Influence of cochlear implantation on vestibular function.

Influence of cochlear implantation on vestibular function.

Acta Otolaryngol. 2016 Mar 23;:1-5

Authors: Chen X, Chen X, Zhang F, Qin Z

Abstract
Conclusion Vestibular function in patients can be damaged following cochlear implantation. Therefore, assessing the pre-operative vestibular status, carefully choosing the side of implantation, and preserving function by using minimally invasive surgical techniques are important. Objectives The aim of this study was to assess the influence of cochlear implantation on vestibular function in patients with severe and profound sensorineural hearing loss, and to analyze a possible correlation between the changes in vestibular testing and post-operative vestibular symptoms. Methods Thirty-four patients were evaluated for vestibular function using the cervical and ocular vestibular-evoked myogenic potentials (cVEMP and oVEMP, respectively), and 29 patients underwent caloric tests pre-operatively and 4 weeks post-operatively. Results Before surgery, the cVEMPs were recorded bilaterally in 22 patients, unilaterally in eight patients, and absent bilaterally in four patients. The oVEMPs were recorded bilaterally in 19 patients, unilaterally in six patients, and absent bilaterally in nine patients. After implantation, the cVEMPs were absent in 10 patients and the oVEMPs were absent in seven patients on the implanted side. Caloric tests demonstrated canal paresis in 17 patients, and normal responses were recorded in 12 of the 29 patients pre-operatively. There was a significant decrease post-implantation in the ear implanted, with the exception of two patients. Two patients presented with vertigo and another two patients reported slight unsteadiness post-operatively, but all symptoms resolved within 7 days. The impaired vestibular function did not correlate with vestibular symptoms, age, or gender. Function on the contralateral side remained unaffected.

PMID: 27008103 [PubMed - as supplied by publisher]

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Clinicopathological analysis of salivary gland tissue from patients with IgG4-related disease.

Clinicopathological analysis of salivary gland tissue from patients with IgG4-related disease.

Acta Otolaryngol. 2016 Mar 23;:1-5

Authors: Takano K, Nomura K, Abe A, Kamekura R, Yamamoto M, Ichimiya S, Takahashi H, Himi T

Abstract
Conclusion The diagnosis of immunoglobulin G4-related disease (IgG4-RD) should be based on the morphology of tissue biopsy, and this study recommends a submandibular gland (SMG) biopsy for accurate diagnosis and to exclude malignant disease. Objective To clarify which type of biopsy specimen (SMG or labial salivary gland [LSG]) should be taken from patients with IgG4-RD. Methods This study included 33 patients with IgG4-RD (21 women; 12 men) who were subjected to both SMG and LSG biopsies at Sapporo Medical University between 2011-2015. Tissues obtained from the SMG and LSG specimens were evaluated. Results All SMG specimens satisfied the diagnostic criteria for IgG4-RD, whereas 19 (57.6%) LSG specimens satisfied the diagnostic criteria for IgG4-RD. Histological evaluation showed fibrosis in all the SMG specimens and in eight LSG specimens (24.2%). Obliterative phlebitis was seen in nine SMG specimens (27.3%), but it was absent in all the LSG specimens.

PMID: 27007955 [PubMed - as supplied by publisher]

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T-status and an oral fluoropyrimidine, S-1, adjuvant chemotherapy are prognostic factors in reduced-RADPLAT for resectable hypopharyngeal cancer.

T-status and an oral fluoropyrimidine, S-1, adjuvant chemotherapy are prognostic factors in reduced-RADPLAT for resectable hypopharyngeal cancer.

Acta Otolaryngol. 2016 Mar 23;:1-7

Authors: Wakisaka N, Hirai N, Kondo S, Aga M, Nakanishi Y, Tsuji A, Endo K, Murono S, Yoshizaki T

Abstract
CONCLUSION: Reduced-RADPLAT for HPC achieved comparative survival and locoregional control rates with lower toxicities compared with concurrent chemoradiotherapies including original RADPLAT. S-1 adjuvant chemotherapy showed a survival benefit.
OBJECTIVES: To evaluate the efficacy and toxicities of targeted intra-arterial (IA) infusion of cisplatin with concurrent radiotherapy with a reduced dose (reduced-RADPLAT) for resectable hypopharyngeal cancer (HPC).
METHODS: Between 1999-2012, 50 patients with stage II-IVA HPC primarily treated by reduced-RADPLAT were analyzed. They were treated by 2-5 courses of IA cisplatin infusion (100 mg per body) with simultaneous systemic infusion of sodium thiosulfate concurrent with conventional radiotherapy (66-70 Gy). After 2003, S-1, an oral fluoropyrimidine, adjuvant chemotherapy was administered to all eligible patients.
RESULTS: During a median follow-up of 48.6 months, the estimated 3- and 5-year overall survival (OS), progression-free survival (PFS), locoregional control, and laryngoesophageal dysfunction-free survival (LEDFS) rates were 76.0% and 62.0%, 58.0% and 50.0%, 66.0% and 62.0%, and 56.0% and 54.0%, respectively. Grade 3 toxicities were observed in 30.0%. No patient had grade 4 or higher toxicities. No patient required tube feeding or tracheotomy at 3 months after treatment. T4-lesions and S-1 administration were significant factors predicting poor and good OS, PFS, and LEDFS, respectively.

PMID: 27007816 [PubMed - as supplied by publisher]

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Detection of pneumolabyrinth after temporal bone trauma using computed tomography.

Detection of pneumolabyrinth after temporal bone trauma using computed tomography.

Acta Otolaryngol. 2016 Mar 23;:1-5

Authors: Choi JW, Lyu AR, Ryu KA, Kim D, Park YH

Abstract
CONCLUSION: Pneumolabyrinth is a very rare condition, even in otic capsule disrupting (OCD) fracture. Hearing was not always impaired, even in cases with OCD fracture. The co-existence of pneumocochlea, regarded as a risk factor for total hearing loss, was extremely rare in cases of pneumolabyrinth.
OBJECTIVES: The purposes of this study were to analyze the radiological and clinical features in patients with pneumolabyrinth and to overcome the diagnostic pitfalls encountered during pneumocochlea detection.
MATERIALS AND METHODS: The temporal bone computed tomographies (TBCT) of 402 patients diagnosed with temporal bone fracture along with their clinical records were retrospectively reviewed.
RESULTS: Only six patients (7% of those with OCD fractures or 1.5% of those with temporal bone fracture) were found to have pneumolabyrinth. Locations of the pneumolabyrinth were in the vestibule in all six cases and three of them showed air densities both in the cochlea and semicircular canal. The size of the air density in the vestibule was 5.38 ± 4.56 mm(2) at the axial view and 6.57 ± 5.67 mm(2) at the coronal view. The mean minimal Hounsfield unit (HU) of air density area in the vestibule was -968.1 ± 22.94 at the axial view and -941 ± 16.88 at the coronal view. Patients with pneumocochlea eventually developed total hearing loss.

PMID: 27007704 [PubMed - as supplied by publisher]

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Are corticosteroids useful in all degrees of severity and rapid recovery of Bell's palsy?

Are corticosteroids useful in all degrees of severity and rapid recovery of Bell's palsy?

Acta Otolaryngol. 2016 Mar 22;:1-6

Authors: Ferreira M, Firmino MJ, Marques EA, Santos PC, Duarte JA

Abstract
Conclusions The results provide preliminary evidence that corticosteroids were not effective in all grades of dysfunction and for achieving a rapid remission in the early phase of BP, highlighting the need to define standard and rigorous criteria to prescribe corticosteroids in these patients. Objectives The main aim of this study was to investigate whether the use of corticosteroids better associated than paralleled with neuromuscular training (C + FNT) is more effective than facial neuromuscular training (FNT) applied alone, in terms of recovery degree and facial symmetry during the early phase of Bell's palsy (BP). Patients and methods A prospective single-blinded study involved 73 patients: the C + FNT group (n = 42; median age = 37.5 years) and FNT group (n = 31; median age = 49.0 years). Patients were assessed before and 6 weeks after treatment by House-Brackmann (HB-FGS) and Sunnybrook Facial Grading System (SB-FGS). Results Recovery degree and facial symmetry improved significantly in both groups (p < 0.001), without differences between groups (p > 0.05). However, the C + FNT group displayed better outcomes for cheek (p = 0.004) and mouth (p = 0.022) resting symmetry at SB-FGS, instead of compared to the FNT group. The corticosteroids had no significant effect on all recovery degrees (p = 0.992) and rapid remission (p = 0.952). Multiple linear regression analysis showed that the type of intervention was not a significant predictor for recovery degree (p = 0.917).

PMID: 27003272 [PubMed - as supplied by publisher]

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Evaluation of cochlear nerve diameter and cross-sectional area in ANSD patients by 3.0-Tesla MRI.

Evaluation of cochlear nerve diameter and cross-sectional area in ANSD patients by 3.0-Tesla MRI.

Acta Otolaryngol. 2016 Mar 22;:1-8

Authors: Peng L, Xiao Y, Liu L, Mao Z, Chen Q, Zhou L, Liao B, Liu A, Wang X

Abstract
CONCLUSIONS: The size of cochlear nerve (CN) is atrophic in adult auditory neuropathy spectrum disorder (ANSD) patients compared with non-ANSD sensorineural hearing loss (SNHL) patients and normal hearing subjects, and CN deficiency is one of the lesions for ANSD patients.
OBJECTIVES: To evaluate the dimensions of CN in adult ANSD patients on magnetic resonance imaging (MRI) and confirm the hypothesis that CN deficiency is one of the lesions for ANSD patients.
METHODS: Medical records and MRI of 24 adult ANSD patients reviewed retrospectively and 20 non-ANSD SNHL and 24 volunteers with normal hearing were recruited as control groups. The long diameter (LD), short diameter (SD), and cross-sectional area (CSA) of CN and facial nerve (FN) were measured.
RESULTS: Among the 24 ANSD patients, this study was able to reconstruct and measure the CN of 91.7% (22/24, total 43 ears) of patients and FN of 83.3% (20/24, total 38 ears) of patients. The mean values and standard deviations of LD, SD, and CSA of CN in ANSD patients were 0.65 ± 0.20 mm, 0.44 ± 0.15 mm, and 0.30 ± 0.19 mm(2), respectively. They were significantly smaller in ANSD patients than in control groups (p < 0.001).

PMID: 27003148 [PubMed - as supplied by publisher]

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Closed reduction for arytenoid dislocation under local anesthesia.

Closed reduction for arytenoid dislocation under local anesthesia.

