| 1. |
- Berg, Thomas, et al.
(författare)
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Agreement between the Sunnybrook, House-Brackmann, and Yanagihara facial nerve grading systems in Bell´s Palsy
- 2004
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Ingår i: Otology and Neurotology. - 1531-7129 .- 1537-4505. ; 25:6, s. 1020-1026
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess the agreement between the Sunnybrook facial nerve grading system and the House-Brackmann and Yanagihara systems. STUDY DESIGN: Prospective clinical facial nerve grading. SETTING: Tertiary referral center. PATIENTS: One-hundred assessments, 94 in patients with Bell's palsy and 6 with herpes zoster. INTERVENTION: Diagnostic. MAIN OUTCOME MEASURES: Evaluation according to the weighted regional Sunnybrook system, the gross House-Brackmann system, and the unweighted regional Yanagihara system. Weighted kappa statistics was used to measure agreement between the grading systems. RESULTS: The average weighted kappa value between the Sunny-brook, House-Brackmann, and Yanagihara grading systems was 0.65; kappa values increased temporally (but not statistically significantly) up to day 180. The highest agreement value, 0.72, was found between the Sunnybrook and Yanagihara grading systems. The weighted kappa value between the Sunnybrook and House-Brackmann systems was 0.59. In Sunnybrook gradings less than 63, there was an overlap between House-Brackmann scores of III to VI. Reliable conversion tables between the gross House-Brackmann system and the regional Sunnybrook and Yanagihara systems could not be established. CONCLUSION: The Sunnybrook system scores at the same agreement level as the House-Brackmann and Yanagihara grading systems. There is an evaluative difference between the weighted regional Sunnybrook and the gross House-Brackmann systems. Substantial agreement was found between the regional Sunnybrook and Yanagihara scales. Sunnybrook grading is easy and quick. By adding objective measurements and additional secondary defects, the Sunnybrook system can be an alternative to the other predominating grading systems.
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| 2. |
- Hellström, Sten, et al.
(författare)
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Tympanic membrane vessel revisited : a study in an animal model
- 2003
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Ingår i: Otology and Neurotology. - 1531-7129 .- 1537-4505. ; 24:3, s. 494-499
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Tidskriftsartikel (refereegranskat)abstract
- HYPOTHESIS: The present study aimed at elucidating whether there are blood vessels in the semitransparent portion of the tympanic membrane. BACKGROUND: The normal semitransparent portions of pars tensa show strikingly few, small-caliber vessels under the otomicroscope. The major portion of a pars tensa seems to be devoid of blood vessels. In inflammatory conditions of the middle ear, the vascular pattern of the tympanic membrane is dramatically altered, and blood vessels traversing the pars tensa can be discernable. METHODS: The study was performed in rats with healthy tympanic membranes and in tympanic membranes obtained from animals with purulent otitis media evoked by inoculation of Str. pneumoniae. The tympanic membrane vessels were dilated by injection of adenosin, and directly afterwards the animal was perfused with china ink. Vessels were also revealed by immunohistochemistry with antibodies for Thy-1 and the von Willebrand factor as well as by detection of carbon particles at an ultrastructural level. RESULTS: Adenosin caused a marked dilation of the mallear and annular vessels. However, no preexisting vasculature was revealed in the normally transparent portions of the pars tensa except single vessels in the posterior quadrant and in the lower quadrants. In Str. pneumoniae-induced acute otitis media, the tympanic membrane thickened, bulged, and discolored. Even then, at 12 hours after inoculation, no vessels could be distinguished in the normally transparent portions of the tympanic membrane. However, at 4 and 7 days of acute purulent otitis media, vessels developed in those areas, most probably through ingrowth of newly formed vessels. CONCLUSION: The results support the view that the semitransparent portions of the pars tensa lack vascularity. In inflammation, new vessels are formed in pars tensa to meet the demand for an increased blood supply.
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| 3. |
- Linder, Birgitta, et al.
