Showing papers in "Acta Oto-laryngologica in 2015"
TL;DR: It is suggested that the different results of rotational and caloric tests in patients with Ménière’s disease may be a consequence of the physical enlargement of the membranous duct in the hydropic labyrinths in MD, causing a reduced response to caloric stimulation.
Abstract: Conclusion: It is suggested that the different results of rotational (video head impulse – vHIT) and caloric tests in patients with Meniere’s disease (MD) may be a consequence of the physical enlargement of the membranous duct in the hydropic labyrinths in MD, causing a reduced response to caloric stimulation. Objectives: There have been reports that the results of two tests of semicircular canal function, the caloric response and the responses to vHIT do not agree. This retrospective study at a tertiary referral hospital examined this disagreement. Methods: This study reviewed the data of 22 patients who met the AAO-HNS criteria for MD and who had both caloric and vHIT testing. Results: There was a clear dissociation: patients with MD had a small or absent response to caloric stimulation of their affected ear, whilst their response to vHIT was in the normal range. Discussion: The accepted Gentine model of the mechanism of caloric stimulation could account for this dissociation: the increased diam...
126 citations
TL;DR: Noise exposure can cause a decline in cochlear ribbon synapses and result in consequent hearing loss and the reduction of synaptic puncta appears reversible and may contribute to hearing restoration in mice after noise exposure, according to a study of C57BL/6J mice.
Abstract: Conclusion: Noise exposure can cause a decline in cochlear ribbon synapses and result in consequent hearing loss. The reduction of synaptic puncta appears reversible and may contribute to hearing restoration in mice after noise exposure. Objective: To detect whether noise induced reversible changes of cochlear ribbon synapses contribute to temporary hearing loss in C57BL/6J mice. Methods: The mice were assigned randomly to five groups and exposed to white noise at 110 dB SPL for 2 h except the control group. ABR thresholds were acquired before noise exposure (control), immediately following exposure (Day 0), or on Days 4, 7, or 14 after noise exposure. Light microscopy, scanning emission microscopy, and whole mounts examination was utilized to study whether there is morphology change of outer hair cells (OHC), inner hair cells (IHC), or spiral ganglion cells (SGN) due to the 110 dB white noise. Moreover, experimental approaches, including immunostaining and confocal microcopy, were used to detect ...
68 citations
TL;DR: It is suggested that HITCal is an excellent method for enhanced exploration of vHIT outputs because the automated saccades algorithm implemented in HITCal has good concordance with the assessment by human observers.
Abstract: Conclusion: The developed software (HITCal) may be a useful tool in the analysis and measurement of the saccadic video head impulse test (vHIT) responses and with the experience obtained during its use the authors suggest that HITCal is an excellent method for enhanced exploration of vHIT outputs. Objective: To develop a (software) method to analyze and explore the vHIT responses, mainly saccades. Methods: HITCal was written using a computational development program; the function to access a vHIT file was programmed; extended head impulse exploration and measurement tools were created and an automated saccade analysis was developed using an experimental algorithm. For pre-release HITCal laboratory tests, a database of head impulse tests (HITs) was created with the data collected retrospectively in three reference centers. This HITs database was evaluated by humans and was also computed with HITCal. Results: The authors have successfully built HITCal and it has been released as open source software...
48 citations
TL;DR: To what extent can adults adapt to sharply different frequency-to-place maps across ears, and to what extent such adaptation remained incomplete for the ear with the shallower electrode insertion, even after extended experience is investigated.
Abstract: Conclusion: The human frequency-to-place map may be modified by experience, even in adult listeners. However, such plasticity has limitations. Knowledge of the extent and the limitations of human auditory plasticity can help optimize parameter settings in users of auditory prostheses. Objectives: To what extent can adults adapt to sharply different frequency-to-place maps across ears? This question was investigated in two bilateral cochlear implant users who had a full electrode insertion in one ear, a much shallower insertion in the other ear, and standard frequency-to-electrode maps in both ears. Methods: Three methods were used to assess adaptation to the frequency-to-electrode maps in each ear: (1) pitch matching of electrodes in opposite ears, (2) listener-driven selection of the most intelligible frequency-to-electrode map, and (3) speech perception tests. Based on these measurements, one subject was fitted with an alternative frequency-to-electrode map, which sought to compensate for her incomplete adaptation to the standard frequency-to-electrode map. Results: Both listeners showed remarkable ability to adapt, but such adaptation remained incomplete for the ear with the shallower electrode insertion, even after extended experience. The alternative frequency-to-electrode map that was tested resulted in substantial increases in speech perception for one subject in the short insertion ear.
