The Department of Otorhinolaryngology-Head and Neck Surgery at McGovern Medical School at UTHealth was the first site in the United...https://ift.tt/2CUAgAX
Σάββατο 20 Οκτωβρίου 2018
Herbert Ross: Among the First in the U. S. to Benefit from a New Surgical Navigation System
The Department of Otorhinolaryngology-Head and Neck Surgery at McGovern Medical School at UTHealth was the first site in the United...https://ift.tt/2CUAgAX
UTHealth Otorhinolaryngology Residents Named HSO Resident Scientific Research Winners
Two UTHealth otorhinolaryngology residents were among four Houston-area residents invited to present their research as winners of the Houston Society...https://ift.tt/2PLqcNs
Dr. Ibrahim Alava, Dr. William Yao and Dr. Sancak Yuksel Receive Dean’s Teaching Excellence Awards
Ibrahim "Trey" Alava, MD; William Yao, MD; and Sancak Yuksel, MD, have been recognized with McGovern Medical School's 2018 Dean's...https://ift.tt/2CX7Nun
UT Physicians Otorhinolaryngology Expands Its Annual Head and Neck Cancer Screening from the Texas Medical Center to Houston Suburbs
The Department of Otorhinolaryngology—Head and Neck Surgery at McGovern Medical School at UTHealth offered four free cancer screening clinics last...https://ift.tt/2PJgbAl
No differences in infections between patient-specific implants and conventional mini-plates in mandibular bilateral sagittal split osteotomy — up to 3-year follow-up
The use of individually designed osteotomies, combined with individually manufactured osteosynthesis material, is rapidly becoming a standard for more challenging maxillofacial surgery. The benefits of patient-specific implants (PSI) in orthognathic surgery are clear in complex cases. PSIs can enhance precision and ease up the surgical protocol. We previously reported on the benefits of PSIs as reposition and fixation systems during Le Fort I osteotomy. The aim of this study was to evaluate a cohort of 28 patients, treated with bilateral sagittal split osteotomy (BSSO) and PSIs for fixation, with regard to healing for up to 3 years.
https://ift.tt/2NT0EMz
Relationship between occlusal force and condylar morphology in class II and III after bi-maxillary osteotomy
The purpose of this study was to examine the relationship between occlusal force and condylar morphology in class II and III after sagittal split ramus osteotomy (SSRO) with Le Fort I osteotomy.
https://ift.tt/2OxWHlP
Auricular reconstruction with polyethylene implants or silicone prosthesis: a single institution experience
Auricular reconstruction is usually necessary in patients with congenital malformations, after traumatic ear amputations or in cases of neoplastic ear disease.Thirty-nine patients who underwent an auricular reconstruction with either silicon prosthesis (21 patients) or porous polyethylene (18 patients) between 2002 and 2013 were retrospectively analysed at a tertiary academic institution.A total of 25 male und 14 female patients were included in the study. In all, 43 implants were installed in 39 patients.
https://ift.tt/2OzJtFk
Toward a higher accuracy in orthognathic surgery by using intraoperative computer navigation, 3D surgical guides, and/or customized osteosynthesis plates: a systematic review
The aim of this study was to systematically review the accuracy of intraoperative computer navigation, three-dimensional surgical guides and customized osteosynthesis plates for the transfer of the virtual surgical plan to the patient in orthognathic surgery. A systematic review of the currently available publications was performed in databases MEDLINE, Embase, and Cochrane Library, using a PICOS search strategy, and reported according to PRISMA. The initial search yielded 3050 articles. In total, 16 studies were included for final quantitative analyses.
https://ift.tt/2NSotV4
Idiopathic Anaphylaxis and Undiagnosed Anorexia Nervosa
This report describes an association between anorexia nervosa and idiopathic anaphylaxis. While eating disorders affect 0.6% of the population1, and idiopathic anaphylaxis occurs in approximately 1 in 10,000 individuals2 an association between anorexia nervosa and mast cell dysfunction has not previously been described. Features of anorexia nervosa include restriction of eating and energy intake, intense fear of gaining weight, and distorted perception of body weight and shape.1 We describe a fourteen-year-old girl with a history of well controlled hypothyroidism who developed sudden lip and eyelid edema, abdominal pain, stool urgency, lethargy, diarrhea, vomiting, throat tightness, and presyncope.
https://ift.tt/2q3rPuY
A Review of the Use and Effectiveness of Digital Health Technologies in Asthma Patients
Despite the availability of evidence-based treatment guidelines and effective therapies for asthma, poor adherence to treatment1-5 and lack of guideline implementation into daily practice6 remain significant barriers to asthma control. Asthma management can be improved by providing information to the patient or caregiver to support adherence and verify correct dose intake, by relaying information to the clinician to facilitate timely therapeutic adjustment, and by allowing patient self-quantification.
https://ift.tt/2QYkqIs
Modification of Lackmann’s classification of facial bite wounds: an aid to assessment and recording
We recently treated a 2-year-old toddler who had sustained serious right-sided facial injuries, including avulsion of the lower eyelid from its medial attachments, when he was attacked by his family's dog.
https://ift.tt/2q2A9uI
Anaphylactic shock to bacitracin irrigation during breast implant surgery
Publication date: Available online 19 October 2018
Source: Annals of Allergy, Asthma & Immunology
Author(s): Mauli Desai, Mariana Castells
https://ift.tt/2q2TZ97
Comparison of inhaled versus intravenous anesthesia for laryngoscopy and laryngeal electromyography in a rat model
Propofol and remifentanil intravenous combination is one popular form of total intravenous anesthesia (TIVA) in mainstream clinical practice, but it has rarely been applied to a rat model for laryngoscopy and ...
https://ift.tt/2q2PRWF
Comparison of the protective immunity elicited by a Brucella cocktail protein vaccine (rL7/L12+rTOmp31+rSOmp2b) in two different adjuvant formulations in BALB/c mice
Publication date: November 2018
Source: Molecular Immunology, Volume 103
Author(s): Maryam Golshani, Mona Amani, Seyed Davar Siadat, Mehdi Nejati-Moheimani, Amin Arsang, Saeid Bouzari
Abstract
In the present study, protective efficacy conferred by a cocktail protein consisted of Brucella L7/L12 ribosomal, truncated outer membrane protein 31 (TOmp31) and SOmp2b recombinant proteins in CpG ODN 1826+ Montanide ISA 70VG or Poly (I:C) adjuvants was evaluated and compared in BALB/c mice. Immunization of mice with both vaccine regimens elicited strong specific IgG responses (higher IgG2a titers over IgG1 titers), provided T helper1 (Th1) oriented immune responses and conferred protection levels compatible to the live vaccines against Brucella challenge. Vaccination of BALB/c mice with the cocktail protein in CpG ODN 1826+ Montanide ISA 70 V G adjuvants induced higher levels of antibody, IFN-γ/IL-2 and conferred more protection levels against B. melitenisis and B. abortus challenge than did the cocktail protein in Poly (I:C) formulation. In conclusion, both vaccine regimens are capable of stimulating specific Th1- biased immune responses and conferring cross protection against B. melitensis and B. abortus infections. Therefore, they could be introduced as new potential candidates for the development of subunit vaccines against Brucella infection.
https://ift.tt/2POAWeh
Molecular characterization and expression analysis of interleukin 15 (IL15) and interleukin-15 receptor subunit alpha (IL15Rα) in dojo loach (Misgurnus anguillicaudatus): Their salient roles during bacterial, parasitic and fungal infection
Publication date: November 2018
Source: Molecular Immunology, Volume 103
Author(s): Xiaoyao Chen, Weiguang Kong, Yongyao Yu, Shuai Dong, Zhenyu Huang, Wei Yu, Jie Xu, Yanzhi Luo, Qingchao Wang, Zhen Xu
Abstract
Interleukin 15 (IL15) is a pleiotropic cytokine that participates in innate and adaptive immunity along with its receptor α-chain (IL15Rα). In order to investigate the potential roles of IL15 and IL15Rα in dojo loach (Misgurnus anguillicaudatus), we firstly cloned the cDNA sequence of Ma-IL15 and Ma-IL15Rα, which contain 1096bp and 1236bp and code proteins of 193 amino acids and 210 amino acids, respectively. A short signal peptide and Pfam IL15 domain were found in Ma-IL15, while a highly conserved sushi domain existed in Ma-IL15Rα. Ontogeny analysis indicated that significantly increased expression of Ma-IL15 and Ma- IL15Rα mRNA were detected in larvae from 1d to 7d post hatching, while relative high expression levels were detected in both systematic and mucosal immune-related tissues of adult dojo loach. Then three dojo loach infection models with F. columnare G4, I. multifiliis and Saprolegnia parasitica were constructed, which resulted in increased skin goblet cells and serious lesions in gill. Ma-IL15 and Ma-IL15Rα showed different expression patterns in different tissues during three infection models. Ma-IL15Rα mRNA was found to be more significantly elevated than Ma-IL15 after infection with F. columnare G4 in all examined tissues including kidney, spleen, gill and skin. I. multifiliis infection induced higher expression of Ma-IL15 in mucosal tissues including skin and gill, while it mainly increased Ma-IL15Rα expression in kidney. Moreover, our study firstly evaluated the influence of fungal infection on IL15 and IL15Rα expression in teleost, and it is interesting to find that both Ma-IL15 and Ma-IL15Rα expression showed consistent up-regulation after Saprolegnia parasitica infection compared to two other infection models. Therefore, our results suggest that Ma-IL15 and Ma-IL15Rα possess important defensive roles in systematic and mucosal tissues of dojo loach during bacterial, fungal and parasitic infection.
https://ift.tt/2CVbcKd
Pirfénidone (Esbriet®) : attention au soleil !
