Acetyl-DL-leucine improves gait variability in patients with cerebellar ataxia-a case series.

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Acetyl-DL-leucine improves gait variability in patients with cerebellar ataxia-a case series.

Cerebellum Ataxias. 2016;3:8

Authors: Schniepp R, Strupp M, Wuehr M, Jahn K, Dieterich M, Brandt T, Feil K

Abstract
Acetyl-DL-leucine is a modified amino acid that was observed to improve ataxic symptoms in patients with sporadic and hereditary forms of ataxia. Here, we investigated the effect of the treatment with Acetyl-DL-leucine on the walking stability of patients with cerebellar ataxia (10x SAOA, 2x MSA-C, 2x ADA, 1x CACNA-1A mutation, 2x SCA 2, 1x SCA 1). Treatment with Acetyl-DL-leucine (500 mg; 3-3-4) significantly improved the coefficient of variation of stride time in 14 out of 18 patients. Moreover, subjective ambulatory scores (FES-I and ABC) and the SARA scores were also improved under treatment. Further prospective studies are necessary to support these class III observational findings.

PMID: 27073690 [PubMed]

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The effect of intratympanic gentamicin for treatment of Ménière's disease on lower frequency hearing.

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The effect of intratympanic gentamicin for treatment of Ménière's disease on lower frequency hearing.

Int J Clin Pharm. 2016 Apr 12;

Authors: Sam G, Chung DW, van der Hoeven R, Verweij S, Becker M

Abstract
Background The intratympanic application of the ototoxic aminoglycoside gentamicin has shown promising results as an ablative treatment for vertigo associated with Ménière's disease. Objective To evaluate the efficacy and safety of intratympanic gentamicin and to specifically analyse the effect of this treatment on high and low hearing frequencies in patients with unilateral definite Ménière's disease. Method Subjects were treated with intratympanic gentamicin and were evaluated on vertigo, tinnitus, mean pure tone audiometry threshold and speech discrimination score. Subjects were followed for evaluation for up to 2 years after treatment. Results The number of vertigo spells per month decreased and subjects experienced less tinnitus. During follow up there was an increase of hearing loss in the low (0.25-, 0.5-, 1-kHz) frequency range (13.3 dB; p = 0.03). There was no significant increase of hearing loss in the high (2-, 4-, 8-kHz) frequency range. A clinically significant change in speech discrimination score was found in 50 % of the subjects. Conclusion Our results indicate that intratympanic gentamicin especially affects the mean pure tone audiometry threshold in the low frequency range, which may have clinical implications. Though many of our results are (statistically) substantial the study was limited by the small cohort size.

PMID: 27073077 [PubMed - as supplied by publisher]

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[Rehabilitation of facial palsy and vertigo in patients with vestibular schwannoma].

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[Rehabilitation of facial palsy and vertigo in patients with vestibular schwannoma].

HNO. 2016 Apr 12;

Authors: Müller B, Volk GF, Guntinas-Lichius O

Abstract
BACKGROUND: Facial palsy and vertigo, as symptoms of vestibular schwannoma (VS) or consequences of its therapy, have a significant impact on patients' quality of life.
OBJECTIVE: This review analyzed current literature on the topic and deduced recommendations for rehabilitation of facial palsy and vertigo.
METHODS: The present review describes a PubMed-based search of the literature of the past 10 years.
RESULTS: There is no evidence-based drug therapy for the treatment of acute facial palsy after VS surgery. Several surgical procedures for facial nerve reconstruction, muscle transfer, and static techniques have been established. Physiotherapeutic movement therapy, optimally with biofeedback, seems to improve facial function in patients with post-paralytic syndrome. Botulinum toxin injections are the method of choice for synkinesis treatment. For treatment of acute and chronic vertigo in patients with VS, the same antivertiginous drugs as for other vertigo patients are used. If the patient shows retained vestibular stimulation function, preoperative intratympanic gentamycin therapy followed by compensation training is a promising approach to decreasing postoperative vertigo. Good vestibular rehabilitation comprises intensive and regular movement training, preferably with real-time feedback and therapy control.
CONCLUSION: There are several conservative, surgical, or combined conservative-surgical treatment options for individualized facial nerve rehabilitation of VS patients, as confirmed by clinical studies. In cases of acute vertigo, standard antivertiginous pharmacotherapy is indicated. In cases of acute and also of chronic vertigo, intensive balance and movement training relieves complaints.