47 citations
TL;DR: Cochlear implant EIT can initiate sensory cell losses via necrosis and PCD within the organ of Corti, which can lead to a loss of residual hearing, andPCD appears to be a major factor in HC loss post-EIT.
Abstract: Conclusion: Programmed cell death (PCD) initially starts in the support cells (SCs) after electrode insertion trauma (EIT), followed by PCD in hair cells (HCs). Activation of caspase-3 was observed only in SCs. Protecting both SCs and HCs with selective otoprotective drugs at an early stage post implantation may help to preserve residual hearing. Objectives: Cochlear implant EIT can initiate sensory cell losses via necrosis and PCD within the organ of Corti, which can lead to a loss of residual hearing. PCD appears to be a major factor in HC loss post-EIT. The current study aimed to: (1) determine the onset of PCD in both SCs and HCs within the traumatized organ of Corti; and (2) identify the molecular mechanisms active within the HCs and SCs that are undergoing PCD. Methods: Adult guinea pigs were assigned to one of two groups: (1) EIT and (2) unoperated contralateral ears as controls. Immunostaining of dissected organ of Corti surface preparations for phosphorylated-Jun, cleaved caspase-3, and 4...
43 citations
TL;DR: Clinical studies and meta-analyses demonstrated that betahistine is effective and safe in the treatment of Ménière’s disease, BPPV (benign paroxysmal positional vertigo), vestibular neuronitis, and other types of peripheral vertigo.
Abstract: Conclusion: Clinical studies and meta-analyses demonstrated that betahistine is effective and safe in the treatment of Meniere’s disease, BPPV (benign paroxysmal positional vertigo), vestibular neuronitis, and other types of peripheral vertigo. Objectives: The goal of this paper is to review the pharmacological profile of betahistine and the evidence for its effectiveness and safety in the treatment of peripheral vertigo. Methods: Selection criteria for the publications on betahistine included randomized clinical trials that evaluated the effectiveness and safety of betahistine vs placebo or active control in the treatment of peripheral vertigo. Recent meta-analyses were also included. Databases searched included PubMed, the Cochrane Ear, Nose and Throat Disorders Group Trials Register, and ICTRP. The review also presents an update on the mechanisms of action, pharmacodynamics, and pharmacokinetics of betahistine. Results: Efficacy and safety of betahistine has been demonstrated in numerous clinic...
38 citations
TL;DR: The sinuses should be considered as a bacterial reservoir and a target for surgery and antibiotic treatment in patients with primary ciliary dyskinesia (PCD) and the observed decrease in serum precipitating antibodies against Pseudomonas aeruginosa may indicate a beneficial effect of combined endoscopic sinus surgery and concomitant medical treatment.
Abstract: Conclusion: The sinuses should be considered as a bacterial reservoir and a target for surgery and antibiotic treatment in patients with primary ciliary dyskinesia (PCD). The observed decrease in serum precipitating antibodies (precipitins) against Pseudomonas aeruginosa may indicate a beneficial effect of combined endoscopic sinus surgery (ESS) and concomitant medical treatment. Objectives: The purpose of this research, which is the first study addressing bacteriology in the sinuses of patients with PCD, was to examine the association between sinus and lung infections. Methods: We reviewed findings of bacterial pathogens from the sinuses obtained during ESS and the lung infection status in eight PCD patients over a 6 year period. Precipitins against P. aeruginosa were used as a marker of severity of chronic infection and effect of treatment. Results: Preoperatively, seven of the eight patients (88%) exhibited intermittent or chronic pulmonary infection with P. aeruginosa. Sinus cultures were obta...