Publication date: Available online 19 October 2018
Source: Annales de Dermatologie et de Vénéréologie
Author(s): J.-L. Schmutz
https://ift.tt/2AjQXTQ
Instant reduction in postural sway during quiet standing by intraoral dental appliance in patients with Whiplash Associated Disorders and non-trauma neck pain
Publication date: Available online 19 October 2018
Source: Archives of Oral Biology
Author(s): Per-Olof Eriksson, Hamayun Zafar, Mattias Backén
Abstract
Objectives
This study tested the hypothesis that modulation of jaw sensorimotor control by intraoral dental appliance can reduce postural sway during quiet standing and hence improve standing balance, in patients with whiplash associated disorders (WAD) and non-trauma neck pain.
Design
Postural sway during quiet standing with feet together was examined in 54 WAD patients (40 females) and 10 non-trauma patients (8 females) using wireless 3D movement recording technique. Recordings were performed alternating without and with intraoral dental appliance, and with closed eyes and open eyes, respectively. In this protocol the participants served as their own controls. A reference group of 30 healthy subjects (17 females) was also recorded. Each recording lasted 120 seconds, followed by 3 to 5 minutes of rest. Speed, acceleration and perimeter of postural sway area were documented.
Results
In the patients, but not in the healthy group, the intraoral dental appliance instantly and significantly reduced standing postural sway in recordings with closed and open eyes.
Conclusions
The prompt reduction in standing postural sway from intervention by intraoral dental appliance i.e. improved standing balance, suggests a potent effect on the postural control system by modulation of the jaw sensorimotor system, probably involving reflex transmission. The result opens for new insight into mechanisms behind postural control and the pathophysiology of balance disorders, and adds to the knowledge on plasticity of the nervous system. It may help developing new procedures for assessment and management of impaired balance in WAD and non-trauma neck pain patients.
https://ift.tt/2AkXlKS
Instant reduction in postural sway during quiet standing by intraoral dental appliance in patients with Whiplash Associated Disorders and non-trauma neck pain
Publication date: Available online 19 October 2018
Source: Archives of Oral Biology
Author(s): Per-Olof Eriksson, Hamayun Zafar, Mattias Backén
Abstract
Objectives
This study tested the hypothesis that modulation of jaw sensorimotor control by intraoral dental appliance can reduce postural sway during quiet standing and hence improve standing balance, in patients with whiplash associated disorders (WAD) and non-trauma neck pain.
Design
Postural sway during quiet standing with feet together was examined in 54 WAD patients (40 females) and 10 non-trauma patients (8 females) using wireless 3D movement recording technique. Recordings were performed alternating without and with intraoral dental appliance, and with closed eyes and open eyes, respectively. In this protocol the participants served as their own controls. A reference group of 30 healthy subjects (17 females) was also recorded. Each recording lasted 120 seconds, followed by 3 to 5 minutes of rest. Speed, acceleration and perimeter of postural sway area were documented.
Results
In the patients, but not in the healthy group, the intraoral dental appliance instantly and significantly reduced standing postural sway in recordings with closed and open eyes.
Conclusions
The prompt reduction in standing postural sway from intervention by intraoral dental appliance i.e. improved standing balance, suggests a potent effect on the postural control system by modulation of the jaw sensorimotor system, probably involving reflex transmission. The result opens for new insight into mechanisms behind postural control and the pathophysiology of balance disorders, and adds to the knowledge on plasticity of the nervous system. It may help developing new procedures for assessment and management of impaired balance in WAD and non-trauma neck pain patients.
https://ift.tt/2AkXlKS
Comparison of inhaled versus intravenous anesthesia for laryngoscopy and laryngeal electromyography in a rat model
Abstract
Background
Propofol and remifentanil intravenous combination is one popular form of total intravenous anesthesia (TIVA) in mainstream clinical practice, but it has rarely been applied to a rat model for laryngoscopy and laryngeal electromyography (LEMG). Our objective was to establish a safe and reproducible general anesthetic protocol for laryngoscopy and endoscopic LEMG in a rat model. Our hypothesis is that TIVA allows a minimally morbid, and feasible laryngoscopy and LEMG.
Methods
Sprague Dawley rats were subjected to either inhalational anesthesia (IA) (isoflurane) or TIVA (propofol and remifentanil) and underwent laryngoscopy and LEMG. The primary outcome was a complete minimally interrupted rigid laryngoscopy and obtaining reproducible motor unit potentials from the posterior cricoarytenoid muscles. The secondary outcome was morbidity and mortality.
Results
Seventeen out of twenty-two rats underwent both TIVA and IA. Only two underwent IA only. All nineteen rats that underwent IA had a successful experiment. Seventeen rats underwent TIVA, however, only nine completed a successful experiment due to difficulty achieving a surgical plane, and respiratory events. Upon comparing the success of the two anaesthetic regimens, IA was superior to TIVA (P = 0.0008). There was no statistical difference between the amplitudes (p = 0.1985) or motor units burst duration (p = 0.82605) of both methods. Three mortalities were encountered, one of which was due to lidocaine toxicity and two were during anesthetic induction. Respiratory related morbidity was encountered in two rats, all seen with TIVA.
Conclusions
TIVA is not an ideal anesthetic regimen for laryngeal endoscopy and LEMG in rat models. Contrary to our hypothesis, IA did not affect the quality of the LEMG and allowed a seamless rigid endoscopy.
https://ift.tt/2q4a3Ym
No differences in infections between patient-specific implants and conventional mini-plates in mandibular bilateral sagittal split osteotomy — up to 3-year follow-up
Publication date: Available online 20 October 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): Juho Suojanen, Sanna Järvinen, Zlatan Hodzic, Justus Reunanen, Junnu Leikola, Patricia Stoor
Abstract
The use of individually designed osteotomies, combined with individually manufactured osteosynthesis material, is rapidly becoming a standard for more challenging maxillofacial surgery. The benefits of patient-specific implants (PSI) in orthognathic surgery are clear in complex cases. PSIs can enhance precision and ease up the surgical protocol. We previously reported on the benefits of PSIs as reposition and fixation systems during Le Fort I osteotomy. The aim of this study was to evaluate a cohort of 28 patients, treated with bilateral sagittal split osteotomy (BSSO) and PSIs for fixation, with regard to healing for up to 3 years. A retrospective cohort of 56 patients with conventional mini-plate repositioned mandibles was also collected for statistical analysis. No statistically significant differences were found with regard to infection, soft tissue problems, or reoperations between these two groups.
https://ift.tt/2PLI5vQ
Mandibular subcondylar fracture accessibility with transparotid approach by rhytidectomy and modified Risdon approach: an anatomical comparative study
Publication date: Available online 19 October 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): Robin Ruiz, Matthias Schlund, Gwénaël Raoul, Maéva Kyheng, Christian Fontaine, Romain Nicot
Abstract
Purpose
The purpose of our anatomical study was to compare the accessibility of the area at the level of the neck of the condyle and the condylar head by two different approaches: the modified Risdon approach and a transparotid approach by rhytidectomy (TPAR).
Methods
An anatomical study was performed on 12 heads of cadavers preserved with a solution rich in glycerin and ethanol, but very low in formalin. A modified Risdon approach and a TPAR were each performed on a hemiface of the same head. The bone surface was rendered digitally accessible on an anatomical diagram using Image J software. The software was used to determine a concordance score between the area of accessibility and the area of interest necessary for osteosynthesis of a high subcondylar fracture. This score was presented as a numerical scale from 0 to 100. We measured the total number of pixels in our area of interest and assigned it a score of 100. We then compared the area of accessibility with the area of interest necessary for osteosynthesis of a high subcondylar fracture.
Results
Using the modified Risdon approach, an average score of 55.88 (SD = 18.96) was found, or 55.88% of the accessible area of interest. Using TPAR, we found a score of 91.05 (SD = 7.95) or 91.05% of the accessible area of interest. This difference in score between the two techniques was significantly different (p < 0.001), taking into account intra-hemiface and intra-individual correlation.
