bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhancement of Consonant Recognition in Bimodal and Normal Hearing Listeners
Authors: Yoon Yang-Soo , Riley Britteny , Patel Henna , Frost Amanda , Fillmore Paul , Gifford Rene , Hansen John 
Published: May 2019

Objectives: The present study investigated the effects of 3-dimensional deep search (3DDS) signal processing on the enhancement of consonant perception in bimodal and normal hearing listeners. Methods: Using an articulation-index gram and 3DDS signal processing, consonant segments that greatly affected performance were identified and intensified with a 6-dB gain. Then consonant recognition was measured unilaterally and bilaterally before and after 3DDS processing both in quiet and noise. Results: The 3DDS signal processing provided a benefit to both groups, with greater benefit occurring in noise than quiet. The benefit rendered by 3DDS was the greatest in binaural listening condition. Ability to integrate acoustic features across ears was also enhanced with 3DDS processing. In listeners with normal hearing, manner and place of articulation were improved in binaural listening condition. In bimodal listeners, voicing and manner and place of articulation were also improved in bimodal and hearing aid ear–alone conditions. Conclusions: Consonant recognition was improved with 3DDS in both groups. This observed benefit suggests 3DDS can be used as an auditory training tool for improved integration and for bimodal users who receive little or no benefit from their current bimodal hearing.
Cochlear Implant Surgery Through Round Window Approach Is Always Possible
Authors: Bae Seong-Cheon , Shin You-Ree , Chun Young-Myoung 
Published: May 2019

Objectives: The benefit of round window (RW) approach for cochlear implant (CI) has been well studied. Because the RW represents a natural door to scala tympani, it facilitates precise electrode insertion. Atraumatic electrode insertion can also be performed without drilling the cochlear lateral wall. However, the RW approach has several limitations. The purpose of this study is to describe successful CI surgeries utilizing the RW approach except for severe cases of temporal bone anomaly. The authors’ successful surgical solution for cases involving difficult RW access is also described. Materials and Methods: We retrospectively analyzed 377 consecutive surgeries of cochlear implantation performed between June 2010 and December 2018 by a single experienced surgeon. Standard and alternative procedures were used according to anatomical variations. Standard procedures included modified techniques of mastoidectomy in the RW approach, opening of facial recess, exposure of RW membrane, and electrode insertion. Difficult cases involving severe rotated cochlea or hypoplastic mastoid were successfully treated with RW insertion using alternative procedures such as external auditory canal (EAC) wall mobilization and endomeatal approach. Results: We performed CI surgery through a reproducible RW technique in two cases involving endomeatal approach and three cases of EAC mobilization. Other cases were treated using the standard procedure. Conclusion: Cochlear implant surgery through RW is reliable, safe, and effective. The RW technique is reproducible via several surgical procedures in most CI cases. Identification and safe exposure of RW membrane is a prerequisite for successful electrode insertion in cochlear implant surgery.
Sublingual Immunotherapy Attenuates Nasal Symptoms Upon Allergen Exposure in Murine Allergic Rhinitis Model via an Induction of IL-10 producing T cells in Submandibular Lymph Node
Authors: Qu Yinfei , Yamada Takaya , Aoi Noriaki , Morikura Ichiro , Fuchiwaki Takafumi , Hotta Yukie , Prokopakis Emmanuel , Kawauchi Hideyuki 
Published: May 2019