Acta Otolaryngol. 2016 Mar 22;:1-7

Authors: Cao L, Wu X, Mao W, Hayes C, Wei C

Abstract
CONCLUSION: Closed reduction under local anesthesia continues to be an effective and well-tolerated method for treating arytenoid dislocation. Bilateral arytenoid dislocation is an uncommon occurrence, and the principles of management are the same as for unilateral dislocation.
OBJECTIVES: To evaluate the treatment outcomes of closed reduction for arytenoid dislocation under local anesthesia and to conduct an exhaustive review of the literature on bilateral arytenoid dislocation.
METHODS: Thirty-three patients with arytenoid dislocation were treated with closed reduction under local anesthesia. Arytenoid motion, GRBAS (grade, roughness, breathiness, asthenia, strain), maximum phonation time (MPT), self-assessed Voice Handicap Index (VHI), and acoustic voice analysis were used to evaluate the clinical outcomes.
RESULTS: Following closed reduction, 33 patients were divided into a 'satisfied' group (n = 26) and a 'dissatisfied' group (n = 7). In the 'satisfied' group, G, R, B, A, MPT, VHI, jitter%, shimmer%, normalized noise energy (NNE), and noise-to-harmonic ratio (NHR) were significantly improved compared with measurements taken before closed reduction (p < 0.05). The results for F0 and S score were not significantly different. In the 'dissatisfied' group, VHI, MPT, F0, and shimmer% were not significantly different 1 month after reduction. However, statistically significant change was observed in jitter% and NHR.

PMID: 27002978 [PubMed - as supplied by publisher]

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Vestibular function disorders and potential mechanisms in irradiation nasopharyngeal carcinoma patients.

Vestibular function disorders and potential mechanisms in irradiation nasopharyngeal carcinoma patients.

Acta Otolaryngol. 2016 Mar 22;:1-5

Authors: Sun D, Zhao M, Yin J, Xu Y, Zhang H, Xia M

Abstract
CONCLUSIONS: Vestibular function disorders were widespread among nasopharyngeal carcinoma (NPC) patients. The radiation doses to the inner ears were associated with the incidence of vestibular function disorders, but the correlations were mild. The inflammatory responses and possible resolution obstacles of inflammation participated in persistent vestibular function disorders after irradiation.
OBJECTIVES: To investigate the incidence of vestibular function disorders in NPC patients after irradiation and potential mechanisms.
METHODS: Patients who received radical intensity-modulated radiotherapy for their NPC were recruited. The serum levels of IL-6 and IL-17 were detected by ELISA method. Vestibular evoked myogenic potential (VEMP) tests were used to evaluate vestibular function and correlation analyses were used to analyze the potential mechanisms of vestibular function disorders.
RESULTS: Thirty-eight patients were included. The incidences of abnormal ocular VEMP (oVEMP) and cervical VEMP (cVEMP) were 65.79% and 80.26% at the time of completion of radiotherapy, and 61.84% and 71.05% at 3 months after radiotherapy. The mean and maximum radiation doses to the inner ears were both significantly associated with abnormal oVEMP and cVEMP (p < 0.05, all), but the correlations were all mild. The serum levels of IL-6 and IL-17 were both significantly associated with abnormal oVEMP and cVEMP after irradiation (p < 0.05, all).

PMID: 27002826 [PubMed - as supplied by publisher]

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Effects of functional endoscopic sinus surgery on the treatment of bronchiectasis combined with chronic rhino-sinusitis.

Effects of functional endoscopic sinus surgery on the treatment of bronchiectasis combined with chronic rhino-sinusitis.

Acta Otolaryngol. 2016 Mar 22;:1-4

Authors: Wang Y, Yang HB

Abstract
CONCLUSION: Idiopathic bronchiectasis is closely associated with chronic rhino-sinusitis. It can effectively control bronchiectasic symptoms to treat chronic rhino-sinusitis by FESS in the cases with bronchiectasis and chronic rhino-sinusitis.
OBJECTIVE: To explore the effect of functional endoscopic sinus surgery (FESS) on the treatment of bronchiectasis combined with chronic rhino-sinusitis.
METHODS: In this study, a total of 161 cases with bronchiectasis and chronic rhino-sinusitis were divided into medication group and operation group according to the therapeutic method for chronic rhino-sinusitis selected by them. For the treatment of chronic rhino-sinusitis, the cases in the operation group received FESS, but in the medication group cases took drugs alone. The score of clinical symptoms for bronchiectasis, forced expiratory volume in one second (FEV1), SNOT-22 score, and Lund-Mackay score were evaluated for all cases before and after treatment, respectively, and then the value changes in the score of clinical symptoms, FEV1, SNOT-22 score, and Lund-Mackay score between both time points were calculated. The frequency of acute exacerbation for bronchiectasis was also recorded within the 6-month follow-up.
RESULTS: In this study, 58.9% of cases with bronchiectasis had chronic rhino-sinusitis. Follow-up lasted 6 months. Compared with pre-therapy, post-therapy score of clinical symptoms, SNOT-22 score, and Lund-Mackay score were all significantly decreased (all p < 0.05), but post-therapy FEV1 failed to significantly improve (p > 0.05) in both groups. During the 6-month follow-up, the frequency of acute exacerbation was significantly less in the operation group than in the medication group (p < 0.01). Post-treatment score of clinical symptoms (p < 0.01), SNOT-22 score (p < 0.05), and Lund-Mackay score (p < 0.05) also were all significantly less in the operation group than in the medication group. However, there was no significant difference in post-therapy FEV1 between the two groups (p > 0.05).

PMID: 27002736 [PubMed - as supplied by publisher]

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Evaluation of carotid artery intima-media thickness in patients with moderate-to-severe obstructive sleep apnea syndrome after nasal surgery and uvulopalatopharyngoplasty.

Evaluation of carotid artery intima-media thickness in patients with moderate-to-severe obstructive sleep apnea syndrome after nasal surgery and uvulopalatopharyngoplasty.

Acta Otolaryngol. 2016 Mar 22;:1

Authors: Onder H, Ozel D, Inci MF, Ozkan F

PMID: 27002632 [PubMed - as supplied by publisher]

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[Balloon dilatation of the Eustachian tube during middle ear surgery : Study planning and first experiences during recruitment].

[Balloon dilatation of the Eustachian tube during middle ear surgery : Study planning and first experiences during recruitment].

HNO. 2016 Mar 22;

Authors: Zirkler J, Rahne T, Lautenschläger C, Honigmann R, Plontke SK

Abstract
BACKGROUND: Eustachian tube dysfunction is considered a major contributor to chronic middle ear disease. In clinical case series, the results of balloon dilation (balloon Eustachian tuboplasty, BET) as a treatment for Eustachian tube dysfunction have been reported.
OBJECTIVE: This study aims to analyze whether patients undergoing planned surgery for chronic middle ear disease would benefit from additional BET.
METHODS: In a randomized controlled, patient and observer (not surgeon)-blind clinical study, 100 adult patients with planned surgery for chronic middle ear disease will be investigated. Patients will be randomized into two groups, one of which (50%) will receive additional BET of the affected side during the planned surgery. Eustachian tube function will be evaluated using the Valsalva maneuver and tubomanometry according to Estève, as well as on the basis of patient reports. Various scores will be used as outcome measures, including ETS-5 (Eustachian Tube Score 5), the extended version ETS-7, and the ETDQ-7 (Seven-Item Eustachian Tube Dysfunction Questionnaire). Follow-up is at 3, 6, and 12 months.
RESULTS: From June to December 2015, 162 patients underwent microscopic ear surgery. Inclusion criteria were not fulfilled by 90 patients. Of the remaining 72 patients with chronic middle ear disease, 12 patients (17 %) have been randomized so far, 28 (39 %) did not exhibit Eustachian tube dysfunction, and 32 (44 %) patients could not be included for other reasons.
CONCLUSION: The rate of recruitment was lower than expected. Depending on the case number calculations for the patient groups identified in the study for whom BET might be particularly beneficial, multicenter studies in specific disease groups may follow.

PMID: 27002857 [PubMed - as supplied by publisher]

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Identification of operculum and surgical results in endolymphatic sac drainage surgery.

Identification of operculum and surgical results in endolymphatic sac drainage surgery.

Auris Nasus Larynx. 2016 Mar 19;

Authors: Kitahara T, Yamanaka T

Abstract
To increase the accuracy of identification of the endolymphatic sac during endolymphatic sac drainage surgery, we focused on the intra-operative identification of the operculum as a structural marker of the endolymphatic sac and the vestibular aqueduct at the rugose portion. Then, we examined the relationship between identification of the operculum and surgical outcomes. We used 100 cases with intractable Meniere's disease who received endolymphatic sac drainage with local steroid administration, superior to traditional endolymphatic sac drainage surgery and non-surgical medical treatment. According to operation records, we divided these 100 cases into those with intra-operative identification of the operculum (n=72) and those without (n=28) and compared the surgical outcomes. The ratio of intra-operative identification of operculum (OPC(+)) was 72.0%. Better hearing results were observed significantly more often in patients with OPC(+), although there were no significant differences in vertigo results between OPC(+) and OPC(-). We concluded that the endolymphatic sac might be exposed adequately at rugose portion and opened for the drug delivery, resulting in better surgical results.

PMID: 27004943 [PubMed - as supplied by publisher]

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[Advances in diagnosis and treatment of Meniere's disease].

[Advances in diagnosis and treatment of Meniere's disease].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Oct;29(19):1749-53

Authors: Zhang X, Dong Y, Shi M

Abstract
Meniere's disease (MD), a kind of common disease of otology, is based on the endolymphatic hydrops. The clinical features of MD are intermittent episodes of vertigo, fluctuating sensorineural hearing loss, tinnitus and ear fullness. With the in-depth exploration of the disease, the diagnosis and treatment of MD has made a series of research results. In this paper, the related literature and research reports in recent years were reviewed.

PMID: 26999855 [PubMed - in process]

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Botulinum Toxin Dosing Trends in Spasmodic Dysphonia Over a 20-year Period.

Botulinum Toxin Dosing Trends in Spasmodic Dysphonia Over a 20-year Period.

