For more than two decades, real ear verification measurements have been positioned as the "gold standard" of the hearing aid fitting. This implies that verification is an extra, rather than essential, to the plan of care. This course discusses why verification should not be the "gold standard" of the hearing aid fitting process, but rather the "baseline minimum."
https://ift.tt/2J8hp5u
Σάββατο 31 Μαρτίου 2018
Establishing Accuracy and Validity: Why Do We Verify?
Multiple roles of lymphatic vessels in tumor progression
Qiaoli Ma | Lothar C Dieterich | Michael Detmar
https://ift.tt/2pTZNlS
Next generation natural killer cells for cancer immunotherapy: the promise of genetic engineering
May Daher | Katayoun Rezvani
https://ift.tt/2GspGzm
The safety and risk factors of revision adenoidectomy in children and adolescents: A nationwide retrospective population-based cohort study
To investigate the safety of adenoidectomy and risk factors of re-adenoidectomy, and intend to provide evidence-based information to clinicians for further consideration.
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The safety and risk factors of revision adenoidectomy in children and adolescents: A nationwide retrospective population-based cohort study
To investigate the safety of adenoidectomy and risk factors of re-adenoidectomy, and intend to provide evidence-based information to clinicians for further consideration.
from ORL via alkiviadis.1961 on Inoreader https://ift.tt/2pWg8pW
Multimodality Surgical Approach in Management of Laryngotracheal Stenosis
Introduction. Postintubation laryngotracheal stenosis requires a precise diagnosis and an experienced operator in both endoscopic and surgical treatment. This report presents surgically treated cases of laryngotracheal stenosis secondary to long-term intubation/tracheostomy with review of the literature. Materials and Methods. In this retrospective study, we present 5 cases (a 23-year-old male, 13-year-old male, 22-year-old male, 19-year-old male, and 33-year-old female) of postintubation/tracheostomy laryngotracheal (glottic/subglottic) stenosis in the years 2016 and 2017. Each patient was managed differently. Intubation characteristics, localization of stenosis, surgical technique and material, postoperative complications, and survival of patients were recorded. Results. The site of stenosis was in the subglottis in 4 patients and glottis in 1 patient. The mean length of the stenosis was greater in the postintubation group. Postintubation stenosis had a mean duration of intubation of 6.8 days, compared to 206.25 days of cannulation following tracheostomies. Each patient underwent an average of 2 procedures during their treatment course. One patient underwent open surgical anastomosis because of recurrent subglottic stenosis after multiple treatments. Phonation improved immediately in almost all except in the patient who underwent only endoscopic dilatation. Discussion. The reasons for laryngeal stenosis and its delayed diagnosis have been reviewed from the literature. Suture tension should be appropriate, and placement of the suture knot outside the trachea minimizes formation of granulation tissue. The published reports suggest that resection by endoscopy with laser and open technique resection and primary anastomosis are the best treatment modality so far as the long-term results are concerned. Conclusion. Resection of stenotic segment by open surgical anastomosis and laser-assisted resection is a safe option for the treatment of subglottic stenosis following intubation without the need for repeated dilation. Endoscopic dilation can be reserved for unfit patients.
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Spinal Accessory Nerve Duplication: A Case Report and Literature Review
Aim of the present study is to expand our knowledge of the anatomy of the 11th cranial nerve and discuss the clinical importance and literature pertaining to accessory nerve duplication. We present one case of duplicated spinal accessory nerve in a patient undergoing neck dissection for oral cavity cancer. The literature review confirms the extremely rare diagnosis of a duplicated accessory nerve. Its clinical implication is of great importance. From this finding, a further extension to our knowledge of the existing anatomy is proposed.
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Multimodality Surgical Approach in Management of Laryngotracheal Stenosis
Introduction. Postintubation laryngotracheal stenosis requires a precise diagnosis and an experienced operator in both endoscopic and surgical treatment. This report presents surgically treated cases of laryngotracheal stenosis secondary to long-term intubation/tracheostomy with review of the literature. Materials and Methods. In this retrospective study, we present 5 cases (a 23-year-old male, 13-year-old male, 22-year-old male, 19-year-old male, and 33-year-old female) of postintubation/tracheostomy laryngotracheal (glottic/subglottic) stenosis in the years 2016 and 2017. Each patient was managed differently. Intubation characteristics, localization of stenosis, surgical technique and material, postoperative complications, and survival of patients were recorded. Results. The site of stenosis was in the subglottis in 4 patients and glottis in 1 patient. The mean length of the stenosis was greater in the postintubation group. Postintubation stenosis had a mean duration of intubation of 6.8 days, compared to 206.25 days of cannulation following tracheostomies. Each patient underwent an average of 2 procedures during their treatment course. One patient underwent open surgical anastomosis because of recurrent subglottic stenosis after multiple treatments. Phonation improved immediately in almost all except in the patient who underwent only endoscopic dilatation. Discussion. The reasons for laryngeal stenosis and its delayed diagnosis have been reviewed from the literature. Suture tension should be appropriate, and placement of the suture knot outside the trachea minimizes formation of granulation tissue. The published reports suggest that resection by endoscopy with laser and open technique resection and primary anastomosis are the best treatment modality so far as the long-term results are concerned. Conclusion. Resection of stenotic segment by open surgical anastomosis and laser-assisted resection is a safe option for the treatment of subglottic stenosis following intubation without the need for repeated dilation. Endoscopic dilation can be reserved for unfit patients.
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Spinal Accessory Nerve Duplication: A Case Report and Literature Review
Aim of the present study is to expand our knowledge of the anatomy of the 11th cranial nerve and discuss the clinical importance and literature pertaining to accessory nerve duplication. We present one case of duplicated spinal accessory nerve in a patient undergoing neck dissection for oral cavity cancer. The literature review confirms the extremely rare diagnosis of a duplicated accessory nerve. Its clinical implication is of great importance. From this finding, a further extension to our knowledge of the existing anatomy is proposed.
from ORL via alkiviadis.1961 on Inoreader https://ift.tt/2uCOanZ
The bidirectional relationship between sleep duration and depression in community-dwelling middle-aged and elderly individuals: Evidence from a longitudinal study
There are several studies that have focused on the relationship between sleep duration and depression, however, only a few prospective studies have centered on the bidirectional relationship between them. This four-year longitudinal study aimed to identify the association between sleep duration and depression in community-dwelling mid-age and elderly individuals.
https://ift.tt/2IkcbT5
The serotonin transporter 5-HTTLPR polymorphism and the risk for insomnia: a non-replication
In the June 2014 issue of Sleep Medicine, Huang et al. (2014) reported a genetic association study investigating the effect of 5-HTTLPR on insomnia [1]. In line with previous findings [2], results demonstrated that the short allele is associated with a higher insomnia risk relative to the long allele. The authors further revealed that an interaction between 5-HTTLPR and stress may contribute to this relationship which corresponds with earlier findings on subjective sleep quality [3].
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Validation of semiautomatic scoring of REM sleep without atonia in patients with RBD
To evaluate REM sleep without atonia (RSWA) in REM sleep behavior disorder (RBD) several automatic algorithms have been developed. We aimed to validate our algorithm (Mayer et al. 2008) in order to assess 1. capability of the algorithm to differentiate between RBD, night terror (NT), somnambulism (SW), Restless legs syndrome (RLS) and obstructive sleep apnea (OSA), 2. cut-off values for short (SMI) and long muscle activity (LMI), 3. which muscles qualify best for differential diagnosis, and 4. comparability of RSWA and registered movements between automatic and visual analysis of videometry.
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A Systematic Review to Explore the Feasibility of a Behavioural Sleep Intervention for Insomnia in Children with Neurodevelopmental Disorders: A Transdiagnostic Approach
Children with neurodevelopmental disorders (NDD) are at high risk for sleep problems, especially insomnia. It is currently not known whether behavioural sleep interventions developed for typically developing (TD) children are effective for children with NDD, and if interventions need to be modified for each diagnostic group. The aim of this systematic review was to identify and evaluate commonalities, trends in outcomes, and the methodological quality of parent-delivered behavioural sleep interventions for children with NDD, specifically Attention-Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), Cerebral Palsy, and Fetal Alcohol Spectrum Disorder.
https://ift.tt/2pVoDkr
Evaluation of the effects of occlusal splint, trigger point injection and arthrocentesis in the treatment of internal derangement patients with myofascial pain disorders
Publication date: Available online 31 March 2018
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Itır Şebnem Bilici, Yusuf Emes, Serhat Yalçın, Buket Aybar
https://ift.tt/2Imj8mC
A Multimodal analysis using flowmeter analysis, laser-Doppler spectrophotometry, and indocyanine green videoangiography for the detection of venous compromise in flaps in rats
Publication date: Available online 30 March 2018
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Lucas M. Ritschl, Leonard H. Schmidt, Andreas M. Fichter, Alexander Hapfelmeier, Klaus-Dietrich Wolff, Thomas Mücke
Venous congestion results in tissue damage and remains the most common failure of free microvascular transfer if it is not recognized early. The purpose of this experimental study was to evaluate venous congestion and describe the findings with two different monitoring tools. A standardized epigastric flap was raised, and total occlusion of the draining vein was temporarily applied for 4, 5, 6, or 7 hours. Blood flow measurements, including laser-Doppler flowmetry, and tissue spectrophotometry (O2C) and indocyanine green (ICG) videoangiography using the FLOW® 800 tool, were performed systematically after each surgical step, an interval of venous occlusion, and 1 week of clinical observation. Both monitoring tools were capable of detecting acute venous occlusion. ICG videoangiography data showed a significant decrease in the first and second maximum, and the area under the curve, during venous occlusion, whereas hemoglobin levels in the O2C analysis remained stable. Changes in fluorescence values in border areas of the flap correlated significantly with the incidence of necrosis. O2C data later showed significant correlation with the area of necrosis, and more individual changes during flap monitoring. ICG videoangiography might therefore be useful in the prediction of flap necrosis in critical areas of perfusion.
