Katrien Vermeire, Andrea Kleine Punte, Paul Van de Heyning
{"title":"Better speech recognition in noise with the fine structure processing coding strategy.","authors":"Katrien Vermeire, Andrea Kleine Punte, Paul Van de Heyning","doi":"10.1159/000319748","DOIUrl":"https://doi.org/10.1159/000319748","url":null,"abstract":"<p><strong>Background: </strong>Recently, a new speech coding strategy named 'fine structure processing' (FSP) has been launched.</p><p><strong>Methods: </strong>32 subjects, all users of the MED-EL PULSARCI(100) system, have been switched over from a TEMPO+ to an OPUS 2 speech processor. In 22 subjects, the FSP strategy could be implemented (FSP group), in 10 patients not (high-definition continuous interleaved sampling, HDCIS, group). Subjects were tested with the Tempo+ (CIS+) just before switch-over and after 12 months of OPUS 2 (FSP/HDCIS) use. Performance with FSP/HDCIS was tested at switch-over, and after 1, 3, 6 and 12 months. A sentence-in-noise test and a Speech Spatial and Qualities of Hearing Scale (SSQ) questionnaire were assessed at each test interval.</p><p><strong>Results: </strong>In the FSP group, the speech reception threshold shows a deterioration of 3.3 dB (n.s.) at the acute switch-over interval, but a significant improvement over time (p < 0.001) with a final benefit of 6.5 dB after 12 months of FSP use. A significant improvement over time can also be seen on the spatial subscore of the SSQ questionnaire (p = 0.009). No significant differences could be seen in the HDCIS group.</p><p><strong>Conclusion: </strong>The results show that by enhancing fine structure coding in the lower frequencies, as implemented in the FSP coding strategy, speech perception in noise can be enhanced.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"305-11"},"PeriodicalIF":1.3,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000319748","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40074121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sofia Lyford-Pike, Patrick K Ha, Heather A Jacene, John R Saunders, Ralph P Tufano
{"title":"Limitations of PET/CT in determining need for neck dissection after primary chemoradiation for advanced head and neck squamous cell carcinoma.","authors":"Sofia Lyford-Pike, Patrick K Ha, Heather A Jacene, John R Saunders, Ralph P Tufano","doi":"10.1159/000237737","DOIUrl":"https://doi.org/10.1159/000237737","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of our study was to evaluate PET/CT in predicting residual nodal disease after primary chemoradiation (CRT) for head and neck cancer (HNSCC) with N2 disease or greater.</p><p><strong>Design: </strong>A retrospective cohort analysis was conducted. Thirty-eight patients received primary CRT for HNSCC with N2 or greater disease, PET/CT after treatment and neck dissection from January 2003 to December 2006. PET/CT results were correlated with pathology results from neck dissection specimens for each respective side.</p><p><strong>Results: </strong>Forty-six neck regions were analyzed. Nine were determined to have either PET/CT result reports (n = 5) or pathology reports (n = 4) that were indeterminate. PET/CT demonstrated a sensitivity and specificity of 57.1 and 73.9%, respectively, an accuracy of 67.5%, a positive predictive value of 57.1% and a negative predictive value of 73.9% when compared to the final pathology.</p><p><strong>Conclusion: </strong>PET/CT is neither highly sensitive nor highly specific for identifying residual nodal metastases after CRT for advanced-stage HNSCC. Physicians should not rely solely on PET/CT to determine interventions on the neck after CRT. A standardization of language for reporting findings and risk of residual disease is needed.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"251-6"},"PeriodicalIF":1.3,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000237737","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40032865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jing Ye, Hongmeng Yu, Wolfgang Draf, Chunquan Zheng, Dehui Wang
{"title":"Technique and results of the anterior-to-posterior-to-anterior approach in revision endoscopic sinus surgery.","authors":"Jing Ye, Hongmeng Yu, Wolfgang Draf, Chunquan Zheng, Dehui Wang","doi":"10.1159/000240648","DOIUrl":"https://doi.org/10.1159/000240648","url":null,"abstract":"<p><strong>Objective: </strong>To perform the anterior-to-posterior-to-anterior technique in revision endoscopic sinus surgery, and to assess the effects and safety of this technique in treating recurrent chronic sinusitis and nasal polyps.