bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Peroneal Perforator Mapping with Dynamic Time‐Resolved Magnetic Resonance Angiography
Authors: Lawson Bradley R. , Ram Roopa , Pandey Tarun , Jambhekar Kedar , Moreno Mauricio A. 
Published: September 2014

Objectives:Dynamic time‐resolved magnetic resonance angiography (DTR MRA) is a novel imaging algorithm that allows for better visualization of small‐caliber vessels when compared with standard MRA. We sought to estimate the technique sensitivity when compared with intraoperative findings.Methods:Retrospective review of 25 patients undergoing reconstruction with free fibula flap at an academic tertiary setting from 2009 to 2013. Preoperative DTR MRA was performed in all cases. Two radiologists performed blind reviews of the images and their findings were compared with surgical descriptions of the perforator anatomy.Results:Surgical exploration identified 32 perforators while DTR MRA identified 45 vessels. The technique confirmed the presence of perforators in 22 out of 23 patients with at least one perforator, and their absence in 1 out of 2 patients who had a negative exploration. There was a significant correlation in the number of perforators identified clinically and radiologically in each case (P =. 005). Twenty‐seven perforators were localized to their correct anatomic location by the technique, yielding a sensitivity of 84.4% and a specificity of 16.7%. Ten out of the 18 vessels incorrectly identified by this technique were located within 30 mm of a confirmed perforator.Conclusions:DTR MRA is a highly sensitive technique for determining the presence and location of cutaneous perforators in patients undergoing reconstruction with free fibula flap. The majority of the false‐positive findings corresponded to vessels located within 30 mm of a confirmed perforator; we hypothesize that they could represent distal branching patterns presenting radiologically as separate entities. These results compare favorably to perforator mapping with standard MRA techniques.
The Effect of Controlled‐Release Hyaluronic Acid on Drug Delivery to the Cochlear Spiral Ganglion
Authors: Inagaki Yozo , Kanzaki Sho , Fujioka Masato , Ogawa Kaoru 
Published: September 2014

Objectives:The spatiotemporal distribution of drugs in the inner ear has not fully been characterized because of the area's small size and complicated compartments. In the present study, we investigate the pharmacokinetics of a small molecule conjugated with different amounts of carrier in the cochlea by using transgenic technology and the IVIS Imaging System.Methods:Luciferin, a 280 MW substrate of luciferase, was conjugated with different MW of hyaluronic acid and was subcutaneously administered to the transgenic mouse, GFAP‐luc, which expresses luciferase specifically in the cochlear spiral ganglion cells. Bioluminescence produced by a chemical reaction of luciferin‐luciferase was monitored using the Xenogen‐IVIS 100.Results:The peak photon count decreased dose‐dependently on the MW of hyaluronic acid, whereas the duration was prolonged.Conclusions:Our imaging system successfully detected differences in the pharmacokinetics of luciferin in the inner ear. The sustained‐release effect of hyaluronic acid was observed and differed by its MW. The result suggests the clinical significance of hyaluronic acid for controlling drug delivery to the cochlea.
Quantitative Analysis of Functional Rhinoplasty Procedures: A Cadaveric Study to Evaluate a Novel Assessment Technique
Authors: Haffey Timothy M. , Vakharia Kalpesh T. 
Published: September 2014

Objectives:A wide array of surgical techniques has been developed to address internal nasal valve collapse. In particular, butterfly grafts and spreader grafts are used ubiquitously without any objective comparison being made on the efficacy of these approaches. The objective of this study was to quantitatively assess the effect that these techniques have on lateral nasal wall compliance.Methods:A total of 11 fresh nonfixed cadavers (22 valves) were utilized for this study. Baseline measurements of lateral wall compliance were performed using a tension gauge and a novel procedure (herein described), and each nasal valve was measured independently. The valves were augmented with butterfly graft, endonasal spreader graft, and open spreader graft. Lateral nasal wall compliance was measured after each technique, and statistical analysis was performed.Results:There was an increase in force required to displace the lateral nasal wall compared with baseline after butterfly and endonasal spreader techniques (P <. 05). The greatest effect was after butterfly‐type graft placement (P <. 05). An endonasal spreader graft technique resulted in a stiffer lateral nasal wall when compared to the open technique (P <. 05). Open spreader graft had no effect relative to baseline measurements.Conclusions:This cadaveric study describes the application of a novel assessment tool used to quantitatively compare different grafting techniques used in functional rhinoplasty. Butterfly grafts are the most effective in strengthening the lateral nasal wall. Endonasal spreader grafts are also effective to a lesser degree. Open spreader techniques had no effect on the compliance of the lateral nasal wall.
The Effects of Cochlear Implant Signal Processing on Discrimination of Musical Instrument Harmonic Changes
Authors: O'Niel Mallory B. , Friedland David R. , Runge Christina 
Published: September 2014

