Complete recovery following hyperbaric oxygen therapy in idiopathic sudden sensorineural hearing loss--a report of two cases.

Complete recovery following hyperbaric oxygen therapy in idiopathic sudden sensorineural hearing loss--a report of two cases.

Undersea Hyperb Med. 2016 Mar-Apr;43(2):161-6

Authors: Agrawal S, Sharma N

Abstract
Idiopathic sudden sensorineural hearing loss (ISSHL), a common otologic emergency, presents mostly as an abrupt onset unilateral hearing loss, aural fullness, often with vertigo and tinnitus, usually upon awakening in the morning. Its etiopathogenesis is multifactorial, so a number of different therapeutic regimens are in practice, hyperbaric oxygen (HBO2) therapy being an effective yet underutilized one. Not all cases recover completely even after treatment. Here we describe two cases of ISSHL, diagnosed on the basis of clinical examination and pure-tone audiometry, who had a complete recovery following administration of HBO2 therapy in addition to medical treatment. These cases are reported to highlight the effectiveness of this modality in a physician's armamentarium.

PMID: 27265993 [PubMed - in process]

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Endolymphatic sac surgery versus tenotomy of the stapedius and tensor tympani muscles in the management of patients with unilateral definite Meniere's disease.

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Endolymphatic sac surgery versus tenotomy of the stapedius and tensor tympani muscles in the management of patients with unilateral definite Meniere's disease.

Eur Arch Otorhinolaryngol. 2015 Dec;272(12):3645-50

Authors: Albu S, Babighian G, Amadori M, Trabalzini F

Abstract
This study aims to compare the outcomes of patients with Meniere's disease submitted to either endolymphatic mastoid shunt (ES) or tenotomy of the stapedius and tensor tympani muscles (TSTM). This is a retrospective chart review of patients treated with ES or TSTM between 2000 and 2010 and followed up for at least 12 months. The main outcomes were represented by: (1) vertigo class, hearing stage and functional level according to the American Academy of Otolaryngology-Head and Neck Surgery criteria; (2) adjustment of dizziness handicap inventory (DHI) and (3) complete and substantial vertigo control using the Kaplan-Meier survival method. Sixty-three patients met the inclusion criteria: 34 underwent ES and 29 TSTM. The baseline demographic characteristics, the hearing stage, the functional level, the DHI and hearing levels were not different between the two groups. No significant difference in vertigo class was demonstrated: 66 % of TSTM patients attained class A compared to 44 % in the ES group (p = 0.14). Kaplan-Meier survival curves specific to class A showed significant differences, favoring TSTM (log-rank test, p = 0.022). TSTM patients demonstrated significantly improved functional level (p = 0.0004) and improved DHI scores (p = 0.001). Eight ES patients (25 %) demanded a second surgical attempt compared to none in the TSTM. Aural fullness was significantly improved in TSTM group (p = 0.01), while the difference in tinnitus improvement was non-significant. Hearing preservation was significantly better in TSTM group (p = 0.001). TSTM is a safe surgical procedure, with significant vertigo control rates, and important hearing preservation rates. More patients and longer follow-up are needed to support our preliminary findings.

PMID: 25488280 [PubMed - indexed for MEDLINE]

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Deconvolution of the vestibular evoked myogenic potential using the power spectrum of the electromyogram.

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Deconvolution of the vestibular evoked myogenic potential using the power spectrum of the electromyogram.

Theor Biol Med Model. 2015;12:21

Authors: Lütkenhöner B

Abstract
BACKGROUND: The vestibular evoked myogenic potential (VEMP) can be modelled reasonably well by convolving two functions: one representing an average motor unit action potential (MUAP), the other representing the temporal modulation of the MUAP rate (rate modulation). It is the latter which contains the information of interest, and so it would be desirable to be able to estimate this function from a combination of the VEMP with some other data. As the VEMP is simply a stimulus-triggered average of the electromyogram (EMG), a supplementary, easily accessible source of information is the EMG power spectrum, which can be shown to be roughly proportional to the squared modulus of the Fourier transform of the MUAP. But no phase information is available for the MUAP so that a straightforward deconvolution is not possible.
METHODS: To get around the problem of incomplete information, the rate modulation is described by a thoughtfully chosen function with just a few adjustable parameters. The convolution model is then used to make predictions as to the energy spectral density of the VEMP, and the parameters are optimized using a cost function that quantifies the difference between model prediction and data.
RESULTS: The workability of the proposed approach is demonstrated by analysing Monte Carlo simulated data and exemplary data from patients who underwent VEMP testing as part of a clinical evaluation of their dizziness symptoms.
CONCLUSIONS: The approach is suited, for example, to estimate the duration of the inhibition causing the VEMP or to disentangle a VEMP consisting of more than one component.

