OtoRhinoLaryngology News

Τετάρτη 20 Ιανουαρίου 2016

Sublingual immunotherapy in patients with house dust mite allergic rhinitis: prospective study of clinical outcomes over a two-year period.

Sublingual immunotherapy in patients with house dust mite allergic rhinitis: prospective study of clinical outcomes over a two-year period.

J Laryngol Otol. 2016 Jan 19;:1-6

Authors: Soh JY, Thalayasingam M, Ong S, Loo EX, Shek LP, Chao SS

Abstract
BACKGROUND: Sublingual immunotherapy in patients with allergic rhinitis sensitised to house dust mites is safe, but its efficacy is controversial and sublingual immunotherapy with Blomia tropicalis has not yet been studied. This study sought to evaluate the efficacy of sublingual immunotherapy with house dust mite extract in children and adults with house dust mite allergic rhinitis over a period of two years.
METHODS: A prospective observational study was conducted of children and adults diagnosed with house dust mite allergic rhinitis who were treated with sublingual immunotherapy from 2008 to 2012. Total Nasal Symptom Scores, Mini Rhinoconjunctivitis Quality of Life scores and medication usage scores were assessed prospectively.
RESULTS: Thirty-nine patients, comprising 24 children and 15 adults, were studied. Total Nasal Symptom Scores and Mini Rhinoconjunctivitis Quality of Life scores dropped significantly at three months into therapy, and continued to improve. Medication usage scores improved at one year into immunotherapy.
CONCLUSION: Sublingual immunotherapy with house dust mite extracts, including B tropicalis, is efficacious as a treatment for patients with house dust mite allergic rhinitis.

PMID: 26781592 [PubMed - as supplied by publisher]

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Epistaxis management: current understanding amongst junior doctors.

Epistaxis management: current understanding amongst junior doctors.

J Laryngol Otol. 2016 Jan 19;:1-4

Authors: Fox R, Nash R, Liu ZW, Singh A

Abstract
BACKGROUND: Epistaxis is a common and potentially life-threatening emergency. This survey assesses understanding and confidence in epistaxis management amongst current junior doctors.
METHOD: A cross-sectional study was conducted of foundation year one and two doctors based at three National Health Service trusts within a single region of the UK, assessing basic understanding and procedural confidence.
RESULTS: A total of 111 foundation doctors completed this survey. The average duration of undergraduate exposure to otolaryngology was 8.1 days. Forty-one per cent of respondents stated that they would apply pressure to the nasal bones to control epistaxis. Seventy-five per cent lacked confidence in their ability to manage epistaxis. Those with two weeks or more of undergraduate exposure to otolaryngology were more confident than those with one week or less of exposure (p < 0.0001).
CONCLUSION: Junior doctors lack understanding and confidence in epistaxis management, with patient safety implications. Confidence is associated with the duration of undergraduate exposure to otolaryngology. A minimum emergency safe competency should be a priority during foundation training if not achieved in UK medical schools.

PMID: 26781469 [PubMed - as supplied by publisher]

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Resistance to Thyroid Hormone Alpha in an 18 Months Old Girl; Clinical, Therapeutic and Molecular Characteristics.

Resistance to Thyroid Hormone Alpha in an 18 Months Old Girl; Clinical, Therapeutic and Molecular Characteristics.

Thyroid. 2016 Jan 18;

Authors: van Gucht A, Meima M, Zwaveling-Soonawala N, Visser WE, Fliers E, Wennink J, Henny C, Visser TJ, Peeters R, van Trotsenburg AS

Abstract
BACKGROUND: Recently, the first patients with resistance to thyroid hormone (RTHα) due to inactivating mutations in the thyroid hormone receptor alpha (TRα) were identified. These patients are characterized by growth retardation, variable motor and cognitive defects, macrocephaly and abnormal thyroid function tests. Our objective was to characterize a young girl (18 months) with a mutation in both TRα1 and TRα2, and study the effects of early levothyroxine (LT4) treatment.
METHODS: The patient was assessed clinically and biochemically before and during 12 months of LT4 treatment. In addition, we studied the consequences of the mutation for TRα1/2 receptor function in vitro.
RESULTS: At 18 months of age, the patient presented with axial hypotonia, delayed motor development, severe growth retardation and abnormally elevated T3/T4 ratios. RTHα was suspected and concomitantly a c.632A>G/p.D211G missense mutation was identified, affecting both the TRα1 and TRα2 proteins. This mutation was also found in the girl's father. LT4 treatment was started, resulting in a marked improvement of her hypotonia, motor skills and growth. Functionally, the missense mutation led to a decreased transcriptional activity of TRα1, which could be overcome by higher T3 levels in vitro. The mutant TRα1 showed a moderate dominant negative activity on WT TRα1. In contrast, WT TRα2 and mutant TRα2 had negligible transcriptional activity and showed no dominant-negative effect over TRα1.
CONCLUSIONS: This report describes the phenotype of a young RTHα patient with a mild TRα mutation before and during early LT4 treatment. Treatment had beneficial effects on her muscle tone, motor development and growth.

PMID: 26782358 [PubMed - as supplied by publisher]

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Efficacy and safety of radiofrequency and ethanol ablation for treating locally recurrent thyroid cancer: A systematic review and meta-analysis.

Efficacy and safety of radiofrequency and ethanol ablation for treating locally recurrent thyroid cancer: A systematic review and meta-analysis.

Thyroid. 2016 Jan 18;

Authors: Suh CH, Baek JH, Choi YJ, Lee JH

Abstract
BACKGROUND: To evaluate the efficacy and safety of radiofrequency ablation (RFA) and ethanol ablation (EA) for treating locally recurrent thyroid cancer.
MATERIALS AND METHODS: Ovid-MEDLINE and EMBASE databases were searched for studies on the efficacy and safety of RFA and EA for treating locally recurrent thyroid cancer. The pooled proportions of the volume reduction ratio (VRR) ≥ 50%, complete disappearance, changes in serum level of thyroglobulin (Tg), recurrence, and complications, were assessed using random-effects modeling. Heterogeneity among studies was determined using the χ2 statistic for the pooled estimates and the inconsistency index I2. To overcome heterogeneity, sensitivity analysis was performed.
RESULTS: A total of 10 eligible studies, which included a sample size of 270 patients and 415 thyroid nodules, were included. The pooled proportion of VRR ≥ 50% after RFA (100.0%, recalculated 100%; I2 = 55.3%, recalculated I2 = 55.3%) was higher than that after EA (89.5%; I2 = 82.4%) (p = .2764), the pooled proportion of complete disappearance after RFA (68.8%) was higher than that after EA (53.4%) (p = .3384), and the pooled proportion of recurrence after RFA (0.0%) was lower than that after EA (2.4%, adjusted 1.6%) (p = .9766), but these differences were not statistically significant. In addition, the pooled proportion of reduction in serum level of Tg after RFA was 71.6% and after EA was 93.8% (p < .0001). The pooled proportion of complications of both RFA (5.8%, adjusted 1.6%) and EA (1.6%) were low (p = .8479). The mean number of RFA sessions was less than 1.3 in five of six RFA studies, and the number of EA sessions was greater than 2 in three of four EA studies.
CONCLUSION: Both RFA and EA are acceptable treatment modalities to manage locally recurrent thyroid cancer in terms of efficacy and safety for poor surgical candidates or those who refuse surgery.

PMID: 26782174 [PubMed - as supplied by publisher]

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Δευτέρα 18 Ιανουαρίου 2016

The comparison of caffeic acid and caffeic acid phenethyl ester against cisplatin-induced hair cell damage.

The comparison of caffeic acid and caffeic acid phenethyl ester against cisplatin-induced hair cell damage.

Int J Pediatr Otorhinolaryngol. 2015 Dec 29;

Authors: Akyol S, Erdemli HK, Armutcu F, Akyol O

PMID: 26774126 [PubMed - as supplied by publisher]

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MEDULLARY MEDIATION OF THE LARYNGEAL ADDUCTOR REFLEX: A POSSIBLE ROLE IN SUDDEN INFANT DEATH SYNDROME.

MEDULLARY MEDIATION OF THE LARYNGEAL ADDUCTOR REFLEX: A POSSIBLE ROLE IN SUDDEN INFANT DEATH SYNDROME.

Respir Physiol Neurobiol. 2016 Jan 13;

Authors: Wang X, Guo R, Zhao W, Pilowsky PM

Abstract
The laryngeal adductor reflex (LAR) is a laryngeal protective reflex. Vagal afferent polymodal sensory fibres that have cell bodies in the nodose ganglion, originate in the sub-glottal area of the larynx and upper trachea. These polymodal sensory fibres respond to mechanical or chemical stimuli. The central axons of these sensory vagal neurons terminate in the dorsolateral subnuclei of the tractus solitarius in the medulla oblongata. The LAR is a critical, reflex in the pathways that play a protective role in the process of ventilation, and the sychronisation of ventilation with other activities that are undertaken by the oropharyngeal systems including: eating, speaking and singing. Failure of the LAR to operate properly at any time after birth can lead to SIDS, pneumonia or death. Despite the critical nature of this reflex, very little is known about the central pathways and neurotransmitters involved in the management of the LAR and any disorders associated with its failure to act properly. Here, we review current knowledge concerning the medullary nuclei and neurochemicals involved in the LAR and propose a potential neural pathway that may facilitate future SIDS research.

PMID: 26774498 [PubMed - as supplied by publisher]

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Κυριακή 17 Ιανουαρίου 2016

Auditory and visual 3D virtual reality therapy as a new treatment for chronic subjective tinnitus: results of a randomized controlled trial.

Auditory and visual 3D virtual reality therapy as a new treatment for chronic subjective tinnitus: results of a randomized controlled trial.

