bluuebunny/crossref_metadata_2025 huggingface dataset:
The Rat as a Potential Animal Model for Dysphonia
Authors: Zolkind Paul A. , Last Jordan , Shuminov Oktay , Silverman Joshua B. , Sundaram Krishnamurthi , Stewart Mark , Kollmar Richard
Published: August 2013

Objectives:

Dysphonia, or hoarseness, is the primary complaint of patients with unilateral vocal‐fold paralysis due to damage to the recurrent laryngeal nerve (RLN). Animal models for RLN injury exist but are generally limited to histological, endoscopic, and electrophysiological approaches. As a step towards using the rat as a model system for dysphonia, we have characterized ultrasonic vocalizations in healthy adult animals.

Methods:

Ultrasonic vocalizations were evoked individually from adult male Sprague‐Dawley rats by manual stroking on two different days one month apart. The vocalizations were visualized and recorded by using an ultrasound microphone attached to a computer. Parameters such as duration, amplitude, pitch, and entropy were measured for each vocalization as well as the preceding silent period with Sound Analysis Pro 2011 software.

Results:

For a total of 980 vocalizations from five rats, the following parameter values (mean ± standard deviation) were obtained: duration, 14 ± 10 msec; amplitude, 13 ± 6 relative units; pitch, 57 ± 7 kHz; and entropy, ‐3.9 ± 1.0. No differences were noticed among animals or days. However, the vocalizations were distinct from the background noise during the preceding silent period: amplitude, ‐1.4 ± 2.9 relative units; pitch, 42 ± 6 kHz; and entropy, ‐1.2 ± 0.9. Virtually none of the vocalizations were located in the 20‐kHz band associated with distress.

Conclusions:

Ultrasound vocalizations can be recorded from adult rats easily and reliably. The features of the vocalizations are consistent among individuals and over time. Experiments with RLN‐lesioned animals are now underway.
Speech Range Profile for Moderate‐to‐Severe Hearing Impaired Persons
Authors: Siupsinskiene Nora , Sruogiene Inga J.
Published: August 2013

Objectives:

Analyze the differences between speech range profile (SRP) parameters in moderate‐to‐severe hearing impaired and well‐hearing persons and to establish the key parameters for speech discrimination.

Methods:

Data were analyzed in a retrospective study of SRPs in combination with voice range profiles (VRP) recorded at a university hospital during 2001‐2004. Standard protocols were derived from 80 adult patients (26 males, 54 females) with moderate‐to‐severe hearing loss without hearing‐aids or laryngeal pathology. Ninety‐eight non‐hearing impaired age and gender matched persons (33 males, 65 females) with normal voices were also analyzed. Eight SRP parameters were assessed: fundamental frequency (F0), maximum speaking frequency and speaking tone range; habitual intensity, maximum speaking intensity and speaking intensity range; location of F0 within VRP pitch range, and slope of speaking curve.

Results:

When compared to ‐normal hearing persons, both genders of hearing impaired individuals exhibited significantly decreased mean values of speaking intensity range and increased in percent of location of F0 within the VRP pitch range (P < 0.05). Overall discrimination accuracy of these two SRP key parameters was 93.3%.

Conclusions.

Moderate‐to‐severe hearing impaired persons demonstrated restricted speaking capabilities in comparison to non‐hearing impaired persons. Key parameters of speech range profile may be useful for assessment of hearing and speech rehabilitation efficacy.
Subglottic Air Escape Causing Subcutaneous Emphysema
Authors: Lerrick Andrew J.
Published: August 2013

Objectives:

Closure of a tracheocutaneous fistula risks air escape into the anterior neck. Vocal cord augmentation establishes a subglottic pressure gradient during exhalation. We present a patient who underwent these procedures concurrently in whom subcutaneous subsequently developed.

Methods:

A 66 year‐old female developed a neck abscess following a dental procedure. She presented to the ER with a compromised airway, requiring intubation. She underwent two separate neck abscess drainage procedures by OMFS. Prolonged intubation necessitated a tracheotomy, performed by cardiothoracic surgery. She was subsequently weaned and decannulated.

Results:

She was referred for dysphonia and a micro‐tracheocutaneous fistula. Laryngoscopy revealed left vocal cord paralysis, not thought to be iatrogenic. Fistula closure with vocal cord augmentation was proposed. Fistula tract excision was followed by a two‐layer muscle and skin closure. An air‐tight seal was confirmed on high‐pressure ventilation. Gelfoam was injected into the left vocal cord. She was discharged the morning after surgery. Twelve hours later she returned to the ER with rapid onset of cervicofacial subcutaneous emphysema. A pressure dressing was applied to the anterior neck. The subcutaneous emphysema subsided, being sub‐totally resorbed within 24 hours.

Conclusions:

Despite the delay in onset, once conditions developed a percentage of subglottic air preferentially escaped through the small defect in the anterior tracheal wall, rather than exclusively through the larger hemi‐glottic aperture, causing subcutaneous emphysema. Caution should be exercised in performing these procedures simultaneously.
Supraglottic Laryngeal Abscess of Idiopathic Etiology Secondary to Community‐Acquired, Methicillin‐Resistant Staphylococcus aureus
Authors: Marston Alexander P. , Lalich Ian J. , Dearking Amy C. , Orvidas Laura J.
Published: August 2013

Objectives:

Prior to the widespread use of antibiotics, laryngeal abscesses typically presented secondary to systemic illnesses. Today, laryngeal abscesses are rarely observed, and most result from disease processes intrinsic to the larynx, such as airway instrumentation or malignancy. This report describes the unique case of an arytenoid abscess of insidious etiology. A supraglottic laryngeal abscess of this anatomic location has not previously been described in the literature and is of particular interest given the increasing prevalence of community acquired, methicillin‐resistant Staphylococcus aureus (MRSA). We seek to characterize the presentation, work‐up, and treatment of this condition.

