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Background Knowledge about the long-term course of the neurologic component of hand–arm vibration syndrome (HAVS) is scarce. Aims To study the course and prognostic factors of the neurosensory component of HAVS over a period of 22 years. Methods Forty male sheet metal workers, with a mean age of 60 (range 45–78) years at follow-up, were examined with a test battery in 1994 and 2017. At baseline, the sample comprised 27 workers with HAVS symptoms and 13 workers without HAVS symptoms. Among the 27 workers, 25 workers reported work-related hand–arm vibration during follow-up (mean 3639 h). In 2017, the mean time since vibration stopped was 8.4 years. Results Among the 27 workers with HAVS in 1994, no overall statistically significant change was observed in hand numbness (Stockholm Workshop Scale), shoulder/arm pain (pain scale) or finger pain from 1994 to 2017. However, vibration exposure during follow-up was associated with increased finger pain. Cotinine, carbohydrate-deficient transferrin, glycosylated haemoglobin and folate were not associated with changes in neurosensory symptoms or manual dexterity (Grooved Pegboard) from 1994 to 2017. A diagnosis of HAVS in 1994 did not predict poor hand strength 22 years later. Isolated hand numbness (without white finger attacks) was more common at baseline than at follow-up. Conclusions This 22-year follow-up study indicates a tendency towards irreversibility of hand numbness and finger pain in workers with HAVS. Continued vibration exposure seems to predict increased finger pain. Our findings highlight the importance of HAVS prevention.

Background Macular hole (MH) may become refractory if the hole does not close after multiple surgeries. We provide a modified surgical technique for refractory MH repair with neurosensory retinal free flap transplantation. Case presentation To treat a 68-year-old female patient with refractory MH after multiple surgeries, we harvested a neurosensory retinal free flap with a 2-MH diameter area. A drop of whole blood was placed within the MH as an adhesive to fix the neurosensory retinal free flap at the MH under gas tamponade. Two months after surgery, optical coherence tomography (OCT) revealed closure of the MH. The flap was visible on OCT and had filled the MH without overlapping the neurosensory retina. The patient’s best-corrected visual acuity (BCVA) improved from 20/500 preoperatively to 20/50 at 2 months postoperatively. Conclusions Using whole blood as an adhesive to aid in the fixation of an autologous neurosensory retinal free flap under gas tamponade provides another option for patients with refractory MH due to multiple prior surgeries. Electronic supplementary material The online version of this article (10.1186/s12886-018-0909-9) contains supplementary material, which is available to authorized users.

The domain within the otic vesicle (OV) known as the neurosensory domain (NSD), contains cells that will give rise to the hair and support cells of the otic sensory organs, as well as the neurons that form the cochleovestibular ganglion (CVG). The molecular dynamics that occur at the NSD boundary relative to adjacent OV cells is not well defined. The Tbx1 transcription factor gene expression pattern is complementary to the NSD, and inactivation results in expansion of the NSD and expression of the Notch ligand, Jag1 mapping, in part of the NSD. To shed light on the role of Jag1 in NSD development, as well as to test whether Tbx1 and Jag1 might genetically interact to regulate this process, we inactivated Jag1 within the Tbx1 expression domain using a knock-in Tbx1Cre allele. We observed an enlarged neurogenic domain marked by a synergistic increase in expression of NeuroD and other proneural transcription factor genes in double Tbx1 and Jag1 conditional loss-of-function embryos. We noted that neuroblasts preferentially expanded across the medial-lateral axis and that an increase in cell proliferation could not account for this expansion, suggesting that there was a change in cell fate. We also found that inactivation of Jag1 with Tbx1Cre resulted in failed development of the cristae and semicircular canals, as well as notably fewer hair cells in the ventral epithelium of the inner ear rudiment when inactivated on a Tbx1 null background, compared to Tbx1Cre/− mutant embryos. We propose that loss of expression of Tbx1 and Jag1 within the Tbx1 expression domain tips the balance of cell fates in the NSD, resulting in an overproduction of neuroblasts at the expense of non-neural cells within the OV., Summary: Normal dosages of Tbx1 and Jag1 are required to maintain a proper balance of cell types within the neurosensory domain of the otic vesicle to form the inner ear.

