| 1. |
- Cervin, Anders, et al.
(författare)
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Effects of halothane on mucociliary activity in vivo
- 1995
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Ingår i: Otolaryngology: Head and Neck Surgery. - 0194-5998. ; 112:6, s. 714-722
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Tidskriftsartikel (refereegranskat)abstract
- The effect of halothane on mucociliary activity in the rabbit maxillary sinus in vivo was recorded photoelectrically. Administration of halothane (1%, 2% or 4%) into the maxillary sinus induced a temporary acceleration of mucociliary activity. The peak increase (39.1% +/- 9.1%, p < 0.05, n = 5) was seen after the 4% concentration. Long-term exposure (60 minutes) of the maxillary sinus to halothane (2%) first induced an increase of 28.4% +/- 4.6% (p < 0.05, n = 6), lasting approximately four minutes, and followed after about 15 minutes by a decrease of mucociliary activity. The maximum decrease during the 60-minute period was 19.6% +/- 2.8% (p < 0.05, n = 6). Mucociliary activity returned to its baseline level approximately 25 minutes after withdrawal of halothane. Halothane delivered to the rabbit through a tracheal cannula at 1.1% for 60 minutes did not impair mucociliary activity in the maxillary sinus. On the contrary, it initially stimulated mucociliary activity, 19.9% +/- 2.7% (p < 0.05, n = 5). There was also an initial increase in respiratory rate from 62 +/- 7.3 to 89 +/- 12.9 breaths per minute (p < 0.05), which was noticeable after approximately 10 seconds and lasted 4 to 5 minutes. The dose-dependent increase in mucociliary activity seen after short-term exposure to halothane is probably due to stimulation of afferent C fibers, because halothane may be considered an airway irritant. The reversible depressant effect seen after 15 minutes of exposure is in accordance with findings in previous studies in vitro. The mechanism by which halothane impairs mucociliary activity is at present not known. However, halothane administered to the lower airways does not impair mucociliary activity in the maxillary sinus, indicating that halothane affects the ciliated epithelium directly and that the state of anesthesia itself has no effect on mucociliary activity.
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| 2. |
- Hammerlid, Eva, et al.
(författare)
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Prospective, longitudinal quality-of-life study of patients with head and neck cancer: a feasibility study including the EORTC QLQ-C30
- 1997
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Ingår i: Otolaryngology: Head and Neck Surgery. - 0194-5998. ; 116:6, s. 666-673
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Tidskriftsartikel (refereegranskat)abstract
- Despite modern advances in the treatment of head and neck cancer, the survival rate fails to improve. Considering the different treatment modalities involved, quality of life has been thought of as an additional end point criterion for use in clinical trials. A Nordic protocol to measure the quality of life of head and neck cancer patients before, during, and after treatment was established. Before the study, a pilot study was done with this protocol. The main purpose of this pilot study was to find out whether this cancer population would answer quality-of-life questionnaires repeatedly (six times) over a 1-year period and whether the chosen questionnaires-a core questionnaire (European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30)), a tumor-specific questionnaire, and a psychological distress measure (Hospital Anxiety and Depression scale (HAD))-were sensitive for changes to functions and symptoms during the study year. The results presented in this article all refer to the pilot study. Forty-eight consecutive patients agreed to participate in the study. The most common tumor locations were the oral cavity (17) and the larynx (12). Almost all patients received combined treatment: 45 of 48 radiation therapy, 18 of 48 chemotherapy, and 17 of 48 surgery. After the primary treatment, 40 patients had complete tumor remission. Four of the 48 patients did not answer any questionnaires and were therefore excluded from the study. Of the remaining 44 patients, 3 died during the study year, and another 6 withdrew for various reasons. Thirty-five (85%) of the 41 patients alive at the 1-year follow-up answered all six questionnaires and thus completed the study. Mailed questionnaires were used throughout the study. All questionnaires were well accepted and found to be sensitive to changes during the study year. The greatest variability was found for symptoms and functions related specifically to head and neck cancer. The symptoms were swallowing difficulties, hoarse voice, sore mouth, dry mouth, and problems with taste. They all showed the same pattern, with an increase of symptoms during and just after finishing the treatment. The HAD scale revealed a high level of psychological distress, with 21% probable cases of psychiatric morbidity at diagnosis. In conclusion, it was shown that the study design and questionnaires were feasible for the forthcoming prospective quality-of-life assessment of Swedish and Norwegian head and neck cancer patients.
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| 3. |
- Runer, Thomas, et al.
