bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detecting Reflux in Adults with Eustachian Tube Dysfunction
Authors: Brunworth Joseph D. , Djalilian Hamid R. , Garg Rohit 
Published: September 2011

Objective1) Ascertain whether adult patients with Eustachian tube dysfunction (ETD) have a higher incidence of reflux into the nasopharynx compared with controls. 2) Utilize recent advances in pH probe technology to detect acidity at the Eustachian tube orifice for direct comparison.MethodA prospective study was performed on 38 adult patients in an outpatient setting between November 2009 and February 2011. Seventeen patients with Eustachian tube dysfunction and 21 control subjects had a Dx‐pH probe (Restech, San Diego, California 2006) placed near the torus tubarius in the posterior nasopharynx for 24 hours.ResultsThe average pH value obtained from the nasopharynx of adults with no history of ETD was 7.03 (range, 6.10‐7.92; SD, 0.69). In comparison, the average pH for patients with ETD was 6.90 (range, 5.33‐8.06; SD, 0.77). This P value for this difference was. 48. The average number of reflux events for subjects was 0.55 events over a 24‐hour period for controls and 2.1 for patients with ETD. Decreases in pH were considered reflux events if the pH dropped below 5.5 while in the upright position or below 5.0 in the supine position.ConclusionBy utilizing a novel pH probe that allows detection of acidity in a non‐liquid environment, a comparison of nasopharyngeal pH between control patients and those with ETD was performed. A trend toward higher numbers of reflux events was found in patients with ETD when compared to control subjects.
Digital Image Stabilization in the Treatment of Oscillopsia
Authors: Pothier David D. , Hughes Cian , Sulway Shaleen , Dillon Wanda , Rutka John A. 
Published: September 2011

Objective1) Develop real‐time image stabilization using immersive augmented reality eyewear to counteract bobbing oscillopsia in patients with bilateral vestibular loss (BVL). 2) Measure change in dynamic visual acuity (DVA) in patients with BVL using the device.MethodImmersive virtual reality glasses used in combination with a compact digital video camera were used. A software algorithm was developed that used a center‐weighted Lucas‐Kanade optical flow method to stabilize video in real time. Six patients were tested for changes in DVA using the eyewear.ResultsThe ability to read a Snellen chart during a 2Hz oscillating head rotation DVA test showed a drop in visual acuity during head movement from a mean of 7.9 (SD = 0.8) lines at rest to 3.1 (SD = 2.0) lines during a 2Hz head rotation. This improved to 5.7 (SD = 1.2) lines with image stabilization with the same 2Hz rotation (P <. 001). All reported a considerable subjective improvement in vision in addition to the Snellen chart test.ConclusionThis is the first successful attempt to improve dynamic visual acuity in patients with bilateral vestibular loss. Recent hardware upgrades are promising in improving these results even further.
ECoG during Cochlear Implantation for Hearing Preservation
Authors: Mandalà Marco , Colletti Liliana , Colletti Vittorio 
Published: September 2011

ObjectiveDetermine if intraoperative electrocochleography (ECoG) during cochlear implant (CI) surgery provides online feedback to the surgeon to modify surgery and reduce trauma for increasing preservation of residual hearing.MethodSeventeen adult patients undergoing CI who had measurable auditory thresholds preoperatively in the low‐ to mid‐frequencies were enrolled. Eight subjects had intraoperative compound action potentials (CAPs) measured to assess cochlear function during surgery. In those patients, surgery was modified according to ECoG feedback. Nine subjects performed CI without ECoG feedback.ResultsThe average preoperative PTA thresholds (0.25‐2 KHz) were 76 ± 9 and 84 ± 12 dBHL in the unmonitored and monitored cohorts, respectively (P >. 05). CAPs recording showed latency shift (0.5‐1.5msec) and normalized amplitude deterioration (10%‐50%) during surgery. All these changes reverted to normal after electrode insertion in all but one subject. The average postoperative PTA threshold shifts (0.25‐2 KHz) were 4 ± 2 and 23 ± 11 dBHL in the monitored and unmonitored cohorts, respectively (P =. 0022). Complete hearing preservation (loss of ≤10 dB) at 6 months was achieved in 88% (7/8) of subjects who had ECoG feedback and in 33% (3/9) of unmonitored patients.ConclusionMonitoring cochlear function with ECoG provides real‐time feedback to the surgeon during CI surgery providing objective data to modify his or her surgical technique in ways that can improve the rate of hearing preservation.
Electroconvulsive Therapy and Cochlear Implantation
Authors: Rivas Alejandro , Hedley‐Williams Andrea , Raj Vidya , Clark Nathaniel , McRackan Theodore R. , Labadie Robert F. 
Published: September 2011

