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Τρίτη 21 Μαΐου 2019

The Annals of otology, rhinology, and laryngology,http://journals.sagepub.com/home/aor

1 Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea.
2 Audiology Institute, Department of Audiology and Speech-Language Pathology, Hallym University of Graduate Studies, Seoul, Korea.,,Soree Ear Clinic, Seoul, Korea.,Department of Head and Neck Surgery, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.,1 Laboratory of Peroxisomes & Lipid Metabolism, Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea.,1
1 Department of Otolaryngology, Faculty of Medicine, Shimane University, Izumo city, Japan.
2 Department of Experimental Animals, Center for Integrated Research in Science, Shimane University, Izumo city, Japan.
3 Department of Otorhinolaryngology, University of Crete, School of Medicine, Crete, Greece.,
1 Oregon Hearing Research Center, Department of Otolaryngology-Head & Neck Surgery, OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA.
2 Sartorius-Stedim North America, Arvada, CO, USA.
3 OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA.,
1 Baylor University, Waco, TX, USA.
2 Texas Tech University Health Sciences Center School of Health Professions, Lubbock, TX, USA.
3 University of Texas-Austin, Austin, TX, USA.
4 University of Texas at Dallas School of Behavioral and Brain Sciences, Callier Center for Communication Disorders, Richardson, TX, USA.
5 Vanderbilt University, Nashville, TN, USA.
6 University of Texas at Dallas Erik Jonsson School of Engineering and Computer Science, Richardson, TX, USA.,1 Department of Otorhinolaryngology, Showa University, Shinjuku-ku, Tokyo, Japan.
2 Product Support Department, Carl Zeiss Microscopy Co. Ltd., Shinjuku-ku, Tokyo, Japan.
3 Department of Otolaryngology, Ebara Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation, Tokyo, Japan.
4 Department of Molecular Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.,
2 Department of Obstetrics and Gynecology, Iksan Hospital, Jeonbuk, Korea.
3 Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Otorhinolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.1 Department of Head & Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
2 Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,1 Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
2 Pasarow Mass Spectrometry Laboratory, Jane and Terry Semel Institute for Neuroscience and Human Behavior and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,,1 Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea.
2 Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea.,1
1 Department of Head & Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
2 Department of Integrative Biology & Physiology, UCLA, Los Angeles, CA, USA.
3 Brain Research Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,
1 Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
2 The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.,
Department of Otolaryngology, Faculty of Medicine, Oita University, Oita, Japan.
1 Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Kangnam Secred Heart Hospital, Seoul, Korea.
2 Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.
3 Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea.
1 University of Iowa, Iowa City, IA, USA.
2 Johns Hopkins University, Baltimore, MD, USA.
1 Department of Ophthalmology, Division of Glaucoma, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
2 Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
3 Sleep Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
4 Robotic Surgery Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
5 Department of Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery, Rush University Medical Center, Chicago, Illinois, USA.
6 Department of Otolaryngology, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA.
7 Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.
8 Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.




1.
 2019 Jun;128(6_suppl):84S-95S. doi: 10.1177/0003489419837990.

Phantom Perception of Sound and the Abnormal Cortical Inhibition System: An Electroencephalography (EEG) Study.

Abstract

OBJECTIVES:

Despite no observable external sound present, a perceived feeling of a recurrent unpleasant sound is a main complaint in the patients with chronic tinnitus. This phantom perception of sound is considered as the auditory equivalent of phantom limb pain, and altered excitability may be involved in its underlying pathology. Tinnitus-related hyper-excitation is suppressed by inhibitory repetitive transcranial magnetic stimulation (rTMS). However, the neural mechanism underlying the treatment is not fully understood, and quantifying the suppression induced by rTMS has yet to be considered.

METHODS:

We evaluated the effect of rTMS on the cortical inhibition status following single-site stimulation over the auditory temporal cortex (T group) or dual-site stimulation over the auditory temporal and the frontal regions (TF group). These effects were also compared with outcomes following sham stimulation (S group). Subjective response was recorded using tinnitus-related handicap index (THI), and changes in the cortical inhibition status were assessed using an auditory paired-pulse suppression index (PPSI).

RESULTS:

TF group showed the greatest benefit from the treatment evidenced in the reduced PPSI and THI scores. T and S groups did not benefit much. TF group overlapped mostly with the responder group, indicating improvement in both subjective THI and objective PPSI measurements.

CONCLUSION:

Our results suggest that rTMS is a beneficial therapeutic treatment for chronic tinnitus patients and the dual-site treatment was the most effective in terms of both tinnitus complaint and quantitative indices. Thus, subjective reports and electrophysiological signatures may be complementary for the diagnosis/prognosis of tinnitus.

KEYWORDS:

cortical inhibition; electroencephalography (EEG); hearing; miscellaneous; otolaryngology; otology; subjective chronic tinnitus; transcranial magnetic stimulation (TMS)

PMID:
 
31092043
 
DOI:
 
10.1177/0003489419837990
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2.
 2019 Jun;128(6_suppl):134S-138S. doi: 10.1177/0003489419837562.

