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Journal of Clinical Medicine May 2024The development of temporal bone pneumatization is related to the postnatal middle ear environment, where the development of air cells is suppressed with otitis media...
The development of temporal bone pneumatization is related to the postnatal middle ear environment, where the development of air cells is suppressed with otitis media in early childhood. However, whether air cell formation restarts when mastoidectomy is performed during temporal bone pneumatization remains unclear. Herein, we evaluated temporal bone pneumatization after canal wall up (CWU) tympanomastoidectomy for middle ear cholesteatoma in children. In total, 63 patients, including 29 patients with congenital cholesteatoma (CC) and 34 patients with acquired cholesteatoma (AC), were assessed using a set of pre- and postoperative computed tomography images. The air cells of the temporal bone were divided into five areas: periantral (anterior), periantral (posterior), periantral (medial), peritubal, and petrous apex. The number of areas with air cells before and after surgery was compared to evaluate temporal bone pneumatization after surgery. A total of 63 patients, comprising 29 with CC and 34 with AC (pars flaccida; 23, pars tensa; 7, unclassified; 4), were evaluated. The median age of patients (18 males and 11 females) with CC was 5.0 (range, 2-15 years), while that of the AC group (23 males and 11 females) was 8 (range, 2-15 years). A significant difference in air cell presence was identified in the CC and AC groups after surgery (Mann-Whitney U, < 0.001 and = 0.003, respectively). Between the two groups, considerably better postoperative pneumatization was observed in the CC group. A correlation between age at surgery and gain of postoperative air cell area development was identified in the CC group (Spearman's rank-order correlation coefficient, r = -0.584, < 0.001). In comparison with the postoperative pneumatization rate of each classified area, the petrous apex area was the lowest in the CC and AC groups. Newly developed air cells were identified in the temporal bones after CWU mastoidectomy for pediatric cholesteatoma. These findings may justify CWU tympanomastoidectomy, at least for younger children and CC patients, who may subsequently develop air cell systems after surgery.
PubMed: 38792475
DOI: 10.3390/jcm13102934 -
Complementary Therapies in Medicine Aug 2024Given the high prevalence of depression in elderly people, appropriate interventions are essential. This study aimed to assess the effects of auriculotherapy on... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Given the high prevalence of depression in elderly people, appropriate interventions are essential. This study aimed to assess the effects of auriculotherapy on depression among elderly people.
METHODS
This randomized controlled clinical trial was conducted in 2021. Fifty-two elderly were conveniently selected and randomly allocated to the sham (n = 26) and intervention (n = 26) groups through block randomization. The intervention group was subjected to four weeks of auriculotherapy at the Shen-Men, zero, heart, antidepressant, and master cerebral points using Vaccaria seeds fixed with adhesive tape. In the sham group, adhesive tapes were attached to the points with neither seeds nor compression. The elderly and data collector were blinded. The 15-item Geriatric Depression Scale was used to assess depression before, immediately after, and four weeks after the intervention (T1-T3). The statistical methods used were repeated measures analysis of variance and covariance.
RESULTS
Groups significantly differed concerning participants' gender, education, and employment (p < 0.05). After adjusting for confounding effects, the time-group interaction significantly affected the mean depression score (p < 0.0001, effect size = 0.54). There was no significant difference between the depression score in the sham and intervention groups at T1 (9.6 ± 2.5 vs 9.5 ± 2.5, p = 0.263); however, this difference was found to be significant at T2 (8.6 ± 2 vs 4.2 ± 1.2, p < 0.0001, effect size = 0.68) and T3 (9.3 ± 2.3 vs 4.3 ± 1.3, p < 0.0001, effect size = 0.65). Within-group analysis revealed significant differences in the depression scores of the intervention group at T1 compared with those at T2 and T3 (p < 0.05). In contrast, the mean depression score in the sham group at T2 was significantly lower than that at T1 (p = 0.003) and greater than that at T3 (p = 0.049).
CONCLUSIONS
Auriculotherapy alleviates depression and can be used as a complementary therapy for elderly people with depression.
Topics: Humans; Male; Aged; Female; Depression; Auriculotherapy; Vaccaria; Middle Aged; Aged, 80 and over
PubMed: 38789059
DOI: 10.1016/j.ctim.2024.103054 -
Investigative Ophthalmology & Visual... May 2024Post-saccadic oscillations (PSOs) reflect movements of gaze that result from motion of the pupil and lens relative to the eyeball rather than eyeball rotations. Here, we...
