Implication of low risk human papillomaviruses, HPV6 and HPV11 in laryngeal papillomatosis in Burkina Faso

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Maïmouna Ilboudo, Théodora Mahoukèdè Zohoncon, Ina Marie Angèle Traore, Esther Mah Alima Traore, Ali Kande, Dorcas Obiri-Yeboah, Florencia W. Djigma, Yvette Marie Chantal Gyebre, Jacques Simpore

Abstract

Purpose

Laryngeal papillomatosis is the most common benign tumor of the larynx of children. It is characterized by the development of exophytic proliferative lesions in the mucosa of the airways. Human papillomavirus (HPV) has been recognized as a causal agent among which HPV types 6 and 11 are the most frequently implicated. This disease affects the vocal cords and other important functions of the child. The difficulty of treatment is related to the high recurrence of papilloma growth after surgical removal. The objective of this study was to describe the implication of HPV6 and HPV11 in cases of laryngeal papillomatosis histologically confirmed in Ouagadougou.

Materials and methods

This was a descriptive cross-sectional study based on histologically diagnosed archival tissue; obtained in the last ten years (2007 to 2017) in the anatomy and cyto-pathology laboratories in Burkina Faso. These fixed and paraffin-embedded tissues were deparaffinized with xylene before HPV DNA extraction; then HPV6 and HPV 11 were identified by real-time multiplex PCR.

Results

The prevalence of low-risk HPV infection (HPV-LR) was 54.84% in histologically confirmed laryngeal papillomatosis in Ouagadougou. Among the HPV-LR positive samples, HPV6 and HPV11 genotype prevalence's were respectively 41.17% and 35.3% while the HPV6 / HPV11 co-infection was 23.53%.

Conclusions

The results show the implication of HPV6 and HPV11 in laryngeal papillomatosis in Burkina Faso with a high prevalence.

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Successful treatment of a child with definite Meniere's disease with the migraine regimen

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Mehdi Abouzari, Arash Abiri, Hamid R. Djalilian

Abstract

Emerging evidence suggests substantial overlap between the symptoms of Meniere's disease (MD) and migraine-related cochlear/vestibular disorders. We report a 5-year-old girl with a 6-month history of left-sided hearing loss followed by daily episodes of vertigo, headache, and vomiting who met the criteria for definite MD. The patient became symptom-free and gained near normal hearing levels after starting on a 6-week migraine diet/lifestyle regimen with riboflavin and magnesium. We believe that the symptoms of MD may be primarily due to a vestibular migraine phenomenon. Pediatric MD patients may benefit from migraine lifestyle/dietary changes with control of both cochlear and vestibular symptoms.

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Doctor Google: Correlating internet search trends for epistaxis with metropolitan climates

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Aykut A. Unsal, Pariket M. Dubal, Julia A. Pfaff, Mark E. Friedel, Jean Anderson Eloy, Stilianos E. Kountakis

Abstract

Objective

Variation in weather patterns is often cited as a risk factor for epistaxis although robust studies investigating specific climate factors are lacking. As society is increasingly utilizing the Internet to learn more about their medical conditions, we explore whether Internet search activity related to epistaxis is influenced by fluctuations in climate.

Methods

Internet search activity for epistaxis-related search terms during 2012–2017 were extracted from Google Trends and localized to six highly populated cities in the US: New York, New York; Los Angeles, California; Chicago, Illinois; Houston, Texas; Philadelphia, Pennsylvania; and Atlanta, Georgia. Data were compared to local average monthly climate data from the National Centers for Environmental Information for the same time period.

Results

Spearmen correlations (r) were statistically strongest for dew point temperature (r_NewYork = −0.82; r_Philadelphia = −0.74; r_Chicago = −0.65; r_Atlanta = −0.49, r_LosAngeles = −0.3). This was followed closely by relative humidity (r_NewYork = −0.63; r_Philadelphia = −0.57; r_LosAngeles = −0.44; r_Atlanta = −0.42; r_Houston = −0.40) and average temperature (r_NewYork = −0.8; r_Philadelphia = −0.72; r_Chicago = −0.62; r_Atlanta = −0.45). Overall, correlations were most significant and predictable for cities with the greatest seasonal climate shifts (New York, Philadelphia, and Chicago). The weakest environmental factor was barometric pressure, which was found to be moderately positive in Atlanta (r_barometric = 0.31), Philadelphia (r_barometric = 0.30) and New York (r_barometric = 0.27).

Conclusions

Google Trends data for epistaxis-related search activity responds closely to climate patterns in most cities studied, thus underscoring the potential utility of Internet search activity data as a resource for epidemiologic study and for the identification of at risk populations.

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Effects of meteorological factor and air pollution on sudden sensorineural hearing loss using the health claims data in Busan, Republic of Korea

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Hyun Min Lee, Min Sik Kim, Dong Jo Kim, Tae Woong Uhm, Seong Baek Yi, Jun Hee Han, Il Woo Lee

Abstract

Purpose

Specific meteorological factors, including air pollution in the form of particulate matter (PM), affect the development of otologic disease and have adverse effects on the cardiovascular and respiratory systems. This study investigated relationships between the development of sudden sensorineural hearing loss(SSNHL) and meteorological factor with air pollution including PM.

Materials and methods

The daily patient number in 2015 admitted to the hospital with SSNHL were extracted from the Health Insurance Review and Assessment Service Bigdata in Busan. The meteorological factors and air pollution data of Busan area were obtained from meteorological stations in Busan. The relationship between the number of hospitalizations and the climatic factors was checked.

Results

SSNHL patient group showed more common in women, and the highest rates were observed in patients in their 50s. The daily mean patient numbers were 2.27. The number of SSNHL patients in spring was statistically significantly higher than that in summer. The mean daily PM10 and PM2.5 concentrations were 48.0 and 29.4 μg/m³, respectively. The mean wind speed, maximum wind speed and daily atmospheric pressure range was weakly positively associated with SSNHL patient number. There were weak negative correlations between maximum PM2.5 and SSNHL admissions. The mean temperature and wind chill index showed non-significantly negative relationships with SSNHL admissions.

Conclusions

In Busan area, statistically significant weak relationships were detected between the daily numbers of patients admitted to the hospital with SSNHL and meteorological data, including PM level. Further investigation of these associations is required.

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Commentary on topical platelet rich plasma versus hyaluronic acid during fat graft myringoplasty

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Kan-Feng Jin, Zhengcai-Lou

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Is septoplasty effective rhinogenic headache in patients with isolated contact point between inferior turbinate and septal spur?

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Fazilet Altin, Cemal Haci, Yalcin Alimoglu, Suleyman Yilmaz

Abstract

Background

Rhinogenic headache is a painful sensation in the head and face due to intranasal contact point without any mass or inflammatory findings. Surgery is recommended in patients with nasal obstruction; however the approach in case of isolated mucosal contact point that does not cause obstruction is controversial. Our aim is to observe changes in the severity of headache in patients with isolated mucosal contact point and headache who do not complain of nasal obstruction.

Methods

Our study included patients with unilateral headache without any nasal and/or paranasal sinus pathology. We confirmed the presence of mucosal contact by nasal endoscopy and by computed tomography (CT). One hundred patients with isolated mucosal contact point without any problem in breathing were included in this study. All participants were treated by topical nasal corticosteroid for a month. Surgery was recommended to the patients with no satisfactory relieve of headache. Visual Analog Scales (VAS) were used to evaluate the severity of headache in patients at time of diagnosis (0 month), after a medical treatment (1st month) and after a surgical or medical treatment (6th month). The results were compared with each other statistically.

Results

There was a decrease in VAS values after a month of medical treatment in all patients with isolated contact point (Z = −8.352; p = 0.0). VAS values significantly improved after surgical treatment group (Z = −4.97; p = 0.0). However, VAS values of patients increased at 6th month in medical treatment group (Z = −5341 p = 0.0). After a successful surgical removal of mucosal contacts, the decrease of headache severity was more intense in patients with surgical treatment group than in the patients with medical treatment group (Z = −8.441; p = 0.0).

Conclusion

Surgical correction provides a more effective outcome in patients with rhinogenic headache. However, it is difficult to convince that headache may improve with surgery in these patients especially with isolated mucosal contact point and without nasal obstruction. In order to prove the benefit of surgery, we believe that medical treatment can be used as a guide.

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TORS excision of lingual thyroid carcinoma: Technique and systematic review

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Aurora Vincent, Ameya Jategaonkar, Sameep Kadakia, Yadranko Ducic

Abstract

Objective

Clinically significant lingual thyroid tissue has a prevalence of 1/3000–10,000, and in 70% of these individuals, the lingual thyroid is their only thyroid tissue. Malignant transformation is exceedingly rare. Herein, we present a case of lingual thyroid carcinoma with a systematic literature review and description of our treatment technique.

Data sources

PubMed, Ovid.

Review method

The primary author performed a search of the literature for reports of lingual thyroid carcinoma or ectopic thyroid carcinoma associated with the tongue. Articles that did not present novel data, presented cases of ectopic thyroid carcinoma outside the tongue, non-malignant cases, non-thyroid carcinomas, or were non-English articles were excluded. Studies were limited to those published in the last 60 years.

Results

There are 39 cases reported in the literature. 23 cases occurred in females. Age at diagnosis ranged from 12 to 86; cases were more commonly diagnosed in the second decade of life, then in the 5th and 6th decades of life. Dysphagia, globus sensation, episodes of bleeding, voice changes, and presence of a neck mass were common symptoms at initial presentation. Nearly all patients underwent some form of pre-operative imaging, but practices varied as to the type of imaging. Treatment included surgical excision of the tumor in all but one case that was successfully treated with radioactive iodine therapy alone.

