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Δευτέρα 25 Ιανουαρίου 2021

Central auditory system responses from children while listening to speech in noise.

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Central auditory system responses from children while listening to speech in noise.

Hear Res. 2021 Jan 05;403:108165

Authors: Benítez-Barrera CR, Key AP, Ricketts TA, Tharpe AM

Abstract
Cortical auditory evoked potentials (CAEPs) have been successfully used to explore the effects of noise on speech processing at the cortical level in adults and children. The purpose of this study was to determine whether +15 dB signal-to-noise ratios (SNRs), often recommended for optimal speech perception in children, elicit higher amplitude CAEPs than more realistic SNRs encountered by children during their daily lives (+10 dB SNR). Moreover, we aimed to investigate whether cortical speech categorization is observable in children in quiet and in noise and whether CAEPs to speech in noise are related to behavioral speech perception in noise performance in children. CAEPs were measured during a passive speech-syllable task in 51 normal hearing children aged 8 to 11 years. The speech syllables /da/ and /ga/ were presented in quiet and in the presence of a 4-talker-babble noise at +15 dB and +10 dB SNR. N1 latencies and P2 amplitudes and latencies varied as a function of SNR, with poorer SNRs (+10 dB) eliciting significantly smaller P2 amplitudes and delayed N1 and P2 latencies relative to the higher SNR (+15 dB). Finally, speech categorization was present at the cortical level in this group of children in quiet and at both SNRs; however, N1 and P2 amplitudes and latencies were not related to behavioral speech-in-noise perception of children.

PMID: 33485110 [PubMed - as supplied by publisher]

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UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) on behalf of the Medicines and Healthcare products Regulatory Agency (MHRA) Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group (PRASEAG).

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UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) on behalf of the Medicines and Healthcare products Regulatory Agency (MHRA) Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group (PRASEAG).

J Plast Reconstr Aesthet Surg. 2021 Jan;74(1):13-29

Authors: Turton P, El-Sharkawi D, Lyburn I, Sharma B, Mahalingam P, Turner SD, MacNeill F, Johnson L, Hamilton S, Burton C, Mercer N

Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T cell Non-Hodgkin Lymphoma (NHL) associated with breast implants. Raising awareness of the possibility of BIA-ALCL in anyone with breast implants and new breast symptoms is crucial to early diagnosis. The tumour begins on the inner aspect of the peri-implant capsule causing an effusion, or less commonly a tissue mass to form within the capsule, which may spread locally or to more distant sites in the body. Diagnosis is usually made by cytological, immunohistochemical and immunophenotypic evaluation of the peri-implant fluid: pleomorphic lymphocytes are characteristically anaplastic lymphoma kinase (ALK) negative and strongly positive for CD30. BIA-ALCL is indolent in most patients but can progress rapidly. Surgical removal of the implant with the intact surrounding capsule (total en-bloc capsulectomy) is usually curative. Late diagnosis may require more radical surgery and systemic therapies a nd although these are usually successful, poor outcomes and deaths have been reported. By adopting a structured approach, as suggested in these guidelines, early diagnosis and successful treatment will minimize the need for systemic treatments, reduce morbidity and the risk of poor outcomes. These guidelines provide an evidence-based and systematic framework for the assessment and treatment of patients with suspected or proven BIA-ALCL and are aimed at all clinicians involved in the care of people with breast implants.

PMID: 33483089 [PubMed - as supplied by publisher]

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The ban of the ipsilateral limb as a skin graft donor site after melanoma excision: A critical review.

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The ban of the ipsilateral limb as a skin graft donor site after melanoma excision: A critical review.

J Plast Reconstr Aesthet Surg. 2021 Jan 08;:

Authors: Hage JJ, van Akkooi ACJ

Abstract
Split-thickness skin grafts are often applied in the management of primary cutaneous melanoma. It is routine surgical practice to use the contralateral limb because of the alleged risk of donor site metastases that may occur when the ipsilateral limb is used. The rationale and clinical evidence for this routine were assessed in light of current understanding of pathways of metastasis of melanoma. We found the preference for the contralateral limb to go back to Paget's ideas on melanoma spread from 1889, and the clinical observation of five cases of split-thickness skin graft donor site metastases in a series of 226 tumours, published in 1962. We traced ten additional reported cases of melanoma metastases occurring in the skin graft donor site. Contralateral donor sites were involved in seven of these cases. In light of current knowledge, the occurrence and the location of any split skin donor site metastasis are to be considered as mere indicators of an aggressive course of s ystemic disease. Any location of a split skin donor site, whether ipsilateral or contralateral in relation to the primary tumour, may become the location of metastases but chances that such metastases occur are extremely rare. Because of the lack of evidence in favour of the use of the contralateral limb and because of sound considerations in favour of using the ipsilateral limb, we conclude that there is no objective argument to sustain the dogmatic ban of the ipsilateral limb as a donor site for a split-thickness skin graft in melanoma surgery.

