Huber Christian Marinus, Benedikter Andreas, Ermert Helmut
et al.
Passive Acoustic Mapping (PAM) is a technique used to localize cavitation events in biomedical applications such as targeted drug delivery, histotripsy, and lithotripsy. Accurate cavitation mapping is essential for optimizing therapeutic efficacy and safety. However, conventional PAM assumes a homogeneous speed of sound within tissue, which does not reflect the heterogeneous acoustic properties of biological media. In this work, we introduce the Fast Marching Method (FMM) to PAM for accurately computing time delays in arbitrary speed of sound distributions. We evaluate the proposed approach through simulations, demonstrating its potential for improved cavitation mapping in realistic tissue environments.
Maria‐Jose Soto, Nanki Hura, Intan Oldakowska
et al.
Abstract Objective Otitis media with effusion (OME) affects 90% of children before school age, with current guidelines recommending tympanostomy tubes for persistent OME and hearing loss after 3 months of “Watchful Waiting,” due to the risk of complications including long‐term conductive hearing loss. Current nonsurgical treatment options are limited. This study evaluates the feasibility of at‐home use of a novel prototype autoinflation device for children with OME or eustachian tube dysfunction. Study Design Single‐arm cohort study. Setting Pediatric otolaryngology private clinic. Methods Children aged 1 to 12 years with OME were recruited from a pediatric otolaryngology clinic and asked to use the device twice daily for 4 weeks. Baseline audiometry and tympanometry were performed at recruitment, with subsequent tympanometry testing after first use and at 2, 4, 8, and 12 weeks. Audiometry testing was repeated at week 4. Compliance was tracked using an App. Results Twenty‐one patients were included (average age: 5.1 years, range: 2‐12 years). After a single session, 86% of patients had middle ear pressure improvement in at least one ear, which maintained stable at 83% at week 4. Additionally, 86% of patients with hearing loss exhibited improvement at 4 weeks, where the average pure tone average in ears with baseline hearing loss improved from 26.8 to 18.9 dB HL. Conclusion These results demonstrate significant improvement in both tympanometry and audiometry after 4 weeks of device use. This indicates a strong potential benefit in regular ventilation of the middle ear for pediatric patients with OME undergoing “Watchful Waiting.”
Relapsing polychondritis (RP) is a rare disease characterized by recurrent systemic inflammation affecting cartilaginous tissues and proteoglycan-rich tissues. The disease may present in several clinical variants, which can delay diagnosis. Corticosteroids are the treatment of choice for RP. In rare cases, RP can be paraneoplastic. The association of RP with thyroid cancer is unusual. We report the first Malagasy case of a 48-year-old man with RP type one diagnosed within less than a year, presenting with recurrent chondritis of the auricular cartilage, tracheobronchial chondritis, and recurrent episcleritis. The disease was associated with papillary thyroid carcinoma.
Christophe Abi Zeid Daou, Elsa Maria Chahine, Randa Barazi
Introduction The optimal time for tracheostomy changes is unknown. Most surgeons opt to wait until five to seven days postoperatively, while more recent studies suggest that changes occurring as early as two to three days postoperatively are also safe.
Ahmed Musaad Abd-Elfattah, Alaa Gaafar, Hisham Atef Ebada
et al.
Abstract Background Tumor-like lesions of the trachea are rare and challenging in diagnosis and management. Inflammatory myofibroblastoma, also known as Inflammatory pseudo tumors (IPTs), as well as Rosai Dorfman Disease (RDD) are inflammatory lesions that may involve the central airways with variable non-specific clinical features mimicking tumors. Case presentation In this study 2 cases with tumor-like lesions are presented. One case with an inflammatory pseudotumor and the other one with Rosai–Dorfman disease affecting the upper trachea. Both cases were successfully managed with tracheal resection anastomosis. Conclusion Tracheal Inflammatory myofibroblastoma, and Rosai–Dorfman diseases are rare tumor like lesions that present with upper airway obstruction. Despite being benign, these lesions may have features suggestive of malignancy, requiring prompt management. Complete surgical excision by segmental resection and primary anastomosis (if feasible) is the treatment of choice with an optimum outcome.
Fatemeh Makouei, Tina Klitmøller Agander, Caroline Ewertsen
et al.
