The Transpetrosal Approaches System in Posterior Fossa Meningiomas Surgery: Rationale and Results

Abstract

Purpose of Review

This is a retrospective review of 90 patients with a posterior fossa meningioma (PFM) treated between 1996 and 2017 in our two tertiary skull base centers. Patients underwent surgical resection via different approaches. We aimed to show how different surgical approaches may help to reach gross total resection (GTR) and low morbidity, especially on facial nerve function.

Recent Findings

PFM is a real surgical challenge with high morbidity and mortality due to the surrounding structures, their common large size at diagnosis, and their potentially invasive behavior. Total resection is the only way to cure people affected. We successfully treated 90 cases of PFM and evaluated different surgical approaches.

Summary

GTR is the aim of the surgery as the extent of resection influences the rate of recurrence, which in turn influences the prognosis. Seventy percent (p < 0.001) of surgical patients achieved a GRT with low morbidity and no mortality.

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The Transpetrosal Approaches System in Posterior Fossa Meningiomas Surgery: Rationale and Results

Abstract

Purpose of Review

This is a retrospective review of 90 patients with a posterior fossa meningioma (PFM) treated between 1996 and 2017 in our two tertiary skull base centers. Patients underwent surgical resection via different approaches. We aimed to show how different surgical approaches may help to reach gross total resection (GTR) and low morbidity, especially on facial nerve function.

Recent Findings

PFM is a real surgical challenge with high morbidity and mortality due to the surrounding structures, their common large size at diagnosis, and their potentially invasive behavior. Total resection is the only way to cure people affected. We successfully treated 90 cases of PFM and evaluated different surgical approaches.

Summary

GTR is the aim of the surgery as the extent of resection influences the rate of recurrence, which in turn influences the prognosis. Seventy percent (p < 0.001) of surgical patients achieved a GRT with low morbidity and no mortality.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Bc6yFm

Validation and Reliability of the French Version of the Sydney Swallow Questionnaire

Abstract

Oropharyngeal dysphagia is frequently under-reported and early detection may lead to adapt strategies of rehabilitation and management decisions. The Sydney Swallow Questionnaire (SSQ), a self-reported questionnaire for the detection and quantification of oropharyngeal dysphagia, was previously adapted and validated in other languages but not in French. The purposes of this study were to develop and validate a French version of SSQ (SSQ-f) and to assess its psychometric properties. This SSQ-f, obtained by back-translation and cross-cultural adaptation, was validated in 27 patients with impaired swallowing and 27 healthy controls. After inclusion, patients filled in the SSQ-f and performed a videofluoroscopic swallow study. The penetration aspiration scale (PAS) and Dysphagia outcome and severity scale (DOSS) were assigned to assess construct validity. Sensitivity and specificity of cut-off scores for the SSQ-f were assessed by the receiver operating characteristic (ROC) curves. Moreover, the SSQ-f was repeated after 2 weeks to evaluate its test–retest reliability. The results supported that SSQ-f was considered understandable. Its total score was strongly correlated to the DOSS (r = − 0.873) and to the PAS (r = 0.738). It demonstrated acceptable internal consistency, with Cronbach's alpha values ranging from 0.744 to 0.956. The test–retest reliability was excellent. According to the ROC curve, cut-off scores of 118.5 or 218.5 were proposed for determining oropharyngeal dysphagia using DOSS as a reference and 755.0, using PAS as reference. No ceiling or floor effects were observed. In conclusion, the SSQ-f is a valid and reliable instrument to measure and detect oropharyngeal dysphagia in French-speaking subjects and can be used in a clinical setting.

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Artificial intelligence: a challenge for third millennium radiologist

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There are more anatomical variants in heaven and earth, Horatio, than are dreamt of in our philosophy: the precaval left renal artery

Abstract

Aim

To describe the CT findings in eight patients with left-sided inferior vena cava (IVC) in whom the left renal artery presented a precaval course (pLRA).

Materials and methods

We searched the teaching files of six radiology departments for patients with pLRAs. Eight patients were found, and the available imaging studies and clinical histories were reviewed. Associated vascular and renal anomalies were noted.

Results

No patient had been examined for problems related to the vascular anomaly found. Four had a double IVC and two a solitary left IVC; in all, the left-sided IVCs had hemiazygos continuation. One patient had situs viscerum inversus. In one case, there was a left kidney in left iliac fossa.

Conclusion

Although rare and probably overlooked, a pLRAs can be encountered in patients with situs viscerum inversus or presenting a left-sided IVC with hemiazygos continuation. These vessels can cause technical problems during surgery at the left renal hilum and should be specifically searched for in patients with vascular anomalies.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2G0orL7

Validation and Reliability of the French Version of the Sydney Swallow Questionnaire

Abstract

Oropharyngeal dysphagia is frequently under-reported and early detection may lead to adapt strategies of rehabilitation and management decisions. The Sydney Swallow Questionnaire (SSQ), a self-reported questionnaire for the detection and quantification of oropharyngeal dysphagia, was previously adapted and validated in other languages but not in French. The purposes of this study were to develop and validate a French version of SSQ (SSQ-f) and to assess its psychometric properties. This SSQ-f, obtained by back-translation and cross-cultural adaptation, was validated in 27 patients with impaired swallowing and 27 healthy controls. After inclusion, patients filled in the SSQ-f and performed a videofluoroscopic swallow study. The penetration aspiration scale (PAS) and Dysphagia outcome and severity scale (DOSS) were assigned to assess construct validity. Sensitivity and specificity of cut-off scores for the SSQ-f were assessed by the receiver operating characteristic (ROC) curves. Moreover, the SSQ-f was repeated after 2 weeks to evaluate its test–retest reliability. The results supported that SSQ-f was considered understandable. Its total score was strongly correlated to the DOSS (r = − 0.873) and to the PAS (r = 0.738). It demonstrated acceptable internal consistency, with Cronbach's alpha values ranging from 0.744 to 0.956. The test–retest reliability was excellent. According to the ROC curve, cut-off scores of 118.5 or 218.5 were proposed for determining oropharyngeal dysphagia using DOSS as a reference and 755.0, using PAS as reference. No ceiling or floor effects were observed. In conclusion, the SSQ-f is a valid and reliable instrument to measure and detect oropharyngeal dysphagia in French-speaking subjects and can be used in a clinical setting.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2t103k6

Artificial intelligence: a challenge for third millennium radiologist

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CXjfnx

There are more anatomical variants in heaven and earth, Horatio, than are dreamt of in our philosophy: the precaval left renal artery

Abstract

Aim

To describe the CT findings in eight patients with left-sided inferior vena cava (IVC) in whom the left renal artery presented a precaval course (pLRA).

Materials and methods

We searched the teaching files of six radiology departments for patients with pLRAs. Eight patients were found, and the available imaging studies and clinical histories were reviewed. Associated vascular and renal anomalies were noted.

Results

No patient had been examined for problems related to the vascular anomaly found. Four had a double IVC and two a solitary left IVC; in all, the left-sided IVCs had hemiazygos continuation. One patient had situs viscerum inversus. In one case, there was a left kidney in left iliac fossa.

Conclusion

Although rare and probably overlooked, a pLRAs can be encountered in patients with situs viscerum inversus or presenting a left-sided IVC with hemiazygos continuation. These vessels can cause technical problems during surgery at the left renal hilum and should be specifically searched for in patients with vascular anomalies.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2G0orL7

Diagnostic Reference Levels for Adult Nuclear Medicine Imaging Established from the National Survey in Korea

Abstract

Purpose

There is substantial need for optimizing radiation protection in nuclear medicine imaging studies. However, the diagnostic reference levels (DRLs) have not yet been established for nuclear medicine imaging studies in Korea.

Materials and Methods

The data of administered activity in 32 nuclear medicine imaging studies were collected from the Korean Society of Nuclear Medicine (KSNM) dose survey database from 2013 and 2014. Through the expert discussions and statistical analyses, the 75th quartile value (Q3) was suggested as the preliminary DRL values. Preliminary DRLs were subjected to approval process by the KSNM Board of Directors and KSNM Council, followed by clinical applications and performance rating by domestic institutes.

Results

DRLs were determined through 32 nuclear medicine imaging studies. The Q3 value was considered as appropriate selection as it was generally consistent with the most commonly administered activity. In the present study, the final version of initial DRL values for nuclear medicine imaging in Korean adults is described including various protocols of the brain and myocardial perfusion imaging.

Conclusion

The first DRLs for nuclear medicine imaging in Korean adults were confirmed. The DRLs will enable optimized radiation protection in the field of nuclear medicine imaging in Korea.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SjlDyt

Diagnostic Reference Levels for Adult Nuclear Medicine Imaging Established from the National Survey in Korea

Abstract

Purpose

There is substantial need for optimizing radiation protection in nuclear medicine imaging studies. However, the diagnostic reference levels (DRLs) have not yet been established for nuclear medicine imaging studies in Korea.

Materials and Methods

The data of administered activity in 32 nuclear medicine imaging studies were collected from the Korean Society of Nuclear Medicine (KSNM) dose survey database from 2013 and 2014. Through the expert discussions and statistical analyses, the 75th quartile value (Q3) was suggested as the preliminary DRL values. Preliminary DRLs were subjected to approval process by the KSNM Board of Directors and KSNM Council, followed by clinical applications and performance rating by domestic institutes.

Results

DRLs were determined through 32 nuclear medicine imaging studies. The Q3 value was considered as appropriate selection as it was generally consistent with the most commonly administered activity. In the present study, the final version of initial DRL values for nuclear medicine imaging in Korean adults is described including various protocols of the brain and myocardial perfusion imaging.

