| 1. |
- Bance, Manohar, et al.
(författare)
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Effects of tensor tympani muscle contraction on the middle ear and markers of a contracted muscle.
- 2013
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Ingår i: The Laryngoscope. - : Wiley. - 1531-4995 .- 0023-852X. ; 123:4, s. 1021-1027
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES/HYPOTHESIS: Many otologic disorders have been attributed to dysfunction of the tensor tympani muscle, including tinnitus, otalgia, Meniere's disease and sensorineural hearing loss. The objective of this study was to determine adequate stimuli for tensor tympani contraction in humans and determine markers of the hypercontracted state that could be used to detect this process in otologic disease. STUDY DESIGN: Multiple types of studies. METHODS: Studies included 1) measuring middle ear impedance changes in response to orbital puffs of air, facial stroking, and self-vocalization; 2) measuring changes in stapes and eardrum vibrations and middle ear acoustic impedance in response to force loading of the tensor tympani in fresh human cadaveric temporal bones; 3) measuring changes in acoustic impedance in two subjects who could voluntarily contract their tensor tympani, and performing an audiogram with the muscle contracted in one of these subjects; and 4) developing a lumped parameter computer model of the middle ear while simulating various levels of tensor tympani contraction. RESULTS: Orbital jets of air are the most effective stimuli for eliciting tensor tympani contraction. As markers for tensor tympani contraction, all investigations indicate that tensor tympani hypercontraction should result in a low-frequency hearing loss, predominantly conductive, with a decrease in middle ear compliance. CONCLUSIONS: These markers should be searched for in otologic pathology states where the tensor tympani is suspected of being hypercontracted.
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| 4. |
- Flynn, Traci, 1973, et al.
(författare)
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A longitudinal study of hearing and middle ear status in adolescents with cleft lip and palate
- 2013
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Ingår i: The Laryngoscope. - : Wiley. - 0023-852X .- 1531-4995. ; 123:6, s. 1374-1380
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES/HYPOTHESIS: To study longitudinal prevalence of otitis media with effusion (OME) in children between 7 and 16 years of age by cleft group, and hearing sensitivity across time and across frequencies. STUDY DESIGN: Retrospective and longitudinal. METHODS: All children with cleft palate born from 1991 to 1993 were included in the study (n = 58). Audiological and otological data were reviewed at 7, 10, 13, and 16 years of age. The group was divided by cleft type (24 unilateral cleft lip and palate, 23 cleft palate only, and 11 bilateral cleft lip and palate). RESULTS: The prevalence of abnormal middle ear status decreased significantly with age. When comparing cleft types, the isolated cleft palate group presented with a significantly lower prevalence of abnormal middle ear status than the other groups at 7 and 16 years of age (21% as compared to 32% in the unilateral group and 38% in the bilateral group). The pure-tone average improved with age, while the high-frequency pure-tone average did not. When cleft types were compared, the bilateral group demonstrated significantly poorer hearing in the high frequencies than the other groups. CONCLUSION: Children with cleft palate need regular audiological and otological follow-up to ensure management is appropriate and timely. The increased hearing thresholds in the high frequencies may be due to the increased episodes of OME.
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| 5. |
- Hellberg, Victoria, et al.
(författare)
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Cochlear Pharmacokinetics of Cisplatin : An In Vivo Study in the Guinea Pig
- 2013
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Ingår i: The Laryngoscope. - : Wiley. - 0023-852X .- 1531-4995. ; 123:12, s. 3172-3177
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Tidskriftsartikel (refereegranskat)abstract
- Objectives/HypothesisCisplatin produces toxic lesions to outer hair cells (OHCs) in the cochlear base but not in the apex. The objective of this study was to compare the pharmacokinetic profile of cisplatin in scala tympani (ST) perilymph in the cochlear base and apex, respectively. Study DesignIn vivo animal study. MethodsForty-seven guinea pigs were given an intravenous bolus injection of an ototoxic dose of cisplatin. Ten to 240 minutes after cisplatin was given, blood, cerebrospinal fluid (CSF), and ST perilymph were aspirated within the same target time. ST perilymph was aspirated from the basal turn and from the apex of the cochlea by two different sampling techniques. Liquid chromatography with postcolumn derivatization was used for quantitative determination of the parent drug. ResultsTen minutes after administration, the concentration of cisplatin in ST perilymph was 4-fold higher in the basal turn of the cochlea than in the apex. At 30 minutes, the drug concentrations did not differ. At 60 minutes, the level of cisplatin in ST perilymph and blood UF was equivalent. The perilymph-blood ratio increased thereafter with time. ConclusionThe pharmacokinetic findings of an early high concentration of cisplatin in the base of the cochlea and delayed elimination of cisplatin from ST perilymph compared to blood might correlate to the cisplatin-induced loss of OHCs in the base of the cochlea. Level of EvidenceN/A. Laryngoscope, 123:3172-3177, 2013
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| 6. |
- Hessen Soderman, Anne-Charlotte, et al.
