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Introduction: While the cochleotoxicity of cisplatin has been well investigated, less is known about the effects of platinum-based chemotherapy on the vestibular system. In particular, there is a lack of prospective studies using modern laboratory vestibular testing that examine the effects of cisplatin on the semicircular canals and on the otolith organs. The aim of the present study was, therefore, to investigate the vestibulotoxic effect of cisplatin in patients with head and neck tumors who are undergoing chemoradiation. Methods: Forty-five patients undergoing cisplatin-based chemoradiation for head and neck cancer received a vestibular assessment consisting of anamnesis, a horizontal video head impulse test (vHIT), ocular and cervical vestibular evoked myogenic potential testing, as well as pure tone audiometry. This assessment was performed before therapy, 6 weeks after therapy, and 3 months after therapy. Results: Video head impulse test showed a significantly reduced median gain 6 weeks after chemoradiation. In addition, significantly more refixational saccades could be detected after therapy. Vestibular evoked myogenic potential testing results also revealed significant changes, whereas pure tone audiometry did not. None of the patients mentioned "dizziness" during the follow-up examinations. Conclusion: We demonstrated a vestibulotoxic effect of cisplatin-based chemoradiation in patients with head and neck cancer. Future studies are needed to better understand cisplatin-induced vestibulotoxicity and to identify possible vestibuloprotective substances. Still, before and after chemoradiation, patients should undergo not only auditory testing but also vestibular testing in order to detect potential vestibular loss as soon as possible and to quickly initiate vestibular physiotherapy. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnea (OSA) is a sleep disorder with a prevalence of 9–38%. The underlying pathology in OSA is a collapse of the upper airway. Especially in more severely affected patients, this collapse is often located at the level of the tongue base. Therefore, various implantable systems (anchors and ligament techniques) were developed to prevent or overcome this collapse. These systems are exposed to various forces. Different models have been developed to measure these forces and data comparing forces in healthy individuals with OSA patients are rare. Purpose: Purpose of the study was to evaluate possible differences in tongue forces between healthy individuals and patients with OSA. Method: To evaluate maximum isometric tongue forces, we conducted a matched pair design study including 20 healthy individuals and 20 patients suffering from OSA. Maximum isometric tongue forces were measured in an anterior/posterior direction with the help of self-designed new device that clamps the tongue. Results: We could show that the maximum isometric force does not differ significantly in healthy individuals (10.7 ± 5.2N) from patients with OSA (14.4 ± 6.3N). Conclusion: Currently there are no indications that maximum isometric tongue force does differ in healthy individuals and patients with OSA. Higher, as well as lower, tongue forces in patients with OSA seem not to differ from healthy subjects and therefore may not be needed to consider, in the development of tongue management devices, for OSA patients. [ABSTRACT FROM AUTHOR]

Background: The most commonly performed surgical procedure for obstructive sleep apnea (OSA) is uvulopalatopharyngoplasty with or without tonsillectomy (UPPP ± TE). However, there is currently no review solely focusing on clinically relevant effects of standard UPPP technique with or without tonsillectomy as a monotherapy in patients with OSA.Methods: A systematic review and meta-analysis were performed to assess the effects of isolated UPPP ± TE in patients with OSA. Studies of any design referring to adult patients with obstructive sleep apnea diagnosed via polysomnography or comparable objective measures were considered, in which isolated "standard" UPPP ± TE was performed.Results: Forty-eight studies were included for the qualitative analysis. All but one study demonstrated a reduction in the frequency of respiratory events and success/response rates ranged from 35 to 95.2%. In the six studies that reported pre- and postoperative mean scores of the Epworth Sleepiness Scale (ESS), a reduction in sleepiness scores was demonstrated. Data addressing the effect of UPPP ± TE in comparison to no treatment or control were available from two randomized controlled trials (RCT). When pooling the data, UPPP ± TE was significantly more effective in reducing the apnea-hypopnea index (AHI) and Epworth Sleepiness Scale (ESS) (large effect): an AHI mean difference (MD) of -18.59 (95% CI -34.14, -3.04) and an ESS MD of -5.37 (95% CI -7,03, -3.72). Data addressing effect of UPPP ± TE in comparison to baseline was available from three RCT. When pooling the data, the AHI was reduced from a mean 35.4 to 17.9 (49.5% reduction); a MD of -20.41, 95% CI -32.78, -8.04 (-1.80, -1.15) (large effect). Various additional beneficial effects of UPPP ± TE were demonstrated including improvement in sexual function, ventricular function, sleep stages, serum lipid, depressive disorder and driving performance.Conclusion: UPPP ± TE reduces respiratory events and daytime sleepiness in adult patients with OSA and UPPP ± TE is superior to non-treated controls in this regard. Further research is needed to establish the long-term benefit, the impact on cardiovascular morbidity and the role of UPPP ± TE in the variety of available treatment options for OSA. [ABSTRACT FROM AUTHOR]

Purpose: Facial palsy (FP) is the most significant complication of parotidectomy. Currently, the use of intermittent intraoperative neuromonitoring (iIONM) in parotid surgery facilitates nerve detection, which is paramount to nerve protection. Continuous IONM (cIONM), as applied in thyroid surgery, enables real-time information on electrophysiological nerve status through continuous nerve stimulation, thereby allowing consequent amplitude analysis. To date, the application of cIONM in parotid surgery has not been noted in literature. Methods: We performed parotidectomies with anterograde facial nerve visualization using cIONM in 32 consecutive patients in a prospective study (German Register of clinical studies—DRKS 00011051) during the period October 2016 to January 2020. After the facial trunk had been exposed, an atraumatic stimulation electrode was placed and the nerve was stimulated at 3 Hz, at a low threshold (0.62 ± 0.06 mA), for the entire duration of the preparation. Selected electrophysiological parameters were collected and compared to postoperative facial nerve function, measured by the House-Brackmann grading system. Results: In the post hoc analysis, a significant correlation between a drop in amplitude (< 50% of the "baseline" amplitude) and postoperative FP was recorded (p = 0.001). True positive prediction of FP was noted in 14 out of 16 patients and true negative in 10 out of 16. The sensitivity was 87.5% (AUC 0.75), with a high negative predictive value of 83.3%. Conclusion: cIONM has significant value in predicting postoperative FP in parotidectomy. Future development of an acoustic/optic warning system in IONM devices could prevent nerve injury in real time. [ABSTRACT FROM AUTHOR]

