Otology

EDITORIAL

The limitations of pure-tone audiometry (as the gold standard test of hearing) that are worthy of consideration [pg. 1]
Mohd Normani Zakaria
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ORIGINAL ARTICLES

Inner ear malformations in cochlear implant recipients [pg. 3]
Luan Viet Tran, Vu Anh Duong, Saim Lokman
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Anatomical variations of round window in different age groups and surgical difficulties associated with them during cochlear implantation [pg. 7]
Rabindra Bhakta Pradhananga, Bigyan Raj Gyawali, Pabina Rayamajhi, Bebek Bhattarai
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Validity of modified whisper test as hearing screening method in presbycusis patients [pg. 11]
Rizki Najoan, Nyilo Purnami
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Detection of two pathogenesis previously unreported myosin xva pathogenic variants in two large Iranian pedigrees with autosomal recessive nonsyndromic hearing loss [pg. 14]
Fatemeh Azadegan-Dehkordi, Korosh Ashrafi, Gholam Reza Mobini, Nasrin Yazdanpanahi, Maryam Shirzad, Effat Farrokhi, Morteza Hashemzadeh-Chaleshtori
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Chronic suppurative otitis media and microbial flora: Adult versus pediatric population [pg. 22]
Ashish Chandra Agarwal, Anitya Srivastava, Manodeep Sen
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Risk of hepatic toxicity and drug response in patients with chronic suppurative otitis media [pg. 26]
S M Tariq Rafi, Shafaque Mehboob, Mejabeen , Naila Tariq, Hurithmina Khan, Moona Mehboob
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Speech intelligibility enhancement in elderly with high-frequency hearing loss through visual speech perception [pg. 30]
Himanshu Chaurasiya
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Effectiveness of intratympanic dexamethasone as salvage therapy in treating sudden sensorineural hearing loss [pg. 36]
Bigyan Raj Gyawali, Rabindra Bhakta Pradhanaga, Pabina Rayamajhi
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Prospective study of use of Island of tragal cartilage in revision tympanoplasty [pg. 40]
Bhavika Verma, Naresh Dawat, Yogesh G Dabholkar, Sachin J Patil
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Antimicrobial susceptibility in patients with chronic suppurative otitis media in a North-Central secondary health facility in Nigeria [pg. 44]
Solomon Joseph Hassan, Yikawe Stephen Semen, Dabit Othniel Josep, Ekuma Otu Gabriel, Osisi Kingsley, Solomon Ndudiri Calista
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Conducting Fukuda stepping test in a noisy clinic and the effects of sound [pg. 47]
Carren Sui Lin Teh, Erica Anak Gima, Hani Binti Mamat, Meng Hon Lye, Sobani Bin Din, Narayanan Prepageran
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Transoral endoscopic vestibular approach Sistrunk procedure: First reported case series

xlomafota13 shared this article with you from Inoreader Transoral endoscopic vestibular approach Sistrunk procedure: First reported case series Via Head & Neck Abstract Background Standard of care for management of thyroglossal duct cysts (TGDCs) is a Sistrunk procedure performed through a transcervical incision. We describe the first series of Sistrunk procedures performed through a transoral endoscopic vestibular approach, eliminating a visible external scar. Methods The transoral endoscopic vestibular approach to the Sistrunk (TEVAS) was performed in patients with TGDCs meeting inclusion criteria who desired a scarless approach. Results Six patients (five females and one male) underwent TEVAS, with a mean age of 38 years (range 16–56 years) and a mean TGDC size of 1.8 cm (range 1.1–2.4 cm). Mean operative time was approximately 5 h (range 2–8 h). There were no surgical complications or recurrences. Conclusions For appropriately selected patients, the TEVAS is an alternative to open neck surgery that provides improved cosmesis while maintaining successful resection outcomes. More data on outcomes including complications and recurrences are needed as additional case information is collected. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High expression of NFX1‐123 in HPV positive head and neck squamous cell carcinomas

