1
Otol Neurotol
. 2019 Dec;40(10):e955-e961. doi: 10.1097/MAO.0000000000002422.
Auditory Characteristics in Patients With Mucopolysaccharidosis
Jungmin Ahn 1, Jung Joo Lee 2, Song-I Park 2, Sung-Yoon Cho 3, Dong-Kyu Jin 3, Yang-Sun Cho 2, Won-Ho Chung 2, Sung-Hwa Hong 4, Il Joon Moon 2
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PMID: 31634273 DOI: 10.1097/MAO.0000000000002422
Abstract
Objective: The purpose of the study was to evaluate audiologic findings according to mucopolysaccharidosis (MPS) subtypes and to estimate hearing changes as the disease progressed, as well as the therapeutic effect of enzyme replacement therapy on the hearing apparatus.

Methods: A total of 124 patients who were diagnosed with MPS between September 1994 and December 2016 were retrospectively analyzed. Play audiometry or pure-tone audiometry was performed for hearing assessment, and auditory brainstem response was conducted in patients with poor compliance.

Results: In total 124 patients were identified, ranging in age at diagnosis from 0 to 33 years. Fourteen of the patients had been diagnosed with type I, while 91 had type II, 2 had type III, 14 had type IV, and 3 had type VI. Mean bone conduction and air conduction for the better ear were 26.13±16.95 dB and 34.77 ± 20.00 dB in all patients, and 34.20±7.64 dB and 40.70±9.67 dB in patients with MPS II. The average auditory brainstem response threshold was 68.96 ±21.93 dB nHL. The most common type of hearing loss was pure sensorineural hearing loss in all subtypes, and the degree of hearing loss was variable mostly within the mild to severe range. The increase in the hearing threshold was also significantly correlated with the disease duration. However, the change in hearing level was not correlated with the duration of enzyme replacement therapy.

Conclusions: Hearing impairment in MPS patients is common and is aggravated as the disease progresses. Thus, adequate intervention and hearing rehabilitation might play an important role in managing hearing disabilities in MPS patients.

Cited by 2 articles
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2
Comparative Study J Otolaryngol Head Neck Surg
. 2019 Nov 27;48(1):67. doi: 10.1186/s40463-019-0386-z.
Comparison of the Anatomical and Functional Success of Fascia and Perichondrium Grafts in Transcanal Endoscopic Type 1 Tympanoplasty
Kadir Özdamar 1, Alper Sen 2
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PMID: 31771648 PMCID: PMC6880544 DOI: 10.1186/s40463-019-0386-z
Free PMC article
Abstract
Background: There are no studies in the literature, comparing the functional and anatomical successes of the use of fascial and perichondrial grafts in endoscopic type 1 tympanoplasties.

Objectives: To compare the anatomical and functional outcomes of grafting with the fascia of the temporalis muscle and with the perichondrium of the tragal cartilage in patients undergoing primary transcanal type 1 tympanoplasty with endoscopy.

Methods: We enrolled a total of 151 patients (80 females and 71 males with a mean age of 26.0 ± 9.3 years in the age range between 18-57) with MERI scores ranging from 1 to 3 and who underwent a transcanal endoscopic type 1 tympanoplasty without tympanomeatal flap elevation. The patients were assigned to two groups according to the type of the graft used. The patients were assigned to either the tragal cartilage perichondrium group (Group A) or the fascia of the temporal muscle (Group B). The groups were compared according to the pre- and postoperative air-bone gaps and to the status of the tympanic membrane.

Results: There were no statistically significant differences in the distribution of the age, gender, localization, MERI scores, the duration of the operation, and the size of the perforation (all p values> 0.05). The pre-operative air-bone gap values of Group A and B did not show a statistically significant difference (p = 0.073). The postoperative improvement in the air-bone gap value did not demonstrate a significant difference between Group A and B (p = 0.202). The graft retention rates were 94.9 and 97.2% in Group A and in Group B respectively. There were no statistically significant differences between the two groups in terms of the graft retention success rates (p = 0.743).

Conclusion: Perichondrium and fascia were suitable for use in endoscopic tympanoplasties.

Keywords: Endoscopic tympanoplasty; Fascia; Perichondrium; Transcanal.

Conflict of interest statement
The authors declare that they have no competing interests.

25 references1 figure
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3
J Otolaryngol Head Neck Surg
. 2019 Nov 21;48(1):65. doi: 10.1186/s40463-019-0388-x.
Cone Beam CT for Perioperative Imaging in Hearing Preservation Cochlear Implantation - A Human Cadaveric Study
Kayvan Nateghifard 1, David Low 1, Lola Awofala 1, Dilakshan Srikanthan 1, Jafri Kuthubutheen 1 2, Michael Daly 3, Harley Chan 3, Jonathan Irish 3 4, Joseph Chen 1, Vincent Lin 1, Trung Ngoc Le 5
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PMID: 31753027 PMCID: PMC6873551 DOI: 10.1186/s40463-019-0388-x
Free PMC article
Abstract
Background: Knowledge of the cochlear implant array's precise position is important because of the correlation between electrode position and speech understanding. Several groups have provided recent image processing evidence to determine scalar translocation, angular insertion depth, and cochlear duct length (CDL); all of which are being used for patient-specific programming. Cone beam computed tomography (CBCT) is increasingly used in otology due to its superior resolution and low radiation dose. Our objectives are as followed: 1.Validate CBCT by measuring cochlear metrics, including basal turn diameter (A-value) and lateral wall cochlear duct length at different angular intervals and comparing it against microcomputed CT (uCT).2.Explore the relationship between measured lateral wall cochlear duct length at different angular intervals and insertion depth among 3 different length electrodes using CBCT.

Methods: The study was performed using fixed human cadaveric temporal bones in a tertiary academic centre. Ten temporal bones were subjected to the standard facial recess approach for cochlear implantation and imaged by CBCT followed by uCT. Measurements were performed on a three-dimensional reconstructed model of the cochlea. Sequential insertion of 3 electrodes (Med-El Flex24, 28 and Soft) was then performed in 5 bones and reimaged by CBCT. Statistical analysis was performed using Pearson's correlation.

Results: There was good agreement between CBCT and uCT for cochlear metrics, validating the precision of CBCT against the current gold standard uCT in imaging. The A-value recorded by both modalities showed a high degree of linear correlation and did not differ by more than 0.23 mm in absolute values. For the measurement of lateral wall CDL at various points along the cochlea, there was a good correlation between both modalities at 360 deg and 720 deg (r = 0.85, p < 0.01 and r = 0.79, p < 0.01). The Flex24 electrode displayed consistent insertion depth across different bones.

Conclusions: CBCT reliably performs cochlear metrics and measures electrode insertion depth. The low radiation dose, fast acquisition time, diminished metallic artifacts and portability of CBCT make it a valid option for imaging in cochlear implant surgery.

Conflict of interest statement
None.

35 references3 figures
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4
Exp Cell Res
. 2019 Sep 1;382(1):111449. doi: 10.1016/j.yexcr.2019.05.030. Epub 2019 May 31.
Sox9 Regulates the Luminal stem/progenitor Cell Properties of Salivary Glands
Junichi Tanaka 1, Yo Mabuchi 2, Kenji Hata 3, Rika Yasuhara 1, Koki Takamatsu 4, Satoko Kujiraoka 1, Akane Yukimori 1, Ikuko Takakura 5, Hidetoshi Sumimoto 6, Toshiyuki Fukada 7, Masayuki Azuma 8, Haruhiko Akiyama 9, Riko Nishimura 3, Toshikazu Shimane 10, Kenji Mishima 11
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PMID: 31153924 DOI: 10.1016/j.yexcr.2019.05.030
Abstract
Exocrine glands share a common morphology consisting of ductal, acinar, and basal/myoepithelial cells, but their functions and mechanisms of homeostasis differ among tissues. Salivary glands are an example of exocrine glands, and they have been reported to contain multipotent stem cells that differentiate into other tissues. In this study, we purified the salivary gland stem/progenitor cells of adult mouse salivary glands using the cell surface marker CD133 by flow cytometry. CD133+ cells possessed stem cell capacity, and the transplantation of CD133+ cells into the submandibular gland reconstituted gland structures, including functional acinar. CD133+ cells were sparsely distributed in the intercalated and exocrine ducts and expressed Sox9 at higher levels than CD133- cells. Moreover, we demonstrated that Sox9 was required for the stem cell properties CD133+ cells, including colony and sphere formation. Thus, the Sox9-related signaling may control the regeneration salivary glands.

Keywords: CD133; Salivary gland; Sox9; Stem/progenitor cells.

Copyright © 2019 Elsevier Inc. All rights reserved.

Comment in
Reply to Karbanová et al.: Prominin-1/CD133, saliva and salivary glands - Integrating existing data to new clinical approaches.
Tanaka J, Mishima K.
Exp Cell Res. 2019 Oct 15;383(2):111567. doi: 10.1016/j.yexcr.2019.111567. Epub 2019 Aug 22.
PMID: 31446163 No abstract available.
Prominin-1/CD133, saliva and salivary glands - Integrating existing data to new clinical approaches.
Karbanová J, Corbeil D, Fargeas CA.
Exp Cell Res. 2019 Oct 15;383(2):111566. doi: 10.1016/j.yexcr.2019.111566. Epub 2019 Aug 27.
PMID: 31470017 No abstract available.
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5
Transplantation
. 2019 Nov;103(11):2275-2286. doi: 10.1097/TP.0000000000002845.
The Role of miR-200b-3p in Modulating TGF-β1-induced Injury in Human Bronchial Epithelial Cells
Shameem S Ladak 1, Eliott Roebuck 1, Jason Powell 1 2, Andrew J Fisher 1 3, Chris Ward 1, Simi Ali 1
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PMID: 31283671 DOI: 10.1097/TP.0000000000002845
Abstract
Background: Dysregulation of microRNAs (miRNAs) has been implicated in airway diseases where transforming growth factor-β (TGF-β)-induced epithelial-mesenchymal transition (EMT) may contribute to pathophysiology. Our study investigated the role of miRNA-200b in TGF-β1-induced EMT in human bronchial epithelial cells.

Methods: NanoString nCounter miRNA assay was used to profile miRNA in control versus TGF-β1 (1, 4, and 24 h) stimulated BEAS-2B cells. Immortalized primary bronchial epithelial cell line (BEAS-2B cells), human primary bronchial epithelial cells (PBECs), and PBECs derived post-lung transplant were transfected with miR-200b-3p mimics and EMT marker expression was examined at RNA and protein level. miRNA target studies were performed and validated using computational tools and luciferase assay. In situ hybridization was done on normal lung tissue to localize miR-200b-3p in airway epithelium.

Results: miR-200b-3p was downregulated post-TGF-β1 treatment compared with control in BEAS-2B. miR-200b-3p mimic transfection before TGF-β1 stimulation maintained epithelial marker expression and downregulated mesenchymal cell markers at RNA and protein level in BEAS-2B cells and PBECs. Furthermore, miR-200b-3p mimics reversed established TGF-β1-induced EMT in BEAS-2B cells. miR-200b-3p targets, ZNF532, and ZEB2 were validated as direct targets using luciferase assay. miR-200b-3p mimics suppress TGF-β1-induced EMT via inhibition of ZNF532 and ZEB2. In situ hybridization showed that miR-200b-3p is expressed in the normal lung epithelium. Additionally, miR-200b-3p mimics inhibit EMT in the presence of TGF-β1 in PBECs derived from lung allograft.

Conclusions: We provide proof of concept that miR-200b-3p protects airway epithelial cells from EMT. Manipulating miR-200b-3p expression may represent a novel therapeutic modulator in airway pathophysiology.

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6
J Otolaryngol Head Neck Surg
. 2019 Dec 16;48(1):71. doi: 10.1186/s40463-019-0394-z.
Diagnosis and Management of Septal Deviation and Nasal Valve Collapse - A Survey of Canadian Otolaryngologists
Yiqiao Wang 1, James P Bonaparte 2
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PMID: 31842991 PMCID: PMC6916251 DOI: 10.1186/s40463-019-0394-z
Free PMC article
Abstract
Background: Management of nasal valve collapse (NVC) in patients with a septal deviation can be challenging. Our objective was to determine the opinions of Canadian Otolaryngologists regarding the diagnosis and management of nasal obstruction in patients with septal deviation and NVC.

Methods: A twenty-question survey was developed for the purpose of our study. Questions were divided into the following areas: diagnosis, management and prognosis. We included all otolaryngologists who were members of the Canadian Society of Otolaryngology.

Results: The response rate to our survey was 18%. The most commonly identified cause of a failed septoplasty was incomplete septoplasty (41.9%), followed by nasal valve collapse (25.6%). The Cottle manoeuvre (62.8%) and visual inspection (39.5%) were noted to be the most important diagnostic tools for external and internal NVC respectively. However, physicians often rely on a variable number of different examinations when making a diagnosis of nasal valve collapse. When evaluating which patients with a septal deviation also required nasal valve surgery, 27.9% of responders believed the current physical examination methods provided a high accuracy, while 55.8% indicated moderate accuracy and 16.3% indicated low accuracy. Compared to other subspecialties in Otolaryngology, Facial Plastic and Reconstruction Surgeons noted higher septoplasty failure rates in patients with co-morbid NVC.

Conclusions: NVC is an important concern for otolaryngologists performing septoplasty. Although most physicians believe that the physical exam provides a moderate effectiveness when predicting who requires a functional rhinoplasty, diagnostic methods used for NVC is varied and inconsistent.

Keywords: Nasal obstruction; Nasal valve collapse; Septoplasty; Survey.

Conflict of interest statement
The authors declare that they have no competing interests.

20 references
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7
Case Reports Otol Neurotol
. 2019 Dec;40(10):e962-e965. doi: 10.1097/MAO.0000000000002408.
Musical Ear Syndrome and Cochlear Explantation: Case Report and Proposal for a Theoretical Framework
Martin Kompis 1, Georgios Mantokoudis, Benjamin von Gunten, Christoph Schmid, Daniela Blaser, Marco Caversaccio
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PMID: 31577637 DOI: 10.1097/MAO.0000000000002408
Abstract
Objective: To report an unusual case of musical ear syndrome, and to present a theoretical framework for this condition, merging information from the presented case and from former case reports.

Patient: A 67-year-old semi-professional musician, who underwent bilateral cochlear implantation and experienced musical ear syndrome, i.e., hearing music, where none was present.

Interventions: Cochlear implantation with a bilateral cochlear implant, and cochlear explantation 17 months later.

Main outcome measure: Report of presence or absence of musical ear syndrome by the patient.

Results: Musical ear syndrome started 1 day after implantation. It ceased immediately after cochlear explantation, but reappeared 3 months later.

Conclusions: Several types of factors seem to determine whether a musical ear syndrome is present or not. We propose to differentiate between triggers, modifiers, and conditions, which determine a base vulnerability. Vulnerability seems to be increased by auditory deprivation and by habitual retrieval of music from memory. Cochlear implantation or explantation seems to act as triggers. The proposed framework may help to stimulate reporting of more potentially relevant factors in future case reports on musical ear syndrome, and ultimately to help to understand this condition better.

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8
J Neurosci
. 2019 Aug 14;39(33):6425-6438. doi: 10.1523/JNEUROSCI.0113-19.2019. Epub 2019 Jun 17.
Semaphorin-5B Controls Spiral Ganglion Neuron Branch Refinement During Development
Johnny S Jung 1, Kaidi D Zhang 1, Zhirong Wang 1, Mark McMurray 2, Andrew Tkaczuk 2, Yoko Ogawa 2, Ronna Hertzano 2 3 4, Thomas M Coate 5
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PMID: 31209173 PMCID: PMC6697390 DOI: 10.1523/JNEUROSCI.0113-19.2019
Free PMC article
Abstract
During nervous system development, axons often undergo elaborate changes in branching patterns before circuits have achieved their mature patterns of innervation. In the auditory system, type I spiral ganglion neurons (SGNs) project their peripheral axons into the cochlear epithelium and then undergo a process of branch refinement before forming synapses with sensory hair cells. Here, we report that Semaphorin-5B (Sema5B) acts as an important mediator of this process. During cochlear development in mouse, immature hair cells express Sema5B, whereas the SGNs express both PlexinA1 and PlexinA3, which are known Sema5B receptors. In these studies, genetic sparse labeling and three-dimensional reconstruction techniques were leveraged to determine the morphologies of individual type I SGNs after manipulations of Sema5B signaling. Treating cultured mouse cochleae with Sema5B-Fc (to activate Plexin-As) led to type I SGNs with less numerous, but longer terminal branches. Conversely, cochleae from Sema5b knock-out mice showed type I SGNs with more numerous, but shorter terminal branches. In addition, conditional loss of Plxna1 in SGNs (using Bhlhb5 Cre) led to increased type I SGN branching, suggesting that PlexinA1 normally responds to Sema5B in this process. In these studies, mice of either sex were used. The data presented here suggest that Sema5B-PlexinA1 signaling limits SGN terminal branch numbers without causing axonal repulsion, which is a role that distinguishes Sema5B from other Semaphorins in cochlear development.SIGNIFICANCE STATEMENT The sensorineural components of the cochlea include hair cells, which respond mechanically to sound waves, and afferent spiral ganglion neurons (SGNs), which respond to glutamate released by hair cells and transmit auditory information into the CNS. An important component of synapse formation in the cochlea is a process of SGN "debranching" whereby SGNs lose extraneous branches before developing unramified bouton endings that contact the hair cells. In this work, we have found that the transmembrane ligand Semaphorin-5B and its receptor PlexinA1 regulate the debranching process. The results in this report provide new knowledge regarding the molecular control of cochlear afferent innervation.

Keywords: Plexin; auditory; axon guidance; cochlea; semaphorin; spiral ganglion.

Copyright © 2019 the authors.

Cited by 1 article7 figures
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9
Otol Neurotol
. 2019 Dec;40(10):e993-e998. doi: 10.1097/MAO.0000000000002404.
Role of Autophagy in Acquired Cholesteatoma
Quancheng Li 1, Yinjie Ao, Qi Yu, Shuihong Zhou
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PMID: 31663994 DOI: 10.1097/MAO.0000000000002404
Abstract
Hypothesis: Autophagy and its enhancement may have a role in the pathogenesis of acquired cholesteatoma.

Background: The etiopathogenesis of acquired cholesteatoma remains unclear. Some clinical features of cholesteatoma are similar to those of cancer. The study of autophagy in cancer has indicated that enhanced autophagy enables tumor cell survival and growth.