Objectives:Compare MED‐EL fine structure processing (FSP) and high‐definition continuous interleaved sampling (HDCIS) in discrimination of musical instrument harmonic changes.Methods:Twelve MED‐EL users were programmed with novel FSP and HDCIS maps. With each map they underwent discrimination testing of paired sound stimuli. The stimuli were native and harmonically‐manipulated sound clips of a single note played by an instrument. The instruments tested were the trumpet, alto saxophone, and tuba. The harmonic manipulations consisted of removal of either the first or second harmonic. Discrimination was quantified by calculating d′; higher d′ values indicated better performance.Results:There were no significant differences in discrimination performance between FSP and HDCIS across conditions. However, for both strategies, significant differences in discrimination were observed between discrimination of the first and the second harmonic manipulation conditions for the trumpet and the tuba. For trumpet, significantly better performance was observed with removal of the second harmonic (d′ = 1.57) compared with removal of the first harmonic (d′ = 0.58; P <. 05). For tuba, the opposite was observed (first d′ = 1.12, second d′ = 0; P <. 05). Discrimination of the saxophone stimuli was significantly more difficult compared to the other instruments, which was likely related to the saxophone harmonics’ close frequency/channel proximity.Conclusions:Results from this novel‐map study did not show a difference in harmonic cue discrimination between FSP and HDCIS. Evidence was found regarding important harmonic information for individual instruments tested. Perception of harmonic cues could be affected by channel discrimination. These results can be used to improve cochlear implant signal processing strategy.
Efficiency of Exploration of Molecular Genetic Etiology for Cochlear Implantees and Its Implication
Authors: Park Joo Hyun , Kim Nayoung K. D. , Kim Ah‐Reum , Koo Ja‐Won , Oh Seung Ha , Park Woong‐Yang , Choi Byung Yoon 
Published: September 2014

Objectives:Evaluate the efficiency of exploration of molecular genetic etiology for cochlear implantees (CI).Methods:Ninety‐four patients of 273 CIs who consented to molecular genetic testing (MGT) were included. Patients with either a characteristic radiologic or audiologic marker were subject to Sanger sequencing of corresponding candidate genes. The GJB2 gene was sequenced in patients with no phenotypic marker. Targeted resequencing of known 200 deafness genes (TRS‐200) was applied to GJB2‐negative cases with no phenotypic marker. The recurrence risk of hearing loss (HL) between undiagnosed probands after TRS‐200 and diagnosed probands with autosomal recessive genotype was evaluated.Results:Thirty of 42 probands (71.4%) who underwent the direct Sanger sequencing of candidate genes were diagnosed. The most rewarding phenotypic markers were enlarged vestibular aqueduct (with/without incomplete partition [IP] type II) and IP type III, followed by long QT syndrome, lateral semicircular canal dysplasia as a part of the constellation of anomalies suggesting a CHARGE syndrome, and ski‐slope type high frequency HL. Focusing upon these 5 markers, the detection rate went up to 83.3% (30/36). Ten of 52 probands carried mutant allele of GJB2. The detection rate by TRS‐200 was 26.0% (12/46). The recurrent risk of HL was calculated to 0.03 (95% confidence interval [CI] 0‐0.13) in undiagnosed group and 0.18 (95% CI 0.09‐0.34) in diagnosed probands.Conclusions:Molecular genetic diagnosis was made in 55.3% (52/94) of CIs through our hierarchical MGT. The sequencing of high‐yield candidate genes associated with phenotypic markers will be useful for evaluating deaf patients cost‐effectively before applying next generation sequencing. A Mendelian genetic etiology does not seem to contribute to undiagnosed probands after TRS‐200.
Electrode Migration after Cochlear Implantation in Association with External Auditory Canal Closure
Authors: Wood Joshua W. , Watkins Jeremy P. , MacDonald Charles B. 
Published: September 2014