(författare)
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Nitric oxide is a regulator of mucociliary activity in the upper respiratory tract
- 1998
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Ingår i: Otolaryngology: Head and Neck Surgery. - 0194-5998. ; 119:3, s. 278-287
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Tidskriftsartikel (refereegranskat)abstract
- The in vitro effects of the nitric oxide (NO) substrate L-arginine on ciliary beat frequency and the in vivo effects of the NO donor sodium nitroprusside (SNP) on mucociliary activity were investigated in the rabbit maxillary sinus mucosa with photoelectric techniques. L-Arginine increased ciliary beat frequency in vitro with a maximum response of 27.1% +/- 6.4% at 10(-3) mol/L, and this effect was reversibly blocked by pretreatment with the NO synthase (NOS) inhibitor N(G)-nitro-L-arginine, whereas D-arginine had no such effect. SNP increased mucociliary activity in vivo, the peak response of 36.8% +/- 4.2% being obtained at the dose of 30.0 microg/kg. No tachyphylaxis was observed after repeat challenge with SNP. The increase in mucociliary activity caused by SNP was largely unaffected by pretreatment with the calcium channel blocker nifedipine, the cyclooxygenase inhibitor diclofenac, and the cholinergic antagonist atropine. The nonselective beta-blocker propranolol delayed the peak response of SNP to 7 to 8 minutes after challenge, compared with 1 to 2 minutes after challenge in animals without pretreatment. The results show the NO substrate L-arginine and the NO donor SNP to have ciliostimulatory effects in vitro and in vivo, respectively. The occurrence of NOS production in the sphenopalatine ganglion and sinus mucosa of the rabbit was studied by immunohistochemistry for NOS activity or nicotinamide adenine dinucleotide phosphate-diaphorase histochemistry. The latter is an indirect sign of neuronal NOS activity. Numerous NOS-containing cell bodies were seen in the sphenopalatine ganglion; in the sinus mucosa a moderate supply of thin NOS-immunoreactive nerve fibers was seen. Taken together, the morphologic findings and the functional results indicate NO to be a regulator of mucociliary activity in upper airways.
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| 4. |
- Bodin, Ingrid, et al.
(författare)
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Deterioration of intraoral recognition of shapes after treatment of oral and pharyngeal cancer.
- 2000
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Ingår i: Otolaryngology and head and neck surgery. - 0194-5998 .- 1097-6817. ; 122:4, s. 584-589
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Tidskriftsartikel (refereegranskat)abstract
- Thirty patients with diagnosed malignant tumors of the oral cavity or pharynx were tested in regards to intraoral shape recognition at 4 test occasions: before all treatment, after radiotherapy, 6 months after surgery, and 1 year after surgery. They were compared within groups as well as with a group of healthy reference individuals of the same age who underwent the same test procedure at a 2-month interval. The tumor itself did not influence the capability of shape recognition. The reference individuals demonstrated significantly better results on the second test occasion, which is known as a learning effect. Learning improvement was not seen in the patients whose second test occasions were after radiotherapy, implying an impediment amounting to the magnitude of the learning effect. At 6 months after surgery the patients' capabilities of shape recognition had deteriorated significantly with no difference between the oral cancer group and the pharyngeal cancer group. No spontaneous rehabilitation had taken place 1 year after surgery. The presence or absence of surgical lingual nerve damage did not influence the results. The nonoperated side does not compensate for the operated one. It is plausible that decreased oral sensory acuity in recognizing the shape of the bolus contributes to postoperative swallowing problems.
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| 5. |
- Hurst, David S., et al.
(författare)
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Levels of eosinophil cationic protein and myeloperoxidase from chronic middle ear effusion in patients with allergy and/or acute infection
- 1996
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Ingår i: Otolaryngology and head and neck surgery. - 0194-5998 .- 1097-6817. ; 114:4, s. 531-544
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND OBJECTIVE: Allergy may play a role in the middle ear inflammation that leads to otitis media with effusion. The purpose of this study was to determine whether an elevated mediator correlated with the patient's disease and thus could be used to differentiate allergy vs. infection as the cause of the middle ear inflammation. METHODS: WE evaluated 57 individuals with otitis media with effusion, 32 with persistent effusion but no recent acute infection, 14 with recent infection and purulent otitis media with effusion, and II healthy subjects. The mediator activity of eosinophils and neutrophils in effusion was studied in patients characterized as having allergy by positive intradermal skin test results and positive radioallergosorbent test results. Eosinophils were characterized by measurement of eosinophil cationic protein in the effusion. Neutrophils were characterized by measurement of myeloperoxidase in the effusion. The levels of eosinophil cationic protein and myeloperoxidase in patients with and without allergy were correlated to patient history. RESULTS: Significantly elevated levels of both eosinophil cationic protein and myeloperoxidase indicated that inflammation in the ear of patients with otitis media with effusion was characterized by a pronounced involvement of both eosinophils and neutrophils. Eighty-nine percent of all patients with disease had allergy. A higher ratio of myeloperoxidase to eosinophil cationic protein in patients with purulent otitis media with effusion indicated that in patients with a superimposed acute infection, neutrophil activity was increased even further. The level of eosinophil cationic protein was elevated only during the effusion of patients with allergies as compared with controls (p < 0.01). Among 29 cases of nonpurulent otitis media with effusion, 96.5% had allergic immune-mediated disease proved by skin testing, which was related clinically to their ear disease. Eighty-nine percent (89.6%) of these patients had eosinophil cationic protein levels greater than 10 microgram/L. CONCLUSION: Middle ear eosinophil cationic protein may be used as a marker of related allergy.
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| 6. |
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| 7. |
- Amble, F R, et al.
(författare)
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Amble FR, Lindberg SOH, McCaffrey TV, Runer T. Mucociliary function and endothelins 1, 2, and 3. Otolaryngol Head Neck Surg 1993;109:634-45.