Methods: Cholesteatoma epithelium and normal external auditory canal (EAC) epithelium were obtained from patients with acquired cholesteatoma, and marginal epithelium of the tympanic membrane perforation was obtained from patients with chronic otitis media (COM). Immunohistochemistry (IHC) was performed to detect the expression of light chain 3 (LC3) in cholesteatoma and EAC epithelium. Western blotting (WB) was performed to detect the expression of LC3, Beclin-1, or the PI3K/AKT pathway in cholesteatoma, EAC, and COM epithelium.

Results: LC3 staining of IHC was stronger in cholesteatoma epithelium compared with normal EAC epithelium. The ratios of LC3-II/I and Beclin-1 expression on WB were significantly higher in cholesteatoma epithelium compared with EAC epithelium or COM epithelium, and there was a significantly higher ratio of p-PI3K/PI3K and p-AKT/AKT in cholesteatoma epithelium compared with EAC epithelium.

Conclusions: Enhanced autophagy might play a role in the pathogenesis of acquired cholesteatoma. PI3Ks might have different regulatory functions on autophagy in the cholesteatoma epithelium.

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10
J Otolaryngol Head Neck Surg
. 2019 Dec 3;48(1):69. doi: 10.1186/s40463-019-0391-2.
Overnight Oximetry in Children Undergoing Adenotonsillectomy: A Single Center Experience
C Carrie Liu 1, Kathleen H Chaput 2, Valerie Kirk 3, Warren Yunker 4
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PMID: 31796111 PMCID: PMC6888940 DOI: 10.1186/s40463-019-0391-2
Free PMC article
Abstract
Background: Obstructive sleep apnea (OSA) is the most common indication for adenotonsillectomy in children. Home-based sleep oximetry continues to be used in the diagnosis of pediatric OSA despite a lack of correlation with lab-based polysomnography. This study investigates whether factors influence surgeons in selecting patients for home-based sleep oximetry, how the study findings are used in patient management, and whether abnormal oximetry findings are associated with post-operative complications.

Methods: A retrospective review was performed on children with suspected OSA who had undergone a tonsillectomy and/or an adenoidectomy over a three-year period. Demographic features, comorbidities, pre-operative oximetry results, and post-operative complications were recorded. Data analysis consisting primarily of logistic regression was performed using Stata 12.0 (College Station, Texas).

Results: Data was collected from 389 children. Two hundred and seventy-one children underwent pre-operative oximetry (69.7%). There was no significant association between age or the presence of comorbidities and the likelihood of undergoing pre-operative sleep oximetry. The post-operative complication rate was 0.8%. There was no significant association between abnormal sleep oximetry parameters and post-operative complications. Children with one or more abnormal sleep oximetry parameters were more likely to be observed in hospital for at least one night (OR 2.4, p < 0.0001).

Conclusions: Our study suggests that surgeons are using home-based sleep oximetry findings to inform the post-operative care of children with suspected OSA, as those with abnormal home-based sleep oximetry findings were more likely to be observed in hospital. These hospital admissions may be unnecessary given the poor correlation of home-based oximetry and PSG as well as the low rate of serious post-operative complications.

Keywords: Obstructive sleep apnea; Sleep disordered breathing; Sleep oximetry.

Conflict of interest statement
None

18 references
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11
J Acoust Soc Am
. 2019 Jan;145(1):417. doi: 10.1121/1.5087693.
Does Good Perception of Vocal Characteristics Relate to Better Speech-On-Speech Intelligibility for Cochlear Implant Users?
Nawal El Boghdady 1, Etienne Gaudrain 1, Deniz Başkent 1
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PMID: 30710943 DOI: 10.1121/1.5087693
Abstract
Differences in voice pitch (F0) and vocal tract length (VTL) improve intelligibility of speech masked by a background talker (speech-on-speech; SoS) for normal-hearing (NH) listeners. Cochlear implant (CI) users, who are less sensitive to these two voice cues compared to NH listeners, experience difficulties in SoS perception. Three research questions were addressed: (1) whether increasing the F0 and VTL difference (ΔF0; ΔVTL) between two competing talkers benefits CI users in SoS intelligibility and comprehension, (2) whether this benefit is related to their F0 and VTL sensitivity, and (3) whether their overall SoS intelligibility and comprehension are related to their F0 and VTL sensitivity. Results showed: (1) CI users did not benefit in SoS perception from increasing ΔF0 and ΔVTL; increasing ΔVTL had a slightly detrimental effect on SoS intelligibility and comprehension. Results also showed: (2) the effect from increasing ΔF0 on SoS intelligibility was correlated with F0 sensitivity, while the effect from increasing ΔVTL on SoS comprehension was correlated with VTL sensitivity. Finally, (3) the sensitivity to both F0 and VTL, and not only one of them, was found to be correlated with overall SoS performance, elucidating important aspects of voice perception that should be optimized through future coding strategies.

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12
Otolaryngol Pol
. 2019 Jul 17;73(6):8-17. doi: 10.5604/01.3001.0013.2957.
Qualification of Unilateral Cochlear Implant Recipients for a Second Device
Maria Drela 1, Karolina Haber 1, Iwona Wrukowska 1, Michael Puricelli 2, Anna Sinkiewicz 3, Jerzy Bruś 1, Justyna Tyra 1, Józef Mierzwiński 1
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PMID: 31823844 DOI: 10.5604/01.3001.0013.2957
Free article
Abstract
Introduction: Although it is recommended to perform cochlear implantation in both ears at the same time for management of profound hearing loss in children, many centers prefer to perform sequential implantation. There are many reasons as to why a simultaneous bilateral implantation is not commonly accepted and performed. The major risk is the possibility of bilateral vestibular organ impairment. However, it is beyond doubt that children who received the first implant should be given a chance for binaural hearing and associated benefits. In the literature, there are no homogenous criteria for bilateral implantation, and it is hard to find uniform and convincing algorithms for second cochlear implantation. The aim of this study is an attempt to identify a safe way of qualifying for second cochlear implantation in children.

Material and methods: Forty children with one cochlear implant were qualified for the second implantation. During qualification, the following were taken into account: time of the first implantation, audiometry results, use of the hearing aid in the ear without an implant and benefit of the device, speech and hearing development, and vestibular organ function. R esults: Fifteen out of forty children (38%) were qualified for the second implantation. In 35% of children, the decision was delayed with possible second implantation in the future. Eleven children (27%) were disqualified from the second surgery.

Discussion: During evaluation according to the protocol presented in our study, 38% of children with a single cochlear implant were qualified for the second implantation with a chance for an optimal development and effective use of the second cochlear implant. We are convinced that sequential implantation with a short interval between surgeries and with an examination of the vestibular organ, hearing and speech development as well as an assessment of potential benefits from the second implant (bimodal stimulation) before the second implantation is the safest and most beneficial solution for children with severe hearing loss.

Keywords: bilateral vestibular loss; children; cochlear implant; deafness; qualification for bilateral implants.

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13
Sci Rep
. 2019 Jan 22;9(1):297. doi: 10.1038/s41598-018-36638-z.
Understanding of Risk Factors for the Human Papillomavirus (HPV) Infection Based on Gender and Race
Nosayaba Osazuwa-Peters 1 2 3, Eric Adjei Boakye 4, Rebecca L Rohde 5, Rajan N Ganesh 5, Ammar S Moiyadi 5, Adnan S Hussaini 6, Mark A Varvares 7
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PMID: 30670748 PMCID: PMC6342910 DOI: 10.1038/s41598-018-36638-z
Free PMC article
Abstract
This study assessed if race and gender predict known sexual risk factors associated with HPV. Data (n = 301) were from a cross-sectional study conducted at a drag racing event on September 12-13, 2015 in Madison, Illinois. Both multivariable logistic and linear regression models estimated the association between race, gender, and sexual risk factors. About 63% of participants were males, and 65% identified as Blacks. Compared to females, males were more likely to have a higher number of oral sexual partners (OR = 2.10; 95% CI: 1.23, 3.57). Males were also more likely to have earlier oral sexual (b = -2.10; 95% CI: -3.60, -0.60) and vaginal sexual (b = -1.10; 95% CI: -1.69, -0.31) debuts compared to females. Blacks were more likely to have higher number of vaginal sexual partners (OR = 3.38; 95% CI: 1.81, 6.31) and earlier vaginal sex (b = -1.09; 95% CI: -1.78, -0.41) but less likely to have earlier oral sexual debuts compared with Whites (b = 2.67; 95% CI: 1.21, -4.13). Because HPV is associated with several cancers, our findings provide impetus for the development of targeted educational interventions aimed at improving the knowledge of these sexual risk factors, especially among men and across race groups.

Conflict of interest statement
The authors declare no competing interests.

36 references
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14
Otol Neurotol
. 2019 Dec;40(10):e984-e988. doi: 10.1097/MAO.0000000000002402.
The Role of Sex on Early Cochlear Implant Outcomes
Mallory J Raymond 1, Samir A Ballestas 1, Justin C Wise 2, Esther X Vivas 1
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PMID: 31663996 DOI: 10.1097/MAO.0000000000002402
Abstract
Objective: To determine the presence of sex differences in cochlear implant outcomes.

Study design: Retrospective chart review.

Setting: Tertiary referral center.

Patients: Adult patients having undergone cochlear implantation from 2009 to 2017.

Intervention(s): Standard electrode length cochlear implantation.

Main outcome measure(s): AzBio scores in quiet of the implanted ear at the 1 to 3 months and 6 to 9 months postoperative time points.

Results: Of 55 patients with complete demographic and speech recognition testing, 36.4% (n = 20) were men. The mean age at time of surgery was 59.81 ± 16.54 years and the mean duration of hearing loss was 26.33 ± 18.54 years; there was no significant difference between men and women. The mean preoperative AzBio score was 11 ± 15.86% and there was no difference between men and women. Through 2 (sex) × 3 (time point) analysis of covariance (ANCOVA), there was no main effect of sex (F[1, 48] = 0.74, p = 0.39, η = 0.02) on postoperative AzBio scores, but there was a significant sex by time point interaction, (F[1.77, 85.03] = 4.23, p = 0.02, η = 0.08). At the 1 to 3 months postoperative time point, women exhibited higher relative improvement in AzBio scores than men (67 ± 27% versus 55 ± 31%). Further, this relative improvement increased and remained significant at the 6 to 9 months postoperative time point (women: 71 ± 22% versus 58 ± 30%).

Conclusions: Sex may play a role in early speech recognition outcomes after adult cochlear implantation.

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15
Mol Imaging
. Jan-Dec 2019;18:1536012119848927. doi: 10.1177/1536012119848927.
Evaluating Cholinergic Receptor Expression in Guinea Pig Primary Auditory and Rostral Belt Cortices After Noise Damage Using [ 3 H]Scopolamine and [ 18 F]Flubatine Autoradiography
Taylor J Forrest 1 2 3, Timothy J Desmond 3, Mohamad Issa 1 2, Peter J H Scott 3, Gregory J Basura 1 2
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PMID: 31099304 PMCID: PMC6537085 DOI: 10.1177/1536012119848927
Free PMC article
Abstract
Noise-induced hearing loss leads to anatomic and physiologic changes in primary auditory cortex (A1) and the adjacent dorsal rostral belt (RB). Since acetylcholine is known to modulate plasticity in other cortical areas, changes in A1 and RB following noise damage may be due to changes in cholinergic receptor expression. We used [3H]scopolamine and [18F]flubatine binding to measure muscarinic acetylcholine receptor (mAChR) and nicotinic acetylcholine receptor (nAChR) expression, respectively, in guinea pig A1 and RB 3 weeks following unilateral, left ear noise exposure, and a temporary threshold shift in hearing. [3H]Scopolamine binding decreased in right A1 and RB (contralateral to noise) compared to sham controls across all cortical layers. [18F]Flubatine binding showed a nonsignificant upward trend in right A1 following noise but only significantly increased in right RB and 2 layers of left RB (ipsilateral to noise). This selective response may ultimately influence cortical plasticity and function. The mechanism(s) by which cholinergic receptors are altered following noise exposure remain unknown. However, these data demonstrate noise exposure may differentially influence mAChRs that typically populate interneurons in A1 and RB more than nAChRs that are traditionally located on thalamocortical projections and provide motivation for cholinergic imaging in clinical patient populations of temporary or permanent hearing loss.

Keywords: autoradiography; hearing loss; muscarinic receptors; nicotinic receptors; radioligand binding.

Conflict of interest statement
Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

62 references7 figures
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16
Sci Rep
. 2019 Jan 22;9(1):305. doi: 10.1038/s41598-018-36299-y.
A Cross-Sectional Study on the Age-Related Cortical and Trabecular Bone Changes at the Femoral Head in Elderly Female Hip Fracture Patients
Tristan Whitmarsh 1, Yoshito Otake 2, Keisuke Uemura 3, Masaki Takao 3, Nobuhiko Sugano 3, Yoshinobu Sato 2
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PMID: 30670734 PMCID: PMC6343024 DOI: 10.1038/s41598-018-36299-y
Free PMC article
Abstract
Bone is in a continuous state of remodeling whereby old bone is absorbed and new bone is formed in its place. During this process, new formations reinforce the bone in the direction of the dominant stress trajectories through a functional adaptation. In normal aging, the balance between bone resorption and formation can be shifted. How this affects the functional adaptation remains to be investigated. Furthermore, how or whether the bone continues to change beyond the age of 85 is not yet studied in detail. In this study we examined the age-related changes in the cortical and trabecular bone in old age, and assessed whether we can find evidence of the presence of functional adaptation. We measured cortical and trabecular parameters from micro-computed tomography scans of the femoral head extracted from hip fracture patients between the age of 70 and 93 years. A significant decrease in global trabecular bone mineral density (38.1%) and cortical thickness (13.0%) was seen from the 9th to the 10th decade of life. The degree of anisotropy was maintained globally as well as locally in both high and low stress regions. The local trabecular bone mineral density decreased in both high stress and low stress regions between the 9th and 10th decade of life with similar trends. This suggests that the role of functional adaptation in maintaining the bone structural integrity in old age may be limited. This study highlights the need for a controlled clinical trial examining the cause of the continued bone degradation throughout old age.

Conflict of interest statement
The authors declare no competing interests.

Cited by 4 articles31 references4 figures
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17
Otolaryngol Pol
. 2019 Sep 2;73(6):32-37. doi: 10.5604/01.3001.0013.4120.
Neurological Complications and Quality of Life After Submandibular Gland Resection. A Prospective, Non-Randomized, Single-Centre Study
Carlos Chiesa Estomba 1, Ariadna Valldeperes-Vilanova 1, Jose González-García 1, Ekhiñe Larruscain-Sarasola 1, Jon Sistiaga-Suarez 1, Xabier Altuna-Mariezcurrena 1
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PMID: 31823841 DOI: 10.5604/01.3001.0013.4120
Free article
Abstract
Introduction: There are different complications related to the submandibular gland resection, like damage to the mandibular branch of the facial nerve, lingual or hypoglossal nerve. Moreover, subjective complaints like dry mouth, altered sensation around the scar and taste alterations were described.

Patients and methods: A prospective, non-randomized study was performed including 20 patients treated with submandibular gland resection.

Results: The most common etiology was sialolithiasis affecting 9 (45%) patients. One (5%) patient presented a lingual nerve paresis, 2 (10%) patients presented a transient marginal mandibular branch paresis and no hypoglossal nerve alteration was observed. Factors like the size of the lithiasis (P = 0.293), size of the tumor (P = 0.445) or type of pathology (P = 0.694) were not related with neurological complications. Altered sensation in the skin around a scar was the most severely weighted problem (55% and 33.3%), and xerostomia was the second one (33% and 27.3%) at one month and at six months after surgery, respectively.

Conclusion: The submandibular gland resection remains to be a safe technique with a low rate of surgical and neurological complications. However, patients should be informed about sequelae like xerostomia, altered sensation in the skin or pain around the scar, which may be discomforting. The cosmetic result can be satisfactory, but a surgical scar can be avoided with another approach. Although rare, the risk of MBFN, lingual and hypoglossal nerve damage should always be included in the preoperative information on surgical risks.

Keywords: neurological complications; salivary gland; submandibular gland; surgery.

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18
J Glob Antimicrob Resist
. 2019 Sep;18:183-186. doi: 10.1016/j.jgar.2019.03.017. Epub 2019 Apr 3.
Comparison of in Vitro Synergistic Effect Between Clarithromycin or Azithromycin in Combination With Amikacin Against Mycobacterium Intracellulare
Zhijian Zhang 1, Jie Lu 2, Yingzhen Du 1, Fei Xie 3, Yufeng Wang 4, Baojun Sun 5, Yu Pang 6
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PMID: 30953831 DOI: 10.1016/j.jgar.2019.03.017
Abstract
Objectives: This study compared the in vitro synergistic effect between clarithromycin or azithromycin in combination with amikacin against Mycobacterium intracellulare.

Methods: In vitro antimicrobial susceptibility of M. intracellulare isolates was determined by the broth microdilution method in cation-adjusted Mueller-Hinton broth. The fractional inhibitory concentration index (FICI) was also calculated to assess synergy between the antimicrobial agents.

Results: A total of 32 respiratory M. intracellulare isolates were included in the study. Clarithromycin was the most potent agent against M. intracellulare, with MIC50 and MIC90 values (minimum inhibitory concentration required to inhibit 50% and 90% of the isolates, respectively) of 0.5μg/mL and 8μg/mL, respectively. Azithromycin and amikacin also showed moderate activity against M. intracellulare, with MIC90 values of 16μg/mL and 4μg/mL, respectively. The percentage of resistant strains among the 32 M. intracellulare isolates was 3.1% for clarithromycin, 9.3% for amikacin and 12.5% for azithromycin. The presence of amikacin had no effect on the MIC50 of clarithromycin, whereas the presence of amikacin resulted in a two-fold increase in the MIC50 of azithromycin. In addition, antagonism for the clarithromycin-amikacin combination was noted in 5 (15.6%) of the 32 M. intracellulare isolates, which was significantly lower than for the azithromycin-amikacin combination (14/32; 43.8%) (P = 0.042).

Conclusion: These data demonstrated that clarithromycin displayed more potent in vitro activity against M. intracellulare isolates than azithromycin. In addition, the antagonistic effect between azithromycin and amikacin was more frequent in M. intracellular isolates than that between clarithromycin and amikacin.

Keywords: Amikacin; Clarithromycin; Mycobacterium intracellulare; Synergy.

Copyright © 2019 International Society for Antimicrobial Chemotherapy. Published by Elsevier Ltd. All rights reserved.