(författare)
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In vitro growth of human endolymphatic sac cells : a transmission electron microscopic and immunohistochemical study in patients with vestibular schwannoma and Ménière's Disease
- 2001
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Ingår i: Otology and Neurotology. - 1531-7129 .- 1537-4505. ; 22:6, s. 938-943
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Tidskriftsartikel (refereegranskat)abstract
- HYPOTHESIS:Human endolymphatic sac cells have been notoriously difficult to maintain in culture. It was hypothesized that an in vitro environment intended for growth of keratinocytes would also be suitable for human endolymph sac cells.BACKGROUND:Studies on cell physiology of human endolymphatic sac cells have been hampered by difficulties in maintaining them in culture.METHODS:Human endolymphatic sac cells were taken from 10 patients during translabyrinthine skull base surgery for vestibular schwannoma, one of whom also had Ménière's disease. Cell lines of proliferating epithelial cells were obtained after trypsinization and growth in a 3:1 mixture of Dulbecco's modified Eagle medium and Ham's F12 medium supplemented with 10% fetal calf serum. Fibroblast overgrowth was counteracted by the use of so-called cloning rings. During various stages, cells were investigated with transmission electron microscopy and/or immunohistochemistry.RESULTS:Proliferation took place after 2 to 3 days of primary cell culture. The cells were cytokeratin-positive and pleomorphic, and they had abundant polarized microvillus-like projections, numerous coated cytoplasmic pits and vesicles, and a well-developed rough endoplasmic reticulum.CONCLUSION:Cell lines of proliferating human endolymphatic sac cells can be produced with the technique described here and may be a valid tool in studies of human endolymph sac physiology.
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| 4. |
- Nordang, Leif, et al.
(författare)
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Morphological changes in round window membrane following topical hydrocortisone and dexamethasone treatment
- 2003
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Ingår i: Otology and Neurotology. - 1531-7129 .- 1537-4505. ; 24:2, s. 339-43
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Tidskriftsartikel (refereegranskat)abstract
- HYPOTHESIS: Are all glucocorticoids supposed to have the same effect on the round window membrane? BACKGROUND: Interest in glucocorticoids for topical treatment of inner ear diseases is increasing. The safety of such treatment should therefore be an important consideration before clinical use. METHODS: In this study the authors investigated the morphology of the round window membrane after topical instillation of dexamethasone or hydrocortisone into the middle ear. Twenty Sprague-Dawley rats were used. Five rats received 5 doses, and five rats 10 doses, of 1 microg (20 microl) dexamethasone in the right ear, and five others were given 5 doses, and five rats 10 doses, of 2% (20 microl) hydrocortisone solution, also in the right ear. Membrane morphology was studied in both light microscopy and transmission electron microscopy. The thickness of exposed membranes was measured and compared with that of control membranes. RESULTS: Thickening and microscopically signs of inflammation were observed in hydrocortisone-exposed membranes but not in dexamethasone-exposed membranes, which did not differ morphologically from those in control ears. CONCLUSION: Although hydrocortisone has anti-inflammatory properties, it seems to provoke inflammation in the round window membrane after topical instillation. Dexamethasone had no such effects, however.
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| 5. |
- Persson, Pekka, et al.
(författare)
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Speech recognition in background noise : Monaural versus binaural listening conditions in normal-hearing patients
- 2001
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Ingår i: Otology and Neurotology. - 1531-7129 .- 1537-4505. ; 22:5, s. 625-630
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Tidskriftsartikel (refereegranskat)abstract
- Hypothesis: Patients with unilateral conductive hearing impairment often experience a great advantage in improved hearing thresholds after reconstructive ear surgery because the binaural hearing leads to increased speech recognition in competing noise. The aim of this study was to develop a clinical audiometric test to quantify the ability of speech recognition in background noise preoperatively and postoperatively. Methods: A model consisting of phonetically balanced (PB) monosyllabic words and/or a just-follow-conversation test (JFC) was used in 16 normal-hearing listeners. In 8 of the participants, JFC at two levels of background noise (60 and 40 dB sound pressure level) was used as the only method. The tasks were performed in an anechoic chamber with varying spatial separations of speech and noise sources under free field conditions. The tests were made binaurally and monaurally, the latter condition was achieved by occluding one ear with a hearing protector. In PB word tests, the percent of correctly repeated words was scored. In the JFC task, the speech signal was adjusted by the listener to a level where he or she could just understand what was being said. This was expressed as a signal-to-noise (S/N) ratio. Results: In both types of tests, the subjects achieved significantly better speech recognition scores in the binaural situations. In summary, compared with monaural conditions, the subjects achieved 17% to 18% better speech recognition in PB tests, and in JFC tests a 2-to 3-dB lower S/N ratio in binaural conditions. Conclusion: These free field tests can be developed further as a clinical tool preoperatively and postoperatively to evaluate the effect of binaural hearing after ear surgery.
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| 8. |
- Larsson, C, et al.
(författare)
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Displacement pattern of the normal pars flaccida in the gerbil
- 2001
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Ingår i: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. - : Ovid Technologies (Wolters Kluwer Health). - 1531-7129. ; 22:4, s. 558-566
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Tidskriftsartikel (refereegranskat)
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| 9. |
- Larsson, C, et al.
(författare)
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Pars flaccida displacement pattern in purulent otitis media in the gerbil
- 2003
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Ingår i: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. - : Ovid Technologies (Wolters Kluwer Health). - 1531-7129. ; 24:3, s. 358-364
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Tidskriftsartikel (refereegranskat)
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| 10. |
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