Influence of smoking history on the perception of radiation-induced dysgeusia/hypogeusia in patients with head and neck cancer.

gnorimies20.15 shared this article with you from Inoreader Influence of smoking history on the perception of radiation-induced dysgeusia/hypogeusia in patients with head and neck cancer. Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Related Articles Influence of smoking history on the perception of radiation-induced dysgeusia/hypogeusia in patients with head and neck cancer. Eur Arch Otorhinolaryngol. 2020 Oct 31;: Authors: Park D, Jain S, Quay-De La Vallee Z, Huber K, O'Leary M, Farag AM Abstract OBJECTIVES: This investigation aimed to assess the effect of smoking on the onset and resolution of dysgeusia/hypogeusia in head and neck cancer (HNC) patients receiving radiotherapy (XRT). MATERIALS AND METHODS: This is a retrospective cohort investigation of HNC patients treated with XRT. Data collected from the patients' medical records included demographics, primary cancer diagnoses, HNC therapeutic modalities, smoking status, and dates of onset/resolution of dysgeusia/hypogeusia. RESULTS: A 103 met inclusion criteria, of which 61.8% developed dysgeusia/hypogeusia. Mean age was 58.3 ± 12.9 and 66% were either former or current smokers. Never smokers seemed to be at higher, but statistically insignificant, the risk for developing dysgeusia/hypogeusia than former or current smokers [HR 1.05 and 1.66; 95% CI (0.60, 1.84) and (0.85, 3.24)]. They were also less likely to recover when compared to former smokers [HR 0.74; 95% CI (0.39, 1.39)]. Although statistically insignificant, never smokers showed rapid dysgeusia/hypogeusia onset after XRT compared to former or current smokers (median 14 days versus 22 and 9 days, respectively; p = 0.25). Never smokers showed quicker but statistically insignificant, recovery time compared to former or current smokers (median 113 days versus 149 and 238 days, respectively; p = 0.57). CONCLUSION: Although results lacked statistical significance, never smokers receiving XRT were prone to higher risk and faster onset of dysgeusia/hypogeusia than former and current smokers. PMID: 33128589 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk Score of Neck Hematoma: How to Select Patients for Ambulatory Thyroid Surgery?

gnorimies20.15 shared this article with you from Inoreader Risk Score of Neck Hematoma: How to Select Patients for Ambulatory Thyroid Surgery? Via World Journal of Endocrine Surgery Related Articles Risk Score of Neck Hematoma: How to Select Patients for Ambulatory Thyroid Surgery? World J Surg. 2020 Oct 30;: Authors: Chereau N, Godiris-Petit G, Noullet S, Di Maria S, Tezenas du Montcel S, Menegaux F Abstract BACKGROUND: The risk of postoperative compressive hematoma is the major limitation for a wide development of ambulatory thyroidectomy (AT). The aim of this study was to establish a risk score of hematoma on the basis of preoperative criteria. METHODS: All patients who underwent thyroidectomy between 2002 and 2017 were reviewed in a high-volume endocrine surgery center. Multivariate analysis of risk factors associated with hematoma was performed in lobectomy and total thyroidectomy (TT). We assigned the risk factors identified by multivariate analysis weighted points proportional to the regression coefficient values. A simple sum of all accumulated points for each patient calculated the total score. RESULTS: For lobectomy [31 hematoma among 3912 patients (0.8%)], the weighted points of Vit K antagonist (VKA) were 3 (OR 9.86), and 1 in male gender (OR 2.4). For TT [162 hematoma among 13,903 patients (1.2%)], the weighted points of VKA were 4 (OR 12.18), 1 in male gender (OR 1.89), and 1 for diabetes (OR 1.86). Other factors weighted 0 in both groups. A total score >1 was linked to a risk of hematoma > 1.3% for lobectomy or TT. AT should not be proposed to any patient under VKA, and in case of TT, to male patients with diabetes. Prospectively, patients had AT from May 2018 to February 2020, 529 patients underwent ambulatory TL (483) or TT (46) and only one patient experienced neck hematoma. CONCLUSION: We established a simple and reproducible predictive score of early discharge for lobectomy and TT that could be useful for patients' management. PMID: 33128087 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thiamine-Responsive Acute Pulmonary Hypertension of Early Infancy (TRAPHEI)-A Case Series and Clinical Review.