Intratympanically Delivered Steroids Impact Thousands More Inner Ear Genes Than Systemic Delivery.

Abstract

OBJECTIVES:

Glucocorticoids are given for sensorineural hearing loss, but little is known of their molecular impact on the inner ear. Furthermore, in spite of claims of improved hearing recovery with intratympanic delivery of steroids, no studies have actually documented the inner ear molecular functions that are enhanced with this delivery method.

METHODS:

To assess steroid-driven processes in the inner ear, gene chip analyses were conducted on mice treated systemically with the glucocorticoids prednisolone or dexamethasone or the mineralocorticoid aldosterone. Other mice were given the same steroids intratympanically. Inner ears were harvested at 6 hours and processed on the Affymetrix 430 2.0 Gene Chip for expression of its 34 000 genes. Results were statistically analyzed for up or down expression of each gene against control (untreated) mice.

RESULTS:

Analyses showed approximately 17 500 genes are normally expressed in the inner ear and steroids alter expression of 55% to 82% of these. Dexamethasone changed expression of 9424 (53.9%) inner ear genes following systemic injection but 14 899 ear genes (85%) if given intratympanically. A similar pattern was seen with prednisolone, as 7560 genes were impacted by oral delivery and 11 164 genes (63.8%) when given intratympanically. The mineralocorticoid aldosterone changed expression of only 268 inner ear genes if given orally, but this increased to 10 124 genes (57.9%) if injected intratympanically. Furthermore, the glucocorticoids given actually impacted more inner ear genes via the mineralocorticoid receptor than the glucocorticoid receptor.

CONCLUSIONS:

Thousands of inner ear genes were affected by steroids, and this number increased significantly if steroids were delivered intratympanically. Also, the impact of glucocorticoids on inner ear mineralocorticoid functions is more substantial than previously known. Thus, the application of therapeutic steroids for hearing loss needs to be reassessed in light of their more comprehensive impact on inner ear genes. Furthermore, simply ascribing the efficacy of steroids to immunosuppression no longer appears to be warranted.

KEYWORDS:

gene microarray; glucocorticoid; inner ear; intratympanic steroids; mineralocorticoid; steroid therapy

PMID:
 
31092042
 
DOI:
 
10.1177/0003489419837562
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3.
 2019 Jun;128(6_suppl):5S. doi: 10.1177/0003489419839586.

A Tribute to Dr. David J. Lim: Remembering His Legacy.


PMID:
 
31092041
 
DOI:
 
10.1177/0003489419839586
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4.
 2019 Jun;128(6_suppl):26S-35S. doi: 10.1177/0003489419835848.

Sublingual Immunotherapy Attenuates Nasal Symptoms Upon Allergen Exposure in Murine Allergic Rhinitis Model via an Induction of IL-10 producing T cells in Submandibular Lymph Node.

Abstract

OBJECTIVE:

Sublingual immunotherapy has been considered to be a painless and effective therapeutic treatment of patients with allergic rhinitis. Its mechanism of action has been elucidated, but there are still controversies among many reports between clinical efficacy and laboratory data. Therefore, its mechanism of action needs to be investigated further by using promising animal models such as rodents and monkeys.

MATERIALS AND METHODS:

Bearing this in mind, in our present study, we successfully constructed an effective murine model for sublingual immunotherapy (SLIT) in allergic rhinitis in which mice were sublingually administered ovalbumin (OVA), followed by intraperitoneal (ip) sensitization and intranasal (i.n.) challenge of OVA.

RESULTS:

To summarize our experimental data, nasal symptoms such as sneezing and nasal rubbing of sublingually treated mice were significantly attenuated in accordance with lower specific IgE antibodies in sera. Histological analysis of eosinophil recruitment in nasal mucosae reveals less allergic inflammation in sublingually treated mice. Interleukin-10 (IL-10) production and IL-10-specific mRNA gene expression of cultured submandibular lymph node (SMLN) cells with OVA, obtained from sublingually treated mice, were significantly higher than those of mice without sublingual treatment.

CONCLUSION:

These results demonstrate that sublingually introduced antigens can actually attenuate nasal symptoms in a murine allergic rhinitis model upon allergen exposures. Furthermore, our immunological data might indicate an important role of IL-10 producing T cells in SMLN to control nasal allergic reaction.

KEYWORDS:

Eosinophil; IL-10; allergic rhinitis; regulatory T cell; sublingual immunotherapy

PMID:
 
31092040
 
DOI:
 
10.1177/0003489419835848
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5.
 2019 Jun;128(6_suppl):103S-110S. doi: 10.1177/0003489419833406.

A 3-Dimensional Model of the Human Round Window Membrane.

Abstract

OBJECTIVES:

The round window membrane (RWM) is small in size, making it difficult to clarify its shape and structure. The authors examined a 40x magnified 3-dimensional model of the human RWM to clarify its morphologic aspects and characteristics.