PMID: 27072637 [PubMed - as supplied by publisher]

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Refractory episodic vertigo: role of intratympanic gentamicin and vestibular evoked myogenic potentials.

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Refractory episodic vertigo: role of intratympanic gentamicin and vestibular evoked myogenic potentials.

Braz J Otorhinolaryngol. 2016 Mar 28;

Authors: Celis-Aguilar E, Hinojosa-González R, Vales-Hidalgo O, Coutinho-Toledo H

Abstract
INTRODUCTION: Even today, the treatment of intractable vertigo remains a challenge. Vestibular ablation with intratympanic gentamicin stands as a good alternative in the management of refractory vertigo patients.
OBJECTIVE: To control intractable vertigo through complete saccular and horizontal canal vestibular ablation with intratympanic gentamicin treatment.
METHODS: Patients with refractory episodic vertigo were included. The inclusion criteria were: unilateral ear disease, moderate to profound sensorineural hearing loss, and failure to other treatments. Included patients underwent 0.5-0.8mL of gentamicin intratympanic application at a 30mg/mL concentration. Vestibular ablation was confirmed by the absence of response on cervical vestibular evoked myogenic potentials and no response on caloric tests. Audiometry, electronystagmography with iced water, and vestibular evoked myogenic potentials were performed in all patients.
RESULTS: Ten patients were included; nine patients with Meniere's disease and one patient with (late onset) delayed hydrops. Nine patients showed an absent response on vestibular evoked myogenic potentials and no response on caloric tests. The only patient with low amplitude on cervical vestibular evoked myogenic potentials had vertigo recurrence. Vertigo control was achieved in 90% of the patients. One patient developed hearing loss >30dB.
CONCLUSIONS: Cervical vestibular evoked myogenic potentials confirmed vestibular ablation in patients treated with intratympanic gentamicin. High-grade vertigo control was due to complete saccular and horizontal canal ablation (no response to iced water in electronystagmography and no response on cervical vestibular evoked myogenic potentials).

PMID: 27068887 [PubMed - as supplied by publisher]

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Developing and piloting a multifactorial intervention to address participation and quality of life in nursing home residents with joint contractures (JointConImprove): study protocol.

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Developing and piloting a multifactorial intervention to address participation and quality of life in nursing home residents with joint contractures (JointConImprove): study protocol.

Ger Med Sci. 2015;13:Doc13

Authors: Müller M, Bartoszek G, Beutner K, Klingshirn H, Saal S, Stephan AJ, Strobl R, Grill E, Meyer G

Abstract
BACKGROUND: Joint contractures are common problems in frail older people in nursing homes. Irrespective of the exact extent of older individuals in geriatric care settings living with joint contractures, they appear to be a relevant problem. Also, the new emphasis on the syndrome of joint contractures, e. g. by the German statutory long term care insurance, led to an increase in assessment and documentation efforts and preventive interventions in clinical care. However, more attention should be paid to the actual situation of older individuals in nursing homes with prevalent joint contractures, particularly their experience of related activity limitations and participation restrictions. Thus, the aim of this study is 1) to develop a tailored intervention to improve functioning, and especially participation and quality of life in older residents with joint contractures in nursing homes and 2) to test the feasibility of the intervention accompanied by a rigorous process evaluation.
METHODS: The complex intervention, which will be developed in this project follows the UK Medical Research Council (MRC) framework and integrates the perspectives of all potentially relevant user groups, from the affected individuals to clinicians and researchers. The development process will comprise a systematic literature review, reanalysis of existing data and the integration of the knowledge of the affected individuals and experts. The developed intervention including a comprehensive process evaluation will be pilot tested with residents with joint contractures in three nursing homes.
DISCUSSION: The projected study will provide a tailored intervention to improve functioning, participation and quality of life in older residents with joint contractures in nursing homes. With this focus, the intervention will support patient relevant outcomes. The pilot study including process evaluation will offer a first opportunity to indicate the size of the intervention's effect and prepare further studies.

