MedWorm: ENT & OMF

Excessive Antibiotic Prescription Caused By Perceived Parent-Pressure

Ear, Nose and Throat News From Medical News Today — Sat, 07 Nov 2009 08:00:00 +0100

Antibiotic over-prescription is promoted by pediatricians' perception of parents' expectations. Research published in the open access journal BMC Pediatrics shows that pediatricians are more likely to inappropriately prescribe antibiotics for respiratory tract infections if they perceived parents were expecting a prescription. (Source: Ear, Nose and Throat News From Medical News Today)

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Introduction to ENT Course in association with the Royal College of Surgeons of England

NLH - ENT and Audiology - Events — Fri, 06 Nov 2009 14:13:21 +0100

(Source: NLH - ENT and Audiology - Events)

DOHNS Refresher Course

NLH - ENT and Audiology - Events — Fri, 06 Nov 2009 14:09:19 +0100

(Source: NLH - ENT and Audiology - Events)

Early Scents Really Do Get 'Etched' In The Brain

Ear, Nose and Throat News From Medical News Today — Fri, 06 Nov 2009 11:00:00 +0100

Common experience tells us that particular scents of childhood can leave quite an impression, for better or for worse. Now, researchers reporting the results of a brain imaging study online on November 5th in Current Biology, a Cell Press publication, show that first scents really do enjoy a "privileged" status in the brain. (Source: Ear, Nose and Throat News From Medical News Today)

Bilateral cochlear implantation: Current concepts, indications, and results

The Laryngoscope — Fri, 06 Nov 2009 00:00:00 +0100

The optimal treatment for bilateral hearing loss continues to evolve as cochlear implant (CI) and hearing aid technologies advance, as does our understanding of the central auditory system. Ongoing discussions continue on the validity and feasibility of bilateral CI in terms of performance, justification of need, medical/surgical safety concerns, and economics. The purpose of this review article is to provide an update on the advantages and disadvantages of bilateral CI and to provide a discussion on timing (simultaneous vs. sequential), technology (bimodal vs. binaural) and feasibility. Binaural advantages are found in both adult and pediatric bilateral CI recipients, the greatest being the head shadow effect and improvements in localization and loudness summation. This theoretically offe...

Altered fractionation and adjuvant chemotherapy for head and neck squamous cell carcinoma

Head and Neck — Fri, 06 Nov 2009 00:00:00 +0100

The aim of this review was to discuss the role of altered fractionation and adjuvant chemotherapy for patients treated with definitive radiotherapy (RT) for head and neck squamous cell carcinoma (HNSCC).This review explores the pertinent literature and discusses the optimal management of previously untreated patients with stage III-stage IVA and/or -B HNSCCs.Depending on the schedule, altered fractionation improves locoregional control and survival. Both hyperfractionation and concomitant boost RT improve locoregional control and are associated with improved overall survival (OS). Adjuvant chemotherapy improves OS; the greatest impact is observed after concomitant versus induction or maintenance chemotherapy. Monochemotherapy appears to be equivalent to polychemotherapy. Drugs associated w...

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Announcements

Journal of Cranio-Maxillofacial Surgery — Thu, 05 Nov 2009 14:16:08 +0100

Dear Colleagues, As the Education and Training Officer of the European Association for Cranio-Maxillofacial Surgery, I would like to draw your attention to the forthcoming educational activities. Courses included in the Rolling Programme of the Association are linked to the EBOMS examination curriculum and cover all aspects related to our specialty and are open to all colleagues working in our field. Trainees are especially invited to attend these Courses. A refund of Euro 150 is available for each EACMFS Trainee Member attending a Course of this Programme. (Source: Journal of Cranio-Maxillofacial Surgery)

EACMFS Prizes and Awards

Journal of Cranio-Maxillofacial Surgery — Thu, 05 Nov 2009 14:16:08 +0100

The Council of EACMFS wishes to ensure that all members of the Association are aware of the current awards and prizes that are available. These are designed to provide educational support and also to allow the opportunity for trainees and those who have recently achieved specialist status to visit units outside their own departments. (Source: Journal of Cranio-Maxillofacial Surgery)

Editorial Board

Journal of Cranio-Maxillofacial Surgery — Thu, 05 Nov 2009 14:16:07 +0100

(Source: Journal of Cranio-Maxillofacial Surgery)

The 28th European Course on The Management of Tinnitus and Hyperacusis

NLH - ENT and Audiology - Events — Thu, 05 Nov 2009 14:16:03 +0100

(Source: NLH - ENT and Audiology - Events)

MEG studies of auditory processing

NLH - ENT and Audiology - Events — Thu, 05 Nov 2009 14:16:03 +0100

(Source: NLH - ENT and Audiology - Events)

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Techniques in Facial Plastics incorporating Minimal Invasive Techniques

NLH - ENT and Audiology - Events — Thu, 05 Nov 2009 14:16:03 +0100

(Source: NLH - ENT and Audiology - Events)

Auditory modelling and clinical applications: Current findings and applications from the Hearing Dummy Project (provisional title)

NLH - ENT and Audiology - Events — Thu, 05 Nov 2009 14:16:03 +0100

(Source: NLH - ENT and Audiology - Events)

Central auditory processing: Current research and implications for clinical practice

NLH - ENT and Audiology - Events — Thu, 05 Nov 2009 14:16:03 +0100

(Source: NLH - ENT and Audiology - Events)

Mechanisms of auditory streaming in the songbird primary cortical fields

NLH - ENT and Audiology - Events — Thu, 05 Nov 2009 14:16:03 +0100

(Source: NLH - ENT and Audiology - Events)

Supraglottic swelling may not correlate with tongue swelling in angiotensin converting enzyme inhibitor-induced angioedema

The Laryngoscope — Thu, 05 Nov 2009 00:00:00 +0100

We present a representative case. This observation suggests that all patients with ACEI-induced angioedema should undergo laryngeal fiberoptic examination and appropriate airway management. Laryngoscope, 2009 (Source: The Laryngoscope)

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Results of vocal rehabilitation using tracheoesophageal voice prosthesis after total laryngectomy and their predictive factors

European Archives of Oto-Rhino-Laryngology — Wed, 04 Nov 2009 19:53:46 +0100

In conclusion the use of voice prosthesis showed a high success rate of vocal rehabilitation with an acceptable complication rate. Content Type Journal ArticleCategory LaryngologyDOI 10.1007/s00405-009-1138-xAuthors Alexandre Bozec, Centre Antoine Lacassagne Département de Chirurgie, Institut Universitaire de la Face et du Cou 33 avenue de Valombrose 06189 Nice FranceGilles Poissonnet, Centre Antoine Lacassagne Département de Chirurgie, Institut Universitaire de la Face et du Cou 33 avenue de Valombrose 06189 Nice FranceEmmanuel Chamorey, Centre Antoine Lacassagne Département de Statistiques Médicales 33 avenue de Valombrose 06189 Nice FranceFrançois Demard, Centre Antoine Lacassagne Département de Chirurgie, Institut Universitaire de la Face et du Cou 33 avenue de Valombrose 0...

Rhino-orbital mucormycosis and aspergillosis: differences in outcome, clinical and imaging characteristics

European Archives of Oto-Rhino-Laryngology — Wed, 04 Nov 2009 19:53:37 +0100

Content Type Journal ArticleCategory Letter to the EditorDOI 10.1007/s00405-009-1136-zAuthors Suneetha Nithyanandam, St John’s Medical College Department of Ophthalmology Sarjapur Road Bangalore 560005 IndiaMarjorie A. Correa, St John’s Medical College Department of Pathology Bangalore India Journal European Archives of Oto-Rhino-LaryngologyOnline ISSN 1434-4726Print ISSN 0937-4477 (Source: European Archives of Oto-Rhino-Laryngology)

Laryngopharyngeal reflux is not always secondary to gastroesophageal reflux

European Archives of Oto-Rhino-Laryngology — Wed, 04 Nov 2009 19:53:30 +0100

Content Type Journal ArticleCategory Letter to the EditorDOI 10.1007/s00405-009-1137-yAuthors Vui Heng Chong, Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital Gastroenterology Unit, Department of Medicine Bandar Seri Begawan BA 1710 Brunei Darussalam Journal European Archives of Oto-Rhino-LaryngologyOnline ISSN 1434-4726Print ISSN 0937-4477 (Source: European Archives of Oto-Rhino-Laryngology)

10th to 12th March 2010: The 3rd Newcastle Head and Neck dissection course

NLH - ENT and Audiology - Events — Wed, 04 Nov 2009 14:20:17 +0100

(Source: NLH - ENT and Audiology - Events)

Tinnitus and Hyperacusis: Developing Evidence Based Practice

NLH - ENT and Audiology - Events — Wed, 04 Nov 2009 14:20:17 +0100

(Source: NLH - ENT and Audiology - Events)

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Presented At CHEST 2009 - New Pediatric Lung Health Research

Ear, Nose and Throat News From Medical News Today — Wed, 04 Nov 2009 11:00:00 +0100

Children With Asthma May Benefit From Reduction in Daily Steroids (#9114) Children with status asthmaticus, those who experience prolonged and serious asthma attacks, may safely be able to reduce their daily corticosteroid dose. Researchers from Kosair Children's Hospital in Kentucky conducted before and after chart reviews of 292 patients younger than 18 years who were hospitalized with status asthmaticus. (Source: Ear, Nose and Throat News From Medical News Today)

In reference to Lemierre's Syndrome: A Systematic Review (Laryngoscope 2009;119:1552-1559)

The Laryngoscope — Wed, 04 Nov 2009 00:00:00 +0100

No abstract. (Source: The Laryngoscope)

Meeting Report - The NIDCR 2nd Salivary Gland Tumor Meeting, November 2008

Head and Neck — Wed, 04 Nov 2009 00:00:00 +0100

No abstract. (Source: Head and Neck)

View the latest update of recent additions to the collection

NLH Specialist Library for ENT and Audiology Latest News — Tue, 03 Nov 2009 12:25:41 +0100

03/11/09 Latest guidelines, systematic reviews and events (Source: NLH Specialist Library for ENT and Audiology Latest News)

Guidelines for referral to audiology of adults with hearing difficulty

NLH Specialist Library for ENT and Audiology Latest News — Tue, 03 Nov 2009 12:18:34 +0100

03/11/09 This document is intended both as a basis for service planning and to guide the practice of those who make direct referral of adults to Audiology services, primarily GPs. (Source: NLH Specialist Library for ENT and Audiology Latest News)

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New systematic review on inferior turbinate reduction surgery outcomes in children

NLH Specialist Library for ENT and Audiology Latest News — Tue, 03 Nov 2009 10:23:36 +0100

03/11/09 A review of outcomes following inferior turbinate reduction surgery in children for chronic nasal obstruction (Source: NLH Specialist Library for ENT and Audiology Latest News)

Detection of metachronous esophageal squamous carcinoma in patients with head and neck cancer with use of transnasal esophagoscopy

Head and Neck — Tue, 03 Nov 2009 00:00:00 +0100

The use of transnasal esophagoscopy was examined for detecting metachronous esophageal squamous carcinoma in patients with head and neck squamous cell carcinoma (HNSCC).In all, 398 transnasal esophagoscopies were performed in 293 previously treated patients with HNSCC between December 2007 and January 2009.Metachronous esophageal squamous carcinoma was detected in 15 (5.1%) patients. The prevalence rate was 15.9% (7/44) in patients with hypopharyngeal cancer, significantly higher than the 8.3% (2/24) with laryngeal, 7.1% (3/42) with oropharyngeal, and 1.6% (3/183) with oral cancer (p = .001). The stage distributions of esophageal squamous carcinoma were I-II in 12 (80%) and III-IV in 3 (20%) patients. Subsequently, curative strategies were performed in 13 (87%) patients.Transnasal esophago...