PURPOSE
Post-saccadic oscillations (PSOs) reflect movements of gaze that result from motion of the pupil and lens relative to the eyeball rather than eyeball rotations. Here, we analyzed the characteristics of PSOs in subjects with age-related macular degeneration (AMD), retinitis pigmentosa (RP), and normal vision (NV). Our aim was to assess the differences in PSOs between people with vision loss and healthy controls because PSOs affect retinal image stability after each saccade.
METHODS
Participants completed a horizontal saccade task and their gaze was measured using a pupil-based eye tracker. Oscillations occurring in the 80 to 200 ms post-saccadic period were described with a damped oscillation model. We compared the amplitude, decay time constant, and frequency of the PSOs for the three different groups. We also examined the correlation between these PSO parameters and the amplitude, peak velocity, and final deceleration of the preceding saccades.
RESULTS
Subjects with vision loss (AMD, n = 6, and RP, n = 5) had larger oscillation amplitudes, longer decay constants, and lower frequencies than subjects with NV (n = 7). The oscillation amplitudes increased with increases in saccade deceleration in all three groups. The other PSO parameters, however, did not show consistent correlations with either saccade amplitude or peak velocity.
CONCLUSIONS
Post-saccadic fixation stability in AMD and RP is reduced due to abnormal PSOs. The differences with respect to NV are not due to differences in saccade kinematics, suggesting that anatomic and neuronal variations affect the suspension of the iris and the lens in the patients' eyes.
Topics: Humans; Saccades; Retinitis Pigmentosa; Female; Male; Fixation, Ocular; Middle Aged; Macular Degeneration; Aged; Pupil; Lens, Crystalline; Adult; Visual Acuity
PubMed: 38787546
DOI: 10.1167/iovs.65.5.39 -
The Journal of the International... May 2024The objective of this paper is to document the feasibility of image acquisition, image optimization, and sonographic appearance of the exposed anatomic windows of...
OBJECTIVE
The objective of this paper is to document the feasibility of image acquisition, image optimization, and sonographic appearance of the exposed anatomic windows of cadaveric inner ear dissection for purposes of potential future clinical evaluation as part of the developing area of physical and rehabilitation space medicine.
METHODS
Cadaveric dissection of the inner ear was conducted with the goal of exposing areas relevant to vestibular balance. Middle and inner ear structures of 3 human cadavers were imaged with multiple broadband transducers, including emphasis with higher frequency transducers.
RESULTS
The images were best optimized with 17 MHz and 22 MHz small footprint transducers. High-frequency ultrasound (US) images of the semicircular canals, vestibular and facial nerves, and utricles with reflected otoliths (otoconia) were obtained and reported in this article. Detailed visualization of both the vestibular nerve and facial nerve was accomplished, including identification of fascicular architecture. In addition, US reflection from the otoliths contained within the utricle was identified with sufficient clarity to provide surface measurements. Bony acoustic landmarks of the middle ear bones were identified by scanning externally from the tympanic membrane, including the dynamic movement of the bones with manual manipulation.
CONCLUSION
US visualization has the potential to be an effective imaging modality to monitor potential changes to the otolith's size throughout extended space flight. To our knowledge, no prior study has reported US images of human inner ear structures.
PubMed: 38784084
DOI: 10.1097/ph9.0000000000000026 -
Scientific Reports May 2024Clinical application of cardiac magnetic resonance (CMR) is expanding but CMR assessment of LV diastolic function is still being validated. The purpose of this study was... (Clinical Trial)
Clinical Trial
Clinical application of cardiac magnetic resonance (CMR) is expanding but CMR assessment of LV diastolic function is still being validated. The purpose of this study was to validate assessments of left ventricular (LV) diastolic dysfunction (DD) using CMR by comparing with transthoracic echocardiography (TTE) performed on the same day. Patients with suspected or diagnosed cardiomyopathy (n = 63) and healthy volunteers (n = 24) were prospectively recruited and included in the study. CMR diastolic parameters were measured on cine images and velocity-encoded phase contrast cine images and compared with corresponding parameters measured on TTE. A contextual correlation feature tracking method was developed to calculate the mitral annular velocity curve. LV DD was classified by CMR and TTE following 2016 guidelines. Overall DD classification was 78.1% concordant between CMR and TTE (p < 0.0001). The trans-mitral inflow parameters correlated well between the two modalities (E, r = 0.78; A, r = 0.90; E/A, r = 0.82; all p < 0.0001) while the remaining diastolic parameters showed moderate correlation (e', r = 0.64; E/e', r = 0.54; left atrial volume index (LAVi), r = 0.61; all p < 0.0001). Classification of LV diastolic function by CMR showed good concordance with standardized grades established for TTE. CMR-based LV diastolic function may be integrated in routine clinical practice.Name of the registry: Technical Development of Cardiovascular Magnetic Resonance Imaging. Trial registration number: NCT00027170. Date of registration: November 26, 2001. URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT00027170.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Cardiomyopathies; Diastole; Echocardiography; Magnetic Resonance Imaging, Cine; Prospective Studies; Ventricular Dysfunction, Left; Ventricular Function, Left
PubMed: 38778036
DOI: 10.1038/s41598-024-61992-6 -
BMJ Open Ophthalmology May 2024This study aims to describe the outcome of corneal grafts, both low risk and high risk, after successfully reversed immunological rejection.
