Predictors of Outcome in Patients Presenting with Acute Ischemic Stroke and Mild Stroke Scale Scores.

Related Articles

Predictors of Outcome in Patients Presenting with Acute Ischemic Stroke and Mild Stroke Scale Scores.

J Stroke Cerebrovasc Dis. 2015 Jul;24(7):1685-9

Authors: Kenmuir CL, Hammer M, Jovin T, Reddy V, Wechsler L, Jadhav A

Abstract
BACKGROUND: Although National Institutes of Health Stroke Scale (NIHSS) is a known predictor of outcome in acute ischemic stroke, there are other factors like age, ambulatory status, and ability to swallow that may be predictors of outcome but are not assessed by the traditional NIHSS. The aim of this retrospective review was to identify predictors of outcome in mild ischemic stroke.
METHODS: Discharge outcomes from patients who presented to our large academic stroke center with acute ischemic stroke from 2005 to 2013 were retrospectively reviewed. Of 7189 patients reviewed, 2597 had initial NIHSS less than 5. Outcome measures were modified Rankin Scale (MRS) score 0-1 and discharge to home.
RESULTS: In all, 65% of patients with NIHSS 0-4 were discharged directly home independent of treatment. Of those patients discharged to home, 74% were able to ambulate independently and 98% passed their dysphagia screen. Of patients not discharged directly home, 66% were unable to ambulate independently and 21% did not pass their dysphagia screen. Multivariate logistic regression analysis revealed a significant effect of dysphagia screen (P = .001), ability to ambulate independently (P = .002), age (P = .016), and NIHSS (P = .005) on discharge to home but not MRS of 0-1 (P = .564).
CONCLUSIONS: In patients with mild stroke scale scores defined as NIHSS 0-4, several factors including age, NIHSS, ambulatory status, and ability to swallow may be independent predictors of functional outcome and discharge home. These data support the development of a modified grading system for assessing functional outcome in mild stroke that considers these factors.

PMID: 25944544 [PubMed - indexed for MEDLINE]

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Sialolithiasis in an Accessory Submandibular Gland Identified by Magnetic Resonance Sialography.

Sialolithiasis in an Accessory Submandibular Gland Identified by Magnetic Resonance Sialography.

Ann Otol Rhinol Laryngol. 2016 Mar 9;

Authors: Sanchez Barrueco A, Santillan Coello J, Sobrino Guijarro B, Villacampa Aubá JM, Cenjor Español C

Abstract
BACKGROUND: Accessory submandibular gland is a very rare anatomical variant. There have been only 6 reported cases of this entity in the English literature, only 1 of which was identified using magnetic resonance imaging.
METHODS: We report the case of a 39-year-old female with symptoms of left submandibular sialoadenitis who was diagnosed of sialolithiasis within the left accessory submandibular gland by magnetic resonance sialography (MR-Si).
RESULTS: The calculus was palpated near the submandibular papilla and was extracted by an intraoral approach. One-year follow-up revealed no evidence of recurrence.
CONCLUSIONS: This is the first case reported to date in the English literature of a patient with sialolithiasis within an accessory submandibular gland diagnosed by MR-Si.

PMID: 26961009 [PubMed - as supplied by publisher]

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Sudden Sensorineural Hearing Loss Associated With Intralabyrinthine Hemorrhage.

Related Articles

Sudden Sensorineural Hearing Loss Associated With Intralabyrinthine Hemorrhage.

Otol Neurotol. 2015 Sep;36(8):e134-5

Authors: Cervantes SS, Barrs DM

PMID: 24914788 [PubMed - indexed for MEDLINE]

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Pathology of advanced buccal mucosa cancer involving masticator space (T4b).

Pathology of advanced buccal mucosa cancer involving masticator space (T4b).

