OtoRhinoLaryngology by Alexandros G.Sfakianakis

Σάββατο 16 Σεπτεμβρίου 2017

Concomitant diseases and their effect on disease prognosis in Meniere's disease: diabetes mellitus identified as a negative prognostic factor.

Concomitant diseases and their effect on disease prognosis in Meniere's disease: diabetes mellitus identified as a negative prognostic factor.

Acta Otolaryngol. 2017 Sep 15;:1-5

Authors: Pieskä T, Kotimäki J, Männikkö M, Sorri M, Hietikko E

Abstract
OBJECTIVE: To study comorbidities and their effect on the disease progression in Meniere's disease (MD).
METHODS: Retrospective study on 350 definite MD patients diagnosed according to AAO-HNS 1995 criteria using hospital records and postal questionnaire.
RESULTS: The prevalence of migraine, hypothyroidism, allergies, coronary heart disease and autoimmune diseases was more common in MD patients than reported in the general population of Finland. Diabetes mellitus was associated with both more severe hearing impairment (p = .033) and more frequent vertigo (p = .028) in MD patients. The number of concomitant diseases was associated with more frequent vertigo (p = .021).
CONCLUSIONS: A patient's concomitant diseases, especially diabetes, should be treated effectively because they might affect the progression of MD. Further studies on the effects of concomitant diseases on MD prognosis are needed.

PMID: 28914106 [PubMed - as supplied by publisher]

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Effects of voice-sparing cricotracheal resection on phonation in women.

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Effects of voice-sparing cricotracheal resection on phonation in women.

Laryngoscope. 2017 Sep;127(9):2085-2092

Authors: Tanner K, Dromey C, Berardi ML, Mattei LM, Pierce JL, Wisco JJ, Hunter EJ, Smith ME

Abstract
INTRODUCTION: Individuals with idiopathic subglottic stenosis (SGS) are at risk for voice disorders prior to and following surgical management. This study examined the nature and severity of voice disorders in patients with SGS before and after a revised cricotracheal resection (CTR) procedure designed to minimize adverse effects on voice function.
METHOD: Eleven women with idiopathic SGS provided presurgical and postsurgical audio recordings. Voice Handicap Index (VHI) scores were also collected. Cepstral, signal-to-noise, periodicity, and fundamental frequency (F0 ) analyses were undertaken for connected speech and sustained vowel samples. Listeners made auditory-perceptual ratings of overall quality and monotonicity.
RESULTS: Paired samples statistical analyses revealed that mean F0 decreased from 215 Hz (standard deviation [SD] = 40 Hz) to 201 Hz (SD = 65 Hz) following surgery. In general, VHI scores decreased after surgery. Voice disorder severity based on the Cepstral Spectral Index of Dysphonia (KayPentax, Montvale, NJ) for sustained vowels decreased (improved) from 41 (SD = 41) to 25 (SD = 21) points; no change was observed for connected speech. Semitone SD (2.2 semitones) did not change from pre- to posttreatment. Auditory-perceptual ratings demonstrated similar results.
CONCLUSION: These preliminary results indicate that this revised CTR procedure is promising in minimizing adverse voice effects while offering a longer-term surgical outcome for SGS. Further research is needed to determine causal factors for pretreatment voice disorders, as well as to optimize treatments in this population.
LEVEL OF EVIDENCE: 4. Laryngoscope, 127:2085-2092, 2017.

PMID: 27882558 [PubMed - indexed for MEDLINE]

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A Hebrew Adaptation of the Tinnitus Functional Index.

A Hebrew Adaptation of the Tinnitus Functional Index.

Clin Otolaryngol. 2017 Sep 15;:

Authors: Oron Y, Shemesh S, Tamir SO, Goldfarb A, Marom T, Gluck O, Shushan S

Abstract
Tinnitus is the perception of sounds, when no external stimuli exists. Its prevalence has been estimated to be between 8% and 30% in the general population (1). Some patients describe intrusive tinnitus which affects many aspects of their lives, while others describe an insignificant disturbance caused by the tinnitus (2). Since tinnitus is a subjective symptom in most cases, defining its effect on patients' lives can be challenging. Several questionnaires have been developed in order to characterize the effects of tinnitus on patients' lives. This article is protected by copyright. All rights reserved.