gnorimies20.15 shared this article with you from Inoreader Thiamine-Responsive Acute Pulmonary Hypertension of Early Infancy (TRAPHEI)-A Case Series and Clinical Review. Via pubmed: voice Related Articles Thiamine-Responsive Acute Pulmonary Hypertension of Early Infancy (TRAPHEI)-A Case Series and Clinical Review. Children (Basel). 2020 Oct 28;7(11): Authors: Panigrahy N, Chirla DK, Shetty R, Shaikh FAR, Kumar PP, Madappa R, Lingan A, Lakshminrusimha S Abstract Persistent pulmonary hypertension of the newborn (PPHN) is a syndrome of high pulmonary vascular resistance (PVR) commonly seen all over the world in the immediate newborn period. Several case reports from India have recently described severe pulmonary hypertension among infants in the postneonatal period. These cases typically present with respiratory distress in 1-6-month-old infants, breastfed by mothers on a polished rice-based diet. Predisposing factors include respiratory tract infection such as acute laryngotracheobronchitis with change in voice, leading to pulmonary hypertension, right atrial and ventricular dilation, pulmonary edema and hepatomegaly. Mortality is high without specific therapy. Respiratory support, pulmonary vasodilator therapy, inotropes, diuretics and thiamine infusion have improved the outcome of these infants. This review outlines four typical patients with thiamine-responsive acute pulmonary hypertension of early infancy (TRAPHEI) due to thiamine deficiency and discusses pathophysiology, clinical features, diagnostic criteria and therapeutic options. PMID: 33126440 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Breaking bad news: what parents would like you to know.

gnorimies20.15 shared this article with you from Inoreader Breaking bad news: what parents would like you to know. Via pubmed: voice Related Articles Breaking bad news: what parents would like you to know. Arch Dis Child. 2020 Oct 30;: Authors: Brouwer MA, Maeckelberghe ELM, van der Heide A, Hein IM, Verhagen EAAE Abstract OBJECTIVE: Breaking bad news about life-threatening and possibly terminal conditions is a crucial part of paediatric care for children in this situation. Little is known about how the parents of children with life-threatening conditions experience communication of bad news. The objective of this study is to analyse parents' experiences (barriers and facilitators) of communication of bad news. DESIGN: A qualitative study consisting of a constant comparative analysis of in-depth interviews conducted with parents. SETTING: The Netherlands. PARTICIPANTS: Sixty-four parents-bereaved and non-bereaved-of 44 children (aged 1-12 years, 61% deceased) with a life-threatening condition. INTERVENTIONS: None. RESULTS: Based on parents' experiences, the following 10 barriers to the communication of bad news were identified: (1) a lack of (timely) communication, (2) physicians' failure to ask parents for input, (3) parents feel unprepared during and after the conversation, (4) a lack of clarity about future treatment, (5) physicians' failure to voice uncertainties, (6) physicians' failure to schedule follow-up conversations, (7) presence of too many or unknown healthcare professionals, (8) parental concerns in breaking bad news to children, (9) managing indications of bad news in non-conversational contexts, and (10) parents' misunderstanding of medical terminology. CONCLUSIONS: This study shows healthcare professionals how parents experience barriers in bad news conversations. This mainly concerns practical aspects of communication. The results provide practical pointers on how the communication of bad news can be improved to better suit the needs of parents. From the parents' perspective, the timing of conversations in which they were informed that their child might not survive was far too late. Sometimes, no such conversations ever took place. PMID: 33127614 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Relationship Between Corrective Saccades and Measures of Physical Function in Unilateral and Bilateral Vestibular Loss

