bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fat Myringoplasty: Better Patient Selection for Better Results
Authors: Garem Hani F. El 
Published: September 2014

Objectives:(1) Evaluate the outcome of fat myringoplasty in relation to the perforation size. (2) Compare the outcome in relation to 2 fat sources (ear lobule and abdominal wall).Methods:This study was conducted between May 2012 and April 2013 in the ENT department, University of Alexandria, Egypt. It was carried out on 30 patients with tympanic membrane perforations <30% of its surface (20 patients with perforations equal or less than 2 mm and 10 patients with perforations exceeding 2 mm in diameter), and with a maximum air bone gap of 20 dB. There were 2 randomized groups. Group A: 15 patients who had myringoplasty with ear lobule fat. Group B: 15 patients operated on using abdominal wall fat. Patients were followed for 6 months postoperatively.Results:Among the 20 patients with a perforation size ≤2 mm, 18 patients (90%) succeeded and 2 (10%) failed. Among the 10 patients with a perforation exceeding 2 mm, 5 patients (50%) succeeded and 5 (50%) failed. There was a significant statistical difference between perforation size and success rate. In group A, 12 patients (80%) had successful operations and 3 patients (20%) failed. In group B, 11 patients (73.3%) were successful and 4 patients (26.7%) failed. There were no significant differences between the 2 groups with regard to the success rate and hence its relation to the fat source (P >. 05).Conclusions:Fat myringoplasty can be performed safely in cases with small perforations, especially up to 2 mm in diameter and small air bone gap. Ear lobule constitutes a convenient source of fat.
Hearing Screening in the Elderly: Preliminary Results
Authors: Vasconcelos Leticia B. , Vasconcelos Natália , Espindola Marcelo , Gomes Erika F. , Diogenes Levi 
Published: September 2014

Objectives:Presbycusis is hearing impairment resulting from aging. Hearing‐impaired elderly are more likely to experience emotional distress, social engagement restrictions, and depression. Hearing loss also affects posture and balance and predisposes patients to falls. In comparison to universal screening of newborns, efforts for early diagnosis and prevention of hearing loss in the elderly are still insufficient. A prevalence study of disabling hearing loss in a developing country detected 30% of affected elderly. The aim of the study was to perform a screening of disabling hearing loss (DHL) in the elderly in a city of a population of 500,000 and to detect hearing loss in the elderly without diagnosis and offer them audiologic rehabilitation.Methods:A cross‐sectional population screening of 70,000 elderly individuals of which approximately 21,000 are probably hearing impaired and about 12,000 are in need of some kind of rehabilitation. The work consists of promoting a city campaign to submit all citizens over 60 years to an ear, nose, and throat (ENT) consultation, including audiometric tests and survey applications.Results:In the first year, 4080 examinations were performed. Of these, 960 had indication for hearing aids. Statistical analysis was performed using descriptive and exploratory techniques of data.Conclusions:The preliminary results indicated a high prevalence of hearing impaired aged adults in whom medical intervention (rehabilitation) can potentially prevent further complications and co morbid conditions. In future perhaps we will have evidence to recommend universal screening in everyone above 65 years.
Histologic Analysis of Chronos in an Optogenetic‐Based Auditory Brainstem Implant Model
Authors: Lehmann Ashton E. , Kozin Elliott D. , Hight Ariel E. , Darrow Keith , Boyden Ed , Brown Chris , Lee Daniel J. 
Published: September 2014