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19
Otol Neurotol
. 2019 Dec;40(10):e999-e1005. doi: 10.1097/MAO.0000000000002361.
Cochlear MRI Signal Change Following Vestibular Schwannoma Resection Depends on Surgical Approach
Niels West 1 2, Hjalte Christian Reeberg Sass 1 2, Martin Nue Møller 1, Per Cayé-Thomasen 1 2
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PMID: 31592928 DOI: 10.1097/MAO.0000000000002361
Abstract
Objective: Information on cochlear MRI signal change following vestibular schwannoma (VS) surgery by the retrolabyrinthine approach (RLA) is nonexisting, and information using the translabyrinthine approach (TLA) is scarce. We aimed to evaluate cochlear MRI fluid signal in patients with a unilateral VS, before and after surgery by the RLA or the TLA, that can have clinical importance for subsequent cochlear implantation feasibility.

Study design: Retrospective cohort study.

Setting: University hospital.

Patients: One hundred one patients with a unilateral VS.

Intervention: VS resection by the TLA or the RLA. Pre- and postoperative T2-weighted MRI.

Main outcome measure: Cochlear signal change using a semiquantitative system for grading cochlear asymmetry, with grades ranging from 1 (normal fluid signal both sides) to 4 (no fluid signal one side).

Results: Seventy-four patients were operated by the TLA and 27 by the RLA. The number of cochleas with grade 3 and 4 asymmetries postoperative was significantly higher than preoperative. The postoperative proportions of grade 1 (TLA 20%, RLA 56%) and grade 2-4 asymmetry (TLA 80%, RLA 44%) were significantly different between the two groups. In the TLA group, 46 patients (62%) demonstrated an increased asymmetry postoperatively, as compared with three patients (11%) in the RLA group.

Conclusions: Postoperative decrease of cochlear MRI fluid signal is more likely to occur after translabyrinthine surgery (occurring in 62%), as compared with retrolabyrinthine surgery (occurring in 11%). The decrease of cochlear signal may be due to compromised vascularity or fibrosis.

Cited by 1 article
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20
J Otolaryngol Head Neck Surg
. 2019 Nov 26;48(1):66. doi: 10.1186/s40463-019-0389-9.
Building an Otoscopic Screening Prototype Tool Using Deep Learning
Devon Livingstone 1, Aron S Talai 2, Justin Chau 3, Nils D Forkert 2
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PMID: 31771647 PMCID: PMC6880418 DOI: 10.1186/s40463-019-0389-9
Free PMC article
Abstract
Background: Otologic diseases are often difficult to diagnose accurately for primary care providers. Deep learning methods have been applied with great success in many areas of medicine, often outperforming well trained human observers. The aim of this work was to develop and evaluate an automatic software prototype to identify otologic abnormalities using a deep convolutional neural network.

Material and methods: A database of 734 unique otoscopic images of various ear pathologies, including 63 cerumen impactions, 120 tympanostomy tubes, and 346 normal tympanic membranes were acquired. 80% of the images were used for the training of a convolutional neural network and the remaining 20% were used for algorithm validation. Image augmentation was employed on the training dataset to increase the number of training images. The general network architecture consisted of three convolutional layers plus batch normalization and dropout layers to avoid over fitting.

Results: The validation based on 45 datasets not used for model training revealed that the proposed deep convolutional neural network is capable of identifying and differentiating between normal tympanic membranes, tympanostomy tubes, and cerumen impactions with an overall accuracy of 84.4%.

Conclusion: Our study shows that deep convolutional neural networks hold immense potential as a diagnostic adjunct for otologic disease management.

Keywords: Artificial intelligence; Automated; Deep learning; Machine learning; Neural network; Otoscopy.

Conflict of interest statement
The authors declare that they have no competing interests.

16 references2 figures
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21
Am J Rhinol Allergy
. 2020 Jun 20;1945892420932487. doi: 10.1177/1945892420932487. Online ahead of print.
Effect of Exposure to Cats and Dogs on the Risk of Asthma and Allergic Rhinitis: A Systematic Review and Meta-analysis
Xiaoping Gao 1, Mei Yin 2, Pei Yang 1, Xia Li 3, Lingling Di 1, Wei Wang 1, Hua Cui 2, Xiaohui Yan 1, Jing Liu 1
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PMID: 32564683 DOI: 10.1177/1945892420932487
Abstract
Background: Controversies persist regarding whether exposure to cat or dog increases the risk of asthma and allergic rhinitis.

Objective: This meta-analysis aimed to assess the associations between exposure to cats or dogs and the development of asthma and allergic rhinitis.

Methods: A systematic review was performed to identify case-control and cohort studies before May 2019, evaluating the association between exposure to cats and dogs and the risk of asthma and rhinitis. The risk of bias was assessed using the Newcastle-Ottawa Scale. The odds ratios (ORs) and risk ratios (RRs) were pooled for case-control and cohort studies, respectively. Subgroup analyses were performed on prespecified study-level characteristics.

Results: The meta-analysis of 34 cohort studies showed a protective role of exposure to cats [RR: 0.88, 95% confidence interval (CI): 0.77-0.99] or dogs (RR: 0.85, 95% CI: 0.73-0.97) in the development of asthma. The subgroup analysis of birth cohort (RR: 0.74, 95% CI: 0.56-0.93) and children population (RR: 0.83, 95% CI: 0.70-0.96) also suggested a favorable role of exposure to dogs in the development of asthma. Pooled evidence from 13 case-control studies indicated no significant impact of cats (OR: 1.66, 95% CI: 0.39-2.94) and dogs (OR: 1.22, 95% CI: 0.92-1.52) on the development of asthma. A pooled analysis of five cohort studies showed a favorable effect of exposure to cats (RR: 0.60, 95% CI: 0.33-0.86) or dogs (RR: 0.68, 95% CI 0.44-0.90) on the development of allergic rhinitis.

Conclusion: The findings indicated a protective effect of exposure to cats and dogs, especially ownership, on the development of asthma and allergic rhinitis.

Keywords: allergic; association; asthma; cat; dog; exposure; meta-analysis; rhinitis; risk; systematic review.

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22
PLoS Pathog
. 2020 Mar 16;16(3):e1008447. doi: 10.1371/journal.ppat.1008447. eCollection 2020 Mar.
STUB1 Is Targeted by the SUMO-interacting Motif of EBNA1 to Maintain Epstein-Barr Virus Latency
Yuyan Wang 1, Shujuan Du 1, Caixia Zhu 1, Chong Wang 1, Nuoya Yu 1, Ziqi Lin 1, Jin Gan 1 2, Yi Guo 3, Xinxin Huang 4, Yuping He 4, Erle Robertson 5, Di Qu 1, Fang Wei 2, Qiliang Cai 1 6
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PMID: 32176739 PMCID: PMC7105294 DOI: 10.1371/journal.ppat.1008447
Free PMC article
Abstract
Latent Epstein-Barr virus (EBV) infection is strongly associated with several malignancies, including B-cell lymphomas and epithelial tumors. EBNA1 is a key antigen expressed in all EBV-associated tumors during latency that is required for maintenance of the EBV episome DNA and the regulation of viral gene transcription. However, the mechanism utilized by EBV to maintain latent infection at the levels of posttranslational regulation remains largely unclear. Here, we report that EBNA1 contains two SUMO-interacting motifs (SIM2 and SIM3), and mutation of SIM2, but not SIM3, dramatically disrupts the EBNA1 dimerization, while SIM3 contributes to the polySUMO2 modification of EBNA1 at lysine 477 in vitro. Proteomic and immunoprecipitation analyses further reveal that the SIM3 motif is required for the EBNA1-mediated inhibitory effects on SUMO2-modified STUB1, SUMO2-mediated degradation of USP7, and SUMO1-modified KAP1. Deletion of the EBNASIM motif leads to functional loss of both EBNA1-mediated viral episome maintenance and lytic gene silencing. Importantly, hypoxic stress induces the SUMO2 modification of EBNA1, and in turn the dissociation of EBNA1 with STUB1, KAP1 and USP7 to increase the SUMO1 modification of both STUB1 and KAP1 for reactivation of lytic replication. Therefore, the EBNA1SIM motif plays an essential role in EBV latency and is a potential therapeutic target against EBV-associated cancers.

Conflict of interest statement
The authors have declared that no competing interests exist.

76 references7 figures
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23
J Otolaryngol Head Neck Surg
. 2019 Dec 30;48(1):73. doi: 10.1186/s40463-019-0396-x.
Evaluating the Effectiveness of Adjuvant Radiotherapy in Addition to Surgery Versus Surgery Alone at Improving Oncologic Outcomes for Early Stage Buccal Carcinoma: A Systematic Review
Corliss Ann Elizabeth Best 1, Alexandra Elizabeth Quimby 2, Brittany Ann Barbara Best 2, Dean Fergusson 3 4, Hussain Alsaffar 2
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PMID: 31888737 PMCID: PMC6937776 DOI: 10.1186/s40463-019-0396-x
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Erratum in
Correction to: Evaluating the effectiveness of adjuvant radiotherapy in addition to surgery versus surgery alone at improving oncologic outcomes for early stage buccal carcinoma: a systematic review.
Best CAE, Quimby AE, Best BAB, Fergusson D, Alsaffar H.
J Otolaryngol Head Neck Surg. 2020 Jan 15;49(1):5. doi: 10.1186/s40463-020-0400-5.
PMID: 31941555 Free PMC article.
Abstract
Objective: To systematically review the evidence to evaluate oncologic outcomes for patients with early stage buccal squamous cell carcinoma treated with surgery versus surgery and adjuvant radiation therapy.

Data sources: Ovid MedLine, EMBASE, Google Scholar, PubMed.

Review methods: The primary purpose was to perform a systematic review to determine the published literature comparing oncologic outcomes of patients with early stage (Stages I&II) buccal mucosal squamous cell carcinoma, treated with surgical resection alone versus surgery plus adjuvant radiation therapy. Oncologic outcomes of interest were overall survival, locoregional recurrence, and disease specific survival. The secondary aim was to perform a meta-analysis to quantitively compare and summarize the data on oncologic outcomes between treatments.

Results: A total of 1457 studies were screened and five retrospective cohort studies (n = 733 patients) were eligible for quantitative analysis. Overall study quality was moderate to high. Pooled relative risk ratios using a fixed effects model did not reveal any statistically significant difference in overall survival (p = 0.70) or locoregional recurrence rates (p = 0.72) in Stage I and II disease.

Conclusions: These results demonstrate there is sparse evidence comparing oncologic outcomes for early stage buccal squamous cell carcinoma treated with surgery alone versus surgery and adjuvant radiation therapy. Our findings based on a limited body of evidence suggest no obvious benefit in the addition of adjuvant radiation therapy, however robust randomized trials are warranted to reach firm conclusions.

Keywords: Buccal squamous cell carcinoma; Early stage disease; Oncologic outcomes; Oral cavity squamous cell carcinoma; Radiation; Surgery.

Conflict of interest statement
The authors declare that they have no competing interests.

Cited by 1 article16 references3 figures
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24
Biochem Biophys Res Commun
. 2019 Jun 4;513(3):635-641. doi: 10.1016/j.bbrc.2019.03.110. Epub 2019 Apr 11.
Construction of an Irreversible Allergic Rhinitis-Induced Olfactory Loss Mouse Model
Caiquan Liang 1, Zixuan Yang 1, Qingyun Zou 1, Mengxia Zhou 1, Huanhai Liu 2, Jingping Fan 3
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PMID: 30981508 DOI: 10.1016/j.bbrc.2019.03.110
Abstract
Clinical data show that part of patients with sinonasal diseases suffered from olfactory dysfunction, especially with allergic rhinitis (AR) and chronic rhinosinusitis (CRS). However, the mechanisms responsible for AR-induced olfactory loss are still largely unknown. Because of the difficulty to obtain human olfactory mucosa, an AR-induced olfactory loss animal model needs to be constructed to clarify the mechanism. The AR mouse model was induced by intraperitoneal sensitizing with ovalbumin (OVA) followed by intranasal challenge lasted from 1 to 12 weeks. For groups with recovery, mice were housed for another 4-week long without any treatment after the last intranasal challenge. Olfactory function, olfactory receptor neurons (ORNs) density and leukocytes infiltration were examined at different time points. Olfactory loss occurs immediately after 1-week intranasal challenge and deteriorates almost to anosmia after 8th week, and after that olfactory loss become irreversible. Nasal inflammation induces significant infiltration of leukocytes into olfactory epithelium (OE), which negatively correlated with the density of ORNs and mouse olfaction in a time dependent manner. The neutrophilic subtype dominates in number amongst the total infiltrated leukocytes, indicating its pivotal role in nasal inflammation-induced olfactory dysfunction. In this study, we constructed a persistent AR-induced olfactory loss mouse model, losing the ability to recover from dysfunction if the disease duration more than eight weeks, which implies that timely treatments are necessary. Meanwhile, this mouse model could provide an easy and reliable system to clarify the mechanisms of AR-induced irreversible olfactory dysfunction.

Keywords: Allergic rhinitis; Leukocytes; Mouse model; Olfactory loss; Olfactory receptor neurons.

Copyright © 2019. Published by Elsevier Inc.

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25
J Otolaryngol Head Neck Surg
. 2019 Dec 30;48(1):74. doi: 10.1186/s40463-019-0395-y.
Examining Seasonal Variation in Epistaxis in a Maritime Climate
Ben McMullin 1, Paul Atkinson 2, Natasha Larivée 1, Christopher J Chin 3 4
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PMID: 31888757 PMCID: PMC6937692 DOI: 10.1186/s40463-019-0395-y
Free PMC article
Abstract
Background: Epistaxis is a common reason patients present to the emergency department. There is significant variation in climate across Canada. Our study aimed to determine if epistaxis is related to season, temperature and humidity in a Maritime climate.

Methods: Ethics approval was obtained. A retrospective chart review was performed. Patients who presented to the Saint John Regional Hospital Emergency Room between July 2015 and December 2017 with a diagnosis of epistaxis were identified. Weather data was collected from Environment Canada. We performed multiple univariate analyses examining confounding variables.

Results: In total, 476 cases of epistaxis were identified. There was a significant seasonal variation; the highest number of epistaxis cases occurred in the winter (p < 0.001). A negative correlation was seen between mean daily humidity and epistaxis (R2 = 0.7794).

Conclusion: The highest number of cases presented in the winter and a negative correlation was found between epistaxis and mean daily humidity.

Keywords: Climate; Epistaxis; Humidity; Maritime; Season; Temperature.

Conflict of interest statement
The authors declare that they have no competing interests.

16 references3 figures
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26
Orbit
. 2020 Aug;39(4):305-310. doi: 10.1080/01676830.2020.1768560. Epub 2020 May 18.
Orbital Cellulitis, Sinusitis and Intracranial Abnormalities in Two Adolescents With COVID-19
Roger E Turbin 1, Peter J Wawrzusin 1, Nicole M Sakla 2, Christin M Traba 3, Kristin G Wong 4, Neena Mirani 5, Jean A Eloy 6, Esther A Nimchinsky 7
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PMID: 32419568 DOI: 10.1080/01676830.2020.1768560
Abstract
We review two cases of adolescents with orbital cellulitis, sinusitis and SARS- CoV-2 infection presenting to emergency departments within a 24 hour period. SARS-CoV-2 samples obtained within 24 hours were positive, supporting prior infection despite relatively limited early symptoms of COVID-19. Unusual clinical and radiographic characteristics included hemorrhagic abscess with blood of varying age in the first, intracranial epidural abscess in the second, radiographic signal consistent with hemorrhagic or thrombotic phenomena, retro-maxillary antral fat changes, and meningeal enhancement or extension in both cases. Radiographic findings thereby mimic fungal infection, although final cultures and ancillary investigation for allergic and invasive fungal disease have remained negative. These cases highlight two unusual orbital presentations of cellulitis occurring in the context of SARS-CoV-2 co-infection.

Keywords: COVID-19; SARS-CoV-2; hemorrhage; orbital cellulitis; thrombosis.

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27
PLoS One
. 2020 Mar 11;15(3):e0230106. doi: 10.1371/journal.pone.0230106. eCollection 2020.
In RRP, Serologic Response to HPV Is Frequently Absent and Slow to Develop
Farrel J Buchinsky 1, Nicole Ruszkay 2, William Valentino 2, Craig S Derkay 3, John E McClay 4, Robert W Bastian 5, Charles M Myer 6, Kevin W Lollar 7, Dalya Guris 8
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PMID: 32160246 PMCID: PMC7065799 DOI: 10.1371/journal.pone.0230106
Free PMC article
Abstract
Background: Recurrent respiratory papillomatosis (RRP) is characterized by repeated formation of papillomas in the respiratory tract and is caused by human papillomavirus (HPV) types 6 and 11. Women with genital HPV infection are slow to develop weak humoral immunity, but respond robustly to the HPV vaccine. We wondered if people with RRP had a similar immune response.

Methods: A convenience cross-sectional sample of patients with RRP were recruited into one of four groups: 1) adults and adolescents with active RRP, 2) children with active RRP, 3) RRP patients who had undergone HPV vaccination prior to enrollment and, 4) people with RRP who were in remission. Anti-HPV6 and HPV11 serology was determined by cLIA on a single blood draw.

Results: Of the 70 subjects enrolled, 36, 16, 8, and 10, were in groups 1, 2, 3, and 4, respectively. 47% of participants aged >11 years and 81% aged ≤11 years possessed no antibodies against HPV6 or HPV11 (ie. double seronegative). 61% of patients in remission were double seronegative. All participants who had received HPV vaccine previously were seropositive to at least one of these low risk HPV types (ie none of them were double seronegative). Among patients who had active RRP and never had HPV vaccination (n = 52) there was an association between duration of symptoms and seropositivity. Of those who were seropositive, the geometric mean duration of symptoms was 11 years compared to 4.7 years for those who were seronegative (p = 0.001).

Conclusion: People with RRP are capable of developing a humoral response to HPV6 and HPV11. That response appears to be robust when initiated by the HPV vaccine, but either nonexistent or slow to develop in response to infection. Most in remission do not have demonstrable antibody levels against HPV6 or HPV11.

Conflict of interest statement
The authors of have read the journal's policy and the authors of this manuscript have the following competing interests: FB was awarded research funding to conduct the study. He has received no funding since the study was executed and initially reported in 2011. There is no ongoing employment, consultancy, patent or product relationship with MSD. DG is a paid employee, and Executive Director of MSD. MSD tested the serum samples and provided funding. JM is a co-owner of Frisco ENT for Children (http://friscoentforchildren.com/). RB is the majority owner of Bastian Voice Institute (https://www.bastianvoice.com/). KL is a partner of Ear, Nose &Throat Center of the Ozarks (https://entozarks.com/). There are no patents, products in development or marketed products associated with this research to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials. The opinions expressed in this paper are those of the authors and do not necessarily represent those of MSD.

