bluuebunny/crossref_metadata_2025_split huggingface dataset:
A New Landmark for the Middle Fossa Craniotomy Approach to the IAC
Authors: Westbrook Benjamin James , Crawford James V. 
Published: September 2011

ObjectiveDocument measurements of the bony operculum of the petrous ridge as it relates to surgical anatomy of the temporal bone and thereby establish a new surgical landmark for the middle fossa craniotomy approach to the internal auditory canal.MethodWe analyzed 25 cadaveric temporal bones. Precise measurements were taken to identify the relationship of the bony operculum of the petrous ridge to: foramen spinosum, foramen of the greater superficial petrosal nerve, arcuate eminence, porus acousticus, and inner table of the calvarium.ResultsThe following measurements of the operculum in relation to well established surgical landmarks of the floor of the middle cranial fossa were identified: operculum to foramen spinosum, 26.3mm [24.6‐28.0]; operculum to foramen of greater superficial petrosal nerve, 16.8mm [14.0‐19.7]; operculum to arcuate eminence, 17.3mm [15.1‐19.4]; operculum to superior border of porus acousticus, 5.3mm [3.5‐7.1]; distance from inner table of calvarium to operculum, 37.0mm [33.5‐40.5]; width of the operculum, 13.5mm [11.3‐15.7].ConclusionThis consistently present bony ridge can be used reliably to help safely identify the IAC when approached via middle fossa craniotomy, as it indicates the appropriate vertical plane of dissection.
An Avatar to Measure Vestibular Sensations of Movement
Authors: Cevette Michael , Galea Anna M. , Smith Benn , Wagner Linsey , Oakley Sarah , Stepanek Jan , Zapada David 
Published: September 2011

Objective1) Report a novel method for measuring vestibular sensations of movement induced by galvanic vestibular stimulation (GVS). 2) Introduce a new approach to quantify vestibular symptoms in patients with vertigo and related disorders.MethodWe created a software program using a Logitech wireless joystick to measure and display in three dimensions the manner in which subjects felt movement in response to GVS. Each subject underwent thirty 20‐second protocols utilizing ten different combinations of GVS scalp electrode pairs.ResultsThree dimensional avatar displays of subject responses to GVS indicated the direction and magnitude of pitch, roll, and yaw as well as the angular velocity of motion. As evident on the avatar display in response to a 2.5 mA GVS pulse, the majority of subjects reported sensation of movement, 19 out of 21 (90%) reporting pitch, 17 out of 21 (81%) reporting yaw, and 17 out of 21 (81%) reporting roll sensations.Conclusion1) These data demonstrate a software‐based 3 dimensional avatar display system to represent perceived vestibular sensation in response to GVS. 2) This technology may play a role in clinical practice by providing the ability to quantify vestibular symptoms in the assessment of patients with vertigo and related disorders.
An Exercise Therapy for the Cupulolithiasis of BPPV
Authors: Yamanaka Toshiaki , Hosoi Hiroshi , Fujita Nobuya , Sawai Yachiyo 
Published: September 2011

ObjectiveDetermine if an exercise therapy was effective for cases with benign paroxysmal positional vertigo (BPPV) suggesting cupulolithiasis of the horizontal semicircular canal as characterized by apogeotropic direction‐changing nystagmus.MethodWe describe herein our head tilt‐hopping (HtH) exercise designed to release and move otoconia adhesive to the cupula. HtH exercises were performed in 14 subjects who were trained to hop with their heads tilted laterally and completed 3 to 5 training sessions a day over a 4‐week period.ResultsThe nystagmus beating toward the uppermost ear disappeared or decreased immediately after the first trial with the exercise in 3 (21.4%) or 2 (14.3%) of 14 cases, respectively. The number of subjects showing improvement as assessed by the disappearance or decrease of the nystagmus were in 9 (64.3%) and 11 (78.6%) of all cases tested at 1 and 4 weeks’ time, respectively. However, the remaining 3 subjects were not affected by this treatment program after 4 week of the training.ConclusionThese results suggest that HtH exercises based on the concepts of release of otoconia from the cupula would appear to be feasible as a new therapy for cupulolithiasis associated with intractable horizontal canal BPPV.
Association between Type 2 Diabetes Mellitus and Deposits in the Semicircular Canals: a Human Temporal Bone Study
Authors: Yoda Shigetoshi , Fukushima Hisaki , Paparella Michael , Morita Norimasa , Cureoglu Sebahattin , Harada Tamotsu 
Published: September 2011

