Bronchipret® syrup containing thyme and ivy extracts suppresses bronchoalveolar inflammation and goblet cell hyperplasia in experimental bronchoalveolitis.

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Bronchipret® syrup containing thyme and ivy extracts suppresses bronchoalveolar inflammation and goblet cell hyperplasia in experimental bronchoalveolitis.

Phytomedicine. 2015 Dec 1;22(13):1172-7

Authors: Seibel J, Pergola C, Werz O, Kryshen K, Wosikowski K, Lehner MD, Haunschild J

Abstract
BACKGROUND/PURPOSE: Acute bronchitis (AB) is a common lung condition characterized by inflammation of the large bronchi in response to infection. Bronchipret(®) syrup (BRO), a fixed combination of thyme and ivy extracts has been effectively used for the treatment of AB. Combining in vivo and mechanistic in vitro studies we aimed to provide a better understanding of the therapeutic potential of BRO on key aspects of AB and to identify potential mechanisms of action.
METHODS: Bronchoalveolitis in rats was induced by intratracheal LPS instillation. BRO was administered p.o. once daily at 1- to 10-fold equivalents of the human daily dose. Animals were sacrificed 24-72 h post LPS challenge to analyze leukocyte numbers in lung tissue, bronchoalveolar lavage fluid (BALF) and blood as well as goblet cells in bronchial epithelium. Inhibitory effects of BRO analogue on leukotriene (LT) production were determined in human neutrophils and monocytes as well as on isolated 5-lipoxygenase (5-LO).
RESULTS: BRO significantly reversed the LPS-induced increase in leukocyte numbers in lung tissue, BALF and blood as well as goblet cell numbers in bronchial epithelium. In vitro, BRO analogue suppressed cellular release of LTB4 (IC50 = 36 µg⋅ml(-1)) and cysLT (IC50 = 10 µg⋅ml(-1)) and inhibited the activity of isolated 5-LO (IC50 = 19 µg⋅ml(-1)).
CONCLUSION: BRO exerts significant anti-inflammatory effects and attenuates goblet cell metaplasia in LPS-induced bronchoalveolitis in vivo potentially via interference with 5-LO/LT signaling. These effects may contribute to its observed clinical efficacy in AB.

PMID: 26598916 [PubMed - indexed for MEDLINE]

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[A rare and unusual cause of dysphonia: The leech].

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[A rare and unusual cause of dysphonia: The leech].

Rev Laryngol Otol Rhinol (Bord). 2014;135(2):105-6

Authors: Abou-Elfadl M, Abada RL, Rouadi S, Mahtar M, Roubal M, Essaadi M, Janah A, Kadiri F

Abstract
We report a case of dysphonia associated with intermittent episodes of hemoptysis low abundance in a patient aged 32, clinical examination is normal, nasofibroscopie objective a leech at the laryngeal orifice, extracted by direct laryngoscopy in emergency.

PMID: 26521350 [PubMed - indexed for MEDLINE]

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Early evaluation of voice quality in glottic cancer (T1, T2) following curative radiotherapy.

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Early evaluation of voice quality in glottic cancer (T1, T2) following curative radiotherapy.