Conclusions

Surgeons should be aware of lingual thyroid, its presentation, workup, and carcinoma treatment. Tumors are amenable to surgical excision, possibly followed by radioactive iodine therapy. Advances in robotic and endoscopic surgery over the past decade now allow for less morbid excisions of lingual thyroid tumors.

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The diagnostic utility of retroperitoneoscopic tissue biopsy for unresectable retroperitoneal lesions excluding urogenital cancers

Retroperitoneal tumors are an uncommon disease known to consist of a diverse group of benign and malignant neoplasms. Treatment of unresectable retroperitoneal lesions requires pathological diagnosis. Here, we...

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A unique presentation of superinfected pseudomyxoma peritonei secondary to a low-grade appendiceal mucinous neoplasm

Pseudomyxoma peritonei (PMP) is an uncommon condition characterized by diffuse mucinous material in the abdomen and pelvis, generally arising from a perforated epithelial neoplasm. Typically, the disease prese...

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Investigation of Human Papillomavirus (HPV) and Epstein-Barr Virus (EBV) in antrochoanal polyps

Publication date: Available online 19 February 2019

Source: American Journal of Otolaryngology

Author(s): Esra Yılmaz, Necat Alatas, Fahrı Ucar, Tulın Cora, Kurtulus Buruk, Yasar Unlu

Abstract

Objectives/hypotheses

This study aimed to investigate the presence of HPV (HPV types 11 and 16) and EBV in antrochoanal polyps and to contribute to the current literature in this regard.

Study design

A case-control study.

Methods

A total of 100 patients (including 43 patients undergoing surgery for antrochoanal polyp, 27 patients undergoing surgery for nasal polyp, and 30 patients undergoing surgery for hypertrophic inferior turbinate) were included in this study. DNA was isolated from formalin-fixed, paraffin-embedded samples with the aid of the Bioneer's AccuPrep Genomic DNA Extraction Kit. In the obtained genomic DNAs, while the detection of HPV DNA was performed using the nested-PCR method, the detection of HPV types 11/16 and EBV DNA was performed using the RT-PCR method.

Results

The mean age of the patients with antrochoanal polyp was 26.7 ± 15.4 years (range 7–70). There were 20 (46.5%) women and 23 (53.5%) men in the antrochoanal polyp group. HPV DNA was positively detected using the nested-PCR method in 14 (32.6%) of the patients with antrochoanal polyp and in 3 (11.1%) of the patients with nasal polyp. HPV DNA was not detected in the hypertrophic inferior turbinate group (control group). There was a statistically significant difference between all groups in terms of HPV DNA positivity. In the antrochoanal polyp group, 2 patients had HPV 11 positivity and 12 patients had HPV 16 positivity. In the nasal polyp group, 1 patient had HPV 11 positivity and 2 patients had HPV 16 positivity. EBV DNA was positively detected in 16 (37.2%) of the patients with antrochoanal polyp, in 11 (40.7%) of the patients with nasal polyp and in 8 (26.7%) of the patients with hypertrophic inferior turbinate, respectively. There was no statistically significant difference between the groups in terms of EBV DNA positivity.

Conclusions

This study demonstrates that there is a need for further studies investigating the presence of viruses in antrochoanal polyps.

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United States-based global otolaryngology surgery: A call to more horizontal sustainable efforts

Publication date: Available online 19 February 2019

Source: American Journal of Otolaryngology

Author(s): Brian M. Lin, Mark A. Varvares, Gregory W. Randolph, David A. Shaye

Abstract

Objective

To examine global surgery involvement among general members of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and characterize international otolaryngology surgical interventions.

Methods

Data on global surgery involvement were derived from responses provided by voluntary online survey respondent members of the AAO-HNS, obtained in October 2017. These data were compared against World Bank metrics of national health expenditure and surgical specialists per capita as benchmarks for need.

Results

There were 362 responses (response rate of 3.7%). A large proportion of respondents reported being involved in global surgery (61.3%). Locations where respondents worked included: South America (13.3%), Central America (17.7%), Caribbean (10.2%), Europe (4.1%), Africa (16.3%), Asia (16.6%), the Middle East (4.1%), and Oceania (3.6%). A greater proportion of respondents reported traveling to locations that have lower health care expenditure per capita and lower mean number of surgical specialists per 100,000 people, according to data from the World Bank. The primary purpose of trips was most commonly surgical mission (60.3%), followed by education (37.8%), and research (1.9%).

Conclusion

Members of the AAO-HNS are active in global surgery efforts around the world. Collaboration among members of the AAO-HNS may serve to improve long-term sustainability of these efforts.

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Reconstruction of a subtotal septorhinectomy defect with a chimeric paramedian-pericranial forehead flap

Publication date: Available online 19 February 2019

Source: American Journal of Otolaryngology

Author(s): Lucas Harrison, Michelle Sieffert, Sangati Kadakia, Sameep Kadakia, Ron Michael Johnson, Yadranko Ducic

Abstract

The nose is a complex structure important for aesthetic appearance, social interaction, and respiration. Full thickness nasal defects with resection of the septum pose a significant challenge to the reconstructive surgeon due to the lack of local tissues to replace the nasal lining and significant risk of nasal collapse owing to the paucity of rigid infrastructure. The purpose of this paper is to present a unique case of nasal reconstruction utilizing a bilaminar paramedian forehead flap (combined pericranial flap and forehead flap) with embedded cantilever rib graft in a patient who underwent resection for an intranasal malignancy involving the septum and soft tissue envelope. This case serves to demonstrate the great utility in using chimeric flaps based on a single pedicle given the low patient morbidity, predictable results, and rapid recovery period.

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Perioperative interdisciplinary approach for reduction of opioid use in pediatric tonsillectomy: Protocol using dexmedetomidine and bupivicaine as adjunct agents

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Austin DeHart, Jessica Potter, Justin Anderson, Iolanda Russo-Menna, Jong Hyung Lee, Derek A. Chapman, Kelley M. Dodson

Abstract

Importance

Pediatric tonsillectomy is a common procedure now being performed most often for patients with obstructive sleep apnea, which has been associated with increased sensitivity to the respiratory side effects of opioid medications. This study investigates a strategy to decrease the use of opiate medications in a particularly vulnerable population.

Objective

Describe an interdisciplinary approach between Otolaryngologists and Anesthesiologists to decrease opiate use in tonsillectomy patients. Demonstrate safety of this protocol. Evaluate the effect of the protocol on intraoperative need for opiate medications and inhaled anesthetic use. Perform cost analysis of the protocol.

Design

Retrospective case-control study with cost analysis.

Setting

Tertiary Care Hospital.

Participants

Pediatric patients undergoing tonsillectomy at a tertiary care hospital.

Interventions

Preoperative and intraoperative dexmedetomidine with local bupivacaine injection into the tonsillar fossa.

Measures

Intraoperative need for sevoflurane, opiate, and propofol. Post-operative pain scores, and utilization of post-operative opiate, acetaminophen, and ibuprofen pain medications. Post-operative adverse events. Cost analysis of protocol.

Results

This protocol led to a decrease in intraoperative opiate use by 49.6%, a decrease in intraoperative sevofluorane use by 18%, and a lower reported maximum post-operative pain score without any increase in adverse events. The protocol added a small increase in medication cost of $4.07 to each procedure.

Conclusion

The use of dexmedetomidine and local anesthetic in pediatric tonsillectomy is a safe and effective protocol that allows for the reduction of opiate use and improved post-operative pain control.

Key points

Question: Can the combination of dexmedetomidine and infiltration of local anesthetic reduce overall opioid use for peediatric patients undergoing tonsillectomy?

Findings: In this case-control study, use of dexmedetomidine and local anesthetic injected into the tonsillar fossa led to a decrease in intraoperative opiate use by 49.6%, a decrease in intraoperative sevofluorane use by 18%, and a lower reported maximum pain score without an increase in adverse events.

Meaning: Use of dexmedetomidine and local anesthetic as anesthetic adjuncts may help reduce need for intraoperative opiates and decrease the use of volatile anesthetic agents in pediatric tonsillectomy patients, which are undesirable medications in the pediatric population for their respective respiratory depression and potentially neurotoxic side effects.

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Behavioral analysis of HPV+ oropharyngeal cancer: Do you know your patients?

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Annika Meyer, Daniel A. Alicea, Rocco M. Ferrandino, Brett A. Miles

Abstract

Objective

Evaluate the epidemiologic makeup of a population of HPV+ OPSCC patients treated at one institution over approximately a decade.

Study design

Prospective survey study of HPV+ OPSCC treated between 2007 and 2016.

Setting

Mount Sinai Health System

Subjects and methods

Patients aged 18+ who underwent treatment for HPV+ OPSCC. 223 patients were asked to complete a health survey including substance use and sexual history in order to specifically characterize the social behaviors of patients with HPV + OPSCC.

Results

Eighty-two patients responded, 70 male (85.4%) and 12 female (14.6%). While half of patients were nonsmokers, 18.3% had a smoking history of <15 pack years, and 32.9% had a 15+ pack-year smoking history. Nearly 25% reported significant drinking history (3+ drinks/day). Males had an average of 18 lifetime sexual partners, and females had 7 partners. Eight patients reported >100 sexual partners.

Conclusions

HPV+ OPSCC was more prevalent in white males with a high number of lifetime sexual partners, as expected. Careful evaluation revealed other findings of significance that are not generally associated with this population. Half of our patients had significant historical tobacco and alcohol consumption. One quarter of patients had a history of another malignancy. These findings highlight the importance of taking a comprehensive history when determining appropriate treatment or designing future de-escalation trials in HPV+ OPSCC.

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Purely intracranial vagal schwannoma: A case report of a rare lesion

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Zachary G. Schwam, Vivian Z. Kaul, R. Shrivastava, George B. Wanna

Abstract

We present a rare intracranial vagal schwannoma along with its preoperative, intraoperative, and postoperative course.

