Study of tonotopic brain changes with functional MRI and FDG-PET in a patient with unilateral objective cochlear tinnitus.

Study of tonotopic brain changes with functional MRI and FDG-PET in a patient with unilateral objective cochlear tinnitus.

Hear Res. 2016 Sep 20;

Authors: Guinchard AC, Ghazaleh N, Saenz M, Fornari E, Prior JO, Maeder P, Adib S, Maire R

Abstract
We studied possible brain changes with functional MRI (fMRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) in a patient with a rare, high-intensity "objective tinnitus" (high-level SOAEs) in the left ear of 10 years duration, with no associated hearing loss. This is the first case of objective cochlear tinnitus to be investigated with functional neuroimaging. The objective cochlear tinnitus was measured by Spontaneous Otoacoustic Emissions (SOAE) equipment (frequency 9689 Hz, intensity 57 dB SPL) and is clearly audible to anyone standing near the patient. Functional modifications in primary auditory areas and other brain regions were evaluated using 3T and 7T fMRI and FDG-PET. In the fMRI evaluations, a saturation of the auditory cortex at the tinnitus frequency was observed, but the global cortical tonotopic organization remained intact when compared to the results of fMRI of healthy subjects. The FDG-PET showed no evidence of an increase or decrease of activity in the auditory cortices or in the limbic system as compared to normal subjects. In this patient with high-intensity objective cochlear tinnitus, fMRI and FDG-PET showed no significant brain reorganization in auditory areas and/or in the limbic system, as reported in the literature in patients with chronic subjective tinnitus.

PMID: 27663095 [PubMed - as supplied by publisher]

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Abnormal vocal cord movement in patients with and without airway obstruction and asthma symptoms.

Abnormal vocal cord movement in patients with and without airway obstruction and asthma symptoms.

Clin Exp Allergy. 2016 Sep 24;

Authors: Low K, Ruane L, Uddin N, Finlay P, Lau KK, Hamza K, Holmes PW, Hamilton G, Bardin PG

Abstract
BACKGROUND: Abnormal vocal cord movements can cause laryngeal extrathoracic airway obstruction (often called vocal cord dysfunction - VCD) leading to asthma-like symptoms. These aberrant movements are characteristically present during inspiration and termed paradoxical vocal cord movement (PVCM). We have reported PVCM in up to 40% of severe asthmatics but it is not known if PVCM is detectable in all patients with asthma-like symptoms and if the condition is more often associated with abnormal lung function.
OBJECTIVE: We hypothesized that PVCM is frequently associated with asthma symptoms accompanied by airflow limitation. Studies examined whether PVCM is solely linked to experiencing asthma symptoms or if PVCM is related to airflow limitation and/or other disease characteristics.
METHODS: Patients with asthma symptoms were recruited from general practice and severe asthma clinics (n=155). Pulmonary function measurements were conducted, asthma control and Nijmegen (dysfunctional breathing) questionaires administered and skin prick testing done. PVCM was quantified using dynamic 320-slice computerised tomography of the larynx. Groups were divided into patients with FEV1 ≥80% predicted or FEV1 <80% predicted and FEV1 /FVC<0.7. ATS/ERS definitions of severity were also applied and evaluated. Detection of PVCM in the groups was compared and analyses performed to identify features associated with PVCM.
RESULTS: Overall (n=155) PVCM was detected in 42 cases (27.1%). Patients with FEV1 <80% predicted had PVCM more often (25/68, 36.8%) than individuals with normal spirometry (17/87, 19.5%; p=0.016). PVCM was associated with older age (p=0.003) and with Nijmegen scores >20 (p=0.04). Patients with FEV1 <80% predicted plus Nijmegen scores >20 were more likely to have PVCM (OR=9.3, p=0.02).
CONCLUSIONS & CLINICAL RELEVANCE: PVCM is more often associated with asthma symptoms accompanied by airflow limitation and dysfunctional breathing. Further studies are needed to determine if PVCM is induced by dysfunctional breathing practices and/or airway obstruction. How PVCM links with symptomatic asthma and VCD also requires evaluation. This article is protected by copyright. All rights reserved.

PMID: 27664415 [PubMed - as supplied by publisher]

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Efficacy of adjunctive mitomycin C in transcanalicular diode laser dacryocystorhinostomy.

Efficacy of adjunctive mitomycin C in transcanalicular diode laser dacryocystorhinostomy.

Eur Arch Otorhinolaryngol. 2016 Sep 23;

Authors: Ozsutcu M, Balci O, Tanriverdi C, Demirci G

Abstract
The objective of the study was to compare the success rate of transcanalicular laser dacryocystorhinostomy (TCL-DCR) with or without the use of adjunctive mitomycin C (MMC) in cases with primary nasolacrimal duct obstruction (NLDO). This retrospective study was comprised of 68 patients with uncomplicated primary NLDO. There were two groups in the study: the Group 1 (n = 35) patients underwent TCL-DCR surgery with MMC and the Group 2 (n = 33) patients underwent TCL-DCR surgery without MMC. All patients had bicanalicular silicone tube intubation. The main outcome measures were patent osteotomy as visualized endoscopically and patent nasolacrimal irrigation. The follow-up period was 12 months. All patients had unilateral TCL-DCR with silicone tube intubation. Six months following surgery, the silicone tubes were removed. At the final evaluation, success rates were 80 % in Group 1 and 78.8 % in Group 2. There was no statistically significant difference between the two groups (p = 0.52). No complications related to MMC usage were recorded during the study period. Intraoperative use of MMC has no beneficial effect on the success rate in TCL-DCR.

PMID: 27664138 [PubMed - as supplied by publisher]

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