Hear Res. 2016 Jan 7;

Authors: Malinvaud D, Londero A, Niarra R, Peignard P, Warusfel O, Viaud-Delmon I, Chatellier G, Bonfils P

Abstract
BACKGROUND: Subjective tinnitus (ST) is a frequent audiologic condition that still requires effective treatment. This study aimed at evaluating two therapeutic approaches: Virtual Reality (VR) immersion in auditory and visual 3D environments and Cognitive Behaviour Therapy (CBT).
METHODS: this open, randomized and therapeutic equivalence trial used bilateral testing of VR versus CBT. Adult patients displaying unilateral or predominantly unilateral ST, and fulfilling inclusion criteria were included after giving their written informed consent. We measured the different therapeutic effect by comparing the mean scores of validated questionnaires and visual analog scales, pre and post protocol. Equivalence was established if both strategies did not differ for more than a predetermined limit. We used univariate and multivariate analysis adjusted on baseline values to assess treatment efficacy. In addition of this trial, purely exploratory comparison to a waiting list group (WL) was provided.
RESULTS: Between August, 2009 and November, 2011, 148 of 162 screened patients were enrolled (VR n = 61, CBT n = 58, WL n = 29). These groups did not differ at baseline for demographic data. Three month after the end of the treatment, we didn't find any difference between VR and CBT groups either for tinnitus severity (p=0.99) or tinnitus handicap (p=0.36).
CONCLUSION: VR appears to be at least as effective as CBT in unilateral ST patients.

PMID: 26773752 [PubMed - as supplied by publisher]

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Peroral endoscopic myotomy: first human experience with a water-jet assisted triangle knife.

Peroral endoscopic myotomy: first human experience with a water-jet assisted triangle knife.

Gastrointest Endosc. 2016 Jan 6;

Authors: Balassone V, Sumi K, Inoue H

PMID: 26772890 [PubMed - as supplied by publisher]

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Σάββατο 16 Ιανουαρίου 2016

Sentinel lymph node biopsy staging for cutaneous malignant melanoma of the head and neck.

Sentinel lymph node biopsy staging for cutaneous malignant melanoma of the head and neck.

Acta Otolaryngol. 2016 Jan 15;:1-7

Authors: Hafström A, Romell A, Ingvar C, Wahlberg P, Greiff L

Abstract
Conclusion Sentinel lymph node biopsies (SLNBs) can be performed safely and with reasonable accuracy in HNM patients. The outcome provides important prognostic information concerning DFS and further treatment. However, one must recognize that SLNB is a multidisciplinary procedure with a learning curve for all. Objectives To evaluate efficacy of performing SLNBs in a series of consecutive patients with cutaneous head and neck melanoma (HNM) ≥ T1b from introduction of the procedure and 10 years onward. Method End-points comprised of SLNB outcome, disease-free survival (DFS), and overall survival (OS). Results SNs were harvested in 128 of 160 patients (median Breslow = 2.0 mm, 29% ulcerated); success rate = 80.0%, or 92.1% if excluding patients where SLNBs were omitted due to non-localization on pre-operative imaging or because of SN-location in the parotid basin. Ten patients (7.8%) had positive SLNBs and were offered early completion neck dissections. Of the 146 patients available for follow-up (median = 27 months), 15.8% had recurrent disease. The risk of a regional nodal recurrence after a negative SLNB was 7.5%. SN-negative patients had improved DFS c.f. SN-positive patients (p < 0.001). A positive SLNB was the most important prognostic predictor of decreased DFS (hazard ratio = 5.70; p < 0.005), but had no significant impact on OS.

PMID: 26767628 [PubMed - as supplied by publisher]

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Skull base osteomyelitis missed in mastoidectomy for cholesteatoma.

Skull base osteomyelitis missed in mastoidectomy for cholesteatoma.

Acta Otolaryngol. 2016 Jan 15;:1-3

Authors: Lee HS, Yang CJ, Lee JH, Ahn JH

Abstract
Conclusions A high suspicion of skull base involvement should be warranted, even if radiological findings are not atypical, in cases of chronic otitis media (COM) with cholesteatoma. Objective To investigate some clues indicating the development of skull base osteomyelitis (SBO) in patients who received mastoidectomy, through reviewing pre-operative temporal bone computed tomography (TBCT). Method Retrospective review of patients with SBO after mastoidectomy for COM. A total of five patients with SBO after mastoidectomy with available pre-operative TBCTs were enrolled in this study. Results All patients were diagnosed as COM with cholesteatoma and open cavity mastoidectomy was performed. After surgery, SBO were occurred. The recovery in these five patients was complicated by lower cranial nerve palsy, and one patient had a stroke due to lateral thrombophlebitis. Through re-interpretation of pre-operative TBCT, the bony destruction around the skull base missed at the initial diagnosis was observed in all cases.

PMID: 26767507 [PubMed - as supplied by publisher]

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Daily music exposure dose and hearing problems using personal listening devices in adolescents and young adults: A systematic review.

Daily music exposure dose and hearing problems using personal listening devices in adolescents and young adults: A systematic review.

Int J Audiol. 2016 Jan 15;:1-9

Authors: Jiang W, Zhao F, Guderley N, Manchaiah V

Abstract
OBJECTIVE: This systematic review aimed to explore the evidence on whether the preferred listening levels (PLLs) and durations of music listening through personal listening devices (PLDs) in adolescents and young adults exceed the current recommended 100% daily noise dose; together with the impact on hearing and possible influential factors of such listening behaviours.
DESIGN: A systematic search was conducted using multiple online bibliographic databases.
STUDY SAMPLE: The 26 studies were included on the basis of the inclusion and exclusion criteria.
RESULTS: The results showed that up to 58.2% of participants exceeded the 100% daily noise dose, particularly in the presence of background noise. Significantly positive correlations were found among background noise levels and mean PLLs, as well as the proportion of participants exceeding the 100% daily noise dose. Moreover, significantly worse hearing thresholds were found in PLD users using audiometry, and significantly poor results in otoacoustic emission (OAE), even in the participants with self-reported 'normal hearing'.
CONCLUSION: It is crucial to develop appropriate standards and safe recommendations for daily music exposure dose in future studies. Providing an essential guide and effective education to adolescents and young adults will help raise awareness, increase knowledge, and consequently change attitudes and listening habits.

PMID: 26768911 [PubMed - as supplied by publisher]

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Noise-Induced Neural Degeneration and Therapeutic Effect of Antioxidant Drugs.

Noise-Induced Neural Degeneration and Therapeutic Effect of Antioxidant Drugs.

J Audiol Otol. 2015 Dec;19(3):111-9

Authors: Choi SH, Choi CH

Abstract
The primary site of lesion induced by noise exposure is the hair cells in the organ of Corti and the primary neural degeneration occurs in synaptic terminals of cochlear nerve fibers and spiral ganglion cells. The cellular basis of noise-induced hearing loss is oxidative stress, which refers to a severe disruption in the balance between the production of free radicals and antioxidant defense system in the cochlea by excessive production of free radicals induced by noise exposure. Oxidative stress has been identified by a variety of biomarkers to label free radical activity which include four-hydroxy-2-nonenal, nitrotyrosine, and malondialdehyde, and inducible nitric oxide synthase, cytochrome-C, and cascade-3, 8, 9. Furthermore, oxidative stress is contributing to the necrotic and apoptotic cell deaths in the cochlea. To counteract the known mechanisms of pathogenesis and oxidative stress induced by noise exposure, a variety of antioxidant drugs including oxygen-based antioxidants such as N-acetyl-L-cystein and acetyl-L-carnitine and nitrone-based antioxidants such as phenyl-N-tert-butylnitrone (PBN), disufenton sodium, 4-hydroxy PBN, and 2, 4-disulfonyl PBN have been used in our laboratory. These antioxidant drugs were effective in preventing or treating noise-induced hearing loss. In combination with other antioxidants, antioxidant drugs showed a strong synergistic effect. Furthermore, successful use of antioxidant drugs depends on the optimal timing of treatment and the duration of treatment, which are highly related to the time window of free radical formation induced by noise exposure.

PMID: 26771008 [PubMed]

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Auditory nerve synapses persist in ventral cochlear nucleus long after loss of acoustic input in mice with early-onset progressive hearing loss.

Auditory nerve synapses persist in ventral cochlear nucleus long after loss of acoustic input in mice with early-onset progressive hearing loss.

Brain Res. 2015 Apr 24;1605:22-30

Authors: McGuire B, Fiorillo B, Ryugo DK, Lauer AM

Abstract
Perceptual performance in persons with hearing loss, especially those using devices to restore hearing, is not fully predicted by traditional audiometric measurements designed to evaluate the status of peripheral function. The integrity of auditory brainstem synapses may vary with different forms of hearing loss, and differential effects on the auditory nerve-brain interface may have particularly profound consequences for the transfer of sound from ear to brain. Loss of auditory nerve synapses in ventral cochlear nucleus (VCN) has been reported after acoustic trauma, ablation of the organ of Corti, and administration of ototoxic compounds. The effects of gradually acquired forms deafness on these synapses are less well understood. We investigated VCN gross morphology and auditory nerve synapse integrity in DBA/2J mice with early-onset progressive sensorineural hearing loss. Hearing status was confirmed using auditory brainstem response audiometry and acoustic startle responses. We found no change in VCN volume, number of macroneurons, or number of VGLUT1-positive auditory nerve terminals between young adult and older, deaf DBA/2J. Cell-type specific analysis revealed no difference in the number of VGLUT1 puncta contacting bushy and multipolar cell body profiles, but the terminals were smaller in deaf DBA/2J mice. Transmission electron microscopy confirmed the presence of numerous healthy, vesicle-filled auditory nerve synapses in older, deaf DBA/2J mice. The present results suggest that synapses can be preserved over a relatively long time-course in gradually acquired deafness. Elucidating the mechanisms supporting survival of central auditory nerve synapses in models of acquired deafness may reveal new opportunities for therapeutic intervention.

PMID: 25686750 [PubMed - indexed for MEDLINE]

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[Frequency-specific analysis of the hVOR Prior of Cochlear Implant Operation].

[Frequency-specific analysis of the hVOR Prior of Cochlear Implant Operation].

