Pub Date : 2025-02-01DOI: 10.1016/j.anl.2024.11.003
Tomoyuki Haji , Yumi Yamaguchi
<div><h3>Objective</h3><div>Haji et al. reported that characteristic click-like sounds during the swallowing reflex were recorded with a small lavalier microphone placed in the ear. They also reported that endoscopic and phototubometric observations showed that these sounds were likely related to the opening and closing of the Eustachian tube during swallowing. In the present study, we performed simultaneous videofluoroscopy and intra-aural swallowing sound recording, as well as simultaneous recording of intra-aural and cervical swallowing sounds, to further verify that intra-aural swallowing click sounds reflect the opening and closing of the Eustachian tube. Additionally, we sought to evaluate the characteristics and usefulness of these sounds for evaluating swallowing function and studying swallowing dynamics.</div></div><div><h3>Methods</h3><div>We performed simultaneous videofluoroscopy and intra-aural swallowing sound recordings in 27 patients without ear lesions whose swallowing function was evaluated as normal, and simultaneous intra-aural and cervical swallowing sound recordings in 25 healthy young adults without subjective dysphagia or ear disease. Intra-aural swallowing sounds were recorded with a lavalier microphone placed in the ear. From simultaneous videofluoroscopy and intra-aural swallowing sound recordings, the point of rise of the intra-aural swallowing click sound, the point of nasopharyngeal closure, the point where the contrast medium reached the hypopharynx, and the point of maximum elevation of the larynx were determined, and their temporal relationship was examined. The differences between the simultaneously recorded intra-aural and cervical swallowing sounds were also investigated in dry and water swallowing.</div></div><div><h3>Results</h3><div>Intra-aural swallowing click sounds occurred immediately before nasopharyngeal closure, followed by contrast medium reaching the hypopharynx and laryngeal elevation. Intra-aural swallowing click sounds were observed to precede cervical swallowing sounds in all cases of both saliva and water swallowing. Conversely, no corresponding click sounds were recorded in cervical swallowing sounds. The interval between the onset of the intra-aural swallowing click sounds and the maximum sound pressure of the cervical swallow sound was found to be significantly different between water and saliva swallowing.</div></div><div><h3>Conclusions</h3><div>The results of this study suggest that intra-aural swallowing click sounds are produced by the opening and closing of the Eustachian tube during swallowing and serve as a temporal indicator of the constant point at which the swallowing reflex begins its sequence. Therefore, recording and analyzing intra-aural swallowing click sounds could be a useful tool for studying swallowing dynamics and assessing swallowing function without the need for expensive equipment. It is important to note, however, that these click sounds may be influenced by Eustachi
{"title":"Intra-aural swallowing sound analysis with simultaneous videofluoroscopy and cervical swallowing sound recording","authors":"Tomoyuki Haji , Yumi Yamaguchi","doi":"10.1016/j.anl.2024.11.003","DOIUrl":"10.1016/j.anl.2024.11.003","url":null,"abstract":"<div><h3>Objective</h3><div>Haji et al. reported that characteristic click-like sounds during the swallowing reflex were recorded with a small lavalier microphone placed in the ear. They also reported that endoscopic and phototubometric observations showed that these sounds were likely related to the opening and closing of the Eustachian tube during swallowing. In the present study, we performed simultaneous videofluoroscopy and intra-aural swallowing sound recording, as well as simultaneous recording of intra-aural and cervical swallowing sounds, to further verify that intra-aural swallowing click sounds reflect the opening and closing of the Eustachian tube. Additionally, we sought to evaluate the characteristics and usefulness of these sounds for evaluating swallowing function and studying swallowing dynamics.