Conclusion
TPAR seems to be more effective in treating high condylar process fractures of the mandible.
https://ift.tt/2CVefSx
Contribution Of Cone-Beam Computed Tomography In The Decision Of Surgical Management For Bone Lesions Of The Maxillofacial Region
Publication date: Available online 19 October 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): Anada Amaral Santos, Fernanda Paula Yamamoto-Silva, Erica Miranda Torres, José Valladares-Neto, Paulo Tadeu Souza Figueiredo, André Ferreira Leite, Maria Alves garcia Silva
Summary
The aim of this study was to evaluate the contribution of cone-beam computed tomography (CBCT) in the decision of surgical management for bone lesions of the maxillofacial region. It is a retrospective cross-sectional observational study that includes a sample of panoramic radiography (PR) and CBCT from patients with some type of bone lesion in the maxillofacial region. PR and CBCT images were evaluated by three previously assessed examiners, specialists in oral and maxillofacial surgery. Each image was evaluated randomly, and a surgical procedure was suggested, initially in PR and then in CBCT. The obtained results were submitted to the McNemar test to evaluate the frequencies of changes in the surgical management between the first and the second evaluation in PR and CBCT, and intra-examiner and inter-examiner agreements were analyzed by the Cohen's kappa test. The level of significance was set at 5% (p < 0.05). Intra-examiner agreement increases when CBCT is used. Inter-examiner agreement was low, independently of the evaluated exam, which shows that the choice of treatment plan is examiner-dependent and not exam-dependent. CBCT increases the certainty of the professional in the evaluation of the bone lesions of the maxillofacial region; however, it does not change the indication of the treatment type.
https://ift.tt/2PKPVFY
The Role of C-Reactive Protein and White Blood Cell Count in the Prediction of Length of Stay in Hospital and Severity of Odontogenic Abscess
Publication date: Available online 19 October 2018
Source: Journal of Cranio-Maxillofacial Surgery
Author(s): Nils Heim, Valentin Wiedemeyer, Rudolf H. Reich, Markus Martini
https://ift.tt/2CW28ov
Genetic Diversity Between Mouse Strains Allows Identification of CC027/GeniUnc as an Orally Reactive Model of Peanut Allergy
Publication date: Available online 19 October 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): Kelly Orgel, Johanna M. Smeekens, Ping Ye, Lauren Fotsch, Rishu Guo, Darla R. Miller, Fernando Pardo-Manuel de Villena, A.Wesley Burks, Martin T. Ferris, Michael D. Kulis
Abstract:
Background
Improved animal models are needed to understand the genetic and environmental factors that contribute to food allergy.
Objective
Assess food allergy phenotypes in a genetically diverse collection of mice.
Methods
We selected 16 Collaborative Cross (CC) mouse strains, as well as the classic inbred C57BL/6J, C3H/HeJ, and BALB/cJ strains for screening. Female mice were sensitized to peanut intragastrically with or without Cholera toxin, then challenged with peanut by oral gavage or intraperitoneal injection, and assessed for anaphylaxis. Peanut-specific immunoglobulins, T cell cytokines, Tregs, mast cells, and basophils were quantified.
Results
Eleven of the 16 CC strains had allergic reactions to intraperitoneal peanut challenge, whereas only CC027/GeniUnc mice reproducibly experienced severe symptoms following oral food challenge (OFC). CC027/GeniUnc, C3H/HeJ, and C57BL/6J all mounted a Th2 response against peanut, leading to the production of IL-4 and IgE but only the CC027/GeniUnc mice reacted to OFC. Orally-induced anaphylaxis in CC027/GeniUnc mice was correlated with serum levels of Ara h 2 in circulation, but not with allergen-specific IgE or MMCP-1 levels, indicating systemic allergen absorption is important for anaphylaxis through the gastrointestinal tract. Furthermore, CC027/GeniUnc mice, but not C3H/HeJ or BALB/cJ, can be sensitized in the absence of Cholera toxin and react upon OFC to peanut.
Conclusions
We have identified and characterized CC027/GeniUnc mice as a strain that is genetically susceptible to peanut allergy and prone to severe reactions following OFC. More broadly, these findings demonstrate the untapped potential of the CC population in developing novel models for allergy research.
https://ift.tt/2yrgqtf
Validation of the maximum symptom day among children with asthma
Publication date: Available online 19 October 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): Tianshi David Wu, Matthew Perzanowski, Roger D. Peng, Robert A. Wise, Susan Balcer-Whaley, Michelle Newman, Amparito Cunningham, Wanda Phipatanakul, Elizabeth C. Matsui, Meredith C. McCormack
https://ift.tt/2Jc0xeA
2B4 (CD244, SLAMF4) and CS1 (CD319, SLAMF7) in systemic lupus erythematosus and cancer
Publication date: Available online 19 October 2018
Source: Clinical Immunology
Author(s): Joseph D. Malaer, Armando M. Marrufo, Porunelloor A. Mathew
Abstract
Signaling Lymphocyte Activation Molecule (SLAM) family receptors are expressed on different types of hematopoietic cells and play important role in immune regulation in health and disease. 2B4 (CD244, SLAMF4) and CS1 (CD319, CRACC, SLAMF7) were originally identified as NK cell receptors regulating NK cell cytolytic activity. 2B4 is expressed on all NK cells, a subpopulation of T cells, monocytes and basophils. Unlike other activating and inhibitory receptors, 2B4 (CD244) interaction with its ligand CD48 has been shown to mediate both activating and inhibitory functions. Defective signaling via 2B4 due to mutations in signaling adaptor SAP contributes to X-linked lymphoproliferative Disease (XLP). Expression of 2B4 and CS1 are altered in systemic lupus erythematosus (SLE). CS1 is overexpressed in multiple myeloma (MM) and anti-CS1 mab (Elotuzumab/Empliciti) has been approved by FDA as a breakthrough drug for treatment for MM patients. CAR -T cells or CAR- NK cells containing full length CS1 or the signaling domain of 2B4 with TCR-ζ have shown promising results to treat cancer and autoimmune diseases.
https://ift.tt/2S2nhS2
Adolescents and young adults (AYAs) affected by chronic immunological disease: A tool-box for success during the transition to adult care
Publication date: Available online 19 October 2018
Source: Clinical Immunology
Author(s): Aurélien Guffroy, Thierry Martin, Anne-Sophie Korganow
Abstract
Adolescence is a time of physical, psychological and social changes between childhood and adulthood. All adolescents and young adults (AYAs) are in transition and experience key underlying processes that will influence their later life. It is a critical period, particularly for AYAs with a chronic medical condition. Diseases can start at any point during adolescence. The transition of care will concern health care providers, as well as more unexpected actors such as social workers, teachers, business managers and the family. In this review, we focus on transition in primary immunodeficiencies (PIDs) and autoimmune diseases (AIDs). We describe the challenges and needs of transition in the field. Questions that AYAs with PID and/or AID must face during transition in their familial, professional and personal life are discussed. We expose a practical, AYA centered approach to help physicians in their daily practice, and we propose a position for the future.
https://ift.tt/2yQhB4X
Probiotics in the treatment of otitis media. The past, the present and the future
Publication date: Available online 19 October 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Andrea Coleman, Anders Cervin
Abstract
Otitis media (OM) is one of the most common infectious diseases in children and the leading cause for medical consultations and antibiotic prescription in this population. The burden of disease associated with OM is greater in developing nations and indigenous populations where the associated hearing loss contributes to poor education and employment outcomes. Current treatment and prevention is largely focused on vaccination and antibiotics. However, rates of OM, particularly in indigenous populations, remain high. With growing concerns regarding antibiotic resistance and antibiotic-associated complications, an alternative, more effective treatment is required. Administration of probiotics, both locally and systemically have been investigated for their ability to treat and prevent OM in children. This review explores the theoretical bases of probiotics, successful application of probiotics in medicine, and their use in the treatment and prevention of OM. We conclude that local administration of niche-specific probiotic bacteria that demonstrates the ability to inhibit the growth of otopathogens in vitro shows promise in the prevention and treatment of OM and warrants further investigation.
https://ift.tt/2yr10VR
Maturation of auditory brainstem response in early term infants at 6 weeks and 9 months
Publication date: Available online 19 October 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Mingyan Li, Li Zhu, Dan Yao, Lin Xu, Chai Ji
Abstract
Background
Emerging evidence indicates that infants who were born between 37∼38 weeks of gestation are at higher risk of adverse long-term neurodevelopmental outcomes. Yet little is known about the auditory neural maturation during the first year of their life.
Aim
To compare the development of auditory brainstem response in early term (ET, 37∼38 weeks gestational age, GA) and full term (FT, 39∼41 weeks GA) infants.
Methods
126 infants received ABR testing at 6 weeks. 107 of them returned for the second assessment at 9 months, among which, 93 completed the ABR recordings. Comparison of the ABR variables were made depending on gestational age.
Results
Analysis of covariance (ANCOVA) was used to identify the differences in ABR outcomes between two groups. After controlling for confounders, latencies for wave III, V and I-III, III-V and I-V intervals were prolonged in ET group compared with FT group at 6 weeks (all p<0.03). ABR parameters of both groups developed as the infants got older. At 9 months, ET infants remain showing the longer wave V latency and I-V interval (all p <0.02) than FT infants.