PMID: 26438301 [PubMed - indexed for MEDLINE]

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Type and severity of septal deviation are not related with the degree of subjective nasal obstruction.

Type and severity of septal deviation are not related with the degree of subjective nasal obstruction.

Rhinology. 2016 Jun 5;

Authors: Verhoeven S, Schmelzer B

Abstract
BACKGROUND: Septoplasty is a frequently performed operation by otolaryngologists to relieve nasal obstruction complaints. When objective measurements tools are not available, preoperative decision-making is based on careful clinical examination. Our aim was to evaluate the relationship between type and severity of septal deviation and patient-reported nasal obstruction.
METHODOLOGY: 196 Patients of a general otolaryngology population were included. Patients indicated subjective nasal obstruction experienced during the past 1 month on a Visual Analog Scale (VAS). Patients underwent clinical examination to evaluate type and severity of septal deviation. We compared clinical examination findings with patients VAS.
RESULTS: We did not find a statistical difference of VAS score between the different types and severities of septal deviation. In 33.9% of the cases without septal deviation, there was a corresponding VAS score of 0. In 26,8% of the cases with septal deviation, there was no complaint of nasal obstruction (VAS = 0). In 7,4% of the cases, there was moderate to severe nasal obstruction complaint (VAS over 4) though no septal deviation was found.
CONCLUSIONS: These results demonstrate that patient-reported nasal obstruction varies greatly among patients with similar type of deviation and similar degree of deviation. Classification of septal deviation into type and severity cannot predict the degree of subjective nasal obstruction. Therefore, the decision to proceed to septoplasty has to be thoughtful, with as much as information, based on the combination of patients history, clinical examination, surgeons experience and cautious interpretation of objective measurement tools.

PMID: 27262342 [PubMed - as supplied by publisher]

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Patients' perspective on the impact of sentinel node biopsy in oral cancer treatment.

Patients' perspective on the impact of sentinel node biopsy in oral cancer treatment.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Mar 31;

Authors: Flach GB, Verdonck-de Leeuw IM, Witte BI, Klop WM, van Es RJ, Schepman KP, de Bree R

Abstract
OBJECTIVE: Assessment of the impact of a sentinel node biopsy (SNB)-based strategy in cT1/T2 N0 oral cancer on the course of health related quality of life, psychological distress, and shoulder disability, and evaluation of the patients' perspective on neck management strategies.
STUDY DESIGN: Fifty-two patients (39 SNB negative; 13 SNB positive) completed the European Organization for Research and Treatment of Cancer (EORTC) questionnaires-QLQ-C30 and QLQ-H&N35, and the HADS, IES, and SDQ questionnaires at baseline, after SNB diagnosis and at the 6-month follow-up. Objective shoulder measurements were performed after 2 years and interviews were conducted after 4.5 months of follow-up.
RESULTS: All the scores of the questionnaires were not significantly different between SNB-negative and SNB-positive patients. Objective shoulder functioning was similar. Most patients preferred a SNB-based strategy to an elective neck dissection strategy.
CONCLUSIONS: The impact of a SNB-based strategy in patients with cT1/T2 N0 oral cancer is comparable for SNB-negative and SNB-positive patients in terms of health-related quality of life, psychological distress and shoulder functioning. Most patients preferred the SNB-based strategy over the elective neck dissection strategy.

PMID: 27262509 [PubMed - as supplied by publisher]

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Endoscopic cartilage butterfly myringoplasty in children.

Endoscopic cartilage butterfly myringoplasty in children.