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Tinnitus in the side with better hearing

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Ho Yun Lee, Su Jin Kim, Dong Sik Chang, Sun Ae Shin

Abstract

Objectives

We aimed to confirm the characteristics of patients with tinnitus in the better-hearing side.

Materials and methods

Among the 778 patients who visited the tinnitus clinic complaining of unilateral tinnitus at a local university hospital between March 2014 and December 2017, we recruited 62 patients who showed tinnitus in the better-hearing side on pure-tone audiometry. The mean hearing threshold was calculated using the arithmetic mean of the pure tone thresholds at 1, 2, 3, and 4 kHz. In addition, patients' medical history, tinnitus questionnaires, and other audiologic test results were thoroughly analyzed together for diagnosis.

Results

Fluctuating hearing loss without vertigo or Ménière's disease were the most common etiologies (n = 16, 25.8%), followed by high-frequency hearing loss (n = 13, 21.0%), sudden idiopathic hearing loss (n = 6, 9.7%), and presbycusis (n = 6, 9.7%). Somatosensory tinnitus was also observed in seven patients. Neck pain was associated with tinnitus in five patients (8.1%), and two other patients (3.2%) experienced temporomandibular disorder in the same side as the tinnitus.

Conclusion

Tinnitus was associated with deterioration of hearing even when it occurred in the better-hearing side. Among the possible etiologies, fluctuating hearing loss in the tinnitus side was the most common audiologic finding. Assessment of hearing level at each frequency was more effective in detecting high-frequency hearing loss rather than the use of the mean hearing level. In addition, somatosensory tinnitus should not be ignored.

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Implication of low risk human papillomaviruses, HPV6 and HPV11 in laryngeal papillomatosis in Burkina Faso

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Maïmouna Ilboudo, Théodora Mahoukèdè Zohoncon, Ina Marie Angèle Traore, Esther Mah Alima Traore, Ali Kande, Dorcas Obiri-Yeboah, Florencia W. Djigma, Yvette Marie Chantal Gyebre, Jacques Simpore

Abstract

Purpose

Laryngeal papillomatosis is the most common benign tumor of the larynx of children. It is characterized by the development of exophytic proliferative lesions in the mucosa of the airways. Human papillomavirus (HPV) has been recognized as a causal agent among which HPV types 6 and 11 are the most frequently implicated. This disease affects the vocal cords and other important functions of the child. The difficulty of treatment is related to the high recurrence of papilloma growth after surgical removal. The objective of this study was to describe the implication of HPV6 and HPV11 in cases of laryngeal papillomatosis histologically confirmed in Ouagadougou.

Materials and methods

This was a descriptive cross-sectional study based on histologically diagnosed archival tissue; obtained in the last ten years (2007 to 2017) in the anatomy and cyto-pathology laboratories in Burkina Faso. These fixed and paraffin-embedded tissues were deparaffinized with xylene before HPV DNA extraction; then HPV6 and HPV 11 were identified by real-time multiplex PCR.

Results

The prevalence of low-risk HPV infection (HPV-LR) was 54.84% in histologically confirmed laryngeal papillomatosis in Ouagadougou. Among the HPV-LR positive samples, HPV6 and HPV11 genotype prevalence's were respectively 41.17% and 35.3% while the HPV6 / HPV11 co-infection was 23.53%.

Conclusions

The results show the implication of HPV6 and HPV11 in laryngeal papillomatosis in Burkina Faso with a high prevalence.

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Successful treatment of a child with definite Meniere's disease with the migraine regimen

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Mehdi Abouzari, Arash Abiri, Hamid R. Djalilian

Abstract

Emerging evidence suggests substantial overlap between the symptoms of Meniere's disease (MD) and migraine-related cochlear/vestibular disorders. We report a 5-year-old girl with a 6-month history of left-sided hearing loss followed by daily episodes of vertigo, headache, and vomiting who met the criteria for definite MD. The patient became symptom-free and gained near normal hearing levels after starting on a 6-week migraine diet/lifestyle regimen with riboflavin and magnesium. We believe that the symptoms of MD may be primarily due to a vestibular migraine phenomenon. Pediatric MD patients may benefit from migraine lifestyle/dietary changes with control of both cochlear and vestibular symptoms.

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Doctor Google: Correlating internet search trends for epistaxis with metropolitan climates

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Aykut A. Unsal, Pariket M. Dubal, Julia A. Pfaff, Mark E. Friedel, Jean Anderson Eloy, Stilianos E. Kountakis

Abstract

Objective

Variation in weather patterns is often cited as a risk factor for epistaxis although robust studies investigating specific climate factors are lacking. As society is increasingly utilizing the Internet to learn more about their medical conditions, we explore whether Internet search activity related to epistaxis is influenced by fluctuations in climate.

Methods

Internet search activity for epistaxis-related search terms during 2012–2017 were extracted from Google Trends and localized to six highly populated cities in the US: New York, New York; Los Angeles, California; Chicago, Illinois; Houston, Texas; Philadelphia, Pennsylvania; and Atlanta, Georgia. Data were compared to local average monthly climate data from the National Centers for Environmental Information for the same time period.

Results

Spearmen correlations (r) were statistically strongest for dew point temperature (r_NewYork = −0.82; r_Philadelphia = −0.74; r_Chicago = −0.65; r_Atlanta = −0.49, r_LosAngeles = −0.3). This was followed closely by relative humidity (r_NewYork = −0.63; r_Philadelphia = −0.57; r_LosAngeles = −0.44; r_Atlanta = −0.42; r_Houston = −0.40) and average temperature (r_NewYork = −0.8; r_Philadelphia = −0.72; r_Chicago = −0.62; r_Atlanta = −0.45). Overall, correlations were most significant and predictable for cities with the greatest seasonal climate shifts (New York, Philadelphia, and Chicago). The weakest environmental factor was barometric pressure, which was found to be moderately positive in Atlanta (r_barometric = 0.31), Philadelphia (r_barometric = 0.30) and New York (r_barometric = 0.27).

Conclusions

Google Trends data for epistaxis-related search activity responds closely to climate patterns in most cities studied, thus underscoring the potential utility of Internet search activity data as a resource for epidemiologic study and for the identification of at risk populations.

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Effects of meteorological factor and air pollution on sudden sensorineural hearing loss using the health claims data in Busan, Republic of Korea

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Hyun Min Lee, Min Sik Kim, Dong Jo Kim, Tae Woong Uhm, Seong Baek Yi, Jun Hee Han, Il Woo Lee

Abstract

Purpose

Specific meteorological factors, including air pollution in the form of particulate matter (PM), affect the development of otologic disease and have adverse effects on the cardiovascular and respiratory systems. This study investigated relationships between the development of sudden sensorineural hearing loss(SSNHL) and meteorological factor with air pollution including PM.

Materials and methods

The daily patient number in 2015 admitted to the hospital with SSNHL were extracted from the Health Insurance Review and Assessment Service Bigdata in Busan. The meteorological factors and air pollution data of Busan area were obtained from meteorological stations in Busan. The relationship between the number of hospitalizations and the climatic factors was checked.

Results

SSNHL patient group showed more common in women, and the highest rates were observed in patients in their 50s. The daily mean patient numbers were 2.27. The number of SSNHL patients in spring was statistically significantly higher than that in summer. The mean daily PM10 and PM2.5 concentrations were 48.0 and 29.4 μg/m³, respectively. The mean wind speed, maximum wind speed and daily atmospheric pressure range was weakly positively associated with SSNHL patient number. There were weak negative correlations between maximum PM2.5 and SSNHL admissions. The mean temperature and wind chill index showed non-significantly negative relationships with SSNHL admissions.

Conclusions

In Busan area, statistically significant weak relationships were detected between the daily numbers of patients admitted to the hospital with SSNHL and meteorological data, including PM level. Further investigation of these associations is required.

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Commentary on topical platelet rich plasma versus hyaluronic acid during fat graft myringoplasty

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Kan-Feng Jin, Zhengcai-Lou

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Is septoplasty effective rhinogenic headache in patients with isolated contact point between inferior turbinate and septal spur?

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Fazilet Altin, Cemal Haci, Yalcin Alimoglu, Suleyman Yilmaz

Abstract

Background

Rhinogenic headache is a painful sensation in the head and face due to intranasal contact point without any mass or inflammatory findings. Surgery is recommended in patients with nasal obstruction; however the approach in case of isolated mucosal contact point that does not cause obstruction is controversial. Our aim is to observe changes in the severity of headache in patients with isolated mucosal contact point and headache who do not complain of nasal obstruction.

Methods

Our study included patients with unilateral headache without any nasal and/or paranasal sinus pathology. We confirmed the presence of mucosal contact by nasal endoscopy and by computed tomography (CT). One hundred patients with isolated mucosal contact point without any problem in breathing were included in this study. All participants were treated by topical nasal corticosteroid for a month. Surgery was recommended to the patients with no satisfactory relieve of headache. Visual Analog Scales (VAS) were used to evaluate the severity of headache in patients at time of diagnosis (0 month), after a medical treatment (1st month) and after a surgical or medical treatment (6th month). The results were compared with each other statistically.

Results

There was a decrease in VAS values after a month of medical treatment in all patients with isolated contact point (Z = −8.352; p = 0.0). VAS values significantly improved after surgical treatment group (Z = −4.97; p = 0.0). However, VAS values of patients increased at 6th month in medical treatment group (Z = −5341 p = 0.0). After a successful surgical removal of mucosal contacts, the decrease of headache severity was more intense in patients with surgical treatment group than in the patients with medical treatment group (Z = −8.441; p = 0.0).

Conclusion

Surgical correction provides a more effective outcome in patients with rhinogenic headache. However, it is difficult to convince that headache may improve with surgery in these patients especially with isolated mucosal contact point and without nasal obstruction. In order to prove the benefit of surgery, we believe that medical treatment can be used as a guide.

