bluuebunny/crossref_metadata_2025_split huggingface dataset:
In Vitro Model of Cochlear Implant Trauma: Oto‐Protection by a Combination of NAC, Dex, and Mannitol
Authors: Eshraghi Adrien A. , Mittal Jeenu , Telischi Fred F. , Rodrigues Helio , Van De Water Thomas R. , Bas Esperanza , Gupta Chhavi 
Published: September 2014

Objectives:(1) Describe the otoprotective mechanisms involved in common otoprotective drugs (ie, NAC, dexamethasone, and mannitol). (2) Describe the otoprotective effect of combining these drugs to prevent hair cell (HC) losses.Methods:Cochlear explants were dissected from P‐3 rats and placed in serum‐free media. Explants were divided into 3 groups: (1) untreated controls; (2) electrode insertion trauma (EIT); (3) Tri‐therapy (L‐NAC + DXM + mannitol). Cochlea of groups 2 and 3 were implanted and HC counts, oxidative stress and cleaved caspase‐3 markers were studied in all explants post EIT.Results:There was a significant increase of HC loss in the EIT explants as opposed to control or the tri‐therapy cochlea. The implantation resulted in an increased production of the total reactive oxygen species (ROS) in both HCs and the supporting cells (SCs) of only EIT group. There is also cleaved caspase‐3 activation in EIT cochlea as compared to the control or tri‐therapy cochlea.Conclusions:The tri‐therapy combining NAC, dexamethasone, and mannitol has an otoprotective effect on survival of hair cells and support cells post–cochlear implantation. This in vitro oto‐protection needs to be tested in vivo, in an animal model of cochlear implantation trauma.
Is the Extent of the Preoperative Air‐Bone Gap an Indictor of Potential Success in Stapedectomy?
Authors: Lavy Jeremy , Huins Charlie , Hall Andrew , Whitcroft Katherine , Khalil Sherif 
Published: September 2014

Objectives:(1) Could preoperative air‐bone gap (ABG) magnitude act as a predictor of postoperative outcome in patients undergoing stapedectomy for otosclerosis? (2) If this were to occur, is it frequency specific?Methods:Retrospective case series from January 2010 to December 2012 in a tertiary London teaching hospital. Intervention: Laser stapedectomy using Smart Nitinol stapes prosthesis. Main outcome measure: Audiometric. Retrospective analysis comparing preoperative and postoperative air‐bone gap in 302 patients undergoing stapedectomy. Patients were stratified into subgroups according to their preoperative ABG and this was compared to their postoperative result of air‐bone closure. In addition, for each commonly tested frequency (0.5, 1, 2, 3, 4 kHz) the preoperative and postoperative air‐bone gap were analyzed in order to ascertain whether the preoperative ABG could act as a predictor. Having not passed normality testing, Wilcoxon matched paired signed rank test and Spearman rank coefficient were used for analysis.Results:Throughout the statistical analysis, preoperative ABG correlated most strongly with net difference in postoperative ABG (P <. 0001). For each commonly tested frequency assessed this demonstrated a “very strong” positive correlation. As such, the greater the preoperative ABG, the greater the closure obtained through stapedectomy in this series.Conclusions:In performing stapedectomy for otosclerosis, our series suggested the preoperative ABG may have a role in preoperative patient counseling and consent but is unable to predict success in stapedectomy surgery.
Long‐term Cross‐Hatching Eustachian Tuboplasty Outcomes
Authors: Yanez Carlos , Velazquez Sandra , Mora Nallely 
Published: September 2014

Objectives:Review the long‐term outcomes of cross‐hatching Eustachian tuboplasty (ChEt) in patients with chronic obstructive Eustachian tube dysfunction (COETD), as well assess the clinical factors associated with surgical success.Methods:Case series with chart review in a tertiary health care institution. This is a retrospective review by the senior author of all cases of patients who had non‐revision ChEt for COETD. Follow‐up period was 5 years. The curvature of the posterior cushion was modified using an argon laser to alter the spring of the cartilage alleviating the obstructed valve's aperture. Several clinical factors were reviewed in relation to the successful opening of the Eustachian tube valve.Results:One hundred twenty patients, 72 males/48 females, average age 42.4 + 2 years old, met inclusion criteria to the study. COETD patients/obstructive causes were: Posterior cushion hypertrophy, 68 (56.6%). Tensor Veli and Levator Veli Palatini muscles hypertrophy, 15 (12.5%). Mucosal hypertrophic disease, 37 (30.8%). Total treated tubes was 198, bilateral 143 (72.2%), 55 unilateral (27.7). ET valve was seen more open postoperatively on simple endoscopy (SE) and slow motion video analysis (SMVEA). There were no complications. Mean pure tone average improved by 20 dB postoperatively; P =. 015. Mean immitance changes in tympanometric measurements improved postoperatively at least 0.10 mmhos in 91% of the patients (P =. 010). Resolution of symptoms was considered a successful outcome. Failure correlated with the severity of disease.Conclusions:High rates of improvement (96%) were found. Therefore, ChEt is a promising technique for the treatment of COETD.
Long‐term Results of Pediatric Cholesteatoma Surgery Using Canal‐Wall‐Down Approach with Primary Obliteration: 5‐Year Observational Study
Authors: Trinidade Aaron , Yung Matthew 
Published: September 2014