PMID: 28914488 [PubMed - as supplied by publisher]

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Interleukin-1β and interleukin-6 enhance thermal prolongation of the LCR in decerebrate piglets.

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Interleukin-1β and interleukin-6 enhance thermal prolongation of the LCR in decerebrate piglets.

Respir Physiol Neurobiol. 2016 Aug;230:44-53

Authors: Xia L, Bartlett D, Leiter JC

Abstract
Thermal stress and prior upper respiratory tract infection are risk factors for the Sudden Infant Death Syndrome. The adverse effects of prior infection are likely mediated by interleukin-1β (IL-1β). Therefore, we examined the single and combined effects of IL-1β and elevated body temperature on the duration of the Laryngeal Chemoreflex (LCR) in decerebrate neonatal piglets ranging in age from post-natal day (P) 3 to P7. We examined the effects of intraperitoneal (I.P.) injections of 0.3mg/Kg IL-1β with or without I.P. 10mg/Kg indomethacin pretreatment on the duration of the LCR, and in the same animals we also examined the duration of the LCR when body temperature was elevated approximately 2°C. We found that IL-1β significantly increased the duration of the LCR even when body temperature was held constant. There was a significant multiplicative effect when elevated body temperature was combined with IL-1β treatment: prolongation of the LCR was significantly greater than the sum of independent thermal and IL-1β-induced prolongations of the LCR. The effects of IL-1β, but not elevated body temperature, were blocked by pretreatment with indomethacin alone. We also tested the interaction between IL-6 given directly into the nucleus of the solitary tract (NTS) bilaterally in 100ngm microinjections of 50μL and pretreatment with indomethacin. Here again, there was a multiplicative effect of IL-6 treatment and elevated body temperature, which significantly prolonged the LCR. The effect of IL-6 on the LCR, but not elevated body temperature, was blocked by pretreatment with indomethacin. We conclude that cytokines interact with elevated body temperature, probably through direct thermal effects on TRPV1 receptors expressed pre-synaptically in the NTS and through cytokine-dependent sensitization of the TRPV1 receptor. This sensitization is likely initiated by cyclo-oxygenase-2 dependent synthesis of prostaglandin E2, which is stimulated by elevated levels of IL-1β or IL-6. Inflammatory sensitization of the LCR coupled with thermal prolongation of the LCR may increase the propensity for apnea and Sudden Infant Death Syndrome.

PMID: 27181326 [PubMed - indexed for MEDLINE]

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Laryngoscopic and stroboscopic signs in the diagnosis of vocal fold paresis.

Laryngoscopic and stroboscopic signs in the diagnosis of vocal fold paresis.

Laryngoscope. 2017 Sep;127(9):2100-2105

Authors: Estes C, Sadoughi B, Mauer E, Christos P, Sulica L

Abstract
OBJECTIVES/HYPOTHESIS: To identify strobolaryngoscopic findings significant in the diagnosis of paresis.
STUDY DESIGN: Retrospective cohort study.
METHODS: Fellowship-trained laryngologists reviewed 34 videostroboscopic examinations (24 with paresis, eight without paresis, two repeat). They indicated presence or absence of paresis, including side and type, degree of confidence in diagnosis, and ranked clinical findings that influenced diagnosis by order of importance. Fleiss's κ was used to assess inter-rater agreement for paresis presence, side, and type. Clinical findings compelling in diagnosis were tabulated and described. Confidence levels for side and type were compared by analysis of variance/Kruskal-Wallis tests and post hoc pairwise comparisons.
RESULTS: Thirty-one laryngologists completed the review. Inter-rater agreement on presence or absence of paresis was fair at 0.334 (Fleiss's κ). Fourteen examinations were diagnosed with paresis by >70% of raters and considered strong paresis-candidate exams. Diagnosis of paresis side and type were inconsistent, although with statistically significant differences in confidence ratings (unilateral vs. bilateral, recurrent laryngeal nerve [RLN] vs. superior laryngeal nerve [SLN], RLN vs. mixed RLN/SLN). Laryngoscopic and stroboscopic findings with the strongest association with paresis were vocal fold motion anomalies, vocal fold degeneration, glottic insufficiency, and mucosal wave anomalies.
CONCLUSIONS: Most laryngologists use strobolaryngoscopy for diagnosis of paresis. Although certain clinical findings were found to be associated with diagnosis, most commonly vocal fold motion anomalies, these varied among raters, especially when determining sidedness and nerve involvement. Future studies should expand the discussion and consideration of strobolaryngoscopic factors and adjunct functional and objective measures to develop a heuristic algorithm for diagnosis of paresis.
LEVEL OF EVIDENCE: 4. Laryngoscope, 127:2100-2105, 2017.