PMID: 33483262 [PubMed - as supplied by publisher]

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Predictors of thyroglobulin in the lymph nodes recurrence of papillary thyroid carcinoma undergoing total thyroidectomy.

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Predictors of thyroglobulin in the lymph nodes recurrence of papillary thyroid carcinoma undergoing total thyroidectomy.

BMC Surg. 2021 Jan 22;21(1):53

Authors: Xing Z, Qiu Y, Li Z, Zhang L, Fei Y, Zhu J, Su A

Abstract
BACKGROUND: To investigate the association between postoperative lymph nodes (LNs) recurrence and distinct serum thyroglobulin (Tg) levels in patients with papillary thyroid carcinoma (PTC).
METHODS: This study included PTC patients who underwent total thyroidectomy (TT) with at least central neck dissection and then re-operated due to recurrence of LNs between January 2013 and June 2018. These patients were grouped by negative or positive serum Tg levels according to the American Thyroid Association guidelines.
RESULTS: Of the 60 included patients, 49 underwent radioactive iodine (RAI) treatment. Maximum unstimulated Tg (uTg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs (P = 0.027), and higher rate of metastatic LNs (P < 0.001). Serum-stimulated Tg (off-Tg) ≥ 1 ng/mL (P = 0.047) and unstimulated Tg (on-Tg) ≥ 0.2 ng/Ml (P = 0.013) were associated with larger diameter of recurrent LNs. Number of metastatic LNs ≥ 8 was an independent predictor for postoperative maximum uTg ≥ 0.2 ng/mL (OR = 8.767; 95% CI = 1.392-55.216; P = 0.021). Ratio of metastatic LNs ≥ 25% was an independent predictor for off-Tg ≥ 1 ng/mL (OR = 20.997; 95% CI = 1.649-267.384; P = 0.019).
CONCLUSION: Postoperative Tg-positive status was associated with larger size of recurrent LNs. Number of metastatic LNs ≥ 8 and ratio of metastatic LNs ≥ 25% were independent predicators for uTg-positive and off-Tg-positive status, respectively.

PMID: 33482804 [PubMed - as supplied by publisher]

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Impact of Dyslipidemia on the Risk of Second Cancer in Thyroid Cancer Patients: A Korean National Cohort Study.

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Impact of Dyslipidemia on the Risk of Second Cancer in Thyroid Cancer Patients: A Korean National Cohort Study.

Ann Surg Oncol. 2021 Jan 22;:

Authors: Ho J, Kim E, Han M, Jung I, Lee J, Jo YS

Abstract
BACKGROUND: Studies have shown that radioactive iodine therapy (RAIT) affects the development of second cancer in thyroid cancer patients. The impact of other factors, such as dyslipidemia are not clear.
METHODS: A retrospective analysis of thyroid cancer patients with a 1,251,913 person-year follow-up was conducted using data from the Health Insurance Review and Assessment database in South Korea from January 2008 to December 2018. We investigated factors related to second cancer development using a nested case-control analysis to avoid length bias.
RESULTS: The overall risk of developing second cancer was higher in thyroid cancer patients than in the general population [standardized incidence ratio, 3.34; 95% confidence interval (CI) 3.30-3.39]. Second cancer incidence was higher in patients who received RAIT than in those who did not [odds ratio (OR) 1.130; 95% CI 1.094-1.169]. Moreover, the risk of second cancer was higher in patients with dyslipidemia than in those without dyslipidemia (OR 1.265; 95% CI 1.223-1.309). After adjustment for RAIT, the incidence of a second cancer was higher in patients with dyslipidemia than in those without dyslipidemia (OR 1.262; 95% CI 1.221-1.306).
CONCLUSIONS: The risk of second cancer development in patients with thyroid cancer appears to be high. Dyslipidemia may be associated with an increased risk of several types of second cancers.

