Value of angiography and embolisation in treatment of head and neck vascular malformations at Otolaryngology Department, Poznań University of Medical Sciences, Poland

Angiography is an invasive, radiological investigation of vascular system. It plays an important role within variety of diagnostic tools in head and neck pathologies. In selected cases with well defined tumor supply vessels, angiography may be combined with intravascular obliteration. This possibility widen indications, which comprise diagnostic arteriographies - visualization of blood supply and extension of vascularization; therapeutic and diagnostic arteriographies - palliative or radical in character, dependent on pathology; and therapeutic angiographies as adjuvant therapy prior to surgical treatment. Authors present their experience with endovascular techniques application in head and neck pathologies. Material comprised 59 angiographies performed in patients treated at Otolaryngology Department at Poznań University of Medical Sciences between 2000-2007. In conclusion authors emphasize advantages and disadvantages, as well as, the role of the endovascular treatment in head and neck surgery.     

Patient,disease, and outcome characteristics of benign paroxysmal positional vertigo with and without Meniere’s disease

Abstract

Background: Meniere’s disease (MD)-associated benign paroxysmal positional vertigo (BPPV) is complex and difficult to diagnose, and reports of its prevalence, pathologic features and outcomes are sparse and conflicting.

Objective: Report disease characteristics and outcomes associated with the presence of MD in patients with BPPV.

Materials/methods: A retrospective study of patients with BPPV between 2007 and 2017 at a single, high-volume institution.

Results: Of 1581 patients with BPPV identified, 7.1% had MD and 71.9% of those patients had BPPV in the same ear(s) as MD. Patients with MD were more likely to have lateral semicircular canalithiasis (11.6% vs. 5.5%, p?=?.009) and multiple canalithiasis (7.1% vs. 2.5%, p?=?.005). MD was associated with an increased rate of resolution of BPPV (p?=?.008) but also increased time to resolution (p?=?.007). There was no association between MD and recurrence of BPPV.

Conclusions: MD is associated with lateral canalithiasis. Contrary to prior reports, BPPV in MD can affect either ear and was not associated with poorer outcomes than idiopathic BPPV.

Significance: The largest series to date investigating disease and outcome characteristics for BPPV in MD is presented. These data inform diagnosis and expectations in the management of these complex patients.     

Questionnaire investigation of musicians’ use of hearing protectors,self reported hearing disorders,and their experience of their working environment

Musicians in symphony orchestras are exposed to harmful sound levels. Although research shows that industrial workers have a higher propensity to noise-induced hearing loss, musicians can also develop a hearing loss from noise exposure. Furthermore, musicians can suffer from tinnitus, hyperacusis, and distortion, among other hearing disorders, which can affect their work more severely than a hearing loss. This study investigated the use of hearing protectors, the prevalence of self-reported hearing disorders among musicians, and the importance of these hearing disorders to the musicians. The musicians at three Danish symphony orchestras were asked to complete a questionnaire on the topic. Results showed that Danish musicians are aware of the dangers of loud music, yet they rarely use hearing protectors and not always correctly; however, musicians with hearing disorders use hearing protectors more frequently. In addition, the musicians questioned suffered from different hearing disorders. Education is needed to change musicians’ opinion of hearing conservation and hearing protectors. The education must be directed to both the musicians and the administration of the symphony orchestras.     

Methods of larynx phoniatory function measurement in the Poznań University Department of Ear, Throat, Nose and Larynx Diseases between 1922 and 1939

INTRODUCTION: Indirect laryngoscopy development and progress initiated in 1854 by the autolaryngoscopy of the famous singing voice teacher Manuel Garcia in ENT speciality is connected with the names of L. Tuerck and J.N. Czermak, the last one being called the father of laryngoscopy. In 1878 M. Oertel used for the first time stroboscopic light in indirect laryngoscopy. The perception of stroboscopic picture is based on the Talbot principle. OBJECT OF THE PAPER: Two apparatuses used for the evaluation of larynx function in the Poznań ENT Department before the II World War are presented:--Polylaryngoscop enabling evaluation the indirect laryngoscopy simultaneously by several individuals.--Mechanical stroboscop of Oertel type with perforated disc moved by electrical engine. CONCLUSION: For 130 years laryngostroboscopy belongs to the basic examination methods of larynx phonatory function.     