Die obstruktive Schlafapnoe (OSA) ist eine der häufigsten schlafbezogenen Atmungsstörungen. Sie betrifft 2-26 % der Gesamtbevölkerung. Die Überdruckbeatmung mittels „continuous positive airway pressure“ (CPAP) wird nach wie vor als Goldstandard in der Therapie angesehen, wobei die Evidenz anderer Behandlungsverfahren stetig wächst. Die am häufigsten durchgeführte chirurgische Therapie der OSA ist die Uvulopalatopharyngoplastik (UPPP). Bisher existiert jedoch keine systematische Übersichtsarbeit hierzu.Es wurden ein systematisches Review und eine Metaanalyse zur Erfassung des Effekts der UPPP bei Patienten mit OSA durchgeführt. Studien jedweden Designs, welche sich auf erwachsene OSA-Patienten bezogen, deren Diagnose mittels Polysomnographie oder mittels vergleichbarer Messung gestellt wurde, wurden in die Analyse einbezogen, solange eine isolierte „Standard-UPPP“ durchgeführt wurde.92 Studien wurden in das systematische Review einbezogen, 53 waren prospektiver und 36 retrospektiver Natur, 3 waren Fallberichte. 18 Studien verwendeten eine Kontrollgruppe zum Vergleich, davon waren 7 randomisiert kontrollierte Studien (RCT). Von diesen qualifizierten sich 3 für die quantitative Metaanalyse. Alle außer 2 (96,4 %) Studien konnten eine Reduktion in der Frequenz der respiratorischen Ereignisse zeigen. Die Erfolgs‑/Ansprechraten variierten zwischen 31,3 und 96 %. In den 7 Studien, die einen prä- und postoperativen Mittelwert der Epworth Sleepiness Scale (ESS) berichteten, konnte eine Reduktion der Schläfrigkeitsscores gezeigt werden. Kombiniert man die Daten der Studien, welche einen Effekt der UPPP im Vergleich mit einer Kontroll- oder unbehandelten Gruppe ausweisen, war die UPPP bezüglich einer Reduktion des Apnoe-Hypopnoe-Index (AHI) sowie des ESS gegenüber einer Kontroll- oder unbehandelten Gruppe signifikant überlegen. Verschiedene andere positive Effekte konnten bezüglich der UPPP in nicht randomisierten Studien nachgewiesen werden.Zusammenfassend reduziert die UPPP sowohl die respiratorischen Ereignisse als auch die Tagesschläfrigkeit bei erwachsenen OSA-Patienten. Die UPPP zeigte sich einer nicht-behandelten Kontrollgruppe in dieser Hinsicht überlegen. Weitere Studien sollten zur differenzierteren Erfassung des Langzeiteffekts, des Einflusses auf die kardiovaskuläre Mortalität und der Rolle der UPPP im verfügbaren Kanon der Therapien der OSA erfolgen. [ABSTRACT FROM AUTHOR]

The evaluation of treatment efficacy for obstructive sleep apnea (OSA) is currently based predominantly on the reduction of respiratory events. However, treatment acceptance and compliance of the patient are of equal importance. To date, no clear definition for measuring and quantifying compliance has been established, although current studies have emphasized the importance of compliance with regard to long-term clinical outcome. The available treatment options for OSA vary significantly with regard to compliance, and the impact on clinical and long-term treatment results is substantial. In order to address the question of compliance when reporting treatment effects and comparing the efficacy of different treatment options, various strategies have been proposed in the literature. Currently, the concept of the mean disease alleviation (MDA) is of particular interest. MDA is based on treatment effect with regard to both the reduction in respiratory events, as well as compliance measured in percent, leading to an overall percentage reduction in disease severity. The concept of MDA has been used to describe treatment effects of various different interventions. Its major advantages are the intuitive report of a single outcome measure and the possibility to directly compare the effects of different treatment strategies. MDA is limited by the definition of compliance, since the values for MDA are only comparable between different treatments as long as the same definition for compliance was used for the calculation of the MDA. With the MDA a new and intuitive outcome measure has become available to assess and compare treatment efficacy; it should be considered as the major outcome measure in future trials. [ABSTRACT FROM AUTHOR]

Initially described in 1998, superior semicircular canal dehiscence syndrome (SCDS) has become a well-studied neurootologic entity in adults by now. Unfortunately, experience with children is limited and a diagnostic and therapeutic algorithm is lacking. The article therefore wants to provide an overview of the existing literature on superior semicircular canal dehiscence syndrome in children. Furthermore a diagnostic algorithm for daily clinical life based on a case report from an eleven-year-old girl is presented. [ABSTRACT FROM AUTHOR]

Adaptation to smells is a well-known phenomenon and appears to be one of the major characteristics of olfaction. However, no standardized protocols for the psychophysical measurement of olfactory adaptation and recovery are available to date. Twenty normosmic participants were included. Hydrogen sulfide (H2S) and phenylethyl alcohol were used in different concentrations based on air dilution olfactometry. Volunteers were exposed to a constant flow of odorous air until perception disappeared completely. For testing recovery, the volunteers were exposed to a reference stimulus following complete self-desensitization with the same odor. The subjects were then again exposed to the same odorant after recovery periods of different lengths and instructed to rate stimulus intensity. The time to complete desensitization increased with increasing stimulus concentration for both odorants. Subjects desensitized more rapidly using H2S. Olfactory adaptation led to a reduction in stimulus intensity for the subsequent identical stimulation. Longer recovery periods resulted in increased intensity of the subsequent stimulus independent of the stimulus used. The results confirm current knowledge regarding the dynamics of olfactory adaptation and demonstrate differences in olfactory desensitization between the 2 odorants used. Olfactory recovery was independent of the odorant used, indicating that olfactory recovery after complete desensitization may be a uniform process. [ABSTRACT FROM AUTHOR]

The interaction of sensory physiology and sleep has been studied for various sensory systems. Nevertheless, the question whether chemosensory stimuli may lead to arousals during sleep remains under discussion. Five young healthy volunteers were included; they were investigated during a total of 37 nights. Intranasal chemosensory stimulation was based on air-dilution olfactometry. For selective olfactory stimulation, H2S, and for trigeminal stimulation CO2was administered in four concentrations each while odorless stimuli were used for control. Arousals were assessed during 30 s intervals after every stimulus using overnight polysomnography. For olfactory testing an average number of 756 olfactory stimuli and 186 controls were used for analysis per subject. Even the highest stimulus concentration did not produce an increase in arousal frequency. For trigeminal testing an average number of 927 stimuli and 223 controls were used for analysis per subject. The trigeminal stimuli produced a significant, linear increase in arousal frequency in relation to stimulus concentration. With the present results we were able to demonstrate that, in contrast to trigeminal stimulation, the presentation of a strong but selective olfactory stimulus does not lead to arousals in non-REM or in REM sleep. [ABSTRACT FROM AUTHOR]