METHODS:

An RWM specimen was obtained from an archival, formalin-fixed, decalcified, left temporal bone of an 84-year-old female cadaver. The data obtained by laser scanning microscopy were input into a 3-dimensional printer. After a model of the RWM was created, the following features were examined: striae on the surfaces, curvatures, thickness, and areas. Cross sections of the original specimen were made for histological observations.

RESULTS:

The contour of this RWM model was approximately elliptic, with a saddle shape. When illuminated from the scala tympani side, the surface facing the fossula exhibited dark anterior and clear posterior portions. A borderline appeared where the 2 portions were bound along the short axis of the ellipse. This borderline was identified as the line of inflection. Collagen fibers were shown to run parallel to the borderline in the posterior portion but were fanned out in the anterior portion.

CONCLUSIONS:

The magnified 3-dimensional model clarified gross anatomy and characteristics of the RWM. It is good teaching material for small tissues, such as the RWM.

KEYWORDS:

3D enlarged model; 3D printer; borderline; gross anatomy; line of inflection; round window membrane

PMID:
 
31092039
 
DOI:
 
10.1177/0003489419833406
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6.
 2019 Jun;128(6_suppl):139S-145S. doi: 10.1177/0003489419832625.

Enhancement of Consonant Recognition in Bimodal and Normal Hearing Listeners.

Abstract

OBJECTIVES:

The present study investigated the effects of 3-dimensional deep search (3DDS) signal processing on the enhancement of consonant perception in bimodal and normal hearing listeners.

METHODS:

Using an articulation-index gram and 3DDS signal processing, consonant segments that greatly affected performance were identified and intensified with a 6-dB gain. Then consonant recognition was measured unilaterally and bilaterally before and after 3DDS processing both in quiet and noise.

RESULTS:

The 3DDS signal processing provided a benefit to both groups, with greater benefit occurring in noise than quiet. The benefit rendered by 3DDS was the greatest in binaural listening condition. Ability to integrate acoustic features across ears was also enhanced with 3DDS processing. In listeners with normal hearing, manner and place of articulation were improved in binaural listening condition. In bimodal listeners, voicing and manner and place of articulation were also improved in bimodal and hearing aid ear-alone conditions.

CONCLUSIONS:

Consonant recognition was improved with 3DDS in both groups. This observed benefit suggests 3DDS can be used as an auditory training tool for improved integration and for bimodal users who receive little or no benefit from their current bimodal hearing.

KEYWORDS:

bimodal hearing; bimodal integration; consonant enhancement; electric acoustic stimulation

PMID:
 
31092038
 
DOI:
 
10.1177/0003489419832625
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7.
8.
 2019 Jun;128(6_suppl):38S-44S. doi: 10.1177/0003489419834311.

Cochlear Implant Surgery Through Round Window Approach Is Always Possible.

Abstract

OBJECTIVES:

The benefit of round window (RW) approach for cochlear implant (CI) has been well studied. Because the RW represents a natural door to scala tympani, it facilitates precise electrode insertion. Atraumatic electrode insertion can also be performed without drilling the cochlear lateral wall. However, the RW approach has several limitations. The purpose of this study is to describe successful CI surgeries utilizing the RW approach except for severe cases of temporal bone anomaly. The authors' successful surgical solution for cases involving difficult RW access is also described.

MATERIALS AND METHODS:

We retrospectively analyzed 377 consecutive surgeries of cochlear implantation performed between June 2010 and December 2018 by a single experienced surgeon. Standard and alternative procedures were used according to anatomical variations. Standard procedures included modified techniques of mastoidectomy in the RW approach, opening of facial recess, exposure of RW membrane, and electrode insertion. Difficult cases involving severe rotated cochlea or hypoplastic mastoid were successfully treated with RW insertion using alternative procedures such as external auditory canal (EAC) wall mobilization and endomeatal approach.

RESULTS:

We performed CI surgery through a reproducible RW technique in two cases involving endomeatal approach and three cases of EAC mobilization. Other cases were treated using the standard procedure.

CONCLUSION:

Cochlear implant surgery through RW is reliable, safe, and effective. The RW technique is reproducible via several surgical procedures in most CI cases. Identification and safe exposure of RW membrane is a prerequisite for successful electrode insertion in cochlear implant surgery.

KEYWORDS:

cochlear implant; round window approach; surgical technique

PMID:
 
31092036
 
DOI:
 
10.1177/0003489419834311
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9.
 2019 Jun;128(6_suppl):117S-124S. doi: 10.1177/0003489419836116.

Pyridoxine Preferentially Induces Auditory Neuropathy Through Mitochondrial Dysfunction and Endoplasmic Reticulum Stress-Mediated Apoptosis.