Conclusion
During early postnatal life, ET has a different pattern of functional auditory brainstem development comparing with FT infants. The prolonged auditory conduction time suggests less mature of the central auditory system in ET infants before 9 months.
https://ift.tt/2JdY2IN
Erratum to “Skewed X-chromosome inactivation and next-generation sequencing to identify a novel SMPX variants associated with X-linked hearing loss in a Chinese family”[Int. J. Pediatr. Otorhinolaryngol. (2018) 88–93]
Publication date: Available online 19 October 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Song Gao, Yi Jiang, Guojian Wang, Yongyi Yuan, Shasha Huang, Xue Gao, Xiaohong Li, Dejun Zhang, Jian Wu, Xiaowen Ji, Tao Deng, Ligang Wang, Dongyang Kang, Pu Dai
https://ift.tt/2ypW2J4
Risk of post-operative hemorrhage after adenoidectomy and tonsillectomy: Value of the preoperative determination of partial thromboplastin time and prothrombin time
Publication date: Available online 19 October 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Mohamad Bitar, Gabriel Dunya, Elie Khalifee, Samar Muwakkit, Randa Barazi
Abstract
Introduction
Tonsillectomy and adenoidectomy (T& A) are the most common pediatric surgical procedures performed world-wide. Bleeding remains the most common complication of these procedures with 1-5.7 % prevalence.
Methods
We recruited 1269 patients who were scheduled for either tonsillectomy, adenoidectomy or both. All patients had preoperative CBC, PT, and aPTT ordered. According to the results, patients were labelled as either "abnormal group" or "normal group".
Results
35 patients had abnormal lab results 18 of these patients were diagnosed with coagulation disorders on further laboratory testing.9 of these patients had no pertinent history of bleeding. Even though an association is noted between abnormal lab tests and preoperative history of risk of bleeding, the correlation did not have high specificity (28.6%).
Conclusion
This study provides evidence that preoperative history can give some information on patients with abnormal coagulation profile but may underestimate the prevalence of such diseases. In addition, patients with abnormal coagulation profile have more risk of postoperative bleeding even after adequate medical treatment perioperative. Thus, identifying these patients will help the clinician in providing the best surgical management with the least morbidity and mortality.
https://ift.tt/2JdXUsN
Burkholderia gladioli sinonasal infection
Publication date: Available online 19 October 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): C. Zanotti, S. Munari, G. Brescia, U. Barion
Abstract
Introduction
Burkholderia gladioli are non-fermenting, Gram-negative, rod-shaped aerobic bacteria that were first identified as a plant pathogen. Most of the B. gladioli infections reported in the literature have involved immunocompromised adults and newborn infants. B. gladioli in humans is often associated with a poor prognosis.
Case report
We describe the first case of sinonasal infection due to B. gladioli and Staphylococcus aureus in an immunocompetent patient who had recently travelled to the Congo.
Discussion
As in the few other reported cases involving immunocompetent patients, the appropriate approach to this multidrug-resistant B. gladioli infection was a combination of surgery and antibiotics chosen in the light of an antibiogram.
https://ift.tt/2J7Rj2M
Maxillary sinus pain with radiolucent sinuses due to agenesis of the membranous ostium
Publication date: Available online 19 October 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): R. Jankowski, C. Rumeau, D.T. Nguyen, P. Gallet
Abstract
Introduction
The absence of opacities on CT scan usually eliminates paranasal sinus disease as a cause of facial pain. The authors report a case, which constitutes an exception to this general rule, corresponding to a new aetiology of sinus pain.
Case report
A 16-year-old boy presented with very painful "recurrent acute sinusitis" triggered by pressure changes (altitude, diving, surfing), with no sinus opacity on CT scan. Surgical exploration demonstrated absence of a primary or accessory maxillary ostium. Middle meatus antrostomy relieved the patient's pain.
Discussion
The pathophysiology of this case of recurrent acute pseudo-sinusitis and the efficacy of antrostomy can be explained by the evo-devo theory of the origin and function of the paranasal sinuses. This case illustrates the absence of communication in the ethmoid of the membranous sac lining the maxillary sinus, formed by degeneration of the maxillary erythropoietic bone marrow. Under stable environmental conditions, the continuous production of nitric oxide by the sinus epithelium is eliminated by simple transmembrane diffusion, but is insufficiently eliminated in the case of rapid pressure changes, inducing sometimes very severe sinus pain, mimicking sinusitis. This case report paves the way for more detailed studies on the role of the paranasal sinuses in facial disease and respiratory physiology.
https://ift.tt/2ytfDrN
Third Molar Patient Education Materials
Publication date: Available online 20 October 2018
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Kevin C. Lee, Hossein E. Jazayeri, Sung-Kiang Chuang
https://ift.tt/2Ez3Xcp
Panoramic Radiographs are of Limited Value in the Evaluation of Maxillary Sinus Disease
Publication date: Available online 19 October 2018
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Dr Sarah Constantine, Dr Bruce Clark, Dr Andreas Kiermeier, Professor Peter Anderson
ABSTRACT
OBJECTIVES
To determine: 1) the diagnostic efficacy of orthopantomography (OPG) in the diagnosis of sinus diseases, using cone beam CT (CBCT) scanning as the imaging gold standard; 2) which diseases were detected by panoramic radiograph and which required CBCT scanning to make the diagnosis; and 3) the inter-observer agreement of two experienced dental radiologists.
STUDY DESIGN
The images of 714 individuals who underwent orthopantomography (OPG) and CBCT on the same day were assessed separately by two dental radiologists. The results were compared using Gwet's AC1 statistical methods.
RESULTS
In total, 1,322 maxillary sinuses were imaged. The sensitivity of OPG for the detection of any maxillary sinus pathology was poor compared with CBCT, and the specificity was high. The sensitivity of OPG for detecting mucosal thickening was 36.7% compared to CBCT. The positive predictive value of OPG for diagnosing mucosal thickening was 79.9 %, but the negative predictive value was 51.9 %. Interobserver agreement was strong (≥0.912) for all lesions except mucosal thickening.
CONCLUSIONS
Panoramic imaging has low efficacy in the diagnosis of sinus disease, even when examined by experienced dental radiologists. OPG can be useful in excluding disease, but three-dimensional scanning is necessary for the definitive investigation of sinus lesions.
https://ift.tt/2q4IBcN
Comparison of mandibular index values determined from standard panoramic versus CBCT reconstructed images
Publication date: Available online 19 October 2018
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Cansu Koseoglu Secgin, Ayse Gulsahi, Yasemin Yavuz, Kivanc Kamburoglu
Abstract
Objectives
To compare the mandibular index values including mandibular cortical index (MCI), mental index(MI), and panoramic mandibular index (PMI) determined from cone-beam computed tomography(CBCT) and panoramic images.
Study design
Panoramic and CBCT images of 182 patients were retrospectively analyzed. Cross-sectional (CS) and panoramic reconstructed (PR) images were obtained from CBCT data. The MCI, MI, and PMI were assessed on CS, PR, and panoramic images and evaluated for intra- and interobserver agreement by kappa or intraclass correlation coefficient (ICC) analysis. Agreement among measurement methods was assessed by Bland–Altman analysis, with CS images as the gold standard for linear measurements.
Results
Measurements from PR and CS images agreed with those from panoramic images in 66.7% and 53.8% of C3 classifications of MCI (porous cortices forming many endosteal residues), respectively. Panoramic and CBCT images exhibited good agreement in MI findings (ICC, 0.91) and moderate (PR and panoramic images: ICC, 0.79) to good (CS and panoramic images: ICC, 0.87) agreement in PMI findings.
Conclusions
Because of the overlapping of buccal and lingual cortices, panoramic images are especially inadequate for determining the C3 category of MCI. However, CS images obtained from available CBCT data provide better visibility than panoramic images and can, therefore, be used for evaluating mandibular indices.
https://ift.tt/2NQVv7H
The Influence of Age on the Relationship Between Allergic Rhinitis and Otitis Media
Abstract
Purpose of Review
To examine the relationship between otitis media, allergic rhinitis, and age.
Recent Findings
Otitis media and allergic rhinitis are prevalent conditions with a controversial relationship. Some data suggest that these entities are significantly associated, either through allergic rhinitis inducing Eustachian tube dysfunction or through allergic pathophysiology simultaneously occurring intranasally and in the ear. Other studies, however, have refuted this relationship. For example, treatment with antihistamines does not reliably improve OME, making causation and association challenging to establish. Age may have an effect on the nature of the relationship between allergic rhinitis and otitis media, by impacting both the individual conditions and their association. Epidemiological, immunological, and adenoidal studies have suggested that differences occur with age, and this review encapsulates the related data and publications. We begin by evaluating how allergic rhinitis and otitis media each are affected by age, then evaluate the role that age may have in the relationship between the two conditions. Adult and pediatric literature are evaluated so as to include the full impact of age across patients' lifespan.
