bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modern Pharmacotherapies Revivify Patulous Eustachian Tube as Di Bartolomeo's Syndrome of Misophonic Autophony
Authors: Di Bartolomeo Joseph R. , Gallo Andrea , Di Bartolomeo Maxine G. , Di Bartolomeo Raymond O. 
Published: August 2013

Objectives:1) Analyze the contemporary etiologic factors for the increasing incidence of rare patulous Eustachian Tube (PET) disorders within this century. 2) Enable physicians to recognize this elusive syndrome in the clinical otologic history and physical examination. 3) Identify the specific etiologies causing the PET in Di Bartolomeo's Syndrome of pathognomic autophony and the complex factors that enable the disturbing autogenic tubular sounds.Methods:Double blind, random clinical trial, employing the preferred topical nasal medication. A collateral PET study (2002‐2006) to formulate a drug‐free remedy which supports healing and tissue strength, within the generally regarded as safe (GRAS) Food and Drug Administration standards. The National Institutes of Health, and collateral PET support group social media forum, informed new PET inquirers of The Ear Foundation's former research website.160 subjects completed the study. In the online forum, 3,500 PET patients (4,000 ears) were treated. The results of the investigational new drug clinical trials and separate drug‐free study are presented.Results:Recent scientific and cultural advances in this century are identified which facilitate the evolution and increase in patients with disabling PET symptoms. Each has an individual multi‐factorial and enigmatic etiology and mechanism of action.Conclusions:None provided by author.
A New Method for Identifying Cochlear Ossification in Cochlear Implant Candidates with Deafness following Meningitis
Authors: Ichikawa Kazunori , Kashio Akinori , Ochi Atushi , Karino Shotaro , Sakamoto Takashi , Kakigi Akinobu , Yamasoba Tatsuya 
Published: August 2013

Objectives:To develop a new method to determine the presence of intracochlear ossification and/or fibrosis in candidates for cochlear implantation (CI) with deafness following meningitis.Methods:This study involved 13 patients (15 ears: normal structures, soft tissue alone, partial bony occlusion, and complete bony occlusion in 4, 3, 2, and 6 ears, respectively) with profound deafness due to meningitis who underwent CI. We measured the radiodensity in Hounsfield Units (HU) using 0.5‐mm‐thick, axial, high‐resolution computed tomography (CT) image slices at 3 different points in the basal turn, including the fenestration site and inferior and ascending segment sites, which were located along the electrode‐insertion path. Pixel‐level analysis on the DICOM viewer yielded actual CT values of intracochlear soft tissues by eliminating the partial volume effect. The values were compared with the intraoperative findings.Results:Values for ossification (n = 12) ranged from +547 HU to +1137 HU (n = 12); for fibrosis (n = 11), from +154 HU to +574 HU (n = 11); and for presence of fluid (n = 22), from −49 HU to +255 HU. From these values, we developed 2 presets of window width (WW) and window level (WL): 1) WW: 1800, WL: 1100 (200 HU to 2000 HU) and 2) WW: 1500, WL: 1250 (500 HU to 2000 HU). The results using these 2 presets corresponded well with the intraoperative findings.Conclusions:Our new method is easy and feasible to preoperatively determine the presence of cochlear ossification and/or fibrosis that develop following meningitis.
Nocturnal Middle Ear Pressure and the Effects of Continuous Positive Airway Pressure
Authors: Thom Joshua J. , Carlson Matthew L. , Driscoll Colin L.W. , St. Louis Erik K. , Ramar Kannan , Olson Eric J. , Neff Brian A. 
Published: August 2013