Abstract

OBJECTIVES:

Auditory neuropathy due to toxicity mechanism of pyridoxine has not yet been fully documented. Therefore, the present study explored a direct mechanism underlying the effects of pyridoxine on auditory neuropathy in organ of Corti (OC) explants ex vivo and cochlear neuroblast cell line, VOT-33 in vitro.

METHODS:

Primary OC explants containing spiral ganglion neurons and cultured VOT-33 cells were treated with pyridoxine.

RESULTS:

In nerve fiber of primary OC explants, pyridoxine decreased staining for NF200, a neuro-cytoskeletal protein. We also found that pyridoxine-induced VOT-33 apoptosis, as indicated by accumulation of the sub-G0/G1 fraction, caspase-3 activation, and PARP cleavage. In addition, pyridoxine induced reactive oxygen species (ROS) generation and alteration of mitochondrial membrane potential transition (MPT), including Bcl-2 family protein expression and consequently Ca2+accumulation and changes of endoplasmic reticulum (ER) stress-related protein expression such as phospho-PERK, caspase-12, Grp78, and CHOP.

CONCLUSION:

Pyridoxine preferentially induced severe cell death on nerve fiber in primary OC explants and markedly increased apoptotic cell death via mitochondria-mediated ER stress in VOT-33 cells.

KEYWORDS:

ER stress; VOT-33; auditory neuropathy; mitochondrial dysfunction; pyridoxine

PMID:
 
31092035
 
DOI:
 
10.1177/0003489419836116
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10.
 2019 Jun;128(6_suppl):8S-15S. doi: 10.1177/0003489419837689.

Involvement of TNF-α and IFN-γ in Inflammation-Mediated Cochlear Injury.

Abstract

OBJECTIVES:

Inflammation is crucial for the pathogenesis of acquired sensorineural hearing loss, but the precise mechanism involved remains elusive. Among a number of inflammatory mediators, tumor necrosis factor-alpha (TNF-α) plays a pivotal role in cisplatin ototoxicity. However, TNF-α alone is cytotoxic to cochlear sensory cells only at the extremely high concentrations, suggesting the involvement of other factors that may sensitize cells to TNF-α cytotoxicity. Since interferon gamma (IFN-γ) importantly contributes to the cochlear inflammatory processes, we aim to determine whether and how IFN-γ affects TNF-α cytotoxicity to cochlear sensory cells.

METHODS:

TNF-α expression was determined with western blotting in RSL cells and immunolabeling of mouse temporal bone sections. HEI-OC1 cell viability was determined with MTT assays, cytotoxicity assays, and cytometric analysis with methylene blue staining. Cochlear sensory cell injury was determined in the organotypic culture of the mouse organ of Corti.

RESULTS:

Spiral ligament fibrocytes were shown to upregulate TNF-α in response to pro-inflammatory stimulants. We demonstrated IFN-γ increases the susceptibility of HEI-OC1 cells to TNF-α cytotoxicity via JAK1/2-STAT1 signaling. TNFR1-mediated Caspase-1 activation was found to mediate the sensitization effect of IFN-γ on TNF-α cytotoxicity. The combination of IFN-γ and TNF-α appeared to augment cisplatin cytotoxicity to cochlear sensory cells ex vivo.

CONCLUSIONS:

Taken together, these findings suggest the involvement of IFN-γ in the sensitization of cochlear cells to TNF-α cytotoxicity, which would enable us to better understand the complex mechanisms underlying inflammation-mediated cochlear injury.

KEYWORDS:

acquired hearing loss; cochlear inflammation; cytokine; ototoxicity; sensitization

PMID:
 
31092034
 
DOI:
 
10.1177/0003489419837689
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11.
 2019 Jun;128(6_suppl):52S-60S. doi: 10.1177/0003489419836226.

Preliminary Characterization of Extracellular Vesicles From Auditory HEI-OC1 Cells.

Abstract

OBJECTIVES:

Isolate, purify, and characterize extracellular vesicles (EVs) obtained from auditory HEI-OC1 cells, and evaluate their suitability for intracochlear transport and delivery of pharmacological drugs and/or pro-resolution mediators of acute inflammatory processes.

METHODS:

HEI-OC1 EVs were isolated and purified using the exoEasy Maxi Kit, and their size was evaluated by nanoparticle tracking techniques. Bottom-up proteomics of the EVs, either freshly obtained or stored for up to 4 months at -20°C, was performed by LC-ESI-MS/MS. LC-ESI-MS/MS-MRM was used to measure the loading of dexamethasone inside EVs following co-incubation at room temperature for 1 hour with and without 5 minutes sonication.

RESULTS:

Routinely, we were able to obtain purified fractions of >2 × 109 EVs/mL, with diameters varying between 50 and 800 nm. Bottom-up proteomics showed that among the most abundant EVs proteins, 19.2% were cytoplasmic, 17.2% were membrane localized, 12.3% were cytosolic, and 14.6% were nucleolar. No significant differences between fresh and stored EVs were detected. Importantly, co-incubation of HEI-OC1 EVs (1 × 108 EVs/mL) with dexamethasone (10 mM) resulted in the incorporation of 10.1 ± 1.9 nM dexamethasone per milliliter of EVs suspension.