Complementary and alternative medicine use in patients presenting to a head and neck oncology clinic

Head and Neck — Tue, 03 Nov 2009 00:00:00 +0100

The aim of this study was to determine the prevalence of complementary and alternative medicine (CAM) use among patients presenting to a head and neck oncology clinic prior to a diagnosis.The study was conducted by administering questionnaires to 102 patients after being seen in the Head and Neck Oncology clinic for their initial consultation. The questionnaire assessed the extent of CAM use, types of CAMs used, and their reasons for use.A total of 132 CAMs were currently being used among 56 patients. The most common CAMs in use were multivitamins (26/132) and vitamin D (21/132). Meditation and yoga were associated with the greatest perceived benefit. The majority of patients obtained their information from family and friends. Most patients were using CAMs for physical health and well-bein...

Immunostaining patterns of CD31 and podoplanin in previously untreated advanced oral/oropharyngeal cancer: Prognostic implications

Head and Neck — Tue, 03 Nov 2009 00:00:00 +0100

The objective of this study was to assess angiogenesis and lymphangiogenesis patterns in advanced oral/oropharyngeal cancer by immunohistochemical techniques.Forty-five patients with advanced oral/oropharyngeal cancer, treated by primary surgery between January 1996 and December 2005, were selected. All cases were followed for at least 24 months. Angiogenesis and lymphangiogenesis were evaluated with antibodies against CD31 and podoplanin, respectively. Survival outcomes were calculated by the Kaplan-Meier method, whereas univariate comparisons were obtained by log-rank, chi-square, and Mann-Whitney tests.Survival correlated with the area of peritumoral blood vessels (p = .02), whereas the number of intratumoral lymphatics (p = .02) correlated with the occurrence of nodal metastasis. The r...

Pilot testing of an assessment tool for competency in mastoidectomy

The Laryngoscope — Tue, 03 Nov 2009 00:00:00 +0100

This study tests the hypothesis that residents of dissimilar training levels differ in their technical performance as measured by this tool.Cross-sectional validation study.Two or more faculty otolaryngologists evaluated each resident performing a cortical mastoidectomy on a cadaveric temporal bone. Performance was rated using global and checklist components of a mastoidectomy assessment tool.Fifteen internal and external faculty members evaluated 23 residents over 3 years resulting in 118 evaluations. Construct validity was observed as scores increased with clinical training year. These differences were greater for more complex tasks. There was a percentage agreement of 78.5% between evaluator pairs in the determination of pass (score 3-5) versus fail (score 1-2) for the checklist instrum...

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Accelerated fractionation radiotherapy and late intensification with 2 intra-arterial cisplatin infusions for locally advanced head and neck squamous cell carcinoma

Head and Neck — Tue, 03 Nov 2009 00:00:00 +0100

This study was established to determine the maximum tolerated dose of intra-arterial cisplatin (IAC) concurrent with accelerated fractionation radiotherapy for locally advanced head and neck squamous cell carcinoma (HNSCC).We conducted a phase I study. Treatment consisted of 70 Gy/35 fractions/5.8 weeks and 2 weekly IAC infusions during the last 2 weeks.Ten patients were recruited. Two patients had stage III, 1 had stage IVa, and 7 had stage IVb disease. Three patients received IAC at 100 mg/m2, 3 at 125 mg/m2, and 4 at 150 mg/m2. Nine patients received both planned infusions. Dose-limiting toxicity occurred at 150 mg/m2 as transient grade 4 leukopenia and prolonged grade 3 acute skin reactions. The maximum tolerated dose was 125 mg/m2. Six patients survived disease-free at 39 to 67 months...

Globus sensation and increased upper esophageal sphincter pressure with distal esophageal acid perfusion

European Archives of Oto-Rhino-Laryngology — Mon, 02 Nov 2009 18:04:33 +0100

In conclusion, the globus sensation is due to elevated UES pressure, resulting from gastroesophageal reflux and does not require direct exposure of the hypopharynx to gastric acid. The incidence of heartburn in combination with a globus sensation would be much higher if the cause of the latter were acid reflux. Content Type Journal ArticleCategory LaryngologyDOI 10.1007/s00405-009-1134-1Authors Ryoji Tokashiki, Tokyo Medical University Department of Otolaryngology 6-7-1 Nishishinjuku, Shinkjyukuku Tokyo 160-0023 JapanNobutoshi Funato, Tokyo Medical University Department of Otolaryngology 6-7-1 Nishishinjuku, Shinkjyukuku Tokyo 160-0023 JapanMamoru Suzuki, Tokyo Medical University Department of Otolaryngology 6-7-1 Nishishinjuku, Shinkjyukuku Tokyo 160-0023 Japan Journal Euro...

A new cochlear implant electrode design for preservation of residual hearing: a temporal bone study.

Acta Oto-Laryngologica — Mon, 02 Nov 2009 00:00:00 +0100

Conclusions: Success in conservation of residual hearing after cochlear implantation has benefited patients with high levels of residual low frequency hearing who were not previously considered for conventional cochlear implantation. Technological developments play a key role in minimizing trauma to the cochlea during placement of electrodes. Objectives: The Nucleus(R) Straight Research Array (SRA) has been designed and developed as a collaboration project between our centre and Cochlear Ltd with the objective of minimizing trauma to the cochlea with insertion of the electrode via the round window. Methods: We studied 22 fresh or thawed fresh-frozen human temporal bones implanted by one otosurgeon with the SRA electrode with a standard round window technique used for cochlear implantation....

Vestibular neuritis: recurrence and incidence of secondary benign paroxysmal positional vertigo.

Acta Oto-Laryngologica — Mon, 02 Nov 2009 00:00:00 +0100

Conclusions: Recurrence of vestibular neuritis (VN) is a rare event in long-term follow-up. The incidence of benign paroxysmal positional vertigo (BPPV) in VN patients represents a quite common outcome. To our knowledge, this study represents the only long-term longitudinal study on recurrence of VN and incidence of secondary BPPV in VN. Objectives: To study a large number of VN patients longitudinally to identify the recurrence rate of VN and incidence of BPPV, other peripheral vestibular disorders, sudden hearing loss or Bell's palsy. Methods: This prospective cohort study assessed a VN patient-based clinic population. All patients received a complete bedside clinical examination and caloric irrigation. Results: Long-term (range 4-6 years, mean 4.9 years) longitudinal follow-up examinati...

Improved prognosis for localized malignant lymphomas of the head and neck.

Acta Oto-Laryngologica — Mon, 02 Nov 2009 00:00:00 +0100

Conclusion: In this study we found localized malignant lymphomas of the head and neck to be highly treatable and to have a significantly improved prognosis with recent treatment methods. The head and neck surgeon should keep in mind that the prognosis, especially for diffuse large B-cell lymphoma, has improved if the patient receives the optimal treatment. Objectives: The purpose of this study was to ascertain the current prognosis of localized malignant lymphoma of the head and neck given recent advancements in treatment and diagnostic features, as well as adding histological subtypes to the literature according to the 2001 classification. Methods: We present a retrospective study including a cohort of 100 consecutive patients who had localized malignant lymphoma within the head and neck ...

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Digital volume tomography (DVT) measurements of the olfactory cleft and olfactory fossa.

Acta Oto-Laryngologica — Mon, 02 Nov 2009 00:00:00 +0100

Conclusion: Preoperative imaging is important, because of the small size of the cribriform plate, different anatomical variants of the olfactory fossa in varied patients and unequal width of the cribriform plate in the anterior and posterior third. Objective: Digital volume tomography (DVT) is a rather new imaging technique for the diagnosis of diseases of paranasal sinuses. This technology is dedicated to the evaluation of the distinctive structures of the anterior skull base due to the high resolution of the DVT. Based on the Keros classification this anatomic area was analyzed radiologically and also in relation to the uncinate process. Methods: The investigation was performed on 111 patients. The Accu-I-tomo F17 was used. Patients with total nasal polyposis and patients who had undergo...

Postural stability during visual stimulation and the contribution from the vestibular apparatus.

Acta Oto-Laryngologica — Mon, 02 Nov 2009 00:00:00 +0100

Conclusion: When combined with vestibular dysfunction, visual flow can exacerbate reductions in postural stability. This effect may be one of the mechanisms underlying visual vertigo, which can be evaluated using frequency analysis of body sway elicited by optokinetic stimulation (OKS). Objective: To clarify the interaction between the postural responses to visual flow and to input from the vestibular apparatus as a mediator of visual vertigo. Methods: Horizontal and vertical OKS with a stable fixation target were presented to 14 healthy subjects and 38 peripheral vestibular patients standing in a Romberg's posture, and the center of standing pressure was monitored using a force platform. The direction and amplitude of induced body sway were analyzed, along with the power spectra of the bo...

Localization of the sentinel lymph node in tongue VX2 carcinoma via indirect CT lymphography combined with methylene blue dye injection.

Acta Oto-Laryngologica — Mon, 02 Nov 2009 00:00:00 +0100

Conclusions: Indirect computed tomography lymphography (CT-LG) combined with blue dye injection can locate the sentinel lymph node (SLN) in tongue carcinoma. Objective: To localize the SLN in tongue VX2 carcinoma using indirect CT-LG combined with methylene blue injection. Methods: Eighteen rabbits were placed into three groups: metastasis, hyperplasia, and control. Indirect CT-LG was performed with an iohexol injection into the tongue submucosa. CT images were acquired at 1, 5, and 15 min after injection. Methylene blue was injected into the same area 24 h after indirect CT-LG, followed by SLN identification and histopathological examination. Results: SLNs were visualized with an identification rate of 100%. SLN location identified using CT lymphography was confirmed by methylene blue dye...

Vestibular schwannoma with absent vestibular evoked myogenic potentials to clicks but normal ABR, caloric responses and vestibular evoked myogenic potentials to 500 Hz tone bursts.

Acta Oto-Laryngologica — Mon, 02 Nov 2009 00:00:00 +0100

We report a case of vestibular schwannoma with absent vestibular evoked myogenic potentials (VEMPs) to clicks but normal auditory brainstem responses, caloric responses, and vestibular evoked myogenic potentials to 500 Hz tone bursts. This patient visited our clinic with complaint of sudden right hearing loss. This was the third episode of hearing loss in his right ear. Due to atypical medical history, he underwent further neuro-otological and neuroradiological examinations. Among the neurophysiological tests, only VEMPs to clicks showed abnormal findings (absent responses on the right). MRI revealed a small vestibular schwannoma in the right internal auditory meatus, which was considered to be of inferior vestibular nerve origin. This case suggested that VEMPs to clicks should still be in...

A modified septoplasty with three high tension lines resection.

Acta Oto-Laryngologica — Mon, 02 Nov 2009 00:00:00 +0100

Conclusion: The modified septoplasty with three tension lines resection is an effective and well-tolerated procedure, which can improve the objective and subjective outcomes, and provide a good approach that is applicable for various septal deviations, especially caudal deviation. Objectives: According to the biomechanics of the septal deviation, a modified septoplasty with three high tension lines resection was redefined. The purpose of this study was to review the surgical technique and objective and subjective outcomes. Methods: A retrospective review was conducted to identify patients undergoing septoplasty between 2005 and 2006 at Beijing Tongren Hospital. The records were reviewed for demographic data, intraoperative technique, surgical indications, objective and subjective outcomes,...

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Imaging of cochlear implant electrode array with flat-detector CT and conventional multislice CT: comparison of image quality and radiation dose.

Acta Oto-Laryngologica — Mon, 02 Nov 2009 00:00:00 +0100

Conclusion: Cochlear implantation assessment is possible using commercially available standard flat-detector computed tomography (FD-CT) protocols. Image quality is superior to multislice CT (MSCT). The radiation dose of FD-CT is lower in comparison with MSCT standard protocols and may therefore overcome the limitations of MSCT in the evaluation of cochlear implants. PMID: 19883180 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

Endogenous protection against oxidative stress caused by cisplatin: role of superoxide dismutase.