37 citations
TL;DR: Surgically treated patients with E-ILO who have undergone surgery had less breathing problems at follow-up compared with conservatively treated subjects and subjects who tested negative for laryngeal obstruction and none of the surgically treated subjects were less physically active or had changed sport due to exercise-induced dyspnoea.
Abstract: Conclusions: Surgery is an effective treatment in severe cases of supraglottic exercise-induced laryngeal obstruction (E-ILO). Conservatively treated subjects and subjects tested negative for E-ILO, who still experience breathing problems 1–3 years after diagnosis, tend to adjust their physical activity to a greater extent than surgically treated subjects. Objective: To investigate how symptoms and level of physical activity change over time in patients with E-ILO who have undergone surgery, patients with E-ILO treated conservatively and patients who tested negative for laryngeal obstruction at continuous laryngoscopy exercise-test (CLE-test). Methods: Patients referred for exercise-induced breathing difficulties answered questionnaires at diagnostic CLE-test and at follow-up. Questions regarded exercise-induced breathing problems, current physical activity level, and medical history of asthma and perennial allergy. Results: Out of 84 invited subjects, 59 (70%) answered both questionnaires. Surgic...
33 citations
TL;DR: Compared with normal-weight individuals, obese young adults exhibited a significantly higher taste threshold for salty taste, and smoking also affected taste functions in this population.
Abstract: Conclusion: Compared with normal-weight individuals, obese young adults exhibited a significantly higher taste threshold for salty taste. Smoking also affected taste functions in this population. Objective: The aim of this study was to investigate the differences in taste detection thresholds between normal-weight and obese young adults. Methods: Taste threshold was measured using electrogustometry (EGM) and chemically with sucrose, NaCl, citric acid, and quinine hydrochloride in 41 volunteers in their twenties, 23 with body mass index (BMI) 25 kg/m2 (obese group). Results: BMI was significantly higher in the obese than in the normal-weight group (p < 0.05). The obese group exhibited significantly higher EGM thresholds than the normal-weight group on the right (p < 0.05) and left (p < 0.05) posterior tongue. In chemical taste tests, the obese group had higher thresholds for sweet, salty, sour, and bitter tastes than the normal-weight group, although...
33 citations
TL;DR: The application described in this study appears to be accurate and valid, thus allowing calculation of a hearing handicap and assessment of the pure-tone air conduction threshold with iPhone/iPad devices.
Abstract: Conclusion: The application described in this study appears to be accurate and valid, thus allowing calculation of a hearing handicap and assessment of the pure-tone air conduction threshold with iPhone/iPad devices. Objective: To develop and evaluate a newly developed professional, computer-based hearing handicap calculator and a manual hearing sensitivity assessment test for the iPhone and iPad (AudCal). Methods: Multi-center prospective non-randomized validation study. One hundred and ten consecutive adult participants underwent two hearing evaluations, a standard audiometry and a pure-tone air conduction test using AudCal with an iOS device. The hearing handicap calculation accuracy was evaluated comparing AudCal vs a web-based calculator. Results: Hearing loss was found in 83 and 84 out of 220 standard audiometries and AudCal hearing tests (Cohen’s Kappa = 0.89). The mean difference between AudCal and standard audiogram thresholds was −0.21 ± 6.38 dB HL. Excellent reliability and concordance ...
32 citations
TL;DR: Daily intake of 480 mg of BNO 1016 for 15 days is an effective treatment in acute viral rhinosinusitis using the pooled efficacy data of two similar randomized placebo-controlled clinical trials.
Abstract: Conclusion: Daily intake of 480 mg of BNO 1016 for 15 days is an effective treatment in acute viral rhinosinusitis. Objectives: The pooled efficacy data of two similar randomized placebo-controlled clinical trials were analyzed. Safety was evaluated on the basis of the individual trials. Methods: The efficacy analysis was based on 589 patients. Treatment was performed orally with either 3 × 160 mg BNO 1016 (n = 294) or 3 × placebo (n = 295) for 15 days. In both trials patients underwent five visits to the investigational sites. Symptoms were evaluated according to the EPOS 2012 guideline. Ultrasonography was used to confirm the diagnosis at onset of treatment and the remission of symptoms at the last visit. Efficacy was evaluated by the investigator as the mean major symptom score (MSS) at the end of treatment (visit 5, day 14). Patients reported symptoms and social/emotional consequences of rhinosinusitis using a quality of life questionnaire (SNOT-20 GAV). Results: MSS improved during the treatm...