The authors sought to investigate the role of a common single nucleotide polymorphism in the μ-opioid receptor gene (OPRM1) 118A > G for nociceptive sensory processing using event-related potentials (ERPs). Specific nociceptive (carbon dioxide [CO2]: 40% volume-to-volume [vol/vol] and 60% vol/vol) and nonnociceptive (hydrogen sulfide, 2 parts per million [ppm] and 4 ppm) stimuli were applied to the nasal mucosa of 45 volunteers. ERPs were recorded from a central lead. In this random sample, we found 37 noncarriers, 7 heterozygous carriers, and 1 homozygous carrier of the variant OPRM1 118G allele (allelic frequency, 10%). Amplitudes of nociceptive ERP in carriers of this allele were, on average, half as high as those of noncarriers. In discriminant analysis, ERP amplitude N1 response to the weaker nociceptive stimuli was the only ERP parameter that discriminated statistically significantly between carriers and noncarriers of the variant 118G allele. On the basis of N1-CO2 (40% vol/vol), the authors correctly backclassified 68.6% of the cases as carriers or noncarriers of the allele. The OPRM1 118A > G polymorphism specifically modulates nociceptive but not nonnociceptive cortical activation. [ABSTRACT FROM AUTHOR]

Abstract: Aim of the present pilot study was to investigate whether cortically generated chemosensory event-related potentials (ERPs) can be recorded during sleep. Chemosensory function during sleep was assessed in 14 healthy female volunteers. An overnight polysomnography was performed to assess nocturnal sleep and to classify sleep stages. Chemosensory ERPs were recorded using air-dilution olfactometry. H2S (4ppm) was used for olfactory and CO2 (40%, v/v) for trigeminal stimulation. Chemosensory ERPs could be recorded during sleep for both olfactory and trigeminal stimuli in some but not all subjects. Compared to baseline, latencies of olfactory ERPs were longer and amplitudes were larger during light sleep and slow wave sleep (SWS). For trigeminal stimulation N1 latencies were longest during REM sleep. These results indicate that both trigeminal and olfactory ERPs can be recorded during sleep suggesting that chemosensory stimuli are processed on a cortical level during sleep. [Copyright &y& Elsevier]

Objective To investigate the safety and efficacy of combined temperature-controlled radio frequency volumetric tissue reduction of the tongue base and soft palate in obstructive sleep apnoea. Material and Methods A total of 20 patients with obstructive sleep apnoea and combined palatal and retrolingual obstruction were included in a non-randomized clinical trial and 51 combined treatments were performed under local anaesthesia. Postoperative pain was assessed using visual analogue scales. Functional parameters, daytime sleepiness and quality of life were assessed using questionnaires (Epworth Sleepiness Scale, Short Form-36) before and 12 weeks after the last treatment session. Concurrently, polysomnography was performed on two consecutive nights. Results The mean postoperative pain score dropped from 5.6 at Day 1 to 0.6 at Day 7. Painkillers were taken for a mean of 3.3 days. There were no postoperative complications or changes in functional parameters. Daytime sleepiness improved significantly ( p <0.05). The mean respiratory disturbance index was reduced from 25.3±11.4 to 16.7±15.3 ( p <0.05). Six out of 18 (33%) patients were cured after a mean of 2.7 treatment sessions. Conclusion Combined radiofrequency volumetric tissue reduction of the tongue base and soft palate is a safe and effective treatment for obstructive sleep apnoea. [ABSTRACT FROM AUTHOR]

Objective—Temperature-controlled radiofrequency volumetric tissue reduction (RFVTR) is a minimally invasive technique used in the treatment of the tongue base, soft palate and turbinates. Complications seem to be rare, but the scope of previous studies was often limited by the small number of patients included. The aim of this study was to evaluate postoperative complications in a large series of patients. Material and Methods—In this retrospective study, temperature-controlled radiofrequency procedures (Somnoplasty®) performed between May 1998 and March 2002 were considered. The charts of the patients were analyzed with regard to intra- or postoperative complications. Results—In total, 322 patients received 497 treatment sessions; 239 of these treatments were isolated and the remaining 258 were combined procedures. Mean follow-up was 122.8 ± 145.5 days. Concerning radiofrequency surgery, nine postoperative complications were observed (2.0%) as follows: ulcerations of the tongue base or soft palate; dysphagia necessitating hospital admission; temporary palsy of the hypoglossal nerve; and an abscess of the base of the tongue. Conclusions—Complications occurring after RFVTR are infrequent and mostly mild. Overall, temperature-controlled RFVTR is a safe procedure when used both in isolation and as part of a combined approach. [ABSTRACT FROM AUTHOR]

In recent years a considerable effort has been made to establish the use of different surgical techniques for the treatment of obstructive sleep apnea syndrome (OSAS). Nevertheless, treatment of hypopharyngeal obstruction due to tongue base hypertrophy remains in many ways an unsolved problem. The aim of this study was to evaluate the safety and efficacy of tongue base reduction with temperature-controlled radiofrequency volumetric tissue reduction in the treatment of OSAS. Twenty patients with OSAS and tongue base hypertrophy were treated with radiofrequency tissue ablation. An intensified treatment protocol was used, delivering 2,800 J per treatment session under local anesthesia. Two nights of polysomnography testing were performed before and after treatment. Daytime sleepiness, snoring and postoperative morbidity were assessed using questionnaires. Mean respiratory disturbance index (RDI) was reduced from 32.1 to 24.9/h after a mean of 3.4 treatment sessions. Six patients (33%) were cured after the procedure (reduction in RDI of ≥50% and a postoperative RDI of <15/h) and ten (55%) showed an improvement of >20% in their RDI. Daytime sleepiness and snoring improved significantly. Peri- and postoperative morbidity was low; one severe complication occurred (tongue base abscess). We were able to achieve similar cure and responder rates to those reported in a recently published pilot study but with a reduced number of treatment sessions. We believe that this technique may improve patient acceptance and have beneficial cost implications. [ABSTRACT FROM AUTHOR]

Presents a study that investigated the morbidity and complications of a combined treatment of tongue base and soft palate with radiofrequency energy in patients with sleep disordered breathing. Assessment of postoperative pain using ten-centimeter visual analogue scales; Evaluation of postoperative complications; Examination of the presence of pharyngeal irritation and changes of functional parameters, such as taste and swallowing after operation.

Aim: Intratympanic injection of corticosteroids (ITC) and gentamicin therapy (ITG) are widely used treatments for vertigo in Meniere's disease (MD). Even though studies show good results after cochlea implantation (CI) in MD patients when compared to non-MD groups, there is no indication on the effect of ITC and ITG prior to CI on hearing after CI. This study compares the post-operative hearing of CI patients with and without MD and patients who have received ITG or ITC prior to CI. Methods: In a retrospective case control study, adult patients with MD who received CI from 2002 till 2021 were compared to a matched control group of CI patients without MD. Patients with prior ITC/ITG were extracted from MD group. Pre-operative audiological results were measured and trends across post-operative monosyllabic word recognition score at 65 decibels (WRS65CI) at switch-on, 3–6 months, 1 year and last yearly value were analyzed across all groups. Results: 28 MD ears were compared with 33 control ears. From MD ears 9 had received ITG and 6 ITC prior to CI. WRS65CI increased significantly with time within MD and control groups, but no difference in WRS65CI was found between these 2 groups. ITG ears showed fluctuating WRS65CI after CI with no change across time, while ITC ears showed significant increase in trend of WRS65CI values across time. Conclusion: MD and non-MD patients showed comparable hearing results after CI. Prior ITC might positively influence hearing preservation after CI in MD patients whereas ITG group showed fluctuating hearing. [ABSTRACT FROM AUTHOR]