Greek DailyNews shared this article with you from Inoreader Relationship Between Corrective Saccades and Measures of Physical Function in Unilateral and Bilateral Vestibular Loss Via Ear and Hearing - Current Issue Objectives: Following the loss of vestibular function, some patients functionally improve and are minimally bothered by their loss of peripheral function while others remain more symptomatic and are unable to return to their activities of daily living. To date, the mechanisms for functional improvement remain poorly understood. The purpose of the present study was to examine the association between corrective saccades and measures of handicap, dynamic visual acuity, gait, and falls. Design: A retrospective chart review was performed to identify patients who were diagnosed with unilateral or bilateral vestibular hypofunction and who also completed a baseline vestibular rehabilitation evaluation. A total of 82 patients with unilateral vestibular hypofunction and 17 patients with bilateral vestibular hypofunction were identified. The video head impulse test results for each patient were grouped based on the type of presenting saccades. Specifically, the saccade grouping included the following: (1) covert, (2) overt, or (3) a combination of both types of saccades. Results: The results show that covert saccades are associated with better performance on measures of dynamic visual acuity, gait, and balance in patients with unilateral vestibular hypofunction. Patients exhibiting overt saccades or combination of both covert and overt saccades were more often found to have an abnormal gait speed and be characterized as being at risk for falls using the Dynamic Gait Index. We observed no differences in physical function for those patients with bilateral vestibular hypofunction as a function of saccade grouping. Conclusions: When comparing saccade groups (covert, overt, or combination of both), patients with unilateral vestibular hypofunction and covert saccades demonstrated better performance on standard baseline physical therapy measures of dynamic visual acuity and gait and balance. We did not observe any significant associations between saccade group and physical function in patients with bilateral vestibular hypofunction; however, additional studies are needed with adequate sample sizes. Our findings may suggest that corrective saccade latency in patients with unilateral vestibular hypofunction is related to measures of physical function. The extent to which saccade latency has the potential to be a useful target for vestibular rehabilitation is still to be determined and may be promising target to improve functional outcomes. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Toward a Better Understanding of Electrocochleography: Analysis of Real-Time Recordings

Greek DailyNews shared this article with you from Inoreader Toward a Better Understanding of Electrocochleography: Analysis of Real-Time Recordings Via Ear and Hearing - Current Issue Objectives: Real-time electrocochleography (ECochG) has been used as a monitoring tool during cochlear implantation (CI), whereby, amplitude drops have been correlated with postoperative acoustic hearing results. However, no consensus has been reached as to how a single event of an amplitude drop should be characterized. The aim of this study was to identify ECochG events that predict loss of hearing 1 month after surgery. Design: Fifty-five patients were included in this prospective cohort study. Real-time ECochG measurements were performed during CI electrode insertion. Single ECochG events were characterized according to their amplitude loss and slope steepness. Results: Using receiver operating characteristic analyses, the most efficient cut-off criterion for a relative hearing loss of 25% was an amplitude loss of 61% at a fixed slope steepness of 0.2 µV/sec. Three-quarters of our population had at least one such event during implantation. Most events occurred shortly before full insertion. With increasing number of events, median residual hearing thresholds deteriorated for all frequencies. Larger amplitude drops trended toward worse hearing preservation. Signal recovery after an ECochG event could not be correlated to acoustic hearing outcomes. Conclusions: Our data suggest that amplitude drops exceeding 61% of the ongoing signal at a slope steepness of 0.2 µV/sec are correlated with worse acoustic hearing preservation. Clearly defined ECochG events have the potential to guide surgeons during CI in the future. This is essential if a fully automated data analysis is to be employed or benchmarking undertaken. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Binaural Pitch Fusion in Children With Normal Hearing, Hearing Aids, and Cochlear Implants

