A comparison of cochlear distribution and glucocorticoid receptor activation in local and systemic dexamethasone drug delivery regimes

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Nathan J. Creber, Hayden T. Eastwood, Amy J. Hampson, Justin Tan, Stephen J. O'Leary
Local and systemically delivered glucocorticoids are commonly administered to protect the cochlea against damage associated with a variety of insults. There is reason to believe that dexamethasone administered by these routes may arrive at cochlear target sites via different pathways. Clinically, there is a lack of clarity as to which route is more effective in any specific circumstance. This study explores dexamethasone distribution within the guinea pig cochlea following local and systemic delivery methods. A combination of mass spectroscopy and immunohistochemistry were employed to compare both perilymph distribution, tissue uptake and receptor activation. Local administration of dexamethasone to the round window membrane resulted in greater perilymph concentrations, with a basal to apical gradient that favours the cochlear base. Tissue immunofluorescence was intimately related to perilymph concentration following local administration. Systemic administration resulted in much lower perilymph concentrations, with an inverse basal to apical gradient favouring the cochlear apex. Lower perilymph concentrations following systemic administration were associated with minimal tissue immunofluorescence. Despite this, GR activation of the SGNs was equivalent in both administration regimes. These results bring into question the efficacy of measuring perilymph concentrations alone as a surrogacy for dexamethasone distribution and activity in the cochlea, suggesting that the steroid ligand may arrive at its target receptor via alternative pathways. Our results suggest an equivalence in efficacy between local and systemic administration routes early after drug delivery, when the ultimate outcome of GR activation is the goal.



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Auditory and audio-vocal responses of single neurons in the monkey ventral premotor cortex

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Steffen R. Hage
Monkey vocalization is a complex behavioral pattern, which is flexibly used in audio-vocal communication. A recently proposed dual neural network model suggests that cognitive control might be involved in this behavior, originating from a frontal cortical network in the prefrontal cortex and mediated via projections from the rostral portion of the ventral premotor cortex (PMvr) and motor cortex to the primary vocal motor network in the brainstem. For the rapid adjustment of vocal output to external acoustic events, strong interconnections between vocal motor and auditory sites are needed, which are present at cortical and subcortical levels. However, the role of the PMvr in audio-vocal integration processes remains unclear. In the present study, single neurons in the PMvr were recorded in rhesus monkeys (Macaca mulatta) while volitionally producing vocalizations in a visual detection task or passively listening to monkey vocalizations. Ten percent of randomly selected neurons in the PMvr modulated their discharge rate in response to acoustic stimulation with species-specific calls. More than four-fifths of these auditory neurons showed an additional modulation of their discharge rates either before and/or during the monkeys' motor production of the vocalization. Based on these audio-vocal interactions, the PMvr might be well positioned to mediate higher order auditory processing with cognitive control of the vocal motor output to the primary vocal motor network. Such audio-vocal integration processes in the premotor cortex might constitute a precursor for the evolution of complex learned audio-vocal integration systems, ultimately giving rise to human speech.



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Hidden hearing loss and endbulbs of Held: Evidence for central pathology before detection of ABR threshold increases

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Michael A. Muniak, Femi E. Ayeni, David K. Ryugo
Reductions in sound-evoked activity in the auditory nerve due to hearing loss have been shown to cause pathological changes in central auditory structures. Hearing loss due strictly to the aging process are less well documented. In this study of CBA/CaH mice, we provide evidence for age-related pathology in the endbulb of Held, a large axosomatic ending arising from myelinated auditory nerve fibers. Endbulbs are known to be involved in the processing of temporal cues used for sound localization and speech comprehension. Hearing thresholds as measured by auditory brainstem response (ABR) thresholds remained stable up to one year, whereas suprathreshold amplitudes of early ABR waves decreased by up to 50% in older mice, similar to that reported for age-related cochlear synaptopathy (Sergeyenko et al., 2013). The reduction of ABR response magnitude with age correlated closely in time with the gradual atrophy of endbulbs of Held, and is consistent with the hypothesis that endbulb integrity is dependent upon normal levels of spike activity in the auditory nerve. These results indicate that central auditory pathologies emerge as consequence of so-called “hidden” hearing loss and suggest that such brain changes require consideration when devising therapeutic interventions.



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A comparison of cochlear distribution and glucocorticoid receptor activation in local and systemic dexamethasone drug delivery regimes

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Nathan J. Creber, Hayden T. Eastwood, Amy J. Hampson, Justin Tan, Stephen J. O'Leary
Local and systemically delivered glucocorticoids are commonly administered to protect the cochlea against damage associated with a variety of insults. There is reason to believe that dexamethasone administered by these routes may arrive at cochlear target sites via different pathways. Clinically, there is a lack of clarity as to which route is more effective in any specific circumstance. This study explores dexamethasone distribution within the guinea pig cochlea following local and systemic delivery methods. A combination of mass spectroscopy and immunohistochemistry were employed to compare both perilymph distribution, tissue uptake and receptor activation. Local administration of dexamethasone to the round window membrane resulted in greater perilymph concentrations, with a basal to apical gradient that favours the cochlear base. Tissue immunofluorescence was intimately related to perilymph concentration following local administration. Systemic administration resulted in much lower perilymph concentrations, with an inverse basal to apical gradient favouring the cochlear apex. Lower perilymph concentrations following systemic administration were associated with minimal tissue immunofluorescence. Despite this, GR activation of the SGNs was equivalent in both administration regimes. These results bring into question the efficacy of measuring perilymph concentrations alone as a surrogacy for dexamethasone distribution and activity in the cochlea, suggesting that the steroid ligand may arrive at its target receptor via alternative pathways. Our results suggest an equivalence in efficacy between local and systemic administration routes early after drug delivery, when the ultimate outcome of GR activation is the goal.



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Auditory and audio-vocal responses of single neurons in the monkey ventral premotor cortex

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Steffen R. Hage
Monkey vocalization is a complex behavioral pattern, which is flexibly used in audio-vocal communication. A recently proposed dual neural network model suggests that cognitive control might be involved in this behavior, originating from a frontal cortical network in the prefrontal cortex and mediated via projections from the rostral portion of the ventral premotor cortex (PMvr) and motor cortex to the primary vocal motor network in the brainstem. For the rapid adjustment of vocal output to external acoustic events, strong interconnections between vocal motor and auditory sites are needed, which are present at cortical and subcortical levels. However, the role of the PMvr in audio-vocal integration processes remains unclear. In the present study, single neurons in the PMvr were recorded in rhesus monkeys (Macaca mulatta) while volitionally producing vocalizations in a visual detection task or passively listening to monkey vocalizations. Ten percent of randomly selected neurons in the PMvr modulated their discharge rate in response to acoustic stimulation with species-specific calls. More than four-fifths of these auditory neurons showed an additional modulation of their discharge rates either before and/or during the monkeys' motor production of the vocalization. Based on these audio-vocal interactions, the PMvr might be well positioned to mediate higher order auditory processing with cognitive control of the vocal motor output to the primary vocal motor network. Such audio-vocal integration processes in the premotor cortex might constitute a precursor for the evolution of complex learned audio-vocal integration systems, ultimately giving rise to human speech.