Rev Laryngol Otol Rhinol (Bord). 2014;135(2):91-6

Authors: Tripathi N, Verma RK, Panda NK, Ghosal S, Sharma A

Abstract
BACKGROUND: This is prospective study analyzing the subjective and objective quality of voice and voice related quality of life in patients of early glottic cancer (T1, T2 disease) before and after receiving curative radiotherapy.
METHODS: Fifteen patients of early glottic carcinoma (T1, T2) underwent voice assessment using multidimensional voice protocol based on recommendation by European Laryngological Society which included Perceptual analysis of voice by speech therapist and otolaryngologist, acoustic analysis; aerodynamic efficiency analysis-Maximum phonation time; patient's self perception of voice analysis--Voice handicap index; and videolaryngostroboscopy. Assessment was done prior to commencement of radiation therapy and at 1 month and 3 months following radio- therapy.
RESULTS: There was significant improvement in majority of the voice parameters post radiotherapy. Perceptual analysis showed significant improvement in GRBAS score following radiotherapy. Perturbation measures (jitter, shimmer, SNR, HNR) showed improvement post radiotherapy though remained inferior compared to controls. Mean fundamental frequency (Mean F0) and habitual frequency (habitual F0) decreased post radiotherapy. Intensity of voice increased following radiotherapy which was statistically significant (p < 0.05). There was significant improvement in the patient's perception of their quality of voice and voice related quality of life post radiotherapy. Maximum phonation time showed statistically significant improvement post-radiotherapy. Perceptual analysis of voice by professional observer correlated well with patients self perception of his own voice.
CONCLUSION: Voice quality improves following radiotherapy but not all the patients regain normal voice. Improvement in voice quality improves quality of life of patients shown by improved voice handicap index.

PMID: 26521348 [PubMed - indexed for MEDLINE]

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Trans-ciliary minimally invasive keyhole craniotomy for skull base and vascular lesions.

Trans-ciliary minimally invasive keyhole craniotomy for skull base and vascular lesions.

J Neurosci Rural Pract. 2015 Oct-Dec;6(4):636-638

Authors: Kumar VR, Madhugiri VS, Ramesh AS, Yadav AK

PMID: 26752926 [PubMed - as supplied by publisher]

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Frontal sinus surgery and sinus distribution of nasal irrigation.

Frontal sinus surgery and sinus distribution of nasal irrigation.

Int Forum Allergy Rhinol. 2016 Jan 11;

Authors: Barham HP, Ramakrishnan VR, Knisely A, Do TQ, Chan LS, Gunaratne DA, Weston JD, Seneviratne S, Marcells GN, Sacks R, Harvey RJ

Abstract
BACKGROUND: Effective mucus lavage and delivery of topical pharmaceuticals are central to successful management of chronic rhinosinusitis (CRS). The frontal sinus remains difficult to penetrate with topical therapies. This study evaluates the benefit of Draf III frontal dissection compared to traditional Draf IIa for distribution of topical therapies.
METHODS: Fresh human cadaver heads were dissected sequentially with Draf IIa frontal sinusotomy and then Draf III procedures. Each cavity was irrigated with pediatric (120 mL) and adult (240 mL) irrigation bottles with 1/1000 10% fluorescein-labeled free water in 2 fixed positions (vertex and Frankfort horizontal). An endoscope at a fixed position within the frontal sinus recorded frontal sinus and frontal recess penetration. The images then underwent blinded evaluation of fluid distribution scored as 0 to 4 (nasal cavity only, frontal recess, medial one-half, lateral one-half, and lavage). Ordinal distribution score was analyzed with Kendall's tau-b.
RESULTS: Eight specimens (age 76 ± 11.2 years; 50% female) were assessed. Draf III was superior to Draf IIa in ability to achieve frontal sinus distribution of irrigation (90.6% vs 50.1%, p < 0.001). Vertex head position improved distribution (90.6% vs 50.1%, p < 0.001), was synergistic with Draf III (100% with 87.5% lavage, p < 0.001), but was unable to overcome Draf IIa (81.2% with 25% lavage, p < 0.001). Irrigation volume trended toward improved distribution with larger volume irrigations.
CONCLUSION: Successful treatment of sinonasal disease may require postoperative delivery of topical therapies. Draf III frontal sinusotomy achieves superior topical access, and access to the frontal sinus with Draf IIa appears limited, despite large volumes and positioning.

PMID: 26750306 [PubMed - as supplied by publisher]

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

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

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

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

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

PMID: 26749605 [PubMed - in process]

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Quantitative Study of Posterior Fossa Crowdedness in Hemifacial Spasm.

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Quantitative Study of Posterior Fossa Crowdedness in Hemifacial Spasm.

