Hasil untuk "Otorhinolaryngology"

Ana Margarida Amorim, Ana Margarida Amorim, Daniela Jardim Pereira et al.

Background and objectivesThe vestibular cortex is a critical component of a complex, distributed network supporting balance and spatial orientation. Despite its importance, the impact of vestibular loss on vestibular cortex structure in conditions associated with bilateral vestibular failure remains largely unexplored. Usher Syndrome (USH), a genetic disorder causing deafness, vestibular dysfunction, and visual impairment, offers a unique model to investigate these effects. This study explores the existence of potential changes on vestibular cortex morphometry of two USH patients, one with mild (type 2) (USH2) and the other with severe bilateral vestibular impairment (type 1) (USH1), respectively.MethodsOne USH1 and one USH2 patient underwent comprehensive evaluations of vestibular function (calorics, video Head Impulse Test (vHIT), Vestibular Evoked Myogenic Potentials (VEMPs), and posturography), auditory function (audiometry), and brain structure using MRI volumetry. MRI was analyzed using the VolBrain platform to quantify gray matter volume (GMV) in regions associated with vestibular function and plasticity (insula, parietal operculum, precuneus, hippocampus, occipital gyrus, lingual gyrus, and cerebellar lobule X). A descriptive analysis of clinical and paraclinical findings was performed.ResultsUSH1 patient exhibited increased GMV in the left precuneus and marked asymmetry index between the right and left posterior insula volume. USH2 patient showed no significant differences in these regions. There was no volume reduction in hippocampal GMV in neither patient, despite the presence of bilateral vestibular loss in USH1. Both patients exhibited reduced GMV in cerebellar lobule X and heterogeneous occipital gyri, asymmetries.ConclusionsVestibular cortex morphometry appears to reflect functional differences between USH subtypes, distinguishing USH1 and USH2. The preserved hippocampal volume in USH1 suggests compensatory neuroplasticity in early-onset deprivation. Heterogeneous visual cortex findings and cerebellar atrophy highlight the complex interplay between multisensory deprivation and brain plasticity and warrants further investigation. This analysis emphasizes the need for an exhaustive evaluation of the impact of multisensory deprivation on the vestibular cortex in a larger number of USH patients in order to support our exploratory data. A clearer understanding of the vestibular network could improve treatment strategies for vestibular disorders, enhancing patient quality of life.

Maxime Fieux, Esther Wang, David T. Liu et al.

ABSTRACT Introduction Topical anesthesia (TA) of the nasal fossa has been shown to be sufficient for patient comfort during nasal endoscopy. However, investigators need to know how soon after the administration of TA they can accurately evaluate olfactory capability. Thus, the main aim of this study was to assess, in healthy volunteers (HV), when the effects of TA wear off to accurately measure olfactory capability after its administration. Methods A prospective, single‐center, pilot study was conducted to evaluate the duration of the effect of TA on olfactory capability, using the UPSIT. Thirty healthy volunteers were recruited and analyzed. Following baseline testing (UPSIT), TA was administered intranasally (lidocaine + oxymetazoline). Then, participants underwent three additional UPSIT evaluations at distinct time points: immediately post‐application (T0), 10 min (T + 10), and 30 min post‐application (T + 30). The primary outcome was the change in UPSIT score from baseline to each subsequent time point. Paired t‐tests were applied to compare within‐subject score differences across time points. Significance was defined as p < 0.05, and the R software was used. Results For the 30 HV included, the mean UPSIT at T0 was 32.8 ± 3.1. At T1, the mean UPSIT (29.6 ± 4.0) was significantly lower than at T0 (3.13 ± 3.7‐point, p < 0.0001). At T2, the mean UPSIT was 31.7 ± 4.2, without any significant difference from T0 (−1.03 ± 3.5‐point, p = 0.350). At T3, the mean UPSIT was 31.7 ± 3.1, without any significant difference compared to T0 (−1.07 ± 2.6‐point, p = 0.067). Regarding subgroup analysis between healthy volunteers with or without ITH, their own perception of smell and UPSIT were significantly different. Conclusion Immediately after receiving 4 sprays per nostril, the mean UPSIT—with testing begun directly after the spray was administered—was significantly lower than baseline, dropping under the threshold for normal olfactory function. It was fully recovered by ten min. Level of Evidence 3.