Methods:

A single case of an arytenoid abscess is described. The electronic medical record was used to collect demographic and clinical information.

Results:

The patient had no prior history of laryngeal disease or airway instrumentation; however, her past medical history was significant for poorly controlled type 1 diabetes mellitus, as well as alcohol and methamphetamine abuse. Severe dysphagia and hoarseness prompted computerized tomographic imaging of the neck, which revealed a laryngeal abscess. Incision and drainage under direct laryngoscopy identified an abscess involving the right arytenoid with extension into the interarytenoid space. Cultures at the time of surgery grew MRSA, and biopsy of the abscess cavity was negative for malignancy. Following surgical drainage and appropriate antibiotic therapy, the patient recovered without long‐term sequelae.

Conclusions:

Laryngeal abscesses are rarely encountered in modern practice. This case offers a previously undescribed example of an idiopathic arytenoid abscess in the setting of an increasingly common infection, community acquired, MRSA.
3D‐FIESTA Screening for Unilateral Auditory Dysfunction
Authors: Lee Yun‐Jae , Kwak Min‐Kyu , Park Chul‐Won , Lee Seung Hwan , Min Hyun Jung , Jeong Jin Hyeok
Published: August 2013

Objectives:

In patients with unilateral auditory dysfunctions such as tinnitus and hearing loss, differential diagnosis of cochlear, retrocochlear, or vascular problems is important. Because unilateral hearing loss and tinnitus patients are increasing recently, screening tools are required. There are many diagnostic tests for differential diagnosis about patients with unilateral auditory dysfunction, but there is no efficient screening tool which can confirm all lesions. The purpose of this work is to assess the clinical usefulness of 3D fast imaging employing steady state acquisition (3D‐FIESTA) sequence in unilateral hearing loss or tinnitus.

Methods:

Two hundred and sixty patients with unilateral tinnitus and hearing loss who underwent 3D‐FIESTA temporal bone imaging were retrospectively analyzed, looking atmedical charts and radiologic reports. Otologic symptoms, which were measured based on pure tone audiometry results, were reviewed. We evaluated radiologic pathologic finding in the cochlear and retrochoclear areas.

Results:

Of the hearing symptoms, tinnitus comprised 49.6%, sudden sensory hearing loss, 31.9%, and unilateral hearing disturbance, 15.7%. Twelve patients were diagnosed with acoustic neuromas, four with enlarged vestibular aqueduct syndrome, two with posterior inferior cerebellar artery aneurysms, inner ear anormaly and vestibular cochlear nerve palsy each by 3D‐FIESTA MR.

Conclusions:

3D‐FIESTA MR is highly sensitive and a cost effective method for differential diagnosis of hearing loss and tinnitus. 3D‐FIESTA MR image is a useful diagnostic tool as screening for cochlear and retrocochlear lesions.
Atrial Natriuretic Peptides in Patients with OME: Serous Otitis Media and Mucoid Otitis Media
Authors: Yoon Yong‐Joo
Published: August 2013

Objectives:

Atrial natriuretic peptides (ANPs) are located within extracardiac tissues known to play an important role in the maintenance of fluid/electrolyte homeostasis. It is not known whether ANPs are expressed in middle ear effusions (MEEs) and whether ANP is correlated in development of serous or mucoid effusion (OME). In order to determine whether secretion of ANP is affected in chronic disease condition, we compared the ANP concentration in the mucoid effusions with that in the serous effusions.

Methods:

MEE concentrations of ANP were measured in 21 patients (12 mucoid, 9 serous) with OME. The patients underwent myringotomy and/or insertion of a ventilation tube for treatment of OME and collected MEEs. The samples were divided into serous or mucoid types based on observation by the naked eye. ANP immunoreactive cells and ANP levels were measured in the tissues and effusions of the patients with OME, using IHC and radioimmunoassay.

Results:

In human MEE samples, ANP levels showed a significant increase with the mucoid effusions when compared with the serous effusions and control plasma. ANP concentration was increased in mucoid effusion but was decreased in patients with serous effusion and in control plasma. ANP‐immunoreactive (ANP‐IR) cells are showed in the tall columnar cells of the middle ear mucosa.

Conclusions:

Our results suggest that a high concentration of ANP in mucoid secretions promotes chronicity of mucoid otitis media and hypothesize that ANP may also play a role in the pathogenesis of OME through changes in the transport of water and ions across the middle ear epithelium.
Auditory Tube Dysfunction Occurring after Jaw Surgery
Authors: Aoki Hideaki
Published: August 2013

Objectives:

Study auditory tube dysfunction that occurs after jaw surgery.

Methods:

Two hundred sixty‐eight patients were enrolled (60 males and 208 females; mean age, 24.3 years old) who were diagnosed with jaw anamorphosis symptoms and underwent orthognathic surgery of the lower jaw, and who were tested for auditory tube function before and after surgery at our hospitals between December 2000 and February 2012. Auditory tube function test pre‐ and post‐operation were conducted, and post‐operatively we searched for auditory tube dysfunction. Auditory tube dysfunction in a high rate was seen after lower jaw orthognathic surgery.

Results:

Post‐operative auditory tube dysfunction was noted subjectively in 49 patients (18.3%) and determined by TM in 162 (60.4%). There is also a relationship between pre‐operative SON and TTAG and post‐operative TM aggravation.

