Comparison of cervical and ocular vestibular-evoked myogenic potential responses between tone burst versus chirp stimulation

paythelady.61 shared this article with you from Inoreader Comparison of cervical and ocular vestibular-evoked myogenic potential responses between tone burst versus chirp stimulation Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Purpose To compare the effectiveness of chirp and tone burst stimuli in oVEMP and cVEMP testing for healthy adults Methods This study was conducted in 56 healthy volunteers (112 ears). Ocular and cervical VEMP (oVEMP, cVEMP) tests were performed for each participant using tone burst and chirp stimuli. VEMP response rates, latency of each peak (p1–n1, n1–p1), peak to peak amplitude (p1–n1 amplitude and n1–p1 amplitude), and rectified amplitudes were measured and compared between these two different stimuli. Results VEMP response rates with chirp stimuli are higher than the tone burst stimuli for both cVEMP and oVEMP tests (The difference was statistically significant for oVEMP, p = 0.001). Chirp stimuli have higher p1n1 amplitude and rectified amplitude and shorter p1and n1 latency then tone burst stimuli for cVEMP (p = 0.015, p = 0.007, p < 0.001, p < 0.001, respectively). Chirp stimuli also have higher n1p1 amplitude and shorter n1and p1 latency then tone burst stimuli for oVEMP (p = 0.006, p < 0.001, p < 0.001, respectively). Conclusion The present findings show that the chirp stimulus triggers earlier VEMP responses with higher amplitudes than the tone burst stimulus during cVEMP and oVEMP testing. VEMP response rate with chirp stimulus is also higher than the tone burst. Therefore chirp stimulus can be used in VEMP testing as effectively as, if not more than, tone burst stimulus in clinical practice. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Conventional approaches versus laser CO2 surgery in stapes surgery: a multicentre retrospective study

paythelady.61 shared this article with you from Inoreader Conventional approaches versus laser CO2 surgery in stapes surgery: a multicentre retrospective study Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Purpose To analyze and compare surgical and audiological outcomes of conventional approaches versus laser CO2 surgery in stapes surgery. Methods 333 patients who underwent stapes surgery were enrolled in the study; the patient population was divided into three groups: group 1: 170 patients treated with conventional stapedotomy with manual microdrill (average age 49.13 years); group 2: 119 patients treated with conventional stapedotomy with electrical microdrill (average age 51.06 years); group 3: 44 patients (average age 50.4 years) who underwent CO2 laser stapedotomy. Intra-operative, postoperative outcomes and audiological results were investigated. Results The average surgical time of laser CO2 surgery was longer than for other surgical procedures. No statistical differences emerged in post-operative abnormal taste sensation. There was also no difference in postoperative dizziness. Air-bone gap (ABG) went down from 29.7 ± 10 dB (group 1) and 27.32 ± 9.20 (group 2) to 10 ± 6.9 dB (group 1) and 10.7 ± 6.03 dB (group 2). In group 3 the preoperative ABG was lowered from 28.3 ± 10.1 to 11.8 ± 10.9, with a statistical difference in auditory recovery (p = 0.0001); The group of patients treated with laser CO2 showed a percentage of patients with an ABG closure of between 0 and 10 dB higher than in the group treated with manual microdrills (77.2% vs. 60%, respectively; p = 0.03). Conclusion Overall surgical results of CO2 laser and conventional stapedotomy are comparable without any significant difference; however, the group treated with CO2 laser appears to have a percentage of patients with an ABG closure 0–10 dB higher than the group treated using the conventional technique. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endolymphatic sac tumor: single-institution series of seven cases with updated review of literature

paythelady.61 shared this article with you from Inoreader Endolymphatic sac tumor: single-institution series of seven cases with updated review of literature Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Background Endolymphatic sac tumour (ELST) is a rare low-grade locally aggressive neoplasm arising from the endolymphatic duct or sac. It presents mostly with vestibulo-cochlear symptoms either sporadically or as part of von Hippel–Lindau (VHL) syndrome. Micro-neurosurgical excision remains the cornerstone of therapy with the role of radiotherapy (RT) being controversial. This is a clinico-pathological analysis of consecutive ELST patients presenting to a single-institution in India. Methods Neuropathology database of a tertiary-care comprehensive cancer centre was searched electronically to identify consecutive patients with histopathological diagnosis of ELST registered at the institute over last one decade. Data regarding demographic profile, clinical presentation, histopathological features, treatment details and outcomes were retrieved from electronic medical records for this retrospective analysis. Results Electronic search identified seven unique patients with biopsy-proven ELST registered at the institute between 2009 and 2020. Median age of the study cohort was 39 years (range 24–65 years) with strong male predilection (5:2 ratio) and left-sided preponderance (71%). Most common presenting symptoms were hearing loss (86%) and earache (71%) on affected side followed by headache (43%). All patients underwent maximal safe resection at initial diagnosis and were followed-up closely with periodic surveillance imaging. Two patients underwent salvage RT using high-precision conformal techniques at recurrence/progression. Conclusion ELST is a rare low-grade locally aggressive neoplasm that arises generally as part of VHL syndrome or sometimes sporadically. Gross total resection provides the best chance of cure with RT being reserved for unresectable disease, large residue, medical inoperability, or as salvage therapy for recurrent/progressive tumor. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT2W–3D–FLAIR reconstructed with magnitude and zero-filled interpolation