The cottontail rabbit papillomavirus (CRPV)-associated VX2 carcinoma of the New Zealand White rabbit serves as a model system for human papillomavirus (HPV)-associated head and neck squamous cell carcinomas (HNSCCs). The aim of this study was to evaluate the tumor-inhibiting effect of RNAi-mediated knockdown of the CRPV oncogenes, E6 and E7, using siRNA-loaded lipopolyplexes (LPPs). VX2-carcinoma-derived cells were cultured for up to 150 passages. In addition, CRPV E6 and E7 oncogenes were transiently expressed in COS-7 cells. Efficiency and safety of LPPs were evaluated in both VX2 cells and the COS-7 cell line. Both of these in vitro CRPV systems were validated and characterized by fluorescence microscopy, Western blot, and RT-qPCR. Efficient knockdown of CRPV E6 and E7 was achieved in VX2 cells and COS-7 cells pretransfected with CRPV E6 and E7 expression vectors. Knockdown of CRPV oncogenes in VX2 cells resulted in reduced viability, migration, and proliferation and led to a G0/G1 block in the cell cycle. CRPV E6 and E7 siRNA-loaded LPPs could represent promising therapeutic agents serving as a paradigm for the treatment of papillomavirus-positive cancers and could be of value for the treatment of CRPV-associated diseases in the rabbit such as papillomas and cancers of the skin. [ABSTRACT FROM AUTHOR]

There are only a few published studies that demonstrate associations between life expectancy, severe comorbidities, and their complications in patients with hereditary hemorrhagic telangiectasia (HHT). Relatives of 73 deceased patients with suspected HHT completed a questionnaire about causes of death, and symptoms and comorbidities that the patients had developed. We compared the data for 55 cases where HHT had been clinically confirmed with the general population. Patients suffering from HHT lost, on average, 19 years (SD 11 years) of potential life compared to the general population. Among the deceased HHT patients, 35% (95% CI: 23-48%) died from sepsis, 26% (95% CI: 16-38%) from cardiac failure, 20% (95% CI: 9-28%) from a severe bleeding episode, and 13% (95% CI: 6-24%) from terminal cancer. Congestive heart failure (69%, 95% CI: 56-80%) and pulmonary hypertension (23%, 95% CI: 14-36%) were the main non-fatal comorbidities in patients with HHT. Patients with HHT appear to have a lower life expectancy than the general population. Sepsis and cardiac failure were the main causes of death. Optimized and targeted screening programs for the most frequent comorbidities followed by improved management of infectious complications may increase life expectancy. [ABSTRACT FROM AUTHOR]

Hereditary hemorrhagic telangiectasia (HHT) type 2 is an autosomal dominant disease in which one allele of the ACVRL1 gene is mutated. Patients exhibit disturbances in TGF-beta/BMP-dependent angiogenesis and, clinically, often present with severe nosebleeds as well as a reduced quality of life. The aim of our study was to use CRISPR/Cas9 to knockout ACVRL1 in normal induced pluripotent stem cells (iPSCs) and evaluate the effects on TGF-beta- and BMP-related gene expression as well as angiogenesis. The CRISPR/Cas9 knockout of the ACVRL1 gene was carried out in previously characterized wild-type (ACVRL1wt/wt) iPSCs. An HHT type 2 iPS cell line was generated via a single-allele knockout (ACVRL1wt/mut) in wild-type (ACVRL1wt/wt) iPSCs, resulting in a heterozygous 17 bp frameshift deletion in the ACVRL1 gene [NG_009549.1:g.13707_13723del; NM_000020.3:c.1137_1153del]. After the generation of embryoid bodies (EBs), endothelial differentiation was induced via adding 4 ng/mL BMP4, 2% B27, and 10 ng/mL VEGF. Endothelial differentiation was monitored via immunocytochemistry. An analysis of 151 TGF-beta/BMP-related genes was performed via RT-qPCR through the use of mRNA derived from single iPS cell cultures as well as endothelial cells derived from EBs after endothelial differentiation. Differential TGF-beta/BMP gene expression was observed between ACVRL1wt/wt and ACVRL1wt/mut iPSCs as well as endothelial cells. EBs derived from CRISPR/Cas9-designed ACVRL1 mutant HHT type 2 iPSCs, together with their isogenic wild-type iPSC counterparts, can serve as valuable resources for HHT type 2 in vitro studies. [ABSTRACT FROM AUTHOR]

Introduction: Pre-operative assessments before cochlear implantation (CI) includes the examination of both tone hearing, and the level of the cochlear reserve indicated by speech understanding. The goal of this study was to explore the predictive influence of tone hearing and cochlear reserve in CI. Methods: We did a retrospective cohort study, which included adult patients who had undergone CI between January 2012 and December 2019 in a tertiary care center. The pre-operative tone hearing, unaided maximum monosyllabic word recognition score (WRSmax), aided hearing gain, aided monosyllabic word recognition score at 65 dB (WRS65(HA)), and speech perception gap (SPG) were measured. The duration of unaided hearing loss (UHL) was also assessed. These variables were compared with post-operative monosyllabic word recognition score after CI at 65 dB (WRS65(CI)). Results: 103 patients and 128 ears were included in this study. Regardless of tone hearing, patients with better pre-operative WRSmax and WRS65(HA) performed better post-operatively. WRSmax was found to be the most important factor that was statistically significantly associated with WRS65(CI). SPG was statistically significantly associated with WRSmax and SPG ≥ 20% group performed better post-operatively. Any duration of unaided hearing loss was statistically significantly inversely associated with WRSmax above 0%. Conclusion: Cochlear reserve represented by WRSmax may play the most important role as a predictive factor in outcomes after CI. SPG should be considered for indicating CI in patients, when WRS65(HA) does not reach WRSmax. Early rehabilitation with hearing aids and duration of hearing aid usage might play an important role in preserving cochlear reserve in adults. [ABSTRACT FROM AUTHOR]