Objectives:1) Quantify normal middle ear pressure during sleep; 2) Quantify middle ear pressure during sleep in the presence of continuous positive airway pressure (CPAP).Methods:A prospective cohort study was conducted on adults without middle ear disease undergoing polysomnography at a tertiary referral sleep medicine center during 2012. Tympanometry was performed on sleeping patients, and middle ear pressure was recorded at 1‐hour intervals during diagnostic polysomnography and at all CPAP levels during CPAP titration. Mean middle ear pressures were calculated. Pearson correlation coefficients (r) were used for analysis.Results:Ten adults with type A tympanograms and normal otoscopic examinations were included (4 females; 6 males; mean age 58 years). The mean awake middle ear pressure was 3.2 decapascals (daPa). The mean middle ear pressure during sleep without CPAP rose steadily from 14.3 daPa at 1 hour to 41.4 daPa at 4 hours, r = 0.53 (P < 0.001). The mean middle ear pressure did not change with sleep stages (P = 0.99). At a CPAP of 5 cm of water, the mean middle ear pressure was 53.7 daPa. The mean middle ear pressure rose with increasing CPAP levels and was 104 daPa at 10 cm of water, r = 0.86 (P < 0.001).Conclusions:In normal ears, middle ear pressure rises with time asleep. CPAP causes a greater than physiologic elevation in middle ear pressure that rises with increasing CPAP levels. These findings may help guide future studies examining the safety of CPAP following ear surgery and potential therapeutic roles for CPAP in patients with middle ear disease.
Modified Z‐Plasty of the Ala to Relieve Nasal Vestibular Stenosis
Authors: Hariri Ahmad , Choudhury Natasha , Saleh Hesham 
Published: August 2013

Objectives:Nasal vestibular stenosis results in significant functional impairment and cosmetic deformity. Various techniques can be used, including excision of the deformed segment and replacement with healthy tissue using local flaps, composite or cartilage grafts, with or without stents. W‐plasty, Z‐plasty, and double‐cross plasty techniques have also been described. We aimed to evaluate the following outcome measures: 1) Describe our modified Z‐plasty technique to widen the ala base. 2) Report patient satisfaction with respect to functional and cosmetic improvement.Methods:A retrospective study over a 4‐year period was conducted on patients who underwent modified Z‐plasty of the ala. This is performed under general anaesthetic, with infiltration of 2% lignocaine, and 1:80,000 adrenaline to the lateral alar margin and adjacent soft tissue, overlying the piriform aperture margin. A Z‐plasty incision is made around the lateral ala and anterior nasal process of maxilla. The two triangular flaps are transposed to lateralize the ala and widen the vestibule.Results:Six patients have undergone modified Z‐plasty of the ala, including 5 females and 1 male, with a mean age of 40 +/‐13.5years. All patients presented with narrowing of the vestibule from scarring of the ala, secondary to burn, blast, and traumatic injuries. All patients confirmed significant improvement in their nasal breathing. There were no post‐operative complications.Conclusions:Nasal vestibular stenosis is a challenging deformity, with a variety of potential surgical approaches. We describe our modified Z‐plasty of the ala, which we have used in 6 patients, all of whom have reported both functional and cosmetic improvement.
Outcomes following Semicircular Canal Plugging
Authors: Goddard John C. , Wilkinson Eric P. , Friedman Rick A. 
Published: August 2013

Objectives:1) Examine audiometric outcomes following semicircular canal plugging for either superior semicircular canal dehiscence syndrome or refractory positional vertigo. 2) Review symptom control rates and complication rates for canal plugging procedures.Methods:Retrospective chart review at a private neurotologic tertiary referral center. Patients undergoing semicircular canal plugging for superior semicircular canal dehiscence syndrome or refractory positional vertigo from January 1, 2007, to December 31, 2012, were included. Pre‐ and postoperative audiometry, operative findings, and clinical symptoms were assessed through chart review. Acoustic reflex testing, vestibular testing, and canal dehiscence size were examined in superior canal dehiscence patients.Results:A total of 28 patients underwent a canal plugging procedure during the study period: 24 superior canal dehiscence syndrome patients and 4 posterior canal occlusion patients. Postoperative air conduction pure‐tone averages were 22.5 and 13.0 dB for these two groups, respectively, compared to their preoperative values of 21.1 and 11.0 dB. The average pre‐ and postoperative word‐recognition scores for the entire cohort were 96.2% and 94.0%. Vestibular evoked myogenic potential data showed reduced thresholds in 7 canal dehiscence patients. The average size of the canal dehiscence, based on preoperative radiological measurements, was 3.4 mm. Surgical complications were limited to one temporary facial weakness (Grade 2). Complete symptom improvement was noted in 35.7% of all patients, while 16.7% of canal dehiscence patients reported no change in symptoms.Conclusions:Semicircular canal plugging procedures are associated with excellent hearing outcomes and may reduce preoperative symptoms in patients with canal dehiscence and refractory positional vertigo.
Randomized Controlled Trial to Assess the ACE Program for Rehabilitation in Patients with Hearing Loss
Authors: Cardemil Felipe , Esquivel Patricia , Barría Tamara , Aguayo Lorena , Fuente Adrian , Espejo Maritza R. 
Published: August 2013