Objectives:Present the results of a 5‐year longitudinal study in a pediatric population undergoing cholesteatoma surgery using a canal wall down approach with obliteration.Methods:Prospective longitudinal study in a district general hospital from 1999 to 2013.46 children (<16 years) with cholesteatoma were included. Outcome measurements were: (1) residual, recurrence, and recidivist cholesteatoma rates at 5 years postsurgery; (2) postoperative hearing; (3) postoperative waterproofing of the ear; (4) number of subsequent ear surgeries required.Results:Using Kaplan‐Meier analysis, the residual cholesteatoma rate at 5‐years post‐surgery was 6.7% at a rate of 20.9 per 1000 years of child follow‐up (95% confidence interval: 7.8‐55.6), representing 4 cases of residual cholesteatoma and no recurrences. No children experienced otorrhea at 5 years and the rate of definitive waterproofing was 94.8%. There was a reoperation rate of 18.3% (n = 11) at 5 years, which included planned ossiculoplasty. Regarding hearing, of the data available (n = 17), 12 children (70.6%) preserved maintained their hearing (change between –10 to =10 dB), 1 child (5.9%) had hearing gain (>10 dB), and 3 children (17.6%) had hearing reduction at 12 months postoperation. Six out of 17 children (35.3%) had a postoperative hearing level of ≤30 dB.Conclusions:The use of a canal wall down approach with obliteration of the mastoid cavity to surgically treat cholesteatoma is safe in pediatric populations and results in a low recurrence rate and high rate of a trouble‐free ear in the long term.
Longitudinal Change of Varicella‐Zoster Virus‐Specific Cell‐Mediated Immunity in Hunt Syndrome and Bell's Palsy
Authors: Ichihara Takahiro , Haginomori Shin‐Ichi , Mori Atsuko , Kanazawa Atsuko , Nishikado Akira , Kawata Ryo 
Published: September 2014

Objectives:(1) Compare longitudinal changes of Varicella‐zoster virus (VZV)‐specific cell‐mediated immunity (CMI) in Hunt syndrome with Bell's palsy using IFN‐γ enzyme‐linked immunospot (ELISPOT). (2) Examine the role of VZV‐specific CMI for VZV reactivation in the facial nerve in Hunt syndrome.Methods:This prospective study was conducted in our tertiary referral hospital between 2010 and 2013. Nineteen Hunt syndrome and 59 Bell's palsy patients were enrolled. Mononuclear cells isolated from whole blood were incubated with VZV antigen in culture plates for 40 hours. Anti IFN‐γ antibody was added and the ELISPOT system counted immunostained spots indicating VZV‐specific CMI. The relationship between the spots and days from the onset of palsy were compared between Hunt syndrome and Bell's palsy patients.Results:Immediately after the onset, the number of spots in the Hunt syndrome group was much lower than in the Bell's palsy group, indicating low VZV‐specific CMI. However, it increased rapidly and showed a strong positive relationship between the number of spots and days from the onset of palsy (r = 0.64) in Hunt syndrome. Several months after the onset, the number of spots in Hunt syndrome decreased gradually. In contrast, the Bell's palsy group showed no such relationship (r = –0.22).Conclusions:These results suggest that low CMI to VZV may play an important role in VZV reactivation in the facial nerve, thus leading to facial palsy in Hunt syndrome. VZV vaccination is considered to be a candidate to promote VZV‐specific CMI for the prevention of Hunt syndrome.
Magnetic Resonance Imaging versus Computed Tomography in Temporal Bone Carcinoma: Radiological and Pathological Correlation
Authors: Spear Samuel A. , Mehta Rahul , Jackson Neal , Ying Yu‐Lan Mary , Nuss Daniel W. , Arriaga Moises A. 
Published: September 2014