PMID: 28349567 [PubMed - indexed for MEDLINE]

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Mild to Moderate Dysphagia Following Very Low-dose Abobotulinumtoxin A for Platysmal Bands.

Mild to Moderate Dysphagia Following Very Low-dose Abobotulinumtoxin A for Platysmal Bands.

J Drugs Dermatol. 2017 Sep 01;16(9):929-930

Authors: Obagi S, Golubets K

Abstract
Onabotulinumtoxin A (Botox) can be a safe and successful off-label treatment of vertical platysma bands of various severities. Due to risk of the botulinum toxin diffusing to the underlying anatomic structures such as the deglutition muscles, the larynx, and the neck flexors, a maximal dose of 100 units has been suggested and there have been no known reports of untoward effects with doses less than 60 units. We present a case of mild to moderate dysphagia in a patient after very low doses of Abobutulinumtoxin (60 units, equivalent to 20 units of Onabotulinumtoxin using a 3:1 conversion ratio). We speculate that the adverse effects noted may be due to several possibilities, such as diffusion, injection technique, or intravascular injection. Thus, although botulinum toxin-A is generally considered a safe off-label treatment for vertical platysma bands, readers should still be aware of the possible side-effects even with low dose use, as supported by our case report of mild to moderate dysphagia with relatively conservative doses of Abobotulinumtoxin A. <p><em>J Drugs Dermatol. 2017;16(9):929-930.</em></p>.

PMID: 28915289 [PubMed - in process]

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Time-driven activity-based costing to estimate cost of care at multidisciplinary aerodigestive centers.

Time-driven activity-based costing to estimate cost of care at multidisciplinary aerodigestive centers.

Laryngoscope. 2017 Sep;127(9):2152-2158

Authors: Garcia JA, Mistry B, Hardy S, Fracchia MS, Hersh C, Wentland C, Vadakekalam J, Kaplan R, Hartnick CJ

Abstract
OBJECTIVES/HYPOTHESIS: Providing high-value healthcare to patients is increasingly becoming an objective for providers including those at multidisciplinary aerodigestive centers. Measuring value has two components: 1) identify relevant health outcomes and 2) determine relevant treatment costs. Via their inherent structure, multidisciplinary care units consolidate care for complex patients. However, their potential impact on decreasing healthcare costs is less clear. The goal of this study was to estimate the potential cost savings of treating patients with laryngeal clefts at multidisciplinary aerodigestive centers.
STUDY DESIGN: Retrospective chart review.
METHODS: Time-driven activity-based costing was used to estimate the cost of care for patients with laryngeal cleft seen between 2008 and 2013 at the Massachusetts Eye and Ear Infirmary Pediatric Aerodigestive Center. Retrospective chart review was performed to identify clinic utilization by patients as well as patient diet outcomes after treatment. Patients were stratified into neurologically complex and neurologically noncomplex groups.
RESULTS: The cost of care for patients requiring surgical intervention was five and three times as expensive of the cost of care for patients not requiring surgery for neurologically noncomplex and complex patients, respectively. Following treatment, 50% and 55% of complex and noncomplex patients returned to normal diet, whereas 83% and 87% of patients experienced improved diets, respectively. Additionally, multidisciplinary team-based care for children with laryngeal clefts potentially achieves 20% to 40% cost savings.
CONCLUSIONS: These findings demonstrate how time-driven activity-based costing can be used to estimate and compare patient costs in multidisciplinary aerodigestive centers.
LEVEL OF EVIDENCE: 2c. Laryngoscope, 127:2152-2158, 2017.