</div></div><div><h3>Methods</h3><div>We performed simultaneous videofluoroscopy and intra-aural swallowing sound recordings in 27 patients without ear lesions whose swallowing function was evaluated as normal, and simultaneous intra-aural and cervical swallowing sound recordings in 25 healthy young adults without subjective dysphagia or ear disease. Intra-aural swallowing sounds were recorded with a lavalier microphone placed in the ear. From simultaneous videofluoroscopy and intra-aural swallowing sound recordings, the point of rise of the intra-aural swallowing click sound, the point of nasopharyngeal closure, the point where the contrast medium reached the hypopharynx, and the point of maximum elevation of the larynx were determined, and their temporal relationship was examined. The differences between the simultaneously recorded intra-aural and cervical swallowing sounds were also investigated in dry and water swallowing.</div></div><div><h3>Results</h3><div>Intra-aural swallowing click sounds occurred immediately before nasopharyngeal closure, followed by contrast medium reaching the hypopharynx and laryngeal elevation. Intra-aural swallowing click sounds were observed to precede cervical swallowing sounds in all cases of both saliva and water swallowing. Conversely, no corresponding click sounds were recorded in cervical swallowing sounds. The interval between the onset of the intra-aural swallowing click sounds and the maximum sound pressure of the cervical swallow sound was found to be significantly different between water and saliva swallowing.</div></div><div><h3>Conclusions</h3><div>The results of this study suggest that intra-aural swallowing click sounds are produced by the opening and closing of the Eustachian tube during swallowing and serve as a temporal indicator of the constant point at which the swallowing reflex begins its sequence. Therefore, recording and analyzing intra-aural swallowing click sounds could be a useful tool for studying swallowing dynamics and assessing swallowing function without the need for expensive equipment. It is important to note, however, that these click sounds may be influenced by Eustachi","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 1","pages":"Pages 20-26"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Deep neck infection with abscess (DNI) may cause dysphagia as a late complication. This study aimed to determine the rate of DNI related dysphagia (DNIRD) and the effectiveness of rehabilitation and surgery for DNIRD.
Methods
As a multicenter retrospective study, we conducted a nationwide survey by sending questionnaires to specialist training institutions certified by the Japan Broncho-esophagological Society (JBES). The questionnaire was sent to 227 facilities. This survey targeted patients with DNI aged 20 years or older who were hospitalized after April 1, 2011 and discharged by March 31, 2021.
Results
Of the 1058 cases of DNI included in this study, DNIRD was observed in 161 of 1058 patients (15.2 %). Of the 1058 cases of DNI, 139 cases showed descending necrotizing mediastinitis (DNM) (13.1 %), and DNIRD was observed in 64 of the DNM cases (46 %). DNIRD cases tended to be older (71 ± 13.5 vs. 64 ± 17.7 years old, p < 0.001), have a higher tracheostomy rate (91.3 % vs. 43.7 %, p < 0.0001), and have a longer hospital stay (51 ± 34.7 vs. 17 ± 15.4 days, p < 0.0001) than non-DNIRD cases. There were 125 cases in which only rehabilitation was performed, 8 cases in which surgery was performed to improve swallowing function, and 28 cases in which the natural course was observed. The improvement rates of DNIRD in the natural history group, rehabilitation group, and surgery group were 78.6 %, 91.8 %, and 100 %, respectively, and the rehabilitation group tended to improve more than the natural course group (p = 0.08).
Conclusion
This nationwide survey revealed that 15.2 % of patients with DNI resulted in DNIRD and that 46 % of descending necrotizing mediastinitis patients developed DNIRD. Rehabilitation for DNIRD is generally useful, and that additional surgical treatment can improve outcomes for DNIRD patients where rehabilitation alone is not effective.