Background: The reprocessing of daily used medical devices is often inadequate, making them a potential source of infection. In addition, there are usually no consistent and technically standardized procedures available for this purpose. Hence, the aim of this study is to analyze the bacterial contamination and the effectiveness of Ultraviolet light-based (UV light-based) reprocessing of daily used medical devices. Material and methods: Six different everyday medical devices (20 each; stethoscopes, tourniquets, bandage scissors, reflex hammers, tuning forks, and nystagmus glasses) were tested for bacterial contamination. All medical devices were then exposed to UV-C light for 25 seconds. Medical devices with a smooth surface were pre-cleaned with a water-based wipe. Contact samples were taken before and after reprocessing. Results: Immediately after clinical use, 104 of 120 contact samples showed an average bacterial contamination of 44.8±64.3 colony forming units (CFU) (0–300 CFU), also including potentially pathogenic bacteria. Two further culture media were completely overgrown with potentially pathogenic bacteria. The stethoscopes were found to have the highest average contamination of 90±91.6 CFU. After reprocessing, 118 of 120 samples were sterile, resulting in an average residual contamination of 0.02±0.1 CFU in two samples, whereby only bacteria of the ordinary skin flora were found. Conclusion: The present study shows the potentially clinically relevant bacterial contamination of everyday used medical devices. The reprocessing method tested here using UV light appears to be a suitable method for disinfection, especially for objects that up to now have been difficult to disinfect or cannot be disinfected in a standardized manner. [ABSTRACT FROM AUTHOR]

Placebo effects substantially contribute to analgesic treatment outcomes and might be leveraged to enhance gold‐standard treatments. The taste of oral medications has been proposed to boost placebo effects. Here, we aimed at estimating how far the taste of an oral medication enhances placebo analgesia. We conducted a randomized, double‐blind, between‐group, single‐visit study, with pre‐treatment baseline. Over the course of three substudies, 318 healthy volunteers (297 included) were tested in a clinical trial setting. Participants were subjected to experimental tonic cold water pain (cold pressor test) before and after receiving taste‐neutral (water), or bitter (quinine), or sweet (saccharin), or no placebo drops. Pre‐ versus post‐treatment changes in area under the pain rating curve, the main outcome, indicated that placebo treatment showed a small analgesic effect versus no treatment. Added taste induced placebo enhancement in the very small effect size range, but accounted for a substantial portion of the overall placebo effect. No noteworthy advantage of sweet over bitter placebo was observed. An exploration of heart rate (HR) recordings indicated that placebo treatments were associated with an increase in peak HR‐response to cold water, but these were not associated with placebo analgesia at an individual level. Placebo treatments were associated with minimal side effects. These results indicate that added taste may be an easy‐to‐implement, cost‐effective, and safe way to optimize treatment outcomes and that taste‐neutral preparations may reduce placebo‐related outcome variance in clinical trials. Further studies are needed to test if these findings can be translated into clinical scenarios. [ABSTRACT FROM AUTHOR]

Zusammenfassung: In der jüngsten Zeit haben sich auf dem Boden technischer Innovationen zahlreiche neue diagnostische Möglichkeiten in der Schlafmedizin entwickelt, insbesondere im Bereich der schlafbezogenen Atmungsstörungen. Dieser Artikel beleuchtet ausgewählte neue diagnostische Ansätze sowie technische Weiterentwicklungen bereits etablierter Verfahren, mit denen der praktisch tätige Schlafmediziner bereits heute konfrontiert wird.Hierzu gehören Systeme, die verglichen mit der derzeitigen Standarddiagnostik auf einer reduzierten Anzahl an Ableitkanälen basieren, wie die periphere Pulsoximetrie oder die kardiopulmonale Kopplung, aber auch tragbaren Geräte (Wearables) und Smartphone-Applikationen sowie die Diagnostik mittels ambulanter EEG-Ableitung. Darüber hinaus sind Alternativen zur etablierten Polygraphie und Polysomnographie verfügbar, unter anderem basierend auf der arteriellen Tonometrie. Innovative Ansätze zeigen sich im Bereich radarbasierter Systeme zur berührungslosen Überwachung des Schlafs sowie im Einsatz von künstlicher Intelligenz, u. a. zur akustischen Analyse von Atemgeräuschen im Schlaf.Insgesamt stellen diese Technologien vielversprechende Weiterentwicklungen in der Schlafmedizin dar, die das Potenzial haben, die Diagnose und das Monitoring von Schlafstörungen zu verbessern. Insbesondere die Möglichkeit zur longitudinalen Erfassung mehrere Nächte im häuslichen Umfeld könnte eine geringere Präzision ausgleichen, die durch eine reduzierte Erfassung biologischer Parameter bedingt ist. Nur ein Teil dieser Verfahren ist bisher jedoch hinreichend validiert. Darüber hinaus besteht für die Mehrzahl dieser Verfahren noch keine Möglichkeit zur Kostenerstattung im Bereich der gesetzlichen Krankenversicherung. [ABSTRACT FROM AUTHOR]

Background: More than twenty years after its discovery, the role of the importin beta superfamily member Ran GTP-binding protein (RanBP) 17 is still ill defined. Previously, we observed notable RanBP17 RNA expression levels in head and neck squamous cell carcinoma (HNSCC) cell lines with disruptive TP53 mutations.Methods: We deployed HNSCC cell lines as well as cell lines from other tumor entities such as HCT116, MDA-MB-231 and H460, which were derived from colon, breast and lung cancers respectively. RNAi was used to evaluate the effect of RanBP17 on cell proliferation. FACS analysis was used for cell sorting according to their respective cell cycle phase and for BrdU assays. Immunocytochemistry was deployed for colocalization studies of RanBP17 with Nucleolin and SC35 (nuclear speckles) domains. TCGA analysis was performed for prognostic assessment and correlation analysis of RanBP17 in HNSCC patients.Results: RNAi knockdown of RanBP17, significantly reduced cell proliferation in HNSCC cell lines. This effect was also seen in the HNSCC unrelated cell lines HCT116 and MDA-MB-231. Similarly, inhibiting cell proliferation with cisplatin reduced RanBP17 in keratinocytes but lead to induction in tumor cell lines. A similar observation was made in tumor cell lines after treatment with the EGFR kinase inhibitor AG1478. In addition to previous reports, showing colocalization of RanBP17 with SC35 domains, we observed colocalization of RanBP17 to nuclear bodies that are distinct from nucleoli and SC35 domains. Interestingly, for HPV positive but not HPV negative HNSCC, TCGA data base analysis revealed a strong positive correlation of RanBP17 RNA with patient survival and CDKN2A.Conclusions: Our data point to a role of RanBP17 in proliferation of HNSCC and other epithelial cells. Furthermore, RanBP17 could potentially serve as a novel prognostic marker for HNSCC patients. However, we noted a major discrepancy between RanBP17 RNA and protein expression levels with the used antibodies. These observations could be explained by the presence of additional RanBP17 splice isoforms and more so of non-coding circular RanBP17 RNA species. These aspects need to be addressed in more detail by future studies. [ABSTRACT FROM AUTHOR]