Conclusion

The first DRLs for nuclear medicine imaging in Korean adults were confirmed. The DRLs will enable optimized radiation protection in the field of nuclear medicine imaging in Korea.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SjlDyt

The Effect of Stimulus Polarity on the Relation Between Pitch Ranking and ECAP Spread of Excitation in Cochlear Implant Users

AbstractAlthough modern cochlear implants (CIs) use cathodic-leading symmetrical biphasic pulses to stimulate the auditory nerve, a growing body of evidence suggests that anodic-leading pulses may be more effective. The positive polarity has been shown to produce larger electrically evoked compound action potential (ECAP) amplitudes, steeper slope of the amplitude growth function, and broader spread of excitation (SOE) patterns. Polarity has also been shown to influence pitch perception. It remains unclear how polarity affects the relation between physiological SOE and psychophysical pitch perception. Using a within-subject design, we examined the correlation between performance on a pitch-ranking task and spatial separation between SOE patterns for anodic and cathodic-leading symmetric bi...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DLSSmb

The Effect of Stimulus Polarity on the Relation Between Pitch Ranking and ECAP Spread of Excitation in Cochlear Implant Users

AbstractAlthough modern cochlear implants (CIs) use cathodic-leading symmetrical biphasic pulses to stimulate the auditory nerve, a growing body of evidence suggests that anodic-leading pulses may be more effective. The positive polarity has been shown to produce larger electrically evoked compound action potential (ECAP) amplitudes, steeper slope of the amplitude growth function, and broader spread of excitation (SOE) patterns. Polarity has also been shown to influence pitch perception. It remains unclear how polarity affects the relation between physiological SOE and psychophysical pitch perception. Using a within-subject design, we examined the correlation between performance on a pitch-ranking task and spatial separation between SOE patterns for anodic and cathodic-leading symmetric bi...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DLSSmb

Hurdles to the Development of the “Surgical Home” in the Low-Resource World

Abstract

Purpose of Review

This chapter assesses the current state of practice of anesthesia in a low-resourced hospital and the hurdles envisaged in the development of perioperative surgical home, PSH, at the Komfo Anokye Teaching Hospital, KATH in Ghana.

Recent Findings

In the PSH model, the patient's experience of care is coordinated by a Director of Perioperative Services, additional Surgical Home Leadership, and supportive personnel, which constitute an interdisciplinary team. KATH is yet to establish working structures that provide a solid foundation that would make implementation of this model possible. Foundational tenets of the PSH being operating room (OR) managers or directors, interdisciplinary teamwork, well-oriented and motivated staff, appreciation of the key roles of the anesthetist by both patients and surgeons among others are either not well established or nonexistent currently at KATH.

Summary

While KATH has the basic infrastructure and personnel compared to other low-resourced countries for delivery of safe anesthesia, there exist several important limitations to the successful establishment of the PSH practice. Besides having to operate currently on limited funding, the necessary interdepartmental cohesion and acceptance of the anesthetist to lead any such model present an important hurdle to be surmounted.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HHS1a3

Quality Assurance in Interventional Radiology: Post-procedural Care

Abstract

Purpose of Review

To review best practices to improve the quality of patient service in the field of interventional radiology after performing the procedure.

Recent Findings

The aim of this paper is to highlight aspects of post-procedural care such as effective communication, post-procedural management of the patient, handling of obtained specimens, post-procedural follow-up, tracking outcomes, and education to assist the interventionalist in providing comprehensive quality post-procedural care.

Summary

Post-procedural communication, follow-up, and outcome tracking are essential elements in the quality assurance of an Interventional Radiology service.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HK9izo

Quality Assurance in Interventional Radiology: Preprocedural Care

Abstract

Purpose of Review

To review best practices to improve the quality of patient service in the field of interventional radiology prior to performing the procedure.

Recent Findings

We highlight a checklist of elements that have a potential for improvement and contribution to overall quality of patient care from the time of taking the consult, until the time of the procedure. Our check list includes establishing appropriateness of the procedure, reducing waiting times, patient-centered care, patient education, shared decision making, establishing expectations, informed consent, managing the patient's medication list, preprocedure diet, prevention of CIN, prevention of contrast reactions, pain control and sedation, and coagulation status and hemostasis risk. Several consensus guidelines are referenced in this chapter. However, individual patients and clinical scenario vary and determine which guideline to follow or modify based in clinical judgment.

Summary

The clinic is a key component of success in any Interventional Radiology practice, as it provides the space for consultation, patient education, and preprocedural planning.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2t0AY8N

Implant treatment of two failing or missing central incisors in the aesthetic region: a treatment protocol and 1-year prospective study

Implant treatment for two central incisors in the maxillary aesthetic region is complex due to concerns regarding inter-implant hard and soft tissue stability. A treatment protocol was therefore developed and implemented in a 1-year prospective case series study involving 16 patients with two failing or missing central incisors in the maxillary aesthetic region. The protocol consists of five options depending on whether teeth are still present (options 1 –3) or not (options 4 and 5) and on the amount of bone available at the start of treatment: (1) extraction followed by immediate implant placement and provisionalization, (2) extraction followed by immediate implant placement and delayed provisionalization, (3) extraction followed by ridge preserv ation, delayed implant placement and imm...

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Three-dimensional analysis of condylar changes in surgical correction for open bite patients with skeletal class II and class III malocclusions

The aim of this study was to quantify three-dimensional condylar displacements as a result of two-jaw surgery for open bite correction in patients with skeletal class II and class III malocclusion. Pre-surgical (T1) and post-surgical (T2) cone beam computed tomography scans were taken for 16 patients with skeletal class II (mean age 22.3 ±9.47years) and 14 patients with skeletal class III (mean age 25.6±6.27years). T2 scans were registered to T1 scans at the cranial base. Translational and rotational condylar changes were calculated by x,y,z coordinates of corresponding landmarks. (Source: International Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HGWGsI

Hurdles to the Development of the “Surgical Home” in the Low-Resource World

Abstract

Purpose of Review

This chapter assesses the current state of practice of anesthesia in a low-resourced hospital and the hurdles envisaged in the development of perioperative surgical home, PSH, at the Komfo Anokye Teaching Hospital, KATH in Ghana.

Recent Findings

In the PSH model, the patient's experience of care is coordinated by a Director of Perioperative Services, additional Surgical Home Leadership, and supportive personnel, which constitute an interdisciplinary team. KATH is yet to establish working structures that provide a solid foundation that would make implementation of this model possible. Foundational tenets of the PSH being operating room (OR) managers or directors, interdisciplinary teamwork, well-oriented and motivated staff, appreciation of the key roles of the anesthetist by both patients and surgeons among others are either not well established or nonexistent currently at KATH.

Summary

While KATH has the basic infrastructure and personnel compared to other low-resourced countries for delivery of safe anesthesia, there exist several important limitations to the successful establishment of the PSH practice. Besides having to operate currently on limited funding, the necessary interdepartmental cohesion and acceptance of the anesthetist to lead any such model present an important hurdle to be surmounted.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HHS1a3

Quality Assurance in Interventional Radiology: Post-procedural Care

Abstract

Purpose of Review

To review best practices to improve the quality of patient service in the field of interventional radiology after performing the procedure.

Recent Findings

The aim of this paper is to highlight aspects of post-procedural care such as effective communication, post-procedural management of the patient, handling of obtained specimens, post-procedural follow-up, tracking outcomes, and education to assist the interventionalist in providing comprehensive quality post-procedural care.

Summary

Post-procedural communication, follow-up, and outcome tracking are essential elements in the quality assurance of an Interventional Radiology service.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HK9izo

Quality Assurance in Interventional Radiology: Preprocedural Care

Abstract

Purpose of Review

To review best practices to improve the quality of patient service in the field of interventional radiology prior to performing the procedure.

Recent Findings

We highlight a checklist of elements that have a potential for improvement and contribution to overall quality of patient care from the time of taking the consult, until the time of the procedure. Our check list includes establishing appropriateness of the procedure, reducing waiting times, patient-centered care, patient education, shared decision making, establishing expectations, informed consent, managing the patient's medication list, preprocedure diet, prevention of CIN, prevention of contrast reactions, pain control and sedation, and coagulation status and hemostasis risk. Several consensus guidelines are referenced in this chapter. However, individual patients and clinical scenario vary and determine which guideline to follow or modify based in clinical judgment.

Summary

The clinic is a key component of success in any Interventional Radiology practice, as it provides the space for consultation, patient education, and preprocedural planning.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2t0AY8N

Three-dimensional analysis of condylar changes in surgical correction for open bite patients with skeletal class II and class III malocclusions

The aim of this study was to quantify three-dimensional condylar displacements as a result of two-jaw surgery for open bite correction in patients with skeletal class II and class III malocclusion. Pre-surgical (T1) and post-surgical (T2) cone beam computed tomography scans were taken for 16 patients with skeletal class II (mean age 22.3 ±9.47years) and 14 patients with skeletal class III (mean age 25.6±6.27years). T2 scans were registered to T1 scans at the cranial base. Translational and rotational condylar changes were calculated by x,y,z coordinates of corresponding landmarks. (Source: International Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2HGWGsI

Quality and potency profile of eight recombinant isoallergens, largely mimicking total Bet v 1‐specific IgE binding of birch pollen

Abstract

Background

To date only limited information on structure, expression levels and IgE binding of Bet v 1 variants, which are simultaneously expressed in birch pollen, is available.

Objective

To analyze and compare structure and serum IgE/IgG binding of rBet v 1 variants to Bet v 1.0101.

Methods

Recombinant Bet v 1 variants were studied with sera of 20 subjects allergic to birch pollen. Folding, aggregation and solubility of the rBet v 1 variants was analyzed to attribute diverging IgE binding to either allergen structure or methodological features. IgE/IgG binding was studied with rBet v 1 in solution or adsorbed to solid phases. Allergen‐mediated crosslinking of FcεRI receptors was determined by mediator release of sensitized humanized rat basophil leukemia cells.