Auris Nasus Larynx. 2016 Jun 1;

Authors: Akyigit A, Karlidag T, Keles E, Kaygusuz I, Yalcın S, Polat C, Eroglu O

Abstract
OBJECTIVE: The present study evaluated the results of the graft success rate and hearing gain of children who underwent endoscopic inlay butterfly myringoplasty due to chronic otitis media.
METHODS: The study included 32 pediatric patients aged between 8 and 17, who had endoscopic inlay butterfly myringoplasty with the diagnosis of chronic otitis media between September 2012 and January 2015 in Elazig Training and Research Hospital Otorhinolaryngology Clinic and Firat University Otorhinolaryngology Clinic. All patients' demographics, perforation size, and hearing status were examined.
RESULTS: Tympanic membrane perforation was ≤3mm in 12 patients and between 3 and 6mm in 20 patients. The air-bone gap (ABG) of the patients was 18.5±6.29dB preoperatively, 8.81±3.53dB postoperatively second month, 8.09±3.55dB postoperatively sixth month, and 7.96±3.32dB postoperatively 12th month. Two (6.3%) of the patients had postoperative myringitis. Two (6.3%) patients had recurrent perforation in the postoperative follow-ups.
CONCLUSION: In children, endoscopic inlay butterfly tympanoplasty is a surgical technique with short duration, high graft success, effective hearing reconstruction, and high levels of postoperative patient comfort.

PMID: 27262221 [PubMed - as supplied by publisher]

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Laryngeal myofascial pain syndrome as a new diagnostic entity of dysphonia.

Laryngeal myofascial pain syndrome as a new diagnostic entity of dysphonia.

Auris Nasus Larynx. 2016 Jun 1;

Authors: Jung SY, Park HS, Bae H, Yoo JH, Park HJ, Park KD, Kim HS, Chung SM

Abstract
OBJECTIVE: To consider the feasibility of diagnosing intrinsic laryngeal muscle myofascial pain syndrome (MPS) in dysphonic patients who demonstrated immediate symptom and stroboscopic finding improvement after laryngeal electromyography (LEMG) without further treatment.
METHODS: A chart review of patients who showed subtle vocal fold movement abnormalities on a stroboscopic examination and underwent ultrasonography (US)-guided LEMG was performed. Patients with vocal fold paralysis, mucosal lesions, spasmodic dysphonia, and vocal tremor on stroboscopic examination were excluded. Among them, patients with normal EMG findings were included in this study. The patients who reported voice symptom improvement after LEMG without further treatment were placed in laryngeal MPS (LMPS) group and the other patients were placed in non-laryngeal MPS (non-MPS) group. Predisposing factors, voice symptom, symptom-duration, and stroboscopic findings of these patients were reviewed.
RESULTS: Among the 16 patients, LEMG findings were normal, five (31%) were included in the LMPS group and the other 11 patients (69%) were included in the non-MPS group. All LMPS group patients had a history of voice abuse and reported odynophonia. The Korean Voice Handicap Index-10 score decreased significantly after US-guided LEMG without additional treatment in the LMPS group. The stroboscopic findings revealed that vocal fold hypomobility was the most common finding in the LMPS group, and two patients showed a muscle tension dysphonia pattern. The LMPS groups showed improvement of vocal fold mobility on 1-week stroboscopic evaluation.
CONCLUSION: LMPS is a potential diagnosis for patients with vocal fold hypomobility finding on stroboscopic findings but with normal EMG results. Diagnosis of LMPS could be considered in patients who showed symptom and vocal fold movement improvement after LEMG.

PMID: 27262220 [PubMed - as supplied by publisher]

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Immune responses to different patterns of exposure to ovalbumin in a mouse model of allergic rhinitis.

Immune responses to different patterns of exposure to ovalbumin in a mouse model of allergic rhinitis.

Eur Arch Otorhinolaryngol. 2016 Jun 4;

Authors: Liang MJ, Fu QL, Jiang HY, Chen FH, Chen D, Chen DH, Lin ZB, Xu R

Abstract
Allergic rhinitis (AR) has been a significant healthcare burden on individuals and society. However, the detailed effect of different patterns of allergen exposure on the development of AR remains controversial. A mouse model of AR was established to address the complex relationships between allergen exposure and the development of AR. Allergic symptom, OVA-specific IgE in serum and nasal lavage fluid, allergic inflammation in nasal tissues were evaluated after intranasal sensitization and challenge of ovalbumin (OVA) in mice treated with two different doses of allergen for different sensitized durations. Exposure to different doses and sensitized durations of OVA were capable of inducing allergic nasal response. Repetitive OVA exposure in the sensitization phase induced the recruitment of eosinophils and goblet cell hyperplasia. The level of OVA-specific IgE in serum depended on OVA exposure and was mediated in a duration-related manner. In addition, mice treated with low-dose OVA for prolonged duration manifested the major features of human local allergic rhinitis. There were dose- and duration-related effects of allergen exposure on the development of AR. LAR was associated with repetitive exposure to low-dose allergen. Thus, allergen avoidance should be an important aim of AR management.