Surgery is the primary treatment for tongue cancer. The goal is a complete resection of the tumor with an adequate margin of healthy tissue around the tumor.Inadequate margins lead to a high risk of local cancer recurrence and the need for adjuvant therapies. Ex vivo imaging of the resected surgical specimen has been suggested for margin assessment and improved surgical results. Therefore, we have developed a novel three-dimensional (3D) ultrasound imaging technique to improve the assessment of resection margins during surgery. In this research protocol, we describe a study comparing the accuracy of 3D ultrasound, magnetic resonance imaging (MRI), and clinical examination of the surgical specimen to assess the resection margins during cancer surgery. Tumor segmentation and margin measurement will be performed using 3D ultrasound and MRI of the ex vivo specimen. We will determine the accuracy of each method by comparing the margin measurements and the proportion of correctly classified margins (positive, close, and free) obtained by each technique with respect to the gold standard histopathology.
Photography, Computer applications to medicine. Medical informatics
Abstract Objective The aim of this study was to identify and analyze the gender breakdown of first authorship contributing to the most‐cited papers in the field of otolaryngology, with a goal of identifying trends in gender representation in publishing. Methods The top 150 most‐cited papers were identified using the Science Citation Index of the Institute for Scientific Information. Among the first authors, gender, h‐index, percentage of first, last, and corresponding authorship positions, total publications, and citations were analyzed. Results The majority of papers were in the English language, from the United States, of clinical nature, and on otologic topics. Eighty‐one percent of papers (n = 122) had men who were first authors, although there was no difference in h‐index score, authorship position, number of publications, citations, and average citations/year between men and women first authors. Upon subgroup analysis by decade (1950s–2010s), there was no difference in the number of articles by women first authors (P = 0.11); however, there was a statistically significant increase in the percentage of women authors (P = 0.001) in papers published later compared to those published earlier. Conclusions While a promising number of women otolaryngologists are publishing high‐powered articles, future initiatives to promote academic inclusivity of women should be considered.
Filipa Ferreira, Henrique Teixeira, Ricardo São Pedro
et al.
Objectivos: Analisar fatores epidemiológicos, demográficos e clínicos que possam estar relacionados com a Apneia Obstrutiva do Sono (AOS). Avaliar a correlação entre vários questionários (Escala Sonolência Epworth, Questionários STOP-Bang e Berlim) com os resultados da polissonografia (PSG), de forma a aplicar os mesmos como uma ferramenta de selecção dos doentes para a realização de PSG.
Material e Métodos: Estudo prospectivo. Preenchimento de questionários no momento da realização do estudo com PSG nível III, no Serviço de Otorrinolaringologia do Hospital Garcia de Orta e consulta do processo clínico.
Resultados: Foram avaliados 193 doentes, com idade média de 57(±14) anos, sendo 57.5% do sexo masculino. A idade (p = 0.001), o IMC (p = 0.001), a presença de hipertensão arterial (p = 0.006) e de diabetes mellitus (p = 0.003) verificaram-se como factores associados à presença de AOS. Dos três questionários testados, apenas o questionário STOP-Bang demonstrou uma correlação estatisticamente significativa com a presença de AOS (p = 0.001) na população estudada. Analisando as curvas ROC, o questionário STOP-Bang foi o que apresentou melhor capacidade discriminativa para a presença de AOS (0.853 p = 0.001), seguido do questionário de Berlim (0.659 p = 0.002) e por último da escala de sonolência de Epworth (0.559 p = 0.257).
Conclusões: O STOP-Bang foi o questionário que demonstrou correlação significativa com a presença de AOS, configurando-se uma ferramenta útil, nomeadamente no contexto de consulta, para a selecção e referenciação de doentes para o estudo com PSG.
Gabriela O'Toole Bom Braga, Robert Zboray, Annapaola Parrilli
et al.