Localisation and direction of spread in oral and oropharyngeal cancer in the material of Head and Neck Oncological Surgery Department, University of Medical Sciences in Poznań

The directions of tumor spread are determined by the anatomy of the affected organ. The vessel, nerve anatomy and presence of structures, that may potentially constitute a barrier for spread out of the tumor are of crucial importance. The aim of this paper was to presentation of the spreading directions of oral cavity and oropharyngeal squamous cell cancer based on the own experience. Material include 163 patients surgically treated between 2003-2003 in Department of ENT, Head and Neck Oncological Surgery Department in Poznań. The examination was conducted on the base of retrospective analysis of ambulatory charts and the hospital files. Results: 163 (90%) patients were operated for primary oral and oropharyngeal cancer. The primary localization included in the palatine tonsil (82 patients), trunk of the tongue (48 patients) and floor of the mouth (20 patients) were predominated. The spread directions included: floor of the mouth (36) soft palate (35), base of tongue (33), hypopharynx (20) and trunk of tongue (16). The 31 crossed the midline, 27 infiltrated the tonsillopalatine angle, 9 retromolar area and 3 the mucosa of the cheek. Knowledge of anatomy facility in clinical evaluation of spreading malignancy. It helps in proper qualification to surgery or radiotherapy.     

Older adults’ performance on the speech,spatial, and qualities of hearing scale (SSQ): Test-retest reliability and a comparison of interview and self-administration methods

Abstract

The purposes of the study were to examine the test-retest properties of the speech, spatial, and qualities of hearing scale (SSQ) and to determine if the method of test administration affected these properties. Four groups of 40 older adult participants completed the SSQ twice at an interval of about a half year, using either the same or different administration methods at the two test times. The SSQ was administered using an interview method and/or it was self-administered and then returned by mail. Although the method of test administration did not systematically affect scores on the SSQ, the highest test-retest correlation (r = 0.83) was observed using the interview method at both test times, making it the best choice for the purpose of demonstrating the effectiveness of interventions. The other three combinations of dual-administration in this study also provided reliable results and may be preferable because the self-administration method is less time-consuming and labour-intensive. In conclusion, both the interview and self-administration methods are recommended, but with the best choice depending on the goals of the tester.

Sumario

El propósito de este estudio fue examinar las propiedades test-retest de la escala de audición del habla, espacial y de cualidades (SSQ) y determinar si el método de administración de la prueba afecta esas propiedades. Cuatro grupos de 40 participantes adultos mayores completaron el SSQ dos veces con un intervalo de cerca de medio año, usando (tanto) el mismo o un diferente método de administración en los dos tiempos de la prueba. El SSQ se administró usando un método de entrevista y/o por la auto aplicación y luego, enviado por correo. No obstante que el método de administración de la prueba no afectó sistemáticamente las puntuaciones del SSQ, la mayor correlación test-retest (r = 0.83) se observó usando el método de entrevista en los dos tiempos de la prueba, haciendo de él la mejor selección para demostrar la efectividad de las intervenciones. Las otras tres combinaciones de la administración doble en este estudio, dieron resultados confiables y pueden ser preferibles, porque el método de auto aplicación consume menos tiempo y requiere menor trabajo intensivo. En conclusión, se recomiendan tanto los métodos de entrevista como el de auto aplicación, pero la mejor selección dependerá de las metas del examinador.     