- 1993
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Ingår i: Otolaryngology: Head and Neck Surgery. - 0194-5998. ; 109:4, s. 45-634
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Tidskriftsartikel (refereegranskat)abstract
- Endothelins are recently discovered peptides that cause vasoconstriction and bronchoconstriction. The significance to the mucociliary system of endothelins (ET) 1, 2 and 3 in upper as well as lower airways has not yet been clarified. Effects of these active peptides were investigated, combining both in vitro and in vivo rabbit models of mucociliary activity from the maxillary sinus and the trachea. The studies were performed using computerized photometric microscopy. Immunohistologic staining procedures were used to determine the presence of endothelins in sinus and trachea epithelium. Significant effects on mucociliary activity were noted for ET-1, -2, and -3 in vitro as well as in vivo. All endothelins were noted to accelerate mucociliary activity of both sinus and tracheal mucosa. The effects of endothelins were greater in the sinus than in the trachea. In vitro studies using the calcium blocker nifedipine and the cyclooxygenase inhibitor diclofenac indicated that the mechanism of action involves an intermediary prostaglandin pathway but is independent of release of intracellular calcium. These results were confirmed using ET-1 in vivo. Immunohistochemical staining showed endothelin to be present in both maxillary and tracheal epithelium of the rabbit. We conclude that endothelins have significant mucociliary stimulatory effects and that the presence of endothelins in normal mucosa indicates a potentially important role in respiratory homeostasis as well as inflammatory conditions.
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| 8. |
- Barenkamp, Stephen J., et al.
(författare)
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Panel 4 : Report of the Microbiology Panel
- 2017
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Ingår i: Otolaryngology - Head and Neck Surgery. - : Wiley. - 0194-5998 .- 1097-6817. ; 156:4_suppl, s. 51-62
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To perform a comprehensive review of the literature from July 2011 until June 2015 on the virology and bacteriology of otitis media in children. Data Sources: PubMed database of the National Library of Medicine. Review Methods: Two subpanels comprising experts in the virology and bacteriology of otitis media were created. Each panel reviewed the relevant literature in the fields of virology and bacteriology and generated draft reviews. These initial reviews were distributed to all panel members prior to meeting together at the Post-symposium Research Conference of the 18th International Symposium on Recent Advances in Otitis Media, National Harbor, Maryland, in June 2015. A final draft was created, circulated, and approved by all panel members. Conclusions: Excellent progress has been made in the past 4 years in advancing our understanding of the microbiology of otitis media. Numerous advances were made in basic laboratory studies, in animal models of otitis media, in better understanding the epidemiology of disease, and in clinical practice. Implications for Practice: (1) Many viruses cause acute otitis media without bacterial coinfection, and such cases do not require antibiotic treatment. (2) When respiratory syncytial virus, metapneumovirus, and influenza virus peak in the community, practitioners can expect to see an increase in clinical otitis media cases. (3) Biomarkers that predict which children with upper respiratory tract infections will develop otitis media may be available in the future. (4) Compounds that target newly identified bacterial virulence determinants may be available as future treatment options for children with otitis media.
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| 9. |
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| 10. |
- Caye-Thomasen, Per, et al.
(författare)
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Panel 3: Recent Advances in Anatomy, Pathology, and Cell Biology in Relation to Otitis Media Pathogenesis
- 2013
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Ingår i: Otolaryngology: Head and Neck Surgery. - : Wiley. - 0194-5998 .- 1097-6817. ; 148, s. 37-51
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Forskningsöversikt (refereegranskat)abstract
- Background and Objectives. The pathogenesis of otitis media (OM) involves a number of factors related to the anatomy, pathology, and cell biology of the middle ear, the mastoid, the Eustachian tube, and the nasopharynx. Although some issues of pathogenesis are fairly well established, others are only marginally indicated by current knowledge, and yet others remain undisclosed. The objective of this article is to provide a state-of-the-art review on recent scientific achievements in the pathogenesis of OM, as related to anatomy, pathology, and cell biology. Data Sources. PubMed, Ovid Medline, and Cochrane Library. Review Methods. Articles published on the pathogenesis of OM and the anatomy, pathology, and cell biology of the middle ear, the mastoid, the Eustachian tube, and the nasopharynx between January 2007 and June 2011 were identified. Among almost 1900 abstracts, the authors selected 130 articles for full article review and inclusion in this report. Results. New knowledge on a number of issues emerged, including cell-specific expression and function of fluid transportation and innate immune system molecules, mucous cell metaplasia, mucin expression, bacterial adherence, and epithelial internalization, as well as the occurrence, composition, dynamics, and potential role of bacterial biofilm. In addition, the potential role of gastroesophageal reflux disease and cigarette smoke exposure has been explored further. Conclusions and Implications for Practice. Over the past 4 years, considerable scientific progress has been made on the pathogenesis of OM, as related to issues of anatomy, pathology, and cell biology. Based on these new achievements and a sustained lack of essential knowledge, suggestions for future research are outlined.
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| 11. |
- Cervin, Anders, et al.
(författare)
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One-year low-dose erythromycin treatment of persistent chronic sinusitis after sinus surgery: clinical outcome and effects on mucociliary parameters and nasal nitric oxide.