Summary
Age induces changes in immunity, patterns of inflammation, and susceptibility to both allergic rhinitis and otitis media with effusion. Age may also be an effect modifier which impacts the nature of the relationship between these two conditions. The influence of age on the association between these highly prevalent conditions remains a topic of active study.
https://ift.tt/2S4lbkz
Long-term quality of life outcomes of maxillomandibular advancement osteotomy in patients with obstructive sleep apnoea syndrome
Publication date: Available online 19 October 2018
Source: International Journal of Oral and Maxillofacial Surgery
Author(s): L. Pottel, N. Neyt, K. Hertegonne, D. Pevernagie, B. Veys, J. Abeloos, C. De Clercq
Abstract
This study was performed to evaluate the long-term impact of maxillomandibular advancement (MMA) surgery on the apnoea–hypopnoea index (AHI) and quality of life (QoL) in patients with obstructive sleep apnoea syndrome (OSAS). The medical files of 12 OSAS patients who underwent MMA by one surgeon between 1995 and 1999 were reviewed retrospectively. Patients received a clinical assessment, polysomnography, and QoL questionnaires as part of routine care preoperatively (n = 12), within 2 years postoperative (n = 12), and again in 2016 (n = 9). A successful surgical outcome was defined as an AHI decrease of >50% with <20 events/h. Of the 66.7% (8/12) of patients who were initially cured, 66.7% (4/6) remained stable at a median follow-up of 19 years. Only the two patients with the highest AHI showed abnormal Epworth Sleepiness Scale scores. After convalescence, most patients reported stable symptomatic improvement. Aesthetic changes were found acceptable and all but one patient stated that they would undergo the surgery again. It is concluded that MMA is a safe and effective procedure. Ageing and weight gain might counterbalance the positive effects of surgery in the long term. It is therefore suggested that re-evaluation every 5 years should be scheduled, since a spontaneous AHI increase over time does not seem to be reflected by symptomatic changes.
https://ift.tt/2q3QzDc
Correction to: Migraine Aura Without Headache
The original version of this article contains an error in the title. The title should be: Migraine Aura Without Headache. The title is corrected in this correction article.
https://ift.tt/2NOwaeF
Clinical and Genetic Risk Factors Associated with Psoriatic Arthritis among Patients with Psoriasis
Abstract
Introduction
Psoriatic arthritis (PsA) is a chronic, inflammatory arthritis that affects an estimated 30% of patients with psoriasis. PsA is underdiagnosed in primary care and dermatology clinics due to a variety of reasons, including failure of healthcare providers to ask about symptoms, overlap of symptoms and signs with other rheumatologic conditions, and lack of a specific diagnostic test. A delay in PsA diagnosis and treatment, even as short as 6 months, can lead to decreased quality of life, increased joint damage, and worse long-term physical function. In this study, we sought to identify the clinical and genetic factors that help discriminate patients with PsA from those with cutaneous psoriasis only.
Methods
We analyzed a cohort of 974 psoriasis patients at an academic medical center, of whom 175 had confirmed PsA, and performed univariate, multivariate, and predictive modeling to determine factors associated with PsA.
Results
The univariate analysis revealed significant positive associations of PsA with age, nail involvement, scalp involvement, skin fold involvement, elbow/knee involvement, psoriasis severity, plaque subtype, erythrodermic subtype, hypertension, type 2 diabetes, and coronary artery disease, and a significant negative association of PsA with the human leukocyte antigen (HLA)-C*06:02 allele. In the multivariate analysis, nail involvement, type 2 diabetes, and pustular psoriasis remained significantly associated with PsA, while HLA-C*06:02 positivity remained protective. There was a trend towards an association of PsA with older age, younger age of psoriasis onset, and skin fold involvement, while there was protective trend for smoking. A predictive model including both clinical and genetic factors showed reasonable discriminative ability between psoriasis and PsA, with an area under the curve of 0.87 for a receiver operating characteristic curve.
Conclusion
This study identified a number of clinical and genetic features that could help stratify patients who are at higher risk for having PsA and for whom rheumatology referral may be beneficial.
https://ift.tt/2NRmlwK
Reduced nasal nitric oxide levels in patients with eosinophilic chronic rhinosinusitis
Publication date: Available online 19 October 2018
Source: Allergology International
Author(s): Kanako Yoshida, Tetsuji Takabayashi, Yoshimasa Imoto, Masafumi Sakashita, Norihiko Narita, Shigeharu Fujieda
Abstract
Background
In Eosinophilic chronic rhinosinusitis (ECRS), it is difficult to estimate the refractoriness and recurrence risk for each patient. Fraction of exhaled nitric oxide (FeNO) is known as a biomarker of eosinophilic inflammation in lower airway. It has been reported that nasal NO has some crucial functions in the upper and lower airways. However, in upper airway, paranasal sinuses, the usefulness of NO measurement remains controversial. The purpose of this study is to identify the usefulness of nasal NO measurement in ECRS and the involvement of nasal NO in the pathogenesis of ECRS.
Methods
We compared the nasal NO levels of ECRS, non-ECRS, and normal control groups. Correlation between nasal NO levels and clinical findings were observed. Then, we compared nasal NO levels before and after endoscopic sinus surgery (ESS). We also examine whether nasal NO levels might discriminate ECRS by the receiver operating characteristic (ROC) curve analysis.
Results
Nasal NO levels were significantly decreased in ECRS compared to the other two groups. Moreover, nasal NO levels in ECRS significantly and negatively correlated with eosinophil levels and CT score. However, they did not correlate with the nasal polyp score. Nasal NO levels were not upregulated soon after opening the sinus ostium by ESS. The ROC curves for nasal NO levels were used to discriminate all CRS patients and ECRS patients from normal controls.
Conclusions
Nasal NO may be useful as a marker of ECRS severity and low nasal NO levels in ECRS may contribute to its pathogenesis.
https://ift.tt/2q240Dy
SEMA4A promotes eosinophil survival and contributes to eosinophil-mediated allergic diseases
Publication date: Available online 19 October 2018
Source: Allergology International
Author(s): Yohei Maeda, Takeshi Tsuda, Yoshito Takeda, Shohei Koyama, Yoshitomo Hayama, Satoshi Nojima, Tetsuya Kimura, Daisuke Ito, Hyota Takamatsu, Sujin Kang, Masayuki Nishide, Keiko Morimoto, Takashi Hosokawa, Yuhei Kinehara, Yasuhiro Kato, Takeshi Nakatani, Kazuya Takeda, Masaki Hayama, Sho Obata, Hitoshi Akazawa
https://ift.tt/2R2hMBB
Highlights.
Highlights.
JAMA Otolaryngol Head Neck Surg. 2018 Sep 01;144(9):767
Authors:
PMID: 30340218 [PubMed - in process]
https://ift.tt/2yLnbFy
UM-HACC-2A: MYB-NFIB fusion-positive human adenoid cystic carcinoma cell line
Publication date: December 2018
Source: Oral Oncology, Volume 87
Author(s): Kristy A. Warner, Alexandra E. Oklejas, Alexander T. Pearson, Zhaocheng Zhang, Weishing Wu, Vasu Divi, Christie Rodriguez-Ramirez, Rogerio M. Castilho, Peter J. Polverini, Jacques E. Nör
Abstract
Objectives
Limited availability of validated human adenoid cystic carcinoma (ACC) cell lines has hindered the mechanistic understanding of the pathobiology of this malignancy and the development of effective therapies. The purpose of this work was to generate and characterize a human ACC cell line.
Material and Methods
Immediately after surgery, a tumor fragment from a minor salivary gland from the tongue of a female Caucasian was minced, dissociated, and a single cell suspension was plated in fibronectin-coated flasks. A culture medium containing bovine brain extract and rhEGF was optimized for these cells. Whole exome sequencing was used to evaluate the presence of MYB-NFIB translocation.
Results
The University of Michigan-Human Adenoid Cystic Carcinoma (UM-HACC)-2A cells showed continuous growth in monolayers for at least 180 in vitro passages while maintaining epithelial morphology. Short-tandem repeat (STR) profiling confirmed a 100% match to patient DNA. Whole exome sequencing revealed the presence of the MYB-NFIB fusion in UM-HACC-2A cells, which was confirmed by PCR analysis. Western blots revealed high expression of epithelial markers (e.g. E-cadherin, EGFR, pan-cytokeratin) and proteins associated with ACC (e.g. c-Myb, p63). Developmental therapeutic studies showed that UM-HACC-2A cells were resistant to cisplatin (IC50 = 44.7 µM) while more responsive to paclitaxel (IC50 = 0.0006 µM). In a pilot study, we observed that UM-HACC-2A cells survived orthotopic transplantation into the submandibular gland. Notably, one of the mice injected with UM-HACC-2A cells exhibited lung metastasis after 6 months.
Conclusion
UM-HACC-2A is a MYB-NFIB fusion-positive ACC cell line that is suitable for mechanistic and developmental therapeutics studies.
https://ift.tt/2EyXUET
The Influence of Age on the Relationship Between Allergic Rhinitis and Otitis Media
Abstract
Purpose of Review
To examine the relationship between otitis media, allergic rhinitis, and age.
Recent Findings
Otitis media and allergic rhinitis are prevalent conditions with a controversial relationship. Some data suggest that these entities are significantly associated, either through allergic rhinitis inducing Eustachian tube dysfunction or through allergic pathophysiology simultaneously occurring intranasally and in the ear. Other studies, however, have refuted this relationship. For example, treatment with antihistamines does not reliably improve OME, making causation and association challenging to establish. Age may have an effect on the nature of the relationship between allergic rhinitis and otitis media, by impacting both the individual conditions and their association. Epidemiological, immunological, and adenoidal studies have suggested that differences occur with age, and this review encapsulates the related data and publications. We begin by evaluating how allergic rhinitis and otitis media each are affected by age, then evaluate the role that age may have in the relationship between the two conditions. Adult and pediatric literature are evaluated so as to include the full impact of age across patients' lifespan.