(författare)
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Reduced Risk of Primary Postoperative Hemorrhage After Tonsil Surgery in Sweden : Results from the National Tonsil Surgery Register in Sweden Covering More Than 10 Years and 54,696 Operations
- 2011
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Ingår i: The Laryngoscope. - Malden, USA : Wiley-Blackwell. - 0023-852X .- 1531-4995. ; 121:11, s. 2322-2326
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Tidskriftsartikel (refereegranskat)abstract
- Objectives/Hypothesis: To analyze the incidence of primary bleeding following tonsil surgery and to evaluate risk factors. less thanbrgreater than less thanbrgreater thanStudy Design: Register study of the results from the National Tonsil Surgery Register in Sweden covering the period 1997 to 2008 and 54,696 operations. less thanbrgreater than less thanbrgreater thanMethods: Data were collected by means of three questionnaires, two filled in by professionals and one 6 months post-operatively by the patient/parent. less thanbrgreater than less thanbrgreater thanResults: A total of 719 patients experienced primary postoperative bleeding during the hospital stay (1.3%). A number of independent factors were correlated with decreased risk of post-tonsillectomy hemorrhage: younger age (P andlt; .0001), female sex (P andlt; .0001), type of surgery (tonsillotomy) (P = .0006), and surgery performed on a day-surgery basis (P andlt; .0001). Indication for surgery and number of operations performed at the department did not correlate with postoperative bleeding risk. A significant decrease in primary postoperative hemorrhage rate from 2% to 0.96% was found during the study period. less thanbrgreater than less thanbrgreater thanConclusions: Primary hemorrhage following tonsil surgery is rare. During the study period, a significant decrease in primary bleeding rates occurred. The changes in practice with an increasing proportion of day-surgery cases and tonsillotomy have contributed to the reduced risk, but cannot completely explain the reduction.
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| 7. |
- Holmlund, Thorbjörn, et al.
(författare)
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Effects of Radiofrequency versus Sham Surgery of the Soft Palate on Daytime Sleepiness
- 2014
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Ingår i: The Laryngoscope. - : Wiley. - 0023-852X .- 1531-4995. ; 124:10, s. 2422-2426
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Tidskriftsartikel (refereegranskat)abstract
- Objectives/Hypothesis: To evaluate the effect of radiofrequency surgery of the soft palate on daytime sleepiness in snoring men with mild or no sleep apnea Study design: Randomized controlled trial Methods: Thirty-five men were recruited from consecutive patients referred to the Ear, Nose and Throat Clinic due to snoring and complaints of daytime sleepiness. The inclusion criteria were an apnea-hypopnea index of ≤ 15, male gender and age 18-65 years. Patients were randomized to either radiofrequency or sham surgery of the soft palate. All but one chose and received the option of three treatments. All patients participated in a follow-up including an overnight sleep apnea recording and questionnaires 12 months after the last treatment. The primary outcome was daytime sleepiness measured with the Epworth Sleepiness Scale (ESS) and other questionnaires. Secondary outcomes were effects on the apnea-hypopnea index and subjective snoring. Results: Thirty-two of 35 patients, 19 of 20 in the radiofrequency surgery group and 13 of 15 in the sham surgery group, completed the study. No differences between the two groups in relation to the ESS or apnea-hypopnea index were found at follow-up. Conclusion: Radiofrequency surgery of the soft palate has no effect on daytime sleepiness, snoring or apnea frequency in snoring men with mild or no sleep apnea, one year after surgery.
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| 9. |
- Marsk, Elin, et al.
(författare)
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Prediction of nonrecovery in Bell's palsy using sunnybrook grading
- 2012
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Ingår i: The Laryngoscope. - : Wiley. - 0023-852X .- 1531-4995. ; 122:4, s. 901-906
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Tidskriftsartikel (refereegranskat)abstract
- Objectives/Hypothesis: To develop a clinical prognostic model to identify Bell's palsy patients with risk for nonrecovery at 12 months. Study Design: Data from a prospective, randomized, double-blind, placebo-controlled, multicenter study. Methods: There were 829 patients with Bell's palsy randomized in a factorial fashion to treatment with prednisolone or no prednisolone. Facial function was assessed with the Sunnybrook grading scale. Univariate and multivariate logistic regression analyses at different time points were used to identify factors predicting nonrecovery, defined as Sunnybrook < 70 at 12 months. Variables studied were age, gender, time to inclusion, prednisolone treatment, side of palsy, pain at inclusion, and Sunnybrook scores. Factors of predictable significance were used to construct prognostic models at baseline, days 11 to 17, and at 1 month. Receiver operating characteristics curves were created to test the predictive capacity of the models. Results: At baseline, treatment with prednisolone or no prednisolone (P = .0005), age (P = .04) and the Sunnybrook score (P = .0002) were significant factors for predicting nonrecovery. The receiver operating characteristics area under the curve at baseline for these three variables was 0.74 (sensitivity 0.83, specificity 0.57). At days 11 to 17 and at 1 month, the Sunnybrook score was the only significant predictive variable. The respective areas under the curves for the Sunnybrook score at these time points were 0.83 (sensitivity 0.81, specificity 0.75) and 0.94 (sensitivity 0.91, specificity 0.85). Conclusions: Sunnybrook grading at 1 month most accurately predicts nonrecovery at 12 months in Bell's palsy.