J Voice. 2016 Mar 18;

Authors: Namin AW, Christopher KM, Eisenbeis JF

Abstract
OBJECTIVES: The study aims to (1) identify the botulinum toxin (BTX) dosing trend in a cohort of patients who received at least 20 injections for the treatment of adductor spasmodic dysphonia (ADSD), (2) describe two distinct BTX dosing trends in treating ADSD (a "classic" dosing trend that initially decreases before stabilizing, and a "fluctuating" dosing trend), and (3) determine if patients with the "classic" dosing trend differed in age or in dosing intervals from those with the "fluctuating" dosing trend.
STUDY DESIGN: This is a retrospective case series.
METHODS: Of 149 patients who received a total of 2484 BTX injections for the treatment of spasmodic dysphonia in 1993-2013, 49 patients received at least 20 injections. The BTX dose and the interval between doses were recorded. The mean dose of injections 1-20 was determined. The age at initial injection, initial dose, and interval in days between treatments were compared for the "fluctuating" and "classic" groups.
RESULTS: The cohort exhibits a significant decrease in dose during the first 10-15 injections. The "fluctuating" group had a significantly shorter interval between injections (mean interval = 97.09 days, SD = 29.41; mean interval = 136.90 days, SD = 43.76, P = 0.002). The mean age at initial dose was not significantly different between the "classic" and "fluctuating" groups.
CONCLUSIONS: The average BTX dose of patients with ADSD who receive long-term injections significantly decreases during the initial 10-15 injections before stabilizing. Patients who exhibit the "fluctuating" dosing pattern have a significantly shorter interval between injections than those with the "classic" dosing pattern.

PMID: 27005439 [PubMed - as supplied by publisher]

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Symptomatic Anterior Cervical Osteophyte Causing Dysphagia: Case Report, Imaging, and Review of the Literature.

Symptomatic Anterior Cervical Osteophyte Causing Dysphagia: Case Report, Imaging, and Review of the Literature.

Cureus. 2016;8(2):e473

Authors: Chen YR, Sung K, Tharin S

Abstract
Anterior cervical osteophytes are found in 20-30% of elderly patients. Rarely, severe osteophytes can cause dysphagia, dysphonia, and dyspnea. Here, we illustrate a case of severe dysphagia caused by a large post-traumatic osteophyte with oropharyngeal swallow study showing a significant mass effect on the pharynx and resolution following osteophytectomy. We also review the literature regarding the etiology, diagnosis, and treatment of symptomatic anterior cervical osteophytes.

PMID: 27004150 [PubMed]

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The Carina© middle ear implant: surgical and functional outcomes.

The Carina© middle ear implant: surgical and functional outcomes.

Eur Arch Otorhinolaryngol. 2016 Mar 23;

Authors: Bruschini L, Berrettini S, Forli F, Murri A, Cuda D

Abstract
The Carina© system (Cochlear Ltd, Sydney, Australia) is a totally implantable prosthesis designed to meet the needs of acoustic amplification in adults with moderate-to-severe sensorineural or mixed hearing loss. It mechanically stimulates the ossicles or labyrinthine windows. The object of this study was to update surgical and functional results obtained in a consistent sample of Carina© recipients. The data sheets of 26 patients who underwent Carina© surgery at two ENT units [i.e., ENT Audiology and Phoniatrics Unit of the University Hospital of Pisa (Pisa, Italy) and ENT Unit of "Guglielmo da Saliceto" Hospital of Piacenza (Piacenza, Italy)] were evaluated for the surgical and audiological outcomes. Twenty patients received a unilateral device, whereas six patients were bilaterally implanted (simultaneously in one patient and sequentially in the remaining five patients). The total number of ears implanted in this study was 32. Most implanted patients expressed a high degree of satisfaction with the prosthesis, which highlights the improvement in hearing in different environmental conditions, the cosmetic advantages, and greater freedom in performing common activities in daily living. Audiological examination demonstrated valid functional gain and significant improvement in speech perception in quiet. Based on this experience, the Carina© is a valid alternative to hearing aids. Moreover, a bilateral implantation, even a simultaneous implantation, is a viable option for selected motivated patients because the intervention is generally well tolerated and the surgery time is relatively fast.

PMID: 27007286 [PubMed - as supplied by publisher]

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Granular cell tumor in two oral anatomic sites.

Granular cell tumor in two oral anatomic sites.

Eur Arch Otorhinolaryngol. 2016 Mar 23;

Authors: Serpa MS, Costa-Neto H, de Oliveira PT, da Silveira ÉJ, de Medeiros AM

Abstract
Granular cell tumor (GCT) is an uncommon benign soft tissue neoplasm, which usually presents as a solitary nodule, appearing especially in the tongue. There are few cases of multiple oral GCT in the English-language literature, with only three cases reported in the last 20 years. This report describes a case of two oral GCT in a young patient and provides a literature review from 1995 to 2015. Clinical characteristics of the reviewed cases were retrieved and compared with the present case. Exceptionally, the current case was the only one that occurred in an adolescent and solely affected the oral cavity. Besides the oral cavity, the other cases also observed GCT lesions in the skin. Although rare, it is important to know multiple oral GCT clinical and histopathological characteristics so they can be correctly diagnosed, treated and followed up.

PMID: 27007285 [PubMed - as supplied by publisher]

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Voice outcomes of laryngopharyngeal reflux treatment: a systematic review of 1483 patients.

Voice outcomes of laryngopharyngeal reflux treatment: a systematic review of 1483 patients.

Eur Arch Otorhinolaryngol. 2016 Mar 23;

Authors: Lechien JR, Finck C, Costa de Araujo P, Huet K, Delvaux V, Piccaluga M, Harmegnies B, Saussez S

Abstract
The aim of this study is to explore voice quality modifications in laryngopharyngeal reflux (LPR) disease and to understand better the pathophysiological mechanisms underlying the development of communicative disability. Biological Abstracts, BioMed Central, Cochrane database, PubMed and Scopus were assessed for subject headings using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) recommendations. Relevant studies published between January 1990 and December 2015 describing the evaluation of voice quality in LPR disease were retrieved. Issues of clinical relevance, such as LPR diagnosis method, treatment efficacy and outcomes, were evaluated for each study. We determined the grade of recommendation for each publication according to the Oxford Centre for Evidence-Based Medicine evidence levels. The search identified 145 publications, of which 25 studies met the inclusion criteria for a total of 1483 LPR patients. Data were extracted by 2 independent physicians who identified 16 trials with a IIb evidence level, 7 trials with a IIa evidence level and 2 RCTs with a Ib evidence level where 4 patient-based instruments and 5 clinician-based instruments were used. The main voice assessment outcomes reported were hoarseness assessments by physicians or patients, followed by acoustic parameters; 15 and 14 articles, respectively, demonstrated significant improvements in subjective and objective voice assessments after treatment. The methodology used to measure acoustic parameters (i.e. sustained vowel duration, the sample portion choice for measurement, etc.) varied from one study to another. The majority of studies indicated that voice quality assessments (especially acoustic parameters) remain an interesting outcome to measure the effectiveness of treatment, but further studies using standardised and transparent methodology to measure acoustic parameters are necessary to confirm the place of each tool in the LPR disease evaluation.

PMID: 27007132 [PubMed - as supplied by publisher]

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A comparison of electrothermal bipolar vessel sealing system and electrocautery in selective neck dissection.

A comparison of electrothermal bipolar vessel sealing system and electrocautery in selective neck dissection.

Eur Arch Otorhinolaryngol. 2016 Mar 23;

Authors: Ozturk K, Kaya I, Turhal G, Ozturk A, Gursan G, Akyildiz S

Abstract
The use of LigaSure™ vessel sealing system in head and neck surgery was reported to be reliable and safe, providing sufficient hemostasis and reducing operating time. The aim of this study was to evaluate efficacy of this technique in patients undergoing selective neck dissections. This study was carried out as a prospective controlled study at an otolaryngology department of a tertiary medical center between July 2013 and July 2015. Twenty-five patients older than 18 years who underwent unilateral selective neck dissection for head and neck cancer were included in the study. In the control group (group 2, 10 patients) only monopolar and bipolar diathermy was used; in the Ligasure group (group 1, 15 patients) Ligasure was used for hemostasis and dissection in addition to the conventional techniques. Cervical lymphadenectomy time, operation time, preoperative hemoglobin levels, preoperative hematocrit levels, postoperative hemoglobin levels, postoperative hematocrit levels, total neck drainage and drain removal time were analyzed and compared between the groups. Median operation time in group 1 and 2 were 95 min (IQR = 35) and 142.5 min (IQR = 63), respectively. Median cervical lymphadenectomy time in group 1 and 2 were 55 min (IQR = 23) and 102.5 min (IQR = 49), respectively. Median operation time and cervical operation time were significantly lower in group 1 (p < 0.05). In conclusion, LigaSure™ vessel sealing system is a safe, efficacious technique and significantly lowers cervical lymphadenectomy and operation time in selective neck dissections compared to controls. Given the superb hemostatic properties, this technique should be in the surgeon's armamentarium when possible.

PMID: 27007131 [PubMed - as supplied by publisher]

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Long-term follow-up after "one-shot" CO2 laser stapedotomy: is the functional outcome stable during the years?

Long-term follow-up after "one-shot" CO2 laser stapedotomy: is the functional outcome stable during the years?

Eur Arch Otorhinolaryngol. 2016 Mar 23;

Authors: Sergi B, Lucidi D, De Corso E, Paludetti G

Abstract
The use of "one-shot" CO2 laser technique for a primary small-fenestra stapedotomy is well established, but few papers report the long-term functional results. We retrospectively reviewed medical records of 198 patients, treated for otosclerosis from January 2008 to December 2011, at the Department of Head and Neck Surgery, Catholic University of Rome. Statistical comparison between audiological thresholds obtained 24 h preoperatively, at early (4 weeks) and late postoperative examinations (mean time 45 months), was performed. Comparison of preoperative vs both early and late postoperative ACPTA showed a statistically significant difference (respectively 55 vs 33 and 31 dB; p < 0.001). No statistical difference was observed between preoperative, early and late postoperative BCPTA (respectively 23 vs 23 and 22 dB; p > 0.05). Both early and late postoperative ABG improved significantly compared to the preoperative one (respectively 10 and 9 vs 32 dB; p < 0.001). No statistical difference was found in comparison of early vs late postoperative ACPTA (respectively 33 vs 31 dB; p > 0.05), early vs late postoperative ABG (respectively 10 vs 9 dB; p > 0.05) and early vs late ABG gain (respectively 22 vs 23 dB; p > 0.05). No subjects developed postoperative complications requiring revision surgery or late deterioration of hearing threshold. The analysis of our data suggests that "one-shot" CO2 laser stapedotomy is an effective and safe procedure: it allows a rapid stapedotomy without damages for the inner ear and optimal functional results that remain stable during the years.

PMID: 27007130 [PubMed - as supplied by publisher]

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A comprehensive 6-year retrospective study on medialisation thyroplasty in the Indian population.

A comprehensive 6-year retrospective study on medialisation thyroplasty in the Indian population.