Conclusions:

Post‐operative auditory tube dysfunction correlated with pre‐operative TTAG values, indicating that TTAG was a useful test for the prediction of TM aggravation. There was no correlation between post‐operative auditory tube dysfunction and SON values.
Autoimmune Saccitis and Cochlear Change
Authors: Friis Morten
Published: August 2013

Objectives:

Injury to the endolymphatic sac may play an important role in the pathogenesis of Ménière's disease. The purpose of this study was to) investigate the effect of an autoimmune stimulation of the endolymphatic sac in rats.

Methods:

Nineteen inbred male Lewis rats in an animal laboratory at the University of Copenhagen were studied. Outcome measurements: Distortion product oto‐acoustic emissions (DPOAE) and transmission electron microscopy (TEM). Independent variables: autoimmunization. Preliminary analyses: Endolymphatic hydrops.

Results:

At day 21 the immunized group showed no significant differences in hearing assessment, on full range of frequencies, compared to the controls (P >0.05; Welsh t‐test). At day 183, the hearing assessment showed a 1.5 dB (6,35%) drop in CDP in the immunized group compared to the controls from 2‐16kHz (P < 0.05; Welsh t‐test) and a 2.5 dB (11.1%) decrease in the low frequency area, from 2‐5kHz (P < 0.01; Welsh t‐test). TEM investigation indicated stimulation of the endolymphatic sacs in all immunized rats: The ribosome‐rich cells appeared hyperactive, and a focal inflammation of immunologically active cells and phagocytosis of ribosome‐rich cells were observed.

Conclusions:

An autoantigen, capable of inducing an endolymphatic saccitis with concomitant cochlear change, exists in the rat. A possible relationship between these observations and Ménière's disease is proposed.
Computed Tomography Is Required to Rule Out Nasopharyngeal Pathology in Adults with Serous Otitis Media
Authors: Toman Julia , Perry Katherine , Strome Scott E. , Eisenman David J. , Hertzano Ronna
Published: August 2013

Objectives:

1) Review the current diagnostic evaluation of adults with new‐onset serous otitis media (SOM). 2) Compare the ability of fiberoptic nasal endoscopy (FNE), random nasopharyngeal biopsies, and computed tomography (CT) to detect nasopharyngeal pathology. 3) Clarify the role of imaging and random nasopharyngeal biopsies in the evaluation of SOM.

Methods:

This is a retrospective chart review of adults who presented with SOM to a tertiary care center from 2006 to 2012 and who underwent pressure equalization tube (PET) placement and nasopharyngeal biopsies. Subjects were identified though a search of operative and pathology records. Charts were reviewed for physical exam findings, including FNE, intraoperative exam, biopsy results, and imaging. FNE findings were classified as suspicious or non‐suspicious.

Results:

Thirty‐four subjects were identified who met the inclusion criteria. Twenty‐nine subjects had non‐suspicious findings on FNE while five had suspicious findings. Two of the twenty‐nine subjects with non‐suspicious findings, and two of the five subjects with suspicious findings proved to have significant nasopharyngeal pathology, including nasopharyngeal carcinoma and sinonasal polyp. Importantly, CT imaging had a negative predictive value of 100% for the presence of nasopharyngeal pathology.

Conclusions:

All adults presenting with persistent new‐onset SOM should undergo CT scanning to rule out nasopharyngeal pathology. The decision to perform a biopsy should be based on CT findings. If imaging is normal, random nasopharyngeal biopsies are not required and PET placement may be performed in the office. Normal FNE does not exclude nasopharyngeal pathology.
Clinical and Radiographic Predictors of Lateral Semicircular Canal Fistula
Authors: Greene Scott M. , Carlson Matthew L. , McRackan Theodore , Rivas Alejandro , Bennett Marc L. , Haynes David S. , Wanna George B.
Published: August 2013

Objectives:

Lateral semicircular canal fistula (LSCCF) may occur in as many as 10% of patients with cholesteatoma. Despite improvements in diagnostic imaging, reliable preoperative identification of LSCC remains elusive. Our objective is to explore preoperative clinical variables and intraoperative findings in order to identify factors associated with the presence of LSCCF.

Methods:

A retrospective matched cohort study was conducted. All patients with LSCCF, determined by intraoperative diagnosis, that had preoperative temporal bone computed tomography (CT) available for review were identified. Subjects were matched to patients without LSCCF according to age, gender and year of surgery. Associations between LSCCF and preoperative vertigo, fistula test results, sensorineural hearing loss (SNHL), stapes superstructure erosion, facial nerve and dural dehiscence, and preoperative radiographic findings were evaluated.

Results:

Eighty‐three patients with LSCCF met inclusion criteria and were matched to subjects without labyrinthine fistula. Patients with LSCCF more commonly had stapes superstructure erosion (34 vs 15, P <. 001), facial nerve dehiscence (55 vs 10, P <. 0001), and dural dehiscence (29 vs 4, P <. 0001) compared to subjects without LSCCF. The presence and severity of preoperative SNHL, vertigo, and fistula test results were unreliable predictors of LSCCF. Furthermore, of those patients with LSCCFs, only 28% were identified on pre‐operative CT.