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| 10. |
- Niklasson, Anders, et al.
(författare)
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The Gelfoam® plug : an alternative treatment for small eardrum perforations
- 2011
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Ingår i: The Laryngoscope. - : John Wiley & Sons. - 0023-852X .- 1531-4995. ; 121:4, s. 782-784
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To examine if a Gelfoam® plug in combination with surgical removal of the perforation edges could be an alternative to the widely accepted fat plug treatment for smaller ear drum perforations.MATERIALS AND METHODS: A prospective study of 17 consecutive patients with persistent small ear drum perforations considered for myringoplasty. The perforations were central perforations 2 to 4 mm in diameter. Patient ages ranged from 6 to 83 years, and the operation was performed under general anesthesia with mask ventilation in children and under topical local anesthesia in adults. A Gelfoam® plug was inserted into the perforation after surgical removal of the perforation edges. The follow-up time was more than 3 months.RESULTS: The closure rate of the ear drum was 83% (15/18). Pure tone average (PTA) was 19 dB preoperatively and 16 dB postoperatively.CONCLUSIONS: We show for the first time in humans that a Gelfoam® plug in combination with surgical removal of the perforation edges seems to result in about the same closure rate as the fat plug technique in persistent small ear drum perforations. Moreover, the method using Gelfoam® is simpler and faster than the fat plug technique. We suggest that randomized studies comparing the Gelfoam® plug technique with the fat plug technique should be performed.
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| 11. |
- Silander, Ewa M, 1952, et al.
(författare)
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An exploration of factors predicting malnutrition in patients with advanced head and neck cancer.
- 2013
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Ingår i: The Laryngoscope. - : Wiley. - 1531-4995 .- 0023-852X. ; 123:10, s. 2428-2434
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Tidskriftsartikel (refereegranskat)abstract
- Malnutrition is common among head and neck cancer patients and negatively impacts on survival and quality of life. This study aimed to identify predictors of malnutrition at time of diagnosis in order to identify patients at risk and enable early nutritional support and prevent malnutrition.
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| 12. |
- Sunnergren, Ola, 1971-, et al.
(författare)
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Soft Palate Sensory Neuropathy in the Pathogenesis of Obstructive Sleep Apnea
- 2011
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Ingår i: The Laryngoscope. - : Laryngoscope. - 0023-852X .- 1531-4995. ; 121:2, s. 451-456
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Tidskriftsartikel (refereegranskat)abstract
- Objectives/Hypothesis: In general, obstructive sleep apnea (USA) seems to be a progressive disorder whose pathogenesis is not fully understood. One hypothesis is that long-standing snoring vibrations cause a local neuropathy in the upper airway, which predisposes to obstructive events during sleep. The aim of this study was to investigate sensory function in the upper airway in a cohort of subjects comprising nonsnorers, snorers, and untreated subjects with USA, and to correlate data to apnea-hypopnea index (AHI) and duration of snoring. Study Design: Cross-sectional cohort study. Methods: Subjects were recruited from primary care hypertension clinics. Whole-night respiratory recordings were performed to determine presence and degree of USA. Three groups were formed based on AHI and snoring history: 1) nonsnorers (n = 25); 2) snorers, AHI andlt; 10 (n = 32); 3) USA subjects, AHI andgt;= 10 (n = 33). Quantitative cold sensory testing of the soft palate and lip was used to assess neuropathy. Results: There were no significant differences concerning lip sensory function between groups. Nonsnorers showed significantly lower thresholds for cold (i.e., better sensitivity) in the soft palate compared to both other groups (P andlt; .01). Snorers had lower thresholds than USA subjects (P andlt; .05). There were significant correlations (P andlt; .01) between decreased sensory function and AHI (r(s) = .41) and to duration of snoring (r(s) = .47). Conclusions: The degree of sensory neuropathy in the upper airway correlates with degree of obstructive sleep disorder. Our results strengthen the hypothesis that snoring vibrations may cause a neuropathy in the upper airway, which contributes to the progression and development of USA.
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