xlomafota13 shared this article with you from Inoreader High expression of NFX1‐123 in HPV positive head and neck squamous cell carcinomas Via Head & Neck Abstract Background High-risk human papillomaviruses (HR HPV) cause nearly all cervical cancers and, in the United States, the majority of head and neck cancers (HNSCCs). NFX1-123 is overexpressed in cervical cancers, and NFX1-123 partners with the HR HPV type 16 E6 oncoprotein to affect multiple growth, differentiation, and immune response genes. However, neither the expression of NFX1-123 nor the levels of these genes have been investigated in HPV positive (HPV+) or negative (HPV−) HNSCCs. Methods The Cancer Genome Atlas Splicing Variants Database and HNSCC cell lines were used to quantify expression of NFX1-123 and cellular genes increased in cervical cancers. Results NFX1-123 was increased in HPV+ HNSCCs compared to HPV− HNSCCs. LCE1B, KRT16, SPRR2G, and FBN2 were highly expressed in HNSCCs compared to normal tissues. Notch1 and CCNB1IP1 had greater expression in HPV+ HNSCCs compared to HPV− HNSCCs. Conclusion NFX1-123 and a subset of its known targets were increased in HPV+ HNSCCs. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Conducting Fukuda stepping test in a noisy clinic and the effects of sound

xlomafota13 shared this article with you from Inoreader Conducting Fukuda stepping test in a noisy clinic and the effects of sound Via Indian Journal of Otology Carren Sui Lin Teh, Erica Anak Gima, Hani Binti Mamat, Meng Hon Lye, Sobani Bin Din, Narayanan Prepageran Indian Journal of Otology 2021 27(1):47-50 Context: The Fukuda stepping test (FST) is used to assess the labyrinthine function via the vestibulospinal reflex. The test is meant to be conducted in a quiet room, but in a busy clinic setting, it is often performed in the clinic itself, and individuals are exposed to environmental sounds. Aims: The aim of this study was to assess the effects of environmental sounds and the effects of fixed directional sound on the outcome of FST. Settings and Design: This is an observational study. Subjects and Methods: Thirty healthy participants performed the FST in the otorhinolaryngology clinic, in a sound-treated room, and then in a sound-treated room with the presence of a fixed directional sound where the angle of rotation, angle of displacement, and distance of displacement were compared. Statistical Analysis Used: Independent t-test and Chi-squared test were used for statistical analysis. Results: There was no statistical difference in the angle of rotation and angle of displacement in all three settings. Although the mean distance of displacement was above 50 cm in all three settings, there was a significant reduction between clinic versus sound-treated room (P = 0.016) and clinic versus room with sound-treated directional sound (P = 0.002). Fixed directional sound had no significant influence on the direction of rotation in all the participants. Conclusions: Performing FST in the standard clinic will not affect the results. Concurrently, we suggest omitting measurement of the distance of displacement in FST as it is not reproducible in our normal sample and is highly susceptible to auditory cues but to focus on the angle of rotation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chronic suppurative otitis media and microbial flora: Adult versus pediatric population

xlomafota13 shared this article with you from Inoreader Chronic suppurative otitis media and microbial flora: Adult versus pediatric population Via Indian Journal of Otology Ashish Chandra Agarwal, Anitya Srivastava, Manodeep Sen Indian Journal of Otology 2021 27(1):22-25 Context: Chronic suppurative otitis media (CSOM) is an inflammatory condition of the middle ear which manifests as recurrent episodes of ear discharge. Due to the inappropriate use of antibiotics, the microbiological profile and the drug sensitivity pattern is changing, leading to either inadequate treatment or recurrence. Hence, there is a need to study the microbial profile and its sensitivity pattern in order to initiate the appropriate treatment. Aim: The study has been done to evaluate the microbiological profile of ear discharge in patients of CSOM and also to assess any difference in the microbiology in the adult and pediatric population. Setting and Design: A cross-sectional record-based study was conducted in a tertiary care hospital in North India on patients diagnosed to have tubotympanic type of CSOM. Materials and Methods: The study duration was 12 months. Sterile swabs were collected from the study individuals. The organisms were isolated using the standard microbiologi cal methods and antimicrobial susceptibility test was performed using diffusion method. Statistical Analysis: Descriptive statistics were used. Appropriate parametric and nonparametric tests were applied to assess the association between various variables. Results: Amongst children, the most common isolate was Staphylococcus aureus and this was followed by Proteus mirabilis and Pseudomonas aeruginosa. Among adults, the most common organism was P. aeruginosa and this was followed by S. aureus. Conclusion: Age, environmental, and geographical conditions of an individual affect the microbiological profile. Antibiotic therapy administered in accordance to the sensitivity pattern achieves best result. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Speech intelligibility enhancement in elderly with high-frequency hearing loss through visual speech perception