Laryngorhinootologie. 2015 Mar;94(3):173-8

Authors: Hülse R, Hülse M, Wenzel A, Hörmann K, Servais JJ

Abstract
Dizziness is one of the most common postoperative complications after a cochlear-implant (CI) surgery. With our prospective, matched-paired controlled study, we could demonstrate that patients with distinctive sensorineural hearing loss--even without any complaints of dizziness--already have a reduced horizontal vestibular-ocular-reflex (hVOR). Compared to controls, CI patients presented with a significantly reduced gain. 9 out of 17 CI patients showed physiological results in rotatory testing and video head thrust testing. One patient presented with pathological results in both tests. Remarkably, there were 2 patients who presented with pathological head impulse testing but normal values in rotatory testing and 5 patients who showed normal gains in video head impulse testing but abnormal rotatory tests. These findings clearly show the importance of a differentiated, frequency-dependent pre-operative vestibular assessment including rotatory testing and video-head impulse testing. Additionally, only an accurate pre-operative vestibular testing allows evaluating possible post-operative dizziness related complications and should be documented precisely, also for forensic reasons. This is the key to differentiate post-operative dizziness from an pre-operatively existing vestibular disorder that possibly might not be clinically apparent by the time of testing.

PMID: 25265227 [PubMed - indexed for MEDLINE]

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[Refractory Hoarseness In Granular Cell Tumor of the Vocal Cord].

[Refractory Hoarseness In Granular Cell Tumor of the Vocal Cord].

Laryngorhinootologie. 2016 Jan 15;

Authors: Reiter R, Ruess J, Brosch S, Pickhard A

PMID: 26771451 [PubMed - as supplied by publisher]

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Cysts of the larynx - Classification.

Cysts of the larynx - Classification.

Laryngoscope. 2015 Dec;125(12):2629

Authors: DeSanto LW, Devine KD, Weiland LH

PMID: 26768765 [PubMed - in process]

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A novel method of intubation and orogastric tube insertion using a C-MAC-D-blade videolaryngoscope-bougie technique.

A novel method of intubation and orogastric tube insertion using a C-MAC-D-blade videolaryngoscope-bougie technique.

Acta Anaesthesiol Belg. 2015;66(3):87-90

Authors: Van Zundert AA, Gatt SP

Abstract
INTRODUCTION: Expertise in airway management is a fundamental aspect of anesthesia practice. Fortunately 'can't intubate, can't ventilate' scenarios are extremely rare. In particular, patients with tumors on the right side of the oropharynx and larynx can be very problematic to intubate.
METHODS: We present an alternative intubation technique, whereby a C-MAC D-blade videolaryngoscope is loaded with a Frova catheter in the narrow, curving channel within the blade's infero-posterior aspect on the left side of the blade. This technique can be a successful alternative in patients with difficult airways.
RESULTS: The proposed technique was successfully demonstrated in a case whereby a 47-year old male with premetrics of a difficult airway, presented with a large mass in the right supraglottis and hypopharynx with through-and-through thyroid cartilage infiltration, obstructing completely the view of the glottis with direct laryngoscopy. The referral hospital considered the patient unintubatable and sent the patient to our academic center for treatment. Endotracheal intubation with the new technique was successful at the first attempt.
CONCLUSIONS: The C-MAC D-Blade videolaryngoscope-bougie technique provides an alternative method to intubate patients with difficult airways, even in exceptional situations such as in patients with a large right-sided oropharynx-larynx tumor.

PMID: 26767233 [PubMed - in process]

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[Contact endoscopy of the vocal folds in combination with narrow band imaging (compact endoscopy].

[Contact endoscopy of the vocal folds in combination with narrow band imaging (compact endoscopy].

Laryngorhinootologie. 2015 Mar;94(3):150-2

Authors: Arens C, Voigt-Zimmermann S

PMID: 25760257 [PubMed - indexed for MEDLINE]

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Gender-related difference in the upper airway dimensions and hyoid bone position in Chinese Han children and adolescents aged 6-18 years using cone beam computed tomography.

Gender-related difference in the upper airway dimensions and hyoid bone position in Chinese Han children and adolescents aged 6-18 years using cone beam computed tomography.

Acta Odontol Scand. 2015 Jul;73(5):391-400

Authors: Jiang YY, Xu X, Su HL, Liu DX

Abstract
OBJECTIVE: To investigate the gender-related differences in upper airway dimensions and hyoid bone position in Chinese Han children and adolescents (6-18 years) using cone-beam computed tomography (CBCT).
MATERIALS AND METHODS: CBCT-scans of 119 boys and 135 girls were selected and divided into four groups (group 1: 6-9 years; group 2: 10-12 years; group 3: 13-15 years; group 4: 16-18 years). The airway dimensions including the cross-sectional area (CSA), anteroposterior (AP) and lateral (LAT) width, length (L), mean CSA and volume (VOL) of upper airway segmentations and hyoid bone position including 11 linear and three angular measurements were investigated using Materialism's interactive medical image control system (MIMICS) 16.01 software. Gender-related differences were analyzed by two independent sample t-tests.
RESULTS: No gender-related difference was found in values of the facial morphology, airway dimensions and hyoid bone position for group 1 (p > 0.05). The children and adolescents in groups 2, 3 and 4 showed significant gender-related differences in the measurement results of facial morphology, airway dimensions and hyoid bone positions (p < 0.05). What's more, the measurement values of boys were obviously larger than those of girls except some measurements in group 2.
CONCLUSIONS: The measurements of airway dimensions and hyoid bone positions have gender-related differences in children and adolescents aged 10-18 years. These results could be taken into consideration during orthodontic diagnosis and treatment.

PMID: 25630980 [PubMed - indexed for MEDLINE]

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Low inter-arytenoid height: a subclassification of type 1 laryngeal cleft diagnosis and management.

Low inter-arytenoid height: a subclassification of type 1 laryngeal cleft diagnosis and management.

Int J Pediatr Otorhinolaryngol. 2015 Jan;79(1):31-5

Authors: Jefferson ND, Carmel E, Cheng AT

Abstract
OBJECTIVE: To report our experience of patients with type 1 laryngeal cleft, (including low inter-arytenoid height) who failed conservative management over a five year period. We describe the diagnostic elements of the history, examination at laryngobronchoscopy and provide a management algorithm including the use of inter-arytenoid submucosal injection of gelfoam as a temporary therapeutic as well as diagnostic tool.
METHODS: A retrospective case note review over a five year period was undertaken to review all cases of type 1 laryngeal cleft who failed conservative management. Presenting symptoms, diagnostic procedures, surgical interventions and clinical outcomes were reviewed.
RESULTS: Seventeen patients were identified. Chronic cough was the most consistent feature in the history (100%). All patients underwent a microlaryngoscopy with binocular microlaryngeal assessment. Six patients (35%) underwent gelfoam injection; four of these went on to a formal repair. The remaining 11 all had a repair performed without injection. The success of surgical repair was 80% (12/15) however in the other three, all had improvement in symptoms.
CONCLUSIONS: Type 1 laryngeal cleft anomalies may extend beyond that described by Benjamin and Inglis. An appropriate history as well as binocular inspection at the time of laryngoscopy is essential. Injection augmentation offers a safe tool in the assessment and management, and endoscopic surgical repair remains the standard for definitive therapy in those that fail conservative management.

PMID: 25481333 [PubMed - indexed for MEDLINE]

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Cricoid reduction laryngoplasty for treatment of dysphonia after pediatric laryngotracheal reconstruction.

Cricoid reduction laryngoplasty for treatment of dysphonia after pediatric laryngotracheal reconstruction.

Int J Pediatr Otorhinolaryngol. 2015 Jan;79(1):80-2

Authors: Bliss M, Houtz D, Smith ME

Abstract
Dysphonia is common after pediatric laryngotracheal reconstruction (LTR). Surgical techniques designed to rehabilitate the voice after LTR have not yet been proposed. Herein we describe a case of a patient with severe glottal insufficiency after LTR who was treated with a cricoid reduction laryngoplasty in order to surgically rehabilitate the voice. Removal of the posterior costal cartilage graft was effective at improving the quality of the voice and left the patient with an adequate airway even during moderate exercise.

PMID: 25465446 [PubMed - indexed for MEDLINE]

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Pretreatment screening for distant metastases in the Dutch head and neck centers: 10 years later.

Pretreatment screening for distant metastases in the Dutch head and neck centers: 10 years later.

Eur Arch Otorhinolaryngol. 2016 Jan 14;

Authors: Senft A, Hoekstra OS, Castelijns JA, Leemans CR, de Bree R

Abstract
To evaluate the current practice and change in practice concerning screening for distant metastases in head and neck squamous cell carcinoma patients, we performed a survey with the same questionnaire as 10 years ago among the eight centers of the Dutch Head and Neck Society treating head and neck cancer in The Netherlands. Factors related to extensive lymph node metastases are the most frequent indication for screening for distant metastases. The combinations of whole body PET-CT and contrast-enhanced chest CT are nowadays the diagnostic techniques for routinely screening for distant metastases. Screening for distant metastases is performed more frequently than 10 years ago. Although the sensitivity of the diagnostic pathway needs to be improved, most centers are satisfied with the current diagnostic pathway. A reduction of variation in indications and diagnostic techniques used for screening for distant metastases is observed during the last 10 years. In future guidelines patients' selection and diagnostic tests need to be specified in more detail.

PMID: 26769038 [PubMed - as supplied by publisher]

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Comparison of CO2 laser and conventional laryngomicrosurgery treatments of polyp and leukoplakia of the vocal fold.

Comparison of CO2 laser and conventional laryngomicrosurgery treatments of polyp and leukoplakia of the vocal fold.

Int J Clin Exp Med. 2015;8(10):18265-74

Authors: Zhang Y, Liang G, Sun N, Guan L, Meng Y, Zhao X, Liu L, Sun G

Abstract
The efficacies of CO2 laser and conventional laryngeal microsurgery for vocal cord benign (vocal cord polyp) and precancerous (vocal cord leukoplakia) lesions were compared. Patients with bilateral vocal cord polyps (n = 60) and leukoplakia (n = 30) were divided randomly into two groups. One group was treated with throat microsurgical instruments and underwent routine lesion resection (conventional group) and the other with CO2 laser (laser group). For the subjective assessment, the tools GRABS and VHI were used. The objective assessment, A multi-dimensional voice program module for voice spectrum analysis was used. The laser group was slightly worse than the conventional group 1 week post-surgery by stroboscopic findings. The subjective and objective data of the two groups pre-and post-surgery showed that the voice recovery of the laser group was significantly better than that of the conventional group (P < 0.05). CO2 laser laryngeal microsurgery for vocal cord polyp and leukoplakia can improve significantly the vocal cord morphology and pronunciation quality. The procedure is especially more effective than conventional surgery in patients with vocal cord leukoplakia.