Objectives:Implement a standardized counselling program in elderly patients with hearing loss users of hearing aids and evaluate its utility in terms of adherence to hearing aids.Methods:A randomized clinical trial was carried out during the period from October 2011 to August 2012, with a follow‐up of 6 months, approved by the hospital ethics committee. Patients 65 years and older with hearing loss diagnosed by pure tone audiometry who were patients from the National Public Health Service were included. The intervention used was a rehabilitation program called Active Communication Education (ACE), designed in Australia in 2007, which aims to improve rehabilitation of hearing aids users. To assess adherence, the International Outcome Inventory for Hearing Aids scale was used.Results:One hundred and eighty patients were evaluated, corresponding to 90 control and 90 rehabilitated patients. The overall adherence of hearing aids use was 78%. There was no difference in sex, age, and audiometric variable groups. The average daily hours of use in the control group were 6.9 hours, compared with 9.6 hours in the intervention group (P < 0.0001). There was a significant association between the intervention and the use of the hearing aid, with a greater proportion of patients who used more than 8 hours per week in the intervention group (66.6% vs 33.3%, P < 0.001).Conclusions:The intervention implemented has shown excellent preliminary results in terms of time of use of the hearing aid. It would be useful to include this intervention in the hearing loss national public policy.
Round Window Vibroplasty in Infants and Children with Atretic Ear
Authors: Colletti Vittorio , Mandala Marco , Colletti Liliana 
Published: August 2013

Objectives:Evaluate long‐term safety and outcome of round window vibroplasty (RWVPL) by the placement of the floating mass transducer (FMT) on the round window membrane in infants and children with congenital aural atresia (CAA).Methods:External auditory canal and middle ear malformation, accompanied by more or less severe conductive or mixed hearing impairment characterize children and infants with CAA. Several atresiaplasty procedures have been proposed without evidence of long‐term air‐bone gap closure despite initial satisfactory outcome. Prospective study at atertiary referral center. Seven infants and 10 children with CAAwere judged not to be candidates for air and bone conductive hearing aids and their parents declined bone‐anchored hearing aids. Intervention: RW implantation with the Med‐El VSB. Main outcome measures: Pure tone audiogram and free‐field speech testing, free‐field Auditory Brainstem Response (ABR).Results:Significant improvements were observed in pure‐tone threshold and speech perception immediately after surgery and at follow‐up intervals (12 to 60 months) in older children (P <0.01). In infants and younger children free‐field ABRs showed a significant shift of the mean air conduction threshold from 110 dB sound pressure level (SPL) preoperatively to 40 dB SPL (P < 0.05) and 30 dB SPL (P < 0.01), respectively postoperatively and at the last follow‐up. No complications or instances of device extrusion were observed in this series of patients.Conclusions:RWVPL offers a safe, viable and improved treatment option for infants and children with CAA.
Single‐Stage Surgery for Placement of Pediatric Bone‐Anchored Hearing Aids
Authors: Agan Ashley D. , Isaacson Brandon , Roland Peter S. , Lee Kenneth H. , Kutz J. Walter 
Published: August 2013

Objectives:1) Determine the incidence of skin overgrowth and failure of osseointegration in pediatric patients undergoing single‐staged placement of a bone anchored hearing aid. 2) Compare these results to patients undergoing staged surgery.Methods:Pediatric patients who underwent placement of a bone anchored hearing aid in an academic pediatric medical center from July 1, 2006, to December 2012 were identified in a retrospective manner using CPT code 69714. Cause of hearing loss, surgical technique, staging of surgery, and postoperative findings including skin overgrowth and failure of osseointegration were recorded.Results:Sixty‐six patients underwent placement of a bone anchored hearing aid, with 11 patients undergoing bilateral surgery. Sixty‐four sides were performed in 1 stage and 13 sides in 2 stages. The overall osseointegration failure rate was 4.5%, all in patients who underwent single‐staged surgery. Two of these patients had Treacher‐Collins syndrome, and the other patient had craniofacial abnormalities. Five patients (7.5%) required revision surgery for skin overgrowth, with 4 having single‐stage surgery and the other having staged surgery.Conclusions:Single‐staged surgery placement of a bone anchored hearing aid is an acceptable alternative to staged surgery with low rates of osseointegration failure or skin overgrowth.
Social Isolation and Hearing Loss in the Elderly
Authors: Mick Paul T. , Lin Frank R. 
Published: August 2013

