Otology

EDITORIAL

The limitations of pure-tone audiometry (as the gold standard test of hearing) that are worthy of consideration [pg. 1]
Mohd Normani Zakaria
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ORIGINAL ARTICLES

Inner ear malformations in cochlear implant recipients [pg. 3]
Luan Viet Tran, Vu Anh Duong, Saim Lokman
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Anatomical variations of round window in different age groups and surgical difficulties associated with them during cochlear implantation [pg. 7]
Rabindra Bhakta Pradhananga, Bigyan Raj Gyawali, Pabina Rayamajhi, Bebek Bhattarai
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Validity of modified whisper test as hearing screening method in presbycusis patients [pg. 11]
Rizki Najoan, Nyilo Purnami
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Detection of two pathogenesis previously unreported myosin xva pathogenic variants in two large Iranian pedigrees with autosomal recessive nonsyndromic hearing loss [pg. 14]
Fatemeh Azadegan-Dehkordi, Korosh Ashrafi, Gholam Reza Mobini, Nasrin Yazdanpanahi, Maryam Shirzad, Effat Farrokhi, Morteza Hashemzadeh-Chaleshtori
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Chronic suppurative otitis media and microbial flora: Adult versus pediatric population [pg. 22]
Ashish Chandra Agarwal, Anitya Srivastava, Manodeep Sen
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Risk of hepatic toxicity and drug response in patients with chronic suppurative otitis media [pg. 26]
S M Tariq Rafi, Shafaque Mehboob, Mejabeen , Naila Tariq, Hurithmina Khan, Moona Mehboob
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Speech intelligibility enhancement in elderly with high-frequency hearing loss through visual speech perception [pg. 30]
Himanshu Chaurasiya
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Effectiveness of intratympanic dexamethasone as salvage therapy in treating sudden sensorineural hearing loss [pg. 36]
Bigyan Raj Gyawali, Rabindra Bhakta Pradhanaga, Pabina Rayamajhi
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Prospective study of use of Island of tragal cartilage in revision tympanoplasty [pg. 40]
Bhavika Verma, Naresh Dawat, Yogesh G Dabholkar, Sachin J Patil
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Antimicrobial susceptibility in patients with chronic suppurative otitis media in a North-Central secondary health facility in Nigeria [pg. 44]
Solomon Joseph Hassan, Yikawe Stephen Semen, Dabit Othniel Josep, Ekuma Otu Gabriel, Osisi Kingsley, Solomon Ndudiri Calista
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Conducting Fukuda stepping test in a noisy clinic and the effects of sound [pg. 47]
Carren Sui Lin Teh, Erica Anak Gima, Hani Binti Mamat, Meng Hon Lye, Sobani Bin Din, Narayanan Prepageran
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Hyperintensity of integrin‐targeted fluorescence agent IntegriSense750 accurately predicts flap necrosis compared to Indocyanine green

xlomafota13 shared this article with you from Inoreader Hyperintensity of integrin‐targeted fluorescence agent IntegriSense750 accurately predicts flap necrosis compared to Indocyanine green Via Head & Neck Abstract Background Flap necrosis is a feared complication of reconstructive surgery. Current methods of prediction using Indocyanine green (ICG) lack specificity. IntegriSense750 is a fluorescence agent that binds sites of vascular remodeling. We hypothesized that IntegriSense750 better predicts flap compromise compared to ICG. Methods Fifteen mice underwent lateral thoracic artery axial flap harvest. Mice received an injection of ICG (n = 7) or IntegriSense750 (n = 8) daily from postoperative days (POD) 0–3 and were imaged daily. Mean signal-to-background ratios quantified the change in fluorescence as necrosis progressed. Results Mean signal-to-background ratio was significantly higher for IntegriSense750 compared to ICG on POD0 (1.47 ± 0.17 vs. 0.86 ± 0.21, p = 0.01) and daily through POD3 (2.12 ± 0.70 vs. 0.96 ± 0.29, p < 0.001). Conclusions IntegriSense750 demonstrates increased signal-to-background ratio at areas of flap distress compared to ICG which may increase identification of flap necrosis and improve patient outcomes. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cortical auditory-evoked potential as a biomarker of central auditory maturation in term and preterm infants during the first 3 months