Objective: Sublingual immunotherapy has been considered to be a painless and effective therapeutic treatment of patients with allergic rhinitis. Its mechanism of action has been elucidated, but there are still controversies among many reports between clinical efficacy and laboratory data. Therefore, its mechanism of action needs to be investigated further by using promising animal models such as rodents and monkeys. Materials and Methods: Bearing this in mind, in our present study, we successfully constructed an effective murine model for sublingual immunotherapy (SLIT) in allergic rhinitis in which mice were sublingually administered ovalbumin (OVA), followed by intraperitoneal (ip) sensitization and intranasal (i.n.) challenge of OVA. Results: To summarize our experimental data, nasal symptoms such as sneezing and nasal rubbing of sublingually treated mice were significantly attenuated in accordance with lower specific IgE antibodies in sera. Histological analysis of eosinophil recruitment in nasal mucosae reveals less allergic inflammation in sublingually treated mice. Interleukin-10 (IL-10) production and IL-10–specific mRNA gene expression of cultured submandibular lymph node (SMLN) cells with OVA, obtained from sublingually treated mice, were significantly higher than those of mice without sublingual treatment. Conclusion: These results demonstrate that sublingually introduced antigens can actually attenuate nasal symptoms in a murine allergic rhinitis model upon allergen exposures. Furthermore, our immunological data might indicate an important role of IL-10 producing T cells in SMLN to control nasal allergic reaction.
Pyridoxine Preferentially Induces Auditory Neuropathy Through Mitochondrial Dysfunction and Endoplasmic Reticulum Stress-Mediated Apoptosis
Authors: Park Channy , Lim Hyewon , Moon Sung K. , Park Raekil 
Published: May 2019

Objectives: Auditory neuropathy due to toxicity mechanism of pyridoxine has not yet been fully documented. Therefore, the present study explored a direct mechanism underlying the effects of pyridoxine on auditory neuropathy in organ of Corti (OC) explants ex vivo and cochlear neuroblast cell line, VOT-33 in vitro. Methods: Primary OC explants containing spiral ganglion neurons and cultured VOT-33 cells were treated with pyridoxine. Results: In nerve fiber of primary OC explants, pyridoxine decreased staining for NF200, a neuro-cytoskeletal protein. We also found that pyridoxine-induced VOT-33 apoptosis, as indicated by accumulation of the sub-G0/G1 fraction, caspase-3 activation, and PARP cleavage. In addition, pyridoxine induced reactive oxygen species (ROS) generation and alteration of mitochondrial membrane potential transition (MPT), including Bcl-2 family protein expression and consequently Ca2+ accumulation and changes of endoplasmic reticulum (ER) stress-related protein expression such as phospho-PERK, caspase-12, Grp78, and CHOP. Conclusion: Pyridoxine preferentially induced severe cell death on nerve fiber in primary OC explants and markedly increased apoptotic cell death via mitochondria-mediated ER stress in VOT-33 cells.
Intratympanically Delivered Steroids Impact Thousands More Inner Ear Genes Than Systemic Delivery
Authors: Trune Dennis R. , Shives Katherine D. , Hausman Fran , Kempton J. Beth , MacArthur Carol J. , Choi Dongseok 
Published: May 2019

Objectives: Glucocorticoids are given for sensorineural hearing loss, but little is known of their molecular impact on the inner ear. Furthermore, in spite of claims of improved hearing recovery with intratympanic delivery of steroids, no studies have actually documented the inner ear molecular functions that are enhanced with this delivery method. Methods: To assess steroid-driven processes in the inner ear, gene chip analyses were conducted on mice treated systemically with the glucocorticoids prednisolone or dexamethasone or the mineralocorticoid aldosterone. Other mice were given the same steroids intratympanically. Inner ears were harvested at 6 hours and processed on the Affymetrix 430 2.0 Gene Chip for expression of its 34 000 genes. Results were statistically analyzed for up or down expression of each gene against control (untreated) mice. Results: Analyses showed approximately 17 500 genes are normally expressed in the inner ear and steroids alter expression of 55% to 82% of these. Dexamethasone changed expression of 9424 (53.9%) inner ear genes following systemic injection but 14 899 ear genes (85%) if given intratympanically. A similar pattern was seen with prednisolone, as 7560 genes were impacted by oral delivery and 11 164 genes (63.8%) when given intratympanically. The mineralocorticoid aldosterone changed expression of only 268 inner ear genes if given orally, but this increased to 10 124 genes (57.9%) if injected intratympanically. Furthermore, the glucocorticoids given actually impacted more inner ear genes via the mineralocorticoid receptor than the glucocorticoid receptor. Conclusions: Thousands of inner ear genes were affected by steroids, and this number increased significantly if steroids were delivered intratympanically. Also, the impact of glucocorticoids on inner ear mineralocorticoid functions is more substantial than previously known. Thus, the application of therapeutic steroids for hearing loss needs to be reassessed in light of their more comprehensive impact on inner ear genes. Furthermore, simply ascribing the efficacy of steroids to immunosuppression no longer appears to be warranted.
Pathophysiologic Findings in the Human Endolymphatic Sac in Endolymphatic Hydrops: Functional and Molecular Evidence
Authors: Kim Sung Huhn , Nam Gi-Sung , Choi Jae Young 
Published: May 2019