https://ift.tt/2Grtchi
Trajectory-guided biopsy of orbital tumor - Technology, principal considerations and clinical implementation -
Publication date: Available online 31 March 2018
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Majeed Rana, Christoph Sproll, Julian Lommen, Madiha Rana, Alexander Zeller, Norbert Kübler, Karsten Hufendiek, Elvis Hermann, Nils-Claudius Gellrich, Henrik Holtmann
Intraorbital space-occupying lesions always pose a challenge, both in terms of definite surgical removal as well as preoperative sampling for histopathological examination. Despite the use of modern high-resolution imaging techniques, the dignity of orbital lesions can often not be determined with sufficient certainty preoperatively. As the amount and complexity of treatment possibilities continue to increase, detailed diagnostics in advance of treatment choice are essential. Histological classification of orbital lesions can still be considered the gold standard for reliable diagnoses, leading to appropriate treatment.Over recent years minimally invasive surgical approaches have gained more importance in the treatment and diagnosis of cranio-maxillo-facial tumor and trauma.The aim of our study was to adapt and establish a precise procedure for orbital biopsies. 23 patients suffering from space-occupying lesions of unknown dignity were included. Trajectory-guided procedures were pre-planned for all cases. In most cases minimally invasive procedures were suitable for taking biopsies of the orbit. For only two patients a conventional, non-minimally invasive, lateral orbitotomy had to be performed. Further evaluation of the presented procedure demonstrates clearly that trajectory-guided biopsies of the orbit can be performed correctly and effectively, regardless of the suspected lesion's size.
https://ift.tt/2Imj46m
Vaginoplasty Complications
Source:Clinics in Plastic Surgery
Author(s): Cecile A. Ferrando
Teaser
Complications after vaginoplasty surgery for the transgender woman exist. These adverse outcomes can be minor and easily treatable, whereas others are considered major events and require ongoing care. Adverse outcomes can be immediate or remote after surgery and include bleeding, hematoma, infection, delayed wound healing, neovaginal stenosis, visceral injury, and fistula. Patients may also experience pelvic floor disorders after surgery. Providers performing these surgeries and those providers caring for postoperative patients should be aware of the incidence of these complications and the treatment options that exist to manage them.https://ift.tt/2EagZYx
Evaluation of the effects of occlusal splint, trigger point injection and arthrocentesis in the treatment of internal derangement patients with myofascial pain disorders
Temporomandibular disorders (TMD) may originate from the joint itself or from pathologies of masticatory muscles. Most pathology seen is myofascial pain disorder (MPD). TMD are characterized by pain, muscle spasms, and constraints in the movements of the temporomandibular joint. In temporomandibular joint disorders, besides the internal derangement, protective muscle spasms are usually observed.
https://ift.tt/2E9Ihym
Implant stability using piezoelectric bone surgery compared with conventional drilling: a systematic review and meta-analysis
The aim of this systematic review was to assess the primary and secondary stability of dental implants placed at sites prepared with piezoelectric bone surgery (PBS) and conventional drilling (CD). The PubMed/MEDLINE and Cochrane Library databases were searched without date or language restriction up to June 2017. Controlled clinical trials in which each patient received implants placed at sites prepared with both PBS and CD were selected. Implant stability had to be measured on day 0 and during the osseointegration period.
https://ift.tt/2pTYHGJ
Implant stability using piezoelectric bone surgery compared with conventional drilling: a systematic review and meta-analysis
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): S. García-Moreno, J. González-Serrano, R.M. López-Pintor, B. Pardal-Peláez, G. Hernández, J.M. Martínez-González
The aim of this systematic review was to assess the primary and secondary stability of dental implants placed at sites prepared with piezoelectric bone surgery (PBS) and conventional drilling (CD). The PubMed/MEDLINE and Cochrane Library databases were searched without date or language restriction up to June 2017. Controlled clinical trials in which each patient received implants placed at sites prepared with both PBS and CD were selected. Implant stability had to be measured on day 0 and during the osseointegration period. Methodological quality was assessed using the Cochrane Collaboration tool. A meta-analysis was performed to compare primary stability (on day 0) and secondary stability (after 2 and 3months) between the two groups. The studies included were determined to have a high risk of bias. There was no significant difference between the two groups for primary stability (on day 0) (P=0.51). After 2 and 3months, secondary stability was statistically higher in implants placed with PBS preparation (P=0.04 and P=0.01, respectively). The implant survival rate was 97.5% in the CD group and 100% in the PBS group. PBS preparation improves secondary stability after 2 and 3months in comparison to CD, with similar implant survival rates. Further studies are needed to determine whether implant osseointegration periods could be shortened with PBS preparation.
https://ift.tt/2pVfWq7
A perspective on brain-behavior relationships and effects of age and hearing using speech-in-noise stimuli
Source:Hearing Research
Author(s): Curtis J. Billings, Brandon M. Madsen
Understanding speech in background noise is often more difficult for individuals who are older and have hearing impairment than for younger, normal-hearing individuals. In fact, speech-understanding abilities among older individuals with hearing impairment varies greatly. Researchers have hypothesized that some of that variability can be explained by how the brain encodes speech signals in the presence of noise, and that brain measures may be useful for predicting behavioral performance in difficult-to-test patients. In a series of experiments, we have explored the effects of age and hearing impairment in both brain and behavioral domains with the goal of using brain measures to improve our understanding of speech-in-noise difficulties. The behavioral measures examined showed effect sizes for hearing impairment that were 6–10 dB larger than the effects of age when tested in steady-state noise, whereas electrophysiological age effects were similar in magnitude to those of hearing impairment. Both age and hearing status influence neural responses to speech as well as speech understanding in background noise. These effects can in turn be modulated by other factors, such as the characteristics of the background noise itself. Finally, the use of electrophysiology to predict performance on receptive speech-in-noise tasks holds promise, demonstrating root-mean-square prediction errors as small as 1–2 dB. An important next step in this field of inquiry is to sample the aging and hearing impairment variables continuously (rather than categorically) – across the whole lifespan and audiogram – to improve effect estimates.
https://ift.tt/2pXVipk
Hearing, self-motion perception, mobility, and aging
Source:Hearing Research
Author(s): Jennifer Campos, Robert Ramkhalawansingh, M. Kathleen Pichora-Fuller
Hearing helps us know where we are relative to important events and objects in our environment and it allows us to track our changing position dynamically over space and time. Auditory cues are used in combination with other sensory inputs (vision, vestibular, proprioceptive) to help us perceive our own movements through space, known as self-motion perception. Whether we are maintaining standing balance, walking, or driving, audition can provide unique and important information to help optimize self-motion perception, and consequently to support safe mobility. Recent epidemiological and experimental studies have shown evidence that hearing loss is associated with greater walking difficulties, poorer overall physical functioning, and a significantly increased risk of falling in older adults. Importantly, the mechanisms underlying the associations between hearing status and mobility are poorly understood. It is also critical to consider that age-related hearing loss is often concomitant with declines in other sensory, motor, and cognitive functions and that these declines may interact, particularly during realistic, everyday tasks. Overall, exploring the role of auditory cues and the effects of hearing loss on self-motion perception specifically, and mobility more generally, is important to both building fundamental knowledge on the perceptual processes underlying the ability to perceive our movements through space, as well as to optimizing mobility-related interventions for those with hearing loss so that they can function better when confronted by everyday real-world sensory-motor challenges. The goal of this paper is to explore the role of hearing in self-motion perception across a range of mobility-related behaviors. First, we briefly review the ways in which auditory cues are used to perceive self-motion and how sound inputs affect behaviors such as standing balance, walking, and driving. Next, we consider age-related changes in auditory self-motion perception and the potential consequences to the performance of mobility-related tasks. We then describe how hearing loss is associated with declines in mobility-related abilities and increased adverse outcomes such as falls. We describe age-related changes to other sensory and cognitive functions and how these may interact with hearing loss in ways that affect mobility. Finally, we briefly consider the implications of the hearing-mobility associations with respect to applied domains such as screening for mobility problems and falls risk in those with hearing loss and developing interventions and training approaches targeting safe and independent mobility throughout the lifespan.
https://ift.tt/2J8RCtH
Pelvic excursion during walking post-stroke: A novel classification system
Source:Gait & Posture
Author(s): Virginia L. Little, Theresa E. McGuirk, Lindsay A. Perry, Carolynn Patten
BackgroundResearchers and clinicians often use gait speed to classify hemiparetic gait dysfunction because it offers clinical predictive capacity. However, gait speed fails to distinguish unique biomechanical characteristics that differentiate aspects of gait dysfunction.Research QuestionHere we describe a novel classification of hemiparetic gait dysfunction based on biomechanical traits of pelvic excursion. We hypothesize that individuals with greater deviation of pelvic excursion, relative to controls, demonstrate greater impairment in key gait characteristics.MethodsWe compared 41 participants (61.0 ± 11.2yrs) with chronic post-stroke hemiparesis to 21 non-disabled controls (55.8 ± 9.0yrs). Participants walked on an instrumented split-belt treadmill at self-selected walking speed. Pelvic excursion was quantified as the peak-to-peak magnitude of pelvic motion in three orthogonal planes (i.e., tilt, rotation, and obliquity). Raw values of pelvic excursion were compared against the distribution of control data to establish deviation scores which were assigned bilaterally for the three planes producing six values per individual. Deviation scores were then summed to produce a composite pelvic deviation score. Based on composite scores, participants were allocated to one of three categories of hemiparetic gait dysfunction with progressively increasing pelvic excursion deviation relative to controls: Type I (n = 15) – minimal pelvic excursion deviation; Type II (n = 20) – moderate pelvic excursion deviation; and Type III (n = 6) – marked pelvic excursion deviation. We assessed resulting groups for asymmetry in key gait parameters including: kinematics, joint powers temporally linked to the stance-to-swing transition, and timing of lower extremity muscle activity.ResultsAll groups post-stroke walked at similar self-selected speeds; however, classification based on pelvic excursion deviation revealed progressive asymmetry in gait kinematics, kinetics and temporal patterns of muscle activity.SignificanceThe progressive asymmetry revealed in multiple gait characteristics suggests exaggerated pelvic motion contributes to gait dysfunction post-stroke.