PMID: 28635036 [PubMed - indexed for MEDLINE]

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NR4A1 is an endogenous inhibitor of vocal fold fibrosis.

NR4A1 is an endogenous inhibitor of vocal fold fibrosis.

Laryngoscope. 2017 Sep;127(9):E317-E323

Authors: Hiwatashi N, Bing R, Kraja I, Branski RC

Abstract
OBJECTIVES/HYPOTHESIS: NR4A1 was recently identified as an endogenous inhibitor of transforming growth factor (TGF)-β-induced fibrosis, and the role of this nuclear receptor has not been elucidated in tissue health or the response to injury in the vocal folds. Given the clinical implications of vocal fold fibrosis, we investigated NR4A1 expression during vocal fold wound healing in vivo and the regulatory roles of NR4A1 on vocal fold fibroblasts (VFFs) in vitro with the ultimate goal of developing targeted therapies for this challenging patient population.
STUDY DESIGN: In vivo and in vitro.
METHODS: In vivo, the temporal pattern of NR4A1 mRNA expression was quantified following rat vocal fold injury. In vitro, the role of NR4A1 on TGF-β1-mediated transcription of genes underlying fibrosis as well as myofibroblast differentiation and collagen gel contraction was quantified in our human VFF line. Small interfering RNA was employed to alter NR4A1 expression to further elucidate this complex system.
RESULTS: Nr4a1 mRNA increased 1 day after injury and peaked at 7 days. Knockdown of NR4A1 resulted in upregulation of COL1A1 and TGF-β1, with TGF-β1 stimulation (both P < .001) in VFFs. NR4A1 knockdown also resulted in increased α-smooth muscle actin-positive cells (P = .013) and contraction (P = .002) in response to TGF-β1.
CONCLUSIONS: NR4A1 has not been described in vocal fold health or disease. Upregulation of TGF-β following vocal fold injury was concurrent with increased NR4A1 expression. These data provide a foundation for the development of therapeutic strategies given persistent TGF-β signaling in vocal fold fibrosis.
LEVEL OF EVIDENCE: N/A Laryngoscope, 127:E317-E323, 2017.

PMID: 28581197 [PubMed - indexed for MEDLINE]

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Phosphorylated FADD is not prognostic for local control in T1-T2 supraglottic laryngeal carcinoma treated with radiotherapy.

Phosphorylated FADD is not prognostic for local control in T1-T2 supraglottic laryngeal carcinoma treated with radiotherapy.

Laryngoscope. 2017 Sep;127(9):E301-E307

Authors: Wachters JE, Schrijvers ML, Slagter-Menkema L, Mastik M, Langendijk JA, de Bock GH, Roodenburg JL, van der Laan BFAM, van der Wal JE, Schuuring E

Abstract
OBJECTIVE: The Fas-Associated Death Domain (FADD) gene is located in the chromosome 11q13-region and frequently is amplified in head and neck squamous cell carcinoma. Expression of FADD and its phosphorylated isoform (pFADD) have been associated with aggressive tumor growth, lymph node metastasis, and overall survival. Previously, we demonstrated that pFADD expression was related to a significantly improved local control in early stage (tumor [T]1 to T2) glottic laryngeal squamous cell carcinoma (LSCC). The aim of this study was to examine the prognostic value of pFADD and FADD in T1 to T2 supraglottic LSCC treated with primarily radiotherapy.
METHODS: Tumor tissue sections of 60 patients with T1 to T2 supraglottic LSCC treated with primarily radiotherapy were assessed immunohistochemically for expression of pFADD and FADD. Expression percentages and clinical parameters and their associations with clinical outcome were studied using Cox regression and Kaplan-Meier survival analyses. Expression percentages in supraglottic and glottic LSCC were compared using the Mann-Whitney U test.
RESULTS: Expression of pFADD and FADD in supraglottic and glottic LSCC did not significantly differ. In supraglottic LSCC, both pFADD and FADD did not show prognostic value for local control (hazard ratio [HR] 1.00, 95% confidence interval [CI] 0.98-1.03; HR 1.03, 95% CI 0.60-1.78, respectively) and overall survival (HR 0.99, 95% CI 0.98-1.01; HR 1.19, 95% CI 0.83-1.71 respectively). In this cohort, lymph node status was the best predictor for local control (HR 3.73, 95% CI 1.30-10.67).
CONCLUSION: In this homogeneous cohort of T1 to T2 supraglottic LSCC primarily treated with radiotherapy, lymph node status was associated with local recurrence, whereas the expression of pFADD was not.
LEVEL OF EVIDENCE: NA. Laryngoscope, 127:E301-E307, 2017.