xlomafota13 shared this article with you from Inoreader Cortical auditory-evoked potential as a biomarker of central auditory maturation in term and preterm infants during the first 3 months Via cortical auditory Clinics (Sao Paulo). 2021 Oct 18;76:e2944. doi: 10.6061/clinics/2021/e2944. eCollection 2021. ABSTRACT OBJECTIVES: To analyze central auditory maturation in term and preterm infants during the first 3 months of life by comparing the latency and amplitude of cortical auditory-evoked potential at different frequencies. METHODS: In this study, 17 term and 18 preterm infants were examined; all had tested positive on the neonatal hearing screening test. Cortical auditory potential was investigated during the first and third months of life. The response of the cortical auditory-evoked potential was investigated at frequencies of 500, 1000, 2000, and 4000 Hz. The latency and amplitude of the cortical response were automatically detected and manually analyzed by three researchers with experience in electrophysiology. The results were compared using analysis of variance and the Bonferroni test. A significance level of 5% was used for all analyse s. RESULTS: Latency values of cortical auditory-evoked potential in the first month of birth were significantly higher than those in the third month, and latency values of the preterm group were higher than those of the term group, regardless of the frequency and time of evaluation. In general, the latency of the cortical auditory-evoked potential was higher at high frequencies. Amplitude values in the third month of life were significantly higher than those in the first month for term and preterm infants. CONCLUSION: Central auditory maturation was observed in both groups but with different results between those born at term and preterm, with latencies of cortical auditory-evoked potential higher for the preterm group and at high frequencies. PMID:34669874 | PMC:PMC8491591 | DOI:10.6061/clinics/2021/e2944 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Detection of two pathogenesis previously unreported myosin xva pathogenic variants in two large Iranian pedigrees with autosomal recessive nonsyndromic hearing loss

xlomafota13 shared this article with you from Inoreader Detection of two pathogenesis previously unreported myosin xva pathogenic variants in two large Iranian pedigrees with autosomal recessive nonsyndromic hearing loss Via Indian Journal of Otology Fatemeh Azadegan-Dehkordi, Korosh Ashrafi, Gholam Reza Mobini, Nasrin Yazdanpanahi, Maryam Shirzad, Effat Farrokhi, Morteza Hashemzadeh-Chaleshtori Indian Journal of Otology 2021 27(1):14-21 Purpose: Hearing loss (HL) is a genetically heterogeneous common neurosensory disorder. Among different ethnic groups, pathogenic variants of Myosin XVa (MYO15A) at the DFNB3 locus are the common causes of autosomal recessive nonsyndromic hearing loss (ARNSHL). The aim of this study was to determine the prevalence and the type of MYO15A pathogenic variants in a subset of Iranian pedigrees with ARNSHL. Materials and Methods: Thirty-eight Iranian pedigrees with no Gap junction beta-2 pathogenic variants were included in the study. For all pedigrees, linkage analysis was performed using five short tandem repeat markers of DFNB3 locus. The DNA sequencing was then applied to identify MYO15A pathogenic variants in linked pedigrees. Results: Altogether, two out of 38 (5.3%) pedigrees were linked to locus 3. After sequencing, five previously unreported MYO15A pathogenic variants (c.1775-1776insA, c.1766-1767insC, c.7694delA, c.611G > C (G204A), and c.6442T > A (W2148R)) were revealed i n homozygous and heterozygous state in the two pedigrees studied. Furthermore, the pathogenicity of pathogenic variants was confirmated by Insilco and cosegregation analysis in this study. Conclusions: Our findings support a relatively high prevalence and specificity of MYO15A pathogenic variant among Iranian ARNSHL patients. Molecular study of MYO15A may lead to elucidation of the population-specific pathogenic variant profile, which is of importance in molecular diagnostics of HL. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Speech intelligibility enhancement in elderly with high-frequency hearing loss through visual speech perception