PMID: 26195926 [PubMed - indexed for MEDLINE]

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Cochlear implant outcomes in patients with superior canal dehiscence.

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Cochlear implant outcomes in patients with superior canal dehiscence.

Cochlear Implants Int. 2015 Jul;16(4):213-21

Authors: Puram SV, Roberts DS, Niesten ME, Dilger AE, Lee DJ

Abstract
OBJECTIVE: To determine whether adult cochlear implant (CI) users with superior canal dehiscence syndrome (SCDS) or asymptomatic superior semicircular canal dehiscence (SCD) have different surgical, vestibular, and audiologic outcomes when compared to CI users with normal temporal bone anatomy.
METHODS: A retrospective single institution review of CI users with either superior semicircular canal dehiscence syndrome or asymptomatic superior semicircular canal dehiscence identified eight post-lingually deafened adults with unilateral or bilateral cochlear implantation between 2006 and 2010. Preoperative and postoperative speech perception scores as well as medical and epidemiological data were recorded and analyzed.
RESULTS: One patient with superior canal dehiscence syndrome and seven patients with asymptomatic superior semicircular canal dehiscence were identified, representing 7% or 8/113 of CI patients that fulfilled selection criteria. Average dehiscence length was 3.3 mm ± 0.79 SEM. Three patients received bilateral implants and five patients received a unilateral implant. Among asymptomatic superior semicircular canal dehiscence patients, subjective rates of post-operative dizziness were similar to those seen in patients with normal temporal bone anatomy (12.5 % vs. 15.9%, respectively). Speech perception abilities after surgery were poorer in SCD patients compared to the non-SCD cohort (Consonant Nucleus Consonant 33.7 ± 7.78 SEM vs. 56.7 ± 2.15 SEM P = 0.011), although both groups improved substantially relative to pre-operative performance. We also completed detailed analyses of auditory and vestibular outcomes in one patient with SCDS who underwent CI surgery in the symptomatic ear, which demonstrated preservation of vestibular function post-operatively, improved quality-of-life measures, and reduced dizziness symptomatology.
CONCLUSIONS: Our data suggest that patients with asymptomatic superior canal dehiscence at the time of CI surgery have similar albeit decreased speech perception scores compared to non-SCD adult CI users. Subjective rate of dizziness or vertigo following CI surgery was similar in both asymptomatic SCD and non-SCD cohorts, with detailed analyses of a single symptomatic SCD patient revealing improved vestibular function and reduced SCD symptoms following CI.

PMID: 24074366 [PubMed - indexed for MEDLINE]

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Tongguan Liqiao acupuncture therapy improves dysphagia after brainstem stroke.

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Tongguan Liqiao acupuncture therapy improves dysphagia after brainstem stroke.

