bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supraglottic Laryngeal Abscess of Idiopathic Etiology Secondary to Community‐Acquired, Methicillin‐Resistant Staphylococcus aureus
Authors: Marston Alexander P. , Lalich Ian J. , Dearking Amy C. , Orvidas Laura J. 
Published: August 2013

Objectives:Prior to the widespread use of antibiotics, laryngeal abscesses typically presented secondary to systemic illnesses. Today, laryngeal abscesses are rarely observed, and most result from disease processes intrinsic to the larynx, such as airway instrumentation or malignancy. This report describes the unique case of an arytenoid abscess of insidious etiology. A supraglottic laryngeal abscess of this anatomic location has not previously been described in the literature and is of particular interest given the increasing prevalence of community acquired, methicillin‐resistant Staphylococcus aureus (MRSA). We seek to characterize the presentation, work‐up, and treatment of this condition.Methods:A single case of an arytenoid abscess is described. The electronic medical record was used to collect demographic and clinical information.Results:The patient had no prior history of laryngeal disease or airway instrumentation; however, her past medical history was significant for poorly controlled type 1 diabetes mellitus, as well as alcohol and methamphetamine abuse. Severe dysphagia and hoarseness prompted computerized tomographic imaging of the neck, which revealed a laryngeal abscess. Incision and drainage under direct laryngoscopy identified an abscess involving the right arytenoid with extension into the interarytenoid space. Cultures at the time of surgery grew MRSA, and biopsy of the abscess cavity was negative for malignancy. Following surgical drainage and appropriate antibiotic therapy, the patient recovered without long‐term sequelae.Conclusions:Laryngeal abscesses are rarely encountered in modern practice. This case offers a previously undescribed example of an idiopathic arytenoid abscess in the setting of an increasingly common infection, community acquired, MRSA.
3D‐FIESTA Screening for Unilateral Auditory Dysfunction
Authors: Lee Yun‐Jae , Kwak Min‐Kyu , Park Chul‐Won , Lee Seung Hwan , Min Hyun Jung , Jeong Jin Hyeok 
Published: August 2013

Objectives:In patients with unilateral auditory dysfunctions such as tinnitus and hearing loss, differential diagnosis of cochlear, retrocochlear, or vascular problems is important. Because unilateral hearing loss and tinnitus patients are increasing recently, screening tools are required. There are many diagnostic tests for differential diagnosis about patients with unilateral auditory dysfunction, but there is no efficient screening tool which can confirm all lesions. The purpose of this work is to assess the clinical usefulness of 3D fast imaging employing steady state acquisition (3D‐FIESTA) sequence in unilateral hearing loss or tinnitus.Methods:Two hundred and sixty patients with unilateral tinnitus and hearing loss who underwent 3D‐FIESTA temporal bone imaging were retrospectively analyzed, looking atmedical charts and radiologic reports. Otologic symptoms, which were measured based on pure tone audiometry results, were reviewed. We evaluated radiologic pathologic finding in the cochlear and retrochoclear areas.Results:Of the hearing symptoms, tinnitus comprised 49.6%, sudden sensory hearing loss, 31.9%, and unilateral hearing disturbance, 15.7%. Twelve patients were diagnosed with acoustic neuromas, four with enlarged vestibular aqueduct syndrome, two with posterior inferior cerebellar artery aneurysms, inner ear anormaly and vestibular cochlear nerve palsy each by 3D‐FIESTA MR.Conclusions:3D‐FIESTA MR is highly sensitive and a cost effective method for differential diagnosis of hearing loss and tinnitus. 3D‐FIESTA MR image is a useful diagnostic tool as screening for cochlear and retrocochlear lesions.
Atrial Natriuretic Peptides in Patients with OME: Serous Otitis Media and Mucoid Otitis Media
Authors: Yoon Yong‐Joo 
Published: August 2013