World Neurosurg. 2015 Oct;84(4):920-6

Authors: Cheng J, Fang Y, Zhang H, Lei D, Wu W, You C, Mao B, Mao K

Abstract
OBJECTIVE: To quantitatively study the degree of posterior fossa crowdedness (PFC) in patients with hemifacial spasm (HFS) and to further investigate whether overcrowding in posterior fossa affects the efficacy and safety of microvascular decompression.
METHODS: We conducted a prospective case-control study of patients diagnosed with HFS and sex- and age-matched healthy control patients. All subjects underwent high-resolution, 3-dimensional magnetic resonance imaging, and posterior fossa crowdedness index (PFCI) and cerebrospinal fluid volume (CSFV) were measured. Patients with HFS underwent primary microvascular decompression and long-term follow-up. Associations of PFCI and other factors with operative outcomes and complications were analyzed.
RESULTS: The study enrolled 153 subjects: 102 patients and 51 control subjects. Compared with control subjects, patients had a more PFC (PFCI: 83.2% vs. 80.2%; P = 0.005) and smaller posterior fossa CSFV (16,248.0 mm(3) vs. 20,054.0 mm(3); P = 0.001). The mean effective space of posterior fossa cerebrospinal fluid in patients with HFS was 11.8% smaller than in control subjects (P = 0.004). Compared with men, women showed larger PFCI (83.6% vs. 82.2%; P = 0.012) and smaller PF CSFV (16,027.5 mm(3) vs. 17,299.5 mm(3); P = 0.009). Sixty-one patients (59.8%) were spasm-free immediately postoperatively, and 95 (93.1%) were spasm-free at follow-up. Complication rates were 9.8% in the short term, and 2.9% at follow-up. Lower PFCI (odds ratio [OR] 0.63; P = 0.019) and severe indention (OR 1.41; P = 0.027) were significantly associated with better short-term outcomes. Greater PFCI (OR 2.05, P = 0.008) was associated with greater early complication incidence.
CONCLUSION: Patients with HFS had more PFC. PFC potentially leads to cranial nerve and vascular structure crowding, which may increase HFS risk. PFC was significantly associated with poor short-term outcomes and greater incidence of early complications but not long-term outcomes and complications.

PMID: 26341431 [PubMed - indexed for MEDLINE]

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35-Year-Old Man with Lytic Skull Lesion. Langerhans Cell Histiocytosis (LCH).

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35-Year-Old Man with Lytic Skull Lesion. Langerhans Cell Histiocytosis (LCH).

Brain Pathol. 2015 May;25(3):367-8

Authors: Schutz PW, Honey CR, Yip S

PMID: 26086055 [PubMed - indexed for MEDLINE]

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Radiographic Evaluation and Clinical Implications of Venous Connections Between Dural Arteriovenous Fistula of the Cavernous Sinus and Cerebellum and the Pontomedullary Venous System.

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Radiographic Evaluation and Clinical Implications of Venous Connections Between Dural Arteriovenous Fistula of the Cavernous Sinus and Cerebellum and the Pontomedullary Venous System.

World Neurosurg. 2015 Oct;84(4):1112-26

Authors: Kobkitsuksakul C, Jiarakongmun P, Chanthanaphak E, Pongpech S

Abstract
OBJECTIVE: The types of cortical venous reflux channels, posterior fossa and pontomesencephalic venous reflux or their connections with the cavernous sinus (CS) are inadequately described in the literature. This study uses angiography, magnetic resonance imaging, and X-ray computed tomography to clarify the possible route of cavernous dural arteriovenous fistulae (CVDAVF) that causes posterior fossa and pontomedullary venous reflux and documents the clinical presentations associated with the reflux.
METHODS: Eighty-six patients with CSDAVF treated at Ramathibodi Hospital, Bangkok, Thailand, during 2009 to 2013 were studied retrospectively. Sixteen cases with posterior fossa and pontomedullary venous reflux were included for analysis.
RESULTS: Bridging veins serve as an important pathway for venous reflux from CS to the posterior fossa and brainstem. The uncal vein directly terminates at the CS and has several connecting routes, ranging from the inferior frontal lobes and insula to the posterior fossa through the basal vein of Rosenthal. The petrosal vein was most frequently and easily detected angiographically. It plays a major role in the cerebellar hemispheric venous reflux. Only 1 patient developed brainstem and cerebellar venous congestion, which returned to normal after endovascular treatment.
CONCLUSIONS: Connections of CS are not limited to intercavernous, ophthalmic veins, sphenoparietal sinuses, and inferior and superior petrosal sinuses. They also occur with complex venous drainages at the base of the frontotemporal lobes, insula, brainstem, and cerebellum. Knowledge of the venous connection of CS is key to understanding the possible locations of venous congestion/hemorrhage and the clinical presentation of patients with CSDAVF.