CONCLUSIONS:

Altogether, the results suggest that EVs from HEI-OC1 cells could be advantageously used as biological nanocarriers for the delivery of specific molecules and pharmacological drugs into the inner ear.

KEYWORDS:

HEI-OC1 cells; drug nanocarriers; extracellular vesicles; intracochlear drug delivery; proteomics

PMID:
 
31092033
 
DOI:
 
10.1177/0003489419836226
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12.
 2019 Jun;128(6_suppl):96S-102S. doi: 10.1177/0003489419834952.

Otopetrin-2 Immunolocalization in the Human Macula Utricle.

Abstract

BACKGROUND:

In the present study, we investigated the localization of otopetrin-2-a member of the otopetrin family that encodes proton-selective ion channels-in the human macula utricle using immunohistochemistry.

METHODS:

Macula utricle were acquired at surgery from patients who required transmastoid labyrinthectomy for intractable vertigo due to Meniere's disease (MD; n = 3) and/or vestibular drops attacks (VDA; n = 2) and from temporal bones (n = 2) acquired at autopsy from individuals with no balance disorders. Immunofluorescence staining with otopetrin-2 (rabbit affinity purified polyclonal antibody) and GFAP (mouse monoclonal antibody) to identify vestibular supporting cells was made in formalin fixed cryostat sections or whole microdissected utricle (for flat mount preparations). Secondary antibodies against rabbit and mouse were used for the identification of both proteins. Digital fluorescent images were obtained using a high-resolution laser confocal microscope.

RESULTS:

Using cryostat sections and flat mount preparations otopetrin-2 immunofluorescence was seen as punctated signal throughout the supporting cells cytoplasm. GFAP immunofluorescence was present in the supporting cell cytoplasm. The distribution of otopetrin-2 was similar in the macula utricle obtained from MD, VDA, or autopsy normative patients.

CONCLUSIONS:

Otopetrin-2 was localized in supporting cells in a similar fashion that otopetrin-1 previously reported in the mouse macula utricle. The differential expression of otopetrin-2 in the supporting cells of the human macula utricle suggest an important role in the vestibular sensory periphery homeostasis and otolith maintenance.

KEYWORDS:

balance disorders; otolith; otopetrin-2; supporting cells; utricle; vestibular hair cells

PMID:
 
31092032
 
DOI:
 
10.1177/0003489419834952
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13.
 2019 Jun;128(6_suppl):111S-116S. doi: 10.1177/0003489419835568.

Role of Phosphorylcholine-Specific Immunoglobulin M in Acute Upper Respiratory Tract Infections.

Abstract

OBJECTIVES:

The aim of this study was to clarify the role of serum phosphorylcholine (PC)-specific immunoglobulin M (IgM) as a natural antibody against infectious diseases.

METHODS:

The relationship between serum PC-specific IgM level and C-reactive protein level or white blood cell counts was examined in patients with severe upper respiratory tract infections (ie, acute epiglottitis and peritonsillar abscess).

RESULTS:

PC-specific IgM level was significantly negatively correlated with C-reactive protein level and white blood cell count. In addition, C-reactive protein level and white blood cell count was significantly lower in women than in men, whereas PC-specific IgM level was significantly higher in women.

CONCLUSIONS:

PC-specific IgM is suggested to have protective and suppressive effects against the progression of infectious and inflammatory reactions. Higher levels of PC-specific IgM in women might be one of the reasons why the incidence and severity of acute epiglottitis and peritonsillar abscess are lower in women.

KEYWORDS:

C-reactive protein; IgM; phosphorylcholine; white blood cell

PMID:
 
31092031
 
DOI:
 
10.1177/0003489419835568
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14.
 2019 Jun;128(6_suppl):69S-75S. doi: 10.1177/0003489419836228.

External Auditory Canal Reconstruction and Mastoid Obliteration Using Modified Palva Flap in Canal Wall Down Mastoidectomy With Tympanoplasty.

Abstract

OBJECTIVE:

To evaluate the effectiveness of a modified Palva flap used for external auditory canal reconstruction and mastoid obliteration in canal wall down mastoidectomy.

METHODS:

We retrospectively analyzed patients who underwent canal wall down mastoidectomy with tympanoplasty using modified Palva flap. All patients underwent pure tone audiometry and temporal bone computed tomography (CT) before surgery, and the same tests were performed in the first year after surgery. The external auditory canal volumes were calculated by summing the areas of each section selected in temporal bone CT. For each patient, the ratio of external auditory canal volume was calculated from CT taken before and after surgery.

RESULTS:

The mean of external auditory canal volume after canal wall down with a modified Palva flap was about 1.4 times larger than before surgery. The modified Palva flap is effective for the reconstruction of the external auditory canal. Both pure tone audiometry level and air-bone gap showed statistically significant improvement after surgery ( Ps = .001 and .002, respectively).