{"title":"A nationwide survey of dysphagia as a complication of deep neck infection with abscess in Japan","authors":"Rina Kato , Ryota Iinuma , Hiroshi Hidaka , Kenichi Mori , Hirofumi Shibata , Hiroshi Okuda , Kosuke Terazawa , Natsuko Obara , Yukio Katori , Takenori Ogawa","doi":"10.1016/j.anl.2024.12.009","DOIUrl":"10.1016/j.anl.2024.12.009","url":null,"abstract":"<div><h3>Objective</h3><div>Deep neck infection with abscess (DNI) may cause dysphagia as a late complication. This study aimed to determine the rate of DNI related dysphagia (DNIRD) and the effectiveness of rehabilitation and surgery for DNIRD.</div></div><div><h3>Methods</h3><div>As a multicenter retrospective study, we conducted a nationwide survey by sending questionnaires to specialist training institutions certified by the Japan Broncho-esophagological Society (JBES). The questionnaire was sent to 227 facilities. This survey targeted patients with DNI aged 20 years or older who were hospitalized after April 1, 2011 and discharged by March 31, 2021.</div></div><div><h3>Results</h3><div>Of the 1058 cases of DNI included in this study, DNIRD was observed in 161 of 1058 patients (15.2 %). Of the 1058 cases of DNI, 139 cases showed descending necrotizing mediastinitis (DNM) (13.1 %), and DNIRD was observed in 64 of the DNM cases (46 %). DNIRD cases tended to be older (71 ± 13.5 vs. 64 ± 17.7 years old, <em>p</em> < 0.001), have a higher tracheostomy rate (91.3 % vs. 43.7 %, <em>p</em> < 0.0001), and have a longer hospital stay (51 ± 34.7 vs. 17 ± 15.4 days, <em>p</em> < 0.0001) than non-DNIRD cases. There were 125 cases in which only rehabilitation was performed, 8 cases in which surgery was performed to improve swallowing function, and 28 cases in which the natural course was observed. The improvement rates of DNIRD in the natural history group, rehabilitation group, and surgery group were 78.6 %, 91.8 %, and 100 %, respectively, and the rehabilitation group tended to improve more than the natural course group (<em>p</em> = 0.08).</div></div><div><h3>Conclusion</h3><div>This nationwide survey revealed that 15.2 % of patients with DNI resulted in DNIRD and that 46 % of descending necrotizing mediastinitis patients developed DNIRD. Rehabilitation for DNIRD is generally useful, and that additional surgical treatment can improve outcomes for DNIRD patients where rehabilitation alone is not effective.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 1","pages":"Pages 84-89"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The high sensitivity and broad frequency selectivity of mammalian hearing are associated with the somatic motility of outer hair cells (OHCs) in the cochlea. This motility is considered to be induced by conformational changes of the motor protein prestin expressing in the lateral plasma membrane of OHCs. Since its identification in 2000, prestin has been actively investigated and its structure and function have gradually been elucidated. These successes are partly due to the development of efficient expression and purification system of the membrane proteins including prestin. To obtain further understandings of prestin, the development of various types of such systems will be essential. However, recent study protocols on membrane proteins have often employed HEK293 cells and have become complexed with expression genes carrying several proteins and peptides for stabilization and purification of the expressed proteins. In the present study, a simple expression and purification system using Chinese hamster ovary (CHO) cells and Hi-tag was developed.
Methods
Full length gerbil prestin was transfected into modified mammalian expression vectors with C-terminal 6 × His-tag. After drug selection with G418 for 4 weeks, single colonies were isolated by limiting dilution method. Cell lines highly expressing prestin were selected (named 3D5, 4D7 and 3C8). These cells were gently disrupted using a Dounce tissue grinder. Membrane fractions were extracted by ultracentrifugation and affinity chromatography was performed. The efficiency of the purification process was evaluated by quantitative Western blotting using a standard protein.
Results
Among the cell lines constructed, Western blotting analysis showed bands at around 100 kDa and the highest intensity was confirmed from the 3C8 cell line, indicating that this cell line has the highest expression of prestin molecules. The membrane fraction was therefore extracted from this cell line and subjected to the following purification procedure. It was found that 78.7 μg of prestin was purified from 2.0 × 109 CHO cells.
Conclusion
In the present study, 78.7 μg of prestin was purified from 2.0 × 109 CHO cells, which stably expressing 6 × His-tagged prestin, by extracting cell membrane fractions and standard affinity chromatography for His-tag.