The ocular surface is comprised of the cornea and conjunctiva, which are structures that not only protect the eye but also enable vision. The corneal epithelium is the most superficial layer of the cornea, and therefore first line of defense against external assaults. Damage to this highly specialized structure could lead to vision loss, making it an important structure to investigate and understand. Here, we conducted a search of the current literature on the mechanisms the corneal epithelium has adapted against three frequent insults: UV-radiation, pathogens, and environmental assaults. This review systematically examines the corneal epithelium's response to each assault in order to maintain its role as an invisible shield. The goal of this review is to provide insight into some of the critical functions the corneal epithelium performs that may be valuable to current regenerative studies.

El presente trabajo pretende abordar las necesidades existentes en una niña de ocho años de edad con hipoacusia neurosensorial, para lo cual se elabora una propuesta de intervención logopédica basada en los puntos fuertes y débiles de la menor. La intervención tiene una duración de seis semanas, divididas en una sesión por semana, con el fin de conseguir mejoras en el nivel comunicativo-lingüístico y, por tanto, la calidad de vida de la pequeña. The aim of this paper is to address the needs of an eight years old girl with sensory hearing impairment, for which a proposal for speech intervention based on the strengths and weaknesses of the child is elaborated. The intervention lasts for six weeks, divided into one session per week, in order to achieve improvements in the communicative-linguistic level and, therefore, the quality of life of the girl.

The present paper aims to evaluate the long-term incidence and severity of the neurosensory disturbance (NSD) of the inferior alveolar nerve following bilateral sagittal split osteotomy (BSSO) of the mandibular ramus performed with piezosurgery. A retrospective study on patients referred to the Maxillofacial Surgery and Dentistry Clinic of the University of Verona for orthognathic surgery between March 2013 and October 2015 was performed. Inclusion criteria were having undergone BSSO with piezosurgery and follow-up lasting at least 24 months. Exclusion criteria were history of surgical infection, osteosynthesis failure or re-do surgery. The extent of mandibular repositioning movements was retrieved and patients underwent 4 clinical neurosensory tests. Descriptive statistical analysis was performed. 52 patients met the inclusion criteria. Average follow-up was 40 months (range 24-75). 83% of the nerves examined have no or slightly altered sensitivity. Seventy-one percent of patients perceive a moderate to none discomfort and none describes the discomfort as serious (Visual Analogue Scale [VAS] >7). The extent of mandibular repositioning did not have significant influence on the development and severity of the NSD. Resulting data led the Authors to infer that using piezosurgery in BSSO, the severity of the NSD of inferior alveolar nerve is reduced, but the incidence of permanent nerve lesions remains unchanged, compared to historical controls.

ObjectiveAn increasing proportion of fetuses are exposed to antenatal corticosteroids (ACS). Despite their immediate beneficial effects, the long-term safety of ACS has been an ongoing source of concern. In the current study, we assessed the likelihood of neurodevelopmental problems among term infants exposed to ACS earlier in pregnancy compared with non-exposed term infants.DesignRetrospective cohort study (2006–2011). Median duration of follow-up was 7.8 (IQR 6.4–9.2) years.SettingPopulation-based study, Ontario, Canada.ParticipantsAll live singleton infants born at term (≥370/7weeks gestation) (n=529 205).ExposureACS during pregnancy.Primary and secondary outcome measuresA composite of diagnostic or billing codes reflecting proven or suspected neurodevelopmental problems during childhood including audiometry testing, visual testing or physician service claim with a diagnosis code related to a suspected neurocognitive disorder.ResultsAt 5 years of age, the cumulative rate for the primary outcome was higher among infants exposed to ACS compared with non-exposed infants: 61.7% (3346/5423) vs 57.8% (302 520/523 782), respectively (pConclusionsWe found an association among term infants between exposure to ACS during pregnancy and healthcare utilisation during childhood related to suspected neurocognitive and neurosensory disorders.