Objectives:Optogenetics affords the potential for improved spatial resolution compared with electric stimulation in future auditory neuroprostheses. No histologic studies have yet examined the virally‐mediated gene transfer of Chronos, a new opsin, to the murine cochlear nucleus (CN). Herein, we aim to (1) identify CN regions and neurons receptive to gene transfer of Chronos and (2) describe the morphology of putative cell types that express Chronos.Methods:CBA/CaJ mice underwent CN‐targeted injection of Chronos. The Chronos construct consisted of an adeno‐associated viral vector (AA2/8), CAG promoter, and a fluorescent marker. Following a 4‐week incubation period, mice were sacrificed and intravascularly fixed with paraformaldehyde, and brains were extracted, sucrose cryoprotected, and cryostatically sectioned. Sections of 35‐µm thickness were co‐labeled with neuron‐specific markers microtubule associated protein‐2 and anti‐tubulin, beta III isoform and DAPI‐fluoromounted. Sections of 60‐µm thickness were DAPI‐fluoromounted, and confocal microscopy revealed cellular morphologies.Results:Opsin‐linked fluorescence demonstrates Chronos expression throughout the dorsal CN with contiguous extension routinely into the ventral CN and variably into the auditory nerve and inferior cerebellar peduncle. Chronos localizes to neuronal‐specific and nonneuronal populations. Confocal microscopy suggests involvement of a wide array of CN cell types, including morphologies consistent with pyramidal cells and giant cells.Conclusions:Our histologic analyses confirm widespread infection of multiple neuronal populations throughout the CN. This work sets the stage for correlation with ongoing neurophysiology experiments. Future work with CN‐specific promoters to target neuronal subpopulations may further improve clinical potential for an optogenetics‐based auditory neuroprosthesis.
Influence of Tinnitus on Auditory Spectral, Temporal Resolution, and Speech Perception Ability in Tinnitus Patients
Authors: Yu Kwang‐Kyu , An Yong‐Hwi , Won Jong Ho , Shim Hyun Joon , Yoon Sang Won 
Published: September 2014

Objectives:(1) Evaluate the influence of tinnitus upon the auditory spectral and temporal resolution. (2) Evaluate the effect of tinnitus on speech perception ability in noise.Methods:To exclude the effect of decreased hearing threshold, unilateral idiopathic tinnitus patients with symmetric hearing threshold were enrolled. The subjects were 13 patients with symmetric hearing loss >20 dB HL and binaural difference <10 dB at 0.25, 0.5, 1, 2, 3, 4, and 8 kHz, or who have normal hearing threshold and binaural difference <10 dB at 0.25, 0.5, 1, 2, 3, 4, and 8 kHz, and threshold discrepancies <15 dB at 9, 11.2, 12.5, 14, 16, 18, and 20 kHz. A total of 13 volunteers with normal hearing were enrolled as a control group. Four different psychoacoustic measurements were performed: (1) spectral‐ripple discrimination, (2) temporal modulation detection, (3) Schroeder‐phase discrimination, and (4) word recognition in noise.Results:There were no significant differences in spectral‐ripple threshold, temporal modulation detection threshold, and Schroeder‐phase discrimination between affected sides and non‐affected sides of unilateral tinnitus patients. For the word in noise test, affected sides showed worse signal‐to‐noise ratio compared to non‐affected side.Conclusions:We could not find any evidence that the tinnitus‐affected ears show worse spectral and temporal processing compared with nontinnitus ears in unilateral tinnitus patients. The spectral ripple discrimination data suggests that the tinnitus‐affected ear does not have more damage in its cochlea (especially the outer hair cell) causing the auditory filters to broaden compared with the nonaffected ear with the same hearing threshold.
In Vivo Cochlea Hair Cell Rescue after Noise‐Induced Hearing Loss Using Low‐Level Laser Therapy
Authors: Kim Se‐Hyung 
Published: September 2014

Objectives:There is no study regarding the effects of low level laser therapy (LLLT) on cochlear after noise‐induced hearing loss (NIHL). The aims of this study were to (1) elucidate the ability of LLLT applied to noise‐induced damaged cochlea to recover NIHL and (2) demonstrate histopathological changes of remaining outer hair cells (OHCs).Methods:A total of 6 rats (C group) for control and 9 rats (N group) as the noise‐exposure group were included. Nine rats were exposed to noise once and the left ears (NL side) were treated with low‐level laser daily. Right ears (N side) were the control sides. Hearing thresholds were observed through auditory brainstem response recordings. Thresholds were monitored before noise exposure and also after the twelfth irradiation. Cochlear pathology and number of OHCs were observed by scanning electron microscopy.Results:The initial average hearing threshold levels were 26 ± 4, 24 ± 5, 24 ± 5, 24 ± 3, 24 ± 5 dB SPL in 4, 8, 12, 16, 32 kHz, respectively. After noise exposure, N group thresholds were 63 ± 15, 64 ± 16, 71 ± 11, 73 ± 15, 67 ± 14 dB SPL. After 12 irradiations, NL side thresholds recovered significantly (27 ± 4, 26 ± 4, 28 ± 8, 30 ± 9, 27 ± 6 dB SPL, P <. 05). N side thresholds were 46 ± 16, 51 ± 13, 63 ± 16, 50 ± 12, 48 ± 14 dB SPL. OHC number was significantly larger in the NL side than the N side. In the C group, OHCs counts were 176 ± 16, 146 ± 5, 154 ± 6 cells for apical, middle, basal turns, respectively. N side counts were 122 ± 2, 113 ± 2, and 116 ± 19. NL side counts displayed promising results (167 ± 27, 140 ± 29, 129 ± 26).Conclusions:This study demonstrates that LLLT promotes recovery of hearing and OHCs survival from apoptotic changes by NIHL.
Is There an Association between Tinnitus Pitch and Hearing Loss?
Authors: Dalligna Celso , Rosito Leticia S. , Dalligna Daniela P. , Deutsch Konrado M. , Pappen Carlos H. , Sangoi Ana P. A. , Borges Felipe M. 
Published: September 2014