{"title":"Affinity purification of the outer hair cell motor protein prestin using His-tag","authors":"Manabu Inaba , Hisashi Sugimoto , Tomokazu Yoshizaki , Michio Murakoshi","doi":"10.1016/j.anl.2024.11.002","DOIUrl":"10.1016/j.anl.2024.11.002","url":null,"abstract":"<div><h3>Objective</h3><div>The high sensitivity and broad frequency selectivity of mammalian hearing are associated with the somatic motility of outer hair cells (OHCs) in the cochlea. This motility is considered to be induced by conformational changes of the motor protein prestin expressing in the lateral plasma membrane of OHCs. Since its identification in 2000, prestin has been actively investigated and its structure and function have gradually been elucidated. These successes are partly due to the development of efficient expression and purification system of the membrane proteins including prestin. To obtain further understandings of prestin, the development of various types of such systems will be essential. However, recent study protocols on membrane proteins have often employed HEK293 cells and have become complexed with expression genes carrying several proteins and peptides for stabilization and purification of the expressed proteins. In the present study, a simple expression and purification system using Chinese hamster ovary (CHO) cells and Hi-tag was developed.</div></div><div><h3>Methods</h3><div>Full length gerbil prestin was transfected into modified mammalian expression vectors with C-terminal 6 × His-tag. After drug selection with G418 for 4 weeks, single colonies were isolated by limiting dilution method. Cell lines highly expressing prestin were selected (named 3D5, 4D7 and 3C8). These cells were gently disrupted using a Dounce tissue grinder. Membrane fractions were extracted by ultracentrifugation and affinity chromatography was performed. The efficiency of the purification process was evaluated by quantitative Western blotting using a standard protein.</div></div><div><h3>Results</h3><div>Among the cell lines constructed, Western blotting analysis showed bands at around 100 kDa and the highest intensity was confirmed from the 3C8 cell line, indicating that this cell line has the highest expression of prestin molecules. The membrane fraction was therefore extracted from this cell line and subjected to the following purification procedure. It was found that 78.7 μg of prestin was purified from 2.0 × 10<sup>9</sup> CHO cells.</div></div><div><h3>Conclusion</h3><div>In the present study, 78.7 μg of prestin was purified from 2.0 × 10<sup>9</sup> CHO cells, which stably expressing 6 × His-tagged prestin, by extracting cell membrane fractions and standard affinity chromatography for His-tag.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 1","pages":"Pages 12-19"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143093762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate the incidence of facial canal dehiscence and its association with the recovery rate of facial palsy in patients with severe Bell's palsy who underwent transmastoid facial nerve decompression surgery.
Methods
This retrospective study included 142 patients with severe Bell's palsy who underwent transmastoid decompression surgery. The presence of a facial canal dehiscence, the site of the dehiscence, the protrusion of the nerve from the dehiscence, and the recovery rate of facial palsy were investigated.
Results
A bone dehiscence of the facial canal was observed in 50 patients (35.2 %) during surgery, with most (92.5 %) being located in the tympanic segment. Protrusion of the facial nerve from the dehiscence was observed in 25 patients (17.6 %). The recovery rate of facial palsy was significantly better in patients without dehiscence of the facial canal (57.6 %) compared to those with bone dehiscence but lacking protrusion of the nerve (32.0 %; p = 0.044) or those having a bone dehiscence with protrusion of the nerve (28.0 %; p = 0.011).
Conclusion
Patients exhibiting dehiscence of the facial canal during transmastoid decompression surgery for severe Bell's palsy demonstrate a diminished recovery rate in comparison to those without dehiscence of the canal.
{"title":"Bone dehiscence of the facial canal during transmastoid decompression surgery is a poor prognostic factor in severe Bell's palsy","authors":"Toshiya Minakata , Shinichi Esaki , Kayoko Kabaya , Sachiyo Katsumi , Akira Inagaki , Shingo Murakami , Shinichi Iwasaki","doi":"10.1016/j.anl.2025.01.009","DOIUrl":"10.1016/j.anl.2025.01.009","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the incidence of facial canal dehiscence and its association with the recovery rate of facial palsy in patients with severe Bell's palsy who underwent transmastoid facial nerve decompression surgery.</div></div><div><h3>Methods</h3><div>This retrospective study included 142 patients with severe Bell's palsy who underwent transmastoid decompression surgery. The presence of a facial canal dehiscence, the site of the dehiscence, the protrusion of the nerve from the dehiscence, and the recovery rate of facial palsy were investigated.</div></div><div><h3>Results</h3><div>A bone dehiscence of the facial canal was observed in 50 patients (35.2 %) during surgery, with most (92.5 %) being located in the tympanic segment. Protrusion of the facial nerve from the dehiscence was observed in 25 patients (17.6 %). The recovery rate of facial palsy was significantly better in patients without dehiscence of the facial canal (57.6 %) compared to those with bone dehiscence but lacking protrusion of the nerve (32.0 %; <em>p</em> = 0.044) or those having a bone dehiscence with protrusion of the nerve (28.0 %; <em>p</em> = 0.011).</div></div><div><h3>Conclusion</h3><div>Patients exhibiting dehiscence of the facial canal during transmastoid decompression surgery for severe Bell's palsy demonstrate a diminished recovery rate in comparison to those without dehiscence of the canal.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 2","pages":"Pages 132-136"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.anl.2024.12.002
Mingjie Zhang , Hui Li , Yuefeng Han , Mengjun Wang , Junjie Zhang , Shiyin Ma
{"title":"Retraction notice to “Clinicopathological significance of SOX4 and epithelial-mesenchymal transition markers in patients with laryngeal squamous cell carcinoma” [Auris Nasus Larynx 48 (2021) 1167–1175]","authors":"Mingjie Zhang , Hui Li , Yuefeng Han , Mengjun Wang , Junjie Zhang , Shiyin Ma","doi":"10.1016/j.anl.2024.12.002","DOIUrl":"10.1016/j.anl.2024.12.002","url":null,"abstract":"","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 1","pages":"Page 27"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The interpretation of ABR results in patients with vestibular schwannoma is often unclear. We investigated the correlation between serviceable hearing in patients with vestibular schwannoma (VS) and factors including auditory brainstem response (ABR) at their initial presentation.