Eur Arch Otorhinolaryngol. 2016 Mar 22;

Authors: Nerurkar NK, Pawar SM, Dighe SN

Abstract
The purpose of this paper is to describe a series of patients who have undergone medialisation thyroplasty (with or without arytenoid adduction) at our centre with respect to demographics, aetiology for unilateral vocal fold paralysis, pre- and postoperative maximum phonation time, amount of anterior and posterior medialisation required and complications. A comparative analysis with international studies was also performed. A retrospective analysis was performed on 67 patients, who underwent medialisation thyroplasty at our centre from August 2008 to August 2014. All the medialisation thyroplasty were performed using Netterville's technique. The average anterior medialisation needed was 2.25 mm (SD 1.05 mm) while the average posterior medialisation needed was 6.75 mm (SD 1.79 mm). Our study is the first to determine the amount of anterior and posterior medialisation needed in the Indian population. Mean anterior and posterior medialisation required was found to be the same, regardless of the age, gender of the patient and side of surgery.

PMID: 27002319 [PubMed - as supplied by publisher]

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Woodworkers and the inflammatory effects of softwood/hardwood dust: evidence from nasal cytology.

Woodworkers and the inflammatory effects of softwood/hardwood dust: evidence from nasal cytology.

Eur Arch Otorhinolaryngol. 2016 Mar 21;

Authors: Lovato A, Staffieri C, Ottaviano G, Cappellesso R, Giacomelli L, Bartolucci GB, Scapellato ML, Marioni G

Abstract
Our primary aim was to use nasal cytology to compare a group of woodworkers with a group of unexposed subjects to see whether wood dust exposure correlates with specific patterns of inflammatory or infectious rhinitis. A secondary aim was to seek any differences in nasal symptoms or nasal cytology between workers exposed to softwood vs hardwood dust, thereby comparing the inflammatory harmful potential of the two woods. Among 117 woodworkers at factories in the Veneto region (Italy), 40 exposed to either softwood or hardwood dust were assessed by means of a questionnaire, nasal cytology, and personal wood dust sampling, and compared with 40 unexposed controls. Woodworkers reported significantly more nasal symptoms than controls (p = 0.0007). The woodworker group's nasal smears contained significantly more neutrophils (p < 0.00001) and lymphocytes (p = 0.02) than the control group's. The softwood workers had significantly lower levels of personal exposure to wood dust than the hardwood workers (p = 0.04); there were no significant differences in age, history of cigarette smoking, or period of exposure between these two sub-cohorts of woodworkers. A statistical trend indicated that softwood workers had more eosinophils (p = 0.05) and lymphocytes (p = 0.05) in their rhinocytograms. Nasal cytology revealed chronic inflammatory rhinitis in a significant proportion of woodworkers' enroled in this study. It also suggested a different harmful potential for softwood and hardwood dust. Nasal cytology could prove useful in screening woodworkers for chronic inflammatory rhinitis. Further investigations are needed to examine the role of different types of wood dust in nasal inflammation.

PMID: 27001257 [PubMed - as supplied by publisher]

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Dizziness and vestibular function before and after cochlear implantation.

Dizziness and vestibular function before and after cochlear implantation.

Eur Arch Otorhinolaryngol. 2016 Mar 21;

Authors: Rah YC, Park JH, Park JH, Choi BY, Koo JW

Abstract
Vestibular problems after cochlear implantation (CI) were explored by categorizing them according to clinical course and changes in objective vestibular function. The changes in vestibular function of 62 patients (66 ears) were analyzed and vestibular symptoms were divided into three categories by their time course and nature. Etiologies were determined by analyzing the symptoms in combination with changes in objective vestibular function, measured using the caloric and/or video head impulse test. Before surgery, vestibular function was normal in 31 cases (47.0 %), unilaterally hypofunctional in 14 (21.2 %), and bilaterally hypofunctional in 21 (31.8 %). Eight cases (12.1 %) reported dizziness before surgery. A total of 18 cases (27.3 %) experienced postoperative dizziness. Ten patients experienced immediate transient dizziness (including 2 cases of benign positional paroxysmal vertigo); four experienced immediate prolonged dizziness (including 3 cases of bilateral vestibular hypofunction); and four experienced recurrent episodic dizziness (including 3 cases of suspicious endolymphatic hydrops). The sums of the maximal slow-phase velocities (SPVs) of the implanted ears were changed from 22.70 ± 17.31 to 12.55 ± 12.02°/s after implantation (p = 0.004) with very little changes in the other side (32.65 ± 24.85-31.40 ± 29.10°/s). Careful review of vestibular status is an important step, especially when deciding implantation in the only vestibular functioning ear or bilateral implantation.

PMID: 27001256 [PubMed - as supplied by publisher]

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A novel prognostic score model incorporating CDGSH Iron Sulfur Domain2 (CISD2) predicts risk of disease progression in laryngeal squamous cell carcinoma.

A novel prognostic score model incorporating CDGSH Iron Sulfur Domain2 (CISD2) predicts risk of disease progression in laryngeal squamous cell carcinoma.

Oncotarget. 2016 Mar 17;

Authors: Yang L, Hong S, Wang Y, He Z, Liang S, Chen H, He S, Wu S, Song L, Chen Y

Abstract
BACKGROUND: The role of CDGSH iron sulfur domain 2 (CISD2) in laryngeal squamous cell carcinoma (LSCC) remains unclear.
RESULTS: CISD2 were up-regulated in LSCC tissues compared with adjacent noncancerous tissues both at mRNA and protein levels. CISD2 was significantly correlated with T stage, lymph node metastasis, clinical stage and disease progression. A prognostic model (C-N model) for PFS was subsequently constructed based on independent prognostic factors including CISD2 and N classification. This model significantly divided LSCC patients into three risk subgroups and was more accurate than the prediction efficacy of TNM classification in the training cohort (C-index, 0.710 vs 0.602, P = 0.027) and validation cohort (C-index, 0.719 vs 0.578, P = 0.014).
METHODS: Real-time PCR and Western blotting were employed to examine the expression of CISD2 in eight fresh paired LSCC samples. Immunohistochemistry was performed to assess CISD2 expression in 490 paraffin-embedded archived LSCC samples. A prognostic model for progression-free survival (PFS) was built using independent factors. The concordance index (C-Index) was used to evaluate the prognostic ability of the model.
CONCLUSIONS: CISD2 was up-regulated in LSCC. The novel C-N model, which includes CISD2 levels and N classification, is more accurate than conventional TNM classification for predicting PFS in LSCC.

PMID: 27007153 [PubMed - as supplied by publisher]

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Collegium Oto-Rhino-Laryngologicum Amicitiae Sacrum.

Collegium Oto-Rhino-Laryngologicum Amicitiae Sacrum.

Acta Otolaryngol. 2016 Mar 21;:1

Authors:

PMID: 26999281 [PubMed - as supplied by publisher]

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The Effect of Otic Melanocyte Destruction on Auditory and Vestibular Function: a Study on Vitiligo Patients.

The Effect of Otic Melanocyte Destruction on Auditory and Vestibular Function: a Study on Vitiligo Patients.

Acta Med Iran. 2016 Feb;54(2):96-101

Authors: Mahdi P, Amali A, Ruzbahani M, Pourbakht A, Mahdavi A

Abstract
The hallmark of vitiligo is the disappearance of melanocytes from the skin. As a result, of melanocytes presence in the auditory and vestibular apparatus, the involvement of these systems in vitiligo which targets the melanocytes of the whole body is possible; suggesting that vitiligo is a systemic disease rather than a purely cutaneous problem. A total of 21 patients with vitiligo were enrolled in this study. A group of 20 healthy subjects served as a control group. Pure tone audiometry (PTA), auditory brainstem responses (ABR) and vestibular evoked myogenic potentials (VEMP) were carried out in all participants. High frequency sensory neural hearing loss was seen in 8 (38.09%) patients. ABR analysis revealed 10 (47.61%) had an abnormal increase in latency of wave III, and 6 (28.57%) had an abnormal prolongation of IPL I-III, however, regarding our VEMP findings, there were no recorded responses on left ear of 1 (4.76%) patient and latency of p13 was prolonged in 5(23.80%) patients. There was no correlation between ages, duration of disease, and any of the recorded parameters (P>0.05). In the present survey, we highlighted the auditory and vestibular involvement in vitiligo patients.

PMID: 26997595 [PubMed - in process]

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The relationship between senile hearing loss and vestibular activity.

The relationship between senile hearing loss and vestibular activity.

Braz J Otorhinolaryngol. 2016 Feb 28;

Authors: Kurtaran H, Acar B, Ocak E, Mirici E

Abstract
INTRODUCTION: A considerable high number of SNHL patients also suffer from dizziness and related vestibular symptoms.
OBJECTIVE: To evaluate the association of vestibular dysfunction and sensorineural hearing loss (SNHL) in adult patients.
METHODS: Prospective, double-blinded, controlled studies composed by 63 adult patients without any vestibular symptoms or diagnosed vestibular diseases. Audiological status was measured with pure tone audiometry and the vestibular system was tested with vestibular evoked myogenic potential (VEMP). Patients were divided into two groups: a study group (patients with SNHL) and a control group (patients without SNHL). VEMP results of the groups were calculated and compared.
RESULTS: Mean P1 (23.54) and N1 (30.70) latencies were prolonged in the study group (p<0.001) and the amplitudes of the study group were significantly reduced (p<0.001). Both parameters of the VEMP test were abnormal in the study group when compared to the control group.
CONCLUSIONS: These findings suggest that age-related SNHL may be accompanied by vestibular weakness without any possible predisposing factors for vestibulopathy.

PMID: 26997575 [PubMed - as supplied by publisher]

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Volumetric modulated arc radiotherapy of the whole larynx, followed by a single affected vocal cord, for T1a glottic cancer: Dosimetric analysis of a case.

Volumetric modulated arc radiotherapy of the whole larynx, followed by a single affected vocal cord, for T1a glottic cancer: Dosimetric analysis of a case.

Mol Clin Oncol. 2016 Mar;4(3):429-432

Authors: Yeo SG

Abstract
Radiation therapy (RT) and endolaryngeal surgery are standard treatments for early-stage glottic cancer. They have closely matched oncological outcomes; however, it is debatable which method is superior in terms of functional outcomes. Several dosimetric studies have demonstrated that, compared with conventional RT, intensity-modulated RT (IMRT) reduces unnecessary radiation of the adjacent normal tissues, including the carotid artery and thyroid gland. However, RT targets the whole larynx, whereas endolaryngeal surgery is a highly focused treatment involving the en bloc resection of a tumor with safety margins. For T1a glottic cancer, in which the tumor is limited to one vocal cord, the technical feasibility of targeting IMRT on the single vocal cord affected has been investigated; however, the clinical feasibility and the possibility of inferior local control remain to be elucidated. In the present case study, IMRT was used to treat the whole larynx first, and then to treat a single vocal cord. The patient in the present study had T1a glottic cancer, and received volumetric modulated arc therapy with a total dose of 63 Gy/28 fractions. The first treatment phase (40.5 Gy/18 fractions) targeted the whole larynx to eliminate subclinical disease. The second treatment phase (22.5 Gy/10 fractions) targeted only the involved vocal cord. During this treatment phase, the exposure of the non-involved right vocal cord, the right carotid artery and the thyroid gland to the radiation was lower compared with the continuation of the initial treatment approach. These findings suggested that changing the target volume from the whole larynx to the affected vocal cord during the course of IMRT is feasible for T1a glottic cancer, and that it may reduce functional side effects while maintaining oncological outcomes.

