bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endolymphatic Sac Assessed by 3D Cone Beam CT in Ménière Disease
Authors: Miuchi Shinya , Hyodo Jun , Yanagihara Naoaki , Sakagami Masafumi 
Published: September 2011

ObjectiveThe poster introduces new 3D Cone‐beam CT (CBCT) images of endolymphatic sac (ELS). The volume rendering provides realistic image of ELS in relation to the semicircular canal, enabling one to assess location, size, and shape preoperatively. The results are compared with operative findings to confirm clinical values of the new imaging technology.MethodThe 3D Cone‐beam CT images of the 12 patients with Ménière diseases who underwent an endolymphatic mastoid shunt operation between 2008 and 2011 were obtained at our hospital. We assessed location, size, and shape of the ELS. The results of preoperative assessments were compared with the operational findings.ResultsFirst we present clear and sharp 3D pictures of ELS and the semicircular canal using volume rendering incomparable to conventional CT. In 11 patients, the ELS was located exactly along the Donaldson line. In one patient, it was located inferiorly to the line. Size of the ELS was moderate in 6 patients, small in 5, and exceedingly small in 1. Cross section of the sac was circular in 3 patients, oval and flat in 8, and unverified in 1 because the size was too small. The above findings agree with the operational findings closely.ConclusionIn 3D Cone‐beam CT, we could get more informative and better quality images than in conventional CT. Thanks to the preoperative realistic 3D images of ELS and the semicircular canal, we could perform the sac operation more safely and easily. Imaging information thus obtained may help deepen the understanding of Ménière’s disease.
Endoscopic 3D Anatomy of the Middle Ear
Authors: Nogueira Joao‐Flavio , Cruz Daniel N. 
Published: September 2011

ObjectiveDemonstrate the stereoscopic tridimensional (3D) endoscopic anatomy of the middle ear, showing important anatomical landmarks and a new endoscopic view of the structures of the middle ear.MethodWe conducted an endoscopic dissection of 5 human temporal bones. The dissections were performed using traditional ear surgery instruments and sinonasal endoscopes. Two different endoscopic pictures of the same anatomical image were taken and merged using a computer program to generate stereoscopic anaglyphic images.ResultsWe were able to generate excellent quality stereoscopic 3D endoscopic images of the anatomy of the middle ear.ConclusionEndoscopic middle ear surgery is becoming more popular. However there are still several limitations, such as the lack of specialized instruments and anatomical studies. We got excellent 3D pictures of the endoscopic anatomy of the middle ear, which can be used to help guide surgeons during procedures.
Enlarged Vestibular Aqueducts from Autosomal Recessive Parents
Authors: Mun Sue Jean 
Published: September 2011

ObjectiveEnlargement of the vestibular aqueduct is a commonly detected inner ear abnormality and is inherited as an autosomal recessive trait caused by bi‐allelic SLC26A4 mutations. Vertical transmission of EVA has rarely been reported in the literature. We report a case where EVA is inherited as a vertical transmission.MethodA bi‐directional sequencing of SLC26A4 was performed to have a molecular genetic diagnosis of the 3 affected members of this family whose radiologic phenotype was documented by temporal bone CT.ResultsThe father and the mother as well as the proband were shown to have either EVA only or incomplete partition type II. The bi‐directional sequencing of SLC26A4 demonstrated homozygous mutations of p.H723R and c.IVS7‐2A>G from the father and the mother, respectively. The proband turned out to be a compound heterozygote of p.H723R and c.IVS7‐2A>G.ConclusionGiven a wide variety of etiology for congenital deafness, it is interesting to find an assortative mating between EVA patients. We observed a vertical transmission of EVA and documented that SLC26A4 mutations segregating in the family with vertical transmission of EVA, which is usually inherited as a recessive manner.
Epitympanum Dimensions Do Not Correlate with Extent of Mastoid Pneumatization
Authors: Villari Craig R. , Todd N. Wendell 
Published: September 2011