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Hidden hearing loss and endbulbs of Held: Evidence for central pathology before detection of ABR threshold increases

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Michael A. Muniak, Femi E. Ayeni, David K. Ryugo
Reductions in sound-evoked activity in the auditory nerve due to hearing loss have been shown to cause pathological changes in central auditory structures. Hearing loss due strictly to the aging process are less well documented. In this study of CBA/CaH mice, we provide evidence for age-related pathology in the endbulb of Held, a large axosomatic ending arising from myelinated auditory nerve fibers. Endbulbs are known to be involved in the processing of temporal cues used for sound localization and speech comprehension. Hearing thresholds as measured by auditory brainstem response (ABR) thresholds remained stable up to one year, whereas suprathreshold amplitudes of early ABR waves decreased by up to 50% in older mice, similar to that reported for age-related cochlear synaptopathy (Sergeyenko et al., 2013). The reduction of ABR response magnitude with age correlated closely in time with the gradual atrophy of endbulbs of Held, and is consistent with the hypothesis that endbulb integrity is dependent upon normal levels of spike activity in the auditory nerve. These results indicate that central auditory pathologies emerge as consequence of so-called “hidden” hearing loss and suggest that such brain changes require consideration when devising therapeutic interventions.



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A comparison of cochlear distribution and glucocorticoid receptor activation in local and systemic dexamethasone drug delivery regimes

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Nathan J. Creber, Hayden T. Eastwood, Amy J. Hampson, Justin Tan, Stephen J. O'Leary
Local and systemically delivered glucocorticoids are commonly administered to protect the cochlea against damage associated with a variety of insults. There is reason to believe that dexamethasone administered by these routes may arrive at cochlear target sites via different pathways. Clinically, there is a lack of clarity as to which route is more effective in any specific circumstance. This study explores dexamethasone distribution within the guinea pig cochlea following local and systemic delivery methods. A combination of mass spectroscopy and immunohistochemistry were employed to compare both perilymph distribution, tissue uptake and receptor activation. Local administration of dexamethasone to the round window membrane resulted in greater perilymph concentrations, with a basal to apical gradient that favours the cochlear base. Tissue immunofluorescence was intimately related to perilymph concentration following local administration. Systemic administration resulted in much lower perilymph concentrations, with an inverse basal to apical gradient favouring the cochlear apex. Lower perilymph concentrations following systemic administration were associated with minimal tissue immunofluorescence. Despite this, GR activation of the SGNs was equivalent in both administration regimes. These results bring into question the efficacy of measuring perilymph concentrations alone as a surrogacy for dexamethasone distribution and activity in the cochlea, suggesting that the steroid ligand may arrive at its target receptor via alternative pathways. Our results suggest an equivalence in efficacy between local and systemic administration routes early after drug delivery, when the ultimate outcome of GR activation is the goal.



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Auditory and audio-vocal responses of single neurons in the monkey ventral premotor cortex

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Steffen R. Hage
Monkey vocalization is a complex behavioral pattern, which is flexibly used in audio-vocal communication. A recently proposed dual neural network model suggests that cognitive control might be involved in this behavior, originating from a frontal cortical network in the prefrontal cortex and mediated via projections from the rostral portion of the ventral premotor cortex (PMvr) and motor cortex to the primary vocal motor network in the brainstem. For the rapid adjustment of vocal output to external acoustic events, strong interconnections between vocal motor and auditory sites are needed, which are present at cortical and subcortical levels. However, the role of the PMvr in audio-vocal integration processes remains unclear. In the present study, single neurons in the PMvr were recorded in rhesus monkeys (Macaca mulatta) while volitionally producing vocalizations in a visual detection task or passively listening to monkey vocalizations. Ten percent of randomly selected neurons in the PMvr modulated their discharge rate in response to acoustic stimulation with species-specific calls. More than four-fifths of these auditory neurons showed an additional modulation of their discharge rates either before and/or during the monkeys' motor production of the vocalization. Based on these audio-vocal interactions, the PMvr might be well positioned to mediate higher order auditory processing with cognitive control of the vocal motor output to the primary vocal motor network. Such audio-vocal integration processes in the premotor cortex might constitute a precursor for the evolution of complex learned audio-vocal integration systems, ultimately giving rise to human speech.



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Hidden hearing loss and endbulbs of Held: Evidence for central pathology before detection of ABR threshold increases

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Michael A. Muniak, Femi E. Ayeni, David K. Ryugo
Reductions in sound-evoked activity in the auditory nerve due to hearing loss have been shown to cause pathological changes in central auditory structures. Hearing loss due strictly to the aging process are less well documented. In this study of CBA/CaH mice, we provide evidence for age-related pathology in the endbulb of Held, a large axosomatic ending arising from myelinated auditory nerve fibers. Endbulbs are known to be involved in the processing of temporal cues used for sound localization and speech comprehension. Hearing thresholds as measured by auditory brainstem response (ABR) thresholds remained stable up to one year, whereas suprathreshold amplitudes of early ABR waves decreased by up to 50% in older mice, similar to that reported for age-related cochlear synaptopathy (Sergeyenko et al., 2013). The reduction of ABR response magnitude with age correlated closely in time with the gradual atrophy of endbulbs of Held, and is consistent with the hypothesis that endbulb integrity is dependent upon normal levels of spike activity in the auditory nerve. These results indicate that central auditory pathologies emerge as consequence of so-called “hidden” hearing loss and suggest that such brain changes require consideration when devising therapeutic interventions.



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A comparison of cochlear distribution and glucocorticoid receptor activation in local and systemic dexamethasone drug delivery regimes

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Nathan J. Creber, Hayden T. Eastwood, Amy J. Hampson, Justin Tan, Stephen J. O'Leary
Local and systemically delivered glucocorticoids are commonly administered to protect the cochlea against damage associated with a variety of insults. There is reason to believe that dexamethasone administered by these routes may arrive at cochlear target sites via different pathways. Clinically, there is a lack of clarity as to which route is more effective in any specific circumstance. This study explores dexamethasone distribution within the guinea pig cochlea following local and systemic delivery methods. A combination of mass spectroscopy and immunohistochemistry were employed to compare both perilymph distribution, tissue uptake and receptor activation. Local administration of dexamethasone to the round window membrane resulted in greater perilymph concentrations, with a basal to apical gradient that favours the cochlear base. Tissue immunofluorescence was intimately related to perilymph concentration following local administration. Systemic administration resulted in much lower perilymph concentrations, with an inverse basal to apical gradient favouring the cochlear apex. Lower perilymph concentrations following systemic administration were associated with minimal tissue immunofluorescence. Despite this, GR activation of the SGNs was equivalent in both administration regimes. These results bring into question the efficacy of measuring perilymph concentrations alone as a surrogacy for dexamethasone distribution and activity in the cochlea, suggesting that the steroid ligand may arrive at its target receptor via alternative pathways. Our results suggest an equivalence in efficacy between local and systemic administration routes early after drug delivery, when the ultimate outcome of GR activation is the goal.



