Book Review: Differential Diagnosis in Neuroimaging: Head and Neck Meyer Steven , Differential Diagnosis in Neuroimaging: Head and Neck . New York : Thieme Publishers ; 2017 . Hard cover, illustrated, 649 pages.
Ann Otol Rhinol Laryngol. 2017 Aug 01;:3489417727523
Authors: Choi KY
PMID: 28849670 [PubMed - as supplied by publisher]
Validation of an Algorithm for Semi-automated Estimation of Voice Relative Fundamental Frequency.
Ann Otol Rhinol Laryngol. 2017 Aug 01;:3489417728088
Authors: Lien YS, Heller Murray ES, Calabrese CR, Michener CM, Van Stan JH, Mehta DD, Hillman RE, Noordzij JP, Stepp CE
Abstract
OBJECTIVES: Relative fundamental frequency (RFF) has shown promise as an acoustic measure of voice, but the subjective and time-consuming nature of its manual estimation has made clinical translation infeasible. Here, a faster, more objective algorithm for RFF estimation is evaluated in a large and diverse sample of individuals with and without voice disorders.
METHODS: Acoustic recordings were collected from 154 individuals with voice disorders and 36 age- and sex-matched controls with typical voices. These recordings were split into training and 2 testing sets. Using an algorithm tuned to the training set, semi-automated RFF estimates in the testing sets were compared to manual RFF estimates derived from 3 trained technicians.
RESULTS: The semi-automated RFF estimations were highly correlated ( r = 0.82-0.91) with the manual RFF estimates.
CONCLUSIONS: Fast and more objective estimation of RFF makes large-scale RFF analysis feasible. This algorithm allows for future work to optimize RFF measures and expand their potential for clinical voice assessment.
PMID: 28849664 [PubMed - as supplied by publisher]
Basal cell carcinoma of the temporal bone and external auditory canal.
Laryngoscope. 2017 Aug 29;:
Authors: Breen JT, Roberts DB, Gidley PW
Abstract
OBJECTIVES/HYPOTHESIS: To review the presenting features, treatment, and outcomes for patients with basal cell carcinoma (BCC) involving the temporal bone or external auditory canal (EAC).
STUDY DESIGN: Retrospective case series.
METHODS: Presenting characteristics, treatment strategies, and outcomes for patients with BCC involving the temporal bone or EAC were reviewed. Main outcome measures included rates of overall and disease-free survival at 5 years.
RESULTS: Forty-two patients met the inclusion criteria (mean age, 67 years). The most common presenting symptoms were hearing loss (15 patients, 36%) and otorrhea (11 patients, 26%). The 5-year overall survival rate was 78%, and the 5-year disease-free survival rate was 77%. Patients who had undergone surgery elsewhere and presented with facial weakness had significantly worse overall survival (P = .004). Ten patients (24%) underwent sacrifice of at least a portion of the facial nerve at the time of their initial procedure at our institution. Two patients (5%) developed regional nodal disease. There was a trend toward better disease-free survival for patients who received adjuvant radiation therapy after surgery at our institution (P = .06).
CONCLUSIONS: BCC originating from or extending to the temporal bone can exhibit a wide range of behavior, ranging from superficial lesions readily managed with surgery to extensive locally invasive tumors with propensity for recurrence, treated with multimodality therapy. BCC may be associated with better prognosis than other temporal bone malignancies.
LEVEL OF EVIDENCE: 4. Laryngoscope, 2017.
PMID: 28850700 [PubMed - as supplied by publisher]
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Candida meningitis after transphenoidal surgery: a single institution case-series and literature review.
World Neurosurg. 2017 Aug 25;:
Authors: Bridges KJ, Li R, Fleseriu M, Cetas JS
Abstract
Candida meningitis following neurosurgical procedures is a rare, but potentially devastating complication. The presentation of meningitis can be insidious in immunosuppressed patients and thus can be easily overlooked. Cerebrospinal fluid studies often resemble bacterial profiles, while cultures can be falsely negative. Candida albicans is the most common species identified in post-surgical Candida meningitis, and delay in diagnosis and treatment can be devastating. The standard induction therapy for Candida meningitis has been amphotericin B combined with flucytosine. A high index of suspicion is needed in any patient with risk factors such as abdominal surgery, bowel perforation, recent broad spectrum antibiotic therapy, intravenous drug use, extremes of age, indwelling catheters, and immunosuppression such as Acquired Immune Deficiency Syndrome (AIDS), malignancy, antineoplastic therapy, and steroid use. Here, we describe three case presentations of patients with giant skull base tumors who developed post-surgical Candida meningitis, each with vastly different clinical courses and outcomes, ranging from benign to catastrophic. We performed a literature review with special focus on common risk factors, Candida species, diagnostic criteria, and treatment.
PMID: 28847554 [PubMed - as supplied by publisher]
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18F-Fluorodeoxyglucose-PET/CT in locally advanced head and neck cancer can influence the stage migration and nodal radiation treatment volumes.
Radiol Med. 2017 Aug 28;:
Authors: Mazzola R, Alongi P, Ricchetti F, Fiorentino A, Fersino S, Giaj-Levra N, Salgarello M, Alongi F
Abstract
AIM: To analyze the impact of 18F-fluorodeoxyglucose-PET/CT (PET/CT) in the radiotherapy (RT) planning strategy in HNC, correlating CT-scan and PET/CT performances.
MATERIALS AND METHODS: Inclusion criteria were: age >18 years old, histologically proven head and neck cancer (HNC), patients candidate to definitive RT ± chemotherapy, stage of disease by means of PET/TC and CT-scan performed at our Cancer Care Center.
RESULTS: Sixty patients were analyzed. The following primary tumor sites were investigated: nasopharynx (13%), oropharynx (42%), oral cavity (32%) and larynx non-glottic (13%). Globally, PET/CT findings caused changes on nodal radiation treatment volumes in 10% of all the population of study. Specifically, in 5 cases out of 19 oral cavity tumors (26%), PET/CT detected neck-nodes positive (not detected at CT-scan). These findings have allowed to change the patients management, including PET/CT neck-nodes positive in the high-risk RT volumes.
CONCLUSION: In the RT planning strategy, the present findings support the use of PET/CT to improve upfront regional staging of HNC disease, particularly for oral cavity tumors. Further investigations are advocated to evaluate if this strategy could impact on long-term outcomes in terms of local control and overall survival.
PMID: 28849308 [PubMed - as supplied by publisher]
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Neck Management with Total Laryngectomy and Adjuvant Radiotherapy in Locally Advanced Larynx Cancer.
Oncol Res Treat. 2017 Aug 21;40(9):503-507
Authors: Kennedy WR, Amdur RJ, Boyce BJ, Dziegielewski P, Morris CG, Mendenhall WM
PMID: 28848123 [PubMed - as supplied by publisher]
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Intubation of the Right Atrium During an Attempted Modified Surgical Airway in a Pig.
J Spec Oper Med. Summer 2017;17(2):96-100
Authors: Bowman J, Juergens A, McClure M, Spear D
Abstract
In modern medicine, the surgical cricothyrotomy is an airway procedure of last resort. In austere environments, however, its simplicity may make it a more feasible option than carrying a full complement of laryngoscopes. To create a Transportation Security Agency-compliant compact first-response bag, we attempted to establish a surgical cricothyrotomy in a pig, using trauma shears, basic medical scissors, a pocket bougie, and an endotracheal tube. Bougies can provide tactile feedback via the "tracheal ring sign" and "stop sign" to indicate positive tracheal placement during orotracheal intubation. We report on a previously unknown serious potential complication that questions the use of scissors to establish a surgical airway and the reliability of tactile bougie signs when translated into certain surgical airways.
PMID: 28599040 [PubMed - indexed for MEDLINE]
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Unilateral Laryngeal Pacing System and Its Functional Evaluation.
Neural Plast. 2017;2017:8949165
Authors: Zeng T, Zhang Z, Peng W, Zhang F, Shi BY, Chen F
Abstract
Goal. To establish a reliable instrumental system for synchronized reactivation of a unilaterally paralyzed vocal fold and evaluate its functional feasibility. Methods. Unilateral vocal fold paralysis model was induced by destruction of the left recurrent laryngeal nerve (RLN) in anesthetized dogs. With a micro controller-based electronic system, electromyography (EMG) signals from cricothyroid (CT) muscle on the ipsilateral side were recorded and used to trigger pacing of paralyzed vocalis muscles. The dynamic movement of vocal folds was continuously monitored using an endoscope, and the opening and closing of the glottis were quantified with customized imaging processing software. Results. The recorded video images showed that left side vocal fold was obviously paralyzed after destructing the RLN. Using the pacing system with feedback triggering EMG signals from the ipsilateral CT muscle, the paralyzed vocal fold was successfully reactivated, and its movement was shown to be synchronized with the healthy side. Significance. The developed unilateral laryngeal pacing system triggered by EMG from the ipsilateral side CT muscle could be successfully used in unilateral vocal fold paralysis with the advantage of avoiding disturbance to the healthy side muscles.
PMID: 28203464 [PubMed - indexed for MEDLINE]
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Runx2, a novel regulator for goblet cell differentiation and asthma development.