OBJECTIVE
This study aims to describe the outcome of corneal grafts, both low risk and high risk, after successfully reversed immunological rejection.
METHODS
Datasets on reversed rejection episodes in penetrating and endothelial keratoplasties between 2014 and 2019 (n=876) were extracted from the Adverse Immune Signatures and their Prevention in Corneal Transplantation database, which contains the prospectively and consecutively collected corneal transplants from five European centres. Stratified by the preoperatively determined risk status for immunological rejection, the outcome parameters analysed included visual acuity, intraocular pressure, endothelial cell density and central corneal thickness before and after reversed rejection episodes.
RESULTS
Fourty-seven (52%) out of a total of 91 identified rejection episodes were successfully reversed and were available for analysis (23 penetrating and 24 endothelial keratoplasties). No statistically significant change was found for any of the parameters studied between the values before and the values 3 months after the rejection episode, irrespective of the preoperative risk status.
CONCLUSION
The outcome of corneal grafts that survive immunological rejection may be clinically indistinguishable from the state before immunological rejection, irrespective of graft type and risk status. These findings support clinicians by providing information on prognosis after reversed rejection episodes and by giving patients realistic expectations regarding the outcome.
Topics: Humans; Graft Rejection; Male; Female; Middle Aged; Visual Acuity; Aged; Graft Survival; Europe; Keratoplasty, Penetrating; Prospective Studies; Adult; Intraocular Pressure; Endothelium, Corneal; Descemet Stripping Endothelial Keratoplasty; Treatment Outcome; Corneal Diseases; Immunosuppressive Agents; Risk Factors
PubMed: 38772878
DOI: 10.1136/bmjophth-2023-001554 -
Ear, Nose, & Throat Journal May 2024A neoplasm was found in the left nasal cavity of a 45-year-old woman during electronic laryngoscopy for reflux pharyngitis. She reported experiencing an occasional...
A neoplasm was found in the left nasal cavity of a 45-year-old woman during electronic laryngoscopy for reflux pharyngitis. She reported experiencing an occasional slight headache in the left parietal region for 1 to 2 years, which she considered a migraine. Electronic laryngoscopy showed a gray, soft, smooth neoplasm in the left nasal meatus, located near the olfactory region blocking the olfactory clef and compressing the left middle turbinate. The neoplasm was resected at endonasal endoscopic surgery. Histological assessments indicated chronic mucus inflammation and cyst formation. This is a rare case because the polyp was large but asymptomatic and originated from nasal septum.
PubMed: 38770963
DOI: 10.1177/01455613241256836 -
Ear, Nose, & Throat Journal May 2024Maxillary sinus pathology is commonly approached through endoscopic middle meatal antrostomy (MMA). However, MMA does not provide full exposure to certain aspects of...
Maxillary sinus pathology is commonly approached through endoscopic middle meatal antrostomy (MMA). However, MMA does not provide full exposure to certain aspects of the maxillary sinus, such as alveolar, zygomatic, and prelacrimal recesses. In these hidden maxillary sinus niches, a combination approach with MMA is required for better exposure and access. In this article, we present a modification of inferior maxillary antrostomy (IMA) to allow for a temporary intraoperative window with no significant postoperative consequences. (1) To describe our modification of IMA. (2) To report the outcome of maxillary sinus disease, postoperative complications, and flap condition. This is a retrospective chart review study. It was performed on 20 patients where submucosal temporary inferior maxillary antrostomy (STIMA) was indicated in the period from January 1, 2020, and July 1, 2023. All patients were assessed for their demographics, diagnosis, indication for STIMA, maxillary disease outcome, presence of postoperative complications, and flap condition. Total of 18 patients fulfilled our inclusion/exclusion criteria; of them, 13 were males while the remaining were females. Mean age of patients was 33 years; most common diagnosis was chronic sinusitis. Status of maxillary sinus mucosa was healthy in all except 4 patients having polypoidal mucosa while flap condition was intact in all patients except 2 patients with pinpoint defects. Postoperative complications assessment demonstrated no neural, orbital, lacrimal, or dental complications in all patients. This retrospective chart review showed promising technique to address challenging maxillary lesions in difficult-to-access locations where combined approaches are necessary.