PMID: 28304089 [PubMed - indexed for MEDLINE]

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Minimally Invasive Laparoscopic Dissected - Deep Inferior Epigastric Artery Perforator Flap (MILD-DIEP): An Anatomic Feasibility Study and a First Clinical Case.

Minimally Invasive Laparoscopic Dissected - Deep Inferior Epigastric Artery Perforator Flap (MILD-DIEP): An Anatomic Feasibility Study and a First Clinical Case.

Plast Reconstr Surg. 2017 Sep 13;:

Authors: Hivelin M, Soprani A, Schaffer N, Hans S, Lantieri L

Abstract
The deep inferior epigastric perforator (DIEP) flap is a workhorse of breast reconstruction. Risks of herniation derive from violation of the rectus abdominis muscle anterior rectus sheath (ARS) and might be reduced by Minimally Invasive Laparoscopic Dissection (MILD) of the deep inferior epigastric vessels. We performed a feasibility study on five anatomical subjects and performed a secondary right breast reconstruction on a 67 year-old woman. A 30° laparoscope was used with laparoscopy ports inset to preserve the flap. Blunt preperitoneal dissection followed by CO2 insufflation allowed the deep inferior epigastric (DIE) pedicle to be dissected and clip-sectioned. The ARS was opened around the perforating vessels, and the flap was anastomosed on the internal mammary vessels. Length of incision in the ARS was compared between laparoscopic and conventional approaches. The mean incision length in the ARS was 3 cm versus 12 cm in the classic approach. Average duration of laparoscopic flap harvest was 50 minutes, including a mean of 30 minutes for DIE dissection. Adhesions led to a 1 cm peritoneal laceration in our first anatomical subject. There were no pre- or post-operative complications in the clinical case. The clinical procedure duration was 8h15 minutes with the ARS incision reduced from the conventional 12 cm to 5 cm. Flap ischemia lasted 50 minutes. The patient was discharged on postoperative day 5. This anatomic study and first successful laparoscopic assisted DIEP flap harvest prove that reduced trauma to the anterior rectus sheath is feasible and promising.

PMID: 28915211 [PubMed - as supplied by publisher]

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Adult acute supraglottitis: Analysis of 358 patients for predictors of airway intervention.

Adult acute supraglottitis: Analysis of 358 patients for predictors of airway intervention.

Laryngoscope. 2017 Sep;127(9):2106-2112

Authors: Shapira Galitz Y, Shoffel-Havakuk H, Cohen O, Halperin D, Lahav Y

Abstract
OBJECTIVES/HYPOTHESIS: Acute supraglottitis is a potentially life-threatening condition due to rapid onset upper airway obstruction. The study aimed to characterize adult acute supraglottitis patients and to recognize factors associated with an aggressive disease course.
STUDY DESIGN: Retrospective chart review.
METHODS: All adult acute supraglottitis patients admitted to a single academic medical center between 2000 and 2014 were included and their medical charts reviewed. The main outcome measures were airway intervention and mortality.
RESULTS: Three hundred fifty-eight patients were enrolled. Mean age was 53 years (range, 16-92 years), with 62.8% males. Sore throat (79%) and dysphagia (70.9%) were the most common symptoms. Stridor (3.6%), tachypnea (5.7%), and dyspnea (6.4%) were uncommon but significantly associated with airway intervention. The epiglottis was most commonly involved (67%). Involvement of the epiglottis and aryepiglottic folds showed a trend of correlation to airway intervention. Blood glucose levels, C-reactive protein (CRP) levels, and relative neutrophilia were significantly higher in patients admitted to the intensive care unit or requiring airway intervention. Thirty-four patients (9.5%) required intensive care unit admission. Sixteen patients (4.4%) required airway intervention. Recurrent episodes of supraglottitis, seen in 19 patients, were more common in males (P = .048), and tended to have a more severe clinical course, requiring more airway interventions (P = .005) and intensive care unit admissions (P = .016).
CONCLUSIONS: The typical high risk patient-a male, with dyspnea and stridor, presenting with edema of the epiglottis and aryepiglottic folds, elevated CRP, hyperglycemia, and a history of recurrent episodes-should warrant more aggressive treatment and closer observation.
LEVEL OF EVIDENCE: 4 Laryngoscope, 127:2106-2112, 2017.