ObjectiveCompare the prevalence of cupular and free‐floating deposits in the semicircular canals between temporal bones of type 2 diabetes mellitus patients and normal controls.MethodForty‐eight temporal bones from 24 patients with type 2 diabetes mellitus and 48 age‐matched normal temporal bones from 24 individuals were histopathologically examined. The cupula and lumina of the semicircular canals were examined for evidence of deposits.ResultsThe prevalence of cupular and free‐floating deposits in the posterior semicircular canal were significantly higher in type 2 diabetes mellitus cases compared with normal temporal bones. The prevalence of cupular deposits in all 3 canals combined had a tendency to be higher in patients treated with insulin therapy than in patients treated via oral hypoglycemic agents. The prevalence of these deposits was not associated with either aging or duration of disease.ConclusionOur findings suggest that type 2 diabetes mellitus can cause cupular and free‐floating deposits in the semicircular canals. Patients with type 2 diabetes mellitus may suffer from benign paroxysmal positional vertigo, unrelated to duration of disease.
Audio‐Vestibular Function in HIV Infected Patients in India
Authors: Mathews Suma Susan , Albert Rita R. , Job Anand 
Published: September 2011

ObjectiveThe impact of HIV/AIDS is felt more in developing countries because of socioeconomic reasons. There is risk of audio vestibular dysfunction with the use of anti‐retroviral therapy, which may be ototoxic. This study was to determine the difference between audio‐vestibular function in asymptomatic HIV infected and AIDS patients.MethodIn this prospective cross sectional study conducted in a tertiary care hospital in South India, the audio‐vestibular system of 30 AIDS subjects (group 1) and 30 asymptomatic HIV positive subjects (group 2) and age‐matched 30 healthy controls (group 3) were assessed using pure tone audiometry and cold caloric test.ResultsSixteen patients each, in group 1 and group 2, were detected to have hearing loss. In the control group, 4 were detected to have hearing loss. Comparing patient groups 1 and 2 with that of group 3, the p‐value was significant (P =. 001). Kobrak’s (modified) test showed 27% of patients in group 1 and 33% of patients in group 2 had a hypofunctioning labyrinth.ConclusionIt was found that the human immunodeficiency virus does affect the audio‐vestibular pathway. There was a significant incidence of audio‐vestibular dysfunction in both study groups compared to the controls. There was no significant difference between the HIV seropositive asymptomatic patients and patients with AIDS. The majority of the patients had no otological symptoms.
Auditory Tube Dysfunction after Plastic Surgery of Mandible
Authors: Aoki Hideaki , Mohri Daisuke , Musunuru Swapna 
Published: September 2011

ObjectiveSome patients with jaw anamorphosis symptom who underwent orthognathic surgery for lower jaw. By conducting auditory tube function tests before and after orthognathic surgery for the lower jaw, studied were the pathophysiology, incidence, causes and treatment of auditory tube dysfunction occurring following orthognathic surgery for lower jaw.MethodRegarding auditory tube function tests, the impedance test, or tympanometry, was sonotubometry, and TTAG were conducted. Patients whose auditory tubes conducted dysfunction was found to be aggravated were observed with daily TM testing until the function recovered to the preoperative level.Results1) Postoperative auditory tube dysfunction was noted subjectively in 18.3% and determined by TM in 60.4%. Lowered auditory tube function was found by TM at a high rate following orthognathic surgery for the lower jaw. Approximately 30% of patients with TM aggravation complained of ear symptoms. Among subjective ear symptoms, the most prevalent was a feeling of ear obstruction, and the second most prevalent was dysacusis. 2) It was suggested that TTAG could be a useful test for prediction of postoperative TM aggravation.ConclusionPostoperative auditory tube dysfunction correlated with preoperative TTAG values, indicating that TTAG was a useful test for the prediction of TM aggravation. There was no correlation between postoperative auditory tube dysfunction and sonotubometry values. Postoperative auditory tube dysfunction recovered spontaneously in an average of 3.48 days without provision of ventilation treatment.
Cognitive Function in Nonbothersome Tinnitus
Authors: Wineland Andre , Pierce Kathy , Piccirillo Jay F. 
Published: September 2011