Results

All variants, except for rBet v 1.0113, were monomeric and had Bet v 1‐type conformation. Serum IgE binding to variants adsorbed to solid phase was reduced to 6.6% ‐ 36.5% compared with Bet v 1.0101. In contrast, inhibition of IgE binding to Bet v 1.0101 by rBet v 1 variants ranged from 62% ‐ 83%. Similarly, mediator release ranged from 30.7% ‐ 55.2% for all variants and was only clearly reduced for rBet v 1.0301 (10.4%). The IgE binding potency of rBet v 1 variants representing their native quantities in birch pollen was only slightly lower compared to extract. IgG binding to variants was between 50.9% ‐ 134.5% compared with rBet v 1.0101 (100%).

Conclusion and clinical relevance

Bet v 1 variants previously classified as hypoallergenic can exhibit similar functional IgE binding as Bet v 1.0101. Eight rBet v 1 variants largely reproduce total Bet v 1‐specific IgE binding of birch pollen extracts. Assay format dependent variation of IgE binding properties needs to be considered in the development of diagnostic or therapeutic products.

This article is protected by copyright. All rights reserved.

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Neurosensory issues after lateralisation of the inferior alveolar nerve and simultaneous placement of osseointegrated implants

Our aim was to evaluate neurosensory symptoms after lateralisation of the inferior alveolar nerve (IAN). We studied a retrospective case series with one-year follow up that included 139 procedures in 123 patients. After the IAN had been located it was deflected from the mandibular body and the implant placed. Sensitivity was mapped 24hours, one month, six months, and one year after the intervention by gently pressing the skin and lips with the tip of a probe. A total of 337 implants were placed in 123 patients aged between 44 and 68 years. (Source: The British Journal of Oral and Maxillofacial Surgery)

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Intraoperative verification of resection margins of maxillary malignancies by cone-beam computed tomography

Resection of maxillary cancer often results in incomplete excision because of the tumour 's proximity to important structures such as the orbit. To deal with this problem we prospectively investigated the feasibility of intraoperative imaging during maxillectomy to verify the planned resection margins. In total, six patients diagnosed with maxillary cancer listed for maxillectomy were included, irrespective of the histological type of tumour. Before resection, an accurate intended resection volume was delineated on diagnostic images. (Source: The British Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S2w5uM

---

The second edition of the Oxford Handbook of Oral and Maxillofacial Surgery is the recently updated, "must have" text for junior maxillofacial trainees (particularly dental core trainees), senior house officers, students, or anyone who is thinking about a career in the specialty. (Source: The British Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Utr3V2

Neurosensory issues after lateralisation of the inferior alveolar nerve and simultaneous placement of osseointegrated implants

Our aim was to evaluate neurosensory symptoms after lateralisation of the inferior alveolar nerve (IAN). We studied a retrospective case series with one-year follow up that included 139 procedures in 123 patients. After the IAN had been located it was deflected from the mandibular body and the implant placed. Sensitivity was mapped 24hours, one month, six months, and one year after the intervention by gently pressing the skin and lips with the tip of a probe. A total of 337 implants were placed in 123 patients aged between 44 and 68 years. (Source: The British Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2UxwwKq

Intraoperative verification of resection margins of maxillary malignancies by cone-beam computed tomography

Resection of maxillary cancer often results in incomplete excision because of the tumour 's proximity to important structures such as the orbit. To deal with this problem we prospectively investigated the feasibility of intraoperative imaging during maxillectomy to verify the planned resection margins. In total, six patients diagnosed with maxillary cancer listed for maxillectomy were included, irrespective of the histological type of tumour. Before resection, an accurate intended resection volume was delineated on diagnostic images. (Source: The British Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S2w5uM

---

The second edition of the Oxford Handbook of Oral and Maxillofacial Surgery is the recently updated, "must have" text for junior maxillofacial trainees (particularly dental core trainees), senior house officers, students, or anyone who is thinking about a career in the specialty. (Source: The British Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Utr3V2

Neuroimaging-Based Classification Algorithm for Predicting 1p/19q-Codeletion Status in IDH-Mutant Lower Grade Gliomas [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Isocitrate dehydrogenase (IDH)-mutant lower grade gliomas are classified as oligodendrogliomas or diffuse astrocytomas based on 1p/19q-codeletion status. We aimed to test and validate neuroradiologists' performances in predicting the codeletion status of IDH-mutant lower grade gliomas based on simple neuroimaging metrics.

MATERIALS AND METHODS:

One hundred two IDH-mutant lower grade gliomas with preoperative MR imaging and known 1p/19q status from The Cancer Genome Atlas composed a training dataset. Two neuroradiologists in consensus analyzed the training dataset for various imaging features: tumor or cyst texture, margins, cortical infiltration, T2-FLAIR mismatch, tumor cyst, T2* susceptibility, hydrocephalus, midline shift, maximum dimension, primary lobe, necrosis, enhancement, edema, and gliomatosis. Statistical analysis of the training data produced a multivariate classification model for codeletion prediction based on a subset of MR imaging features and patient age. To validate the classification model, 2 different independent neuroradiologists analyzed a separate cohort of 106 institutional IDH-mutant lower grade gliomas.

RESULTS:

Training dataset analysis produced a 2-step classification algorithm with 86.3% codeletion prediction accuracy, based on the following: 1) the presence of the T2-FLAIR mismatch sign, which was 100% predictive of noncodeleted lower grade gliomas, (n = 21); and 2) a logistic regression model based on texture, patient age, T2* susceptibility, primary lobe, and hydrocephalus. Independent validation of the classification algorithm rendered codeletion prediction accuracies of 81.1% and 79.2% in 2 independent readers. The metrics used in the algorithm were associated with moderate-substantial interreader agreement ( = 0.56–0.79).

CONCLUSIONS:

We have validated a classification algorithm based on simple, reproducible neuroimaging metrics and patient age that demonstrates a moderate prediction accuracy of 1p/19q-codeletion status among IDH-mutant lower grade gliomas.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S1l6lx

3T MRI Whole-Brain Microscopy Discrimination of Subcortical Anatomy, Part 1: Brain Stem [ADULT BRAIN]

BACKGROUND AND PURPOSE:

The brain stem is compactly organized with life-sustaining sensorimotor and autonomic structures that can be affected by numerous pathologies but can be difficult to resolve on conventional MR imaging.

MATERIALS AND METHODS:

We applied an optimized TSE T2 sequence to washed postmortem brain samples to reveal exquisite and reproducible brain stem anatomic MR imaging contrast comparable with histologic atlases. This resource-efficient approach can be performed across multiple whole-brain samples with relatively short acquisition times (2 hours per imaging plane) using clinical 3T MR imaging systems.

RESULTS:

We identified most brain stem structures at 7 canonical axial levels. Multiplanar or oblique planes illustrate the 3D course and spatial relationships of major brain stem white matter pathways. Measurements of the relative position, course, and cross-sectional area of these pathways across multiple samples allow estimation of pathway location in other samples or clinical subjects. Possible structure-function asymmetries in these pathways will require further study—that is, the cross-sectional area of the left corticospinal tract in the midpons appeared 20% larger (n = 13 brains, P < .10).

CONCLUSIONS:

Compared with traditional atlases, multiplanar MR imaging contrast has advantages for learning and retaining brain stem anatomy for clinicians and trainees. Direct TSE MR imaging sequence discrimination of brain stem anatomy can help validate other MR imaging contrasts, such as diffusion tractography, or serve as a structural template for extracting quantitative MR imaging data in future postmortem investigations.

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Imaging of Patients with Suspected Large-Vessel Occlusion at Primary Stroke Centers: Available Modalities and a Suggested Approach [PRACTICE PERSPECTIVES]

SUMMARY:

The overwhelming benefit of endovascular therapy in patients with large-vessel occlusions suggests that more patients will be screened than treated. Some of those patients will be evaluated first at primary stroke centers; this type of evaluation calls for standardizing the imaging approach to minimize delays in assessing, transferring, and treating these patients. Here, we propose that CT angiography (performed at the same time as head CT) should be the minimum imaging approach for all patients with stroke with suspected large-vessel occlusion presenting to primary stroke centers. We discuss some of the implications of this approach and how to facilitate them.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S1zmLb

Neuroimaging-Based Classification Algorithm for Predicting 1p/19q-Codeletion Status in IDH-Mutant Lower Grade Gliomas [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Isocitrate dehydrogenase (IDH)-mutant lower grade gliomas are classified as oligodendrogliomas or diffuse astrocytomas based on 1p/19q-codeletion status. We aimed to test and validate neuroradiologists' performances in predicting the codeletion status of IDH-mutant lower grade gliomas based on simple neuroimaging metrics.

MATERIALS AND METHODS:

One hundred two IDH-mutant lower grade gliomas with preoperative MR imaging and known 1p/19q status from The Cancer Genome Atlas composed a training dataset. Two neuroradiologists in consensus analyzed the training dataset for various imaging features: tumor or cyst texture, margins, cortical infiltration, T2-FLAIR mismatch, tumor cyst, T2* susceptibility, hydrocephalus, midline shift, maximum dimension, primary lobe, necrosis, enhancement, edema, and gliomatosis. Statistical analysis of the training data produced a multivariate classification model for codeletion prediction based on a subset of MR imaging features and patient age. To validate the classification model, 2 different independent neuroradiologists analyzed a separate cohort of 106 institutional IDH-mutant lower grade gliomas.

RESULTS:

Training dataset analysis produced a 2-step classification algorithm with 86.3% codeletion prediction accuracy, based on the following: 1) the presence of the T2-FLAIR mismatch sign, which was 100% predictive of noncodeleted lower grade gliomas, (n = 21); and 2) a logistic regression model based on texture, patient age, T2* susceptibility, primary lobe, and hydrocephalus. Independent validation of the classification algorithm rendered codeletion prediction accuracies of 81.1% and 79.2% in 2 independent readers. The metrics used in the algorithm were associated with moderate-substantial interreader agreement ( = 0.56–0.79).

CONCLUSIONS:

We have validated a classification algorithm based on simple, reproducible neuroimaging metrics and patient age that demonstrates a moderate prediction accuracy of 1p/19q-codeletion status among IDH-mutant lower grade gliomas.