Since the first statement of the German Society of Oto-Rhino-Laryngology, hypoglossal nerve stimulation (HNS) is meanwhile an established treatment option for obstructive sleep apnea (OSA). There are three HNS systems available in Germany which differ in their technical details of the underlying comparable basic principle. For the unilateral HNS with respiratory sensing, several comparative studies, high-volume register analysis and long-term reports exist. The continuous HNS without respiratory sensing does not require a sleep endoscopy for indication. For the bilateral continuous HNS as the single partially implantable device, a feasibility study exists. For indication, the assessment of positive airway pressure failure by sleep medicine is crucial, and the decision for HNS should be made in discussion of other treatment options for at least moderate OSA. The implantation center holds primarily responsibility among the interdisciplinary sleep team and is primary contact for the patient in problems. This depicts why structural processes are required to secure outcome quality and minimize the complications. The aftercare of HNS patients can be provided interdisciplinary and by different medical institutions, whereat, minimal reporting standards to document outcome and usage are recommended. [ABSTRACT FROM AUTHOR]

Purpose: No standardized treatment regimen exists for juvenile recurrent parotitis (JRP). The investigators hypothesized that irrigation with saline only without local anesthesia will be an effective and beneficial option. Methods: Using a retrospective study design, a series of children with typical symptoms of JRP who were treated with at least one irrigation therapy were evaluated. This treatment consisted of irrigation of the affected gland with 3–10 ml saline solution without any type of anesthesia. The outcome variables were patient/parent satisfaction, frequency and duration of acute JRP episodes, and the need for antibiotics before and after irrigation therapy. Results: The case series was composed of six boys aged 3.3–7.7 years who experienced one to eight sessions of irrigation therapy. The period of follow-up was 9–64 months. We observed a total resolution of symptoms in two children and an improvement in the other four. No relevant side effects were seen. Conclusion: Our results suggest that irrigation therapy is a reasonable, simple, and minimally invasive treatment alternative for JRP. In contrast to sialendoscopy or sialography, there is no need for general anesthesia or radiation exposure. [ABSTRACT FROM AUTHOR]

Objectives: Surgical treatment of obstructive sleep apnea (OSA) caused by hypopharyngeal collapse of the upper airway can be considered in patients who are intolerant to continuous positive airway pressure (CPAP). The present procedures addressing the hypopharynx are invasive and have substantial morbidity and limited efficacy. Methods: Ten patients (mean age, 44 years) with moderate to severe OSA, ie, an apnea-hypopnea index (AHI) between 15 and 50, with CPAP intolerance were included in a prospective, nonrandomized. multicenter study to evaluate the feasibility, safety, and efficacy of a novel tongue advancement procedure. The procedure consists of the implantation of a tissue anchor in the tongue base and an adjustment spool at the mandible. Titration of this tissue anchor results in advancement of the tongue and a patent upper airway. Results: The mean AHI decreased from 22.8 at baseline to 11.8 at the 6-month follow-up (p = 0.007). The Epworth Sleepiness Scale score decreased from 11.4 at baseline to 7.7 at the 6-month follow-up (p = 0.094), and the snoring score decreased from 7.5 at baseline to 3.9 at the 6-month follow-up (p = 0.005). Four technical adverse events were noted, and 1 clinical adverse event occurred. Conclusions: Adjustable tongue advancement is a feasible and relatively safe way to reduce the AHI and snoring in selected patients with moderate to severe OSA and CPAP intolerance. Technical improvements and refinements to the procedure are ongoing. [ABSTRACT FROM AUTHOR]

Objectives: Obstructive sleep apnea (OSA) is a common sleep disorder, which is associated with recurrent oxygen desaturation during sleep. It has already been shown that nocturnal hypoxia may lead to cochlear dysfunction in patients with OSA. Less is known whether hypoxia during sleep also impacts vestibular function in those patients. Thus, the aim of the presented study was to assess a potential vestibulotoxic effect of nightly desaturations with hypoxia in patients with OSA by investigating a possible correlation between respiratory parameters and vestibular function tests. Methods: A total of 56 patients were included in the study and underwent a fully attended cardiorespiratory polysomnography (PSG). Vestibular function was assessed using video head impulse test to evaluate horizontal semicircular canal function and cervical vestibular evoked myogenic potentials (cVEMPs) and ocular vestibular evoked myogenic potentials (oVEMPs) to measure otolith function. Descriptive data analysis was conducted and correlation analysis between selected PSG parameters and the results of vestibular testing was performed using Kendall τ coefficient. Results: A significant correlation between vestibular function and respiratory polysomnographic parameters could not be demonstrated in the study (P >.05) but cVEMP and oVEMP results showed a trend toward a correlation with oxygen desaturation indices and apnea–hypopnea index. Additionally, otolith hypofunction was more prevalent in patients with hypertension as well as OSA. Conclusion: The results of our study show that there is no significant correlation between vestibular function and sleep apnea parameters, although otolith dysfunction might be more prevalent in patients with OSA and hypertension. [ABSTRACT FROM AUTHOR]

Background: Reprocessing of flexible endoscopes (FEs) is often expensive, time consuming, and becomes increasingly complex, due to rising demands of hygiene. After beneficial results in reprocessing of rigid endoscopes using Impelux™ UV-C light technology, we tested the same method for reprocessing of FEs without working channel. Materials and methods: Testing was performed on FEs without working channel after routine clinical use (transnasal flexible endoscopy). Disinfection consisted of mechanical precleaning and 60 s exposure to Impelux™ UV-C light technology. Bacterial contamination was tested on 50 FEs before and after disinfection. Further 50 FEs regarding protein residuals. The absolute effectiveness of the D60 was tested on 50 test bodies (RAMS) with a standardized contamination of 107 colony-forming units (CFU) of Enterococcus faecium. Results: The FEs were contaminated with a high average value of 916.7 CFU (± 1057 CFU) after clinical usage. After reprocessing, an average contamination of 2.8 CFU (± 1.6) on 14% (n = 7) of the FEs was detected consisting of non-pathogenic species, the remaining FE were sterile. After reprocessing, all FEs were protein-free (< 1 μg). The artificially contaminated test bodies showed no remaining bacterial contamination after disinfection, resulting in an average absolute germ reduction of about 107 CFU. Conclusion: Impelux™ UV-C light technology efficiently reduces bacterial contamination of FEs and might be useful in daily practice. [ABSTRACT FROM AUTHOR]

Simple Summary: Complete removal of the larynx (total laryngectomy) offers a curative approach for advanced laryngeal and pharyngeal cancer. If the operation is performed after radiotherapy wound healing problems have to be taken into account which can be managed by adapted reconstructive techniques. Laryngectomy results in the loss of voice which can be managed e.g., by using a voice prosthesis with a significant increase in quality of life. Total laryngectomy still represents a relevant surgical procedure in modern head and neck oncology. Surgical removal of the larynx (total laryngectomy) offers a curative approach to patients with advanced laryngeal and hypopharyngeal (squamous cell) cancer without distant metastases. Particularly in T4a carcinoma, laryngectomy seems prognostically superior to primary radio(chemo)therapy. Further relevant indications for laryngectomy include massive laryngeal dysfunction associated with aspiration and recurrence after radio(chemo)therapy, resulting in salvage surgery. The surgical procedure including neck dissection is highly standardised and safe. The resulting aphonia can be compensated by functional rehabilitation (e.g., voice prosthesis) associated with a significant quality of life improvement. This article presents an overview of indications, preoperative diagnostics, surgical procedures, including new developments (robotics), possible complications, the choice of adjuvant treatment, alternative therapeutic approaches, rehabilitation and prognosis. In summary, total laryngectomy still represents a relevant surgical procedure in modern head and neck oncology. [ABSTRACT FROM AUTHOR]