xlomafota13 shared this article with you from Inoreader Speech intelligibility enhancement in elderly with high-frequency hearing loss through visual speech perception Via Indian Journal of Otology Himanshu Chaurasiya Indian Journal of Otology 2021 27(1):30-35 Background: Pathological and physiological disabilities of human auditory receptors reduce speech intelligibility under hearing loss (HL) at high frequencies. Objectives: The objective of the study is to investigate the speech-intelligibility-enhancement (SIE) in elderly with high-frequency HL (HFHL) through visual-speech-perception (VSP). The hypothesis is that the VSP of spondee words (two-syllable words with equal stress on both syllables) is properly recognized and reproduced with HFHL. Also; to decide the statistical relevance of the precise significant difference in speech discrimination (SD) with VSP on the subjected ear. Methods: Observational and descriptive studies of SIE with VSP on 12 elderly listeners (24 clear ears; without wax impaction) with progressive and bilateral HFHL were examined. The entire experimental records were checked for distribution with normal (Gaussian) using the Shapiro–Wilk's and paired Student's t-test (parametric test) had the 5% (0.05) signific ance level (α). Results: We analyzed, improved, and better performance in SIE with HFHL through VSP. The statistical P (probability) measure was calculated nothing, i.e., 0 (P < 0.05). Therefore, investigators strongly and carefully discarded the null hypothesis consideration. There was some significant value of statistical variation also exists with VSP. Moreover, with the help of the confidence-interval analysis, the same conclusion was achieved. Conclusions: In this study, it is concluded that the elderly-individuals of this experiment, whose mother tongue and official language is Hindi and English, respectively, they demonstrate the SIE with HFHL through VSP. This investigation also helps to improve the hearing sensitivity to some extent with VSP. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effectiveness of intratympanic dexamethasone as salvage therapy in treating sudden sensorineural hearing loss

xlomafota13 shared this article with you from Inoreader Effectiveness of intratympanic dexamethasone as salvage therapy in treating sudden sensorineural hearing loss Via Indian Journal of Otology Bigyan Raj Gyawali, Rabindra Bhakta Pradhanaga, Pabina Rayamajhi Indian Journal of Otology 2021 27(1):36-39 Introduction: The steroid is the drug of choice in patients with sudden sensorineural hearing loss (SSNHL). Thirty to fifty percent of cases, despite receiving steroids may have incomplete recovery. Furthermore, there are a significant number of patients in whom systemic steroids are contraindicated such as cases with uncontrolled diabetes, uncontrolled hypertension, and pregnancy. Intratympanic steroids can play a vital role as salvage therapy in these cases. The aim of this study was to evaluate the effectiveness of intratympanic Dexamethasone as salvage therapy in cases who fail to respond with systemic steroids, who present late (>1 week) after the onset of symptoms and cases, in whom systemic steroids are contraindicated. Materials and Methods: This was a retrospective study conducted in the Department of ENT-Head and Neck Studies, T.U. Teaching Hospital, Kathmandu, Nepal. Approval from the Institutional Review Committee was taken. A prospectively set record data of cases wit h SSNHL receiving intratympanic Dexamethasone as a salvage therapy from April 2018 to April 2020 were analyzed for improvement in hearing outcome. We used SPSS version 25 for the statistical analysis. Chi-square test and Fisher's exact test were used to draw statistical co-relation. Value of P < 0.05 was considered statistically significant. Results: A total of 34 cases met the inclusion criteria. M: F was 3:1 with the majority of cases in the third–fifth decades of life. A total of 11 cases showed partial improvement and one case had complete improvement. There was no statistically significant co-relation between hearing outcome and time interval (from the onset of symptoms to intratympanic injection), level of hearing loss, comorbidities, and prior use of systemic steroid therapy (P > 0.05). Conclusion: Intratympanic Dexamethasone has audiological benefits as a salvage therapy in cases with SSNHL failing to respond with systemic steroid therapy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Inner ear malformations in cochlear implant recipients