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3T MRI Whole-Brain Microscopy Discrimination of Subcortical Anatomy, Part 1: Brain Stem [ADULT BRAIN]

BACKGROUND AND PURPOSE:

The brain stem is compactly organized with life-sustaining sensorimotor and autonomic structures that can be affected by numerous pathologies but can be difficult to resolve on conventional MR imaging.

MATERIALS AND METHODS:

We applied an optimized TSE T2 sequence to washed postmortem brain samples to reveal exquisite and reproducible brain stem anatomic MR imaging contrast comparable with histologic atlases. This resource-efficient approach can be performed across multiple whole-brain samples with relatively short acquisition times (2 hours per imaging plane) using clinical 3T MR imaging systems.

RESULTS:

We identified most brain stem structures at 7 canonical axial levels. Multiplanar or oblique planes illustrate the 3D course and spatial relationships of major brain stem white matter pathways. Measurements of the relative position, course, and cross-sectional area of these pathways across multiple samples allow estimation of pathway location in other samples or clinical subjects. Possible structure-function asymmetries in these pathways will require further study—that is, the cross-sectional area of the left corticospinal tract in the midpons appeared 20% larger (n = 13 brains, P < .10).

CONCLUSIONS:

Compared with traditional atlases, multiplanar MR imaging contrast has advantages for learning and retaining brain stem anatomy for clinicians and trainees. Direct TSE MR imaging sequence discrimination of brain stem anatomy can help validate other MR imaging contrasts, such as diffusion tractography, or serve as a structural template for extracting quantitative MR imaging data in future postmortem investigations.

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Language recovery following stroke.

Conclusions: Significant recovery of language function is possible following a stroke, but prediction of level of recovery in an individual patient is difficult. Information about initial aphasia severity and the integrity of cognitive domains other than language can help guide the rehabilitation team, as well as manage expectations for recovery. PMID: 30698070 [PubMed - as supplied by publisher] (Source: The Clinical Neuropsychologist)

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Experiences of communication changes following spinal cord injury: a qualitative analysis.

CONCLUSIONS: Individuals with cervical spinal cord injury perceive and experience meaningful changes on communication function post-injury, with salient impacts to daily-living and social participation. IMPLICATIONS FOR REHABILITATION As a result of communication changes post-injury, individuals with cervical spinal cord injury experience several challenges across a variety of domains in daily life The current study highlights the benefit of using a biopsychosocial framework, such as The International Classification of Functioning, Disability and Health (ICF), to consider the complex and diverse impact of communication changes on the functioning of individuals with cervical spinal cord injury, as well as the influence of environmental factors, on rehabilitation planning The current data de...

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Language recovery following stroke.

Conclusions: Significant recovery of language function is possible following a stroke, but prediction of level of recovery in an individual patient is difficult. Information about initial aphasia severity and the integrity of cognitive domains other than language can help guide the rehabilitation team, as well as manage expectations for recovery. PMID: 30698070 [PubMed - as supplied by publisher] (Source: The Clinical Neuropsychologist)

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Experiences of communication changes following spinal cord injury: a qualitative analysis.

CONCLUSIONS: Individuals with cervical spinal cord injury perceive and experience meaningful changes on communication function post-injury, with salient impacts to daily-living and social participation. IMPLICATIONS FOR REHABILITATION As a result of communication changes post-injury, individuals with cervical spinal cord injury experience several challenges across a variety of domains in daily life The current study highlights the benefit of using a biopsychosocial framework, such as The International Classification of Functioning, Disability and Health (ICF), to consider the complex and diverse impact of communication changes on the functioning of individuals with cervical spinal cord injury, as well as the influence of environmental factors, on rehabilitation planning The current data de...

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Jan 2019 Clinical Case Vid. 1

Video 1. Axial (horizontal) CT of the left temporal bone showing the fluid in the mastoid and the encephalocele. (Source: The Hearing Journal - Video)

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Jan 2019 Clinical Case Vid. 2

Video 2. Axial (horizontal) CT of the right temporal bone showing the normal mastoid with the dominant jugular bulb. (Source: The Hearing Journal - Video)

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Jan 2019 Clinical Case Vid. 3

Video 3. Coronal (parallel to the face superiorly-inferiorly) CT of the left temporal bone showing the tegmen mastoideum (roof of mastoid) defect with meningocele or encephalocele in antrum. (Source: The Hearing Journal - Video)

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Jan 2019 Clinical Case Vid. 5

Video 5. Sagittal (looking outside-in from laterally) CT of the temporal bone showing the sagittal anatomy of the encephalocele and its relationship with the ossicles. (Source: The Hearing Journal - Video)

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Jan 2019 Clinical Case Vid. 6

Video 6. Coronal (parallel to the face superiorly-inferiorly) T1 MRI showing that the contents of the mastoid are in continuity with the brain. (Source: The Hearing Journal - Video)

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Jan 2019 Clinical Case Vid. 1

Video 1. Axial (horizontal) CT of the left temporal bone showing the fluid in the mastoid and the encephalocele. (Source: The Hearing Journal - Video)

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Jan 2019 Clinical Case Vid. 2

Video 2. Axial (horizontal) CT of the right temporal bone showing the normal mastoid with the dominant jugular bulb. (Source: The Hearing Journal - Video)

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Jan 2019 Clinical Case Vid. 3

Video 3. Coronal (parallel to the face superiorly-inferiorly) CT of the left temporal bone showing the tegmen mastoideum (roof of mastoid) defect with meningocele or encephalocele in antrum. (Source: The Hearing Journal - Video)

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Jan 2019 Clinical Case Vid. 4

Video 4. Coronal (parallel to the face superiorly-inferiorly) CT of the right temporal bone showing a thin tegmen mastoideum (roof of mastoid) with no encephalocele. (Source: The Hearing Journal - Video)

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Jan 2019 Clinical Case Vid. 5

Video 5. Sagittal (looking outside-in from laterally) CT of the temporal bone showing the sagittal anatomy of the encephalocele and its relationship with the ossicles. (Source: The Hearing Journal - Video)

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Jan 2019 Clinical Case Vid. 6

Video 6. Coronal (parallel to the face superiorly-inferiorly) T1 MRI showing that the contents of the mastoid are in continuity with the brain. (Source: The Hearing Journal - Video)

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LORATADINE ALLERGY RELIEF (Loratadine) Tablet [Denton Pharma, Inc. DBA Northwind Pharmaceuticals]

Updated Date: Jan 31, 2019 EST (Source: DailyMed Drug Label Updates)

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LORATADINE ALLERGY RELIEF (Loratadine) Tablet [Denton Pharma, Inc. DBA Northwind Pharmaceuticals]

Updated Date: Jan 31, 2019 EST (Source: DailyMed Drug Label Updates)

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Tenosynovial Giant Cell Tumours of the Hand: A Multicentre Case Control Study

Many factors have been proposed to contribute to the risk of recurrent TSGCT (Tenosynovial Giant Cell Tumours); however, we remain unable to predict those at risk which formed the rationale for this multicentre retrospective case control study of 28 patients with recurrence. We age and sex matched cases of recurrence 1:1 with controls over 10 years. Using Cox regression, we present hazard ratios (HR) for recurrence with 95% confidence intervals (CI). Out of 285 cases, 28 individuals developed recurrence after a median 2.4 years.

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Implant treatment of two failing or missing central incisors in the aesthetic region: a treatment protocol and 1-year prospective study

Implant treatment for two central incisors in the maxillary aesthetic region is complex due to concerns regarding inter-implant hard and soft tissue stability. A treatment protocol was therefore developed and implemented in a 1-year prospective case series study involving 16 patients with two failing or missing central incisors in the maxillary aesthetic region. The protocol consists of five options depending on whether teeth are still present (options 1–3) or not (options 4 and 5) and on the amount of bone available at the start of treatment: (1) extraction followed by immediate implant placement and provisionalization, (2) extraction followed by immediate implant placement and delayed provisionalization, (3) extraction followed by ridge preservation, delayed implant placement and immediate provisionalization, (4) delayed implant placement and guided bone regeneration with delayed provisionalization, (5) guided bone regeneration (extensive bone augmentation of the alveolar ridge), delayed implant placement, and delayed provisionalization.

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Three-dimensional analysis of condylar changes in surgical correction for open bite patients with skeletal class II and class III malocclusions

The aim of this study was to quantify three-dimensional condylar displacements as a result of two-jaw surgery for open bite correction in patients with skeletal class II and class III malocclusion. Pre-surgical (T1) and post-surgical (T2) cone beam computed tomography scans were taken for 16 patients with skeletal class II (mean age 22.3±9.47years) and 14 patients with skeletal class III (mean age 25.6±6.27years). T2 scans were registered to T1 scans at the cranial base. Translational and rotational condylar changes were calculated by x,y,z coordinates of corresponding landmarks.

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Levels Propagation Approach to Image Segmentation: Application to Breast MR Images

Abstract

Accurate segmentation of a breast tumor region is fundamental for treatment. Magnetic resonance imaging (MRI) is a widely used diagnostic tool. In this paper, a new semi-automatic segmentation approach for MRI breast tumor segmentation called Levels Propagation Approach (LPA) is introduced. The introduced segmentation approach takes inspiration from tumor propagation and relies on a finite set of nested and non-overlapped levels. LPA has several features: it is highly suitable to parallelization and offers a simple and dynamic possibility to automate the threshold selection. Furthermore, it allows stopping of the segmentation at any desired limit. Particularly, it allows to avoid to reach the breast skin-line region which is known as a significant issue that reduces the precision and the effectiveness of the breast tumor segmentation. The proposed approach have been tested on two clinical datasets, namely RIDER breast tumor dataset and CMH-LIMED breast tumor dataset. The experimental evaluations have shown that LPA has produced competitive results to some state-of-the-art methods and has acceptable computation complexity.