Neural Regen Res. 2016 Feb;11(2):285-91

Authors: Zhang CH, Bian JL, Meng ZH, Meng LN, Ren XS, Wang ZL, Guo XY, Shi XM

Abstract
Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in patients with brainstem infarction. Sixty-four patients with dysphagia following brainstem infarction were recruited and divided into a medulla oblongata infarction group (n = 22), a midbrain and pons infarction group (n = 16), and a multiple cerebral infarction group (n = 26) according to their magnetic resonance imaging results. All patients received Tongguan Liqiao acupuncture for 28 days. The main acupoints were Neiguan (PC6), Renzhong (DU26), Sanyinjiao (SP6), Fengchi (GB20), Wangu (GB12), and Yifeng (SJ17). Furthermore, the posterior pharyngeal wall was pricked. Before and after treatment, patient swallowing functions were evaluated with the Kubota Water Test, Fujishima Ichiro Rating Scale, and the Standard Swallowing Assessment. The Barthel Index was also used to evaluate their quality of life. Results showed that after 28 days of treatment, scores on the Kubota Water Test and Standard Swallowing Assessment had decreased, but scores on the Fujishima Ichiro Rating Scale and Barthel Index had increased in each group. The total efficacy rate was 92.2% after treatment, and was most obvious in patients with medulla oblongata infarction (95.9%). These findings suggest that Tongguan Liqiao acupuncture therapy can repair the connection of upper motor neurons to the medulla oblongata motor nucleus, promote the recovery of brainstem infarction, and improve patient's swallowing ability and quality of life.

PMID: 27073382 [PubMed]

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Voice analysis before and after vocal rehabilitation in patients following open surgery on vocal cords.

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Voice analysis before and after vocal rehabilitation in patients following open surgery on vocal cords.

Vojnosanit Pregl. 2016 Feb;73(2):165-8

Authors: Bunijevac M, Petrović-Lazić M, Jovanović-Simić N, Vuković M

Abstract
BACKGROUND/AIM: The major role of larynx in speech, respiration and swallowing makes carcinomas of this region and their treatment very influential for patients' life quality. The aim of this study was to assess the importance of voice therapy in patients after open surgery on vocal cords.
METHODS: This study included 21 male patients and the control group of 19 subjects. The vowel (A) was recorded and analyzed for each examinee. All the patients were recorded twice: firstly, when they contacted the clinic and secondly, after a three-month vocal therapy, which was held twiceper week on an outpatient basis. The voice analysis was carried out in the Ear, Nose and Throat (ENT) Clinic, Clinical Hospital Center "Zvezdara" in Belgrade.
RESULTS: The values of the acoustic parameters in the patients submitted to open surgery on the vocal cords before vocal rehabilitation and the control group subjects were significantly different in all specified parameters. These results suggest that the voice of the patients was damaged before vocal rehabilitation. The results of the acoustic parameters of the vowel (A) before and after vocal rehabilitation of the patients with open surgery on vocal cords were statistically significantly different. Among the parameters--Jitter (%), Shimmer (%)--the observed difference was highly statistically significant (p < 0.01). The voice turbulence index and the noise/harmonic ratio were also notably improved, and the observed difference was statistically significant (p < 0.05). The analysis of the tremor intensity index showed no significant improvement and the observed difference was not statistically significant (p > 0.05 ). CONCLUSION. There was a significant improvement of the acoustic parameters of the vowel (A) in the study subjects three months following vocal therapy. Only one out of five representative parameters showed no significant improvement.

PMID: 27071284 [PubMed - in process]

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Ebi, a Drosophila homologue of TBL1, regulates the balance between cellular defense responses and neuronal survival.

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Ebi, a Drosophila homologue of TBL1, regulates the balance between cellular defense responses and neuronal survival.

Am J Neurodegener Dis. 2016;5(1):62-8

Authors: Lim YM, Tsuda L

Abstract
Transducin β-like 1 (TBL1), a transcriptional co-repressor complex, is a causative factor for late-onset hearing impairments. Transcriptional co-repressor complexes play pivotal roles in gene expression by making a complex with divergent transcription factors. However, it remained to be clarified how co-repressor complex regulates cellular survival. We herein demonstrated that ebi, a Drosophila homologue of TBL1, suppressed photoreceptor cell degeneration in the presence of excessive innate immune signaling. We also showed that the balance between NF-κB and AP-1 is a key component of cellular survival under stress conditions. Given that Ebi plays an important role in innate immune responses by regulating NF-κB activity and inhibition of apoptosis induced by associating with AP-1, it may be involved in the regulation of photoreceptor cell survival by modulating cross-talk between NF-κB and AP-1.