ObjectiveThe epitympanum is an anatomic region of great surgical importance, yet its dimensions have gone largely unstudied since Bezold in the 1800s. We investigated the radiologic dimensions of the epitympanum, compared these dimensions with those determined at anatomic dissection by Bezold, and compared them to mastoid pneumatization.MethodOf 41 clinically normal human crania, the 5 with the smallest mastoid pneumatization areas and the 5 with the largest areas were imaged by high‐resolution computed tomography, both direct axial and direct coronal. The two authors measured the heights, breadths, and lengths independently.ResultsWide ranges were found for epitympanum heights (5.0‐10.0 mm), breadths (6.0‐7.0 mm). and (lengths 9.5‐12.5 mm), and for mastoid sizes. The range of heights was wider than Bezold reports, but the range of breadths was tighter. Bilateral symmetry was found for mastoid pneumatization.ConclusionEpitympanic heights and breadths were generally consistent with the report by Bezold over 100 years ago. Epitympanic dimensions were unrelated to mastoid size.
Evaluation of Hearing and Cochlear Function in Patients with Ankylosing Spondylitis
Authors: Kahveci Orhan Kemal , Duran Abidin , Altuntas Ali , Demirdal Secil , Kavuncu Vural , Okur Erdogan 
Published: September 2011

ObjectiveAnkylosing spondylitis (AS) is a chronic systemic inflammatory disorder that primarily affects spine and sacroiliac joints. Recent studies described audiovestibular impairment in AS patients. The aim of this study was to evaluate the hearing and function of cochlear system in patients with AS.MethodWe prospectively evaluated 37 AS patients and 20 healthy controls. Otorhinolaryngologic examinations were performed in all patients together with pure tone audiometry, speech tests, tympanometry, and distortion product otoacoustic emission (DPOE). Disease duration, Basdai scores, and hematolgic findings (CRP, Sedimentation) were also collected.ResultsPure tone audiometry findings and of the patients and controls were significantly different in all frequencies (P >. 05). No significant difference was found between DPOE responses of the patients and controls (P > 0.05).ConclusionThis study demonstrated that there is an association between AS and hearing loss. But the cochlea is not the main source of hearing loss.
Facial Nerve Grading 2.0 and Sunnybrook Facial Grading System
Authors: Soon Sue Rene , Heah Harold , Yuen Heng‐Wai 
Published: September 2011

ObjectiveWe aim to measure the intra‐system reliability and the inter‐system agreement between the Facial Nerve Grading 2.0 and Sunnybrook Facial Grading system (SFGS).MethodVideo clips of 12 patients with facial nerve dysfunction performing a protocol of facial expressions were recorded. Thirteen physicians were asked to evaluate the videos independently using the 2 scales.ResultsThe ICC score for FNG 2.0 and SFGS was 0.820 (95% CI=0.677‐0.931) and 0.831 (95% CI=0.696‐0.936), respectively. The FNG 2.0 and SFGS inter‐system agreement ICC score was 0.959 (95% CI=0.944‐0.970).ConclusionStudies have established high intra‐system reliability for the SFGS, and our results corroborate these. FNG 2.0 similarly shows high intra‐system reliability. As the inter‐system agreement was found to be near perfect in our study, the new FNG 2.0 should be considered as an alternative grading scale for facial nerve palsy.
Facial Nerve Paralysis in Head Injury Cases
Authors: Agrawal Rahul , Morwani K. P. , Agrawal S. R. 
Published: September 2011

ObjectiveTiming of surgical intervention in posthead injury facial nerve paralysis cases has been a constant topic of discussion. This study’s objectives are: 1) know the site of facial nerve trauma, and 2) determine the best timing of surgical intervention in post head injury facial nerve paralysis.MethodProspective study of 18 patients who underwent facial nerve surgery in past 3 years for facial nerve paralysis due to head injury at Agrawal Hospital & Research Institute was done. Site of injury, timing of surgery, and facial nerve outcome were noted. This is an analysis of an ongoing study.ResultsThe most common site of injury was found to be at the first genu (83.33%) followed by the horizontal segment (11.11%). Earlier surgical intervention showed better results in the form of time duration taken for recovery and also facial nerve status (House‐Brackmann grading).ConclusionIn our series, earlier surgical intervention gives better results, and the most common site of injury is found to be at the first genu followed by the horizontal segment.
Factors Affecting Myringoplasty Success
Authors: Carr Simon , Raine Chris 
Published: September 2011