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Predicting Breast Cancer Molecular Subtype with MRI Dataset Utilizing Convolutional Neural Network Algorithm

Abstract

To develop a convolutional neural network (CNN) algorithm that can predict the molecular subtype of a breast cancer based on MRI features. An IRB-approved study was performed in 216 patients with available pre-treatment MRIs and immunohistochemical staining pathology data. First post-contrast MRI images were used for 3D segmentation using 3D slicer. A CNN architecture was designed with 14 layers. Residual connections were used in the earlier layers to allow stabilization of gradients during backpropagation. Inception style layers were utilized deeper in the network to allow learned segregation of more complex feature mappings. Extensive regularization was utilized including dropout, L2, feature map dropout, and transition layers. The class imbalance was addressed by doubling the input of underrepresented classes and utilizing a class sensitive cost function. Parameters were tuned based on a 20% validation group. A class balanced holdout set of 40 patients was utilized as the testing set. Software code was written in Python using the TensorFlow module on a Linux workstation with one NVidia Titan X GPU. Seventy-four luminal A, 106 luminal B, 13 HER2+, and 23 basal breast tumors were evaluated. Testing set accuracy was measured at 70%. The class normalized macro area under receiver operating curve (ROC) was measured at 0.853. Non-normalized micro-aggregated AUC was measured at 0.871, representing improved discriminatory power for the highly represented Luminal A and Luminal B subtypes. Aggregate sensitivity and specificity was measured at 0.603 and 0.958. MRI analysis of breast cancers utilizing a novel CNN can predict the molecular subtype of breast cancers. Larger data sets will likely improve our model.

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Integrating an Ontology of Radiology Differential Diagnosis with ICD-10-CM, RadLex, and SNOMED CT

Abstract

An ontology offers a human-readable and machine-computable representation of the concepts in a domain and the relationships among them. Mappings between ontologies enable the reuse and interoperability of biomedical knowledge. We sought to map concepts of the Radiology Gamuts Ontology (RGO), an ontology that links diseases and imaging findings to support differential diagnosis in radiology, to terms in three key vocabularies for clinical radiology: the International Classification of Diseases, version 10, Clinical Modification (ICD-10-CM), the Radiological Society of North America's radiology lexicon (RadLex), and the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT). RGO (version 0.7; Jan 2018) incorporated 16,918 terms (classes) for diseases, interventions, and imaging observations linked by 1782 subsumption (class-subclass) relations and 55,569 causal ("may cause") relations. RGO classes were mapped to RadLex (46,656 classes, version 3.15), SNOMED CT (347,358 classes, version 2018AA), and ICD-10-CM (94,645 classes, version 2018AA) using the National Center for Biomedical Ontology (NCBO) Annotator web service. We identified 1275 exact mappings from RGO to RadLex, 5302 to SNOMED CT, and 941 to ICD-10-CM. RGO terms mapped to one ontology (n = 3401), two ontologies (n = 1515), or all three ontologies (n = 198). The mapped ontologies provide additional terms to support data mining from textual information in the electronic health record. The current work builds on efforts to map RGO to ontologies of diseases and phenotypes. Mappings between ontologies can support automated knowledge discovery, diagnostic reasoning, and data mining.

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Tenosynovial Giant Cell Tumours of the Hand: A Multicentre Case Control Study

Many factors have been proposed to contribute to the risk of recurrent TSGCT (Tenosynovial Giant Cell Tumours); however, we remain unable to predict those at risk which formed the rationale for this multicentre retrospective case control study of 28 patients with recurrence. We age and sex matched cases of recurrence 1:1 with controls over 10 years. Using Cox regression, we present hazard ratios (HR) for recurrence with 95% confidence intervals (CI). Out of 285 cases, 28 individuals developed recurrence after a median 2.4 years.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RZAAq8

Implant treatment of two failing or missing central incisors in the aesthetic region: a treatment protocol and 1-year prospective study

Implant treatment for two central incisors in the maxillary aesthetic region is complex due to concerns regarding inter-implant hard and soft tissue stability. A treatment protocol was therefore developed and implemented in a 1-year prospective case series study involving 16 patients with two failing or missing central incisors in the maxillary aesthetic region. The protocol consists of five options depending on whether teeth are still present (options 1–3) or not (options 4 and 5) and on the amount of bone available at the start of treatment: (1) extraction followed by immediate implant placement and provisionalization, (2) extraction followed by immediate implant placement and delayed provisionalization, (3) extraction followed by ridge preservation, delayed implant placement and immediate provisionalization, (4) delayed implant placement and guided bone regeneration with delayed provisionalization, (5) guided bone regeneration (extensive bone augmentation of the alveolar ridge), delayed implant placement, and delayed provisionalization.

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Three-dimensional analysis of condylar changes in surgical correction for open bite patients with skeletal class II and class III malocclusions

The aim of this study was to quantify three-dimensional condylar displacements as a result of two-jaw surgery for open bite correction in patients with skeletal class II and class III malocclusion. Pre-surgical (T1) and post-surgical (T2) cone beam computed tomography scans were taken for 16 patients with skeletal class II (mean age 22.3±9.47years) and 14 patients with skeletal class III (mean age 25.6±6.27years). T2 scans were registered to T1 scans at the cranial base. Translational and rotational condylar changes were calculated by x,y,z coordinates of corresponding landmarks.

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Levels Propagation Approach to Image Segmentation: Application to Breast MR Images

Abstract

Accurate segmentation of a breast tumor region is fundamental for treatment. Magnetic resonance imaging (MRI) is a widely used diagnostic tool. In this paper, a new semi-automatic segmentation approach for MRI breast tumor segmentation called Levels Propagation Approach (LPA) is introduced. The introduced segmentation approach takes inspiration from tumor propagation and relies on a finite set of nested and non-overlapped levels. LPA has several features: it is highly suitable to parallelization and offers a simple and dynamic possibility to automate the threshold selection. Furthermore, it allows stopping of the segmentation at any desired limit. Particularly, it allows to avoid to reach the breast skin-line region which is known as a significant issue that reduces the precision and the effectiveness of the breast tumor segmentation. The proposed approach have been tested on two clinical datasets, namely RIDER breast tumor dataset and CMH-LIMED breast tumor dataset. The experimental evaluations have shown that LPA has produced competitive results to some state-of-the-art methods and has acceptable computation complexity.

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Integrating an Ontology of Radiology Differential Diagnosis with ICD-10-CM, RadLex, and SNOMED CT

Abstract

An ontology offers a human-readable and machine-computable representation of the concepts in a domain and the relationships among them. Mappings between ontologies enable the reuse and interoperability of biomedical knowledge. We sought to map concepts of the Radiology Gamuts Ontology (RGO), an ontology that links diseases and imaging findings to support differential diagnosis in radiology, to terms in three key vocabularies for clinical radiology: the International Classification of Diseases, version 10, Clinical Modification (ICD-10-CM), the Radiological Society of North America's radiology lexicon (RadLex), and the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT). RGO (version 0.7; Jan 2018) incorporated 16,918 terms (classes) for diseases, interventions, and imaging observations linked by 1782 subsumption (class-subclass) relations and 55,569 causal ("may cause") relations. RGO classes were mapped to RadLex (46,656 classes, version 3.15), SNOMED CT (347,358 classes, version 2018AA), and ICD-10-CM (94,645 classes, version 2018AA) using the National Center for Biomedical Ontology (NCBO) Annotator web service. We identified 1275 exact mappings from RGO to RadLex, 5302 to SNOMED CT, and 941 to ICD-10-CM. RGO terms mapped to one ontology (n = 3401), two ontologies (n = 1515), or all three ontologies (n = 198). The mapped ontologies provide additional terms to support data mining from textual information in the electronic health record. The current work builds on efforts to map RGO to ontologies of diseases and phenotypes. Mappings between ontologies can support automated knowledge discovery, diagnostic reasoning, and data mining.

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Writing Systematic Reviews of the Literature—It Really Is a Systematic Process!

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Intraoperative verification of resection margins of maxillary malignancies by cone-beam computed tomography

Resection of maxillary cancer often results in incomplete excision because of the tumour's proximity to important structures such as the orbit. To deal with this problem we prospectively investigated the feasibility of intraoperative imaging during maxillectomy to verify the planned resection margins. In total, six patients diagnosed with maxillary cancer listed for maxillectomy were included, irrespective of the histological type of tumour. Before resection, an accurate intended resection volume was delineated on diagnostic images.

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Neurosensory issues after lateralisation of the inferior alveolar nerve and simultaneous placement of osseointegrated implants

Our aim was to evaluate neurosensory symptoms after lateralisation of the inferior alveolar nerve (IAN). We studied a retrospective case series with one-year follow up that included 139 procedures in 123 patients. After the IAN had been located it was deflected from the mandibular body and the implant placed. Sensitivity was mapped 24hours, one month, six months, and one year after the intervention by gently pressing the skin and lips with the tip of a probe. A total of 337 implants were placed in 123 patients aged between 44 and 68 years.

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Intraoperative verification of resection margins of maxillary malignancies by cone-beam computed tomography

Resection of maxillary cancer often results in incomplete excision because of the tumour's proximity to important structures such as the orbit. To deal with this problem we prospectively investigated the feasibility of intraoperative imaging during maxillectomy to verify the planned resection margins. In total, six patients diagnosed with maxillary cancer listed for maxillectomy were included, irrespective of the histological type of tumour. Before resection, an accurate intended resection volume was delineated on diagnostic images.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2B7uERx

Neurosensory issues after lateralisation of the inferior alveolar nerve and simultaneous placement of osseointegrated implants

Our aim was to evaluate neurosensory symptoms after lateralisation of the inferior alveolar nerve (IAN). We studied a retrospective case series with one-year follow up that included 139 procedures in 123 patients. After the IAN had been located it was deflected from the mandibular body and the implant placed. Sensitivity was mapped 24hours, one month, six months, and one year after the intervention by gently pressing the skin and lips with the tip of a probe. A total of 337 implants were placed in 123 patients aged between 44 and 68 years.