PMID: 26770428 [PubMed]

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Bedside diagnosis of dysphagia: a systematic review.

http:--media.wiley.com-assets-7315-19-Wi

Bedside diagnosis of dysphagia: a systematic review.

J Hosp Med. 2015 Apr;10(4):256-65

Authors: O'Horo JC, Rogus-Pulia N, Garcia-Arguello L, Robbins J, Safdar N

Abstract
Dysphagia is associated with aspiration, pneumonia, and malnutrition, but remains challenging to identify at the bedside. A variety of exam protocols and maneuvers are commonly used, but the efficacy of these maneuvers is highly variable. We conducted a comprehensive search of 7 databases, including MEDLINE, Embase, and Scopus, from each database's earliest inception through June 9, 2014. Studies reporting diagnostic performance of a bedside examination maneuver compared to a reference gold standard (videofluoroscopic swallow study or flexible endoscopic evaluation of swallowing with sensory testing) were included for analysis. From each study, data were abstracted based on the type of diagnostic method and reference standard study population and inclusion/exclusion characteristics, design, and prediction of aspiration. The search strategy identified 38 articles meeting inclusion criteria. Overall, most bedside examinations lacked sufficient sensitivity to be used for screening purposes across all patient populations examined. Individual studies found dysphonia assessments, abnormal pharyngeal sensation assessments, dual axis accelerometry, and 1 description of water swallow testing to be sensitive tools, but none were reported as consistently sensitive. A preponderance of identified studies was in poststroke adults, limiting the generalizability of results. No bedside screening protocol has been shown to provide adequate predictive value for presence of aspiration. Several individual exam maneuvers demonstrated reasonable sensitivity, but reproducibility and consistency of these protocols was not established. More research is needed to design an optimal protocol for dysphagia detection.

PMID: 25581840 [PubMed - indexed for MEDLINE]

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Re: "Five-year alveolar bone level changes in women of varying skeletal bone mineral density and bone trabeculation-a commentary".

Re: "Five-year alveolar bone level changes in women of varying skeletal bone mineral density and bone trabeculation-a commentary".

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Nov 14;

Authors: Kumar S, Patil V, Pai KM, Vineetha R

PMID: 26768078 [PubMed - as supplied by publisher]

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Maxillary reconstruction assisted by preoperative planning and accurate surgical templates.

Maxillary reconstruction assisted by preoperative planning and accurate surgical templates.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Oct 23;

Authors: Zheng GS, Wang L, Su YX, Liao GQ, Zhang SE, Lao XM

Abstract
OBJECTIVE: Surgical reconstruction of maxilla is technically challenging and time consuming. The study reports a new method of maxillary reconstruction assisted by preoperative surgical simulation and accurate transferring templates.
STUDY DESIGN: Six patients requiring maxillary reconstruction were enrolled in our study. Templates of maxillary resection, fibula cutting, and positioning were designed based on computed tomography (CT) data and fabricated via rapid prototyping technique. Resection, fibula cutting, and positioning were performed according to the templates. Accuracy was evaluated by measuring deviation, performed by superimposing preoperative planning and postoperative maxilla.
RESULTS: The surgery was performed faithfully to the preoperative planning. The facial contour was satisfied. Postoperative CT scans showed high accuracy of the surgical implementation. The average central point deviation, maximum deviation, and rotation were 0.58 mm, 1.53 mm, and 6.0°, respectively.
CONCLUSION: With preoperative surgical simulation and templates, maxillary reconstruction can be performed accurately.

PMID: 26768077 [PubMed - as supplied by publisher]

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Prognostic value of 2-[(18) F]fluoro-2-deoxy-D-glucose positron emission tomography for patients with oral squamous cell carcinoma treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy.

Prognostic value of 2-[(18) F]fluoro-2-deoxy-D-glucose positron emission tomography for patients with oral squamous cell carcinoma treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Oct 24;

Authors: Shimizu M, Mitsudo K, Koike I, Taguri M, Iwai T, Koizumi T, Oguri S, Kioi M, Hirota M, Inoue T, Tohnai I

Abstract
OBJECTIVE: To investigate whether 2-[(18) F]fluoro-2-deoxy-D-glucose (FDG) uptake of primary tumor in oral squamous cell carcinoma (OSCC) could predict prognosis.
STUDY DESIGN: Sixty-nine patients with OSCC who underwent retrograde superselective intra-arterial chemoradiotherapy were recruited and underwent dual-time-point FDG positron emission tomography twice, before treatment and 4 weeks after treatment. FDG uptake was defined as the standardized uptake value (SUVmax). The retention index (RI) and the percent change in SUV (% change SUV), derived from the dual-time-point scan, were calculated.
RESULTS: On univariate analysis, patients with high pre-SUV, RI, and percent change SUV values had significantly worse overall survival and disease-free survival compared with patients with low values. On multivariate analysis, high pre-RI (≥20.6%) and high percent change SUV (≥60.0%) (delayed-image) were associated with significantly worse overall survival. High pre-SUV (≥9.6) (delayed-image) and high pre-RI (≥20.6%) were associated with significantly shorter disease-free survival.
CONCLUSIONS: Dual-time-point FDG positron emission tomography in OSCC provided prognostic information and predicted patient outcome.

PMID: 26768076 [PubMed - as supplied by publisher]

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Ameloblastic carcinoma (secondary type) with extensive squamous differentiation areas and dedifferentiated regions.

Ameloblastic carcinoma (secondary type) with extensive squamous differentiation areas and dedifferentiated regions.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Oct 13;

Authors: Fonseca FP, de Almeida OP, Vargas PA, Gonçalves F, Corrêa Pontes FS, Rebelo Pontes HA

Abstract
Ameloblastic carcinoma is rare, accounting for 1.5%-2.0% of all odontogenic tumors. Few small series are available, but data on its clinicopathologic characteristics derive mainly from single case reports; therefore, descriptions of new cases may help to better understand the biological characteristics of this rare odontogenic malignancy. In the current report we describe an ameloblastic carcinoma affecting a 27-year-old female patient who had a previous diagnosis of ameloblastoma 7 years before. The carcinoma featured extensive areas of squamous differentiation resembling a primary intraosseous squamous cell carcinoma, as well as areas of dedifferentiation, a poorly documented histologic characteristic of ameloblastic carcinoma. This case provides new insights on the microscopic spectrum of ameloblastic carcinoma, permitting a critical discussion of the current World Health Organization classification of this odontogenic tumor.

PMID: 26768075 [PubMed - as supplied by publisher]

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Approaches of robot-assisted neck dissection for head and neck cancer: a review.

Approaches of robot-assisted neck dissection for head and neck cancer: a review.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Nov 14;

Authors: Zhou S, Zhang C, Li D

Abstract
Robot-assisted surgery is being increasingly used by surgeons because of its enhancement of visualization, precision, and articulation compared with conventional minimally invasive techniques. In recent years, robot-assisted neck dissection (RAND) has begun to be used as an alternative method of neck dissection, one of the classic surgical procedures in the area of head and neck surgery. Currently, there are four kinds of approaches for RAND: (1) modified facelift or retroauricular incision, (2) combined transaxillary and retroauricular incision, (3) transaxillary incision, and (4) transoral incision. RAND may help perform minimally invasive surgery and achieve excellent cosmetic results as well as the desired oncologic outcomes, and this requires selecting an appropriate approach based on the different needs of neck dissections. Although experienced surgeons wishing to avoid large cervical incisions in patients can safely perform RAND, there are still quite a few limitations; in particular, surgical morbidity and oncologic outcomes should be verified by further prospective clinical trials with longer follow-up periods. Also, RAND needs to be standardized and its use disseminated. In this review, we introduce the applications of different approaches for RAND and their indications and determine whether RAND can be more beneficial compared with conventional surgeries.

PMID: 26768074 [PubMed - as supplied by publisher]

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Ophthalmologic complications after administration of local anesthesia in dentistry: a systematic review.

Ophthalmologic complications after administration of local anesthesia in dentistry: a systematic review.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Nov 10;

Authors: Alamanos C, Raab P, Gamulescu A, Behr M

Abstract
OBJECTIVE: The aim of this review was to investigate the association between the occurrence of ocular adverse events and dental local anesthesia, the most plausible anatomic mechanisms, and the measures that offer patients a restitutio ad integrum.
STUDY DESIGN: This systematic review adopted a structured protocol to access available publications and followed the PRISMA statement.
RESULTS: Eighty-nine cases of patients experiencing ocular adverse events after administration of dental local anesthesia have been reported in the literature. Most of the complications manifested as double vision. Only 8% of the complications caused permanent functional damage, either as vision deficit or anisocoria. Complete permanent blindness was not reported.
CONCLUSIONS: Ocular complications as a result of dental local anesthesia may be seen as rare occurrences with usually low intensity. However, visual function may become permanently impaired and serious medical conditions may obscure ocular dysfunction.

PMID: 26768073 [PubMed - as supplied by publisher]

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Direct effects of Facio-Oral Tract Therapy(®) on swallowing frequency of non-tracheotomised patients with acute neurogenic dysphagia.

Direct effects of Facio-Oral Tract Therapy(®) on swallowing frequency of non-tracheotomised patients with acute neurogenic dysphagia.

SAGE Open Med. 2015;3:2050312115578958

Authors: Konradi J, Lerch A, Cataldo M, Kerz T

Abstract
OBJECTIVES: The aim of this study was to investigate the direct effect of Facio-Oral Tract Therapy(®) on swallowing frequency of non-tracheotomised patients with acute neurogenic dysphagia.
METHODS: Within a pre-, post-/during and follow-up study design, 19 non-tracheotomised dysphagic patients were included consecutively and treated according to three specific preselected Facio-Oral Tract Therapy stimulation techniques.
RESULTS: The primary outcome was the direct effect of the three different Facio-Oral Tract Therapy stimulation techniques on the number of swallows. We found a significant effect of Facio-Oral Tract Therapy on swallowing frequency as compared to baseline with an increase by 65.63% and medium effect size of D = 0.62. No significant difference could be demonstrated when comparing baseline to follow-up.
CONCLUSION: For the first time, this positive therapy effect could be demonstrated on a population of non-tracheotomised patients. Facio-Oral Tract Therapy seems to be an appropriate means for improving effectiveness and safety of swallowing. Since improvement was not long lasting, it appears to be reasonable to apply therapy frequently during the day with the plausible result of minimising the amount of aspirated saliva and thereby reducing the risk of aspiration pneumonia. Further studies may consider choosing a randomised controlled trial design to demonstrate that change in swallow frequency is related to the target intervention only.