https://ift.tt/2J4lOq5
Objective measures of unobstructed walking and obstacle avoidance in Parkinson’s disease subtypes
Source:Gait & Posture
Author(s): Diego Orcioli-Silva, Rodrigo Vitório, Ellen Lirani-Silva, Paulo Cezar Rocha dos Santos, Victor Spiandor Beretta, Lilian Teresa Bucken Gobbi
BackgroundObjective measures of gait in Parkinson's disease (PD) patients according to motor subtypes are not yet fully understood. Although recent advances have been made for unobstructed walking, further work is required on locomotor tasks challenging postural stability, such as obstacle avoidance.Research questionThis study aimed to investigate the influence of PD motor subtypes on objective measures of locomotion during unobstructed walking and obstacle avoidance.MethodsThirty-five PD patients classified as postural instability and gait disorder (PIGD) and 30 as tremor dominant (TD), as well as 45 healthy controls (CG) walked along an 8-m pathway under two conditions: (a) unobstructed walking and (b) obstacle avoidance. Outcome measures included spatiotemporal parameters recorded by an optoelectronic tridimensional system.ResultsDuring unobstructed walking, the PIGD group exhibited shorter stride length, slower velocity, and longer double support phase compared to the TD and CG groups. The TD group also presented slower stride velocity compared to the CG. The PIGD and TD groups presented shorter stride duration than the CG. Regarding obstacle avoidance, the PIGD group exhibited shorter distances for leading foot placement before obstacle, trailing foot placement after obstacle and trailing crossing step length compared to the TD and CG groups. The PIGD group exhibited wider leading crossing step width, lower trailing toe clearance, and slower leading and trailing velocity during obstacle avoidance compared to the CG.SignificancePIGD subtype patients showed worse modifications in objective measures of unobstructed walking and obstacle avoidance. The observed modifications may contribute to increased fall occurrence in PIGD patients.
https://ift.tt/2pZ5iiv
A novel approach for the detection and exploration of joint coupling patterns in the lower limb kinetic chain
Source:Gait & Posture
Author(s): Kevin Deschamps, Maarten Eerdekens, Jurre Geentjens, Lieselot Santermans, Lien Steurs, Bart Dingenen, Maarten Thysen, Filip Staes
BackgroundA comprehensive perspective on foot and lower limb joint coupling is lacking since previous studies did not consider the multi-articular nature of the foot and lower limb neither accounted for biomechanical heterogeneity.Research questionThe current manuscript describes a novel methodological process for detection and exploration of joint coupling patterns in the lower limb kinetic chain.MethodsThe first stage of the methodological process encompasses the measurement of 3D joint kinematics of the foot and lower limb kinetic chain during dynamic activities. The second stage consists of selecting the kinematic waveforms of interest. In the third stage, cross-correlation coefficients are calculated across the selected one-dimensional continua of each subject. In the fourth stage, all cross-correlation coefficients per subject are used as input variable in a cluster algorithm. Algorithm specific qualitative metrics are subsequently considered to determine the most robust clustering. Finally, in the fifth stage the process of biomechanical interpretation is initiated and further exploration is recommended by triangulating with other biomechanical variables.ResultsA first clinical illustration of the novel method was provided using data of fourteen young elite athletes. Cross-correlation coefficients for each leg were calculated across continua of the pelvis, hip, knee, rear foot and midfoot. A hierarchical clustering approach stratified the coefficients into two distinct clusters which was mainly guided by the frontal plane knee kinematics. Both clustered differed significantly from each other with respect to their frontal plane ankle, knee and hip kinetics.SignificanceThe presented method seems to provide a valuable approach to gain insight into foot and lower joint coupling.
https://ift.tt/2J4Ro6V
Modeling margin of stability with feet in place following a postural perturbation: Effect of altered anthropometric models for estimated extrapolated centre of mass
Source:Gait & Posture
Author(s): Keaton A. Inkol, Andrew H. Huntley, Lori Ann Vallis
BackgroundMaintaining the centre of mass (CoM) of the body within the base of support is a critical component of upright balance; the ability to accurately quantify balance recovery mechanisms is critical for many research teams.Research QuestionThe purpose of this study was to investigate how exclusion of specific body segments in an anthropometric CoM model influenced a dynamic measure of postural stability, the margin of stability (MoS) following a support-surface perturbation.MethodsHealthy young adults (n = 10) were instrumented with kinematic markers and a safety harness. Sixteen support-surface translations, scaled to ensure responses did not involve a change in base of support, were then issued (backwards, forwards, left, or right). Whole-body CoM was estimated using four variations of a 13-segment anthropometric model: i) the full-model (WFM), and three simplified models, ii) excluding upper limbs (NAr); iii) excluding upper and lower limbs (HTP); iv) pelvis CoM (CoMp). The CoM calculated for each variant was then used to estimate extrapolated CoM (xCoM) position and the resulting MoS within the plane of postural disturbance.ResultsComparisons of simplified models to the full model revealed significant differences (p < 0.05) in MoS for all models in each perturbation condition; however, the largest differences were following sagittal-based perturbations. Poor estimates of WFM MoS were most evident for HTP and CoMp models; these were associated with the greatest values of RMS/maximum error, poorest correlations, etc. The simplified models provided low-error approximates for frontal perturbations.SignificanceFindings suggest that simplified calculations of CoM can be used by researchers without reducing MoS measurement accuracy, however the degree of simplification should be context-dependent. For example,CoMp models may be appropriate for questions pertaining to frontal MoS; sagittal MoS necessitates inclusion of lower limb and HTP segments to prevent underestimation of postural stability.
https://ift.tt/2pUUaTu
An audiological evaluation of syndromic and non-syndromic craniosynostosis in pre-school going children
Source:International Journal of Pediatric Otorhinolaryngology, Volume 109
Author(s): Liang Chye Goh, Ali Azman, Hufaidah binti Konting Siti, Wee Vien Khoo, Premala a/p Muthukumarasamy, Meow Keong Thong, Zulkiflee Abu Bakar, Anura Michelle Manuel
ObjectiveTo study the audiological outcome and early screening of pre-school going children with craniosynostosis under follow-up at the University of Malaya Medical Center(UMMC), Kuala Lumpur, Malaysia over a 10 year period.MethodsA retrospective descriptive cohort study on the audiological findings detected during the first hearing assessment done on a child with craniosynostosis using otoacoustic emissions, pure tone audiometry or auditory brainstem response examination. The main aim of this study was to evaluate the type and severity of hearing loss when compared between syndromic and non-sydromic craniosynostosis, and other associated contributory factors.ResultsA total of 31 patients with 62 ears consisting of 14 male patients and 17 female patients were evaluated. Twenty two patients (71%) were syndromic and 9 (29%) were non-syndromic craniosynostosis. Amongst the syndromic craniosynostosis, 9 (41%) had Apert syndrome, 7 (32%) had Crouzon syndrome, 5 (23%) had Pfieffer syndrome and 1 (4%) had Shaethre Chotzen syndrome. Patients with syndromic craniosynostosis were more likely to present with all types and severity of hearing loss, including severe to profound sensorineural hearing loss while children with non-syndromic craniosynostosis were likely to present with normal hearing (p < 0.05). In addition, when the first hearing test was done at a later age, a hearing loss including sensorineural hearing loss is more likely to be present in a child with syndromic craniosynostosis (p < 0.05).ConclusionOur study suggested that children who are born with syndromic craniosynostosis were more likely to suffer from a hearing loss, including that of a severe to profound degree compared to children with non-syndromic craniosynostosis. In addition to that, hearing loss is more likely to be detected when the first hearing test is done at a later age, and this can be an irreversible sensorineural hearing loss. We would like to advocate the need for early audiological screening and follow up in children with syndromic craniosynostosis.
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Surgical timing for bilateral simultaneous cochlear implants: When is best?
Publication date: June 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 109
Author(s): Sebastiano Franchella, Roberto Bovo, Luigia Bandolin, Flavia Gheller, Silvia Montino, Daniele Borsetto, Sara Ghiselli, Alessandro Martini
IntroductionHearing loss is considered the most common congenital disease and the prevalence of neonatal deafness can be estimated between 1 and 2 cases per 1000 live births.Infant deafness must be diagnosed as early as possible and an effective therapeutic intervention needs to be carried out in order to avoid the serious consequences of hearing deprivation during the evolutionary period: alterations in the development of central auditory pathways and lack of language acquisition.The cochlear implant (CI) has proved to be the best instrument to solve the problem of auditory deprivation. In particular, the bilateral CI gives the patient access to binaural hearing which results in benefits in terms of sound localisation and discrimination.The optimal age of application of the CI is a widely discussed topic in the scientific community and the current guidelines indicate a period between 12 and 24 months of age, even though the supporters of the application before 12 months of age are nowadays increasing.Materials and methodsThe study is observational, retrospective, monocentric. 49 paediatric patients (<18 years) with simultaneous bilateral CIs were included. The audiometric threshold and speech tests were carried out during the follow-up 3, 6 and 12 months after the CIs activation and when the patient reached 2 years of age.ResultsThe statistical analysis showed that undergoing bilateral implantation surgery before 2 years of age allows a satisfactory audiometric performance, while there are no particular benefits in performing the surgery before 1 year of age. As far as the speech outcome is concerned, the statistical analysis didn't show significant correlation between the earlier age of implantation and better speech performance if the operation is carried out before 2.5 years of age.ConclusionsThe results of the study indicate that the optimal age to perform the simultaneous bilateral CIs surgery is between 12 and 24 months, without demonstrating any particular benefit in carrying out the procedure before 1 year of age. This may be clinically relevant in terms of avoiding the risks of diagnostic mistakes and reducing the related surgical risk in children under 1 year of age.