ObjectiveA retrospective study in a teaching hospital on all patients who underwent myringoplasty between January 2005 and January 2010 in order to determine the independent factors which significantly affect success in myringoplasty in a pediatric and adult age groups.MethodMain outcome measures were recurrence of tympanic membrane perforation and closure of the air‐bone gap to within 10dbHL. Chi‐squared analysis determined the significance of: surgeon grade, condition of the ipsilateral and contralateral middle ear, perforation site and size, and cortical mastoidectomy for both the pediatric and adult groups.ResultsA total of 395 procedures were included. A total of 39 of these were on patients aged ≤ 16 years. Mean overall age: 35.8 years (range, 10‐72 years). Mean length of follow‐up: 7.5 months (range, 2‐48 years). Overall graft take rate was 81%. Graft take in those aged 16 months was 85%. Significant factors in the adult age group were the site of perforation, with anterior perforations associated with the poorest outcome, and simultaneous cortical mastoidectomy (P <. 05). These were not significant in the pediatric age group. Perforation size, the condition of the ipsilateral and contralateral middle ear and grade of surgeon were insignificant in both age groups.ConclusionIt is important for the operating surgeon to have an appreciation of the factors which affect graft take in myringoplasty when deciding to operate and when consenting the patient preoperatively, as these may affect the chance of success.
Florical and Early Otosclerosis
Authors: Cheng Jeffrey , Chandrasekhar Sujana S. , Del Signore Anthony 
Published: September 2011

ObjectiveReport our results with Florical in stabilizing hearing loss in patients with early otosclerosis.MethodA retrospective chart review was undertaken of patients with early otosclerosis treated with Florical. Using a paired t test, comparisons were made in amount of change between speech recognition threshold (SRT) and pure tone average (PTA) air‐bone gap (ABG). A P‐value of <. 05 was considered statistically significant.ResultsEight patients with 10 affected ears were studied. Average age was 44.1 ± 14.2 years old. No statistically significant decline was detected at 3, 6, and 12 months in SRT (P‐value = 1.0,. 68,. 68, respectively) and PTA ABG (P‐value =. 46,. 61, and. 39, respectively). Baseline average ABG was 10.5 ± 8.7 dB. Eight of the 10 ears experienced improvement of PTA ABG (mean = 6.6 ± 5.7 dB). One patient (1 ear) had complete closure of the PTA ABG. Mean follow‐up was 5.7 months. No patients discontinued use of Florical because of adverse side effects. Only 2 patients (25%) reported dyspepsia.ConclusionOur early experience demonstrates that Florical may prevent hearing deterioration and even reversal of early conductive hearing loss. It may be better tolerated than other sodium fluoride preparations, as calcium carbonate may help to alleviate the gastrointestinal side effects associated with sodium fluoride administration.
Foil Technique for Optimized Cosmetic Results in CI Surgery
Authors: Pein M. Katharina , Hoffmann Kerstin 
Published: September 2011

ObjectiveCosmetic results in bilateral cochlear implantations strongly depend on the symmetric position of the coils, not only the scars. The primary purpose of this work is to present a simple method to find the correct position for the second coil and to ensure symmetry in single and 2‐step implantation procedures.MethodIn a proof‐of‐principle study, 5 CI patients were supplied with a second CI. Important reference points were marked using a silicone foil. The foil then was transferred to the opposite side, and according to reference points, the exact symmetric position of the speech‐processor coil could be located.ResultsCoil positions were measured postoperatively, and photographs were taken to evaluate success. In all patients, the second coil could be placed symmetrically to the opposite side. The location error is less then 5 mm, measured with the pre‐ or intraoperatively drawn transparency. The cosmetic outcome was associated with a high degree of patient satisfaction in all patients. Furthermore, silicone transparencies have excellent hygienic properties and are easily to sterilize.ConclusionThe introduced silicone foil technique is easy and quickly implemented. Other intraoperative methods in coil positioning, such as those based on photography, are less accurate and depend highly on the surgeon’s capabilities. Especially in bilateral CI‐surgery, silicone transparencies should become a standard technique for higher patient satisfaction and outstanding cosmetic results.
Rehabilitation of Microglossia with Mandibular Distraction
Authors: Berg Erik , Laskarides Constantinos , Vecchiotti Mark A. , Scott Andrew R. 
Published: September 2011