- 2002
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Ingår i: Otolaryngology: Head and Neck Surgery. - : Wiley. - 0194-5998 .- 1097-6817. ; 126:5, s. 481-489
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: In 17 patients with chronic sinusitis persistent after sinus surgery, long-term, low-dose erythromycin therapy was tested. The aim of the investigation was to study the clinical outcome and effects on nasal nitric oxide (NO), ciliary beat frequency (CBF), and mucociliary transport (saccharine transit time). STUDY DESIGN AND SETTING: We conducted a prospective open study at a tertiary teaching hospital. Symptoms were assessed using visual analog scales. NO was measured using a chemiluminescence analyzer, and mucociliary transport was measured with the saccharine crystal technique. CBF was measured in nasal brush samples using a phase contrast microscope. All patients were treated with erythromycin succinate 250 mg 2x daily or clarithromycin 250 mg 1x daily and were assessed after 3 months. In cases where there was no response, treatment was abandoned. The remaining patients (responders) were reassessed after 12 months of treatment. RESULTS: Of 17 patients, 12 responded to treatment. The 12-month follow-up showed an improvement in saccharine transit time (P < 0.05) but no significant change in CBF. There was a trend toward an increase in NO (P = 0.12). Endoscopic nasal examination scoring improved significantly (P < 0.01). In the visual analog scale scoring, the most pronounced improvements were seen in nasal congestion, sticky secretion, and runny nose at 3 and 12 months (P < 0.01). Improvements were also seen in headache (P < 0.05). CONCLUSION: The present study suggests that long-term, low-dose treatment with erythromycin is effective in persistent chronic sinusitis that does not respond to sinus surgery or systemic steroid/antibiotic treatment. SIGNIFICANCE: Long-term, low-dose erythromycin therapy seems to be a promising alternative when more conventional therapy fails. However, placebo-controlled studies are needed to validate the potential of this treatment.
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| 12. |
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| 13. |
- Engström, Mats, et al.
(författare)
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Electroneurographic facial muscle pattern in Bell's palsy.
- 2000
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Ingår i: Otolaryngology and head and neck surgery. - 0194-5998 .- 1097-6817. ; 122:2, s. 290-297
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Tidskriftsartikel (refereegranskat)abstract
- To study the electroneurographic facial muscle pattern in Bell's palsy over time, electroneurographic recordings in the frontalis, orbicularis oculi, nasalis, and mentalis muscle regions were performed early (mean, day 11) and 1 and 3 months after the onset of the condition in 30 consecutive patients. The correlation between facial muscle electroneurographic recordings over time was also calculated. An additional aim was to assess whether further prognostic information could be obtained by electroneurographic recordings in more than one facial region. The recovery pattern was similar in all 4 facial regions. Initially, the correlation between the facial recordings was weak (r = 0.20-0.27), but it was improved at follow-up examinations (r = 0.33-0.65). Favorable outcome in 23 of 24 patients (96%) could have been predicted by the initial nasalis and/or mentalis recordings. The gap between patients with favorable outcome and patients with unfavorable outcome increased when the average electroneurography values were calculated from 1, 2, and 4 muscle recordings (4%, 8%, and 15%, respectively). Our results indicate that in Bell's palsy, electroneurographic examination of more than one facial muscle region may add prognostic information and that the degree of degeneration is initially different in the nerve branches.
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| 14. |
- Engström, Mats, et al.
(författare)
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Serial gadolinium-enhanced magnetic resonance imaging and assessment of facial nerve function in Bell's palsy
- 1997
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Ingår i: Otolaryngology and head and neck surgery. - 0194-5998 .- 1097-6817. ; 117:5, s. 559-566
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Tidskriftsartikel (refereegranskat)abstract
- Eleven patients with mild or moderate acute idiopathic peripheral facial palsy, so-called Bell's palsy, were serially examined by gadolinium-DTPA-enhanced MRI on mean days 11, 40, and 97 (third examination, n = 10) after the onset of palsy. Results of the clinical and neurophysiologic assessment of facial nerve function were compared with the gadolinium-enhanced MRI findings. Eight of the 11 patients demonstrated contrast enhancement of the facial nerve at the initial examination, but in 7 of them, the enhancement had disappeared by the time of the serial follow-up gadolinium-enhanced MRI scans. The disappearance of facial nerve enhancement was found to be related to clinical and neurophysiologic improvements in facial nerve function during recovery from Bell's palsy. The three patients whose scans were negative at the initial gadolinium-enhanced MRI examination had the same clinical severity of palsy, but initially they had milder neurophysiologic involvement than those who demonstrated enhancement; these three patients did not exhibit enhancement at serial follow-up scans. These findings indicate that the presence of enhancement at the initial MRI scan is not necessarily indicative of a poor prognosis for recovery.
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| 15. |
- Gudnadottir, Gunnhildur, et al.
(författare)
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Intranasal Budesonide and Quality of Life in Pediatric Sleep-Disordered Breathing: A Randomized Controlled Trial.
- 2018
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Ingår i: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. - : Wiley. - 1097-6817. ; 158:4, s. 752-759
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Tidskriftsartikel (refereegranskat)abstract
- Objective To study the efficacy of budesonide nasal spray on the health-related quality of life and symptoms among children with sleep-disordered breathing. Study Design Randomized, parallel, double-blind, placebo-controlled trial. Setting Tertiary referral center. Subjects and Methods Sixty children (ages, 4-10 years) who were referred because of snoring and/or apneas for >3 months were included between January 2015 and June 2016 and randomized in a double-blind design to treatment with 64 μg/mL of budesonide nasal spray (n = 30) or placebo nasal spray (n = 30) twice daily for 6 weeks. The primary outcome measurement was the change in the mean OSA-18 total score from baseline. Other variables examined were individual OSA-18 domains, a visual analog scale for quality of life, symptoms (snoring, apneas, and nasal obstruction), and adenoid and tonsil size. The trial was investigator initiated and not sponsored by the pharmaceutical industry. Results Fifty-five children completed the trial. An intention-to-treat analysis revealed a significantly greater improvement in the mean OSA-18 total score after treatment with budesonide than placebo (19.5 vs 7.5, P = .0014). Intranasal budesonide also improved 2 OSA-18 domains (sleep disturbance, caregivers' concerns), the visual analog scale score for quality of life, as well as snoring, apneas, and nasal obstruction. No serious adverse events were reported that could be linked to the treatment. Conclusion Among children with sleep-disordered breathing, 6 weeks' treatment with intranasal budesonide significantly improved quality of life and symptoms as compared with placebo nasal spray.
