bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tracking Myoblasts in the Development of Laryngeal Cellular Engineering Using Fluorescence Nanoparticles (“Quantum Dots”)
Authors: Fishman Jonathan M. , Urbani Luca , Ramesh Bala , Loizidou Marilena , Seifalian Alex M. , de Coppi Paolo , Birchall Martin A. 
Published: August 2013

Objectives:Stem‐cell based techniques have previously been successfully used to replace patients’ tracheae, but using similar techniques to replace an entire larynx remains challenging. Additionally, non‐immunogenic labelling techniques are required to track cells in vivo to determine the relative contribution of the implanted/donor stem cells with respect to the regeneration seen.Methods:We have developed and synthesized two quantum‐dots (QDs) using gold and mercury‐cadmium‐telluride (HgCdTe) that emit at near‐infrared wavelength (>700nm). Labelled C2C12 myoblasts were characterized with both QDs at different concentrations and incubation times. Labelled cells were visualized by confocal microscopy and transmission electron microscopy (TEM). Toxicity in vitro was determined using Alamar Blue assays and Ki67‐immunofluorescence. Myosin heavy chain and MyoD‐immunofluorescence were used to determine the effect of QDs on cellular differentiation.Results:We show that myoblasts can be optimally labelled with 800nm‐emitting gold‐nanoparticles that are non‐toxic and do not affect cell proliferation or differentiation in vitro (P > 0.05). Some toxicity‐related effects were seen with HgCdTe QDs, which led to smaller, less‐mature myofibers (P < 0.05). On TEM, QDs were seen early on adhering to cell membranes and within phagosomes at later time points.Conclusions:We present new data demonstrating that cells may be optimally labelled with QDs for tracking cells in organ development using tissue‐engineering approaches. Labelling with gold‐nanoparticles is associated with minimal associated toxicity and may provide an immunomodulatory influence, thereby preventing cell rejection. Such cell‐labelling techniques may be useful in tracking cells in real time in vivo to better understand the contribution of such cells towards regeneration.
Cholesteatoma Growth Patterns: Are There Audiometric Differences between Posterior Epitympanics and Mesotympanics?
Authors: Rosito Leticia S. , Selaimen Fábio A. , Pinto Bruno S. , Giugno Claudia S. , Tibes Pauletti Marcos G. , Smith Alessandra L. , da Costa Sady S. 
Published: August 2013

Objectives:Verify if there are differences in hearing impairment between posterior epitympanic and posterior mesotympanic cholesteatomas.Methods:This cross‐sectional study evaluated 278 ears with cholesteatoma and no previous surgery between August 2000 and January 2013. Otoendoscopy and pure tone audiometry were performed at the first evaluation. The video‐otoscopys were later analyzed and classified between the two main possible routes involved in cholesteatoma formation (posterior epitympanic and posterior mesotympanic). To compare the audiometric thresholds, we employed the Student t test.Results:The mean age was 33.7 years old, and 51.1% were male. The posterior epitympanic cholesteatoma was found in 51.4%. There were no differences in air and bone conduction thresholds between the two groups (P > 0.05). When the air‐bone gaps were compared, however, the posterior mesotympanics had greater thresholds in 500 Hz, 2000Hz, and tritonal mean (P = 0.003, P = 0.03, and P = 0.02, respectively)Conclusions:The posterior mesotympanic cholesteatomas had greater air‐bone gap thresholds in the speech frequencies when compared with posterior epitympanic cholesteatomas. However, the two growth patterns were very similar in the other audiometric parameters.
Clinical Efficacy and Safety of AM‐101 in the Treatment of Acute Tinntius
Authors: Staecker Hinrich , Morris John R. , Maxwell Kenneth , Van de Heyning Paul , Morawski Krzysztof F. , Muehlmeier Guido 
Published: August 2013