Conclusions:

Preoperative variables including SNHL, vertigo, fistula test results as well as preoperative temporal bone CT were not reliable predictors of LSCCF. However, intraoperative findings including stapes superstructure erosion, facial nerve and dural dehiscence were found to be associated with LSCCF and should raise suspicion of disease.
Clinical Characteristics and Treatment Outcome in Patients with Migrainous Vertigo
Authors: Jung Jae‐Hoon , Lee Jaeryung , Yoo Myeong‐Hoon , Park Hong Ju , Chung Jong Woo
Published: August 2013

Objectives:

Migrainous vertigo (MV) is accepted as a common cause of episodic vertigo. The peripheral or central vestibular localization of the deficit as well as the pathophysiology is unclear. This retrospective study was designed to assess the clinical features and treatment outcomes of MV.

Methods:

132 patients with MV were studied. Comprehensive neurological tests were performed and pure tone audiometry, caloric test, vestibular evoked myogenic potential (VEMP), and posturography were also conducted. For medical management, sibelium, amitryptilin, and topamax were tried.

Results:

31% of patients reported cochlear symptoms including hearing disturbance, tinnitus, earfullness during MV symptom, and 41% showed head‐shaking nystagmus. Caloric test results revealed unilateral caloric hypofunction in 23%, and 29% showed VEMP asymmetry. Posturography results revealed vestibular dysfunction in 24%. Symptom relief was experienced in 55% with flunarizine, 33% with amitriptyline, and 9% with topiramate.

Conclusions:

MV demonstrated various clinical features, however, this disease can be treated well by medical management.
Cochlear Duct Length: Are We Giving It Adequate Importance?
Authors: Grover Mohnish , Mishra Prakash , Gupta Gaurav , Jangid Manoj
Published: August 2013

Objectives:

1) Calculate radiologically length of cochlear duct in children with congenital bilateral profound sensorineural hearing loss. 2) Analyze above calculation to decide about length of electrode array of cochlear implant. 3) Implement this calculation as part of mandatory workup for cochlear implantation.

Methods:

Prospective study conducted over 18 months to study high‐resolution computed tomography (HRCT) temporal bone of children less than 6 years old being evaluated for cochlear implant at SMS Medical College and Hospital, Jaipur, India. Minimum intensity projection reconstruction cuts were made to calculate largest distance from round window to lateral wall of cochlea (A). Cochlear duct length (CDL) was calculated by: CDL = 4.16A – 3.98.

Results:

HRCT temporal bone of 124 patients with hearing loss were analyzed. Twenty patients were excluded in view of vestibulocochlear anomaly. Overall average of A was found to be 8.12 mm (7.7mm to 9.2mm). Mean cochlear duct length was calculated to be 29.8 mm (28mm to 34.3 mm).

Conclusions:

This study revealed that the length of cochlea is smaller in Asian population. The variability of cochlear length also needs to be taken into consideration before putting in a fixed length cochlear implant in every patient. In view of this we propose that cochlear duct length should be calculated in every patient preoperatively.
Cochlear Implant Outcomes in Adults and Children with Inner Ear Malformations
Authors: Szudek Jacek , Dettman Shani , Zraika Linda , Briggs Robert
Published: August 2013

Objectives:

Bony cochlear or vestibular malformations occur in approximately 20% of patients with congenital hearing loss, but their impact on audiologic outcomes is not entirely clear. Our objective was to assess the impact of inner ear malformations on surgical and audiologic outcomes in cochlear implantation (CI).

Methods:

A retrospective review of a single CI clinic identified a cohort of 57 children and 31 adults with inner ear malformations who had undergone CI between 1994 and 2010. Patients were classified into: common cavity, incomplete partition ‐I (IP‐I); IP‐II with or without enlarged vestibular aqueduct (EVA); IP‐III, or EVA alone. We compared speech perception language development and surgical outcomes between the groups.

Results:

The type of malformation was not associated with CI performance in either adults or children. In children, the duration of profound hearing loss was correlated with scores for: open‐set phoneme (r = ‐0.43, P = 0.004); open‐set word (OSW) (r =‐0.32, P = 0.03); Bench Kowal Bamford sentence (BKB) (r =‐0.35, P = 0.02), and Peabody Picture Vocabulary Test delay (r = 0.49, P = 0.001). In adults, the duration of profound hearing loss was correlated with OSW (r=‐0.36, P = 0.04) and BKB (r =‐0.41, P = 0.02).

Conclusions:

The extent of inner ear malformation alone cannot predict CI performance. However, the presence of a gusher, incomplete insertion, and a longer duration of pre‐implant hearing loss were associated with worse speech perception and language outcomes in children and adults.
Comparison of Functional Outcomes in Complete and Incomplete Bilateral Vestibulopathy
Authors: Chung Won‐Ho , Byun Ha‐Young , Ryu Nam‐Gyu , Choi Ji‐Eun
Published: August 2013

Objectives:

Patients with bilateral vestibulopathy (BV) suffer from significant functional disability despite appropriate rehabilitation. We hypothesized that the presence of residual vestibular function would positively affect rehabilitation and final functional outcomes. The aim of this study was to compare long‐term functional outcomes between complete and incomplete BV cases.

Methods:

Fifty patients who have been diagnosed with BV in Samsung Medical Center from 2002 to 2012 were retrospectively reviewed. The subjects were divided into two groups according to the presence of residual vestibulo‐ocular reflex (VOR): the complete BV group (n = 19) and incomplete BV group (n = 31). Thirty‐one patients (6 complete BV and 25 incomplete BV) out of 50 patients completed our telephone survey which evaluated 5 symptom categories including dizziness severity, oscillopsia, unsteadiness, depression, and restriction on daily life. Each symptom was scored by the patients in reference to the initial status at diagnosis and the latest status at survey.