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| 16. |
- Hammerlid, Eva, 1957, et al.
(författare)
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Quality-of-life effects of psychosocial intervention in patients with head and neck cancer.
- 1999
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Ingår i: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. - 0194-5998. ; 120:4, s. 507-16
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Tidskriftsartikel (refereegranskat)abstract
- METHODS: Two studies of psychosocial interventions in head and neck cancer patients at different stages of their disease were performed. We explored the feasibility and effectiveness of different approaches, offered for the first time to this population. The first study concerned long-term group psychological therapy for patients with newly diagnosed head and neck cancer. Quality of life was measured longitudinally for 1 year and compared with that of a control group. The second study comprised a short-term psychoeducational program 1 year after treatment for head and neck cancer. Quality-of-life assessments were made repeatedly from diagnosis until 1 month after the intervention. RESULTS: Thirteen patients started the psychological group therapy, and 8 of them completed both the intervention and evaluation procedure. The quality of life of the therapy group improved more than that of a control group in most areas measured during the study year, in particular psychiatric morbidity, social functioning, emotional functioning, and global quality of life. The results indicate benefits from the therapy, although the therapy group scored worse than the control group at diagnosis. Most of the variables representing functioning and symptoms improved after the 1-week psychoeducational program, especially items reflecting "trouble eating" and "problems enjoying your meals." Patients' judgments of the intervention quality indicated satisfaction with all separate elements, mostly education, about cancer and the opportunity to socialize with the other guests. CONCLUSION: These pilot studies suggest that head and neck cancer patients can benefit from different psychosocial interventions. Quality-of-life questionnaires were well accepted and sensitive to changes during the studies. Thus our early findings seem promising and would justify confirmation in larger studies.
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| 17. |
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| 18. |
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| 19. |
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| 20. |
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| 21. |
- Kanerva, Mervi, et al.
(författare)
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Sunnybrook and House-Brackmann Systems in 5397 Facial Gradings
- 2011
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Ingår i: Otolaryngology: Head and Neck Surgery. - : Wiley. - 0194-5998 .- 1097-6817. ; 144:4, s. 570-574
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. To study the correlation between Sunnybrook and House-Brackmann facial grading systems at different time points during the course of peripheral facial palsy. Study Design. Prospective multicenter trial. Setting. Seventeen otorhinolaryngological centers. Subjects and Methods. Data are part of the Scandinavian Bell's palsy study. The facial function of 1920 patients with peripheral facial palsy was assessed 5397 times with both Sunnybrook and House-Brackmann (H-B) facial grading systems. Grading was done at initial visit, at days 11 to 17 of palsy onset, and at 1 month, 2 months, 3 months, 6 months, and 12 months. Statistical evaluation was by Spearman correlation coefficient and box plot analysis. Results. Spearman correlation coefficient varied from -0.81 to -0.96, with the weakest correlation found at initial visit. Box plot analysis for all assessments revealed that Sunnybrook scores were widely spread over different H-B grades. With 50% of the results closest to the median, Sunnybrook composite scores varied in H-B grades as follows: H-B I, 100; H-B II, 71 to 90; H-B III, 43 to 62; H-B IV, 26 to 43; H-B V, 13 to 25; and H-B VI, 5 to 14. Conclusion. Gradings correlated better in follow-up assessments than at initial visit. As shown by the wide overlap of the grading results, subjective grading systems are only approximate. However, a conversion table for Sunnybrook and H-B gradings was obtained and is included in the article. It can be used for further development of facial grading systems.
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| 22. |
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| 23. |
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| 24. |
- Li, Jian-Dong, et al.
(författare)
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Panel 4: Recent Advances in Otitis Media in Molecular Biology, Biochemistry, Genetics, and Animal Models
- 2013
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Ingår i: Otolaryngology: Head and Neck Surgery. - : Wiley. - 0194-5998 .- 1097-6817. ; 148, s. 52-63
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Forskningsöversikt (refereegranskat)abstract
- Background. Otitis media (OM) is the most common childhood bacterial infection and also the leading cause of conductive hearing loss in children. Currently, there is an urgent need for developing novel therapeutic agents for treating OM based on full understanding of molecular pathogenesis in the areas of molecular biology, biochemistry, genetics, and animal model studies in OM. Objective. To provide a state-of-the-art review concerning recent advances in OM in the areas of molecular biology, biochemistry, genetics, and animal model studies and to discuss the future directions of OM studies in these areas. Data Sources and Review Methods. A structured search of the current literature (since June 2007). The authors searched PubMed for published literature in the areas of molecular biology, biochemistry, genetics, and animal model studies in OM. Results. Over the past 4 years, significant progress has been made in the areas of molecular biology, biochemistry, genetics, and animal model studies in OM. These studies brought new insights into our understanding of the molecular and biochemical mechanisms underlying the molecular pathogenesis of OM and helped identify novel therapeutic targets for OM. Conclusions and Implications for Practice. Our understanding of the molecular pathogenesis of OM has been significantly advanced, particularly in the areas of inflammation, innate immunity, mucus overproduction, mucosal hyperplasia, middle ear and inner ear interaction, genetics, genome sequencing, and animal model studies. Although these studies are still in their experimental stages, they help identify new potential therapeutic targets. Future preclinical and clinical studies will help to translate these exciting experimental research findings into clinical applications.