Jérôme Houdu, Maxime Barron, Thierry Civit et al.

ABSTRACT After surgery involving cranial nerves and more generally the central nervous system, nonbacterial meningitis should raise suspicion of herpes simplex virus type 1 reactivation. No time should be wasted in diagnosis and treatment; therefore, a polymerase chain reaction testing on cerebrospinal fluid should be systematic in this situation, without neglecting to consider other differential diagnoses.

Rebecca Black, BApSc, Speech Pathologist(SP), Duy Duong Nguyen, MD PhD, Anna Miles, PhD et al.

Background: Oropharyngeal dysphagia and laryngeal dysfunction are complications of lung and heart transplantation. However, there is a lack of understanding around pre-operative function and an absence of standardized assessment protocols. We aimed to trial a pre- and post-operative protocol for assessing voice and swallowing function. Method: A prospective, longitudinal study of 14 adults undergoing investigation for lung or heart transplantation was conducted at a tertiary referral hospital. Patients were assessed pre-surgery and up to 6 months afterwards. The protocol involved phonation tasks with auditory-perceptual and acoustic analysis, videolaryngostroboscopy, a flexible endoscopic examination of swallowing and patient reported quality of life measures. Risk factors and clinical outcomes were extracted from patient records. Results: Patient self-reports of swallowing and voice difficulties were elevated pre-operatively. No evidence of swallowing difficulty was observed under endoscopic examination pre-transplant (Penetration-Aspiration Scale score <2; no accumulated secretions) and only one patient presented with incomplete glottic closure. Auditory perceptual ratings revealed voices were largely within the healthy range at baseline. One out of five patients presented with severe dysphonia post-operatively. Completion of evaluation measures prior to transplantation was 79% but post- operative rates were low due to feasibility challenges with follow up in this complex population. Conclusion: Novel evidence of self-reported pre-transplant voice and swallowing changes indicate value in baseline screening. Discrepancies between patient-report and instrumental assessment results highlight the need for multi-faceted evaluation. Large cohort studies are needed to determine the salient evaluation measures and time points for voice and swallowing assessment in this population.

Shitong Zhou, Shitong Zhou, Yu Jiang et al.

IntroductionHead and neck squamous cell carcinoma (HNSCC) is a highly heterogeneous malignancy with poor overall prognosis. Recent studies have suggested that propionate metabolism-related genes (PMRGs) may play key roles in tumor progression and immune regulation, yet their functions in HNSCC remain unclear.MethodsTranscriptomic data from 502 HNSCC tumor samples and 44 normal tissue samples were obtained from the UCSC Xena database as the training set. Two independent datasets (GSE41613 and GSE6631) from the GEO database were used for validation. Differentially expressed genes (DEGs), key module genes identified via weighted gene co-expression network analysis (WGCNA), and PMRGs were intersected to identify candidate genes. A prognostic model was constructed using Cox regression and LASSO analysis. Immune infiltration, somatic mutations, and drug sensitivity were compared between high- and low-risk groups. Gene expression was further validated by RT-qPCR using clinical samples.ResultsA total of 42 intersecting genes were identified, and four feature genes (PRKAA2, SLC7A5, GRIP2, CHGB) were selected to build the prognostic model. The model effectively stratified patients into high- and low-risk groups with significant survival differences in both the training and validation cohorts. The high-risk group exhibited marked differences in immune cell infiltration, immune checkpoint expression, and cancer immune cycle activity. Mutation burden and drug sensitivity also varied significantly between risk groups. A nomogram combining risk score and pathological N stage showed strong predictive performance.DiscussionThis study highlights the potential role of PMRGs in immune regulation and tumor progression in HNSCC. The proposed four-gene signature provides a novel tool for prognosis prediction and offers new insights for risk stratification and individualized therapy. Further multicenter validation and mechanistic studies are warranted.

Daniela A. Brake, Sam Snider, Amar Miglani et al.