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TORS excision of lingual thyroid carcinoma: Technique and systematic review

Publication date: Available online 18 February 2019

Source: American Journal of Otolaryngology

Author(s): Aurora Vincent, Ameya Jategaonkar, Sameep Kadakia, Yadranko Ducic

Abstract

Objective

Clinically significant lingual thyroid tissue has a prevalence of 1/3000–10,000, and in 70% of these individuals, the lingual thyroid is their only thyroid tissue. Malignant transformation is exceedingly rare. Herein, we present a case of lingual thyroid carcinoma with a systematic literature review and description of our treatment technique.

Data sources

PubMed, Ovid.

Review method

The primary author performed a search of the literature for reports of lingual thyroid carcinoma or ectopic thyroid carcinoma associated with the tongue. Articles that did not present novel data, presented cases of ectopic thyroid carcinoma outside the tongue, non-malignant cases, non-thyroid carcinomas, or were non-English articles were excluded. Studies were limited to those published in the last 60 years.

Results

There are 39 cases reported in the literature. 23 cases occurred in females. Age at diagnosis ranged from 12 to 86; cases were more commonly diagnosed in the second decade of life, then in the 5th and 6th decades of life. Dysphagia, globus sensation, episodes of bleeding, voice changes, and presence of a neck mass were common symptoms at initial presentation. Nearly all patients underwent some form of pre-operative imaging, but practices varied as to the type of imaging. Treatment included surgical excision of the tumor in all but one case that was successfully treated with radioactive iodine therapy alone.

Conclusions

Surgeons should be aware of lingual thyroid, its presentation, workup, and carcinoma treatment. Tumors are amenable to surgical excision, possibly followed by radioactive iodine therapy. Advances in robotic and endoscopic surgery over the past decade now allow for less morbid excisions of lingual thyroid tumors.

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The diagnostic utility of retroperitoneoscopic tissue biopsy for unresectable retroperitoneal lesions excluding urogenital cancers

Retroperitoneal tumors are an uncommon disease known to consist of a diverse group of benign and malignant neoplasms. Treatment of unresectable retroperitoneal lesions requires pathological diagnosis. Here, we...

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A unique presentation of superinfected pseudomyxoma peritonei secondary to a low-grade appendiceal mucinous neoplasm

Pseudomyxoma peritonei (PMP) is an uncommon condition characterized by diffuse mucinous material in the abdomen and pelvis, generally arising from a perforated epithelial neoplasm. Typically, the disease prese...

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Chronic maxillary atelectasis (including silent sinus syndrome) can present bilaterally.

Related Articles

Chronic maxillary atelectasis (including silent sinus syndrome) can present bilaterally.

J Laryngol Otol. 2019 Feb 18;:1-5

Authors: Ho JPK, Wong E, Gunaratne DA, Singh N

Abstract
OBJECTIVE: Chronic maxillary atelectasis is a rare and underdiagnosed condition in which there is a persistent and progressive decrease in maxillary sinus volume secondary to inward bowing of the antral walls. Chronic maxillary atelectasis is typically unilateral. Simultaneous bilateral chronic maxillary atelectasis is extremely uncommon.
METHODS: A retrospective review was performed of patient data collected by the senior clinician over a three-year period (2015-2018). A comprehensive literature search was conducted to locate all documented cases of chronic maxillary atelectasis in English-language literature. Abstracts and full-text articles were reviewed.
RESULTS: Three patients presented with sinonasal symptoms. Imaging findings were consistent with bilateral chronic maxillary atelectasis. The literature review revealed at least nine other cases of bilateral chronic maxillary atelectasis. Management is typically via endoscopic middle meatus antrostomy.
CONCLUSION: Chronic maxillary atelectasis was initially defined as a unilateral disorder, but this description has been challenged by reports of bilateral cases. Further investigation is required to determine the aetiology and pathophysiology of the disease.

PMID: 30773158 [PubMed - as supplied by publisher]

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Intraluminal three-dimensional optical coherence tomography - a tool for imaging of the Eustachian tube?

Related Articles

Intraluminal three-dimensional optical coherence tomography - a tool for imaging of the Eustachian tube?

J Laryngol Otol. 2019 Feb 18;:1-8

Authors: Schuon R, Mrevlje B, Vollmar B, Lenarz T, Paasche G

Abstract
OBJECTIVES: The cause of Eustachian tube dysfunction often remains unclear. Therefore, this study aimed to examine the feasibility and possible diagnostic use of optical coherence tomography in the Eustachian tube ex vivo.
METHODS: Two female blackface sheep cadaver heads were examined bilaterally. Three conditions of the Eustachian tube were investigated: closed (resting position), actively opened and stented. The findings were compared (and correlated) with segmented histological cross-sections.
RESULTS: Intraluminal placement of the Eustachian tube with the optical coherence tomography catheter was performed without difficulty. Regarding the limited infiltration depth of optical coherence tomography, tissues can be differentiated. The localisation of the stent was accurate as was the lumen.
CONCLUSION: The application of optical coherence tomography in the Eustachian tube under these experimental conditions is considered to be a feasible, rapid and non-invasive diagnostic method, with possible diagnostic value for determining the luminal shape and superficial lining tissue of the Eustachian tube.

PMID: 30773144 [PubMed - as supplied by publisher]

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Quality of life after total laryngectomy: evaluating the effect of socioeconomic status.

Related Articles

Quality of life after total laryngectomy: evaluating the effect of socioeconomic status.

J Laryngol Otol. 2019 Feb 18;:1-6

Authors: Scott AJ, McGuire JK, Manning K, Leach L, Fagan JJ

Abstract
OBJECTIVE: Total laryngectomy is considered the primary treatment modality for advanced laryngeal carcinoma. This study assessed the quality of life in patients after total laryngectomy, and ascertained whether quality of life is affected by socioeconomic status.
METHOD: Forty-seven patients (20 state- and 27 private-sector) who underwent total laryngectomy between 1998 and 2014 responded to the University of Washington Quality of Life Questionnaire, the Voice-Related Quality of Life Questionnaire and the Brief Illness Perception Questionnaire.
RESULTS: Significant differences were found in socioeconomic status between state- and private-sector patients (p < 0.001). There was no significant difference in overall quality of life between groups (p = 0.210). State-sector patients scored significantly higher Voice-Related Quality of Life Questionnaire scores (p = 0.043). Perception of illness did not differ significantly between groups.
CONCLUSION: Overall quality of life after total laryngectomy appears to be similar in patients from different socioeconomic backgrounds. However, patients from lower socioeconomic circumstances have better voice-related quality of life. The results illustrate the importance of including socioeconomic status when reporting voice outcomes in total laryngectomy patients.

PMID: 30773143 [PubMed - as supplied by publisher]

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Chronic maxillary atelectasis (including silent sinus syndrome) can present bilaterally.

Related Articles

Chronic maxillary atelectasis (including silent sinus syndrome) can present bilaterally.

J Laryngol Otol. 2019 Feb 18;:1-5

Authors: Ho JPK, Wong E, Gunaratne DA, Singh N

Abstract
OBJECTIVE: Chronic maxillary atelectasis is a rare and underdiagnosed condition in which there is a persistent and progressive decrease in maxillary sinus volume secondary to inward bowing of the antral walls. Chronic maxillary atelectasis is typically unilateral. Simultaneous bilateral chronic maxillary atelectasis is extremely uncommon.
METHODS: A retrospective review was performed of patient data collected by the senior clinician over a three-year period (2015-2018). A comprehensive literature search was conducted to locate all documented cases of chronic maxillary atelectasis in English-language literature. Abstracts and full-text articles were reviewed.
RESULTS: Three patients presented with sinonasal symptoms. Imaging findings were consistent with bilateral chronic maxillary atelectasis. The literature review revealed at least nine other cases of bilateral chronic maxillary atelectasis. Management is typically via endoscopic middle meatus antrostomy.
CONCLUSION: Chronic maxillary atelectasis was initially defined as a unilateral disorder, but this description has been challenged by reports of bilateral cases. Further investigation is required to determine the aetiology and pathophysiology of the disease.

PMID: 30773158 [PubMed - as supplied by publisher]

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Intraluminal three-dimensional optical coherence tomography - a tool for imaging of the Eustachian tube?

Related Articles

Intraluminal three-dimensional optical coherence tomography - a tool for imaging of the Eustachian tube?

J Laryngol Otol. 2019 Feb 18;:1-8

Authors: Schuon R, Mrevlje B, Vollmar B, Lenarz T, Paasche G

Abstract
OBJECTIVES: The cause of Eustachian tube dysfunction often remains unclear. Therefore, this study aimed to examine the feasibility and possible diagnostic use of optical coherence tomography in the Eustachian tube ex vivo.
METHODS: Two female blackface sheep cadaver heads were examined bilaterally. Three conditions of the Eustachian tube were investigated: closed (resting position), actively opened and stented. The findings were compared (and correlated) with segmented histological cross-sections.
RESULTS: Intraluminal placement of the Eustachian tube with the optical coherence tomography catheter was performed without difficulty. Regarding the limited infiltration depth of optical coherence tomography, tissues can be differentiated. The localisation of the stent was accurate as was the lumen.
CONCLUSION: The application of optical coherence tomography in the Eustachian tube under these experimental conditions is considered to be a feasible, rapid and non-invasive diagnostic method, with possible diagnostic value for determining the luminal shape and superficial lining tissue of the Eustachian tube.

PMID: 30773144 [PubMed - as supplied by publisher]

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Quality of life after total laryngectomy: evaluating the effect of socioeconomic status.

Related Articles

Quality of life after total laryngectomy: evaluating the effect of socioeconomic status.