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| 25. |
- Lindberg, Sven, et al.
(författare)
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VIP potentiates cholinergic effects on the mucociliary system in the maxillary sinus
- 1988
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Ingår i: Otolaryngology: Head and Neck Surgery. - 0194-5998. ; 99:4, s. 401-407
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Tidskriftsartikel (refereegranskat)abstract
- The neuropeptide vasoactive intestinal polypeptide (VIP), which is found in a population of cholinergic parasympathetic neurons in the airways, has no effects per se on mucociliary activity. In order to test the hypothesis that VIP may modulate cholinergic regulation of the mucociliary system, VIP was infused intraarterially (8.4 pmol/kg/min), and the response to challenges with methacholine in the maxillary sinus of rabbits were recorded with a photoelectric technique. Occurrence of VIP-like immunoreactivity in the rabbit maxillary sinus, maxillary nerve, and sphenopalatine ganglion was investigated. Immunoreactivity against VIP was found in nerve fibers in the subepithelial layer of the maxillary sinus and in numerous nerve cell bodies in the sphenopalatine ganglion. Infusion of VIP potentiated the mucociliary increase induced by methacholine. The mucociliary wave frequency change increased from 6.1% +/- 1.7% to 13.3% +/- 3.9% (0.01 micrograms/kg methacholine), from 11.6% +/- 3.6% to 18.8% +/- 2.2% (0.05 micrograms/kg) and from 17.0% +/- 3.0% to 27.4% +/- 3.6% (0.1 micrograms/kg). Both peak responses and response durations increased during infusions. In contrast, the vasodilating agent papaverine sulphate did not influence the mucociliary response to methacholine. The modulating effect of VIP on the mucociliary system, taken together with the morphologic observations, suggest that VIP may have a physiologic role in the regulation of the mucociliary system in the maxillary sinus.
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| 26. |
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| 27. |
- Ntouniadakis, Eleftherios, 1983-, et al.
(författare)
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Monitoring Adult Subglottic Stenosis With Spirometry and Dyspnea Index : A Novel Approach
- 2022
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Ingår i: Otolaryngology and head and neck surgery. - : Sage Publications. - 0194-5998 .- 1097-6817. ; 167:3, s. 517-523
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim was to examine the correlations among the anatomic Cotton-Myer classification, pulmonary function tests (PFTs), and patient-perceived dyspnea or dysphonia in patients with subglottic stenosis and identify measurements accurately reflecting treatment effects.STUDY DESIGN: Prospective cohort study.SETTING: Tertiary referral center.METHOD: Fifty-two adults receiving endoscopic treatment for isolated subglottic stenosis were consecutively included. Correlations were calculated among the preoperative Cotton-Myer scale, PFTs, the Dyspnea Index (DI), and the Voice Handicap Index. Receiver operating characteristic curves were determined for PFT, DI, and Voice Handicap Index pre- and postoperative measurements.RESULTS: The Cotton-Myer classification correlated weakly with peak expiratory flow (r = -0.35, P = .012), expiratory disproportion index (r = 0.32, P = .022), peak inspiratory flow (r = -0.32, P = .022), and total peak flow (r = -0.36, P = .01). The DI showed an excellent area under the curve (0.99, P < .001), and among PFTs, the expiratory disproportion index demonstrated the best area under the curve (0.89, P < .001), followed by total peak flow (0.88, P < .001), peak expiratory flow (0.87, P < .001), and peak inspiratory flow (0.84, P < .001). Patients treated endoscopically with balloon dilatation showed a 53% decrease in expiratory disproportion index (95% CI, 41%-66%; P < .001) and a 37% improvement in peak expiratory flow (95% CI, 31%-43%; P < .001).CONCLUSION: Expiratory disproportion index or peak expiratory flow combined with DI was a feasible measurement for the monitoring of adult subglottic stenosis. The percentage deterioration of peak expiratory flow and increase in expiratory disproportion index correlated significantly with a proportional percentage increase in DI.
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| 28. |
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| 29. |
- Pettigrew, Melinda M, et al.
(författare)
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Panel 6 : Vaccines
- 2017
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Ingår i: Otolaryngology - Head and Neck Surgery. - : Wiley. - 0194-5998 .- 1097-6817. ; 156:4_suppl, s. 76-87
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To review the literature on progress regarding (1) effectiveness of vaccines for prevention of otitis media (OM) and (2) development of vaccine antigens for OM bacterial and viral pathogens. Data Sources: PubMed database of the National Library of Science. Review Methods: We performed literature searches in PubMed for OM pathogens and candidate vaccine antigens, and we restricted the searches to articles in English that were published between July 2011 and June 2015. Panel members reviewed literature in their area of expertise. Conclusions: Pneumococcal conjugate vaccines (PCVs) are somewhat effective for the prevention of pneumococcal OM, recurrent OM, OM visits, and tympanostomy tube insertions. Widespread use of PCVs has been associated with shifts in pneumococcal serotypes and bacterial pathogens associated with OM, diminishing PCV effectiveness against AOM. The 10-valent pneumococcal vaccine containing Haemophilus influenzae protein D (PHiD-CV) is effective for pneumococcal OM, but results from studies describing the potential impact on OM due to H influenzae have been inconsistent. Progress in vaccine development for H influenzae, Moraxella catarrhalis, and OM-associated respiratory viruses has been limited. Additional research is needed to extend vaccine protection to additional pneumococcal serotypes and other otopathogens. There are likely to be licensure challenges for protein-based vaccines, and data on correlates of protection for OM vaccine antigens are urgently needed. Implications for Practice: OM continues to be a significant health care burden globally. Prevention is preferable to treatment, and vaccine development remains an important goal. As a polymicrobial disease, OM poses significant but not insurmountable challenges for vaccine development.