Summary
Age induces changes in immunity, patterns of inflammation, and susceptibility to both allergic rhinitis and otitis media with effusion. Age may also be an effect modifier which impacts the nature of the relationship between these two conditions. The influence of age on the association between these highly prevalent conditions remains a topic of active study.
https://ift.tt/2S4lbkz
Eating disorders: experiences of and attitudes toward oral health and oral health behavior
European Journal of Oral Sciences, EarlyView.
https://ift.tt/2q43RQ8
Immunochemical detection of mycotoxins in donkey milk
Abstract
The applicability of enzyme immunoassays (EIA) for aflatoxin M1 (AFM1), ochratoxin A (OTA) and zearalenone (ZEN) to analyse these toxins in donkey milk (Equus asinus) was studied. For AFM1 and OTA analysis, milk could be analysed by EIA without sample pretreatment. For ZEN, heat treatment at 78 °C for 30 min prior EIA analysis was required to avoid false positives. To include detection of phase II metabolites of ZEN, samples were additionally treated with glucuronidase/sulfatase for this EIA. Detection limits were 5 ng/kg (AFM1), 9 ng/kg (OTA) and 600 ng/kg (ZEN). All donkey milk samples were negative for all three toxins. Satisfactory quantitation was achieved for spiked samples. Analysis of some cereal-containing donkey feed components (pellets, oats) by EIA revealed absence of aflatoxin B1 (AFB1, < 3 μg/kg) and OTA (< 4 μg/kg), while ZEN was found in pellets (180 μg/kg) and in oats (7 μg/kg). This is the first one study on multitoxin determination in donkey milk by antibody-based test systems. In general, the results confirm that EIAs are convenient tools for mycotoxin detection in donkey milk. However, false-positive results may occur, possibly due to the high lysozyme content of donkey milk, which may exert inhibitory activity in some competitive EIA systems. Therefore, specific validation of each EIA for this specific matrix is required, and re-analysis after heat treatment of EIA-positive donkey milk is highly recommended.
https://ift.tt/2OzXGSw
Effect of the three Enterococcus faecalis strains on apoptosis in MC3T3 cells
Oral Diseases, EarlyView.
https://ift.tt/2J8HRw6
Niacinamide and 12‐hydroxystearic acid prevented benzo(a)pyrene and squalene peroxides induced hyperpigmentation in skin equivalent
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2S14TJz
Expression of Proton‐sensing G‐Protein‐coupled receptors in selected skin tumors
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2yPuJav
On the relevance of an in vitro reconstructed human epidermis model for drug screening in atopic dermatitis
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2S3Ez1m
Impact of cochlear implantation on the management strategy of patients with neurofibromatosis type 2
Abstract
Purpose
To investigate the outcomes of cochlear implantation in patients with neurofibromatosis type 2 (NF2), and to discuss the current management strategy for NF2 patients.
Methods
The medical records of NF2 patients who received cochlear implants (CI) at our center between 2012 and 2016 were retrospectively reviewed. Pre-operative hearing status, tumor status, treatment of tumors, and auditory outcomes post-implantation were evaluated.
Results
Twelve patients were included in the study. Five were implanted with the tumor in situ; two of them received radiotherapy pre-implantation, and three were implanted without any previous treatment. Four patients were implanted simultaneously with tumor removal. Three patients were implanted as second-stage after failed hearing preservation surgery. The mean pure tone audiometry with the implant was 44 dB (range 25–80 dB) and the mean sentence recognition score (SRS) in a quiet environment without lip reading was 63% (range 0–97%). A poorer objective auditory outcome was identified in one patient who showed no response to electrical promontory stimulation (EPS), but the sound perception was still helpful. In total, 11 of 12 (91%) patients were daily users, and the other patient used the implant as a "sleeper" device due to its interference with contralateral hearing provided by a hearing aid.
Conclusion
CI is an effective option in auditory rehabilitation and should be considered primarily for NF2 patients with intact cochlear nerve. EPS might be a predictor for cochlear implant performance. Good contralateral hearing may present a barrier to daily use.
https://ift.tt/2q0roRN
Endoscopic management of paediatric meningoencephaloceles: a case series
Abstract
Introduction
Congenital meningoencephaloceles represent a rare clinical entity, with its frequency being around 1 out of 4000–5000 live births. They usually present as a midline mass and the differential diagnosis includes dermoids, encephaloceles, and gliomas. Although the standard coronal approach with frontal craniotomy and pericranial flap has been considered the preferred method for several years, it is associated with risks and prolonged hospitalization. The endoscopic procedure is gaining ground and we are aiming to present our experience from five cases that were treated endoscopically.
Materials and methods
Five cases of paediatric meningoencephaloceles (age ranging from 2.5 to 10 years) were treated in our department between the years 2007–2017. Four children had a congenital and one child a post-traumatic meningoencephalocele. The presenting symptoms included nasal obstruction, meningitis and CSF leak. All patients had pre-operative imaging with CT and MRI scans and the preferred method of repair was multi-layered closure.
Results
All our patients had uneventful recovery, without any post-operative complications. The follow-up period ranges from 39 to 98 months. All five patients remain asymptomatic and recurrence-free.
Conclusion
Endoscopic management of paediatric meningoencephaloceles is a reliable and safe approach and it is known to have no adverse effects on facial growth. It carries a satisfactory success rate, reduces the in-hospital stay with lower cost of treatment, better cosmesis and lower morbidity than external procedures. It requires multidisciplinary team setting in a tertiary centre with experienced endoscopic anterior skull base surgeons. Pre-operative assessment and post-operative care are of paramount importance and larger series need to be studied to reach safe conclusions and establish management guidelines.
https://ift.tt/2QXYjlw
Ultrahigh-resolution CT scan of the temporal bone
Abstract
Objective
Ultrahigh-resolution CT (U-HRCT) provides better spatial resolution than conventional multi-detector row CT (ConvCT) and could be expected to identify microstructures with its 0.25-mm collimation, 1792 channels and 160 detector rows, 0.4 × 0.5 mm focus size, and a 1024 matrix. The aim of the study was to evaluate key anatomic structures in temporal bone using U-HRCT comparing it to ConvCT.
Materials and methods
A total of 30 patients (14 males and 16 females; age range, 8–82 years; median 49 years) underwent both U-HRCT and ConvCT. All CT images were obtained with 0.5 mm section thickness and a 512 × 512 matrix, and field of view of 80 mm. Transverse scans were acquired in a plane parallel to the orbitomeatal plane in the helical mode with 120 kV. Images of the 30 temporal bones of unaffected side were reviewed by two independent neuroradiologists who rated the visibility of key anatomic structures for both U-HRCT and ConvCT. The ratings between U-HRCT and ConvCT were compared using Wilcoxon matched-pairs signed rank test. The interobserver agreement on the rating of stapedius tendon was evaluated using weighted κ statistics.
Results
Excellent interobserver agreement was shown for U-HRCT (κ = 0.920), whereas good agreement was obtained for ConvCT (κ = 0.733). According to both observers, stapedius tendon was more clearly visualized using U-HRCT than ConvCT (p < 0.0001). All other anatomic structures were well visualized using both CT scanners.
Conclusion
The anatomy of temporal bone is more conspicuous on U-HRCT than on ConvCT because of its ultra-high-resolution detector. U-HRCT may provide beneficial information for determining surgical indication or procedures.
https://ift.tt/2q3AzBe
Chronic sinusitis in head and neck cancer patients who received radiotherapy or chemoradiotherapy
Abstract
Purpose
The aim of this study was to evaluate the status of paranasal sinus and to identify risk factors associated with the development of chronic sinusitis based on imaging studies in head and neck cancer patients.
Materials and methods
We retrospectively analyzed the medical records of 186 patients who were diagnosed with head and neck squamous cell carcinoma at Korea University Guro Hospital from February 2003 to July 2015. Only patients with at least 1 year of follow-up after treatment were included.
Results
Chronic sinusitis occurred in 32 patients (17.2%), including seven patients (16.3%) in non-radiotherapy group and 25 patients (17.5%) in radiotherapy group. Maxillary sinus was most commonly involved (56.9%), followed by ethmoid, frontal, and sphenoid sinuses. Age (1.006; 0.874–1.158; p = 0.936), TNM stage (0.104; 0.007–1.598; p = 0.105), and underlying disease (0.242; 0.036–1.646; p = 0.147) were not significantly associated with the need for surgery due to sinusitis. Although radiotherapy itself (1.319; 0.019–2.821; p = 0.251) was not significantly associated with surgery due to sinusitis, concurrent chemotherapy (10.729; 1.361–84.611; p = 0.024) was significantly associated with surgical procedures.
Conclusion
Higher T stage and concurrent chemotherapy with radiotherapy showed significant association with chronic sinusitis. Concurrent chemotherapy also showed significant association with surgical treatment in head and neck cancer patients. Therefore, more careful surveillance and aggressive treatment of chronic sinusitis is needed in head and neck cancer patients who receive radiotherapy with concurrent chemotherapy or higher T stage.
https://ift.tt/2R61OGP
Anatomical and functional long-term results of endoscopic butterfly inlay myringoplasty
Abstract
Purpose
The aim of this study was to evaluate the long-term anatomical (graft success) and functional (audiological) results of endoscopic butterfly inlay myringoplasty.
