Tuesday, January 12, 2021

Level of sex hormones and their association with acetylsalicylic acid intolerance and nasal polyposis

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by Julia Espersen, Ursula Weber, Ariane Römer-Franz, Thomas Lenarz, Stefan R. O. Stolle, Athanasia Warnecke

Background

Chronic rhinosinusitis may be associated with nasal polyposis. Recurrence of disease is often observed and may be due to an intolerance of acetylsalicylic acid. Sex hormones are known to modulate allergic reactions and inflammation. Whether they may be involved in the development and progression of nasal polyposis has not been investigated yet.

Aim

Examine the relationship between levels of sex hormones and nasal polyposis.

Methods

Hormonal levels (estradiol, testosterone and progesterone) in patients with nasal polyposis (n = 26) with or without acetylsalicylic acid-intolerance were determined and compared to hormonal levels in patients with septal deviation (n = 35). Cone-beam computed tomography scans were analysed by using scores as defined by Lund and Mackay and by Kennedy.

Results

Our results show a 5 times greater odds (p = 0.01) for developing nasal polyposis in the presence of lowered estradiol plasma levels than in the presence of normal / elevated levels. When analyzing females and males separately, a 6 times greater odds for females to develop nasal polyposis in the presence of lowered estradiol plasma levels was calculated (p = 0.02). Thus, females are more likely to develop nasal polyposis when they have lowered estradiol levels than males. In addition, female patients showed an increased risk for developing ASA intolerance (p = 0.01).

Conclusion

Variation of sex hormones may be involved in nasal polyposis. Further studies including more patients to validate the presented results are required.

Significance

Retrospective clinical investigation suggesting a correlation between varying sex hormones and nasal polyposis.

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Systematic review and meta-analysis of late auditory evoked potentials as a candidate biomarker in the assessment of tinnitus

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Via Tinnitus

journal.pone.0243785.g005&size=inline

by Emilie Cardon, Iris Joossen, Hanne Vermeersch, Laure Jacquemin, Griet Mertens, Olivier M. Vanderveken, Vedat Topsakal, Paul Van de Heyning, Vincent Van Rompaey, Annick Gilles

Subjective tinnitus, the perception of sound in the absence of any sound source, is routinely assessed using questionnaires. The subjective nature of these tools hampers objective evaluation of tinnitus presence, severity and treatment effects. Late auditory evoked potentials (LAEPs) might be considered as a potential biomarker for assessing tinnitus complaints. Using a multivariate meta-analytic model including data from twenty-one studies, we determined the LAEP components differing systematically between tinnitus patients and controls. Results from this model indicate that amplitude of the P300 component is lower in tinnitus patients (standardized mean difference (SMD) = -0.83, p
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Blast-induced tinnitus : Using a formulation of N-acetylcysteine (NAC) and disodium 2,4-disulfophenyl-N-tert-butylnitrone (HPN-07) as a therapeutic for addressing blast-induced neurodegeneration

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Via Tinnitus

journal.pone.0243903.g013&size=inline

by Jianzhong Lu, Matthew B. West, Xiaoping Du, Qunfeng Cai, Donald L. Ewert, Weihua Cheng, Don Nakmali, Wei Li, Xiangping Huang, Richard D. Kopke