42 references6 figures
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28
Subst Use Misuse
. 2020;55(9):1533-1544. doi: 10.1080/10826084.2019.1657149.
An Overview on Betel Quid and Areca Nut Practice and Control in Selected Asian and South East Asian Countries
Shilpa Gunjal 1, Deepak Gowda Sadashivappa Pateel 2, Yi-Hsin Yang 3, Jennifer Geraldine Doss 4, Sobia Bilal 5, Thaddius Herman Maling 6, Ravi Mehrotra 7, Sok Ching Cheong 8, Rosnah Binti Mohd Zain 2 9 10
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PMID: 32569533 DOI: 10.1080/10826084.2019.1657149
Abstract
Background: Areca nut (AN) and betel quid (BQ) chewing are ancient practices followed by an extensive proportion of the world's population. These practices are endemic in larger parts of South and Southeast Asia and selected Western Pacific countries. The prevalence of these habits varies across regions, age, gender, cultural practice, and socioeconomic status groups. Considerable variations exist between countries with respect to prevention/intervention programs, and policy guidelines of BQ usage. Objectives: (1) To provide an overview of the BQ chewing prevalence, practices, preventive interventions and policies in selected Asian and Western Pacific countries. (2) To explore the different terminologies associated with BQ use. Method: A narrative review of the current literature related to BQ, AN, and oral cancer was conducted by searching PUBMED, CINAHL, and GOOGLE databases. Results: The literature review revealed that the prevalence of BQ was found to be highest in Papua New Guinea, followed by Bangladesh, India, Pakistan, Myanmar and Sri Lanka. While, Cambodia, Malaysia, Indonesia and Taiwan had comparatively lower prevalence. Smokeless tobacco, BQ with tobacco, BQ without tobacco, AN were some of the terminologies used for BQ in various studies. Conclusions: The prevalence, and the interventional policies related to BQ and AN chewing habits varies widely among the selected countries. With the increasing awareness and association of BQ with oral cancer, there is a need to have better awareness, prevention and interventional strategies in place. We also found considerable variation in the use of terminologies associated with BQ.

Keywords: Areca nut; betel quid; chewing tobacco; intervention; piper betel; prevalence; terminology.

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29
Immun Inflamm Dis
. 2020 Jun 21. doi: 10.1002/iid3.325. Online ahead of print.
Human Leukocyte Antigen Class I (A, B) and Class II (DRB1) Allele and Haplotype Frequencies in Iranian Patients With Buerger's Disease
Fatemeh Dehghani Firouzabadi 1 2 3 4, Javad Salimi 1, Aliakbar Amirzargar 2, Mohammad Dehghani Firouzabadi 1 2 3, Hani Arbabi 5, Seyyed M Mousavizadeh 6, Kambiz Izadpanah 1
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PMID: 32567246 DOI: 10.1002/iid3.325
Free article
Abstract
Objective: The aim of this study was to investigate the human leukocyte antigen (HLA) class I (HLA-A and HLA-B) and II (HLA-DRB1) allele and haplotype frequencies in a group of Iranian patients with Buerger's disease (BD) in comparison with a normal healthy control group.

Methods: A total of 70 unrelated male patients and 100 healthy controls from Sina Hospital, Tehran, Iran, belonging to the same ethnic background, were enrolled in this case-control study. HLA-A, B, and DRB1 typing were performed by polymerase chain reaction with sequence-specific primers (PCR-SSP).

Results: The results of this case-control study showed that the frequency of the HLA-A*03:01 (odds ratio (OR) = 2.88, P value (Pv) = .002), HLA-A*29:01 (OR = 15.31, Pv < .001), HLA-DRB1*04:02 (OR = 3.41, Pv < .001), and HLA-DRB1*16:01 (OR = 8.16, Pv < .001) was significantly higher in BD patients compared with healthy controls, whereas the frequency of the HLA-DRB1*01:01 (OR = 0.03, Pv < .001) was significantly lower in BD patients. The most frequent extended haplotypes in our patients were HLA-A*02:01-B*55:01-DRB1*04:03.

Conclusion: This study is the first study evaluating an association between the HLA pattern and BD in the patients with BD from North West and North Iran.

Keywords: Buerger's disease; HLA-DNA typing; MHC; polymerase chain reaction.

© 2020 The Authors. Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.

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30
Laryngoscope
. 2020 Jun 22. doi: 10.1002/lary.28850. Online ahead of print.
Does the Expiratory Disproportion Index Remain Predictive of Airway Stenosis in Obese Patients?
Kevin Calamari 1, Stephen Politano 1, Laura Matrka 2
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PMID: 32569409 DOI: 10.1002/lary.28850
Abstract
Objectives/hypothesis: The expiratory disproportion index (EDI) is the ratio of forced expiratory volume in 1 second divided by peak expiratory flow rate multiplied by 100. An elevated EDI (>50) can help differentiate upper airway stenosis from other dyspnea etiologies, but this has not been verified when considering body habitus. We hypothesize that the predictive value of elevated EDI in diagnosing airway stenosis will be lower in obese patients as compared to nonobese patients.

Study design: Retrospective cohort study.

Methods: Patients >18 years old with recorded pulmonary function test values, body mass index (BMI), and airway imaging were reviewed retrospectively from January 2011 to October 2018. EDI was recorded for four cohorts: nonobese and nonstenotic, obese and nonstenotic, nonobese and stenotic, and obese and stenotic, to determine the mean EDI and the sensitivity and specificity of an elevated EDI.

Results: Mean EDI values were 66.53 ± 17.66 and 49.55 ± 2.04 in the nonobese stenotic and nonstenotic groups, respectively (P < .01). They were 58.00 ± 10.79 and 45.02 ± 1.42 in the obese stenotic and nonstenotic groups, respectively (P < .01). At a threshold of >50, EDI had a sensitivity of 83.3% and specificity of 56.2% in differentiating between stenotic and nonstenotic cases in the nonobese cohort and 50.0% and 71.9% in the obese cohort.

Conclusions: As previously established, mean EDI values were significantly different in stenotic and nonstenotic patients in both BMI cohorts. However, at the established threshold of >50, EDI was not as sensitive at identifying stenotic cases in obese patients as in nonobese patients. This suggests that the EDI remains useful in obese patients when elevated but should not be relied upon to rule out stenosis.

Level of evidence: 4 Laryngoscope, 2020.

Keywords: Expiratory disproportion index; airway stenosis; obesity; tracheal stenosis.

© 2020 The American Laryngological, Rhinological and Otological Society, Inc.

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31
Laryngoscope
. 2020 Jun 22. doi: 10.1002/lary.28854. Online ahead of print.
Impact of Cochlear Implant With Diametric Magnet on Imaging Access, Safety, and Clinical Care
Nancy M Young 1 2 3, Stephen R Hoff 1 2, Maura Ryan 2 4
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PMID: 32569426 DOI: 10.1002/lary.28854
Abstract
Objectives/hypothesis: Review safety and effectiveness of magnetic resonance imaging (MRI) of patients implanted with a cochlear implant (CI) containing a diametric magnet housed within the undersurface of the device.

Study design: Retrospective chart review with additional review of MRI at a tertiary-care children's hospital.

Methods: Seven patients with mean age of 8.4 years (range = 1.3-19 years) with a diametric magnet in situ during MRI. The intervention comprised one or more sessions of 1.5 T or 3.0 T MRI without a head wrap. The main outcome measures were the occurrence of magnet-related complications including discomfort and magnet displacement, use of anesthesia or sedation, and clinical usefulness of MRI studies.

Results: Seven CI recipients underwent 17 episodes of 1.5 or 3.0 T MRI with an in situ diametric magnet. Thirteen of 17 (76%) MRI sessions were completed in awake patients. No patients had device-related discomfort. No magnet-related complications occurred. Thirteen of 14 (93%) brain studies were clinically useful despite artifacts.

Conclusions: The diametric magnet enabled MRI with magnet in situ without the discomfort or magnet displacement associated with removable axial magnets. The reduction in MRI magnet-related complications occurred because torque is not directed perpendicular and outward from the plane of the magnet, and the magnet is securely contained within its housing. The design of this device increased access and reduced the need for sedation or anesthesia.

Level of evidence: 4 Laryngoscope, 2020.

Keywords: Cochlear implant; diametric magnet; safety.

© 2020 The Authors. The Laryngoscope published by Wiley Periodicals, Inc. on behalf of The American Laryngological, Rhinological and Otological Society, Inc.

19 references
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32
Acta Otolaryngol
. 2020 Jun 21;1-7. doi: 10.1080/00016489.2020.1773532. Online ahead of print.
Impact of Surgical Resection Margins Less Than 5 Mm in Oral Cavity Squamous Cell Carcinoma: A Systematic Review
Alexandra Bungum 1, Jakob Schmidt Jensen 1, Kathrine Kronberg Jakobsen 1, Anders Christensen 1, Christian Grønhøj 1, Christian von Buchwald 1
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PMID: 32564643 DOI: 10.1080/00016489.2020.1773532
Abstract
Background: The width of the surgical resection margin impacts recurrence and survival in oral cavity squamous cell carcinoma (OSCC). The most commonly used definition of a clear margin is one larger than 5 mm, although due to anatomical restrictions to e.g. bone or vessels, this size is not always feasible. Margins less than 5 mm affect postsurgical strategies and prognoses, and further knowledge of margins smaller than 5 mm is needed.Aims/objectives: We aimed to systematically review the literature on the impact of surgical resection margins less than 5 mm addressing recurrence and survival in OSCC.Methods/materials: A systematic literature search was performed in the PubMed and EMBASE databases identifying studies regardless of publication date that examined margin less than 5 mm, with or without a comparison to size of 5 mm or greater, in patients with OSCC. We assessed the impact on recurrence and survival.Results: We identified six studies (n = 1514 patients); all studies, investigated recurrence, and three (n = 768 patients) evaluated survival. The studies had noteworthy variability in, e.g. follow-up times, anatomical sublocations, T- and N-stage classifications, and outcome measures. Five studies (n = 1387 patients) reported that margins smaller than 5 mm would be safe and would not affect survival or recurrence negatively compared to their own data on larger margins. One study reported that a clear resection margin greater than five mm was necessary to ensure optimal outcomes.Conclusion/significance: The literature showed significant bias and risk issues. In five of the included studies with 1387 patients, we found in selected cases, where margins larger than 5 mm are not possible, a tendency regarding resection margins less than 5 mm to be sufficient for the surgical treatment of patients with primary OSCC. However, the data is insufficient to enable altered recommendations of resection margins in patients with primary OSCC.

Keywords: Systematic review; oral cavity; resection margin; squamous cell carcinoma.

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33
J Plast Reconstr Aesthet Surg
. 2020 Jan;73(1):103-110. doi: 10.1016/j.bjps.2019.07.004. Epub 2019 Aug 7.
Morphological Analysis of Ischemia-Reperfusion Injury in a Cold Ischemia Model of Jejunal Free Flap for Hypopharyngeal Reconstruction
Simone Mauramati 1, Patrizia Morbini 2, Giuseppina Ferrario 2, Mohamed Alnemr 3, Elona Luka 4, Antonio Occhini 5, Giulia Bertino 5, Catherine Klersy 4, Mario Alessiani 6, Marco Benazzo 5
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PMID: 31494055 DOI: 10.1016/j.bjps.2019.07.004
Abstract
Background: Jejunal free flap (JFF) reconstruction is a popular treatment option for advanced hypopharyngeal cancer. Several factors including ischemia-reperfusion injury (IRI) can cause mucosal damage and progressive flap necrosis. We investigated the development and time-related progression of morphological and cellular changes in patients with JFF reconstruction including cold preservation of the graft.

Methods: Eleven patients were enrolled. Biopsies were taken during surgery from normally perfused tissue, before loop isolation (T0), at the end of back-table surgery (T1), immediately before reperfusion (T2), 15' after reperfusion (T3), and at the end of the digestive anastomoses (T4) and from the external monitor daily from the 1st to the 5th postoperative day (M1-M5). Histomorphological and immunohistochemical parameters in the intraoperative and postoperative samples were evaluated and compared.

Results: Delayed flap necrosis was observed in 2 patients. The cold ischemia phase did not negatively affect mucosal regeneration after reperfusion; morphological and cellular damage parameters returned to normal by the end of surgery or along the early postoperative period. Significant enterocyte replication activity was observed at the end of revascularization, which continued in the postoperative phase, leading to recovery of the epithelial morphological integrity and disappearance of apoptotic cells. An inflammatory infiltrate persisted in the M samples, and in a significant proportion of samples, mucosal fibrosis developed by the end of the postoperative observation.

Conclusion: Cold perfusion and preservation of the JFF can effectively limit the negative effects of IRI and to prevent short- and medium-term complications that can compromise the final outcome.

Keywords: Cold perfusion; Graft failure; Hypopharyngeal cancer; Ischemia-reperfusion injury; Jejunal free flap.

Copyright © 2019 Elsevier Ltd. All rights reserved.

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34
Review Int Forum Allergy Rhinol
. 2020 Jun 22. doi: 10.1002/alr.22624. Online ahead of print.
Treatment of Post-Viral Olfactory Dysfunction: An Evidence-Based Review With Recommendations
Nanki Hura 1, Deborah X Xie 1, Garret W Choby 2, Rodney J Schlosser 3, Cinthia Orlov 1, Stella M Seal 1, Nicholas R Rowan 1
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PMID: 32567798 DOI: 10.1002/alr.22624
Abstract
Background: Post-viral olfactory dysfunction (PVOD) is one of the most common causes of olfactory loss. Despite its prevalence, optimal treatment strategies remain unclear. This article provides a comprehensive review of PVOD treatment options and provides evidence-based recommendations for their use.

Methods: A systematic review of the Medline, Embase, Cochrane, Web of Science, Scopus, and Google Scholar databases was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies with defined olfactory outcomes of patients treated for PVOD following medical, surgical, acupuncture, or olfactory training interventions were included. The Clinical Practice Guideline Development Manual and Conference on Guideline Standardization (COGS) instrument recommendations were followed in accordance with a previously described, rigorous, iterative process to create an evidence-based review with recommendations.

Results: From 552 initial candidate articles, 36 studies with data for 2183 patients with PVOD were ultimately included. The most common method to assess olfactory outcomes was Sniffin' Sticks. Broad treatment categories included: olfactory training, systemic steroids, topical therapies, a variety of heterogeneous non-steroidal oral medications, and acupuncture.

Conclusion: Based on the available evidence, olfactory training is a recommendation for the treatment of PVOD. The use of short-term systemic and/or topical steroids is an option in select patients after careful consideration of potential risks of oral steroids. Though some pharmacological investigations offer promising preliminary results for systemic and topical medications alike, a paucity of high-quality studies limits the ability to make meaningful evidence-based recommendations for the use of these therapies for the treatment of PVOD. This article is protected by copyright. All rights reserved.

Keywords: budesonide; evidence-based medicine; olfaction disorders; olfactory training; smell; viral infection.

This article is protected by copyright. All rights reserved.

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35
Subst Use Misuse
. 2020;55(9):1545-1551. doi: 10.1080/10826084.2020.1753772.
Betel Nut Use: The South Asian Story
Arjun Singh 1, Rajesh Dikshit 2, Pankaj Chaturvedi 1
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PMID: 32569532 DOI: 10.1080/10826084.2020.1753772
Abstract
Background: Few traditions in South Asia have the antiquity and universal acceptance of betel quid and areca nut chewing. Its popularity dates back to ancient times in the South-Asian community with a foundation based on four factors, i.e. social acceptability, religious beliefs, perceived health benefits and addiction. We aim to provide an overview of its use in the South Asian region. Methods: We performed an electronic search on Medline, Embase and Google Scholar to identify the origins of the various betel quid and areca nut practices pertaining to the South Asian region along with their social and cultural influences. We also studied the prevalence across the region and the health effects, especially carcinogenic, along with the impact of diverse immigration today. Results: Other than the debate of where it originates, there is a diverse plethora of terms and methods of use of areca nut and betel quid in the region. Although established as a known carcinogen, the incidence is high, especially in the Indian subcontinent, with very few studies focusing on its use alone (without tobacco). The effect of globalization and increased movement of Asians across borders is resulting in changes in the patterns of diseases as well due to wider dissemination of areca nut and betel quid use. Conclusions: There is a huge loss of lives due to the addiction that areca nut causes. Governments need to tightly regulate the laws and set up tailored programs to tackle this specific issue in this region.

Keywords: Areca nut; South Asia; South East Asia; betel quid.

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36
Otol Neurotol
. 2020 Jun 19. doi: 10.1097/MAO.0000000000002715. Online ahead of print.
A Structural Analysis of Tympanic Compartments of the Middle Ear in Patients With Down's Syndrome: A Temporal Bone Study
Taketoshi Nogaki 1 2, Michael M Paparella 3, Sebahattin Cureoglu 1
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PMID: 32569132 DOI: 10.1097/MAO.0000000000002715
Abstract
: Hypothesis: There may be findings peculiar to the temporal bones of children with Down's syndrome (DS). The purpose of this study is to investigate the temporal bone histopathology of the children with DS.

Background: Otitis media with effusion is a highly prevalent condition with DS. Knowledge of the volume of the tympanic compartments and the area of the tympanic isthmus might be important to find out the pathogenesis of highly prevalent otitis media with effusion in those patients.

Methods: We compared the volume of the epitympanum, mesotympanum, and the areas of the tympanic isthmus and tympanic orifice of eustachian tube in temporal bones from patients with DS. We also investigated the eustachian tube histopathologically.

Results: The mean volume of the epitympanum and the mesotympanum was significantly smaller in the DS group than the control group. We found no significant difference in the mean diameter of the protympanic opening and tympanic orifice between the two groups. The mean narrowest area of the aerated and bony tympanic isthmus also was not significantly different between the two groups. An immature development of eustachian tube and cartilage was seen. We found mesenchyme remaining at the epitympanum and/or mesotympanum in all specimens in the DS group, and in five specimens in the control group.

Conclusion: In the presence of the small middle ear, poorly developed eustachian tube, and tensor muscle, a vicious circle occurs, making otitis media with effusion difficult to resolve.