Methods
We retrospectively analyzed initial magnetic resonance imaging findings, Gardner–Robertson (G&R) classification, ABR, and related data from 72 patients with VS who visited our institution between February 2017 and January 2023. Factors affecting hearing thresholds and nonserviceable hearing were examined.
Results
Univariate analysis revealed a significant association between nonserviceable hearing and Koos stage 4, ABR Ⅴ-wave negative, and tumor diameter ≥21.5 mm. In a multivariate analysis, ABR Ⅴ-wave negative was independently associated with nonserviceable hearing.
Conclusion
In the present single-center, retrospective sample population, inadequate Ⅴ-waves in the ABR were independently associated with nonserviceable hearing. The findings are useful in explaining serviceable hearing to patients with VS.
{"title":"Relationship between nonserviceable hearing and auditory brainstem response in patients with vestibular schwannoma","authors":"Kohei Fukuda , Shin Matsumoto , Yuka Hattori , Kazuki Takahashi , Kotaro Osawa , Yuki Hirose , Masahide Matsuda , Keiji Tabuchi","doi":"10.1016/j.anl.2024.12.011","DOIUrl":"10.1016/j.anl.2024.12.011","url":null,"abstract":"<div><h3>Objective</h3><div>The interpretation of ABR results in patients with vestibular schwannoma is often unclear. We investigated the correlation between serviceable hearing in patients with vestibular schwannoma (VS) and factors including auditory brainstem response (ABR) at their initial presentation.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed initial magnetic resonance imaging findings, Gardner–Robertson (G&R) classification, ABR, and related data from 72 patients with VS who visited our institution between February 2017 and January 2023. Factors affecting hearing thresholds and nonserviceable hearing were examined.</div></div><div><h3>Results</h3><div>Univariate analysis revealed a significant association between nonserviceable hearing and Koos stage 4, ABR Ⅴ-wave negative, and tumor diameter ≥21.5 mm. In a multivariate analysis, ABR Ⅴ-wave negative was independently associated with nonserviceable hearing.</div></div><div><h3>Conclusion</h3><div>In the present single-center, retrospective sample population, inadequate Ⅴ-waves in the ABR were independently associated with nonserviceable hearing. The findings are useful in explaining serviceable hearing to patients with VS.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 1","pages":"Pages 39-42"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.anl.2024.09.003
Ken Ito
Pure tone audiometry including “masking” is the most basic test in audiological medicine. Masking is based on theoretical models of sound perception and propagation and has been widely discussed since the 1950s. In Japan, such discussion has been conducted extensively, starting from early periods up to recent times, with success to enable mathematical simulation, but the achievements have little been disclosed to the English-speaking world. Here, Japanese experiences are introduced with explicit theoretical derivation from “Grand Principles (GPs)” appropriate for learning the basics of masking. Two models, Standard Masking Model and Extended Masking Model, are explained in detail with variables classified into three categories to avoid common misunderstandings. In particular, a smart heuristic method called “ABC” method, which makes excellent use of “sufficient masking” and “overmasking (cross-masking)”, is presented with computerized evaluation for its accuracy. The author hopes that this article will serve as a common basis for discussion among researchers and as a theoretical introduction for those motivated to learn masking.