Indian J Cancer. 2015 Oct-Dec;52(4):611-5

Authors: Trivedi NP, Kekatpure VD, Shetkar G, Gangoli A, Kuriakose MA

Abstract
BACKGROUND: Buccal mucosa cancer involving masticator space is classified as very advanced local disease (T4b). The local recurrence rate is very high due to poor understanding of the extent of tumor spread in masticator space and technically difficult surgical clearance. The objective of this study is to understand the extent of tumor spread in masticator space to form basis for appropriate surgical resection.
MATERIALS AND METHODS: All consecutive patients with T4b-buccal cancer underwent compartment resection, with complete anatomical removal of involved soft-tissue structures. Specimens were systematically studied to understand the extent of invasion of various structures. The findings of clinical history, imaging and pathologic evaluation were compared and the results were evaluated.
RESULTS: A total of 45 patients with advanced buccal cancer (T4b) were included in this study. The skin, mandible and lymph nodes were involved in 30, 24 and 17 cases respectively. The pterygoid muscles were involved in 34 cases (medial-pterygoid in 12 and both pterygoids in 22 cases) and masseter-muscle in 32 cases. Average distance for soft-tissue margins after compartment surgery was 2 cm and the margins were positive in 3 cases. The group with involvement of medial pterygoid muscle had safest margin with compartment surgery while it was also possible to achieve negative margins for group involving lateral pterygoid muscle and plates.The involvement of pterygomaxillary fissure was area of concern and margin was positive in 2 cases with one patient developing local recurrence with intracranial extension. At 21 months median follow-up (13-35 months), 38 patients were alive without disease while two developed local recurrence at the skull base.
CONCLUSIONS: T4b buccal cancers have significant soft-tissue involvement in the masticator space. En bloc removal of all soft-tissues in masticator space is advocated to remove tumor contained within space. The compartment surgery provides an opportunity to achieve negative margins for cancers actually contained within masticator space.It is inappropriate to club all patients with masticator space involvement in one group.

PMID: 26960493 [PubMed - in process]

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Endoscopic endonasal anterior skull base surgery: a systematic review of complications over the past 65 years.

Endoscopic endonasal anterior skull base surgery: a systematic review of complications over the past 65 years.

World Neurosurg. 2016 Mar 4;

Authors: Borg A, Kirkman MA, Choi D

Abstract
BACKGROUND: Endoscopic skull base surgery is becoming more popular as an approach to the anterior skull base for tumors and CSF fistulae. It offers the advantages of better cosmesis and improved quality of life after surgery. We reviewed the complication rates reported in the literature.
METHODS: A literature search was performed using the electronic database Ovid MEDLINE (1950 to 25(th) August 2015) using the search item "((Anterior) AND Skull base surgery) AND endoscopic".
RESULTS: We identified 82 relevant studies that included 7460 cases. An average overall complication rate of 17.1% (range 0 - 68.0%) and a mortality rate of 0.4% (0 -10.0%) was demonstrated in a total of 82 studies that included 7460 cases. The average CSF leak rate for all studies was 8.9% (0 - 40.0%) with meningiomas and clival lesions having the highest CSF leak rates. The most frequent benign pathology encountered was pituitary adenomas (n = 3720, 49.8% of all cases) and the most frequent malignant tumour was esthesioneuroblastoma (n = 120, 1.6% of all cases). Studies that included only CSF fistula repairs had a lower average total complication rate (12.9%) but a higher rate of meningitis when compared to studies that reported mixed pathology (2.4% vs. 1.3%). A trend towards a lower total complication rate with increasing study size was observed.
CONCLUSION: The endoscopic approach is an increasingly accepted technique for anterior skull base tumor surgery and is associated with acceptable complication rates. Increasing experience with this technique can decrease complication rates .

PMID: 26960277 [PubMed - as supplied by publisher]

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[Epidemiology and etiology of posterior fossa tumors with particular emphasis on astrocytomas from the Małopolska and Podkarpacki regions].

Related Articles

[Epidemiology and etiology of posterior fossa tumors with particular emphasis on astrocytomas from the Małopolska and Podkarpacki regions].