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Auditory and audio-vocal responses of single neurons in the monkey ventral premotor cortex

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Steffen R. Hage
Monkey vocalization is a complex behavioral pattern, which is flexibly used in audio-vocal communication. A recently proposed dual neural network model suggests that cognitive control might be involved in this behavior, originating from a frontal cortical network in the prefrontal cortex and mediated via projections from the rostral portion of the ventral premotor cortex (PMvr) and motor cortex to the primary vocal motor network in the brainstem. For the rapid adjustment of vocal output to external acoustic events, strong interconnections between vocal motor and auditory sites are needed, which are present at cortical and subcortical levels. However, the role of the PMvr in audio-vocal integration processes remains unclear. In the present study, single neurons in the PMvr were recorded in rhesus monkeys (Macaca mulatta) while volitionally producing vocalizations in a visual detection task or passively listening to monkey vocalizations. Ten percent of randomly selected neurons in the PMvr modulated their discharge rate in response to acoustic stimulation with species-specific calls. More than four-fifths of these auditory neurons showed an additional modulation of their discharge rates either before and/or during the monkeys' motor production of the vocalization. Based on these audio-vocal interactions, the PMvr might be well positioned to mediate higher order auditory processing with cognitive control of the vocal motor output to the primary vocal motor network. Such audio-vocal integration processes in the premotor cortex might constitute a precursor for the evolution of complex learned audio-vocal integration systems, ultimately giving rise to human speech.



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Hidden hearing loss and endbulbs of Held: Evidence for central pathology before detection of ABR threshold increases

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Michael A. Muniak, Femi E. Ayeni, David K. Ryugo
Reductions in sound-evoked activity in the auditory nerve due to hearing loss have been shown to cause pathological changes in central auditory structures. Hearing loss due strictly to the aging process are less well documented. In this study of CBA/CaH mice, we provide evidence for age-related pathology in the endbulb of Held, a large axosomatic ending arising from myelinated auditory nerve fibers. Endbulbs are known to be involved in the processing of temporal cues used for sound localization and speech comprehension. Hearing thresholds as measured by auditory brainstem response (ABR) thresholds remained stable up to one year, whereas suprathreshold amplitudes of early ABR waves decreased by up to 50% in older mice, similar to that reported for age-related cochlear synaptopathy (Sergeyenko et al., 2013). The reduction of ABR response magnitude with age correlated closely in time with the gradual atrophy of endbulbs of Held, and is consistent with the hypothesis that endbulb integrity is dependent upon normal levels of spike activity in the auditory nerve. These results indicate that central auditory pathologies emerge as consequence of so-called “hidden” hearing loss and suggest that such brain changes require consideration when devising therapeutic interventions.



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A comparison of cochlear distribution and glucocorticoid receptor activation in local and systemic dexamethasone drug delivery regimes

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Nathan J. Creber, Hayden T. Eastwood, Amy J. Hampson, Justin Tan, Stephen J. O'Leary
Local and systemically delivered glucocorticoids are commonly administered to protect the cochlea against damage associated with a variety of insults. There is reason to believe that dexamethasone administered by these routes may arrive at cochlear target sites via different pathways. Clinically, there is a lack of clarity as to which route is more effective in any specific circumstance. This study explores dexamethasone distribution within the guinea pig cochlea following local and systemic delivery methods. A combination of mass spectroscopy and immunohistochemistry were employed to compare both perilymph distribution, tissue uptake and receptor activation. Local administration of dexamethasone to the round window membrane resulted in greater perilymph concentrations, with a basal to apical gradient that favours the cochlear base. Tissue immunofluorescence was intimately related to perilymph concentration following local administration. Systemic administration resulted in much lower perilymph concentrations, with an inverse basal to apical gradient favouring the cochlear apex. Lower perilymph concentrations following systemic administration were associated with minimal tissue immunofluorescence. Despite this, GR activation of the SGNs was equivalent in both administration regimes. These results bring into question the efficacy of measuring perilymph concentrations alone as a surrogacy for dexamethasone distribution and activity in the cochlea, suggesting that the steroid ligand may arrive at its target receptor via alternative pathways. Our results suggest an equivalence in efficacy between local and systemic administration routes early after drug delivery, when the ultimate outcome of GR activation is the goal.



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via IFTTT

Auditory and audio-vocal responses of single neurons in the monkey ventral premotor cortex

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Steffen R. Hage
Monkey vocalization is a complex behavioral pattern, which is flexibly used in audio-vocal communication. A recently proposed dual neural network model suggests that cognitive control might be involved in this behavior, originating from a frontal cortical network in the prefrontal cortex and mediated via projections from the rostral portion of the ventral premotor cortex (PMvr) and motor cortex to the primary vocal motor network in the brainstem. For the rapid adjustment of vocal output to external acoustic events, strong interconnections between vocal motor and auditory sites are needed, which are present at cortical and subcortical levels. However, the role of the PMvr in audio-vocal integration processes remains unclear. In the present study, single neurons in the PMvr were recorded in rhesus monkeys (Macaca mulatta) while volitionally producing vocalizations in a visual detection task or passively listening to monkey vocalizations. Ten percent of randomly selected neurons in the PMvr modulated their discharge rate in response to acoustic stimulation with species-specific calls. More than four-fifths of these auditory neurons showed an additional modulation of their discharge rates either before and/or during the monkeys' motor production of the vocalization. Based on these audio-vocal interactions, the PMvr might be well positioned to mediate higher order auditory processing with cognitive control of the vocal motor output to the primary vocal motor network. Such audio-vocal integration processes in the premotor cortex might constitute a precursor for the evolution of complex learned audio-vocal integration systems, ultimately giving rise to human speech.



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Hidden hearing loss and endbulbs of Held: Evidence for central pathology before detection of ABR threshold increases

Publication date: Available online 20 March 2018
Source:Hearing Research
Author(s): Michael A. Muniak, Femi E. Ayeni, David K. Ryugo
Reductions in sound-evoked activity in the auditory nerve due to hearing loss have been shown to cause pathological changes in central auditory structures. Hearing loss due strictly to the aging process are less well documented. In this study of CBA/CaH mice, we provide evidence for age-related pathology in the endbulb of Held, a large axosomatic ending arising from myelinated auditory nerve fibers. Endbulbs are known to be involved in the processing of temporal cues used for sound localization and speech comprehension. Hearing thresholds as measured by auditory brainstem response (ABR) thresholds remained stable up to one year, whereas suprathreshold amplitudes of early ABR waves decreased by up to 50% in older mice, similar to that reported for age-related cochlear synaptopathy (Sergeyenko et al., 2013). The reduction of ABR response magnitude with age correlated closely in time with the gradual atrophy of endbulbs of Held, and is consistent with the hypothesis that endbulb integrity is dependent upon normal levels of spike activity in the auditory nerve. These results indicate that central auditory pathologies emerge as consequence of so-called “hidden” hearing loss and suggest that such brain changes require consideration when devising therapeutic interventions.