PMID: 26998298 [PubMed - as supplied by publisher]

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The postnatal ontogeny of the sexually dimorphic vocal apparatus in goitred gazelles (Gazella subgutturosa).

The postnatal ontogeny of the sexually dimorphic vocal apparatus in goitred gazelles (Gazella subgutturosa).

J Morphol. 2016 Mar 21;

Authors: Efremova KO, Frey R, Volodin IA, Fritsch G, Soldatova NV, Volodina EV

Abstract
This study quantitatively documents the progressive development of sexual dimorphism of the vocal organs along the ontogeny of the goitred gazelle (Gazella subgutturosa). The major, male-specific secondary sexual features, of vocal anatomy in goitred gazelle are an enlarged larynx and a marked laryngeal descent. These features appear to have evolved by sexual selection and may serve as a model for similar events in male humans. Sexual dimorphism of larynx size and larynx position in adult goitred gazelles is more pronounced than in humans, whereas the vocal anatomy of neonate goitred gazelles does not differ between sexes. This study examines the vocal anatomy of 19 (11 male, 8 female) goitred gazelle specimens across three age-classes, that is, neonates, subadults and mature adults. The postnatal ontogenetic development of the vocal organs up to their respective end states takes considerably longer in males than in females. Both sexes share the same features of vocal morphology but differences emerge in the course of ontogeny, ultimately resulting in the pronounced sexual dimorphism of the vocal apparatus in adults. The main differences comprise larynx size, vocal fold length, vocal tract length, and mobility of the larynx. The resilience of the thyrohyoid ligament and the pharynx, including the soft palate, and the length changes during contraction and relaxation of the extrinsic laryngeal muscles play a decisive role in the mobility of the larynx in both sexes but to substantially different degrees in adult females and males. Goitred gazelles are born with an undescended larynx and, therefore, larynx descent has to develop in the course of ontogeny. This might result from a trade-off between natural selection and sexual selection requiring a temporal separation of different laryngeal functions at birth and shortly after from those later in life. J. Morphol., 2016. © 2016 Wiley Periodicals, Inc.

PMID: 26997608 [PubMed - as supplied by publisher]

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Tracheo-bronchial soft tissue and cartilage resonances in the subglottal acoustic input impedance.

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Tracheo-bronchial soft tissue and cartilage resonances in the subglottal acoustic input impedance.

J Acoust Soc Am. 2015 Jun;137(6):3436-46

Authors: Lulich SM, Arsikere H

Abstract
This paper offers a re-evaluation of the mechanical properties of the tracheo-bronchial soft tissues and cartilage and uses a model to examine their effects on the subglottal acoustic input impedance. It is shown that the values for soft tissue elastance and cartilage viscosity typically used in models of subglottal acoustics during phonation are not accurate, and corrected values are proposed. The calculated subglottal acoustic input impedance using these corrected values reveals clusters of weak resonances due to soft tissues (SgT) and cartilage (SgC) lining the walls of the trachea and large bronchi, which can be observed empirically in subglottal acoustic spectra. The model predicts that individuals may exhibit SgT and SgC resonances to variable degrees, depending on a number of factors including tissue mechanical properties and the dimensions of the trachea and large bronchi. Potential implications for voice production and large pulmonary airway tissue diseases are also discussed.

PMID: 26093432 [PubMed - indexed for MEDLINE]

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The source-filter theory of whistle-like calls in marmosets: Acoustic analysis and simulation of helium-modulated voices.

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The source-filter theory of whistle-like calls in marmosets: Acoustic analysis and simulation of helium-modulated voices.

J Acoust Soc Am. 2015 Jun;137(6):3068-76

Authors: Koda H, Tokuda IT, Wakita M, Ito T, Nishimura T

Abstract
Whistle-like high-pitched "phee" calls are often used as long-distance vocal advertisements by small-bodied marmosets and tamarins in the dense forests of South America. While the source-filter theory proposes that vibration of the vocal fold is modified independently from the resonance of the supralaryngeal vocal tract (SVT) in human speech, a source-filter coupling that constrains the vibration frequency to SVT resonance effectively produces loud tonal sounds in some musical instruments. Here, a combined approach of acoustic analyses and simulation with helium-modulated voices was used to show that phee calls are produced principally with the same mechanism as in human speech. The animal keeps the fundamental frequency (f0) close to the first formant (F1) of the SVT, to amplify f0. Although f0 and F1 are primarily independent, the degree of their tuning can be strengthened further by a flexible source-filter interaction, the variable strength of which depends upon the cross-sectional area of the laryngeal cavity. The results highlight the evolutionary antiquity and universality of the source-filter model in primates, but the study can also explore the diversification of vocal physiology, including source-filter interaction and its anatomical basis in non-human primates.

PMID: 26093398 [PubMed - indexed for MEDLINE]

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Articulation and vocal tract acoustics at soprano subject's high fundamental frequencies.

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Articulation and vocal tract acoustics at soprano subject's high fundamental frequencies.

J Acoust Soc Am. 2015 May;137(5):2586-95

Authors: Echternach M, Birkholz P, Traser L, Flügge TV, Kamberger R, Burk F, Burdumy M, Richter B

Abstract
The role of the vocal tract for phonation at very high soprano fundamental frequencies (F0s) is not yet understood in detail. In this investigation, two experiments were carried out with a single professional high soprano subject. First, using two dimensional (2D) dynamic real-time magnetic resonance imaging (MRI) (24 fps) midsagittal and coronal vocal tract shapes were analyzed while the subject sang a scale from Bb5 (932 Hz) to G6 (1568 Hz). In a second experiment, volumetric vocal tract MRI data were recorded from sustained phonations (13 s) for the pitches C6 (1047 Hz) and G6 (1568 Hz). Formant frequencies were measured in physical models created by 3D printing, and calculated from area functions obtained from the 3D vocal tract shapes. The data showed that there were only minor modifications of the vocal tract shape. These changes involved a decrease of the piriform sinus as well as small changes of tongue position. Formant frequencies did not exhibit major differences between C6 and G6 for F1 and F3, respectively. Only F2 was slightly raised for G6. For G6, however, F2 is not excited by any voice source partial. Therefore, this investigation was not able to confirm that the analyzed professional soprano subject adjusted formants to voice source partials for the analyzed F0s.

PMID: 25994691 [PubMed - indexed for MEDLINE]

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Small intestinal injury in mice infected with respiratory influenza A virus: evidence for virus induced gastroenteritis.

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Small intestinal injury in mice infected with respiratory influenza A virus: evidence for virus induced gastroenteritis.

Biotechnol Lett. 2015 Aug;37(8):1585-92

Authors: Zhang S, Wei T, Tianv H, Cheng J, Xiao J, Wang M, Hu Y

Abstract
OBJECTIVES: Influenza in humans is often accompanied by gastroenteritis-like symptoms such as diarrhea and abdominal pain nausea, but the underlying mechanism remains unclear.
RESULTS: Mice infected with three subtypes of respiratory influenza A virus (IAV), particularly H5N1 and H7N2, developed intestinal injury. The avian H5N1 and H7N2 IAV were detected in the small intestine, whereas the human H1N1 was not detected. Section staining with the sialic acid (SA) receptor demonstrated that the small intestine mainly expressed SA α2, 3 Gal instead of SA α2, 6 Gal which preferentially binds to avian IAV. The number of goblet and sIgA cells in the small intestine increased, whereas CD4(+) and CD8(+) T cells decreased in all infected mice except for CD8(+) T cells increased in H7N2 infected mice.
CONCLUSIONS: Respiratory IAV infection, particularly infected by avian IAV, can cause small intestine structural damage and modify the local immune response, thereby resulting in gastroenteritis-like symptoms.

PMID: 25967033 [PubMed - indexed for MEDLINE]

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Investigation of nanostructural changes following acute injury using atomic force microscopy in rabbit vocal folds.

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Investigation of nanostructural changes following acute injury using atomic force microscopy in rabbit vocal folds.

Microsc Res Tech. 2015 Jul;78(7):569-76

Authors: Lee YC, Kim HJ, Kim KS, Choi S, Kim SW, Park HK, Eun YG

Abstract
There continues to be a paucity of data regarding the nanostructural changes of vocal fold (VF) collagen after injury. The aim of this study is to investigate the nanostructural and morphological changes in the rabbit VF lamina propria following acute injury using atomic force microscopy (AFM). Unilateral VF injury was performed on 9 New Zealand breeder rabbits. Sacrifice and laryngeal harvest were performed at three time points: 1 day, 3 days, and 7 days after injury. Histology and immunohistochemistry data were collected to confirm extracellular matrix (ECM) changes in rabbit VF. The progressive changes in thickness and D-spacing of VF collagen fibrils were investigated over a 7-day postinjury period using AFM. At post-injury day 1, a fibrin clot and inflammatory cell infiltration were observed at the injured VF. The inflammatory score at postinjury day 1 was highest in injured VF tissue, with a significant decrease at postinjury day 7. The immunoreactivity of inflammatory proteins (COX-2, TNF-α) was observed in VF up to day 7 after injury. AFM investigation showed clustered and disorganized collagen fibrils at the nanoscale resolution at post-injury day 7. Collagen fibrils in injured VF at postinjury day 7 were significantly thicker than control and postinjury days 1 and 3 (P < 0.001). D-spacing of collagen at postinjury day 7 was not studied due to loss of distinct edges resulting from immature collagen deposition. AFM investigation of VF could add valuable information to understanding micromechanical changes in VF scar tissue.

PMID: 25900427 [PubMed - indexed for MEDLINE]

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Elemental diet induces the proliferation of sialomucin goblet cells in the rat duodenum and jejunum.

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Elemental diet induces the proliferation of sialomucin goblet cells in the rat duodenum and jejunum.