CONCLUSIONS:

The external auditory canal volume slightly increased, but the status of mastoid obliteration was well maintained 1 year after surgery. The modified Palva flap used in this study is an easy and effective method in external auditory canal reconstruction and mastoid obliteration.

KEYWORDS:

Palva flap; canal wall down mastoidectomy; external auditory canal reconstruction; mastoid obliteration; volume

PMID:
 
31092030
 
DOI:
 
10.1177/0003489419836228
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15.
 2019 Jun;128(6_suppl):76S-83S. doi: 10.1177/0003489419837993.

Pathophysiologic Findings in the Human Endolymphatic Sac in Endolymphatic Hydrops: Functional and Molecular Evidence.

Kim SH1,2Nam GS1Choi JY1,2.

Abstract

BACKGROUND:

The endolymphatic sac (ES) is a cystic structure situated on the posterior fossa dura and is connected to the luminal space of the vestibular organ through the endolymphatic duct, which branches into the utricular and saccular ducts. Unlike the cochlea and vestibule, the ES does not contain sensory epithelium in its luminal space, and a single layer of epithelial cells line the luminal surface area. The ES in the inner ear is thought to play a role in the regulation of inner ear homeostasis, fluid volume, and immune reaction. If these functions of the ES are disrupted, dysfunction of the inner ear may develop. The most well-known pathology arising from dysfunction of the ES is endolymphatic hydrops, characterized by an enlarged endolymphatic space due to the accumulation of excessive endolymphatic fluid. Although, molecular identities and functional evidence for the roles were identified in animal studies, basic studies of the human ES are relatively uncommon compared with those using animal tissues, because of limited opportunity to harvest the human ES.

METHODS:

In this study, molecular and functional evidence for the role of the human ES in the development of endolymphatic hydrops are reviewed.

RESULTS AND CONCLUSIONS:

Although evidence is insufficient, studies using the human ES have mostly produced findings similar to those of animal studies. This review may provide a basis for planning further studies to investigate the pathophysiology of disorders with the finding of endolymphatic hydrops.

KEYWORDS:

Meniere’s disease; endolymphatic hydrops; endolymphatic sac

PMID:
 
31092029
 
DOI:
 
10.1177/0003489419837993
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16.
 2019 Jun;128(6_suppl):125S-133S. doi: 10.1177/0003489419834596.

On the Legacy of Genetically Altered Mouse Models to Explore Vestibular Function: Distribution of Vestibular Hair Cell Phenotypes in the Otoferlin-Null Mouse.

Abstract

OBJECTIVES:

Early in his career, David Lim recognized the scientific impact of genetically anomalous mice exhibiting otoconia agenesis as models of drastically compromised vestibular function. While these studies focused on the mutant pallid mouse, contemporary genetic tools have produced other models with engineered functional modifications. Lim and colleagues foresaw the need to analyze vestibular epithelia from pallid mice to verify the absence of downstream consequences that might be secondary to the altered load represented by otoconial agenesis. More generally, however, such comparisons also contribute to an understanding of the susceptibility of labyrinthine sensory epithelia to more widespread cellular changes associated with what may appear as isolated modifications.

METHODS:

Our laboratory utilizes a model of vestibular hypofunction produced through genetic alteration, the otoferlin-null mouse, which has been shown to exhibit severely compromised stimulus-evoked neurotransmitter release in type I hair cells of the utricular striola. The present study, reminiscent of early investigations of Lim and colleagues that explored the utility of a genetically altered mouse to explore its utility as a model of vestibular hypofunction, endeavored to compare the expression of the hair cell marker oncomodulin in vestibular epithelia from wild-type and otoferlin-null mice.

RESULTS:

We found that levels of oncomodulin expression were much greater in type I than type II hair cells, though were similar across the 3 genotypes examined (ie, including heterozygotes).

CONCLUSION:

These findings support the notion that modifications resulting in a specific component of vestibular hypofunction are not accompanied by widespread morphologic and cellular changes in the vestibular sensory epithelia.

KEYWORDS:

bootstrap resampling; labyrinth; oncomodulin; sensory epithelia; utricle

PMID:
 
31092028
 
DOI:
 
10.1177/0003489419834596
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17.
 2019 Jun;128(6_suppl):61S-68S. doi: 10.1177/0003489419835234.

Clinical Value of Measurement of Internal Auditory Canal in Pediatric Cochlear Implantation.

Abstract

OBJECTIVES:

The aims of this study were to clarify the clinical value of the bony cochlear nerve canal (BCNC) and internal auditory canal (IAC) in children with bilateral sensorineural hearing loss (b-SNHL) and to reveal the correlation between these parameters and outcomes after cochlear implantation (CI).

METHODS:

Ninety-four ears with b-SNHL that received CI and 100 ears with normal hearing were enrolled. Parameters of IAC and pre- and post-CI categories of auditory performance scores were analyzed.