PMID: 26074430 [PubMed - indexed for MEDLINE]

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Long-Term Outcomes After Small-Bone-Window Posterior Fossa Decompression and Duraplasty in Adults with Chiari Malformation Type I.

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Long-Term Outcomes After Small-Bone-Window Posterior Fossa Decompression and Duraplasty in Adults with Chiari Malformation Type I.

World Neurosurg. 2015 Oct;84(4):998-1004

Authors: Deng X, Yang C, Gan J, Wu L, Yang T, Yang J, Xu Y

Abstract
BACKGROUND: Small-bone-window posterior fossa decompression with duraplasty is one of the popular surgical options for Chiari malformation type I, but its efficacy is controversial and the risk factors of clinical outcome remain unclear.
METHODS: The study cohort included 152 patients with Chiari malformation type I who received small-bone-window posterior fossa decompression at Beijing Tiantan hospital from January 2008 to September 2009. All patients underwent combined surgical procedures: a small-bone-window suboccipital decompression (diameter, 2.5-3 cm) and a C1 laminectomy (1.5- to 2-cm wide) followed by a duraplasty with an autologous graft. Clinical manifestations, radiologic features, and follow-up data during a 6-year span were analyzed. Risk factors associated with outcome were investigated by the use of χ(2) analysis and logistic regression analysis.
RESULTS: The average follow-up duration was 74 months. Symptoms were improved in 126 patients (82.9%), remained stable in 21 patients (13.8%), and deteriorated in 5 patients (3.3%). There was no mortality. Postoperative magnetic resonance imaging scans were available for all patients. Preoperatively, 112 patients were associated with syringomyelia, and the follow-up magnetic resonance images showed obvious reduction of syringomyelia in 73 patients (65.2%) and no significant change in 39 patients (34.8%). In addition, enlargement of the cistern magna was observed in 92 patients (85.2%). Regression analysis indicates preoperative motor dysfunction, brainstem herniation and basilar invagination may influence the clinical outcome (P < 0.05).
CONCLUSIONS: Small-bone-window posterior fossa decompression with duraplasty is an effective and safe treatment option with a low complication rate. Motor dysfunction, brainstem herniation, and basilar invagination are predictors of poor clinical prognosis.

PMID: 25701768 [PubMed - indexed for MEDLINE]

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Effect of 90° counterclockwise rotation of the endotracheal tube on its advancement through the larynx during nasal fiberoptic intubation in children: a randomized and blinded study.

Effect of 90° counterclockwise rotation of the endotracheal tube on its advancement through the larynx during nasal fiberoptic intubation in children: a randomized and blinded study.

Paediatr Anaesth. 2016 Jan 7;