PMID: 33483844 [PubMed - as supplied by publisher]

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Spontaneous spinal cerebrospinal fluid-venous fistulas in patients with orthostatic headaches and normal conventional brain and spine imaging.

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Spontaneous spinal cerebrospinal fluid-venous fistulas in patients with orthostatic headaches and normal conventional brain and spine imaging.

Headache. 2021 Jan 23;:

Authors: Schievink WI, Maya M, Prasad RS, Wadhwa VS, Cruz RB, Moser FG, Nuno M

Abstract
OBJECTIVE: To determine the occurrence of cerebrospinal fluid (CSF)-venous fistulas, a type of spinal CSF leak that cannot be detected with routine computerized tomography myelography, among patients with orthostatic headaches but normal brain and spine magnetic resonance imaging.
BACKGROUND: Spontaneous spinal CSF leaks cause orthostatic headaches but their detection may require sophisticated spinal imaging techniques.
METHODS: A prospective cohort study of patients with orthostatic headaches and normal brain and conventional spine imaging who underwent digital subtraction myelography (DSM) to look for CSF-venous fistulas, between May 2018 and May 2020, at a quaternary referral center for spontaneous intracranial hypotension.
RESULTS: The mean age of the 60 consecutive patients (46 women and 14 men) was 46 years (range, 13-83 years), who had been suffering from orthostatic headaches between 1 and 180 months (mean, 43 months). DSM demonstrated a spinal CSF-venous fistula in 6 (10.0%; 95% confidence interval [CI]: 3.8-20.5%) of the 60 patients. The mean age of these five women and one man was 50 years (range, 41-59 years). Spinal CSF-venous fistulas were identified in 6 (19.4%; 95% CI: 7.5-37.5%) of 31 patients with spinal meningeal diverticula but in none (0%; 95% CI: 0-11.9%) of the 29 patients without spinal meningeal diverticula (p = 0.024). All CSF-venous fistulas were located in the thoracic spine. All patients underwent uneventful surgical ligation of the fistula. Complete and sustained resolution of symptoms was obtained in five patients, while in one patient, partial recurrence of symptoms was noted 3 months postoperatively.
CONCLUSION: Concerns about a spinal CSF leak should not be dismissed in patients suffering from orthostatic headaches when conventional imaging turns out to be normal, even though the yield of identifying a CSF-venous fistula is low.

PMID: 33484155 [PubMed - as supplied by publisher]

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Lateral semicircular canal-BPPV: Prospective randomized study on the efficacy of four repositioning maneuvers

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https://link.springer.com/article/10.1007/s12070-019-01737-4#:~:text=BPPV%20originating%20from%20stimulation%20of,lateral%20canal%20instead%20of%20the



Lateral Semicircular Canal BPPV…Are We Still Ignorant?
Jaskaran Singh & Bhanu Bhardwaj
Indian Journal of Otolaryngology and Head & Neck Surgery volume 72, pages175–183(2020)Cite this article

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Abstract
Benign Paroxysmal Vertigo is one of the most common causes of vertigo. The most common semicircular canal involved in pathogenesis of BPPV is Posterior semicircular canal. However anterior and lateral semicircular canals can also sometimes be responsible for BPPV but their involvement in pathogenesis is still underrated. The incidence of lateral semicircular canal BPPV is in literature is around 10–12% while anterior canal is about 3%. The main objective of this study was to provide the database for incidence of lateral canal BPPV from a tertiary care hospital with the aim that more clinicians incorporate this entity into their differential diagnosis when their cases of posterior canal BPPV are refractory. This was an observational cross-sectional study of 300 patients of BPPV who were coming in ENT OPD as primum or as referral. All the patients underwent both the Dix–Hallpike maneuver as well as the supine roll test. The patients who were having upbeating torsional vertical nyst agmus on Dix–Hallpike were treated on lines of posterior canal BPPV whereas those with horizontal nystagmus on supine roll test were treated on lines of lateral canal BPPV. The data was tabulated and analysed for the incidence of lateral canal BPPV. Out of 300 patients; 188 were males and 122 were females. Most commonly affected age group by BPPV was 40–50 years. Out of 300 cases 260 cases (86.6%) had posterior BPPV and 37 cases (12.3%) had lateral canal BPPV. 3 cases (1%) also had anterior canal BPPV. 30/37 cases of lateral BPPV had geotropic nystagmus while 7 cases had apo-geotropic nystagmus. Posterior canal BPPv was treated by Epleys maneuver. Superior canal BPPV was treated by Yacovino maneuver. The cases of lateral canal BPPV were treated by either Vannucchi-asprella; Gufoni; Lempert maneuver or by the combination of two maneuvers. Lateral canal BPPV is an important diagnosis to consider in all cases of BPPV. Its true incidence is still under blanket as many clinicians are not using supine roll test routinely in their practice while diagnosing BPPV. Many refractory cases of BPPV can be cured if the involvement of other canals in its pathogenesis is kept in the mind so that correct diagnostic and repositioning maneuvers can be applied. We also encourage more institutional studies on lateral canal BPPV so that a standard treatment protocol with clear indications can be designed for this entity as is available for BPPV.