Abstract Objective To determine whether septal perforations have an effect on nasal swell body (NSB) size. Study Design Retrospective cohort study. Setting Two tertiary academic medical centers. Methods Computed tomography maxillofacial scans of 126 patients with septal perforation and 140 control patients from November 2010 to December 2020 were evaluated. Perforation etiology was determined. Measurements included perforation length and height and swell body width, height, and length. Swell body volume was calculated. Results The width and volume of the NSB are significantly smaller in perforation patients when compared to controls. The swell body is significantly smaller and thinner in perforations exceeding 14 mm in height compared to small perforations. Perforation etiology groupings into prior septal surgery, septal trauma, septal inflammatory, and mucosal vasoconstriction categories all demonstrated decreased swell body volume and width compared to controls. Inflammatory etiology had the greatest decrease in swell body size. The hemi‐swell body on the contralateral side of a septal deviation is significantly thicker than the ipsilateral side. Conclusion The NSB is smaller in patients with septal perforation regardless of perforation size or etiology.

Huiqin Zong, Zhengcai Lou

Abstract Objective The objective was to compare the recurrence rate and complications between endoscopic middle meatal antrostomy (MMA) and extended MMA for the treatment of antrochoanal polyps (ACPs). Methods and materials 95 ACPs were prospectively enrolled to undergo MMA (n = 48) or extended MMA (n = 47). The recurrence rate and complications were compared between these groups. Results All patients completed 24 months of follow-up. The recurrence of ACP was demonstrated by only endoscope at 6 and 12 months postoperatively but at 24 months postoperatively by endoscope and CT. Rates of recurrence of ACP differed between groups and significance at postoperative month 6 (7/48 patients in the MMA group and 0/47 patients in the extended MMA group, P = 0.02), month 12 (16/48 vs. 2/47, P < 0.01) and month 24 (21/48 vs. 3/47, P < 0.01). No MMA closure was found in any group, 19.15% (9/47) patients complained of cheek numbness in the extended MMA group, however, no major complications were observed in both groups. Conclusions Extended MMA via antidromic extended medial wall of MS may effectively reduce the recurrence of ACP with lower complications.

Serpil Allusoglu, Songul Aksoy

Objectives: Decreased Sound Tolerance (DST) is a negative reaction to a sound that does not cause any reaction in an individual with normal hearing. DST’s subclasses include hyperacusis, phonophobia, and misophonia, which are distinct and have therapy variations. There is no diagnostic method or scale that distinguishes them in the literature. This study’s purpose was to develop a screening scale that distinguishes these three DSTs. Methods: The study comprised 257 willing participants with normal hearing. Cronbach alpha coefficient, item-total correlation, and item differentiation of the Decreased Sound Tolerance Scale-Screening (DSTS-S) were evaluated. Structural validity of DSTS-S was performed by Varimax rotation with Kaiser normalization using Explanatory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA) was performed to assess its structural compatibility. The scale’s total scores from each section were compared using the Mann-Whitney U test in symptom (+) and symptom (–) participants. Results: The Cronbach alpha value for hyperacusis, phonophobia, and misophonia sections of DSTS-S was calculated as 0.881, 0.775, and 0.938, respectively. The difference between the independent samplet-test and the variables was statistically significant (p < 0.01). The Mann-Whitney U test showed a significant difference between the median values of the total groups’ scores with and without hyperacusis, phonophobia, and misophonia (HTS, PTS, and MTS, respectively) (p < 0.05). Evaluation by ROC analysis showed that hyperacusis was useful in predicting the presence of hyperacusis, phonophobia was useful in predicting the presence of phonophobia, and misophonia was useful in predicting the presence of misophonia (p < 0.001). Hyperacusis and misophonia sections showed high reliability, and phonophobia section showed a moderately reliable level. The Kappa test showed that the compatibility between test–retest for the total scores was statistically significant (p < 0.001). Conclusion: The study’s results indicated that DSTS-S is a valid and reliable scale for identifying subtypes/problems/classes of decreased sound tolerance.

Chong Cui, Daqi Wang, Bowei Huang et al.