Przegl Lek. 2015;72(8):435-9

Authors: Ciepiela L, Ciepiela K, Kwiatkowski S

Abstract
Brain tumors in children are rare compared with other diseases childhood. Virtually every pediatrician working at the local hospital has been in contact or brain tumor diagnosis was that more half of them recognized the posterior fossa tumor. Analysis of surveys showed difficulties in the interpretation of basic neurological symptoms. Lessons learned from these studies point to the fact that the success of the surgery affects mainly the histological type of tumor and its location. It is extremely important to analyze complaints and symptoms young patients, we should listen to the parents of children with, because usually just parents are the first to notice that their offspring something was wrong.

PMID: 26827561 [PubMed - indexed for MEDLINE]

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An Unusually Benign Course of Extensive Posterior Circulation Occlusion.

Related Articles

An Unusually Benign Course of Extensive Posterior Circulation Occlusion.

J Stroke Cerebrovasc Dis. 2015 Jul;24(7):e165-8

Authors: Datar S, Lanzino G, Rabinstein AA

Abstract
BACKGROUND: Acute basilar artery occlusion is associated with poor outcome. In a few cases, occlusion occurs over a period allowing adequate collateral circulation to the posterior fossa. We describe a rare presentation with transient loss of consciousness (LOC) in a patient with extensive occlusion of the posterior circulation.
METHODS: Case report.
RESULTS: We describe a 70-year-old right-handed man with a history significant for atrial fibrillation and dolichoectasia of the basilar artery. Fourteen years ago, he had a small infarction in the pons resulting in right hemiparesis. Magnetic resonance angiogram at that time showed mild intracranial atherosclerosis. He was treated with warfarin for secondary stroke prevention. He presented to our emergency department after a witnessed spell of LOC after a large meal. On regaining consciousness, he had 2 episodes of emesis. Examination revealed only a spastic right hemiparesis from the old stroke in the pons. Cerebral angiogram showed absent flow in the mid and distal basilar arteries, both posterior cerebral arteries, and both posterior communicating arteries with bilateral stenoses of internal carotid arteries. His international normalized ratio in the emergency department was 1.1. He was treated with intravenous heparin and did well. Three months later, he underwent stent treatment of the worsening stenosis (90%) of the right internal carotid artery.
CONCLUSIONS: Occasionally, collateral circulation has the potential to maintain adequate perfusion to the posterior fossa in severe cases of posterior circulation occlusion and diffuse intracranial atherosclerotic disease. Careful patient selection is essential before planning any endovascular intervention.

PMID: 25881774 [PubMed - indexed for MEDLINE]

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Therapeutic role of Vitamin B12 in patients of chronic tinnitus: A pilot study.

Therapeutic role of Vitamin B12 in patients of chronic tinnitus: A pilot study.

Noise Health. 2016 Mar-Apr;18(81):93-7

Authors: Singh C, Kawatra R, Gupta J, Awasthi V, Dungana H

Abstract
True tinnitus is a phantom auditory perception arising from a source or trigger in the cochlea, brainstem, or at higher centers and has no detectable acoustic generator. The most accepted is the famous neurophysiologic model of Jastreboff, which stresses that tinnitus, is a subcortical perception and results from the processing of weak neural activity in the periphery. The aim of this study is to determine the role of Vitamin B12 in treatment of chronic tinnitus. In this randomized, double-blind pilot study, total 40 patients were enrolled, of which 20 in Group A (cases) received intramuscular therapy of 1 ml Vitamin B12 (2500 mcg) weekly for a period of 6 weeks and Group B (20) patients received placebo isotonic saline 01 ml intramuscular. The patients were subjected to Vitamin B12 assay and audiometry pre- and post-therapy. Of the total patients of tinnitus, 17 were Vitamin B12 deficient that is 42.5% showed deficiency when the normal levels were considered to be 250 pg/ml. A paired t-test showed that in Group A, patients with Vitamin B12 deficiency showed significant improvement in mean tinnitus severity index score and visual analog scale (VAS) after Vitamin B12 therapy. This pilot study highlights the significant prevalence of Vitamin B12 deficiency in North Indian population and improvement in tinnitus severity scores and VAS in cobalamin-deficient patients receiving intramuscular Vitamin B12 weekly for 6 weeks further provides a link between cobalamin deficiency and tinnitus thereby suggestive of a therapeutic role of B12 in cobalamin-deficient patients of tinnitus.