xlomafota13 shared this article with you from Inoreader Speech intelligibility enhancement in elderly with high-frequency hearing loss through visual speech perception Via Indian Journal of Otology Himanshu Chaurasiya Indian Journal of Otology 2021 27(1):30-35 Background: Pathological and physiological disabilities of human auditory receptors reduce speech intelligibility under hearing loss (HL) at high frequencies. Objectives: The objective of the study is to investigate the speech-intelligibility-enhancement (SIE) in elderly with high-frequency HL (HFHL) through visual-speech-perception (VSP). The hypothesis is that the VSP of spondee words (two-syllable words with equal stress on both syllables) is properly recognized and reproduced with HFHL. Also; to decide the statistical relevance of the precise significant difference in speech discrimination (SD) with VSP on the subjected ear. Methods: Observational and descriptive studies of SIE with VSP on 12 elderly listeners (24 clear ears; without wax impaction) with progressive and bilateral HFHL were examined. The entire experimental records were checked for distribution with normal (Gaussian) using the Shapiro–Wilk's and paired Student's t-test (parametric test) had the 5% (0.05) signific ance level (α). Results: We analyzed, improved, and better performance in SIE with HFHL through VSP. The statistical P (probability) measure was calculated nothing, i.e., 0 (P < 0.05). Therefore, investigators strongly and carefully discarded the null hypothesis consideration. There was some significant value of statistical variation also exists with VSP. Moreover, with the help of the confidence-interval analysis, the same conclusion was achieved. Conclusions: In this study, it is concluded that the elderly-individuals of this experiment, whose mother tongue and official language is Hindi and English, respectively, they demonstrate the SIE with HFHL through VSP. This investigation also helps to improve the hearing sensitivity to some extent with VSP. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Validity of modified whisper test as hearing screening method in presbycusis patients

xlomafota13 shared this article with you from Inoreader Validity of modified whisper test as hearing screening method in presbycusis patients Via Indian Journal of Otology Rizki Najoan, Nyilo Purnami Indian Journal of Otology 2021 27(1):11-13 Background: Presbycusis is a hearing loss due to the degeneration process which is found at the age of more than 65 years old, with decreased hearing sensitivity in both ears, asymmetrical bilateral sensorineural detection type. Objective: To identify the validity of modified whisper test by detecting the hearing level in presbycusis patients. Methods: The design of this study was comparative, cross-sectional, prospective study. Subjects were elderly undergoing hearing monitoring at URJ Geriatric and URJ Audiology Dr. Soetomo Hospital, in August–September 2018 and examined using whisper test and audiometry. The statistical analysis used 2 × 2 tables, sensitivity, specificity, positive predictive value, and negative predictive value. Results: The lowest sensitivity at frequencies > 41–55 dB was at 100%, the lowest specificity at 100%, lowest sensitivity at frequencies >56–70 dB was at 23.07% with specificity at 100%. The positive predictive value (NRP) at frequencies > ;25–40 dB was 88.46% while the negative predictive value (NPV) was of 100%. Conclusion: The modified whisper test can be used as early detection of hearing impairment. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Antimicrobial susceptibility in patients with chronic suppurative otitis media