Background: The histological differentiation of individual types of vascular anomalies (VA), such as lymphatic malformations (LM), hemangioma (Hem), paraganglioma (PG), venous malformations (VeM), arteriovenous malformations (AVM), pyogenic granulomas (GP), and (not otherwise classified) vascular malformations (VM n.o.c.) is frequently difficult due to the heterogeneity of these anomalies. The aim of the study was to evaluate digital image analysis as a method for VA stratification Methods: A total of 40 VA tissues were examined immunohistologically using a selection of five vascular endothelial-associated markers (CD31, CD34, CLDN5, PDPN, VIM). The staining results were documented microscopically followed by digital image analyses based quantification of the candidate-marker-proteins using the open source program ImageJ/Fiji. Results: Differences in the expression patterns of the candidate proteins could be detected particularly when deploying the quotient of the quantified immunohistochemical signal values. Deploying signal marker quotients, LM could be fully distinguished from all other tested tissue types. GP achieved stratification from LM, Hem, VM, PG and AVM tissues, whereas Hem, PG, VM and AVM exhibited significantly different signal marker quotients compared with LM and GP tissues. Conclusion: Although stratification of different VA from each other was only achieved in part with the markers used, the results of this study strongly support the usefulness of digital image analysis for the stratification of VA. Against the background of upcoming new diagnostic techniques involving artificial intelligence and deep (machine) learning, our data serve as a paradigm of how digital evaluation methods can be deployed to support diagnostic decision making in the field of VAs. [ABSTRACT FROM AUTHOR]

Background: The role of Cytokeratin fraction 21-1 (CYFRA 21-1) as a tumour marker for head and neck cancer is still a matter of research. The aim of the present study was to evaluate the clinical impact of CYFRA 21-1 for patients with oropharyngeal squamous cell carcinoma (OSCC). Patients and methods: Data of 180 patients with an initial diagnosis of OSCC of any stage between 2003 and 2017 were retrospectively analysed regarding the association between pretherapeutic CYFRA 21-1 levels, clinical characteristics, overall and disease-free survival. Additionally, the potential of CYFRA 21-1 for the detection of recurrent disease in the follow-up was evaluated. The cut-off value was set at 3.3 ng/ml. The median follow-up time was 2.85 years. Results: A significant correlation of the CYFRA 21-1 concentration at the time of diagnosis and the N-stage was detected (p = 0.01). Patients with CYFRA 21-1 levels > 3.3 ng/ml at first diagnosis showed a significantly shorter overall survival. In the case of disease-progression, a significant increase of CYFRA 21-1 value was found compared to post-therapeutic CYFRA 21-1 levels (9.1 ng/ml versus 5.1 ng/ml; p < 0.01). CYFRA 21-1 level after treatment showed only a low sensitivity of 32% and a specificity of 78% for tumour recurrence. Conclusion: CYFRA 21-1 correlates with the tumour stage and, therefore, the survival of OSCC patients. Posttreatment CYFRA21-1 seems not to be a suitable predictor of tumour recurrence in the further course of the disease. However, a sudden increase of CYFRA 21-1 during follow-up may indicate a tumour recurrence in the individual patient. [ABSTRACT FROM AUTHOR]

Background: Reprocessing of endoscopes becomes increasingly complex, due to rising demands of hygiene. Established methods are often expensive/time-consuming. Recent studies suggest beneficial aspects of disinfection by UV light. In this study we analyzed the efficiency of UV light disinfection of rigid otorhinolaryngological endoscopes. Materials and methods: After mechanical pre-cleaning, the endoscopes were decontaminated for 25 s in the D25 using Impelux™ UV C light technology (UV Smart B.V., Delft, The Netherlands). First, the surface contact samples were taken from 50 used endoscopes to evaluate the bacterial load. Additionally, surface contact samples were taken from further 50 used endoscopes after reprocessing with the D25. Another 50 endoscopes were tested on protein residuals. Furthermore, the absolute effectiveness of the D25 was tested on 50 test bodies (RAMS) with a standardized contamination of 107 colony-forming units (CFU) of Enterococcus faecium. Results: The used endoscopes showed a high bacterial contamination with an average value of 66.908 (± 239.215) CFU. After reprocessing, only a minimal contamination on 10% (n = 5) of the endoscopes with a mean value of 0.12 CFU (± 0.39) was found, resulting in a log-5 reduction in a clinical environment. The documented bacteria were components of the normal skin flora. All tested endoscopes were practically protein-free (< 1 μg). Furthermore, the average absolute germ reduction of the D25 was about 106 CFU on the tested RAMS. Conclusion: The D25 UV light system seems to be an effective device for the reprocessing of rigid ORL endoscopes, and therefore, might be suitable for the usage in clinical practice on site. [ABSTRACT FROM AUTHOR]

Plasma cells (PCs) in human palatine tonsils are predominantly located in the germinal centres (GCs), in the subepithelial space and near the deep connective tissue septa surrounding each crypt. We analysed the location, phenotype, and proliferation of GC PCs by immunohistology comparing them to PCs in the other two locations. Most PCs in GCs were strongly positive for CD38, CD138, CD27, IRF4, and intracellular (ic) IgG. They often accumulated in the basal light zone, but could also be found scattered in the entire light zone. In addition, rows of PCs occurred at the surface of the GC bordering the mantle zone, i.e., in the outer zone, and at the surface of the dark zone. The latter cells were often continuous with PCs in the extrafollicular area. The vast majority of GC PCs were negative for Ki-67. Only a few Ki-67+ plasmablasts, predominantly icIgG+ or icIgM+, were found inside GCs. In certain GCs PCs accumulated around capillaries and the adjacent perikarya of follicular dendritic cells (FDCs). Newly formed PCs might migrate from the basal to the superficial part of the light zone and then back to the dark zone surface to leave the GC. This guarantees an even distribution of secreted Ig for exchange with immune complexes on FDCs. The surface of the dark zone may also be an exit site for Ki-67+CD30+ B lymphoblasts, which seed perifollicular and extrafollicular sites. We speculate that these cells tend to downmodulate CD20 and activation-induced deaminase and further up-regulate CD30 when developing into pre-plasmablasts. [ABSTRACT FROM AUTHOR]