Objectives:(1) Review the occurrence of electrode migration following cochlear implantation. (2) Compare the rate of migration in those patients who underwent concurrent radical mastoidectomy.Methods:A retrospective case series of all patients who underwent cochlear implantation at our institution, with a single surgeon, between 2001 and 2013. The specific outcome studied was implant migration. A total of 224 patients underwent cochlear implantation with a total of 294 implants performed. Four patients (1.3%) underwent radical mastoidectomy with Rambo type obliteration of the external auditory canal.Results:This approach was used in 2 young children with congenital malformations to provide adequate exposure for cochleostomy, and both of these patients experienced electrode migration. In 2 older patients this approach was used due to chronic infections, and neither of these patients has electrode migration. Of the 224 patients in the series who underwent cochlear implantation, these 2 children are the only patients who have experienced implant migration.Conclusions:Electrode migration is a rare complication following cochlear implantation. In our experience, there seems to be a higher incidence of electrode migration in patients who have undergone cochlear implantation in association with radical mastoidectomy with external auditory canal obliteration. Alternative techniques to avoid the need for the canal‐wall‐down mastoidectomy with Rambo closure have been used with success and are described in detail.
Evaluation of Hearing Results of Anterior Atticoantrostomy in Childhood Cholesteatoma
Authors: Uyar Yavuz , Kumral Tolgar L. , Salturk Ziya , Atar Yavuz , Berkiten Güler , Yildirim Guven , Kilic Mehmet V. 
Published: September 2014

Objectives:We aimed to evaluate hearing results and complications of anterior atticoantrostomy in pediatric patients who had cholesteatoma.Methods:This is a clinical retrospective study. Fifty children who underwent anterior atticoantrostomy for cholesteatoma were included. Patients’ preoperative and postoperative pure tone audiometry results were compared. In addition, postoperative complications including formation of retraction pockets, perforation, recurrence of cholesteatoma, and absorption of cartilage were analyzed.Results:The mean age of the patients was 12.7 years, with 27 female and 23 male patients. Patients’ preoperative and postoperative air‐bone gaps were narrowed significantly. Number of retraction pockets, recurrence of cholesteatoma, and perforations seen were 3, 7, and 4, respectively.Conclusion:Anterior atticoantrostomy is a safe method with low complication rate and can be applied in pediatric cholesteatoma cases with good hearing results.
Evolution of the Degree of Peripheral Facial Palsy in Diabetic and Nondiabetic Patients
Authors: Ribeiro Thais K. , Testa José Ricardo G. 
Published: September 2014

Objectives:Peripheral facial palsy (PFP) is a disorder of common neural causes that are still unknown. Other possible causes include vascular disorders, inflammatory and immunological factors, and possibly viral infections. According to the literature there is an association between the incidence of PFP and diabetes mellitus (DM), a disease which is known to cause neuropathies. The objective of this study is to evaluate the outcome of patients with concomitant DM and PFP, as well as to compare the evolution of these patients compared to patients without DM and PFP through clinical, laboratory, and electrophysiological tests.Methods:An observational case‐control study. Outpatient follow‐up between 2011‐2012 of 50 patients according to the presence or absence of PFP and DM that were divided into 4 groups and matched. All patients underwent the following tests: tearing (Schirmer's test), tonal and speech audiometry, tympanometry with reflex of the stapedius muscle, Test Hilger, and glucose analysis.Results:The rate of complete recovery considered grade I or II of the House‐Brackman classification at the end of 6 months of follow‐up showed that 58.4% of diabetic patients presented a good evolution in contrast to 80% of nondiabetics.Conclusions:In our findings we concluded that diabetic patients had a slower recovery time and poor degree of facial paralysis when compared to nondiabetics.
The Exclusive Endoscopic Traspromontorial Approach and Its Pilot Clinical Experiences
Authors: Alicandri‐Ciufelli Matteo , Marchioni Daniele , Presutti Livio 
Published: September 2014