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An audiological evaluation of syndromic and non-syndromic craniosynostosis in pre-school going children
Source:International Journal of Pediatric Otorhinolaryngology, Volume 109
Author(s): Liang Chye Goh, Ali Azman, Hufaidah binti Konting Siti, Wee Vien Khoo, Premala a/p Muthukumarasamy, Meow Keong Thong, Zulkiflee Abu Bakar, Anura Michelle Manuel
ObjectiveTo study the audiological outcome and early screening of pre-school going children with craniosynostosis under follow-up at the University of Malaya Medical Center(UMMC), Kuala Lumpur, Malaysia over a 10 year period.MethodsA retrospective descriptive cohort study on the audiological findings detected during the first hearing assessment done on a child with craniosynostosis using otoacoustic emissions, pure tone audiometry or auditory brainstem response examination. The main aim of this study was to evaluate the type and severity of hearing loss when compared between syndromic and non-sydromic craniosynostosis, and other associated contributory factors.ResultsA total of 31 patients with 62 ears consisting of 14 male patients and 17 female patients were evaluated. Twenty two patients (71%) were syndromic and 9 (29%) were non-syndromic craniosynostosis. Amongst the syndromic craniosynostosis, 9 (41%) had Apert syndrome, 7 (32%) had Crouzon syndrome, 5 (23%) had Pfieffer syndrome and 1 (4%) had Shaethre Chotzen syndrome. Patients with syndromic craniosynostosis were more likely to present with all types and severity of hearing loss, including severe to profound sensorineural hearing loss while children with non-syndromic craniosynostosis were likely to present with normal hearing (p < 0.05). In addition, when the first hearing test was done at a later age, a hearing loss including sensorineural hearing loss is more likely to be present in a child with syndromic craniosynostosis (p < 0.05).ConclusionOur study suggested that children who are born with syndromic craniosynostosis were more likely to suffer from a hearing loss, including that of a severe to profound degree compared to children with non-syndromic craniosynostosis. In addition to that, hearing loss is more likely to be detected when the first hearing test is done at a later age, and this can be an irreversible sensorineural hearing loss. We would like to advocate the need for early audiological screening and follow up in children with syndromic craniosynostosis.
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Surgical timing for bilateral simultaneous cochlear implants: When is best?
Publication date: June 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 109
Author(s): Sebastiano Franchella, Roberto Bovo, Luigia Bandolin, Flavia Gheller, Silvia Montino, Daniele Borsetto, Sara Ghiselli, Alessandro Martini
IntroductionHearing loss is considered the most common congenital disease and the prevalence of neonatal deafness can be estimated between 1 and 2 cases per 1000 live births.Infant deafness must be diagnosed as early as possible and an effective therapeutic intervention needs to be carried out in order to avoid the serious consequences of hearing deprivation during the evolutionary period: alterations in the development of central auditory pathways and lack of language acquisition.The cochlear implant (CI) has proved to be the best instrument to solve the problem of auditory deprivation. In particular, the bilateral CI gives the patient access to binaural hearing which results in benefits in terms of sound localisation and discrimination.The optimal age of application of the CI is a widely discussed topic in the scientific community and the current guidelines indicate a period between 12 and 24 months of age, even though the supporters of the application before 12 months of age are nowadays increasing.Materials and methodsThe study is observational, retrospective, monocentric. 49 paediatric patients (<18 years) with simultaneous bilateral CIs were included. The audiometric threshold and speech tests were carried out during the follow-up 3, 6 and 12 months after the CIs activation and when the patient reached 2 years of age.ResultsThe statistical analysis showed that undergoing bilateral implantation surgery before 2 years of age allows a satisfactory audiometric performance, while there are no particular benefits in performing the surgery before 1 year of age. As far as the speech outcome is concerned, the statistical analysis didn't show significant correlation between the earlier age of implantation and better speech performance if the operation is carried out before 2.5 years of age.ConclusionsThe results of the study indicate that the optimal age to perform the simultaneous bilateral CIs surgery is between 12 and 24 months, without demonstrating any particular benefit in carrying out the procedure before 1 year of age. This may be clinically relevant in terms of avoiding the risks of diagnostic mistakes and reducing the related surgical risk in children under 1 year of age.
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Thyroid Cartilage Window Approach to Extract a Foreign Body after Migration into the Paraglottic Space
We report a case of fish bone impaction in the paraglottic space, which caused palsy of the left vocal cord. The patient was a 45-year-old man. He presented with throat pain and hoarseness of voice for approximately one week. The diagnosis was made after careful history taking and confirmed by the use of computed tomography scan as the fish bone was not visible endoscopically under local and general anaesthesia. The patient underwent thyroid cartilage window approach, and the fish bone was retrieved. His symptoms have improved significantly, and he did not require tracheostomy. Other cases reported the removal of foreign bodies by other techniques such as laryngofissure and posterolateral approach. Our case is different in that we used a modification of thyroplasty type 1 technique as it has less reported complications than other approaches that were published in literature.
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Soft Palate Pleomorphic Adenoma of a Minor Salivary Gland: An Unusual Presentation
Approximately 10% of pleomorphic adenomas occur in the minor salivary glands with the palate being the most common site. Pleomorphic adenomas account for the majority of palatal tumours; however, minor salivary gland tumours have a higher risk of malignancy compared to tumours of the major salivary glands, so appropriate diagnostic evaluation should be prompt. We present a case of a 52-year-old man with a longstanding history of a soft palate pleomorphic adenoma which required excision under general anaesthetic via a mandibular swing approach. As well as the surgical approach to access this tumour; this case is unique as it is the largest soft palate pleomorphic adenoma reported in the literature. We discuss the appropriate preoperative investigations and airway considerations for this patient, as well as the factors to consider when planning operative management of palatal tumours.
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Thyroid Cartilage Window Approach to Extract a Foreign Body after Migration into the Paraglottic Space
We report a case of fish bone impaction in the paraglottic space, which caused palsy of the left vocal cord. The patient was a 45-year-old man. He presented with throat pain and hoarseness of voice for approximately one week. The diagnosis was made after careful history taking and confirmed by the use of computed tomography scan as the fish bone was not visible endoscopically under local and general anaesthesia. The patient underwent thyroid cartilage window approach, and the fish bone was retrieved. His symptoms have improved significantly, and he did not require tracheostomy. Other cases reported the removal of foreign bodies by other techniques such as laryngofissure and posterolateral approach. Our case is different in that we used a modification of thyroplasty type 1 technique as it has less reported complications than other approaches that were published in literature.
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Soft Palate Pleomorphic Adenoma of a Minor Salivary Gland: An Unusual Presentation
Approximately 10% of pleomorphic adenomas occur in the minor salivary glands with the palate being the most common site. Pleomorphic adenomas account for the majority of palatal tumours; however, minor salivary gland tumours have a higher risk of malignancy compared to tumours of the major salivary glands, so appropriate diagnostic evaluation should be prompt. We present a case of a 52-year-old man with a longstanding history of a soft palate pleomorphic adenoma which required excision under general anaesthetic via a mandibular swing approach. As well as the surgical approach to access this tumour; this case is unique as it is the largest soft palate pleomorphic adenoma reported in the literature. We discuss the appropriate preoperative investigations and airway considerations for this patient, as well as the factors to consider when planning operative management of palatal tumours.
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Induction of a central memory and stem cell memory phenotype in functionally active CD4 + and CD8 + CAR T cells produced in an automated good manufacturing practice system for the treatment of CD19 + acute lymphoblastic leukemia
Abstract
Relapsed/refractory B-precursor acute lymphoblastic leukemia (pre-B ALL) remains a major therapeutic challenge. Chimeric antigen receptor (CAR) T cells are promising treatment options. Central memory T cells (Tcm) and stem cell-like memory T cells (Tscm) are known to promote sustained proliferation and persistence after T-cell therapy, constituting essential preconditions for treatment efficacy. Therefore, we set up a protocol for anti-CD19 CAR T-cell generation aiming at high Tcm/Tscm numbers. 100 ml peripheral blood from pediatric pre-B ALL patients was processed including CD4+/CD8+-separation, T-cell activation with modified anti-CD3/-CD28 reagents and transduction with a 4-1BB-based second generation CAR lentiviral vector. The process was performed on a closed, automated device requiring additional manual/open steps under clean room conditions. The clinical situation of these critically ill and refractory patients with leukemia leads to inconsistent cellular compositions at start of the procedure including high blast counts and low T-cell numbers with exhausted phenotype. Nevertheless, a robust T-cell product was achieved (mean CD4+ = 50%, CD8+ = 39%, transduction = 27%, Tcm = 50%, Tscm = 46%). Strong proliferative potential (up to > 100-fold), specific cytotoxicity and low expression of co-inhibitory molecules were documented. CAR T cells significantly released TH1 cytokines IFN-γ, TNF-α and IL-2 upon target-recognition. In conclusion, partly automated GMP-generation of CAR T cells from critically small blood samples was feasible with a new stimulation protocol that leads to high functionality and expansion potential, balanced CD4/CD8 ratios and a conversion to a Tcm/Tscm phenotype.
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Cholesteatoma labyrinthine fistula: prevalence and impact.
| Related Articles |
Cholesteatoma labyrinthine fistula: prevalence and impact.
Braz J Otorhinolaryngol. 2018 Mar 09;:
Authors: Rosito LPS, Canali I, Teixeira A, Silva MN, Selaimen F, Costa SSD
Abstract
INTRODUCTION: Labyrinthine fistula is one of the most common complications associated with cholesteatoma. It represents an erosive loss of the endochondral bone overlying the labyrinth. Reasons for cholesteatoma-induced labyrinthine fistula are still poorly understood.
OBJECTIVE: Evaluate patients with cholesteatoma, in order to identify possible risk factors or clinical findings associated with labyrinthine fistula. Secondary objectives were to determine the prevalence of labyrinthine fistula in the study cohort, to analyze the role of computed tomography and to describe the hearing results after surgery.
METHODS: This retrospective cohort study included patients with an acquired middle ear cholesteatoma in at least one ear with no prior surgery, who underwent audiometry and tomographic examination of the ears or surgery at our institution. Hearing results after surgery were analyzed according to the labyrinthine fistula classification and the employed technique.
RESULTS: We analyzed a total of 333 patients, of which 9 (2.7%) had labyrinthine fistula in the lateral semicircular canal. In 8 patients, the fistula was first identified on image studies and confirmed at surgery. In patients with posterior epitympanic and two-route cholesteatomas, the prevalence was 5.0%; and in cases with remaining cholesteatoma growth patterns, the prevalence was 0.6% (p=0.16). In addition, the prevalence ratio for labyrinthine fistula between patients with and without vertigo was 2.1. Of patients without sensorineural hearing loss before surgery, 80.0% remained with the same bone conduction thresholds, whereas 20.0% progressed to profound hearing loss. Of patients with sensorineural hearing loss before surgery, 33.33% remained with the same hearing impairment, whereas 33.33% showed improvement of the bone conduction thresholds' Pure Tone Average.