PMID: 26960786 [PubMed - in process]

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Efficacy of octreotide against chylothorax following lateral neck dissection for thyroid cancer: A case report.

Efficacy of octreotide against chylothorax following lateral neck dissection for thyroid cancer: A case report.

Int J Surg Case Rep. 2016 Feb 27;21:107-110

Authors: Hayashibara N, Ogawa T, Tsuji E, Ishizuna K

Abstract
INTRODUCTION: Postsurgical chylothorax is a rare complication of cervical dissection for thyroid cancer. We report that octreotide, a synthetic analog of somatostatin, is effective in treating chylothorax after thyroid carcinoma surgery.
PRESENTATION OF CASE: The patient was a 48-year-old woman who presented to our institution complaining of a left anterior cervical mass. We diagnosed this as thyroid papillary carcinoma and performed a subtotal excision of the thyroid gland with left cervical lymph node dissection. The patient developed dyspnea, and a chest X-ray revealed bilateral chylothorax on Day 4 post-surgery. Octreotide was administered since bilateral chylothorax was noted. A marked decrease in chyle effusion was noted just 3 days after starting octreotide, and after a total of 9 days of treatment, there were no further signs of chylous effusion.
DISCUSSION: Octreotide is effective against postsurgical chylothorax; however, if there are no signs of improvement, we believe surgical treatment should be considered.
CONCLUSION: Octreotide should be administered first to treat postsurgical chylothorax before surgical treatment is considered.

PMID: 26963261 [PubMed - as supplied by publisher]

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Redislocation After a Failed Surgery to Treat C6/7 Fracture-Dislocation With Pedicular Fracture of the C6 Vertebra: Case Report of a Successful Revision Surgery, Analysis of the Causes, and Discussion of Revision Surgical Strategies.

Redislocation After a Failed Surgery to Treat C6/7 Fracture-Dislocation With Pedicular Fracture of the C6 Vertebra: Case Report of a Successful Revision Surgery, Analysis of the Causes, and Discussion of Revision Surgical Strategies.

Medicine (Baltimore). 2016 Mar;95(10):e3123

Authors: Yang Y, Ma L, Li T, Liu H

Abstract
Cervical spinal fracture-dislocation with pedicular fracture of the vertebra has been little reported and the management of such a patient is difficult. Considering the little knowledge of this area, we present this special case of a successful revision surgery for the treatment of redislocation after a failed surgery to treat C6/7 fracture-dislocation with pedicular fracture of the C6 vertebra to share our experience.A 45-year-old male patient presented to our hospital with history of neck pain for 4 months. According to his medical records, he was involved in an architectural accident and diagnosed with C6/7 fracture-dislocation with pedicular fracture of the C6 vertebra (ASIA: D). A surgery of posterior lateral mass screw fixation (bilateral in C5 and C7; left side in C6) was performed in a different institution. However, 4 months after his primary surgery, he was still troubled by serious neck pain and muscle weakness in all right side limbs. The physical examination of the patient showed hypoesthesia in the right side limbs, myodynamia of the right side limbs weakened to Grade 4. Cervical X-rays, computed tomography (CT), and magnetic resonance imaging confirmed the redislocation of C6/7. A successful revision surgery of anterior cervical corpectomy and fusion (ACCF) with nanohydroxyapatite/polyamide 66 composite fulfilled with vertebral autograft plus anterior plate was performed. The 3 months postoperative X-rays and CT scan showed the good position of the implant and bony fusion. The patient's neck pain was relived and the neurological function recovered to ASIA E grade at the 3rd month follow-up.ACCF with nanohydroxyapatite/polyamide 66 composite fulfilled with vertebral autograft plus anterior plate is effective for the treatment of redislocation after a failed surgery in patients of fracture-dislocation with pedicular fracture. The best method to avoid such a failed surgery is a combined anterior-posterior approach surgery in our opinion.