Results:

There was no difference in etiology between complete and incomplete groups. Symptom scores of incomplete BV group showed significant interval improvement in dizziness, oscillopsia, unsteadiness and restriction on daily life (P < 0.005 by Wilcoxon signed rank test), whereas those of complete group did not. In the analysis of score (calculated as [score at survey] – [score at diagnosis]), improvement of dizziness score was significantly higher in incomplete group compared to complete group (P = 0.035 by Mann‐Whitney U test).

Conclusions:

Patients with BV who had residual VOR on caloric test showed better functional outcomes than those without residual function.
Conservative Management of Vestibular Schwannoma in the West of Scotland: A 20‐Year Experience
Authors: Oozeer Nashreen B. , O'Reilly Brian F. , Crowther John
Published: August 2013

Objectives:

In our skull base unit, large vestibular schwannomas (VS) over 30 mm at presentation are usually offered surgery but the remainder have their growth monitored by interval imaging with treatment (surgery or stereotactic radiotherapy) being offered to patients whose tumors are growing significantly.

Methods:

A prospective database of consecutive patients diagnosed with sporadic VS and referred to the Skull Base unit in South Glasgow, United Kingdom, over the last 20 years was retrospectively reviewed. Patients with neurofibromatosis type II were excluded. Patients who consented to being managed conservatively by initial interval imaging using 6‐monthly axial T1‐weighted post‐gadolinium magnetic resonance imaging (MRI) had the growth of their VS assessed. Growth (defined as >2mm) was the primary outcome measure. Intracanalicular tumors were compared to cerebellopontine angle (CPA) ones.

Results:

There were 62 intracanalicular (IC) tumors, mean size of 8mm, and 102 CPA VS, mean size of 11mm. One third of patients managed conservatively showed evidence of growth and 50% showed no change (IC > CPA). Twenty percent reduced in size (CPA > IC). Two‐thirds of the VS showing growth stabilized or regressed over time. Audiometry was not found to be a useful tool to predict growth but interval MRI scans were. The quality of life of the VS group managed conservatively was found to be comparable across all domains of the short‐form 36 (SF‐36) with an age and sex match control group.

Conclusions:

All asymptomatic patients and symptomatic ones with a VS size of <30 mm should initially be offered conservative management with interval imaging.
Development Research of Communication Systems for the Deaf in a Major Disaster
Authors: Yabe Takao
Published: August 2013

Objectives:

Based on the field work regarding difficulties the deaf faced during the earthquakes in Japan, we designed a visual information delivery system using Android mobile devices and cloud networking during a major disaster to communicate information about the evacuation and the shelter to them quickly. We present the results of the evaluation test of this system.

Methods:

Evaluation tests were carried out at a school for the deaf. Subjects were 28 people with hearing impairment (HI) and 26 with normal hearing (NH), aged 12 to 65 and 24 females and 30 males. Visual information delivery system consisted of Android mobile devices with Wi‐Fi, cloud networking system, and LED display. Evaluation items were 1) recognition of LED display, 2) usefulness of the system, 3) size of the characters on LED, 4) color of the characters on LED, and 5) speed of the character scroll on LED. Results were statistically analyzed.

Results:

The LED display was recognized by 65% in the HI group and 53% in the NH group. Usefulness was highly evaluated by 80% in HI and 72% in NH. Larger sized characters were evaluated by 30% in HI and 56% in NH. Green color was evaluated more in HI and red color more in NH. Faster scroll was evaluated more in HI (p<0.05).

Conclusions:

These findings suggest that this system was useful for the deaf, and they preferred green characters on faster scroll on LED.
Diluted Gadoteridol Causes Mild Ototoxicity in Cochlear Outer Hair Cells
Authors: Tanigawa Tohru , Katahira Nobuyuki , Tanaka Hirokazu , Ueda Hiromi
Published: August 2013

Objectives:

Recently, visualization of endolymphatic hydrops has been achieved through intratympanic injection of gadolinium‐based contrast agents (GBCAs) and three‐dimensional fluid‐attenuated inversion recovery (3‐D FLAIR) magnetic resonance imaging. However, the effects of gadoteridol (ProHance®) on inner ear cells are not yet understood. Here, we investigated the physiological and morphological responses of guinea pig cochlear cells to gadoteridol.

Methods:

Distortion product otoacoustic emission (DPOAE) levels were measured before and 1, 2, and 4 weeks after intratympanic injection of a 1/8 or 1/16 dilution of gadoteridol in guinea pigs. Moreover, morphological changes of isolated cochlear outer hair cells (OHCs) were observed after application of gadoteridol and GdCl3.

Results:

At the highest frequency (F2 = 12000 Hz), DPOAE level was significantly (P < 0.05) lower in the 1/8 diluted gadoteridol group than in the control group. Cell shape changes were observed in 24% (6/25) and 3% (1/33) OHCs after application of 1/8 and 1/16 diluted gadoteridol, respectively. The occurrence of morphological damage was significantly lower after application of saline compared to 1/8 diluted gadoteridol (P < 0.05). Moreover, morphological damage was significantly lower after application of 1/16 diluted gadoteridol compared to 1/8 diluted gadoteridol (P < 0.05). Morphological damages were shown at high rate (8/10 cells, 80%) after application of GdCl3.

Conclusions:

Administration of diluted solutions of gadoteridol might cause considerably less toxic effects on cochlear OHCs.
Does the ENoG Value of the Orbicularis Oris Muscle Reflect All Facial Nerve Degeneration?
Authors: Haginomori Shin‐Ichi , Wada Shin‐Ichi , Ichihara Takahiro , Mori Atsuko , Kanazawa Atsuko , Matsumura Rei , Kawata Ryo
Published: August 2013

Objectives:

1) Compare electroneuronography (ENoG) values in patients with facial palsy using two different methods, the midline method that records compound muscle action potentials (CMAPs) from the orbicularis oris muscle (the standard muscle for facial ENoG) and five electroneurogram recordings that records five CMAPs from five different facial muscles. 2) Reveal whether the ENoG value obtained with the midline method reflects entire facial nerve degeneration.