Objectives:Correlate tinnitus pitch to the audiometric frequencies of hearing loss.Methods:This cross‐sectional study evaluated 378 ears of consecutive patients diagnosed with hearing loss and chronic tinnitus of any etiology. Audiometry and acufenometry were performed at the first clinical evaluation; a tinnitus pitch within the frequencies of greatest hearing loss indicated a positive association. The acufenometric frequency was similarly assessed relative to the greatest hearing loss on audiometry. Data were compared using the Spearman correlation test and analyzed using SPSS.Results:In total, 61.6% of patients were female, and the mean patient age was 57.9 years. In 58% of cases, the tinnitus frequency was within the region of greatest hearing loss, but only 20% corresponded exactly to the highest hearing loss frequency. There was a weak correlation (r = 0.1, P =. 02) between the tinnitus pitch in acufenometry and the greatest hearing loss frequency in audiometry.Conclusions:The tinnitus pitch and the region of audiometric loss were correlated in most patients. In several cases, the tinnitus pitch corresponded to the exact frequency of greatest hearing impairment, and the 2 variables had a weak association.
Scar Cosmesis: Assessment, Perception, and Impact on Body Image and Quality of Life—A Systematic Review
Authors: Sethukumar Priya , Awad Zaid , Catling Finneas J. R. , Tolley Neil S. 
Published: September 2014

Objectives:(1) Review current validated scar assessment tools and (2) describe the impact of scar cosmesis perception on body image and quality of life.Methods:Three independent reviewers performed comprehensive searches and identified 680 English language studies published between 1950 and 2014 (data sources: Medline, EMBASE, Cochrane Library, and Web of Science). Literature including case series, cross sectional studies, meta‐analyses, and reviews was then screened and selected according to strict inclusion/exclusion criteria.Results:Scar assessment: Review included Vancouver Scar Scale, Patient and Observer Scar Assessment Scale, Manchester Scar Scale, Wound Evaluation Scale, and Western Scar Index. Validated qualitative assessment tools were clinically more useful than their quantitative counterparts. Patient perception input increased validity. Subjective satisfaction rating had little correlation with objective assessment of scarring. Perceptions: The size of defect did not correlate with impact, however location and visibility did. Psychosocial distress correlated with subjective severity. The large impact on physical and psychosocial quality of life (ascertained by generic and symptom‐specific validated assessment tools, as well as qualitative studies with interpretive phenomenologic analysis) is not to be overlooked.Conclusions:Careful selection of scar assessment tools is vital to gauge severity and plan further treatment. No consensus exists on the single most appropriate tool. A validated assessment tool is important in the assessment of scarring. There is a tendency to underestimate and thereby worsen the impact of scarring on patients’ quality of life. Further studies are required, particularly in the context of thyroid surgery.
Localization of a Specific Inward Rectifying Potassium Channel Protein in the Human Cochlea
Authors: Moore Michael W. , Conaway LaShardai , Hao Xingping , Schulte Bradley A. , Meyer Ted A. , Dubno Judy R. , Lang Hainan 
Published: September 2014