Greek DailyNews shared this article with you from Inoreader Binaural Pitch Fusion in Children With Normal Hearing, Hearing Aids, and Cochlear Implants Via Ear and Hearing - Current Issue Objectives: Binaural pitch fusion is the perceptual integration of stimuli that evoke different pitches between the ears into a single auditory image. Adults who use hearing aids (HAs) or cochlear implants (CIs) often experience abnormally broad binaural pitch fusion, such that sounds differing in pitch by as much as 3 to 4 octaves are fused across ears, leading to spectral averaging and speech perception interference. The main goal of this study was to measure binaural pitch fusion in children with different hearing device combinations and compare results across groups and with adults. A second goal was to examine the relationship of binaural pitch fusion to interaural pitch differences or pitch match range, a measure of sequential pitch discriminability. Design: Binaural pitch fusion was measured in children between the ages of 6.1 and 11.1 years with bilateral HAs (n = 9), bimodal CI (n = 10), bilateral CIs (n = 17), as well as normal-hearing (NH) children (n = 21). Depending on device combination, stimuli were pure tones or electric pulse trains delivered to individual electrodes. Fusion ranges were measured using simultaneous, dichotic presentation of reference and comparison stimuli in opposite ears, and varying the comparison stimulus to find the range that fused with the reference stimulus. Interaural pitch match functions were measured using sequential presentation of reference and comparison stimuli, and varying the comparison stimulus to find the pitch match center and range. Results: Children with bilateral HAs had significantly broader binaural pitch fusion than children with NH, bimodal CI, or bilateral CIs. Children with NH and bilateral HAs, but not children with bimodal or bilateral CIs, had significantly broader fusion than adults with the same hearing status and device configuration. In children with bilateral CIs, fusion range was correlated with several variables that were also correlated with each other: pure-tone average in the second implanted ear before CI, and duration of prior bilateral HA, bimodal CI, or bilateral CI experience. No relationship was observed between fusion range and pitch match differences or range. Conclusions: The findings suggest that binaural pitch fusion is still developing in this age range and depends on hearing device combination but not on interaural pitch differences or discriminability. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic Accuracy of Intracochlear Test Electrode for Acoustic Nerve Monitoring in Vestibular Schwannoma Surgery

Greek DailyNews shared this article with you from Inoreader Diagnostic Accuracy of Intracochlear Test Electrode for Acoustic Nerve Monitoring in Vestibular Schwannoma Surgery Via Ear and Hearing - Current Issue Objectives: Cochlear implants (CIs) are a well-known hearing restoration option for patients with vestibular schwannoma (VS) in cases of neurofibromatosis type-2 and, more recently, for patients with sporadic VS. One of the main limitations when performing CI during VS surgery is the capability to preserve the acoustic nerve (AN) anatomically and functionally. Significant efforts have been directed toward developing an intraoperative testing method for monitoring the AN function to determine if, after tumor removal, it is suitable for conducting stimuli delivered by a CI. However, all these methods have significant limitations, and none of them have documented diagnostic efficacy. To overcome these limitations and to obtain reliable information before CI insertion, a minimally invasive intracochlear test electrode (TE) has been recently developed. This TE has demonstrated to be suitable to test the integrity of the AN before CI in patients without any residual hearing by recording electrically e voked auditory brainstem responses (EABR). The present study constitutes the next phase of this research, which was to determine the usefulness of EABR obtained intraoperatively with the intracochlear TE after the resection of a VS and to calculate its diagnostic accuracy to assess the functionality of the AN for CI. Design: This was a prospective, multicenter study of diagnostic accuracy. It was conducted in three tertiary referral centers between January 2015 and 2018. This study was designed following the Standards for Reporting of Diagnostic Accuracy Studies (STARD) statement guidelines. The STARD statement are guidelines to improve the completeness and transparency of reports of diagnostic accuracy studies. The diagnostic accuracy of the EABR evoked with the intracochlear TE after tumor removal was studied. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Patients eligible for the study were consecutive adults undergoing surgery for VS with simultaneous CI. The test under evaluation (index test) was the EABR obtained with the intracochlear TE after resection of the tumor. The reference test (gold standard) was the presence of auditory perception with the CI, defined as the presence of sound detection on an audiogram at 500, 1000, 2000, and 4000 Hz of no greater than 50 dB. In all the cases, auditory perception was verified by the presence of a positive EABR evoked with the CI. Results: Twenty-one patients were included during the study period; seven patients were excluded from the diagnostic efficacy analysis due to inconclusive EABR results or absence of the gold standard to compare (they did not finally receive the CI). Thus, the outcome of the gold standard was assessed in 14 cases: 9 cases had positive EABR, all of them obtained auditory perception with the CI, and 5 cases had negative EABR, only one case had auditory perception with the CI, which constitutes the only false negative of this study. Accuracy of the TE was 93% (95% confidence interval, 66 to 100%), sensitivity 90% (95% confidence interval, 71 to 100%), specificity 100% (95% confidence interval, 100 to 100%), positive predictive value 100% (95% confidence interval, 100 to 100%), and negative predictive value 80% (95% confidence interval, 45 to 100%). Conclusions: EABR elicited with the intracochlear TE had a diagnostic accuracy of 93% for predicting auditory perception with CIs after VS removal. These results suggest that the intracochlear TE can be used intraoperatively after tumor removal to test the integrity of the AN as a useful tool to complement the surgeon's perception for decision-making regarding implantation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Operationalization of the Brief ICF Core Set for Hearing Loss: An ICF-Based e-Intake Tool in Clinical Otology and Audiology Practice

