Evaluation of Reliability of Ultrasonographic Parameters in Differentiating Benign and Metastatic Cervical Group of Lymph Nodes

The aim of the current study is to determine the efficacy of ultrasound in differentiating between benign and metastatic group of cervical lymph nodes. The study included forty-five subjects who were divided into three groups with 15 in each, by stratified random sampling method. Group 1 comprised fifteen patients without signs and symptoms of any infection and neoplasms in head and neck region (control group). Group 2 included fifteen patients with signs and symptoms of malignancy in head and neck region. Group 3 consisted of fifteen patients with signs and symptoms of odontogenic infections. “MY LAB-40” ultrasound machine with linear array transducer of 7.5 MHZ frequency was used for detecting cervical lymph nodes following Hajek’s classification. The patients further underwent ultrasound guided FNAC under standard aseptic protocol and samples were subjected to cytopathological evaluation. Chi square analysis and one way ANOVA test were applied to obtain the results. We concluded that ultrasound and USG FNAC can be used accurately to assess the status of lymph nodes. The ultrasonographic features of lymph nodes with round shape, absence of hilar echo, sharp nodal borders, hyperechoic internal echogenicity, and presence of intranodal necrosis were highly suggestive of metastatic cervical lymph nodes.

Association of Auditory Steady State Responses with Perception of Temporal Modulations and Speech in Noise

Amplitude modulations in the speech convey important acoustic information for speech perception. Auditory steady state response (ASSR) is thought to be physiological correlate of amplitude modulation perception. Limited research is available exploring association between ASSR and modulation detection ability as well as speech perception. Correlation of modulation detection thresholds (MDT) and speech perception in noise with ASSR was investigated in twofold experiments. 30 normal hearing individuals and 11 normal hearing individuals within age range of 18–24 years participated in experiments 1 and 2, respectively. MDTs were measured using ASSR and behavioral method at 60 Hz, 80 Hz, and 120 Hz modulation frequencies in the first experiment. ASSR threshold was obtained by estimating the minimum modulation depth required to elicit ASSR (ASSR-MDT). There was a positive correlation between behavioral MDT and ASSR-MDT at all modulation frequencies. In the second experiment, ASSR for amplitude modulation (AM) sweeps at four different frequency ranges (30–40 Hz, 40–50 Hz, 50–60 Hz, and 60–70 Hz) was recorded. Speech recognition threshold in noise (SRTn) was estimated using staircase procedure. There was a positive correlation between amplitude of ASSR for AM sweep with frequency range of 30–40 Hz and SRTn. Results of the current study suggest that ASSR provides substantial information about temporal modulation and speech perception.

The Vestibular-Auditory Interaction for Auditory Brainstem Response to Low Frequencies

Since saccular projection is sound sensitive, the objective is to investigate the possibility that the saccular projections may contribute to auditory brainstem response to 500 HZ tone burst (ABR500 HZ). During the case-control research, twenty healthy controls compared to forty selected case groups as having chronic and resistant BPPV were evaluated in the audiology department of Hamadan University of Medical Sciences (Hamadan, Iran). Assessment is comprised of audiologic examinations, cervical vestibular evoked myogenic potentials (cVEMPs), and ABR500 HZ. We found that forty affected ears of BPPV patients with decreased vestibular excitability as detected by abnormal cVEMPs had abnormal results in ABR500 HZ, whereas unaffected ears presented normal findings. Multiple comparisons of mean p13, n23 latencies, and peak-to-peak amplitudes between three groups (affected, unaffected, and healthy ears) were significant. In conclusion, the saccular nerves can be projective to auditory bundles and interact with auditory brainstem response to low frequencies. Combine the cVEMPs and ABR500 HZ in battery approach tests of vestibular assessment and produce valuable data for judgment on the site of lesion. Regarding vestibular cooperation for making of wave V, it is reasonable that the term of ABR500 HZ is not adequate and the new term or vestibular-auditory brainstem response to 500 HZ tone burst is more suitable.