CONCLUSION: Labyrinthine fistula must be ruled out prior to ear surgery, particularly in cases of posterior epitympanic or two-route cholesteatoma. Computed tomography is a good diagnostic modality for lateral semicircular canal fistula. Sensorineural hearing loss can occur post-surgically, even in previously unaffected patients despite the technique employed.
PMID: 29599061 [PubMed - as supplied by publisher]
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Stability of allergens
Source:Molecular Immunology
Author(s): Judith Pekar, Davide Ret, Eva Untersmayr
For proteins to cause IgE-mediated allergic reactions, several common characteristics have to be defined, including small molecular size, solubility and stability to changing pH levels and enzymatic degradation. Nevertheless, these features are not unique for potent allergens, but are also observed in non-allergenic proteins. Due to the increasing awareness by regulatory authorities regarding the allergy pandemic, definition of characteristics unique to potent allergens would facilitate allergenicity assessment in the future. Despite major research efforts even to date the features unique for major allergens have not been elucidated so far. The route of allergen entry into the organism determines to a great extent these required characteristics. Especially orally ingested allergens are exposed to the harsh milieu of the gastrointestinal tract but might additionally be influenced by food processing. Depending on molecular properties such as disulphide bonds contributing to protein fold and formation of conformational IgE epitopes, posttranslational protein modification or protein food matrix interactions, enzymatic and thermal stability might differ between allergens. Moreover, also ligand binding influences structural stability. In the current review article, we aim at highlighting specific characteristics and molecular pattern contributing to a stabilized protein structure and overall allergenicity.
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Nebulized lidocaine ameliorates allergic airway inflammation via downregulation of TLR2
Source:Molecular Immunology, Volume 97
Author(s): Lixia Wang, Muzi Wang, Shuai Li, Huimei Wu, Qiying Shen, Shihai Zhang, Lei Fang, Rongyu Liu
Nebulized lidocaine has been suggested to be beneficial in asthma therapy, but the underlying mechanisms are little known. We aimed to investigate whether Toll-like receptor (TLR) 2 was involved in the protective effect of lidocaine on allergic airway inflammation. Female C57BL/6 mice were sensitized and challenged with ovalbumin (OVA). Meanwhile, some of the mice were treated with TLR2 agonist (Pam3CSK4, 100 μg) intraperitoneally in combination with OVA on day 0. Just after allergen provocation, mice were treated with inhaled lidocaine or vehicle for 30 min. In this model, we found that lidocaine markedly attenuated OVA-evoked airway inflammation, leukocyte recruitment and mucus production. Moreover, lidocaine abrogated the increased concentrations of T cytokines and TNF-α in bronchoalveolar lavage fluid (BALF) of allergic mice, as well as reducing the expression of phosphorylated nuclear factor (P-NF)-κBp65 and the NOD-like receptor pyridine containing 3 (NLRP3), which are important for the production of pro-inflammatory cytokines. In addition, our study showed that lidocaine dramatically decreased OVA-induced increased expression of TLR2 in the lung tissues. Furthermore, activation of TLR2 aggravated OVA-challenged airway inflammation, meanwhile, it also elevated OVA-induced expression of P-NF-κBp65 and NLRP3 in the lungs. However, lidocaine effectively inhibited airway inflammation and counteracted the expression of P-NF-κBp65 and NLRP3 in allergic mice pretreated with Pam3CSK4. Taken together, the present study demonstrated that lidocaine prevented allergic airway inflammation via TLR2 in an OVA-induced murine allergic airway inflammation model. TLR2/NF-κB/NLRP3 pathway may serve as a promising therapeutic strategy for allergic airway inflammation.
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New insights into the structure of the MHC class I peptide-loading complex and mechanisms of TAP inhibition by viral immune evasion proteins
Source:Molecular Immunology
Author(s): Patrique Praest, A. Manuel Liaci, Friedrich Förster, Emmanuel J.H.J. Wiertz
Several hundred million years of co-evolution of vertebrates and invading pathogens have shaped the adaptive immune system to fight back the unwanted invaders through highly sophisticated defense mechanisms. Herpesviruses manage to dodge this immune response by hampering one of the central hinges of human adaptive immunity, the major histocompatibility complex (MHC) class I antigen presentation pathway. One of the bottlenecks of this pathway is the loading of pathogen-derived peptides onto MHC-I molecules in the endoplasmic reticulum (ER). This task is accomplished by the MHC class I peptide-loading complex (PLC), of which the transporter associated with antigen-processing (TAP) is a central component. In this review, we summarize recent structural and functional insights into the molecular architecture of the PLC, how TAP accomplishes the transport of peptides across the ER membrane, and how herpes- and poxviruses inhibit TAP-mediated peptide translocation and subsequent antigen presentation.
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Couples coping with sensory loss: A dyadic study of the roles of self- and perceived partner acceptance.
Couples coping with sensory loss: A dyadic study of the roles of self- and perceived partner acceptance.
Br J Health Psychol. 2018 Mar 30;:
Authors: Lehane CM, Nielsen T, Wittich W, Langer S, Dammeyer J
Abstract
OBJECTIVES: Hearing-, vision-, and dual-sensory loss have been linked to relational and psychological distress among adults with sensory loss (AWSLs) and their spouses. Regardless, research on factors associated with couples' adjustment is lacking. This study examined the stability and strength of associations between self-acceptance of sensory loss, perceived partner acceptance of sensory loss, and relationship satisfaction and psychological distress among AWSLs and their spouses over time.
DESIGN: A total of 122 AWSLs and their spouses completed an online survey at two time points over a 6-month period.
METHODS: A multigroup (i.e., time 1 and time 2) actor-partner interdependence model assessed the stability and strength of actor and partner effects of self-acceptance and perceived partner acceptance on each partner's relationship satisfaction and psychological distress over time.
RESULTS: No moderation by time was identified, indicating stability in associations over the 6-month period. Overall, both actor and partner effects were evident. Specifically, self-acceptance among AWSLs was inversely associated with own psychological distress and the relationship satisfaction of spouses. Self-acceptance by spouses was inversely associated with the psychological distress of AWSLs and spouses. Perception of spouse acceptance by AWSLs was positively associated with own and spouse relationship satisfaction.
CONCLUSIONS: Interventions targeting acceptance that incorporate a family systems perspective may be beneficial in alleviating psychological and relational distress among couples coping with sensory loss. Statement of contribution What is already known on this subject? The experience of hearing and/or vision loss has been linked to heightened distress both psychologically and within intimate relationships. Prior research has demonstrated a link between an individual's ability to accept their sensory loss and healthier well-being. What does this study add? This is the first dyadic study of sensory loss acceptance and its link to relationship satisfaction and distress. Acceptance operates interpersonally protecting against distress for those with sensory loss and their spouses. Perceiving that one's spouse accepts the sensory loss is important for both partner's relationship satisfaction.
PMID: 29602197 [PubMed - as supplied by publisher]
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Do turbinate reduction procedures restore epithelial integrity in patients with turbinate hypertrophy secondary to allergic rhinitis? A histopathological study.
| Related Articles |
Do turbinate reduction procedures restore epithelial integrity in patients with turbinate hypertrophy secondary to allergic rhinitis? A histopathological study.
Eur Arch Otorhinolaryngol. 2018 Mar 29;:
Authors: Lukka VK, Jacob TM, Jeyaseelan V, Rupa V
Abstract
PURPOSE: Consensus has not been reached regarding the optimal reduction procedure for inferior turbinate hypertrophy in allergic rhinitis and whether such procedures result in improvement in mucosal architecture.
METHODS: Twenty-nine patients aged 18-45 years (mean 26.8 years), with allergic rhinitis and inferior turbinate hypertrophy not responsive to medical therapy who underwent endoscopic submucosal diathermy (ESMD) (14 patients) or endoscopic submucosal resection (ESMR) (15 patients) with intraoperative and 3-6 months postoperative inferior turbinate biopsies, were included in the study. Epithelial and mucosal architecture was compared between the two groups.
RESULTS: Both groups showed a significant decrease in epithelial denudation (p < 0.001), reversal of basement membrane thickening (p < 0.001) and increase in density of cilia (p < 0.001). The degree of improvement in histological characteristics between ESMD and ESMR groups was not significant.
CONCLUSIONS: Surgical intervention for inferior turbinate hypertrophy by both ESMD and ESMR results in significant restoration of nasal mucosal epithelium in patients with allergic rhinitis as early as 3-month postoperatively. There was, however, no significant difference in the histological changes between those who underwent ESMD and ESMR.
CLINICAL TRIALS OF INDIA, REGISTRY NUMBER: CTRI/2015/01/005373.
PMID: 29600318 [PubMed - as supplied by publisher]
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Septal branches of the anterior ethmoidal artery: anatomical considerations and clinical implications in the management of refractory epistaxis.
| Related Articles |
Septal branches of the anterior ethmoidal artery: anatomical considerations and clinical implications in the management of refractory epistaxis.
Eur Arch Otorhinolaryngol. 2018 Mar 29;:
Authors: Turri-Zanoni M, Arosio AD, Stamm AC, Battaglia P, Salzano G, Romano A, Castelnuovo P, Canevari FR
Abstract
PURPOSE: Epistaxis is a commonly presenting complaint. In severe cases, nosebleeds may occur despite antero-posterior nasal packing and often in the absence of identifiable sources of bleeding. In such cases, epistaxis may occur from septal branches of the anterior ethmoidal artery (sbAEA). The purposes of this study are to highlight the clinical role of the sbAEA in different fields of endoscopic endonasal surgery and to evaluate the efficacy and safety of their selective endoscopic endonasal ligation in the management of refractory epistaxis.
METHODS: A retrospective review was performed of all patients presenting with epistaxis who underwent endoscopic endonasal coagulation of sbAEA in three Italian tertiary-care referral centers between October 2010 and October 2017.