</p><p><strong>Methods: </strong>One hundred and thirteen patients with recurrent chronic sinusitis and nasal polyps received anterior-to-posterior-to-anterior revision endoscopic sinus surgery. This surgical technique has 5 important steps, including exposing the choana, enlarging the maxillary sinus ostium, opening the sphenoid sinus and posterior ethmoid sinus anteriorly to posteriorly, resecting the ethmoid sinus posteriorly to anteriorly, and opening the frontal sinus posteriorly to anteriorly. The choana, maxillary sinus ostium, middle turbinate remnant, and the roof and lateral wall of the sphenoid sinus are 4 stable anatomic reference points.</p><p><strong>Results: </strong>Twelve months postoperatively, the mean SNOT-22 score had improved by 18.48 and 100 (88.50%) patients had an improvement in nasal obstruction; thick nasal discharge, loss of smell or taste, and facial pain/pressure improvements were noted in 102 (90.27%), 64 (56.64%) and 76 (67.26%) patients, respectively. Postoperative endoscopic evaluation after 12 months indicated that 29 (25.66%), 12 (10.62%), 5 (4.42%), 6 (5.31%), and 2 (1.77%) patients had mucosal edema, nasal discharge, synechiae, polyps, and crusting, respectively. No severe complications were observed.</p><p><strong>Conclusion: </strong>The anterior-to-posterior-to-anterior technique is an effective and safe approach to revision endoscopic sinus surgery. The 4 stable anatomic reference points are helpful for preventing severe complications in total ethmoidectomy.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"257-62"},"PeriodicalIF":1.3,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000240648","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40041868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ménière's disease is a viral neuropathy.","authors":"Richard R Gacek","doi":"10.1159/000189783","DOIUrl":"https://doi.org/10.1159/000189783","url":null,"abstract":"<p><p>Morphological and clinical evidence supports a viral neuropathy in Ménière's disease (MD). Quantitative examination of 11 sectioned temporal bones (TBs) from 8 patients with a history of MD revealed a significant loss of vestibular ganglion cells in both the endolymph hydropic (EH) and non-EH ears. Transmission electron microscopy of vestibular ganglion cells excised from a patient with MD revealed viral particles enclosed in transport vesicles. Antiviral treatment controlled vertigo in 73 of 86 patients with vestibular neuronitis (85%) and 32 of 35 patients with MD (91%).</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"78-86"},"PeriodicalIF":1.3,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000189783","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39989734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joel Guss, W M Abuzeid, Laurel Doghramji, Paul H Edelstein, Alexander G Chiu
{"title":"Fluoroquinolone-resistant Pseudomonas aeruginosa in chronic rhinosinusitis.","authors":"Joel Guss, W M Abuzeid, Laurel Doghramji, Paul H Edelstein, Alexander G Chiu","doi":"10.1159/000242428","DOIUrl":"https://doi.org/10.1159/000242428","url":null,"abstract":"<p><strong>Background: </strong>Pseudomonas aeruginosa is cultured in nearly 1 of 5 patients with chronic rhinosinusitis and a history of sinus surgery. Fluoroquinolones are the only enterally administered antibiotics with efficacy against P. aeruginosa, but their frequent empiric use in the community raises concern for a rise in resistance.</p><p><strong>Objective: </strong>It was the aim of this study to determine the prevalence of fluoroquinolone-resistant P. aeruginosa in a tertiary rhinology practice.</p><p><strong>Methods: </strong>All bacterial sinus culture results from the outpatient otolaryngology clinic that yielded P. aeruginosa over a 5-year period (2002-2007) were reviewed along with the medical records of a randomly selected subset of patients.</p><p><strong>Results: </strong>In total, 689 culture results of 324 patients were examined. Nearly all patients had a history of endoscopic sinus surgery. Of all P. aeruginosa cultured, 13% were resistant to levofloxacin and 5% were intermediately sensitive, while 5% were resistant to ciprofloxacin and 7% intermediately sensitive. Of the 324 patients in the study, 19 and 15% had a history of a P. aeruginosa culture resistant to levofloxacin or ciprofloxacin, respectively. Mucoid strains of P. aeruginosa were significantly more likely to be fluoroquinolone resistant. No patient comorbidities were associated with a higher rate of resistance. The prevalence of resistant cultures remained stable over the 5-year study period.</p><p><strong>Conclusions: </strong>P. aeruginosa is cultured primarily in patients with previous sinus surgery. Nearly 20% of isolates are resistant to fluoroquinolones. Resistance to levofloxacin is more common than resistance to ciprofloxacin. This study supports the use of culture-directed therapy in the management of the postfunctional endoscopic sinus surgery patient and the avoidance of empiric use of fluoroquinolones.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"263-7"},"PeriodicalIF":1.3,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000242428","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40050336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Badr Eldin Mostafa, Lobna M El Fiky, Mohammed M El Sharnouby