PMID: 27073743 [PubMed]

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Clinical outcome and patient satisfaction using biodegradable (NasoPore) and non-biodegradable packing, a double-blind, prospective, randomized study.

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Clinical outcome and patient satisfaction using biodegradable (NasoPore) and non-biodegradable packing, a double-blind, prospective, randomized study.

Braz J Otorhinolaryngol. 2016 Mar 28;

Authors: Burduk PK, Wierzchowska M, Grześkowiak B, Kaźmierczak W, Wawrzyniak K

Abstract
INTRODUCTION: Nasal packing after endoscopic sinus surgery is used as a standard procedure. The optimum solution to minimize or eliminate all disadvantages of this procedure may be accomplished using biodegradable packs.
OBJECTIVE: The aim of this study was to compare patient satisfaction and clinical outcome associated with absorbable and non-absorbable packing after FESS.
METHODS: In total, 50 patients were included in a prospective, double-blind, randomized trial. One side was packed with polyurethane foam, while the opposite side was packed with gauze packing. On the 2nd, 10th, and 30th postoperative day, the patients were questioned with the aid of a visual analog scale. The standardized questionnaires for bleeding, nasal breathing, feeling of pressure, and headache were used. The presence of synechiae, infection, or granulation was noted and recorded with the video-endoscopy.
RESULTS: A significant difference according to lower pressure was found in the NasoPore group compared to the controls on day ten after surgery. The NasoPore packing had lower scores with respect to postoperative nose blockage on the 2nd and 10th days. Mucosal healing was better for the NasoPore group, both at day ten and 30 compared with the control group.
CONCLUSION: The overall patient comfort is higher when using NasoPore compared to non-resorbable traditional impregnated gauze packing. Intensive saline douches applied three to four times per day are mandatory after the operation to prevent synechiae formation and fluid resorption by the packing.

PMID: 27068885 [PubMed - as supplied by publisher]

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Expression of estrogen and progesterone receptors in angioleiomyoma of the nasal cavity of six patients.

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Expression of estrogen and progesterone receptors in angioleiomyoma of the nasal cavity of six patients.

Oncol Lett. 2016 Apr;11(4):2359-2364

Authors: Zhu G, Xiao D, Sun P

Abstract
Angioleiomyoma of the nasal cavity is extremely rare. There are only a small number of studies in the literature that demonstrate that the estrogen receptor (ER) and progesterone receptor (PR) are expressed in angioleiomyoma, and the results from these studies are inconsistent. The present study identified 6 patients with nasal angioleiomyoma that were treated between 2004 and 2013. All patients underwent endoscopic surgery and were followed-up for 1-10 years. Resected tumors were investigated for the presence of ER and PR using immunoperoxidase staining. Of the 6 patients, 4 were men and 2 were woman. The mean age of the patients was 60.5 years. The tumors of the 6 patients were identified in the nasal septum, middle turbinate, inferior turbinate, lateral wall of the nasal cavity and nasal vestibule. The clinical manifestations reported by the patients consisted of a painless mass, recurrent epistaxis and nasal obstruction. There were no specific features observed in any of the patients using computed tomography or magnetic resonance imaging. All the patients underwent tumor dissection visualized with a nasal endoscope and recovered without recurrence or malignancy of the tumor post-surgery. Hematoxylin and eosin and immunoperoxidase staining confirmed the diagnosis of angioleiomyoma in all patients. In 5 patients the nuclei of the smooth muscle tumor cells markedly expressed ER and PR. To the best of our knowledge, the present study is the first to demonstrate that ER and PR are clearly expressed in nasal angioleiomyoma. The present study suggests that the sex hormones are possibly associated with the growth of angioleiomyoma.

PMID: 27073480 [PubMed - as supplied by publisher]

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Papillary Thyroid Cancer in a Child with Progressive Transformation of Germinal Centers.