ObjectiveElectroconvulsive therapy (ECT), used for recalcitrant psychiatric illnesses, is contraindicated in patients with cochlear implants (CI) because of potential risk of damage to the CI and/or the patient. With increasing numbers of CI recipients, ECT in this population warrants further study. Herein, we present a cadaveric study of such.MethodTen functional CIs were unilaterally implanted in fresh cadaveric heads. Each head then received 12 ECT treatments replicating a standard clinical treatment protocol. CI impedance testing was performed prior to and immediately after CI insertion, and then after the 1st, 3rd, 5th, 7th, 9th, and 12th ECT treatments.ResultsTwelve rounds of ECT (800 mA per treatment) were performed on each of the implanted heads by a staff psychiatrist. Measured responses were typical to those encountered clinically. Impedance measurements after each ECT treatment did not show any increases. No open circuits developed because of ECT. After the first ECT treatment there was a trend toward decreased impedance measurements, which were sustained throughout the rest of the testing. Regarding ipsilateral vs contralateral application of ECT therapy, no statistically significant differences (all P >. 5) in impedance measurements were noted.ConclusionECT does not cause any electrically measureable damage to CIs via either ipsilateral or contralateral therapy. Coupled with case reports on the safety of ECT in patients with CIs and similar technology (ie, deep brainstimulators), this study suggests that ECT can be safely used in patients with CIs.
Etiologic Diagnosis of Nonsyndromic Genetic Hearing Loss in Adult vs Pediatric Populations
Authors: King Peter , Angeli Simon I. , Ouyang Xiaomei , Liu Xue‐Zhong 
Published: September 2011

Objective1) Determine the diagnostic yield of a shared genetic screening algorithm in adult and pediatric populations with sensorineural hearing loss (SNHL). 2) Recommend effective testing strategies to evaluate for genetic causes of deafness in patients presenting with idiopathic sensorineural hearing loss.MethodA total of 221 adult and 163 pediatric patients with non‐syndromic sensorineural hearing impairment were recruited from otology clinics between 2001 and 2011. Peripheral blood samples were screened for mutations in GJB2 and GJB6 and mitochondrial DNA mutations 1555A>G, 7444G>A, and 3243A>G. Audiometric data and family history were also collected.ResultsGJB2/GJB6 related deafness was diagnosed in 23 out of 163 pediatric patients (14%) compared with only 3 out of 221 adults (1%). All 3 adults had a family history of hearing loss, and 2 patients noted deafness onset at birth. Nineteen GJB2 mutations were identified with 35delG, the most common mutation. The 35delG homozygous state was the most common pathogenic genotype (54%). Mitochondrial DNA (mtDNA) mutations were found in 6 adult probands (3%). No mtDNA mutations were found in pediatric patients.ConclusionTesting for common GJB2/GJB6 mutations in pediatric patients has considerable value in establishing an etiologic diagnosis for SNHL. Similar testing in adults is of very low yield except perhaps in cases of early onset HL or strong family history. Mitochondrial DNA testing should be considered in adults with idiopathic SNHL.
Inner Ear Anomalies and Risk for Stapedectomy
Authors: Brickman Daniel S. , Warren Frank Manley 
Published: September 2011

Objective1) Quantify the anatomic relationships within the vestibule of temporal bones with known inner ear malformations that are relevant to stapes surgery complication rates. 2) Evaluate for pathologic evidence of stapes complications in temporal bones with structural inner ear malformations that have undergone stapes surgery.MethodSensorineural hearing loss after primary stapes surgery is rare. Histologic examinations in these cases have identified hydrops formation, scala media atrophy, adhesion formation, and perilymph fistula. The study is a pathologic review of the National Temporal Bone Database for cases of inner ear malformations with and without otosclerosis.ResultsThe database contains 7,490 subjects with greater than 12,000 temporal bone specimens from 16 institutions. Database queries yielded 122 examples of structural inner ear malformations not related to chronic ear disease or malignancy. Of these, 10 had pathologic evidence of otosclerosis, and 6 of these had stapes surgery performed. Though retrospective and with malformations diagnosed postmortem, the clinical record of this group noted no operative complications. Only 1 of these 6 patients had documented worsening of hearing from the first to last clinical visit. Four of 6 patients had documented hearing improvement.ConclusionThe decision to perform stapes surgery in patients with known inner ear malformations has been dictated by surgical dogma in the past. This review may lend histopathological evidence to loosen those criteria, though more rigorous clinical testing is needed.
Double‐Doyle Intranasal Airway Splint Technique
Authors: Paik Young S. , Rice Gabriel , Liess Benjamin D. , Renner Gregory J. 
Published: September 2011

