (domains III-IV=neurosis) and Self-Rating Depression Scale (score>40=depression) were applied during acute vertigo remissions in all patients.
RESULTS: Neurosis and depression, respectively, were diagnosed in 62.7% and 82.4% of bilateral Menière's, 32.7% and 48.9% of unilateral Menière's, 15.7% and 38.6% of sudden deafness/vertigo, and 12.7% and 31.3% of vestibular neuritis patients. Multivariable logistic regression analysis showed that Menière's disease with longer disease duration (Oz 1.212; P=0.021) and worse hearing in the secondary affected ear (Oz 1.131; P=0.042); sudden deafness/vertigo with persistent nystagmus (Oz 1.895; P=0.005); and vestibular neuritis with longer disease duration (Oz 1.422; P=0.019) and persistent nystagmus (Oz 1.950; P=0.0003) had mental illness significantly more often than those with shorter-duration disease, better hearing and no persistent nystagmus.
CONCLUSION: Mental disorder increased in accordance with solo vertigo, vertigo/hearing loss, repeated symptoms, and bilateral lesions. Treatment strategies should be carefully constructed for patients with persistent nystagmus, long disease duration, and hearing loss in the secondary affected ear to avoid psychological disorders.

PMID: 26922128 [PubMed - as supplied by publisher]

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Pediatric central auditory processing disorder showing elevated threshold on pure tone audiogram.

Pediatric central auditory processing disorder showing elevated threshold on pure tone audiogram.

Auris Nasus Larynx. 2016 Feb 24;

Authors: Maeda Y, Nakagawa A, Nagayasu R, Sugaya A, Omichi R, Kariya S, Fukushima K, Nishizaki K

Abstract
Central auditory processing disorder (CAPD) is a condition in which dysfunction in the central auditory system causes difficulty in listening to conversations, particularly under noisy conditions, despite normal peripheral auditory function. Central auditory testing is generally performed in patients with normal hearing on the pure tone audiogram (PTA). This report shows that diagnosis of CAPD is possible even in the presence of an elevated threshold on the PTA, provided that the normal function of the peripheral auditory pathway was verified by distortion product otoacoustic emission (DPOAE), auditory brainstem response (ABR), and auditory steady state response (ASSR). Three pediatric cases (9- and 10-year-old girls and an 8-year-old boy) of CAPD with elevated thresholds on PTAs are presented. The chief complaint was difficulty in listening to conversations. PTA showed elevated thresholds, but the responses and thresholds for DPOAE, ABR, and ASSR were normal, showing that peripheral auditory function was normal. Significant findings of central auditory testing such as dichotic speech tests, time compression of speech signals, and binaural interaction tests confirmed the diagnosis of CAPD. These threshold shifts in PTA may provide a new concept of a clinical symptom due to central auditory dysfunction in CAPD.

PMID: 26922127 [PubMed - as supplied by publisher]

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Response.

Response.

Auris Nasus Larynx. 2016 Feb 24;

Authors: Kim CW

PMID: 26922126 [PubMed - as supplied by publisher]

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Ultrasonography of the Tympanic Bullae and Larynx in Cattle.

Ultrasonography of the Tympanic Bullae and Larynx in Cattle.

Vet Clin North Am Food Anim Pract. 2016 Mar;32(1):119-131

Authors: Gosselin VB, Babkine M, Francoz D

Abstract
Diseases of the middle ear or the larynx are not numerous in cattle but their diagnosis can be challenging for veterinary practitioners in the field. This article presents the ultrasonography of these 2 anatomic structures in order to provide new diagnostic tools to veterinary practitioners in the field. Brief anatomic reminders are first reported. The scanning techniques and normal images are then described. Finally, abnormal images of specific conditions are presented.

PMID: 26922115 [PubMed - as supplied by publisher]

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Episodic Laryngeal Breathing Disorders: Literature Review and Proposal of Preliminary Theoretical Framework.

Episodic Laryngeal Breathing Disorders: Literature Review and Proposal of Preliminary Theoretical Framework.

J Voice. 2016 Feb 24;

Authors: Shembel AC, Sandage MJ, Verdolini Abbott K

Abstract
OBJECTIVE: The purposes of this literature review were (1) to identify and assess frameworks for clinical characterization of episodic laryngeal breathing disorders (ELBD) and their subtypes, (2) to integrate concepts from these frameworks into a novel theoretical paradigm, and (3) to provide a preliminary algorithm to classify clinical features of ELBD for future study of its clinical manifestations and underlying pathophysiological mechanisms.
STUDY DESIGN: This is a literature review.
METHODS: Peer-reviewed literature from 1983 to 2015 pertaining to models for ELBD was searched using Pubmed, Ovid, Proquest, Cochrane Database of Systematic Reviews, and Google Scholar. Theoretical models for ELBD were identified, evaluated, and integrated into a novel comprehensive framework. Consensus across three salient models provided a working definition and inclusionary criteria for ELBD within the new framework. Inconsistencies and discrepancies within the models provided an analytic platform for future research.
RESULTS: Comparison among three conceptual models-(1) Irritable larynx syndrome, (2) Dichotomous triggers, and (3) Periodic occurrence of laryngeal obstruction-showed that the models uniformly consider ELBD to involve episodic laryngeal obstruction causing dyspnea. The models differed in their description of source of dyspnea, in their inclusion of corollary behaviors, in their inclusion of other laryngeal-based behaviors (eg, cough), and types of triggers.
CONCLUSION: The proposed integrated theoretical framework for ELBD provides a preliminary systematic platform for the identification of key clinical feature patterns indicative of ELBD and associated clinical subgroups. This algorithmic paradigm should evolve with better understanding of this spectrum of disorders and its underlying pathophysiological mechanisms.

PMID: 26922093 [PubMed - as supplied by publisher]

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