Gene therapy would benefit from the effective editing of targeted cells with CRISPR-Cas9 tools. However, it is difficult to precisely assess the editing performance in vivo because the tissues contain many non-targeted cells, which is one of the major barriers to clinical translation. Here, in the Atoh1-GFP;Kcnq4+/G229D mice, recapitulating a novel mutation we identified in a hereditary hearing loss pedigree, the high-efficiency editing of CRISPR-Cas9 in hair cells (34.10% on average) was precisely detected by sorting out labeled cells compared with only 1.45% efficiency in the whole cochlear tissue. After injection of the developed AAV_SaCas9-KKH_sgRNA agents, the Kcnq4+/G229D mice showed significantly lower auditory brainstem response (ABR) and distortion product otoacoustic emission (DPOAE) thresholds, shorter ABR wave I latencies, higher ABR wave I amplitudes, increased number of surviving outer hair cells (OHCs), and more hyperpolarized resting membrane potentials of OHCs. These findings provide an innovative approach to accurately assess the underestimated editing efficiency of CRISPR-Cas9 in vivo and offer a promising strategy for the treatment of KCNQ4-related deafness.

Keitaro Miyake, Kyoko Shirai, Nobuhiro Nishiyama et al.

Abstract Cochlear implants (CIs) are generally considered useful in the treatment of hereditary hearing loss with progressive deafness. Early CI can be beneficial for maintaining social activities in POU4F3 mutation patients.

Mikel García-Martín, Ignacio Toribio-Ruano, Pablo Torrico-Román

Mujer de 34 años que presentaba tumoración en área Va derecha de 2.5cm, indurada, ni adherida, ni dolorosa a la palpación. En Punción Aspiración con Aguja Fina (PAAF) se observaban células sueltas de aspecto plasmocitoide. En Tomografía Computarizada (CT) se objetivó una imagen heterogénea de 3x2cm entre los músculos trapecio y escalenos derechos. En Tomografía por Emisión de Positrones (PET-CT) se resaltaba una masa cervical derecha a nivel Va, con elevada actividad metabólica. Se llevo a cabo una exéresis íntegra de la tumoración. El estudio anatomopatológico presentaba resultados compatibles con sarcoma asociado a reordenamiento de CIC (19q13.2). Se decidió tratamiento complementario con radioterapia tras el cual la paciente se mantuvo asintomática. En CT de control se encontraron múltiples lesiones ocupantes de espacio en pulmón. En nuevo PET-CT se apreciaban lesiones hipermetabólicas en pulmón compatibles con metástasis. Fue valorada por Oncología Médica remitiéndose a unidad de referencia de sarcomas para tratamiento.

Rania E. Ahmed

Abstract Background Cochlear hearing loss causes variations in the way that sounds are represented in the auditory system and for cochlear implant (Cl) users, pitch information that is transmitted to the central nervous system is not ideal. The aim of this study was to compare between pitch discrimination and its associated language development in normal children, children with cochlear implant and children with hearing aids to know which prostheses is more useful to the patient. Materials and methods The study measured pitch discrimination test, just noticeable difference test and language evaluation in 45 children divided into 3 groups. Results This study suggested that CI had less pitch discrimination ability but better language development than HA. Conclusions The benefit that CI users get through better accessibility to high frequencies outweighs the deficit in pitch discrimination.

Filiz Uzumcugil, Emre Can Celebioglu, Demet Basak Ozkaragoz et al.