Background: The endolymphatic sac (ES) is a cystic structure situated on the posterior fossa dura and is connected to the luminal space of the vestibular organ through the endolymphatic duct, which branches into the utricular and saccular ducts. Unlike the cochlea and vestibule, the ES does not contain sensory epithelium in its luminal space, and a single layer of epithelial cells line the luminal surface area. The ES in the inner ear is thought to play a role in the regulation of inner ear homeostasis, fluid volume, and immune reaction. If these functions of the ES are disrupted, dysfunction of the inner ear may develop. The most well-known pathology arising from dysfunction of the ES is endolymphatic hydrops, characterized by an enlarged endolymphatic space due to the accumulation of excessive endolymphatic fluid. Although, molecular identities and functional evidence for the roles were identified in animal studies, basic studies of the human ES are relatively uncommon compared with those using animal tissues, because of limited opportunity to harvest the human ES. Methods: In this study, molecular and functional evidence for the role of the human ES in the development of endolymphatic hydrops are reviewed. Results and Conclusions: Although evidence is insufficient, studies using the human ES have mostly produced findings similar to those of animal studies. This review may provide a basis for planning further studies to investigate the pathophysiology of disorders with the finding of endolymphatic hydrops.
Survival Outcomes for Advanced Cutaneous Squamous Cell Carcinoma of the Head and Neck
Authors: Sullivan Christopher Blake , Andresen Nicholas S. , Kendell Nicholas , Al-Qurayshi Zaid , Pagedar Nitin A. 
Published: May 2019

Objectives: Survival outcomes for advanced non-melanoma skin cancers of the head and neck treated with surgical resection are not well described in the literature. We aimed to describe outcomes for T3 and T4 cutaneoous squamous cell carcinoma of the head or neck treated with surgical resection at 1 tertiary academic medical center. Methods: We analyzed a retrospective cohort of patients diagnosed with T3 or T4 cutaneous squamous cell carcinoma (SCC) of the head or neck from 2005 to 2016 treated with definitive surgical resection. Survival outcomes were examined using Kaplan-Meier analysis, and multivariate analysis was completed with Cox proportional hazard model. Results: Forty-three patients met inclusion criteria. The mean age at diagnosis was 74.7 years (SD = 10.2), and 34 (79.1%) patients were male. Twelve (27.9%) patients were immunosuppressed. Radical resection, defined as temporal bone resection, orbital exenteration, calvarial resection, mandibulectomy, or maxillectomy, was performed in 25 (58.1%) cases. Final surgical margins were positive in 19 (44.2%) cases. Patients with tumors of the scalp/neck had a 1-year survival probability of 85.7%, and the probability of survival 1 year after a neck dissection was greater than 93%. Conclusion: Anatomical subsites, specifically scalp/neck tumors, tended to have worse overall survival. Positive final margins tended to indicate a worse prognosis, and overall survival and recurrence were not significantly different among patients who underwent radical surgical resection compared to soft tissue resection.
Extending the Reach of Pediatric Emergency Preparedness: A Virtual Tabletop Exercise Targeting Children’s Needs
Authors: So Marvin , Dziuban Eric J. , Franks Jessica L. , Cobham-Owens Karen , Schonfeld David J. , Gardner Aaron H. , Krug Steven E. , Peacock Georgina , Chung Sarita 
Published: May 2019