Acta Oto-Laryngologica — Mon, 02 Nov 2009 00:00:00 +0100

Conclusion: The administration of cisplatin induces the activation of superoxide dismutase (SOD) as a response to oxidative stress in the cochleae of Sprague-Dawley rats and this activation is proportional to the activation of the intrinsic pathway of apoptosis. Objectives: To determine the role of the antioxidant endogenous mechanism in the preservation of cochlear integrity and function in an experimental model of cisplatin ototoxicity. Methods: Sixteen Sprague-Dawley rats were studied at 7 days after intraperitoneal injection of CDDP (n = 8) or 10 ml/kg NaCl 0.9% w/v in the control group (n = 8) by means of auditory steady-state responses. These findings were compared with the expression of SOD and caspase-3/7 and caspase-9 activities. Results: Groups receiving cisplatin showed increase...

Moderately differentiated neuroendocrine carcinoma of the larynx.

Acta Oto-Laryngologica — Mon, 02 Nov 2009 00:00:00 +0100

Conclusions: Laryngeal moderately differentiated neuroendocrine carcinoma (LMDNEC) is an aggressive and uncommon malignancy. Thorough histological evaluation is the key to correct diagnosis and differentiation. Complete surgical resection of laryngeal primary lesions and suitable neck dissection of cervical nodes provide reasonable therapy, and postoperative radiotherapy should also be considered. Objective: To explore the diagnosis and treatment of LMDNEC. Methods: Clinical information regarding patient, presentation, immunohistochemical results, treatment, and outcome was obtained through review of patients' charts. Follow-up until the time of death or last contact with us was obtained for all patients. Results: Eight patients (six males, two females) were pathologically confirmed to hav...

Kimura's disease in a white man

Head and Neck — Mon, 02 Nov 2009 00:00:00 +0100

We report on a rare case of Kimura's disease in the hard palate of a white man.A 56-year-old white man was seen with a rapidly growing mass in the upper jaw. A complete tumor resection with hemimaxillectomy was performed. The tumor, which showed signs of inflammation, was located within the bone and the soft tissue.Kimura's disease was diagnosed by histopathologic examination of the resected tumor.This case demonstrates that Kimura's disease, though rare, is not limited to the Asian population. We present a case of a tumor in a white man. This adds another possibility for uncertain differential diagnoses of rapidly growing tumor masses. © 2009 Wiley Periodicals, Inc. Head Neck, 2009 (Source: Head and Neck)

Nuclear factor-[kappa]B expression as a novel marker of radioresistance in early-stage laryngeal cancer

Head and Neck — Mon, 02 Nov 2009 00:00:00 +0100

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Anaplastic thyroid cancer: Clinical outcomes with conformal radiotherapy

Head and Neck — Mon, 02 Nov 2009 00:00:00 +0100

Conclusions.Outcomes for anaplastic thyroid cancer treated with 3DRT or IMRT remain equivalent to historical results. Healthy patients with localized disease who tolerate full dose irradiation can potentially enjoy prolonged survival. Biologically targeted radiosensitization merits prioritized investigation. © 2009 Wiley Periodicals, Inc. Head Neck, 2009 (Source: Head and Neck)

Canadian Canadian Association of Speech-Language Pathologists and Audiologists Conference 2010

NLH - ENT and Audiology - Events — Sun, 01 Nov 2009 14:15:59 +0100

(Source: NLH - ENT and Audiology - Events)

The ERA & OAE Course

NLH - ENT and Audiology - Events — Sun, 01 Nov 2009 14:15:59 +0100

(Source: NLH - ENT and Audiology - Events)

6th Widex Congress of Paediatric Audiology

NLH - ENT and Audiology - Events — Sun, 01 Nov 2009 14:15:59 +0100

(Source: NLH - ENT and Audiology - Events)

Emergency Skills in Maxillofacial Surgery

NLH - ENT and Audiology - Events — Sun, 01 Nov 2009 14:15:59 +0100

(Source: NLH - ENT and Audiology - Events)

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Combined Universities Course in Advanced Surgical Otology

NLH - ENT and Audiology - Events — Sun, 01 Nov 2009 14:15:59 +0100

(Source: NLH - ENT and Audiology - Events)

Section of Otology and Laryngology & Rhinology

NLH - ENT and Audiology - Events — Sun, 01 Nov 2009 14:15:59 +0100

(Source: NLH - ENT and Audiology - Events)

International Mastercourse on Endoscopic Sinus Surgery

NLH - ENT and Audiology - Events — Sun, 01 Nov 2009 14:15:59 +0100

(Source: NLH - ENT and Audiology - Events)

Calendar Listings

Journal of Voice — Sun, 01 Nov 2009 00:00:00 +0100

(Source: Journal of Voice)

Calendar

Journal of Voice — Sun, 01 Nov 2009 00:00:00 +0100

(Source: Journal of Voice)

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Editorial Board

Journal of Voice — Sun, 01 Nov 2009 00:00:00 +0100

(Source: Journal of Voice)

Journal of Voice — Sun, 01 Nov 2009 00:00:00 +0100

(Source: Journal of Voice)

Instructions for Contributors

Journal of Voice — Sun, 01 Nov 2009 00:00:00 +0100

(Source: Journal of Voice)

Author Index

Journal of Voice — Sun, 01 Nov 2009 00:00:00 +0100

(Source: Journal of Voice)

Subject Index

Journal of Voice — Sun, 01 Nov 2009 00:00:00 +0100

(Source: Journal of Voice)

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Hearing and vestibular functions after plugging surgery for the posterior semicircular canal.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:23:35 +0100

CONCLUSIONS: Results of audiometry, caloric testing and vestibular evoked myogenic potential (VEMP) testing were hardly influenced by plugging surgery. OBJECTIVE: To evaluate the influence of surgical plugging of the posterior semicircular canal on inner ear function in patients with benign paroxysmal positional vertigo (BPPV). SUBJECTS AND METHODS: The subjects were five consecutive patients with intractable BPPV who underwent plugging surgery. The following functions of the inner ear were examined before and 6 months after surgery. Cochlea function was evaluated by the average hearing level of three frequencies (500, 1000 and 2000 Hz), that of the semicircular canal by canal paresis percent (CP%) in caloric testing and that of the otolith by the left-right difference ratio on VEMP testin...

An animal model of cochlear implantation with an intracochlear fluid delivery system.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:23:32 +0100

CONCLUSION: An animal model of cochlear implantation with a local intracochlear fluid through a microcatheter included in the array has been developed. It is suitable for evaluation of putative therapeutic agents to decrease cochlear trauma after cochlear implantation. OBJECTIVES: The purpose of this study was to design an animal model of cochlear implantation with an intracochlear fluid delivery system to demonstrate the stability of the device and study the patterns of hearing loss. MATERIALS AND METHODS: Eleven guinea pigs were implanted with a prototype array that comprised one electrode and a microcatheter connected to an osmotic minipump containing saline serum. Three animals were implanted with the same electrode carrier without any connection to the minipump. Preoperative and posto...

Utility of immunologic parameters in the evaluation of Meniere's disease.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:23:30 +0100

CONCLUSION: Because of the lack of association between a positive test and response to corticosteroid treatment, at present, detection of anti-HSP 70 antibody, tumor necrosis factor (TNF)-alpha, erythrocyte sedimentation rate (ESR), or antinuclear antibody (ANA), does not offer clinically useful information in the treatment of Meniere's disease (MD). OBJECTIVES: The study was designed to investigate the performance of various laboratory tests, including anti-HSP 70, TNF-alpha, ESR, ANA, and anti-phospholipid antibodies, in the diagnosis and treatment response of patients with MD. PATIENTS AND METHODS: Thirty patients who presented with MD and 30 healthy people were selected as study and control groups, respectively. The laboratory panel included the following tests: anti-HSP 70 antibody im...

Assessment of the reuniting duct by three-dimensional CT rendering.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:23:25 +0100

CONCLUSION: The rendering strategy sometimes induces misunderstanding of the image. We demonstrated a more accurate image of the bony groove of the reuniting duct using three-dimensional (3D) cone beam CT image, which was less affected by artifacts created by the rendering effect. OBJECTIVE: To obtain a suitable image of the groove of the reuniting duct for future morphological study. MATERIALS AND METHODS: The grooves of reuniting ducts in 10 healthy human subjects were analyzed by cone beam CT in comparison with a cadaver study. RESULTS: We could obtain more accurate 3D CT images of the bony groove in human subjects by checking the landmarks of 3D CT images. PMID: 19863305 [PubMed - in process] (Source: Acta Oto-Laryngologica)

Endolymphatic space imaging in patients with delayed endolymphatic hydrops.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:23:21 +0100

CONCLUSION: Magnetic resonance imaging (MRI) after intratympanic gadolinium injection can reveal endolymphatic hydrops (ELH) in patients with delayed ELH (DELH). Patients with contralateral DELH may have bilateral ELH. OBJECTIVE: DELH has previously been diagnosed based on clinical history, hearing and vestibular examinations. DELH is classified into three types: ipsilateral, contralateral and bilateral indicate the side with the longstanding hearing loss. Ipsilateral DELH occurs in the ear with a profound hearing loss, contralateral DELH in the better hearing ear and bilateral DELH in both ears. Imaging diagnosis of the endolymphatic space may add a new dimension to the diagnosis and treatment of DELH. PATIENTS AND METHODS: Gadodiamide hydrate was diluted eightfold with saline. The dilute...

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Estrogen receptors in the inner ear during different stages of pregnancy and development in the rat.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:23:19 +0100

CONCLUSION: ERalpha and ERbeta are present in the inner ear and are up- and down-regulated depending on the stage of maturation, development and pregnancy, suggesting that estrogen may have an effect on the cochlea during various stages of life. No estrogen receptors (ERs) were found in the cochlea of the developing fetus, which suggests that estrogen does not have an effect on the cochlea during gestation. OBJECTIVE: To investigate the distribution of ERs in the cochlea during pregnancy, maturation and development in a female rat model. MATERIALS AND METHODS: The cochleas of 24 rats in 4 groups in different time periods of maturation (21 and 56 days old) and pregnancy (day 8 and 18 of pregnancy) and 16 fetuses at gestational ages of 8 and 18 days were collected. All specimens were stained...

Pressure changes in the human middle ear without opening the eustachian tube.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:23:16 +0100

CONCLUSION: By means of a direct, though non-invasive experiment on healthy humans we could demonstrate that middle ear (ME) pressure decreases when the eustachian tube (ET) does not open. Thus with a very simple method the basic theory of continuous gas loss from the ME into the circulation and the replenishment of the loss through the ET could be validated. OBJECTIVES: To record changes in ME pressure over a period of time in normal human ears, while the ET is kept closed. SUBJECTS AND METHODS: On-line tympanometry was carried out in three subjects, who refrained from swallowing for 20-120 min. RESULTS: During the time when the ET was kept closed by refraining from swallowing, tympanometric monotonous pressure decrease was recorded. Once the tested subject could not refrain from swallowi...

The imbalance of enzymatic antioxidants in cholesteatoma.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:23:13 +0100

CONCLUSION: Depletion of enzymatic antioxidants was observed in cholesteatoma. However, a relationship between activity of enzymatic antioxidants and the extent of bone erosion was not found. OBJECTIVES: To measure the level of major enzymatic antioxidants in cholesteatoma, and to investigate the relationship between the level of enzymatic antioxidants and the extent of bone erosion. PATIENTS AND METHODS: The cholesteatoma and skin samples were obtained during otologic surgeries. All cases were grouped according to the number of bone erosion sites. Samples were examined biochemically and the levels of enzymatic antioxidants were measured. The results were analyzed statistically. RESULTS: Thirteen patients were included in the study. The mean level of superoxide dismutase in cholesteatoma a...