Tinnitus, the phantom perception of sound, often occurs as a clinical sequela of auditory traumas. In an effort to develop an objective test and therapeutic approach for tinnitus, the present study was performed in blast-exposed rats and focused on measurements of auditory brainstem responses (ABRs), prepulse inhibition of the acoustic startle response, and presynaptic ribbon densities on cochlear inner hair cells (IHCs). Although the exact mechanism is unknown, the "central gain theory" posits that tinnitus is a perceptual indicator of abnormal increases in the gain (or neural amplification) of the central auditory system to compensate for peripheral loss of sensory input from the cochlea. Our data from vehicle-treated rats supports this rationale; namely, blast-induced cochlear synaptopathy correlated with imbalanced elevations in the ratio of centrally-derived ABR wave V amplitudes to peripherally-derived wave I amplitudes, resulting in behavioral evidence of tinnitus. Logisti c regression modeling demonstrated that the ABR wave V/I amplitude ratio served as a reliable metric for objectively identifying tinnitus. Furthermore, histopathological examinations in blast-exposed rats revealed tinnitus-related changes in the expression patterns of key plasticity factors in the central auditory pathway, including chronic loss of Arc/Arg3.1 mobilization. Using a formulation of N-acetylcysteine (NAC) and disodium 2,4-disulfophenyl-N-tert-butylnitrone (HPN-07) as a therapeutic for addressing blast-induced neurodegeneration, we measured a significant treatment effect on preservation or restoration of IHC ribbon synapses, normalization of ABR wave V/I amplitude ratios, and reduced behavioral evidence of tinnitus in blast-exposed rats, all of which accorded with mitigated histopathological evidence of tinnitus-related neuropathy and maladaptive neuroplasticity.
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Electrophysiological assessment and pharmacological treatment of blast-induced tinnitus

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Via Tinnitus

journal.pone.0243903.g013&size=inline

by Jianzhong Lu, Matthew B. West, Xiaoping Du, Qunfeng Cai, Donald L. Ewert, Weihua Cheng, Don Nakmali, Wei Li, Xiangping Huang, Richard D. Kopke

Tinnitus, the phantom perception of sound, often occurs as a clinical sequela of auditory traumas. In an effort to develop an objective test and therapeutic approach for tinnitus, the present study was performed in blast-exposed rats and focused on measurements of auditory brainstem responses (ABRs), prepulse inhibition of the acoustic startle response, and presynaptic ribbon densities on cochlear inner hair cells (IHCs). Although the exact mechanism is unknown, the "central gain theory" posits that tinnitus is a perceptual indicator of abnormal increases in the gain (or neural amplification) of the central auditory system to compensate for peripheral loss of sensory input from the cochlea. Our data from vehicle-treated rats supports this rationale; namely, blast-induced cochlear synaptopathy correlated with imbalanced elevations in the ratio of centrally-derived ABR wave V amplitudes to peripherally-derived wave I amplitudes, resulting in behavioral evidence of tinnitus. Logisti c regression modeling demonstrated that the ABR wave V/I amplitude ratio served as a reliable metric for objectively identifying tinnitus. Furthermore, histopathological examinations in blast-exposed rats revealed tinnitus-related changes in the expression patterns of key plasticity factors in the central auditory pathway, including chronic loss of Arc/Arg3.1 mobilization. Using a formulation of N-acetylcysteine (NAC) and disodium 2,4-disulfophenyl-N-tert-butylnitrone (HPN-07) as a therapeutic for addressing blast-induced neurodegeneration, we measured a significant treatment effect on preservation or restoration of IHC ribbon synapses, normalization of ABR wave V/I amplitude ratios, and reduced behavioral evidence of tinnitus in blast-exposed rats, all of which accorded with mitigated histopathological evidence of tinnitus-related neuropathy and maladaptive neuroplasticity.
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Early Physiological and Cellular Indicators of Cisplatin-Induced Ototoxicity

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Abstract

Cisplatin chemotherapy often causes permanent hearing loss, which leads to a multifaceted decrease in quality of life. Identification of early cisplatin-induced cochlear damage would greatly improve clinical diagnosis and provide potential drug targets to prevent cisplatin's ototoxicity. With improved functional and immunocytochemical assays, a recent seminal discovery revealed that synaptic loss between inner hair cells and spiral ganglion neurons is a major form of early cochlear damage induced by noise exposure or aging. This breakthrough discovery prompted the current study to determine early functional, cellular, and molecular changes for cisplatin-induced hearing loss, in part to determine if synapse injury is caused by cisplatin exposure. Cisplatin was delivered in one to three treatment cycles to both male and female mice. After the cisplatin treatment of three cycles, threshold shift was observed across frequencies tested like previous studies. After t he treatment of two cycles, beside loss of outer hair cells and an increase in high-frequency hearing thresholds, a significant latency delay of auditory brainstem response wave 1 was observed, including at a frequency region where there were no changes in hearing thresholds. The wave 1 latency delay was detected as early cisplatin-induced ototoxicity after only one cycle of treatment, in which no significant threshold shift was found. In the same mice, mitochondrial loss in the base of the cochlea and declining mitochondrial morphometric health were observed. Thus, we have identified early spiral ganglion-associated functional and cellular changes after cisplatin treatment that precede significant threshold shift.