Authors: Choudhry DK, Brenn BR, Lutwin-Kawalec M, Sacks K, Nesargi S, He Z

Abstract
BACKGROUND: Resistance to the passage of the endotracheal tube (ETT) is frequently encountered in children as it is advanced over the fiberoptic scope for placement into the trachea because it gets hung up at the laryngeal inlet. Literature in adults indicates that a 90° counterclockwise rotation (CCR) of the ETT before advancing results in smooth passage. We found no literature in children.
OBJECTIVES: Our aim was to study if a 90° counterclockwise rotation (CCR) of the ETT before advancement leads to smooth passage of the ETT into the larynx in children.
METHODS: Following IRB approval, we performed this study in two parts: Part 1: An unblinded, observational, pilot study on 20 children scheduled for oral rehabilitation where we concurrently used a fiberoptic scope nasally and GlideScope orally. We visualized the ETT path and observed that 90° CCR allowed smooth passage without hang up. Part 2: A blinded and randomized study on 40 children to confirm if 90° CCR from the outset would improve passage of the ETT during nasal intubation with a fiberoptic scope in children. All children were divided into two groups: group S, ETT bevel facing left; group R, ETT bevel facing down.
RESULTS: In Part 1, we observed that the ETT got hung up in 57% of children with standard bevel direction (facing left) and in 0% of children when prerotated. In Part 2, efficacy of prerotation was confirmed; the ETT got hung up in 50% of children in group S but in only 10.5% of children in group R.
CONCLUSION: A change in ETT tip orientation from bevel facing left to facing down by 90° CCR, leads to a significantly higher first-attempt success rate by nasal approach in children. We believe the ETT should be rotated before insertion into the nostril to ensure that full 90° CCR of the tip has been accomplished.

PMID: 26749187 [PubMed - as supplied by publisher]

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Therapeutic antibodies reveal Notch control of transdifferentiation in the adult lung.

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Therapeutic antibodies reveal Notch control of transdifferentiation in the adult lung.

Nature. 2015 Dec 3;528(7580):127-31

Authors: Lafkas D, Shelton A, Chiu C, de Leon Boenig G, Chen Y, Stawicki SS, Siltanen C, Reichelt M, Zhou M, Wu X, Eastham-Anderson J, Moore H, Roose-Girma M, Chinn Y, Hang JQ, Warming S, Egen J, Lee WP, Austin C, Wu Y, Payandeh J, Lowe JB, Siebel CW

Abstract
Prevailing dogma holds that cell-cell communication through Notch ligands and receptors determines binary cell fate decisions during progenitor cell divisions, with differentiated lineages remaining fixed. Mucociliary clearance in mammalian respiratory airways depends on secretory cells (club and goblet) and ciliated cells to produce and transport mucus. During development or repair, the closely related Jagged ligands (JAG1 and JAG2) induce Notch signalling to determine the fate of these lineages as they descend from a common proliferating progenitor. In contrast to such situations in which cell fate decisions are made in rapidly dividing populations, cells of the homeostatic adult airway epithelium are long-lived, and little is known about the role of active Notch signalling under such conditions. To disrupt Jagged signalling acutely in adult mammals, here we generate antibody antagonists that selectively target each Jagged paralogue, and determine a crystal structure that explains selectivity. We show that acute Jagged blockade induces a rapid and near-complete loss of club cells, with a concomitant gain in ciliated cells, under homeostatic conditions without increased cell death or division. Fate analyses demonstrate a direct conversion of club cells to ciliated cells without proliferation, meeting a conservative definition of direct transdifferentiation. Jagged inhibition also reversed goblet cell metaplasia in a preclinical asthma model, providing a therapeutic foundation. Our discovery that Jagged antagonism relieves a blockade of cell-to-cell conversion unveils unexpected plasticity, and establishes a model for Notch regulation of transdifferentiation.

PMID: 26580007 [PubMed - indexed for MEDLINE]

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Geographic variation in human papillomavirus-related oropharyngeal cancer: Data from four multinational randomized trials.

Geographic variation in human papillomavirus-related oropharyngeal cancer: Data from four multinational randomized trials.