Biosci Biotechnol Biochem. 2015;79(6):992-6

Authors: Hino S, Ito A, Kondo T, Morita T

Abstract
We histologically examined the effects of elemental diet (ED) on the goblet cell profile in the rat small intestine. The sulfomucin goblet cells were predominant throughout the small intestine in the control group, while sialomucin goblet cells were manifest in the duodenum and jejunum in the ED group. Next, we investigated the possible relevance of luminal osmolality to the goblet cell profile. Gastric osmolality in the ED group was within the physiological range. Meanwhile, ingestion of high glucose diet elevated gastric osmolality and increased the number of sialomucin goblet cells in the duodenum and jejunum. Further, it turned out that the lower sulfur contents in ED was not related to the unique goblet cell profile by ED ingestion. It is inductively suggested that the influx of high concentrations of low molecular nutrients into the small intestine could be associated with the goblet cell alteration, but the alteration was not necessarily due to the changes in the gastric osmolality by ED ingestion.

PMID: 25727739 [PubMed - indexed for MEDLINE]

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Puerarin and betahistine treatment of vertebrobasilar ischemia vertigo: A meta-analysis of randomized controlled trials.

Puerarin and betahistine treatment of vertebrobasilar ischemia vertigo: A meta-analysis of randomized controlled trials.

Exp Ther Med. 2016 Mar;11(3):1051-1058

Authors: Chen YY, Chen W, Zhang Q, Li H, Zhang YW, Kang Q, Lan YI, Wu Q

Abstract
The present meta-analysis aimed to evaluate the effectiveness and safety of puerarin co-treatment with betahistine in treating vertebrobasilar ischemia (VBI) vertigo. A total of 6 medical databases were searched, identifying randomized controlled trials (RCTs) of VBI vertigo performed until August 2014 that investigated a combined treatment of puerarin with betahistine or with other conventional drugs. The quality of the literature was evaluated using the Cochrane Collaboration's tool for assessing risk of bias, and Rev Man 5.0 software was used for statistical analysis and evaluation. The present study included 7 RCTs, involving a total of 664 subjects, and revealed a statistically significant increase in efficacy between the control and the experimental group (odds ratio [OR], 4.99; 95% confidence interval [CI], 3.05 to 8.15). The average blood flow velocity within the vertebrobasilar arteries increased following treatment with puerarin and betahistine compared with that of the control groups (OR, 7.59; 95% CI, 6.19 to 9.00); however, no difference was detected between these groups in the average flow velocity within the left vertebral artery (OR, 6.17; 95% CI, 5.22 to 7.13). The frequency of adverse reactions in the experimental group was lower (OR, 0.75; 95% CI, 0.32 to 1.77) compared with the control group. Combined puerarin and betahistine regimens were more effective in treating VBI vertigo compared with other, conventional drugs; effectively alleviating the associated symptoms, including dizziness and increased average blood flow velocity within the vertebrobasilar arteries, without causing an increased number of serious side effects. However, the efficacy and safety of puerarin and betahistine use in treating VBI vertigo requires additional investigation.

PMID: 26998036 [PubMed - as supplied by publisher]

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You're the Flight Surgeon: vestibular neuritis.

Related Articles

You're the Flight Surgeon: vestibular neuritis.

Aerosp Med Hum Perform. 2016 Feb;87(2):150-2

Authors: Brown MR

Abstract
Brown MR. You're the flight surgeon: vestibular neuritis. Aerosp Med Hum Perform. 2016; 87(2):150-152.

PMID: 26802384 [PubMed - indexed for MEDLINE]

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Collegium Oto-Rhino-Laryngologicum Amicitiae Sacrum.

Collegium Oto-Rhino-Laryngologicum Amicitiae Sacrum.

Acta Otolaryngol. 2016 Mar 21;:1

Authors:

PMID: 26999281 [PubMed - as supplied by publisher]

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How I do it: modified Todd's meatoplasty.

How I do it: modified Todd's meatoplasty.

J Laryngol Otol. 2016 Mar 21;:1-4

Authors: Elsamanody AN, Topsakal V, Grolman W, Tange RA

Abstract
BACKGROUND: Chronic otorrhoea after canal wall down mastoidectomy can be a clinical challenge. Basic principles for canal wall down surgery include establishing a large meatus. Several meatoplasty techniques have been reported. This paper describes this new indication for Todd's meatoplasty with surgical improvements.
STUDY DESIGN: Retrospective review.
SETTING: Academic tertiary referral centre.
METHODS: Modifications of transposition postauricular flap meatoplasty are reported. This technique was applied in a series of patients with chronic otorrhoea after a canal wall down mastoidectomy.
RESULTS: In general, a dry radical cavity was successfully created within six weeks and follow-up visits at the out-patient clinic were reduced. Only minor complications occurred, which are all reported.
CONCLUSION: The postauricular flap meatoplasty is a valuable tool in the management of chronic otorrhoea after an open cavity approach for cholesteatoma.

PMID: 26996631 [PubMed - as supplied by publisher]

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The Effect of Stimulus Intensity and Carrier Frequency on Auditory Middle- and Long-Latency Evoked Potentials Using a Steady-State-Response Approach

Purpose

The purpose of this study was to measure magnitude changes of auditory steady-state responses (ASSRs) and respective transient middle- and long-latency responses as a function of stimulus intensity and carrier frequency. The literature lacks clear consensus, including relationship to loudness.

Method

A cohort of 48 adults with normal hearing was examined from a companion study (Tlumak, Durrant, & Delgado, 2015) on effects of aging. ASSRs were elicited by repeated tone-burst stimuli presented at rates of 40 and 0.75 Hz at 3 frequencies and 5 levels of stimulus intensity. The design also permitted scrutiny of any gender bias to the results.

Results

Similar to derived transient response findings, ASSR magnitude (harmonic sum) systematically increased with intensity. Input–output function only at 0.75 Hz approximated a log–log linear function. However, slopes fell well below that of doubling of loudness per 10 dB SPL. Results failed to demonstrate significance as a function of carrier frequency and gender for both repetition rates.

Conclusion

Effects of stimulus intensity, carrier frequency, and gender on ASSRs were similar to those of their transient counterparts. Findings remain disappointing for objective loudness estimation. Results suggest only a clear linkage to the long-latency response and the 0.75-Hz magnitude but require careful consideration of limitations/underlying mechanisms when measuring loudness-related effects.

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Relating Hearing Aid Use to Social and Emotional Loneliness in Older Adults

Purpose

Hearing loss is a risk factor for social isolation and loneliness. We investigated the buffering effects of hearing aid use on perceived social and emotional loneliness.

Method

Forty older adults participated. Prior to and following the hearing aid fitting, participants completed the De Jong Gierveld Loneliness Scale (De Jong Gierveld & Kamphuis, 1985); a change in feelings of loneliness following hearing aid use was the outcome indicator.

Results

There was a significant decline in perceptions of loneliness following 4 to 6 weeks of hearing aid use. A dose effect emerged with persons with moderate-to-severe hearing loss experiencing the greatest reduction in perceived loneliness with hearing aid use.

Conclusion

Associated with poorer health status and higher consumption of health care services, perceived loneliness is a challenge to treat. Hearing aid use appears to be a buffer against the experience of loneliness.

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Relapsing polychondritis and lymphocytic meningitis with varied neurological symptoms.

Relapsing polychondritis and lymphocytic meningitis with varied neurological symptoms.

Rev Bras Reumatol. 2016 Feb 5;

Authors: Ducci RD, Germiniani FM, Czecko LE, Paiva ES, Teive HA

Abstract
BACKGROUND: Relapsing polychondritis is a rare multisystem disease characterized by bilateral auricular and nasal chondritis and vestibular involvement, additionally affecting various other organs/systems. However, Central Nervous System involvement has only been reported in a few instances.
OBJECTIVE: To report the case of a patient with relapsing polychondritis and several neurological manifestations.
CASE REPORT: We report the case of a 69 year-old male with a 20-day history of ataxia, paraparesis, tinnitus, vertigo and confusion. Two months prior to his admission he started with bilateral auricular chondritis and arthritis of metacarpophalangeal joints and ankles. He had been previously seen at another hospital, where he had been treated for herpetic encephalitis, with improvement of confusion. On examination he had nystagmus, rigidity of upper limbs, paraparesis, absent reflexes, tactile hypoesthesia, dysmetric movements, gross postural and action tremor, bradykinesia and truncal ataxia. He also had swelling and a purplish erythema of both ear lobes and arthritis in the metacarpophalangeal joints of the right hand. Brain and cervical MRI disclosed a mild thickening of the dura. A lumbar puncture confirmed the presence of elevated leukocytes and laboratory exams disclosed augmented inflammatory activity. A diagnosis of relapsing polychondritis was made based on the association of chondritis, arthritis and vestibular ataxia with predominant neurological symptoms. Following a course of Prednisone 1mg/kg/d there was major improvement of chondritis, arthritis, ataxia and paraparesis, but the tremor remained unchanged.
CONCLUSION: Relapsing polychondritis is a challenging disease that can rarely manifest with varied neurological symptoms; recognition is extremely important, because high-dose corticosteroids should be used as soon as possible in suspected cases.

PMID: 26995500 [PubMed - as supplied by publisher]

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Surgical treatment of substernal goiter: An analysis of 44 cases.

Surgical treatment of substernal goiter: An analysis of 44 cases.

Auris Nasus Larynx. 2016 Mar 16;

Authors: Nakaya M, Ito A, Mori A, Oka M, Omura S, Kida W, Inayoshi Y, Inoue A, Fuchigami T

Abstract
OBJECTIVE: Substernal goiters are classified as primary or secondary intrathoracic goiters. Here, we report the diagnosis, symptoms, treatment, and postoperative complications of 44 substernal goiters (2 primary mediastinal goiter and 42 secondary mediastinal goiters).
METHODS: A retrospective chart review of 351 patients undergoing thyroidectomy at the Department of Otolaryngology-Head and Neck Surgery of the Tokyo Metropolitan Tama Medical Center. Between 2009 and 2015, 44 patients underwent surgery for substernal goiter.
RESULTS: The frequency of primary and secondary mediastinal goiters was 0.5% and 11.9%, respectively. The preoperative symptoms were neck mass, dyspnea, and dysphagia. Eight patients were asymptomatic. Thirty-nine patients had benign masses and 5 patients had malignant masses. Most patients were operated on for adenomatous goiters (52.2%). In ten cases beyond the aortic arch, the tumors were benign and there were eight cases of adenomatous goiter. All patients underwent a successful transcervical incision without sternotomy. Even the primary intrathoracic goiters were extracted after total thyroidectomy via the cervical approach without complications. Although one case showed unilateral recurrent nerve paralysis as a postoperative complication, phonetic function improved in 6 postoperative months. No instances of postoperative bleeding or definitive hypoparathyroidism occurred, and tracheostomy was not performed in any of the cases.
CONCLUSION: The cervical approach was safely performed in almost all substernal goiters without an extracervical procedure. Selected cases of primary mediastinal goiter may be excised via the cervical approach.