ObjectiveTinnitus is a ubiquitous problem with no effective cure, yet only a minority of sufferers are “bothered.” Neurocognitive testing of these “bothered” patients reveals poor performance in verbal learning and attention. The goal of the present investigation was to assess the effects of non‐bothersome tinnitus on standardized neurocognitive tests.MethodCross‐sectional study of 13 nonbothersome tinnitus participants (age 18‐60 years) with subjective, unilateral or bilateral, non pulsatile tinnitus for at least 6 months’ duration, and a score 38). Each participant underwent comprehensive neurocognitive assessment.ResultsThirteen participants (9 male) with a mean age of 55 years (range, 47‐60 years) were enrolled. Median THI was 9 (range, 0‐20), median tinnitus duration was 11 years (range, 2‐35 years), and all had hearing loss. A comprehensive neurocognitive battery was performed. Participants were found to score higher than a vetted normative sample on the Stroop Color Test (P =.002) and Conners Continuous Performance Test (CCPT) Perseverations (P =.032). However, this group performed worse on Stroop Word (P =. 03) and Color‐Word (p =. 036) as well as CCPT‐Hit Reaction Time (P =. 01), and Hit Standard Error Block Change (P =. 041).ConclusionIn this small sample of non‐bothersome tinnitus patients, neurocognitive testing revealed deficits in attention and processing speed, an increase in inattentiveness, and decline in performance over time.
Comparison of the Traditional and New Classification System of Temporal Bone Fractures for Clinical Relevance
Authors: Kang Homin , Lee Joonseok , Lee So Yoon , Yeo Seung Geun 
Published: September 2011

ObjectiveThe traditional classification of temporal bone fracture is subdivided into transverse, longitudinal, and mixed fracture. But questions have arisen about its limited correlation with clinical symptoms. Recent studies have been introduced, including petrous bone invasion and otic capsule violation. And a newer system is introduced about invasion of four areas of temporal bone.MethodClinical records and computed tomography scans were reviewed retrospectively on patients diagnosed with temporal bone fractures for the last seven years. We evaluated correlations of clinical presentation with each category of temporal bone fracture.ResultsA total of 129 temporal bone fracture patients were reviewed. In the traditional classification scheme, transverse fracture presented at a significantly higher rate of sensorineural hearing loss (SNHL). The invasion of petrous bone system showed a significantly higher rate of SNHL, dizziness, and perforation of the tympanic membrane. The otic capsule‐based system demonstrated a statistically significant rate and severity of SNHL among patients with otic capsule violation (P <. 05).ConclusionAlthough the traditional classification scheme, otic capsule involvement, and four areas of temporal bone systems did not demonstrate clear clinical correlations, petrous bone involvement showed significant correlations. So a petrous involvement based scheme better reflects clinical aspects.
Deafness after Skull Encephalic Trauma and Cochlear Implant
Authors: Graziadio Marilena , Negri Maurizio , Cola Claudio 
Published: September 2011

ObjectiveTotal deafness may be among the consequences of a skull encephalic trauma with bilateral fracture of the temporal bone. The recovery of hearing function can occur with the application of a cochlear implant. The functional results will depend on the presence of neurological or neuropsychological alterations both morphological at cochlear level.MethodWe present four cases of postverbal total deafness subsequent to single and/or bilateral fracture of the temporal bone who underwent cochlear implantation from 2000 to 2009. Two patients had monolateral anacusia with onset in childhood contralateral to the fracture, and 2 patients had injuries with bilateral fracture of the petrosal bone.ResultsIn all cases correct positioning of the electrode array was possible without complications after surgery, and at the activation all electrodes were working. Because of the greater encephalic damage and the reduced capacity of cortical integration, in 2 patients the spectral type of stimulation strategies was chosen with low rates of stimulation. One year after the activation of the perceptual‐verbal ability all patients reached the recognition level in open set, and 3 patients were able to have telephone conversations with familiar voices. The patients with greater neurological complications also obtained significant benefits on the cognitive side.ConclusionIn these cases different variables affect the recovery of hearing function with the cochlear implant. CNS damage may be associated with fibrosis or ossification of the cochlea and limits to the proper insertion of the electrodes array. The neuropsychological and neurological complications, in our opinion, are not factors of exclusion.
Defining the Level of Abnormal ECOG in a Neurotology Practice
Authors: Klumpp Micah L. , Gusman Makarena , Arriaga Moises A. 
Published: September 2011