Greek DailyNews shared this article with you from Inoreader Operationalization of the Brief ICF Core Set for Hearing Loss: An ICF-Based e-Intake Tool in Clinical Otology and Audiology Practice Via Ear and Hearing - Current Issue Objectives: According to the International Classification of Functioning, Disability and Health (ICF), functioning reflects the interplay between an individual's body structures and functions, activities, participation, environmental, and personal factors. To be useful in clinical practice, these concepts need to be operationalized into a practical and integral instrument. The Brief ICF Core Set for Hearing Loss (CSHL) provides a minimum standard for the assessment of functioning in adults with hearing loss. The objective of the present study was to operationalize the Brief CSHL into a digital intake tool that could be used in the otology–audiology practice for adults with ear and hearing problems as part of their intake assessment. Design: A three-step approach was followed: (1) Selecting and formulating questionnaire items and response formats, using the 27 categories of the Brief CSHL as a basis. Additional categories were selected based on relevant literature and clinical expertise. Items were selected from existing, commonly used disease-specific questionnaires, generic questionnaires, or the WHO's official descriptions of ICF categories. The response format was based on the existing item's response categories or on the ICF qualifiers. (2) Carrying out an expert survey and a pilot study (using the three-step test interview. Relevant stakeholders and patients were asked to comment on the relevance, comprehensiveness, and comprehensibility of the items. Results were discussed in the project group, and items were modified based on consensus. (3) Integration of the intake tool into a computer-based system for use in clinical routine. Results: The Brief CSHL was operationalized into 62 items, clustered into six domains: (1) general information, including reason for visit, sociodemographic, and medical background; (2) general body functions; (3) ear and hearing structures and functions; (4) activities and participation (A&P); (5) environmental factors (EF); and (6) personal factors (mastery and coping). Based on stakeholders' responses, the instructions of the items on A&P and EF were adapted. The three-step test interview showed that the tool had sufficient content validity but that some items on EF were redundant. Overall, the stakeholders and patients indicated that the intake tool was relevant and had a logical and clear structure. The tool was integrated in an online portal. Conclusions: In the current study, an ICF-based e-intake tool was developed that aims to screen self-reported functioning problems in adults with an ear/hearing problem. The relevance, comprehensiveness, and comprehensibility of the originally proposed item list was supported, although the stakeholder and patient feedback resulted into some changes of the tool on item-level. Ultimately, the functioning information obtained with the tool could be used to promote patient-centered ear and hearing care taking a biopsychosocial perspective into account. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Linguistic Complexity of Speech Recognition Test Sentences and Its Influence on Children’s Verbal Repetition Accuracy