Objectives:Correlate the findings of preoperative magnetic resonance imaging (MRI) and computed tomography (CT) in temporal bone carcinoma with histopathological findings following lateral temporal bone resection.Methods:In this retrospective review, 11 cases of temporal bone carcinoma over the past 3 years were reviewed at our institution. Preoperative CT and MRI scans were systematically reviewed for tumor involvement in 10 anatomic areas involving and surrounding the temporal bone. These were compared with results found on final histopathology.Results:Among the 11 cases, 30 anatomic areas of tumor involvement identified on CT imaging were also found on MRI and confirmed on final histopathology. Two areas suggestive on tumor involvement on CT and MRI (parotid gland and regional lymph nodes) and 2 areas on MRI alone (mastoid antrum and middle ear) were negative on final histopathology. MRI did not change the preoperative clinical staging in any of the 11 cases, however, examination of the MRI in 1 case suggested temporal lobe involvement that was not seen on CT images and subsequently changed the management of the patient.Conclusions:The addition of MRI in the preoperative evaluation of these patients confirmed the extent of tumor involvement seen on CT and did not identify additional tumor or facial nerve involvement in most cases except for one advanced case. In this case, the addition of the MRI findings changed the treatment plan. While CT remains the imaging gold‐standard for preoperative evaluation and staging, MRI should be obtained in evaluating advanced temporal bone tumors.
Trauma‐Induced Parkinson's Syndrome
Authors: Ho Brian , Yu Jack C. , Davis Franklin , Morgan John 
Published: September 2014

Objectives:Investigate if facial fractures predispose patients to developing Parkinson's disease. Facial trauma ranges from lacerations to complex facial fractures. These fractures can result from sports, motor vehicle collisions, or assaults. The long‐term neurologic effects of facial fractures have not been studied. Significant force is required to break midface buttresses or the mandible. Such force is transmitted toward the cranial vault contents. The location of the basal ganglia along the skull base predispose this area to higher strain. Chronic traumatic encephalopathy (CTE) shows similar neurologic damage related to repeated head injuries, as seen in the NFL and boxing.Methods:A total of 146 Parkinson's patients were recruited from the neurology clinic. They were given a voluntary survey. This survey consisted of demographic questions: sex, age, age of diagnosis, involvement in sports, and history of facial fractures. The incidences of facial fracture ICD9 820.0 were analyzed with Wolfram Alpha and then chi‐square.Results:Twenty‐two of 146 (15%) had a positive history of facial fractures. Of the 22, 9 (6%) experienced multiple fractures. Twenty‐six of 146 (17.8%) patients were involved in contact sports, with 7 out of 26 patients having fractures and participating in sports. Utilizing Wolfram Alpha, the incidence of ICD9 820.0 was calculated to be 1 out of 4100 (0.024%) in the US population. A chi‐square test comparing our results showed a P value of. 023Conclusions:Based on these statistically significant results, patients who experience facial fractures show an increased predilection for developing Parkinson's disease.
Marginal Tympanic Membrane Perforations: A Critical View
Authors: da Costa Sady S. , Rosito Leticia S. , Canali Inesangela , Jung Yuri P. , Pauletti Marcos G. T. , Freitas Luiza A. , Jung Larissa P. 
Published: September 2014

Objectives:(1) Assess the marginal perforation prevalence in patients with chronic otitis media (COM). (2) Analyze evidence suggesting prior moderate or severe tympanic retractions (TM) of the pars tensa in marginal perforation cases. (3) Correlate the abnormal findings with those in the contralateral ear (CLE).Methods:Prevalence study. The bilateral videotoscopies of 1510 patients diagnosed with COM in a tertiary hospital were analyzed. Previous TM retraction was evaluated according to: (1) medialization of the manubrium of malleus, (2) remnant tympanum adhered to the ossicular chain, (3) remnant tympanum adhered to the promontory, and (4) ossicular chain erosion. The videotoscopies of the CLE were also described.Results:Of the 1510 patients evaluated, 34 (2.25%) had marginal TM perforation. Only 5.9% of ears showed no evidence of previous retraction, and 88.3% showed 2 or more abnormal findings. The CLE was diagnosed with perforation‐retraction (2.9%), moderate or severe retraction (52.9%), and cholesteatoma (14.7%); 23.5% were normal.Conclusions:The study population had a low marginal perforation prevalence. The vast majority of ears with marginal perforation had evidence suggesting previous TM retraction. In addition, retraction or cholesteatoma occurred in 70.5% of CLE.
Molecular Network of Tinnitus Focusing on BDNF Signal and Autophagy in Auditory Cells
Authors: Hayashi Ken , Goto Fumiyuki , Tsuchihashi Nana A. , Fujioka Masato , Kanzaki Sho , Ogawa Kaoru 
Published: September 2014