J Laryngol Otol. 2019 Feb 18;:1-6

Authors: Scott AJ, McGuire JK, Manning K, Leach L, Fagan JJ

Abstract
OBJECTIVE: Total laryngectomy is considered the primary treatment modality for advanced laryngeal carcinoma. This study assessed the quality of life in patients after total laryngectomy, and ascertained whether quality of life is affected by socioeconomic status.
METHOD: Forty-seven patients (20 state- and 27 private-sector) who underwent total laryngectomy between 1998 and 2014 responded to the University of Washington Quality of Life Questionnaire, the Voice-Related Quality of Life Questionnaire and the Brief Illness Perception Questionnaire.
RESULTS: Significant differences were found in socioeconomic status between state- and private-sector patients (p < 0.001). There was no significant difference in overall quality of life between groups (p = 0.210). State-sector patients scored significantly higher Voice-Related Quality of Life Questionnaire scores (p = 0.043). Perception of illness did not differ significantly between groups.
CONCLUSION: Overall quality of life after total laryngectomy appears to be similar in patients from different socioeconomic backgrounds. However, patients from lower socioeconomic circumstances have better voice-related quality of life. The results illustrate the importance of including socioeconomic status when reporting voice outcomes in total laryngectomy patients.

PMID: 30773143 [PubMed - as supplied by publisher]

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Cross-kingdom interaction of Candida albicans and Actinomyces viscosus elevated cariogenic virulence

Publication date: Available online 18 February 2019

Source: Archives of Oral Biology

Author(s): Ling Deng, Wei Li, Yuanli He, Juan Wu, Biao Ren, Ling Zou

ABSTRACT

Objective

How the interactions betweenCandida albicans and Actinomyces viscosus contributed to the root caries was not clear. This study aimed to investigated their cross-kingdom interactions on the biomass and the cariogenic virulence in dual-species biofilms.

Design

Suspensions ofC. albicans and A.viscosus were formed the mono and polymicrobial biofilms in vitro. Crystal violet assay, viable plate count, scanning electron microscopy and fluorescence in situ hybridization were used to analyze the biomass and biofilm structure. Glycolytic pH drop and the spectrophotometric method were used to evaluate the acid production and hydroxyapatite dissolution, respectively. The exopolysaccharide production was measured by the anthrone-sulfuric acid method, while the adhesion force was measured by atomic force microscopy.

Results

The biomass and colony-forming units of mixed-species was significantly increased compared to that of the mono-speciesat 24 h, 48 h, 72 h.The structure of dual-species biofilm had more microcolonies and was much denser. The dual-species biofilms significantly decreased the pH value and damaged the hydroxyapatite compared with the mono-species biofilms at various time points, indicating the strong cariogenic virulence. Moreover, the dual-species biofilms significantly enhanced the exopolysaccharide production and adhesion force suggesting the increase of biofilm adhesion.

Conclusions

Cross-kingdom interactions ofC. albicans and A. viscosus significantly elevated the biomass and cariogenic virulence of dual-species biofilm.

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FimH as a mucosal adjuvant enhances persistent antibody response and protective efficacy of the anti-caries vaccine

Publication date: Available online 18 February 2019

Source: Archives of Oral Biology

Author(s): Zhong-Fang Liu, Jun-Lan Chen, Wu-You Li, Ming-Wen Fan, Yu-Hong Li

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Cross-kingdom interaction of Candida albicans and Actinomyces viscosus elevated cariogenic virulence

Publication date: Available online 18 February 2019

Source: Archives of Oral Biology

Author(s): Ling Deng, Wei Li, Yuanli He, Juan Wu, Biao Ren, Ling Zou

ABSTRACT

Objective

How the interactions betweenCandida albicans and Actinomyces viscosus contributed to the root caries was not clear. This study aimed to investigated their cross-kingdom interactions on the biomass and the cariogenic virulence in dual-species biofilms.

Design

Suspensions ofC. albicans and A.viscosus were formed the mono and polymicrobial biofilms in vitro. Crystal violet assay, viable plate count, scanning electron microscopy and fluorescence in situ hybridization were used to analyze the biomass and biofilm structure. Glycolytic pH drop and the spectrophotometric method were used to evaluate the acid production and hydroxyapatite dissolution, respectively. The exopolysaccharide production was measured by the anthrone-sulfuric acid method, while the adhesion force was measured by atomic force microscopy.

Results

The biomass and colony-forming units of mixed-species was significantly increased compared to that of the mono-speciesat 24 h, 48 h, 72 h.The structure of dual-species biofilm had more microcolonies and was much denser. The dual-species biofilms significantly decreased the pH value and damaged the hydroxyapatite compared with the mono-species biofilms at various time points, indicating the strong cariogenic virulence. Moreover, the dual-species biofilms significantly enhanced the exopolysaccharide production and adhesion force suggesting the increase of biofilm adhesion.

Conclusions

Cross-kingdom interactions ofC. albicans and A. viscosus significantly elevated the biomass and cariogenic virulence of dual-species biofilm.

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FimH as a mucosal adjuvant enhances persistent antibody response and protective efficacy of the anti-caries vaccine

Publication date: Available online 18 February 2019

Source: Archives of Oral Biology

Author(s): Zhong-Fang Liu, Jun-Lan Chen, Wu-You Li, Ming-Wen Fan, Yu-Hong Li

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Evaluation of the psychometric properties of the cannabis use disorders identification test - revised among college students

Publication date: Available online 18 February 2019

Source: Addictive Behaviors

Author(s): Nicole R. Schultz, Drew T. Bassett, Bryan G. Messina, Christopher J. Correia

Abstract

Objective

Cannabis use is common among college students and is associated with a variety of negative consequences. The Cannabis Use Disorders Identification Test Revised (CUDIT-R) is an 8-item screening instrument designed to identify potentially problematic or harmful recent cannabis use. The purpose of the current study was to evaluate the internal consistency and validity of the CUDIT-R in a sample of college students who reported recent cannabis use (past 30 day).

Methods

Participants (n = 229) completed the CUDIT-R and measures of smoking behavior (Daily Smoking Questionnaire; DSQ), cannabis related consequences (Marijuana Problem Index; MPI), and problematic cannabis use (self-reported DSM-5 Cannabis Use Disorder Criteria).

Results

The CUDIT-R showed good internal consistency and concurrent validity with cannabis related outcome measures including; frequency of use, cannabis related consequences, and total DSM-5 criteria endorsed. The CUDIT-R also showed evidence of discriminant validity across DSM-5 severity classifications, achieved high levels of sensitivity (0.929) and specificity (0.704), and excellent area under the receiver operating characteristics curve when using a cutoff score of six. All items displayed high levels of discrimination and varied in terms of difficulty and information provided.

Conclusions

Overall, the CUDIT-R appears to be a reliable and valid screening measure when used to identify college students at risk for cannabis related problems. Future research should further evaluate the sensitivity and specificity of the CUDIT-R threshold scores with more rigorously established DSM-5 diagnoses, and across a range of populations. Research on the utility of using the CUDIT-R for measuring treatment outcomes is also warranted.

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Perceived barriers to quitting cigarettes among hospitalized smokers with substance use disorders: A mixed methods study

Publication date: Available online 18 February 2019

Source: Addictive Behaviors

Author(s): Hasmeena Kathuria, Ryan G. Seibert, Vinson Cobb, Nicole Herbst, Zoe M. Weinstein, Minda Gowarty, Reha Jhunjhunwala, Eric D. Helm, Renda Soylemez Wiener

Abstract

Aims

Smoking cessation may promote long-term recovery in patients with substance use disorders (SUD). Yet smoking rates remain alarmingly high in this population. Using a sequential explanatory mixed methods approach, we examined smoking rates among hospitalized patients with SUD at a large safety-net hospital, and then characterized factors associated with smoking behaviors both quantitatively and qualitatively.

Method

We abstracted data from all hospital admissions (7/2016–6/2017) and determined demographics, substance use type, and other characteristics associated with cigarette use among those with SUD. We then conducted semi-structured qualitative interviews with 20 hospitalized SUD smokers. We analyzed transcripts to characterize factors that affect patients' smoking habits, focusing on the constructs of the Health Belief Model.

Results

The prevalence of cigarette smoking among hospitalized smokers with SUD was three times higher than those without SUD. Qualitative analyses showed that patients perceived that smoking cigarettes was a less serious concern than other substances. Some patients feared that quitting cigarettes could negatively impact their recovery and perceived that clinicians do not prioritize treating tobacco dependence. Almost all patients with heroin use disorder described how cigarette use potentiated their heroin high. Many SUD patients are turning to vaping and e-cigarettes to quit smoking.

Conclusion

Hospitalized patients with SUD have disproportionately high smoking rates and perceive multiple barriers to quitting cigarettes. When designing and implementing smoking cessation interventions for hospitalized patients with SUD, policymakers should understand and take into account how patients with SUD perceive smoking-related health risks and how that influences their decision to quit smoking.

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Effectiveness and safety comparison of three eye and orbital reconstruction techniques in facial plastic surgery

Publication date: Available online 18 February 2019

Source: Annales de Chirurgie Plastique Esthétique

Author(s): C. Keilani, A. Baus, S. Tick, J.-A. Sahel, J. Boumendil

Summary

Purpose

To compare the effectiveness and the safety of three eye reconstruction techniques with porous bioceramic implantation in facial surgery: the "four petals" eye evisceration (EE) technique, the "russian doll" EE technique and the enucleation with "on-the-table" evisceration technique.

Methods

Retrospective review of patients who underwent surgical orbit reconstruction with primary placement of a porous bioceramic orbital implant using three techniques at Quinze-Vingts National Center (Paris, France). We compared outcomes of three surgical orbit reconstruction techniques: the "four petal" EE technique, the "russian doll" EE technique and the enucleation with "on-the-table" evisceration technique. The primary endpoint was to determine the rate of implant exposure and the facial cosmetic result during the first year after surgery for each technique. The mean of the Numeric Pain Rating Scale (NRS) after surgery at day 1 was also a primary endpoint. In addition, data such as analgesic intake and rate of revision surgery were compared for each technique.