Greek DailyNews shared this article with you from Inoreader Linguistic Complexity of Speech Recognition Test Sentences and Its Influence on Children's Verbal Repetition Accuracy Via Ear and Hearing - Current Issue Objectives: Speech recognition (SR)-tests have been developed for children without considering the linguistic complexity of the sentences used. However, linguistic complexity is hypothesized to influence correct sentence repetition. The aim of this study is to identify lexical and grammatical parameters influencing verbal repetition accuracy of sentences derived from a Dutch SR-test when performed by 6-year-old typically developing children. Design: For this observational, cross-sectional study, 40 typically developing children aged 6 were recruited at four primary schools in the Netherlands. All children performed a sentence repetition task derived from an SR-test for adults. The sentence complexity was described beforehand with one lexical parameter, age of acquisition, and four grammatical parameters, specifically sentence length, prepositions, sentence structure, and verb inflection. A multiple logistic regression analysis was performed. Results: Sentences with a higher age of acquisition (odds ratio [OR] = 1.59) or greater sentence length (OR = 1.28) had a higher risk of repetition inaccuracy. Sentences including a spatial (OR = 1.25) or other preposition (OR = 1.25) were at increased risk for incorrect repetition, as were complex sentences (OR = 1.69) and sentences in the present perfect (OR = 1.44) or future tense (OR = 2.32). Conclusions: The variation in verbal repetition accuracy in 6-year-old children is significantly influenced by both lexical and grammatical parameters. Linguistic complexity is an important factor to take into account when assessing speech intelligibility in children. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Speech-in-Noise Recognition With More Realistic Implementations of a Binaural Cochlear-Implant Sound Coding Strategy Inspired by the Medial Olivocochlear Reflex

Greek DailyNews shared this article with you from Inoreader Speech-in-Noise Recognition With More Realistic Implementations of a Binaural Cochlear-Implant Sound Coding Strategy Inspired by the Medial Olivocochlear Reflex Via Ear and Hearing - Current Issue Objectives: Cochlear implant (CI) users continue to struggle understanding speech in noisy environments with current clinical devices. We have previously shown that this outcome can be improved by using binaural sound processors inspired by the medial olivocochlear (MOC) reflex, which involve dynamic (contralaterally controlled) rather than fixed compressive acoustic-to-electric maps. The present study aimed at investigating the potential additional benefits of using more realistic implementations of MOC processing. Design: Eight users of bilateral CIs and two users of unilateral CIs participated in the study. Speech reception thresholds (SRTs) for sentences in competition with steady state noise were measured in unilateral and bilateral listening modes. Stimuli were processed through two independently functioning sound processors (one per ear) with fixed compression, the current clinical standard (STD); the originally proposed MOC strategy with fast contralateral control of compression (MOC1); a MOC strategy with slower control of compression (MOC2); and a slower MOC strategy with comparatively greater contralateral inhibition in the lower-frequency than in the higher-frequency channels (MOC3). Performance with the four strategies was compared for multiple simulated spatial configurations of the speech and noise sources. Based on a previously published technical evaluation of these strategies, we hypothesized that SRTs would be overall better (lower) with the MOC3 strategy than with any of the other te sted strategies. In addition, we hypothesized that the MOC3 strategy would be advantageous over the STD strategy in listening conditions and spatial configurations where the MOC1 strategy was not. Results: In unilateral listening and when the implant ear had the worse acoustic signal-to-noise ratio, the mean SRT was 4 dB worse for the MOC1 than for the STD strategy (as expected), but it became equal or better for the MOC2 or MOC3 strategies than for the STD strategy. In bilateral listening, mean SRTs were 1.6 dB better for the MOC3 strategy than for the STD strategy across all spatial configurations tested, including a condition with speech and noise sources colocated at front where the MOC1 strategy was slightly disadvantageous relative to the STD strategy. All strategies produced significantly better SRTs for spatially separated than for colocated speech and noise sources. A statistically significant binaural advantage (i.e., better mean SRTs across spatial configurations and participants in bilateral than in unilateral listening) was found for the MOC2 and MOC3 strategies but not for the STD or MOC1 strategies. Conclusions: Overall, performance was best with the MOC3 strategy, which maintained the benefits of the originally proposed MOC1 strategy over the STD strategy for spatially separated speech and noise sources and extended those benefits to additional spatial configurations. In addition, the MOC3 strategy provided a significant binaural advantage, which did not occur with the STD or the original MOC1 strategies. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.