FASEB J. 2017 Jan;31(1):412-420
Authors: Shi N, Zhang J, Chen SY
Abstract
Airway goblet cell differentiation and related mucus overproduction are critical processes in the development of respiratory diseases, including asthma. The underlying mechanisms, however, are not fully understood. We identified Runt-related transcription factor 2 (Runx2) as a novel regulator for goblet cell differentiation. Runx2 was up-regulated by 6.4-fold during IL-13-induced goblet cell differentiation of human bronchial epithelial cells. Knockdown of Runx2 attenuated the IL-13-induced differentiation/mucus production by 67%. Mechanistically, Runx2 bound to the promoter of SAM-pointed domain-containing Ets-like factor (SPDEF), a known factor for goblet cell differentiation, resulting in an activation of SPDEF transcription. In vivo, Runx2 was induced by 6.2-fold in pulmonary epithelium of house dust mite-challenged mice. Blockade of Runx2 inhibited the house dust mite-induced goblet cell differentiation with a 75% reduction in mucus overproduction while improving airway responsiveness to methacholine by 41%. More importantly, a 12.3-fold increase in Runx2 expression was observed in human asthma lung epithelium, underlying the potential clinical importance of these findings.-Shi, N., Zhang, J., Chen, S.-Y. Runx2, a novel regulator for goblet cell differentiation and asthma development.
PMID: 27825108 [PubMed - indexed for MEDLINE]
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Intestinal bacteria are necessary for doxorubicin-induced intestinal damage but not for doxorubicin-induced apoptosis.
Gut Microbes. 2016 Sep 02;7(5):414-23
Authors: Rigby RJ, Carr J, Orgel K, King SL, Lund PK, Dekaney CM
Abstract
Doxorubicin (DOXO) induces significant, but transient, increases in apoptosis in the stem cell zone of the jejunum, followed by mucosal damage involving a decrease in crypt proliferation, crypt number, and villus height. The gastrointestinal tract is home to a vast population of commensal bacteria and numerous studies have demonstrated a symbiotic relationship between intestinal bacteria and intestinal epithelial cells (IEC) in maintaining homeostatic functions of the intestine. However, whether enteric bacteria play a role in DOXO-induced damage is not well understood. We hypothesized that enteric bacteria are necessary for induction of apoptosis and damage associated with DOXO treatment. Conventionally raised (CONV) and germ free (GF) mice were given a single injection of DOXO, and intestinal tissue was collected at 6, 72, and 120 h after treatment and from no treatment (0 h) controls. Histology and morphometric analyses quantified apoptosis, mitosis, crypt depth, villus height, and crypt density. Immunostaining for muc2 and lysozyme evaluated Paneth cells, goblet cells or dual stained intermediate cells. DOXO administration induced significant increases in apoptosis in jejunal epithelium regardless of the presence of enteric bacteria; however, the resulting injury, as demonstrated by statistically significant changes in crypt depth, crypt number, and proliferative cell number, was dependent upon the presence of enteric bacteria. Furthermore, we observed expansion of Paneth and goblet cells and presence of intermediate cells only in CONV and not GF mice. These findings provide evidence that manipulation and/or depletion of the enteric microbiota may have clinical significance in limiting chemotherapy-induced mucositis.
PMID: 27459363 [PubMed - indexed for MEDLINE]
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Oat-cell carcinoma of the tongue.
Acta Otorrinolaringol Esp. 2016 Sep-Oct;67(5):297-9
Authors: Aguilar F, Cuadrado M, Serra J, Bernal-Escoté X
PMID: 26956201 [PubMed - indexed for MEDLINE]
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Expression of pro-inflammatory cytokines in the auditory cortex of rats with salicylate-induced tinnitus.
Mol Med Rep. 2017 Aug 11;:
Authors: Chen XH, Zheng LL
Abstract
Tinnitus often results in severe psychological distress. The present study hypothesized that tinnitus acts as a chronic stressor and induces dysregulation of the production of cytokines. The gap pre‑pulse inhibition of acoustic startle paradigm was applied to test tinnitus‑like behavior in rats. Following this, the mRNA and protein expression levels of interferon (IFN)‑γ, tumor necrosis factor (TNF)‑α, interleukin (IL)‑6 and N‑methyl D‑aspartate receptor subunit 2A (NR2A) were measured in rats subjected to acute and chronic salicylate treatment, using reverse transcription‑quantitative polymerase chain reaction and western blot analysis, respectively. The gap prepulse inhibition of acoustic startle paradigm detected the tinnitus‑like behavior of rats. The expression of TNF‑α and NR2A genes were increased in the auditory cortex (AC) following long‑term administration of salicylate, whereas the expression of IFN‑γ genes decreased; however, the mRNA levels reversed back to normal baseline 14 days following the cease of salicylate administration. IL‑6 gene expression, however, was not fundamentally altered by salicylate treatment. The data demonstrated that chronic salicylate administration induces tinnitus, in part, via dysregulation of cytokines and specific membrane receptors in the AC.
PMID: 28849125 [PubMed - as supplied by publisher]
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Exploring Tinnitus-Induced Disablement by Persistent Frustration in Aging Individuals: A Grounded Theory Study.
Front Aging Neurosci. 2017;9:272
Authors: Dauman N, Erlandsson SI, Albarracin D, Dauman R
Abstract
Background: Qualitative research can help to improve the management of patients, meet their expectations and assist physicians in alleviating their suffering. The perception of moment-to-moment variability in tinnitus annoyance is an emerging field of exploration. This study sought to enlighten variability in tinnitus-induced disablement using a qualitative approach. Methods: Twelve participants (six females, six males, aged 51-79) were recruited via the French Tinnitus Association Journal for participation in recorded semi-structured interviews. Each participant had three interviews lasting 1 h, the sessions being separated one from the other by 2 weeks. Following recommendations of Charmaz (2014), the second and third interviews were aimed at gathering rich data, by enhancing the participants' reflexivity in the circumstances of distress caused by tinnitus. After transcription, the data (n = 36 interviews) were analyzed using the approach to Grounded Theory proposed by Strauss and Corbin (1998). Results: Tinnitus as persistent frustration emerged as being the core category uniting all the other categories of the study. Hence, the core category accounted for the broader scope in participants' experience of chronic tinnitus. It is suggested that tinnitus-induced disablement varied according to the degree of frustration felt by the participants in not being able to achieve their goals. The implications of this were analyzed using the following categories: "Losing body ownership," "Lacking perspectives," and "Persevering through difficulties." Based on these findings, we draw a substantive theory of tinnitus tolerance that promotes an active, disciplined and individualized approach to tinnitus-induced disablement. The model distinguishes pathways from sustained suffering to reduced annoyance (i.e., emerging tolerance). It accounts for difficulties that the participants experienced with a perceived unchanged annoyance over time. Furthermore, this model identifies a set of new attitudes toward oneself and others that tinnitus tolerance would entail. Conclusion: The subjective experience of frustration enlightens tinnitus-induced disablement, offering new perspectives for long-term self-management. Modulation of frustration, rather than moderation of tinnitus interference, is suggested as a new approach to the clinical management of tinnitus-related distress.
PMID: 28848429 [PubMed]
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Vagus Nerve Stimulation Enhances Extinction of Conditioned Fear in Rats and Modulates Arc Protein, CaMKII, and GluN2B-Containing NMDA Receptors in the Basolateral Amygdala.
Neural Plast. 2016;2016:4273280
Authors: Alvarez-Dieppa AC, Griffin K, Cavalier S, McIntyre CK
Abstract
Vagus nerve stimulation (VNS) enhances the consolidation of extinction of conditioned fear. High frequency stimulation of the infralimbic cortex (IL) produces long-term potentiation in the basolateral amygdala (BLA) in rats given VNS-paired extinction training, whereas the same stimulation produces long-term depression in sham-treated rats. The present study investigated the state of synaptic plasticity-associated proteins in the BLA that could be responsible for this shift. Male Sprague-Dawley rats were separated into 4 groups: auditory fear conditioning only (fear-conditioned); fear conditioning + 20 extinction trials (extended-extinction); fear conditioning + 4 extinction trials paired with sham stimulation (sham-extinction); fear conditioning + 4 extinction trials paired with VNS (VNS-extinction). Freezing was significantly reduced in extended-extinction and VNS-extinction rats. Western blots were used to quantify expression and phosphorylation state of synaptic plasticity-associated proteins such as Arc, CaMKII, ERK, PKA, and AMPA and NMDA receptors. Results show significant increases in GluN2B expression and phosphorylated CaMKII in BLA samples from VNS- and extended-extinction rats. Arc expression was significantly reduced in VNS-extinction rats compared to all groups. Administration of the GluN2B antagonist ifenprodil immediately after fear extinction training blocked consolidation of extinction learning. Results indicate a role for BLA CaMKII-induced GluN2B expression and reduced Arc protein in VNS-enhanced extinction.
PMID: 27957346 [PubMed - indexed for MEDLINE]
Spasmodic Dysphonia: A Review. Part 1: Pathogenic Factors.
Otolaryngol Head Neck Surg. 2017 Aug 01;:194599817728521
Authors: Hintze JM, Ludlow CL, Bansberg SF, Adler CH, Lott DG
Abstract
Objective The purpose of this review is to describe the recent advances in identifying possible factors involved in the pathogenesis of spasmodic dysphonia. Spasmodic dysphonia is a task-specific focal laryngeal dystonia characterized by irregular and uncontrolled voice breaks. Pathogenesis of the disorder is poorly understood. Data Sources PubMed, Google Scholar, and Cochrane Library. Review Methods The data sources were searched using the following search terms: ( spasmodic dysphonia or laryngeal dystonia) and ( etiology, aetiology, diagnosis, pathogenesis, or pathophysiology). Conclusions Several potential etiological factors have been proposed by epidemiological, genetic, and neuropathological studies. Spasmodic dysphonia is a rare disorder primarily affecting females beginning in their 40s. Vocal tremor co-occurs in 30% to 60%. Large cohort studies identified risk factors such as a family history of neurological disorders including dystonia and tremor, recent viral illness, and heavy voice use. As none are rare events, a complex interactive process may contribute to pathogenesis in a small proportion of those at risk. Consequences to pathogenesis are neurological processes found in spasmodic dysphonia: loss of cortical inhibition, sensory processing disturbances, and neuroanatomical and physiological differences in the laryngeal motor control system. Implications for Practice Diagnosis of spasmodic dysphonia usually includes speech and laryngoscopic assessment. However, as diagnosis is sometimes problematic, measurement of neurophysiological abnormalities may contribute useful adjuncts for the diagnosis of spasmodic dysphonia in the future.