Objectives:Our study aims to determine the immunostaining pattern of Kir4.1 channels in human cochlear tissues. Potassium recycling pathways critical for maintaining cochlear ion homeostasis and the endocochlear potential have been defined largely in animal models. Potassium effluxed from sensory hair cells is taken up by supporting cells and returned to the stria vascularis via two distinct transcellular syncytial networks consisting of epithelial cells and spiral ligament fibrocytes. The inward rectifying potassium channel Kir4.1 appears to be an essential component of this process, as evidenced by murine knockout models lacking an endocochlear potential. Animal models have demonstrated robust Kir4.1 expression in several cell types along the cochlear potassium recycling pathway. However, Kir4.1 immunostaining patterns in the human cochlea remain undefined.Methods:Postmortem human temporal bones were collected through the Hearing Research Program at the Medical University of South Carolina. Temporal bones were fixed within 6 to 11 hours of death and underwent microwave decalcification prior to immunohistochemical staining for Kir4.1.Results:Robust Kir4.1 immunoreactivity was present in strial intermediate cells, outer sulcus root processes and glial cells in Rosenthal's canal. The distribution of Kir4.1 in the human cochlea was generally similar to that reported in animal models.Conclusions:Our findings suggest that Kir4.1 channels play a critical role in the regulation of potassium recirculation in the human cochlea. Further immunohistochemical analyses are necessary to fully delineate the precise location of Kir4.1 in the complex potassium recycling pathway and elucidate its potential role in lateral wall degeneration and associated hearing loss.
Mastoid Reduction in Combination with Corner‐Tag Meatoplasty: Refining Mastoidectomy and Canalplasty Outcomes
Authors: Zhang Edward Z. , Tan Leonard , Soon Sue Rene , Yuen Heng‐Wai 
Published: September 2014

Objectives:Prevention of “a problem cavity” following modified radical mastoidectomies (MRM) and canalplasties requires careful preoperative consideration and an adept surgical technique. We aim to describe our technique of a superiorly‐based middle temporal artery flap, with an inferiorly‐based musculoperiosteal flap, in combination with a Corner‐Tag‐meatoplasty, and to evaluate the surgical outcomes on a semi‐quantitative scale.Methods:Retrospective consecutive case review from 2010‐2013. Primary end‐point measure of creating a low maintenance dry mastoid cavity was graded using Merchant's grading system.Results:Twenty‐four patients (13 males and 11 females) with a mean age of 42.6 years (range, 17‐76 years) were included. All except 3 cases were primary ear cases. None had previous reduction procedures done. Nineteen cases were MRMs, 3 were revision mastoidectomies, and 2 were canalplasties. A well‐epithelized, dry mastoid cavity was achieved in 12 patients by 1‐month post surgery, with another 9 achieving this by 3‐months. Twenty‐three cases (96%) resulted in cavities with adequate control of infection based on Merchant's summary grade. The cavities took an average of 1.75 months to epithelize. Three patients had recurrent tympanic membrane perforation with one requiring revision surgery. None had disease recurrence at mean 15.8 months follow‐up (range, 6‐25 months). Our technique of meatoplasty allowed excellent visualization of the mastoid bowl affording bimanual instrumentation in the clinic setting.Conclusion:The middle temporal artery and inferior musculoperiosteal flap in combination with the Corner‐Tag meatoplasty is an effective technique in reducing the mastoid cavity, aiding epithelization, has low complication rates, and allows good surveillance postoperatively.
Microtopographical Features Recruit RhoA/ROCK through TRPV1 Channels to Direct Cell and Neurite Growth
Authors: Polacco Marc A. , Li Shufeng , Tuft Bradley , Xu Linjing , Clarke Joseph C. , Guymon Allan , Hansen Marlan R. 
Published: September 2014