Results

One hundred and ten patients were included: 70 patients in the "four petals" procedure group, 31 in the "on-the-table" procedure group and 9 in the "russian doll" procedure group. NRS pain at day 1 was statistically significantly lower in the "four petals" procedure group 0.9 [standard deviation (SD)] (1.8) and in the "russian doll" procedure group 1 (1.7) than in the "on-the-table" procedure group 2.5 (2.4) (P = 0.001). Implant exposure was statistically significantly lower in the "four petals" procedure group (2.9%) and in the "on-the-table" procedure group (3.2%) when compared to the "russian doll" procedure group (22.2%) (P = 0.03). Rate of revision surgery was lower in the "four petals" procedure group (11.5%) than in the "russian doll" procedure group (33.3%) and the "on-the-table" procedure group (22.6%). "russian doll" evisceration procedure group had the highest orbital lipofilling rate due to the highest rate of enophthalmos. Therefore, the cosmetic result was better in the "four petals" and the "on-the-table" procedure group.

Conclusion

The "four petals" EE technique for surgical eye and orbital reconstruction seems to be a method that reduce implant extrusion, postoperative pain and improve facial esthetic result.

Résumé

Objectif

Comparer l'efficacité et la tolérance de trois techniques de reconstruction oculaire et orbitaire avec implantation d'un implant poreux en biocéramique en chirurgie faciale : la technique d'éviscération oculaire (EO) dite « quatre pétales », la technique d'EO dite « poupée russe » et la technique « d'énucléation-éviscération sur table ».

Méthodes

Étude rétrospective de patients ayant subi une reconstruction chirurgicale oculaire et orbitaire avec mise en place d'un implant orbitaire poreux en biocéramique selon trois techniques au Centre national des Quinze-Vingts (Paris, France). Nous avons comparé les résultats des trois techniques de reconstruction orbitaires : la technique « quatre pétales », la technique « poupée russe » et la technique « d'énucléation-éviscération sur table ». Le critère d'évaluation principal était de déterminer le taux d'extrusion d'implant orbitaire et le résultat esthétique au niveau de la face au cours de la première année postopératoire pour chaque technique. La moyenne de l'échelle numérique (EN) de la douleur le lendemain de la chirurgie était également un critère principal d'évaluation. De plus, des données telles que la consommation d'analgésie et le taux de reprise chirurgicale ont été comparées pour chaque technique.

Résultats

Cent dix patients ont été inclus : 70 patients dans le groupe procédure « quatre pétales », 31 dans le groupe procédure « énucléation-éviscération table » et 9 dans le groupe procédure « poupée russe ». La douleur sur l'EN le lendemain de la chirurgie était statistiquement significativement plus faible dans le groupe « quatre pétales » 0,9 [écart-type ET)] (1,8) et dans le groupe « poupée russe » 1 (1,7) par rapport au groupe « énucléation-éviscération sur la table » 2,5 (2,4) (p = 0,001). Le taux d'extrusion de l'implant était statistiquement significativement plus faible dans le groupe « quatre pétales » (2,9 %) et dans le groupe « énucléation-éviscération sur la table » (3,2 %) par rapport au groupe « poupée russe » (22,2 %) (p = 0,03). Le taux de reprise chirurgicale était inférieur dans le groupe « quatre pétales » (11,5 %) par rapport au groupe « poupée russe » (33,3 %) et au groupe « énucléation-éviscération sur table » (22,6 %). Le groupe « poupées russes » affichait le taux de lipofilling orbitaire le plus élevé en raison du taux d'enophtalmie important. Par conséquent, le résultat esthétique était meilleur dans les groupes « quatre pétales » et « énucléation-éviscération sur table ».

Conclusion

La technique d'EO « quatre pétales » pour la reconstruction chirurgicale oculaire et orbitaire semble être une méthode permettant de réduire l'extrusion d'implant, la douleur postopératoire et d'améliorer les résultats esthétiques du visage.

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The Impact of Permanent Early-Onset Unilateral Hearing Impairment in Children – A Systematic Review

Publication date: Available online 19 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Kerttu Huttunen, Elsa Erixon, Ulrika Löfkvist, Elina Mäki-Torkko

Abstract

Background

Decision-making on treatment and (re)habilitation needs to be based on clinical expertise and scientific evidence. Research evidence for the impact of permanent unilateral hearing impairment (UHI) on children's development has been mixed and, in some of the reports, based on fairly small, heterogeneous samples. Additionally, treatment provided has been highly variable, ranging from no action taken or watchful waiting up to single-sided cochlear implantation. Published information about the effects of treatment has also been heterogeneous. Moreover, earlier reviews and meta-analyses published on the impact of UHI on children's development have generally focused on select areas of development.

Objectives

This systematic review aimed to summarize the impact of children's congenital or early onset unilateral hearing impairment on listening and auditory skills, communication, speech and language development, cognitive development, educational achievements, psycho-social development, and quality of life.

Methods

Literature searches were performed to identify reports published from inception to February 16th, 2018 with the main electronic bibliographic databases in medicine, psychology, education, and speech and hearing sciences as the data sources. PubMed, CINALH, ERIC, LLBA, PsychINFO, and ISI Web of Science were searched for unilateral hearing impairment with its synonyms and consequences of congenital or early onset unilateral hearing impairment. Eligible were articles written in English, German, or Swedish on permanent unilateral hearing impairments that are congenital or with onset before three years of age. Hearing impairment had to be of at least a moderate degree with PTA ≥ 40 dB averaged over frequencies 0.5 to 2 or 0.5 to 4 kHz, hearing in the contralateral ear had to have PTA_{0.5-2 kHz} or PTA_{0.5-4 kHz} ≤ 20 dB, and consequences of unilateral hearing impairment needed to be reported in an unanimously defined population in at least one of the areas the review focused on.

Four researchers independently screened 1,618 abstracts and 566 full-text articles for evaluation of study eligibility. Eligible full-text articles were then reviewed to summarize the results and assess the quality of evidence. Additionally, data from 13 eligible case and multi-case studies, each having less than 10 participants, were extracted to summarize their results.

Quality assessment of evidence was made adapting the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) process, and reporting of the results adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards.

Results

Three articles with the quality of evidence graded as very-low to low, fulfilled the eligibility criteria set. Due to the heterogeneity of the articles, only a descriptive summary could be generated from the results. Unilateral hearing impairment was reported to have a negative impact on preverbal vocalization of infants and on sound localization and speech perception both in quiet and in noise.

Conclusions

No high-quality studies of consequences of early-onset UHI in children were found. Inconsistency in assessing and reporting outcomes, the relatively small number of participants, low directness of evidence, and the potential risk of confounding factors in the reviewed studies prevented any definite conclusions. Further well-designed prospective research using larger samples is warranted on this topic.

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The Impact of Permanent Early-Onset Unilateral Hearing Impairment in Children – A Systematic Review

Publication date: Available online 19 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Kerttu Huttunen, Elsa Erixon, Ulrika Löfkvist, Elina Mäki-Torkko

Abstract

Background

Decision-making on treatment and (re)habilitation needs to be based on clinical expertise and scientific evidence. Research evidence for the impact of permanent unilateral hearing impairment (UHI) on children's development has been mixed and, in some of the reports, based on fairly small, heterogeneous samples. Additionally, treatment provided has been highly variable, ranging from no action taken or watchful waiting up to single-sided cochlear implantation. Published information about the effects of treatment has also been heterogeneous. Moreover, earlier reviews and meta-analyses published on the impact of UHI on children's development have generally focused on select areas of development.

Objectives

This systematic review aimed to summarize the impact of children's congenital or early onset unilateral hearing impairment on listening and auditory skills, communication, speech and language development, cognitive development, educational achievements, psycho-social development, and quality of life.

Methods

Literature searches were performed to identify reports published from inception to February 16th, 2018 with the main electronic bibliographic databases in medicine, psychology, education, and speech and hearing sciences as the data sources. PubMed, CINALH, ERIC, LLBA, PsychINFO, and ISI Web of Science were searched for unilateral hearing impairment with its synonyms and consequences of congenital or early onset unilateral hearing impairment. Eligible were articles written in English, German, or Swedish on permanent unilateral hearing impairments that are congenital or with onset before three years of age. Hearing impairment had to be of at least a moderate degree with PTA ≥ 40 dB averaged over frequencies 0.5 to 2 or 0.5 to 4 kHz, hearing in the contralateral ear had to have PTA_{0.5-2 kHz} or PTA_{0.5-4 kHz} ≤ 20 dB, and consequences of unilateral hearing impairment needed to be reported in an unanimously defined population in at least one of the areas the review focused on.

Four researchers independently screened 1,618 abstracts and 566 full-text articles for evaluation of study eligibility. Eligible full-text articles were then reviewed to summarize the results and assess the quality of evidence. Additionally, data from 13 eligible case and multi-case studies, each having less than 10 participants, were extracted to summarize their results.

Quality assessment of evidence was made adapting the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) process, and reporting of the results adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards.

Results

Three articles with the quality of evidence graded as very-low to low, fulfilled the eligibility criteria set. Due to the heterogeneity of the articles, only a descriptive summary could be generated from the results. Unilateral hearing impairment was reported to have a negative impact on preverbal vocalization of infants and on sound localization and speech perception both in quiet and in noise.

Conclusions

No high-quality studies of consequences of early-onset UHI in children were found. Inconsistency in assessing and reporting outcomes, the relatively small number of participants, low directness of evidence, and the potential risk of confounding factors in the reviewed studies prevented any definite conclusions. Further well-designed prospective research using larger samples is warranted on this topic.