Ear, nose, and throat manifestations of Sjögren's syndrome: retrospective review of a multidisciplinary clinic

OBJECTIVE: To assess the otolaryngologic manifestations of S?gren's syndrome (SS). DESIGN: A retrospective case study. SETTING: The Toronto Hospital. METHOD: Case note review of 196 patients evaluated in a multidisciplinary clinic for this disease. Patients were retrospectively classified according to the revised international classification. MAIN OUTCOME MEASURES: The prevalence of subjective and objective audiologic and otorhinolaryngologic abnormalities. RESULTS: One hundred eleven patients were diagnosed with primary and 26 with secondary SS, leaving 60 with unclassified sicca syndrome. There was minimal otologic pathology. There was a mildly increased prevalence of sensorineural deafness in secondary SS (41-60 years, 36%; 61-80 years, 70%). Approximately 50% of patients in each group complained of nasal symptoms, but only 20% had abnormal findings on rhinoscopy. Similarly, 60 to 70% in each group complained of throat symptoms, but only 20% had abnormal findings on indirect laryngoscopy. Thirty-eight percent of primary patients had parotid gland symptoms, and 25% had abnormally swollen glands, with eight subsequently diagnosed with lymphoma. No patients in the other two groups had abnormal parotid glands. CONCLUSIONS: SS does not appear to be associated with increased otologic or audiologic disease, except perhaps in conjunction with systemic autoimmunity. Nose and throat symptoms are common in SS, but the complications of mucosal dryness on examination are unusual (approximately 20%). Primary SS can cause serious parotid morbidity secondary to inflammation and infection. There is also a significant risk of lymphomas that often present as parotid masses, necessitating long-term follow-up.     

Psychological, neural, endocrine, and immune study of stress in tinnitus patients: any correlation between psychometric and biochemical measures?

OBJECTIVES: The present study was carried out in tinnitus patients in order to study the psychological distress and the biochemical measures of this stressful condition. Psychological features were compared to immune and neuroendocrine parameters in order to verify in these subjects the possible presence of psychological and somatic responses to stress. METHODS: We studied 85 tinnitus patients who underwent hematochemical immune tests: lymphocyte subpopulations (CD3; CD4; CD3+CD4; CD8; CD19; CD16NK; CD3+CD16+CD56; and CD4/CD8), cortisol, adrenocorticotropic hormone, beta-endorphin, prolactin, and urinary catecholamine. RESULTS: Clinically, significant scores were obtained for hysteria, depression, paranoia, hypochondrias, and social introversion; and high scores were obtained for anxiety, depression, care for health, difficulty of treatment, low self-esteem, family and work difficulties, and social discomfort. There was a low to medium level of self-perception of stress. The less a subject felt stressed, the higher was his or her satisfaction level in the areas of psychological and physical functioning. The scores on the tests and the biochemical measures did not show a significant correlation, but there was a tendency to correlation for the lymphocytes CD19 and CD16NK and for adrenocorticotropic hormone. CONCLUSIONS: The comparison between the psychometric and biochemical variables did not reveal any significant correlation among stress perception, daily satisfaction, and the biochemical parameters of stress.     

Epidemiological features of cancers of the oral cavity,oropharynx, hypopharynx and larynx cancer in Réunion Island

IntroductionThis study had two objectives: firstly, to identify and compare characteristics of cancer of the oral cavity, oropharynx, hypopharynx and larynx in Réunion Island, a tropical French overseas territory in the southern hemisphere; and secondly, to discuss how incidence of these cancers is presented in the international literature.Material and methodA retrospective study included 599 patients diagnosed with cancer of the oral cavity, oropharynx, hypopharynx or larynx between 2009 and 2013 in Réunion Island. Demographic characteristics and data on alcohol consumption, smoking habits and HPV infection were analyzed. Standardized incidences were calculated for the worldwide population for both genders.ResultsSex ratio was 7.7 and mean age was 60 years. Cancer consisted of squamous cell carcinoma in 99.1% of patients. Three hundred and forty over 375 patients (81.25%) showed alcohol abuse; 309/359 (86.1%) were smokers; 31/184 (16%) had HPV infection. On the International Agency for Research on Cancer (IARC) anatomic classification, the incidence of “other pharynx” locations was 9.3/100,000 for men and 0.7/100,000 for women, and incidence of “larynx” locations was 6.4/100,000 for men and 0.4/100,000 for women.ConclusionRéunion Island features some particularities in terms of incidence: women are less than half as likely as in Metropolitan France to develop any type of cancer, whereas incidence in males is among highest in France. The presentation of results in cancer registries could be improved in line with everyday practice in head and neck surgery.     