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Papillary Thyroid Cancer in a Child with Progressive Transformation of Germinal Centers.

Case Rep Otolaryngol. 2016;2016:6469073

Authors: Mohan S, DeNardo B, Stachurski D, Greene Welch J, Groblewski JC

Abstract
Objectives. To describe the presentation and management of a child with Progressive Transformation of Germinal Centers (PTGC), an uncommon condition characterized by significant persistent lymphadenopathy, who developed papillary thyroid carcinoma and to explore and review potential links between PTGC and neoplastic processes in the head and neck. Methods. Case presentation and literature review are used. Results. A 10-year-old female presented with a right parotid mass and cervical lymphadenopathy. Multiple biopsies revealed PTGC without malignancy. Two years later, she developed fatigue and weight gain, and a thyroid nodule was found. Fine needle aspiration was strongly suggestive of papillary thyroid carcinoma. The patient underwent total thyroidectomy and central neck dissection without surgical management of the longstanding right lateral neck lymphadenopathy. Final pathology confirmed papillary thyroid carcinoma. She was treated with radioactive iodine therapy postoperatively and remains free of disease at three years of follow-up. Conclusions. PTGC is considered a benign condition but has previously been associated with Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL). This is the first reported case of papillary thyroid cancer in a child with preexisting cervical PTGC and no defined risk factors for thyroid malignancy. No link has been established with thyroid carcinoma, but patients with PTGC may have a defect in immune surveillance that predisposes them to malignancy.

PMID: 27069706 [PubMed]

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Computer-assisted navigation: its role in intraoperatively accurate mandibular reconstruction.

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Computer-assisted navigation: its role in intraoperatively accurate mandibular reconstruction.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Feb 13;

Authors: Wu J, Sun J, Shen SG, Xu B, Li J, Zhang S

Abstract
OBJECTIVE: This article presents our experiences of computer-assisted navigation in mandibular reconstruction and evaluates its effectiveness.
STUDY DESIGN: Eight patients who underwent navigation-guided mandibular reconstruction with a fibula free flap were reviewed. Under intraoperative navigation, the ideal positions of the mandibular angles and condyles were confirmed by the navigation probe. The surgical results were evaluated through postoperative panoramic radiographs, coronal computed tomography scans, and image fusion.
RESULTS: Navigation-guided mandibular reconstructions were successfully completed on the basis of preoperative planning and simulation. The surgical discrepancy in the mandibular angle between the actual surgical results and the preoperative designs was 1.92 ± 0.97 mm. Panoramic radiographs and coronal computed tomography scans illustrated that all the condyles fitted into their glenoid fossae. All patients were satisfied with their functional and aesthetic outcomes.
CONCLUSIONS: Computer-assisted navigation is a viable technology for improving surgical outcomes in mandibular reconstruction, which can assist the surgeons by providing real-time three-dimensional surgical references during the operation.

PMID: 27068681 [PubMed - as supplied by publisher]

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The use of immunohistochemistry in detection of perineural invasion in mucoepidermoid carcinoma.

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The use of immunohistochemistry in detection of perineural invasion in mucoepidermoid carcinoma.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Feb 13;

Authors: Lanzel E, Robinson RA, Zimmerman MB, Pourian A, Hellstein JW

Abstract
OBJECTIVES: To retrospectively study the prevalence of perineural invasion (PNI) in cases of mucoepidermoid carcinoma (MEC). The study evaluated if previously assessed PNI would be increased by re-review of the original hematoxylin and eosin-stained (H&E) slides and also review of slides reacted immunohistochemically with S100 to enhance nerve visualization and whether this is associated with clinical outcome.
STUDY DESIGN: Thirty-one cases were reviewed for PNI with H&E-stained slides as well as S-100-reacted slides. These results were compared with the original pathology report's PNI status when available (13 of 31). Subject demographic characteristics and clinical outcome were collected from electronic medical records.
RESULTS: PNI was identified in 23% (3 of 13) of tumors in the original reports, 13% (4 of 31) of the authors' re-review of the slides, and 29% (9 of 31) by immunohistochemical assessment for S100. PNI and larger-diameter nerve involvement were significantly associated with death at 5-year follow-up.
CONCLUSIONS: Immunohistochemical assessment for S100 improves the accuracy of PNI determination. PNI is a significant factor in the survival outcome of cases of MEC.