xlomafota13 shared this article with you from Inoreader Inner ear malformations in cochlear implant recipients Via Indian Journal of Otology Luan Viet Tran, Vu Anh Duong, Saim Lokman Indian Journal of Otology 2021 27(1):3-6 Objective: The aim of this study is to determine the prevalence of the inner ear malformations (IEMs) in cochlear implant recipients according to Sennaroglu's classification, and to document the intraoperative difficulties and complications in those cases. Methods: This was a descriptive cross-sectional study performed at our hospital between January 2016 and October 2019. IEMs on temporal bone computed tomography scans were identified in all patients who received cochlear implants during the study. Intraoperative difficulties and complications relating to these malformations were described. Results: Twelve patients with IEMs were identified from a total of 212 cochlear implant recipients, representing a prevalence of 5.7%. Among them, one patient with incomplete partition (IP) Type I (8.3%), seven patients with IP Type II (58.3%), one patient with IP Type III (8.3%), one patient with cochlear hypoplasia (CH) Type I (8.3%), and two patients with CH Type III (16.7%) were identified. A ssociated enlarged vestibular aqueduct was found in four cases with IP Type II (33.3%). Round windows were not identified intraoperatively in 3 cases with CH (25%). Three cases (25%) had cerebrospinal fluid gusher (one patient in each of the following anomalies: IP-I, IP-II, and IP-III). The mean categories of auditory performance score was 6, which was collected within 23.3 months after the surgery. Conclusion: This study documents the prevalence of IEMs in cochlear implant recipients (classified by Sennaroglu in 2017). The identification of such anomalies will significantly aid surgeons in making decisions regarding cochlear implant candidacy and surgical strategy when cochlear implantation is contemplated to obtain optimal outcomes. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Machine learning for the identification of decision boundaries during the transition from radial to vertical growth phase superficial spreading melanomas

xlomafota13 shared this article with you from Inoreader Machine learning for the identification of decision boundaries during the transition from radial to vertical growth phase superficial spreading melanomas Via Melanoma Research - Published Ahead-of-Print To compute threshold values for the diameter of superficial spreading melanomas (SSMs) at which the radial growth phase (RGP) evolves into an invasive vertical growth phase (VGP). We examined reports from 1995 to 2019 of 834 primary SSMs. All the patients underwent complete surgical removal of the tumor and the diagnosis wa s confirmed after histologic examination. Machine learning was used to compute the thresholds. For invasive non-naevus-associated SSMs, a threshold for the diameter was found at 13.2 mm (n = 634). For the lower limb (n = 209) the threshold was at 9.8 mm, whereas for the upper limb (n = 117) at 14.1 mm. For the back (n = 106) and the trunk (n = 173), the threshold was at 16.2 mm and 17.1 mm, respectively. When considering non-naevus-associated and naevus-associated SSMs together (n = 834) a threshold for the diameter was found at 16.8 mm. For the lower limb (n = 248) the threshold was at 11.7 mm, whereas for the upper limb (n = 146) at 16.4 mm. For the back (n = 170) and the trunk (n = 236), the threshold was at 18.6 mm and 14.1 mm, respectively. Thresholds for various anatomic locations and for each gender were defined. They were based on the diameter of the melanoma and computed to suggest a transition from RGP to VGP. The transition from a r adial to a more invasive vertical phase is detected by an increase of tumor size with a numeric cutoff. Besides the anamnestic, clinical and dermatoscopic findings, our proposed approach may have practical relevance in vivo during clinical presurgical inspections. Received 15 March 2021 Accepted 25 July 2021 Correspondence to Andrea Moglia, PhD, EndoCAS, Center for Computer Assisted Surgery, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy, Tel: +39 050 995 689; fax: +39 050 992 273; e-mail: andrea.moglia@endocas.org Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sensitivity of treatment-free survival to subgroup analyses in patients with advanced melanoma treated with immune checkpoint inhibitors

xlomafota13 shared this article with you from Inoreader Sensitivity of treatment-free survival to subgroup analyses in patients with advanced melanoma treated with immune checkpoint inhibitors Via Melanoma Research - Published Ahead-of-Print Patients with advanced melanoma treated with immune checkpoint inhibitors can experience ongoing disease control after treatment discontinuation without subsequent systemic anticancer therapy. We previously defined a novel outcome, treatment-free survival (TFS), as the time between protocol therapy cessation and sub sequent therapy initiation/death. We assessed the effect of established prognostic variables [lactate dehydrogenase (LDH), programmed death ligand 1 status, BRAF mutation status, performance status, and sex] on TFS in different treatment scenarios: treatment until toxicity/progression with frequent early cessation (nivolumab plus ipilimumab), treatment until toxicity/progression with a well-tolerated regimen (nivolumab), and treatment for a short fixed duration (ipilimumab). Data were pooled from 1077 patients with advanced melanoma treated in the CheckMate 069 and 067 trials. TFS was defined as the area between the Kaplan–Meier curves for time to therapy cessation and time to subsequent therapy initiation/death. TFS was estimated by restricted mean (r-mean) survival time at 36 months since randomization. Clinically meaningful TFS (r-mean TFS 3.7–12.7 months) was observed across all patient subgroups. TFS was longest in patients treated with nivolumab plus ipilimumab. The la rgest differences in r-mean TFS were observed with LDH in the nivolumab plus ipilimumab and ipilimumab treatment groups (TFS difference 4.7 and 4.9 months, respectively). In the nivolumab group, there was little difference in TFS across subgroups (r-mean TFS 3.7–5.5 months). TFS was sensitive to prognostic subgroup differences; however, duration of treatment affected the sensitivity of TFS. These results provide further support for TFS as a clinical outcome measure. Received 8 February 2021 Accepted 29 September 2021 Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www.melanomaresearch.com. Correspondence to Meredith M. Regan, ScD, Division of Biostatistics, Dana-Farber Cancer Institute, Department of Medicine, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA, Tel: +617 632 2471; e-mail: mregan@jimmy.harvard.edu This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ponatinib-induced eruptive nevi and melanocytic proliferation