Objectives:By the end of the presentation the participant should better understand 1) the association between social isolation and hearing loss in the elderly; and 2) the consequences of social isolation and age‐related hearing loss on the health and functioning of older adults.Methods:Data from the National Health and Nutrition Examination Survey (NHANES) from 1999‐2006 were used to calculate odds ratios (OR) for the cross‐sectional association between social isolation and hearing level using multivariate logistic regression models. Social isolation was defined as a binary variable based on the presence or absence of emotional support, financial support, close friends, spouse, or partner. Hearing level was defined by pure tone average in the better hearing ear. Results were stratified by age categories (60‐69 and 70+).Results:1613 NHANES participants completed hearing testing and the social support questionnaire. Nine hundred and forty‐eight were aged 60‐69, and 664 were older than 70. The association between social isolation and 25 dB increments of hearing loss was significant in the 60‐69 year old age group (OR = 2.4, 95% CI = (1.36, 4.23) P = 0.003) but not in the 70+ age group (OR = 1.06, 95% CI = (0.62, 1.82), P = 0.82). The association in the 60‐69 year old age group was significantly stronger in women (OR = 4.0, 95% CI = (2.21, 7.36), P < 0.001) than men (OR = 0.98, 95% CI = (0.53,1.84), P = 0.96).Conclusions:There was a strong association between social isolation and hearing loss in 60‐69 year old women. The finding may contribute to our understanding of the consequences of hearing loss on the aging process.
Oncologic Safety of the Submental Flap for Reconstruction in Oral Cavity Malignancies
Authors: Howard Brittany E. , Nagel Thomas H. , Donald Carrlene B. , Hinni Michael L. , Hayden Richard E. 
Published: August 2013

Objectives:1) Recognize the submental flap as an excellent option for oral cavity reconstruction. 2) Evaluate the oncologic safety of the submental flap given transposition of potentially involved nodal basins to the reconstruction site.Methods:Retrospective chart review of submental flap reconstructions for oral cavity defects secondary to cancer resections performed at a tertiary referral center between 2001 and 2012. Analysis included tumor location, staging, reconstructive details, postoperative course, and outcomes.Results:Fifty patients were identified having undergone submental flap reconstruction of defects following resection for oral cavity malignancies. No patient had identifiable Level I nodal involvement. Patients’ ages ranged from 35 to 88 (mean 70) years old. Subsites involved were mobile tongue (n=11), buccal mucosa (n=12), retromolar trigone (n=9), hard palate (n=5), lip (n=3), superior alveolar ridge (n=3), and inferior alveolar ridge (3). AJCC staging of patients included stage II (n=16, 32%), stage III (n=10, 20%), and stage IVa disease (n = 28, 48%). All patients underwent a level 1A and 1B dissection with removal of the nodal basin and submandibular gland. The prevalence of occult lymph node metastasis involving level 1 was 10.6%. On follow‐up there were no local recurrences associated with submental flap transposition to the oral cavity. Tongue recurrence occurred in 1 patient with multifocal disease discrete from the submental flap reconstruction. There was 100% flap survival.Conclusions:The submental flap provides a rapid and reliable option for oral cavity defect reconstruction. With appropriate management of the level 1 nodal compartment oncologic outcomes are not compromised.
A Systematic Review of Electrocochleography (ECochG) in Ménière's Disease Diagnosis
Authors: Qi Li , Nunez Desmond A. 
Published: August 2013