The Occurrence of Laryngeal Penetration and Aspiration in Patients with Glottal Closure Insufficiency

Glottal closure during the pharyngeal phase of swallowing is one of the important steps in protecting the airway. Generally, it is believed that any deficiency in this process can lead to laryngeal penetration and aspiration. This study investigated the incidence of laryngeal penetration and aspiration among 44 patients with glottal closure insufficiencies that were referred for voice and swallowing evaluation to our institution. The videostroboscopy and 3 oz water swallow test were performed for all of the patients and dysphagic patients were screened and referred for videofluoroscopy. Overall, 15.90% of patients demonstrated signs of laryngeal penetration (13.63%) and aspiration (2.27%). The patients with the pattern of incomplete closure illustrated the highest percentage of penetration-aspiration (21.73%, 4.34%) among other GCI patterns. Thus, early interventions for these patients’ swallowing condition seem necessary.

Oral Tongue Squamous Cell Carcinoma in Young Women: A Matched Comparison—Do Outcomes Justify Treatment Intensity?

Background. The incidence of oral tongue squamous cell carcinoma (OTSCC) in young women is increasing with uncertain outcomes compared to traditional patients. Published outcomes data are at odds in this cohort of young women. Methods. Retrospective analysis comparing demographic, clinicopathologic, and outcomes data of women OTSCC patients younger than 45 years old matched 1 : 2 by stage with men both younger and older than 45 and women older than 45. Results. No disease-free or overall survival differences were found between cohorts. Young women were significantly more likely to receive radiation therapy, particularly in stage I disease, even when controlling for common pathologic indications. Conclusions. OTSCC in young women was not associated with worse outcomes compared to a matched cohort of other patients. Increased frequency of radiation treatment for this cohort may not be justified.

Feasibility of Endoscopic Treatment of Middle Ear Myoclonus: A Cadaveric Study

Stapedius and tensor tympani tenotomy is a relatively simple surgical procedure commonly performed to control pulsatile tinnitus due to middle ear myoclonus and for several other indications. We designed a cadaveric study to assess the feasibility of an entirely endoscopic approach to stapedius and tensor tympani tenotomy. We performed this endoscopic ear surgery in 10 cadaveric temporal bones and summarized our experience. Endoscopic stapedius and tensor tympani section is a new, minimally invasive treatment option for middle ear myoclonus that should be considered as the first line surgical approach in patients who fail medical therapy. The use of an endoscopic approach allows for easier access and vastly superior visualization of the relevant anatomy, which in turn allows the surgeon to minimize tissue dissection. The entire operation, including raising the tympanomeatal flap and tendon section, can be safely completed under visualization with a rigid endoscope.

Hypersensitivity of Vestibular System to Sound and Pseudoconductive Hearing Loss in Deaf Patients

The objective of this cross-sectional study is to compare bone-conducted low-frequency hearing thresholds (BClf) to cervical vestibular evoked myogenic potentials (cVEMPs) findings in prelingual adult deaf patients. The fifty participants (100 ears) included twenty healthy controls and thirty other subjects selected from patients who presented with bilateral prelingual deafness to Department of Audiology of Hamadan University of Medical Sciences and Health Services (Hamadan, Iran). Assessments comprised of audiological evaluations, cVEMPs, and computerized tomography scans. Twenty deaf patients (forty affected ears) with bilateral decreased vestibular excitability as detected by abnormal cVEMPs revealed that BClf hearing thresholds were completely absent. Ten deaf patients (twenty unaffected ears) with normal cVEMPs reported a sensation of the sound at BClf hearing thresholds (the mean for 250 Hz=41 dBHL and for 500 Hz=57.75 dBHL). Multiple comparisons of mean p 13 latencies, mean n23 latencies and peak-to-peak amplitudes between three groups were significant (P = 0.01 for all, one-way ANOVA test). Multiple Comparisons of mean BClf between three groups were significant (P = 0.00, One-way ANOVA test). Conclusion. Hypersensitivity of vestibular system to sound augments BClf hearing thresholds in deaf patients. The sensation of the sound at low frequencies may be present in patients with total deafness and normal vestibular function (predominantly saccule). This improvement disappears when saccular function is lost.