paythelady.61 shared this article with you from Inoreader High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT2W–3D–FLAIR reconstructed with magnitude and zero-filled interpolation Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Background It is still challenging to detect endolymphatic hydrops (EH) in patients with Meniere's disease (MD) using MRI. The aim of the present study was to optimize a sensitive technique generating strong contrast enhancement from minimum gadolinium–diethylenetriamine pentaacetic acid (Gd–DTPA) while reliably detecting EH in the inner ear, including the apex. Materials and methods All imaging was performed using a 3.0 T MR system 24 h after intratympanic injection of low-dose Gd–DTPA. Heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery reconstructed with magnitude and zero-filled interpolation (hT2W–FLAIR–ZFI) was optimized and validated in phantom studies and compared with medium inversion time inversion recovery imaging with magnitude reconstruction (MIIRMR). The following parameters were used in hT2W–FLAIR–ZFI: repetition time 14,000 ms, echo time 663 ms, inversion time 2900 ms, flip angle 120°, echo train length 271, and field of view 166 × 196 mm2. Results MRI obtained using hT2W–FLAIR–MZFI yielded high-quality images with sharper and smoother borders between the endolymph and perilymph and a higher signal intensity ratio and more homogenous perilymph enhancement than those generated with MIIRMR (p < 0.01). There were predominantly grade II EHs in the cochleae and grade III EHs in the vestibule in definite MD. EH was detected in the apex of 11/16 ipsilateral ears, 3/16 contralateral ears in unilateral definite MD and 3/6 ears in bilateral MD. Conclusions The novel hT2W–FLAIR–MZFI technique is sensitive and demonstrates strong and homogenous enhancement by minimum Gd–DTPA in the inner ear, including the apex, and yields high-quality images with sharp borders between the endolymph and perilymph. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Taste impairment after endoscopic stapes surgery: Do anatomic variability of chorda tympani and surgical technique matter?

paythelady.61 shared this article with you from Inoreader Taste impairment after endoscopic stapes surgery: Do anatomic variability of chorda tympani and surgical technique matter? Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Purpose To investigate how the anatomical configuration of the oval window region (OWR) influences the management of the chorda tympani (ChT) and the curetting of adjacent bony structures, in a setting of patients undergoing endoscopic stapes surgery (EStS); to assess the incidence of early and late post-operative dysgeusia and to identify anatomical and surgical factors influencing taste function after EStS. Methods Surgical video recordings of 48 patients undergoing EStS for otosclerosis between January 2019 and July 2020 were retrospectively revised, to classify the anatomical variability of selected middle ear structures and the management strategies for the ChT. Clinical records of included patients were reviewed for subjective early and late post-operative taste impairment using a 5-point Likert-scale. Results The most common configuration of the OWR was type III. The extension of the bony curettage resulted inversely proportional to the exposure of the OWR. The long-term rate of preserved post-operative taste function was 85%. Displacement of the ChT was necessary in 43/48 cases (90%), mostly medially (36/48, 75%). Conclusion Bone curetting during EStS does not correlate with post-operative taste impairment. Despite 100% ChT preservation rate, dysgeusia may occur in a minority of patients, with no apparent relationship to anatomical variability or intraoperative management of the ChT. The use of CO2 laser could have a role in increasing the risk of post-operative dysgeusia after EStS. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of PET-CT, CT and MRI scan in initial staging and management of head and neck cancers

paythelady.61 shared this article with you from Inoreader Comparison of PET-CT, CT and MRI scan in initial staging and management of head and neck cancers Via Latest Results for European Archives of Oto-Rhino-Laryngology Abstract Background To evaluate the utility of positron-emission tomography (FDG PET) in initial staging and management of head and neck cancers. Methods This is a retrospective study of 99 treatment naïve head and neck cancer patients treated between January 2017 and December 2020 at a tertiary teaching centre. Change in initial staging and management was noted based on PET scan compared to cross-sectional imaging (CT and MRI). Results There were 73 (73.7%) males and 26 (26.2%) females with male-to-female ratio of 2.8:1.Overall, change in management was seen in 36/99 (36.4%) patients due to PET scan. With regards to initial staging, T, N and M stage was changed in 14/99 (14.1%), 19/99 (19.1%) and 3/99 (3%) patients, respectively. These changes were significantly higher in patients with unknown primary (63.3%, p value −0.001) and N3 (41%, p −0.045) nodal disease. Conclusion PET-CT plays an important role in appropriate initial staging and subsequent treatment planning of head and neck cancers. Advances in knowledge Initial staging PETCT changes management in 36.4% cases. Accuracy of various different imaging modalities have been compared. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of deep convolutional neural network models for mandibular fracture detection in panoramic radiographs

paythelady.61 shared this article with you from Inoreader Assessment of deep convolutional neural network models for mandibular fracture detection in panoramic radiographs Via International Journal of Oral and Maxillofacial Surgery The aim of this study was to develop automated models for the identification and detection of mandibular fractures in panoramic radiographs using convolutional neural network (CNN) algorithms. A total of 1710 panoramic radiograph images from the years 2016 to 2020, including 855 images containing mandibular fractures, were obtained retrospectively from the regional trauma centre. CNN-based classification models, DenseNet-169 and ResNet-50, were fabricated to identify fractures in the radiographic images. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.