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Behavioral Profile of Children With Vocal Fold Nodules—A Case-control Study

Publication date: Available online 20 March 2018
Source:Journal of Voice
Author(s): Ângela Reis-Rego, Pedro Henriques Santos, Gustavo Santos, Pedro Carvalho Santos, David Dias, Susana Vaz Freitas, Isabel Carvalho, Miguel Coutinho, Telma Feliciano, Cecília Almeida
ObjectivesThe aim of this case-control study was to evaluate the overall behavior of children with vocal fold nodules (VNs).MethodsThe study group included children with VNs between 4 and 15 years old diagnosed using fiberoptic video laryngoscopy with stroboscopy in a tertiary university hospital. As a control group, children between 4 and 13 years old without VNs, routinely followed up in a primary care facility, were included in the study. Parents of the participants completed the parent-proxy strengths and difficulties questionnaire (SDQ), a brief behavioral screening questionnaire designed for children. The SDQ evaluates emotional, conduct, and peer problems, and also focuses on hyperactivity and prosocial behavior. Children are classified into “normal,” “borderline,” or “abnormal” according to the total SDQ score.ResultsTwenty-seven children (24 boys and 3 girls) with VNs and 41 controls (33 boys and 8 girls) were enrolled in the study. The two groups did not differ significantly in age or gender (P > 0.05). Statistical analysis revealed that 52% individuals of the VNs group presents borderline or abnormal overall behavioral, which is statistically different from the general population (P < 0.001). Total, hyperactivity, and prosocial SDQ subscales were statistically different between study groups (P < 0.05).ConclusionsOur findings suggest association between VNs and hyperactivity and also with poorer prosocial behaviors in children for the first time. We propose that every child with VNs must be evaluated from a behavioral point of view to detect and to treat potential underlying psychological conditions that may interfere with VNs treatment and prognosis.



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Motor learning in people with Parkinson’s disease: Implications for fall prevention across the disease spectrum

Publication date: March 2018
Source:Gait & Posture, Volume 61
Author(s): Serene S. Paul, Leland E. Dibble, Daniel S. Peterson
BackgroundFalls are a significant burden for people with Parkinson’s disease (PD), however, individuals across the spectrum of disease severity respond differently to fall prevention interventions. Despite the multifactorial causes of falls in people with PD, recent work has provided insight into interventions that hold promise for fall prevention. Further, studies have begun to identify patient characteristics that may predict responsiveness to such interventions.Research questionWe discuss (i) the postural motor learning abilities of people with mild versus severe PD that could affect their ability to benefit from fall prevention interventions, (ii) how people with different severity of PD respond to such interventions, and (iii) the practical considerations of providing effective fall prevention interventions for people with PD across the spectrum of disease severity.MethodsThis narrative review consolidates recent work on postural motor learning and fall prevention rehabilitation involving exercise in people with PD.ResultsPeople with PD are able to improve postural motor control through practice, enabling them to benefit from exercise which challenges their gait and balance to reduce falling. Worsening of axial and cognitive symptoms may result in diminished learning, and those with more severe PD may require fully supervised, high intensity programs to reduce falls.SignificanceUnderstanding how people with PD across the spectrum of disease severity differ in their postural motor learning ability and response to different fall prevention interventions will enable researchers and clinicians to refine such interventions and their delivery to minimize falls and their negative sequelae in people with PD.



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Methods to assess patellofemoral joint stress: A systematic review

Publication date: March 2018
Source:Gait & Posture, Volume 61
Author(s): Guilherme S. Nunes, Rodrigo Scattone Silva, Ana Flávia dos Santos, Ricardo A.S. Fernandes, Fábio Viadanna Serrão, Marcos de Noronha
Changes in patellofemoral joint (PFJ) stress are related to the development and course of PFJ dysfunctions. Different methods for PFJ stress calculation have been used, making the comparison of PFJ stress values across different studies difficult. The purpose of this study was to systematically review the methods for PFJ stress calculation and highlight the differences among the methods. A systematic literature search was conducted in Medline, Embase, CINAHL, SPORTDiscus and Web of Science databases. Included studies examined PFJ stress in subjects with or without musculoskeletal conditions. Of 12,670 identified studies, 53 were included, with a total of 1134 subjects evaluated. The main differences among the methods to calculate PFJ stress were: i) method to calculate PFJ contact area; ii) method to calculate a constant (coefficient k) that defines the relation between quadriceps force and PFJ reaction force; iii) the inclusion of adjustments for sagittal plane forces. Considerable variability in PFJ stress results was observed. The greatest PFJ stress value was 55.03 MPa during a dance jump and the lowest value was 1.9 MPa during walking at the speed of 1.4 m/s. Most studies applied methods which use data from previous studies. However, methods which use data from their own participants for most parts of the calculation might be preferred to minimize potential errors. When direct measures are not possible, a standard method could be applied to facilitate comparisons among studies.



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Effects of high heeled shoes on gait. A review

Publication date: March 2018
Source:Gait & Posture, Volume 61
Author(s): M.M. Wiedemeijer, E. Otten
BackgroundWalking in high heels (HH) may alter gait in various ways, which may be of importance to designers and physicians.Research questionHow does walking in high heels alter gait and how can this be explained from a biomechanical and control point of view.MethodsRelevant literature has been collected in which high heeled walking was studied, after which the results were bundled and interpreted in a framework of biomechanics and control.ResultsMajor changes were found in the rollover function of the feet, the ankle and knee joints and the lower back, while step length and balance were compromised. An increase in heel height forces the foot in an increased plantar flexion, which in its turn increases knee flexion and lordosis of the lower back. All changes can be related with each other in a plausible pattern of movement and control.



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Motor learning in people with Parkinson’s disease: Implications for fall prevention across the disease spectrum

Publication date: March 2018
Source:Gait & Posture, Volume 61
Author(s): Serene S. Paul, Leland E. Dibble, Daniel S. Peterson
BackgroundFalls are a significant burden for people with Parkinson’s disease (PD), however, individuals across the spectrum of disease severity respond differently to fall prevention interventions. Despite the multifactorial causes of falls in people with PD, recent work has provided insight into interventions that hold promise for fall prevention. Further, studies have begun to identify patient characteristics that may predict responsiveness to such interventions.Research questionWe discuss (i) the postural motor learning abilities of people with mild versus severe PD that could affect their ability to benefit from fall prevention interventions, (ii) how people with different severity of PD respond to such interventions, and (iii) the practical considerations of providing effective fall prevention interventions for people with PD across the spectrum of disease severity.MethodsThis narrative review consolidates recent work on postural motor learning and fall prevention rehabilitation involving exercise in people with PD.ResultsPeople with PD are able to improve postural motor control through practice, enabling them to benefit from exercise which challenges their gait and balance to reduce falling. Worsening of axial and cognitive symptoms may result in diminished learning, and those with more severe PD may require fully supervised, high intensity programs to reduce falls.SignificanceUnderstanding how people with PD across the spectrum of disease severity differ in their postural motor learning ability and response to different fall prevention interventions will enable researchers and clinicians to refine such interventions and their delivery to minimize falls and their negative sequelae in people with PD.