RESULTS:

The width of the BCNC and the width, height, and length of the IAC were shorter in the b-SNHL group. BCNC and IAC width were associated with b-SNHL. The calculated cutoff values for BCNC and IAC width were 2.055 mm in the BCNC and 4.245 mm in the IAC, setting the sensitivity to 90%. Patients with narrow BCNCs and IACs had significantly worse post-CI auditory performance.

CONCLUSIONS:

BCNC and IAC widths were narrower in children with b-SNHL than in normal-hearing children. Narrow BCNC and IAC width had a negative impact on post-CI outcomes. The proposed cutoff values for BCNC and IAC width were meaningful when predicting the auditory outcome after CI, especially considering both.

KEYWORDS:

cochlear implantation; inner ear; sensorineural hearing loss; temporal bone

PMID:
 
31092027
 
DOI:
 
10.1177/0003489419835234
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18.
 2019 Jun;128(6_suppl):45S-51S. doi: 10.1177/0003489419837994.

Interaction Between Regulatory T Cells and Antibody-Producing B Cells for Immune Responses at the Upper Respiratory Mucosa Against Nontypeable Haemophilus influenzae: In Vitro Assay Model.

Abstract

OBJECTIVES:

The aim of this study was to investigate the effect of regulatory T cells (Tregs) on B-cell immune responses against outer membrane protein (OMP) from nontypeable Haemophilus influenzae (NTHi) in vitro, to clarify its exact mechanism from an immunologic standpoint.

METHODS:

Mice were vaccinated intranasally with OMP to induce OMP-specific immune responses in the nasal mucosa. Mononuclear cells (MNCs) were collected from the nasal mucosa, and Tregs and helper T (Th) cells were isolated separately from the spleens of those mice. Three different cell culture groups were allocated: MNCs cocultured with Tregs, MNCs cocultured with Th cells, and MNCs cultured alone. At 24 and 72 hours after cell culture, the concentrations of various cytokines and antibodies in culture supernatants were measured to assess the effects of Tregs and Th cells on B-cell responses. Cytokine levels and specific anti-OMP antibody levels in culture media were determined using enzyme-linked immunosorbent assay. CD69 or CD80 expression on B220-positive cells was detected using flow cytometric analysis.

RESULTS:

Th1 and Th2 cytokine concentrations were significantly elevated in the 3 groups incubated with OMP from 24 to 72 hours. Additionally, interleukin-10 levels were significantly higher in the Treg and Th groups than in the control group. Levels of OMP-specific immunoglobulin A did not differ significantly among the groups. The ratios of CD69+B220+ B2 cells were nearly the same in the 3 groups; however, the ratio of CD80+B220+ B2 cells was higher in the control group than in the Treg and Th groups during incubation.

CONCLUSIONS:

Tregs and Th cells did not affect OMP-specific immunoglobulin A production in this study. However, these cells may partially inhibit B-cell functions, such as T-cell activation. These inhibitory effects may be related to interleukin-10.

KEYWORDS:

B cell; in vitro; mucosa; nontypeable ; outer membrane protein; regulatory T cell

PMID:
 
31092026
 
DOI:
 
10.1177/0003489419837994
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19.
 2019 Jun;128(6_suppl):16S-25S. doi: 10.1177/0003489419837687.

Auditory Cortical Plasticity and Reorganization in Rats With Single-Sided Deafness During Early Developmental Period.

Abstract

OBJECTIVE:

We aimed to examine the serial change of sound-specific auditory cortical activation patterns in age-matched normal hearing (NH) and young single-sided deafness (YSSD) rats to understand the critical period that influences a benefit of a binaural hearing.

METHOD:

Experiments were performed on the age-matched 64 Sprague-Dawley rats; NH group = 45 rats, and YSSD group = 19 rats. NH rats were evaluated the multi-unit neural activities from the age of post-14 days (P14ds) to P73ds by week interval. For YSSD group, left-side cochlear ablations were done at the age of P10ds, and multineural recordings were implemented at the post-deafening (PD) 2 weeks (W), PD4W, PD6W, and PD8W, with age matching. After craniotomy, tungsten wire-based 16-channel microelectrode array was inserted to the surface of the auditory cortex. Gaussian white sound stimulation was introduced to the right ear every 500 ms, and analyses were performed of the Peri-stimulus time histogram. The parameters, including peak latency, peak amplitude, total responsive area, and index of contralaterality, were evaluated.

RESULTS:

In NH group, larger peak amplitude and total responsive area and shorter peak latency of the contralateral hemisphere to sound stimulation were observed in all ages. Interestingly, YSSD group demonstrated that total reactive area in the contralateral side was significantly smaller than that in the ipsilateral side at PD2W and PD4W, indicating the disappearance of contralateral dominance within PD4W. Subsequently, monaural stimulation from the hearing ear exclusively activated the contralateral hemisphere at PD6W and PD8W.