TL;DR: Technical improvements, including an image guidance system, extended the indications for endoscopic surgery for PNS osteomas, especially in the frontal sinus region, where the most common site was the ethmoid sinus.
Abstract: Conclusion: The incidence of paranasal sinus (PNS) osteoma was 6.4%. The most common site of PNS osteoma was the ethmoid sinus. All surgically treated patients underwent endoscopic surgery, and there was no recurrence in any patient. Technical improvements, including an image guidance system, extended the indications for endoscopic surgery for PNS osteomas, especially in the frontal sinus region. Objective: The purpose of this study was to investigate the incidence and location of PNS osteomas detected by computed tomography (CT) scan at our hospital, and to describe our experience in the surgical treatment of PNS osteomas. Methods: This study was performed on 1724 patients undergoing CT scans because of suspected sinus disease between 2004 and 2013. Endoscopic surgery was performed in 34 symptomatic patients. Medical records of the patients were reviewed, and clinical findings and treatment outcomes were investigated. Results: PNS osteomas were detected in 110 patients (6.4%). Triple osteomas wer...
TL;DR: The facial recess approach is preferred in common cavity (CC) malformation with an incomplete basal turn, and the transmastoid single-slit labyrinthotomy approach in classic CC malformation.
Abstract: Conclusion: The facial recess approach is preferred in common cavity (CC) malformation with an incomplete basal turn, and the transmastoid single-slit labyrinthotomy approach in classic CC malformation. Patients with CC benefit from cochlear implantation (CI) over time, but the audiological and speech development is poorer than in cases with normal cochleas. Objectives: To discuss the surgical aspects and performance of CI in 21 patients with CC malformation. Methods: Twenty-one CC malformations were classified into 2 types: classic CC malformation and CC malformation with an incomplete basal turn. Twenty-one patients without inner ear malformation were set as the control group. Thus, data for 42 patients were analyzed. Results: The facial recess approach was used in 3 patients with CC malformation with an incomplete basal turn, and the transmastoid single-slit labyrinthotomy approach in 18 patients with classic CC malformation. After follow-up for 36 months, the average free-field hearing thresho...
TL;DR: It was demonstrated that juvenile nasopharyngeal angiofibromas (JNAs) express high levels of hormone receptors and vascular endothelial growth factor (VEGF) compared with normal nasal mucosa, suggesting that the interaction between hormone receptor and VEGF may be involved in the initiation and growth of JNA.
Abstract: Conclusion: This work demonstrated that juvenile nasopharyngeal angiofibromas (JNAs) express high levels of hormone receptors and vascular endothelial growth factor (VEGF) compared with normal nasal mucosa. The interaction between hormone receptors and VEGF may be involved in the initiation and growth of JNA. Objectives: JNA is a rare benign tumor that occurs almost exclusively in male adolescents. Although generally regarded as a hormone-dependent tumor, this has not been proven in previous studies. The aim of this study was to investigate the role of hormone receptors in JNA and the relationship with clinical characteristics. Methods: Standard immunohistochemical microarray analysis was performed on 70 JNA samples and 10 turbinate tissue samples. Specific antibodies for androgen receptor (AR), estrogen receptor-α (ER-α), estrogen receptor-β (ER-β), progesterone receptor (PR), and VEGF were examined, and the relationships of receptor expression with age, tumor stage, and bleeding were evaluated. ...
TL;DR: It is shown that working performance, quality of life, and quality of hearing are better with two compared with a single cochlear implant (CI), and the impact of the second CI on the patient’s QoL is as significant as that of the first CI.