Objectives:Atrial natriuretic peptides (ANPs) are located within extracardiac tissues known to play an important role in the maintenance of fluid/electrolyte homeostasis. It is not known whether ANPs are expressed in middle ear effusions (MEEs) and whether ANP is correlated in development of serous or mucoid effusion (OME). In order to determine whether secretion of ANP is affected in chronic disease condition, we compared the ANP concentration in the mucoid effusions with that in the serous effusions.Methods:MEE concentrations of ANP were measured in 21 patients (12 mucoid, 9 serous) with OME. The patients underwent myringotomy and/or insertion of a ventilation tube for treatment of OME and collected MEEs. The samples were divided into serous or mucoid types based on observation by the naked eye. ANP immunoreactive cells and ANP levels were measured in the tissues and effusions of the patients with OME, using IHC and radioimmunoassay.Results:In human MEE samples, ANP levels showed a significant increase with the mucoid effusions when compared with the serous effusions and control plasma. ANP concentration was increased in mucoid effusion but was decreased in patients with serous effusion and in control plasma. ANP‐immunoreactive (ANP‐IR) cells are showed in the tall columnar cells of the middle ear mucosa.Conclusions:Our results suggest that a high concentration of ANP in mucoid secretions promotes chronicity of mucoid otitis media and hypothesize that ANP may also play a role in the pathogenesis of OME through changes in the transport of water and ions across the middle ear epithelium.
Auditory Tube Dysfunction Occurring after Jaw Surgery
Authors: Aoki Hideaki 
Published: August 2013

Objectives:Study auditory tube dysfunction that occurs after jaw surgery.Methods:Two hundred sixty‐eight patients were enrolled (60 males and 208 females; mean age, 24.3 years old) who were diagnosed with jaw anamorphosis symptoms and underwent orthognathic surgery of the lower jaw, and who were tested for auditory tube function before and after surgery at our hospitals between December 2000 and February 2012. Auditory tube function test pre‐ and post‐operation were conducted, and post‐operatively we searched for auditory tube dysfunction. Auditory tube dysfunction in a high rate was seen after lower jaw orthognathic surgery.Results:Post‐operative auditory tube dysfunction was noted subjectively in 49 patients (18.3%) and determined by TM in 162 (60.4%). There is also a relationship between pre‐operative SON and TTAG and post‐operative TM aggravation.Conclusions:Post‐operative auditory tube dysfunction correlated with pre‐operative TTAG values, indicating that TTAG was a useful test for the prediction of TM aggravation. There was no correlation between post‐operative auditory tube dysfunction and SON values.
Autoimmune Saccitis and Cochlear Change
Authors: Friis Morten 
Published: August 2013

Objectives:Injury to the endolymphatic sac may play an important role in the pathogenesis of Ménière's disease. The purpose of this study was to) investigate the effect of an autoimmune stimulation of the endolymphatic sac in rats.Methods:Nineteen inbred male Lewis rats in an animal laboratory at the University of Copenhagen were studied. Outcome measurements: Distortion product oto‐acoustic emissions (DPOAE) and transmission electron microscopy (TEM). Independent variables: autoimmunization. Preliminary analyses: Endolymphatic hydrops.Results:At day 21 the immunized group showed no significant differences in hearing assessment, on full range of frequencies, compared to the controls (P >0.05; Welsh t‐test). At day 183, the hearing assessment showed a 1.5 dB (6,35%) drop in CDP in the immunized group compared to the controls from 2‐16kHz (P < 0.05; Welsh t‐test) and a 2.5 dB (11.1%) decrease in the low frequency area, from 2‐5kHz (P < 0.01; Welsh t‐test). TEM investigation indicated stimulation of the endolymphatic sacs in all immunized rats: The ribosome‐rich cells appeared hyperactive, and a focal inflammation of immunologically active cells and phagocytosis of ribosome‐rich cells were observed.Conclusions:An autoantigen, capable of inducing an endolymphatic saccitis with concomitant cochlear change, exists in the rat. A possible relationship between these observations and Ménière's disease is proposed.
Computed Tomography Is Required to Rule Out Nasopharyngeal Pathology in Adults with Serous Otitis Media
Authors: Toman Julia , Perry Katherine , Strome Scott E. , Eisenman David J. , Hertzano Ronna 
Published: August 2013