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37
Otol Neurotol
. 2020 Jun 19. doi: 10.1097/MAO.0000000000002739. Online ahead of print.
Association of Speech Recognition Thresholds With Brain Volumes and White Matter Microstructure: The Rotterdam Study
Nicole M Armstrong 1, Pauline H Croll 2 3 4, Berthe C Oosterloo 2 3, Frank R Lin 5 6, M Arfan Ikram 3, André Goedegebure 2, Meike W Vernooij 3 4
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PMID: 32569139 DOI: 10.1097/MAO.0000000000002739
Abstract
Objectives: Brain volumetric declines may underlie the association between hearing loss and dementia. While much is known about the peripheral auditory function and brain volumetric declines, poorer central auditory speech processing may also be associated with decreases in brain volumes.

Methods: Central auditory speech processing, measured by the speech recognition threshold (SRT) from the Digits-in-Noise task, and neuroimaging assessments (structural magnetic resonance imaging [MRI] and fractional anisotropy and mean diffusivity from diffusion tensor imaging), were assessed cross-sectionally in 2,368 Rotterdam Study participants aged 51.8 to 97.8 years. SRTs were defined continuously and categorically by degrees of auditory performance (normal, insufficient, and poor). Brain volumes from structural MRI were assessed on a global and lobar level, as well as for specific dementia-related structures (hippocampus, entorhinal cortex, parahippocampal gyrus). Multivariable linear regression models adjusted by age, age-squared, sex, educational level, alcohol consumption, intracranial volume (MRI only), cardiovascular risk factors (hypertension, diabetes, obesity, current smoking), and pure-tone average were used to determine associations between SRT and brain structure.

Results: Poorer central auditory speech processing was associated with larger parietal lobe volume (difference in mL per dB increase= 0.24, 95% CI: 0.05, 0.42), but not with diffusion tensor imaging measures. Degrees of auditory performance were not associated with brain volumes and white matter microstructure.

Conclusions: Central auditory speech processing in the presence of both vascular burden and pure-tone average may not be related to brain volumes and white matter microstructure. Longitudinal follow-up is needed to explore these relationships thoroughly.

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38
Otol Neurotol
. 2020 Jun 19. doi: 10.1097/MAO.0000000000002745. Online ahead of print.
The National Landscape of Acute Mastoiditis: Analysis of the Nationwide Readmissions Database
Zachary G Schwam 1 2, Rocco Ferrandino 1 2, Vivian Z Kaul 1 2, Aisosa Omorogbe 3, Daniel Bu 3, Daniel-Georges Faddoul 4, Maura K Cosetti 1 2, George B Wanna 1 2
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PMID: 32569137 DOI: 10.1097/MAO.0000000000002745
Abstract
Objective: To determine risk factors for readmission, prolonged length of stay, and discharge to a rehabilitation facility in patients with acute mastoiditis. Trends in treatment and complication rates were also examined.

Study design: Retrospective cohort study.

Setting: Nationwide Readmissions Database (2013, 2014).

Patients: Pediatric and adult patients in the Nationwide Readmissions Database with a primary diagnosis of acute mastoiditis.

Interventions: Medical treatment, surgical intervention.

Outcome measures: Rates of and risk factors for readmission, prolonged length of stay, and discharge to a rehabilitation facility. Procedure and complication rates were also examined.

Results: Four thousand two hundred ninety-five pediatric and adult admissions for acute mastoiditis were analyzed. The overall rates of readmission, prolonged length of stay, and discharge to a rehabilitation facility were 17.0, 10.4, and 10.2%, respectively. Children 4 to 17 years of age had the highest rates of intracranial complications, and children ≤3 years were most likely to undergo operative intervention. Any procedure was performed in 31.2% of cases, and undergoing myringotomy or mastoidectomy was associated with lower rates of readmission but higher rates of prolonged length of stay. Those with intracranial complications and subperiosteal abscesses had the highest surgical intervention rates.

Conclusions: Readmission, prolonged length of stay, and discharge to a rehabilitation facility are common in patients with acute mastoiditis with various sociodemographic and disease-related risk factors. While once a primarily surgical disease, a minority of patients in our cohort underwent procedures. Undergoing a surgical procedure was protective against readmission but a risk factor for prolonged length of stay.

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39
Neural Plast
. 2020 May 27;2020:5743972. doi: 10.1155/2020/5743972. eCollection 2020.
Repeated Galvanic Vestibular Stimulation Modified the Neuronal Potential in the Vestibular Nucleus
Gyutae Kim 1, Sangmin Lee 2, Kyu-Sung Kim 1 3
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PMID: 32565777 PMCID: PMC7273393 DOI: 10.1155/2020/5743972
Free PMC article
Abstract
Vestibular nucleus (VN) and cerebellar flocculus are known as the core candidates for the neuroplasticity of vestibular system. However, it has been still elusive how to induce the artificial neuroplasticity, especially caused by an electrical stimulation, and assess the neuronal information related with the plasticity. To understand the electrically induced neuroplasticity, the neuronal potentials in VN responding to the repeated electrical stimuli were examined. Galvanic vestibular stimulation (GVS) was applied to excite the neurons in VN, and their activities were measured by an extracellular neural recording technique. Thirty-eight neuronal responses (17 for the regular and 21 for irregular neurons) were recorded and examined the potentials before and after stimulation. Two-third of the population (63.2%, 24/38) modified the potentials under the GVS repetition before stimulation (p = 0.037), and more than half of the population (21/38, 55.3%) changed the potentials after stimulation (p = 0.209). On the other hand, the plasticity-related neuronal modulation was hardly observed in the temporal responses of the neurons. The modification of the active glutamate receptors was also investigated to see if the repeated stimulation changed the number of both types of glutamate receptors, and the results showed that AMPA and NMDA receptors decreased after the repeated stimuli by 28.32 and 16.09%, respectively, implying the modification in the neuronal amplitudes.

Copyright © 2020 Gyutae Kim et al.

Conflict of interest statement
There are no conflicts of interest regarding the publication of this study.

58 references7 figures
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40
Saudi J Biol Sci
. 2020 Jul;27(7):1710-1716. doi: 10.1016/j.sjbs.2020.04.045. Epub 2020 May 7.
The Potential Role of Pomegranate and Its Nano-Formulations on Cerebral Neurons in Aluminum Chloride Induced Alzheimer Rat Model
Mohammed S Almuhayawi 1, Wafaa S Ramadan 2 3, Steve Harakeh 4 5, Soad K Al Jaouni 6 5, Dhruba J Bharali 7 8, Shaker A Mousa 7 8, Saad M Almuhayawi 9
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PMID: 32565686 PMCID: PMC7296487 DOI: 10.1016/j.sjbs.2020.04.045
Free PMC article
Abstract
The oxidative stress leading to degenerative changes in the brain of Alzheimer's disease (AD) is evident. Our aim was to evaluate the therapeutic and protective effects of pomegranate extract (PE) and pomegranate extract-loaded nanoparticles (PE nano) in an AlCl 3-induced AD rat model. Nanoparticles were synthesized with a PE load of 0.68% w/w, and 70 male Wistar rats were divided into 7 groups: Group I was the control, Group II received PE., Group III received PE nano for 2 weeks, Group IV received AlCl 3 (50 mg/kg) daily orally for 4 weeks, Group V received PE for 2 weeks, Group VI received PE nano for 2 weeks, and Groups V and VI were started after AlCl 3 administration was stopped. Group VII received PE for 2 weeks and was stopped before AlCl 3 was administered. The Results revealed that the discrimination index in the novel object recognition test was the least in AD rat model but increased in cases protected with PE treated with PE nano. Similar results were shown based on calculating the brain weight/body weight percent. The biomarkers of antioxidant activity (catalase, glutathione and total antioxidant activity) in brain homogenate were significantly increased in groups treated with either PE or PE nano. The thiobarbituric acid reactive substance measured to estimate lipid peroxidation was significantly increased in AD rat model and decreased in groups protected with PE or treated with PE nano. Histopathological studies using hematoxylin and eosin, cresyl violet, and silver stains revealed hyaline degeneration, chromatolysis, and hallmarks of AD; neurofibrillary tangles and the senile plaques in brains of AD rat model. Restoration of the histological architecture, Nissl granules, and minimal appearance of hallmarks of AD characterized brains treated with PE or PE nano. In conclusion, PE was more effective as a protectant than a therapeutic measure in alleviating the antioxidant, lipid peroxidative effects and histopathological hallmarks in AD brains. But, the therapeutic PE-loaded nanoparticles increased the efficacy of active components and produced similar results as the protective PE.

Keywords: Alzheimer's; Antioxidant markers; Histopathology; Lipid peroxidation; Nanoformulations; Novel object recognition test; Pomegranate extract.

© 2020 The Authors.

Conflict of interest statement
The authors declared that there is no conflict of interest.

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41
Cir Cir
. 2020;88(4):453-460. doi: 10.24875/CIRU.19001111.
Treatment and Outcome in 12 Cases of Olfactory Neuroblastoma at Mexico´s National Cancer Institute: A Retrospective Clinical Analysis and Literature Review
José O Navarro-Fernández 1, Juan L Serrato-Avila 2, Mariana Hernández-Varela 3, Ma Fernanda Tejada-Pineda 4, Rodrigo E Hernández-Reséndiz 5, Alejandro Monroy-Sosa 1, Bernardo Cacho-Díaz 1, Ángel Herrera-Gómez 6, Gervith Reyes-Soto 1
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PMID: 32567594 DOI: 10.24875/CIRU.19001111
Abstract in English , Spanish
Introduction: Olfactory neuroblastoma (ONB) is a malignant neoplasm that arises from the upper nasal vault.

Objective: We present a retrospective case series and clinical analysis of 12 ONB cases.

Materials and methods: Patients with ONB treated at Mexico´s National Cancer Institute between 2011 and 2018.

Results: The Kadish proportion of B, C, and D stage was 16%, 58%, or 25%, respectively. Hyams Grade 1, 2, or 3 was 25%, 50%, and 25%, respectively. The most common surgical approach was the craniofacial in 5 cases (42%), followed by the transfacial in 4 cases (33%), and the endonasal endoscopic approach in 3 cases (25%). Gross total resection was achieved in 8 patients (67%). Five patients (42%) underwent a second operation due to recurrent/progressive disease. The surgical complication rate was 8.3%. Progression-free survival was 41 months and the mean overall survival was 63.6 months.

Conclusions: Surgical resection followed by radiotherapy, and chemotherapy for metastatic and recurrent disease provides the best outcome in terms of survival and recurrence. To the best of our knowledge, this is the first series of cases reported in Mexico.

Keywords: Abordaje craneofacial; Abordaje endoscópico endonasal; Base del cráneo; Craniofacial approach; Endoscopic endonasal approach.; Hyams; Kadish; Neuroblastoma olfatorio; Olfactory neuroblastoma; Skull base.

Copyright: © 2020 Permanyer.

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42
Int J Otolaryngol
. 2020 May 18;2020:8060971. doi: 10.1155/2020/8060971. eCollection 2020.
Comparison of Postoperative Pain and Appetite in Pediatric Patients Undergoing Monopolar Tonsillotomy and Cold Steel Tonsillectomy
Youssef El Sayed Ahmad 1 2, Jade Nehme 2 3, Nabil Moukarzel 2 3
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PMID: 32565818 PMCID: PMC7284958 DOI: 10.1155/2020/8060971
Free PMC article
Abstract
Objectives: Adenotonsillectomy (AT) is amongst the most widely performed pediatric surgeries in the United States (US) and the whole world. AT includes two major surgical techniques: total tonsillectomy (TT) and partial tonsillectomy (PT). Several studies have been conducted to evaluate the difference between TT and PT and assess the comparative effectiveness, benefits, and sequelae between both. In Lebanon, very few studies were done tackling this issue and assessing its sequelae on the pediatric population.

Methods: A prospective study was conducted including pediatric patients aged between 2 and 9 years, who were admitted for partial tonsillectomy (PT) or total tonsillectomy (TT) in 2018. An estimated number of children included were 50: 25 patients underwent PT and 25 patients underwent TT. Patients were sent home on day 1 post-op with a questionnaire that evaluates the following over the first 10 days post-op: pain using the Wong-Baker Faces Pain Rating Scale and the "Parents Postoperative Pain Measure" (PPPM) questionnaire, and appetite using the visual analogue scale (VAS).

Results: Patients in the PT group and in the TT group had no demographical differences in terms of age, BMI, exposure to smoking, area of living, and attending a day care center. Comparison between PT and TT revealed a significant difference in both pain and appetite scales. Patients who underwent PT had significantly lower PPPM scores on the 1st, 2nd, 4th, 5th, 6th, and 10th day after surgery compared to the TT patients. Further validation was revealed by the Wong-Baker Faces Pain Rating Scale, showing that the PT surgery group experienced significantly less postoperative pain compared to the TT surgery group. Assessing the appetite using the visual analogue scale favored PT over TT. Comparisons revealed that most PT patients returned to their normal eating habits starting at day 4 while this was applicable in the TT group at day 10. Postoperative pain improved from day 1 to day 10 in both surgical groups.

Conclusion: In conclusion, the recovery process after the PT surgery causes less postoperative morbidity, thus an earlier return to normal activity compared to the TT. The patients of the latter group are affected by more pain and less appetite over the first 10 days after the surgery.

Copyright © 2020 Youssef El Sayed Ahmad et al.

Conflict of interest statement
The authors declare that there are no conflicts of interest.

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43
Subst Use Misuse
. 2020;55(9):1501-1508. doi: 10.1080/10826084.2020.1750031.
Effects of Betel Quid, Smoking and Alcohol on Oral Cancer Risk: A Case-Control Study in Hunan Province, China
Yina Hu 1, Rui Zhong 2, Hongyan Li 1, Yanhui Zou 3
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PMID: 32569534 DOI: 10.1080/10826084.2020.1750031
Abstract
Background: The high prevalence of betel quid chewing is associated with a serious burden of oral diseases. However, there is limitertd research on the effects of betel quid, smoking, and alcohol on oral cancer in the Hunan province, China. Objectives: We investigated the relationship between oral cancer and betel quid chewing, smoking, and alcohol consumption in the betel quid endemic area of Hunan province. Methods: A paired case-control study from January 2014 to September 2015 was conducted in the Hunan province, China. We recruited 304 oral cancer patients and 304 controls as subjects, and both groups were treated in the same provincial cancer hospital. Control subjects and cancer patients were matched by sex, age (3-year groups), education level, and residential district. Conditional logistic regression analyses were used to examine the associations between oral cancer and betel quid, smoking, and alcohol consumption. Results: A significantly increased risk of oral cancer was associated with smoking, alcohol consumption, and betel quid chewing (odds ratio [OR] of 1.49, 1.56, and 5.80, respectively; p < .05). The risk of cancer was significantly elevated at high levels of intake and prolonged duration of consumption of betel quid, smoking, and alcohol. After adjusting for confounders, betel quid chewers were found to have almost 5 times increased risk for oral cancer (OR = 5.41, 95% confidence interval: 3.32-8.80, p < .001). Conclusions: There was a positive correlation between betel quid chewing and risk of oral cancer in the Hunan Province.

Keywords: Hunan province; Oral cancer; alcohol drinking; betel quid chewing; smoking.

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44
J Craniofac Surg
. 2020 Jun 15. doi: 10.1097/SCS.0000000000006708. Online ahead of print.
Breast Cancer Metastases to the Paranasal Sinuses Mimicking Inflammatory Sinus Disease
Jennifer L Harb 1, Ameer T Shah, Miriam A O'Leary, Elie E Rebeiz
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PMID: 32569060 DOI: 10.1097/SCS.0000000000006708
Abstract
Introduction: Breast cancer is one of the most common cancers in women. Metastatic disease is a leading cause of morbidity and mortality. It frequently metastasizes to bone, lungs, regional lymph nodes, liver and brain. Metastasis to the orbit and paranasal sinuses is uncommon. Patients presenting with sinus pain, nasal congestion, or visual disturbance can be misdiagnosed with an infectious process.

Methods: The authors describe 2 patients with metastatic breast cancer to the paranasal sinuses presenting with signs and symptoms of sinusitis and orbit pathology unresponsive to antibiotics. The authors discuss diagnostic strategy and perform a literature review. Both patients had biopsy-proven metastatic breast adenocarcinoma lesions, and subsequently underwent various treatment options.

Results: A literature review reveals that metastatic breast adenocarcinoma lesions to the paranasal sinuses are a rare entity that commonly denotes a very poor prognosis. These lesions can significantly affect one's quality of life, and can cause blurry vision, diplopia, proptosis, sinus pressure and pain, nasal congestion, mandibular misalignment or difficulty with mastication. However, early diagnosis and treatment of these lesions can lead to prolonged survival and improved quality of life. If the lesion is surgically resectable, endoscopic sinus surgery is generally considered to be the optimal treatment. However, radiotherapy, chemotherapy, and immunotherapy can potentially play a role in controlling the symptomatology.

Conclusion: Metastatic lesions to the paranasal sinuses are a rare entity that should be considered in the appropriate clinical setting in order to expedite the proper treatment modality for improved morbidity and mortality.

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45
Am J Rhinol Allergy
. 2020 Jun 20;1945892420930945. doi: 10.1177/1945892420930945. Online ahead of print.
Differences in Mechanisms of Steroid Therapy and Olfactory Training for Olfactory Loss in Mice
Boo-Young Kim 1, Ju Yeon Park 2, EuiJin Kim 2
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PMID: 32564682 DOI: 10.1177/1945892420930945
Abstract
Objective: Steroid therapy and olfactory training are common treatments for olfactory loss. Systemic steroid treatment is the most effective approach for treating sinonasal olfactory loss. Olfactory training is typically effective for treating sensorineural olfactory loss. However, the differences in mechanisms of steroid therapy and olfactory training for olfactory dysfunction are unclear. The aim of this study was thus to evaluate the differences in mechanisms of olfactory training and steroid therapy.

Subjects and methods: Mice in each group were administered 3-methylindole at a dose of 300 mg/kg. Olfactory function was evaluated with a food-finding test once a week. The olfactory neuroepithelium was harvested for histologic examination and protein analysis. Subsequently, data analysis, gene ontology and pathway analysis, quantitative real-time polymerase chain reaction of mRNA, and western blot analysis were conducted.

Results: Mice were divided into four groups according to treatment. Control, anosmia, training, and steroid groups resumed food-finding. MMP27, CCL22 and IL18rap mRNA expression were significantly increased in the training group compared to that in the steroid group. IL1R2 mRNA expression was significantly higher in the olfactory neuroepithelium of steroid-treated mice than in that of the training group mice.

Conclusions: Steroid therapy improved olfactory function via anti-inflammatory effects, unlike olfactory training which involved cell regeneration and tissue remodeling. Protein and gene analyses revealed that steroid therapy and olfactory training are underpinned by distinct mechanisms. Selection of the most appropriate treatment will be dependent on the cause of olfactory loss.