PMID: 26962843 [PubMed - as supplied by publisher]

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D-methionine (D-met) significantly reduces kanamycin-induced ototoxicity in pigmented guinea pigs.

D-methionine (D-met) significantly reduces kanamycin-induced ototoxicity in pigmented guinea pigs.

Int J Audiol. 2016 Mar 10;:1-6

Authors: Campbell KC, Martin SM, Meech RP, Hargrove TL, Verhulst SJ, Fox DJ

Abstract
OBJECTIVE: Test D-methionine (D-met) as an otoprotectant from kanamycin-induced ototoxicity and determine the lowest maximally protective D-met dose.
DESIGN: Auditory brainstem responses (ABR) were measured at 4, 8, 14, and 20 kHz at baseline and two, four, and six weeks after kanamycin and D-met administration initiation. ABR threshold shifts assessed auditory function. Following six-week ABR testing, animals were decapitated and cochleae collected for outer hair cell (OHC) quantification.
STUDY SAMPLE: Eight groups of 10 male pigmented guinea pigs were administered a subcutaneous kanamycin (250 mg/kg/dose) injection once per day and an intraperitoneal D-met injection (0 (saline), 120, 180, 240, 300, 360, 420, or 480 mg/kg/day) twice per day for 23 days.
RESULTS: Significant ABR threshold shift reductions and increased OHC counts (p ≤0.01) were measured at multiple D-met-dosed groups starting at two-week ABR assessments. A 300 mg/kg/day optimal otoprotective D-met dose provided 34-41 dB ABR threshold shift reductions and OHC protection. Lesser, but significant, D-met otoprotection was measured at lower and higher D-met doses.
CONCLUSIONS: D-met significantly reduced ABR threshold shifts and increased OHC percentages compared to kanamycin-treated controls. Results may be clinically significant particularly for multidrug-resistant tuberculosis patients who frequently suffer from kanamycin-induced hearing loss in developing countries.

PMID: 26963517 [PubMed - as supplied by publisher]

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Psychometric properties of a Mandarin version of the tinnitus questionnaire.

Psychometric properties of a Mandarin version of the tinnitus questionnaire.

Int J Audiol. 2016 Mar 10;:1-9

Authors: Meng Z, Chen Z, Xu K, Li G, Tao Y, Kwong JS

Abstract
OBJECTIVE: To develop a Mandarin version of the tinnitus questionnaire (MTQ) and determine the reliability and validity, and to assess whether it could be used clinically in the Chinese population.
DESIGN: The MTQ, short-form (36) health survey, hospital anxiety and depression scale, Mandarin (Chinese) tinnitus handicap inventory, and visual analogue scale were completed by the participants.
STUDY SAMPLE: We included 192 adults seeking treatment for primary or secondary tinnitus.
RESULTS: Five factors, namely, emotional distress, auditory perceptual difficulties, cognitive distress, sleep disturbance, and intrusiveness, were extracted from the MTQ. Thirty-seven items were included. The MTQ had high test-retest reliability (Spearman correlation coefficients: 0.87-1.00). The MTQ and its subscales had good internal consistency and reliability (total α = 0.93, subscales α = 0.71-0.86). A single measure of severity can be acquired by summing the five subscale scores. The MTQ was significantly correlated with psychological distress and tinnitus-related handicap.
CONCLUSION: Our results demonstrated that the MTQ is a reliable and valid measure of tinnitus-related psychopathological symptoms and could be used clinically to evaluate tinnitus-related psychological problems. Questionnaires designed to explore tinnitus-related depression and other symptoms not covered by the scope of the MTQ are needed.

PMID: 26963398 [PubMed - as supplied by publisher]

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Comorbidities and recurrence of benign paroxysmal positional vertigo: personal experience.