Objective1) Identify the different levels of sensitivity and specificity of electrocochleography (ECOG) in our laboratory setting as normal or abnormal SP/AP ratio; and 2) select the level of specificity as the desired parameter of the abnormal SP/AP ratio of ECOG.MethodThis retrospective study reviews 61 patients undergoing ECOG in our vestibular laboratory who were diagnosed with unilateral endolymphatic hydrops (Ménière syndrome or cochlear hydrops) on the basis of clinical findings, audiogram, and vestibular studies. Sensitivity and specificity levels of ECOG in our laboratory are reported across various SP/AP ratios.ResultsSensitivity and specificity levels of ECOG obtained in our vestibular laboratory are demonstrated for SP/AP ratios ranging from greater than 30% to greater than 50%. These data are the following: 1) greater than 30% (sensitivity, 0.72; specificity, 0.57); 2) greater than 35% (sensitivity, 0.66; specificity, 0.84); 3) greater than 40% (sensitivity, 0.52; specificity, 0.92); 4) greater than 45% (sensitivity, 0.43; specificity, 0.98); and 5) greater than 50% (sensitivity, 0.28; specificity, 0.98).ConclusionInherent inter‐site testing variability requires that each laboratory should set its own level of “abnormal” for ECOG. This study demonstrates sensitivity and specificity for ECOG at different ratios. For our use as a confirmatory test, we selected 80% specificity and set 35% as our abnormal SP/AP ratio.
Determining a Suitable Material to Simulate the Tympanic Membrane Based on Quantitative Linear Elasticity
Authors: Lai Elizabeth , Chang C. W. David 
Published: September 2011

ObjectiveFind a material to simulate the quantitative, as well as qualitative, qualities of the tension and compliance of a tympanic membrane based on published values of the elastic modulus for a tympanic membrane.MethodProspective study that took place from August to December 2009. Using the Instron Testing Instrument, an elastic modulus was calculated for various materials. Based on these values, 3 materials were chosen. Seven physicians performed a myringotomy and completed a survey to rank subjective qualities of the materials.ResultsNitrile gloves, Kimwipes, and laboratory stretch film all had an elastic modulus that fell within the previously published range of the tympanic membrane elastic modulus and were chosen to undergo further evaluation. Kimwipes scored the highest in terms of compliance, tension, and texture compared with an actual TM during blunt palpation. Nitrile gloves scored the highest in terms of compliance, tension, and texture while making the myringotomy incision. Nitrile gloves scored best when comparing how the incision split open, responded to suction, and felt during introduction of the PE tube. Overall Nitrile gloves scored the highest.ConclusionAs competency‐based teaching and evaluation becomes a bigger part of resident‐training, the utility of training models will also likely become more widespread. Nitrile gloves represent a material that is inexpensive, is widely available, and displays a quantitative and qualitative linear elasticity similar to that of a true tympanic membrane.
Effect of Glutathione S‐transferase Polymorphisms to Music‐Induced Hearing Loss
Authors: Chang Yu‐Tuan , Chao Chun‐Chih , Lin Cheng‐Yu , Wu Jiumm‐Liang 
Published: September 2011

ObjectiveBoth genetic and environmental factors contribute to noise‐induced hearing loss (NIHL). The objective of this study is to investigate the hypothesis that Glutathione S‐transferase (GST) genetic polymorphisms is related to susceptibility to developing NIHL caused by music exposure.MethodThis cross‐sectional study recruited high school students who habitually listen to music with portable players. PTA, distortion product otoacoustic emission (DPOAE), and questionnaire were obtained. Cumulative noise exposure (CNE) was calculated by listening time and volume of using portable players. Effects of GST1, GSTM1, and GSTP1‐105 on NIHL were analyzed.ResultsA total of 312 subjects were analyzed. Mean of PTA at high frequency (average of 3000, 4000, and 6000 Hz) was 8.07 dB HL (SD = 5.98). DPOAE amplitude level at high frequency was 20.28 dB SPL (SD = 5.10). Mean of CNE was 84.57 dB‐year (SD = 11.42). With the regression analysis model, there was a good dose‐response relationship between CNE and DPOAE amplitude levels at high frequency (P <. 05). Furthermore, those subjects, with GSTT1‐null, GSTM1‐null, and GSTP1‐105 Ile/Ile genotypes, had higher susceptibility for developing hearing threshold elevation at high frequency (P <. 05).ConclusionThis study identified that GST genetic polymorphisms might modify the susceptibility of hearing threshold elevation at high frequency caused by music exposure. Moreover, investigations of other genotypic variants involved in oxidative stress response for elucidating the gene‐environment interaction for NIHL are warranted.
Effects of Early Surgical Exploration on Hearing Outcomes in Suspected Traumatic Perilymph Fistulas
Authors: Byun Hayoung , Choi Jeesun , Park Ga Young , Ho‐Chung Won 
Published: September 2011