Keywords: olfactory disturbance; olfactory training; steroid.

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46
Oncol Lett
. 2020 Jul;20(1):921-930. doi: 10.3892/ol.2020.11628. Epub 2020 May 14.
Comparison of Long-Term Treatment Outcomes of T2N0M0 Laryngeal Squamous Cell Carcinoma Using Different Treatment Methods
Eun Kyung Jung 1, Seong-Min Jin 1, Jae-Gu Kim 1, Jae-Uk Jung 2, Dong Hoon Lee 1, Joon Kyoo Lee 1, Sang Chul Lim 1, Woong-Ki Chung 2, Hee Kyung Kim 3, Jun-Eul Hwang 3, Hyun-Jeong Shim 3, Woo-Kyun Bae 3, Sang-Hee Cho 3, Ik-Joo Chung 3, Tae Mi Yoon 1
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PMID: 32566021 PMCID: PMC7285832 DOI: 10.3892/ol.2020.11628
Free PMC article
Abstract
Early [stage I and II (T2N0M0)] laryngeal cancer types are currently recommended to be treated with a single modality, consisting of definitive radiation therapy or larynx-preserving surgery. Although the treatment outcomes of stage I are good, the frequency of successful outcomes decreases with T2N0M0. Therefore, the present study investigated the treatment outcomes of different treatment methods in T2N0M0 laryngeal cancer. In total, 83 patients with previously untreated T2N0M0 laryngeal squamous cell carcinoma were enrolled. Patients were grouped by treatment method: Radiation therapy (RT; 27 patients); chemoradiotherapy (CRT; 46 patients) with cisplatin base; and surgery-based therapy (SBT; ten patients). The recurrence rates of the RT, CRT and SBT groups were 44.4, 19.6 and 50%, respectively. Moreover, the local control rates of the RT, CRT and SBT groups were 55.6, 87.0 and 80%, respectively. The CRT group had a significantly lower recurrence rate and higher local control rate compared with the RT group (P<0.05). In the survival analysis, overall and disease-specific survival rate did not differ significantly among the treatment groups. However, 3- and 5-year disease-free survival rates (DFS) of the RT group were both 55%, those of the SBT group were both 50% and those of the CRT group were both 80%. Furthermore, the DFS was significantly higher in CRT group compared with the other groups (P=0.02). Using multivariate analysis with Cox regression, it was found that the treatment method was the most important factor for DFS and had a significant impact in the CRT group. In addition, in patients with glottic cancer with anterior commissure and subglottic invasion, the CRT group had significantly improved DFS compared with the RT group, whereas there was no significant difference between the two groups in patients without subglottic invasion. According to National Cancer Institution Common Toxicity Criteria (version 5.0), more patients had toxicity in the CRT group compared with the RT group. However, in the RT and CRT groups, no patients demonstrated mortality due to toxicity, and treatment-related toxicities were manageable. Collectively, although definitive conclusions could not be established, due to the limitations of this retrospective study, the results suggest that CRT had a positive impact on the local control and DFS rates with manageable toxicity in patients with T2N0M0 laryngeal cancer.

Keywords: chemoradiotherapy; disease-free survival; laryngeal neoplasms; radiotherapy; survival rate.

Copyright © 2020, Spandidos Publications.

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47
Oncol Lett
. 2020 Jul;20(1):907-913. doi: 10.3892/ol.2020.11620. Epub 2020 May 14.
Expression of lncRNA-HOTAIR in the Serum of Patients With Lymph Node Metastasis of Papillary Thyroid Carcinoma and Its Impact
Lan Wu 1, Yanqing Shi 1, Baoguo Liu 2, Mengting Zhao 1
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PMID: 32566019 PMCID: PMC7285833 DOI: 10.3892/ol.2020.11620
Free PMC article
Abstract
The present study aimed to investigate the expression of long non-coding HOX transcript antisense RNA (lncRNA-HOTAIR) in the serum of patients with lymph node metastasis of papillary thyroid carcinoma (PTC) and the underlying mechanism. A total of 89 patients with PTC at Beijing Geriatric Hospital were recruited in this study. Based on the results of color Doppler ultrasound examination, the patients were evaluated for cervical lymph node metastases, and were thereby divided into a metastasis-negative group and a metastasis-positive group. Quantitative fluorescent PCR was used to assess the expression of HOTAIR in serum samples. The PTC cell line TPC-1 was randomly divided into a control and siRNA group. The control group was transfected with a nonsense sequence, while the siRNA group was transfected with si-HOTAIR. After transfection, cell proliferation was evaluated using the MTT assay, and cell migration and invasion were assessed using the cell scratch assay and Transwell assay. Expression levels of vimentin, E-cadherin and proteins associated with the Wnt/β-catenin signaling pathway were assessed using western blot analysis. Based on the results of the ultrasound examination, 53 patients were allocated to the metastasis-negative group, and 36 to the metastasis-positive group. The expression level of lncRNA-HOTAIR was higher in the metastasis-positive group than that in the metastasis-negative group (P<0.05). Compared with the control group, cell proliferation was reduced while cell migration rate and the number of migrating cells were increased in the siRNA group. Compared with the control group, the expression levels of WIF1 and E-cadherin were significantly increased, while the levels of β-catenin and vimentin were significantly decreased. In conclusion, lncRNA-HOTAIR is overexpressed in the serum of patients with lymph node metastasis of PTC. In vitro experiments showed that HOTAIR promoted the proliferation and metastasis of PTC cells by regulating epithelial-mesenchymal transition (EMT) mediated by the Wnt/catenin pathway. Thus, lncRNA-HOTAIR is proposed as a molecular target for the treatment of lymph node metastasis of PTC.

Keywords: HOTAIR; lncRNA; lymph node metastasis; papillary thyroid carcinoma; ultrasound.

Copyright: © Wu et al.

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48
Medicine (Baltimore)
. 2020 Jun 19;99(25):e20818. doi: 10.1097/MD.0000000000020818.
Eagle Syndrome After a Fracture of Complete Ossified Stylohyoid Ligament From Indirect Trauma Treated Using Local Steroid Injection: A Case Report
Yong Won Lee 1, Jihyun Chung 2 3
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PMID: 32569230 DOI: 10.1097/MD.0000000000020818
Free article
Abstract
Rationale: Stylohyoid complex syndrome is characterized by various cervicopharyngeal symptoms related to the ossification and abnormality of the styloid process, stylohyoid ligament, and the lesser horn of the hyoid bone. Eagle syndrome is the most well-known of the spectra of these diseases. Although surgical treatment is considered effective, conservative treatment may be beneficial if symptoms arise because of inflammation of the soft tissues attached to the styloid process or hyoid bone.

Patient concerns: A 68-year-old man presented with pain in the right side of the neck and odynophagia after trauma on his philtrum. He was diagnosed with Eagle syndrome elicited by a fracture from indirect trauma. Despite analgesic medication and physiotherapy, the pain had somewhat relieved but persisted for 1 year.

Diagnosis: Computed tomography revealed complete ossification of the bilateral stylohyoid complex. A fracture was observed in the ampulla on the right side of the neck. One year later, the fracture resolved by complete union.

Interventions: Ultrasonography was performed and abnormal ossification was observed on the right side of the neck. Five milligrams of dexamethasone at a concentration of 1 kg/m was slowly injected into the tender point under ultrasonographic guidance.

Outcomes: The patient reported immediate reduction of pain and was satisfied with the resolution. No recurrence was observed during a 6-month follow-up period.

Lessons: Although traumatic fracture of the ossified ligament elicited the syndrome, the results were satisfactory because the origin of the patient's pain was presumed to arise from inflammatory conditions. This case demonstrates that treatment with local steroid injection may be appropriate for patients who present with pain originating from muscles and ligaments.

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49
Comparative Study J Otolaryngol Head Neck Surg
. 2019 Sep 6;48(1):46. doi: 10.1186/s40463-019-0361-8.
Electrophysiological Measurements With Electrode Types of Different Perimodiolar Properties and the Same Cochlear Implant Electronics - A Retrospective Comparison Study
A Perenyi 1, F Toth 2, B Dimak 2, R Nagy 2, P Schoerg 3, J Jori 2, J G Kiss 2, G Sprinzl 3, M Csanady 2, L Rovo 2
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PMID: 31492190 PMCID: PMC6731597 DOI: 10.1186/s40463-019-0361-8
Free PMC article
Abstract
No abstract available
Keywords: CI512; CI522; CI532; Cochlear implant; Electrode array; Electrophysiology; Perimodiolar.

Conflict of interest statement
The authors declare that they have no competing interests.

29 references4 figures
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50
Otol Neurotol
. 2020 Jun 18. doi: 10.1097/MAO.0000000000002723. Online ahead of print.
Necrotizing Otitis Externa: A Systematic Review and Analysis of Changing Trends
Young Jae Byun 1 2, Jaimin Patel 1, Shaun A Nguyen 1, Paul R Lambert 1
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PMID: 32569149 DOI: 10.1097/MAO.0000000000002723
Abstract
Objective: To assess for changes in trends of the disease process, management, and outcomes of necrotizing otitis externa (NOE) over the last decade.

Data sources: Articles in English, published between January 2011 and June 2019, were searched in PubMed, Scopus, Web of Science, ScienceDirect, and the Cochrane Database.

Study selection: Inclusion criteria: 1) reported evidence of NOE, 2) details on patient demographic and underlying medical disorder, 3) details on treatments, 4) documented outcomes, and 5) greater than 10 cases.

Data extraction: Study demographics, underlying conditions, infectious etiology, treatments, signs and symptoms, and outcomes.

Data synthesis: Ten studies, totalling 284 patients with a mean age of 67.8 years, were included. The time period of collected patient data ranged from 2000 to 2018. Temporal subgroup analysis was conducted before and after 2009. Cure rate was lower in the post-2009 group (76.0 versus 94.1%, p < 0.01) while disease-specific mortality remained stable. Increases in proportions of diabetes and culture negative results (p < 0.01) were also observed in this latter group. Rate of extensive surgery and the use of ciprofloxacin decreased (p < 0.01), while the use of ceftazidime increased in the post-2009 group (p < 0.01).

Conclusion: A decrease in cure rate of NOE patients was observed in the setting of an increase in prevalence of diabetes. Various antipseudomonal agents are being used and an increase in culture negative results is seen.

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51
Cancer Biomark
. 2020 Jun 12. doi: 10.3233/CBM-191362. Online ahead of print.
MicroRNA-134 Inhibits Tumor Stem Cell Migration and Invasion in Oral Squamous Cell Carcinomas via Downregulation of PI3K-Akt Signaling Pathway by Inhibiting LAMC2 Expression
Yong-Mei Zhou 1 2 3 1, Yi-Lin Yao 2 3 1, Wei Liu 3 4, Xue-Min Shen 2 3, Lin-Jun Shi 2 3, Lan Wu 2 3
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PMID: 32568182 DOI: 10.3233/CBM-191362
Abstract
Background: Oral squamous cell carcinoma (OSCC) is the most common malignant neoplasm of the mouth. Some studies have found that multiple microRNAs (miRs) participate in OSCC physiological and pathological processes.

Methods: We explored the mechanism of action of miR-134 in OSCC involving the PI3K-Akt signaling pathway. Different bioinformatics methods were used to analyze the potential genes and their related miRs in OSCC. Tumor stem cells were separated from OSCCs through magnetic cell sorting. Regulatory pattern between miR-134 and LAMC2 in OSCC was evaluated by ectopic expression, knockdown and reporter assay experiments. The expression of miR-134, LAMC2, genes in PI3K-Akt signaling pathway, and apoptosis-related genes was detected. Cell proliferation was assessed by MTT assay, cell invasion by scratch test, cell migration by Transwell assay, cell cycle and apoptosis by flow cytometry, and cell growth and migration by xenograft tumor in nude mice. LAMC2 was predicted as the crucial factor related to OSCC using different chip data, and miR-134 was predicted to specifically bind LAMC2 in all five databases.

Results: Overexpressed miR-134 or silenced LAMC2 was observed to inhibit cell proliferation, migration, invasion of OSCC cells, growth of subcutaneous xenograft in nude mice, as well as promote OSCC cell apoptosis. LAMC2, a target gene of miR-134, decreased following miR-134 promotion, while the PI3K-Akt signaling pathway was inactivated following LAMC2 knockdown. Furthermore, we also observed that the effect of overexpressed miR-134 was enhanced when LAMC2 was knocked down.

Conclusions: Taken together, these findings suggest that miR-134-mediated direct downregulation of LAMC2 inhibits migration and invasion of tumor stem cells in OSCC by suppressing the PI3K-Akt signaling pathway.

Keywords: LAMC2; MicroRNA-134; PI3K-Akt signaling pathway; cell invasion; cell migration; oral squamous cell carcinoma.

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52
Oncol Lett
. 2020 Jul;20(1):774-784. doi: 10.3892/ol.2020.11595. Epub 2020 May 7.
Long Non-Coding RNA AC023794.4-201 Exerts a Tumor-Suppressive Function in Laryngeal Squamous Cell Cancer and May Serve as a Potential Prognostic Biomarker
Zhisen Shen 1, Jie Yuan 1 2, Qiaoling Tong 3, Wenjuan Hao 1, Hongxia Deng 1, Qun Li 1, Chongchang Zhou 1, Yan Hu 1 2, Jie Xu 1 2
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PMID: 32566004 PMCID: PMC7286120 DOI: 10.3892/ol.2020.11595
Free PMC article
Abstract
After the expression level of lncRNA AC023794.4-201 was upregulated in 2 laryngeal squamous cell carcinoma (LSCC) cell lines (AMC-HN-8 and TU-212) and LSCC xenografts, the biological function of lncRNA AC023794.4-201 in LSCC was further investigated using in vitro and in vivo experiments, such as cell function experiments and nude mice transplantation. In our previous study, it was demonstrated that the expression level of the long non-coding RNA (lncRNA) AC023794.4-201 were decreased in laryngeal squamous cell carcinoma, particularly in cases of LSCC with lymphatic metastasis. Moreover, low expression levels of AC023794.4-201 were revealed to be an adverse prognostic factor for patients with LSCC. In the present study, lentiviruses were used to overexpress AC023794.4-201 before a series of cell function assays were performed and a xenograft nude mouse model was constructed, in order to further investigate the functions of AC023794.4-201 in LSCC. AC023794.4-201 inhibited the proliferation and the cloning capacity of LSCC cells compared with the negative control group as indicated by real-time cell analysis and the plate colony formation assay. Flow cytometry and transwell migration assays demonstrated that AC023794.4-201 inhibited the migration, induced cell cycle arrest and increased the apoptotic rate of LSCC cells. The results of the in vivo studies demonstrated that AC023794.4-201 significantly inhibited the growth of LSCC xenografts, and promoted apoptosis. In conclusion, the findings of the present study suggested that AC023794.4-201 may exert tumor-suppressive functions in the progression of LSCC and may serve as a potential prognostic biomarker for LSCC.

Keywords: AC023794.4-201; laryngeal squamous cell carcinoma; long non-coding RNA; prognostic biomarker.

Copyright: © Shen et al.

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53
Ann Otol Rhinol Laryngol
. 2020 Jun 21;3489420936711. doi: 10.1177/0003489420936711. Online ahead of print.
Adult Palatopharyngoplasty: Trends in Morbidity and Mortality From the NSQIP Database
Christopher Gates 1, Jad Ramadan 2, Steven Coutras 3, Michele Carr 4
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PMID: 32567393 DOI: 10.1177/0003489420936711
Abstract
Objectives: Describe the postop morbidity of adults undergoing palatopharyngoplasty (PPP).

Method: Adults who underwent PPP were studied using ACS-NSQIP (American College of Surgeons National Surgical Quality Improvement Program) database (2016-2017) via CPT code 42145. Analyzed outcomes included length of stay (LOS), readmission, reoperation, and postop complications. Predictive variables were age, gender, BMI, comorbidities.

Results: A total of 1081 patients (73.7% male, mean age 42.0 years, range 18-79 years) were included. 95 (8.8%) were diabetic, 183 (16.9%) were smokers, 30 (2.8%) had preoperative dyspnea. 328 (30.3%) took medicine for hypertension. Concurrent procedures occurred in 646 (59.76%), 357 (33.02%) had nasal procedures, 320 (29.60%) had tonsil procedures, 66 (6.11%) had tongue procedures. Within 30 days postop, there were two (0.19%) mortalities. Complications included six wound infections, two dehiscences, four with pneumonia, two pulmonary embolisms, three myocardial infarctions, one DVT, three sepsis, one UTI, one who required CPR, and two who were ventilated for >48 hours. Five required reintubation. A total of 41 (3.79%) returned to OR for a related reason, at least 27 (65.90%) for bleeding. LOS ranged from 0 to 15 days, median 1 day. Overall 38 (3.52%) were readmitted for a related reason, 12 (31.58%) for bleeding and three (7.89%) for pain. Using a significance level of 0.002 (Bonferroni correction), LOS varied with presence of any concurrent procedure, BMI, and estimated probability of mortality and morbidity indices; readmission and reoperation had no significantly associated variables.

Conclusion: PPP is associated with low frequency but significant morbidity and mortality.

Keywords: obstructive sleep apnea; quality improvement; surgical complications; uvulopalatopharyngoplasty.

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54
Mol Genet Genomic Med
. 2020 Jun 22;e1367. doi: 10.1002/mgg3.1367. Online ahead of print.
Recurrent De Novo WFS1 Pathogenic Variants in Chinese Sporadic Patients With Nonsyndromic Sensorineural Hearing Loss
Jing Guan 1 2 3 4, Hongyang Wang 1 2 3 4, Lan Lan 1 2 3 4, Yusen Wu 1 2 3 4, Guohui Chen 1 2 3 4, Cui Zhao 1 2 3 4, Dayong Wang 1 2 3 4, Qiuju Wang 1 2 3 4
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PMID: 32567228 DOI: 10.1002/mgg3.1367
Free article
Abstract
Background: Hereditary hearing loss (HL) is heterogeneous in terms of their phenotypic features, modes of inheritance, and causative gene mutations. The contribution of genetic variants to sporadic HL remains largely expanding. Either recessive or de novo dominant variants could result in an apparently sporadic occurrence of HL. In an attempt to find such variants we recruited 128 Chinese patients with sporadic nonsyndromic sensorineural HL (NSHL) and performed targeted deafness multigene sequencing in these unrelated trios-families to elucidate the molecular basis.