{"title":"Models for pure tone audiometry enabling computational evaluation: Introduction to Japanese extensive experiences","authors":"Ken Ito","doi":"10.1016/j.anl.2024.09.003","DOIUrl":"10.1016/j.anl.2024.09.003","url":null,"abstract":"<div><div>Pure tone audiometry including “masking” is the most basic test in audiological medicine. Masking is based on theoretical models of sound perception and propagation and has been widely discussed since the 1950s. In Japan, such discussion has been conducted extensively, starting from early periods up to recent times, with success to enable mathematical simulation, but the achievements have little been disclosed to the English-speaking world. Here, Japanese experiences are introduced with explicit theoretical derivation from “Grand Principles (GPs)” appropriate for learning the basics of masking. Two models, Standard Masking Model and Extended Masking Model, are explained in detail with variables classified into three categories to avoid common misunderstandings. In particular, a smart heuristic method called “ABC” method, which makes excellent use of “sufficient masking” and “overmasking (cross-masking)”, is presented with computerized evaluation for its accuracy. The author hopes that this article will serve as a common basis for discussion among researchers and as a theoretical introduction for those motivated to learn masking.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 1","pages":"Pages 90-100"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
An optimal surgical approach for intermediate-risk papillary thyroid cancer (PTC) has not yet been established. The surgical procedure should be determined based on treatment outcomes and postoperative complications. This study aimed to evaluate appropriate surgical strategies for patients with intermediate-risk PTC by comparing treatment outcomes and postoperative complications following total thyroidectomy and lobectomy.
Methods
This retrospective analysis was conducted on 123 patients with intermediate-risk PTC treated in our department between January 2008 and December 2022. The risk of PTC was classified according to the 2024 Guidelines for the Clinical Treatment of Thyroid Nodules from the Japan Association of Endocrine Surgery.
Results
Of the 123 patients, 27 underwent total thyroidectomy, and 96 underwent lobectomy. No significant differences were observed between the two surgical groups in terms of survival or recurrence rates. None of the patients showed bilateral recurrent laryngeal nerve (RLN) palsy postoperatively. Postoperative unilateral RLN palsy occurrence differed significantly between the total thyroidectomy and lobectomy groups, with five cases in each (5.2 and 18.5 %, respectively; p = 0.04). Permanent hypoparathyroidism was observed in two patients (7.4 %) in the total thyroidectomy group. Postoperative hypothyroidism developed in 42 (43.8 %) lobectomy cases, with 32 requiring the administration of levothyroxine therapy. A significant association was observed between preoperative thyroid-stimulating hormone (TSH) levels (≥2.0 μIU/mL) and postoperative hypothyroidism (p < 0.001).
Conclusion
No significant difference in treatment outcomes was observed between patients with intermediate-risk PTC who underwent total thyroidectomy and those who underwent lobectomy. In cases with preoperative TSH levels ≥2.0 μIU/mL, total thyroidectomy may be a more suitable approach, given the increased likelihood of requiring postoperative levothyroxine administration following lobectomy.
{"title":"Treatment strategy for intermediate-risk papillary thyroid cancer: Focus on postoperative hypothyroidism following lobectomy","authors":"Akifumi Kariya , Tomoyasu Tachibana , Asuka Sato , Chieko Furukawa , Yuto Naoi , Yorihisa Orita , Mizuo Ando","doi":"10.1016/j.anl.2024.12.005","DOIUrl":"10.1016/j.anl.2024.12.005","url":null,"abstract":"<div><h3>Objective</h3><div>An optimal surgical approach for intermediate-risk papillary thyroid cancer (PTC) has not yet been established. The surgical procedure should be determined based on treatment outcomes and postoperative complications. This study aimed to evaluate appropriate surgical strategies for patients with intermediate-risk PTC by comparing treatment outcomes and postoperative complications following total thyroidectomy and lobectomy.</div></div><div><h3>Methods</h3><div>This retrospective analysis was conducted on 123 patients with intermediate-risk PTC treated in our department between January 2008 and December 2022. The risk of PTC was classified according to the 2024 Guidelines for the Clinical Treatment of Thyroid Nodules from the Japan Association of Endocrine Surgery.