xlomafota13 shared this article with you from Inoreader Antimicrobial susceptibility in patients with chronic suppurative otitis media in a North-Central secondary health facility in Nigeria Via Indian Journal of Otology Solomon Joseph Hassan, Yikawe Stephen Semen, Dabit Othniel Josep, Ekuma Otu Gabriel, Osisi Kingsley, Solomon Ndudiri Calista Indian Journal of Otology 2021 27(1):44-46 Introduction: Antibiotic resistance is a major challenge in managing patients with chronic inflammation of the middle ear cleft in our facility. This is also a concern in many sub-Saharan African and Asian countries. Many secondary and primary health facilities lack the services of trained ear nose and throat nurses, and it is rare to have an otorhinolarynogologist in these centers. To reduce the risks of antibiotics resistance and complications from middle ear cleft infection, there is a need to know the pattern of microbial susceptibility to facilitate the selection of antibiotics in treating patients with chronic otitis media in the region. Methodology: We carried out a prospective, hospital-based study in a secondary health facility in Makurdi, North-Central Nigeria, for 11 months from August 2018 to July 2019. One hundred and twelve patients of all age groups with chronically discharging ear (s) were consecutively recruited for the study. Ear swabs were carefully taken from the middle ear using sterile swab sticks and quickly taken for microscopy culture and sensitivity. The results were analyzed using IBM-SPSS version 20. Results: One hundred and twelve patients were recruited with ages ranging from <1 year to 56 years. Nearly 57.1% were female and 42.9% were male. Thirty-two (28.6%) of the swab taken yielded no growth. Pseudomonas spp. was the most frequent isolate (50%), and Staphylococcus, Klebsiella, and Streptococcus spp. isolated in 10.7%, 7.1%, and 3.6%, respectively. Pseudomonas, Streptococcus, and Klebsiella spp. had the highest susceptibility to ciprofloxacin (88%–98%); only 50% by Staphylococcus spp. Gentamicin was effective against all the isolates (70%–97%). All four isolates also showed moderate-to-high susceptibility to levofloxacin and pefloxacin; organisms showed least sensitivity to ofloxacin (30%–58%). Conclusion: Pseudomonas spp. is the most common isolate in chronic otitis media patients in this subregion, with excellent susc eptibility to ciprofloxacin (98%). All isolates had a good level of susceptibility to the commonly used topical antibiotics, except for ofloxacin (30%–58%). More studies should be done at intervals to note any change in microbial isolates and susceptibility pattern, this will enhance success in treating chronic otitis media. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk of hepatic toxicity and drug response in patients with chronic suppurative otitis media

xlomafota13 shared this article with you from Inoreader Risk of hepatic toxicity and drug response in patients with chronic suppurative otitis media Via Indian Journal of Otology S M Tariq Rafi, Shafaque Mehboob, Mejabeen , Naila Tariq, Hurithmina Khan, Moona Mehboob Indian Journal of Otology 2021 27(1):26-29 Objective: The aim of the current study was to evaluate the risk of hepatic and renal toxicity in patients with chronic suppurative otitis media (CSOM) and the effects of antibiotics (ciprofloxacin and co-amoxicillin) on it. Methods: This is a case–control study conducted on patients and healthy volunteers divided into four groups; G1 (negative control), G2 (positive control), G3 (patients treated with ciprofloxacin), and G4 (patients treated with co-amoxicillin). The study was conducted in Jinnah Postgraduate Medical College in Karachi, Pakistan, from May 2018 to October 2018. Results: There was a significant (P < 0.05) increase in total bilirubin, direct bilirubin, alkaline phosphatase, Serum glutamic pyruvic transaminase (SGPT), and Gamma-glutamyl transferase (GGT) in patients of G2 (positive control) as compared to G1 (negative control). However, the treatment with antibiotics may recover the normal liver enzyme levels except direct bilirubin and SGPT. An insignificant inc rease in blood glucose levels and urea was found in G2, G3, and G4 with insignificant increased creatinine levels. Conclusion: Hepatic toxicity may be induced in patients with CSOM, particularly if not properly treated. Therefore, precautions with proper follow-up of liver function test should be taken in CSOM. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sensitivity of treatment-free survival to subgroup analyses in patients with advanced melanoma treated with immune checkpoint inhibitors