Objectives The age-based Cole formula has been employed for the estimation of endotracheal tube (ETT) size due to its ease of use, but may not appropriately consider growth rates among children. Child growth is assessed by calculating the body surface area (BSA). The association between the outer diameter of an appropriate uncuffed-endotrachealtube (ETT-OD) and the BSA values of patients at 24–96 months of age was our primary outcome. Methods Cole formula, BSA, age, height, weight and ultrasound measurement of subglottic-transverse-diameter were evaluated for correlations with correct uncuffed ETT-OD. The Cole formula, BSA, and ultrasound measurements were analyzed for estimation rates in all patients and age subgroups. The maximum allowed error for the estimation of ETT-OD was ≤0.3 mm. Patients’ tracheas were intubated with tubes chosen by Cole formula and correct ETT-OD values were determined using leak test. ETT exchange rates were recorded. Results One-hundred twenty-seven patients were analyzed for the determination of estimation rates. Thirteen patients aged ≥72 months were intubated with cuffed ETT-OD of 8.4 mm and were accepted to need uncuffed ETT-OD >8.4 mm in order to be included in estimation rates, but excluded from correlations for size analysis. One-hundred fourteen patients were analyzed for correlations between correct ETT-OD (determined by the leak test) and outcome parameters. Cole formula, ultrasonography, and BSA had similar correct estimation rates. All three parameters had higher underestimation rates as age increased. Conclusion. The Cole formula, BSA, and ultrasonography had similar estimation rates in patients aged ≥24 to ≤96 months. BSA had a correct estimation rate of 40.2% and may not be reliable in clinical practice to predict uncuffedETT-size.

Allessandra Fraga Da Ré, Léia Gonçalves Gurgel, Gabriela Buffon et al.

Abstract Introduction In Brazil, estimates show that 14.7% of the adult population smokes, and changes in smell and taste arising from tobacco consumption are largely present in this population, which is an aggravating factor to these dysfunctions. Objectives The objective of this study is to systematically review the findings in the literature about the influence of smoking on smell and taste. Data Synthesis Our research covered articles published from January 1980 to August 2014 in the following databases: MEDLINE (accessed through PubMed), LILACS, Cochrane Library, and SciELO. We conducted separate lines of research: one concerning smell and the other, taste. We analyzed all the articles that presented randomized controlled studies involving the relation between smoking and smell and taste. Articles that presented unclear methodologies and those whose main results did not target the smell or taste of the subjects were excluded. Titles and abstracts of the articles identified by the research strategy were evaluated by researchers. We included four studies, two of which were exclusively about smell: the first noted the relation between the perception of puff strength and nicotine content; the second did not find any differences in the thresholds and discriminative capacity between smokers and nonsmokers. One article considered only taste and supports the relation between smoking and flavor, another considered both sensory modalities and observes positive results toward the relation immediately after smoking cessation. Conclusion Three of the four studies presented positive results for the researched variables.

Shai Chordekar, Cahtia Adelman, Haim Sohmer et al.

Context: Damage to the auditory system by loud sounds can be avoided by hearing protection devices (HPDs) such as earmuffs, earplugs, or both for maximum attenuation. However, the attenuation can be limited by air conduction (AC) leakage around the earplugs and earmuffs by the occlusion effect (OE) and by skull vibrations initiating bone conduction (BC). Aims: To assess maximum attenuation by HPDs and possible flanking pathways to the inner ear. Subjects and Methods: AC attenuation and resulting thresholds were assessed using the real ear attenuation at threshold (REAT) procedure on 15 normal-hearing participants in four free-field conditions: (a) unprotected ears, (b) ears covered with earmuffs, (c) ears blocked with deeply inserted customized earplugs, and (d) ears blocked with both earplugs and earmuffs. BC thresholds were assessed with and without earplugs to assess the OE. Results: Addition of earmuffs to earplugs did not cause significantly greater attenuation than earplugs alone, confirming minimal AC leakage through the external meatus and the absence of the OE. Maximum REATs ranged between 40 and 46 dB, leading to thresholds of 46–54 dB HL. Furthermore, calculation of the acoustic impedance mismatch between air and bone predicted at least 60 dB attenuation of BC. Conclusion: Results do not support the notion that skull vibrations (BC) contributed to the limited attenuation provided by traditional HPDs. An alternative explanation, supported by experimental evidence, suggests transmission of sound to inner ear via non-osseous pathways such as skin, soft tissues, and fluid. Because the acoustic impedance mismatch between air and soft tissues is smaller than that between air and bone, air-borne sounds would be transmitted to soft tissues more effectively than to bone, and therefore less attenuation is expected through soft tissue sound conduction. This can contribute to the limited attenuation provided by traditional HPDs. The present study has practical implications for hearing conservation protocols.