</div></div><div><h3>Results</h3><div>Of the 123 patients, 27 underwent total thyroidectomy, and 96 underwent lobectomy. No significant differences were observed between the two surgical groups in terms of survival or recurrence rates. None of the patients showed bilateral recurrent laryngeal nerve (RLN) palsy postoperatively. Postoperative unilateral RLN palsy occurrence differed significantly between the total thyroidectomy and lobectomy groups<strong>,</strong> with five cases in each (5.2 and 18.5 %, respectively; <em>p =</em> 0.04). Permanent hypoparathyroidism was observed in two patients (7.4 %) in the total thyroidectomy group. Postoperative hypothyroidism developed in 42 (43.8 %) lobectomy cases, with 32 requiring the administration of levothyroxine therapy. A significant association was observed between preoperative thyroid-stimulating hormone (TSH) levels (≥2.0 μIU/mL) and postoperative hypothyroidism (<em>p <</em> 0.001).</div></div><div><h3>Conclusion</h3><div>No significant difference in treatment outcomes was observed between patients with intermediate-risk PTC who underwent total thyroidectomy and those who underwent lobectomy. In cases with preoperative TSH levels ≥2.0 μIU/mL, total thyroidectomy may be a more suitable approach, given the increased likelihood of requiring postoperative levothyroxine administration following lobectomy.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 1","pages":"Pages 66-70"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.anl.2025.01.001
Taizo Takeda , Setsuko Takeda , Akinobu Kakigi
Endolymphatic hydrops, which is one of the pathologic features of Ménière's disease, has been experimentally and clinically confirmed to be influenced by the blood circulation of vasopressin (VP). It is widely acknowledged that VP plays a pivotal role in regulating water homeostasis. It should also be noted that VP is susceptible to a number of external factors, including changes in the environment, dehydration, and fluctuations in atmospheric pressure. Furthermore, VP is a key regulator of the hypothalamic-pituitary-adrenal (HPA) axis. The HPA axis is a significant neuroendocrine system that plays a role in regulating responses to emotional and physical stress, as well as the sleep/wake cycle (circadian rhythm). It seems that VP is changeable via the HPA axis. It may be beneficial to consider pharmacological normalization of VP as a potential approach to controlling Ménière's disease. Nevertheless, measuring 8-Arg-vasopressin (AVP), the most prevalent variant of VP, poses certain challenges for a number of reasons. Copeptin is co-released with AVP, is relatively stable in the posterior pituitary as well as in blood plasma, and is increasingly being used as an AVP surrogate in clinical diagnostics. It is thought that the use of copeptin as a marker for AVP may help to clarify the clinical features of Ménière's disease.
In this review, we will consider trials to control the formation of endolymphatic hydrops from the viewpoint of the vasopressin-aquaporin 2 system. Furthermore, we will explore reports on clinical treatment, pharmacological agents, and future prospects.
{"title":"Trial to control the formation of endolymphatic hydrops from the viewpoint of the water homeostasis of the inner ear","authors":"Taizo Takeda , Setsuko Takeda , Akinobu Kakigi","doi":"10.1016/j.anl.2025.01.001","DOIUrl":"10.1016/j.anl.2025.01.001","url":null,"abstract":"<div><div>Endolymphatic hydrops, which is one of the pathologic features of Ménière's disease, has been experimentally and clinically confirmed to be influenced by the blood circulation of vasopressin (VP). It is widely acknowledged that VP plays a pivotal role in regulating water homeostasis. It should also be noted that VP is susceptible to a number of external factors, including changes in the environment, dehydration, and fluctuations in atmospheric pressure. Furthermore, VP is a key regulator of the hypothalamic-pituitary-adrenal (HPA) axis. The HPA axis is a significant neuroendocrine system that plays a role in regulating responses to emotional and physical stress, as well as the sleep/wake cycle (circadian rhythm). It seems that VP is changeable via the HPA axis. It may be beneficial to consider pharmacological normalization of VP as a potential approach to controlling Ménière's disease. Nevertheless, measuring 8-Arg-vasopressin (AVP), the most prevalent variant of VP, poses certain challenges for a number of reasons. Copeptin is co-released with AVP, is relatively stable in the posterior pituitary as well as in blood plasma, and is increasingly being used as an AVP surrogate in clinical diagnostics. It is thought that the use of copeptin as a marker for AVP may help to clarify the clinical features of Ménière's disease.</div><div>In this review, we will consider trials to control the formation of endolymphatic hydrops from the viewpoint of the vasopressin-aquaporin 2 system. Furthermore, we will explore reports on clinical treatment, pharmacological agents, and future prospects.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 2","pages":"Pages 137-140"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.anl.2024.12.004
Ji-Sun Kim , Gulnaz Stybayeva , Se Hwan Hwang
Objective
To evaluate the impact of additional vidian neurectomy or posterior nasal neurectomy in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and allergic rhinitis (AR), compared to the outcomes of conventional endoscopic sinus surgery alone.