xlomafota13 shared this article with you from Inoreader Sensitivity of treatment-free survival to subgroup analyses in patients with advanced melanoma treated with immune checkpoint inhibitors Via Melanoma Research - Published Ahead-of-Print Patients with advanced melanoma treated with immune checkpoint inhibitors can experience ongoing disease control after treatment discontinuation without subsequent systemic anticancer therapy. We previously defined a novel outcome, treatment-free survival (TFS), as the time between protocol therapy cessation and sub sequent therapy initiation/death. We assessed the effect of established prognostic variables [lactate dehydrogenase (LDH), programmed death ligand 1 status, BRAF mutation status, performance status, and sex] on TFS in different treatment scenarios: treatment until toxicity/progression with frequent early cessation (nivolumab plus ipilimumab), treatment until toxicity/progression with a well-tolerated regimen (nivolumab), and treatment for a short fixed duration (ipilimumab). Data were pooled from 1077 patients with advanced melanoma treated in the CheckMate 069 and 067 trials. TFS was defined as the area between the Kaplan–Meier curves for time to therapy cessation and time to subsequent therapy initiation/death. TFS was estimated by restricted mean (r-mean) survival time at 36 months since randomization. Clinically meaningful TFS (r-mean TFS 3.7–12.7 months) was observed across all patient subgroups. TFS was longest in patients treated with nivolumab plus ipilimumab. The la rgest differences in r-mean TFS were observed with LDH in the nivolumab plus ipilimumab and ipilimumab treatment groups (TFS difference 4.7 and 4.9 months, respectively). In the nivolumab group, there was little difference in TFS across subgroups (r-mean TFS 3.7–5.5 months). TFS was sensitive to prognostic subgroup differences; however, duration of treatment affected the sensitivity of TFS. These results provide further support for TFS as a clinical outcome measure. Received 8 February 2021 Accepted 29 September 2021 Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www.melanomaresearch.com. Correspondence to Meredith M. Regan, ScD, Division of Biostatistics, Dana-Farber Cancer Institute, Department of Medicine, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA, Tel: +617 632 2471; e-mail: mregan@jimmy.harvard.edu This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epithelial component and intraepithelial lymphocytes of conjunctiva-associated lymphoid tissue in healthy children

xlomafota13 shared this article with you from Inoreader Epithelial component and intraepithelial lymphocytes of conjunctiva-associated lymphoid tissue in healthy children Via Cellular and Molecular Biology Histol Histopathol. 2021 Oct 26:18385. doi: 10.14670/HH-18-385. Online ahead of print. ABSTRACT Conjunctiva-associated lymphoid tissue (CALT) plays a key role in protecting the eye surface by initiating and regulating immune responses. The aim of this study was to investigate in healthy children the proportion of intraepithelial lymphocytes (IELs), the degree of viability and/or apoptosis and cell proliferation in three different topographic areas of the conjunctiva. Superior tarsal, superior bulbar, and inferior tarsal-bulbarfornix conjunctival cells were collected by brush cytology (BC) from 24 healthy paediatric subjects (13 boys and 11 girls, mean age 6±2 years) who were to undergo strabismus correction surgery under general anaesthesia. Subsequently, these cells were analysed phenotypically and functionally by flow cytometry (FC). Flow cytometry analysis showed that not all the cells obtained by BC were of the epithelial lineage, but that there was a population of CD45+ cells (IELs) regularly present in the conjunctiva of healthy children. These IELs were mostly T-lymphocytes (CD3+) and B-lymphocytes (CD19+), with higher levels of T-lymphocytes (CD3+) in the upper areas than in the inferior tarsal-bulbar-fornix, where the highest levels of B-lymphocytes (CD19+) were found. In the apoptosis assay, two groups of cell populations were differentiated by cell size and complexity (cytoplasmic granularity), with more complex cells predominating in the upper areas of the conjunctiva and less complex cells being more abundant in the inferior tarsal-bulbar-fornix. Finally, the proliferative capacity of the conjunctival epithelium was significantly higher in the upper tarsal zone than in the rest of the zones analysed. These results suggest that the epithelial component and the IELs of CALT are also regularly present in the conjunctiva of the healthy child, varying in phenotype, viability and cell proliferation accord ing to the different conjunctival regions analysed, which could lead us to believe that each conjunctival zone plays a different, specific role in the regulation of the immune response at the ocular level. PMID:34698365 | DOI:10.14670/HH-18-385 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.