PMID: 28850801 [PubMed - as supplied by publisher]
Spasmodic Dysphonia: A Review. Part 2: Characterization of Pathophysiology.
Otolaryngol Head Neck Surg. 2017 Aug 01;:194599817728465
Authors: Hintze JM, Ludlow CL, Bansberg SF, Adler CH, Lott DG
Abstract
Objective The purpose of this review is to describe the recent advances in characterizing spasmodic dysphonia. Spasmodic dysphonia is a task-specific focal laryngeal dystonia characterized by irregular and uncontrolled voice breaks. The pathophysiology is poorly understood, and there are diagnostic difficulties. Data Sources PubMed, Google Scholar, and Cochrane Library. Review Methods The data sources were searched using the following search terms: ( spasmodic dysphonia or laryngeal dystonia) and ( etiology, aetiology, diagnosis, pathogenesis, or pathophysiology). Conclusion The diagnosis of spasmodic dysphonia can be difficult due to the lack of a scientific consensus on diagnostic criteria and the fact that other voice disorders may present similarly. Confusion can arise between spasmodic dysphonia and muscle tension dysphonia. Spasmodic dysphonia symptoms are tied to particular speech sounds, whereas muscle tension dysphonia is not. With the advent of more widespread use of high-speed laryngoscopy and videokymography, measures of the disruptions in phonation and delays in the onset of vocal fold vibration after vocal fold closure can be quantified. Recent technological developments have expanded our understanding of the pathophysiology of spasmodic dysphonia. Implications for Practice A 3-tiered approach, involving a questionnaire, followed by speech assessment and nasolaryngoscopy is the most widely accepted method for making the diagnosis in most cases. More experimental and invasive techniques such as electromyography and neuroimaging have been explored to further characterize spasmodic dysphonia and aid in diagnosing difficult cases.
PMID: 28850796 [PubMed - as supplied by publisher]
Impact of Type 2 Diabetes Mellitus on Survival in Head and Neck Squamous Cell Carcinoma.
Otolaryngol Head Neck Surg. 2017 Aug 01;:194599817726756
Authors: Foreman A, Lee DJ, McMullen C, de Almeida J, Muhanna N, Gama RR, Giuliani M, Liu G, Bratman SV, Huang SH, O'Sullivan B, Song Y, Xu W, Goldstein DP
Abstract
Objective To identify any association between type 2 diabetes mellitus (T2DM) and survival outcomes for mucosal squamous cell carcinoma of the head and neck. An association has been demonstrated between T2DM and cancer outcomes at numerous sites, but data for the head and neck are limited. Improving our understanding of the impact that diabetes has on head and neck cancer survival is relevant for making treatment decisions and counseling patients regarding prognosis. Study Design Retrospective cohort study. Setting Academic tertiary referral head and neck cancer center. Subjects and Methods By accessing data retrospectively from prospectively collected databases at the Princess Margaret Cancer Centre, patients were studied who were treated for mucosal head and neck squamous cell cancer between January 2005 and December 2011. Collection of clinical, pathologic, and survival data was completed with an emphasis on T2DM. Results Of 2498 patients identified in the study period, 319 (12.8%) had T2DM. Five-year overall survival was not different between the diabetic (64%, 95% CI = 58%-71%) and nondiabetic (67%, 95% CI = 65%-69%; P = .078) groups. Furthermore, cause-specific survival did not demonstrate a statistically significant difference between groups (diabetic: 84%, 95% CI = 79%-88%, vs nondiabetic: 84%, 95% CI = 82%-86%; P = .67). Conclusion Despite contradictory evidence at other cancer sites, the presence of T2DM alone does not appear to adversely affect cancer survival outcomes in head and neck squamous cell cancer. This is encouraging for the diabetic patients with head and neck squamous cell cancer, and it provides guidance for the multidisciplinary team that treats them.
PMID: 28849730 [PubMed - as supplied by publisher]
Critical Airway Team: A Retrospective Study of an Airway Response System in a Pediatric Hospital.
Otolaryngol Head Neck Surg. 2017 Aug 01;:194599817719400
Authors: Sterrett EC, Myer CM, Oehler J, Das B, Kerrey BT
Abstract
Objective Study the performance of a pediatric critical airway response team. Study Design Case series with chart review. Setting Freestanding academic children's hospital. Subjects and Methods A structured review of the electronic medical record was conducted for all activations of the critical airway team. Characteristics of the activations and patients are reported using descriptive statistics. Activation of the critical airway team occurred 196 times in 46 months (March 2012 to December 2015); complete data were available for 162 activations (83%). For 49 activations (30%), patients had diagnoses associated with difficult intubation; 45 (28%) had a history of difficult laryngoscopy. Results Activation occurred at least 4 times per month on average (vs 3 per month for hospital-wide codes). The most common reasons for team activation were anticipated difficult intubation (45%) or failed intubation attempt (20%). For 79% of activations, the team performed an airway procedure, most commonly direct laryngoscopy and tracheal intubation. Bronchoscopy was performed in 47% of activations. Surgical airway rescue was attempted 4 times. Cardiopulmonary resuscitation occurred in 41 activations (25%). Twenty-nine patients died during or following team activation (18%), including 10 deaths associated with the critical airway event. Conclusion Critical airway team activation occurred at least once per week on average. Direct laryngoscopy, tracheal intubation, and bronchoscopic procedures were performed frequently; surgical airway rescue was rare. Most patients had existing risk factors for difficult intubation. Given our rate of serious morbidity and mortality, primary prevention of critical airway events will be a focus of future efforts.
PMID: 28849711 [PubMed - as supplied by publisher]
Management of Large-Volume Subperiosteal Abscesses of the Orbit: Medical vs Surgical Outcomes.
Otolaryngol Head Neck Surg. 2017 Aug 01;:194599817728490
Authors: Nation J, Lopez A, Grover N, Carvalho D, Vinocur D, Jiang W
Abstract
Objectives To compare clinical variables and outcomes for children with subperiosteal abscesses of the orbit (SPAO) managed medically vs surgically to identify clinical prognosticators. Study Design Case series with chart review. Setting Tertiary children's academic institution. Subjects and Methods The study included 48 children between the age of 1 month and 14 years, with SPAO from 2003 to 2013. Variables included age, sex, physical examination findings, laboratory results, computed tomography (CT) findings, hospital length of stay, length of antibiotic therapy, and placement of a peripherally inserted central catheter (PICC). Intended methods for comparison were the Student t test for continuous variables and Fisher's exact test for categorical variables, and a forward stepwise multiple logistic regression. Results Thirty-two (67%) children were successfully treated with antibiotic therapy only, and 16 (33%) required surgery. Abscess volume, abscess width, and the presence of gaze restriction were statistically different between the 2 groups. A multivariate analysis found abscess volume as the only predictor for surgical intervention. A subgroup analysis including only patients with an abscess volume of ≥500 mm(3) (n = 26) was performed. Eleven patients were treated medically and 15 treated surgically, with the medical group having longer hospital stays ( P = .048), duration of antibiotic therapy ( P = .035), and higher incidence of PICC placement ( P = .005). Conclusions This is the first study to report that abscess volume has clinical implications, as children with SPAO volume ≥500 mm(3) treated medically have longer inpatient admissions, antibiotic therapy durations, and PICC placement. When children present with an abscess ≥500 mm(3), early surgical intervention should be strongly considered, even in the absence of other surgical criteria, to shorten duration of hospitalization and accelerate clinical improvement.
PMID: 28849710 [PubMed - as supplied by publisher]
Auditory Outcomes with Hearing Rehabilitation in Children with Unilateral Hearing Loss: A Systematic Review.
Otolaryngol Head Neck Surg. 2017 Aug 01;:194599817726757
Authors: Appachi S, Specht JL, Raol N, Lieu JEC, Cohen MS, Dedhia K, Anne S
Abstract
Objective Options for management of unilateral hearing loss (UHL) in children include conventional hearing aids, bone-conduction hearing devices, contralateral routing of signal (CROS) aids, and frequency-modulating (FM) systems. The objective of this study was to systematically review the current literature to characterize auditory outcomes of hearing rehabilitation options in UHL. Data Sources PubMed, EMBASE, Medline, CINAHL, and Cochrane Library were searched from inception to January 2016. Manual searches of bibliographies were also performed. Review Methods Studies analyzing auditory outcomes of hearing amplification in children with UHL were included. Outcome measures included functional and objective auditory results. Two independent reviewers evaluated each abstract and article. Results Of the 249 articles identified, 12 met inclusion criteria. Seven articles solely focused on outcomes with bone-conduction hearing devices. Outcomes favored improved pure-tone averages, speech recognition thresholds, and sound localization in implanted patients. Five studies focused on FM systems, conventional hearing aids, or CROS hearing aids. Limited data are available but suggest a trend toward improvement in speech perception with hearing aids. FM systems were shown to have the most benefit for speech recognition in noise. Studies evaluating CROS hearing aids demonstrated variable outcomes. Conclusions Data evaluating functional and objective auditory measures following hearing amplification in children with UHL are limited. Most studies do suggest improvement in speech perception, speech recognition in noise, and sound localization with a hearing rehabilitation device.
PMID: 28849705 [PubMed - as supplied by publisher]
Hearing Outcomes after Ossicular Reconstruction with Removal of the Malleus.