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Clinical and survival analysis of nasopharyngeal carcinoma with consistently negative Epstein–Barr virus DNA

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Abstract

Background

To assess the clinical and survival features of nasopharyngeal carcinoma (NPC) with consistently negative Epstein–Barr virus (EBV) DNA level.

Methods

Propensity score matching (PSM) method was used to create well‐balanced cohorts. Kaplan–Meier method and Cox proportional hazards models were performed to conduct survival analysis.

Results

Four hundred and eighty patients were enrolled. Patients with consistently negative plasma EBV DNA level had a greater chance to present a relatively earlier T and N classification compared with those with positive EBV DNA level (p < .001; p = .015). And patients with consistently negative EBV level were significantly associated with preferable 3‐year DFS (95.0% vs. 84.4%, p = .004), DMFS (98.3% vs. 89.4%, p = .009), and OS (100% vs. 97.6%, p = .004).

Conclusions

NPC patients with consistently negative EBV DNA level performed an earlier clinical stage and negative EBV DNA level was related to preferable survival outcomes.

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Odontogenic infection and antiresorptive agent-related osteonecrosis of the jaw with facial subcutaneous abscess formation: A retrospective clinical study of difficult-to-diagnose cases

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1-s2.0-S0385814620X00071-cov150h.gif

Publication date: Available online 9 January 2021

Source: Auris Nasus Larynx

Author(s): Yuma Matsumoto, Hidenori Yokoi, Tetsuya Ikeda, Michitsugu Kawada, Masataka Ogawa, Koichiro Saito

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Management of tracheostomy in COVID-19 patients: The Japanese experience

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1-s2.0-S0385814620X00071-cov150h.gif

Publication date: Available online 9 January 2021

Source: Auris Nasus Larynx

Author(s): Taizo Yokokawa, Yosuke Ariizumi, Mariko Hiramatsu, Yujin Kato, Kazuhira Endo, Kazufumi Obata, Kayoko Kawashima, Toshifumi Sakata, Shigeru Hirano, Torahiko Nakashima, Tatsurou Sekine, Asanori Kiyuna, Saeko Uemura, Keisuke Okubo, Taro Sugimoto, Ichiro Tateya, Yasushi Fujimoto, Arata Horii, Yurika Kimura, Masamitsu Hyodo

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A Novel Visualization System of Using Augmented Reality in Knee Replacement Surgery: Enhanced Bidirectional Maximum CorrentropyAlgorithm

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Abstract

Background and aim

Image registration and alignment are the main limitations of augmented reality‐based knee replacement surgery. This research aims to decrease the registration error, eliminate outcomes that are trapped in local minima to improve the alignment problems, handle the occlusion and maximize the overlapping parts.

Methodology

markerless image registration method was used for Augmented reality‐based knee replacement surgery to guide and visualize the surgical operation. While weight least square algorithm was used to enhance stereo camera‐based tracking by filling border occlusion in right to left direction and non‐border occlusion from left to right direction.

Results

This study has improved video precision to 0.57 mm ∼ 0.61 mm alignment error. Furthermore, with the use of bidirectional points, i.e. Forwards and backwards directional cloud point, the iteration on image registration was decreased. This has led to improved t he processing time as well. The processing time of video frames was improved to 7.4 ∼11.74 fps.

Conclusions

It seems clear that this proposed system has focused on overcoming the misalignment difficulty caused by movement of patient and enhancing the AR visualization during knee replacement surgery. The proposed system was reliable and favourable which helps in eliminating alignment error by ascertaining the optimal rigid transformation between two cloud points and removing the outliers and non‐Gaussian noise. The proposed augmented reality system helps in accurate visualization and navigation of anatomy of knee such as femur, tibia, cartilage, blood vessels, etc.