Comorbidities and recurrence of benign paroxysmal positional vertigo: personal experience.

Int J Audiol. 2016 Mar 10;:1-6

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

Abstract
OBJECTIVE: The aim of this study is to evaluate the correlation between clinical features of benign paroxysmal positional vertigo (BPPV) and age, sex, trauma, presence of one or more comorbidities such as cardiovascular, neurological, endocrinological, metabolic, psychiatric diseases.
DESIGN: Retrospective review of medical records (chart review).
STUDY SAMPLE: A total of 475 patients aged from 14 to 87 years, affected by BPPV.
RESULTS: Recurrence of BPPV occurred in 139/475 patients (29.2%). The recurrence rate was significantly higher in female and older patients. Comorbidities were present in 72.6% of subjects with recurrent BPPV vs. 48.9% of patients with no recurrence (p <0.01). Forty-two patients (8.8%) reported a cranial trauma as a triggering event. Post-traumatic patients showed a significantly higher persistence rate (45.2%) compared to patients affected by non-traumatic BPPV (20.5%). Recurrence rates are overlapping between the two groups.
CONCLUSION: Our results confirm the association between recurrence of BPPV and age, female sex, and presence of comorbidities. The correlation is stronger in patients affected by multiple associated diseases; the most frequently involved pathologies are psychiatric disorders, followed by neurological and vascular diseases. Collecting a complete medical history is important for prognostic stratification and detection of potential underlying pathological conditions.

PMID: 26963274 [PubMed - as supplied by publisher]

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Evidence-based guidelines for recommending cochlear implantation for postlingually deafened adults.

Evidence-based guidelines for recommending cochlear implantation for postlingually deafened adults.

Int J Audiol. 2016 Mar 10;:1-6

Authors: Leigh JR, Moran M, Hollow R, Dowell RC

Abstract
OBJECTIVE: Adult selection criteria for cochlear implantation have been developed based on analysis of the post-operative performance of a large group of postlingually deafened adults. Original criteria published in 2004 were reviewed and amended to reflect outcomes currently being achieved by implant recipients.
DESIGN: Retrospective review of 12-month post-operative speech perception performance of adults implanted at the Eye and Ear Hospital, Melbourne, Australia.
STUDY SAMPLE: A total of 382 postlingually deafened adults, using a Freedom, Nucleus 5, or CI422 Slim Straight cochlear implant were used to create a comparative set of data.
RESULTS: Revised guidelines suggest that adults with postlingual hearing loss can now be considered cochlear implant candidates if they obtain scores of up to 55% for open-set phonemes in quiet in the ear to be implanted. Functional benefit may vary depending on the recipients' contralateral hearing.
CONCLUSIONS: This study supports the provision of cochlear implants to candidates with significant residual hearing when at least one ear meets the criterion outlined above. Patient-specific counseling is required to ensure the potential to benefit predicted by the current model is acceptable to the individual patient and their family. Counseling regarding functional benefit must take into consideration hearing in the contralateral ear.

PMID: 26963131 [PubMed - as supplied by publisher]

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D-methionine (D-met) significantly reduces kanamycin-induced ototoxicity in pigmented guinea pigs.

D-methionine (D-met) significantly reduces kanamycin-induced ototoxicity in pigmented guinea pigs.