Objectives:Glutamate excitotoxicity following cochlear trauma can trigger aberrant excitation of the auditory neurons, resulting in tinnitus. AM‐101, a small molecule NMDA receptor antagonist, has shown evidence of preventing onset of tinnitus in animal models of cochlear trauma after intratympanic delivery. We present the results of the European and U.S. phase II clinical trials.Methods:Three hundred and twenty subjects with persistent tinnitus were enrolled in a double blind placebo controlled trial of AM‐101. Efficacy endpoints included change in subjective tinnitus loudness, annoyance, sleep difficulties, the THI‐12 questionnaire, and minimum masking level and loudness match. A patient global impression of change assessed the change in tinnitus severity over the study duration.Results:A dose dependent and statistically significant improvement of tinnitus loudness, annoyance, sleep difficulties, and the THI‐12 over placebo could be demonstrated in subjects with tinnitus following acute noise trauma or otitis media. The improvement was most pronounced in the AM‐101 810 µg/mL treatment group and continued to increase to Day 90 of the study. In contrast, the subgroup of sudden hearing loss related tinnitus did not show an improvement in tinnitus. The study drug was well tolerated.Conclusions:The study established human proof of concept for application of AM‐101 in the treatment of tinnitus arising from cochlear glutamate excitotoxicity. Local delivery of AM‐101 in a defined patient population in the acute stage of injury allows for a substantial and persisting attenuation of tinnitus with minimal systemic exposure and side effects.
Clinical Use of a Novel, Single‐Dose Treatment for Bacterial or Fungal Otitis Externa
Authors: Branch Matthew P. , Oglesbee Vance J. 
Published: August 2013

Objectives:To assess the efficacy of a novel, single‐dose, physician‐administered viscous suspension for treatment of either acute bacterial otitis externa (ABOE) or fungal otitis externa (FOE).Methods:Eighty‐nine consecutive patients seen by a single author in an outpatient, private practice clinic were diagnosed empirically with either ABOE (n = 52) or FOE (n = 37) based on patient symptoms, appearance of the external auditory canal, and presence or absence of fungal elements. All external auditory canals were debrided when necessary under microscopy, then filled with a viscous otic suspension containing clotrimazole 1%, ciprofloxacin 0.3%, and dexamethasone 0.1%. The canal was occluded with a cotton ball, and patients were followed up at various intervals.Results:Of the 52 ABOE patients, 48 experienced complete symptom resolution at 2.5 days on average and all patients had complete resolution on exam (2 patients had cellulitis requiring systemic antibiotics, 1 patient was nonverbal, and 1 patient had temporal‐mandibular joint arthralgia pain that persisted despite treatment). All 37 FOE patients experienced complete symptom relief at 3 days on average and normal exam at follow‐up. No patient experienced adverse effects from treatment, required debridement at follow‐up, or experienced recurrence.Conclusions:The novel suspension used in this study was capable of achieving a very high rate of clinical cure and complete symptom relief in three days or less on average for patients with ABOE or FOE using a single physician administered dose without adverse reactions.
Cochlear Trajectory in Pediatric Patients
Authors: Jackson Neal , Givens Victoria , Carpenter Clelie , Hurth Charles , Arriaga Moises , Ying Yu‐Lan Mary , Jeyakumar Anita S. 
Published: August 2013

Objectives:1) Study pediatric temporal bone anatomy using high resolution temporal bone imaging. 2) Analyze the anatomical differences in infant (< 2 years old) versus toddler (2‐5 years old) versus child (6‐10 years old) versus preadolescent and adolescent (>10 years old) as it pertains to cochlear implantationMethods:A retrospective chart and radiologic review was done of pediatric patients at our institution undergoing high resolution computed tomography (CT) scan of the temporal bones from April 2001 to February 2013. Charts were reviewed for clinical and demographic information. Scans were reviewed by experienced surgeons, radiologists, or both to study the Cobb angle between an ideal trajectory of a cochlear implant into the basal turn of the cochlea and a realistic approach for surgical insertion.Results:Seven hundred fifty patients were identified. Seven hundred and twenty‐three charts and scans (1446 ears) were reviewed, and 27 patients were eliminated due to poor scan quality. The age range was 8 days to 22 years. Fifty‐six point three percent (n = 407) of patients were male. Each group of patients was evaluated. One hundred and five patients were < 2 years old, with Cobb's angle ranging 22.3‐36.4°. One hundred and forty‐seven patients were 2‐5 years old, with Cobb's angle ranging 14.6‐31.7°. Two hundred four patients were 6‐10 years old, with Cobb's angle ranging 7.7‐22.3°. Two hundred and fifty‐seven patients were >10 years old, with Cobb's angle ranging 7.7‐27.2°.Conclusions:Despite considerable variations, there is a substantial difference in the Cobb's angle among the age groups. The largest difference is between infancy (< 2 years old) and toddler (2‐5 years old). These differences are surgically relevant for round window identification and facial nerve safety during cochlear implant surgery in infants.
The Correlation between Hearing Loss and Obesity in Adolescents
Authors: Ahmed Sameer , Shapiro Nina L. , Bhattacharyya Neil 
Published: August 2013