Andrie Jeremy Formanez

Objective: To determine the risk of vocal fold paralysis in patients who underwent total thyroidectomy with and without intraoperative recurrent laryngeal nerve identification. Methods:             Study design:             Retrospective cohort study             Setting:                       Tertiary military hospital             Population: 237 adult patients who underwent total thyroidectomy for benign lesions based on post-operative histopathology operated on by senior third or fourth year residents. Excluded were those who underwent lobectomy with isthmusectomy or reoperation/completion thyroidectomy, had intrathoracic goiters, confirmed malignancies based on post-operative histopathology, or cases wherein the RLN had to be sacrificed due to gross involvement of the nerve caused by malignancy. Results: Group A, wherein intraoperative identification of RLN was done, had a temporary and permanent RLN injury incidence of 2.75% and 0.92% respectively. Group B, wherein intraoperative identification of RLN was not done, had a temporary and permanent RLN injury incidence of 17.19% and 12.5% respectively.  Through binary linear regression, the probability of having temporary paralysis increases almost two-fold if the nerve is not identified, and the probability of having permanent paralysis increases by almost nine-fold if the nerve is not identified. Conclusion: We recommend routine intraoperative RLN identification, which has a lower risk for temporary and permanent vocal fold paralysis when compared to non-identification of the RLN. Keywords: cranial nerve injuries/prevention and control, recurrent laryngeal nerve injuries, thyroid neoplasms/surgery, thyroidectomy/adverse effects, vocal cord paralysis/prevention control

Shazly Mohamed, Abdel-Hamid Asmaa, Fawzy Aisha et al.

En Abstract Objective The aim of this study was to assess short-term auditory memory in children with cochlear implant and to assess the possible correlation of their language ages with their memory scores to consider memory training during rehabilitation program for cochlear-implanted patients. Patients and methods Sixty-one Egyptian children were included in this study. Thirty prelingual deaf children implanted with the nucleus multichannel cochlear implant were included. Their ages at the time of implantation ranged from 4 years to 4 years 11 months. All of the children had normal intellectual abilities. All cases were selected from Wadi El Neel Hospital where they received their aural-oral rehabilitation program for 1 year. A total of 31 normal children of matched sex and age were selected as a control group. A battery of auditory short-term memory assessments for Arabic-speaking children were applied to all children. An Arabic language test was also applied. Results A significant defect in short-term auditory memory in cochlear-implanted children as compared with controls was proven. A positive correlation between short-term auditory memory and their language ages was found. Conclusion The study revealed defective short-term auditory memory in cochlear-implanted children. This defect is more evident in cochlear-implanted children with poor language skills.

Gerlane Karla Bezerra Oliveira Nascimento, Leilane Maria de Lima, Maria Clara Rodrigues de Freitas et al.

OBJETIVO: observar se existe relação entre a preferência do lado mastigatório, antropometria facial e atividade elétrica do músculo masseter em laringectomizados totais. MÉTODOS: a coleta de dados, realizada no setor de Fonoaudiologia do Hospital de Câncer de Pernambuco (HCP), contou com a participação de quinze voluntários laringectomizados totais do gênero masculino e idade média de 64 anos. Foi realizada aferição das distâncias entre os pontos antropométricos faciais ex e ch nas hemifaces dos voluntários e posteriormente executado exame eletromiográfico dos músculos masseteres, bilateralmente, nos momentos de máxima intercuspidação habitual (MIH), mastigações unilaterais direita e esquerda e durante mastigação habitual. Realizou-se filmagem durante a mastigação habitual para identificação do lado de preferência mastigatória. RESULTADOS: os indivíduos cuja preferência mastigatória foi do lado direito, apresentaram o lado esquerdo da face com maior medida (72,37mm); já os indivíduos cuja preferência mastigatória foi do lado esquerdo, apresentaram maior medida da face do lado direito (68,85mm). Quando a mastigação apresentou-se unilateral direita a atividade elétrica do masseter direito atingiu média de 123,57% enquanto o masseter esquerdo alcançou média igual a 84,85% de atividade em relação à MIH (p = 0,016). CONCLUSÃO: em laringectomizados as medidas antropométricas faciais correlacionam-se com o lado de preferência de mastigação e os valores eletromiográficos dos masseteres durante a mastigação.