Int J Audiol. 2016 Mar 10;:1-6

Authors: Campbell KC, Martin SM, Meech RP, Hargrove TL, Verhulst SJ, Fox DJ

Abstract
OBJECTIVE: Test D-methionine (D-met) as an otoprotectant from kanamycin-induced ototoxicity and determine the lowest maximally protective D-met dose.
DESIGN: Auditory brainstem responses (ABR) were measured at 4, 8, 14, and 20 kHz at baseline and two, four, and six weeks after kanamycin and D-met administration initiation. ABR threshold shifts assessed auditory function. Following six-week ABR testing, animals were decapitated and cochleae collected for outer hair cell (OHC) quantification.
STUDY SAMPLE: Eight groups of 10 male pigmented guinea pigs were administered a subcutaneous kanamycin (250 mg/kg/dose) injection once per day and an intraperitoneal D-met injection (0 (saline), 120, 180, 240, 300, 360, 420, or 480 mg/kg/day) twice per day for 23 days.
RESULTS: Significant ABR threshold shift reductions and increased OHC counts (p ≤0.01) were measured at multiple D-met-dosed groups starting at two-week ABR assessments. A 300 mg/kg/day optimal otoprotective D-met dose provided 34-41 dB ABR threshold shift reductions and OHC protection. Lesser, but significant, D-met otoprotection was measured at lower and higher D-met doses.
CONCLUSIONS: D-met significantly reduced ABR threshold shifts and increased OHC percentages compared to kanamycin-treated controls. Results may be clinically significant particularly for multidrug-resistant tuberculosis patients who frequently suffer from kanamycin-induced hearing loss in developing countries.

PMID: 26963517 [PubMed - as supplied by publisher]

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Psychometric properties of a Mandarin version of the tinnitus questionnaire.

Psychometric properties of a Mandarin version of the tinnitus questionnaire.

Int J Audiol. 2016 Mar 10;:1-9

Authors: Meng Z, Chen Z, Xu K, Li G, Tao Y, Kwong JS

Abstract
OBJECTIVE: To develop a Mandarin version of the tinnitus questionnaire (MTQ) and determine the reliability and validity, and to assess whether it could be used clinically in the Chinese population.
DESIGN: The MTQ, short-form (36) health survey, hospital anxiety and depression scale, Mandarin (Chinese) tinnitus handicap inventory, and visual analogue scale were completed by the participants.
STUDY SAMPLE: We included 192 adults seeking treatment for primary or secondary tinnitus.
RESULTS: Five factors, namely, emotional distress, auditory perceptual difficulties, cognitive distress, sleep disturbance, and intrusiveness, were extracted from the MTQ. Thirty-seven items were included. The MTQ had high test-retest reliability (Spearman correlation coefficients: 0.87-1.00). The MTQ and its subscales had good internal consistency and reliability (total α = 0.93, subscales α = 0.71-0.86). A single measure of severity can be acquired by summing the five subscale scores. The MTQ was significantly correlated with psychological distress and tinnitus-related handicap.
CONCLUSION: Our results demonstrated that the MTQ is a reliable and valid measure of tinnitus-related psychopathological symptoms and could be used clinically to evaluate tinnitus-related psychological problems. Questionnaires designed to explore tinnitus-related depression and other symptoms not covered by the scope of the MTQ are needed.

PMID: 26963398 [PubMed - as supplied by publisher]

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Comorbidities and recurrence of benign paroxysmal positional vertigo: personal experience.

Comorbidities and recurrence of benign paroxysmal positional vertigo: personal experience.

Int J Audiol. 2016 Mar 10;:1-6

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

Abstract
OBJECTIVE: The aim of this study is to evaluate the correlation between clinical features of benign paroxysmal positional vertigo (BPPV) and age, sex, trauma, presence of one or more comorbidities such as cardiovascular, neurological, endocrinological, metabolic, psychiatric diseases.
DESIGN: Retrospective review of medical records (chart review).
STUDY SAMPLE: A total of 475 patients aged from 14 to 87 years, affected by BPPV.
RESULTS: Recurrence of BPPV occurred in 139/475 patients (29.2%). The recurrence rate was significantly higher in female and older patients. Comorbidities were present in 72.6% of subjects with recurrent BPPV vs. 48.9% of patients with no recurrence (p <0.01). Forty-two patients (8.8%) reported a cranial trauma as a triggering event. Post-traumatic patients showed a significantly higher persistence rate (45.2%) compared to patients affected by non-traumatic BPPV (20.5%). Recurrence rates are overlapping between the two groups.
CONCLUSION: Our results confirm the association between recurrence of BPPV and age, female sex, and presence of comorbidities. The correlation is stronger in patients affected by multiple associated diseases; the most frequently involved pathologies are psychiatric disorders, followed by neurological and vascular diseases. Collecting a complete medical history is important for prognostic stratification and detection of potential underlying pathological conditions.