Objectives:Understand the relationship between obesity and hearing loss (HL) in adolescents.Methods:Adolescents (ages 12‐19) were examined in the National Health and Nutrition Examination Survey from 2007‐08 and 2009‐10. Extracted data included age, sex, ethnicity, poverty‐income ratio, and body mass index (BMI). Obesity was assessed according to age/sex specific criteria. Patients underwent formal audiometry as part of the survey protocol. The “low” pure tone average (PTA at 500, 1000, and 2000 Hz) and “high” PTA (3000, 4000, 6000, and 8000 Hz) were computed. Patients were classified as having low and/or high tone HL if the respective PTA was greater than 15 dB. Multivariate analyses were conducted to determine the relationship between obesity and hearing loss.Results:27.7 +/‐ 1.2 million adolescents (unweighted n = 2,062) were examined. 13.1 +/‐ 2.1% of obese adolescents had low tone HL versus 8.5 +/‐ 1.0% of non‐obese adolescents. Similarly, 20.0 +/‐ 2.6% of obese adolescents had high tone HL versus 13.4 +/‐ 1.3% of non‐obese adolescents. On multivariate analysis, low tone HL was not associated with obesity (P = 0.074). However, obesity was associated with high tone HL in either ear with an increased odds ratio of 1.58 (95% confidence interval 1.12‐2.22; P = 0.011). Similarly, obesity was associated with bilateral high tone HL with an increased odds ratio of 1.88 (1.15‐3.07; P = 0.013). Both low and high PTAs in the better hearing ear increased with increasing BMI (P = 0.001 and P = 0.006, respectively).Conclusions:Obesity has a notable relationship with the presence and degree of HL in adolescents, particularly in the high frequencies, and further investigation is warranted.
Effect of Alcohol Consumption on Balance as Measured by Posturography
Authors: Stansifer Kyle J. , Moran‐Hansen Jessica , Aberle Katherine , Morrow Trish , Moore Gary , Jones Dwight T. 
Published: August 2013

Objectives:Evaluate the effect of increasing blood alcohol concentration (BAC) on the vestibular system as measured by abnormal body sway on posturography. Determine if there is a consistent level of BAC during which sway becomes adversely affected, as suggested by legal state limits of BAC for driving.Methods:Prospective study of 30 healthy adults randomized to alcohol versus no alcohol who consumed one beverage hourly followed by BAC measurement by BACtrack Select S80 Breathalyzer and posturography on both firm/soft surfaces with eyes open/closed. Primary outcome was dose‐response rate of BAC on mean body sway. Nonlinear growth models were used to control for covariates.Results:The experimental (alcohol) group had 20 adults, and the control (no alcohol) group had 10 adults. BAC levels measured by breathalyzer ranged from 0 to 0.12. Overall analysis showed no statistically significant difference between male and female performance (P > 0.05). Increased alcohol consumption was associated with increased abnormal body sway (P < 0.05); however, the exact level of BAC inducing abnormal sway was variable from individual to individual. An ANOVA model demonstrated a trend toward a learning curve with repeat posturography for the control group.Conclusions:This study demonstrated increasing vestibular dysfunction from increasing alcohol ingestion as measured with abnormal body sway by posturography. While all participants eventually showed increased sway with increased BAC, the point at which abnormal sway became evident was highly variable between individuals. Therefore, using strict state legal BAC limits do not always correlate with balance impairment.
Effects of Gonadal Steroids and Electrical Stimulation on Cell Survival following Intracranial Facial Nerve Injury
Authors: Amine Muhamad , Monaco Gina N. , Burgette Ryan C. , Benscoter Brent J. , Marzo Sam J. , Foecking Eileen 
Published: August 2013