Objectives:Recent studies show that the expression of brain‐derived neurotrophic factor (BDNF) is decreasing in patients with depression and severe tinnitus. However, the relationship between the incidence of tinnitus and the role of BDNF remains unclear in auditory cells. The aim of this study is to consider the molecular network of tinnitus focusing on BDNF signal and autophagy in auditory cells.Methods:We used auditory cell line (HEI‐OC1) in this study. Tunicamycin was used as endoplasmic reticulum (ER) stress. The viability of HEI‐OC1 was determined by cell viability assays. Morphological observation was performed under transmission electron microscope (TEM). Western blot analysis was performed.Results:The cell viability after treatment of tunicamycin was decreased in dose‐ and time‐dependent matter. Autophagosomes and autolysososmes were confirmed into the cytoplasm of HEI‐OC1 under TEM. The expression of LC3‐II was increased in HEI‐OC1 after treatment of tunicamycin. These results mean that autophagy was consistently induced in tunicamycin‐treated cells. The expression of CHOP was decreased after peaking at 12 hours after the treatment of tunicamycin. The expression of BDNF, which has the potential to become a biomarker of tinnitus, and calcium‐dependent activator protein for secretion 2 (CAPS2) that promotes BDNF section, were decreased in tunicamycin‐treated cells. The expression of Bcl‐2 that control apoptosis and Beclin1 that regulate autophagy were decreased in tunicamycin‐treated cells.Conclusions:Our results lead to the suggestion that the autophagy‐mediated regulation of cell death and molecular network focusing on BDNF signal play a major part of the incidence of tinnitus.
Ossicular Chain Trauma during Middle Ear Endoscopy
Authors: Abou‐Bieh Alaa A. 
Published: September 2014

Objectives:(1) Evaluate the risk of ossicular chain trauma and injuries due to different middle ear endoscopic techniques and maneuvers. (2) Describe types, incidence, and causes of these injuries. (3) Suggest methods to avoid them.Methods:Thirty temporal bones were approached using 0°, 30°, and 70° otoendoscopes with 2.7 mm and 4 mm diameters. Three areas were systematically approached in each bone: retrotympanum, protympanum and epitympanum. They were also manipulated using 3 sets of otologic surgical instruments: regular straight, regular curved and especially designed for endoscopic ear surgery.Results:The most common injury was the fracture of the posterior stapedial curs (27%). Other types were incudostapedial joint dislocation (23%), fracture of foot plate (23%), stapes dislocation (17%), fracture both stapedial crura (13%), fracture of the incus long process (6%), and incudomalleolar joint dislocation (3%). Single injuries were 44% and combined or multiple injuries were 56%. Highest incidence of injuries was with the 70° otoendoscope (89%) and with both the straight and curved regular instruments (67%). The diameter of otoendoscopes did not affect the number of injuries. Positioning of the scopes and familiarity with the technique reduced the incidence of trauma.Conclusions:Middle ear endoscopy can lead to a significant risk of ossicular chain injuries with their sequelae on hearing. Minimizing this risk necessitates adequate familiarity with the anatomy, techniques and otoendoscopes and usage of especially designed surgical instruments. In addition, combining both microscopic and otoendoscopic approaches or surgically assisted otoendoscopic approaches can reduce this risk considerably.
Otologic Surgery Preoperative Imaging: Mandatory or Recommended? Useful or Defensive?
Authors: Peixoto Maria , Oliveira José , Caiado Ricardo , Melo Ana , Bastos José 
Published: September 2014