Head Neck. 2016 Jan 8;

Authors: Mehanna H, Franklin N, Compton N, Robinson M, Powell N, Biswas-Baldwin N, Paleri V, Hartley A, Fresco L, Al-Booz H, Junor E, El-Hariry I, Roberts S, Harrington K, Ang KK, Dunn J, Woodman C

Abstract
BACKGROUND: There are variations in the proportions of head and neck cancers caused by the human papillomavirus (HPV) between countries and regions. It is unclear if these are true variations or due to different study designs and assays.
METHODS: We tested formalin-fixed paraffin-embedded diagnostic biopsies for p16 immunohistochemistry and HPV-DNA (by polymerase chain reaction [PCR] and in situ hybridization [ISH]) using validated protocols on samples from 801 patients with head and neck cancer recruited prospectively between 2006 and 2011 in 4 randomized controlled trials (RCTs).
RESULTS: Twenty-one percent of patients (170 of 801) showed both HPV-DNA and p16-positivity, detected almost exclusively in oropharyngeal cancer (55%; 15 of 302); and only 1% of the patients (5 of 499) with nonoropharyngeal cancer were HPV positive. HPV-positive oropharyngeal cancer differed between Western and Eastern Europe (37%, 155 of 422 vs 6%, 8 of 144; p < .0001) and between Western Europe and Asia (37% vs 2%; 4 of 217; p < .0001). Other independent determinants of HPV positivity were tumor site and smoking.
CONCLUSION: This is the first study to establish geographic variability as an independent risk factor in HPV-positive oropharyngeal cancer prevalence, with higher prevalence in Western Europe. © 2016 The Authors Head & Neck Published by Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 26749143 [PubMed - as supplied by publisher]

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Management of CSF leakage after microsurgery for vestibular schwannoma via the middle cranial fossa approach.

Management of CSF leakage after microsurgery for vestibular schwannoma via the middle cranial fossa approach.

Eur Arch Otorhinolaryngol. 2016 Jan 9;

Authors: Scheich M, Ginzkey C, Ehrmann-Müller D, Shehata-Dieler W, Hagen R

Abstract
Microsurgery is one of the primary current standard options for the treatment of vestibular schwannoma (VS). Especially the middle cranial fossa (MCF) approach is a safe and efficacious technique for the preservation of hearing and facial nerve function in small VS. Postoperative complications are rare, although a leakage of cerebrospinal fluid (CSF) is common. The aim of this study was to analyze postoperative CSF leaks and to describe strategies for postoperative treatment. Between October 2005 and May 2012, 148 patients suffering from VS and selected for microsurgery via the MCF approach were treated in our department. Postoperative CSF leakage occurred in 19 patients. We found a leakage via the Eustachian tube into the nasopharynx in 18 patients and one case of incisional leakage. In 13 cases leaking stopped within 5 days by conservative management including bed rest and intravenous (i.v) antibiotics. Five patients needed lumbar drainage (LD) and only two patients had to undergo revision surgery to seal and pack the mastoid. Analyzed risk factors were age, gender, tumor size and pneumatization of the mastoid. Only the latter showed a significant influence on CSF leakage. We could demonstrate that a stepwise strategy is needed for successful treatment of CSF leaks.

PMID: 26749560 [PubMed - as supplied by publisher]

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Modified facelift incision for partial parotidectomy versus bayonet-shaped incision: a comparison using visual analog scale.

Modified facelift incision for partial parotidectomy versus bayonet-shaped incision: a comparison using visual analog scale.

Eur Arch Otorhinolaryngol. 2016 Jan 9;

Authors: Bulut OC, Plinkert P, Federspil PA

Abstract
The aim of this study is to show differences between a modified facelift incision (MFI) for partial parotidectomy versus a bayonet-shaped incision (BSI). 24 patients presenting with a parotid tumor were surgically treated with a partial parotidectomy using a MFI. We generated a "matched pair control group" regarding age, tumor size and gender, who received a BSI. A questionnaire was sent to all patients and relevant data reviewed. The cosmetic satisfaction on a VAS with a MFI was 9.74 (±0.47) compared to BSI with 7.63 (±2.44, p = 0.004). The scoring in the two subgroups "visible scar" and "people noticed my surgery" was significantly better in the MFI group The postoperative skin numbness, skin depression, facial nerve function postoperatively showed no statistical differences. The MFI for parotid tumors has a better outcome than the BSI regarding cosmetic satisfaction and visible scarring.

PMID: 26749559 [PubMed - as supplied by publisher]

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Cervicogenic somatosensory tinnitus: An indication for manual therapy? Part 1: Theoretical concept.