Methods:

Forty patients with facial palsy were enrolled. CMAPs were recorded using the midline method, in which the anode was placed on the mental protuberance and the cathode was placed on the philtrum. Additionally, five electroneurogram recordings were obtained by placing the anode on the skin of the parietal region and five cathodes on the skin over five facial muscles (frontalis, orbicularis oculi, nasalis, orbicularis oris, and depressor anguli oris muscles). ENoG values recorded using the two methods were compared.

Results:

The ENoG values of the five facial muscles did not differ from those obtained using the midline method. The total ENoG value calculated by summing five CMAPs from five facial muscles, which is considered to reflect total facial nerve degeneration, was not significantly different from that using midline methods; moreover, a strong positive correlation coefficient (r = 0.87) was found between them.

Conclusions:

The midline ENoG method that records CMAP from the orbicularis oris muscle reflects entire facial nerve degeneration. The ENoG value calculated from the orbicularis oris muscle might be suitable to evaluate the total prognosis of facial palsy.
Does Tinnitus Annoyance Correlate to Auditory Brainsteam Responses?
Authors: Sampaio Andre L. L. , Kehrle Helga M. , Oliveira Taciana S. C. , Granjeiro Ronaldo C. , Oliveira Carlos A. C. P.
Published: August 2013

Objectives:

Tinnitus is more common in patients with some degree of hearing loss, but may be present in approximately 10‐20% of people with normal hearing. There is evidence of involvement of the central auditory nervous system and interrelation with various parts of the nervous system, which may be involved in the mechanism of central processing of auditory signals. We aimed to analyze the annoyance of tinnitus in patients without hearing loss and to correlate the findings with auditory brainsteam response (ABR).

Methods:

We selected 84 patients with tinnitus and 47 patients without tinnitus, with ages ranging from 18 to 48 years old and hearing threshold less than or equal to 25 dB at frequencies between 500 and 8000Hz. We conducted the evaluation of tinnitus annoyance with the Tinnitus Handicap Inventory (THI), and examination of ABR.

Results:

Among the 84 patients in the study group, we found 35.7% of abnormal tests in at least one of the seven parameters tested, however, only the difference in the interaural wave V latency in patients with unilateral tinnitus was significant difference between the study and control group. Most patients in the study group had mild or very mild tinnitus. The discomfort of tinnitus showed no correlation with the results of ABR results.

Conclusions:

ABR results did not play a role in tinnitus annoyance in this study. It is important to investigate the role of anxiety and depression in the discomfort of tinnitus.
The Effect of Gingko Biloba (EGB 761) as an Otoprotector Against Cisplatin Ototoxicity
Authors: Sampaio Andre L. L. , Dias Mirella A. , Venosa Alessandra R. , Tauil Pedro L. , Alencar Elienai , Oliveira Carlos A. C. P.
Published: August 2013

Objectives:

Evaluate, by using distortion product oto‐acoustic emissions (DPOAE) test, the effect of ginkgo biloba extract (EGB761), which has shown antioxidant properties as a possible otoprotector against cisplatin induced hearing loss. Ototoxicity is an alteration caused by drugs that compromises the auditory and vestibular functions. Cisplatin (CDDP) is a potent antineoplastic agent used for the treatment of cancer although it has several side effects like ototoxicity (a dose‐limiting condition). Currently, cisplatin ototoxicity occurs due to alterations in the antioxidant system of the outer hair cells (OHC) of the cochlea. Different antioxidant drugs have been tested to evaluate the potential otoprotector effect combined to cisplatin administration. Distortion product otoacoustic emission test (DPOAE) has been showed to be a sensitive test for diagnosis of OHC injury and has been used for monitoring treatment of ototoxic drugs.

Methods:

The study was conducted on individuals that would begin cisplatin treatment. They were randomized and allocated in two groups: Control group (CG) (n =07) received placebo and CDDP and study group (SG n = 08) received EGB761 (240mg/day) and CDDP. Both groups ingested the drugs before first cisplatin dose. They were treated and followed up for approximately ninety days.

Results:

The maximum cumulative cisplatin dosage was 300mg/m2. Comparisons were made between baseline measurements and those records after maximum cumulative cisplatin dosage. The CG showed smaller amplitudes of the signal and signal/noise ratio compared to baseline.

Conclusions:

These results demonstrate that EGB761, because of their antioxidant properties, showed potential otoprotector effect.
Effect of Medication for Residual Symptoms in BPPV: Randomized Controlled Trials
Authors: Lee Jung‐Yup , Kim Min‐Beom , Ban Jae Ho , Lee Kyung Chul
Published: August 2013

Objectives:

Even after successful canalith repositioning procedures (CRPs) in benign paroxysmal positional vertigo (BPPV), residual symptoms could be continued without positional nystagmus. The aim of this study was to evaluate the effect of adjuvant medication on residual symptoms after successful CRPs

Methods:

Between January 2011 and August 2012, 150patients with idiopathic BPPV participated. Patients who had previous history of psychiatric disorder or migraine were excluded. All participants were diagnosed by video‐nystagmography (VNG), and Dizziness Handicap Inventory (DHI) questionnaires were completed before CRPs. All subjects were divided into three groups after successful CRPs. Medication (M) group was treated with vestibular suppressant (dimenhydrinate 25mg), placebo (P) group and no medication (N) group. One week after, all patients completed follow up VNG for recurrence and repeated DHI questionnaires for comparing residual symptoms.