PMID: 28493349 [PubMed - indexed for MEDLINE]

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SMAD3 expression and regulation of fibroplasia in vocal fold injury.

SMAD3 expression and regulation of fibroplasia in vocal fold injury.

Laryngoscope. 2017 Sep;127(9):E308-E316

Authors: Hiwatashi N, Benedict PA, Dion GR, Bing R, Kraja I, Amin MR, Branski RC

Abstract
OBJECTIVE: Recent reports highlight the efficacy of small interfering RNA (siRNA) targeting SMAD3 to regulate transforming growth factor β (TGF-β)-mediated fibroplasia in vocal fold fibroblasts. The current study sought to investigate SMAD3 expression during wound healing in vivo and quantify the downstream transcriptional events associated with SMAD3 knockdown in vitro.
STUDY DESIGN: In vivo and in vitro.
METHODS: Unilateral vocal fold injury was created in a rabbit model. SMAD3 and SMAD7 mRNA expression was quantified at 1 hour and 1, 3, 7, 14, 30, 60, and 90 days following injury. In vitro, multi-gene analysis technology was employed in our immortalized human vocal-fold fibroblast cell line following TGF-β1 stimulation ± SMAD3 knockdown across time points.
RESULTS: SMAD3 mRNA expression increased following injury; upregulation was significant at 3 and 7 days compared to control (both P < 0.001). SMAD7 mRNA was also upregulated at 3, 7, and 14 days (P = 0.02, P < 0.001, and P < 0.001, respectively). In vitro, SMAD3 knockdown reduced the expression of multiple profibrotic, TGF-β signaling, and extracellular matrix metabolism genes at 6 and 24 hours following TGF-β1 stimulation.
CONCLUSION: Cumulatively, these data support SMAD3 as a potential master regulator of TGF-β-mediated fibrosis. SMAD3 transcription peaked 7 days following injury. Multi-gene analysis indicated that the therapeutic effectiveness of SMAD3 knockdown may be related to regulation of downstream mediators of fibroplasia and altered TGF-β signaling.
LEVEL OF EVIDENCE: NA. Laryngoscope, 127:E308-E316, 2017.

PMID: 28543554 [PubMed - indexed for MEDLINE]

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Effects of voice-sparing cricotracheal resection on phonation in women.

Effects of voice-sparing cricotracheal resection on phonation in women.

Laryngoscope. 2017 Sep;127(9):2085-2092

Authors: Tanner K, Dromey C, Berardi ML, Mattei LM, Pierce JL, Wisco JJ, Hunter EJ, Smith ME

PMID: 27882558 [PubMed - indexed for MEDLINE]

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Giant epiglottic cyst: Is tracheostomy essential?

Giant epiglottic cyst: Is tracheostomy essential?

Acta Otorrinolaringol Esp. 2016 Jan-Feb;67(1):e6-7

Authors: Temsamani H, Hemmaoui B, Benariba F

PMID: 25308793 [PubMed - indexed for MEDLINE]

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Concomitant diseases and their effect on disease prognosis in Meniere's disease: diabetes mellitus identified as a negative prognostic factor.

Concomitant diseases and their effect on disease prognosis in Meniere's disease: diabetes mellitus identified as a negative prognostic factor.