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Genes Involved in the Development and Physiology of Both the Peripheral and Central Auditory Systems.

Authors: Michalski N, Petit C Abstract The genetic approach, based on the study of inherited forms of deafness, has proven to be particularly effective for deciphering the molecular mechanisms underlying the development of the peripheral auditory system, the cochlea and its afferent auditory neurons, and how this system extracts the physical parameters of sound. Although this genetic dissection has provided little information about the central auditory system, scattered data suggest that some genes may have a critical role in both the peripheral and central auditory systems. Here, we review the genes controlling the development and function of the peripheral and central auditory systems, focusing on those with demonstrated intrinsic roles in both systems and highlighting the curren...

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Neuronal Development of Hearing and Language: Cochlear Implants and Critical Periods.

Authors: Kral A, Dorman MF, Wilson BS Abstract The modern cochlear implant (CI) is the most successful neural prosthesis developed to date. CIs provide hearing to the profoundly hearing impaired and allow the acquisition of spoken language in children born deaf. Results from studies enabled by the CI have provided new insights into ( a) minimal representations at the periphery for speech reception, ( b) brain mechanisms for decoding speech presented in quiet and in acoustically adverse conditions, ( c) the developmental neuroscience of language and hearing, and ( d) the mechanisms and time courses of intramodal and cross-modal plasticity. Additionally, the results have underscored the interconnectedness of brain functions and the importance of top-down processes in perception and l...

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Genes Involved in the Development and Physiology of Both the Peripheral and Central Auditory Systems.

Authors: Michalski N, Petit C Abstract The genetic approach, based on the study of inherited forms of deafness, has proven to be particularly effective for deciphering the molecular mechanisms underlying the development of the peripheral auditory system, the cochlea and its afferent auditory neurons, and how this system extracts the physical parameters of sound. Although this genetic dissection has provided little information about the central auditory system, scattered data suggest that some genes may have a critical role in both the peripheral and central auditory systems. Here, we review the genes controlling the development and function of the peripheral and central auditory systems, focusing on those with demonstrated intrinsic roles in both systems and highlighting the curren...

MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.

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Neuronal Development of Hearing and Language: Cochlear Implants and Critical Periods.

Authors: Kral A, Dorman MF, Wilson BS Abstract The modern cochlear implant (CI) is the most successful neural prosthesis developed to date. CIs provide hearing to the profoundly hearing impaired and allow the acquisition of spoken language in children born deaf. Results from studies enabled by the CI have provided new insights into ( a) minimal representations at the periphery for speech reception, ( b) brain mechanisms for decoding speech presented in quiet and in acoustically adverse conditions, ( c) the developmental neuroscience of language and hearing, and ( d) the mechanisms and time courses of intramodal and cross-modal plasticity. Additionally, the results have underscored the interconnectedness of brain functions and the importance of top-down processes in perception and l...

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The causative–anticausative alternation in Jordanian Arabic (JA)

Publication date: Available online 30 January 2019Source: LinguaAuthor(s): Aseel ZibinAbstractThe current study aims to provide a description of the causative-anticausative alternation in Jordanian Arabic (henceforth, JA), focusing on the structural, morphological and semantic characteristics of causative and anticausative verbs. I adopt a non-derivational approach (i.e. the common-base approach), in which the two variants share a single root to account for the alternation in JA. The fact that JA exhibits two processes, i.e. causativisation and anticausativisation, with distinct morphological markings, provides evidence that neither a causativisation analysis nor an anticausativisation one accounts for the behaviour of verbs in JA. The analysis shows that the causative alternation in JA co...

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End-to-End Acoustic Modeling using Convolutional Neural Networks for HMM-based Automatic Speech Recognition

Publication date: Available online 30 January 2019Source: Speech CommunicationAuthor(s): Dimitri Palaz, Mathew Magimai-Doss, Ronan CollobertAbstractIn hidden Markov model (HMM) based automatic speech recognition (ASR) system, modeling the statistical relationship between the acoustic speech signal and the HMM states that represent linguistically motivated subword units such as phonemes is a crucial step. This is typically achieved by first extracting acoustic features from the speech signal based on prior knowledge such as, speech perception or/and speech production knowledge, and, then training a classifier such as artificial neural networks (ANN), Gaussian mixture model that estimates the emission probabilities of the HMM states. This paper investigates an end-to-end acoustic modeling ap...

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From visual perception to evidentiality: A functional empirical approach to se ve que in Spanish

Publication date: Available online 30 January 2019Source: LinguaAuthor(s): Marta Albelda Marco, Marlies JansegersAbstractThe Spanish sequence se ve (que) presents intricate functional polysemy, including constructionalization as an evidential. The present paper investigates its different formal-functional combinations and degrees of specialization as an evidential construction. The following questions were addressed: (1) How many different senses can be distinguished in the sequence se ve (que) and what are their respective frequencies? (2) How do these senses correlate with the morphosyntactic behavior of the sequence se ve (que)? (3) Which senses of se ve (que) are more closely related to each other, and how does the evidential construction relate to this polysemous network? The semantic...

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Comment on “Sarcopenia is an Independent Risk Factor for Dysphagia in Community-Dwelling Older Adults”

(Source: Dysphagia)

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Predicting the Outcome of Unilateral Vocal Fold Paralysis: A Multivariate Discriminating Model Including Grade of Dysphonia, Jitter, Shimmer, and Voice Handicap Index-10.

CONCLUSIONS:: Delayed diagnosis and speech therapy was associated with negative outcomes. Higher grade of dysphonia, jitter, shimmer, and VHI-10 score on initial phoniatric assessment may help clinicians in predicting the outcomes of UVFP patients. PMID: 30693800 [PubMed - as supplied by publisher] (Source: The Annals of Otology, Rhinology, and Laryngology)

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Effect of effortful swallowing training on tongue strength and oropharyngeal swallowing function in stroke patients with dysphagia: a double-blind, randomized controlled trial.

CONCLUSIONS & IMPLICATIONS: We recommend EST as a remedial strategy for improving tongue strength and oral swallowing function in patients with stroke. PMID: 30693627 [PubMed - as supplied by publisher] (Source: International Journal of Language and Communication Disorders)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sYHnRS

Feasibility and initial efficacy of project-based treatment for people with ABI.

CONCLUSIONS & IMPLICATIONS: Project-based treatment is feasible with indications of initial efficacy for both communication skills and QOL. The treatment provides a promising new approach for improving communication skills and QOL in people with chronic acquired brain injuries in the community setting. PMID: 30693611 [PubMed - as supplied by publisher] (Source: International Journal of Language and Communication Disorders)

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The causative–anticausative alternation in Jordanian Arabic (JA)

Publication date: Available online 30 January 2019Source: LinguaAuthor(s): Aseel ZibinAbstractThe current study aims to provide a description of the causative-anticausative alternation in Jordanian Arabic (henceforth, JA), focusing on the structural, morphological and semantic characteristics of causative and anticausative verbs. I adopt a non-derivational approach (i.e. the common-base approach), in which the two variants share a single root to account for the alternation in JA. The fact that JA exhibits two processes, i.e. causativisation and anticausativisation, with distinct morphological markings, provides evidence that neither a causativisation analysis nor an anticausativisation one accounts for the behaviour of verbs in JA. The analysis shows that the causative alternation in JA co...

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End-to-End Acoustic Modeling using Convolutional Neural Networks for HMM-based Automatic Speech Recognition

Publication date: Available online 30 January 2019Source: Speech CommunicationAuthor(s): Dimitri Palaz, Mathew Magimai-Doss, Ronan CollobertAbstractIn hidden Markov model (HMM) based automatic speech recognition (ASR) system, modeling the statistical relationship between the acoustic speech signal and the HMM states that represent linguistically motivated subword units such as phonemes is a crucial step. This is typically achieved by first extracting acoustic features from the speech signal based on prior knowledge such as, speech perception or/and speech production knowledge, and, then training a classifier such as artificial neural networks (ANN), Gaussian mixture model that estimates the emission probabilities of the HMM states. This paper investigates an end-to-end acoustic modeling ap...

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From visual perception to evidentiality: A functional empirical approach to se ve que in Spanish

Publication date: Available online 30 January 2019Source: LinguaAuthor(s): Marta Albelda Marco, Marlies JansegersAbstractThe Spanish sequence se ve (que) presents intricate functional polysemy, including constructionalization as an evidential. The present paper investigates its different formal-functional combinations and degrees of specialization as an evidential construction. The following questions were addressed: (1) How many different senses can be distinguished in the sequence se ve (que) and what are their respective frequencies? (2) How do these senses correlate with the morphosyntactic behavior of the sequence se ve (que)? (3) Which senses of se ve (que) are more closely related to each other, and how does the evidential construction relate to this polysemous network? The semantic...

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In vitro and In vivo toxicity assessment of phytofabricated ZnO nanoparticles showing bacteriostatic effect and larvicidal efficacy against Culex quinquefasciatus

Publication date: Available online 30 January 2019Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Mariappan Yazhiniprabha, Baskaralingam Vaseeharan, Avinash Sonawane, Ananyaashree BeheraAbstractMurraya koenigii berry extract based zinc oxide nanoparticles (Mk-ZnO NPs) were synthesized by simple co-precipitation method and examined for bacteriostatic and larvicidal efficiency. Synthesized Mk-ZnO NPs were characterized by UV–Vis spectroscopy at 336 nm. X-Ray diffraction (XRD) showed crystalline nature as hexagonal. Fourier transform infrared spectroscopy (FTIR) spectrum exhibited strong peak at 3442.80 cm−1. Field emission scanning electron microscopy (FE-SEM) showed hexagonal shape of the particle. Transmission electron microscopy (TEM) measured 10–15 nm ...