PMID: 27068680 [PubMed - as supplied by publisher]

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Establishing a targeted plan for prophylactic dental extractions in patients with laryngeal cancer receiving adjuvant radiotherapy.

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Establishing a targeted plan for prophylactic dental extractions in patients with laryngeal cancer receiving adjuvant radiotherapy.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Feb 13;

Authors: Hentz C, Diaz AZ, Borrowdale RW, Emami B, Kase M, Choi M

Abstract
OBJECTIVE: The purpose of this study was to determine dose delivered to individual mandibular tooth-bearing regions during adjuvant intensity-modulated radiotherapy for laryngeal cancers.
STUDY DESIGN: Twenty patients with laryngeal cancer treated with intensity-modulated radiotherapy were included. Individual mandibular tooth-borne areas were manually contoured. Average doses were calculated for individual teeth.
RESULTS: Doses to individual teeth increased with more posterior location. Highest dose was observed for third molar (M3) (43.1 Gy; P < .001). Doses to molars and premolars correlated with T- and N-stage (P = .007; P < .001, respectively). For ipsilateral nodal disease, there was no difference between the doses to ipsilateral teeth and contralateral teeth. Only in N2 c tumors, dose was above our threshold for extraction for M3 only (51.5 Gy).
CONCLUSIONS: T- and N-stage drive dose to individual mandibular tooth-borne areas. With the exception of the posterior molars, particularly in node-positive patients, radiation exposure falls below the threshold reported for pre-RT tooth extractions (50 Gy). We concluded that a more conservative approach to prophylactic tooth extraction with a greater emphasis on dental management may be warranted for the prevention of osteoradionecrosis in patients with laryngeal cancer receiving adjuvant RT.

PMID: 27068679 [PubMed - as supplied by publisher]

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Microvascular stent anastomosis using N-fibroin stents: feasibility, ischemia time, and complications.

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Microvascular stent anastomosis using N-fibroin stents: feasibility, ischemia time, and complications.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):e97-e103

Authors: Smeets R, Vorwig O, Wöltje M, Gaudin R, Luebke AM, Beck-Broichsitter B, Rheinnecker M, Heiland M, Grupp K, Gröbe A, Hanken H

Abstract
OBJECTIVE: To evaluate a novel microvascular anastomosis technique using N-fibroin stents.
STUDY DESIGN: Cylinder stents of 1 mm diameter and 5 mm length were fabricated using N-fibroin from silkworms. In 22 rats, aortas were dissected, and the stent was inserted into the two ends of the aorta and fixed using methylmethacrylate.
RESULTS: Stent anastomosis was successful in 21 (96%) rats. The mean ischemia time was 7.4 minutes, significantly shorter than the 15.9 minutes in the control group with conventional sutures (P < .0001). After 4 months, anastomosis was functionally patent in all cases. However, elastic fibers remained interrupted in all stent anastomosis cases, and marked host rejection was evident at the stent anastomosis sites. Around the stents, thrombi were frequent (52%).
CONCLUSIONS: Our study demonstrated the basic feasibility of stent anastomosis using N-fibroin stents and reduced ischemia time. However, thrombus formation, frequent and severe abdominal infections, and heavy host rejection remain critical issues.

PMID: 27068318 [PubMed - in process]

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Comparison of the performance of intraoral X-ray sensors using objective image quality assessment.