Objectives:Look for and implement guidelines for preoperative imaging requests to facilitate clinical practice and avoid medico‐legal problems.Methods:A review of contemporary English medical literature via Medline using the terms imaging, preoperative imaging, computed tomography (CT) scan/CT, magnetic resonance imaging (MRI)/magnetic resonance plus otosclerosis, chronic otitis media, cholesteatoma, simple chronic otitis, tympanoplasty/myringoplasty, and middle ear was performed. Abstracts were reviewed independently by two authors and relevant articles were then evaluated. Indications for preoperative imaging study for each pathology considered, benefits, main findings and the cost‐beneficial relationship were investigated.Results:Few articles address this issue. Otosclerosis: 152 articles, with some of the studies referring to the assessment of activity and extension of the disease, but only 3 were related to the demand for imaging. Myringoplasty/tympanoplasty: a total of 87 items were found but only 4 address the issue of preoperative imaging evaluation. Chronic otitis media/cholesteatoma: 467 articles, with 32 approaching this subject. For each abstract evaluated, conditions were considered: the indications and relevant findings versus the diagnosis controversial aspects and the real need of the request (findings that can be easily diagnosed intraoperatively).Conclusions:There is a growing number of otolaryngologists who routinely request preoperative imaging before middle ear surgery based on ambiguous criteria. The proposal for the creation of guidelines will help clinicians in their diagnostic decisions and to avoid medico‐legal problems.
PENTOCLO for Treatment of Osteoradionecrosis of the Temporal Bone
Authors: Glicksman Jordan T. , Khalili Sammy , Fung Kevin , Parnes Lorne S. , Agrawal Sumit K. 
Published: September 2014

Objectives:Osteoradionecrosis is a rare but devastating complication of radiation therapy that often requires surgical intervention. The objective of this report is to describe a case of osteoradionecrosis (ORN) of the temporal bone that was managed medically with PENTOCLO (pentoxifylline‐tocopherol‐clodronate). The use of PENTOCLO in the treatment of ORN of other sites in the head and neck will also be described.Methods:We report the case of a patient treated at our institution and present a review of literature. A 52‐year‐old woman presented with ORN of the temporal bone 20 years following radiation therapy for an ipsilateral parotid tumor. The patient had chronic infections and otorrhea.Results:She failed conservative treatment including antibiotic‐steroid ear drops and aural lavage. As an alternative to hyperbaric oxygen and/or temporal bone resection, treatment with PENTOCLO was pursued and her condition improved dramatically. A literature review of ORN of the temporal bone and the use of PENTOCOLO in the management of ORN of other sites of the head and neck are described.Conclusions:PENTOCLO was effectively used in the management of our patient and may represent a valuable management option for other patients with ORN of the temporal bone. Further research is required to determine the effectiveness of PENTOCLO.
Perilymphatic Gentamicin Trafficking through Basolateral Channels May Underlie Enhanced Ototoxicity by Noise‐Induced Threshold Shifts
Authors: Luk Lauren J. , Li Hongzhe , Steyger Peter 
Published: September 2014

Objectives:(1) Demonstrate gentamicin uptake from perilymph into hair cells via basolateral channels such as the postsynaptic acetylcholine receptor (nAChR) and the TRPA1 in neonatal mice in vivo and in vitro. (2) Recognize alternative gentamicin trafficking pathways to the well established endolymphatic mechanoelectrotransducer channel underlying aminoglycoside ototoxicity.Methods:Neonatal mice were intraperitoneally injected with fluorescently‐conjugated Gentamicin‐Texas Red (GTTR), prior to fixation 30 minutes later. Cochlear explants were treated with GTTR 1 µg/mL, with or without 100 µM acetylcholine or cinnamaldehyde then fixed, and analyzed. Fluorescence intensities were measured by calculating the mean gray value of each cell with Image J. Student t test was used to determine any significant differences in fluorescence values between treatment groups.Results:Application of acetylcholine increased GTTR uptake by wildtype outer hair cells (OHC) in vivo and in vitro. These results were also replicated in Myo7a8J/8J mice, which lack functional mechanoelectrotransducer channels. Application of cinnamaldehyde (TRPA1 agonist) also increased GTTR uptake in OHCs in wildtype, myo7a8J/8J mice and guinea pigs.Conclusions:Endolymphatic gentamicin trafficking via the mechanoelectrotransducer (MET) channel is a well established mechanism of ototoxicity. Noise‐induced threshold shifts (NITS) have been shown to damage the mechanically gated tip link, thus closing MET channel. However, aminoglycoside hair cell uptake is enhanced by NITS. This suggests one or more aminoglycoside entry route(s) into hair cells in addition to, and independent of, the MET channel. The results of this study support perilymphatic trafficking of gentamicin via basolateral channels including the nAChR Ca2+ channel, and TRPA1.