PurposeOtospongiotic plaques can be seen on conventional computed tomography (CT) as focal lesions around the cochlea. However, the resolution remains insufficient to enable evaluation of intracochlear damage. MicroCT technology provides resolution at the single micron level, offering an exceptional amplified view of the otosclerotic cochlea. In this study, a non-decalcified otosclerotic cochlea was analyzed and reconstructed in three dimensions for the first time, using microCT technology. The pre-clinical relevance of this study is the demonstration of extensive pro-inflammatory buildup inside the cochlea which cannot be seen with conventional cone-beam CT (CBCT) investigation.Materials and MethodsA radiological and a three-dimensional (3D) anatomical study of an otosclerotic cochlea using microCT technology is presented here for the first time. 3D-segmentation of the human cochlea was performed, providing an unprecedented view of the diseased area without the need for decalcification, sectioning, or staining.ResultsUsing microCT at single micron resolution and geometric reconstructions, it was possible to visualize the disease's effects. These included intensive tissue remodeling and highly vascularized areas with dilated capillaries around the spongiotic foci seen on the pericochlear bone. The cochlea's architecture as a morphological correlate of the otosclerosis was also seen. With a sagittal cut of the 3D mesh, it was possible to visualize intense ossification of the cochlear apex, as well as the internal auditory canal, the modiolus, the spiral ligament, and a large cochleolith over the osseous spiral lamina. In addition, the oval and round windows showed intense fibrotic tissue formation and spongiotic bone with increased vascularization. Given the recently described importance of the osseous spiral lamina in hearing mechanics and that, clinically, one of the signs of otosclerosis is the Carhart notch observed on the audiogram, a tonotopic map using the osseous spiral lamina as region of interest is presented. An additional quantitative study of the porosity and width of the osseous spiral lamina is reported.ConclusionIn this study, structural anatomical alterations of the otosclerotic cochlea were visualized in 3D for the first time. MicroCT suggested that even though the disease may not appear to be advanced in standard clinical CT scans, intense tissue remodeling is already ongoing inside the cochlea. That knowledge will have a great impact on further treatment of patients presenting with sensorineural hearing loss.
Medical physics. Medical radiology. Nuclear medicine
Introduction: Aminoglycosides are widely known for their ototoxic side effects. Nevertheless, they are potent antibiotics used in the treatment of life-threatening conditions because of the current concern for antibiotic resistance. We hypothesized that creatine supplements which are believed to improve mitochondrial antioxidant defense system and maintain optimal energy homeostasis may improve the ototoxic side effects. Objective: This study aimed to investigate the protective effects of creatine monohydrate against ototoxicity induced by amikacin in rats in an experimental animal model, using distortion product otoacoustic emissions and auditory brainstem response. Methods: Twenty healthy rats were assigned to four groups (5 rats in each): the control group, the creatine monohydrate group, the amikacin group and the amikacin + creatine monohydrate group. The creatine monohydrate group received creatine at a dose of 2 g/kg once daily via gastric gavage for 21 days. The amikacin group received amikacin at a dose of 600 mg/kg by intramuscular injections once daily for 21 days. The amikacin + creatine monohydrate group received intramuscular injections of amikacin (600 mg/kg) once daily for 21 days and creatine monohydrate (2 g/kg) once daily via gastric gavage for 21 days. The control group received nothing. The distortion product otoacoustic emissions and auditory brainstem response measurements were performed on all rats on days 0, 7, 21. Results: Regarding auditory brainstem response values, a significant increase in the auditory threshold was observed in the amikacin group on day 21 (p < 0.001). The amikacin+creatine monohydrate group showed significantly lower levels of auditory brainstem response auditory thresholds on day 21 in comparison to the amikacin group (p < 0.001). Additionally, the control group and the amikacin+creatine monohydrate group did not differ significantly with respect to auditory brainstem response thresholds on treatment day 21 (p > 0.05). When we compare distortion product otoacoustic emissions values, there was no significant difference between the amikacin and amikacin+creatine monohydrate groups on day 7 (p > 0.05), However significantly greater distortion product otoacoustic emissions values were observed in the amikacin+creatine monohydrate group on day 21 compared to the amikacin group (p < 0.001). Conclusion: Our findings demonstrate that creatine treatment protects against amikacin ototoxicity when given at a sufficient dose and for an adequate time period.