Abstract: Conclusions: This prospective study shows that working performance, quality of life (QoL), and quality of hearing (QoH) are better with two compared with a single cochlear implant (CI). The impact of the second CI on the patient’s QoL is as significant as the impact of the first CI. Objectives: To evaluate the benefits of sequential bilateral cochlear implantation in working, QoL, and QoH. Methods: We studied working performance, work-related stress, QoL, and QoH with specific questionnaires in 15 patients with unilateral CI scheduled for sequential CI of another ear. Sound localization performance and speech perception in noise were measured with specific tests. All questionnaires and tests were performed before the second CI surgery and 6 and 12 months after its activation. Results: Bilateral CIs increased patients’ working performance and their work-related stress and fatigue decreased. Communication with co-workers was easier and patients were more active in their working environment. Sequenti...
TL;DR: Electrochemotherapy can be a safe curative mono modality treatment, especially in tongue cancer, and the 1-year quality-of-life (QoL) outcome 1 year after ECT showed a significant increase in problems with senses, speech, mouth opening and xerostomia.
Abstract: Conclusion: ECT can be a safe curative mono modality treatment, especially in tongue cancer. The future role for ECT in head and neck cancer needs to be further investigated.Introduction: Electroch ...
TL;DR: Hypertrophy of lingual tonsils can be safely and effectively managed by transoral robotic surgery via a minimally invasive approach and the operating costs can be relatively high although the advantages to patients seem to justify the procedure.
Abstract: Conclusion: Hypertrophy of lingual tonsils can be safely and effectively managed by transoral robotic surgery via a minimally invasive approach. The operating costs can be relatively high although the advantages to patients seem to justify the procedure. Transoral robotic surgery can represent the definitive treatment in hypertrophy of the lingual tonsils. Objective: The purpose of this work was to assess the feasibility, safety, and outcomes of transoral robotic surgery for lingual tonsillar hypertrophy in adults with obstructive sleep apnea. Methods: Retrospective medical records of six patients who underwent tongue base resection using the da Vinci Surgical Robotic System from September, 2012 through December, 2013 in a tertiary care hospital were evaluated. Demographic data, preoperative and postoperative polysomnography and Epworth Sleepiness Scale (ESS) scores, robot docking time, operative and postoperative aspects including surgical time, amount of bleeding, and early and late complication...
TL;DR: The main symptom of AN was hearing loss, and the most frequent accompanying symptom was tinnitus, and audiometry results did not correlate with lesion site or tumor size (p > 0.05).
Abstract: Conclusion: Many patients with acoustic neuroma (AN) experience hearing loss and tinnitus. Time from first symptoms to diagnosis can be considerable. AN should be suspected, and MRI scans performed, in patients with hearing loss accompanied by asymmetry, tinnitus, low speech discrimination score (SDS), and abnormal auditory brainstem response (ABR). Objectives: To determine the otorhinolaryngological factors associated with AN by analyzing the clinical manifestations and diagnostic test results of patients with AN before MRI scanning. Methods: This study enrolled 114 patients definitively diagnosed with AN after visiting the Ear-Nose-and-Throat and Neurosurgery Departments of Kyung Hee University Medical Center from 2001 to 2013. Factors retrospectively analyzed included patient age, gender, major symptoms, accompanying symptoms, symptom duration, pure-tone audiometry, SDS, asymmetry, tinnitogram, ABR, and MRI scan results. Results: The main symptom of AN was hearing loss, and the most frequent ac...
TL;DR: The addition of transoral robotic surgery (TORS) in the diagnostic management of patients classified with head and neck squamous cell carcinoma of unknown primary (SCCUP) is promising and appears to improve detection rates of the primary tumour.
Abstract: Conclusion: The addition of transoral robotic surgery (TORS) in the diagnostic management of patients classified with head and neck squamous cell carcinoma of unknown primary (SCCUP) is promising and appears to improve detection rates of the primary tumour. The approach presented in this first Scandinavian study could potentially minimize the radiation field to the pharyngeal axis in patients with identified primary tumours. Objectives: The aim of the study was to investigate whether bilateral lingual tonsillectomy performed with TORS is feasible, and whether it could improve the detection rates of primary tumours in patients diagnosed and classified as having SCCUP. Methods: The study was retrospective and included 13 patients with SCCUP who were referred to TORS between October 2013 and January 2015. All 13 patients had previously undergone a full investigation programme following the national guidelines including whole-body PET/CT, examination in general anaesthesia, including random biopsies o...