{"title":"Complications of suppurative otitis media: still a problem in the 21st century.","authors":"Badr Eldin Mostafa, Lobna M El Fiky, Mohammed M El Sharnouby","doi":"10.1159/000191472","DOIUrl":"https://doi.org/10.1159/000191472","url":null,"abstract":"<p><p>The purpose of this study was to review the incidence of complicated suppurative otitis media in 10 years at a tertiary referral university hospital. During this period, 3,364 patients with suppurative otitis media (acute and chronic) were admitted to the department. The number of patients presenting with complications was 422 (12.54%). The ratio of extracranial to intracranial complications was nearly 1:1. The most frequent extracranial complication was mastoiditis while the most frequent intracranial one was lateral sinus thrombophlebitis. Multiple complications may present in the same patient. The onset of complications was insidious and 96% of the patients were already aware of their disease. There were 6 mortalities (1.42%), and additional morbidity was recorded in 16 patients (3.79%). Changes in the clinical picture should always alert the physician to the onset of a complication. Complications tended to occur in young patients from a lower socioeconomic class and without sex preponderance. Physicians should be aware of the continuing incidence of complications and the subtleness of their onset and investigate patients for the presence of more than one complication.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"87-92"},"PeriodicalIF":1.3,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000191472","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39993490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joel Guss, Laurel Doghramji, Christine Reger, Alexander G Chiu
{"title":"Olfactory dysfunction in allergic rhinitis.","authors":"Joel Guss, Laurel Doghramji, Christine Reger, Alexander G Chiu","doi":"10.1159/000242429","DOIUrl":"https://doi.org/10.1159/000242429","url":null,"abstract":"<p><strong>Background: </strong>Olfactory dysfunction in patients with allergic rhinitis has long been thought to be secondary to coexisting chronic rhinosinusitis and polyposis with obstruction of airflow over the olfactory epithelium. Recent evidence suggests that the allergic inflammatory infiltrate may itself affect olfaction in the absence of mucosal hypertrophy.</p><p><strong>Objective: </strong>We undertook a study to determine olfactory function in patients with allergic rhinitis in the presence and absence of chronic sinusitis.</p><p><strong>Methods: </strong>Fifty-one subjects with symptoms of rhinitis who presented for allergy testing were administered the University of Pennsylvania Smell Identification Test. In addition each patient underwent computed tomography (CT) scanning of the sinuses.</p><p><strong>Results: </strong>Eighty percent of subjects were allergic. Subjects with allergic rhinitis and no evidence of sinusitis scored on average in the 30th percentile (95% CI 20-40th percentile) on objective olfactory testing compared to age- and gender-specific norms. Half the allergic patients were classified as normosmic, while half had some degree of hyposmia.</p><p><strong>Conclusions: </strong>Our study demonstrates that even in the absence of mucosal disease on CT scan, a significant subset of patients with allergic rhinitis will exhibit hyposmia, mostly to a mild or moderate degree. The pathophysiology and potential treatments for olfactory loss in these patients should be further explored.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"268-72"},"PeriodicalIF":1.3,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000242429","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40050337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S Grützenmacher, D M Robinson, C Lang, E Lebe, U Knape, G Mlynski
{"title":"Investigations of the influence of external nose deformities on nasal airflow.","authors":"S Grützenmacher, D M Robinson, C Lang, E Lebe, U Knape, G Mlynski","doi":"10.1159/000086017","DOIUrl":"https://doi.org/10.1159/000086017","url":null,"abstract":"<p><strong>Background: </strong>Abnormalities of the external shape of the nose are often felt as cosmetically disturbing. In many cases an additional hampering of the respiratory function of the nose is seen and causes pathological nasal airflow patterns. For the functional outcome of aesthetic-surgery of the nose, knowledge of nasal flow is essential. In the medical literature there are some discrepancies between the relationship of nasal shape and nasal flow. We investigated typical airflow patterns in different abnormalities of the external nose.