Chronic rhinosinusitis is a common condition affecting 5–12% of the general population worldwide. In a limited number of cases, the disease is recalcitrant to medical and surgical interventions, causing a major impact on physical, social and emotional well-being and increasing pressure on healthcare systems. Biofilm formation and dysbiosis caused by Staphylococcus aureus and Pseudomonas aeruginosa play a role in the pathogenesis of recalcitrant chronic rhinosinusitis. In these cases, a promising treatment alternative is the application of bacteriophages, which are viruses that infect and lyse bacteria. In this review, we appraise the evidence for the use of bacteriophages in the treatment of recalcitrant chronic rhinosinusitis. Additionally, (dis)advantages of bacteriophages and considerations for implementation of phage therapy in otorhinolaryngology practice will be discussed.
Department of Otolaryngology-Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, United States, Department of Otorhinolaryngology, Graduate School of Medicine, Saitama Medical University, Saitama, Japan, Departments of Otolaryngology, Neurobiology, Communication Science & Disorders, Bioengineering and Mechanical
1 Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy 2 Department of Otorhinolaryngology Head and Neck Surgery, Humanitas Clinical and Research Center -IRCCS-, Rozzano, Milan, Italy 3 Department of Neurology, Humanitas Clinical and Research Center -IRCCS-, Rozzano, Milan, Italy 4 Department of Neuroscience, Catholic University, Milan, Italy 5 Department of Neuroradiology, Humanitas Clinical and Research Center -IRCCS-, Rozzano, Milan, Italy
Introductıon Deep neck infections are a group of diseases with serious complications and mortality, which can occur as a result of common diseases in the community and which have surgical and medical treatment options. Objectives Patients ages, genders, complaints, physical examination findings, hospitalization complaints, history of antibiotic use before the application, additional diseases, radiological tests and analysis of examinations, type of treatment method, antibiotic agents selected in treatment, bacterial culture results, duration of hospitalization, complications, mortality rates were systematically recorded. In the study, anaerobic bacterial factors, which are difficult to produce in routine, were produced by considering special transport conditions and culture media. Methods A total of 74 patients who were hospitalized in the Department of Otorhinolaryngology, University of Mersin, between 01.07.2016 and 01.07.2017 for deep neck infection were evaluated prospectively. The study included 37 female and 37 male patients. The ages of the patients ranged from 1 to 69 and the mean age was 31 years. Results According to the analysis of the obtained data, there was a statistically significant relationship between the patients with additional diseases and the treatment modalities of the patients (p = 0.017). The surgical treatment rate was increased in this group of patients. In patients with a history of antibiotic use, it was found that patients in the pediatric group were in hospital longer in terms of length of stay compared to adults (p = 0.036). In adult patients who underwent surgery, the absorptive long axis was found to be longer in mm than in patients receiving isolated medical treatment (p = 0.008). Conclusions Deep neck infections is a disease group that seriously concerns public health, with significant mortality and morbidity. Ensuring airway safety of patients should be the first intervention. Abscesses located lateral to the tonsil capsule may not drain adequately without concomitant tonsillectomy.
The His723Arg (H723R) mutation in SLC26A4, encoding pendrin, is the most prevalent mutation in East Asia, resulting in DFNB4, an autosomal recessive type of genetic hearing loss. Although the main pathological mechanism of H723R was identified as a protein-folding defect in pendrin, there is still no curative treatment for associated hearing loss. Here, we show that H723R-pendrin expression and activity are rescued by activation of the chaperonin DNAJC14. In vitro, DNAJC14 was activated via Japanese encephalitis virus (JEV) inoculation, and toxin-attenuated JEV rescued the surface expression and anion exchange activity of H723R-pendrin. Human H723R-pendrin transgenic mice (hH723R Tg) were established in a mouse slc26a4 knockout background, in which only hH723R-pendrin was expressed in the inner ear (Pax2-Cre dependent) to mimic human DFNB4 pathology. Crossing hH723R Tg with DNAJC14-overexpressing mice resulted in reduced cochlear hydrops and more preserved outer hair cells in the cochlea compared to those in hH723R Tg mice. Furthermore, the stria vascularis and spiral ligament were thicker and KCNJ10 expression was increased with DNAJC14 overexpression; however, hearing function and enlarged endolymphatic hydrops were not recovered. These results indicate that DNAJC14 overexpression ameliorates the cochlear degeneration caused by misfolded pendrin and might be a potential therapeutic target for DFNB4.