TL;DR: Prone positioning reveals promising results in improving the apnoea-hypopnoeA index (AHI) and oxygen desaturation index (ODI) in patients with obstructive sleep apnOEa (OSA).
Abstract: Conclusions: Prone positioning reveals promising results in improving the apnoea-hypopnoea index (AHI) and oxygen desaturation index (ODI) in patients with obstructive sleep apnoea (OSA). O...
TL;DR: Computed tomography lymphography provides preoperative images of anatomic relationships between a tumor, its associated lymph vessels, and the sentinel lymph node (SLN) and it may aid in directing the SLN biopsy for management of early tongue cancer.
Abstract: Conclusions: Because computed tomography (CT) lymphography provides preoperative images of anatomic relationships between a tumor, its associated lymph vessels, and the sentinel lymph node (SLN), it may aid in directing the SLN biopsy for management of early tongue cancer Objectives: SLN biopsy using a radioisotope (RI) generally has been performed in head and neck cancer However, this method can be performed only at institutions that are licenced for its use In this study, we evaluated the utility of performing SLN biopsy in patients with early tongue cancer using the newly developed technique of CT lymphography Methods: Enrolled in this study were 31 patients with T1N0 or T2N0 tongue cancer CT images were obtained before and after injection of iopamidol into the peritumoral region and the SLN was identified as the first enhanced lymph node SLN biopsy was performed using CT lymphographic guidance combined with blue dye injection Results: The SLN was detected by CT lymphography in 28 cases (903%) By intraoperative frozen section examination, metastases to SLNs were found in 4 (143%) (T1N0, 1 patient; T2N0, 3 patients) of the 28 patients Of these four, SLN micrometastases were found in one patient
TL;DR: Cone Beam Computed Tomography can be widely used in imaging of bony structures of the anterior and lateral skull base and significant differences of applied dosages result from the different protocols of the various indications.
Abstract: Conclusion: Cone Beam Computed Tomography (CBCT) can be widely used in imaging of bony structures of the anterior and lateral skull base. Significant differences of applied dosages result from the different protocols of the various indications. Objectives: CBCT is increasingly being used in head and neck imaging. Until now, no precise knowledge about its dedicated usage existed. Methods: All CBCT of 2012 and 2013 were analysed with regard to the technical parameters, the performance, and the indication for imaging. Results: In total, 1862 patients were examined in 2012 and 2013. The top eight indications of the anterior skull were (1) chronic rhinosinusitis with disturbed nasal breathing (30.3%); (2) chronic rhinosinusitis (17.6%); (3) midfacial traumatology (13.7%); (4) disturbed nasal breathing (12.8%); (5) acute rhinosinusitis (7.9%); (6) polyposis nasi (6.3%); (7) search for focus (3.9%); and (8) persistent rhinorrhea (1.2%). For the lateral skull base, the top eight were (1) control after coc...
TL;DR: It is shown that tracheoesophageal diversion and laryngotracheal separation can prevent aspiration pneumonia and improve the morbidity of patients with severe motor and intellectual disability (SMID).
Abstract: Conclusions: Tracheoesophageal diversion (TED) and laryngotracheal separation (LTS) can prevent aspiration pneumonia and improve the morbidity of patients with severe motor and intellectual disability (SMID). By improving hospitalization rates and care needs, the quality-of-life can be improved for the patients and their parents. Objectives: This study evaluated the clinical outcomes of TED and LTS in patients with intractable aspiration and SMID. Methods: This study retrospectively reviewed patients with SMID and intractable aspiration pneumonia who underwent TED or LTS at the institution between January 2008 and January 2015. It assessed the frequency of sputum suctioning, the number of pre-operative and post-operative hospitalizations, the operative time, and complications. Results: Forty patients were identified during the study period. After surgery, there were significant reductions in the frequency of secretion suctioning (from 165.0 times/day to 33.0 times/day) and the number of hospitaliz...