Objectives:Electrocochleography (ECochG) is an objective test that can be used in the diagnosis of Ménière's Disease (MD). This study 1) reviews the sensitivity and specificity of non‐invasive ECochG in articles reporting on MD diagnosis over the past 10 years; 2) determines the non‐invasive ECochG test parameters that increase the test's sensitivity in MD diagnosis.Methods:An extensive search of Medline, the Cochrane library, EBASE, Web of Science, and Google Scholar was performed. Only English language articles published from 2002 to 2012 that diagnosed Ménière's disease based on the 1995 American Academy of Otolaryngology—Head and Neck Surgery criteria were included. The Oxford Centre for Evidence‐Based Medicine (March 2009) levels of evidence were adopted.Results:The most widely used diagnostic criteria show the click induced SP/AP amplitude ratio provides approximately 53‐70% sensitivity and 80‐90% specificity (evidence level 2). Combining click and tone burst induced ECochG derived measurement parameters SP/AP area ratio, latencies shift, amplitude ratio, and interaural SP/AP ratio provide approximately 84‐92% sensitivity with a specificity of approximately 85‐90% (evidence level 2).Conclusions:ECochG diagnostic specificity for MD is 80‐90%; however, the 53‐70% sensitivity of ECochG can be increased to 84‐92% by combining multiple measurements derived from click and tone burst ECochG.
Targeted Amelioration of Cisplatin‐Induced Ototoxicity
Authors: Mohan Shaulnie , Gratton Michael A. , Smyth Brendan , Phillips Grady , Namin Arya 
Published: August 2013

Objectives:Determine if local intratympanic (IT) administration of N‐acetylcysteine (LNAC) improves cochlear glutathione levels versus systemic LNAC intraperitoneal (IP) administration, as indicated by decreased oxidized (GSSG)/reduced (GSH) glutathione ratios. Cisplatin is a platinum based ototoxic chemotherapeutic agent that induces injury secondary to the accumulation of reactive oxygen species. This pilot study assesses if different LNAC formulations or modes of administration decrease cochlear oxidative stress (GSSG/GSH ratio).Methods:Cisplatin was administered subcutaneously for 3 days (5.5 mg/kg SC/day x 3). Single LNAC formulations were administered to guinea pigs either via IT (solution), IT (nanocapsular gel), or IP (250mg/kg) 2 hours prior to Day 1 cisplatin dosing. On Day 3, cochlear tissue was microdissected, flash frozen, stored ‐70ºC, and assayed within 21 days. The levels of GSSG and GSH in homogenized cochlear tissue supernatants were determined in white half area 96‐well plates (Corning) by assay kits (Promega) via luminometry (Dynex) and referenced per total protein (BCA assay, Pierce).Results:The greatest reduction in cisplatin induced GSSG/GSH occurred for LNAC 250 mg/kg IP pretreated animals, compared to the IT formulations and cisplatin only control groups.Conclusions:The greatest decrease of cochlear oxidative stress was seen when L‐NAC was delivered IP prior to cisplatin treatment. Further studies are needed to determine the effects on hearing thresholds and the utility of this proposed cisplatin protective treatment.
Transmastoid Approach to Spontaneous Temporal Bone CSF Leaks: Hearing Improvement and Success of Repair
Authors: Kim Leslie , Wisely Clayton E. , Dodson Edward E. 
Published: August 2013

Objectives:1) Recognize that transmastoid repair of spontaneous CSF leaks is safe and effective. 2) Recognize that improvement in conductive hearing loss is an achievable goal with this approach.Methods:This is a retrospective case review at a tertiary academic medical center of 17 consecutive patients (18 ears) who presented with spontaneous temporal bone CSF leaks over an 8‐year period. Clinical data, imaging, audiometry, operative reports, and postoperative course were reviewed. The primary outcome was success of the repair. The secondary outcome was hearing preservation.Results:Median age was 57.5 years. Mean body mass index was 39.27mg/kg2. All presented with chronic otorrhea after tympanostomy tube placement and conductive/mixed hearing loss. The mean preoperative air‐bone gap was 19dB. A transmastoid approach alone was used in 17 cases; 1 underwent middle fossa craniotomy approach. Defects were located over the tegmen mastoideum and tegmen tympani. Most repairs used autologous mastoid bone, temporalis fascia, and tissue sealant. Primary surgical repair was successful in 17 cases; 1 patient with persistent postoperative otorrhea subsequently underwent middle fossa craniotomy, but no frank leakage was found. No complications were encountered. The average improvement in postoperative air‐bone gap was 12dB. Closure of the air‐bone gap to <10dB occurred in over 80% of the cases.Conclusions:The transmastoid approach for repair of temporal bone CSF leak is safe and highly successful. Furthermore, the majority of patients in this series had excellent hearing results with closure of their air‐bone gap to <10dB, which has not been previously described.