Sunitinib Improves Some Clinical Aspects and Reverts DMBA-Induced Hyperplasic Lesions in Hamster Buccal Pouch

Oral squamous cell carcinoma (OSCC) is a public health problem. The hamster buccal pouch model is ideal for analyzing the development of OSCC. This research analysed the effects of sunitinib (tyrosine kinase inhibitor) in precancerous lesions induced by 7,12-dimethylbenz(a)anthracene (DMBA) in this model. Thirty-four male hamsters, divided into six groups: control—C n=7, acetone—A n=12, carbamide peroxide—CP n=5, acetone and CP—A+CP n=8, 1% DMBA in acetone and CP—DA+CP n=6, and 1% DMBA in acetone and CP and 4-week treatment with sunitinib—DA+CP+S n=7. The aspects evaluated were anatomopathological features (peribuccal area, paws, nose, and fur), histological sections of the hamster buccal pouches (qualitatively analyzed), epithelium thickness, and the rete ridge density (estimated). Sunitinib was unable to attenuate the decrease in weight gain induced by DMBA; no increase in volume was detected in the pouch and/or ulceration, observed in 43% of the animals in the DA+CP group. DA+CP groups presented a significant increase in rete ridge density compared to the control groups (P<0.01) which was reverted by sunitinib in the DA+CP+S group. Sunitinib seems to have important benefits in early stage carcinogenesis and may be useful in chemoprevention.

Value and Efficacy of Foley Catheter Removal of Blunt Pediatric Esophageal Foreign Bodies

Objective. To discuss the safety and efficacy of Foley catheter removal of blunt pediatric esophageal foreign bodies. Methods. Analyzing our first 17 cases of pediatric esophageal foreign bodies removed by Foley catheter method in respect of the efficacy, removal methods, and complications. We also reviewed related literature and discussed the background, current status, and technical matters that need attention of this method. Results. In three-year period between May 2010 and May 2013, in 16 out of 17 children blunt radiopaque foreign bodies impacted in the esophagus were successfully removed by a Foley catheter. There were no complications. In one patient, the foreign body was advanced into stomach and came out with stool 2 days later. Conclusions. The technique is safe, rapid, and cost-effective procedure and applicable for blunt, flat foreign bodies impacted in the esophagus.

Maxillofacial Fractures in the Province of Pescara, Italy: A Retrospective Study

The aim of the present study was to assess the etiology and pattern of maxillofacial fractures in the Province of Pescara, Abruzzo, Central Italy. Was performed a retrospective review of patients treated at the Department of Maxillofacial Surgery of Spirito Santo Hospital from January 2010 to December 2012. Data collected and analyzed included sex, age, cause of injury, site of fracture, monthly distribution, and alcohol misuse. A total of 306 patients sustaining 401 maxillofacial fractures were treated. There were 173 males (56.5%) and 133 females (43.5%). Most of the patients (36.9%) were in the age group of 18–44 years. The most common causes of injuries were road traffic accidents (26.4%); the second leading cause was interpersonal violence (23.2%), followed by injuries associated with falls (19.2%). Fractures of the mandible (31%) and zygoma (23%) were the most common maxillofacial fractures in our study. The monthly distribution peaked in the summer (July and August, 30.4%) and in October (13.1%). In conclusion, this study confirms the close correlation between the incidence and etiology of facial fractures and the geographical, cultural, and socioeconomic features of a population. The data obtained provide important information for the design of future plans for injury prevention and for education of citizens.