ObjectivePresent a novel technique utilized by the senior author for support of unstable, comminuted nasal bone fractures and its adaptation to rhinoplasty and septal surgery to provide greater stabilization of the nasal septum and bones. Illustrate safe and adequate results with this technique.MethodRetrospective chart review of the senior author’s past surgical procedures since 2001 utilizing this Double‐Doyle intranasal airway splint technique. Patient demographics, diagnoses, surgical procedure, stenting duration, and complications were identified. This technique involves 2 modified Doyle II intranasal airway splints (Medtronic) to provide greater intranasal support.ResultsEighty‐seven cases involving the Double‐Doyle intranasal airway splint technique performed for closed nasal reduction, selected cases of open rhinoplasty, and septal procedures revealed overall that this intranasal splint modification was safe, tolerated well by patients, and presented minimal morbidity. All but one patient experienced a successful cosmetic and functional outcome as described by the senior author. Six overall possible complications were noted; 3c cases of minor nasal mucosa damage and 3c cases of possible infection that resolved after removal of the splint and treatment with antibiotics.ConclusionWe present a safe technique that provides prolonged nasal dorsal support in severely comminuted nasal bone fractures without the need for external suspension devices or additional incisions. Additionally, this technique may be applied to rhinoplasty and septal procedures involving significant septal correction to allow greater stabilization of the septum postoperatively.
Isolation of Transtympanic Characteristics Utilitizing a High‐Definition Video Otoscope at Individual Visible Light Frequencies
Authors: Roehm Corrie , Valdez Tulio A. 
Published: September 2011

ObjectiveOtoscopic diagnosis has relied on virtually unchanged century‐old otoscopic technology utilizing white light reflection from the tympanic membrane to the examiner. The utility of a specific visible light video‐otoscopic alternative was investigated using multiple wavelengths including 405, 450, 532, and 635 nanometers to isolate unique transtympanic characteristics.MethodHigh‐definition tympanic membrane images of normal adult subjects were obtained under 405, 450, 532, and 635 nanometer (nm) wavelength illumination using a high‐definition color CCD camera video otoscope.ResultsUnder 405 nm wavelength light, improved definition of the ossicles and promontory was seen compared with white light and the other 3 individual wavelengths. Large absorption by hemoglobin along the annulus and malleus was seen using 532 nm wavelength. Cerumen and keratin debris were found to have highly reflective properties on both 405 nm and 450 nm wavelength.ConclusionSpecific visible light reflectance high‐definition CCD otoscopy at 405 and 450 nm wavelengths offers additional definition of transtympanic features over traditional white light otoscopy, specifically highlighting bony landmarks including the ossicular chain and promontory.
Jellyfish Model for Aminoglycoside Toxicity
Authors: McAfee Jacob Seth , Strasnick Barry 
Published: September 2011