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Methods to assess patellofemoral joint stress: A systematic review

Publication date: March 2018
Source:Gait & Posture, Volume 61
Author(s): Guilherme S. Nunes, Rodrigo Scattone Silva, Ana Flávia dos Santos, Ricardo A.S. Fernandes, Fábio Viadanna Serrão, Marcos de Noronha
Changes in patellofemoral joint (PFJ) stress are related to the development and course of PFJ dysfunctions. Different methods for PFJ stress calculation have been used, making the comparison of PFJ stress values across different studies difficult. The purpose of this study was to systematically review the methods for PFJ stress calculation and highlight the differences among the methods. A systematic literature search was conducted in Medline, Embase, CINAHL, SPORTDiscus and Web of Science databases. Included studies examined PFJ stress in subjects with or without musculoskeletal conditions. Of 12,670 identified studies, 53 were included, with a total of 1134 subjects evaluated. The main differences among the methods to calculate PFJ stress were: i) method to calculate PFJ contact area; ii) method to calculate a constant (coefficient k) that defines the relation between quadriceps force and PFJ reaction force; iii) the inclusion of adjustments for sagittal plane forces. Considerable variability in PFJ stress results was observed. The greatest PFJ stress value was 55.03 MPa during a dance jump and the lowest value was 1.9 MPa during walking at the speed of 1.4 m/s. Most studies applied methods which use data from previous studies. However, methods which use data from their own participants for most parts of the calculation might be preferred to minimize potential errors. When direct measures are not possible, a standard method could be applied to facilitate comparisons among studies.



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Effects of high heeled shoes on gait. A review

Publication date: March 2018
Source:Gait & Posture, Volume 61
Author(s): M.M. Wiedemeijer, E. Otten
BackgroundWalking in high heels (HH) may alter gait in various ways, which may be of importance to designers and physicians.Research questionHow does walking in high heels alter gait and how can this be explained from a biomechanical and control point of view.MethodsRelevant literature has been collected in which high heeled walking was studied, after which the results were bundled and interpreted in a framework of biomechanics and control.ResultsMajor changes were found in the rollover function of the feet, the ankle and knee joints and the lower back, while step length and balance were compromised. An increase in heel height forces the foot in an increased plantar flexion, which in its turn increases knee flexion and lordosis of the lower back. All changes can be related with each other in a plausible pattern of movement and control.



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Motor learning in people with Parkinson’s disease: Implications for fall prevention across the disease spectrum

Publication date: March 2018
Source:Gait & Posture, Volume 61
Author(s): Serene S. Paul, Leland E. Dibble, Daniel S. Peterson
BackgroundFalls are a significant burden for people with Parkinson’s disease (PD), however, individuals across the spectrum of disease severity respond differently to fall prevention interventions. Despite the multifactorial causes of falls in people with PD, recent work has provided insight into interventions that hold promise for fall prevention. Further, studies have begun to identify patient characteristics that may predict responsiveness to such interventions.Research questionWe discuss (i) the postural motor learning abilities of people with mild versus severe PD that could affect their ability to benefit from fall prevention interventions, (ii) how people with different severity of PD respond to such interventions, and (iii) the practical considerations of providing effective fall prevention interventions for people with PD across the spectrum of disease severity.MethodsThis narrative review consolidates recent work on postural motor learning and fall prevention rehabilitation involving exercise in people with PD.ResultsPeople with PD are able to improve postural motor control through practice, enabling them to benefit from exercise which challenges their gait and balance to reduce falling. Worsening of axial and cognitive symptoms may result in diminished learning, and those with more severe PD may require fully supervised, high intensity programs to reduce falls.SignificanceUnderstanding how people with PD across the spectrum of disease severity differ in their postural motor learning ability and response to different fall prevention interventions will enable researchers and clinicians to refine such interventions and their delivery to minimize falls and their negative sequelae in people with PD.



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Methods to assess patellofemoral joint stress: A systematic review

Publication date: March 2018
Source:Gait & Posture, Volume 61
Author(s): Guilherme S. Nunes, Rodrigo Scattone Silva, Ana Flávia dos Santos, Ricardo A.S. Fernandes, Fábio Viadanna Serrão, Marcos de Noronha
Changes in patellofemoral joint (PFJ) stress are related to the development and course of PFJ dysfunctions. Different methods for PFJ stress calculation have been used, making the comparison of PFJ stress values across different studies difficult. The purpose of this study was to systematically review the methods for PFJ stress calculation and highlight the differences among the methods. A systematic literature search was conducted in Medline, Embase, CINAHL, SPORTDiscus and Web of Science databases. Included studies examined PFJ stress in subjects with or without musculoskeletal conditions. Of 12,670 identified studies, 53 were included, with a total of 1134 subjects evaluated. The main differences among the methods to calculate PFJ stress were: i) method to calculate PFJ contact area; ii) method to calculate a constant (coefficient k) that defines the relation between quadriceps force and PFJ reaction force; iii) the inclusion of adjustments for sagittal plane forces. Considerable variability in PFJ stress results was observed. The greatest PFJ stress value was 55.03 MPa during a dance jump and the lowest value was 1.9 MPa during walking at the speed of 1.4 m/s. Most studies applied methods which use data from previous studies. However, methods which use data from their own participants for most parts of the calculation might be preferred to minimize potential errors. When direct measures are not possible, a standard method could be applied to facilitate comparisons among studies.



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Effects of high heeled shoes on gait. A review

Publication date: March 2018
Source:Gait & Posture, Volume 61
Author(s): M.M. Wiedemeijer, E. Otten
BackgroundWalking in high heels (HH) may alter gait in various ways, which may be of importance to designers and physicians.Research questionHow does walking in high heels alter gait and how can this be explained from a biomechanical and control point of view.MethodsRelevant literature has been collected in which high heeled walking was studied, after which the results were bundled and interpreted in a framework of biomechanics and control.ResultsMajor changes were found in the rollover function of the feet, the ankle and knee joints and the lower back, while step length and balance were compromised. An increase in heel height forces the foot in an increased plantar flexion, which in its turn increases knee flexion and lordosis of the lower back. All changes can be related with each other in a plausible pattern of movement and control.



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A de novo and novel mutation in the EYA1 gene in a Chinese child with branchio-oto-renal syndrome.

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A de novo and novel mutation in the EYA1 gene in a Chinese child with branchio-oto-renal syndrome.