Objectives: Virtual tabletop exercises (VTTXs) simulate disaster scenarios to help participants improve their emergency-planning capacity. The objectives of our study were to (1) evaluate the effectiveness of a VTTX in improving preparedness capabilities specific to children’s needs among pediatricians and public health practitioners, (2) document follow-up actions, and (3) identify exercise strengths and weaknesses. Methods: In February 2017, we conducted and evaluated a VTTX facilitated via videoconferencing among 26 pediatricians and public health practitioners from 4 states. Using a mixed-methods design, we assessed participants’ knowledge and confidence to fulfill targeted federal preparedness capabilities immediately before and after the exercise. We also evaluated the degree to which participants made progress on actions through surveys 1 month (n = 14) and 6 months (n = 14) after the exercise. Results: Participants reported a greater ability to identify their state’s pediatric emergency preparedness strengths and weaknesses after the exercise (16 of 18) compared with before the exercise (10 of 18). We also observed increases in (1) knowledge of and confidence in performing most pediatric emergency preparedness capabilities and (2) most dimensions of interprofessional collaboration. From 1 month to 6 months after the exercise, participants (n = 14) self-reported making progress in increasing awareness for potential preparedness partners and in conducting similar pediatric exercises (from 4-7 for both). Conclusions: Participants viewed the VTTX positively and indicated increased pediatric emergency preparedness knowledge and confidence. Addressing barriers to improving local pediatric emergency preparedness—particularly long term—is an important target for future tabletop exercises.
Acute Effects of Antileukotrienes on Sinonasal Polyposis and Sinusitis
Authors: Parnes Steven M. , Chuma Andrew V. 
Published: May 2019

Recently, leukotrienes have been implicated in the mediation of bronchoconstriction and inflammatory changes in asthma. Leukotriene levels have also been shown to be elevated in patients with asthma as well as in those with sinonasal polyposis and sinusitis. The leukotriene synthesis inhibitor zileuton and the leukotriene receptor antagonist zafirlukast have been shown to produce subjective and objective improvements in patients with mild to moderate asthma. Given these findings, we evaluated the efficacy of these two medications in controlling sinonasal polyposis and their associated symptoms. We treated 40 patients diagnosed with sinonasal polyposis and sinusitis with either zileuton or zafirlukast. No other change was made in their standard therapy. Outcome measures included subjective interviews and questionnaire responses, as well as office endoscopic examinations and chart reviews. At study's end, 36 patients were available for evaluation. Twenty-six had taken zafirlukast, five had taken zileuton, and five others had switched from zafirlukast to zileuton. Overall, 26 patients (72%) experienced subjective improvement in their symptomatology after starting their medication. Statistically significant improvement was noted with respect to headache, facial pain and pressure, ear discomfort, dentalgia, purulent nasal discharge, postnasal drip, nasal congestion and obstruction, olfaction, and fever. An objective alleviation, or at least stabilization, of sinonasal polyposis was seen in 50% of the patients. Four patients (11%) discontinued their medication because of side effects. We conclude that antileukotrienes might play a significant role in controlling polyposis and symptoms secondary to sinonasal disease, and they might be a viable alternative to long-term oral steroid therapy and repeated surgical debridement.
Standardized Measurements of Radiographic Films of the Frontal Sinuses: An Aid to Identifying Unknown Persons
Authors: De Andrade Quintanilha Ribeiro Fernando 
Published: May 2019

Many methods have been used to identify unknown persons. The most common is the study of fingerprints, which is one of the few methods in which data can be stored and retrieved in a precise and cost-effective manner. The asymmetry of the frontal sinuses has stimulated several attempts to identify persons by analyzing measurements of the sinuses obtained from plain x-ray films. However, an objective and reproducible method has not been achieved. The objective of this paper is to report on a method of making standardized measurements of the frontal sinuses on radiographs and storing the resultant information in a computer databank. To test the system, the author made new measurements on 100 x-rays and entered the results into a computer databank that contained information on earlier measurements of the same 100 x-rays and on 400 others. With the aid of the databank, the author was able to rapidly and accurately match each new measurement with the earlier measurement. The author concludes that such a system is a simple and cost-effective method of establishing the identification of unknown persons for whom frontal sinus x-rays exist.
Fibrous Dysplasia of the Temporal Bone: Report of a Case and a Review of its Characteristics
Authors: Papadakis Chariton E. , Skoulakis Charalambos E. , Prokopakis Emmanuel P. , Nikolidakis Antonios A. , Bizakis John G. , Velegrakis George A. , Helidonis Emmanuel S. 
Published: May 2019