Latex allergy, a special risk for patients of otorhinolaryngology and head and neck surgery?

A total of 206 patients of the otorhinolaryngology (ORL) department and 204 of the visceral surgery department of the Ludwig Maximilians University of Munich were preoperatively evaluated for latex-specific sensitization. A prick test, a questionnaire, and an enzyme-linked immunosorbent assay immunoprecipitation for IgE antibodies were performed. Latex is a widely spread allergen, and it does not only concern healthcare populations. Within the ORL surgery group, 43 (20.9%) patients were sensitized against latex allergen, and 2 of them were reported to manifest symptoms in consorting with latex. In the cohort of visceral surgery patients, we detected only 23 patients (11.3%) with sensitization against latex. Moreover, most patients were positively detected with the skin prick test (86.4%), whereas the enzyme-linked immunosorbent assay method was less sensitive (18.3%). Patients of the ORL department were considerably more frequently exposed to latex protein particles than patients of the visceral surgery department. This difference attributes to their significant difference in mean age: 44 years in the ORL patients group versus 58 years in the visceral patients cohort. Furthermore, we did not find any correlation to the number of past operations--although undergoing any surgical procedures is a well-known risk factor in other studies about latex sensitization in surgical patients.     

Increased expression of VEGF, iNOS, IL-1β, and IL-17 in a rabbit model of gastric content-induced middle ear inflammation

Objective

To investigate the histopathological changes and the expression of vascular endothelial growth factor (VEGF), inducible NO-synthase (iNOS), endothelial NO-synthase (eNOS), interleukin (IL)-1β, and IL-17 in the rabbit middle ear mucosa after direct gastric content exposure.

Methods

Exploratory controlled study in which histological and immunochemical features were studied after gastric content-induced inflammation was established in rabbits. Sixteen healthy rabbits were divided into two equal groups. Gastric contents of an animal were injected into the middle ear of the same animal for 20 days. Saline was injected into the middle ear of the animals in the control group. The rabbits were humanely killed on day 27. Inflammation was assayed by light microscopy. Immunochemical staining was performed for VEGF, iNOS, eNOS, IL-1β, and IL-17 expression. Experimental and control animals were examined using the same protocol.

Results

The expression levels of VEGF, iNOS, IL-1β, and IL-17 differed significantly between the experimental and control groups (p = 0.018, p = 0.010, p = 0.002, and p = 0.002, respectively). The expression level of eNOS was not significantly different between the two groups (p = 0.132).

Conclusion

This study demonstrates that gastroesophagial reflux induced middle ear inflammation is associated with increased expression of VEGF, IL-1β, IL-17, and iNOS.     

Pitch and lexical tone perception of bilingual English–Mandarin-speaking cochlear implant recipients,hearing aid users,and normally hearing listeners

Abstract

Objectives

The purpose of this current study was to investigate whether pitch, lexical tone, and/or speech-in-noise perception were significantly correlated for Singaporean teenagers or adults who spoke both Mandarin and English.

Methods

Thirty-three normal hearing or near-normal hearing listeners who did not use a hearing device (NNH group), eight postlingually deafened cochlear implant (CI) recipients (CI group), and three postlingually deafened bilateral hearing aid (HA) users (HA group) were recruited. All participants were bilingual Mandarin–English-speaking Singaporean residents. Participants were assessed on tests of pitch-ranking, lexical tone perception, and speech-in-noise.