Methods
Up to May 2024, six databases were systematically searched. We evaluated studies that compared the clinical improvement of chronic sinusitis-related symptoms and endoscopic findings between the neurectomy group (endoscopic sinus surgery plus vidian neurectomy or posterior nasal neurectomy) and the control group (endoscopic sinus surgery only).
Results
The neurectomy group showed a significant reduction in the Lund-Kennedy endoscopic score (SMD = -1.3163 [-1.6519; -0.9807]; I² = 53.3 %). However, this treatment did not have a significant effect on the Quality-of-life score (SMD = -0.1222 [-0.3427; 0.0983]; I² = 27.5 %) or patient-reported nasal symptom-related VAS scores (SMD = -1.6690 [-3.7062; 0.3682]; I² = 96.3 %). In the subgroup analyses of these results according to time points of measurement, the Lund-Kennedy endoscopic score was statistically lower in the treatment group during treatment periods (postop 6months, 12months, and 24months). However, there were no statistically significant differences in Quality-of-life score and VAS between the treatment and control groups during all treatment periods. There was no significant difference in the recurrent rate of CRS during the following up periods (odds ratio=0.5263 [0.1518; 1.8254], I2 = NA) between two groups. Regarding the adverse effect of neurectomy, this additional procedure did not induce the postoperative bleeding (odds ratio=0.8886 [0.3411; 2.3150]; I2 = 0.0 %) and dry eye related discomfort (odds ratio=65.3560 [0.1044; 40,908.1619]; I2 = 88.9 %) significantly compared to control group.
Conclusions
Additional neurectomy shows better efficacy in improving endoscopic findings and is safer in patients with CRSwNP combined with AR; however, more clinical studies are needed to evaluate its long-term symptomatic effects and disease recurrence.
{"title":"Efficacy of vidian neurectomy in treating chronic rhinosinusitis with nasal polyps combined with allergic rhinitis: A systematic review and meta-analysis","authors":"Ji-Sun Kim , Gulnaz Stybayeva , Se Hwan Hwang","doi":"10.1016/j.anl.2024.12.004","DOIUrl":"10.1016/j.anl.2024.12.004","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of additional vidian neurectomy or posterior nasal neurectomy in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and allergic rhinitis (AR), compared to the outcomes of conventional endoscopic sinus surgery alone.</div></div><div><h3>Methods</h3><div>Up to May 2024, six databases were systematically searched. We evaluated studies that compared the clinical improvement of chronic sinusitis-related symptoms and endoscopic findings between the neurectomy group (endoscopic sinus surgery plus vidian neurectomy or posterior nasal neurectomy) and the control group (endoscopic sinus surgery only).</div></div><div><h3>Results</h3><div>The neurectomy group showed a significant reduction in the Lund-Kennedy endoscopic score (SMD = -1.3163 [-1.6519; -0.9807]; I² = 53.3 %). However, this treatment did not have a significant effect on the Quality-of-life score (SMD = -0.1222 [-0.3427; 0.0983]; I² = 27.5 %) or patient-reported nasal symptom-related VAS scores (SMD = -1.6690 [-3.7062; 0.3682]; I² = 96.3 %). In the subgroup analyses of these results according to time points of measurement, the Lund-Kennedy endoscopic score was statistically lower in the treatment group during treatment periods (postop 6months, 12months, and 24months). However, there were no statistically significant differences in Quality-of-life score and VAS between the treatment and control groups during all treatment periods. There was no significant difference in the recurrent rate of CRS during the following up periods (odds ratio=0.5263 [0.1518; 1.8254], I<sup>2</sup> = NA) between two groups. Regarding the adverse effect of neurectomy, this additional procedure did not induce the postoperative bleeding (odds ratio=0.8886 [0.3411; 2.3150]; I<sup>2</sup> = 0.0 %) and dry eye related discomfort (odds ratio=65.3560 [0.1044; 40,908.1619]; I<sup>2</sup> = 88.9 %) significantly compared to control group.</div></div><div><h3>Conclusions</h3><div>Additional neurectomy shows better efficacy in improving endoscopic findings and is safer in patients with CRSwNP combined with AR; however, more clinical studies are needed to evaluate its long-term symptomatic effects and disease recurrence.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 1","pages":"Pages 28-34"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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