Intractable Rare Dis Res. 2018 Feb;7(1):42-45

Authors: Li G, Shen Q, Sun L, Liu H, An Y, Xu H

Abstract
Branchio-oto-renal (BOR) syndrome is a rare autosomal dominant disorder characterized by branchial cleft fistulae or cysts, preauricular pits, ear malformations, hearing loss, and renal anomalies. Mutations in the human homologue of the Drosophila eyes absent gene (EYA1) are the most common cause of BOR syndrome. PCR and direct sequencing were used to investigate all of the exons and exon-intron boundaries in the EYA1 gene in a patient with BOR syndrome from China. The patient was a child who displayed clinical features of BOR syndrome. Analysis of mutations in the EYA1 gene revealed a novel single base-pair deletion resulting in a truncated protein (c.1381delA; p.R461fs467X), and an analysis of mutations in the family revealed that this mutation was a de novo mutation. This is the first case of BOR syndrome in mainland China to be diagnosed based on clinical manifestations and mutations in the EYA1 gene. The novel c.1381delA mutation detected here expands the spectrum of known mutations in the EYA1 gene.

PMID: 29552445 [PubMed]

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A novel mutation in SLITRK6 causes deafness and myopia in a Moroccan family.

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A novel mutation in SLITRK6 causes deafness and myopia in a Moroccan family.

Gene. 2018 Mar 15;:

Authors: Salime S, Riahi Z, Elrharchi S, Elkhattabi L, Charoute H, Nahili H, Rouba H, Kabine M, Bonnet C, Petit C, Barakat A

Abstract
Deafness and myopia syndrome is characterized by moderate-profound, bilateral, congenital or prelingual deafness and high myopia. Autosomal recessive non-syndromic hearing loss is one of the most prevalent human genetic sensorineural defects. Myopia is by far the most common human eye disorder that is known to have a clear heritable component. The analysis of the two exons of SLITRK6 gene in a Moroccan family allowed us to identify a novel single deleterious mutation c.696delG, p.Trp232Cysfs*10 at homozygous state in the exon 2 of the SLITRK6, a gene reported to cause deafness and myopia in various populations.

PMID: 29551497 [PubMed - as supplied by publisher]

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Identification of risk factors for hearing impairment in newborns: a hospital based study.

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Identification of risk factors for hearing impairment in newborns: a hospital based study.

Med Glas (Zenica). 2018 Feb 01;15(1):29-36

Authors: Hrnčić N

Abstract
Aim To identify risk factors for hearing impairment presented in neonates born in Cantonal Hospital Zenica (CHZ) and to estimate their influence on outcome of hearing tests in Newborn Hearing Screening (NHS). Methods Retrospective-prospective study was done at the Department of Gynaecology and Maternity. The NHS was performed with transitory evoked otoacoustic emissions (TEOAE) during a six-month period using "Titan" device (Interacoustics, Denmark). The questionnaire was written for the purpose of getting more structured basic information about every newborn and to identify risk factors for hearing impairment. Chi-square test was used to investigate the difference between experimental and control group refer incidence. Results A total of 1217 newborns was screened for hearing impairment of which 259 (21.28%) with one or more known risk factors for hearing impairment. The following risk factors for hearing impairment were identified during the study period: family history of permanent childhood hearing impairment in 42 (3.45%) newborns, prematurity in 39 (3.21%), low APGAR scores in 29 (2.40%), asphyxia in 31 (2.55%), hyperbilirubinemia in 41 (3.37%), admission of ototoxic medication (aminoglycosides) after birth in 155 (12.74%). Conclusion There were many serious risk factors for hearing loss identified in this study. Identification of risk factors for hearing impairment in neonates is necessary because a follow up of the children with risk factors is very important.

PMID: 29549688 [PubMed - in process]

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Maternal knowledge and attitudes to universal newborn hearing screening: Reviewing an established program.

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Maternal knowledge and attitudes to universal newborn hearing screening: Reviewing an established program.

Int J Pediatr Otorhinolaryngol. 2018 Feb;105:146-153

Authors: Lam MYY, Wong ECM, Law CW, Lee HHL, McPherson B

Abstract
OBJECTIVES: To facilitate early diagnosis of infants with hearing loss, a universal newborn hearing screening program (UNHS) has been implemented in Hong Kong's public hospitals for over a decade. However, there have been no known studies investigating parent attitudes to, and satisfaction with, UNHS since its launch in Hong Kong. The present study aimed to investigate knowledge of UNHS as well as infant hearing development, and attitudes and satisfaction with UNHS, in Hong Kong mothers with newborns. The study was designed to help evaluate and improve an established UNHS public hospital program, based on the perspectives of service users.
METHODS: A researcher-developed questionnaire was administered to 102 mothers whose newborn had received UNHS in the postnatal wards of a large public hospital in Hong Kong. The questionnaire considered parental knowledge of UNHS and infant hearing development, attitudes and satisfaction toward public hospital UNHS. In the knowledge dimension, parents' preferred time and location for pre-test information delivery, interpretation of screening results, and knowledge of hearing developmental milestones were surveyed. In addition, maternal attitudes to and satisfaction with UNHS screening services, the potential impact of UNHS on parent emotions and parent-baby bonding, attitudes toward informed consent, and willingness to comply with diagnostic assessment referral were also be surveyed.
RESULTS: Mean participant scores on knowledge of infant hearing development were relatively low (M = 2.59/6.0, SD = 0.90). Many mothers also underestimated the potential ongoing risks of hearing impairment in babies. Around 80% of mothers thought an infant could not have hearing impairment after passing the screening. In addition, one-third of mothers thought a baby could not later develop hearing impairment in infancy or childhood. In terms of attitudes and satisfaction, participants gave somewhat negative ratings for questions regarding receiving sufficient information about the screening (M = 2.90/5.0, SD = 1.27), screening procedure (M = 2.20/5.0, SD = 1.08), and sufficiency of information about results (M = 2.87/5.0, SD = 1.14). Nonetheless, participants gave positive ratings concerning whether screening could lead to early diagnosis (M = 4.61/5.0, SD = 0.57) and over 95% of mothers supported UNHS despite potential for false positive results. Mothers reported a high willingness to bring their baby to follow-up assessments if required (M = 4.53/5.0, SD = 0.56). Participants gave positive ratings for their level of satisfaction with the time and location of first UNHS information provision (M = 4.34/5.0, SD = 0.80) and the way permission was asked for screening the baby (M = 4.04/5.0, SD = 0.97) but alternative procedures were also recommended. Most recommendations focused on providing more information about the test and a more detailed explanation of screening results.
CONCLUSIONS: The survey results highlighted the need to provide more information to parents about infant hearing development to support home monitoring for signs of hearing loss after UNHS, as well as more detailed explanation and information regarding hearing screening and the implications of results to parents. Regardless of location, surveys of this type may provide valuable support for UNHS program quality assurance.