PMID: 27262883 [PubMed - as supplied by publisher]

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Transposition of lingual thyroid gland to the submandibular region by transoral approach.

Transposition of lingual thyroid gland to the submandibular region by transoral approach.

Auris Nasus Larynx. 2016 Jun 1;

Authors: Akbay E, Simsek G, Kilic R

Abstract
The purpose of this case report is to demonstrate surgical technique of only functional but symptomatic lingual thyroid gland transposition to submandibular region by transoral approach without mandibulotomy and tongue-splitting. A 37-year-old female patient was admitted to our hospital with dysphagia and apnea symptoms. Physical examination revealed 3cm×3cm lingual thyroid gland was detected at the tongue base. The patient was euthyroid and thyroid gland was not detected in the neck. Under general anesthesia, right submandibular gland excision and transposition of lingual thyroid tissue to submandibular region with dorsal lingual artery axis flap were performed by transoral approach. Thyroid hormones remained normal in the postoperative period. In conclusion transoral transposition of lingual thyroid to submandibular region as a flap without mandibulotomy is a minimally invasive and function preserving alternative approach. Besides preserving thyroid functions, this transoral surgical technique can be preferred by patients who avoid skin incision for esthetic concerns.

PMID: 27262219 [PubMed - as supplied by publisher]

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Gamma Knife Radiosurgery in Sphenopetroclivalmeningiomas:PreliminaryExperience at Iran Gamma Knife Center.

Gamma Knife Radiosurgery in Sphenopetroclivalmeningiomas:PreliminaryExperience at Iran Gamma Knife Center.

World Neurosurg. 2016 Jun 1;

Authors: Azar M, Kazemia F, Chanideh I, Amirjamshidi A, Amini E, Ghanavati P

Abstract
OBJECTIVE: The aims of this study were to characterize the epidemiological, histological, and radiological aspects of sphenopetroclival meningiomas (SpPCMs), and to evaluate the outcome of Gamma Knife radiosurgery (GKRS) either as an adjunct to microsurgery or as a primary SpPCM treatment modality.
METHODS: In this retrospective study, medical records of patients with SpPCM who underwent GKRS at the Iran Gamma Knife Center between April 2003 and March 2012 were analyzed.
RESULTS: We assessed 122 patients with SpPCMs, including 101 women and 21 men, aged 24-94 years. The mean tumor volume was 12.24 ± 9.30 mL. Patients received 22.32 ± 3.29 Gy and 13.18 ± 1.02 Gy maximal and average marginal dose of GKRS, respectively. The most common complaint was visual impairment, followed by facial sensory impairment and headache. The most frequently involved cranial nerves were III, IV, and VI in 72.1% of patients, followed by II in 52.9%, and V in 35.5%. Following radiosurgery, headaches improved in 90.0%, diplopia in 75.0%, and ptosis in 63.0% of patients. On magnetic resonance imaging, tumor size was reduced, unchanged, or increased in 77, 44, and 1 patient, respectively. Progression-free survival at the 5-year follow-up was 56.6%. Lower age (hazard ratio [HR] = 0.972, P = 0.011) and lower tumor volume (HR = 0.959, P = 0.009) were the main prognostic factors for progression-free survival.
CONCLUSION: GKRS can be an effective alternative treatment for controlling SpPCM tumor progression, producing appropriate clinical outcomes and few complications.

PMID: 27262654 [PubMed - as supplied by publisher]

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Laryngeal myofascial pain syndrome as a new diagnostic entity of dysphonia.

Laryngeal myofascial pain syndrome as a new diagnostic entity of dysphonia.