Results

The NNH group scored significantly better than the CI group for all tests and subtests. There were no significant differences for the pitch test between the HA group and either the CI or NNH group. However, HA users scored significantly better than the CI group, and more aligned with the NNH group's scores for both the lexical tone and Mandarin speech-in-noise test. There were highly significant moderate positive correlations between all three tests.

Discussion

Overall, the performance of the CI users in this study indicates that CI recipients still struggle on pitch-related auditory perception tasks. Additionally, although the test scores from the HA users were better than the CI recipients, they were not as good as the NNH listeners. The significant moderate correlations between all three tests indicate that there is at least some degree of overlap in the skills required to accurately perceive these stimuli.

Conclusion

The overall results suggest that CI users, and to a lesser extent HA users, still struggle with complex auditory perceptual tasks, particularly when it requires the perception of pitch. However, it may be possible that training one of these skills (e.g. musical pitch) may then generalize to other tasks (e.g. lexical tone and/or speech-in-noise). This is important for counseling, as well as for planning effective rehabilitation programs.     

Distribution of the Na,K-ATPase α Subunit in the Rat Spiral Ganglion and Organ of Corti

Processing of sound in the cochlea involves both afferent and efferent innervation. The Na,K-ATPase (NKA) is essential for cells that maintain hyperpolarized membrane potentials and sodium and potassium concentration gradients. Heterogeneity of NKA subunit expression is one mechanism that tailors physiology to particular cellular demands. Therefore, to provide insight into molecular differences that distinguish the various innervation pathways in the cochlea, we performed a variety of double labeling experiments with antibodies against three of the α isoforms of the NKA (NKAα1–3) and markers identifying particular subsets of neurons or supporting cells in whole mount preparations of the organ of Corti and spiral ganglion. We found that the NKAα3 is abundantly expressed within the membranes of the spiral ganglion somata, the type I afferent terminals contacting the inner hair cells, and the medial efferent terminals contacting the outer hair cells. We also found expression of the NKAα1 in the supporting cells that neighbor the inner hair cells and express the glutamate transporter GLAST. These findings suggest that both the NKAα1 and NKAα3 are poised to play an essential role in the regulation of the type I afferent synapses, the medial efferent synapses, and also glutamate transport from the afferent-inner hair cell synapse.     

Endoscopic Treatment of Intraorbital and IntracranialComplications of Sinusitis

The paranasal sinuses are located adjacent to the orbit and the skull base,which may allowdirect spread of infection through to those regions. While the incidence of these complications hasdecreased with improved antimircrobial. therapy,inappropriate use of antibiotics may make earlydiagnosis of complications delayed. Because intraorbital and intracranial complications can resultin serious neurological morbidity or motality,aggressive treatment utilizing a multi-disciplinarysurgical approach a…     

Inflammation and apoptosis in malignant transformation of sinonasal inverted papilloma: the role of the bridge molecules,cyclooxygenase-2, and nuclear factor κB

Purpose

This study examined the early events in the neoplastic progression of the sinonasal inverted papilloma to squamous cell carcinoma from the viewpoint of chronic inflammation and apoptosis.

Materials and methods

In total, 118 archival slides stained with hematoxylin and eosin from 45 patients were graded according to histopathology (grades I-IV). Their representative portions were transferred to a tissue microarray, sections of which were stained immunohistochemically for cyclooxygenase-2, p53, bax, bcl-2, and nuclear factor κB.

Results

Cyclooxygenase-2 expression was positively correlated with histopathologic grade, with higher expression in advanced grades. p53s were detected in all cores from advanced grades (III, IV), but not in early grades (I, II). The expressions of nuclear factor κB, bax, and bcl-2 were not correlated with the grade.

Conclusions

A p53 mutation seems be a critical event for the malignant transformation of the sinonasal inverted papilloma. Cyclooxygenase-2–mediated inflammatory signals, activated as a consequence of the p53 mutation, may contribute to promoting the proliferation of the advanced sinonasal inverted papilloma.