PMID: 29447803 [PubMed - indexed for MEDLINE]

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Novel mitochondrial gene variants in Northwestern Chinese probands with non-syndromic hearing loss by whole mitochondrial genome screening.

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Novel mitochondrial gene variants in Northwestern Chinese probands with non-syndromic hearing loss by whole mitochondrial genome screening.

Gene. 2018 Apr 30;652:59-65

Authors: Chen X, Wang F, Maerhaba A, Li Q, Wang J, Liu X, Zheng J, Chen Y, Guo Y

Abstract
Mitochondrial DNA mutations play an important role in hereditary hearing loss. The present study aimed at identifying more novel genetic variants of mitochondrial DNA. Complete Mitochondrial genomes were detected in 97 Northwestern Chinese probands with non-syndromic hearing loss and 376 control subjects. The variants were evaluated for the pathogenicity using the following criteria: (1) present in <1% of the controls, (2) evolutional conservation, (3) potential structural and functional alterations. Mutational analysis in probands identified 706 variants, including 180 variants in the D loop region, 27 variants in the 12S rRNA gene, 29 variants in the 16S rRNA gene, 122 missense variants and 312 silent variants in the protein coding gene, 29 variants in the tRNA genes and 7 variants in the non-coding region. After further analysis assessed for the potential structural and functional significance, we identified 5 new candidate variants for hearing loss: 12S rRNA1473C>T, tRNAPhe 614A>C, tRNALys 8339A>G, ND1 3866T>C and non-coding 5656A>G. Our findings may provide the role of these genes in hearing loss development in China and valuable information for the further understanding of pathogenic mechanism of hearing loss.

PMID: 29408584 [PubMed - indexed for MEDLINE]

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Audiologic characteristics in a sample of recently-separated military Veterans: The Noise Outcomes in Servicemembers Epidemiology Study (NOISE Study).

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Audiologic characteristics in a sample of recently-separated military Veterans: The Noise Outcomes in Servicemembers Epidemiology Study (NOISE Study).

Hear Res. 2017 Jun;349:21-30

Authors: Gordon JS, Griest SE, Thielman EJ, Carlson KF, Helt WJ, Lewis MS, Blankenship C, Austin D, Theodoroff SM, Henry JA

Abstract
Military Service Members are often exposed to high levels of occupational noise, solvents, and other exposures that can be damaging to the auditory system. Little is known about hearing loss and how it progresses in Veterans following military service. This epidemiology study is designed to evaluate and monitor a cohort of Veterans for 20 years or more to determine how hearing loss changes over time and how those changes are related to noise exposure and other ototoxic exposures encountered during military service. Data reported here are from baseline assessments of the first 100 study participants (84 males; 16 females; mean age 33.5 years; SD 8.8; range 21-58). Each participant was asked to complete a comprehensive audiologic examination and self-report questionnaires regarding sociodemographic characteristics, noise and solvent exposures, health conditions common among post-deployment Veterans, and the social and emotional consequences of hearing loss. For this relatively young cohort, 29% exhibited hearing loss, defined as average hearing threshold >20 dB HL in the conventional audiometric range. Forty-two percent exhibited hearing loss in the extended-high-frequency audiometric range using the same criterion (average hearing threshold >20 dB HL). Certain factors were found to be associated with poorer hearing in both conventional and extended-high-frequency ranges, including age, type of military branch, years of military service, number of military deployments, noise exposure, tinnitus, and a positive screen for post-traumatic stress disorder. Although the majority of participants had hearing within normal limits, 27% reported a self-perceived mild/moderate hearing handicap and 14% reported a significant handicap. Further research is needed to identify a cause for this discrepancy in audiologic results versus self-report. The information obtained from this longitudinal study could be used in future resource planning with the goal of preventing, as much as possible, the development of hearing loss during military service, and the exacerbation of prevalent hearing loss after military service and over Veterans' lifetimes.

PMID: 27913314 [PubMed - indexed for MEDLINE]

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In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Menière's Disease Ears and Normal Hearing Ears.

In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Menière's Disease Ears and Normal Hearing Ears.

J Vis Exp. 2018 Feb 21;(132):

Authors: Flatz WH, Henneberger A, Reiser MF, Gürkov R, Ertl-Wagner B

Abstract
Analysis of neural structures in Menière's Disease (MD) is of importance, since a loss of such structures has previously been proposed for this patient group but has yet to be confirmed. This protocol describes a method of in vivo evaluation of neural changes especially well suitable for cranial nerve analysis using magnetic resonance imaging (MRI). MD-patients and normal hearing persons were examined in a 3-T MR-scanner using a scan protocol including strongly T2-weighted 3D gradient-echo-sequence (3D-CISS). In the patient group, MD was additionally confirmed using MRI-based assessment of endolymphatic hydrops. Morphometric analysis was performed using a freeware DICOM viewer. Evaluation of cranial nerves included measurements of cross-sectional areas (CSAs) of the nerves at different levels as well as orthogonal diametric measurements.

PMID: 29553505 [PubMed - in process]

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Sound energy absorbance characteristics of cartilage grafts used in type 1 tympanoplasty.

Related Articles

Sound energy absorbance characteristics of cartilage grafts used in type 1 tympanoplasty.

Auris Nasus Larynx. 2018 Mar 15;:

Authors: Yüksel Aslıer NG, Gürkan S, Aslıer M, Kirkim G, Güneri EA, Ikiz AÖ

Abstract
OBJECTIVE: The purpose of this prospective case-control study is to evaluate the sound energy absorbance characteristics of cartilage grafts in patients, who have undergone type 1 cartilage tympanoplasty.
METHODS: Thirty-four operated ears of 32 patients and 70 ears of 35 control subjects were included. Differences of pure-tone audiometry thresholds and wideband ambient-pressure absorbance ratios with respect to the graft material, graft thickness, cartilage surface area ratio and elapsed time after surgery were analyzed. Receiver operating characteristics curve was generated to detect the absorbance level at which the reconstructed tympanic membrane behaves as 'near-normal tympanic membrane'.
RESULTS: In the surgical group, wideband energy absorbance ratios at all 1/2-octave band frequencies were significantly worse than normal ears. Energy absorbance ratios at 2000 and 2828Hz frequencies were higher in patients with tragal cartilage grafts. Higher absorbance ratios at 250-750Hz range were obtained in patients with 400μm cartilage graft thickness, <50% cartilage surface area ratio and ≥5 years since surgery. A multivariate generalized linear model revealed common effects of the independent variables at 8000Hz. The receiver operating characteristics analysis generated a cut-off level of 63.20% of sound energy absorbance at 1400Hz with 83% sensitivity and 88% specificity.
CONCLUSION: Even though no differences in hearing thresholds were observed; graft material, graft thickness, cartilage surface area ratio and elapsed time after surgery affected the course of sound energy absorbance after type 1 cartilage tympanoplasty as evidenced by wideband tympanometry.