Objectives:1) Review the current diagnostic evaluation of adults with new‐onset serous otitis media (SOM). 2) Compare the ability of fiberoptic nasal endoscopy (FNE), random nasopharyngeal biopsies, and computed tomography (CT) to detect nasopharyngeal pathology. 3) Clarify the role of imaging and random nasopharyngeal biopsies in the evaluation of SOM.Methods:This is a retrospective chart review of adults who presented with SOM to a tertiary care center from 2006 to 2012 and who underwent pressure equalization tube (PET) placement and nasopharyngeal biopsies. Subjects were identified though a search of operative and pathology records. Charts were reviewed for physical exam findings, including FNE, intraoperative exam, biopsy results, and imaging. FNE findings were classified as suspicious or non‐suspicious.Results:Thirty‐four subjects were identified who met the inclusion criteria. Twenty‐nine subjects had non‐suspicious findings on FNE while five had suspicious findings. Two of the twenty‐nine subjects with non‐suspicious findings, and two of the five subjects with suspicious findings proved to have significant nasopharyngeal pathology, including nasopharyngeal carcinoma and sinonasal polyp. Importantly, CT imaging had a negative predictive value of 100% for the presence of nasopharyngeal pathology.Conclusions:All adults presenting with persistent new‐onset SOM should undergo CT scanning to rule out nasopharyngeal pathology. The decision to perform a biopsy should be based on CT findings. If imaging is normal, random nasopharyngeal biopsies are not required and PET placement may be performed in the office. Normal FNE does not exclude nasopharyngeal pathology.
Clinical and Radiographic Predictors of Lateral Semicircular Canal Fistula
Authors: Greene Scott M. , Carlson Matthew L. , McRackan Theodore , Rivas Alejandro , Bennett Marc L. , Haynes David S. , Wanna George B. 
Published: August 2013

Objectives:Lateral semicircular canal fistula (LSCCF) may occur in as many as 10% of patients with cholesteatoma. Despite improvements in diagnostic imaging, reliable preoperative identification of LSCC remains elusive. Our objective is to explore preoperative clinical variables and intraoperative findings in order to identify factors associated with the presence of LSCCF.Methods:A retrospective matched cohort study was conducted. All patients with LSCCF, determined by intraoperative diagnosis, that had preoperative temporal bone computed tomography (CT) available for review were identified. Subjects were matched to patients without LSCCF according to age, gender and year of surgery. Associations between LSCCF and preoperative vertigo, fistula test results, sensorineural hearing loss (SNHL), stapes superstructure erosion, facial nerve and dural dehiscence, and preoperative radiographic findings were evaluated.Results:Eighty‐three patients with LSCCF met inclusion criteria and were matched to subjects without labyrinthine fistula. Patients with LSCCF more commonly had stapes superstructure erosion (34 vs 15, P <. 001), facial nerve dehiscence (55 vs 10, P <. 0001), and dural dehiscence (29 vs 4, P <. 0001) compared to subjects without LSCCF. The presence and severity of preoperative SNHL, vertigo, and fistula test results were unreliable predictors of LSCCF. Furthermore, of those patients with LSCCFs, only 28% were identified on pre‐operative CT.Conclusions:Preoperative variables including SNHL, vertigo, fistula test results as well as preoperative temporal bone CT were not reliable predictors of LSCCF. However, intraoperative findings including stapes superstructure erosion, facial nerve and dural dehiscence were found to be associated with LSCCF and should raise suspicion of disease.
Clinical Characteristics and Treatment Outcome in Patients with Migrainous Vertigo
Authors: Jung Jae‐Hoon , Lee Jaeryung , Yoo Myeong‐Hoon , Park Hong Ju , Chung Jong Woo 
Published: August 2013

Objectives:Migrainous vertigo (MV) is accepted as a common cause of episodic vertigo. The peripheral or central vestibular localization of the deficit as well as the pathophysiology is unclear. This retrospective study was designed to assess the clinical features and treatment outcomes of MV.Methods:132 patients with MV were studied. Comprehensive neurological tests were performed and pure tone audiometry, caloric test, vestibular evoked myogenic potential (VEMP), and posturography were also conducted. For medical management, sibelium, amitryptilin, and topamax were tried.Results:31% of patients reported cochlear symptoms including hearing disturbance, tinnitus, earfullness during MV symptom, and 41% showed head‐shaking nystagmus. Caloric test results revealed unilateral caloric hypofunction in 23%, and 29% showed VEMP asymmetry. Posturography results revealed vestibular dysfunction in 24%. Symptom relief was experienced in 55% with flunarizine, 33% with amitriptyline, and 9% with topiramate.Conclusions:MV demonstrated various clinical features, however, this disease can be treated well by medical management.
Cochlear Duct Length: Are We Giving It Adequate Importance?
Authors: Grover Mohnish , Mishra Prakash , Gupta Gaurav , Jangid Manoj 
Published: August 2013