ObjectivePharmacologic ototoxicity is well described in the medical literature, yet efficient models are lacking. Aurelia aurita aphyrae, transparent jellyfish with identifiable, easily stained hair cells, are effective models because hair cell changes are readily observed and ototoxicity is manifested behaviorally. We treated ephyrae with various gentamycin dilutions, evaluated motility, and quantified structural changes.MethodCultured Aurelia aurita polyps underwent strobilation, yielding ephyrae. Baseline pulsing (P), swimming (S), and orientation (O) values were recorded. Ephyrae were transferred to test tubes containing artificial sea water (ASW) or gentamycin (GM). P, S, and O were scored at 30 minutes, 1 hour, 12 hours, and 24 hours. Ephyrae were fixed in formalin, and hair cells were stained and imaged with confocal microscopy, then analyzed with Metamorph image processing program.ResultsP was impaired in a dose dependent fashion, with controls maintaining baseline P, S, and O values through 48 hours. Impairment of S and O occurred with 3.5 mM GM at 12 and 24 hours. Changes occurred rapidly (within 30 minutes) and were stable at 24 hours. For 6 experiments using 10 ephyrae (n = 60), at 24 hours P was reduced on average from 75 in ASW to 29, 12, and 2 for GM concentrations of 1, 2, and 3.5 mM, respectively (P <. 001 in all cases compared with control). Hair cell loss per rhopalia at 48 hours (3.5 mM GM) compared with control was significant (36 vs 43, P <. 002), correlating with motility.ConclusionThe ephyrae model readily demonstrates functional and histological impairments when treated with GM, showing promise as a tool for ototoxicity screening and identification of chemoprotective agents.
Low‐Cost Auditory Biofeedback for Bilateral Vestibular Loss
Authors: Pothier David D. , Hubbard Bradley , Hughes Cian , Sulway Shaleen , Dillon Wanda , Rutka John A. 
Published: September 2011

Objective1) Develop an auditory biofeedback device based on the Apple iPod Touch. 2) Investigate the efficacy of auditory biofeedback for patients with bilateral vestibular loss (BVL) using posturography.MethodThe “Vestio” vestibular prosthesis provides auditory biofeedback via a small head‐mounted device that can be housed in a cap. It uses inputs from the iPod’s onboard accelerometer and gyroscope to determine head movement. This generates auditory biofeedback using a combination of pure tone sounds and wide‐band pulses.ResultsFollowing a short training period, 5 patients with BVL were tested using the modified Clinical Test of Sensory Interaction on Balance (mCTSIB). Path length and COP were determined for each participant with Vestio turned off then repeated with the Vestio device turned on. These were compared using path length and sway. Both were found to be statistically significantly improved (P =. 001). Repeat testing without the device showed a return to pre‐test conditions. Patients in our pilot study went from falling on a hard surface with their eyes open to being stable on a compliant surface with their eyes closed.ConclusionAuditory biofeedback can be successfully applied using this specialized software on a widely available, low‐cost device. Further work is being undertaken to exploit real‐time gait measurement to incorporate a walking version of the algorithm.
Mastoidectomy Cavity Obliteration with Bioactive Glass
Authors: Silvola Juha Tapio 
Published: September 2011

Objective1) Show that mastoid cavities with continuous infections and cleaning problems can be obliterated with bioactive glass (BG). Bioactive glass S53P4 inhibits bacterial growth, turns slowly into bone, and activates new bone formation. 2) Present results of a pilot study for 16 operations on adults.MethodA prospective follow‐up of mastoid obliterations started in 2007. The mean follow‐up time is 1.16 years. Fourteen ears had a large open radical cavity with recurrent infections. Two ears had discharge and pain after simple mastoidectomy. A re‐mastoidectomy included support of the cavity skin and obliteration with BG.ResultsAll ears become dry. One reoperation was needed, as the fascia support to the EC skin was too weak and part of the BG leaked into the EC. The ear stayed dry, and the missing BG was replaced in a reoperation. A slightly short musculoperiosteal flap supported the EC skin in one ear. A minor amount of BG leaked into the EC. The ear stayed dry. The aim was an ample ear canal (EC). One ear was overfilled and waits for meatoplasty. Simple mastoid cavities were isolated from the middle ear and became asymptomatic.ConclusionBG works as obliteration material in problematic open radical cavities safely and with success. BG seems to tolerate chronic infection in the mastoid and prevent postoperative infections.
Ménière Disease: Intratympanic Gentamicin or Dexamethasone
Authors: Casani Augusto P. , Cerchiai Niccolò , Seccia Veronica , Dallan Iacopo , Sellari Stefano 
Published: September 2011