The Ohio State University Wexner Medical Center1, London Health Sciences Centre2, University of Western Australia3, University of Manchester4, University of North Carolina at Chapel Hill5, University of Bern6, King Abdulaziz University7, Capital Medical University8, Karolinska University Hospital9, Blackpool Victoria Hospital10, Ludwig Maximilian University of Munich11, University of Innsbruck12, University of Kansas13, Shinshu University14
TL;DR: Bone conduction implants are useful in patients with conductive and mixed hearing loss for whom conventional surgery or hearing aids are no longer an option and may also be used in patients affected by single-sided deafness.
Abstract: Conclusion: Bone conduction implants are useful in patients with conductive and mixed hearing loss for whom conventional surgery or hearing aids are no longer an option. They may also be used in patients affected by single-sided deafness. Objectives: To establish a consensus on the quality standards required for centers willing to create a bone conduction implant program. Method: To ensure a consistently high level of service and to provide patients with the best possible solution the members of the HEARRING network have established a set of quality standards for bone conduction implants. These standards constitute a realistic minimum attainable by all implant clinics and should be employed alongside current best practice guidelines. Results: Fifteen items are thoroughly analyzed. They include team structure, accommodation and clinical facilities, selection criteria, evaluation process, complete preoperative and surgical information, postoperative fitting and assessment, follow-up, device failure,...
TL;DR: An unexpected rapid hearing decline remained after the 10-year follow up, similar to the hearing decline in 70-year-old women in reference materials, and the rate of decline during the menopausal period was higher than compared with reference materials for the same age group.
Abstract: Conclusions: An unexpected rapid hearing decline remained after the 10-year follow up, similar to the hearing decline in 70-year-old women in reference materials. No clear changes concerning hearing in the peri- and postmenopausal period were noted. Objective: To assess whether hearing decline correlates with menopause and/or cortisol blood levels. Methods: A prospective individual longitudinal study of peri-menopausal women followed for 10 years was performed at baseline, and after 2, 7 and 10 years, respectively. With a starting age of around 51 years, 100 women remained in the study after 10 years. Pure-tone audiometry and cortisol blood testing were performed at all visits. Results: A continuous hearing decline, at all frequencies, was found during the follow-up time. The rate of decline during the menopausal period was higher than compared with reference materials for the same age group. The correlation with time for menopause is most apparent at 1 and 3 kHz where the hearing decline is more ...
TL;DR: Serum squamouscell carcinoma antigen (SCC-Ag) level was an independent prognostic factor for survival in patients with head and neck squamous cell carcinoma (HNSCC), and the prognostic value depended on the carcinoma site.
Abstract: Conclusions: Serum squamous cell carcinoma antigen (SCC-Ag) level was an independent prognostic factor for survival in patients with head and neck squamous cell carcinoma (HNSCC), and the prognostic value depended on the carcinoma site. Objectives: To assess the value of SCC-Ag as a prognostic indicator in patients with HNSCC and to determine the effect of primary tumor site on prognosis. Methods: We reviewed 493 patients with HNSCC between 2004 and 2012. The chi-squared test was used to assess associations between SCC-Ag levels and TNM classification. A Cox proportional hazard model was used to assess the hazard ratio of SCC-Ag at different sites for death, and it was analyzed as a continuous variable. Results: The median serum level of SCC-Ag was 1.1 ng/ml (range 0–20). SCC-Ag was significantly higher in patients with advanced T and N classification tumors. Primary sites in the oral cavity, in the hypopharynx, advanced T and N classification, distant metastasis, and SCC-Ag were negatively associ...
TL;DR: Preoperative chemoradiotherapy (CRT) was associated with a significantly higher rate of pharyngocutaneous fistula (PCF), the most frequent complication following total laryngectomy, and was the only preoperative treatment that had a significant effect on PCF.