Objectives:The purpose of this study was to assess 1) the degree of motoneuron cell loss and 2) the combinatorial effects of electrical stimulation (ES) and testosterone propionate (TP) on cell survival following an intracranial facial nerve crush injury and 3) to compare these results to distal injuries.Methods:Study Design: Prospective, randomized, controlled animal study. Sprague‐Dawley rats were randomly divided into three groups: intracranial sham surgery or intracranial crush injury with or without ES and TP treatments. The intracranial sham group underwent exposure of the meatal segment of the right facial nerve. The intracranial crush groups underwent a crush of the meatal segment following exposure with or without ES and TP treatment immediately following the injury and were followed for 8 weeks. Brain sections were thionin‐stained, and facial motoneurons were counted using light microscopy. Results were compared to intratemporal and extracranial facial nerve crush injuries.Results:Intracranial crush injury resulted in a significant decrease in cell survival of 65.6% as compared to the sham group (99.4%). The treatments increased cell survival to 93.8%. The cell loss in the intracranial facial nerve injury is more substantial than the intratemporal (85.8%) and extracranial (103.3%) injuries.Conclusions:Intracranial injury results in a more profound cell loss compared to the distal injuries; however, combinatory treatments improve facial motoneuron survivability regardless of injury location. These data suggest the important clinical implication that this combinatorial treatment may significantly improve cell survival and therefore facial nerve function following even the most severe facial nerve injuries.
Endolymphatic Periductal Channels: Possible Role in Ménière's Disease
Authors: Doherty Joni K. , Richard Celine , Fayad Jose N. , Linthicum Frederick H. 
Published: August 2013

Objectives:Characterize the osseous periductal channels surrounding the human endolymphatic duct. Endolymphatic hydrops is the fundamental pathophysiology underlying Ménière's disease. Elucidating the regulation of endolymphatic circulation is central to understanding the cause of Ménière's disease attacks of vertigo and hearing loss.Methods:Formalin‐fixed, celloidin‐embedded human temporal bones were sectioned to 20 microns, and every section was stained with hematoxylin & eosin. Amira software was used to construct a three dimensional image of the periductal channels. We performed immunohistochemical analysis using antibodies directed against vascular, lymphatic, and neural crest markers. The microanatomy was investigated with electron microscopy of the periductal channel epithelium. Finally, we injected horseradish peroxidase into the scala media of guinea pigs to investigate the flow patterns involving these peri‐ductal channels.Results:Surrounding the human endolymphatic duct is a group of small channels that originate in the proximal cisternal area of the endolymphatic sac and terminate in the supporting tissue of the saccule, as demonstrated by 3D reconstructions. Endolymphatic hydrops was found in eight bones with blocked ducts and blocked or absent periductal channels. Proliferation of channels was evident in temporal bones when the channels were disrupted on one side. Immunohistochemical analysis results suggest a neuroectodermal origin, similar to the cells of the cochlear spiral ligament. Some contain micro‐vessels with single endothelial walls that could represent lymphatics or empty capillaries while others suggest a complex absortive epithelium.Conclusions:This temporal bone study suggests a role for the periductal channels in absorption of endolymph.
Endolymphatic Shunt Surgery in the Era of Intratympanic Gentamycin
Authors: Moon Il J. , Golub Justin S. , Rubinstein Jay T. 
Published: August 2013