PubMed: 38770939
DOI: 10.1177/01455613241255727 -
IEEE Sensors Journal Jul 2023For the last 20 years, researchers have developed accelerometers to function as ossicular vibration sensors in order to eliminate the external components of hearing aid...
For the last 20 years, researchers have developed accelerometers to function as ossicular vibration sensors in order to eliminate the external components of hearing aid and cochlear implant systems. To date, no accelerometer has met all of the stringent performance requirements necessary to function in this capacity. In this work, we present an accelerometer design with an equivalent noise floor less than 20 phon equal-loudness-level over a 0.1-8 kHz bandwidth in a package small enough to be implanted in the middle ear. Our approach uses a dual-bandwidth (two sensing elements) microelectromechanical systems piezoelectric accelerometer, sized using an area-minimization process based on an experimentally-validated analytical model of the sensor. The resulting bandwidth of the low-frequency sensing element is 0.1-1.25 kHz and that of the high-frequency sensing element is 1.25-8 kHz. These sensing elements fit within a silicon frame that is 795 μm × 778 μm, which can reasonably be housed along with a required integrated circuit in a 2.2 mm × 2.7 mm × 1 mm package. The estimated total mass of the packaged system is approximately 14 mg. This dual-bandwidth MEMS sensor fills a technological gap in current completely implantable auditory prosthesis research and development by enabling a device capable of meeting physical and performance specifications needed for use in the middle ear.
PubMed: 38766647
DOI: 10.1109/jsen.2023.3276271 -
Hearing Research Jul 2024In recent studies, psychophysiological measures have been used as markers of listening effort, but there is limited research on the effect of hearing loss on such...
In recent studies, psychophysiological measures have been used as markers of listening effort, but there is limited research on the effect of hearing loss on such measures. The aim of the current study was to investigate the effect of hearing acuity on physiological responses and subjective measures acquired during different levels of listening demand, and to investigate the relationship between these measures. A total of 125 participants (37 males and 88 females, age range 37-72 years, pure-tone average hearing thresholds at the best ear between -5.0 to 68.8 dB HL and asymmetry between ears between 0.0 and 87.5 dB) completed a listening task. A speech reception threshold (SRT) test was used with target sentences spoken by a female voice masked by male speech. Listening demand was manipulated using three levels of intelligibility: 20 % correct speech recognition, 50 %, and 80 % (IL20 %/IL50 %/IL80 %, respectively). During the task, peak pupil dilation (PPD), heart rate (HR), pre-ejection period (PEP), respiratory sinus arrhythmia (RSA), and skin conductance level (SCL) were measured. For each condition, subjective ratings of effort, performance, difficulty, and tendency to give up were also collected. Linear mixed effects models tested the effect of intelligibility level, hearing acuity, hearing asymmetry, and tinnitus complaints on the physiological reactivity (compared to baseline) and subjective measures. PPD and PEP reactivity showed a non-monotonic relationship with intelligibility level, but no such effects were found for HR, RSA, or SCL reactivity. Participants with worse hearing acuity had lower PPD at all intelligibility levels and showed lower PEP baseline levels. Additionally, PPD and SCL reactivity were lower for participants who reported suffering from tinnitus complaints. For IL80 %, but not IL50 % or IL20 %, participants with worse hearing acuity rated their listening effort to be relatively high compared to participants with better hearing. The reactivity of the different physiological measures were not or only weakly correlated with each other. Together, the results suggest that hearing acuity may be associated with altered sympathetic nervous system (re)activity. Research using psychophysiological measures as markers of listening effort to study the effect of hearing acuity on such measures are best served by the use of the PPD and PEP.
Topics: Humans; Male; Female; Middle Aged; Adult; Speech Perception; Aged; Heart Rate; Hearing; Auditory Threshold; Speech Intelligibility; Speech Reception Threshold Test; Audiometry, Pure-Tone; Acoustic Stimulation; Perceptual Masking; Galvanic Skin Response; Pupil; Persons With Hearing Impairments
PubMed: 38761554
DOI: 10.1016/j.heares.2024.109031