RESULTS: A total of 30 patients met the inclusion criteria. Sixteen patients had never experienced nosebleeds before, while 14 patients recalled previous epistaxes. Seventeen patients were treated under local anesthetic, while 13 required general anesthesia. No intra- or post-operative complications were observed and none of the patients received nasal packing after the procedure. In all cases the coagulation was effective in controlling the bleeding, with only two relapses in the series (2/30, 6.7%).
CONCLUSIONS: The sbAEA are of great interest in endoscopic endonasal surgery, both as surgical landmarks and as feeding vessels for a variety of pedicled nasal flaps. What is more, they can be crucial for the management of refractory epistaxis. Their selective endoscopic coagulation represents an effective and safe procedure in cases of difficult-to-control epistaxis from the upper nasal fossa, with several advantages over nasal packing.
PMID: 29600317 [PubMed - as supplied by publisher]
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Three-dimensional imaging assessment of anatomic invasion and volumetric considerations for chemo/radiotherapy-based laryngeal preservation in T3 larynx cancer.
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Three-dimensional imaging assessment of anatomic invasion and volumetric considerations for chemo/radiotherapy-based laryngeal preservation in T3 larynx cancer.
Oral Oncol. 2018 Apr;79:1-8
Authors: Kamal M, Ng SP, Eraj SA, Rock CD, Pham B, Messer JA, Garden AS, Morrison WH, Phan J, Frank SJ, El-Naggar AK, Johnson JM, Ginsberg LE, Ferrarotto R, Lewin JS, Hutcheson KA, Cardenas CE, Zafereo ME, Lai SY, Hessel AC, Weber RS, Gunn GB, Fuller CD, Mohamed ASR, Rosenthal DI
Abstract
OBJECTIVES: To investigate the impact of 3-Diminsional (3D) tumor volume (TV) and extent of involvement of primary tumor on treatment outcomes in a large uniform cohort of T3 laryngeal carcinoma patients treated with nonsurgical laryngeal preservation strategies.
MATERIALS AND METHODS: The pretreatment contrast-enhanced computed tomography images of 90 patients with T3 laryngeal carcinoma were reviewed. Primary gross tumor volume (GTVp) was delineated to calculate the 3D TV and define the extent of invasion. Cartilage and soft tissue involvement was coded. The extent of invasion was dichotomized into non/limited invasion versus multiple invasion extension (MIE), and was subsequently correlated with survival outcomes.
RESULTS: The median TV was 6.6 cm3. Sixty-five patients had non/limited invasion, and 25 had MIE. Median follow-up for surviving patients was 52 months. The 5-year local control and overall survival rates for the whole cohort were 88% and 68%, respectively. There was no correlation between TV and survival outcomes. However, patients with non/limited invasion had better 5-year local control (LC) than those with MIE (95% vs 72%, p = .009) but did not have a significantly higher rate of overall survival (OS) (74% vs 67%, p = .327). In multivariate correlates of LC, MIE maintained statistical significance whereas baseline airway status showed a statistically significance trend with poor LC (p = .0087 and 0.06, respectively). Baseline good performance status was an independent predictor of improved OS (p = .03) in multivariate analysis.
CONCLUSION: The extent of primary tumor invasion is an independent prognostic factor of LC of the disease after definitive radiotherapy in T3 larynx cancer.
PMID: 29598944 [PubMed - in process]
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Nonsurgical Treatment for Vocal Fold Leukoplakia: An Analysis of 178 Cases.
  | Related Articles |
Nonsurgical Treatment for Vocal Fold Leukoplakia: An Analysis of 178 Cases.
Biomed Res Int. 2017;2017:6958250
Authors: Chen M, Cheng L, Li CJ, Chen J, Shu YL, Wu HT
Abstract
OBJECTIVE: To assess the effectiveness and identify vocal fold leukoplakia types appropriate for nonsurgical treatment.
METHODS: The vocal fold leukoplakia in 178 patients was divided by gross appearance into three subtypes: flat and smooth, elevated and smooth, and rough. All patients received nonsurgical treatment including smoking and drinking cessation, voice rest, omeprazole, and Chinese medication therapy. The clinical response of three subtypes was assessed after a 6-month follow-up.
RESULTS: Vocal fold leukoplakia subtypes included flat and smooth (n = 66; 37.1%), elevated and smooth (n = 103; 57.9%), and rough (n = 9; 5.0%). The rate of complete response was 80.3%, 66.0%, and 0.0% for the 3 lesion types, respectively (rough versus flat and smooth, P < 0.001; rough versus elevated and smooth, P < 0.001, Fisher's exact test). The incidence of carcinoma in rough leukoplakia was significantly higher than that in smooth leukoplakia (44.4% versus 2.4%, P = 0.002, Fisher's exact test). Clinical type was the only significant factor for clinical response of nonsurgical treatment (P = 0.005, ordinal logistic regression).
CONCLUSIONS: The effectiveness of nonsurgical treatment for smooth vocal fold leukoplakia is better in comparison to rough vocal fold leukoplakia. Smooth leukoplakia could be managed with nonsurgical treatment; more aggressive treatments should be considered for rough leukoplakia.
PMID: 28695129 [PubMed - indexed for MEDLINE]
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Pre-diagnostic dynamic HPV16 IgG seropositivity and risk of oropharyngeal cancer: Methodologic issues
Source:Oral Oncology
Author(s): Karen S. Anderson, Jon Mork, Hilde Langseth, Garrick Wallstrom
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Osteochondroma of the Zygomatic Arch: A Case Report and Review of the Literature
Source:Journal of Oral and Maxillofacial Surgery
Author(s): R. Patel, G. Obeid
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Assessing the Quality of Life in Patients with Dentofacial Deformities Before and After Orthognathic Surgery
Publication date: Available online 31 March 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Hong Sun, Hong-tao Shang, Li-sheng He, Ming-chao Ding, Zhong-ping Su, Yu-lin Shi
PurposeThis study aimed to assess the effect of health-related quality of life (QoL) among patients with dentofacial deformities who underwent orthognathic surgery, compared to a control group without dentofacial deformities, by using generic oral health and condition-specific approaches.Patients and MethodsIn this prospective study, two questionnaires were administered to 85 patients (31 men and 54 women) who were evaluated before undergoing orthognathic surgery. The Short Form Oral Health Impact Profile Questionnaire (OHIP-14) and the Orthognathic Quality of Life Questionnaire (OQLQ) were administered before and 5–7 months after orthognathic surgery. The control group comprised 96 young university student volunteers without dentofacial deformities.ResultsThe questionnaires were collected 5–7 months post-surgery. The preoperative scores of the patients and the control group were contrasted separately. The respondents' OHIP-14 and OQLQ post-surgery scores were significantly lower (total scores, P < 0.001). The pre-surgery OQLQ all domains scores were significantly higher among the patients than among the controls (total scores, P < 0.001); however, the total scores and three subscale scores of the OHIP-14 in the functional and psychological domains were significantly higher among the patients than among the controls (total scores, P < 0.05). The pre- and post-surgery total OQLQ scores were remarkably different between males and females (P < 0.05). The post-surgery total OQLQ scores were considerably higher in older patients than in younger patients (P < 0.05). All patients in the Class III group who underwent double jaw surgery showed remarkable changes post-surgery (total scores, P < 0.001).ConclusionPatients with dentofacial deformities had a poorer quality of life, compared to the normal population, especially in functional and psychological aspects. Orthognathic surgery had a significant positive impact on QoL. Patients with Class III malocclusion who underwent double jaw surgery seemingly benefitted the most after surgery.
Graphical abstract
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Fracture healing and bone remodeling with human standard-sized magnesium versus polylactide-co-glycolide (PLGA) plate and screw systems using a mini-swine craniomaxillofacial osteotomy fixation model
Publication date: Available online 31 March 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Benoît Schaller, John Patrik Matthias Burkhard, Madeleine Chagnon, Stefan Beck, Thomas Imwinkelried, Michel Assad
PurposeThis study compared the degradation profile, safety and efficacy of a bioresorbable magnesium (Mg) alloy and polylactide-co-glycolide (PLGA) polymer osteosynthesis systems for the treatment of fractures in a load-sharing maxillofacial environment using a new mini-swine fracture fixation model.MethodsTwo types of clinically relevant situations were evaluated in five Yucatan miniature pigs. Defined porcine midface osteotomies of the supra-orbital rim and zygoma were created and fixed with either coated Mg (test animals) or PLGA plate and screw osteosynthesis systems (control animals). Following surgery, mini-pigs were able to recover for either one or nine months with continuous in vivo post-implantation monitoring. Standardized computed tomography (CT) imaging was taken immediately post-operatively and at termination for all animals. The nine-month cohort additionally underwent CT at 2, 4, and 6 months post-surgery. At necropsy, osteotomy sites and bone-implant units were harvested and the healing was evaluated under micro-CT, histopathology and histomorphometry.ResultsFollowing clinical and radiological follow-up examination, all fracture sites healed well for both magnesium and polymer groups regardless of time. Complete bone union and gradually disappearing osteotomy lines were observed across all implantation sites, with no major consistency change in periprosthetic soft tissue nor soft tissue calcification. Macroscopic and microscopic examination showed no negative influence of gas formation observed with Mg during the healing process. Histopathology demonstrated similar fracture healing outcomes for both plating systems with good biocompatibility as evidenced by a minimal or mild tissue reaction.ConclusionThe present study confirms that WE43-Mg alloy exhibited excellent fracture healing properties before its full degradation and without causing any significant inflammatory reactions in a long-term porcine model. Compared to PLGA implants, magnesium represent a promising new biomaterial with reduced sizes and improved mechanical properties in order to support fracture healing in a load-sharing environment.