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Impact of years of blindness on neural circuits underlying auditory spatial representation

Publication date: 1 May 2019

Source: NeuroImage, Volume 191

Author(s): Maria Bianca Amadeo, Claudio Campus, Monica Gori

Abstract

Early visual deprivation impacts negatively on spatial bisection abilities. Recently, an early (50–90 ms) ERP response, selective for sound position in space, has been observed in the visual cortex of sighted individuals during the spatial but not the temporal bisection task.

Here, we clarify the role of vision on spatial bisection abilities and neural correlates by studying late blind individuals. Results highlight that a shorter period of blindness is linked to a stronger contralateral activation in the visual cortex and a better performance during the spatial bisection task. Contrarily, not lateralized visual activation and lower performance are observed in individuals with a longer period of blindness.

To conclude, the amount of time spent without vision may gradually impact on neural circuits underlying the construction of spatial representations in late blind participants. These findings suggest a key relationship between visual deprivation and auditory spatial abilities in humans.

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The association of health-related quality of life and cerebral gray matter volume in the context of aging: A voxel-based morphometry study with a general population sample

Publication date: Available online 19 February 2019

Source: NeuroImage

Author(s): Stefanie Hahm, Martin Lotze, Martin Domin, Silke Schmidt

Abstract

Health-related quality of life is likely associated with the brain via processes relating to physiology, behavior, cognition, emotion and stress. Previous studies with small student or clinical samples have identified associations with gray matter volume in the anterior cingulate cortex, prefrontal cortex, insular cortex, (para)hippocampal area, amygdala, and precuneus. The present study investigated the association of gray matter volume of these brain areas with mental and physical components of health, as well as general health perception, measured with the 12-item Short Form Health Survey, in a large sample of 3027 participants from the Study of Health in Pomerania, using voxel-based morphometry for T1-weighted magnetic resonance imaging. Higher physical, but not mental, health-related quality of life and general health perception were associated with larger gray matter volume of the anterior cingulate cortex, medial prefrontal cortex, insular cortex, and the precuneus with a substantial decrease when controlling for lifestyle, comorbidity and symptoms. Age-stratified analyses revealed significantly higher partial correlations of physical health and left insular gray matter volume in the oldest age group. Our study emphasizes the importance of high medial prefrontal and anterior insula gray matter volume for health-related quality of life on the basis of a large sample size.

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Contributions of non-primary cortical sources to auditory temporal processing

Publication date: Available online 19 February 2019

Source: NeuroImage

Author(s): Ehsan Darestani Farahani, Jan Wouters, Astrid van Wieringen

Abstract

Temporal processing is essential for speech perception and directional hearing. However, the number and locations of cortical sources involved in auditory temporal processing are still a matter of debate. Using source reconstruction of human EEG responses, we show that, in addition to primary sources in the auditory cortices, sources outside the auditory cortex, designated as non-primary sources, are involved in auditory temporal processing. Non-primary sources within the left and right motor areas, the superior parietal lobe and the right occipital lobe were activated by amplitude-modulated stimuli, and were involved in the functional network. The robustness of these findings was checked for different stimulation conditions. The non-primary sources showed weaker phase-locking and lower activity than primary sources. These findings suggest that the non-primary sources belong to the non-primary auditory pathway. This pathway and non-primary sources detected in motor area explain how, in temporal prediction of upcoming stimuli and motor theory of speech perception, the motor area receives auditory inputs.

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Age differences in specific neural connections within the Default Mode Network underlie theory of mind

Publication date: Available online 19 February 2019

Source: NeuroImage

Author(s): Colleen Hughes, Brittany S. Cassidy, Joshua Faskowitz, Andrea Avena-Koenigsberger, Olaf Sporns, Anne C. Krendl

Abstract

Theory of mind (i.e., the ability to infer others' mental states) – a fundamental social cognitive ability – declines with increasing age. Prior investigations have focused on identifying task-evoked differences in neural activation that underlie these performance declines. However, these declines could also be related to dysregulation of the baseline, or 'intrinsic', functional connectivity of the brain. If so, age differences in intrinsic connectivity may provide novel insight into the mechanisms that contribute to poorer theory of mind in older adults. To examine this possibility, we assessed younger and older adults' theory of mind while they underwent task-based fMRI, as well as the intrinsic functional connectivity measured during resting-state within the (task-defined) theory of mind network. Older adults exhibited poorer theory of mind behavioral performance and weaker intrinsic connectivity within this network compared to younger adults. Intrinsic connectivity between the right temporoparietal junction and the right temporal pole mediated age differences in theory of mind. Specifically, older adults had weaker intrinsic connectivity between right temporoparietal junction and right temporal pole that explained their poorer theory of mind behavioral performance. These findings broaden our understanding of aging and social cognition and reveal more specific mechanisms of how aging impacts theory of mind.

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Age-related alterations in axonal microstructure in the corpus callosum measured by high-gradient diffusion MRI

Publication date: Available online 18 February 2019

Source: NeuroImage

Author(s): Qiuyun Fan, Qiyuan Tian, Ned A. Ohringer, Aapo Nummenmaa, Thomas Witzel, Sean M. Tobyne, Eric C. Klawiter, Choukri Mekkaoui, Bruce R. Rosen, Lawrence L. Wald, David H. Salat, Susie Y. Huang

Abstract

Cerebral white matter exhibits age-related degenerative changes during the course of normal aging, including decreases in axon density and alterations in axonal structure. Noninvasive approaches to measure these microstructural alterations throughout the lifespan would be invaluable for understanding the substrate and regional variability of age-related white matter degeneration. Recent advances in diffusion magnetic resonance imaging (MRI) have leveraged high gradient strengths to increase sensitivity toward axonal size and density in the living human brain. Here, we examined the relationship between age and indices of axon diameter and packing density using high-gradient strength diffusion MRI in 36 healthy adults (aged 22–72) in well-defined central white matter tracts in the brain. A recently validated method for inferring the effective axonal compartment size and packing density from diffusion MRI measurements acquired with 300 mT/m maximum gradient strength was applied to the in vivo human experiment to obtain indices of axon diameter and density in the corpus callosum, its sub-regions, and adjacent anterior and posterior fibers in the forceps minor and forceps major. The relationships between the axonal metrics, corpus callosum area and regional gray matter volume were also explored. Results revealed a significant increase in axon diameter index with advancing age in the whole corpus callosum. Similar analyses in sub-regions of the corpus callosum showed that age-related alterations in axon diameter index and axon density were most pronounced in the genu of the corpus callosum and relatively absent in the splenium, in keeping with findings from previous histological studies. The significance of these correlations was mirrored in the forceps minor and forceps major, consistent with previously reported decreases in FA in the forceps minor but not in the forceps major with age. Alterations in the axonal imaging metrics paralleled decreases in corpus callosum area and regional gray matter volume with age. Among older adults, results from cognitive testing suggested an association between larger effective compartment size in the corpus callosum, particularly within the genu of the corpus callosum, and lower scores on the Montreal Cognitive Assessment, largely driven by deficits in short-term memory. The current study suggests that high-gradient diffusion MRI may be sensitive to the axonal substrate of age-related white matter degeneration reflected in traditional DTI metrics and provides further evidence for regionally selective alterations in white matter microstructure with advancing age.

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Amygdala-prefrontal cortex white matter tracts are widespread, variable and implicated in amygdala modulation in adolescents

Publication date: Available online 18 February 2019

Source: NeuroImage

Author(s): Leigh G. Goetschius, Tyler C. Hein, Whitney I. Mattson, Nestor Lopez-Duran, Hailey L. Dotterer, Robert C. Welsh, Colter Mitchell, Luke W. Hyde, Christopher S. Monk

Abstract

The amygdala is critically involved in processing emotion. Through bidirectional connections, the prefrontal cortex (PFC) is hypothesized to influence amygdala reactivity. However, research that elucidates the nature of amygdala-PFC interactions – through mapping amygdala-prefrontal tracts, quantifying variability among tracts, and linking this variability to amygdala activation – is lacking. Using probabilistic tractography to map amygdala-prefrontal white matter connectivity in 142 adolescents, the present study found that white matter connectivity was greater between the amygdala and the subgenual cingulate, orbitofrontal (OFC), and dorsomedial (dmPFC) prefrontal regions than with the dorsal cingulate and dorsolateral regions. Then, using a machine-learning regression, we found that greater amygdala-PFC white matter connectivity related to attenuated amygdala reactivity. This effect was driven by amygdala white matter connectivity with the dmPFC and OFC, supporting implicit emotion processing theories which highlight the critical role of these regions in amygdala regulation. This study is among the first to map and compare specific amygdala-prefrontal white matter tracts and to relate variability in connectivity to amygdala activation, particularly among a large sample of adolescents from a well-sampled study. By examining the association between specific amygdala-PFC tracts and amygdala activation, the present study provides novel insight into the nature of this emotion-based circuit.