Acute tympanic membrane perforations and the early immunological response in rats.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:23:10 +0100

CONCLUSIONS: This study showed that macrophages, B cells, and T cells occurred at different frequencies, localizations, and times after acute laser tympanic membrane perforation. Immunological cells were most prevalent in the proliferative mass adjacent to the annulus region. The cellular immunological response in freshly perforated eardrums was unexpectedly aggressive. OBJECTIVES: To study the occurrence of immunocompetent cells during the healing process of fresh perforated tympanic membranes. The information could be used to develop alternative outpatient procedures in the cure of chronic perforations, replacing conventional surgery. MATERIALS AND METHODS: A laser myringotomy was carried out in Sprague-Dawley rats, which were sacrificed at 3 and 6 days after the myringotomy. Tympanic me...

Vestibular evoked myogenic potentials of children with inner ear malformations before and after cochlear implantation.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:23:08 +0100

CONCLUSIONS: Our results show that among the patients with inner ear malformations, there were two patients with sensory cells of sacculus and inferior vestibular neurons and at least five patients with inferior vestibular neurons only, but no patients without sensory cells and vestibular neurons, as determined on the basis of vestibular evoked myogenic potentials (VEMPs). OBJECTIVE: The aim of this study was to investigate whether sensory cells of sacculus or inferior vestibular neurons or both are present in cochlear implant patients with inner ear malformations, particularly common cavity (CC) deformity, using VEMPs. PATIENTS AND METHODS: Seven children with inner ear malformation who underwent cochlear implantation (CI) participated in this study. The patients had CC deformity (n=2), i...

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Vestibular evoked myogenic potentials in chronic otitis media before and after surgery.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:23:04 +0100

CONCLUSION: The pathology of chronic otitis media (COM) could delay and reduce the energy transfer of sound to the inner ear. The significant improvement of postoperative vestibular evoked myogenic potential (VEMP) response rate and p13 latencies in the group of patients with no or negative postoperative ABG gain provided evidence that the sound energy inducing a VEMP might be different from the energy producing the auditory perception. OBJECTIVE: To evaluate the VEMP in patients with COM before and after surgery. SUBJECTS AND METHODS: Twenty-four subjects with unilateral COM were enrolled. A pure tone audiogram and VEMP using 500 Hz unilateral short tone-burst stimulations were recorded before and 3 months after surgery. The postoperative VEMP responses were compared with the responses be...

Effect of topical use of mitomycin C and 5-fluorouracil on the closure time of myringotomies created by radiofrequency unit.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:23:02 +0100

CONCLUSION: Both mitomycin C (MC) and 5-fluorouracil (5-FU) had a significant effect in prolonging the patency rate of radiofrequency myringotomy. OBJECTIVE: To compare the effect of topical use of MC and 5-FU on the closure time of myringotomies created by a radiofrequency unit. MATERIALS AND METHODS: Myringotomies were performed using a radiofrequency unit on 80 tympanic membranes of 40 rats. Rats were divided into two study groups and one control group. MC (0.4 mg/ml) and 5-FU (50 mg/ml) pledgets were applied topically in the right ears (study groups, 20 ears each) for 10 min and saline pledgets in the left ears (control group, 40 ears). Animals were monitored using otomicroscopy weekly and patency rates were recorded until myringotomy closure. RESULTS: The mean patency times were 4.85 ...

Bedside therapeutic experiences with horizontal canal benign paroxysmal positional vertigo (cupulolithiasis).

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:59 +0100

CONCLUSIONS: After forced prolonged position type one (FPP-one) and the appropriate repositioning maneuvers, or FPP-two, 95.45% of patients with cupulolithiasis of the horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV).were symptom-free. OBJECTIVES: To treat patients with cupulolithiasis of the HSC-BPPV. SUBJECTS AND METHODS: This was a prospective study including 22 subjects with HSC-BPPV (cupulolithiasis) based on apogeotropic direction-changing positional nystagmus (apo-DCPN). Patients adopted FPP-one, which means lying down on the side of the weaker nystagmus during nightly rest for 2 weeks. If apo-DCPN persisted, subjects adopted type two FPP (FPP-two), which means lying on the strongest nystagmus side during nightly rest for 2 weeks. RESULTS: No vertigo or ...

Poly(ADP-ribose) polymerase-1 (PARP-1) longer alleles spanning the promoter region may confer protection to bilateral Meniere's disease.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:57 +0100

CONCLUSION: The longer alleles (CA)17-20 of the promoter region of PARP-1 gene may confer some protection against bilateral Meniere's disease (BMD). OBJECTIVE: To analyze microsatellite (CA)(n) polymorphisms in the promoter region of PARP-1 gene and seek out risk and protective variants for BMD. SUBJECTS AND METHODS: Eighty patients from two ethnically defined groups with definite BMD, according to the diagnostic scale of the American Academy of Otolaryngology Head and Neck Surgery, were compared with a group of 371 normal controls from the same origin in a prospective multicenter study. We developed a specific amplification protocol to determine the PARP1-promotor CA microsatellite polymorphisms. RESULTS: We found that the longer alleles (CA)17-20 had a very low frequency in BMD (2/160, 1...

A head-tilt caloric test for evaluating the vertical semicircular canal function.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:54 +0100

CONCLUSIONS: The caloric test with head-tilt can be used as a tool for assessing vertical canal function as an office procedure. OBJECTIVE: Evaluation of vertical canal function. PATIENTS AND METHODS: We provoked caloric response by cold water in the vertiginous patients in supine position. During the culmination of the response we rotated the head 45 degrees from the sagittal plane to place the posterior canal to earth-vertical. Thereafter we rotated the head 45 degrees to the opposite direction to place the anterior canal to earth-vertical. The eye movements were recorded by two-dimensional electronystagmography. The data collected from the examination of 100 ears with normal caloric response in horizontal component were analyzed. RESULTS: The down-beating vertical component intensified ...

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Wine produced by ecological methods produces relatively little nasal blockage in wine-sensitive subjects.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:51 +0100

CONCLUSION: Subjects with self-reported nasal symptoms following consumption of red wine may respond with less nasal blockage to a wine produced with ecological methods than to wine not labelled as ecologically produced. OBJECTIVE: To compare nasal symptoms following intake of three different wines--one that was ecologically produced and two that were traditionally produced. SUBJECTS AND METHODS: Individuals with self-reported nasal symptoms following consumption of red wine were subjected to controlled intake of three different wines in a double-blinded, randomized, and crossover design. Nasal symptoms and peak nasal inspiratory flow (PNIF) were monitored before and 15, 30, 45, and 60 min following intake of wine. RESULTS: All wines produced nasal symptoms, notably nasal blockage. While b...

Value of nasal mucosa congestion index in choosing treatment strategies for chronic rhinosinusitis.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:48 +0100

CONCLUSION: The mucosa compliance in lesions is determined by the congestion index, enabling us to determine whether the patient is sensitive to pharmacotherapy and to choose surgical management rationally. OBJECTIVE: To explore the correlation between the nasal mucosa congestion index and tissue remodeling in chronic rhinosinusitis (CRS) and to provide objective evidence for clinical choice of therapeutic methods. PATIENTS AND METHODS: Forty-four patients with CRS who underwent nasal endoscopic surgery were enrolled in the study. The congestion indexes of the nasal mucosa were measured using an acoustic rhinometer and specimens were taken from the uncinate process mucosa to evaluate vascular density and degree of fibrosis. The correlations were statistically analyzed. RESULTS: There was a...

Expression of p53, p16INK4A, pRb, p21WAF1/CIP1, p27KIP1, cyclin D1, Ki-67 and HPV DNA in sinonasal endophytic Schneiderian (inverted) papilloma.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:45 +0100

CONCLUSIONS: Human papilloma virus (HPV) was associated with sinonasal inverted papilloma (SIP) in 14/20 (70%) patients with a prevalence of HPV 6/11; alterations of the cell cycle proteins were statistically significant. OBJECTIVES: We investigated SIPs relationships between HPV infection and aberrant expression of cell cycle proteins. MATERIALS AND METHODS: Twenty SIPs were evaluated for p53, p16(INK4a), pRb, p21(WAF1), p27(Kip1), cyclin D1 and Ki-67 expression by immunohistochemistry. HPV was investigated by polymerase chain reaction (PCR). RESULTS: HPV DNA was detected in 14/20 patients with inverted papillomas (IPs) (70%). The majority of tumours showed strong p16, p21, p27, pRb and cyclin D1 staining and little or no p53 expression. Tumours harbouring dysplasia were significantly mor...

Effects of short inter-stimulus intervals on olfactory and trigeminal event-related potentials.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:42 +0100

CONCLUSION: Chemosensory event-related potentials (CSERPs) were identified in all measurements using the 20 s and the 10 s inter-stimulus interval (ISI) protocol, reducing the recording time to 75% or 57% compared with the standard protocol. A possible explanation for the rising CSERP amplitudes by shortening the ISI in CO(2) stimulation is due to a phenomenon known as trigeminal sensitization during repeated stimulation. OBJECTIVES: CSERPs are influenced by the ISI. The aim of this study was to evaluate the changes in CSERPs by decreasing the ISI from 30 s to 20 s or 10 s, respectively. SUBJECTS AND METHODS: Ten normosmic healthy subjects participated this study. Phenyl ethyl alcohol (PEA), hydrogen sulphide (H(2)S) and carbon dioxide (CO(2)) were used in CSERP measurements with different...

Effects of topical drops and sprays on mucociliary transport time and nasal air flow.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:40 +0100

CONCLUSION: This study revealed that the nasal topical drops, which could be purchased without a proper prescription, should not be used randomly and non-selectively. OBJECTIVE: To investigate the effect of nasal drops and sprays on the nasal air flow and mucociliary transport time (MTT) in healthy volunteers with no septal deviation and no history of frequent upper respiratory infection. SUBJECTS AND METHods: Saline, fluticasone propionate drops and sprays, mometasone furoate, budesonide, xylometasoline chloride, fusafungine spray, Ringer's lactate and sea water were selected as the agents to be investigated. Volunteers were subdivided into two subgroups according to their rhinomanometric scores: group 1 consisted of subjects with nasal respiration > or =500 ml at 150 daPa and group 2 ...

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Cytology of the nasal mucosa after total laryngectomy.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:37 +0100

CONCLUSION: This study demonstrates morphological changes in the nasal mucosa as a consequence of functional changes of the nasal cavity after total laryngectomy (TLE). OBJECTIVE: Observation of the changes of the nasal mucosa in patients after TLE. PATIENTS AND METHODS: A cohort observational study contained 30 patients after TLE. These patients underwent nasal endoscopy and cytological and microbiological examination of the nasal mucosa. The control group comprised 30 patients. RESULTS: In patients who underwent TLE, morphological changes occurred in the nasal mucosa. The hyperplasia of the cells in the basal zone was the most remarkable change after TLE. The difference was statistically significant (p=0.0002) in comparison with the control group. No statistically significant difference ...

Surgical intervention represents a feasible option for patients with mild obstructive sleep apnoea.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:35 +0100

CONCLUSIONS: Patients with mild obstructive sleep apnoea (OSA) depict the disease as being detrimental to their health, causing significant symptoms. These patients were found to achieve significant improvements in OSA-related symptoms after surgical intervention. OBJECTIVES: Although the effects of surgical treatment on OSA have been encouraging in many previous studies, little is known about its effects in patients with mild OSA. The aim of our study was to assess the evolution of symptoms experienced by mild OSA patients after surgical intervention. SUBJECTS AND METHODS: This was an observational follow-up study in a university hospital in Finland. The change in daytime and night-time symptoms was assessed by a standardized questionnaire before treatment and after a mean follow-up time ...

Surgical management of retropharyngeal abscesses.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:32 +0100

CONCLUSION: Retropharyngeal abscess (RPA) is a rare, potentially life-threatening disease, requiring appropriate otorhinolaryngologic as well as radiologic diagnostics, and medical and surgical intervention by a transoral, transcervical or transnasal approach in a multidisciplinary setting. OBJECTIVES: The risks and benefits of surgical intervention in patients with RPA were assessed. The main outcome measure was the clinical resolution of the abscess. PATIENTS AND METHODS: A retrospective chart review was performed at a tertiary care university hospital over a period of 28 months. Eleven patients aged 1 to 68 years with the diagnosis of RPA were included. RESULTS: All patients presented with restricted cervical mobility and all patients had CT and/or MRI scan on admission. The mean absces...