Objectives:Describe a minimally invasive transcanal endoscopic approach, starting from the external auditory canal and reaching the internal auditory canal, used to treat inner ear pathology.Methods:Three patients, affected respectively by cochlear schwannoma, acoustic neuroma, and temporal bone cholesteatoma, were treated by an exclusive endoscopic approach without external incisions. Surgical steps and useful landmarks were reviewed and described.Results:The operation provided a direct transcochlear intradural approach from lateral to medial and from external to internal auditory canal, without any external incision. The pathology was totally removed in all patients. Results regarding facial nerve were very satisfying. Hospital stay was markedly reduced compared to traditional approaches.Conclusions:The transcanal exclusive endoscopic approach proved successful for pathology removal involving the fundus, internal auditory canal, and cochlea. Potential future application of this kind of approach in lateral skull base surgery will depend on the development of technology and surgical and anatomical refinements.
Expression of Angiogenic Molecules in Cochlear Vasculature
Authors: Lee Sungsu , Cho Hyong‐Ho 
Published: September 2014

Objectives:(1) Three‐dimensionally (3D) visualize the cochlear vessels and blood‐labyrinth barrier. (2) Analyze the expression of angiogenic molecules in cochlear vessels.Methods:Postnatal day 5 and 8‐week old mice were used. After obtaining the cochlea, bony shell was removed. Whole mount immunostaining was done with endothelial cell marker PECAM‐1 and VE‐cadherin. NG2 and demins were used for pericyte marker. aSMA was used as vascular smooth muscle cell and S100 was used as fibrocyte marker. 3D reconstruction was done to visualize the blood‐labyrinth barrier components. VEGFR2, VEGFR3, Sox17, angiopoietin‐2, Dll4 were used for angiogenic markers. Claudin‐5 was used to visualize the tight junction.Results:We could visualize the cochlear vasculature in overall, from precapillar arteriole, stria vascularis, and postcapillary venule. The relationship between components of blood‐labyrinth barrier also could be visualized from basal turn to apical turn of the cochlea. Cochlear vessels well expressed VEGFR3, VEGFR2, Sox17 in the endothelial cell showing that cochlea is in active state, not static. Claudin‐5 was robustly expressed suggesting its important role in blood‐labyrinth barrier. aSMA was well expressed demonstrating its need for vessel contraction.Conclusions:A vessel is not merely a conduit for blood flow. It is newly made and is also regressed. It permits or limits many molecules on crossing over to the tissue. The cochlear vessel is an active vessel. We suggest that visualizing the cochlear vessel and checking the expression of angiogenic molecules could help understand the pathophysiology in hearing loss models.
Reconstruction of Oromandibular Defects after Prior Irradiation Using a Temporalis Muscle and Temporoparietal Fascia Flap
Authors: Zenga Joseph , Diaz Jason A. , Nussenbaum Brian A. , Rich Jason T. , Sclaroff Allen 
Published: September 2014

Objectives:Reconstruction of oromandibular defects in the setting of previous treatment, or significant patient comorbidities, presents a significant challenge. Although free tissue transfer has shown success, it is not without considerable risk, especially in patients with poor baseline functional status. In these patients, regional pedicled flaps may provide a more suitable alternative. The combined temporalis muscle and temporoparietal fascia flap is a versatile option for oromandibular reconstruction in a previously treated field, or in patients with severe comorbidities and poor functional status. Our objective was to report our experience using a combined temporalis muscle and temporoparietal fascia flap for reconstruction of oromandibular defects in high‐risk situations.Methods:Three patients were identified, medical records were reviewed, and their clinical courses were described. Functional outcomes were reviewed. We include a discussion of the relevant surgical anatomy and operative technique. All patients had previously undergone extensive treatment. They needed additional ablative surgery for different reasons: new malignancy, intractable trismus, and osteoradionecrosis. A combined temporalis muscle and temporoparietal fascia flap was used to reconstruct the oromandibular defects in each patient.Results:All flaps survived. Functional status improved in all patients. There were no significant operative or postoperative complications.Conclusions:The combined temporalis muscle and temporoparietal fascia flap provides a reliable option for reconstruction of complex oromandibular defects in high‐risk situations. In previously treated fields, the transfer of a vascularized flap into the wound hastens healing and improves the quality of native oral cavity tissue.
Hearing Efficacy of Intratympanic Methylprednisolone Perfusion for Severe and Profound Sudden Sensorineural Hearing Loss
Authors: She Wandong , Dai Yanhong , Hou Jie , Lu Ling 
Published: September 2014