Cervicogenic somatosensory tinnitus: An indication for manual therapy? Part 1: Theoretical concept.

Man Ther. 2015 Dec 18;

Authors: Oostendorp RA, Bakker I, Elvers H, Mikolajewska E, Michiels S, De Hertogh W, Samwel H

Abstract
Tinnitus can be evoked or modulated by input from the somatosensory and somatomotor systems. This means that the loudness or intensity of tinnitus can be changed by sensory or motor stimuli such as muscle contractions, mechanical pressure on myofascial trigger points, transcutaneous electrical stimulation or joint movements. The neural connections and integration of the auditory and somatosensory systems of the upper cervical region and head have been confirmed by many studies. These connections can give rise to a form of tinnitus known as somatosensory tinnitus. To date only a handful of publications have focussed on (cervicogenic) somatosensory tinnitus and manual therapy. Broadening the current understanding of somatosensory tinnitus would represent a first step towards providing therapeutic approaches relevant to manual therapists. Treatment modalities involving the somatosensory systems, and particularly manual therapy, should now be re-assessed in the subgroup of patients with cervicogenic somatosensory tinnitus. The conceptual phase of this study aims to uncover underlying mechanisms linking the auditory and somatosensory systems in relation to subjective tinnitus through (i) review of the literature (part 1) and (ii) through design of a that will explore characteristics of the study population and identify relevant components and outcomes of manual therapy in patients with cervicogenic somatosensory tinnitus (part 2). This manuscript focusses the theoretical concept of (cervicogenic) somatosensory tinnitus, either with or without secondary central tinnitus or tinnitus sensitization.

PMID: 26749460 [PubMed - as supplied by publisher]

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Management of CSF leakage after microsurgery for vestibular schwannoma via the middle cranial fossa approach.

Management of CSF leakage after microsurgery for vestibular schwannoma via the middle cranial fossa approach.

Eur Arch Otorhinolaryngol. 2016 Jan 9;

Authors: Scheich M, Ginzkey C, Ehrmann-Müller D, Shehata-Dieler W, Hagen R

Abstract
Microsurgery is one of the primary current standard options for the treatment of vestibular schwannoma (VS). Especially the middle cranial fossa (MCF) approach is a safe and efficacious technique for the preservation of hearing and facial nerve function in small VS. Postoperative complications are rare, although a leakage of cerebrospinal fluid (CSF) is common. The aim of this study was to analyze postoperative CSF leaks and to describe strategies for postoperative treatment. Between October 2005 and May 2012, 148 patients suffering from VS and selected for microsurgery via the MCF approach were treated in our department. Postoperative CSF leakage occurred in 19 patients. We found a leakage via the Eustachian tube into the nasopharynx in 18 patients and one case of incisional leakage. In 13 cases leaking stopped within 5 days by conservative management including bed rest and intravenous (i.v) antibiotics. Five patients needed lumbar drainage (LD) and only two patients had to undergo revision surgery to seal and pack the mastoid. Analyzed risk factors were age, gender, tumor size and pneumatization of the mastoid. Only the latter showed a significant influence on CSF leakage. We could demonstrate that a stepwise strategy is needed for successful treatment of CSF leaks.

PMID: 26749560 [PubMed - as supplied by publisher]

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Productivity outcomes following endoscopic sinus surgery for recurrent acute rhinosinusitis.

Productivity outcomes following endoscopic sinus surgery for recurrent acute rhinosinusitis.