Objectives:(1) Identify intracellular signaling pathways required for translating biophysical cues into directed neurite growth. (2) Describe the role of TRPVI channels as mediators of cell response to microtopographical features.Methods:Microscopic parallel grooves were generated on methacrylate polymers using photopolymerization. Spiral ganglion neurites (SGNs) were cultured on the polymers, and alignment to grooves was quantified using a ratio of aligned length to total neurite length. Control alignment was compared with that of SGNs treated with RhoA activator, RhoA inhibitor, ROCK inhibitors, cAMP and cGMP analogs, and TRPV channel inhibitors. RNA interference was used to reduce expression of ROCK and TRPVI to confirm that activity of each was required for alignment. Alignment of NIH3T3 fibroblasts was compared to fibroblasts transfected with TRPVI.Results:Neurites aligned preferentially to micropattern grooves. RhoA activator and cGMP analogs increased alignment, while RhoA inhibitor and cAMP analogs decreased alignment. ROCK inhibitors decreased neurite alignment, and SGNs transfected with ROCK‐targeted oligonucleotides also displayed reduction in alignment. Neurites exposed to TRPV inhibitors exhibited poor alignment, as did TRPVI knockdown cells. TRPVI‐transfected fibroblasts aligned more strongly than NIH3T3 fibroblasts. For all alignment comparisons, P <. 05.Conclusions:Microtopographic features generated via photopolymerization of methacrylate polymers activate RhoA and ROCK through TRPVI channels to direct cell and neurite alignment.
Osteonecrosis of the Temporal Bone Secondary to Bisphosphonates: A Potentially Life‐Threatening Complication
Authors: Amiraraghi Natasha , Yaneza May M. C. , Husami Yahya , Iyer Arunachalam 
Published: September 2014

Objectives:(1) Describe how osteonecrosis of the temporal bone can present as a potentially life‐threatening side effect of bisphosphonates. (2) Recognize that bisphosphonates are commonly prescribed and as such many of our patients could potentially experience these complications. (3) Apply this knowledge to achieve a timely diagnosis and to ensure patients are counseled regarding the risk of temporal bone osteonecrosis.Methods:Case study of 2 patients presenting to our clinic in Lanarkshire, Scotland, from 2012‐2013: Patient A: A 53‐year‐ old female with cholesteatoma was also receiving intravenous bisphosphonate therapy for osteoporosis. Patient B: A 57‐year‐ old female on bisphosphonates presented with a left‐sided facial palsy.Results:Patient A: During mastoidectomy the whole of the tegmen was noted to be brittle. A large piece of tegmen was found detached from the surrounding bone but was not affected by cholesteatoma. The tegmen defect was repaired and the patient is being followed up. Patient B had examination findings in keeping with otitis externa. A computed tomography scan demonstrated bone erosion involving the descending facial nerve. Comorbidities have prevented surgical management and despite discontinuing the bisphosphonate. The facial palsy has not resolved.Conclusions:Bisphosphonates can cause osteonecrosis of the temporal bone, including lower doses used to treat osteoporosis, especially in presence of localized infections. The otolaryngologist should be aware that complications such as tegmen erosion and facial palsy may occur. Patients with known infectious ear conditions considering treatment with bisphosphonates for osteoporosis should be counseled regarding the risk of osteonecrosis of the temporal bone.
Otitis Media with Effusion: Effectiveness of Clinical Treatment Assessed with Tympanometry
Authors: Almeida Emyle M. , Guercio Wilson B. , Vilela Marcela M. P. , Gomes Erika F. , Silva Renata F. , Chaves Kenia A. , Vasconcelos Natália 
Published: September 2014

Objectives:Otitis media with effusion (OME) is a common problem that generally affects children ages 6 months to 3 years. There are various otoscopic signs that indicate effusion, and the findings on tympanometry may help to diagnose OME. The aim of this ongoing study is to evaluate response to clinical treatment based on tympanometry.Methods:Prospective noncontrolled clinical assay of 25 patients with OME diagnosis, treated with oral antibiotics and nasal topical steroids from January 2013 to January 2014 in the otolaryngology department of Juiz de Fora Medical School in Brazil. The inclusion criteria were age from 2 to 12 years and signs of effusion on otoscopy and tympanometry. The exclusion criteria were antibiotic use during the previous month and history of chronic otologic disorder or congenital anomalies. The subjects were evaluated by tympanometry at the time of diagnosis and on day 30.Results:A total of 25 patients included 11 girls and 14 boys (3‐15 years old). Of the 50 ears assessed at the time of diagnosis, 28 (56%) had curve B and 22 (44%) had curve C. After 30 days, only 8 ears (16%) remained with curve B, 12 (24%) had curve C and 30 (60%) had curve A.Conclusions:Tympanometric results show that oral antibiotics associated with nasal topical steroids was effective in treating OME. Although watchful waiting is a recommendation of guidelines, there was a need for antibiotics because of upper airway infection. In developing countries access to medical attention could limit frequent consultations and lead to higher morbidity of untreated children.