Uvulopalatopharyngoplasty in 158 OSAS patients failing non-surgical treatment.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:29 +0100

CONCLUSIONS: Uvulopalatopharyngoplasty (UPPP) in patients with obstructive sleep apnoea syndrome (OSAS) who had failed treatment with continuous positive airway pressure (CPAP) and mandibular retaining device (MRD) was effective and safe. The satisfaction rate was high. We recommend UPPP in selected OSAS patients, especially younger patients. OBJECTIVES: To evaluate the efficacy and complication rate of UPPP. PATIENTS AND METHODS: This was a non-randomized prospective study of 139 men and 19 women, median age 45 years (range 20-75), median body mass index (BMI) 29 (range 20-48), who underwent UPPP. One year follow-up comprised ambulant sleep apnoea recordings and questionnaires with the Epworth Sleepiness Scale (ESS). RESULTS: In all, 76% of the patients underwent sleep recordings preopera...

Outcomes of type II thyroplasty for adductor spasmodic dysphonia: analysis of revision and unsatisfactory cases.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:27 +0100

CONCLUSION: The factors responsible for the observed failures can be broken into two major groups: (1) a wrong indication and (2) an inadequate technique to achieve relief from an excessively tight glottal closure. The use of a titanium bridge in place of a silicone shim was found to be essential. Type II thyroplasty can relieve the symptoms of adductor spasmodic dysphonia (AdSD) when implemented with a modern technique using titanium bridges. OBJECTIVES: To identify the factor or factors that necessitated revision surgery in type II thyroplasty for AdSD, detailed analytical examinations were made of individual cases with unsatisfactory outcomes. PATIENTS AND METHODS: A retrospective analysis of a case series with follow-up periods of 2-5 years. RESULTS: Ninety AdSD patients underwent type...

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Weekly paclitaxel for platin-resistant stage IV head and neck cancer patients.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:24 +0100

CONCLUSIONS: Weekly paclitaxel may be an active and well tolerated chemotherapy regimen for patients with platin-resistant advanced head and neck cancer. OBJECTIVES: Weekly paclitaxel should be an active and well tolerated regimen for palliative treatment of platin-resistant patients with recurrent or metastatic carcinoma of the head and neck. We analyzed the antitumor activity and toxicity profile. PATIENTS AND METHODS: Sixty consecutive patients with advanced head and neck cancer were treated with 1 h infusion of paclitaxel, 80 mg/m(2) weekly, for 6 consecutive weeks. Patients who showed disease response or disease stabilization continued until progression of disease. RESULTS: A total of 719 doses of paclitaxel were administered to the 60 patients. No complete response was observed. Part...

Sleep apnoea in patients after treatment of head neck cancer.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:22 +0100

CONCLUSIONS: The prevalence of sleep apnoea among patients following treatment of head and neck carcinomas seems to be slightly higher than in the normal population. The possible importance of tumour treatment features, especially transient tracheostoma, needs further assessment. OBJECTIVES: The epidemiology of sleep apnoea in patients following the treatment of head and neck cancer remains unclear. This study was undertaken to assess the prevalence of sleep apnoea in head and neck cancer patients by characterizing their clinical, anatomical and tumour treatment features. PATIENTS AND METHODS: Our study examined 31 patients in a prospective non-controlled study using a standardized questionnaire that included the Epworth Sleepiness Scale (ESS) and a polygraph. RESULTS: Six of the 31 patien...

Identification of epidermal growth factor receptor (EGFR) exon 20 single nucleotide polymorphism in Chinese squamous cell carcinoma of head and neck (SCCHN).

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:19 +0100

CONCLUSION: The 78th single nucleotide polymorphism (SNP) in exon 20 of epidermal growth factor receptor (EGFR) might be a predictor of the clinical course of squamous cell carcinoma of the head and neck (SCCHN), and genetic predisposition could influence the progression of SCCHN in Chinese subjects. OBJECTIVE: To analyze the clinical significance of EGFR SNP in Chinese SCCHN patients. MATERIALS AND METHODS: Direct sequencing of exons 18-21 was used to analyze somatic mutations of EGFR. Reverse transcriptase polymerase chain reaction (RT-PCR) was used to evaluate the expression level of EGFR. The chi-square test and Kaplan-Meier method were the main statistical methods used to analyze the correlation of the investigated variables and prognostic significance. RESULTS: In analyzing exons 18-...

Prognostic factors for squamous cell carcinoma of the temporal bone: extensive bone involvement or extensive soft tissue involvement?

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:15 +0100

CONCLUSION: Extensive bone erosion correlated with a worse prognosis of the squamous cell carcinoma (SCC) of the temporal bone but extensive soft tissue involvement did not correlate with prognosis in this study. Resectability of the tumor seems to be major prognostic factor of temporal bone SCC. OBJECTIVE: Prognostic factors for SCC of the temporal bone were evaluated regarding initial clinical symptoms and radiographic imaging. PATIENTS AND METHODS: Clinical symptoms of the patients with primary SCC of the external auditory canal (EAC) or middle ear (ME) were reviewed based on medical records. Correlation of clinical symptoms and cancer severity staging using the modified Pittsburgh classification was analyzed, along with disease-specific survival (DSS). RESULTS: Sixteen patients with pr...

Clinical and pathological analysis of malignant carotid body tumour: a report of nine cases.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:12 +0100

CONCLUSIONS: Malignant carotid body tumour (MCBT) is a clinically rare disease that often invades the carotid artery and cranial nerves. Diagnosis of malignant tumour should be based on extensive invasion of neighbouring organs and distant metastasis. Extensive resection should be undertaken early. Radiotherapy is effective, whereas chemotherapy is uncertain. OBJECTIVE: To summarize the clinical pathological and prognostic characteristics of MCBT and explore methods for diagnosis and treatment. MATERIALS AND METHODS: The study material comprised clinical, pathological, therapeutic and follow-up data concerning nine patients (four males, five females) with MCBT, treated at Tianjin Cancer Hospital between January 1956 and June 2006. The material was analysed retrospectively. Disease duration...

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Endolymphatic hydrops and therapeutic effects are visualized in 'atypical' Meniere's disease.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:09 +0100

Authors: Miyagawa M, Fukuoka H, Tsukada K, Oguchi T, Takumi Y, Sugiura M, Ueda H, Kadoya M, Usami S A 53-year-old male with fluctuating low frequency sensorineural hearing loss and tinnitus, but without vertigo, was evaluated by MRI obtained by intratympanic injection of a gadolinium-based contrast agent (GBCA) before and after the administration of isosorbide. The endolymphatic hydrops was semi-quantitatively evaluated by a 3.0-T MR scanner. For quantification, the affected side/contralateral side ratios were calculated. A gadodiamide (a kind of GBCA)-enhanced space surrounding the endolymph in the affected side with a 0.50 ratio (which may have represented endolymphatic hydrops) improved after isosorbide therapy to a 0.98 ratio. Thus, endolymphatic hydrops was demonstrated in a patie...

Neural response thresholds in the Nucleus Contour cochlear implant before and after stylet removal.

Acta Oto-Laryngologica — Sat, 31 Oct 2009 15:22:06 +0100

CONCLUSION: The study shows that there are differences in the measurement of the action potentials with and without the stylet in the Nucleus Freedom Contour Advance that are higher in the apex than in the base of the cochlea. OBJECTIVES: To determine if there are differences in the intraoperative impedances and in the neural response telemetry threshold values in the Nucleus Freedom Contour Advance before and after stylet removal. SUBJECTS AND METHODS: This was a prospective clinical study. Intraoperative impedances and neural response telemetry in users of the Freedom Contour Advance Cochlear Implant were measured before and after stylet removal. RESULTS: There was a significant reduction in the impedance values of an average 1.5 kOmega+/-2.3 in common ground mode and 1.3 kOmega+/-2.3 fo...

The Ear and the Child (joint RSM/BSA/BAPA Meeting)

NLH - ENT and Audiology - Events — Sat, 31 Oct 2009 14:09:27 +0100

(Source: NLH - ENT and Audiology - Events)

Acousticofacial–Glossopharyngeal Triangle: An Anatomic Model for Rapid Surgical Orientation

Skull Base — Sat, 31 Oct 2009 14:09:25 +0100

This study examined the relationship between the glossopharyngeal nerve (CN IX) and the acousticofacial complex (AFC). Retrosigmoid suboccipital dissections were preformed on 10 cadaveric specimens. A triangle formed by the AFC, CN IX, and the skull base was consistently observed. The cisternal portions of the AFC and CN IX formed two sides of the triangle. The base was formed by a line traversing the respective dural portals of these nerves at the skull base. Triangular proportions were utilized to predict distances from five points along the course of CN IX to a corresponding point along the course of the AFC. Predicted distances were not statistically different when compared with cadaveric measurements in all 10 specimens ( > 0.05). A table of predicted distances between ...

Prognostic factors of long-term outcomes after ossiculoplasty using multivariate analysis

European Archives of Oto-Rhino-Laryngology — Sat, 31 Oct 2009 12:53:01 +0100

The objective of the retrospective study is to investigate the prognostic factors of long-term outcomes following ossiculoplasty. The setting was a tertiary referral and academic center. The series consisted of 269 patients, who underwent ossiculoplasty by the same surgeon between 1989 and 2003 and were followed for more than 5 years. Postoperative hearing outcomes were considered successful, if the postoperative air-bone gap was <20 dB. Prognostic factors were analyzed using multivariate analysis with logistic regression. Successful hearing was achieved in 143 patients (53.2%). The presence of the stapes and primary surgery was significantly favorable predictive factors. Better knowledge of these predictive factors may contribute to improve the surgeon’s judgement and...

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Geniculate Ganglion Meningioma

Skull Base — Sat, 31 Oct 2009 02:43:41 +0100

We present a case of meningioma intrinsic to the geniculate ganglion that presented peculiar features on high-resolution computed tomography (HRCT) and magnetic resonance imaging. On HRCT, we found erosion of the geniculate ganglion with enlargement of the facial canal associated with the appearance of some calcifications within the lesion. These latter findings were confirmed at histological examination. In our patient, the T1- and T2-weighted magnetic resonance images had an intermediate signal and a mild hyperintensity, respectively. Although intracranial meningiomas can have calcifications within the mass, none of the cases of geniculate ganglion meningiomas described in the literature presented with calcifications. To our knowledge, our case is the first with this combination. The pre...

Allogreffe de face et implantologie basale (implant-disques à appuis corticaux).

Revue de Stomatologie et de Chirurgie Maxillo-Faciale — Sat, 31 Oct 2009 00:00:00 +0100

We report a case of total oral rehabilitation with basal implants (cortically anchored disk-design implants) on a patient who received a facial allograft 1 year earlier. OBSERVATION: A 31-year-old patient was suffering from a plexiforme neurofibroma spread into the soft tissues of the oral cavity with huge deformations of the jaws. The operation consisted in pulling out numerous supernumerary impacted teeth, removing unnecessary soft tissues, settling six basal implants in the maxilla and seven in the mandible. The following day, two resin bridges were adjusted and cemented onto the implant abutments. The permanent bridges were settled 2 months and half later. The outcome was still unremarkable 2 years after the implant procedure. DISCUSSION: This case report raises important issues, notab...