Objectives:Investigate the efficacy of intratympanic methylprednisolone perfusion (IMP) for severe and profound sudden sensorineural hearing loss (SSNHL).Methods:Hearing recovery was analyzed retrospectively in SSNHL patients, who received IMP after not fully responding to conventional treatments and were hospitalized in our department between January 2008 and December 2012.Results:Eighty‐seven patients with SSNHL were divided into 4 types according to primary hearing curve: total deafness (77.01%), mild to moderate hearing loss in all frequencies (18.39%), hearing loss in low‐tone frequencies (2.30%), and hearing loss in high‐tone frequencies (2.30%). The effective rate was 66.7% and average pure tone average (PTA) improvements were 18.53 ± 13.54 dB in the patients of interval from onset to IMP within 15 days, 21.2% and 5.92 ± 15.18 dB in the patients of interval between 16 and 30 days, 4.8% and 3.69 ± 7.00 dB in the patients of interval more than 30 days, respectively. The effective rate had significant differences among the 3 different interval groups (χ2 = 25.91, P =. 000), and the PTA improvements in the patients of interval within 15 days were the best in the 3 groups (F = 11.182， P =. 000). A total of 30 cases were responsive to IMP, one of them was hearing loss in low tone frequencies and the other 29 cases were in all frequencies. The average hearing improvements in the lower 3 frequencies (0.25 kHz‐1 kHz)were better than those in the higher 3 frequencies (2 kHz‐8 kHz; F = 9.494, P =. 000).Conclusions:Receiving IMP earlier may help to improve hearing recovery for the patients with SSNHL not fully responding to conventional treatments. The hearing improvements in the lower frequencies may be better than those in the higher frequencies after IMP.
Hyperbaric Oxygen Therapy for Sudden Hearing Loss after Failure of Intratympanic and Oral Corticosteroid Therapy
Authors: Celis‐Aguilar Erika , Burgos‐Paez Alan , Mayoral‐Flores Homero O. , Bernal‐Espinoza Yancy M. , López‐Ramos Enrique G. 
Published: September 2014

Objectives:Determine the efficacy of hyperbaric oxygen therapy (HBOT) in idiopathic sudden sensorineural hearing loss (ISSHL) after unsuccessful treatment with oral and intratympanic corticosteroids. The current treatment for ISSHL remains controversial. Systemic and intratympanic steroids are usually prescribed; unfortunately, only 61% of patients achieve full recovery. Recently, hyperbaric oxygen therapy has emerged as a new possible treatment.Methods:Case series at a secondary care center. Patients were included from March 2013 to July 2013. Inclusion criteria: age >18 years, failure to systemic and intratympanic corticosteroids. Ten sessions of HBOT were conducted, 60 minutes each, at 2 atmospheres. All patients underwent audiometry before and after treatment. Pure tone average (PTA) was defined as the average of the frequencies of 500, 1000, 2000, and 4000 Hz.Results:We included 4 female patients, mean age 51 years. The mean time from onset of illness to HBOT was 108.75 days. Initial mean PTA was 55.31 dB, final PTA was 54.6875 dB (P =. 958). Mean hearing gain was 0.625 dB. One patient had complete hearing recovery, 2 patients slight improvement (recovery of 3.75 dB), and 1 patient worsened. Two patients reported subjective improvement of dizziness. Although hearing gain was observed at low frequencies in 2 patients (25 dB and 20 dB), no statistical significance was achieved (P =. 817). No complications were reported.Conclusions:The use of HBOT in patients who fail steroid therapy did not demonstrate a beneficial hearing effect in ISSHL patients. However, symptoms such as dizziness improved subjectively. More studies are needed to corroborate our results.