Objectives:Report hearing and vertigo outcomes of endolymphatic shunt surgery (ESS) patients with American Academy of Otolaryngology—Head and Neck Surgery (AAO‐HNS) definite Ménière's disease.Methods:We retrospectively reviewed charts of medically intractable Ménière's patients who underwent ESS at the University of Washington Medical Center. Thirty patients underwent ESS between 2005 and 2012. The surgical outcome was evaluated based on the 1995 guidelines of the American Academy of Otolaryngology—Head and Neck Surgery. Frequency of major vertiginous episodes was measured, and successful control of vertigo is considered as Class A or B (reduced by 60% to 100%). Pure‐tone average (PTA; 0.5, 1, 2, and 4 kHz) and word recognition score (WRS) that were obtained before and after treatment are compared.Results:Mean age was 46.9 years, and mean follow‐up duration was 23.1 months. Mean symptom duration prior to ESS was 5.3 years. Control of vertigo was achieved in 77.8% of the patients at the last follow‐up. Seven (25.9%) patients underwent secondary treatment, such as vestibular neurectomy or labyrinthectomy, for definite vertigo control. The mean PTA before and after surgery changed from 43.9 dB to 40.0 dB (P = 0.097), and the mean WRS significantly improved from 68.6% to 77.8% (P = 0.003). Three (10%) patients showed hearing deterioration following treatment.Conclusions:Endolymphatic shunt surgery provided successful vertigo control with a low rate of hearing deterioration associated with the surgery. Despite the good results reported by some authors with intratympanic gentamycin, ESS remains a valuable intervention after failure of medical management.
The Diaspora of Otolaryngologists after Residency Training
Authors: Thompson Christopher R. , Otto Randal A. , Miller Frank R. 
Published: August 2013

Objectives:1) Describe the transition of otolaryngologists from residency to clinical practice. 2) Provide data to state and local communities who could be sources of supplementary funding for graduate medical education.Methods:Cross sectional data from the 2009‐2010 Member Directory of the American Academy of Otolaryngology‐Head and Neck Surgery were analyzed. The sample included fellows of the AAO‐HNS practicing within the US and graduating from residency programs accredited by the ACGME. First year fellows, fellows of greater than thirty‐five years, and military fellows were excluded. Data from 5,870 otolaryngologists were analyzed. To evaluate trends within generations and career paths, subsets were divided by academic or non‐academic practice and by decade of completion of residency.Results:Relative to their residency program, 1/3 of otolaryngologists practice within 100 miles, 1/3 practice within 100‐500 miles, and 1/3 practice greater than 500 miles away. This was relatively constant for those in academic and non‐academic practice. This was also relatively constant across decades of graduation. Approximately 1/3 of otolaryngologists practice in the same state as their residency program whether in academic or non‐academic practice.Conclusions:Proposed reductions in federal funding of graduate medical education could result in the closure of approximately 18.4% of all ACGME training programs. This should stimulate otolaryngology leaders to explore alternative sources of funds from their state and local community, ie, those who most benefit from retaining valuable practitioners. Our data demonstrate a substantial portion of otolaryngologists practice within the area and state surrounding their residency program.
How Much Additional Information Is Provided by High‐Frequency‐Audiometry in Tinnitus Patients with Normal Standard Audiogram?
Authors: Kleinjung Tobias , Lehner Astrid , Fiedler Isabella , Steffens Thomas , Strutz Jurgen , Langguth Berthold , Vielsmeier Veronika 
Published: August 2013

Objectives:The majority of tinnitus patients suffer from hearing loss. However, a significant proportion of tinnitus patients show normal hearing thresholds in the standard pure tone audiogram (PTA, 125Hz – 8kHz). It has been argued that PTA is not sensitive for all forms of hearing impairment and the additional measurement of high frequencies (9 – 16 kHz) should complete the diagnostic set‐up. Here we aimed to investigate whether the results of high frequency audiometry (HFA) provide relevant additional information in tinnitus patients with normal standard PTA.Methods:From the database of the Tinnitus Clinic of the University of Regensburg we identified 75 patients with normal hearing thresholds in the standard PTA. We then contrasted patients with normal and pathological HFA and compared these two groups with respect to tinnitus severity, laterality, duration, tinnitus pitch, the presentation of selected somatic symptoms, and triggers of tinnitus onset.Results:Patients with pathological HFA were significantly older and had higher scores on the Tinnitus Questionnaire and the Tinnitus Handicap Inventory in comparison to patients with normal HFA. Furthermore, there was an association of high frequency audiograms and the laterality of tinnitus: patients with left and bilateral tinnitus had more pronounced high frequency hearing loss in the left ear.Conclusions:In summary, our data indicate that in patients with normal hearing in standard PTA, some additional information is provided by HFA. The association between tinnitus laterality and asymmetry of HFA suggests a potential causal role for the high frequency hearing loss in tinnitus etiopathogenesis.