Auris Nasus Larynx. 2016 Jun 1;

Authors: Jung SY, Park HS, Bae H, Yoo JH, Park HJ, Park KD, Kim HS, Chung SM

Abstract
OBJECTIVE: To consider the feasibility of diagnosing intrinsic laryngeal muscle myofascial pain syndrome (MPS) in dysphonic patients who demonstrated immediate symptom and stroboscopic finding improvement after laryngeal electromyography (LEMG) without further treatment.
METHODS: A chart review of patients who showed subtle vocal fold movement abnormalities on a stroboscopic examination and underwent ultrasonography (US)-guided LEMG was performed. Patients with vocal fold paralysis, mucosal lesions, spasmodic dysphonia, and vocal tremor on stroboscopic examination were excluded. Among them, patients with normal EMG findings were included in this study. The patients who reported voice symptom improvement after LEMG without further treatment were placed in laryngeal MPS (LMPS) group and the other patients were placed in non-laryngeal MPS (non-MPS) group. Predisposing factors, voice symptom, symptom-duration, and stroboscopic findings of these patients were reviewed.
RESULTS: Among the 16 patients, LEMG findings were normal, five (31%) were included in the LMPS group and the other 11 patients (69%) were included in the non-MPS group. All LMPS group patients had a history of voice abuse and reported odynophonia. The Korean Voice Handicap Index-10 score decreased significantly after US-guided LEMG without additional treatment in the LMPS group. The stroboscopic findings revealed that vocal fold hypomobility was the most common finding in the LMPS group, and two patients showed a muscle tension dysphonia pattern. The LMPS groups showed improvement of vocal fold mobility on 1-week stroboscopic evaluation.
CONCLUSION: LMPS is a potential diagnosis for patients with vocal fold hypomobility finding on stroboscopic findings but with normal EMG results. Diagnosis of LMPS could be considered in patients who showed symptom and vocal fold movement improvement after LEMG.

PMID: 27262220 [PubMed - as supplied by publisher]

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Prediction of the treatment outcome using intravoxel incoherent motion and diffusional kurtosis imaging in nasal or sinonasal squamous cell carcinoma patients.

Related Articles

Prediction of the treatment outcome using intravoxel incoherent motion and diffusional kurtosis imaging in nasal or sinonasal squamous cell carcinoma patients.

Eur Radiol. 2016 Jun 2;

Authors: Fujima N, Yoshida D, Sakashita T, Homma A, Tsukahara A, Shimizu Y, Tha KK, Kudo K, Shirato H

Abstract
OBJECTIVES: To evaluate the diagnostic value of intravoxel incoherent motion (IVIM) and diffusional kurtosis imaging (DKI) parameters in nasal or sinonasal squamous cell carcinoma (SCC) patients to determine local control/failure.
METHODS: Twenty-eight patients were evaluated. MR acquisition used single-shot spin-echo EPI with 12 b-values. Quantitative parameters (mean value, 25th, 50th and 75th percentiles) of IVIM (perfusion fraction f, pseudo-diffusion coefficient D*, and true-diffusion coefficient D), DKI (kurtosis value K, kurtosis corrected diffusion coefficient Dk) and apparent diffusion coefficient (ADC) were calculated. Parameter values at both the pretreatment and early-treatment period, and the percentage change between these two periods were obtained.
RESULTS: Multivariate logistic regression analysis: the percentage changes of D (mean, 25th, 50th, 75th), K (mean, 50th, 75th), Dk (mean, 25th, 50th), and ADC (mean, 25th, 50th) were predictors of local control. ROC curve analysis: the parameter with the highest accuracy = the percentage change of D value with the histogram 25th percentile (0.93 diagnostic accuracy). Multivariate Cox regression analyses: the percentage changes of D (mean, 25th, 50th), K (mean, 50th, 75th), Dk (mean, 25th, 50th) and ADC (mean, 25th, 50th) are predictors.
CONCLUSIONS: IVIM and DKI parameters, especially the D-value's histogram 25th percentile, are useful for predicting local control.
KEY POINTS: • Noninvasive assessment of treatment outcome in SCC patients was achieved using IVIM/DKI. • Several IVIM and DKI parameters can predict the local control. • Especially, the D-value's histogram 25th percentile has high diagnostic accuracy.

PMID: 27255401 [PubMed - as supplied by publisher]

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Age-related changes in mastication are not improved by tongue exercise in a rat model.