This article is protected by copyright. All rights reserved.

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Evaluation and comparison of tympanoplasty efficacy with tympanic membrane perforation after chronic suppurative otitis media in dry ear with different microorganisms

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1-s2.0-S0196070920X0007X-cov150h.gif

Publication date: Available online 9 January 2021

Source: American Journal of Otolaryngology

Author(s): Bingbing Yang, Linghao Zhang, Xiaoyun Chen

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Predominant Vertical Location of Benign Vocal Fold Lesions by Sex and Music Genre: Implication for Pathogenesis

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Objectives/Hypothesis

Vertical locations of vocal fold mucosal lesions (VFMLs) vary along the free edge. As the vertical contact area of vocal folds (VFs) depends on the vocal register, lesions may occur in the contact area of more frequently used vocal registers. This study investigated the cause of location variations by comparing the vertical sites of VFMLs in singers of both sexes with different music genres.

Study Design

Retrospective review.

Methods

Sixty professional classical and rock singers (11 male classical [M‐classical], 22 male rock [M‐rock], 13 female classical [F‐classical], and 14 female rock [F‐rock] singers) who underwent microlaryngeal surgery for VF polyps and nodules and their 108 lesions were enrolled. The VF free edge was vertically divided into three equal parts and classified into the following four lesion sites: upper, middle, lower, and multiple sites.

Results

Upper lesions were most common among F‐classical singers (73.9%), whereas lower lesions were most common among M‐classical (90.0%) and M‐rock (60.6%) singers. Among lesions localized to a single site, lower lesions were most common among F‐rock singers (37.0%). F‐classical singers had significantly more upper lesions than the other groups (P < .001). M‐classical singers had significantly more lower lesions than female singers of any genre (P < .001).

Conclusion

Upper lesions were most common among F‐classical singers who mostly used the head voice. Lower lesions were most common among singers who mainly used the modal voice. This study suggests that sex, the dominant vocal register used for singing, and mechanical stress on VFs influence the vertical site of VFMLs.

Level of Evidence

4 Laryngoscope, 2021

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Surgical Management of Cervical Non‐seminomatous Germ Cell Tumor Metastases

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Objective/Hypothesis

Testicular cancer is the most common malignancy of young males. Limited reports describe perioperative and long‐term outcomes after surgical resection of metastatic, cervical, non‐seminomatous germ cell tumors (NSGCT). The objective of this study was to investigate the effectiveness and safety of cervical lymphadenectomy in the management of metastatic NSGCT.

Study Design

Retrospective case series.

Methods

A single institution, retrospective review from 1998 to 2020 of patients with metastatic NSGCT who underwent cervical lymphadenectomy was conducted. Clinicopathological, surgical, and postoperative data were collected and analyzed.

Results

Sixty‐eight predominantly white (91.0%) male patients with mean age 33.0 ± 11.3 years were included. Most (82.2%) presented with stage III disease at initial diagnosis. All patients had undergone primary platinum‐based chemotherapy 1.0 to 22.7 months prior to selective ND. Surgery mainly involved nodal levels III (67.6%), IV (92.6%) and/or Vb (77.9%) and was frequently performed with concomitant thoracoabdominal NSGCT resections (63.2%). Cervical specimens predominantly revealed mature teratoma (83.8%) as solitary (69.1%) or component of mixed (14.7%) NSGCT. Ten (14.7%) perioperative complications occurred as vocal cord paresis (n = 6) from thoracic surgery and chyle leakage (n = 4). All resolved conservatively except two vocal cord paralyzes that required surgical repair due to tumor involvement of vagus nerve. Six instances of cervical recurrence occurred at median 12.5 (range, 5.8–38.6) months from ND, all re‐demonstrating purely mature teratoma. The two‐year cervical, non‐cervical, and overall recurrence‐free survivals were 83%, 55%, and 55%, respectively. Two‐year disease‐free and overall survivals were both 93%.

Conclusions

Selective neck dissection is a safe, effective method for managing cervical NSGCT metastases.

Level of Evidence

IV Laryngoscope, 2021

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