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Does sphenopalatine ganglion block improve pain control and intra-operative hemodynamics in children undergoing palatoplasty? A randomized control trial
Publication date: Available online 30 March 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Anantanarayanan Parameswaran, Muruganand V. Ganeshmurthy, Yashoda Ashok, Manikandhan Ramanathan, Anthony F. Markus, Hermann F. Sailer
BackgroundChildren undergoing cleft palate repair suffer pain, dysphagia and wound irritation in the immediate post-operative phase which may compromise surgical outcome. This trial evaluates the efficacy of spheno-palatine ganglion block (SPGB) in optimizing intra-operative hemodynamics and post-operative analgesia in children undergoing primary palatoplastyMaterials and MethodsThe study was designed as a prospective, double blinded, randomized control trial comparing the use of SPGB with general anesthesia (GA) versus a control group of GA only. Routine pre-operative documentation included type of cleft, patient's weight, hemoglobin(Hb%), packed cell volume(PCV), blood pressure(BP) and echo-cardiogram. Intra-operative monitoring included heart rate, blood pressure and surgical field assessment. Post-operatively, the pain score, pain free duration and need for rescue analgesics were recorded. Post-surgical change in Hb% and PCV values were assessed. Data analysis of collected variables was done using SPSS Version 16 (IBM Corp, Chicago, USA). Quantitative data was assessed for normality using Shapiro Wilk's test and analysed using the Imdependent sample t test, and Fisher Exact test was used for comparison of the binary variable (Gender). The outcome variables were compared between the study and control groups after adjusting for confounding variables. P value of <0.05 was considered statistically significant.Results100 Patients undergoing primary palatoplasty under GA were randomised into control group A (N=49) and study group B (SPGB)(N=51). Three patients were excluded from the Control group due to changes in intraoperative anesthetic protocol. The results demonstrated stastistically significant differences in the post-surgical pain free duration (19.46 Vs 87.59 mins) and mean blood loss (105.5 Vs 62 mL), in favour of the study group. Surgical field and post-op reduction of Hb% and PCV were also significantly favourable for the study group.ConclusionWe conclude that the SPGB is a potent pre-emptive technique offering excellent perioperative analgesia, hemodynamic stability and a clear surgical field.
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Παρασκευή 30 Μαρτίου 2018
The mechanisms of β-catenin on keloid fibroblast cells proliferation and apoptosis
OBJECTIVE: To investigate the role of β-catenin siRNA on proliferation and apoptosis of keloid fibroblast cell.
PATIENTS AND METHODS: Real-time polymerase chain reaction (RT-PCR) and Western blot were performed to monitor the mRNA and protein expression levels of β-catenin in pathological scar tissue and adjacent normal tissue. Human keloid fibroblast cells (KFB) were isolated from the keloid's tissue by enzyme digestion assay and identified by immunocytochemistry assay. Keloid fibroblast cell lines in vitro were transfected with 3 pairs of specific β-catenin small interfering RNA (siRNA); RT-PCR and Western blot were performed to identify the best siRNA. The proliferation and apoptosis of KFB transfected with β-catenin were estimated by MTT 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay and flow cytometry (FCM). In addition, the expression levels of Bcl-2, p53, and active-caspase-3 were detected by Western blot.
RESULTS: The RT-PCR and Western blot assay results showed that the expression levels of β-catenin mRNA and protein in pathological scar tissue were significantly higher than those in adjacent normal tissue (p<0.05). KFB were successfully separated from human pathological scar tissue, and immunofluorescence staining results showed that cells were spindle and positively stained with vimentin. The β-catenin siRNA2 remarkably inhibited the expression of β-catenin at mRNA and proteins levels in the human keloid fibroblasts. Compared with the control group, cell proliferation was decreased, and apoptotic rate was increased in β-catenin siRNA2 group.
CONCLUSIONS: Knockdown of β-catenin significantly decreased the proliferation and increased apoptosis of KFB, which could inhibit the formation of pathological scar.
L'articolo The mechanisms of β-catenin on keloid fibroblast cells proliferation and apoptosis sembra essere il primo su European Review.
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Transoral endoscopic thyroid surgery via the tri‐vestibular approach with a hybrid space‐maintaining method: A preliminary report
Head &Neck, EarlyView.
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Systematic review evaluating randomized controlled trials of smoking and alcohol cessation interventions in people with head and neck cancer and oral dysplasia
Head &Neck, EarlyView.
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Case Report of an open Neck Procedure Complication Associated with Laryngeal Mask Airway Use.
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Case Report of an open Neck Procedure Complication Associated with Laryngeal Mask Airway Use.
Iran J Otorhinolaryngol. 2018 Mar;30(97):121-123
Authors: Subramaniam T, Casserly P
Abstract
Introduction: The laryngeal mask airway (LMA) is a safe method to establish airway control during general anaesthesia. In otolaryngology surgery, the use of a LMA is well established in ear surgery; however, the use of a LMA during open neck procedures remains controversial. We report a case in which the pharyngeal distortion by the LMA cuff resulted in an iatrogenic complication.
Case Report: A 38-year-old female with a background of multiple myeloma was referred to the otolaryngology team for an open cervical lymph node biopsy. The patient was in remission after a 2 year post chemotherapy treatment, but now presented with a 4-week history of persistent nodal enlargement. During the elective procedure, pharyngeal distortion from the laryngeal airway mask used for airway management resulted in an iatrogenic pharyngeal injury. This case is reported to highlight the importance of communication between the surgeon and anesthetist about the mode of airway management in open neck surgery.
Conclusion: Communication between the otolaryngologist and anesthetist is pertinent when selecting the method of airway management in open neck procedures. A LMA should be used with caution during open neck procedures, with the surgeon recognizing the potential for pharyngeal distortion.
PMID: 29594081 [PubMed]
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Surgery and Anesthesia Management for Intraoral Synechia: A Case Report.
| Related Articles |
Surgery and Anesthesia Management for Intraoral Synechia: A Case Report.
Iran J Otorhinolaryngol. 2018 Mar;30(97):117-119
Authors: Gharavifard M, Kashani I, Joudi M, Sharifian M, Sayedi SJ, Mohammadipanah B, Jamali-Behnam F
Abstract
Introduction: Intraoral synechia is a rare congenital condition, generally associated with other maxillo-facial malformations. We present a neonate with congenital intraoral bilateral synechia without any other facial anomalies.
Case Report: In this paper, we present a 19-day-old male neonate with congenital intraoral bilateral synechia without any other facial anomalies. We review the literature to discuss the surgical and anesthesia management of this rare congenital disease.
Conclusion: The disease manifested with a wide spectrum of symptoms. Most cases need surgery and airway management. In patients with a low risk of bleeding or a compromised airway, it is possible to manage them with face mask-inhalation anesthesia and maintain spontaneous breathing.
PMID: 29594080 [PubMed]
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Sudden Bilateral Sensorineural Hearing Loss Secondary to Cerebral Venous Thrombosis.
| Related Articles |
Sudden Bilateral Sensorineural Hearing Loss Secondary to Cerebral Venous Thrombosis.
Iran J Otorhinolaryngol. 2018 Mar;30(97):113-116
Authors: Ishak MN, Nik-Abdul-Ghani NM, Mohamad I
Abstract
Introduction: Sudden sensorineural hearing loss (SSNHL) is an important otological emergency. Up to 90% of the cases are idiopathic. Cerebral venous thrombosis (CVT) is an extremely rare identifiable cause as it only represents 0.5% of all strokes.
Case Report: In this paper, an unusual case of bilateral SSNHL secondary to bilateral CVT with rapid and complete recovery is reported. The patient presented with sudden bilateral hearing loss associated with some neurological symptoms. Initial computed tomography (CT) venography revealed a CVT of bilateral transverse sinuses. The patient was started on an anticoagulant and imaging was repeated after five days, revealing the absence of the thrombosis. Serial pure tone audiometry (PTA) showed complete recovery of bilateral hearing within 10 days.
Conclusion: Early detection and intervention may fasten hearing recovery and improve the quality of life. The immediate restoration of venous blood flow and intracranial pressure may lead to the complete recovery of bilateral hearing loss.
PMID: 29594079 [PubMed]
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Malignant Melanoma of the External Auditory Canal: A Rare Entity.
| Related Articles |
Malignant Melanoma of the External Auditory Canal: A Rare Entity.
Iran J Otorhinolaryngol. 2018 Mar;30(97):107-111
Authors: Khonglah Y, Das N, Raphael V, Jitani AK, Shunyu NB
Abstract
Introduction: Although malignant melanomas (MM) are common in the head and neck region; primary malignant melanoma of the external auditory canal (EAC) is rare.
Case Report: We present the case of a 50-year-old symptomatic man with a malignant melanoma of the external auditory canal, which clinically masqueraded as a haemangioma. The patient subsequently developed extensive loco-regional metastasis, requiring extensive surgery. We describe the clinical presentation, differential diagnosis, both clinical and pathological in terms of other pigmented lesions in the external auditory canal, detailed histopathology, and literature review.
Conclusion: We want to emphasize the importance of immediate and adequate biopsy of any pigmented lesion in the head and neck region to rule out MM. Also, we emphasize the importance of deep biopsy for proper histopathological assessment in addition to distinguishing it from benign melanocytic nevi, in order to initiate treatment.
PMID: 29594078 [PubMed]
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Results of Type I Tympanoplasty Using Fascia with or without Cartilage Reinforcement: 10 Years' Experience.
| Related Articles |
Results of Type I Tympanoplasty Using Fascia with or without Cartilage Reinforcement: 10 Years' Experience.
Iran J Otorhinolaryngol. 2018 Mar;30(97):103-106
Authors: Kouhi A, Khorsandi Ashthiani MT, Jalali MM
Abstract
Introduction: There remains controversy about the optimal kind of graft to repair tympanic membrane. The purpose of this study was to evaluate the anatomical and auditory outcomes of type I tympanoplasty using fascia with or without cartilage reinforcement.
Materials and Methods: This retrospective cohort study was conducted from 2005 to 2015. All cases were surgically treated by a single surgeon. We excluded cases in which the etiology of chronic otitis media was cholesteatoma. According to the use of cartilage reinforcement in the posterosuperior part of the graft, patients were divided into two groups, and the results of anatomical and auditory evaluation were compared between the two groups. The anatomical outcome was grafting success and the auditory outcome was improvement of air bone gap (ABG).