Results:

All participants regardless of groups showed significant symptom improvement after successful CRPs, but 76 patients complained of residual symptoms. Presence of residual symptoms was more prevalent in P or N group compared with M group (P = 0.048, P = 0.03, respectively). Most frequent characteristics of residual symptoms were lightheadedness or mild headache (n = 36). However, in the analysis of DHI, total and subscale scores of DHI were not different between three groups before and after successful CRPs.

Conclusions:

Vestibular suppressant significantly reduced residual symptoms after CRPs. However, there is no significant reduction on DHI scores compared to a control group. It seems that residual symptoms may not be true vertigo but lightheadedness or headache.
Efficacy of Intratympanic Steroid Therapy as a Salvage Treatment for Idiopathic Sudden Sensorineural Hearing Loss
Authors: Yeo Sang‐Won , Bae Seong‐Cheon , Lee Sung Hun , Park Kyoung‐Ho , Park Shi‐Nae
Published: August 2013

Objectives:

Recently, comparable therapeutic efficacy of intratympanic steroid injection (IT‐S) as a salvage treatment for sudden sensorineural hearing loss (SSNHL) has been reported. We aimed to compare the efficacy of intratympanic steroid injection as salvage treatment, systemic steroid, and intratympanic steroid injection alone.

Methods:

A retrospective, multicenter study investigating therapeutic efficacies of systemic steroid, intratympanic steroid, and combined therapy as a salvage treatment for SSNHL was designed in 660 patients with idiopathic SSNHL. Patients were divided into three groups according to the therapy they received: Intratympanic steroid injection group (IT‐S group), systemic steroid therapy group (SST group) and salvage therapy group (systemic steroid failure + intratympanic steroid, ST group). Hearing was evaluated and more than a 10dBHL decrease was defined as hearing improvement in our study.

Results:

Among a total number of 660 patients with SSNHL, 94 patients were included in IT‐S group, while 444 patients and 122 patients were included in SS and ST group, respectively. Age, gender, time interval from onset to treatment, and initial hearing level of each group were not statistically different. Patients who had concomitant medical disorders such as diabetes mellitus, hypertension and chronic renal failure were more frequently treated with IT‐S. There was no significant difference in hearing gain or the ratio of improvement in hearing among three different therapeutic groups of our study. (P = 0.140, P = 0.450).

Conclusions:

IT‐S as a salvage treatment seemed to be as effective as SS or IT‐S alone. We can conclude that IT‐S as a salvage therapy is not superior to other monotherapy.
Differences in Thyroid Cancer Trends between New York and Surveillance, Epidemiology, and End Results Database
Authors: Wong Kenneth , Patel Neha A. , Geliebter Jan , Shin Edward J.
Published: August 2013

Objectives:

Thyroid cancer is the most common endocrine malignancy in the United States. The objective of this study was to examine regional trends in thyroid cancer in New York (NY) and compare results with national trends in the Surveillance, Epidemiology, and End Results (SEER) database.

Methods:

Thyroid malignancies were identified between 2000‐2009 from the NY State Cancer Registry and SEER‐18 database. Incidence rates were determined for subgroups, including age cohorts, race, histologic subtype, and stage. Annual percent change (APC) and incidence rate ratios (IRR) were calculated with 95% confidence intervals (CI) between subgroups.

Results:

IRR was significant between NY and SEER in the overall group (1.23, CI 1.21‐1.24, P < 0.0001), whites (1.26, CI 1.23‐1.28, P < 0.0001), Asians (1.30, CI 1.23‐1.37, P = 0.0001), blacks (1.12, CI 1.06‐1.17, P = 0.0002), age cohort 10‐24 (1.26, CI 1.18‐1.34, P = 0.0003), age cohort 25‐44 (1.25, CI 1.22‐1.28, P < 0.0001), age cohort 45‐64 (1.25, CI 1.22‐1.27, P < 0.0001), age cohort 65‐84 (1.15, CI 1.11‐1.19, P < 0.0001), age cohort 85+ (1.27, CI 1.10‐1.39, P = 0.003), local (1.21, CI 1.18‐1.23, P < 0.0001), regional (1.24, CI 1.20‐1.28, P < 0.0001), and papillary (1.23, CI 1.21‐1.25, P < 0.0001). There were also significant increases in APC in these subgroups.

Conclusions:

Thyroid cancer incidence has been increasing overall between 2000‐2009 in both NY and the SEER database. However, rates in NY are significantly increased for select subgroups, especially among white and Asian females between 25‐64 years. Physicians treating patients in these subgroups should be aware of the increased incidence of thyroid cancer and have a higher index of suspicion to monitor for potential malignancy.
Evaluation of Postoperative Hearing Outcome and Recurrence for Pars Flaccida Cholesteatoma
Authors: Hoshi Yujiro , Kashio Akinori , Karino Shotaro , Sakamoto Takashi , Kakigi Akinobu , Iwasaki Shinichi , Yamasoba Tatsuya
Published: August 2013

Objectives:

Find out which factors affect postoperative hearing outcomes and those which affect recurrence rate in cases of pars flaccida cholesteatoma.

Methods:

Fifty‐six ears of 54 patients who underwent tympanoplasty for pars flaccida cholesteatoma for the first time at our hospital between 2006 and 2011 were enrolled. Progression of cholesteatoma, results of postoperative hearing, and the incidence of recurrence were compared. To define the progression of cholesteatoma, we used components of the classification proposed by American Academy of Otolaryngology—Head and Neck Surgery (AAO‐HNS) and the Japan Otological Society.