PMID: 26770778 [PubMed]

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Feasibility and Safety of Transcutaneous Vagus Nerve Stimulation Paired with Notched Music Therapy for the Treatment of Chronic Tinnitus.

Feasibility and Safety of Transcutaneous Vagus Nerve Stimulation Paired with Notched Music Therapy for the Treatment of Chronic Tinnitus.

J Audiol Otol. 2015 Dec;19(3):159-67

Authors: Shim HJ, Kwak MY, An YH, Kim DH, Kim YJ, Kim HJ

Abstract
BACKGROUND AND OBJECTIVES: A recent study demonstrated that tinnitus could be eliminated by vagus nerve stimulation (VNS) paired with notched sounds in a rat tinnitus model. The aims of this clinical study were to investigate the effects and safety of transcutaneous VNS (tVNS) by patch-type electrode paired with notched music for treating chronic tinnitus.
SUBJECTS AND METHODS: Thirty patients with refractory chronic tinnitus for >12 months were included in this study. A patch-type electrode was attached to the auricular concha of the patient's left ear and tVNS was performed for 30 min (pulse rate 25 Hz, pulse width 200 µs, and amplitude 1-10 mA) using a transcutaneous electric nerve stimulation eco2. During tVNS, the patients listened to notched music cleared of the frequency spectrum corresponding to the tinnitus with a 0.5 octave notch width.
RESULTS: After 10 treatment sessions, 15/30 patients (50%) reported symptom relief in terms of a global improvement questionnaire. The mean tinnitus loudness (10-point scale) and the mean tinnitus awareness score (%) improved significantly from 6.32±2.06 to 5.16±1.52 and from 82.40±24.37% to 65.60±28.15%, respectively (both p<0.05). None of the patients had any specific side effects, such as changes in heart rate or blood pressure.
CONCLUSIONS: This study has demonstrated the feasibility and safety of tVNS paired with notched music therapy in patients with chronic tinnitus, with the use of a pad-type electrode attached to the auricular concha.

PMID: 26771015 [PubMed]

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Tinnitus in patients with temporo-mandibular joint disorder: proposal for a new treatment protocol.

Tinnitus in patients with temporo-mandibular joint disorder: proposal for a new treatment protocol.

Br Dent J. 2016 Jan 15;220(1):15

Authors:

Abstract
Only if otologic disorders and neurological diseases have been excluded, could treatment of a patient suffering from tinnitus be focussed on managing TMD.

PMID: 26768460 [PubMed - in process]

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Detection of the Epstein-Barr virus, Human Bocavirus and novel KI and KU polyomaviruses in adenotonsillar tissues.

Detection of the Epstein-Barr virus, Human Bocavirus and novel KI and KU polyomaviruses in adenotonsillar tissues.

Int J Pediatr Otorhinolaryngol. 2015 Mar;79(3):423-7

Authors: Günel C, Kırdar S, Ömürlü İK, Ağdaş F

Abstract
OBJECTIVES: We aimed to investigate the seasonal disturbations and the rates of detection of Epstein-Barr virus (EBV), Human Bocavirus (HBoV), and polyomaviruses KI and WU (KIPyV and WUPyV) in adenoid and tonsil tissues during the absence of acute infection symptoms.
STUDY DESIGN: Cross-sectional prospective study.
SETTING: Tertiary hospital.
METHODS: DNA expressions of EBV, HBoV, polyomaviruses KIPyV and WUPyV were investigated in children with chronic tonsillar and adenoidal diseases using real-time polymerase chain reaction. The patients were grouped as follows: adenoid, recurrent tonsillitis and hypertrophic tonsillitis group. The relationships of the expressions of these viruses with age, gender, recurrent infection and airway obstruction were also analyzed. Seasonal variations in rates of detection of these viruses in adenoid and tonsil tissues were also investigated.
RESULTS: Considering adenoid specimens, HBoV was found to be the most frequent virus with the rate of 43.1%. In specimens of recurrent tonsillitis and hypertrophic tonsils, EBV was the most frequently encountered virus (53.8%, and 32.0%, respectively). In children with hypertrophic adenoids, while HBoV was detected to be positive throughout the year, EBV was present throughout the year in children with recurrent tonsillitis.
CONCLUSIONS: The detection of HBoV and EBV throughout the year in samples of children with asymptomatic chronic adenotonsillar diseases may indicate that these viruses may remain persistently in lymphoepithelial tissues of upper respiratory tract. Virus persistence may have a pathogenetic potential for development of lymphoid hypertrophy and a chronic stimulatory effect for inflammation.

PMID: 25631935 [PubMed - indexed for MEDLINE]

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Clinical characteristics of 15 cases of chronic subdural hematomas due to spontaneous intracranial hypotension with spinal cerebrospinal fluid leak.

Clinical characteristics of 15 cases of chronic subdural hematomas due to spontaneous intracranial hypotension with spinal cerebrospinal fluid leak.

Acta Neurol Belg. 2016 Jan 14;

Authors: Wan Y, Xie J, Xie D, Xue Z, Wang Y, Yang S

Abstract
The etiology of chronic subdural hematoma (CSDH) in patients is diverse. The primary objective of this article was to discuss one of the causes, spontaneous intracranial hypotension with spinal cerebrospinal fluid (CSF) leak, which is usually neglected by the neurosurgeon. All the consecutive 15 patients who underwent operation for CSDHs between June 2012 and June 2014 at Sir Run Run Shaw Hospital of Zhejiang University were included in this retrospective cohort study. The clinical and imaging data of these patients with CSDHs due to spinal CSF leak were retrospectively studied. Fifteen patients, with a mean age of 53.8 ± 8.3 years, underwent operations for CSDH. Hematomas were unilateral in 4 patients and bilateral in 11 patients. Among these patients, eight patients had recurrence of hematomas after operation due to neglect of spinal CSF leak. All patients had fully recovery. Spinal CSF leak is a cause of cSDH, which is overlooked by the doctor.

PMID: 26769700 [PubMed - as supplied by publisher]

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Microsurgical management of vestibular schwannoma after failed previous surgery.

Microsurgical management of vestibular schwannoma after failed previous surgery.

J Neurosurg. 2016 Jan 15;:1-6

Authors: Samii M, Metwali H, Gerganov V

Abstract
OBJECTIVE Microsurgical treatment of recurrent vestibular schwannoma (VS) is difficult and poses specific challenges. The authors report their experience with 53 cases of surgically treated recurrent VS. Outcome of these tumors was compared to that of primarily operated on VS. Special attention was given to the facial nerve functional outcome. METHODS A retrospective analysis was performed of the patients who underwent surgery for recurrent VS at one institution from 2000 to 2013. The preoperative data, intraoperative findings, and outcome in terms of facial nerve function and improvement of the preoperative symptoms were analyzed and compared with those in a control group of 30 randomly selected patients with primarily operated on VS. A multivariate regression analysis was performed to test the factors that could affect the facial nerve outcome in each group. RESULTS Fifty-three consecutive patients underwent surgery for recurrent VS. Seventeen patients were previously operated on and received postoperative radiosurgery (Group A). Thirty-six patients were previously operated on but did not receive postoperative radiosurgery (Group B). The overall postoperative facial nerve function was significantly worse in Groups A and B in comparison with the control group (Group C). Interestingly, there was no significant difference in the facial nerve outcome among the 3 groups in patients who had good preoperative facial nerve function. The tumor size and the preoperative facial nerve function are variables that significantly affect the facial nerve outcome. Most of the patients showed improvement of the preoperative symptoms, such as trigeminal hypesthesia, gait disturbance, and headache. CONCLUSIONS Complete microsurgical tumor removal is the optimal management for patients with recurrent or regrowing VS. The procedure is safe, associated with favorable facial nerve outcome, and may also improve existing neurological symptoms.

PMID: 26771854 [PubMed - as supplied by publisher]

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Comprehensive review on endonasal endoscopic sinus surgery.

Comprehensive review on endonasal endoscopic sinus surgery.

GMS Curr Top Otorhinolaryngol Head Neck Surg. 2015;14:Doc08

Authors: Weber RK, Hosemann W

Abstract
Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases. Appropriate frame conditions provided, the respective procedures are safe and successful. These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery. The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinus surgery with extended surgery of the frontal (Draf type III), maxillary (grade 3-4, medial maxillectomy, prelacrimal approach) and sphenoid sinus. In addition there are operations outside and beyond the paranasal sinuses. The development of surgical technique is still constantly evolving. This article gives a comprehensive review on the most recent state of the art in endoscopic sinus surgery according to the literature with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment.

PMID: 26770282 [PubMed]

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Trauma of the midface.

Trauma of the midface.

GMS Curr Top Otorhinolaryngol Head Neck Surg. 2015;14:Doc06

Authors: Kühnel TS, Reichert TE

Abstract
Fractures of the midface pose a serious medical problem as for their complexity, frequency and their socio-economic impact. Interdisciplinary approaches and up-to-date diagnostic and surgical techniques provide favorable results in the majority of cases though. Traffic accidents are the leading cause and male adults in their thirties are affected most often. Treatment algorithms for nasal bone fractures, maxillary and zygomatic fractures are widely agreed upon whereas trauma to the frontal sinus and the orbital apex are matter of current debate. Advances in endoscopic surgery and limitations of evidence based gain of knowledge are matters that are focused on in the corresponding chapter. As for the fractures of the frontal sinus a strong tendency towards minimized approaches can be seen. Obliteration and cranialization seem to decrease in numbers. Some critical remarks in terms of high dose methylprednisolone therapy for traumatic optic nerve injury seem to be appropriate. Intraoperative cone beam radiographs and preshaped titanium mesh implants for orbital reconstruction are new techniques and essential aspects in midface traumatology. Fractures of the anterior skull base with cerebrospinal fluid leaks show very promising results in endonasal endoscopic repair.