ObjectiveDetermine the efficacy (control of acute vertigo attacks) and effects on hearing (evaluated by pure tone average, PTA, and speech discrimination score) of low dose intratympanic gentamicin (IG) compared with intratympanic dexamethasone (ID) in patients with unilateral intractable “definite” Ménière Disease (MD).MethodThis was an open, prospective study. Sixty patients affected with unilateral MD were enrolled between January 1, 2007, and June 30, 2008. A total of 32 patients were treated with IG (maximum 2 injections); 28 patients were treated with ID (4 mg/ml, 3 injections at intervals of one every three days).ResultsAt 2‐year follow‐up, in the gentamicin group, complete control of vertigo (class A) was achieved in 26 patients (81%), and substantial control of vertigo (class B) was achieved in 4 (12.5%). In the ID group, complete control of vertigo was obtained in 12 patients (43%), and substantial control was achieved in 5 (18%). Nine patients (32%) reported limited control despite 1 to 2 series of retreatment with ID. In the gentamicin group, 4 patients showed a reduction of PTA of 10 or more decibels. In the ID group, PTA results improved in 10 patients, were unchanged in 7 (belonging to class A‐B), and were worse in 11.ConclusionThe results of this study suggest that IG achieved better outcome than ID in the control of vertigo attacks, with a very low incidence of hearing deterioration. ID was associated with good hearing preservation (only in class A‐B subjects), but the control of vertigo spells showed a high failure rate.
Microbiology Reporting of Ear Swab Results in Otitis Externa
Authors: Geyer Marcel , Howell‐Jones Rebecca , Cunningham Richard , McNulty Cliodna A. M. 
Published: September 2011

ObjectiveTo review current microbiology laboratory reporting of ear swab specimens in primary care and reach an evidence‐based reporting policy consensus.MethodProspective primary care study commenced June 2006. Analyzed 50 consecutive ear swab reports of otitis externa from 12 laboratories in the southwest UK to determine reporting practice. The HPA GP Laboratory Use Group achieved consensus of expert microbiology opinion for reporting using a modified version of the Delphi technique.Results487 reports were reviewed (54% female; 46% male). Pseudomonas species (36%), Staphylococcus species (21%), Streptococcus species (15%), and fungi (11%) predominated. Five reporting policies agreed. Policy 1: Common pathogens (above) — “Reported by name with antibiotic susceptibilities.” Policy 2: Pseudomonas species— “Always reported; antibiotic susceptibilities in severe disease.” Policy 3: Aspergillus, Candida, coliform etc— “Only reported if moderate numbers of colonies and predominant organism present; if appropriate report antibiotic susceptibilities.” Policy 4: Coagulase‐negative staphylococci, diphtheroids— and enterococci, “generic terms used; susceptibilities not reported.” Policy 5: “When antibiotic susceptibilities reported, these should include susceptibility to a topical antibiotic.”ConclusionThis paper provides microbiology laboratories with consensus reporting guidelines for ear swabs of otitis externa.
Effect of Glucocorticoids on Facial Nerve Injury
Authors: Seth Rahul , Alam Daniel , Ghosh Debabrata , Rajasekaran Karthik , Meltzer Noah , Revenaugh Peter , Kaltenbach James A. 
Published: September 2011

ObjectiveExamine the effect of both local and systemic dexamethasone administration on facial nerve return of function after complete axotomy and immediate microsurgical repair in a rat model. After nerve injury, an exaggerated neuro‐inflammatory process may hinder regeneration. Therefore, our hypothesis is that glucocorticoid administration will improve nerve recovery.MethodA total of 74 Wistar rats underwent facial nerve axotomy with immediate neurorrhaphy. Blinded and randomized, rats were assigned a postoperative group: control (no therapy), systemic dexamethasone 0.5, 1, 5, or 10 mg/kg for 3 doses, or topical dexamethasone 2 or 4 mg/mL. Standardized facial assessments and nerve conduction studies (NCS) were performed.ResultsAt 8 weeks, rats receiving systemic dexamethasone at 1 and 5 mg/kg attained greater eye blink closure (P =. 014 and P =. 018, respectively) and vibrissae motion (P =. 018 and P =. 023, respectively) compared with controls. Systemic dexamethasone at 0.5 and 10 mg/kg had similar facial motion to controls. Intraoperative topical application of dexamethasone 2 or 4 mg/mL to the neurorrhaphy site was not superior to controls. Gross facial motion assessments were corroborated with vibrissae motion frequency video analysis. NCS’s indicated an increased return of compound muscle action potential amplitude levels to baseline among rats that received systemic dexamethasone 5 mg/kg (P =. 048).ConclusionIn a rat facial nerve axotomy model, postneurorrhaphy systemic dexamethasone therapy improved functional and neurophysiological outcomes at doses of 1 and 5 mg/kg. Locally delivered steroid was not beneficial compared with control groups. Therefore, systemic glucocorticoid administration may provide a substantial recovery benefit after facial nerve injury.