Otolaryngol Head Neck Surg. 2017 Aug 01;:194599817726279
Authors: Haberman RS, Salapatas AM
Abstract
Objectives (1) Evaluate hearing outcomes of patients after planned malleus removal during ossicular chain reconstruction. (2) Analyze hearing results for titanium (Ti) and hydroxyapatite (HA) total ossicular prostheses (TOPs) and partial ossicular prostheses (POPs). (3) Compare Ti and HA partial prostheses. Study Design Retrospective case series with chart review. Setting Tertiary health care organization. Subjects and Methods A chart review was conducted of 139 consecutive patients who presented with chronic otitis media with perforation (with or without cholesteatoma) and were treated with initial-stage tympanoplasty (with or without mastoidectomy) and managed with TOP (n = 22) or POP (n = 117) between July 2010 and July 2015. The malleus was completely removed in all cases. Hearing was assessed via bone and air conduction pretone averages (0.5, 1, 2 kHz) pre- and postoperatively. Air-bone gap (ABG) and change in ABG (ΔABG) were analyzed. Pre- and postoperative values were compared. Results The overall mean ABG decreased from 29.4 ± 12.3 dB to 18.2 ± 11.4 dB postoperatively ( P < .001) with a mean ΔABG of 14.5 dB (95% CI, 12.793-16.203). Overall success was achieved by 69.1%. The POP group achieved higher success (70.9%) than the TOP group (59.1%; P = .0001). Mean ABG decreased significantly within surgical groups (TOP and POP) and prosthesis material groups (Ti and HA; all P < .001). Ti had statistically higher success than HA in both techniques: POP ( P = .0478) and TOP ( P = .0251). There was a 98% graft take rate. Conclusion Planned malleus removal during ossicular chain reconstruction, regardless of disease extent, allows for simpler reconstruction and comparable favorable results to preservation of the malleus and should be considered during surgical planning.
PMID: 28849699 [PubMed - as supplied by publisher]
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NLRP3 mutation and cochlear autoinflammation cause syndromic and nonsyndromic hearing loss DFNA34 responsive to anakinra therapy.
Proc Natl Acad Sci U S A. 2017 Aug 28;:
Authors: Nakanishi H, Kawashima Y, Kurima K, Chae JJ, Ross AM, Pinto-Patarroyo G, Patel SK, Muskett JA, Ratay JS, Chattaraj P, Park YH, Grevich S, Brewer CC, Hoa M, Kim HJ, Butman JA, Broderick L, Hoffman HM, Aksentijevich I, Kastner DL, Goldbach-Mansky R, Griffith AJ
Abstract
The NLRP3 inflammasome is an intracellular innate immune sensor that is expressed in immune cells, including monocytes and macrophages. Activation of the NLRP3 inflammasome leads to IL-1β secretion. Gain-of-function mutations of NLRP3 result in abnormal activation of the NLRP3 inflammasome, and cause the autosomal dominant systemic autoinflammatory disease spectrum, termed cryopyrin-associated periodic syndromes (CAPS). Here, we show that a missense mutation, p.Arg918Gln (c.2753G > A), of NLRP3 causes autosomal-dominant sensorineural hearing loss in two unrelated families. In family LMG446, hearing loss is accompanied by autoinflammatory signs and symptoms without serologic evidence of inflammation as part of an atypical CAPS phenotype and was reversed or improved by IL-1β blockade therapy. In family LMG113, hearing loss segregates without any other target-organ manifestations of CAPS. This observation led us to explore the possibility that resident macrophage/monocyte-like cells in the cochlea can mediate local autoinflammation via activation of the NLRP3 inflammasome. The NLRP3 inflammasome can indeed be activated in resident macrophage/monocyte-like cells in the mouse cochlea, resulting in secretion of IL-1β. This pathway could underlie treatable sensorineural hearing loss in DFNA34, CAPS, and possibly in a wide variety of hearing-loss disorders, such as sudden sensorineural hearing loss and Meniere's disease that are elicited by pathogens and processes that stimulate innate immune responses within the cochlea.
PMID: 28847925 [PubMed - as supplied by publisher]
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Succinyl-CoA synthetase (SUCLA2) deficiency in two siblings with impaired activity of other mitochondrial oxidative enzymes in skeletal muscle without mitochondrial DNA depletion.
Mol Genet Metab. 2017 Mar;120(3):213-222
Authors: Huang X, Bedoyan JK, Demirbas D, Harris DJ, Miron A, Edelheit S, Grahame G, DeBrosse SD, Wong LJ, Hoppel CL, Kerr DS, Anselm I, Berry GT
Abstract
Mutations in SUCLA2 result in succinyl-CoA ligase (ATP-forming) or succinyl-CoA synthetase (ADP-forming) (A-SCS) deficiency, a mitochondrial tricarboxylic acid cycle disorder. The phenotype associated with this gene defect is largely encephalomyopathy. We describe two siblings compound heterozygous for SUCLA2 mutations, c.985A>G (p.M329V) and c.920C>T (p.A307V), with parents confirmed as carriers of each mutation. We developed a new LC-MS/MS based enzyme assay to demonstrate the decreased SCS activity in the siblings with this unique genotype. Both siblings shared bilateral progressive hearing loss, encephalopathy, global developmental delay, generalized myopathy, and dystonia with choreoathetosis. Prior to diagnosis and because of lactic acidosis and low activity of muscle pyruvate dehydrogenase complex (PDC), sibling 1 (S1) was placed on dichloroacetate, while sibling 2 (S2) was on a ketogenic diet. S1 developed severe cyclic vomiting refractory to therapy, while S2 developed Leigh syndrome, severe GI dysmotility, intermittent anemia, hypogammaglobulinemia and eventually succumbed to his disorder. The mitochondrial DNA contents in skeletal muscle (SM) were normal in both siblings. Pyruvate dehydrogenase complex, ketoglutarate dehydrogenase complex, and several mitochondrial electron transport chain (ETC) activities were low or at the low end of the reference range in frozen SM from S1 and/or S2. In contrast, activities of PDC, other mitochondrial enzymes of pyruvate metabolism, ETC and, integrated oxidative phosphorylation, in skin fibroblasts were not significantly impaired. Although we show that propionyl-CoA inhibits PDC, it does not appear to account for decreased PDC activity in SM. A better understanding of the mechanisms of phenotypic variability and the etiology for tissue-specific secondary deficiencies of mitochondrial enzymes of oxidative metabolism, and independently mitochondrial DNA depletion (common in other cases of A-SCS deficiency), is needed given the implications for control of lactic acidosis and possible clinical management.
PMID: 27913098 [PubMed - indexed for MEDLINE]
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Contrasting results of tests of peripheral vestibular function in patients with bilateral large vestibular aqueduct syndrome.
Clin Neurophysiol. 2017 Aug;128(8):1513-1518
Authors: Zhou YJ, Wu YZ, Cong N, Yu J, Gu J, Wang J, Chi FL
Abstract
OBJECTIVE: To analyze and summarize the effect of bilateral large vestibular aqueducts in peripheral vestibular organ function.
METHODS: Eighteen patients with bilateral large vestibular aqueduct syndrome (LVAS; Study Group) and 18 healthy volunteers (Control Group) were investigated using audiometry, caloric test, sensory organization test (SOT), and vestibular-evoked myogenic potential (VEMP) tests.
RESULTS: All 18 patients (36 ears) exhibited sensorineural hearing loss. For cervical VEMP (cVEMP), the Study Group showed lower thresholds (Study Group vs.
CONTROL GROUP: 71.4vs. 75.3dBnHL; p=0.006), N1 latencies (24.1vs. 25.2ms; p=0.026) and shorter P1 (15.3vs. 16.6ms; p=0.003), and higher amplitudes (400.7vs. 247.2µV; p<0.001) than the Control Group. For ocular VEMP (oVEMP), the Study Group had lower thresholds (79.3vs. 81.8dBnHL; p=0.046) and higher amplitudes (40.6vs. 14.4µV; p<0.001) than the Control Group. Fourteen of 16 patients (87.5%) who completed caloric tests had abnormal results, and 10 of 18 patients (55.6%) exhibited abnormal results in SOTs.
CONCLUSIONS: The hyperfunction of vestibular test in otolithic organs and the hypofunction of vestibular test in semicircular canals, as well as the dysfunction in the balance test were demonstrated in patients with LVAS.
SIGNIFICANCE: Our findings can help clinicians gain a better understanding of the characteristics of vestibular organ function in patients with LVAS, which can facilitate optimal targeted treatment.
PMID: 28667933 [PubMed - indexed for MEDLINE]
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Analysis of the correlation between dental arch and articular eminence morphology: a cone beam computed tomography study.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Jul 26;:
Authors: Verner FS, Roque-Torres GD, Ramírez-Sotello LR, Devito KL, Almeida SM
Abstract
OBJECTIVE: The aim of the study was to assess the correlation between the morphology of the dental arches (DAs) of patients with normal occlusion and of the articular eminence (AE) by using cone beam computed tomography (CBCT).
STUDY DESIGN: CBCT scans of 60 patients were evaluated in terms of height and inclinations (angles α, β, and δ) of the AE. DAs were classified according to their shapes (tapered, square, ovoid), and their perimeters, widths, and depths were measured. One-way analysis of variance, Pearson's correlation coefficients, and simple and multivariate linear regression models were used for the calculations.
RESULTS: The ovoid arch was the most predominant shape (n = 66/120). Inclination of the AE (angle β) had the greatest difference between DA shapes, with this angle usually being greater in the ovoid arch and smaller in the square arch (P < .05). The height of the AE presented greater correlation with DA measurements, with tapered arches having the most significant correlations (P < .05). DA depth had no influence on AE measurements (P > .05). The perimeter and width of the DAs had some influence (P < .05).