Background: The standard therapy for obstructive sleep apnea (OSA) is nighttime positive airway pressure (PAP). Generally, it has few side effects and represents a long-term treatment. However, not every patient is able to tolerate or accept the therapy or is willing to comply long-term. Other patients even have to terminate treatment for objective reasons. Objectives: There are no clear terms defined yet in clinical guidelines for the noncompliance of PAP therapy. The aim of our article is to introduce standardized definitions that may be used as a reference for clinical practice and scientific approaches. Materials and Methods: A board of experts has extensively studied the literature, definitions and background information regarding the topic. They considered different types of noncompliance or termination of PAP treatment and thus formed categories and definitions. Results: These are the categories of PAP noncompliance as proposed by the board of experts: PAP non-acceptance, PAP incompatibility, PAP intolerance, PAP failure, and PAP discontinuance. Conclusion: These categories, including definitions, may serve as a foundation for standardized management of OSA patients that need to be prepared for PAP therapy. [ABSTRACT FROM AUTHOR]

Purpose: The clinical significance of cytokeratin fraction 21-1 (CYFRA 21-1) for patients with head and neck cutaneous squamous cell carcinoma (CSCC) is unknown. Thus, the aim of the study was to evaluate the clinical value of CYFRA 21-1 in the context of treatment and follow-up for these patients. Methods: The clinical, histological and laboratory data of a total of 55 patients with the first diagnosis of head and neck cutaneous squamous cell carcinoma (T1–T4, N0–N2b, M0–1) between 2003 and 2017 were retrospectively analyzed. In 25 cases, the primary tumor could be treated successfully without residual or recurrent disease in the further course. The average follow-up period was 2.3 years. In all patients, pretherapeutic determination of CYFRA 21-1 was performed using the ECLIA test kit. The cut-off value was set at 3.3 ng/ml. Results: In 18 patients (32.7%), regional recurrence was found in the course of treatment. Distant metastases could be observed in two patients (3.6%). In these cases, no significant increase of CYFRA 21-1 blood concentration was detected at the time of recurrence/metastasis. At the time of the first diagnosis, the mean value of CYFRA 21-1 blood concentration was 2.4 ng/ml; and in cases of regional recurrence or distant metastases, the initial mean CYFRA 21-1 concentration was 2.0 ng/ml. There was no statistically significant relationship between CYFRA 21-1 blood concentration and analyzed tumor characteristics. Conclusions: According to current knowledge, the tumor marker CYFRA 21-1 is not clinically significant for treatment and follow-up of patients with head and neck CSCC. [ABSTRACT FROM AUTHOR]

We present a novel daytime intra-oral NEMS device for the tongue to treatment snoring and mild OSA. B CLINICAL IMPLICATIONS: b Daytime neuromuscular stimulation of the tongue muscles can give primary snorers and those with mild OSA a treatment option to improve snoring and sleep quality. [Extracted from the article]

Objective: Eustachian tube dysfunction (ETD) affects approximately 1% of adults in the general population. Non treated Eustachian tube dysfunction can result in chronic middle ear diseases, which have been shown to significantly affect taste sensitivity. A promising treatment is balloon dilatation of the Eustachian tube. The primary aim of the present study was to investigate whether individuals with ETD had impairment in chemosensory functions, and the changes of the chemosensory function after balloon dilatation of the Eustachian tube.Methods: 26 patients (17 female, 9 male) (=56 ears) suffering from ETD with a mean age of 39±15years were included in the present study. 20 patients (76%) returned to be evaluated at the follow up (=40 ears) 51±22days after balloon dilatation. For pre- and post operation, gustatory function was measured with a lateralized gustatory test with the taste strips and olfactory function was tested by means of the Sniffin' Sticks test battery (threshold, discrimination and identification (ID)).Results: Patients' baseline taste function (summed taste score 9.8±3.5 (mean±SD)) was significantly impaired compared to normative data (summed taste score 12.4±2.3; p=0.002). After balloon dilatation of the Eustachian tube, the taste function remained stable (summed taste score 9.4±4.3; p=0.814). Olfactory function (odor ID, summed score (TDI)) improved postoperatively (TDI 32.4±3.6) compared to pre-operative scores (TDI 33.6±4.0; p=0.012), but not to a clinically relevant extent.Conclusion: This study suggests, that patients suffering from ETD exhibit reduced taste scores. Balloon dilatation of the Eustachian tube does not seem to influence gustatory function, but olfactory function showed improvement. [ABSTRACT FROM AUTHOR]

Introduction: CD73 is an enzyme crucial in the metabolism of immunosuppressive adenosine. In cancer, it has various functions including tumor growth and metastases. Squamous cell carcinoma of the head and neck has an overall poor prognosis, also due to early spread of metastatic cells. Materials and methods: Tumor and lymph node specimens of 65 patients with HNSCC were subjected to immunohistochemical and H-score analysis of CD73 expression. Demographics, diagnoses, histopathology and subsequent outcome were analyzed. Results: The primary cancer was squamous cell carcinoma in all patients (male/female 55:10) with the following locations: oral cavity n:16, oropharynx n:28, hypopharynx n:11 and larynx n:10. H-score for CD73 expression in the primary lesion and metastatic lymph nodes was significantly higher in advanced compared to early stages with no significant differences among tumor locations. High CD73 expression was associated with reduced overall survival rates at a mean follow-up of 83.4 months (6-204 months). Conclusions: CD73 expression in HNSCC correlated positively with tumor stage and was associated with poor prognosis. Therefore, CD73 expression in primary lesions and regional metastases appears to predict HNSCC patients at high risk of all tumor sites. Therapeutic approaches targeting CD73 might seem promising for this patient population. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence and activity of regulatory T cells in patients with cancer correlates with poor prognosis. These cells are characterized by their expression of Forkhead box protein-3 (Foxp3). Squamous cell carcinoma is the most prevalent type of cancer in the head and neck region with overall poor survival rates, also due to early spread of metastatic cells. Material and methods: Primary tumor specimens as well as lymph node specimens harvested during neck dissection of 65 patients with a diagnosis of HNSCC were subjected to immunohistochemical and H-score analysis of Foxp3 expression. Demographics, diagnoses, histopathology and subsequent outcome were analyzed. Results: The primary cancer was squamous cell carcinoma in all patients (male/female 55:10) with the following tumor locations: oral cavity n=16, oropharynx n=28, hypopharynx n=11 and larynx n=10 (Stage III n=18; Stage IVA n=45; Stage IVB n=2). The H-score for Foxp3 expression in the primary lesion as well as metastatic lymph nodes was significantly higher in advanced stages compared to early stages with differences among tumor locations, which were not significant. High Foxp3 expression was associated with inferior overall survival rates at a mean follow-up of 83.4 months (6-204 months) Conclusions: Foxp3 expression in HNSCC varied from the anatomical site and correlated positively with tumor stage and was associated with poor prognosis. Therefore, Foxp3 expressions in primary lesions as well as lymphogenic metastases appear to predict high-risk HSNCC patients. Novel therapeutic approaches targeting Foxp3+ cells might seem promising for this patient population. [ABSTRACT FROM AUTHOR]