Methods: We analyzed a total of 384 available members (probands and their two parents) from 128 unrelated Chinese families presenting with bilateral sensorineural HL, in which previous screening had found no mutations with the GJB2, SLC26A4, and MT-RNR1 genes. We used a targeted genomic enrichment platform to simultaneously capture exons, splicing sites, and immediate flanking intron sequences of 127 known deafness genes. Sanger sequencing was used to identify probands and their two parents segregating causative variants in the candidate gene.

Results: We observed that two heterozygous de novo WFS1 mutations in exon 8: c.2051C>T (p.A684V) and c.2590G>A (p.E864K) in five families. The two de novo WFS1 mutations were found in 3.9% (5/128) of sporadic HL patients. We found that four of the five patients had the same de novo p.A684V mutation, and their audiograms showed symmetrical bilateral and profound sensorineural hearing impairments at all frequencies, but only the proband with de novo p.E864K mutation demonstrated significantly bilateral moderate low-mid frequency sensorineural HL. Our data suggest that this WFS1 p.A684V is likely to be a de novo mutational hot spot.

Conclusions: We found 3.9% (5/128) of sporadic NSHL is caused by de novo WFS1 mutations. Our data provide that the de novo p.E864K mutation is first identified and de novo p.A684V mutation is likely to be a mutational hot spot in WFS1. It is the first study to highlight that WFS1 gene with the two de novo mutations has been indicated to classify the distinct hearing impairment phenotypes. Furthermore, de novo p.A684V serves as a WFS1 mutational hot spot that was found in the Chinese population with sporadic childhood NSHL, and our study also provides pointers toward the necessity for sequencing of asymptomatic parents of a sporadic case with an apparent dominant pathogenic variant.

Keywords: WFS1; de novo mutation; nonsyndromic hearing loss.

© 2020 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals LLC.

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55
Cell Death Discov
. 2020 Jun 11;6:47. doi: 10.1038/s41420-020-0273-4. eCollection 2020.
Zoledronic Acid Regulates the Synthesis and Secretion of IL-1β Through Histone Methylation in Macrophages
Xiaojie Yang 1, Xing Xu 2, Jun Chen 2, Qing Wang 1, Guangfei Wang 1, Xuemin Ai 1, Xu Wang 2, Jinsong Pan 1
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PMID: 32566254 PMCID: PMC7289826 DOI: 10.1038/s41420-020-0273-4
Free PMC article
Abstract
Long-term administration of nitrogen-containing bisphosphonates increases the risk of detrimental side effects, such as bisphosphonate-related osteonecrosis of the jaw (BRONJ). BRONJ development is associated with inflammation, but its pathophysiology remains unknown. Here, we examined whether histone methylation is responsible for zoledronic acid (Zol)-induced inflammatory responses. We found that Kdm6a and Kdm6b markedly increased interleukin 1β expression and Gasdermin D cleavage, which are both activated by Caspase 1, in macrophages. Inhibitors of Kdm6a and Kdm6b robustly abolished Zol-enhanced interleukin 1β synthesis and secretion from macrophages. When Kdm6a and Kdm6b were pharmacologically inhibited in vivo, poor healing of the alveolar socket and inflammatory responses were ameliorated in Zol-treated mice. Taken together, we showed the pathologic role of Kdm6a and Kdm6b in Zol-promoted inflammatory responses and demonstrated that Kdm6a and Kdm6b are potential therapeutic targets for the treatment of BRONJ.

Keywords: Epigenetics; Inflammation.

© The Author(s) 2020.

Conflict of interest statement
Conflict of interestThe authors declare no conflict of interest.

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56
Am J Pathol
. 2020 Jun;190(6):1332-1342. doi: 10.1016/j.ajpath.2020.01.017. Epub 2020 Mar 16.
Specific Deletion of p16 INK4a With Retention of p19 ARF Enhances the Development of Invasive Oral Squamous Cell Carcinoma
Kazuhisa Ishida 1, Hiroyuki Tomita 2, Tomohiro Kanayama 3, Kei Noguchi 3, Ayumi Niwa 3, Masaya Kawaguchi 4, Masafumi Miyai 5, Mikiko Matsuo 3, Yuko Imaizumi 3, Keizo Kato 6, Yuichiro Hatano 3, Akihiro Hirata 7, Hideshi Okada 8, Toshiyuki Shibata 6, Akira Hara 3
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PMID: 32194051 DOI: 10.1016/j.ajpath.2020.01.017
Free article
Abstract
The cyclin-dependent kinase inhibitor 2A (CDKN2A)/alternate reading frame (ARF) locus consists of two overlapping tumor suppressor genes, p16INK4a and p14ARF (p19ARF in mice), encoding two unrelated proteins in alternative reading frames. Previous reports suggest that p16INK4a and p14ARF alterations independently exhibit differential roles, and p16INK4a is more closely associated with a poor prognosis in oral cancer. However, the role of p16INK4a-specific loss in oral squamous cell carcinogenesis remains unclear. The authors assessed chemical carcinogen 4-nitroquinoline 1-oxide (4NQO)-induced multistep oral squamous cell carcinogenesis in mice carrying p16INK4a-specific loss with retention of the p19ARF gene (p16INK4a-/-). 4NQO-treated p16-/- mice exhibited a higher incidence and multiplicity of oral squamous cell carcinoma (OSCC) development relative to 4NQO-treated wild-type mice. 4NQO-treated p16INK4a-/- OSCC cells exhibited higher proliferation and up-regulation of Arf, transcription factor E2f1, tumor protein p63 (tp63), and oncogenic ΔNp63, an isoform p63, compared with observations in 4NQO-treated wild-type OSCC cells. Furthermore, the overexpression of oncogenic ΔNp63 was associated with human OSCC. In conclusion, these results in mice indicate the biological significance of p16INK4a-specific loss with retention of p19ARF in oral squamous cell carcinogenesis, and ΔNp63 may be a potential target for OSCC.

Copyright © 2020 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

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57
Acta Otolaryngol
. 2020 Jun 21;1-5. doi: 10.1080/00016489.2020.1776385. Online ahead of print.
Current Status on Researches of Meniere's Disease: A Review
Yupeng Liu 1 2 3, Jun Yang 1 2 3, Maoli Duan 4 5
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PMID: 32564698 DOI: 10.1080/00016489.2020.1776385
Abstract
Background: Meniere's disease (MD) is a complex and multifactorial inner ear disease. The etiology of MD is unclear. Significant progress had been made in diagnosis and treatment. Complete cure for this disease is still impossible.Objectives: This review covers the updated research results in MD in the past decades.Material and methods: Recent publications were critically reviewed.Results: The relationship between Endolymphatic hydrops and Meniere symptoms requires further study. Direct visualization of EH is achieved by special sequences of inner ear MRI. Appearance of EH could be observed in MD patients both in symptomatic and asymptomatic ears. Visualization of EH in vivo might make a great substantial improvement in diagnose of MD. The first goal of the management of MD is to reduce the attack frequency. Several safe and effective medical and surgical therapies are practiced to help patients to control vertigo and preserve hearing.Conclusions and significance: There has been no major breakthrough in the pathogenesis research of MD in recent years. Visualization of EH in vivo might make a great substantial improvement in diagnose of MD. Clinicians still have few effective ways to alleviate the progress of the disease.

Keywords: Meniere’s disease; diagnosis; mechanism; treatment.

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58
Otol Neurotol
. 2020 Jun 16. doi: 10.1097/MAO.0000000000002698. Online ahead of print.
Gentamicin Vestibulotoxicity: Further Insights From a Large Clinical Series
Terence S Fu 1, Simon D Carr 1, Paul Douglas-Jones 1, Wanda Dillon 1, Ophir Ilan 1, Iqbal Mohammed Syed 1, Jerome Leis 2, Wayne Gold 2, David D Pothier 1, John A Rutka 1
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PMID: 32569143 DOI: 10.1097/MAO.0000000000002698
Abstract
Objective: To review insights gained from a 21-year experience with gentamicin-induced vestibulotoxicity including differences in vestibulotoxicity between single daily dosing (SDD) and multiple daily dosing (MDD) regimens.

Study design: Retrospective case series.

Setting: Tertiary care center.

Patients: Patients with gentamicin vestibulotoxicity referred to the Hertz Multidisciplinary Neurotology Clinic between January 1993 and September 2014.

Intervention: None.

Main outcome measures: Spectrum of vestibular dysfunction measured using videonystagmography, vestibular evoked myogenic potentials, video head impulse testing, and magnetic scleral search coil testing.

Results: Of 53 patients with gentamicin-induced vestibulotoxicity, 24 received SDD and 29 received MDD treatment. The most common indications for treatment were sepsis, endocarditis, and osteomyelitis. Angular acceleration receptor function (semicircular canals) was more commonly affected than linear acceleration receptor function (otolithic organ of the saccule; 100% vs. 62%). A significant proportion of patients (53%) developed vestibulotoxicity in the absence of nephrotoxicity and 40% experienced vestibulotoxicity in a delayed fashion up to 10 days posttreatment cessation (mean 3.9 ± 0.7). Therapeutic monitoring did not necessarily prevent delayed vestibulotoxicity. Nephrotoxicity was less common for SDD compared with MDD (60% vs. 35%, p = 0.01). However, the SDD group experienced vestibulotoxicity at a lower cumulative dose (6.3 vs. 7.0 g, p = 0.04) and shorter duration of therapy (20.7 vs 29.4 d, p = 0.02).

Conclusions: Our study further highlights important insights regarding gentamicin-induced vestibulotoxicity. While SDD is associated with decreased risk for nephrotoxicity compared with MDD, it confers a higher risk for vestibulotoxicity.

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59
Br J Neurosurg
. 2020 Jun 22;1-7. doi: 10.1080/02688697.2020.1779178. Online ahead of print.
Arachnoid Prolapse in Endoscopic Transsphenoidal Surgery of Pituitary Adenoma, Technical Note
Guive Sharifi 1 2, Nader Akbari Dilmaghani 2 3, Seyed Mousa Sadrhosseini 4, Shima Arastou 2
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PMID: 32567376 DOI: 10.1080/02688697.2020.1779178
Abstract
Purpose: An arachnoid prolapse after endoscopic transsphenoidal surgery for a pituitary adenoma is an uncommon, but important, phenomenon which should be managed. We have evaluated the efficacy of a new simple technique to correct the prolapsed arachnoid following endoscopic surgery of pituitary adenomas.Methods: A total of 1352 patients with pituitary adenomas, 24-76 years old, who underwent full endoscopic transsphenoidal surgeries between February 2014 and February 2019 in Erfan and Loghman Hakim hospitals. 46 patients with arachnoid prolapse participated in this study and41 patients completed the study. Arachnoid prolapse was repaired by bipolar cauterization with either autologous fat grafts (36 patients) or without autologous fat grafts (5patients).Results: Of 41 patients who completed the study, all except one, had large adenomas with significant suprasellar extension and enlarged diaphragma sellae. All patients had arachnoid prolapse at the end of the tumor removal stage and 13 patients had very minor intraoperative CSF leakage. Prolapsed arachnoid was repaired using a bipolar cautery with or without the autologous fat graft. During the postoperative follow-up period, none of the patient experienced early or delayed postoperative CSF leakage, meningitis, visual deterioration, delayed epistaxis, cranial nerve palsy, recurrence, or death.Conclusion: Bipolar cauterization is a safe, effective technique to repair a suprasellar arachnoid prolapse during reconstruction of the sellar floor following endoscopic transsphenoidal pituitary surgery.

Keywords: Arachnoid; adenoma; pituitary.

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60
Otol Neurotol
. 2020 Jul;41(6):e686-e694. doi: 10.1097/MAO.0000000000002638.
Assessing Cochlear Implant Insertion Angle From an Intraoperative X-ray Using a Rotating 3D Helical Scala Tympani Model
Christopher K Giardina 1 2, Michael W Canfarotta 1, Nicholas J Thompson 1, Douglas C Fitzpatrick 1, Sarah E Hodge 1, Jenna Baker 1, Brendan P O'Connell 1
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PMID: 32569244 DOI: 10.1097/MAO.0000000000002638
Abstract
Background: Angular insertion depth (AID) of the electrode array provides valuable information regarding intracochlear positioning, which can be used to predict outcomes and optimize performance. While computed tomography (CT) offers high-resolution imaging, there is a need to develop technology to accurately determine AID from intraoperative x-rays acquired at unknown angles.

Methods: An algorithm was developed using a three-dimensional model of the scala tympani to estimate AID from an x-ray acquired at an unknown angle. The model is manipulated over the x-ray until the projection angle is inferred and the location of the round window and individual electrode contacts are identified. Validation of the algorithm involved 1) assessing accuracy with deviation from cochlear view by comparing AID determined with simulated x-rays to those determined with CT in a temporal bone model, and 2) assessing reproducibility in the clinical setting, by comparing intra- and inter-rater reliability with intraoperative x-ray in cochlear implant (CI) recipients, which were subsequently compared to AID determined with postoperative CT.

Results: Estimates of AID from x-rays were generally within 10 degrees of CT regardless of deviation from cochlear view. Excluding two outliers with poor imaging quality, the intraclass correlation coefficients for intra- and inter-rater reliability were excellent (0.991 and 0.980, respectively).

Conclusion: With intraoperative x-rays of sufficient quality, the helical scala tympani model can be used to accurately and reliably determine AID without the need to specify a preferred image angle. The application can therefore be used in most CI recipients when a postoperative CT is not available.

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61
Ann Otol Rhinol Laryngol
. 2020 Jun 21;3489420936713. doi: 10.1177/0003489420936713. Online ahead of print.
First Bite Syndrome Following Rhytidectomy: A Case Report
Anne E Gunter 1, Charles M Llewellyn 1, Paloma B Perez 1, Marc H Hohman 1, Scott B Roofe 1
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PMID: 32567395 DOI: 10.1177/0003489420936713
Abstract
Background: First bite syndrome (FBS) is a known complication of parotid gland resection, parapharyngeal space dissection, and cervical sympathetic chain injury. It can be described as severe cramping or spasms in the parotid region triggered by the first bite of a meal, with the pain lessening during each subsequent bite. Although dissection for a rhytidectomy is in the vicinity of the parotid parenchyma, face-lift is not typically characterized as a procedure that can lead to FBS.

Case description: A 53-year-old female underwent a deep plane face-lift to address her goals of improving jowls, nasolabial folds, and cervicomental angle. Intraoperatively, the dissection proceeded without any complications. Initially, her postoperative course was uneventful; 3 weeks after surgery, she noticed pain at the start of mastication that would improve throughout the course of a meal. She elected to proceed with observation. At 6 months after surgery, she began to experience improvement in her symptoms, and shortly thereafter had complete resolution.

Discussion: First bite syndrome is a complication associated with deep lobe parotid resection, first described in 1998. The innervation of the parotid gland is complex and includes contributions from the auriculotemporal nerve, the great auricular nerve, and the cervical sympathetic chain. During rhytidectomy, dissection occurs along the parotidomasseteric fascia in order to elevate a flap of the superficial musculoaponeurotic system. Inadvertent injury to the parotid parenchyma can lead to damage to the postganglionic sympathetic fibers innervating the myoepithelial cells. Ultimately, expectant management is the mainstay of treatment and symptoms typically resolve within 6 months to 1 year.

Conclusion: First bite syndrome is a complication that can be seen with a variety of facial surgeries. In the case of rhytidectomy, FBS should be considered a potential risk, as dissection into the parenchyma of the parotid gland can result in postoperative autonomic dysfunction.

Keywords: facelift; parapharyngeal space; postoperative complications; postoperative pain; rhytidectomy; superficial parotidectomy.

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62
Case Reports Clin Nucl Med
. 2020 Mar;45(3):214-216. doi: 10.1097/RLU.0000000000002786.
Asymptomatic Metastasis to Thyroid Cartilage Detected by 18F-Choline and 64Cu-PSMA PET/CT as a Single Site of Disease Relapse in a Patient With Castration-Resistant Prostate Carcinoma
Alessio Annovazzi 1, Adriana Faiella 2, Edoardo Pescarmona 3, Giuseppe Sanguineti 2, Rosa Sciuto 1
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PMID: 31652161 DOI: 10.1097/RLU.0000000000002786
Abstract
Metastatic involvement of the larynx is rare due to the absence of vessels within the cartilaginous tissue. The probability of metastatic spread increases with aging as a result of larynx ossification. The secondary involvement of larynx is more frequently associated with melanoma and renal cell carcinoma. Few observations have been reported also in prostate cancer patients, usually associated with advanced disease and diffuse metastatic bone involvement. We report a case of an 83-year-old man with castration-resistant prostate cancer in whom a metastasis to the thyroid cartilage was the only site of relapse.

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63
J Vis Exp
. 2020 Jun 4;(160). doi: 10.3791/60597.
A Revised Surgical Approach to Induce Endolymphatic Hydrops in the Guinea Pig
Carla V Valenzuela 1, Choongheon Lee 1, Craig A Buchman 1, Jeffery T Lichtenhan 2
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PMID: 32568243 DOI: 10.3791/60597
Abstract
Endolymphatic hydrops is an enlargement of scala media that is most often associated with Meniere's disease, though the pathophysiologic mechanism(s) remain unclear. In order to adequately study the attributes of endolymphatic hydrops, such as the origins of low-frequency hearing loss, a reliable model is needed. The guinea pig is a good model because it hears in the low-frequency regions that are putatively affected by endolymphatic hydrops. Previous research has demonstrated that endolymphatic hydrops can be induced surgically via intradural or extradural approaches that involve drilling on the endolymphatic duct and sac. However, whether it was possible to create an endolymphatic hydrops model using an extradural approach that avoided dangerous drilling on the endolymphatic duct and sac was unknown. The objective of this study was to demonstrate a revised extradural approach to induce experimental endolymphatic hydrops at 30 days post-operatively by obliterating the endolymphatic sac and injuring the endolymphatic duct with a fine pick. The sample size consisted of seven guinea pigs. Functional measurements of hearing were made and temporal bones were subsequently harvested for histologic analysis. The approach had a success rate of 86% in achieving endolymphatic hydrops. The risk of cerebrospinal fluid leak was minimal. No perioperative deaths or injuries to the posterior semicircular canal occurred in the sample. The presented method demonstrates a safe and reliable way to induce endolymphatic hydrops at a relatively quick time point of 30 days. The clinical implications are that the presented method provides a reliable model to further explore the origins of low-frequency hearing loss that can be associated endolymphatic hydrops.