Objectives:1) Calculate radiologically length of cochlear duct in children with congenital bilateral profound sensorineural hearing loss. 2) Analyze above calculation to decide about length of electrode array of cochlear implant. 3) Implement this calculation as part of mandatory workup for cochlear implantation.Methods:Prospective study conducted over 18 months to study high‐resolution computed tomography (HRCT) temporal bone of children less than 6 years old being evaluated for cochlear implant at SMS Medical College and Hospital, Jaipur, India. Minimum intensity projection reconstruction cuts were made to calculate largest distance from round window to lateral wall of cochlea (A). Cochlear duct length (CDL) was calculated by: CDL = 4.16A – 3.98.Results:HRCT temporal bone of 124 patients with hearing loss were analyzed. Twenty patients were excluded in view of vestibulocochlear anomaly. Overall average of A was found to be 8.12 mm (7.7mm to 9.2mm). Mean cochlear duct length was calculated to be 29.8 mm (28mm to 34.3 mm).Conclusions:This study revealed that the length of cochlea is smaller in Asian population. The variability of cochlear length also needs to be taken into consideration before putting in a fixed length cochlear implant in every patient. In view of this we propose that cochlear duct length should be calculated in every patient preoperatively.
Cochlear Implant Outcomes in Adults and Children with Inner Ear Malformations
Authors: Szudek Jacek , Dettman Shani , Zraika Linda , Briggs Robert 
Published: August 2013

Objectives:Bony cochlear or vestibular malformations occur in approximately 20% of patients with congenital hearing loss, but their impact on audiologic outcomes is not entirely clear. Our objective was to assess the impact of inner ear malformations on surgical and audiologic outcomes in cochlear implantation (CI).Methods:A retrospective review of a single CI clinic identified a cohort of 57 children and 31 adults with inner ear malformations who had undergone CI between 1994 and 2010. Patients were classified into: common cavity, incomplete partition ‐I (IP‐I); IP‐II with or without enlarged vestibular aqueduct (EVA); IP‐III, or EVA alone. We compared speech perception language development and surgical outcomes between the groups.Results:The type of malformation was not associated with CI performance in either adults or children. In children, the duration of profound hearing loss was correlated with scores for: open‐set phoneme (r = ‐0.43, P = 0.004); open‐set word (OSW) (r =‐0.32, P = 0.03); Bench Kowal Bamford sentence (BKB) (r =‐0.35, P = 0.02), and Peabody Picture Vocabulary Test delay (r = 0.49, P = 0.001). In adults, the duration of profound hearing loss was correlated with OSW (r=‐0.36, P = 0.04) and BKB (r =‐0.41, P = 0.02).Conclusions:The extent of inner ear malformation alone cannot predict CI performance. However, the presence of a gusher, incomplete insertion, and a longer duration of pre‐implant hearing loss were associated with worse speech perception and language outcomes in children and adults.
Comparison of Functional Outcomes in Complete and Incomplete Bilateral Vestibulopathy
Authors: Chung Won‐Ho , Byun Ha‐Young , Ryu Nam‐Gyu , Choi Ji‐Eun 
Published: August 2013

Objectives:Patients with bilateral vestibulopathy (BV) suffer from significant functional disability despite appropriate rehabilitation. We hypothesized that the presence of residual vestibular function would positively affect rehabilitation and final functional outcomes. The aim of this study was to compare long‐term functional outcomes between complete and incomplete BV cases.Methods:Fifty patients who have been diagnosed with BV in Samsung Medical Center from 2002 to 2012 were retrospectively reviewed. The subjects were divided into two groups according to the presence of residual vestibulo‐ocular reflex (VOR): the complete BV group (n = 19) and incomplete BV group (n = 31). Thirty‐one patients (6 complete BV and 25 incomplete BV) out of 50 patients completed our telephone survey which evaluated 5 symptom categories including dizziness severity, oscillopsia, unsteadiness, depression, and restriction on daily life. Each symptom was scored by the patients in reference to the initial status at diagnosis and the latest status at survey.Results:There was no difference in etiology between complete and incomplete groups. Symptom scores of incomplete BV group showed significant interval improvement in dizziness, oscillopsia, unsteadiness and restriction on daily life (P < 0.005 by Wilcoxon signed rank test), whereas those of complete group did not. In the analysis of score (calculated as [score at survey] – [score at diagnosis]), improvement of dizziness score was significantly higher in incomplete group compared to complete group (P = 0.035 by Mann‐Whitney U test).Conclusions:Patients with BV who had residual VOR on caloric test showed better functional outcomes than those without residual function.
Conservative Management of Vestibular Schwannoma in the West of Scotland: A 20‐Year Experience
Authors: Oozeer Nashreen B. , O'Reilly Brian F. , Crowther John 
Published: August 2013