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Rethinking agreement: Cognition-to-form mapping

Journal Name: Cognitive Linguistics Issue: Ahead of print (Source: Cognitive Linguistics)

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Comment on “Sarcopenia is an Independent Risk Factor for Dysphagia in Community-Dwelling Older Adults”

(Source: Dysphagia)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TiU8lU

Predicting the Outcome of Unilateral Vocal Fold Paralysis: A Multivariate Discriminating Model Including Grade of Dysphonia, Jitter, Shimmer, and Voice Handicap Index-10.

CONCLUSIONS:: Delayed diagnosis and speech therapy was associated with negative outcomes. Higher grade of dysphonia, jitter, shimmer, and VHI-10 score on initial phoniatric assessment may help clinicians in predicting the outcomes of UVFP patients. PMID: 30693800 [PubMed - as supplied by publisher] (Source: The Annals of Otology, Rhinology, and Laryngology)

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Is All Formulaic Language Created Equal? Unpacking the Processing Advantage for Different Types of Formulaic Sequences.

Authors: Carrol G, Conklin K Abstract Research into recurrent, highly conventionalized "formulaic" sequences has shown a processing advantage compared to "novel" (non-formulaic) language. Studies of individual types of formulaic sequence often acknowledge the contribution of specific factors, but little work exists to compare the processing of different types of phrases with fundamentally different properties. We use eye-tracking to compare the processing of three types of formulaic phrases-idioms, binomials, and collocations-and consider whether overall frequency can explain the advantage for all three, relative to control phrases. Results show an advantage, as evidenced through shorter reading times, for all three types. While overall phrase frequency contributes much of the proc...

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Effect of effortful swallowing training on tongue strength and oropharyngeal swallowing function in stroke patients with dysphagia: a double-blind, randomized controlled trial.

CONCLUSIONS & IMPLICATIONS: We recommend EST as a remedial strategy for improving tongue strength and oral swallowing function in patients with stroke. PMID: 30693627 [PubMed - as supplied by publisher] (Source: International Journal of Language and Communication Disorders)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sYHnRS

Feasibility and initial efficacy of project-based treatment for people with ABI.

CONCLUSIONS & IMPLICATIONS: Project-based treatment is feasible with indications of initial efficacy for both communication skills and QOL. The treatment provides a promising new approach for improving communication skills and QOL in people with chronic acquired brain injuries in the community setting. PMID: 30693611 [PubMed - as supplied by publisher] (Source: International Journal of Language and Communication Disorders)

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The effect of baclofen combined with a proton pump inhibitor in patients with refractory laryngopharyngeal reflux: a prospective, open‐label study in thirty‐two patients

Abstract

Thirty‐two patients with refractory LPR confirmed by 24‐h MII‐pH were given a 3‐month course of baclofen 10 mg three times a day combined with PPI 15 mg twice a day.

Changes in RSI and reflux‐related quality of life from baseline to after treatment were evaluated.

MII‐pH monitoring of refractory LPR patients showed that the number of non‐acid reflux was much higher than acid reflux in laryngopharyngeal reflux and full‐column reflux.

After 3 months of PPI + baclofen medication, most RSI items and quality of life score showed a significant improvement compared to the baseline score, and the percentage of responders at 3 months was 53.1%.

In our experience, when a PPI therapy is unresponsive to LPR patients, baclofen can be considered as a second treatment option.

This article is protected by copyright. All rights reserved.

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The effect of baclofen combined with a proton pump inhibitor in patients with refractory laryngopharyngeal reflux: a prospective, open‐label study in thirty‐two patients

Abstract

Thirty‐two patients with refractory LPR confirmed by 24‐h MII‐pH were given a 3‐month course of baclofen 10 mg three times a day combined with PPI 15 mg twice a day.

Changes in RSI and reflux‐related quality of life from baseline to after treatment were evaluated.

MII‐pH monitoring of refractory LPR patients showed that the number of non‐acid reflux was much higher than acid reflux in laryngopharyngeal reflux and full‐column reflux.

After 3 months of PPI + baclofen medication, most RSI items and quality of life score showed a significant improvement compared to the baseline score, and the percentage of responders at 3 months was 53.1%.

In our experience, when a PPI therapy is unresponsive to LPR patients, baclofen can be considered as a second treatment option.

This article is protected by copyright. All rights reserved.

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Effectiveness of a multifaceted intervention to manage musculoskeletal disorders in workers of a medium-sized company.

CONCLUSIONS: A multifaceted intervention consisting of PE, WE and Acupuncture as the main resource of PT performed at the workstations may be relevant to managing MSDs in working populations. PMID: 30696364 [PubMed - as supplied by publisher] (Source: International Journal of Occupational Safety and Ergonomics)

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[Tinnitus: psychosomatic aspects].

Authors: Boecking B, Brueggemann P, Mazurek B Abstract Tinnitus is a common symptom of unclear origin that can be multifactorially caused and maintained. It is frequently, but not inevitably, associated with hearing loss. Emotional distress and maladaptive coping strategies - that are associated with or amplified by the tinnitus percept - pose key targets for psychological interventions. Once somatic contributors are identified and treated as applicable, psychological approaches comprise normalizing psychoeducational and psychotherapeutic interventions. Measures to improve hearing perception (e. g., hearing aids or cochlear implants) can also contribute to tinnitus habituation through direct (improvement of hearing perception) or indirect (improvement of emotional wellbeing or ...

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Effectiveness of a multifaceted intervention to manage musculoskeletal disorders in workers of a medium-sized company.

CONCLUSIONS: A multifaceted intervention consisting of PE, WE and Acupuncture as the main resource of PT performed at the workstations may be relevant to managing MSDs in working populations. PMID: 30696364 [PubMed - as supplied by publisher] (Source: International Journal of Occupational Safety and Ergonomics)

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[Tinnitus: psychosomatic aspects].

Authors: Boecking B, Brueggemann P, Mazurek B Abstract Tinnitus is a common symptom of unclear origin that can be multifactorially caused and maintained. It is frequently, but not inevitably, associated with hearing loss. Emotional distress and maladaptive coping strategies - that are associated with or amplified by the tinnitus percept - pose key targets for psychological interventions. Once somatic contributors are identified and treated as applicable, psychological approaches comprise normalizing psychoeducational and psychotherapeutic interventions. Measures to improve hearing perception (e. g., hearing aids or cochlear implants) can also contribute to tinnitus habituation through direct (improvement of hearing perception) or indirect (improvement of emotional wellbeing or ...

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Probabilistic Modeling of Exam Durations in Radiology Procedures

Abstract

In this paper, we model the statistical properties of imaging exam durations using parametric probability distributions such as the Gaussian, Gamma, Weibull, lognormal, and log-logistic. We establish that in a majority of radiology procedures, the underlying distribution of exam durations is best modeled by a log-logistic distribution, while the Gaussian has the poorest fit among the candidates. Further, through illustrative examples, we show how business insights and workflow analytics can be significantly impacted by making the correct (log-logistic) versus incorrect (Gaussian) model choices.

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Probabilistic Modeling of Exam Durations in Radiology Procedures

Abstract

In this paper, we model the statistical properties of imaging exam durations using parametric probability distributions such as the Gaussian, Gamma, Weibull, lognormal, and log-logistic. We establish that in a majority of radiology procedures, the underlying distribution of exam durations is best modeled by a log-logistic distribution, while the Gaussian has the poorest fit among the candidates. Further, through illustrative examples, we show how business insights and workflow analytics can be significantly impacted by making the correct (log-logistic) versus incorrect (Gaussian) model choices.

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Medical News Today: How does alcohol affect allergies?

Alcohol has many effects, sometimes leading to symptoms that resemble allergies. This may be a sign of an alcohol allergy or intolerance. Alcohol may also worsen existing allergies. Learn more alcohol allergies, and alcohol's effects on existing allergies, here. (Source: Health News from Medical News Today)

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How to Prevent and Treat Eye Allergies

THURSDAY, Jan. 31, 2019 -- When it comes to allergies, allergic rhinitis with its congested, itchy nose gets a lot of attention. But for some, allergic conjunctivitis with itchy, watery eyes is the greater nuisance. You might even have both... (Source: Drugs.com - Daily MedNews)

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How to Prevent and Treat Eye Allergies

THURSDAY, Jan. 31, 2019 -- When it comes to allergies, allergic rhinitis with its congested, itchy nose gets a lot of attention. But for some, allergic conjunctivitis with itchy, watery eyes is the greater nuisance. You might even have both... (Source: Drugs.com - Daily MedNews)

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Medical News Today: How does alcohol affect allergies?

Alcohol has many effects, sometimes leading to symptoms that resemble allergies. This may be a sign of an alcohol allergy or intolerance. Alcohol may also worsen existing allergies. Learn more alcohol allergies, and alcohol's effects on existing allergies, here. (Source: Health News from Medical News Today)

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How to Prevent and Treat Eye Allergies

THURSDAY, Jan. 31, 2019 -- When it comes to allergies, allergic rhinitis with its congested, itchy nose gets a lot of attention. But for some, allergic conjunctivitis with itchy, watery eyes is the greater nuisance. You might even have both... (Source: Drugs.com - Daily MedNews)

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Survival and Long-Term Biochemical Cure in Medullary Thyroid Carcinoma in Denmark 1997–2014: A Nationwide Study

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2WxSC1t

Medical News Today: How does alcohol affect allergies?