PMID: 29551206 [PubMed - as supplied by publisher]

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Outcomes of middle fossa craniotomy for the repair of superior semicircular canal dehiscence.

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Outcomes of middle fossa craniotomy for the repair of superior semicircular canal dehiscence.

J Clin Neurosci. 2017 Sep;43:103-107

Authors: Ung N, Chung LK, Lagman C, Bhatt NS, Barnette NE, Ong V, Gopen Q, Yang I

Abstract
Superior semicircular canal dehiscence (SSCD) is a rare defect of the arcuate eminence that causes an abnormal connection between the superior semicircular canal and middle cranial fossa. Patients often present with a variety of auditory and vestibular symptoms. Trigger avoidance is the initial strategy, but surgery may be necessary in debilitating cases. We retrospectively reviewed SSCD patients undergoing repair via a middle fossa craniotomy between March 2011 and September 2015. Forty-nine patients undergoing 58 surgeries were identified. Autophony was the most common symptom at presentation (n=44; 90%). Mean follow-up was 10.9months, with 100% of patients reporting resolution of at least one symptom. Aural fullness was the most commonly resolved symptom following surgical repair (n=19/22; 86%). Hearing loss (n=11/25; 44%) and tinnitus (n=11/38; 29%) were the most common symptoms to persist following surgery. The most common symptom to develop after surgery was disequilibrium (n=4/18; 22%). Upon comparing the overall pre-operative and post-operative groups, the number of patients with autophony (p<0.0001), aural fullness (p=0.0006), hearing loss (p=0.0119), disequilibrium (p=0.0002), sound- and pressure-induced vertigo (p<0.0001), and tinnitus (p<0.0001) were significantly different. Improved clinical outcomes were demonstrated in patients undergoing SSCD repair through a middle cranial fossa approach. The most common presenting symptom (autophony) was also most likely to resolve after surgery. Hearing loss is less amenable to surgical correction. Disequilibrium developed in a small number of patients after repair.

PMID: 28622893 [PubMed - indexed for MEDLINE]

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In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Menière's Disease Ears and Normal Hearing Ears.

In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Menière's Disease Ears and Normal Hearing Ears.

J Vis Exp. 2018 Feb 21;(132):

Authors: Flatz WH, Henneberger A, Reiser MF, Gürkov R, Ertl-Wagner B

Abstract
Analysis of neural structures in Menière's Disease (MD) is of importance, since a loss of such structures has previously been proposed for this patient group but has yet to be confirmed. This protocol describes a method of in vivo evaluation of neural changes especially well suitable for cranial nerve analysis using magnetic resonance imaging (MRI). MD-patients and normal hearing persons were examined in a 3-T MR-scanner using a scan protocol including strongly T2-weighted 3D gradient-echo-sequence (3D-CISS). In the patient group, MD was additionally confirmed using MRI-based assessment of endolymphatic hydrops. Morphometric analysis was performed using a freeware DICOM viewer. Evaluation of cranial nerves included measurements of cross-sectional areas (CSAs) of the nerves at different levels as well as orthogonal diametric measurements.

PMID: 29553505 [PubMed - in process]

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Sound energy absorbance characteristics of cartilage grafts used in type 1 tympanoplasty.

Related Articles

Sound energy absorbance characteristics of cartilage grafts used in type 1 tympanoplasty.

Auris Nasus Larynx. 2018 Mar 15;:

Authors: Yüksel Aslıer NG, Gürkan S, Aslıer M, Kirkim G, Güneri EA, Ikiz AÖ

Abstract
OBJECTIVE: The purpose of this prospective case-control study is to evaluate the sound energy absorbance characteristics of cartilage grafts in patients, who have undergone type 1 cartilage tympanoplasty.
METHODS: Thirty-four operated ears of 32 patients and 70 ears of 35 control subjects were included. Differences of pure-tone audiometry thresholds and wideband ambient-pressure absorbance ratios with respect to the graft material, graft thickness, cartilage surface area ratio and elapsed time after surgery were analyzed. Receiver operating characteristics curve was generated to detect the absorbance level at which the reconstructed tympanic membrane behaves as 'near-normal tympanic membrane'.
RESULTS: In the surgical group, wideband energy absorbance ratios at all 1/2-octave band frequencies were significantly worse than normal ears. Energy absorbance ratios at 2000 and 2828Hz frequencies were higher in patients with tragal cartilage grafts. Higher absorbance ratios at 250-750Hz range were obtained in patients with 400μm cartilage graft thickness, <50% cartilage surface area ratio and ≥5 years since surgery. A multivariate generalized linear model revealed common effects of the independent variables at 8000Hz. The receiver operating characteristics analysis generated a cut-off level of 63.20% of sound energy absorbance at 1400Hz with 83% sensitivity and 88% specificity.
CONCLUSION: Even though no differences in hearing thresholds were observed; graft material, graft thickness, cartilage surface area ratio and elapsed time after surgery affected the course of sound energy absorbance after type 1 cartilage tympanoplasty as evidenced by wideband tympanometry.

PMID: 29551206 [PubMed - as supplied by publisher]

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Outcomes of middle fossa craniotomy for the repair of superior semicircular canal dehiscence.

Related Articles

Outcomes of middle fossa craniotomy for the repair of superior semicircular canal dehiscence.

J Clin Neurosci. 2017 Sep;43:103-107

Authors: Ung N, Chung LK, Lagman C, Bhatt NS, Barnette NE, Ong V, Gopen Q, Yang I

Abstract
Superior semicircular canal dehiscence (SSCD) is a rare defect of the arcuate eminence that causes an abnormal connection between the superior semicircular canal and middle cranial fossa. Patients often present with a variety of auditory and vestibular symptoms. Trigger avoidance is the initial strategy, but surgery may be necessary in debilitating cases. We retrospectively reviewed SSCD patients undergoing repair via a middle fossa craniotomy between March 2011 and September 2015. Forty-nine patients undergoing 58 surgeries were identified. Autophony was the most common symptom at presentation (n=44; 90%). Mean follow-up was 10.9months, with 100% of patients reporting resolution of at least one symptom. Aural fullness was the most commonly resolved symptom following surgical repair (n=19/22; 86%). Hearing loss (n=11/25; 44%) and tinnitus (n=11/38; 29%) were the most common symptoms to persist following surgery. The most common symptom to develop after surgery was disequilibrium (n=4/18; 22%). Upon comparing the overall pre-operative and post-operative groups, the number of patients with autophony (p<0.0001), aural fullness (p=0.0006), hearing loss (p=0.0119), disequilibrium (p=0.0002), sound- and pressure-induced vertigo (p<0.0001), and tinnitus (p<0.0001) were significantly different. Improved clinical outcomes were demonstrated in patients undergoing SSCD repair through a middle cranial fossa approach. The most common presenting symptom (autophony) was also most likely to resolve after surgery. Hearing loss is less amenable to surgical correction. Disequilibrium developed in a small number of patients after repair.

PMID: 28622893 [PubMed - indexed for MEDLINE]

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