PMID: 26770280 [PubMed]

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Comprehensive review on rhino-neurosurgery.

Comprehensive review on rhino-neurosurgery.

GMS Curr Top Otorhinolaryngol Head Neck Surg. 2015;14:Doc01

Authors: Hosemann W, Schroeder HW

Abstract
In the past 2 decades, an innovative and active field of surgical collaboration has been evolved and established combining the expertise of neurosurgery and rhinosurgery in the endonasal treatment of different lesions affecting the anterior skull base together with the adjacent intranasal and intradural areas. Important prerequisites for this development were improvements of technical devices, definitions of transnasal surgical corridors, and approvements in endonasal reconstructions, e.g. by use of pedicled nasal mucosal flaps. Due to these improvements, the rate of perioperative infectious complications remained acceptable. Interdisciplinary surgical teams (4-hands-2-minds) have been established constituting specialized centers of "rhino-neurosurgery". With growing expertise of these groups, it could be shown that oncological results and perioperative complications were comparable to traditional surgery while at the same time the patients' morbidity could be reduced. The present review encompasses the recent literature focusing on the development, technical details, results, and complications of "rhino-neurosurgery".

PMID: 26770276 [PubMed]

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Skull base osteomyelitis missed in mastoidectomy for cholesteatoma.

Skull base osteomyelitis missed in mastoidectomy for cholesteatoma.

Acta Otolaryngol. 2016 Jan 15;:1-3

Authors: Lee HS, Yang CJ, Lee JH, Ahn JH

PMID: 26767507 [PubMed - as supplied by publisher]

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National trends, complications, and hospital charges in pediatric patients with Chiari malformation type I treated with posterior fossa decompression with and without duraplasty.

http:--misc.karger.com-LinkOutIcons-sk_n

National trends, complications, and hospital charges in pediatric patients with Chiari malformation type I treated with posterior fossa decompression with and without duraplasty.

Pediatr Neurosurg. 2015;50(1):31-7

Authors: Shweikeh F, Sunjaya D, Nuno M, Drazin D, Adamo MA

Abstract
BACKGROUND: The treatment of type 1 Chiari malformation (CM-1) with posterior fossa decompression without (PFD) or with duraplasty (PFDD) is controversial. The authors analyze both options in a national sample of pediatric patients.
METHODS: Utilizing the Kids' Inpatient Database, CM-1 patients undergoing PFD or PFDD from 2000 through 2009 were analyzed.
RESULTS: 1,593 patients with PFD and 1,056 with PFDD were evaluated. The average age was 10.3 years, slightly younger in PFD (9.8 vs. 10.9 years, p = 0.001). PFDD patients were more likely White (81.2 vs 75.6%, p = 0.04) and less likely admitted emergently (8.4 vs. 13.8%, p = 0.007). They also underwent more reoperations (2.1 vs. 0.7%, p = 0.01), had more procedure-related complications (2.3 vs. 0.8%, p = 0.003), a longer length of stay (4.4 vs. 3.8 days, p = 0.001) and higher charges (USD 35,321 vs. 31,483, p = 0.01).
CONCLUSIONS: This large national study indicates that PFDD is performed more often in Caucasians, less so emergently, and associated with significantly more complications and immediate reoperations, while PFD is more frequent in those with syringomyelia and more economical, requiring fewer hospital resources. Overall, PFD is more favorable for CM-1, though it would be prudent to conduct a prospective trial, as this analysis is limited by data on preoperative presentations and long-term outcomes.

PMID: 25721939 [PubMed - indexed for MEDLINE]

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Craniofacial and pharyngeal airway morphology in patients with acromegaly.

Craniofacial and pharyngeal airway morphology in patients with acromegaly.

Acta Odontol Scand. 2015 Aug;73(6):433-40

Authors: Balos Tuncer B, Canigur Bavbek N, Ozkan C, Tuncer C, Eroglu Altinova A, Gungor K, Akturk M, Balos Toruner F

Abstract
OBJECTIVE: The aim of this study was to assess differences in craniofacial characteristics, upper spine and pharyngeal airway morphology in patients with acromegaly compared with healthy individuals.
MATERIALS AND METHODS: Twenty-one patients with acromegaly were compared with 22 controls by linear and angular measurements on cephalograms. The differences between the mean values of cephalometric parameters were analyzed with Mann-Whitney U-test.
RESULTS: With respect to controls, anterior (p<0.05), middle (p<0.01) and posterior (p<0.05) cranial base lengths were increased, sella turcica was enlarged (p<0.001) and upper spine morphology demonstrated differences in the height of atlas (p<0.01) and axis (p<0.05) in patients with acromegaly. Craniofacial changes were predominantly found in the frontal bone (p<0.01) and the mandible (p<0.05). As for the airway, patients with acromegaly exhibited diminished dimensions at nasal (p<0.001), uvular (p<0.01), mandibular (p<0.01) pharyngeal levels and at the narrowest point of the pharyngeal airway space (p<0.001) compared to healthy controls. Soft palate width was significantly higher (p<0.001) and the hyoid bone was more vertically positioned (p<0.01) in patients with acromegaly.
CONCLUSIONS: Current results point to the importance of the reduced airway dimensions and that dentists and/or orthodontists should be aware of the cranial or dental abnormalities in patients with acromegaly.

PMID: 25543455 [PubMed - indexed for MEDLINE]

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Παρασκευή 15 Ιανουαρίου 2016

Expression of MAGE-A1, -A9, -A11 in laryngeal squamous cell carcinoma and their prognostic significance: a retrospective clinical study.

Expression of MAGE-A1, -A9, -A11 in laryngeal squamous cell carcinoma and their prognostic significance: a retrospective clinical study.

Acta Otolaryngol. 2016 Jan 14;:1-8

Authors: Liu S, Sang M, Xu Y, Gu L, Liu F, Shan B

Abstract
Conclusion The melanoma-associated antigens A1, -A9, -A11 (MAGE-A1, -A9, -A11) are relatively tumor-specific in laryngeal squamous cell carcinoma (LSCC), and could be ideal antigens for LSCC immunotherapy. In addition, MAGE-A9 probably is a poor prognostic marker for LSCC patients. Objective The MAGE-A family belongs to Cancer/testis antigens (CTA). However, the expression pattern of MAGE-A1, MAGE-A9, and MAGE-A11 in LSCC is still unclear. This study aims to evaluate the expression and possible prognostic role of MAGE-A1, MAGE-A9, and MAGE-A11 in LSCC patients. Methods The expression of MAGE-A1, MAGE-A9, and MAGE-A11 in LSCC specimens was investigated by immunohistochemistry, and the association of their expression and the clinical parameters and the survival of LSCC patients were analyzed by chi-square test, Kaplan-Meier survival and Cox regression analysis. Results The expression rates of MAGE-A1, MAGE-A9, and MAGE-A11 in LSCC were 54.7%, 46.2%, and 51.9%, respectively. The expression of MAGE-A1, MAGE-A9, and MAGE-A11 in LSCC was correlated with clinical stage, lymph node metastasis, and tumor size. The overall survival of LSCC patients with positive MAGE-A1, MAGE-A9, or MAGE-A11 expression was lower than the patients without MAGE-A1, MAGE-A9, or MAGE-A11 expression. Cox's multivariable analysis showed that MAGE-A9 expression was an independently poor prognostic factor for LSCC patients.

PMID: 26766421 [PubMed - as supplied by publisher]

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Deafness gene mutations in newborns in Beijing.

Deafness gene mutations in newborns in Beijing.

Acta Otolaryngol. 2016 Jan 14;:1-5

Authors: Han S, Yang X, Zhou Y, Hao J, Shen A, Xu F, Chu P, Jin Y, Lu J, Guo Y, Shi J, Liu H, Ni X

Abstract
Objective To determine the incidence of congenital hearing loss (HL) in newborns by the rate of deafness-related genetic mutations. Design Clinical study of consecutive newborns in Beijing using allele-specific polymerase chain reaction-based universal array. Study sample This study tested 37 573 newborns within 3 days after birth, including nine sites in four genes: GJB2 (35 del G, 176 del 16, 235 del C, 299 del AT), SLC26A4 (IVS7-2 A > G, 2168 A > G), MTRNR1 (1555 A > G, 1494 C > T), and GJB3 (538 C > T). The birth condition of infants was also recorded. Results Of 37 573 newborns, 1810 carried pathogenic mutations, or 4.817%. The carrier rates of GJB2 (35 del G, 176 del 16, 235 del C, 299 del AT), GJB3 (538 C > T), SLC26A4 (IVS7-2 A > G, 2168 A > G), and MTRNR1 (1555 A > G, 1494 C > T) mutations were 0.005%, 0.104%, 1.924%, 0.551%, 0.295%, 0.253%, 1.387%, 0.024%, and 0.274%, respectively. Logistic regression analysis indicated no statistically significant relationship between mutations and infant sex, premature delivery, twin status, or birth weight. Conclusions The 235delC GJB2 mutation was the most frequent deafness-related mutation in the Chinese population. Genetic screening for the deafness gene will help detect more cases of newborn congenital HL than current screening practices.

PMID: 26766211 [PubMed - as supplied by publisher]

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[Surgical treatement by intracapsular enucleation of cervical peripheral neural sheath tumors].

[Surgical treatement by intracapsular enucleation of cervical peripheral neural sheath tumors].

Rev Laryngol Otol Rhinol (Bord). 2015;136(1):45-7

Authors: Raguin T, Alhabib SF, Schultz P, Dupret-Bories A

Abstract
Schwannomas and neurofibromas are benign tumors of the peripheral neural sheath tumors (PNST), representing 5% of soft tissue tumors. Cervical PNST are mainly located on the vagus nerve or in the sympathetic nervous system. The treatment is based on a tumor resection with preservation of nerve function. Classical surgery consists in total tumor removal after dissection of the nerve and is frequently complicated by nerve paralysis. The authors describe a simpler surgical technique consisting in a resection of the intracapsular enucleation of PNST that can limit the risk of nerve injury without increasing recidivism. The description of this surgical technique is illustrated by its use in a type I neurofibromatosis patient with a large vagal nerve neurofibroma.