CONCLUSIONS: Correlations were found between the DA and AE morphologies. The correlations should be taken into consideration, although the results do not prove absolute association between the variables. Whenever possible, the morphologic features of DAs should be preserved to avoid possible changes in AE.
PMID: 28847629 [PubMed - as supplied by publisher]
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Idiopathic Ulcerative Laryngitis: An uncommon disease.
Acta Otorrinolaringol Esp. 2016 Sep-Oct;67(5):293-6
Authors: Valls M, Vilaseca I
PMID: 26748984 [PubMed - indexed for MEDLINE]
Chirurgie der inneren Nase.
Laryngorhinootologie. 2017 Aug;96(8):572-576
Authors: Kastenbauer ER
PMID: 28850997 [PubMed - in process]
Fragen für die Facharztprüfung.
Laryngorhinootologie. 2017 Aug;96(8):570-571
Authors:
PMID: 28850996 [PubMed - in process]
Neugeborenen-Hörscreening, Tracking und hörgerichtete Frühförderung.
Laryngorhinootologie. 2017 Aug;96(8):555-569
Authors: Loderstedt M, Vorwerk W, Arens C, Vorwerk U
PMID: 28850995 [PubMed - in process]
Mindestmengen: Die Qual der Zahl oder Mittel der Qualitätssicherung?
Laryngorhinootologie. 2017 Aug;96(8):552-554
Authors: Kuball L, Wienke A
PMID: 28850994 [PubMed - in process]
[Benign and malignant disorders of the jaw].
Laryngorhinootologie. 2017 Aug;96(8):544-548
Authors: Kloth C, Horger M, Bösmüller H, Haap M, Ioanoviciu SD
PMID: 28850993 [PubMed - in process]
Die Behandlung des M. Menière mit Betahistin: Kritische Anmerkungen zur BEMED-Studie.
Laryngorhinootologie. 2017 Aug;96(8):519-521
Authors: Ernst A, Schlattmann P, Waldfahrer F, Westhofen M
Abstract
The BEMED study (BMJ 2016; 352: DOI 10.1136) was designed as multi-centric, double-blind, plaebo-controlled study in patients with Menière's disease. It should compare a low-level (2 × 24 mg/d) vs. high-level (3 × 48 mg/d) betahstine intake vs. placebo. The primary endpoint was the "number of vertigo attacks lasting longer than 20 min as documented in a patient's diary". The main finding of the study was that betahistine did not significantly better reduced the number of vertigo attacks than placebo. Therefore, the BEMED study should be critically discussed in the present paper.
PMID: 28850992 [PubMed - in process]
[Cancer and nutrition - a paradigma shift].
Laryngorhinootologie. 2017 Aug;96(8):514-518
Authors: Imoberdorf R, Rühlin M, Ballmer PE
Abstract
Substantial international differences in the prevalence of cancer disease suppose that nutrition may be an important factor in the development of cancer. Many experts believe, that nutritional factors may contribute up to 35 % to the development of malignant tumors. Many patients have lost substantial body weight already at the time of the diagnosis of the disease as consequence of undernutrition and malnutrition, respectively. During the course of the disease the nutritional status often is deteriorating further. Caused by both the cancer disease itself and the treatment, loss of appetite, changes in taste, nausea and vomiting may additionally contribute to undernutrition. Undernutrition is a relevant factor for the outcome of the disease and for the tolerance of the treatment as well. Therefore, supporting the heavily impaired patients in nutritional intake is of paramount importance and an urgent task for physicians and nurses. In view of physiology, pathophysiology, genetics and molecular biology, metabolic processes in cancer are highly complex regulated and there is increasing evidence that a diet rich in fat and protein is favourable. This, however, implies a paradigma shift away from the "healthy" balanced diet rich in fruit, vegetable and complex carbohydrates. So far, the evidence based data of this new concept is, however, a controversial issue.
PMID: 28850991 [PubMed - in process]
Laryngozele.
Laryngorhinootologie. 2017 Aug;96(8):512-513
Authors: Nawka T
PMID: 28850990 [PubMed - in process]
Präoperative Beratung mit früherer Entlassung nach Laryngektomie assoziiert.
Laryngorhinootologie. 2017 Aug;96(8):510-511
Authors:
PMID: 28850989 [PubMed - in process]
Die Belastung der US-Notaufnahmen mit Angioödem-Patienten.
Laryngorhinootologie. 2017 Aug;96(8):509-510
Authors:
PMID: 28850988 [PubMed - in process]
Epistaxis bei HHT: vorübergehend Nasenlöcher zukleben.
Laryngorhinootologie. 2017 Aug;96(8):508-509
Authors:
PMID: 28850987 [PubMed - in process]
[Editor's Comment].
Laryngorhinootologie. 2017 Aug;96(8):506-507
Authors: Dietz A
PMID: 28850986 [PubMed - in process]
Stabwechsel bei der Federführung: auf Orlando Guntinas-Lichius folgt Andreas Dietz.
Laryngorhinootologie. 2017 Aug;96(8):505
Authors: Dietz A, Guntinas-Lichius O
PMID: 28850985 [PubMed - in process]
| Related Articles |
Beyond Cell-Cell Adhesion: Sensational Cadherins for Hearing and Balance.
Cold Spring Harb Perspect Biol. 2017 Aug 28;:
Authors: Jaiganesh A, Narui Y, Araya-Secchi R, Sotomayor M
Abstract
Cadherins form a large family of proteins often involved in calcium-dependent cellular adhesion. Although classical members of the family can provide a physical bond between cells, a subset of special cadherins use their extracellular domains to interlink apical specializations of single epithelial sensory cells. Two of these cadherins, cadherin-23 (CDH23) and protocadherin-15 (PCDH15), form extracellular "tip link" filaments that connect apical bundles of stereocilia on hair cells essential for inner-ear mechanotransduction. As these bundles deflect in response to mechanical stimuli from sound or head movements, tip links gate hair-cell mechanosensitive channels to initiate sensory perception. Here, we review the unusual and diverse structural properties of these tip-link cadherins and the functional significance of their deafness-related missense mutations. Based on the structural features of CDH23 and PCDH15, we discuss the elasticity of tip links and models that bridge the gap between the nanomechanics of cadherins and the micromechanics of hair-cell bundles during inner-ear mechanotransduction.
PMID: 28847902 [PubMed - as supplied by publisher]
| Related Articles |
Thyroid Hormone Receptor α is Essential to Maintain the Satellite Cell Niche during Skeletal Muscle Injury and Sarcopenia of Aging.
Thyroid. 2017 Aug 28;:
Authors: Milanesi A, Lee JW, Yang A, Liu YY, Sedrakyan S, Cheng SY, Perin L, Brent GA
Abstract
BACKGROUND: Myopathic changes are commonly described in hypothyroid and hyperthyroid patients, including muscular atrophy and weakness. Satellite cells (SCs) play a major role in skeletal muscle maintenance and regeneration after injury. A mouse model of Resistance to Thyroid Hormone (RTH)-TRα1PV demonstrated impaired skeletal muscle regeneration after injury with significant reduction of SCs, suggesting that exhaustion of the SC pool contributes to the impaired regeneration. To test this hypothesis, we analyzed SC activation and proliferation in vivo in response to skeletal muscle injury and during aging.
METHODS: We analyzed SCs of TRα1PV male mice 4 days after cardiotoxin-induced muscle injury and compared with wild type (WT) male animals. We injected TRα-knockdown C2C12 myoblasts into injured skeletal muscle and compared the in vivo behavior, 4 days after transplantation, with control C2C12 myoblasts. We compared skeletal muscle regeneration in younger and older TRα1PV and WT animals.
RESULTS: The total number of SCs in skeletal muscle of TRα1PV mice was significantly lower than control, both before and shortly after muscle injury, with significant impairment of SC activation, consistent with SC pool exhaustion. TRα-knockdown myoblasts showed impaired in vivo proliferation and migration. TRα1PV mice had skeletal muscle loss and significant impairment in skeletal muscle regeneration with aging. This translated to a significant reduction of the SC pool with aging, compared with wild type mice.
CONCLUSION: TRα plays an important role in maintenance of the SC pool. Impaired skeletal muscle regeneration in TRα1PV mice is associated with insufficient SC activation and proliferation, as well as the progressive loss of the satellite cell pool with aging. Regulation of the SC pool and SC proliferation provides a therapeutic target to enhance skeletal muscle regeneration and possible slow age-associated sarcopenia.
PMID: 28847239 [PubMed - as supplied by publisher]
| Related Articles |
Dynamic Risk Stratification in Stage I Papillary Thyroid Cancer Patients Younger than 45 Years.
Thyroid. 2017 Aug 28;:
Authors: Sung TY, Cho JW, Lee YM, Lee YH, Kwon H, Jeon M, Kim WG, Choi YJ, Song DE, Chung KW, Yoon JH, Hong SJ
Abstract
BACKGROUND: This study validated the dynamic risk stratification (DRS) system with regard to its association with structural recurrence and risk factors associated with non-excellent responses in patients with stage I classical papillary thyroid cancer (PTC) younger than 45 years.
METHODS: This historical cohort study included 598 patients with stage I classical PTC under the age of 45 years treated with total thyroidectomy followed by radioactive iodine (RAI) remnant ablation (n = 440), total thyroidectomy without RAI remnant ablation (n = 23), and thyroid lobectomy alone (n = 135).
RESULTS: The median follow-up period was 123 months. Structural recurrence occurred in 4.2% of the patients with excellent response (n = 18/432), 17.1% of patients with indeterminate response (n = 18/105), 44.7% of patients with biochemically incomplete response (n = 17/38), and 82.6% of patients with structurally incomplete response (n = 19/23) (p < 0.001) during the follow up. The disease-free survival curves of each response showed significant differences (p < 0.001). Extensive extrathyroidal extension and extranodal extension were the independent risk factors associated with non-excellent response (p < 0.05).