ObjectiveDescribe an approach to surgical rehabilitation of feeding, speech, and upper airway obstruction in an infant with microglossia and micrognathia.MethodCase report and literature review.ResultsWe describe a 17‐month‐old child with micrognathia, microglossia, and submucus cleft palate who was initially fed via g‐tube and did not require early airway interventions. As the child was attaining normal developmental milestones, the decision was made to perform bilateral mandibular distraction osteogenesis as a means of improving feeding, speech, and clinical symptoms of obstructive sleep apnea. In this report, relevant literature is also reviewed as it pertains to the rehabilitation and reconstruction of this rare craniofacial anomaly.ConclusionMandibular distraction osteogenesis improved glossoptosis and created a more favorable position of the tongue within the oral cavity. This in turn allowed for an overall improvement in oral motor function culminating in removal of the feeding tube.
Glomus Jugulare Tumors: A Series of 24 Cases
Authors: Escada Pedro Alberto , de Almeida Gonçalo Neto , Vitala José Pratas , Branco Gabriel 
Published: September 2011

ObjectiveDescribe the surgical technique and experience of a neurotology surgical team working in Lisbon, Portugal, in the surgical treatment of glomus jugulare tumors.MethodThe retrospective study included 24 patients operated between 1988 and 2007. Data were obtained from the medical records and after a recent evaluation of the patients. The outcome measures were: clinical manifestations, preoperative embolization and surgical technique, tumor removal, morbidity, mortality, and evolution of residual lesions.ResultsSymptoms included hearing loss (33%); pulsatile tinnitus (21%); and cranial nerves X (29%), VII (25%), and XII (21%) paralysis. Preoperative embolization was performed in 92% of the cases, and the surgical technique was the infratemporal fossa aproach type A in all the cases. Total removal of the tumor was obtained in 11 (45%) cases. Only 21% of the patients had a grade III‐IV House‐Brackmann or worse after 12 months. Two patients died from pneumonia. Five (21%) of the patients required a second surgery, but only one patient required radiotherapy after incomplete removal of the tumor.ConclusionGlomus jugulare tumors and their treatment have significant morbidity and mortality. Neurotology surgical teams should be created to develop surgical expertise and competence in the treatment of the disease in order to offer the best options to these patients.
Hearing Loss as Factor That Influences the Quality of Life in Tinnitus Patients
Authors: Rosito Letícia Petersen Schmidt , Vanni Bruna , Deutsch Konrado , de Brito Belline Vanessa 
Published: September 2011

ObjectiveTinnitus is a sensation of noise. In most cases it is accompanied by hearing loss, but it can be an independent symptom occurring in patients with normal hearing. We want to compare the impact of tinnitus on quality of life in patients with or without associated hearing loss.MethodWe selected patients with chronic and disturbing tinnitus. They underwent audiometry and answered the Tinnitus Handicap Inventory (THI) in order to evaluate and quantify the impact of tinnitus. The criterion defined as the threshold of hearing loss records was less than 25 dB at all frequencies in either ear.ResultsFrom January 2005 to January 2011, 308 patients were included. The patients were divided into 2 groups: 1) with hearing loss (n = 272), and 2) with normal hearing (n = 34). Among patients with normal hearing, the average score on the THI was 33.8, whereas among patients with hearing loss, the average was 42.33, P =. 04 (t test).ConclusionPatients with hearing loss have a mean THI significantly higher than patients with normal hearing. Thus, we found that although the tinnitus alone would lead to worse quality of life of patients, hearing loss is one factor that contributes additionally and independently.
Hearing Recovery by Local IGF1 Therapy in Sudden Deafness
Authors: Nakagawa Takayuki , Sakamoto Tatsunori , Tabata Yasuhiko , Hiraumi Harukazu , Ito Juichi , Yamamoto Norio 
Published: September 2011

ObjectiveEvaluate hearing recovery following local application of insulin‐like growth factor 1 (IGF1) in patients with sudden sensorineural hearing loss (SSHL) that was refractory to systemic steroids.MethodSubjects were 25 patients with SSHL showing no hearing recovery following systemic steroid treatment. We applied gelatin hydrogels, impregnated with IGF1, into the round window niche, and examined alterations in pure tone audiometry and evoked otoacoustic emission over time.ResultsIn total, 25 patients received the test treatment at a median of 23 days after the onset of SSHL. Before the test treatment, the mean hearing level at the 5 frequencies tested was 81.2 dB. At 24 weeks after the test treatment, 11.9 dB recovery in the mean hearing level was found. Statistically significant recovery was identified at 0.5 kHz (16.6 dB). Hearing recovery of more than 10 dB in pure tone audiometry appeared within 4 weeks after the test treatment and saturated. Four patients showed the recovery in evoked otoacoustic emission together with hearing recovery in pure tone audiometry.ConclusionLocal IGF1 application via gelatin hydrogels may be efficacious for hearing recovery in patients with SSHL that is resistant to systemic steroids, and induces recovery of outer hair cell function similarly to previous findings in animal experiments.
Hippocampus Function Related with Space Map in Humans
Authors: Sunami Kishiko , Yamamoto Hidefumi , Morino Michiharu , Tsuyuguchi Naochiro , Yamane Hideo 
Published: September 2011