PMID: 26749606 [PubMed - in process]

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Recurrent mandibular ameloblastoma with anterior skull base invasion: Case report.

Recurrent mandibular ameloblastoma with anterior skull base invasion: Case report.

Rev Laryngol Otol Rhinol (Bord). 2015;136(1):41-3

Authors: Santini L, Varoquaux A, Giovanni A, Dessi P, Michel J

Abstract
Recurrent ameloblastoma with skull base invasion is a rare clinical entity with poor prognosis. We report a case of a mandibular ameloblastoma recurrence involving the anterior skull base. The diagnostic and therapeutic processes are presented with emphasis on the radiologic features of ameloblastoma. Another aim of this case report is to underline the importance of close and long-term follow-up after resection. Ameloblastoma recurrences are frequent and mainly occur after incomplete surgical resection. These recurrences may be diagnosed late because of lack of symptoms in the mandibular area.

PMID: 26749605 [PubMed - in process]

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[The silent sinus syndrome: A reconstruction of the orbital floor with Medpor implant].

[The silent sinus syndrome: A reconstruction of the orbital floor with Medpor implant].

Rev Laryngol Otol Rhinol (Bord). 2015;136(1):37-40

Authors: Clarós P, Ahmed H, Minka Ngom EG, Clarós A

Abstract
INTRODUCTION: The silent sinus syndrome (SSS) is a rare clinical entity in both ENT and ophthalmology. It is characterized by enophthalmos and ptosis associated with a reduction in pressure in the maxillary sinus caused by chronic hypoventilation. The objective of this study was to demonstrate the importance of maxillary hypoplasia whether congenital or acquired in this disease, and the use of Medpor implant for reconstruction of the orbital floor.
MATERIAL AND METHODS: We report 3 cases of silent sinus syndrome proved clinically and radiologically. The first is a 45 year old male patient complaining of enophthalmos which occurred gradually, without any medical history; the second case is that of a woman of 39 years with a gradual onset enophthalmos, with a history of sinusitis; the third case, a man of 25 years who had a history of nasal trauma and consults for enophthalmos and diplopia.
RESULTS: Endoscopic surgery is performed quickly allowing a disappearance of enophthalmos and diplopia. All patients underwent a reconstruction of the orbital floor with a Medpor implant fixed by miniplates without complications.

PMID: 26749604 [PubMed - in process]

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Audiological comparison between two different clips prostheses in stapes surgery.

Audiological comparison between two different clips prostheses in stapes surgery.

Rev Laryngol Otol Rhinol (Bord). 2015;136(1):33-6

Authors: Potena M, Portmann D, Guindi S

Abstract
OBJECTIVES: To compare audiometric results and complications of stapes surgery with two different types of piston prosthesis, the Portmann Clip Piston (Medtronic) (PCP) and the Soft Clip Piston (Kurz) (SCP).
MATERIAL AND METHODS: Study conducted on 64 patients who underwent primary stapedotomy from 2008 to 2011. We matched for each case of stapedotomy with the PCP (Medtronic Xomed Inc. Portmann Clip Piston Stainless Steel/Fluoroplastic) a case with the SCP (Heinz Kurz GmbH Medizintechnik Soft Piston Clip Titanium). Each group consisted of 32 patients, and patients in both groups were matched with respect to gender, age, bilateral or unilateral otosclerosis, otological symptoms (tinnitus, vertigo or dizziness), family history, operated side and the Portmann grading for otosclerosis. The length of the prosthesis used was reported. Post-operative complications such as tinnitus, vertigo, hearing loss and altered taste were documented. Each patient was subjected to a preoperative and postoperative audiogram (follow-up at the second month after the surgery). We used the Student test for statistical analysis. Statistical significance was set at < 0.01.
RESULTS: None of the patients experienced a post-operative hearing loss and none required a later revision surgery. No statistically significant difference was found between the two populations regarding demographic data (age, sex, side, bilaterality, family history, stage and lenght of piston) and hearing level (> 0.01) in the air, bone conduction and air-bone gap (ABG). Postoperative complications did not result to be significantly different between the two groups. Also, both groups showed a significant improvement (< 0.01) in the post-operative air, bone conduction and air-bone gap. There was no statistically significant difference (> 0.01) between the post-operative hearing results (bone conduction, air conduction, air-bone gap) using the two pistons. The mean ABG improvement was respectively 16.63 dB in the SCP group and 20.59 dB in the PCP group.
CONCLUSION: The titanium Soft clip piston (SCP) is a good alternative to the Portmann clip piston (PCP). Nevertheless there are some differences in the surgical fixing of these two pistons in the correct position.

PMID: 26749603 [PubMed - in process]

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Vestibular disorders in Bell's palsy: A prospective study.

Vestibular disorders in Bell's palsy: A prospective study.

Rev Laryngol Otol Rhinol (Bord). 2015;136(1):29-31

Authors: Santos MA, Vianna MF, Nishino LK, Lazarini PR

Abstract
OBJECTIVES: To ascertain the prevalence of vestibular abnormalities in individuals with Bell's palsy (BP) compared with a normal population and to correlate these findings with clinical evolution.
METHOD: A prospective study involving 120 individuals submitted to computerized vector-electronystagmography (VENG) was conducted. The sample included 60 BP patients and 60 control subjects, matched for gender and age.
RESULTS: Twenty-five percent of the Bell's palsy patients had results consistent with deficient peripheral vestibular syndrome. All exams were normal in the control group (p< 0.001). No relationship between vestibular abnormalities and degree of palsy improvement was observed.
CONCLUSION: Patients with Bell's palsy exhibited 25% vestibular abnormalities on vector- electronystagmography exams. Vestibular abnormalities were more frequent in patients with BP compared to normal control individuals. No relationship between vestibular abnormalities and degree of palsy improvement was observed.

PMID: 26749602 [PubMed - in process]

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Vestibular neuritis: Evaluation and effect of vestibular rehabilitation.

Vestibular neuritis: Evaluation and effect of vestibular rehabilitation.

Rev Laryngol Otol Rhinol (Bord). 2015;136(1):21-7

Authors: Lorin P, Donnard M, Foubert F

Abstract
UNLABELLED: Vestibular neuritis (VN) is a caloric vestibular areflexia that occurs suddenly, and whose compensation can take several weeks, sometimes several months. Usually these patients are rehabilitated, but the most affected patients (cervical vestibular evoked myogenic potential (cVEMP) absent) have a worse prognosis of vestibulo-ocular compensation. Thanks to symptomatic, videographic and posturographic evaluation tools, we objectify and quantify which factors influence the recovery or more accurately the compensation of this type of disorder. EQUIPMENT AND METHOD: We have colligated 34 observations of VN whose beginning could be precisely dated. These 34 unilateral caloric areflexic patients had a symptomatic evaluation (SE) with scales (vertigo symptom scale, dizziness handicap inventory, short form 36), an evaluation of the vestibulo-ocular reflex (VOR) (spontaneous nystagmus, head shaking test, mastoid bone skull vibration test, and finally an evaluation of the vestibulo-spinal function (VSF) on a dynamic posturography platform (DPY). On the other hand were evaluated eight elements supposed to influence (influence factors FI) the care and/or the outcome of the treatment (age, cVEMP absent, duration of deficiency, sports and walk practice, rehabilitation of VOR, rehabilitation of VSF, waiting period before application of rehabilitation, vertigo medications treatment).
RESULTS: By comparing averages and with a Fischer's exact test, we can show here that the medical treatment, the waiting period before the application of the rehabilitation, the number of rehabilitation sessions or the type of rehabilitation influence only partially the state of health of neuritis. The age of the patients and absent cVEMP don't have a major influence either. However, patients with the most important physical activity feel better from a symptomatic point of view, over a long period after the episode. The effect of rehabilitation might be temporary if daily activity is minimal.
CONCLUSION: The evaluation of the vestibulo-ocular reflex has long remained the main element for the evaluation of the state of health of vestibular neuritis. But if you use in addition posturography and symptomatic scales to assess the state of health, the neuritis considered to be compensated with the VOR will not always be symptomatically compensated. Estimating the functional recovery of neuritis can't be limited to estimating or quantifying the VOR. Rehabilitating neuritis can't be limited to rehabilitating the VOR. Finally we show here that physical activity is probably more necessary than any type of rehabilitation.

PMID: 26749601 [PubMed - in process]

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[Functional comparison of the voice quality after either open conservative surgery or only radiotherapy for early glottic carcinoma].

[Functional comparison of the voice quality after either open conservative surgery or only radiotherapy for early glottic carcinoma].

Rev Laryngol Otol Rhinol (Bord). 2015;136(1):17-20

Authors: El Ouakif F, Veresezan O

Abstract
OBJECTIVES: The aim of this article is to compare the functional results after open conservative surgery versus radiotherapy alone in the management of early glottic carcinoma using the Voice Handicap Index questionnaire (VHI).
METHODS: Retrospective study was done using VHI for evaluation of 37 patients treated either by open conservative surgery or radiotherapy in T1-T2N0M0 glottic laryngeal carcinoma.
RESULTS: 19 patients were treated with radiotherapy. The overall survival rate and disease free after 5 years were 91.3%. The functional result was mild in 89%. 18 patients were treated surgically. The overall survival rate and disease free after 5 years were 93.1% and 95.4% respectively. The functional result was mild in 61% after surgery.
CONCLUSION: Radiotherapy alone seems to provide better functional results than partial surgery in T1-T2 glottic tumors.

PMID: 26749600 [PubMed - in process]

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[Covering of parotid and cervical lymph nodes metastasis of cutaneous squamous cell carcinoma of the head, about 18 cases].

[Covering of parotid and cervical lymph nodes metastasis of cutaneous squamous cell carcinoma of the head, about 18 cases].