xlomafota13 shared this article with you from Inoreader Ponatinib-induced eruptive nevi and melanocytic proliferation Via Melanoma Research - Published Ahead-of-Print Ponatinib, an oral third-generation tyrosine kinase inhibitor, is indicated for the treatment of imatinib-resistant leukemia. We experienced a case of ponatinib-induced eruptive nevi, and the biologic effects of ponatinib on melanocytes were investigated. Treatment with ponatinib significantly increased the proliferat ion of normal human melanocyte or melanoma cells through the upregulation of the extracellular signal-regulated kinase and protein kinase B signaling pathways. The downstream molecules of cyclin B1 and D1 were significantly increased in ponatinib-treated melanocytes. These results demonstrate the capacity of ponatinib to induce the proliferation and tumorigenesis of melanocytes. Received 23 July 2021 Accepted 21 September 2021 Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www.melanomaresearch.com. Correspondence to Hee Young Kang, MD, PhD, Department of Dermatology, Ajou University School of Medicine, Ajou University Hospital, 164, World Cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, 16499, South Korea, Tel: +82 31 219 5190; fax: +82 31 219 5189; e-mail: hykang@ajou.ac.kr Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epithelial component and intraepithelial lymphocytes of conjunctiva-associated lymphoid tissue in healthy children

xlomafota13 shared this article with you from Inoreader Epithelial component and intraepithelial lymphocytes of conjunctiva-associated lymphoid tissue in healthy children Via Cellular and Molecular Biology Histol Histopathol. 2021 Oct 26:18385. doi: 10.14670/HH-18-385. Online ahead of print. ABSTRACT Conjunctiva-associated lymphoid tissue (CALT) plays a key role in protecting the eye surface by initiating and regulating immune responses. The aim of this study was to investigate in healthy children the proportion of intraepithelial lymphocytes (IELs), the degree of viability and/or apoptosis and cell proliferation in three different topographic areas of the conjunctiva. Superior tarsal, superior bulbar, and inferior tarsal-bulbarfornix conjunctival cells were collected by brush cytology (BC) from 24 healthy paediatric subjects (13 boys and 11 girls, mean age 6±2 years) who were to undergo strabismus correction surgery under general anaesthesia. Subsequently, these cells were analysed phenotypically and functionally by flow cytometry (FC). Flow cytometry analysis showed that not all the cells obtained by BC were of the epithelial lineage, but that there was a population of CD45+ cells (IELs) regularly present in the conjunctiva of healthy children. These IELs were mostly T-lymphocytes (CD3+) and B-lymphocytes (CD19+), with higher levels of T-lymphocytes (CD3+) in the upper areas than in the inferior tarsal-bulbar-fornix, where the highest levels of B-lymphocytes (CD19+) were found. In the apoptosis assay, two groups of cell populations were differentiated by cell size and complexity (cytoplasmic granularity), with more complex cells predominating in the upper areas of the conjunctiva and less complex cells being more abundant in the inferior tarsal-bulbar-fornix. Finally, the proliferative capacity of the conjunctival epithelium was significantly higher in the upper tarsal zone than in the rest of the zones analysed. These results suggest that the epithelial component and the IELs of CALT are also regularly present in the conjunctiva of the healthy child, varying in phenotype, viability and cell proliferation accord ing to the different conjunctival regions analysed, which could lead us to believe that each conjunctival zone plays a different, specific role in the regulation of the immune response at the ocular level. PMID:34698365 | DOI:10.14670/HH-18-385 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.