PMID: 26963274 [PubMed - as supplied by publisher]

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Evidence-based guidelines for recommending cochlear implantation for postlingually deafened adults.

Evidence-based guidelines for recommending cochlear implantation for postlingually deafened adults.

Int J Audiol. 2016 Mar 10;:1-6

Authors: Leigh JR, Moran M, Hollow R, Dowell RC

Abstract
OBJECTIVE: Adult selection criteria for cochlear implantation have been developed based on analysis of the post-operative performance of a large group of postlingually deafened adults. Original criteria published in 2004 were reviewed and amended to reflect outcomes currently being achieved by implant recipients.
DESIGN: Retrospective review of 12-month post-operative speech perception performance of adults implanted at the Eye and Ear Hospital, Melbourne, Australia.
STUDY SAMPLE: A total of 382 postlingually deafened adults, using a Freedom, Nucleus 5, or CI422 Slim Straight cochlear implant were used to create a comparative set of data.
RESULTS: Revised guidelines suggest that adults with postlingual hearing loss can now be considered cochlear implant candidates if they obtain scores of up to 55% for open-set phonemes in quiet in the ear to be implanted. Functional benefit may vary depending on the recipients' contralateral hearing.
CONCLUSIONS: This study supports the provision of cochlear implants to candidates with significant residual hearing when at least one ear meets the criterion outlined above. Patient-specific counseling is required to ensure the potential to benefit predicted by the current model is acceptable to the individual patient and their family. Counseling regarding functional benefit must take into consideration hearing in the contralateral ear.

PMID: 26963131 [PubMed - as supplied by publisher]

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A computer-guided minimally invasive technique for orthodontic forced eruption of impacted canines.

A computer-guided minimally invasive technique for orthodontic forced eruption of impacted canines.

Minerva Stomatol. 2016 Mar 10;

Authors: BERTELé M, Minniti PP, Dalessandri D, Bonetti S, Visconti L, Paganelli C

Abstract
BACKGROUND: The aim of this study was to develop a computer-guided minimally invasive protocol for the surgical application of an orthodontic traction during the forced eruption of an impacted canine.
METHODS: 3Diagnosys® software was used to evaluate impacted canines position and to plan the surgical access, taking into account soft and hard tissues thickness, orthodontic traction path and presence of possible obstacles. Geomagic® software was used for reverse engineering and RhinocerosTM software was employed as three-dimensional modeller in preparing individualized surgical guides. Surgical access was gained flapless through the use of a mucosal punch for soft tissues, followed by a trephine bur with a pre-adjusted stop for bone path creation. A diamond bur mounted on SONICflex® 2003/L handpiece was used to prepare a 2 mm deep calibrated hole into the canine enamel where a titanium screw connected with a stainless steel ligature was screwed. In-vitro pull-out tests, radiological and SEM analysis were realized in order to investigate screw stability and position.
RESULTS: In two out of ten samples the screw was removed after the application of a 1 kg pull-out force. Radiological and SEM analysis demonstrated that all the screws were inserted into the enamel without affecting dentine integrity.
CONCLUSION: This computer-guided minimally invasive technique allowed a precise and reliable positioning of screws utilized during the orthodontic traction of impacted canines.

PMID: 26963945 [PubMed - as supplied by publisher]

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Low level laser therapy in non-surgical management of osteoradionecrosis of the jaws.

Low level laser therapy in non-surgical management of osteoradionecrosis of the jaws.

Minerva Stomatol. 2016 Mar 10;

Authors: Moreschi C, CAPPARé P, Meleti M, Vescovi P, Bonanini M, Gherlone EF, Gastaldi G

PMID: 26963944 [PubMed - as supplied by publisher]

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