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| 30. |
- Preciado, Diego, et al.
(författare)
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Panel 8 : Report on Recent Advances in Molecular and Cellular Biochemistry
- 2017
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Ingår i: Otolaryngology - Head and Neck Surgery. - : Wiley. - 0194-5998 .- 1097-6817. ; 156:4_suppl, s. 106-113
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To update the medical literature on recent cellular and molecular advances in otitis media disease models with a principal focus on developments in the past 5 years. We also aim to explain recent translational advances in cellular and molecular biology that have influenced our understanding and management of otitis media. Data Sources: PubMed-indexed peer-reviewed articles. Review Methods: A comprehensive review of the literature was conducted with the term otitis media and the following search terms: molecular biology, cell biology, innate immunity, oxidative stress, mucins, molecular diagnostics. Included articles were published in the English language from January 1, 2010, to July 31, 2015. Implications for Practice: The molecular understanding of otitis media disease progression has rapidly advanced over the last 5 years. The roles of inflammation, mucins, and cell signaling mechanisms have been elucidated and defined. Advances in the field provide a plethora of opportunities for innovative molecular targeting in the development of novel therapeutic strategies for otitis media.
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| 31. |
- Priwin, Claudia, 1971, et al.
(författare)
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The bone-anchored hearing aid in children: a surgical and questionnaire follow-up study
- 2005
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Ingår i: Otolaryngol Head Neck Surg. - : Wiley. - 0194-5998. ; 132:4, s. 559-65
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The main objectives were to evaluate the surgical techniques and problems seen in children with bone-anchored hearing aids (BAHA) as well as to determine the children's attitudes toward BAHA. STUDY DESIGN: A retrospective study of 41 children with unilateral BAHA was conducted. Surgical recordings were investigated and a questionnaire was distributed. RESULTS: Surgery was performed as a 2-stage procedure. Available bone thickness was measured in 29 patients and found to be on average 2.5 mm. Thin temporal bone necessitated bone augmentation in 8 patients. Of the implants, 70.5% were installed in contact with the dura or the sigmoid sinus. Implant failures were seen in 9.1% and adverse skin reactions appeared in 7.6% of the patients. Twenty-seven patients responded to the questionnaire, 19 were still BAHA users. Overall, these patients were very content with their BAHAs. CONCLUSION: BAHA is a good alternative in children despite limited thickness of the temporal bone.
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| 32. |
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| 33. |
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| 34. |
- Swarts, J. Douglas, et al.
(författare)
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Panel 2: Eustachian Tube, Middle Ear, and Mastoid-Anatomy, Physiology, Pathophysiology, and Pathogenesis
- 2013
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Ingår i: Otolaryngology: Head and Neck Surgery. - : Wiley. - 0194-5998 .- 1097-6817. ; 148, s. 26-36
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Forskningsöversikt (refereegranskat)abstract
- Objective. This report reviews the literature to identify the advances in our understanding of the middle ear (ME)Eustachian tube (ET) system during the past 4 years and, on that basis, to determine whether the short-term goals elaborated in the last report were achieved and propose updated goals to guide future otitis media (OM) research. Data Sources. Databases searched included PubMed, Web of Science (1945-present), Medline (1950 to present), Biosis Previews (1969-present), and the Zoological Record (1978 to present). The initial literature search covered the time interval from January 2007 to June 2011, with a supplementary search completed in February 2012. Review Methods. The panel topic was subdivided; each contributor performed a literature search and provided a preliminary report. Those reports were consolidated and discussed when the panel met on June 9, 2011. At that meeting, the progress was evaluated and new short-term goals proposed. Conclusions. Progress was made on 16 of the 19 short-term goals proposed in 2007. Significant advances were made in the characterization of ME gas exchange pathways, modeling ET function, and preliminary testing of treatments for ET dysfunction. Implications for Practice. In the future, imaging technologies should be developed to noninvasively assess ME/ET structure and physiology with respect to their role in OM pathogenesis. The new data derived from form/function experiments should be integrated into the finite element models and used to develop specific hypotheses concerning OM pathogenesis and persistence. Finally, rigorous studies of treatments, medical or surgical, of ET dysfunction should be undertaken.
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| 35. |
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| 36. |
- Wennmo, Carsten, et al.
(författare)
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Visually evoked slow eye movements, visual-vestibular interaction, and infratentorial lesions
- 1983
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Ingår i: Otolaryngology - Head and Neck Surgery. - : Wiley. - 0194-5998 .- 1097-6817. ; 91:1, s. 76-80
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Tidskriftsartikel (refereegranskat)abstract
- The maximum velocity gain of smooth pursuit and optokinetic, vestibular, and optovestibular slow phases was examined in 15 patients with pontine, 10 with medullary, 10 with cerebellar, and 5 with combined cerebello-brain stem disorders. Marked dissociations were observed between smooth pursuit and optokinetic slow phases, especially in medullary disease. A cerebellar deficit enhanced slow phase velocity gain during rotation in darkness, whereas the corresponding gain during rotation in light was normal.
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| 37. |
- Wetmore, Stephen J., et al.