The most common complications that are associated with bilateral sagittal split osteotomy are: bad splits, postoperative infection, removal of osteosynthesis material, and neurosensory disturbances of the lower lip. Particularly in elective orthognathic surgery, it is important that surgeons inform their patients about the risk of these complications and attempt to minimize these risks. The purpose of this literature review and meta-analysis is to provide an overview of these common complications and their risk factors.After a systematic electronic database search, 59 studies were identified and included in this review. For each complication, a pooled mean incidence was computed. Both the pooled study group and the pooled 'complication group' were analysed.The mean incidences for bad split (2.3% per SSO), postoperative infection (9.6% per patient), removal of the osteosynthesis material (11.2% per patient), and neurosensory disturbances of the lower lip (33.9% per patient) are reported. Regularly reported risk factors for complications were the patient's age, smoking habits, presence of third molars, the surgical technique and type of osteosynthesis material. This information may help the surgeon to minimize the risk of these complications and inform the patient about the risks of complications associated with bilateral sagittal split osteotomy. (C) 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Objectives Chronic pain syndromes are frequently associated with balance disorders [1] . For example, studies showed a linear relationship between pain and stability [1] in no-specific low back pain [2] . The reexamination of the links between nerves and pain [3] modifies the traditional perception of these chronic pain syndromes without organic cause and these neural dysfunctions. The aim of this communication is to propose a new, original and innovative clinical approach to the management of chronic pain syndrome by the use of postural investigation and neurosensory stimulation. Methods The neurosensory Posturotherapy [3] uses a simple methodology to understand neural physiology through a palpatory sensory evaluation and then to perform manual neurostimulation. These stimulations include the neural saturation of the dysfunctional nerve associated with a sideration of muscles innervated by the nerve being treated. This approach can be completed by plantar neurostimulations inducing postural remediation. Results Firstly, the dysfunction of a nerve is associated with hypertonia of the muscles which it innervates. Secondly, the nervi nervorum compose the intrinsic innervations of nerve sheath. They are polymodal receptors located at the periphery of the nerve sheath. They encode the mechanical information exerted on the nerve. The response of the mechanoreceptors increases with the intensity of the stimulation up to a plateau and then decreases from a threshold value. Thirdly, pressure and vibration, exerted with intensity higher than the threshold value, induces a saturation of the response of the mechanoreceptor. Lastly, the saturation points used by the treatment are most often found at the points of cutaneous emergence of the nerve. Conclusion The neurosensory Posturotherapy is a simple method of diagnosis and treatment of neural dysfunction involved in neuropathic pain and balance disorders. It represents a new therapeutic contribution in the management of subjects with specific chronic pain syndrome.

مقدمه: جهت تصحیح ناهنجاری‏های فکی از جراحی‏های ارتوگناتیک استفاده می‏شود. یکی از تکنیک‏های رایج در فک پایین استئوتومی‏ ساژیتال اسپلیت دو طرفه می‏باشد. هدف از این مطالعه بررسی اختلالات حسی لب پایین تا 6 ماه بعد از جراحی یاد شده و تاثیر این تغییرات حسی بر زندگی روزمره افراد و میزان رضایت مندی آنها از نتیجه عمل جراحی بود. مواد و روش ها: در این مطالعه 22 بیمار (44 سمت) با میانگین سنی 4/21 سال مورد استئوتومی‏ساژیتال قرار گرفتند. جهت معاینه عینی قبل از عمل جراحی و نیز 3 و 6 ماه بعد از عمل، تست تمایز دو نقطه‏ای انجام گرفت. جهت معاینه ذهنی بیماران پرسشنامه‏هایی را در پیگیری‏های 3 و 6 ماهه تکمیل کردند. داده‏ها به وسیله توزیع فراوانی و آزمون های Mc Nemar، آزمون Wilcoxon ، t-test ، Paired Samples t-test آنالیز شدند. یافته‏ها: در پیگیری سه ماه بعد از عمل جراحی 6/63% از موارد و در پیگیری شش ماه بعد از عمل، 1/43% از موارد، دارای تغییرات حسی بودند. آزمون Wilcoxon تفاوت معنی‏داری را در تغییر وسعت بی حسی بین پیگیری سه ماهه و شش ماهه نشان داد (007/0=P) که نشانگر بهبودی نواحی دارای تغییر حسی بود. میانگین تست تمایز دو نقطه‏ای قبل از عمل، سه و شش ماه بعد از عمل به ترتیب 81/3، 9/6 و2/5 میلی‏متر بود. در پیگیری شش ماهه، تفاوت میانگین بین سمت راست و چپ mm04/1 و از لحاظ آماری معنی‏دار بود (027/0=P). علیرغم وجود تغییرات حسی در لب، تمامی‏ بیماران از نتیجه عمل خود رضایت داشتند. نتیجه گیری: با گذشت زمان از عمل جراحی (از 3 ماه تا 6 ماه) درصد موارد دارای نقایص حسی کاهش یافت که علت آن بهبود خودبخودی عصب می‏باشد. نتایج نشان داد اختلالات حسی و مشکلات ایجاد شده به علت آنها، عامل تعیین کننده مهمی‏در رضایت مندی بیمار نیست.