Fibrous dysplasia is an uncommon benign disorder of unknown etiology. It represents a disturbance of normal bone development—specifically a defect in osteoblastic differentiation and maturation that originates in the mesenchymal precursor of the bone. Because fibrous dysplasia shows a predilection for the facial and cranial bones, where it causes deformity and dysfunction, the disease is of particular interest to the otolaryngologist. In this paper, we report a case of fibrous dysplasia of the temporal bone, the first symptom of which was a mixed hearing loss. We discuss the characteristic features of this specific location of the disease, the differential diagnosis, and the treatment policy. We also address the issue of secondary sensorineural hearing loss.
Yolk Sac Tumor of the Temporal Bone: Report of a Case
Authors: Frank Thomas C. , Anand Vinod K. , Subramony Charu 
Published: May 2019

Yolk sac tumor (endodermal sinus tumor) is rarely encountered in the temporal bone. Facial nerve paralysis can be a primary manifestation of this condition. Histologically, the tumor can be difficult to diagnose, although elevated levels of alpha fetoprotein can facilitate its identification. In this report, we describe the case of an 18-month-old girl who developed peripheral VIIth nerve palsy and a polypoid mass in the left external ear canal 3 months following myringotomy. Computed tomography and magnetic resonance imaging revealed that the tumor involved the left external ear canal, middle ear space, and mastoid air cells. Biopsies were consistent with a yolk sac tumor. Special staining demonstrated that only a very few tumor cells were positive for alpha fetoprotein, despite the markedly elevated level of alpha fetoprotein in her serum. The patient was treated with chemotherapy, which included cisplatin, etoposide, and bleomycin. Within a period of weeks, she experienced a complete reversal of her left VIIth nerve palsy, a marked decrease in her serum alpha fetoprotein levels, and a dramatic resolution of the tumor as demonstrated radio graphically. Such a successful chemotherapeutic response in this case argues against surgical intervention in other cases, particularly in view of the risk of serious complications with surgery.
Persistent Measles Virus Infection as a Possible Cause of Otosclerosis: State of the Art
Authors: Niedermeyer Hans P. , Arnold Wolfgang , Neubert Wolfgang J. , Sedlmeier Reinhard 
Published: May 2019

The etiopathogenesis of otosclerosis is still largely unexplained and remains controversial. Morphologic examinations have shown the presence of a chronic inflammation in otosclerotic tissue. Among the proposed explanations for this inflammation are an immunologic reaction against collagen, mutations of collagen gene 1A1, and a viral infection. In this paper, we focus on the role of measles virus in otosclerosis, and we review the current literature, devoting particular attention to a suspected paramyxoviral etiopathogenesis in Paget's disease. Our examination of footplate fragments by reverse transcription polymerase chain reaction testing in 95 patients with otosclerosis revealed the presence of measles virus RNA in 83% of cases. Quantification of measles virus immunoglobulin G (IgG) in otosclerosis patients indicated that the ratio of antimeasles virus IgG in total IgG was higher in perilymph than in serum. Furthermore, an almost identical incidence of otosclerosis and measles virus-caused mortality in women suggests that women are more susceptible to measles virus infection. Finally, since the introduction of the measles virus vaccination program in Europe, there has been a decline in the incidence of otosclerosis. Moreover, the average age of patients at diagnosis and surgery at our hospital has increased to 54 years. Our findings, when they are considered along with findings regarding the presence of paramyxoviral RNA in Paget's disease, support the hypothesis that measles virus is involved in the etiopathogenesis of otosclerosis.
Extrusion Rate of Shah and Shepard Ventilation Tubes in Children
Authors: Hussain S. S. M. 
Published: May 2019

Shah and Shepard ventilation tubes are the two most commonly used ventilation tube in current practice. In some centres these two tubes are used interchangeably, in others the Shepard is often used as the first ‘grommet’ of insertion and the Shah for subsequent insertions. A study was undertaken of extrusion rate of these ventilation tubes in 180 children who had surgery for Serous otitis media in 1987. Extrusion time was found to be very significantly different between these tubes. The Shah ventilation tube remains in situ 3 months longer than the Shepard. A case is made for the use of Shah ventilation tubes as the first “grommet” of insertion. Otorrhoea following insertion of ventilation tube did not affect the extrusion rate of ventilation tubes in this study. Nor has otorrhoea a predilection for any particular ventilation tube.