CONCLUSIONS: DRS may reduce unnecessary additional treatments by re-classifying initial risk estimates of structural recurrence. Furthermore, applying the risk factors associated with non-excellent response to initial therapy may be a more useful and viable surrogate of the risk for structural recurrence in stage I PTC patients younger than 45 years.
PMID: 28847226 [PubMed - as supplied by publisher]
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Definitive pronouncements about IGF-IR involvement in thyroid-associated ophthalmopathy are premature.
Thyroid. 2017 Aug 28;:
Authors: Smith TJ, Janssen JA
Abstract
no abstract.
PMID: 28847224 [PubMed - as supplied by publisher]
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The comparability of drug-induced sedation endoscopy classification systems.
Eur Arch Otorhinolaryngol. 2017 Aug 28;:
Authors: Dijemeni E, D'Amone G
PMID: 28849335 [PubMed - as supplied by publisher]
20 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
These pubmed results were generated on 2017/08/29
PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
| Related Articles |
Is voice therapy effective for the treatment of dysphonic patients with benign vocal fold lesions?
Auris Nasus Larynx. 2017 Aug 22;:
Authors: Ogawa M, Inohara H
Abstract
OBJECTIVE: To update our knowledge regarding the effectiveness of voice therapy for the treatment of vocal disturbance associated with benign vocal fold lesions, including vocal polyps, nodules and cysts, and for determining the utility of voice therapy in treating organic voice disorders, while highlighting problems for the future development of this clinical field.
METHODS: We conducted a review of the most recent literature on the therapeutic effects of voice therapy, vocal hygiene education or direct vocal training on vocal quality, the lesion appearance and discomfort felt by patients due to the clinical entity of benign vocal fold mass lesions.
RESULTS: Although voice therapy is principally indicated for the treatment of functional dysphonia without any organic abnormalities in the vocal folds, a number of clinicians have attempted to perform voice therapy even in dysphonic patients with benign mass lesions in the vocal folds. The two major possible reasons for the effectiveness of voice therapy on vocal disturbance associated with benign vocal fold lesions are hypothesized to be the regression of lesions and the correction of excessive/inappropriate muscle contraction of the phonatory organs. According to the current literature, a substantial proportion of vocal polyps certainly tend to shrink after voice therapy, but whether or not the regression results from voice therapy, vocal hygiene education or a natural cure is unclear at present due to the lack of controlled studies comparing two groups with and without interventions. Regarding vocal nodules, no studies have investigated the effectiveness of voice therapy using proper experimental methodology. Vocal cysts are difficult to cure by voice therapy without surgical excision according to previous studies. Evidences remains insufficient to support the use of voice therapy against benign vocal fold lesions.
CONCLUSION: Evidences at present is therefore still insufficient to support the use of voice therapy for the treatment of benign vocal fold lesions.
PMID: 28844607 [PubMed - as supplied by publisher]
20 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
These pubmed results were generated on 2017/08/29
PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
| Related Articles |
Symptomatic Long Pauses and Bradycardia due to Massive Multinodular Goiter.
Case Rep Cardiol. 2017;2017:4201942
Authors: Deshmukh A, Ozcan C
Abstract
Sinus node dysfunction with symptomatic bradycardia or chronotropic incompetence is generally an indication for pacemaker implantation. However, in patients with symptomatic sinus bradycardia, the identification and treatment of underlying pathologies may avoid the need for permanent pacemaker implantation. We present a case of carotid sinus syndrome and severe obstructive sleep apnea due to a massive multinodular goiter in a patient who presented with recurrent sinus pauses and syncope. The patient was managed without pacemaker implantation but instead with thyroidectomy resulting in decompression of the carotid sinus and airway and resolution of bradycardic episodes.
PMID: 28845312 [PubMed]
A Preliminary Study Investigating the Association Between Hearing Acuity and a Screening Cognitive Tool.
Ann Otol Rhinol Laryngol. 2017 Aug 01;:3489417727547
Authors: Mukari SZS, Ishak WS, Maamor N, Wan Hashim WF
Abstract
OBJECTIVES: Studies in cognitive aging demonstrated inconsistent association between hearing and cognition in older adults. Furthermore, it is still unclear if hearing loss at high frequencies, which is the earliest to be affected, is associated with cognitive functioning. This study aimed to determine the association between global cognitive status and pure tone average (PTA) at 0.5, 1, and 2 kHz (PTA low) and PTA at 4 and 8 kHz (PTA high).
METHODS: This study involved 307 adults aged 60 years and older. Participants had their hearing and cognition measured using pure tone audiometry and Mini Mental State Examination (MMSE), respectively.
RESULTS: Pure tone average (low) accounted for significant but minimal amount of variance in measure of MMSE. Multiple regression analyses were also performed on normal and impaired hearing cohorts and cohorts with younger (60-69 years) and older (≥70 years) groups. The results revealed a significant relationship between PTA (low) and MMSE only in the younger age group. In contrast, no significant relationship was found between PTA (high) and cognition in any of the cohorts.
CONCLUSION: Pure tone average (low) is significantly but minimally related to measure of general cognitive status. Similar relationship is not observed between high-frequency hearing and cognition. Further research using a more comprehensive cognitive test battery is needed to confirm the lack of association between high-frequency hearing and cognition.
PMID: 28845678 [PubMed - as supplied by publisher]
| Related Articles |
Costal and Auricular Cartilage Grafts for Nasal Reconstruction: An Anatomic Analysis.
Ann Otol Rhinol Laryngol. 2017 Aug 01;:3489417727549
Authors: Ho TT, Cochran T, Sykes KJ, Humphrey CD, Kriet JD
Abstract
OBJECTIVES: The aim of this study was to measure the length, width, and surface area of costal and auricular cartilage harvested for grafting in rhinoplasty and nasal reconstruction. We also compared the sizes of ear cartilage grafts harvested from the anterior and posterior approaches.
METHODS: Fifty-eight nasal reconstructive surgeries requiring rib or ear cartilage were performed by 2 facial plastic surgeons from February 2015 through January 2016. Among the 57 cases that met inclusion criteria, they comprised of 33 costal cartilage grafts and 24 auricular cartilage grafts (17 via anterior approach and 7 via posterior approach).
RESULTS: The mean length, width, and surface area for the auricular cartilage grafts were 3.39 cm, 1.22 cm, and 4.38 cm(2), respectively. The mean length, width, and surface area of the costal cartilage grafts were 4.21 cm, 1.46 cm, and 17.87 cm(2), respectively. The differences in length, width, and surface area between the anterior versus posterior approach groups were all statistically significant.
CONCLUSIONS: In our study, ear cartilage grafts harvested from the posterior approach had significantly greater length, width, and surface area. While this analysis has several limitations, it sets quantitative norms for costal and auricular cartilage harvest that can aid in surgical planning.
PMID: 28844147 [PubMed - as supplied by publisher]
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Gastrointestinal: Peroral endoscopic myotomy for distal esophageal spasm.
J Gastroenterol Hepatol. 2017 Sep;32(9):1536
Authors: Tang X, Ren Y, Huang S, Zhang X, Gong W
PMID: 28845589 [PubMed - in process]
Otolaryngic manifestations of Cushing disease.
Ear Nose Throat J. 2017 Aug;96(8):E28-E30
Authors: Kuan EC, Peng KA, Suh JD, Bergsneider M, Wang MB
Abstract
Cushing disease is a relatively rare cause of Cushing syndrome secondary to a hyperfunctioning pituitary adenoma. In addition to signs and symptoms of hypercortisolism, Cushing disease may present with diverse otolaryngic manifestations, which may guide diagnosis and management. We performed a retrospective chart review of patients who were found to have Cushing disease and who underwent transnasal transsphenoidal surgery for pituitary adenomas between January 1, 2007, and July 1, 2014, at a tertiary academic medical center. There were 37 consecutive patients in this series with Cushing disease caused by a pituitary adenoma. Fifteen (41%) patients complained of visual changes. Five (14%) patients suffered from obstructive sleep apnea. Four (11%) patients had thyroid disease. Other symptoms included hearing loss, vertigo, tinnitus, epistaxis, dysphagia, and salivary gland swelling. Although Cushing disease traditionally presents with classic "Cushingoid" systemic features, it also may present with various otolaryngic manifestations. A thorough workup by otolaryngologists is critical in the comprehensive management of these patients.
PMID: 28846797 [PubMed - in process]
Platelet-rich plasma myringoplasty: A new office procedure for the repair of small tympanic membrane perforations.
Ear Nose Throat J. 2017 Aug;96(8):312-326
Authors: El-Anwar MW, Elnashar I, Foad YA
Abstract
We conducted a prospective study to assess the effectiveness of a platelet-rich plasma hourglass graft in the repair of small tympanic membrane perforations as an office-based procedure. Our study population was made up of 25 patients-10 men and 15 women, aged 19 to 45 years (mean: 30.4 ± 7.2)-who each underwent repair of one eardrum. After administration of topical anesthesia, a single piece of platelet-rich plasma approximately double the size of the perforation was obtained from each patient's intravenous blood sample. After the margin of the perforation was freshened, the platelet-rich plasma was placed in an hourglass configuration, with equal portions lying medial and lateral to the perforation. Successful perforation repair was achieved in 21 of the 25 ears (84%). No patient developed an infection, hearing impairment, tinnitus, vertigo, bleeding, taste disturbance, or hyperkeratosis. We conclude that office-based platelet-rich plasma myringoplasty is a safe and effective minimally invasive procedure that is suitable for repairing small tympanic membrane perforations.
PMID: 28846786 [PubMed - in process]
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EBV driven natural killer cell disease of the central nervous system presenting as subacute cognitive decline.