</p><p><strong>Methods: </strong>We performed fluid dynamic experiments on exact, anatomical nasal models and functional nasal models (so-called modified Mink boxes). We investigated the inspiratory flow pattern in nose-models with typical variations of the shape of the external nose.</p><p><strong>Results and conclusions: </strong>There were typical airflow patterns for every external nasal abnormalities. The normal nose shows a disturbance of the streamlines over the entire nasal cavum. Under physiological flow velocities we find laminar and turbulent flow. The pathological variations of the nasal shape show mostly different airflow patterns and characteristics. The main reason for that is a deformed or anatomically false configurated inflow area (vestibulum, isthmus and anterior cavum). During rhinoplasty the reconstruction of the nasal inflow area has to be taken into account.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"154-9"},"PeriodicalIF":1.3,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000086017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41017126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Badr E Mostafa, Hossam Abdel Hay, Hussam E Mohammed, Mohammed Yamani
{"title":"Role of leukotriene inhibitors in the postoperative management of nasal polyps.","authors":"Badr E Mostafa, Hossam Abdel Hay, Hussam E Mohammed, Mohammed Yamani","doi":"10.1159/000086016","DOIUrl":"https://doi.org/10.1159/000086016","url":null,"abstract":"<p><p>This was a prospective double blind comparative study on 40 patients. It compared the effects of the leukotriene receptor antagonist montelukast and beclomethasone nasal spray on the post-operative course of patients with sinonasal polyps. All patients underwent endoscopic sphenoethmoidectomy and were randomized post-operatively into two groups. Group I: 20 patients (9 females and 11 males) age 17 to 67 (32.4 +/- 9.5 years), receiving 10 mg montelukast orally daily and Group II: 20 patients (6 females and 14 males) age 17 years to 57 years (33.5 +/- 11.9 years), receiving 400 ug beclomethasone local sprays daily. All patients were followed up for 1 year and a symptom score was recorded throughout this period. There was a significant reduction in symptom scores in both groups throughout the study period. In the montelukast group improvement was more marked in itching, post-nasal discharge and headache. The control of sneezing and rhinorrhea was comparable in both groups with a marginal advantage of montelukast. Steroids had a more marked effect on smell disturbances and obstruction. There was no difference in the recurrence rate or in the need for rescue medications between both groups. Both drugs seem to have a complementary action and further studies are needed to determine which patients should receive which treatment.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"148-53"},"PeriodicalIF":1.3,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000086016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41017125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S Grützenmacher, R Mlynski, C Lang, S Scholz, R Saadi, G Mlynski
{"title":"The nasal airflow in noses with septal perforation: a model study.","authors":"S Grützenmacher, R Mlynski, C Lang, S Scholz, R Saadi, G Mlynski","doi":"10.1159/000085958","DOIUrl":"https://doi.org/10.1159/000085958","url":null,"abstract":"<p><strong>Background: </strong>Septal perforation is a common clinical problem in rhinology. Affected patients suffer from a dry nose, crusts as well as recurrent epistaxis and sometimes an inspiratory whistle. The aim of this study was to investigate the underlying flow dynamic mechanisms.</p><p><strong>Methods: </strong>The physical flow effects of such pathologies were examined in functional nose models (box models) and anatomically exact models of the nose. Therefore, septal perforations of different sizes and localisations were studied in straight and deviated nasal septa.</p><p><strong>Results and conclusions: </strong>It could be seen that the localisation of the perforation has no impact on the flow pattern. In large septal perforations, the air jet collides with the posterior edge of the perforation and disintegrates turbulently. Since airflow is physiologically turbulent in the posterior part of the nose, posterior perforations do not cause clinical complaints. The inspiratory whistling sound during respiration is based on the principle of a lip whistle. Large perforations do not cause a whistling sound. The necessary high flow velocity needed in large perforations is usually not achievable.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"142-7"},"PeriodicalIF":1.3,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000085958","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41017124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}