Abstract: Conclusion: Preoperative chemoradiotherapy (CRT) was associated with a significantly higher rate of pharyngocutaneous fistula (PCF). Objective: PCF is the most frequent complication following total laryngectomy. Although organ-preserving radiotherapy (RT) or CRT offer good locoregional control, many patients still require salvage laryngectomy. The aim of this study was to evaluate the factors that predispose patients to PCF, with a focus on preoperative RT, induction chemotherapy (ICT), and CRT. Methods: This was a retrospective case series; 151 patients who underwent TL were reviewed. Preoperative RT, ICT, CRT, and some surgical parameters were analyzed as potential risk factors. Results: The overall PCF rate was 13%. CRT was the only preoperative treatment that had a significant effect on PCF (35.3%, p = 0.004, odds ratio (OR) = 10.75). Surgery extended to the pharynx (p = 0.005, OR = 8.34) and vacuum drain duration (p = 0.012, OR = 5.16) were observed to be associated with PCF.
TL;DR: The ratio of the two slopes curves, the target lymph node and primary lesion, respectively, might contribute to the clinical diagnosis of cervical lymph nodes in laryngeal and hypopharyngean squamous carcinoma after the reconstruction of imaging in dual-energy CT gemstone spectral imaging.
Abstract: Conclusion: After the reconstruction of imaging in dual-energy CT gemstone spectral imaging, the ratio of the two slopes curves, the target lymph node and primary lesion, respectively, might contribute to the clinical diagnosis of cervical lymph nodes in laryngeal and hypopharyngeal squamous carcinoma. Objective: To investigate the value of the dual-energy CT gemstone spectral imaging for clinical detecting of metastatic cervical lymph nodes in laryngeal and hypopharyngeal squamous carcinoma. Methods: Forty-seven cases who were suffering from laryngeal or hypopharyngeal squamous carcinoma and had complete clinical and pathological data were included, and 79 cervical lymph nodes were studied retrospectively (including 31 metastatic nodes and 48 non-metastatic nodes). Contrast-enhanced energy spectral imaging and reconstruction were performed. After the reconstruction, the slope of the curve in the target lymph node and the lesion were calculated. The ratio of the two slopes was studied. The patholo...
TL;DR: Most patients benefitted from immediate facial nerve grafting after radical parotidectomy, and post-operative radiotherapy does not seem to affect the final outcome of facial function.
Abstract: Conclusion: Most patients benefitted from immediate facial nerve grafting after radical parotidectomy. Even weak movement is valuable and can be augmented with secondary static operations. Post-operative radiotherapy does not seem to affect the final outcome of facial function. Objectives: During radical parotidectomy, the sacrifice of the facial nerve results in severe disfigurement of the face. Data on the principles and outcome of facial nerve reconstruction and reanimation after radical parotidectomy are limited and no consensus exists on the best practice. Method: This study retrospectively reviewed all patients having undergone radical parotidectomy and immediate facial nerve reconstruction with a free, non-vascularized nerve graft at the Helsinki University Hospital, Helsinki, Finland during the years 1990–2010. There were 31 patients (18 male; mean age = 54.7 years; range = 30–82) and 23 of them had a sufficient follow-up time. Results: Facial nerve function recovery was seen in 18 (78%) o...
TL;DR: Post-operative outcomes of salvage surgery for recurrent oropharyngeal squamous-cell carcinoma (OPSCC) were acceptable and pathologic overall, T- or N-stage and patient comorbidities were the main predictors of patient clinical outcomes.
Abstract: Conclusion: Post-operative outcomes of salvage surgery for recurrent oropharyngeal squamous-cell carcinoma (OPSCC) were acceptable. Pathologic overall, T- or N-stage and patient comorbidities were the main predictors of patient clinical outcomes. Objectives: To evaluate post-operative outcomes of salvage surgery in patients with recurrent OPSCC and to determine their predictive factors. Materials and methods: This study retrospectively reviewed the electronic medical records of all patients who underwent salvage surgery for recurrent OPSCC, between 2000–2013, in our institution. Overall survival (OS) and cause-specific survival (SS) were determined by Kaplan-Meier analysis. Predictive factors of post-operative outcomes were investigated by using univariate and multivariate analyses. Results: A total of 34 patients were included in this study. Local and general post-operative complication rates were 26% and 27%, respectively. A high level of comorbidity (Kaplan Feinstein Index: KFI ≥ 2) was the onl...