ObjectivePerception of spatial orientation and self‐motion can benefit from integration of multiple sensory cues, including vestibular signals. Place cells were found in hippocampus areas, and correlates of head orientation collectively map spatial locations. To elucidate hippocampus function related with spatial orientation in humans, we examined subjects who had undergone hippocampectom.MethodData were obtained from 16 patients with hippocampus sclerosis and temporal lobe epilepsy. Eleven patients were also investigated after amygdalohippocampectomy. To determine the path integration, they were investigated by modified step test. We also investigated sound lateralization test (the interaural time difference and interaural level difference).ResultsA modified step test may provide a sense of direction and path integration. In this test, initially the subjects walk for 1m on a straight road and turn 90° to the right or left, and then walk straight for 1m with their eyes opened. Subsequently they return with their eyes closed. The results of the modified step test got worth after amygdalohippocampectomy. Sound is an important factor of a sense of direction. The insufficiency of the sound lateralization test was detected in patients, and this was also detected after amygdalohippocampectomy.ConclusionThe hippocampus should play a role in path integration and sound lateralization in humans.
Histopathological Differences between Polyvinyl Alcohol and Ethylene Vinyl Alcohol Copolymer in Preoperative Glomus Jugulare Embolization
Authors: Herman Bjorn S. , Angeli Simon I. , Gomez Carmen , Aziz‐Sultan Mohammed Ali , Telischi Fred F. , Elhammady Mohamed Samy 
Published: September 2011

Objective1) Histopathologically characterize glomus jugulare paragangliomas preoperatively embolized with ethylene vinyl alcohol copolymer (EVAC). 2) Describe histopathological differences between glomus jugulare paragangliomas preoperatively embolized with polyvinyl alcohol (PVA) and EVAC.MethodCase series of glomus jugulare paragangliomas preoperatively embolized with EVAC. The tumors were subsequently resected at a tertiary care center between 2003 and 2010. Patient demographic and clinical data were collected, and histopathological analysis of the preoperatively embolized tumors was performed.ResultsGlomus jugulare paragangliomas embolized with EVAC demonstrated 100% or near 100% occlusion of arterial vessels by histopathological analysis, whereas in previous studies PVA demonstrated a significantly lower percentage of embolization. Even when resection was performed several months after embolization, there was no revascularization of EVAC embolized vessels, whereas PVA embolized vessels have demonstrated partial revascularization. In one patient whose tumor was not completely resected after embolization with EVAC, there was no evidence of subsequent growth of the remnant disease.ConclusionHistopathological analysis of preoperatively embolized glomus jugulare paragangliomas indicates that EVAC provides a more thorough and longer lasting embolic profile than PVA.
Impairments in Estimation of Target Velocity in SCA 6
Authors: Takeichi Norihito , Tsubuku Takashi , Fujiwara Keishi , Fukuda Satoshi 
Published: September 2011

ObjectivePerception during visual motion is a fundamental function for the equilibrium system. Neural substrates for these systems are still incompletely known. We examined the role of cerebellum for those systems in Spinocerebellar ataxia type 6 patients.MethodSeven SCA6 patients and 7 age‐matched normal controls participated in this study. Two tasks were tested. Task 1 examined subjects’ ability to estimate the timing of a target movement indicated by a finger movement. Task 2 examined the ability to match the remembered velocity of visual pattern movement.ResultsIn Task 1, when the target was always visible, the difference between the 2 groups was not significant at 2°/s and 5°/s of target movement. At 8°/s, there was significant difference between them. During the 50% target blanking condition, the patients showed lower successful ratios at 5°/s and 8°/s, respectively. In Task 2, when both subject groups fixated a stationary spot, there was no significant difference between the two groups at 2°/s and 5°/s. However, at 8°/s, the difference was significant. When a fixation spot was not presented, the difference was significant at all three velocities.ConclusionMost SCA6 patients exhibited a larger variability in their timing estimation, and their estimations significantly lagged compared with controls. The present findings shed light on the mechanisms of estimation of target velocity and timing of movement initiation and support the conclusion that the cerebellum is involved in these functions.