Methods
The files of 56 patients (29 female, 27 male) who were diagnosed with noncomplicated chronic otitis media and underwent endoscopic butterfly inlay myringoplasty in 2014–2016 at a tertiary referral center were reviewed. Age, gender, follow-up time, perforation location (anterior, posterior and central), perforation size (small, medium), pre- and postoperative pure tone audiometry (PTA) thresholds, pre- and postoperative air-bone gaps (ABG) and complications were noted.
Results
Graft success rate was 98.2% in postoperative 12th month and 94.6% in postoperative 24th month. In all patients, mean PTA for air conduction was 35.2 ± 3.9 dB preoperatively and 27.5 ± 4.3 dB in postoperative 6th month, 25.1 ± 3.5 dB in postoperative 12th month and 20.4 ± 3.2 in postoperative 24th month. Preoperative mean ABG was 24.2 ± 3.8 dB, whereas 19.5 ± 4.3 dB 6 months after surgery, 17.1 ± 3.5 dB 12 months after surgery and 12.4 ± 3.1 dB 24 months after surgery. There was significant difference between pre- and postoperative PTA and ABG in all 6th, 12th, 24th month follow-up (p = 0.001 for all measurements). Three patients (5%) had myringitis after surgery. Two patients (3%) had total graft resorption.
Conclusion
We suggested that endoscopic butterfly inlay myringoplasty is a safe surgical method with high graft success and effective hearing reconstruction. Follow-up is necessary for at least 2 years for precise anatomical and functional evaluation of the surgery.
https://ift.tt/2q1q2Gs
Functional identification of abductor and adductor branches for laryngeal transplantation
Abstract
Purpose
This is a feasibility study of functional identification of the abductor and adductor recurrent laryngeal nerve branches, which could be used in the donor's larynx for functional laryngeal transplantation.
Methods
The study was performed on swine (n = 3) and human (n = 4) models of a donor larynx. The recurrent laryngeal nerve and its branches were found. Using stimulator, abductor and adductor branches were identified, and glottis closing and opening were captured with an endoscope.
Results
The result was positive if two ENT specialists noticed at least one adduction and one abduction movement in the same subject. It was obtained in three out of three swine and three out of four humans.
Conclusions
This study shows a way of reinnervation of a transplanted larynx which might result in a functional organ. It describes the first step of the procedure: functional identification of the abductor and adductor branches of the recurrent laryngeal nerve in the donor before the larynx is excised for transplantation.
https://ift.tt/2R1iqzm
Evaluation of vestibular system with vHIT in industrial workers with noise-induced hearing loss
Abstract
Purpose
Industrial workers are frequently exposed to noise and the noise can cause hearing loss. The relationship between vestibular abnormalities and long-term exposure to occupational noise has been reported. The aim of this study was to use vHIT (video head impulse test) to evaluate the semicircular canal's function in industrial workers with noise-induced hearing loss.
Methods
In the present study, we included 36 male patients (aged 28–55 years, mean 44.4 ± 6.1 years) with hearing loss due to noise exposure from working in the steel and metal industry for at least 4 years, and a control group of 30 healthy men (aged 34–50 years, mean 41.1 ± 4.5 years) without hearing loss. The gain of the vestibulo-ocular reflex for all 6 semicircular canals was examined by vHIT in 66 patients.
Results
Canal deficit was detected in 20 (55.5%) of 36 patients in the noise exposure hearing loss group and was detected in 2 (6.6%) of 30 participants in the control group. There was significant loss of capacity for VOR gain in patients with noise exposure hearing loss.
Conclusions
In the present study we found that exposure to noise can cause vestibular dysfunction. And the vHIT is easily applicable, quick and practical and can individually evaluate all semicircular channels. Therefore, to evaluate vestibular function with vHIT is quick and practical.
https://ift.tt/2q1RDY8
The effect of electrolyte balance on the voice in hemodialysis patients
Abstract
Objective
The aim of the study was to demonstrate the effect of blood electrolytes on the voice in chronic hemodialysis patients.
Methods
The study included a total of 59 hemodialysis patients. Pre- and post-dialysis voice recordings were performed. In the analysis of vocal acoustic parameters, fundamental frequency (F0), jitter, shimmer, the noise-to-harmonics ratio (NHR), and F0 minimum and F0 maximum were measured. The Voice Handicap Index-10 (VHI-10), and maximum phonation time (MPT) were evaluated. For perceptual evaluation, the GRBAS scale was used. The duration of dialysis (years) and changes in weight during dialysis were recorded for each patient. From venous blood samples, measurements were taken of hemoglobin (Hb), albumin, Na+, K+, creatinine, uric acid, phosphorus, Ca++, and parathormone.
Results
The difference in the pre and post-dialysis values of F0, shimmer, NHR and MPT were found to be statistically significant (p = 0.001). The only variable determined to have an effect on the change in F0 values was uric acid, and the change in the F0 values was statistically significant (p = 0.009). The only variable determined to have an effect on the change in shimmer values was sodium, and the change was statistically significant (p = 0.034). The only variable determined to have an effect on the change in NHR values was creatinine, and the change in the NHR values was statistically significant (p = 0.028). Hb and the duration of dialysis were determined to have a statistically significant effect on the change in MPT values (p = 0.001).
Conclusions
The results showed that uric acid was the agent creating a reduction in vocal cord vibration, the agent increasing the difference between vibration waves was Na+, and creatinine increased the NHR rate. The effect of these variables can be considered important in the understanding of vocal cord physiology.
https://ift.tt/2QXgeZI
A comparison of phonatory outcome between trans-oral CO 2 Laser cordectomy and radiotherapy in T1 glottic cancer
Abstract
Purpose
This study aimed at comparing phonatory outcomes between Trans-oral Laser Surgery and Radiotherapy in T1 glottic cancer.
Introduction
Early glottic carcinoma, i.e. T1 stage, can be treated using trans-oral surgery, radiotherapy, or partial open surgery. Trans-oral laser (TOL) surgical techniques and Radiotherapy (RT) have undergone significant advancement in the past few years leading to a decrease in open procedures. Various studies have been published comparing voice quality after TOL surgery and RT. There are few works which consider patients' opinions, i.e. subjective parameters regarding functional voice quality post treatment. This study uses both subjective and objective parameters to evaluate phonatory outcome of both treatment options.
Methods
Phonatory outcomes were measured in patients who underwent RT and CO2 Laser excision for early laryngeal cancer. VHI, GRBAS and MDVP were used to measure the vocal outcome of treatment modality after 1 year of cancer-free survival. A comparison was then made between the outcomes in the two groups.
Results
Superior vocal outcomes in G, R and S criteria of the GRBAS scale, a better VHI index, and better jitter, shimmer and NHR were found in patients who underwent CO2 laser excision as compared to patients who underwent RT. Other parameters were comparable between the two groups.
Conclusions
TOL surgery provides excellent vocal outcome as compared to RT in management of early glottic cancer and should be considered as the first line of management for the same.
https://ift.tt/2q3AzkI
The (templar) knight cap: a new and simple way to prevent hair interference during ear surgery
Abstract
Introduction
Hair interference is a critical problem in ear surgery. The hair around the surgical area can get stuck unwantedly, making the surgeon habitually struggling with this hair rather than the surgery itself. Hair shaving can cause psychological discomfort, especially for women and data about shaving efficacy are conflicting. With the aim of solving this problem, we developed a new way to clear hair from the operating field named "The (Templar) Knight cap".
Technical description
This is a medical elastic stocking open at the ear to be treated and at the face that recalls the typical cap worn by Templar knight. This cap allows good hair retention and marks the surgical site. It is easy to wear does not require additional time for clinical staff.
Conclusions
The described cap could be a valid instrument during ear surgery with a low cost pricing, making it applicable in very poor settings, such as developing countries.
https://ift.tt/2R5gndH
Role of leptin in allergic rhinitis during sublingual immunotherapy
Abstract
Objective
Increasing evidence suggests that leptin is upregulated during allergic reactions in the airway and related to the severity of disease in allergic rhinitis (AR). In this study, we aimed to investigate the expression of leptin during sublingual immunotherapy (SLIT) in AR patients.
Methods
Forty AR patients without obesity were recruited in this study. Twenty patients received house dust mite (HDM) allergen extract for SLIT and twenty patients received placebo randomly. Protein expression of leptin in serum and nasal lavage was tested by enzyme-linked immuno sorbent assay (ELISA) 1 and 2 years after SLIT treatment, respectively. Peripheral blood mononuclear cells (PBMCs) and human nasal epithelial cell were prepared and stimulated by recombinant leptin after 24 months' SLIT treatment and the induction of Th2 cytokines (IL-4/IL-5/IL-13) were detected by ELISA.
Results
SLIT treatment decreased the expression of leptin protein in serum and nasal lavage significantly compared with placebo group 1 and 2 years after SLIT treatment. Nasal leptin level was correlated to decreased Th2 response (IL-4/IL-5/IL-13) and enhanced Treg (IL-10/TGF-beat) response after 2 years' SLIT. We also found that SLIT decreased the ability of leptin in promoting Th2 cytokines expression by PBMCs and human nasal epithelial cell after 2 years' SLIT treatment.