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Complication rates and clinical outcomes of osseous free flaps: a retrospective comparison of CAD/CAM versus conventional fixation in 128 patients

Publication date: Available online 19 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): C. Rendenbach, C. Steffen, H. Hanken, K. Schluermann, A. Henningsen, B. Beck-Broichsitter, K. Kreutzer, M. Heiland, C. Precht

Abstract

Studies evaluating plate-related complications in patient-specific versus conventional fixation systems in free flap surgery are lacking. This was a retrospective study of 128 osseous free flaps with a minimum follow-up of 12 months. Wound healing disorders, plate exposure, fixation failure, and subtotal osseous union were recorded and evaluated statistically by univariate and regression analysis. Complication rates were as follows: wound healing disorders 33.6% (computer-aided design and computer-aided manufacturing (CAD/CAM) vs. conventional: 35.1% vs. 33.0%); plate exposure 21.9% (29.7% vs. 18.7%); fixation failure 7.0% (8.1% vs. 6.6%); subtotal osseous union 36.7% (45.9% vs. 33.0%). Radiotherapy (P < 0.001) and more than two segments (P = 0.026) were independent variables for the overall complication rate and were negatively correlated with the dental implantation rate. The time between diagnosis and ablative surgery was increased by 11.0 days in the CAD/CAM group (34.2 ± 16.2 days vs. 23.2 ± 12.0 days; P = 0.002). Rates of dental rehabilitation were not significantly different (35.1% vs. 44.0%, P = 0.358). On average, 3.2 ± 1.7 dental implants were placed into flap segments. Plate-related complications were increased with radiotherapy and multisegment flaps. There was a non-significant trend towards increased complications with patient-specific plates in comparison to conventional reconstruction plates.

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Three-dimensional analysis of nasolabial soft tissue changes after Le Fort I osteotomy: a systematic review of the literature

Publication date: Available online 18 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): A. Paredes de Sousa Gil, R. Guijarro-Martínez, O.L. Haas, F. Hernández-Alfaro

Abstract

A systematic review was conducted to investigate the three-dimensional (3D) effect of Le Fort I osteotomy on the nasolabial soft tissues. The literature search was conducted using the MEDLINE (accessed via PubMed), Embase, and Cochrane electronic databases until January 2018. A total of 333 studies were identified (PubMed, n = 292; Embase, n = 41; Cochrane Library, n = 0). Seventeen met the inclusion criteria. The studies were essentially retrospective. The risk of bias was considered high in 15 studies, medium in one study, and low in one study. 3D soft tissue analysis was performed at least 6 months after surgery (mean 8.3 months). The main image acquisition technique reported was cone beam computed tomography (CBCT), associated or not with 3D photography. Approximately 50% of the studies performed two-jaw surgery, 25% performed maxillary surgery only, and the other 25% included heterogeneous intervention groups. The most reported nasolabial changes were anterior and lateral movements of the nasomaxillary soft tissues and upper lip, together with anterior and superior movement of the nasal tip. The alar cinch suture and V–Y closure technique seemed to have little effect in counteracting the undesirable postoperative nasolabial changes. CBCT superimposition presented a reliable 3D assessment for simultaneous measurement of skeletal and soft tissue changes.

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Idiopathic bone cavity of the jaws: an updated analysis of the cases reported in the literature

Publication date: Available online 18 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): B.R. Chrcanovic, R.S. Gomez

Abstract

The aim of this systematic review was to compare the clinical and radiological features of solitary and multiple idiopathic bone cavities (IBCs) reported in the jaws, as well as to identify possible features that may have some influence on the frequency of persistence of IBC following treatment. An electronic search was undertaken in August 2018. Eligibility criteria included publications with sufficient clinical, radiological, and histological information to confirm the diagnosis. A total of 284 publications reporting 1253 IBCs were included. Multiple IBCs affected older patients and female patients more frequently in comparison to solitary IBCs. While trauma was more commonly found in cases of solitary IBC, scalloping around teeth, bone expansion, and persistence of the cavity following treatment were more significantly associated with multiple lesions. The most relevant factors that are suggested to influence the persistence of the cavity are 'surgical access only' in comparison to 'curettage', presence of scalloping around teeth, patients with multiple IBCs, and a larger lesion size. Solitary and multiple IBCs differ in some clinical and radiological aspects and show distinct rates of persistence following treatment. Curettage is the treatment of choice for IBCs compared to surgical access only.

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The association of health-related quality of life and cerebral gray matter volume in the context of aging: A voxel-based morphometry study with a general population sample

Publication date: Available online 19 February 2019

Source: NeuroImage

Author(s): Stefanie Hahm, Martin Lotze, Martin Domin, Silke Schmidt

Abstract

Health-related quality of life is likely associated with the brain via processes relating to physiology, behavior, cognition, emotion and stress. Previous studies with small student or clinical samples have identified associations with gray matter volume in the anterior cingulate cortex, prefrontal cortex, insular cortex, (para)hippocampal area, amygdala, and precuneus. The present study investigated the association of gray matter volume of these brain areas with mental and physical components of health, as well as general health perception, measured with the 12-item Short Form Health Survey, in a large sample of 3027 participants from the Study of Health in Pomerania, using voxel-based morphometry for T1-weighted magnetic resonance imaging. Higher physical, but not mental, health-related quality of life and general health perception were associated with larger gray matter volume of the anterior cingulate cortex, medial prefrontal cortex, insular cortex, and the precuneus with a substantial decrease when controlling for lifestyle, comorbidity and symptoms. Age-stratified analyses revealed significantly higher partial correlations of physical health and left insular gray matter volume in the oldest age group. Our study emphasizes the importance of high medial prefrontal and anterior insula gray matter volume for health-related quality of life on the basis of a large sample size.

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Contributions of non-primary cortical sources to auditory temporal processing

Publication date: Available online 19 February 2019

Source: NeuroImage

Author(s): Ehsan Darestani Farahani, Jan Wouters, Astrid van Wieringen

Abstract

Temporal processing is essential for speech perception and directional hearing. However, the number and locations of cortical sources involved in auditory temporal processing are still a matter of debate. Using source reconstruction of human EEG responses, we show that, in addition to primary sources in the auditory cortices, sources outside the auditory cortex, designated as non-primary sources, are involved in auditory temporal processing. Non-primary sources within the left and right motor areas, the superior parietal lobe and the right occipital lobe were activated by amplitude-modulated stimuli, and were involved in the functional network. The robustness of these findings was checked for different stimulation conditions. The non-primary sources showed weaker phase-locking and lower activity than primary sources. These findings suggest that the non-primary sources belong to the non-primary auditory pathway. This pathway and non-primary sources detected in motor area explain how, in temporal prediction of upcoming stimuli and motor theory of speech perception, the motor area receives auditory inputs.

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Age differences in specific neural connections within the Default Mode Network underlie theory of mind

Publication date: Available online 19 February 2019

Source: NeuroImage

Author(s): Colleen Hughes, Brittany S. Cassidy, Joshua Faskowitz, Andrea Avena-Koenigsberger, Olaf Sporns, Anne C. Krendl

Abstract

Theory of mind (i.e., the ability to infer others' mental states) – a fundamental social cognitive ability – declines with increasing age. Prior investigations have focused on identifying task-evoked differences in neural activation that underlie these performance declines. However, these declines could also be related to dysregulation of the baseline, or 'intrinsic', functional connectivity of the brain. If so, age differences in intrinsic connectivity may provide novel insight into the mechanisms that contribute to poorer theory of mind in older adults. To examine this possibility, we assessed younger and older adults' theory of mind while they underwent task-based fMRI, as well as the intrinsic functional connectivity measured during resting-state within the (task-defined) theory of mind network. Older adults exhibited poorer theory of mind behavioral performance and weaker intrinsic connectivity within this network compared to younger adults. Intrinsic connectivity between the right temporoparietal junction and the right temporal pole mediated age differences in theory of mind. Specifically, older adults had weaker intrinsic connectivity between right temporoparietal junction and right temporal pole that explained their poorer theory of mind behavioral performance. These findings broaden our understanding of aging and social cognition and reveal more specific mechanisms of how aging impacts theory of mind.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BHgWF7

Age-related alterations in axonal microstructure in the corpus callosum measured by high-gradient diffusion MRI

Publication date: Available online 18 February 2019

Source: NeuroImage

Author(s): Qiuyun Fan, Qiyuan Tian, Ned A. Ohringer, Aapo Nummenmaa, Thomas Witzel, Sean M. Tobyne, Eric C. Klawiter, Choukri Mekkaoui, Bruce R. Rosen, Lawrence L. Wald, David H. Salat, Susie Y. Huang

Abstract

Cerebral white matter exhibits age-related degenerative changes during the course of normal aging, including decreases in axon density and alterations in axonal structure. Noninvasive approaches to measure these microstructural alterations throughout the lifespan would be invaluable for understanding the substrate and regional variability of age-related white matter degeneration. Recent advances in diffusion magnetic resonance imaging (MRI) have leveraged high gradient strengths to increase sensitivity toward axonal size and density in the living human brain. Here, we examined the relationship between age and indices of axon diameter and packing density using high-gradient strength diffusion MRI in 36 healthy adults (aged 22–72) in well-defined central white matter tracts in the brain. A recently validated method for inferring the effective axonal compartment size and packing density from diffusion MRI measurements acquired with 300 mT/m maximum gradient strength was applied to the in vivo human experiment to obtain indices of axon diameter and density in the corpus callosum, its sub-regions, and adjacent anterior and posterior fibers in the forceps minor and forceps major. The relationships between the axonal metrics, corpus callosum area and regional gray matter volume were also explored. Results revealed a significant increase in axon diameter index with advancing age in the whole corpus callosum. Similar analyses in sub-regions of the corpus callosum showed that age-related alterations in axon diameter index and axon density were most pronounced in the genu of the corpus callosum and relatively absent in the splenium, in keeping with findings from previous histological studies. The significance of these correlations was mirrored in the forceps minor and forceps major, consistent with previously reported decreases in FA in the forceps minor but not in the forceps major with age. Alterations in the axonal imaging metrics paralleled decreases in corpus callosum area and regional gray matter volume with age. Among older adults, results from cognitive testing suggested an association between larger effective compartment size in the corpus callosum, particularly within the genu of the corpus callosum, and lower scores on the Montreal Cognitive Assessment, largely driven by deficits in short-term memory. The current study suggests that high-gradient diffusion MRI may be sensitive to the axonal substrate of age-related white matter degeneration reflected in traditional DTI metrics and provides further evidence for regionally selective alterations in white matter microstructure with advancing age.

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