CONCLUSION:

Early onset of unilateral deafening leads to the alternation of contralateral dominance in the early period, replaced by faster and massive reorganization toward the ipsilateral cortex. But, gradual adaptation in the contralateral side was exclusively observed. Given the short critical period in the young SSD model, early intervention may be crucial for the development of binaural hearing if SSD occurs early in life.

KEYWORDS:

auditory cortex; development; neuronal plasticity; rats; unilateral deafness

PMID:
 
31092025
 
DOI:
 
10.1177/0003489419837687
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20.
 2019 May 15:3489419848786. doi: 10.1177/0003489419848786. [Epub ahead of print]

Survival Outcomes for Advanced Cutaneous Squamous Cell Carcinoma of the Head and Neck.

Abstract

OBJECTIVES:

Survival outcomes for advanced non-melanoma skin cancers of the head and neck treated with surgical resection are not well described in the literature. We aimed to describe outcomes for T3 and T4 cutaneoous squamous cell carcinoma of the head or neck treated with surgical resection at 1 tertiary academic medical center.

METHODS:

We analyzed a retrospective cohort of patients diagnosed with T3 or T4 cutaneous squamous cell carcinoma (SCC) of the head or neck from 2005 to 2016 treated with definitive surgical resection. Survival outcomes were examined using Kaplan-Meier analysis, and multivariate analysis was completed with Cox proportional hazard model.

RESULTS:

Forty-three patients met inclusion criteria. The mean age at diagnosis was 74.7 years (SD = 10.2), and 34 (79.1%) patients were male. Twelve (27.9%) patients were immunosuppressed. Radical resection, defined as temporal bone resection, orbital exenteration, calvarial resection, mandibulectomy, or maxillectomy, was performed in 25 (58.1%) cases. Final surgical margins were positive in 19 (44.2%) cases. Patients with tumors of the scalp/neck had a 1-year survival probability of 85.7%, and the probability of survival 1 year after a neck dissection was greater than 93%.

CONCLUSION:

Anatomical subsites, specifically scalp/neck tumors, tended to have worse overall survival. Positive final margins tended to indicate a worse prognosis, and overall survival and recurrence were not significantly different among patients who underwent radical surgical resection compared to soft tissue resection.

KEYWORDS:

Cutaneous squamous cell carcinoma; Miscellaneous; Outcome Studies; Skin cancer; head and neck oncology; survival

PMID:
 
31091995
 
DOI:
 
10.1177/0003489419848786
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Effects of OSA Surgery on Ophthalmological Microstructures.

Lin PW1Lin HC2,3,4Friedman M5,6Chang HW7Salapatas AM6Lin MC3,8Chin CH3,8.

Author information


1
1 Department of Ophthalmology, Division of Glaucoma, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
2
2 Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
3
3 Sleep Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
4
4 Robotic Surgery Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
5
5 Department of Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery, Rush University Medical Center, Chicago, Illinois, USA.
6
6 Department of Otolaryngology, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA.
7
7 Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.
8
8 Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Abstract

OBJECTIVE:

Obstructive sleep apnea/hypopnea syndrome (OSA) could compromise oxygenation of the optic nerve and cause glaucomatous optic neuropathy; however, there were no studies to investigate the changes of visual function and retinal microstructures in OSA patients after upper airway surgery. We aim to assess the changes in the visual sensitivity and retinal fiber layer thickness in OSA patients before and after surgery.

METHODS:

This prospective single-blind study enrolled patients with OSA from a tertiary academic medical center who had unsuccessful conservative therapy and then underwent surgery. The patients were referred for comprehensive ophthalmologic evaluation at baseline and 6 months after OSA surgery. The polysomnographic findings were collected pre- and postoperatively. Visual sensitivities on standard automated perimetry (SAP) were assessed. Peripapillary retinal nerve fiber layer (RNFL) thickness and macular layer (ML) thickness parameters were measured by spectral-domain optical coherence tomography (OCT).

RESULTS:

A total of 108 OSA patients were enrolled. Six months after surgery, the major parameters of polysomnography (PSG), mean deviation, and pattern standard deviation of SAP significantly improved in these OSA patients. Regarding the OCT parameters, thickness of ML in the nasal-outer, superior-inner, temporal-inner, inferior-inner, nasal-inner sectors, and total ML thickness significantly increased 6 months after upper airway surgery in the severe OSA group (apnea/hypopnea index ⩾30 per hour).

CONCLUSION:

The visual sensitivities on SAP, ML thickness on OCT, and oxygenation status on PSG significantly improved 6 months after upper airway surgery in patients with severe OSA. Upper airway surgery may ameliorate the microstructures of the retina in patients with severe OSA.

KEYWORDS:

glaucoma; macular thickness; obstructive sleep apnea surgery; obstructive sleep apnea syndrome; retinal nerve fiber layer

PMID:
 
31091983
 
DOI:
 
10.1177/0003489419849082
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