(författare)
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Challenges and Opportunities in Managing the Dizzy Older Adult
- 2011
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Ingår i: Otolaryngology: Head and Neck Surgery. - : Wiley. - 0194-5998 .- 1097-6817. ; 144:5, s. 651-656
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Konferensbidrag (refereegranskat)abstract
- Balance disorders are common in elderly people, not only resulting in distressing sensations but also leading to reduced activity levels and quality of life. It has been estimated that 30% of elderly patients experience a balance disorder. Managing these disorders is a substantial challenge for patients and their caregivers and physicians. Moreover, abnormalities in balance are associated with falls, a major cause of morbidity and mortality for elderly people. Management is complicated by the inherent difficulties in assessing the generic complaint of dizziness, as well as the likelihood of multiple, often nonvestibular causes. The authors of this mini-seminar review both vestibular and nonvestibular causes of balance disorders in elderly people, emphasizing practical therapeutic maneuvers that can be used.
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| 38. |
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| 39. |
- Ödkvist, L., et al.
(författare)
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Otoneurologic disturbances caused by solvent pollution
- 1992
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Ingår i: Otolaryngology and head and neck surgery. - 0194-5998 .- 1097-6817. ; 106:6, s. 687-692
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Tidskriftsartikel (refereegranskat)abstract
- Subjects exposed to industrial solvents may experience vertigo and nausea. Solvents are usually volatile hydrocarbon compounds, which are important parts of everyday life in a modern society. They may also cause neurastenia, personality changes, and reduced intellectual capacity. The syndrome that may develop was formerly named psycho-organic syndrome (POS), but in modern terminology it is called chronic toxic encephalopathy (CTE). The syndrome develops slowly, and during the first years no pathological findings will be found using various test batteries. Somewhat later, when the syndrome still might be reversible, psychometric, auditory, and otoneurologic testing may well unveil disturbances within the posterior fossa structures. Animal experiments suggest one site of effect for solvents to be within the cerebellum and brainstem regions with close relationship to the gamma-amino-butyric acid (GABA) transmission. In the otoneurologic test battery, visual suppression and smooth pursuit are of extreme value, as are some auditory tests such as discrimination of interrupted speech and cortical response audiometry using frequency glides as stimuli. Dynamic posturography and magnetic resonance imaging (MRI) have recently proved valuable in the diagnosis. Research is needed concerning the most efficient test battery for early detection of solvent-induced lesions. During further research it is important to unveil other toxic agents, like heavy metals and alcohol, and their damage to the central nervous system and to make comparisons between these substances and the lesions caused by hydrocarbon solvents.
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| 40. |
- Ödkvist, Lars, et al.
(författare)
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Vestibulo-oculomotor disturbances caused by industrial solvents
- 1983
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Ingår i: Otolaryngology - Head and Neck Surgery. - 0194-5998. ; 91:5, s. 537-539
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Tidskriftsartikel (refereegranskat)abstract
- Animal experiments show that intoxication with hydrocarbon solvents influences the vestibulo-oculomotor reflex arc and indicate that the solvents block the inhibition of the vestibulo-oculomotor reflex presumably exerted by the cerebellum. The blood concentrations necessary to elicit oculomotor disturbances in animals were smaller than those that disturbed the vestibular function. Accordingly, in human experiments styrene and toluene exposure did not elicit any positional nystagmus but caused an increased saccade speed and a diminished visual suppression of vestibular nystagmus. Some cerebellar clinical pathologic process in patients who suffer from a psycho-organic syndrome caused by solvents leads us to believe that the cerebellum might be the most vulnerable part of the brain. Some patients had a positional nystagmus, but the most prominent pathologic signs were elicited by the visual suppression test. Our findings compare well with the increased saccade speed and diminished visual suppression in patients with cerebellar tumors and infarctions
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| 41. |
- Østvoll, Eirik, et al.
(författare)
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Increasing Readmission Rates for Hemorrhage after Tonsil Surgery: A Longitudinal (26 Years) National Study
- 2018
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Ingår i: Otolaryngology - Head and Neck Surgery. - : Wiley. - 0194-5998 .- 1097-6817. ; 158:1, s. 167-176
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the readmission rates due to postoperative hemorrhage in relation to tonsil surgery clinical practice in a national population. Study Design: Retrospective longitudinal population-based cohort study. Setting: Based on register data from the Swedish National Patient Register (NPR). Subjects and Methods: All benign tonsil operations (256 053) performed in Sweden from 1987 to 2013 were identified through a search in the NPR. For all identified cases, data on gender, age, date of surgery, indication, type of surgery, level of care, length of stay (LOS) for inpatient surgery, readmission and reoperation because of postoperative bleeding (within 31 days) were collected. Results: Overall frequency of readmission for hemorrhage was 2.61%, and the reoperation rate for hemostasis was 0.84%. The longitudinal analysis showed an increase from 1% (1987) to 5% (2013) in readmissions caused by hemorrhage. Tonsillectomies, surgery performed for infectious disease, and surgery on adult patients (age >18 years) showed readmission rates approaching 10% (2013). Male gender, increasing age, tonsillectomy, infectious indication, and recent year of surgery were identified as risk factors for readmission and reoperation due to hemorrhage. An increasing share of patients readmitted for hemorrhage underwent reoperation for hemostasis: 18% (1987) versus 43% (2013). Conclusion: Readmissions for hemorrhage have increased by a factor of 5 in Sweden from 1987 to 2013. The design of the study and the data in NPR do not allow determination of the true reasons behind the alarming results. © 2017, © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2017.
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