Hum Pathol (N Y). 2017 Nov;10:64-68
Authors: Brett FM, Flavin R, Chen D, Loftus T, Looby S, McCarthy A, de Gascun C, Jaffe ES, Nor N, Javadpour M, McCabe D
Abstract
Brain biopsy in patients presenting with subacute encephalopathyis never straightforward and only undertaken when a 'treatable condition' is a realistic possibility. This 63 year old right handed, immunocompetent Caucasian woman presented with an 8 month history of rapidly progressive right-sided hearing impairment, a 4 month history of intermittent headaches, tinnitus, 'dizziness', dysphagia, nausea and vomiting, with the subsequent evolution of progressive gait ataxia and a subacute global encephalopathy. The possibility of CJD was raised. Brain biopsy was carried out. Western blot for prion protein was negative. She died 9 days later and autopsy brain examination confirmed widespread subacute infarction due to an EBV positive atypical NK/T-cell infiltrate with positivity for CD3, CD56, granzyme B, perforin and EBER with absence of CD4, CD5 and CD8 expression. Molecular studies for T-cell clonality were attempted but failed due to insufficient DNA quality. Serology was consistent with past EBV infection (EBV VCA and EBNA IgG Positive). There was no evidence of disease outside the CNS. Primary central nervous system NK/T-cell lymphoma is extremely rare. The rare reported cases all present with a discrete intracranial mass, unlike the diffuse infiltrative pattern in this case. Whilst the diffuse interstitial pattern is reminiscent of chronic active EBV infection (CAEBV) seen in other organ systems such as the liver and bone marrow, the clinical presentation and epidemiologic profile are not typical for CAEBV.
PMID: 28845389 [PubMed]
StatPearls
Book. 2017 06
Authors:
Abstract
Production of cerumen (earwax) is a normal and naturally occurring process in humans and many other mammals. It protects the ear from infection and provides a barrier for insects and water. Cerumen is typically expelled from the ear canal spontaneously through natural jaw movement. However, in certain individuals, the self-cleaning mechanism fails, and cerumen can become impacted. Cerumen impaction can occlude the canal or press against the tympanic membrane, potentially causing ear discomfort, conductive hearing loss, itching, and tinnitus. Cerumen impaction occurs in up to 6% of the general population, affecting 10% of children and over 30% of the elderly and cognitively impaired populations. It is often seen in those with hearing aids or earplugs, in an external canal occluded by a foreign body, or in people with ear canal anatomic abnormality. Excessive buildup of cerumen is likely underdiagnosed and undertreated. In the United States, it leads to 12 million patient visits and eight million cerumen removal procedures each year. It can interfere with tympanic membrane examination in the clinical setting. It is diagnosed by direct visualization by a trained provider using an otoscope.
PMID: 28846265
Deficits in comprehending wh-questions in children with hearing loss - the contribution of phonological short-term memory and syntactic complexity.
Clin Linguist Phon. 2017 Aug 28;:1-18
Authors: Penke M, Wimmer E
Abstract
The aim of the study is to investigate if German children with hearing loss (HL) display persisting problems in comprehending complex sentences and to find out whether these problems can be linked to limitations in phonological short-term memory (PSTM). A who-question comprehension test (picture pointing) and a nonword repetition (NWR) task were conducted with 21 German children with bilateral sensorineural HL (ages 3-4) and with age-matched 19 normal hearing (NH) children. Follow-up data (ages 6-8) are reported for 10 of the children with HL. The data reveal that the comprehension of who-questions as well as PSTM was significantly more impaired in children with HL than in children with NH. For both groups of participants, there were no correlations between question comprehension scores and performance in the NWR test. Syntactic complexity (subject vs. object question) affected question comprehension in children with HL, however, these problems were overcome at school age. In conclusion, the data indicate that a hearing loss affects the comprehension of complex sentences. The observed problems did, however, not persist and were, therefore, unlikely to be caused by a genuine syntactic deficit. For the tested wh-questions, there is no indication that syntactic comprehension problems of children with HL are due to limitations in PSTM.
PMID: 28846461 [PubMed - as supplied by publisher]
| Related Articles |
Laryngeal Manual Therapies for Behavioral Dysphonia: A Systematic Review and Meta-analysis.
J Voice. 2017 Aug 24;:
Authors: Ribeiro VV, Pedrosa V, Silverio KCA, Behlau M
Abstract
OBJECTIVES: The aim of this study was to review systematically the literature and to analyze the effectiveness of laryngeal manual therapy in addressing the overall severity of vocal deviation, the intensity of vocal and laryngeal symptoms, and musculoskeletal pain in adults with behavioral dysphonia.
STUDY DESIGN: This is a systematic review and meta-analysis.
METHODS: Two independent authors selected clinical trials that analyzed the effectiveness of laryngeal manual therapy compared with other interventions in the treatment of adults with behavioral dysphonia from the Cochrane Library, PubMed, Web of Science, and LILACS. The analyzed outcomes were the overall severity of vocal deviation, the intensity of vocal and laryngeal symptoms, and musculoskeletal pain. Data analysis was conducted based on the following steps: the assessment of the risk of bias, the measures of treatment effect and descriptive data analysis, the assessment of heterogeneity, subgroup analysis, sensitivity analysis, and the assessment of reporting biases.
RESULTS: A total of 2135 studies were identified, three of which met the selection criteria. Data analysis showed an unclear risk of 100% of performance bias and 66% of detection bias, in addition to a 33% high risk of selection bias. Low statistical and clinical heterogeneities were found. In addition, no significant difference was found in the relative risk of improvement with laryngeal manual therapy and with other interventions in the analyzed outcomes.
CONCLUSIONS: Various types of laryngeal manual therapies are available with similar objectives and effects, but their effectiveness is equivalent to that of other interventions involving direct voice therapy in the rehabilitation of adults with behavioral dysphonia.
PMID: 28844806 [PubMed - as supplied by publisher]
| Related Articles |
Is voice therapy effective for the treatment of dysphonic patients with benign vocal fold lesions?
Auris Nasus Larynx. 2017 Aug 22;:
Authors: Ogawa M, Inohara H
Abstract
OBJECTIVE: To update our knowledge regarding the effectiveness of voice therapy for the treatment of vocal disturbance associated with benign vocal fold lesions, including vocal polyps, nodules and cysts, and for determining the utility of voice therapy in treating organic voice disorders, while highlighting problems for the future development of this clinical field.
METHODS: We conducted a review of the most recent literature on the therapeutic effects of voice therapy, vocal hygiene education or direct vocal training on vocal quality, the lesion appearance and discomfort felt by patients due to the clinical entity of benign vocal fold mass lesions.
RESULTS: Although voice therapy is principally indicated for the treatment of functional dysphonia without any organic abnormalities in the vocal folds, a number of clinicians have attempted to perform voice therapy even in dysphonic patients with benign mass lesions in the vocal folds. The two major possible reasons for the effectiveness of voice therapy on vocal disturbance associated with benign vocal fold lesions are hypothesized to be the regression of lesions and the correction of excessive/inappropriate muscle contraction of the phonatory organs. According to the current literature, a substantial proportion of vocal polyps certainly tend to shrink after voice therapy, but whether or not the regression results from voice therapy, vocal hygiene education or a natural cure is unclear at present due to the lack of controlled studies comparing two groups with and without interventions. Regarding vocal nodules, no studies have investigated the effectiveness of voice therapy using proper experimental methodology. Vocal cysts are difficult to cure by voice therapy without surgical excision according to previous studies. Evidences remains insufficient to support the use of voice therapy against benign vocal fold lesions.
CONCLUSION: Evidences at present is therefore still insufficient to support the use of voice therapy for the treatment of benign vocal fold lesions.
PMID: 28844607 [PubMed - as supplied by publisher]
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Modified type IV thyroplasty (cricothyroid approximation) in a patient with androphonia.
Acta Otorrinolaringol Esp. 2016 May-Jun;67(3):179-81
Authors: Bernal GL, Morales LJ, Hernández VJ, Beltran O
PMID: 26028542 [PubMed - indexed for MEDLINE]
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[Neurogenic dysphagia].
Internist (Berl). 2017 Feb;58(2):132-140
Authors: Wirth R, Dziewas R
Abstract
Approximately half of neurological and geriatric inpatients suffer from oropharyngeal dysphagia. This often leads to pneumonia, malnutrition and dehydration; however, the underlying dysphagia is frequently not diagnosed and treated. This is particularly the case for patients with so-called silent aspiration. Knowledge on the physiology of swallowing, including the central nervous system control of swallowing and the therapeutic options have achieved considerable progress in recent years. In particular, the increasing implementation of flexible endoscopic evaluation of swallowing (FEES) has significantly contributed to this knowledge. It provides the ability to identify the individual pattern of oropharyngeal dysphagia leading to a suitable selection of therapeutic and compensatory strategies for individual patients. The various therapeutic options range from modification of the consistency of the diet, over diverse logopedic strategies and stimulation techniques up to interventional procedures.
PMID: 28084502 [PubMed - indexed for MEDLINE]
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The Voiced Oral High-frequency Oscillation Technique's Immediate Effect on Individuals With Dysphonic and Normal Voices.
J Voice. 2017 Aug 24;:
Authors: Saters TL, Ribeiro VV, Siqueira LTD, Marotti BD, Brasolotto AG, Silverio KCA
Abstract
OBJECTIVE: The aim of this study was to verify the effect of the voiced oral high-frequency oscillation (VOHFO) on voice quality in acoustic voice symptoms and self-reported sensations in individuals with voice complaints and dysphonic voices, and in individuals with normal voices.