ObjectiveAnalyze the outcomes of early surgical exploration in suspected traumatic perilymph fistulas (PLF).MethodStudy Design: Retrospective case review. Setting: Tertiary otology referral center. Patients and Intervention: Nine patients (10 cases) that developed sudden sensorineural hearing loss and dizziness following head trauma underwent exploratory tympanotomy and PLF repair with the clinical impression of traumatic PLF. Outcome Measure: Postoperative hearing changes and control of dizziness.ResultsAll patients had sudden or progressive hearing loss and dizziness following head trauma; a car accident, slap injury, and barotraumas. Surgical exploration was performed 2 to 47 days after the trauma. Possible evidence of PLF was found in 9 cases and included: fibrous web around the oval window (OW) (n = 3), perilymph collection around the round window (RW) (n = 5), and bulging of the RW membrane (n = 1). After surgical repair, the mean hearing gain was 28dB (10~55dB); the hearing improved to serviceable levels in 6 out of 10 cases (60%). All patients had resolution of the vestibular symptoms after the surgery.ConclusionSudden or progressive sensorineural hearing loss accompanied by dizziness following head trauma should prompt the consideration of a traumatic PLF. Early surgical exploration is recommended to control dizziness and improve hearing outcomes.
Electronystagmography in the Diagnosis of Central Vertigo
Authors: Mora Renzo , Salami Angelo , Salzano Francesco‐Antonio , Guastini Luca , Dellepiane Massimo 
Published: September 2011

ObjectiveDetermine the efficacy and applicability of electronystagmography (ENG) testing in the differential diagnosis between peripheral and central vertigo, through the visual‐vestibular interaction test, in patients with vertigo.MethodPatients were submitted to ENG recording. Patients sat on a rotatory chair, which was placed in the middle of a rotary rotatory cylindrical chamber. The rotatory chamber was driven by a direct current engine, which turned it clockwise and counterclockwise, and its internal area was covered with 32 black vertical contrast.ResultsAll patients underwent rotatory vestibular stimulation by Stop test (VOR), optokinetic stimulation (OKN), and contemporary rotatory vestibular and optokinetic stimulation (VVOR). Our experiences highlight as normal that subjects and/or patients affected by peripheral vertigo present a VVOR nystagmus homodirectional to optokinetic nystagmus; patients affected by central vertigo present a VVOR nystagmus homodirectional to vestibular‐ocular‐reflex (VOR). In healthy patients, VVOR nystagmus is always homodirectional to OKN and indicates the optokinetic system prevalence on VOR.ConclusionThe presence of a VVOR nystagmus homodirectional to VOR indicates the absence of the optokinetic system prevalence due to a central nervous system (CNS) modification, and highlights a CNS disease. Our data highlight the role of ENG in the diagnosis between peripheral and central vertigo.
Emerging Role of Nonmuscle Myosin II and Implications for NMMII Associated Deafness
Authors: Kozin Elliott , Kachar Bechara , Salles Felipe , Adelstein Robert , Ma Xuefei , Zhang Yingfan , Andrade Leonardo R. 
Published: September 2011

ObjectiveData are scarce regarding the role of nonmuscle myosin II (NMMII) isoforms in the postnatal inner ear. Here we seek to: 1) understand the localization and function of each isoform in the postnatal environment, and 2) investigate the cause of hearing loss observed in mutations of NMMII.MethodOrgan of Corti tissue was dissected from neonatal eGFP‐NMMII‐A or ‐B mice, and immunohistochemistry was performed using NMMII‐isoform specific antibodies. OC cultures of rat were exposed to NMMII inhibitors at multiple time points. NMMII‐C KO mice were stained with NMMII‐isoform specific antibodies. ABRs on NMMII‐A mutants were performed at various frequencies.ResultsIn WT mice, NMMII isoforms localize to the apical junction between hair and supporting cells. In eGFP‐NMMII‐A‐ or ‐B mice, NMMII isoform antibodies show a similar pattern of distribution, but are potentially expressed at different amounts. At the adhesion belt, the isoforms take on a “sarcomeric‐like” pattern. NMMII inhibition results in variability of hair cell shape. In NMMII‐C KO mice, NMMII‐A demonstrates a new distribution and NMMII‐B is upregulated. ABRs reveal an absence of hearing loss in NMMII‐A D1424N and R702C mutant mice compared to controls.ConclusionNMMII has a previously unrecognized “sarcomeric‐like” pattern of organization, compatible with a contractile structure. Absence of hearing loss in NMMII‐A mutants indicates that hearing loss may require a secondary insult, and isoforms have potential for compensation and overlap in function, which may also mitigate hearing loss.