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Affiliations
Sri Guru Ram Das Institute of Health Sciences and Research, Amritsar, India

Jaskaran Singh & Bhanu Bhardwaj

Mohali, India

Jaskaran Singh

Amritsar, India

Bhanu Bhardwaj

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Correspondence to Bhanu Bhardwaj.

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Before starting the study Ethical Clearance was taken from the institutional ETHICAL Committee as per DECLARATION OF HELSINKI.

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Cite this article
Singh, J., Bhardwaj, B. Lateral Semicircular Canal BPPV…Are We Still Ignorant?. Indian J Otolaryngol Head Neck Surg 72, 175–183 (2020). https://doi.org/10.1007/s12070-019-01737-4

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Received
06 September 2019

Accepted
09 September 2019

Published
26 September 2019

Issue Date
June 2020

DOI
https://doi.org/10.1007/s12070-019-01737-4

Keywords
Horizontal canal BPPV
Lateral canal BPPV
Geotropic nystagmus
Apo-geotropic nystagmus
Supine roll test
Bow and bean test
Vannucchi asprella maneuver
Gufoni maneuver
Lempert maneuver

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Publication date: Available online 23 January 2021

Source: Acta Otorrinolaringológica Española

Author(s): Filipe Correia, Luís Castelhano, Pedro Cavilhas, Pedro Escada

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Therapeutic options in Meniere's disease: Our experience

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Arch Otolaryngol
1977 Oct;103(10):589-93. doi: 10.1001/archotol.1977.00780270057007.
Therapeutic options in Meniere's disease
I K Arenberg, R F Bayer
PMID: 303093 DOI: 10.1001/archotol.1977.00780270057007


Emphasis on treatment in Meniere's disease has recently shifted from a concentration on the vertiginous component alone to include conservation or improvement of hearing as well. This presentation tabulates the current otological literature's reports of both the medical and surgical options available in the treatment of Meniere's disease. The authors conclude that these more recent reports deemphasize the importance of the vertiginous component, while emphasizing the importance of the hearing component in evaluation of the efficacy of any therapeutic modality. Furthermore, these reports indicate that endolymphatic sac decompression and drainage surgery alone offers a considerable chance for conservation or improvement in hearing, as well as relief of vertigo in early cases of reversible, fluctuating hearing deficits. In nonreversible or nonfluctuating hearing deficits with hearing worth conserving, vestibular neurectomy with excision of Scarpa's ganglion yields the best results.

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Publication date: Available online 23 January 2021

Source: American Journal of Otolaryngology

Author(s): Pietro De Luca, Claudia Cassandro, Massimo Ralli, Arianna Di Stadio, Pasquale Viola, Ettore Cassandro, Alfonso Scarpa

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Do collagen‐related diseases represent a risk factor for hidradenitis suppurativa?

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We read with great interest the work of Boer et al [1] that explores the role of mechanical stress as a potential triggering factor for hidradenitis suppurativa (HS). The authors reported two cases of patients who developed HS along the striae distensae (SD). The hypothesis proposed by the authors to explain this ectopic lesions is the fact that SD are characterized by a decrease of dermal thickness due to destruction of collagen fibres which may reduce the mechanical support to the pilosebaceous structures and if combined to frictional forces, may trigger the onset of HS by promoting skin inflammation. Matrix metalloproteinases (MMPs) are proteases able to degrade the major components of the extracellular matrix (ECM).

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