Alcohol has many effects, sometimes leading to symptoms that resemble allergies. This may be a sign of an alcohol allergy or intolerance. Alcohol may also worsen existing allergies. Learn more alcohol allergies, and alcohol's effects on existing allergies, here. (Source: Health News from Medical News Today)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2MHOh7k

How to Prevent and Treat Eye Allergies

THURSDAY, Jan. 31, 2019 -- When it comes to allergies, allergic rhinitis with its congested, itchy nose gets a lot of attention. But for some, allergic conjunctivitis with itchy, watery eyes is the greater nuisance. You might even have both... (Source: Drugs.com - Daily MedNews)

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Unique considerations in pediatric skull base surgery

Publication date: Available online 30 January 2019Source: Operative Techniques in Otolaryngology-Head and Neck SurgeryAuthor(s): Irit Duek, Dan M. FlissPediatric skull base and craniofacial surgery presents a unique challenge since the potential benefits of therapy must be balanced against the cumulative impact of multimodality treatment on craniofacial growth, donor-site morbidity, and the potential for serious psychosocial issues. Skull base reconstruction using locoregional flaps or free flaps may be safely performed in pediatrics. Although the general principles of skull base reconstruction are applicable to nearly all patients, the unique demands of skull base surgery in pediatrics merit special attention. Multidisciplinary care in experienced centers is of utmost importance. (Source:...

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Unique considerations in pediatric skull base surgery

Publication date: Available online 30 January 2019Source: Operative Techniques in Otolaryngology-Head and Neck SurgeryAuthor(s): Irit Duek, Dan M. FlissPediatric skull base and craniofacial surgery presents a unique challenge since the potential benefits of therapy must be balanced against the cumulative impact of multimodality treatment on craniofacial growth, donor-site morbidity, and the potential for serious psychosocial issues. Skull base reconstruction using locoregional flaps or free flaps may be safely performed in pediatrics. Although the general principles of skull base reconstruction are applicable to nearly all patients, the unique demands of skull base surgery in pediatrics merit special attention. Multidisciplinary care in experienced centers is of utmost importance. (Source:...

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The Effect of Stimulus Polarity on the Relation Between Pitch Ranking and ECAP Spread of Excitation in Cochlear Implant Users

Abstract

Although modern cochlear implants (CIs) use cathodic-leading symmetrical biphasic pulses to stimulate the auditory nerve, a growing body of evidence suggests that anodic-leading pulses may be more effective. The positive polarity has been shown to produce larger electrically evoked compound action potential (ECAP) amplitudes, steeper slope of the amplitude growth function, and broader spread of excitation (SOE) patterns. Polarity has also been shown to influence pitch perception. It remains unclear how polarity affects the relation between physiological SOE and psychophysical pitch perception. Using a within-subject design, we examined the correlation between performance on a pitch-ranking task and spatial separation between SOE patterns for anodic and cathodic-leading symmetric biphasic pulses for 14 CI ears. Overall, there was no effect of polarity on either ECAP SOE patterns, pitch ranking performance, or the relation between the two. This result is likely due the use of symmetric biphasic pulses, which may have reduced the size of the effect previously observed for pseudomonophasic pulses. Further research is needed to determine if a pseudomonophasic stimulus might further improve the relation between physiology and pitch perception.

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The Effect of Stimulus Polarity on the Relation Between Pitch Ranking and ECAP Spread of Excitation in Cochlear Implant Users

Abstract

Although modern cochlear implants (CIs) use cathodic-leading symmetrical biphasic pulses to stimulate the auditory nerve, a growing body of evidence suggests that anodic-leading pulses may be more effective. The positive polarity has been shown to produce larger electrically evoked compound action potential (ECAP) amplitudes, steeper slope of the amplitude growth function, and broader spread of excitation (SOE) patterns. Polarity has also been shown to influence pitch perception. It remains unclear how polarity affects the relation between physiological SOE and psychophysical pitch perception. Using a within-subject design, we examined the correlation between performance on a pitch-ranking task and spatial separation between SOE patterns for anodic and cathodic-leading symmetric biphasic pulses for 14 CI ears. Overall, there was no effect of polarity on either ECAP SOE patterns, pitch ranking performance, or the relation between the two. This result is likely due the use of symmetric biphasic pulses, which may have reduced the size of the effect previously observed for pseudomonophasic pulses. Further research is needed to determine if a pseudomonophasic stimulus might further improve the relation between physiology and pitch perception.

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The Effect of Stimulus Polarity on the Relation Between Pitch Ranking and ECAP Spread of Excitation in Cochlear Implant Users

Abstract

Although modern cochlear implants (CIs) use cathodic-leading symmetrical biphasic pulses to stimulate the auditory nerve, a growing body of evidence suggests that anodic-leading pulses may be more effective. The positive polarity has been shown to produce larger electrically evoked compound action potential (ECAP) amplitudes, steeper slope of the amplitude growth function, and broader spread of excitation (SOE) patterns. Polarity has also been shown to influence pitch perception. It remains unclear how polarity affects the relation between physiological SOE and psychophysical pitch perception. Using a within-subject design, we examined the correlation between performance on a pitch-ranking task and spatial separation between SOE patterns for anodic and cathodic-leading symmetric biphasic pulses for 14 CI ears. Overall, there was no effect of polarity on either ECAP SOE patterns, pitch ranking performance, or the relation between the two. This result is likely due the use of symmetric biphasic pulses, which may have reduced the size of the effect previously observed for pseudomonophasic pulses. Further research is needed to determine if a pseudomonophasic stimulus might further improve the relation between physiology and pitch perception.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TpFoBN

The Effect of Stimulus Polarity on the Relation Between Pitch Ranking and ECAP Spread of Excitation in Cochlear Implant Users

Abstract

Although modern cochlear implants (CIs) use cathodic-leading symmetrical biphasic pulses to stimulate the auditory nerve, a growing body of evidence suggests that anodic-leading pulses may be more effective. The positive polarity has been shown to produce larger electrically evoked compound action potential (ECAP) amplitudes, steeper slope of the amplitude growth function, and broader spread of excitation (SOE) patterns. Polarity has also been shown to influence pitch perception. It remains unclear how polarity affects the relation between physiological SOE and psychophysical pitch perception. Using a within-subject design, we examined the correlation between performance on a pitch-ranking task and spatial separation between SOE patterns for anodic and cathodic-leading symmetric biphasic pulses for 14 CI ears. Overall, there was no effect of polarity on either ECAP SOE patterns, pitch ranking performance, or the relation between the two. This result is likely due the use of symmetric biphasic pulses, which may have reduced the size of the effect previously observed for pseudomonophasic pulses. Further research is needed to determine if a pseudomonophasic stimulus might further improve the relation between physiology and pitch perception.

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The antimicrobial protein S100A12 identified as a potential autoantigen in a subgroup of atopic dermatitis patients

Atopic dermatitis (AD) is a complex heterogeneous chronic inflammatory skin disease. Specific IgE antibodies against autoantigens have been observed in a subgroup of AD patients, however, little is known about...

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The antimicrobial protein S100A12 identified as a potential autoantigen in a subgroup of atopic dermatitis patients

Atopic dermatitis (AD) is a complex heterogeneous chronic inflammatory skin disease. Specific IgE antibodies against autoantigens have been observed in a subgroup of AD patients, however, little is known about...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RZw2Qz

Survival and Long-Term Biochemical Cure in Medullary Thyroid Carcinoma in Denmark 1997–2014: A Nationwide Study

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S2KNCj

Survival and Long-Term Biochemical Cure in Medullary Thyroid Carcinoma in Denmark 1997–2014: A Nationwide Study

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S2KNCj

Survival and Long-Term Biochemical Cure in Medullary Thyroid Carcinoma in Denmark 1997–2014: A Nationwide Study

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2WxSC1t

Survival and Long-Term Biochemical Cure in Medullary Thyroid Carcinoma in Denmark 1997–2014: A Nationwide Study

Thyroid, Ahead of Print.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2WxSC1t

Interprofessional two-man team approach for interhospital transport of ARDS-patients under extracorporeal membrane oxygenation: a 10 years retrospective observational cohort study

Abstract

Background

Extra Corporeal Membrane Oxygenation (ECMO) has become an accepted treatment option for severely ill patients. Due to a limited availability of ECMO support therapy, patients must often be transported to a specialised centre before or after cannulation. According to the ELSO guidelines, an ECMO specialist should be present for such interventions. Here we describe the safety and efficacy of a reduced team approach involving one anaesthesiologist, experienced in specialised intensive care medicine, and a specialised critical care nurse.

Methods

This study is a 10 years retrospective, single institution analysis of all data collected between January 2007 and December 2016 from the medical records at the University Hospital Bonn, Germany.

Results

The Bonner mobile ECMO team was deployed in 170 cases for on-site evaluation for ECMO support therapy. 4 (2.4%) patients died prior to arrival or during the implementation of ECMO support. Of the remaining 166 patients, 126 were cannulated at the referring site, 40 were transported without ECMO. Of those, 21 were subsequently cannulated out our centre. 19 patients never received ECMO treatment. The primary indication for ECMO treatment was ARDS (159/166 patients). Veno-venous ECMO was initiated in 137, whilst 10 patients received veno-arterial ECMO treatment. Mean transportation time was 75 ± 36 min, and mean transport distance was 56 ± 57 km. In total, 26 complications were observed, three being directly transport-related. The overall survival was 55%.

Conclusions

Initiation of extracorporeal membrane oxygenation and subsequent transport can be safely and efficiently performed by a two-man team with good outcome.

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A Career in Global Surgery

This Viewpoint suggests that academic surgical departments are well positioned to lead global surgery efforts given their focus on teaching, innovation, and service.

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Toward a Broader, More Global Perspective for US Otolaryngology Residents

This essay discusses the benefits of the medical education system offering US otolaryngology residents the opportunity to gain a broader, more global perspective on the practice of otolaryngology.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ToqTy5

Papillary Thyroid Microcarcinoma

A patient who was referred to our clinic for a second opinion on management of a small localized papillary thyroid cancer (PTC) asked, "Why should I have surgery to remove my thyroid if it's such a good cancer?" At the time of diagnosis, her health care practitioner told her she had a good cancer and recommended thyroidectomy. This question directly relates to the work by Davies et al in this issue of JAMA Otolaryngology–Head & Neck Surgery. However, it is important to first clarify some misconceptions about the experiences of patients with thyroid cancer.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BaO5Ja