Transcondylar Fossa (Supracondylar Transjugular Tubercle) Approach: Anatomic Basis for the Approach, Surgical Procedures, and Surgical Experience

Skull Base — Fri, 30 Oct 2009 14:13:08 +0100

Skull BaseDOI: 10.1055/s-0029-1242193ABSTRACTThe authors clarify the anatomic basis and the usefulness of the transcondylar fossa approach (T-C-F A), in which the posterior portion of the jugular tubercle is removed extradurally through the condylar fossa with the atlanto-occipital joint intact. The authors first performed an anatomic study to identify the area to be removed using cadaveric specimens and then applied the T-C-F A to foramen magnum surgeries. The surgeries included clipping a vertebral artery–posterior inferior cerebellar artery aneurysm in 11 cases, microvascular decompression for glossopharyngeal neuralgia in 15 cases, and removing intradural foramen magnum tumors in 17 cases. Only the condylar fossa was removed, but the approach offered very good visualization of th...

A Case of High-Grade Undifferentiated Sarcoma after Surgical Resection and Stereotactic Radiosurgery of a Vestibular Schwannoma

Skull Base — Fri, 30 Oct 2009 14:13:08 +0100

Skull BaseDOI: 10.1055/s-0029-1242195ABSTRACTStereotactic radiosurgery has become a more frequently used treatment modality for vestibular schwannomas; a few reports of malignant transformation and/or radiation-associated tumors have surfaced. The majority of these reported cases were in patients with underlying neurofibromatosis. The authors report a case of a 74-year-old man with rapid progression of a cerebellar-pontine angle tumor 14 years after surgical resection of a vestibular schwannoma (VS) from the same site, and 6 years after stereotactic radiosurgery. A pathological study of the recent tumor showed a high-grade spindle cell neoplasm that bore no resemblance to the initial schwannoma. The patient had no diagnosis of neurofibromatosis. Secondary malignancy occurred in a non-neuro...

'Positive Support' Will Mean Better Service Provision For Families Of Young Deaf Children, UK

Ear, Nose and Throat News From Medical News Today — Fri, 30 Oct 2009 10:00:00 +0100

An innovative four-year project to help families, service providers and policy makers understand the effectiveness of the different types of support available for young deaf children has come to an end, with some interesting findings. Positive Support in the lives of Deaf Children and their Families was a research project funded by the Big Lottery Fund via a partnership with Deafness Research UK. (Source: Ear, Nose and Throat News From Medical News Today)

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Economic analysis of CPAP for sleep apnea

NLH Specialist Library for ENT and Audiology Latest News — Fri, 30 Oct 2009 08:16:13 +0100

30/10/09 An economic analysis of continuous positive airway pressure for the treatment of obstructive sleep apnea-hypopnea syndrome (Source: NLH Specialist Library for ENT and Audiology Latest News)

Median Facial Cleft with a Frontoethmoidal Encephalocele Treated with Craniofacial Bipartition and Free Radial Forearm Flap: A Case Report

Skull Base — Fri, 30 Oct 2009 08:11:23 +0100

We describe a patient with a median facial cleft with a frontoethmoidal encephalocele, hypertelorism, hydrocephalus, and cerebrospinal fluid (CSF) leakage referred to our department due to numerous complications after previous surgical treatments. An 8-year-old girl, born with median cleft syndrome, underwent neurosurgical repair of the encephalocele at another hospital and cleft lip/palate repair later in the same year. Her hydrocephalus was treated with a ventriculoperitoneal shunt, but she underwent numerous shunt revisions due to recurrent intracerebral infections. In 2008, she was rehospitalized due to a gram-negative meningitis and cerebral abscess. She underwent surgery where part of her frontal bone was removed due to osteomyelitis. She was referred to our department due to persist...

Additional heterozygous 2507A>C mutation of WFS1 in progressive hearing loss at lower frequencies

The Laryngoscope — Fri, 30 Oct 2009 00:00:00 +0100

To describe the audiological profiles in a Japanese family with autosomal dominant hereditary sensorineural hearing loss (SNHL) and to identify the causative gene.A family study at an academic tertiary referral center.A family with autosomal dominant hereditary SNHL was enrolled. Hearing loss (HL) of affected members showed mid-frequency SNHL in childhood and progressed at lower frequencies with age, resulting in low-frequency SNHL. To understand the pathology of HL of this family, we performed a genetic analysis of WFS1, TECTA, and GJB2 by direct sequencing, and further audiovestibular examinations, including speech audiometry, distortion product otoacoustic emissions, electrocochleography, auditory brainstem responses, and electronystagmography for some affected members.A heterozygous A-...

Long-Term Results of Plastipore Prostheses in Reconstruction of the Middle Ear Ossicular Chain

ORL — Thu, 29 Oct 2009 23:00:00 +0100

ORL 2009;71:284-288 (DOI:10.1159/000253487) (Source: ORL)

Application of bone growth factors—the potential of different carrier systems

Oral and Maxillofacial Surgery — Thu, 29 Oct 2009 06:57:34 +0100

Conclusion The variety of carrier materials requires different strategies to either couple growth factors to the material surface or to incorporate them into the carrier matrix. The present review outlines current technical approaches and discusses future trends in the use of carrier materials for bone growth factors. Content Type Journal ArticleCategory Review ArticleDOI 10.1007/s10006-009-0185-1Authors Henning Schliephake, George-Augusta-University Department of Oral and Maxillofacial Surgery Robert-Koch-Str. 40 37075 Göttingen Germany Journal Oral and Maxillofacial SurgeryOnline ISSN 1865-1569Print ISSN 1865-1550 (Source: Oral and Maxillofacial Surgery)

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Bilateral vocal cord paralysis associated with laryngeal myxedema

European Archives of Oto-Rhino-Laryngology — Thu, 29 Oct 2009 06:56:57 +0100

Abstract For managing dyspnea caused by bilateral vocal cord paralysis as a complication of thyroidectomy in the acute postoperative period, reversible vocal cord lateralisation is performed at the authors’ departments. However, in the later postoperative period of thyroidectomy when there is no chance for recovery of the recurrent laryngeal nerves, they perform irreversible procedure. Applying these operative techniques satisfactory breathing can be achieved in about 95% of cases avoiding tracheostomy. In 5% of cases there are other comorbidities in the background of unsuccessful operative results which can cause potential dyspnea as well. From these complications the authors emphasize the role of laryngeal obstruction and myxedema as a consequence of hypothyroidism dev...

Eco-conservation and healthcare ethics: A call to action

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

No abstract. (Source: The Laryngoscope)

Management of the N0 neck in recurrent laryngeal squamous cell carcinoma

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

To evaluate the utility of neck dissections in patients undergoing salvage laryngectomy with a clinically negative neck.Retrospective cohort study.This retrospective review identified 71 patients with N0 necks who underwent salvage laryngectomy from 2001 to 2007. The standard practice of surgeons within our institution was different, thus neck dissections were performed on approximately one half of the patients, creating two groups for comparison. The number of neck dissections with positive metastasis were examined. Postoperative complications, overall survival, and site of recurrence were compared between patients with neck dissection and no neck dissection.Thirty-eight patients underwent 71 neck dissections concurrently with salvage laryngectomy. A total of 33 patients had salvage laryn...

Outcomes of minimally invasive endoscopic resection of anterior skull base neoplasms

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

This study validated technical feasibility of MIER for diversity of benign and malignant ASB histopathology. Majority of patients were able to avoid adjunct craniotomy, whereas lumbar drainage was utilized in selective cases. This surgical strategy resulted in low complication rate and acceptable disease-free survival in patients with advanced T3 and T4 malignant lesions. Future studies should focus on multicenter trials to facilitate more robust survival analysis and comparison to open surgical approaches. Laryngoscope, 2009 (Source: The Laryngoscope)

Multifactorial dysphagia: Diffuse idiopathic skeletal hyperostosis and eosinophilic esophagitis

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

Swallowing is a complex, multistage event with oral, pharyngeal, and esophageal phases. A thorough clinical examination for swallowing complaints begins to differentiate whether the problem is due to anatomic, mechanical, or neurologic etiologies. Based on the clinical suspicion, additional tests may be beneficial, including fluoroscopic and direct imaging methods, and electrophysiologic measurements. A multidisciplinary approach may also be advantageous, as in this case of dysphagia from diffuse idiopathic skeletal hyperostosis and eosinophilic esophagitis, which incorporated care from otolaryngology, speech pathology, orthopedic surgery, and gastroenterology. Laryngoscope, 2009 (Source: The Laryngoscope)

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Patterns of recurrence and survival of head and neck adenoid cystic carcinoma after definitive resection

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

To determine factors impacting recurrence and long-term survival of adenoid cystic carcinoma (ACC) of the head and neck after definitive resection.Retrospective cohort study at an academic tertiary care hospital.Patients with ACC of the head and neck treated at our institution were reviewed. Those not receiving surgery, or with metastatic disease were excluded. Clinicopathological data on each patient was collected.Of 113 patients identified with ACC, 99 were studied. The overall median survival for the cohort was 71 months (mean ± standard deviation, 94 ± 79 months). American Joint Committee on Cancer (AJCC) tumor stage and N stage were independent predictors of survival on multivariate analysis. Mean overall survival (P = .001) and time to recurrence (P = .006) were lower for patients ...

Primary middle ear Epstein-Barr virus-related lymphoepithelial carcinoma: Case reports and systematic review

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

To report two cases of primary lymphoepithelial carcinoma in the middle ear and to determine the optimal treatment for such lesions.Case reports and a systematic review of the literature.Primary lymphoepithelial carcinoma in the middle ear is an exceptionally rare condition with only two other cases reported in the literature. There appears to be an association with Epstein-Barr virus infection and in those patients originating from the Guangdong province of China, much as is the case for similar lesions found in the nasopharynx. Piecemeal rather than en bloc excision, in combination with adjuvant radiotherapy, appears to adequately control the disease.Primary lymphoepithelial carcinoma of the middle ear is a rare lesion, which when treated has a good prognosis. Laryngoscope, 2009 (Source:...

Is severe epistaxis associated with acetylsalicylic acid intake?

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

Epistaxis represents a very common emergency in any ear, nose, and throat (ENT) department around the world. Despite other risk factors, acetylsalicylic acid (ASA) contributes to nosebleeds by its intrinsic ability to impair thrombocyte aggregation. The aim of this study was to investigate the influence of ASA on the severity of epistaxis and to compare it with other potential risk factors.A prospective cohort study was performed at the ENT department of University Hospital Zurich.A total of 591 events were evaluated concerning surgical interventions and the length of in-hospital stay. Further analyses regarding recurrences and number of treatments and a specially designed severity score, as well as other outcome parameters, were performed.Ninety-nine patients needed to stay in-hospital fo...

Management of patients treated with chemoradiotherapy for head and neck cancer without prophylactic feeding tubes: The University of Pittsburgh experience

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

Mucositis and dysphagia are common complications of chemoradiotherapy (CRT) for head and neck cancer that may necessitate nutritional support with a gastrostomy tube (G-tube).We reviewed records of patients who underwent and completed CRT, which included at least one traditional chemotherapeutic, for previously untreated head and neck cancer. G-tubes were placed as needed. The timing and duration of G-tube placement and treatment-related complications and risk factors for long-term G-tube use were analyzed.A total of 91 consecutive patients who received CRT, 68 as primary and 23 as postoperative treatment, were studied. Radiation doses ranged from 59.4 to 74 Gy (median, 70 Gy). Seventy-nine percent of patients received platinum-based therapy during CRT. Severe mucositis occurred in 40% of ...

Improvement of respiratory compromise through abductor reinnervation and pacing in a patient with bilateral vocal fold impairment

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

To determine whether respiratory compromise from bilateral vocal fold impairment (paralysis) can be objectively alleviated by reinnervation and pacing.A patient with paramedian vocal folds and synkinesis had a tracheotomy for stridor after bilateral laryngeal nerve injury and Miller Fisher syndrome. One posterior cricoarytenoideus (PCA) received a nerve-muscle pedicle fitted with a perineural electrode for pacemaker stimulation. The airway was evaluated endoscopically and by spirometry for up to 1 year.Bilateral vocal fold patency during quiet breathing was reversed to active vocal fold adduction during tracheal occlusion. Peak inspiratory flows (PIFs) were significantly higher (P < .001) after reinnervation. PIFs and glottic apertures increased further under stimulation (42 Hz, 1-4 mA, 42...