Mohammed Dhafer Al Ahmari, Jadwiga Anna Wedzicha, John Robert Hurst

ObjectivesAcoustic rhinometry is a rapid, reliable and non-invasive technique for the evaluation of conditions associated with impaired nasal patency. This study aimed to examine the intersession repeatability of acoustic rhinometry measurements of unilateral and combined nasal parameters in a group of healthy volunteers.MethodsTwenty healthy volunteers were studied. In each subject, acoustic rhinometry measurements were performed on five consecutive days, with multiple recordings. Five clinically relevant parameters were measured in each session and the intersession repeatability of these measurements was expressed in terms of mean coefficient of variation, intraclass correlation coefficient and inter-item correlations.ResultsIntraclass correlation coefficients showed a high, and greater repeatability over time for all the combined (mean) values compared to the unilateral values. All intraclass correlations for combined values were ≥0.80 confirming almost perfect agreement. All intraclass correlations and inter-item correlations were associated with P<0.001. The mean coefficient of variation was low (<10%) for all but the proximal minimum cross sectional area (MCA1) measurements.ConclusionAcoustic rhinometry provides highly repeatable measurements of nasal patency, which is best for combined (mean) nasal parameters. This property makes it suitable for use in the diagnosis and follow-up of conditions associated with nasal obstruction, either structural or functional.

André Gurr, Marc David Pearson, Dazert S

É difícil encontrar ossos temporais humanos para o ensino de cirurgia otológica. Ossos temporais de ovelhas podem representar uma possível alternativa. MATERIAIS E MÉTODOS: Os ossos temporais de ovelhas foram dissecados em um programa convencional de dissecação de osso temporal no laboratório. Incluímos mastoidectomia, abordagens endaurais, mas também analisamos a aparência externa, o meato acústico externo e o hipotímpano. Algumas etapas são diferentes das preparações de ossos humanos. Os resultados morfométricos foram comparados à anatomia conhecida de humanos para verificar se o osso temporal de ovelhas seria utilizável para o ensino de cirurgia otológica. RESULTADOS: O osso temporal de ovelhas parece menor do que o humano. Encontramos uma área bolhosa se estendendo ao hipotímpano abaixo do meato acústico externo. A membrana timpânica é muito semelhante à humana. O meato acústico externo é menor e mais curto. A cadeia ossicular exibe analogias para com a humana. DISCUSSÃO: Esse estudo mostra que especificamente o ouvido médio, a membrana timpânica e o conduto auditivo externo são morfologicamente semelhantes às suas contrapartidas encontradas nos ossos temporais humanos. A ovelha parece ser um modelo viável para o ensino da anatomia do ouvido. A menor escala de algumas estruturas, especialmente dos componentes externos do osso temporal representa uma desvantagem. CONCLUSÕES: A ovelha parece representar uma alternativa viável no ensino de cirurgia otológica.<br>Human temporal bones in teaching ear surgery are rare. The lamb's temporal bone might be a possible alternative. MATERIAL AND METHODS: Temporal bones of the lamb were dissected with a typical temporal bone lab drilling program. We included a mastoidectomy, endaural approaches, but also analyzed the outer appearance, the external ear canal and the hypotympanon. Some steps differed from preparation done in humans. The morphometric results were compared to the known anatomy of human in order to verify the lambs' temporal bone for suitability in otosurgic training. RESULTS: The lambs' temporal bone appears smaller than the human one. We found a bullous extended hypotympanon located under the external ear canal. The tympanic membrane is very similar to the human one. The external ear canal is smaller and shorter. The ossicular chain shows analogies to human one. DISCUSSION: This study shows, that especially the middle ear, the tympanic membrane and the external ear canal are morphologically equal to the structures found in human temporal bones. The lamb seems feasible for teaching the anatomy of the ear. The smaller scales of some structures, especially the outer components of the temporal bone are a disadvantage. CONCLUSIONS: The lamb seems to be an alternative in teaching ear surgery.