Related Articles

Age-related changes in mastication are not improved by tongue exercise in a rat model.

Laryngoscope. 2016 Jun 3;

Authors: Krekeler BN, Connor NP

Abstract
OBJECTIVES/HYPOTHESIS: Aging results in progressive changes in deglutitive functions, which may be due in part to alterations in muscle morphology and physiology. Mastication is a critical component of bolus formation and swallowing, but aging effects on masticatory function have not been well studied.
STUDY DESIGN: The purpose of this study was to 1) quantify the effects of aging on mastication, and 2) determine the effects of tongue exercise on mastication in young adult and old rats. We hypothesized that there would be significant differences in mastication characteristics (number of bites, interval between bites, time to eat) as a function of age, and that tongue exercise would resolve preexercise differences between age groups.
METHODS: We expanded the established model of progressive, 8-week tongue exercise to include a mastication measurement: acoustic recordings of vermicelli pasta biting from 17 old and 17 young adult rats, randomized into exercise and control groups.
RESULTS: We found the following: 1) Mastication characteristics were impacted by age. Specifically in older rats, there was an increase in time to eat and number of bites and intervals between bites decreased, suggesting increased oral motor-processing requirements for bolus formation. 2) tongue exercise did not impact mastication behaviors in young adult or old rats.
CONCLUSION: Tongue exercise may not have been specific enough to result in behavioral changes in mastication or exercise dose may not have been sufficient. Nevertheless, results were noteworthy in expanding the established rat model of aging and have relevant clinical implications for future translation to human populations.
LEVEL OF EVIDENCE: N/A. Laryngoscope, 2016.

PMID: 27260802 [PubMed - as supplied by publisher]

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Oral medicine in academia.

Oral medicine in academia.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Jul;122(1):111

Authors: Scully C

PMID: 27260281 [PubMed - in process]

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Reliability of three-dimensional measurements of the upper airway on cone beam computed tomography images.

Reliability of three-dimensional measurements of the upper airway on cone beam computed tomography images.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Jul;122(1):104-10

Authors: Chen H, Aarab G, Parsa A, de Lange J, van der Stelt PF, Lobbezoo F

Abstract
OBJECTIVES: The aim of this study was (1) to assess intra- and interobserver reliability of the localization of anatomic landmarks of the upper airway on cone beam computed tomography (CBCT) images; and (2) to assess intra- and interobserver reliability of the three-dimensional measurements of the upper airway based on these landmarks.
STUDY DESIGN: Fifteen NewTom 5G (QR systems, Verona, Italy) CBCT data sets were randomly selected from the archives of the Department of Oral Radiology, Academic Centre for Dentistry (ACTA) at University of Amsterdam and VU University, Amsterdam, The Netherlands. Three observers localized six anatomic landmarks that are relevant for upper airway analysis twice, with a 10-day interval, using 3Diagnosys software (v5.3.1, 3diemme, Cantu, Italy). Subsequently, the observers performed upper airway volume measurement based on those landmarks twice as well, again with a 10-day interval, using Amira software (v4.1, Visage Imaging Inc., Carlsbad, CA). The upper airway measurements also included the minimum cross-sectional area (CSAmin), location of the CSAmin, and anteroposterior and lateral dimensions of the CSAmin.
RESULTS: Both intraobserver reliability and interobserver reliability were excellent for the localization of the anatomic landmarks of the upper airway (intraclass correlation coefficients = 0.97-1.00) as well as for the three-dimensional upper airway measurements (intraclass correlation coefficients = 0.78-1.00).
CONCLUSIONS: The methodology of landmark localization and upper airway measurements, as used in this study, showed an excellent reliability and can thus be recommended for upper airway analysis on CBCT images.

PMID: 27260280 [PubMed - in process]

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Etiology and pathogenesis of oral lichen planus: an overview.

Etiology and pathogenesis of oral lichen planus: an overview.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Jul;122(1):72-80

Authors: Kurago ZB

Abstract
Oral lichen planus is a noninfectious, chronic inflammatory condition that involves the oral mucosal stratified squamous epithelium and the underlying lamina propria and may be accompanied by skin lesions. This overview describes the current understanding of the immunopathologic mechanisms implicated in oral lichen planus.