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Chronic vocal fold scar restoration with hepatocyte growth factor hydrogel

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

Therapeutic challenges exist in the management of vocal fold scarring. We have previously demonstrated the therapeutic potential of hepatocyte growth factor (HGF) in the management of acute phase vocal fold scarring using a novel hydrogel-based HGF drug delivery system (DDS). However, the effect of HGF on matured vocal fold scarring remains unclear. The current study aims to investigate the effect of HGF-DDS on chronic vocal fold scarring using a canine model.Animal model.Vocal folds from eight beagles were unilaterally scarred by stripping the entire layer of the lamina propria; contralateral vocal folds were kept intact as normal controls. Six months after the procedures, hydrogels (0.5 mL) containing 1 [mu]g of HGF were injected into the scarred vocal folds of four dogs (HGF-treated gro...

Pediatric cholesteatoma and variants in the gene encoding connexin 26

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

Connexin 26 is a gap junction protein encoded by the GJB2 gene. It is expressed in cholesteatoma, and mutations cause proliferative skin disorders and sensorineural hearing loss (SNHL). Deletions of GJB6, which encodes connexin 30, cause SNHL in a digenic manner with a heterozygous GJB2 mutation. We hypothesize that GJB2 and GJB6 mutations might influence the development of cholesteatoma.Prospective observational study to identify GJB mutations in pediatric cholesteatoma.Peripheral blood samples from 98 children with cholesteatoma were screened for mutations in the GJB2 gene by direct sequencing of the coding region (exon 2 and the intron/exon boundary). Deletions of the GJB6 gene were tested using multiple ligation probe amplification methods. GJB status was compared with other population...

Vocal process granuloma and glottal insufficiency: An overlooked etiology?

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

Vocal process granuloma has been attributed to intubation, laryngopharyngeal reflux, and phonotraumatic/hyperfunctional vocal behaviors. Vocal process granuloma has recurrence rates following surgical excision approaching 92%. We hypothesize that a portion of persistent or idiopathic cases of vocal process granuloma result from underlying glottal insufficiency (GI) caused by paresis, scar, or atrophy. Our goal was to examine our vocal process granuloma population and determine the incidence of GI, treatment interventions, and outcomes.Retrospective chart review.Thirty-four patients with vocal process granuloma were divided into surgically or conservatively managed groups. Patients were identified if they carried a diagnosis of GI. The time to resolution and number of recurrences within the...

Transoral resection of short segment Zenker's diverticulum and cricopharyngeal myotomy: An alternative minimally invasive approach

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

Transoral treatment of cricopharyngeal bar and small Zenker's diverticulum remains a challenge. We propose a new transoral approach for transoral cricopharyngeal myotomy (TOCPM) for patients with cricopharyngeal spasm and pharyngeal bar, and for transoral resection of diverticula (TORD) with cricopharyngeal myotomy in the patient with small ( (Source: The Laryngoscope)

A new mouse laryngeal transplantation rejection grading system

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

Development of a rat laryngeal transplantation model allowed for the first total human laryngeal transplantation by the senior author in 1998. In an effort to further our knowledge of the immune system's role in laryngeal rejection, a change to the mouse model was required. Prior to initiating immunosuppressive research protocols, a reliable mouse larynx rejection classification had to be established.Animal study.Thirty-one mouse laryngeal transplants (C57 BL/6 donors to C3H recipients) were performed and allowed to reject. Six time points were evaluated histologically: 1, 3, 5, 7, 9, and 15 days post-transplant. Eight anatomic sites were evaluated and assigned a point value. A linear regression model was constructed using the group number as the response and the scores from the eight hist...

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Patient reported voice outcome in recurrent respiratory papillomatosis

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

In this study cohort, 68% scored above the VHI cutoff point, and 18% had an increased risk for depression or anxiety disorders (HADS). VHI scores were related to age, time between consecutive surgeries, time since last surgery, and passive coping. They were not related to gender, onset of RRP, or location. VHI scores were related to the SF-36 subscales social functioning (r = -0.43) and mental health (r = -0.43).Patients with RRP often report voice problems in daily life, and this is related to (a passive) coping style, social functioning, and mental health. Psychosocial intervention targeting an adaptive coping style may be beneficial in selected cases. Laryngoscope, 2009 (Source: The Laryngoscope)

Decoy NF-[kappa]B fortified immature dendritic cells maintain laryngeal allograft integrity and provide enhancement of regulatory T cells

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

The increased risk of malignancy associated with post-transplant immunosuppression limits the potential of laryngeal transplantation as a reconstructive option. This risk may be mitigated by utilizing decoy nuclear factor kappa B (NF-[kappa]B) immature dendritic cells (iDC) to provide donor-specific tolerance. The purpose of this study was to explore whether tolerogenic properties of iDC can be applied to composite tissue transplantation.Animal study.Five iDC-injected mice were euthanized at 15, 30, and 60 days post-laryngeal transplant. Control groups included five transplanted mice without immunosuppression, one iDC-injected mouse euthanized prior to transplantation, one mouse without injection or transplantation, and one mouse administered mature DC to serve as an accelerated rejection ...

Clarithromycin inhibits rhinovirus-induced bacterial adhesions to nasal epithelial cells

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

We investigated the inhibitory effects of clarithromycin (CM) on the rhinovirus (RV)-induced expression of fibronectin (Fn) and carcinoembryonic antigen-related cell adhesion molecules (CEACAMs), which act as major receptors for Staphylococcus aureus and Haemophilus influenzae, respectively. We further investigated the effects of CM on secondary S. aureus and H. influenzae adhesions to RV-infected primary human nasal epithelial cells (HNECs).Cells were pretreated with 10 [mu]M CM 24 hours before RV-16 infection and for 48 hours thereafter. The expression levels of Fn and CEACAMs were assayed by reverse transcriptase-polymerase chain reaction and Western blotting. Bacterial adhesion to cells was assessed by confocal microscopy and the fluorescence intensity of adherent bacteria was analyzed...

Bone chip-induced rhinosinusitis

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

This case report describes both the pathophysiology and management of chronic rhinosinusitis (CRS). Specifically, we report a case of chronic maxillary rhinosinusitis with a free-floating maxillary sinus calcification (bone chip). After obtaining the computed tomography scan, the patient underwent endoscopic sinus surgery, with removal of the uncinate, enlargement of the diseased natural ostium of the maxillary sinus, and removal of the diseased bone chip. This eliminated the nidus for infection, ultimately restoring mucociliary flow. Laryngoscope, 2009 (Source: The Laryngoscope)

Trends in the management of vestibular schwannomas at Johns Hopkins 1997-2007

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

To assess trends in the management of unilateral vestibular schwannomas over an 11-year period and to identify disease- and provider-related influences.Retrospective chart review.Subjects presented to the Department of Otolaryngology-Head and Neck Surgery and the Department of Neurosurgery for management of unilateral vestibular schwannoma from 1997 through 2007, with at least two visits within the first year of presentation. The proportion of patients for whom initial management consisted of observation, surgical resection, or radiation therapy was determined, and the relative influence of study year, patient age, hearing status, and tumor size was analyzed.Over the study period there was an increase in the proportion of cases that were observed with follow-up scanning (10.5% to 28.0%) an...

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Spiral ganglion loss outpaces inner hair cell loss in endolymphatic hydrops

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

This study quantifies the relationship between neuronal degeneration and hair cell degeneration in ELH to evaluate the hypothesis that a primary neural insult would yield greater loss in the spiral ganglion than at the inner hair cell level.Following induction and histopathologic confirmation of endolymphatic hydrops in guinea pigs, the degree of hydrops, spiral ganglion loss, and hair cell degeneration were quantified and compared.Guinea pigs with surgically induced unilateral hydrops were sacrificed and their cochleas preserved. Hydrops severity and spiral ganglion density were quantified using automated methods. Hair cells were counted manually. Values were normalized against the contralateral ear to create loss indexes.Inner hair cell (IHC) loss at the apex is significantly lower than ...

Transoral approach for plunging ranula - 10-Year experience

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

In this study, we demonstrated our experience managing PRs via transoral excision of the SLG with marsupialization.Retrospective study.We retrospectively reviewed 20 patients at Chang Gung Memorial Hospital, Linkou, between January 1999 and April 2009. All patients received preoperative computed tomography or magnetic resonance imaging and were clinically diagnosed with PR. At surgery, the SLG was excised transorally with preservation of Wharton's duct and lingual nerve. The mucus contents of the PRs were drained through the posterior edge of the mylohyoid muscle.Two patients were found to have final diagnosis of lymphangioma. Eighteen patients were eligible for analysis. The age distribution ranged from 6 to 48 years old. Sexual distribution was equally distributed. The successful rate wa...

Tissue-engineered allograft tracheal cartilage using fibrin/hyaluronan composite gel and its in vivo implantation

The Laryngoscope — Thu, 29 Oct 2009 00:00:00 +0100

Treatment and management of tracheal defects remain challenging in head and neck surgery. Various reconstruction techniques have been used, with no consensus on the best approach. The purpose of this study was to explore a novel strategy to fabricate tissue-engineered trachea by using fibrin/hyaluronic acid (HA) composite gel and evaluate the feasibility of creating tracheal cartilage.A preliminary animal experiment.Chondrocytes from rabbit cartilage were expanded and seeded into a culture dish at high density to form mechanically stable allograft tracheal cartilage using fibrin/HA composite gel. After a longitudinal cervical skin incision, the trachea was exposed and a rectangular defect (1 × 0.5 cm) was created on the cervical trachea by scalpel on six rabbits. Tissue-engineered cartila...

Proliferation, migration and apoptosis of periodontal ligament cells after tooth replantation

Oral Diseases — Thu, 29 Oct 2009 00:00:00 +0100

Conclusion: These results suggest that both cell proliferation and apoptosis occur in different patterns and at different times to maintain regular spacing of the PDL after tooth replantation. (Source: Oral Diseases)

Implant migration into maxillary sinus: description of two asymptomatic cases

Oral and Maxillofacial Surgery — Wed, 28 Oct 2009 20:26:03 +0100

Conclusion Both treatment modalities treatments allowed installation of implant-supported prosthesis. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s10006-009-0184-2Authors Leandro Eduardo Kluppel, State University of Campinas Department of Oral Diagnosis, Oral and Maxillofacial Surgery Division Piracicaba Dental School Piracicaba BrazilSaulo Ellery Santos, State University of Campinas Department of Oral Diagnosis, Oral and Maxillofacial Surgery Division Piracicaba Dental School Piracicaba BrazilSergio Olate, State University of Campinas Department of Oral Diagnosis, Oral and Maxillofacial Surgery Division Piracicaba Dental School Piracicaba BrazilFrancisco Wagner Vasconcelos Freire Filho, Fortaleza University Oral and Maxillofacial Surgery Fortaleza Brazi...

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Modified intratympanic treatment for idiopathic sudden sensorineural hearing loss

European Archives of Oto-Rhino-Laryngology — Wed, 28 Oct 2009 07:10:13 +0100

Abstract Steroids are the only proven drugs in the treatment for idiopathic sudden sensorineural hearing loss. In the recent studies, it has been suggested that, steroids delivered through the intratympanic route obtained higher perilymph levels, resulting in better hearing outcomes. The purpose of this study is to compare the hearing outcomes of the two routes of steroid treatment: intratympanic route and systemic route. In this prospective study, 60 consecutive patients with idiopathic sensorineural hearing loss treated between January 2005 and September 2008 were enrolled: 29 were in the intratympanic steroid group (ITSG) and 31 were in the systemic steroid group (SSG). In the ITSG, 5 intratympanic injections of dexamethasone were performed with the dose of 4 mg/ml...