Results: A total of 320 patients were classified in Group A (tympanoplasty with fascia temporalis only) and 346 were in Group B (tympanoplasty with cartilage reinforcement). All patients were followed for at least 2 years. The overall success rate in the two groups was 91.6% and 93.4%, respectively (P=0.3). The most common cause of failure in the two groups was re-perforation (5.6% and 3.8%, respectively). The improvement of ABG in two groups was 18.5 dB and 3.2 dB, respectively. The difference between two groups was statistically significant (P<0.001).
Conclusion: In patients with dry perforation of the tympanic membrane, the anatomical success with tympanoplasty with fascia only or with cartilage reinforcement was similar. However, hearing improvement in the fascia only group was greater than in the group undergoing cartilage reinforcement.
PMID: 29594077 [PubMed]
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Translation, Cross-Cultural Adaptation, Validation and Reliability of the Northwestern Dysphagia Patient Check Sheet (NDPCS) in Iran.
| Related Articles |
Translation, Cross-Cultural Adaptation, Validation and Reliability of the Northwestern Dysphagia Patient Check Sheet (NDPCS) in Iran.
Iran J Otorhinolaryngol. 2018 Mar;30(97):97-101
Authors: Bakhtiyari J, Salmani M, Noruzi R, Sarraf P, Barzegar E, Mirmohammadkhani M
Abstract
Introduction: Speech and language therapists (SLTs) require proper tools to detect dysphagia in the early stages. One of these screening tools is the Northwestern Dysphagia Patient Check Sheet (NDPCS). However, this tool needs to be adapted, validated, and shown to be reliable for the Persian culture. The aim of the present study was to report the validity and reliability of the Persian NDPCS (P-NDPCS).
Materials and Methods: The NDPCS has 28 items and five sections. Beaton's guidelines were followed in terms of the translation process. To report the content validity index (CVI) and the content validity ratio (CVR), eight SLTs experienced in swallowing disorders examined the content and face validities of the P-NDPCS in terms of the quality of translation, fluency, understandability, and the cultural context. In total, 140 patients with neurogenic and mechanical dysphagia were evaluated using the P-NDPCS. Internal consistency reliability was investigated using the Kuder-Richardson formula 20. The interclass correlation coefficient (ICC) was used for test-retest reliability.
Results: The P-NDPCS preserved the 28 items and the five categories of the original version. However, semantic and food adjustments were applied due to cultural differences. The scoring system was changed from safe/unsafe to yes/no for four subsections and to normal/abnormal for the oromotor section. Food requirements were also changed. The CVR and CVI were both 75%. The P-NDPCS was shown to have good content validity. The internal reliability was 0.95, indicating excellent reliability.
Conclusion: The equivalence between the original version of the NDPCS and the P-NDPCS was preserved. Our findings indicate that the P-NDPCSis a valid and reliable screening tool for the diagnosis of dysphagia in the early phase.
PMID: 29594076 [PubMed]
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Islamic Attitudes and Rhinoplasty.
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Islamic Attitudes and Rhinoplasty.
Iran J Otorhinolaryngol. 2018 Mar;30(97):91-96
Authors: Bakhshaee M, Asghari M, Sharifian MR, Jafari Ashtiyani S, Rasoulian B
Abstract
Introduction: Although the psychological aspects of rhinoplasty have been fully investigated in the medical literature, the religiosity of rhinoplasty candidates has not been taken into consideration.
Materials and Methods: In this cross-sectional study, the religious attitudes of 157 rhinoplasty candidates were compared with those of 74 subjects who had not requested rhinoplasty. A domestic validated reliable questionnaire was completed by all subjects to classify them with respect to religious attitude. Other factors such as age, sex and economic and educational status were also taken into consideration. From the surgeon's perspective, subjects were put into three categories: subjects who had a relative indication for rhinoplasty (Category.1), subjects with a well-defined nose based on accepted standards of facial aesthetic analysis (Category.2) and finally subjects with a severely deformed nose, such as deviated nose or nasal cleft lip deformity (Category.3).
Results: The mean age among subjects was 28.63 ± 7.05 years, and the majority were female (87%). The two groups of participants (those who did and did not express a desire for rhinoplasty) were analyzed from the point view of age, sex, economic and educational status. The economic and educational status of the two groups did not differ significantly (P>0.05). The religious score showed a significant difference between those who were interested in rhinoplasty (122.75±23.49) and those were not interested (138.78±21.85; P<0.001).
Conclusion: Religion may affect a patient's decision to undergo rhinoplasty surgery, such that persons with a higher religious attitude tend to undertake it less often. However, individuals with major nasal deformities tend to decide undertake the surgery, irrespective of religious beliefs.
PMID: 29594075 [PubMed]
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Effect of Early Vestibular Rehabilitation on Vertigo and Unsteadiness in Patients with Acute and Sub-Acute Head Trauma.
| Related Articles |
Effect of Early Vestibular Rehabilitation on Vertigo and Unsteadiness in Patients with Acute and Sub-Acute Head Trauma.
Iran J Otorhinolaryngol. 2018 Mar;30(97):85-90
Authors: Jafarzadeh S, Pourbakht A, Bahrami E, Jalaie S, Bayat A
Abstract
Introduction: Vestibular rehabilitation is a treatment option for the management of vertigo and unsteadiness, which are very common in head trauma patients and more challenging in the early months after trauma. This study evaluated the effectiveness of a vestibular rehabilitation program in the recovery of acute and sub-acute head trauma patients. The goal of this study was evaluation of the effect of early vestibular rehabilitation on patients with acute and sub-acute head trauma.
Materials and Methods: This study was performed in 20 head trauma patients with vertigo and unsteadiness. The patients were randomly divided into two groups: one group received medical therapy (Betaserc) and the other received rehabilitation and medical therapy. An individualized vestibular rehabilitation program was designed that was then revised and verified by a joint committee of vestibular rehabilitation groups. The effectiveness of interventions was measured using the Dizziness Handicap Inventory (DHI) by comparing the results before and after therapy.
Results: The physical conditions and DHI scores of patients in both groups were similar at baseline. After 1 month of rehabilitation, patients receiving vestibular rehabilitation and medication showed greater progress than patients receiving medication only (P=0.000).
Conclusion: Vestibular rehabilitation can aid in the recovery from vertigo and increase the stability of head trauma patients. Simultaneous treatment with medicine and vestibular rehabilitation exercises can result in quicker and better therapeutic effects.
PMID: 29594074 [PubMed]
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Enhancing Working Memory Capacity in Persian Cochlear Implanted Children: A Clinical Trial Study.
| Related Articles |
Enhancing Working Memory Capacity in Persian Cochlear Implanted Children: A Clinical Trial Study.
Iran J Otorhinolaryngol. 2018 Mar;30(97):77-83
Authors: Doosti A, Jalalipour M, Ahmadi T, Hashemi SB, Haghjou S, Bakhshi E
Abstract
Introduction: Sensory deprivations such as hearing impairment that affect sensory input have a secondary impact on cognitive functions such as working memory (WM). WM capacity is an important cognitive component that processes language-related activities. Moreover, several studies have shown a deficit in WM in children with a cochlear implant (CI). We aimed to assess the performance of children with CIs in pre- and post-training sessions and compare their scores on a battery of WM tests to investigate the efficacy of a WM training program.
Materials and Methods: Twenty-five children aged 7-10 years with a CI participated in this study. To train their WM, a computer game was used. In order to examine auditory WM, a test battery including standardized digit span (forward and backward variations), non-word and sentence repetition (subtest of the Test of Language Development-Primary) were assessed in pre- and post-training test sessions at Shiraz Implant Center.
Results: There were statistically significant differences between pre- and post-training test scores on all subtests. Test score differences were statistically significant for forward digit span (P=0.003), backward digit span (P=0.001), non-word repetition (P=0.001), and sentence repetition tasks (P=0.003) before and after training sessions.
Conclusion: Training may enhance WM capacity. With regards to the importance of WM in literacy and learning, it seems applying such intervention programs may be helpful in the rehabilitation of implanted children.
PMID: 29594073 [PubMed]
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Tonsillar Lymphoma in Children According to Age Group: A Systematic Review.
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Tonsillar Lymphoma in Children According to Age Group: A Systematic Review.
Iran J Otorhinolaryngol. 2018 Mar;30(97):69-75
Authors: de Carvalho GM, Pauna HF, Crespo AN, Gusmão RJ, Guimarães AC
Abstract
Introduction: Lymphoma is a common malignant tumor of the head and neck occurring during childhood. Early diagnosis is very important in terms of prognosis in patients with tonsillar lymphoma.Our objective was to evaluate the clinical manifestations of pediatric tonsillar lymphoma according to different age groups.
Materials and Methods: A systematic review of available English, Spanish, or Portuguese literature from January 1996 to June 2012 was performedin the BIREME, Cochrane, IBECS, Lilacs, PubMed/Medline, SCIELO, and Scopus databases, using "tonsillar lymphoma" and "children" as keywords. Inclusion criteria were pediatric case reports, patients aged up to 18 years, and information on clinical features at the time of diagnosis.
Results: Out of 87 identified publications, 13 articles were selected describing 53 patients. Tonsillar asymmetry was the most common sign. Snoring is a common sign in patients aged under 5 years; clinical lymphadenopathy is frequent among patients aged between 6 and 10 years; and dysphagia is a common sign in patients between 11 and 18 years of age. Burkitt's lymphoma is the most common form among all ages studied, followed by B-cell lymphoma.
Conclusion: Clinical manifestations differ according to age group. However, tonsillar asymmetry is the most frequent sign regardless of age group.
PMID: 29594072 [PubMed]
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Transoral resection of extensive pediatric supraglottic neurofibroma
The Laryngoscope, EarlyView. (Source: The Laryngoscope)
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Cost ‐effectiveness of sialendoscopy versus medical management for radioiodine‐induced sialadenitis
The Laryngoscope, EarlyView. (Source: The Laryngoscope)
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Allergic phenotype of chronic rhinosinusitis based on radiologic pattern of disease
The Laryngoscope, EarlyView. (Source: The Laryngoscope)
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Post ‐acute care use after major head and neck oncologic surgery with microvascular reconstruction
The Laryngoscope, EarlyView. (Source: The Laryngoscope)
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Editorial Board
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 135, Issue 2
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Contents
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 135, Issue 2
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Editorial Board
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 135, Issue 2
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