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64
Review Otolaryngol Clin North Am
. 2020 Jun 18;S0030-6665(20)30084-0. doi: 10.1016/j.otc.2020.05.006. Online ahead of print.
Assessment and Management of Postoperative Pain Associated With Sleep Apnea Surgery
Jonathan A Waxman 1, Kerolos G Shenouda 2, Ho-Sheng Lin 2
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PMID: 32564947 DOI: 10.1016/j.otc.2020.05.006
Abstract
A literature review was conducted regarding the assessment and treatment of postoperative pain following surgery for obstructive sleep apnea (OSA). Given the risks of opioid use by patients with OSA, special attention to opioid risk reduction and avoidance is warranted in this population. The results of this review demonstrate the existence of a body of evidence that supports the use of nonopioid analgesics and nonpharmacologic approaches pain management. Strategies for managing postoperative pain should emphasize the use of local anesthetic infiltration, nonsteroidal antiinflammatory drugs, acetaminophen, topical analgesics, surgical wound cooling, and when necessary, safer opioid medications, such as tramadol and intranasal butorphanol.

Keywords: OSA; Opioids; Pain; Postoperative; Surgery.

Copyright © 2020 Elsevier Inc. All rights reserved.

Conflict of interest statement
Disclosure The authors report no financial or other relationships that may lead to a conflict of interest.

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65
Clin Nucl Med
. 2020 Mar;45(3):195-199. doi: 10.1097/RLU.0000000000002928.
Prostate-Specific Membrane Antigen Expression in Primary Juvenile Nasal Angiofibroma-A Pilot Study
Pirabu Sakthivel 1, Alok Thakar 1, Arun Prashanth 2, Ashu Seith Bhalla 3, Aanchal Kakkar 4, Kapil Sikka 1, Chirom Amit Singh 1, Rajeev Kumar 1, Suresh Chandra Sharma 1, Rakesh Kumar 5
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PMID: 31977481 DOI: 10.1097/RLU.0000000000002928
Abstract
Purpose: Prostate-specific membrane antigen (PSMA) is highly expressed in prostate cancer cells and is exploited for imaging and treatment of patients with prostate cancer. Prostate-specific membrane antigen expression is also demonstrated in the tumor-associated neovasculature endothelium. Juvenile nasal angiofibroma (JNA), being a similar highly vascular tumor, may also demonstrate significant PSMA expression, which may be utilized for its imaging and treatment.

Methods: In this prospective study, 25 clinicoradiologically diagnosed primary JNA patients underwent PSMA PET/CT scan. The scan was performed after 45 to 60 minutes of intravenous injection of 2 to 3 mCi (74-111 MBq) of Ga-PSMA-HBED-CC on a dedicated PET/CT scanner. Low-dose CT scan was acquired from vertex to sternoclavicular joint (100 mA, 20 kVp, 3-mm slice thickness, 0.8 pitch). Images were reconstructed with iterative reconstruction technique (4 iterations, 24 subsets). The objective was to assess the intensity and pattern of PSMA uptake in primary JNA patients.

Results: All cases (n = 25) of primary JNA showed PSMA expression in the tumor (100%). The median PSMA SUVmax ratio of tumor to background was 4.57 (range, 2.08-7.27). Intracranial extension in 14 of 25 patients was prominently visualized because of absence of background uptake in the brain. Advanced stage tumors demonstrated greater uptake than early tumors (P = 0.011). A statistically nonsignificant trend was noted for decreasing uptake with increasing age after normalizing for stage (Spearman correlation coefficient r = -0.08).

Conclusions: Assessment of PSMA expression in JNA by PSMA PET/CT opens up a new window of opportunity with respect to its radiological staging, vascularity assessment, and molecular characterization. A potential role in identification of the difficult residual-recurrent disease is anticipated and perhaps also in radioligand therapy for residual/recurrent JNA.Clinical Trials Registry of India (CTRI/2018/08/015479).

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66
Acta Otolaryngol
. 2020 Jun 21;1-5. doi: 10.1080/00016489.2020.1775292. Online ahead of print.
Dexamethasone Protects the Hearing of Meniere's Disease Patients After Triple Semicircular Canal Plugging
Yafeng Lyu 1, Daogong Zhang 1, Xiaofei Li 1, Yuechen Han 1, Yawei Li 1, Jing Wang 1, Yongdong Song 1, Ligang Kong 1, Huirong Jian 1, Zhaomin Fan 1, Haibo Wang 1
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PMID: 32564634 DOI: 10.1080/00016489.2020.1775292
Abstract
Background: TSCP has shown its efficacy in vertigo control for intractable Meniere's disease. However, hearing impairment remains a problem and hampered the application of the surgery.Aims/objectives: To investigate the effect of dexamethasone on the hearing of Meniere's disease patients after TSCP to determine whether inflammation is involved in this processMaterial and methods: Meniere's disease patients who received TSCP surgeries were treated with or without dexamethasone postoperatively. All patients' hearing function were evaluated during a follow up of 2 years after surgery and compared between the two groups.Results: Hearing worsening and word recognition score loss were milder in the dexamethasone group than in the non-dexamethasone group. The rates of profound hearing worsening and word recognition score loss remained significantly lower in the dexamethasone group than in the non-dexamethasone group even 2 years after surgery.Conclusions: Dexamethasone protects the hearing of Meniere's patients after TSCP. Inflammation may be involved in the mechanism by which TSCP causes hearing impairment in these patients.Significance: This finding suggests that steroids should be used routinely after TSCP for hearing preservation, and operative precedures need to be modified to minimize inflammation in the inner ear.

Keywords: Meniere’s disease; dexamethasone; hearing loss; semicircular canal plugging.

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67
Meta-Analysis Acta Oncol
. 2020 Jan;59(1):96-100. doi: 10.1080/0284186X.2019.1670354. Epub 2019 Sep 25.
The Impact of Smoking on the Effectiveness of Immune Checkpoint Inhibitors - A Systematic Review and Meta-Analysis
Kirsty Wai Chung Lee 1, Sarah J Lord 2 3, Lawrence Kasherman 1, Ian Marschner 2 4, Martin Stockler 2, Richard Gralla 5, James Chih-Hsin Yang 6 7, Tony Mok 8, Chee Khoon Lee 1 2
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PMID: 31552770 DOI: 10.1080/0284186X.2019.1670354
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68
Case Reports Int J Pediatr Otorhinolaryngol
. 2020 Jun 14;136:110190. doi: 10.1016/j.ijporl.2020.110190. Online ahead of print.
Hemorrhagic Tonsillitis in an Infant: A Case Report
J David Wilson 1, Bella Zeisler 2, Nancy Grover 3
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PMID: 32570060 DOI: 10.1016/j.ijporl.2020.110190
Abstract
This case report describes a case of severe hemorrhagic tonsillitis in a nine month-old child who suffered significant amount of blood loss and was emergently taken to operating room for control of hemorrhage. The child was brought to emergency room by mom after noticing blood around child's mouth and nose and a subsequent episode of hematemesis having awoken from sleep. Initial impression was bleeding secondary to epistaxis however a thorough bedside otolaryngology exam including flexible rhinolaryngoscopy ruled this out. Rapid pooling of blood in oropharynx, continued hemorrhage with significant blood loss and recent history of hematemesis prompted emergent intervention in operating room for endoscopy for control of hemorrhage including esophagogastroduodenoscopy (EGD). Bleeding was identified from a blood vessel at left lower tonsil pole. Although there is a description in literature of such cases, these are uncommon in the pediatric population and none has been described in a patient this young requiring emergent operative intervention. This case report discusses the diagnostic and decision making dilemma in an infant in setting of ongoing active hemorrhage and the role of multidisciplinary team management.

Keywords: Hematemesis; Hemorrhagic tonsillitis; Spontaneous tonsillar hemorrhage; Tonsillar bleeding; Tonsillitis.

Copyright © 2020 Elsevier B.V. All rights reserved.

Conflict of interest statement
Declaration of competing interest None.

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69
Otol Neurotol
. 2020 Jun 19. doi: 10.1097/MAO.0000000000002726. Online ahead of print.
Insertion Depth for Optimized Positioning of Precurved Cochlear Implant Electrodes
Rueben A Banalagay 1, Robert F Labadie 2, Srijata Chakravorti 1, Jack H Noble 1
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PMID: 32569133 DOI: 10.1097/MAO.0000000000002726
Abstract
Hypothesis: Generic guidelines for insertion depth of precurved electrodes are suboptimal for many individuals.

Background: Insertion depths that are too shallow result in decreased cochlear coverage, and ones that are too deep lift electrodes away from the modiolus and degrade the electro-neural interface. Guidelines for insertion depth are generically applied to all individuals using insertion depth markers on the array that can be referenced against anatomical landmarks.

Methods: To normalize our measurements, we determined the optimal position and insertion vector where a precurved array best fits the cochlea for each patient in an IRB-approved, N = 131 subject CT database. The distances from the most basal electrode on an optimally placed array to anatomical landmarks, including the round window (RW) and facial recess (FR), was measured for all patients.

Results: The standard deviations of the distance from the most basal electrode to the FR and RW are 0.65 mm and 0.26 mm, respectively. Owing to the high variability in FR distance, using the FR as a landmark to determine insertion depth results in >0.5 mm difference with ideal depth in 44% of cases. Alignment of either of the two most proximal RW markers with the RW would result in over-insertion failures for >80% of cases, whereas the use of the third, most medial marker would result in under-insertion in only 19% of cases.

Conclusions: Normalized measurements using the optimized insertion vector show low variance in distance from the basal electrode position to the RW, thereby suggesting it as a better landmark for determining insertion depth than the FR.

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70
Head Neck
. 2020 Jun 22. doi: 10.1002/hed.26334. Online ahead of print.
Safety Parameters of Ferromagnetic Device During Thyroid Surgery: Porcine Model Using Continuous Neuromonitoring
Tzu-Yen Huang 1 2, Yi-Chu Lin 1, Hsin-Yi Tseng 1, Gianlorenzo Dionigi 3, Hoon Yub Kim 4, Young Jun Chai 5, I-Cheng Lu 6, Pi-Ying Chang 6, Feng-Yu Chiang 7 8, Che-Wei Wu 1 9
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PMID: 32567742 DOI: 10.1002/hed.26334
Abstract
Background: The ferromagnetic (FM) device is a new surgical energy modality. This study investigated dynamic recurrent laryngeal nerve (RLN) electromyographic (EMG) data to define safety parameters for using FM devices in thyroidectomy.

Methods: Real-time EMG tracings obtained under continuous neuromonitoring were recorded from 24 RLNs (12 piglets). In the activation study, FM devices were activated at varying distances from the RLN. In the cooling study, FM devices were cooled for varying time intervals, or muscle touch maneuver was performed, before contact with the RLN.

Results: During the FMwand/FMsealer activation, no adverse EMG events occurred at distances of 2 mm or longer. The cooling study revealed no adverse EMG events after 1-second (FMwand) or 3-second (FMsealer) intervals or after muscle touch maneuver.

Conclusions: An FM device should be activated at a distance of 2 mm from the RLN and should be adequately cooled before further contact with the RLN. Surgeons can avoid RLN injury by observing standard procedures for using FM devices.

Keywords: continuous intraoperative neuromonitoring; ferromagnetic device; nerve thermal injury; recurrent laryngeal nerve; thyroid surgery.

© 2020 Wiley Periodicals, Inc.

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71
Small
. 2020 Jun 22;e2000746. doi: 10.1002/smll.202000746. Online ahead of print.
Shedding Light on Metal-Based Nanoparticles in Zebrafish by Computed Tomography With Micrometer Resolution
Emre Cörek 1, Griffin Rodgers 2, Stefan Siegrist 1, Tomaz Einfalt 1, Pascal Detampel 1, Christian M Schlepütz 3, Sandro Sieber 1, Pascal Fluder 1, Georg Schulz 2, Harald Unterweger 4, Christoph Alexiou 4, Bert Müller 2, Maxim Puchkov 1, Jörg Huwyler 1
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PMID: 32567135 DOI: 10.1002/smll.202000746
Abstract
Metal-based nanoparticles are clinically used for diagnostic and therapeutic applications. After parenteral administration, they will distribute throughout different organs. Quantification of their distribution within tissues in the 3D space, however, remains a challenge owing to the small particle diameter. In this study, synchrotron radiation-based hard X-ray tomography (SRμCT) in absorption and phase contrast modes is evaluated for the localization of superparamagnetic iron oxide nanoparticles (SPIONs) in soft tissues based on their electron density and X-ray attenuation. Biodistribution of SPIONs is studied using zebrafish embryos as a vertebrate screening model. This label-free approach gives rise to an isotropic, 3D, direct space visualization of the entire 2.5 mm-long animal with a spatial resolution of around 2 µm. High resolution image stacks are available on a dedicated internet page (http://zebrafish.pharma-te.ch). X-ray tomography is combined with physico-chemical characterization and cellular uptake studies to confirm the safety and effectiveness of protective SPION coatings. It is demonstrated that SRμCT provides unprecedented insights into the zebrafish embryo anatomy and tissue distribution of label-free metal oxide nanoparticles.

Keywords: digital histology; nanoparticle detection; superparamagnetic iron oxide nanoparticles; synchrotron radiation-based micro computed tomography; zebrafish embryos.

© 2020 The Authors. Published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

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72
Case Reports Case Rep Otolaryngol
. 2020 Jun 7;2020:8985730. doi: 10.1155/2020/8985730. eCollection 2020.
Rare Tumors Presenting as a Mastoid Mass
Jiyeon Lee 1, Kyujin Han 1, Chang-Hee Kim 1
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PMID: 32566344 PMCID: PMC7298327 DOI: 10.1155/2020/8985730
Free PMC article
Abstract
In terms of diagnosis, a painless isolated mass lesion around the mastoid area is rarely encountered in general practice. In the present study, we report two cases of painless benign mastoid tumors located in the postauricular region. The first patient visited our department with a painless progressing mass lesion behind the right ear, which was later revealed as an intramuscular lipoma in the mastoid origin site of the sternocleidomastoid muscle. The second patient similarly presented to our department with a chief complaint of a painless, palpable mass in the mastoid region. Biopsy results confirmed the diagnosis of an osteoma. In both cases, the tumor was surgically removed by a postauricular approach. Although osteoma and lipoma are benign tumors rarely involved in the mastoid area, presenting without symptoms, it is recommended of complete excision, especially in cases with symptoms or cosmetic deformity.

Copyright © 2020 Jiyeon Lee et al.

Conflict of interest statement
The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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73
Braz Dent J
. Jan-Apr 2020;31(2):190-196. doi: 10.1590/0103-6440202003040.
The First-Year Follow-Up of a Cleft Lip and Palate Patient Treated With Nasoalveolar Molding (NAM)
Nathália Viegas de Oliveira 1, Gabriel Antônio Anjos Tou 2, Raquel Souto Silva 1, Sérgio Edriane Rezende 3 4, Henrique Pretti 2, Soraia Macari 2
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PMID: 32556020 DOI: 10.1590/0103-6440202003040
Free article
Abstract
The objectives of pre-surgical orthopedics are to allow surgical repair with minimal tension of the involved tissues and less restriction to the craniofacial growth. The aim of this study was to evaluate the benefits of nasoalveolar model (NAM) as a pre-operative therapy in a patient with bilateral cleft lip and palate followed by labioplasty and palatoplasty. A 15-day-old patient underwent orthopedic treatment with NAM. After pre-operative treatment, retraction of the pre-maxilla was observed with reduction of the fissure. Due to the successful effects of NAM treatment the patient had a one-step surgery for lip correction. Six months later, due to lip pressure the fissure was further decreased. After six months, the patient underwent palatoplasty. Both surgeries contributed to the remaining closure of the fissure, which were reduced by half compared to the end of pre-operative treatment. The uses of NAM as a pre-operative treatment approached the alveolar segments, centralized the pre-maxilla, decreased the cleft palate resulting in a marked improvement of the arch and provide superior surgical results. In addition, it allows the primary repair of the patient's lip with asymmetric bilateral fissure in only one-step surgery; in consequence, it will reduce treatment morbidity and decrease cost of treatment.

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74
Ann Surg
. 2020 Jun 16. doi: 10.1097/SLA.0000000000003934. Online ahead of print.
Using Surgical Video to Classify Intraoperative Events
Alexander Langerman 1 2 3
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PMID: 32568746 DOI: 10.1097/SLA.0000000000003934
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75
Head Neck
. 2020 Jun 22. doi: 10.1002/hed.26333. Online ahead of print.
Letter to the Editor Regarding "How to Avoid Nosocomial Spread During Tracheostomy for Covid-19 Patients"
Luca D'Ascanio 1, Manlio Pandolfini 1, Cristina Cingolani 1, Gino Latini 1, Damiano Giardini 1
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PMID: 32567738 DOI: 10.1002/hed.26333
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76
Head Neck
. 2020 Jun 22. doi: 10.1002/hed.26332. Online ahead of print.
Reply to Letter to the Editor (HED-20-0582) Regarding "How to Avoid Nosocomial Spread During Tracheostomy for COVID-19 Patients"
Hongjun Xiao 1, Yi Zhong 1, Xiaomeng Zhang 1, Fucheng Cai 1, Mark A Varvares 2
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PMID: 32567758 DOI: 10.1002/hed.26332
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77
Commun Stat Appl Methods
. 2020 Mar;27(2):225-239. doi: 10.29220/csam.2020.27.2.225. Epub 2020 Mar 31.
Ranking Subjects Based on Paired Compositional Data With Application to Age-Related Hearing Loss Subtyping
Jin Hyun Nam 1, Aastha Khatiwada 1, Lois J Matthews 2, Bradley A Schulte 2 3, Judy R Dubno 2 3, Dongjun Chung 1
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PMID: 32566544 PMCID: PMC7304553 DOI: 10.29220/csam.2020.27.2.225
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Abstract
Analysis approaches for single compositional data are well established; however, effective analysis strategies for paired compositional data remain to be investigated. The current project was motivated by studies of age-related hearing loss (presbyacusis), where subjects are classified into four audiometric phenotypes that need to be ranked within these phenotypes based on their paired compositional data. We address this challenge by formulating this problem as a classification problem and integrating a penalized multinomial logistic regression model with compositional data analysis approaches. We utilize Elastic Net for a penalty function, while considering average, absolute difference, and perturbation operators for compositional data. We applied the proposed approach to the presbyacusis study of 532 subjects with probabilities that each ear of a subject belongs to each of four presbyacusis subtypes. We further investigated the ranking of presbyacusis subjects using the proposed approach based on previous literature. The data analysis results indicate that the proposed approach is effective for ranking subjects based on paired compositional data.

Keywords: composition; elastic net; penalized logistic regression; presbyacusis.

Conflict of interest statement
Competing interests The authors declare no conflict of interest.

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Abstract
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