PMID: 26995097 [PubMed - as supplied by publisher]

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Clinical Challenge: An Orbital Hickam's Dictum.

Clinical Challenge: An Orbital Hickam's Dictum.

Surv Ophthalmol. 2016 Mar 16;

Authors: Wilson ME, Thornton S, Murchison AP, Bilyk JR

Abstract
A 53-year old man with hyperthyroidism presented with asymmetric proptosis and diplopia. Thyroid stimulating immunoglobulin was elevated, suggesting active thyroid eye disease (TED). Imaging of the orbits revealed enlargement of the extraocular muscles including irregular enlargement of the left lateral rectus muscle. Biopsy of the lateral rectus muscle demonstrated infiltration of the muscle with Bcl-2 positive B lymphocytes, consistent with chronic lymphocytic leukemia (CLL). Evaluation for systemic lymphoproliferative disease was negative. The patient was treated with orbital radiotherapy at specific dosages for both TED and CLL. He responded well to therapy with a reduction in proptosis and diplopia, and no evidence of recurrent CLL.

PMID: 26994869 [PubMed - as supplied by publisher]

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Structural and functional changes of cortical and subcortical structures following peripheral vestibular damage in humans.

Structural and functional changes of cortical and subcortical structures following peripheral vestibular damage in humans.

Eur Arch Otorhinolaryngol. 2016 Mar 19;

Authors: Maxime M, Philippe F, Landry SP, François C, Saliba I

PMID: 26994901 [PubMed - as supplied by publisher]

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Feasibility of injectable thermoreversible gels for use in intramuscular injection of parathyroid autotransplantation.

Feasibility of injectable thermoreversible gels for use in intramuscular injection of parathyroid autotransplantation.

Eur Arch Otorhinolaryngol. 2016 Mar 19;

Authors: Park HS, Jung SY, Kim HY, Ko DY, Chung SM, Jeong B, Kim HS

Abstract
Surgical transplantation of parathyroid tissue into the forearm muscle is one of the most commonly used surgical techniques. While simple, the procedure suffers from drawbacks. This study evaluated the feasibility of thermoreversible gel as an injectable carrier for parathyroid autotransplantation. Polyethyleneglycol-polyalanine-co-phenylalanine (PEG-PAF) thermoreversible gel (sol form at 4 °C, gel form at 37 °C) were manufactured. Thirty-eight Sprague-Dawley rats were divided into two groups (19 control, C group; 19 experimental, P group). The parathyroid glands of rats were excised. Parathyroid tissues were transplanted into the muscle pocket in sternocleidomastoid muscle in the C group. In the P group, the tissues were injected into the same muscle mixed with 0.3 ml thermoreversible gel. The serum levels of parathyroid hormone (PTH), ionized calcium, and phosphorous were measured before surgical procedure, on 7, 21, 56, and 70 days after surgery. Histology and immunohistochemistry were performed. Preoperative median PTH level of the C and the P group were 60.80 and 43.85 pg/ml, respectively (p = 0.641). Seventy days after surgery, median PTH level was 32.8 and 25.61 pg/ml, respectively. On day 70, the PTH level was restored by 54 % in the C group and 56 % in the P group compared to the preoperative value (p = 0.620). There were no significant intergroup differences in the ionized calcium/phosphorous level. Histology and immunohistochemistry revealed the successful transplantation of parathyroid tissues into the muscles in both groups. In conclusion, the PEG-PAF-based thermoreversible gel is a good candidate carrier material for intramuscular parathyroid autotransplantation.

PMID: 26994900 [PubMed - as supplied by publisher]

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Ultrasound visual feedback in articulation therapy following partial glossectomy.

Ultrasound visual feedback in articulation therapy following partial glossectomy.

J Commun Disord. 2016 Mar 2;61:1-15

Authors: Blyth KM, Mccabe P, Madill C, Ballard KJ

Abstract
Disordered speech is common following treatment for tongue cancer, however there is insufficient high quality evidence to guide clinical decision making about treatment. This study investigated use of ultrasound tongue imaging as a visual feedback tool to guide tongue placement during articulation therapy with two participants following partial glossectomy. A Phase I multiple baseline design across behaviors was used to investigate therapeutic effect of ultrasound visual feedback during speech rehabilitation. Percent consonants correct and speech intelligibility at sentence level were used to measure acquisition, generalization and maintenance of speech skills for treated and untreated related phonemes, while unrelated phonemes were tested to demonstrate experimental control. Swallowing and oromotor measures were also taken to monitor change. Sentence intelligibility was not a sensitive measure of speech change, but both participants demonstrated significant change in percent consonants correct for treated phonemes. One participant also demonstrated generalization to non-treated phonemes. Control phonemes along with swallow and oromotor measures remained stable throughout the study. This study establishes therapeutic benefit of ultrasound visual feedback in speech rehabilitation following partial glossectomy.
LEARNING OUTCOMES: Readers will be able to explain why and how tongue cancer surgery impacts on articulation precision. Readers will also be able to explain the acquisition, generalization and maintenance effects in the study.

PMID: 26994583 [PubMed - as supplied by publisher]

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Surgical treatment for childhood obstructive sleep apnoea: Cold-knife tonsillar dissection versus bipolar radiofrequency thermal ablation.

Surgical treatment for childhood obstructive sleep apnoea: Cold-knife tonsillar dissection versus bipolar radiofrequency thermal ablation.

Acta Otorrinolaringol Esp. 2016 Mar 15;

Authors: Esteller E, Villatoro JC, Pedemonte G, Agüero A, Ademà JM, Girabent-Farrés M

Abstract
INTRODUCTION AND OBJECTIVE: Adenotonsillectomy for treatment of childhood obstructive sleep apnoea is effective. The uncomfortable postoperative period and possible complications have significantly increased the use of partial techniques, seeking to improve these aspects while achieving the same results in resolving sleep apnoea. The aim was to present the experience with 2 consecutive groups of patients, comparing total tonsillectomy to bipolar radiofrequency ablation (RFA).
METHOD: A group of 96 children that underwent total tonsilloadenoidectomy using cold dissection were compared to another group of 101 children that underwent RFA. In all cases, polysomnography was performed before and 1 year after surgery. The percentage of cases with persistent disease (apnea-hypopnea index ≥ 3) and the improvement of clinical symptoms at one year were evaluated. The percentages of surgical and anaesthetic complications in both groups were also compared.
RESULT: The persistence of the syndrome was comparable in both groups: 25% in the cold dissection and 22.77% in the radiofrequency ablation group. Anaesthetic complications (5% in the group where cold dissection was used and 4.2% in the radiofrequency ablation group) and postoperative bleeding rates were very low and statistically comparable with both techniques.
CONCLUSION: In the treatment of childhood obstructive sleep apnoea syndrome, both extracapsular surgery using cold scalpel and bipolar radiofrequency tunnelling techniques are safe. Likewise, results as to resolution of the syndrome show no statistically significant differences.

PMID: 26992775 [PubMed - as supplied by publisher]

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Aging and Hearing Health: The Life-course Approach.

Aging and Hearing Health: The Life-course Approach.

Gerontologist. 2016 Apr;56(Suppl 2):S256-S267

Authors: Davis A, McMahon CM, Pichora-Fuller KM, Russ S, Lin F, Olusanya BO, Chadha S, Tremblay KL

Abstract
Sensory abilities decline with age. More than 5% of the world's population, approximately 360 million people, have disabling hearing loss. In adults, disabling hearing loss is defined by thresholds greater than 40 dBHL in the better hearing ear.Hearing disability is an important issue in geriatric medicine because it is associated with numerous health issues, including accelerated cognitive decline, depression, increased risk of dementia, poorer balance, falls, hospitalizations, and early mortality. There are also social implications, such as reduced communication function, social isolation, loss of autonomy, impaired driving ability, and financial decline. Furthermore, the onset of hearing loss is gradual and subtle, first affecting the detection of high-pitched sounds and with difficulty understanding speech in noisy but not in quiet environments. Consequently, delays in recognizing and seeking help for hearing difficulties are common. Age-related hearing loss has no known cure, and technologies (hearing aids, cochlear implants, and assistive devices) improve thresholds but do not restore hearing to normal. Therefore, health care for persons with hearing loss and people within their communication circles requires education and counseling (e.g., increasing knowledge, changing attitudes, and reducing stigma), behavior change (e.g., adapting communication strategies), and environmental modifications (e.g., reducing noise). In this article, we consider the causes, consequences, and magnitude of hearing loss from a life-course perspective. We examine the concept of "hearing health," how to achieve it, and implications for policy and practice.

PMID: 26994265 [PubMed - as supplied by publisher]

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A Genomic Alternative to Preoperatively Identify Medullary Thyroid Cancer in Thyroid Nodules with Indeterminate Cytology.

A Genomic Alternative to Preoperatively Identify Medullary Thyroid Cancer in Thyroid Nodules with Indeterminate Cytology.

Thyroid. 2016 Mar 18;

Authors: Kloos RT, Monroe RJ, Traweek ST, Lanman RB, Kennedy GC

Abstract
BACKGROUND: The use of calcitonin screening for the rare medullary thyroid cancer (MTC) is controversial due to questions of efficacy, accuracy, and cost-effectiveness. We report the results of a large prospective validation using a machine-trained algorithm (MTC Classifier) to pre-operatively identify MTC in fine-needle aspiration biopsies in lieu of calcitonin measurements.
METHODS: Cytology analysis on a prospective consecutive series of 50,430 thyroid nodule biopsies yielded a total of 7,815 indeterminate (Bethesda categories III/IV) cases which were tested with the MTC classifier. A prospective, consecutively submitted series of 2,673 Bethesda III-VI cases with cytology determined locally was also evaluated. RNA was isolated and tested for the MTC Classifier using microarrays.
RESULTS: Forty-three cases were positive by the MTC Classifier among 10,488 tested nodules (0.4%), consistent with the low prevalence of MTC. Of these, all but one was histologically or biochemically confirmed as MTC, yielding a positive predictive value (PPV) of 98%. Of the positive cases, only 19 (44%) had been specifically suspected of MTC by cytology, highlighting the limitations of light microscopy to detect this disease. Three surgically confirmed MTC cases that were detected by the MTC Classifier had low basal serum calcitonin values, indicating these would have been missed by traditional calcitonin screening methods. A pooled analysis of 3 independent validation sets demonstrates high test sensitivity (97.9%), specificity (99.8%), PPV (97.9%), and negative predictive value (99.8%).
CONCLUSIONS: We propose a clinical paradigm whereby cytologically indeterminate thyroid nodules being tested for common malignancies using gene expression can be simultaneously tested for MTC using the same genomic assay, at no added cost.