Rev Laryngol Otol Rhinol (Bord). 2015;136(1):9-15

Authors: Vatin L, Morvan JB, Rivière D, Okremchouk I, Abed S, Verdalle P

Abstract
AIM: To describe 18 cases of patients treated for advanced cutaneous squamous cell carcinoma (CSCC) of the head metastasing to cervical lymph nodes and parotid gland. To estimate their survival and the risk factors of metastases.
PATIENTS AND METHODS: 18 cases of patients affected by CSCC of the head, metastatic to parotid and cervical lymph nodes were afterward analyzed. Two populations were differentiated: the patients already treated for their CSCC, with secondary appearance of metastases in the Population A, the patients by whom the metastase is concomitantly discovered to the CSCC in the Population B.
RESULTS: The treatment consisted of a parotidectomy and neck dissection, possibly associated with excision of the primary tumour. Adjuvant radiotherapy was systematic. Metastatic progression was on lungs most of the time (57%), in patients of the population B (80%), or of whom primitive CSCC was of bad forecast (group 2) (78%). The mortality was bound to the complications induced by distant metastases (63%), at 5 years it was superior in the population B (100%) than in the population A (77%).
CONCLUSION: CSCC of the head, metastatic to parotid and cervical lymph nodes have a severe prognosis for survival in spite of an optimal curative treatment applied to fragile old patients.

PMID: 26749599 [PubMed - in process]

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INCREASING THE UPPER AIRWAY SPACE USING ORAL APPLIANCES IN PATIENTS WITH MILD SLEEP APNOEA CAUSED BY STOMATOGNATHIC DYSFUNCTIONS.

INCREASING THE UPPER AIRWAY SPACE USING ORAL APPLIANCES IN PATIENTS WITH MILD SLEEP APNOEA CAUSED BY STOMATOGNATHIC DYSFUNCTIONS.

Ann Acad Med Stetin. 2014;60(2):74-9

Authors: Ey-Chmielewska H, Teul I, Lorkowski J

Abstract
INTRODUCTION: Abnormal breathing can be caused by developmental malformations or anatomical variations in the upper airways. Stomatognathic diseases may significantly impair the patency of the upper respiratory tract. Treatment of advanced stomatognathic dysfunctions is difficult due to their multifactorial aetiology, and often involves many phases. Sleep apnoea is one of the most bothersome complications. The mainstay therapeutic strategy relies on modifying the position of the mandible against the maxilla, achieved by using different types of oral appliances.
MATERIAL AND METHODS: The study was carried out in 2006-2010 on 92 patients (mean age 42.5 years) with diagnosed advanced dysfunction of the stomatognathic system. The treatment relied on the use of an orthodontic appliance (54 patients) or combined multi-phase therapy with splints used in the first phase (22 patients). Two different appliances were used (one of them was modified by the authors). Parameters assessed in the study included time to resolution of pain, reduction in the incidence of sleep apnoea, and improvement in nasal breathing.
RESULTS: Change in the protrusion of the mandible not only relieved problems with the stomatognathic system, but also improved breathing in patients. The use of modified oral appliances reduced treatment duration and improved patients' comfort. Therefore, it may be useful in the treatment of patients with mild sleep apnoea.

PMID: 26591113 [PubMed - indexed for MEDLINE]

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Characteristics of a Dysphonic Population Referred for Voice Assessment and/or Voice Therapy.

Characteristics of a Dysphonic Population Referred for Voice Assessment and/or Voice Therapy.

Folia Phoniatr Logop. 2016 Jan 15;67(4):178-186

Authors: De Bodt M, Van den Steen L, Mertens F, Raes J, Van Bel L, Heylen L, Pattyn J, Gordts F, van de Heyning P

Abstract
OBJECTIVE: The aim of this study was to define patient characteristics of a dysphonic population in terms of voice disorder, gender, age, and subjective and objective vocal parameters and to explore the relevant characteristics of the most frequent groups of voice disorders.
PATIENTS AND METHODS: Patient records from 4,447 subjects referred for voice assessment and/or voice therapy were analyzed.
RESULTS: Significantly more cases of dysphonia were structural as compared to nonstructural. This significant difference was found in almost all age groups. Significantly more women were diagnosed with dysphonia than men. The most common symptom was light-to-moderate hoarseness. The average voice handicap index was 31 and the average dysphonia severity index was -0.6. Vocal fold nodules (VFN), functional voice disorders (FVD) and vocal fold paralysis (VFP) were the three most frequently diagnosed vocal pathologies and were analyzed in detail. Women were found to be significantly more vulnerable to FVD, VFN and cysts, whereas men were significantly more often diagnosed with carcinoma, hyperkeratosis, laryngitis, papillomatosis, presbyphonia, puberphonia and VFP.
CONCLUSIONS: The results of this study allow a better estimation of the clinical needs and costs for a specific dysphonic population looking for help and highlight the gender-related risks of specific voice disorders.

PMID: 26766133 [PubMed - as supplied by publisher]

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Πέμπτη 14 Ιανουαρίου 2016

[Digital health : A paradigm shift in clinical medicine?]

[Digital health : A paradigm shift in clinical medicine?]

HNO. 2016 Jan 13;

Authors: Schönermark MP

PMID: 26759059 [PubMed - as supplied by publisher]

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Τετάρτη 13 Ιανουαρίου 2016

Melanoma in pregnancy: a case report and review of the literature.

Melanoma in pregnancy: a case report and review of the literature.

Postepy Dermatol Alergol. 2015 Dec;32(6):483-7

Authors: Wielowieyska-Szybińska DK, Spałkowska M, Wojas-Pelc A

PMID: 26755917 [PubMed]

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Successful treatment of multiple cutaneous leiomyomas with carbon dioxide laser ablation.

Successful treatment of multiple cutaneous leiomyomas with carbon dioxide laser ablation.

Postepy Dermatol Alergol. 2015 Dec;32(6):480-2

Authors: Michajłowski I, Błażewicz I, Karpinsky G, Sobjanek M, Nowicki R

PMID: 26755916 [PubMed]

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Effectiveness of omalizumab in an asthmatic patient with severe airway and blood eosinophilia.

Effectiveness of omalizumab in an asthmatic patient with severe airway and blood eosinophilia.

Postepy Dermatol Alergol. 2015 Dec;32(6):478-9

Authors: Kupryś-Lipińska I, Kołacińska-Flont M, Marczak J, Górski P, Kurmanowska Z, Kuna P

PMID: 26755915 [PubMed]

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Interstitial granulomatous dermatitis: a characteristic histological pattern with variable clinical manifestations.

Interstitial granulomatous dermatitis: a characteristic histological pattern with variable clinical manifestations.

Postepy Dermatol Alergol. 2015 Dec;32(6):475-7

Authors: Błażewicz I, Szczerkowska-Dobosz A, Pęksa R, Stawczyk-Macieja M, Barańska-Rybak W, Nowicki R

PMID: 26755914 [PubMed]

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Seckel syndrome with cutaneous pigmentary changes: two siblings and a review of the literature.

Seckel syndrome with cutaneous pigmentary changes: two siblings and a review of the literature.

Postepy Dermatol Alergol. 2015 Dec;32(6):470-4

Authors: Kilic A, Çakmak SK, Tuncali T, Koz O, Ozhamamci E, Yasun O, Artuz F

PMID: 26755913 [PubMed]

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Quality of life in patients with leg ulcers or skin lesions - a pilot study.

Quality of life in patients with leg ulcers or skin lesions - a pilot study.

Postepy Dermatol Alergol. 2015 Dec;32(6):465-9

Authors: Szewczyk MT, Mościcka P, Jawień A, Cwajda-Białasik J, Cierzniakowska K, Ślusarz R, Hancke E

Abstract
INTRODUCTION: Attempts to determine the quality of life are advisable in patients with ulcers as the group affected with this problem is relatively large. According to one Polish randomized trial, approximately 0.3-2% of the adult population suffers from active or healed venous ulcers.
AIM: To compare the quality of life of patients with leg ulcers of venous and arterial etiology and those with lower limb skin lesions due to chronic venous insufficiency.
MATERIAL AND METHODS: This study included 90 consecutive patients with ulcers of venous (n = 30) or arterial etiology (n = 30), or patients with trophic disorders of the skin associated with chronic venous insufficiency (n = 30) treated at the Venous Ulceration Outpatient Clinic and at the Department and Clinic of General Surgery, Dr. J. Biziel Memorial University Hospital No. 2, in Bydgoszcz. This study was designed as a questionnaire survey and included the Skindex-29 instrument for the assessment of quality of life in patients with dermatological conditions.
RESULTS: Overall, the global Skinndex-29 scores of all studied participants ranged between 37 and 136 points, 23.93 points on average. The analyzed groups of patients differed significantly with respect to the average level of the global quality of life determined using the Skindex-29 questionnaire.
CONCLUSIONS: Significant differences were observed in the global quality of life of patients who suffered from venous or arterial leg ulcers or skin lesions resulting from chronic venous insufficiency.

PMID: 26755912 [PubMed]

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Self-assessment of striae gravidarum prophylaxis.

Self-assessment of striae gravidarum prophylaxis.

Postepy Dermatol Alergol. 2015 Dec;32(6):459-64

Authors: Antoszewski B, Sobczak M, Kasielska-Trojan A

Abstract
INTRODUCTION: Striae are the most frequently occurring pathology of connective tissue during pregnancy. According to the statistical data, 70-90% of women suffer from striae gravidarum.
AIM: To assess effectiveness of topical products and massage used by pregnant women in striae gravidarum prophylaxis.
MATERIAL AND METHODS: The questionnaire study was conducted among 299 women who were maximum 6 months after delivery at term. The questionnaire included questions concerning age, occurrence of striae gravidarum during pregnancy, their location, week of gestation when the lesions appeared and used striae prophylaxis as well as its effectiveness in respondents' opinion.
RESULTS: Analysis of the correlation between striae gravidarum occurrence and use of different types of cosmetics showed that this kind of prophylaxis is effective when applied at least twice a day (63.7% vs. 77.6%). No correlation between the type of cosmetics and presence of striae was observed (p > 0.05).
CONCLUSIONS: Use of prophylactic measures like skin emollients and oils with the appropriate frequency significantly reduces the risk of striae gravidarum occurrence.

PMID: 26755911 [PubMed]

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