Acta Otolaryngol. 2017 Sep 15;:1-5

Authors: Pieskä T, Kotimäki J, Männikkö M, Sorri M, Hietikko E

PMID: 28914106 [PubMed - as supplied by publisher]

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Honest signaling in domestic piglets (Sus scrofa domesticus): vocal allometry and the information content of grunt calls.

Honest signaling in domestic piglets (Sus scrofa domesticus): vocal allometry and the information content of grunt calls.

J Exp Biol. 2016 Jun 15;219(Pt 12):1913-21

Authors: Garcia M, Wondrak M, Huber L, Fitch WT

Abstract
The information conveyed in acoustic signals is a central topic in mammal vocal communication research. Body size is one form of information that can be encoded in calls. Acoustic allometry aims to identify the specific acoustic correlates of body size within the vocalizations of a given species, and formants are often a useful acoustic cue in this context. We conducted a longitudinal investigation of acoustic allometry in domestic piglets (Sus scrofa domesticus), asking whether formants of grunt vocalizations provide information concerning the caller's body size over time. On four occasions, we recorded grunts from 20 kunekune piglets, measured their vocal tract length by means of radiographs (X-rays) and weighed them. Controlling for effects of age and sex, we found that body weight strongly predicts vocal tract length, which in turn determines formant frequencies. We conclude that grunt formant frequencies could allow domestic pigs to assess a signaler's body size as it grows. Further research using playback experiments is needed to determine the perceptual role of formants in domestic pig communication.

PMID: 27059064 [PubMed - indexed for MEDLINE]

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Bilateral dystrophic ossification of the thyroid cartilage.

Bilateral dystrophic ossification of the thyroid cartilage.

Acta Otorrinolaringol Esp. 2016 Jan-Feb;67(1):e4-5

Authors: Hernández-Montero E, Berrocal-Morales L, Mesa-Marrero M

PMID: 25542673 [PubMed - indexed for MEDLINE]

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Upper aerodigestive tract cancer and oral health status before radiotherapy: a cross-sectional study of 154 patients.

Upper aerodigestive tract cancer and oral health status before radiotherapy: a cross-sectional study of 154 patients.

J Stomatol Oral Maxillofac Surg. 2017 Sep 11;:

Authors: Raskin A, Ruquet M, Weiss-Pelletier L, Mancini J, Boulogne O, Michel J, Fakhry N, Foletti JM, Chossegros C, Giorgi R

Abstract
OBJECTIVES: We aimed to determine primarily the oral health status of patients with upper aerodigestive tract cancer before radiotherapy, and secondarily the prevalence of risk factors for poor oral status.
METHODS: A cross-sectional study was conducted in Marseille University hospital. Assessment criteria were the Decay, Missing and Filled (DMF) index and periodontal status.
RESULTS: One hundred and fifty-four patients, mean age 60.9 years, were included. The most common sites of primary tumors were the larynx (28.6%) and oral cavity (26.6%). Current or past smokers accounted for 80.5% of patients and 67% were alcohol abusers. Most patients (83.8%) did not have xerostomia. They ate three meals a day (61%), with sugar consumption in 40%. The median number of daily tooth brushings was 2, with a manual toothbrush (81.2%). Few patients used dental floss or interproximal brushes. Individual DMF index was 17.6 (D=2.3, M=9.3, F=6.0) and was higher in patients with xerostomia and alcohol abusers (p=0.01). Osseous level was 62.3% and 57.8% of patients had osseous infections, which were more common with poor hygiene (p=0.04). Most patients (85.7%) had periodontal disease, but incidence did not significantly differ according to risk factors.
DISCUSSION: The DMF index was higher in presence of periodontal disease and osseous infections. Alcohol and xerostomia were associated with a high individual DMF index and osseous infections were more frequent in patients with poor hygiene.Patients with upper aerodigestive tract cancer are at high risk of osteoradionecrosis if they do not receive dental treatment before radiotherapy.

PMID: 28911982 [PubMed - as supplied by publisher]

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Παρασκευή 15 Σεπτεμβρίου 2017

JAAA CEU Program.

JAAA CEU Program.

J Am Acad Audiol. 2017 Sep;28(8):770-771

Authors:

PMID: 28906247 [PubMed - in process]

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