Conclusion
Changes of leptin expression in serum and nasal lavage may be correlated with Th2/Treg regulation during SLIT. Our results suggested that leptin served as an important biomarker during SLIT.
https://ift.tt/2q20Cc1
The lamellar cell: a radiological study and a new classification proposal
Abstract
Purpose
A pneumatized middle turbinate is called concha bullosa. Bolger classified it in bulbous, lamellar, and extensive. Lamellar cells could have a variable extension. We propose the first radiologic classification of lamellar cells.
Methods
195 CT sinonasal scans were included in the study. Lamellar cells were classified into four categories according to their degree of aeration.
Results
Lamellar cells were found in 47.7% of patients: unilateral in 14.9% of cases and bilateral in the remaining 32.8%. The most common lamellar cell is type 1, followed by types 3, 2, and 4; there were no statistically significant differences regarding side. A subgroup analysis was performed in 106 patients with no inflammatory diseases of the nasal cavity; there were no significant differences.
Conclusion
Cell types 3 and 4 are a complete pneumatization of the insertion of the middle turbinate; these cells are rare and could be associated with middle turbinate instability.
https://ift.tt/2QXYhtU
Posterior pillar mucosal suspension technique for posttonsillectomy pain and wound healing: a prospective, randomized, controlled trial
Abstract
Objectives/hypothesis
To investigate the efficacy of a simple and feasible suturing technique on posttonsillectomy pain control and wound healing.
Methods
A prospective, randomized, controlled trial was conducted on a sample of 121 children between 3 and 10 years of age. Group A comprised children undergoing surgery with bipolar cautery and the posterior pillar mucosal suspension technique. Bipolar alone (Group B) and cold dissection tonsillectomy (Group C) were used as control groups. Pain was assessed at 1, 3, 5, 7, and 10 days postoperatively via visual analog scale scores. Peritonsillar edema, erythema, and granulation tissue in the tonsillar fossa were evaluated by direct visual examination for wound healing on days 1, 3, 5, 7, and 10.
Results
There were consecutive 121 patients which were included, with mean ages being 6.2 ± 2.5, 6.1 ± 2.4, and 6.1 ± 2.6 in groups A, B, and C, respectively. Postoperative pain scores on days 1 and 3 were significantly lower in Group A than Group B and C (P < .001) and scores were 0.87 ± 1.1, 3.83 ± 2.29, and 4.29 ± 2.48 on day 1 and 0.38 ± 0.88, 2.25 ± 2.13, and 2.76 ± 2.12 on day 3 respectively. The wound-healing scores on postoperative 1st, 3rd, 5th, and 7th days were significantly lower in Group A than control groups (P < .001). The wound-healing score on postoperative day 10 was only different than Group C (P = .020).
Conclusions
The posterior pillar mucosal suspension technique is an effective and comparable method in terms of wound healing, maintains the preoperative anatomical structures, and enables a better pain control with reduced analgesic/opioid usage.
https://ift.tt/2q1thxH
Preoperative diagnostic of parotid gland neoplasms: fine-needle aspiration cytology or core needle biopsy?
Abstract
A preoperative cytologic or histologic diagnosis of parotid gland neoplasms is mandatory to decide which surgical procedure would be appropriate. Open biopsies are contraindicated because of the risk of recurrence secondary to tumour cell seeding; furthermore a subsequent curative parotid surgery can be complicated by a previous open biopsy. While fine-needle aspiration cytology (FNAC) was the only preoperative diagnostic procedure to distinguish benign versus malignant neoplasms over the past decades, core needle biopsy (CNB) has been increasingly used over the last few years. This created a debate as to whether FNAC or CNB should be the preoperative procedure of choice. The focus of this editorial is to analyse the advantages and disadvantages of FNAC and CNB, and to discuss which procedure is more appropriate in the preoperative work-up of parotid neoplasms.
https://ift.tt/2R2DQvX
Facial nerve dysfunction after superficial parotidectomy with or without continuous intraoperative electromyographic neuromonitoring: a prospective randomized pilot study
Abstract
Purpose
There are no randomized trials comparing the incidence or severity of facial nerve dysfunction after superficial parotidectomy with or without continuous intraoperative electromyographic neuromonitoring. This pilot study aimed to assess the variability in outcomes to help determine the needs and possible ethical issues in a full-scale study.
Methods
Prospective randomized pilot study comparing the incidence and grade of facial nerve dysfunction among 106 patients subjected to superficial parotidectomy with or without continuous four channels electromyographic neuromonitoring (52 monitored patients and 54 controls).
Results
The incidences of immediate (38.3% vs. 51.8%, p = 0.1) and late facial dysfunction, up to 180 days following surgery, (3.8% vs. 5.5%, p = 0.4) were similar between monitored patients and controls. Immediate facial nerve dysfunction with a House–Brackmann ≥ grade III was more frequent among the non-monitored patients (57.8% vs. 30%, p = 0.2), and outcomes were significantly poorer in this group (mean sum score of 68.7 vs. 81.5, p = 0.002), when assessed with the regional Sunnybrook scale. A full-scale prospective randomized study to detect a significant reduction in the incidence of immediate facial nerve dysfunction with the use of continuous intraoperative electromyographic neuromonitoring, with 80% power and a 5% significant level, would require 560 patients allocated to the monitored and control groups. Considering a mean rate of 30 patients/year/center, such a study would require the participation of five centers for 4 years.
Conclusions
In the present pilot study, the incidences of immediate and late facial nerve dysfunction were similar between patients with benign parotid tumors subjected to superficial parotidectomy with or without continuous intraoperative electromyographic neuromonitoring. However, immediate facial dysfunction was more severe among the non-monitored patients.
https://ift.tt/2q0OTKL
Outcome of compartment resection of locally advanced oral cancers extending to infratemporal fossa: a tertiary rural hospital experience
Abstract
Locally advanced oral cancers extending to infratemporal fossa (ITF) are a challenge to head and neck surgeons. These tumors are classified as T4b whenever the masticator space (MS), pterygoid muscles (PM), and pterygoid plates (PP) are involved according to AJCC classification. Until recently, these tumors were considered inoperable and treated only with palliative intent. However, a few studies in the last decade showed that many of these tumors could be resected with a reasonably favorable prognosis by compartment resection of ITF, particularly when the tumor was below sigmoid notch of mandible. A few studies attempted to downstage these tumors by neo-adjuvant chemotherapy before attempting resection. Oral Squamous cell carcinoma has a high prevalence in South India. Majority of these patients are females addicted to tobacco quid chewing and present with locally advanced disease. In this retrospective analysis, we evaluated the outcome of treatment of oral squamous cell carcinoma extending to ITF and staged T4b in 52 patients. All patients underwent Composite resection including compartment resection of ITF followed by adjuvant treatment. 20 patients had received neo-adjuvant chemotherapy. Pectoralis major myocutaneous flap was the mainstay of reconstruction. After mean follow-up of 2 years, 31 patients are alive and disease free. 14 patients had local recurrence in ITF and 2 patients had recurred in cervical nodes. 8 patients died due to disease and 6 are on palliative care. Neo-adjuvant chemotherapy did not benefit the outcome. Close margins of resection, extra nodal spread from lymph nodes and supra notch and involvement of posterior part of ITF were factors which predisposed to recurrence.
https://ift.tt/2R3E4TD
A pilot study of oral tranexamic acid and Glycyrrhizin compound in the treatment of recalcitrant Riehl’s melanosis
Journal of Cosmetic Dermatology, EarlyView.
https://ift.tt/2R0UHiI
Thymic localization of erythrodermic cutaneous T‐cell lymphoma
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2J6DQZ6
The epithelial zinc transporter ZIP10 epigenetically regulates human epidermal homeostasis by modulating histone acetyltransferase activity
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2yrDhFj
Letter in response: Mid‐face Toddler Excoriation Syndrome (MiTES) can be caused by autosomal recessive biallelic mutations in a gene for congenital insensitivity to pain, PRDM12
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2J73i0F
Alitretinoin in punctate palmoplantar keratoderma
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2yoa8e0
C5a receptor 1‐/‐ mice are protected from the development of IgE‐mediated experimental food allergy
Allergy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2yQmhYJ
Harnessing autophagy to overcome MEK‐inhibitor induced resistance in metastatic melanoma
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2J9OcHF
Association of CCL2 with systemic inflammation in Schnitzler's syndrome
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2ysWFl5
Reporting of sample size calculations for randomized trials in dermatology: comparison of publications with registries
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2J7vwbu
Atopic dermatitis, educational attainment and psychological functioning: a national cohort study
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2ytRUHU
Multiple ulcerated nodules on the leg
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2EBLHPX
Salivary biomarkers and their efficacies as diagnostic tools for Oral Squamous Cell Carcinoma: systematic review and meta‐analysis
Journal of Oral Pathology &Medicine, Volume 0, Issue ja, -Not available-.
https://ift.tt/2PbadLL
Superior vena cava syndrome in a patient with locally advanced lung cancer with good response to definitive chemoradiation: a case report
The incidence of superior vena cava syndrome within the United States is roughly 15,000 cases per year. Superior vena cava syndrome is a potentially life-threatening medical condition; however, superior vena c...
https://ift.tt/2ySY97Q
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