PMID: 26992356 [PubMed - as supplied by publisher]

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Middle ear capillary haemangioma: Review of literature and appraisal of management options.

Middle ear capillary haemangioma: Review of literature and appraisal of management options.

Auris Nasus Larynx. 2016 Mar 15;

Authors: Salamat AA, Casselden E, Theaker J, Batty V, Thomas S

Abstract
Infantile middle ear capillary haemangiomas (MECH) are a rare entity with only five reported cases in the literature. At present there is no consensus regarding the management of such lesions. Extra-cutaneous haemangiomas have been successfully managed with oral propranolol but not yet reported in MECH. We present a further case and appraise the management options. At present oral propranolol has not been used in the treatment of MECH. The literature suggests that infantile MECH have a higher propensity to spontaneously involute and a greater likelihood of response to propranolol. Surgical excision is the best option in older children and adults.

PMID: 26992272 [PubMed - as supplied by publisher]

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Randomized trial of standard pain control with or without gabapentin for pain related to radiation-induced mucositis in head and neck cancer.

Randomized trial of standard pain control with or without gabapentin for pain related to radiation-induced mucositis in head and neck cancer.

Auris Nasus Larynx. 2016 Mar 15;

Authors: Kataoka T, Kiyota N, Shimada T, Funakoshi Y, Chayahara N, Toyoda M, Fujiwara Y, Nibu KI, Komori T, Sasaki R, Mukohara T, Minami H

Abstract
OBJECTIVE: Radiation-induced mucositis (RIM) in chemoradiotherapy (CRT) for head and neck cancer (HNC) causes severe pain and worsens CRT compliance, QOL and outcome. Following retrospective reports, we conducted a randomized trial of the safety and efficacy of gabapentin for RIM-associated pain during CRT.
METHODS: HNC patients (pts) receiving CRT were randomized to standard pain control (SPC) with acetaminophen and opioids, or SPC plus gabapentin (SPC+G). Gabapentin was maintained at 900mg/day for 4 weeks after CRT. Primary endpoint was maximum visual analogue scale (VAS) score during CRT, and secondary endpoints were total opioid dose, changes in QOL (EORTC QLQ-C30 and QLQ-HN 35) from baseline to 4 weeks after CRT, and adverse events.
RESULTS: Twenty-two eligible Stage III or IV pts were randomly assigned to SPC or SPC+G (n=11 each). Twelve were treated in a locally advanced setting and 10 in a postoperative setting. Median maximum VAS scores, median total dose of opioids at maximum VAS and total dose of opioids at 4 weeks after CRT tended to be higher in the SPC+G arm (47 in SPC vs. 74 in SPC+G, p=0.517; 215mg vs. 745.3mg, p=0.880; and 1260mg vs. 1537.5mg, p=0.9438, respectively), without significance. QOL analysis showed significantly worse scores in the SPC+G arm for weight gain (p=0.005). Adverse events related to gabapentin were manageable.
CONCLUSIONS: This pilot study is the first prospective randomized trial of gabapentin for RIM-related pain. Gabapentin had no apparent beneficial effect. Further research into agents for RIM-related pain is warranted.

PMID: 26992271 [PubMed - as supplied by publisher]

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Treatment in elderly patients with head and neck cancer : A challenging dilemma.

Treatment in elderly patients with head and neck cancer : A challenging dilemma.

HNO. 2016 Mar 18;

Authors: Teymoortash A, Ferlito A, Halmos GB

Abstract
Despite the increasing number of elderly patients requiring treatment for head and neck cancer, there is insufficient available evidence about the oncological results of treatment and its tolerability in such patients. Owing to comorbidities, elderly patients often need complex evaluation and pretreatment management, which often results in their exclusion from clinical trials. The question of which patients constitute the highest-risk groups regarding treatment-related morbidity and mortality, and who can tolerate and benefit from aggressive treatment, has not been adequately studied. Biologic rather than chronologic age should be a more important factor in treatment protocols. Age-specific prospective clinical studies are needed on the treatment of head and neck cancer in elderly patients.

PMID: 26992385 [PubMed - as supplied by publisher]

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[Hydropic inner ear disease of the vestibular type].

[Hydropic inner ear disease of the vestibular type].

HNO. 2016 Mar 18;

Authors: Volgger V, Krause E, Ertl-Wagner B, Gürkov R

Abstract
We report the case of a patient with episodic rotational vertigo for years. Ear symptoms were negated. The clinical diagnosis was not clear - Menière's disease, vestibular migraine and recurrent vertigo after vestibular neuritis all qualified for differential diagnoses. A locally enhanced inner-ear MRI established clarity by showing an endolymphatic hydrops in the vestibulum. Besides the classical triad of Menière's disease there are other clinical appearances of endolymphatic hydrops, which can be visualized with inner-ear MRI.

PMID: 26992384 [PubMed - as supplied by publisher]

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[Is (chemo)radiotherapy really the future standard in the treatment of oropharyngeal carcinoma?]

[Is (chemo)radiotherapy really the future standard in the treatment of oropharyngeal carcinoma?]

HNO. 2016 Mar 18;

Authors: Knecht R, Bussmann L, Möckelmann N, Lörincz BB

Abstract
Treatment of patients with oropharyngeal squamous cell carcinoma (OPSCC) requires interdisciplinary collaboration. Besides oncologic control, organ and function preservation are important priorities. One treatment option is primary concomitant chemoradiotherapy (CRT), particularly for locally advanced head and neck cancer. Another option is sequential CRT, where induction chemotherapy may be followed either by radiation alone or by CRT. An important aspect of these modalities is the development of functional sequelae with regards to swallowing as a direct consequence of radiogenic fibrosis, as well as tissue ctoxicity associated with cisplatin-based chemotherapy. Conventional open surgical approaches are being increasingly replaced by transoral surgical modalities with less treatment-related morbidity. As a further, equally important goal of appropriately indicated surgery, adjuvant (C)RT may be omitted or the dose significantly reduced. The advantages of primary surgery over primary CRT may be less obvious in cases still requiring adjuvant treatment, although not necessarily completely eliminated. For patients with human papillomavirus (HPV)-driven OPSCC, it is important to note that primary surgery may provide comparable or even increased survival benefit. To date, there is no evidence for a clear advantage of primary CRT over primary surgery in this group. In these cases, a de-escalated treatment package may be the preferred option. Here, the application of radioimmunotherapy as well as a reduced radiation dose may minimize long-term treatment-related morbidities.

PMID: 26992383 [PubMed - as supplied by publisher]

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[Malignant intraorbital tumor: Primary tumor or metastasis?]

[Malignant intraorbital tumor: Primary tumor or metastasis?]

HNO. 2016 Mar 18;

Authors: Pausch NC, Sterker I, Bauer U

PMID: 26992382 [PubMed - as supplied by publisher]

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Optimisation of the round window opening in cochlear implant surgery in wet and dry conditions: impact on intracochlear pressure changes.

Optimisation of the round window opening in cochlear implant surgery in wet and dry conditions: impact on intracochlear pressure changes.

Eur Arch Otorhinolaryngol. 2016 Mar 18;

Authors: Mittmann P, Ernst A, Mittmann M, Todt I

Abstract
To preserve residual hearing in cochlear implant candidates, the atraumatic insertion of the cochlea electrode has become a focus of cochlea implant research. In a previous study, intracochlear pressure changes during the opening of the round window membrane were investigated. In the current study, intracochlear pressure changes during opening of the round window membrane under dry and transfluid conditions were investigated. Round window openings were performed in an artificial cochlear model. Intracochlear pressure changes were measured using a micro-optical pressure sensor, which was placed in the apex. Openings of the round window membrane were performed under dry and wet conditions using a cannula and a diode laser. Statistically significant differences in the intracochlear pressure changes were seen between the different methods used for opening of the round window membrane. Lower pressure changes were seen by opening the round window membrane with the diode laser than with the cannula. A significant difference was seen between the dry and wet conditions. The atraumatic approach to the cochlea is assumed to be essential for the preservation of residual hearing. Opening of the round window under wet conditions produce a significant advantage on intracochlear pressure changes in comparison to dry conditions by limiting negative outward pressure.

PMID: 26993657 [PubMed - as supplied by publisher]

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Clinical impact of malnutrition on complication rate and length of stay in elective ENT patients: a prospective cohort study.

Clinical impact of malnutrition on complication rate and length of stay in elective ENT patients: a prospective cohort study.

Eur Arch Otorhinolaryngol. 2016 Mar 18;

Authors: Kisser U, Kufeldt J, Adderson-Kisser C, Becker S, Baumeister P, Reiter M, Harréus U, Thomas MN, Rittler P

Abstract
Malnutrition is considered as an independent risk factor for morbidity, mortality and a prolonged hospital stay for in-hospital patients. While most available data on the impact of malnutrition on health-related and financial implications refer to gastroenterologic or abdominal surgery patients, little is known about the impact of malnutrition on Ear Nose Throat (ENT)/head and neck surgery patients. The objective of this study was to investigate the impact of malnutrition on morbidity and length of hospital stay in an elective ENT/head and neck surgery patient cohort. The study was performed as a single-center, prospective cohort study at a tertiary referral centre. Nutritional risk at admission was assessed using the NRS-2002 screening tool. Multivariate regression models were used to determine independent risk factors for complications and a prolonged hospitalization. Three hundred fifty one participants were included in the study. A malignant disease was found in 62 participants (17.7 %). 62 patients (17.7 %) were at a moderate to severe risk of malnutrition. A bad general health condition and complications during hospital stay could be identified as independent risk factors for a prolonged hospitalization. Patients with a malignant tumor showed a more than fourfold higher risk of developing at least one complication. Malnutrition, however, was not statistically associated with a higher complication rate or a prolonged hospital stay. Our data suggests that malnutrition does not seem to play such an important role as a risk factor for complications and a prolonged hospital stay in ENT patients as it does in other disciplines like abdominal surgery or gastroenterology.

PMID: 26993656 [PubMed - as supplied by publisher]

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Expansion sphincter pharyngoplasty for obstructive sleep apnea: an update to the recent meta-analysis.

Expansion sphincter pharyngoplasty for obstructive sleep apnea: an update to the recent meta-analysis.

Eur Arch Otorhinolaryngol. 2016 Mar 18;

Authors: Camacho M, Zaghi S, Piccin O, Certal V

PMID: 26993655 [PubMed - as supplied by publisher]

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