Results:

Cholesteatoma was present in eustachian tube, protympanum, or both in 13 cases, in the mesotympanum in 36, and in the mastoid cavity in 39. The stapes was intact in 47 cases, in which mucosa surrounding the stapes was normal in 15 and granulation tissue and/or cholesteatoma were present adjacent to the stapes in 32. Stapes superstructures were (nearly) completely destroyed in 8, and the stapes was not observed in one. Hearing was improved in 39 cases, with no significant difference in postoperative hearing among the regions involved by cholesteatoma. The cholesteatoma recurred in 5 cases. Recurrence was significantly more frequent when cholesteatoma involved the eustachian tube and/or protympanum (P = 0.041) and also when the stapes was destroyed (P = 0.043).

Conclusions:

Progression into the eustachian tube and/or protympanum and the destruction of the stapes superstructure are considered important factors to predict postoperative recurrence of pars flaccid cholesteatoma.
Evaluation of Vascular Activity in Otosclerosis by Laser‐Doppler Flowmetry: Comparison with CT Densitometry
Authors: Sone Michihiko , Yoshida Tadao , Suga Kenji , Kato Ken , Otake Hironao , Teranishi Masaaki , Nakashima Tsutomu
Published: August 2013

Objectives:

Evaluate vascular activity in ears with otosclerosis by intraoperative measurement of blood flow using laser‐Doppler flowmetry, and compare the data with densitometry on computed tomography (CT).

Methods:

Thirty‐nine ears from patients who underwent surgery for otosclerosis were assessed in the present study. The subjects were divided into the fenestral (29 ears) and the retrofenestral (10 ears) groups by CT. Ratios of bone density in the area anterior to the oval window (AOW) or the promontory (PT) near the round window niche to that of the basis labyrinthine otic capsule were calculated on CT images. Measurements of blood flow were performed with a laser‐Doppler flowmeter at the two corresponding areas evaluated by CT.

Results:

In both groups, relatively young subjects with high blood flow values in the AOW or PT had rather low ratios of bone density in the corresponding areas. In contrast, old subjects with low ratios of bone density showed low blood flow values in the same areas. In the retrofenestral group, subjects with high blood flow values in the PT showed low blood flow values in the AOW, but their ratios of bone density were similarly low in both areas.

Conclusions:

Blood flow varied and did not correlate with CT densitometry. Measurement of blood flow by laser‐Doppler flowmetry could yield useful information to evaluate the progress of vascular activity.
Hearing Impairment in 351 Middle Ear Cholesteatomas
Authors: Rosito Leticia S. , Selaimen Fábio A. , Noschang Maurício , Da Costa Sady S.
Published: August 2013

Objectives:

1) Analyze the hearing loss in ears with cholesteatoma 2) Verify differences between children and adults.

Methods:

A cross sectional study involving 351 ears with middle ear cholesteatoma and no previous surgery submitted to pure tone audiometry between August 2000 and January 2013. The air and bone conduction thresholds and the air‐bone gaps were compared. Statistical analysis was performed using student t test.

Results:

The mean age was 31.5 ± 18.1 years old. 53.4% were men and 65.3% adults. The tritonal air and bone conduction thresholds media were 43.2 ± 18.7dB and 14.3 ± 12.8dB, respectively. The tritonal air‐bone gaps media was 28.9 ± 13.8dB. Profound hearing loss was found in only 3.4% (8 adults and 4 children). The air and bone conduction thresholds were significantly greater in adults in all frequencies (P < 0.001). When the air‐bone gaps were compared between the two groups, however, children had greater values in 500Hz (P = 0.05). There were no other differences between the groups in the further frequencies.

Conclusions:

Middle ear cholesteatoma is associated with significant hearing impairment although profound hearing loss is rare. Adults have greater thresholds in air and bone conduction than children. The air bone gaps are similar between the groups but can be greater in children.
Hearing Loss in Singers
Authors: Hofmann Erik , Hu Amanda , Davis John , Sataloff Robert T.
Published: August 2013

Objectives:

Singers need good hearing; however, they are exposed to loud noises during their musical activities. The objectives of this study were to: 1) Describe the incidence and type of hearing loss in singers, and 2) Identify risk factors associated with hearing loss in singers.

Methods:

A retrospective chart review was conducted of singers who had had an audiogram during the past three years. Billing records identified patients who had videostroboscopy and audiogram at the same visit. Charts were then reviewed to identify singers. A singer was defined as anyone who self‐identified as a singer (professional or avocational). Demographic data, clinical factors, and audiograms were recorded. Outcome measurements included the presence of hearing loss, type of hearing loss, and pure tone average (PTA).

Results:

Out of 125 singers (43.8 ± 19.0 years, 35.2% male), 21 (16.8%) had hearing loss with a mean left PTA of 28.5 ± 10.4 dB and right PTA of 29.3 ± 6.5 dB. If mild hearing loss is included, the number increases to 32 (42.4%). Twenty (95.2%) had sensorineural hearing loss and 18 (85.7%) had bilateral hearing loss. Older age (P = 0.00) and male gender (P = 0.00) were associated with hearing loss in singers. There were no associations with voice type or genre of music.

Conclusions:

The incidence of hearing loss in singers is 16.8%. Bilateral sensorineural hearing loss is most common. This is one of the few studies to examine hearing loss in singers. Data collection is ongoing to find age and gender matched controls.