PMID: 27260276 [PubMed - in process]

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The efficacy of botulinum toxin for the treatment of trigeminal and postherpetic neuralgia: a systematic review with meta-analyses.

The efficacy of botulinum toxin for the treatment of trigeminal and postherpetic neuralgia: a systematic review with meta-analyses.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Jul;122(1):61-71

Authors: Shackleton T, Ram S, Black M, Ryder J, Clark GT, Enciso R

Abstract
OBJECTIVE: To evaluate the efficacy of a botulinum toxin type A (BoTN-A) in treating trigeminal neuralgia (TN) and postherpetic neuralgia (PHN).
STUDY DESIGN: Three databases were searched: Medline, Web of Science, and Cochrane Library. The search was restricted to English-language randomized, placebo-controlled trials. Three review authors evaluated the cases for risk of bias.
RESULTS: Six studies were eligible for inclusion. Pooled results showed a difference in post-treatment pain intensity of -3.009 (95% confidence interval -4.566 to -1.453; P < .001) in favor of BoTN-A compared with placebo in managing TN or PHN. Of the six studies, five had unclear risk of bias, and one showed high risk.
CONCLUSIONS: Although the studies had unclear or high risk of bias, moderate evidence regarding the efficacy of BoTN-A in treating TN and PHN was found. BoTN-A might be an alternative treatment to those patients who are either unable to manage their pain medically or would like adjunct therapy.

PMID: 27260275 [PubMed - in process]

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Oral Medicine-the new dental specialty.

Oral Medicine-the new dental specialty.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Jul;122(1):1-2

Authors: Miller CS

PMID: 27260274 [PubMed - in process]

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ACR Appropriateness Criteria Head Trauma.

ACR Appropriateness Criteria Head Trauma.

J Am Coll Radiol. 2016 Jun;13(6):668-679

Authors: Shetty VS, Reis MN, Aulino JM, Berger KL, Broder J, Choudhri AF, Kendi AT, Kessler MM, Kirsch CF, Luttrull MD, Mechtler LL, Prall JA, Raksin PB, Roth CJ, Sharma A, West OC, Wintermark M, Cornelius RS, Bykowski J

Abstract
Neuroimaging plays an important role in the management of head trauma. Several guidelines have been published for identifying which patients can avoid neuroimaging. Noncontrast head CT is the most appropriate initial examination in patients with minor or mild acute closed head injury who require neuroimaging as well as patients with moderate to severe acute closed head injury. In short-term follow-up neuroimaging of acute traumatic brain injury, CT and MRI may have complementary roles. In subacute to chronic traumatic brain injury, MRI is the most appropriate initial examination, though CT may have a complementary role in select circumstances. Advanced neuroimaging techniques are areas of active research but are not considered routine clinical practice at this time. In suspected intracranial vascular injury, CT angiography or venography or MR angiography or venography is the most appropriate imaging study. In suspected posttraumatic cerebrospinal fluid leak, high-resolution noncontrast skull base CT is the most appropriate initial imaging study to identify the source, with cisternography reserved for problem solving. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

PMID: 27262056 [PubMed - as supplied by publisher]

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An Overview of Nanoparticle Based Delivery for Treatment of Inner Ear Disorders.

An Overview of Nanoparticle Based Delivery for Treatment of Inner Ear Disorders.

Methods Mol Biol. 2016;1427:363-415

Authors: Pyykkö I, Zou J, Schrott-Fischer A, Glueckert R, Kinnunen P

Abstract
Nanoparticles offer new possibilities for inner ear treatment as they can carry a variety of drugs, protein, and nucleic acids to inner ear. Nanoparticles are equipped with several functions such as targetability, immuno-transparency, biochemical stability, and ability to be visualized in vivo and in vitro. A group of novel peptides can be attached to the surface of nanoparticles that will enhance the cell entry, endosomal escape, and nuclear targeting. Eight different types of nanoparticles with different payload carrying strategies are available now. The transtympanic delivery of nanoparticles indicates that, depending on the type of nanoparticle, different migration pathways into the inner ear can be employed, and that optimal carriers can be designed according to the intended cargo. The use of nanoparticles as drug/gene carriers is especially attractive in conjunction with cochlear implantation or even as an inclusion in the implant as a drug/gene reservoir.

PMID: 27259938 [PubMed - in process]

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