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Comparison of the performance of intraoral X-ray sensors using objective image quality assessment.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):e129-37

Authors: Hellén-Halme K, Johansson C, Nilsson M

Abstract
OBJECTIVES: The main aim of this study was to evaluate the performance of 10 individual sensors of the same make, using objective measures of key image quality parameters. A further aim was to compare 8 brands of sensors.
STUDY DESIGN: Ten new sensors of 8 different models from 6 manufacturers (i.e., 80 sensors) were included in the study. All sensors were exposed in a standardized way using an X-ray tube voltage of 60 kVp and different exposure times. Sensor response, noise, low-contrast resolution, spatial resolution and uniformity were measured.
RESULTS: Individual differences between sensors of the same brand were surprisingly large in some cases. There were clear differences in the characteristics of the different brands of sensors. The largest variations were found for individual sensor response for some of the brands studied. Also, noise level and low contrast resolution showed large variations between brands.
CONCLUSIONS: Sensors, even of the same brand, vary significantly in their quality. It is thus valuable to establish action levels for the acceptance of newly delivered sensors and to use objective image quality control for commissioning purposes and periodic checks to ensure high performance of individual digital sensors.

PMID: 27068317 [PubMed - in process]

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Gnathodiaphyseal dysplasia: report of a family with a novel mutation of the ANO5 gene.

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Gnathodiaphyseal dysplasia: report of a family with a novel mutation of the ANO5 gene.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):e123-8

Authors: Duong HA, Le KT, Soulema AL, Yueh RH, Scheuner MT, Holick MF, Christensen R, Tajima TL, Leung AM, Mallya SM

Abstract
Gnathodiaphyseal dysplasia (GDD) is a rare autosomal dominant disorder characterized by florid osseous dysplasia of the jaws, bone fragility, and diaphyseal cortical thickening and bowing of long bones. We present a family with previously undiagnosed GDD. The disorder was identified by the characteristic gnathic and skeletal manifestations in the father. Clinical and radiologic examination of the patient's son also revealed the characteristic features of GDD. Gene sequencing revealed a novel mutation (c. 1067 G>A, p. Cys356 Tyr) in the ANO5 gene, which is causative for GDD. This mutation was predicted to be detrimental by computational analyses and by structural modeling of the protein. The implications for recognition and management of this disease are discussed.

PMID: 27068316 [PubMed - in process]

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WhatsApp: a telemedicine platform for facilitating remote oral medicine consultation and improving clinical examinations-a commentary.

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WhatsApp: a telemedicine platform for facilitating remote oral medicine consultation and improving clinical examinations-a commentary.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):573

Authors: Pentapati KC, Smriti K, Gadicherla S

PMID: 27068315 [PubMed - in process]

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Morphometric features of the mandibular condyle and association with disk abnormalities.

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Morphometric features of the mandibular condyle and association with disk abnormalities.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 May;121(5):566-72

Authors: Torres MG, Crusoé-Rebello IM, Rosário M, Albuquerque MC, Campos PS

Abstract
OBJECTIVE: The aim of this study was to evaluate the relationship between the morphometric characteristics of the condyle and temporomandibular joint (TMJ) disk displacement.
STUDY DESIGN: One hundred and nine individuals who underwent magnetic resonance imaging of the TMJ were evaluated. Linear (D1: condyle width; D2: condyle thickness) and angular (A1: horizontal condylar angle; A2: anterior condylar angle; A3: medial condylar angle) measurements were made. These measurements were associated with articular disk displacement, with and without reduction.
RESULTS: There was statistically significant association between limited D1 and D2 and between A1 above and A1 below the mean and displacement of the joint disk. There was statistically significant association between A2 and anterior displacement of the disk. Furthermore, thicker condyles and/or condyles with smaller horizontal angles and/or with smaller medial angles were associated with articular disk reduction.
CONCLUSIONS: The morphometric characteristics of the bony components of the TMJ are related to articular disk displacement and with its reduction or nonreduction.

PMID: 27068314 [PubMed - in process]

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