Three-dimensional imaging of the larynx for pre-operative planning of laryngeal framework surgery

European Archives of Oto-Rhino-Laryngology — Wed, 28 Oct 2009 07:10:13 +0100

We examined four cadaver larynx and one patient larynx. In the five larynges, all relevant structures and landmarks could be 3D visualised. Superimposing of two HRCT scans shows that when the arytenoids move from ‘respiration’ to ‘phonation’, they perform a rotating, translating and tilting motion. Moreover, we could demonstrate that the vocal fold elongates by 7% with cricothyroid approximation. We conclude that MIMCS® is well suited for 3D imaging of the larynx, analysis of laryngeal biomechanics and pre-operative planning of LFS procedures. Content Type Journal ArticleCategory LaryngologyDOI 10.1007/s00405-009-1129-yAuthors Claudio Storck, University Hospital Basel Department of Otorhinolaryngology, Head and Neck Surgery and Phoniatrics Petersgraben 4 4031 Basel Switze...

Comparison of biofilm formation on new Phonax and Provox 2 voice prostheses - A pilot study

Head and Neck — Wed, 28 Oct 2009 00:00:00 +0100

In voice rehabilitation for laryngectomized patients, voice prosthetic biofilm formation is still an unsolved problem. Design and materials of voice prostheses have been altered by manufacturers to improve function and extend the lifetime of devices. The goal of the study was to investigate biofilm formation on Provox 2 and Phonax, recently introduced voice prostheses made of thermoplastic polyurethane.Five laryngectomized patients were equipped with both Phonax and Provox 2 voice prostheses. Microbial colonization was analyzed using standard microbiological methods. Biofilm formation and material infiltration were illustrated using scanning electron microscopy, fluorescence microscopy, and thin-section light microscopy.Although no differences in quality or quantity of microbial colonizati...

Information for Readers

Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:16:00 +0100

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Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:16:00 +0100

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Editorial Board

Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:16:00 +0100

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Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:16:00 +0100

(Source: Otolaryngology - Head and Neck Surgery)

Correction

Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:16:00 +0100

Due to a printer error, the figure in a letter to the Editor for the June 2008 issue of Otolaryngology-Head and Neck Surgery was distorted. Della Santina CC. Cochleostomy placement and vestibular injury. Otolaryngol Head Neck Surg. 2008 Jun;138(6):812-3. Please see the correct here. (Source: Otolaryngology - Head and Neck Surgery)

Correction

Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:16:00 +0100

The following article, which also ran in the April 2007 issue of Otolaryngology-Head and Neck Surgery, contained the same typographical error noted in the previous correction. (Source: Otolaryngology - Head and Neck Surgery)

Correction

Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:16:00 +0100

The following article, which ran in the April 2007 issue of Otolaryngology-Head and Neck Surgery, contained an error. “Biofilm formation in cochlear implants with cochlear drug delivery channels in an in vitro model” by TA Johnson, KA Loeffler, RA Burne, CN Jolly, and PJ Antonelli, pages 577-582. Under the Materials and Methods section, page 579, Quantitative Microbiology subheading, “… and plating 100 mL on 5% sheep blood agar.” should have been “… and plating 100 μL on 5% sheep blood agar.” (Source: Otolaryngology - Head and Neck Surgery)

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Modification of the mandibular genial osteotomy for “drop down” access to the base of the tongue

Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:15:58 +0100

We describe our modification of the pedicled genial osteotomy during mandibular lingual releasing access. (Source: Otolaryngology - Head and Neck Surgery)

Prevention of unplanned pharyngocutaneous fistula in salvage laryngectomy

Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:15:58 +0100

We present the formula used by the senior author at the Downstate Medical Center and affiliated hospitals in his last 11 cases, in which healing occurred without unplanned fistula formation, and length of stay was 10 days. Prior to the introduction of the formula, out of nine salvage laryngectomies (historical controls), the same surgeon had six cases of wound dehiscence and unplanned occurrence of a pharyngocutaneous fistula (67%). In these nine cases, one or more components of the formula were not used. Results using this fistula reduction formula appear superior to other reported attempts at fistula rate reduction and thus warrant reporting. (Source: Otolaryngology - Head and Neck Surgery)

Additional diagnostic value of 18F-FDG PET-CT in detecting retropharyngeal nodal metastases

Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:15:58 +0100

Conclusion: 18F-FDG PET-CT, when used in combination with CT/MRI, increases diagnostic efficacy in the detection of RPLN metastases and may therefore be useful in screening high-risk patients. (Source: Otolaryngology - Head and Neck Surgery)

2D-DIGE proteomic characterization of head and neck squamous cell carcinoma

Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:15:58 +0100

Conclusions: Downregulation of cornulin is a prominent feature of the molecular signature of HNSCC identified by comparative proteomics. Cornulin may represent a link between HNSCC and other pathologies arising in stratified squamous epithelium. (Source: Otolaryngology - Head and Neck Surgery)

Volume and distances of the maxillary sinus in craniofacial deformities with midfacial hypoplasia

Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:15:58 +0100

Conclusion: There were differences in the structure of the maxillary sinuses among patients with different CFDs. (Source: Otolaryngology - Head and Neck Surgery)

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In vitro testing of tympanostomy tube occlusion

Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:15:53 +0100

Conclusions: The in vitro TT chamber simulates the in vivo environment and yields results consistent with in vivo observations. This model system may allow for rapid prototyping and evaluation of new TTs that may be less vulnerable to occlusion. (Source: Otolaryngology - Head and Neck Surgery)

Complications/adverse effects of maxillomandibular advancement for the treatment of OSA in regard to outcome

Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:15:53 +0100

Conclusion: Maxillomandibular advancement can induce local adverse effects and cosmetic changes, but they seem to be considered as secondary to the patients according to the surgical outcome. (Source: Otolaryngology - Head and Neck Surgery)

Direct drug application to the round window: A comparative study of ototoxicity in rats

Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:15:53 +0100

Conclusion: Situating a sponge soaked in kanamycin and furosemide on the round window membrane through the ventral approach is a reliable method to provoke local ototoxicity in rats. (Source: Otolaryngology - Head and Neck Surgery)

Hearing outcomes of daily intratympanic dexamethasone alone as a primary treatment modality for ISSHL

Otolaryngology - Head and Neck Surgery — Tue, 27 Oct 2009 14:15:53 +0100

Conclusion: IT dexamethasone might be a good primary treatment method for ISSHL; but, for the management of ISSHL, we should keep in mind the differences in hearing outcomes with regard to frequency. (Source: Otolaryngology - Head and Neck Surgery)

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Excessive Antibiotic Prescription Caused By Perceived Parent-Pressure

Introduction to ENT Course in association with the Royal College of Surgeons of England

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Early Scents Really Do Get 'Etched' In The Brain

Bilateral cochlear implantation: Current concepts, indications, and results

Altered fractionation and adjuvant chemotherapy for head and neck squamous cell carcinoma

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The 28th European Course on The Management of Tinnitus and Hyperacusis

MEG studies of auditory processing

Techniques in Facial Plastics incorporating Minimal Invasive Techniques

Auditory modelling and clinical applications: Current findings and applications from the Hearing Dummy Project (provisional title)

Central auditory processing: Current research and implications for clinical practice

Mechanisms of auditory streaming in the songbird primary cortical fields

Supraglottic swelling may not correlate with tongue swelling in angiotensin converting enzyme inhibitor-induced angioedema

Results of vocal rehabilitation using tracheoesophageal voice prosthesis after total laryngectomy and their predictive factors

Rhino-orbital mucormycosis and aspergillosis: differences in outcome, clinical and imaging characteristics

Laryngopharyngeal reflux is not always secondary to gastroesophageal reflux

10th to 12th March 2010: The 3rd Newcastle Head and Neck dissection course

Tinnitus and Hyperacusis: Developing Evidence Based Practice

Presented At CHEST 2009 - New Pediatric Lung Health Research

In reference to Lemierre's Syndrome: A Systematic Review (Laryngoscope 2009;119:1552-1559)

Meeting Report - The NIDCR 2nd Salivary Gland Tumor Meeting, November 2008

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Guidelines for referral to audiology of adults with hearing difficulty

New systematic review on inferior turbinate reduction surgery outcomes in children

Detection of metachronous esophageal squamous carcinoma in patients with head and neck cancer with use of transnasal esophagoscopy

Complementary and alternative medicine use in patients presenting to a head and neck oncology clinic

Immunostaining patterns of CD31 and podoplanin in previously untreated advanced oral/oropharyngeal cancer: Prognostic implications

Pilot testing of an assessment tool for competency in mastoidectomy

Accelerated fractionation radiotherapy and late intensification with 2 intra-arterial cisplatin infusions for locally advanced head and neck squamous cell carcinoma

Globus sensation and increased upper esophageal sphincter pressure with distal esophageal acid perfusion

A new cochlear implant electrode design for preservation of residual hearing: a temporal bone study.

Vestibular neuritis: recurrence and incidence of secondary benign paroxysmal positional vertigo.

Improved prognosis for localized malignant lymphomas of the head and neck.

Digital volume tomography (DVT) measurements of the olfactory cleft and olfactory fossa.

Postural stability during visual stimulation and the contribution from the vestibular apparatus.

Localization of the sentinel lymph node in tongue VX2 carcinoma via indirect CT lymphography combined with methylene blue dye injection.

Vestibular schwannoma with absent vestibular evoked myogenic potentials to clicks but normal ABR, caloric responses and vestibular evoked myogenic potentials to 500 Hz tone bursts.

A modified septoplasty with three high tension lines resection.

Imaging of cochlear implant electrode array with flat-detector CT and conventional multislice CT: comparison of image quality and radiation dose.

Endogenous protection against oxidative stress caused by cisplatin: role of superoxide dismutase.

Moderately differentiated neuroendocrine carcinoma of the larynx.

Kimura's disease in a white man

Nuclear factor-[kappa]B expression as a novel marker of radioresistance in early-stage laryngeal cancer

Anaplastic thyroid cancer: Clinical outcomes with conformal radiotherapy

Canadian Canadian Association of Speech-Language Pathologists and Audiologists Conference 2010

The ERA & OAE Course

6th Widex Congress of Paediatric Audiology

Emergency Skills in Maxillofacial Surgery

Combined Universities Course in Advanced Surgical Otology

Section of Otology and Laryngology & Rhinology

International Mastercourse on Endoscopic Sinus Surgery

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Hearing and vestibular functions after plugging surgery for the posterior semicircular canal.

An animal model of cochlear implantation with an intracochlear fluid delivery system.

Utility of immunologic parameters in the evaluation of Meniere's disease.

Assessment of the reuniting duct by three-dimensional CT rendering.

Endolymphatic space imaging in patients with delayed endolymphatic hydrops.

Estrogen receptors in the inner ear during different stages of pregnancy and development in the rat.

Pressure changes in the human middle ear without opening the eustachian tube.

The imbalance of enzymatic antioxidants in cholesteatoma.

Acute tympanic membrane perforations and the early immunological response in rats.

Vestibular evoked myogenic potentials of children with inner ear malformations before and after cochlear implantation.

Vestibular evoked myogenic potentials in chronic otitis media before and after surgery.

Effect of topical use of mitomycin C and 5-fluorouracil on the closure time of myringotomies created by radiofrequency unit.

Bedside therapeutic experiences with horizontal canal benign paroxysmal positional vertigo (cupulolithiasis).

Poly(ADP-ribose) polymerase-1 (PARP-1) longer alleles spanning the promoter region may confer protection to bilateral Meniere's disease.

A head-tilt caloric test for evaluating the vertical semicircular canal function.

Wine produced by ecological methods produces relatively little nasal blockage in wine-sensitive subjects.

Value of nasal mucosa congestion index in choosing treatment strategies for chronic rhinosinusitis.

Expression of p53, p16INK4A, pRb, p21WAF1/CIP1, p27KIP1, cyclin D1, Ki-67 and HPV DNA in sinonasal endophytic Schneiderian (inverted) papilloma.