Objectives:In our skull base unit, large vestibular schwannomas (VS) over 30 mm at presentation are usually offered surgery but the remainder have their growth monitored by interval imaging with treatment (surgery or stereotactic radiotherapy) being offered to patients whose tumors are growing significantly.Methods:A prospective database of consecutive patients diagnosed with sporadic VS and referred to the Skull Base unit in South Glasgow, United Kingdom, over the last 20 years was retrospectively reviewed. Patients with neurofibromatosis type II were excluded. Patients who consented to being managed conservatively by initial interval imaging using 6‐monthly axial T1‐weighted post‐gadolinium magnetic resonance imaging (MRI) had the growth of their VS assessed. Growth (defined as >2mm) was the primary outcome measure. Intracanalicular tumors were compared to cerebellopontine angle (CPA) ones.Results:There were 62 intracanalicular (IC) tumors, mean size of 8mm, and 102 CPA VS, mean size of 11mm. One third of patients managed conservatively showed evidence of growth and 50% showed no change (IC > CPA). Twenty percent reduced in size (CPA > IC). Two‐thirds of the VS showing growth stabilized or regressed over time. Audiometry was not found to be a useful tool to predict growth but interval MRI scans were. The quality of life of the VS group managed conservatively was found to be comparable across all domains of the short‐form 36 (SF‐36) with an age and sex match control group.Conclusions:All asymptomatic patients and symptomatic ones with a VS size of <30 mm should initially be offered conservative management with interval imaging.
Development Research of Communication Systems for the Deaf in a Major Disaster
Authors: Yabe Takao 
Published: August 2013

Objectives:Based on the field work regarding difficulties the deaf faced during the earthquakes in Japan, we designed a visual information delivery system using Android mobile devices and cloud networking during a major disaster to communicate information about the evacuation and the shelter to them quickly. We present the results of the evaluation test of this system.Methods:Evaluation tests were carried out at a school for the deaf. Subjects were 28 people with hearing impairment (HI) and 26 with normal hearing (NH), aged 12 to 65 and 24 females and 30 males. Visual information delivery system consisted of Android mobile devices with Wi‐Fi, cloud networking system, and LED display. Evaluation items were 1) recognition of LED display, 2) usefulness of the system, 3) size of the characters on LED, 4) color of the characters on LED, and 5) speed of the character scroll on LED. Results were statistically analyzed.Results:The LED display was recognized by 65% in the HI group and 53% in the NH group. Usefulness was highly evaluated by 80% in HI and 72% in NH. Larger sized characters were evaluated by 30% in HI and 56% in NH. Green color was evaluated more in HI and red color more in NH. Faster scroll was evaluated more in HI (p<0.05).Conclusions:These findings suggest that this system was useful for the deaf, and they preferred green characters on faster scroll on LED.
Diluted Gadoteridol Causes Mild Ototoxicity in Cochlear Outer Hair Cells
Authors: Tanigawa Tohru , Katahira Nobuyuki , Tanaka Hirokazu , Ueda Hiromi 
Published: August 2013

Objectives:Recently, visualization of endolymphatic hydrops has been achieved through intratympanic injection of gadolinium‐based contrast agents (GBCAs) and three‐dimensional fluid‐attenuated inversion recovery (3‐D FLAIR) magnetic resonance imaging. However, the effects of gadoteridol (ProHance®) on inner ear cells are not yet understood. Here, we investigated the physiological and morphological responses of guinea pig cochlear cells to gadoteridol.Methods:Distortion product otoacoustic emission (DPOAE) levels were measured before and 1, 2, and 4 weeks after intratympanic injection of a 1/8 or 1/16 dilution of gadoteridol in guinea pigs. Moreover, morphological changes of isolated cochlear outer hair cells (OHCs) were observed after application of gadoteridol and GdCl3.Results:At the highest frequency (F2 = 12000 Hz), DPOAE level was significantly (P < 0.05) lower in the 1/8 diluted gadoteridol group than in the control group. Cell shape changes were observed in 24% (6/25) and 3% (1/33) OHCs after application of 1/8 and 1/16 diluted gadoteridol, respectively. The occurrence of morphological damage was significantly lower after application of saline compared to 1/8 diluted gadoteridol (P < 0.05). Moreover, morphological damage was significantly lower after application of 1/16 diluted gadoteridol compared to 1/8 diluted gadoteridol (P < 0.05). Morphological damages were shown at high rate (8/10 cells, 80%) after application of GdCl3.Conclusions:Administration of diluted solutions of gadoteridol might cause considerably less toxic effects on cochlear OHCs.