METHODS: The participants, which included 60 individuals from 18 to 45 years of age, both genders, were divided into two groups: G1, 30 individuals without voice complaints and normal voices; and G2, 30 individuals with voice complaints and dysphonic voices. We used the following measures: acoustic analysis, voice and larynx symptom investigation, and phonation time before and after 3 minutes of performing the VOHFO technique. The sensations were reported only after the VOHFO technique. Data were analyzed using the Wilcoxon test (P ≤ 0.05), paired t test (P ≤ 0.05), and the Mann-Whitney test (P ≤ 0.05).
RESULTS: After the VOHFO, in G1, there was an increased fundamental frequency (both genders), a higher voice turbulence index, and a decrease in dryness symptoms (women); in G2, there was a decrease in the following symptoms: strong voice, dryness and lump in the throat, sensitive throat (women), and roughness and weak voice (men). The phonation measures and sensations did not present differences. The soft phonation index decreased in G1 and increased in G2 (women), in addition to a significant decrease in strong voice and sensitive throat (women) and roughness (men) in G2.
CONCLUSIONS: The VOHFO technique improves the source-filter relationship and the severity of voice and larynx symptoms in dysphonic and normal individuals. Women improved more in terms of larynx symptoms, whereas men improved more in terms of voice symptoms.
PMID: 28844805 [PubMed - as supplied by publisher]
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Characterization of FaDu-R, a radioresistant head and neck cancer cell line, and cancer stem cells.
Auris Nasus Larynx. 2017 Aug 24;:
Authors: Cho KJ, Park EJ, Kim MS, Joo YH
Abstract
OBJECTIVES: The aim of this study was to evaluate the impact of CSC on insensitivity to radiotherapy in HNSCC.
METHODS: A radioresistant cell line, FaDu-R, was established using fractionated ionizing radiation. Cells with high and low CD44/ALDH activity were isolated.
RESULTS: FaDu-R cells demonstrated significantly increased cell viability after radiation exposure compared with parental cells. CD44(high)/ALDH(high) FaDu-R cells demonstrated significantly faster wound closure (p<0.05) and more efficient invasion (p<0.05) compared to the CD44(high)/ALDH(high) FaDu cells or the CD44(low)/ALDH(low) FaDu-R cells. There was a significant difference in tumor volume between the CD44(high)/ALDH(high) FaDu-R cells and the CD44(high)/ALDH(high) FaDu cells (p<0.05) as well as the CD44(low)/ALDH(low) FaDu-R cells (p<0.05).
CONCLUSION: Cancer stem cells (CSC) were associated with invasion and tumorigenesis in a radioresistant head and neck squamous cell carcinoma (HNSCC) cell line. This concept might help to improve the understanding of these mechanisms and to develop drugs that can overcome radioresistance during radiotherapy.
PMID: 28844650 [PubMed - as supplied by publisher]
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A case of ectopic salivary gland of the larynx.
Auris Nasus Larynx. 2017 Aug 22;:
Authors: Tajima S, Yamauchi K, Higo R, Ikeda K
Abstract
A 46-year-old man presented with sore throat. Laryngoscopic findings revealed a smooth yellow mass occupying the anterior portion of the false vocal fold on the left side. The authors performed biopsy under general anesthesia. The histopathological diagnosis was ectopic salivary gland. Because salivary glands are usually not found under the false vocal fold mucosa, ectopic salivary gland of the larynx was diagnosed. It is necessary to consider the possibility of ectopic salivary gland for mass lesions if swelling of the provisional vocal cord is found.
PMID: 28844609 [PubMed - as supplied by publisher]
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Risk factors for the occurrence of epistaxis: Prospective study.
Auris Nasus Larynx. 2017 Aug 22;:
Authors: Côrte FC, Orfao T, Dias CC, Moura CP, Santos M
Abstract
OBJECTIVE: Analyse and compare the characteristics of patients with epistaxis admitted to the otolaryngology emergency department with those provided by a control group. Establish a model to identify epistaxis predictive factors.
METHODS: Prospective analysis of 283 consecutive adults, admitted to the otolaryngology emergency department of a tertiary referral centre between 25 January and 25 February 2014. Comparison of gender, age, co-morbidities, usual medication, history of epistaxis or nasal trauma, presence of septal deviation and blood pressure value on admission, between the elements that were admitted to the emergency due to epistaxis (group 1) and a group composed of patients with other symptoms (group 2). Intergroup variations were analyzed using t student and chi-square tests. Multivariate logistic regression and a receiver operating characteristic curve were used to establish a predictive model and test its suitability.
RESULTS: Male gender (OR=2.57, 95% CI 1.1-6.0, p=0.029), older age (OR=1.03, 95% CI 1.0-1.1, p=0.002), existence of peripheral vascular disease (OR=13.47, 95% CI 1.9-95.3, p=0.009), cardiovascular disease (OR=3.91, 95% CI 1.6-9.7, p=0.003) and previous history of epistaxis (OR=5.53, 95% CI 2.5-12.1, p<0.001) were predictors of epistaxis when adjusted for the presence of elevated blood pressure, history of hypertension, cerebrovascular disease and chronic use of anticoagulants or antiplatelet drugs. The model revealed a good applicability (area under the curve of 0.852).
CONCLUSIONS: The only predictive factors of admission to the emergency department due to epistaxis were male gender, older age, peripheral vascular disease, cardiovascular disease and history of epistaxis.
PMID: 28844608 [PubMed - as supplied by publisher]
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Is voice therapy effective for the treatment of dysphonic patients with benign vocal fold lesions?
Auris Nasus Larynx. 2017 Aug 22;:
Authors: Ogawa M, Inohara H
Abstract
OBJECTIVE: To update our knowledge regarding the effectiveness of voice therapy for the treatment of vocal disturbance associated with benign vocal fold lesions, including vocal polyps, nodules and cysts, and for determining the utility of voice therapy in treating organic voice disorders, while highlighting problems for the future development of this clinical field.
METHODS: We conducted a review of the most recent literature on the therapeutic effects of voice therapy, vocal hygiene education or direct vocal training on vocal quality, the lesion appearance and discomfort felt by patients due to the clinical entity of benign vocal fold mass lesions.
RESULTS: Although voice therapy is principally indicated for the treatment of functional dysphonia without any organic abnormalities in the vocal folds, a number of clinicians have attempted to perform voice therapy even in dysphonic patients with benign mass lesions in the vocal folds. The two major possible reasons for the effectiveness of voice therapy on vocal disturbance associated with benign vocal fold lesions are hypothesized to be the regression of lesions and the correction of excessive/inappropriate muscle contraction of the phonatory organs. According to the current literature, a substantial proportion of vocal polyps certainly tend to shrink after voice therapy, but whether or not the regression results from voice therapy, vocal hygiene education or a natural cure is unclear at present due to the lack of controlled studies comparing two groups with and without interventions. Regarding vocal nodules, no studies have investigated the effectiveness of voice therapy using proper experimental methodology. Vocal cysts are difficult to cure by voice therapy without surgical excision according to previous studies. Evidences remains insufficient to support the use of voice therapy against benign vocal fold lesions.
CONCLUSION: Evidences at present is therefore still insufficient to support the use of voice therapy for the treatment of benign vocal fold lesions.
PMID: 28844607 [PubMed - as supplied by publisher]
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Laryngeal Injury in a Male Lacrosse Player: A Case for Prevention.
Pediatr Emerg Care. 2017 Mar;33(3):185-187
Authors: Murtagh-Kurowski E, Gittelman MA, Arjmand E
Abstract
Lacrosse has become increasingly popular among US children and teens. Because a lacrosse ball can serve as a projectile, neck injuries, although uncommon, can cause a severe and long-lasting injury. We report the case of a 16-year-old adolescent who experienced direct neck trauma while playing lacrosse. The clinical presentation, treatment strategies, and intubation considerations are reviewed. Finally, a call to action to prevent future, similar injuries is discussed.
PMID: 28248757 [PubMed - indexed for MEDLINE]
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Laryngeal pacing for bilateral vocal fold paralysis: Voice and respiratory aspects.
Laryngoscope. 2017 Aug;127(8):1838-1844
Authors: Mueller AH, Hagen R, Pototschnig C, Foerster G, Grossmann W, Baumbusch K, Gugatschka M, Nawka T
Abstract
OBJECTIVE: To evaluate the effects of neurostimulation with the laryngeal pacemaker (LP) system in patients with bilateral vocal fold paralysis (BVFP) in terms of voice quality and respiratory function.
STUDY DESIGN: Feasibility study, first-in-human, single-arm, open-label, prospective, multicenter study with group-sequential design and 6-month follow-up period, as described in details in our previous publication.
METHODS: Nine symptomatic BVFP subjects were unilaterally implanted with the LP system at three study sites in Germany and Austria. Subjective and objective voice function, spirometric parameters other than peak expiratory/inspiratory flow (PEF/PIF), and PEF-meter self-assessment were evaluated pre- and 6 months postimplantation.
RESULTS: In general, the LP system did not considerably change the voice quality of the implanted patients. Only the sound pressure level range improved significantly 6 months postimplantation (P = 0.018). The LP system implantation did not affect the glottal closure configuration, the duration of the closed phase, and the mucosal wave of the implanted side. The evaluated spirometric parameters were not significantly affected by laryngeal pacing, whereas PEF meter self-assessment showed a stable and significant (P = 0.028) improvement of the PEF within a week upon activation of the LP system.
CONCLUSION: Neurostimulation with the LP system results in an immediate and stable PEF improvement, without negative effects on the voice quality. The PEF meter self-assessment confirmed the spirometry results of the PEF. The stimulated abduction did not affect the glottal closure during phonation. These results should be confirmed in larger and more homogenous patient cohorts.
LEVEL OF EVIDENCE: 2b Laryngoscope, 127:1838-1844, 2017.
PMID: 27943294 [PubMed - indexed for MEDLINE]