Laryngoscope. 2016 Jan 9;

Authors: Steele TO, Detwiller KY, Mace JC, Strong EB, Smith TL, Alt JA

Abstract
OBJECTIVES/HYPOTHESIS: We sought to evaluate preoperative and postoperative productivity losses and quality of life (QOL) impairment reported by patients with recurrent acute rhinosinusitis (RARS) as compared to patients with chronic rhinosinusitis without nasal polyposis (CRSsNP).
STUDY DESIGN: Prospective, multi-institutional, nested case-control.
METHODS: Participants with RARS (n = 20) and CRSsNP (n = 20) undergoing endoscopic sinus surgery (ESS) were enrolled as part of a prospective cohort study. For comparison, participants diagnosed with RARS cases were age/gender-matched to control participants diagnosed with CRSsNP using a 1:1 ratio.
RESULTS: RARS and CRSsNP participants were followed for ∼14 months postoperatively. Productivity losses were reported as the number of days missed from normal productive activities out of the previous 90 days. RARS participants reported similar baseline productivity losses (12.6 ± 27.1 [standard deviation]) as participants with CRSsNP (11.7 ± 20.9; P = .314). Postoperatively, improvement in productivity losses was similar between RARS participants and CRSsNP controls (-6.7 ± 20.0 vs. -9.8 ± 19.1; P = .253). Preoperative and postoperative disease-specific QOL measures (Sino-Nasal Outcomes Test-22 and Rhinosinusitis Disability Index) were similar between the two groups. RARS participants reported a significant decrease in days of previous antibiotic (P = .009) and nasal decongestant (P = .004) use following ESS, whereas participants with CRSsNP reported a significant decrease in antibiotic (P = .002) and oral corticosteroid use (P = .002).
CONCLUSIONS: RARS patients report baseline productivity losses and disease-specific QOL impairment to levels that parallel those with CRSsNP. Patients with RARS report improvement in QOL following ESS in all disease-specific QOL measures and in several medication measures. Productivity losses and postoperative improvements are similar between patients with RARS and CRSsNP.
LEVEL OF EVIDENCE: 3b Laryngoscope, 2015.

PMID: 26749066 [PubMed - as supplied by publisher]

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A novel approach to neoplasms medial to the condyle: a condylectomy with anterior displacement of the condyle.

A novel approach to neoplasms medial to the condyle: a condylectomy with anterior displacement of the condyle.

Int J Oral Maxillofac Surg. 2015 Dec 31;

Authors: Ye ZX, Yang C, Chen MJ, Abdelrehem A

Abstract
Resecting neoplasms involving the infratemporal space has a high risk of damaging critical nerves and vessels, in addition to joint form and function. The purpose of this study was to introduce a novel approach to lesions medial to the condyle, which comprises a condylectomy with anterior displacement of the condyle. The indications evaluated using digital surgical simulation, the critical surgical technique, and the preliminary clinical effects are presented here. Five cases underwent this approach between January 2006 and December 2014. The common characteristics of the five masses were (1) that they were non-malignant neoplasms involving the posterior-medial region of the condyle; (2) the upper and lower borders were between the skull base and the lingula, while the anterior border did not exceed the coronoid process. All masses were resected successfully with no damage to any critical nerves or vessels. The average follow-up period was 29.8 months (range 6-56 months). There was no recurrence, secondary deformity, or facial paralysis. The average mouth opening improved from an original 27mm to 34mm after surgery. The condyles were well fixed, with no resorption, as shown on computed tomography scans.

PMID: 26748864 [PubMed - as supplied by publisher]

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Review on clinical update of essential tremor.

Review on clinical update of essential tremor.

Neurol Sci. 2016 Jan 9;

Authors: Chunling W, Zheng X

Abstract
Essential tremor (ET) is considered a benign disease without any pathological changes. Nevertheless, this point of view has recently been challenged. In recent years, studies have shown that ET occurs with other non-motor symptoms, such as cognitive deficits, depression, anxiety, balance disorder, hearing impairment, olfactory dysfunction and sleep problems. Advancements in neuroimaging have revealed widespread alterations in the brain, and cerebellar involvement was the most consistent finding. In addition, studies have also shown that ET patients might experience poor quality of life, reflecting motor or non-motor symptoms. Both pharmacotherapy and non-pharmacotherapy have recently been suggested for the treatment of ET. This review briefly describes the current information on ET, including the non-movement symptoms, neuroimaging findings, the impact on daily life and ET therapy.

PMID: 26749268 [PubMed - as supplied by publisher]

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