Neurobehavioral tests are being increasingly used in human risk assessment and there is a strong need for guidance. The field of neurobehavioral toxicology has evolved from research which initially focused on using traditional neuropsychological tests to identify “abnormal cases” to include methods used to detect sub-clinical deficits, to further incorporate the use of neurosensory assessment, and to expand testing from occupational populations to vulnerable populations including older adults and children. Even as exposures in the workplace are reduced, they have been increasing in the environment and research on exposure has now expanded to cross the entire lifetime. These neurobehavioral methods are applied in research and the findings used for regulatory purposes to develop preventative action for exposed populations. This paper reflects a summary of the talks presented at the Neurobehavioral Testing in Human Risk Assessment symposium presented at the 11th meeting of the International Neurotoxicology Association.

Introducción: la hipoacusia neurosensorial es la forma más común de déficit auditivo. Presenta gran heterogeneidad clínica y etiológica; la frecuencia relativa de su causa varía de acuerdo con el método de estudio empleado. El implante coclear es el tratamiento más eficaz en la hipoacusia neurosensorial bilateral profunda. Objetivos: identificar las causas de la hipoacusia en pacientes cubanos con implante coclear y describir sus características clínicas. Material y Método: se realizó un estudio descriptivo transversal en el período septiembre de 2012 a diciembre de 2013. Se evaluaron clínicamente niños y adultos receptores de un implante coclear, implantados en Cuba hasta diciembre de 2012. Resultados: se identificó el origen genético en 33.8% de los implantados; distribuidos en sindrómicos y no sindrómicos, en proporciones similares; en 36.4% se atribuyó un factor ambiental al origen del déficit auditivo y en 29.8% no se logró identificar su causa. El inicio y evolución de la hipoacusia se correspondió con lo descrito para los distintos grupos etiológicos. Conclusiones: se evidenció la heterogeneidad clínica y etiológica de la hipoacusia neurosensorial en los implantados, cuya evaluación clínica es necesaria, no solo para proponer o descartar un origen genético, sino también para el asesoramiento de los pacientes y las familias. Palabras clave: sordera, hipoacusia, etiología, genética, asesoramiento genético.ABSTRACT Introduction: neurosensory hearing loss is the most frequent auditory disability. It has great clinical and etiologic heterogeneity; its relative etiology frequency may vary depending upon the study method. Cochlear implantation is the most efficient treatment for bilateral and profound neurosensory hearing loss. Objectives: to identify causes of Neurosensory hearing lost in Cuban patients with Cochlear implantation and to describe its clinical features. Material and Methods: a transversal descriptive study was performed between September 2012 and December 2013. Children and adults with Cochlear implantation, implanted in Cuba until 2012 were clinically studied. Results: genetic origin was identified in 33.8% of the implanted patients; syndromic and nonsyndromic forms had similar proportions. In 36.4% an environmental factor was attributed to cause the hearing deficiency and in 29.8% the origin was not identified. The onset and evolution of the hearing loss behaved as described in different etiologic groups. Conclusion: clinical and etiological heterogeneity was evident among patients with Cochlear implantation; clinical assessment is necessary to establish genetic origin and provide genetic counseling to patients and their family.Key words: Deafness, etiology, genetics, Neurosensory, Genetic Counseling.

Introduction Congenital abnormalities of the inner ear is the most common cause of neurosensory hearing loss. Michel inner ear deformity is a rare developmental anomaly refers to the total aplasia of the inner ear. It is caused by developmental arrest of otic placode early during the third week of gestational age. Case report We have discussed here that three year old girl diagnosed Michel aplasia with temporal bone computed tomography (CT) and temporal magnetic resonance imaging (MRI) findings.

Objetivo: El propósito de nuestro estudio fue conocer el déficit neurosensorial a los 2 años de edad corregida (EC) en niños con antecedentes de muy bajo peso de nacimiento (MBPN) en control en el policlínico de seguimiento del Servicio de Recién Nacidos del Hospital Dr. Sótero del Río, Santiago, Chile. Método y participantes: 254 RN de 268 sobrevivientes de un total de 424 RNMBPN nacidos entre 1994 a 1996 fueron seguidos prospectivamente por un equipo multidisciplinario, que realiza evaluación clínica, neurológica, auditiva y psicomotora. Del grupo en seguimiento: 181 niños, que representa el 71% del grupo, completan adecuadamente los controles. Resultados: Treinta y dos por ciento (59/181) de los niños tiene una evaluación neurosensorial anormal a los 24 meses de EC; 13% (24/181) presenta anormalidad neurosensorial severa: 6,6% (12/181) parálisis cerebral, 6% coeficiente del desarrollo mental menor de 70,3% sordera neurosensorial severa bilateral y 1 presentó ceguera. La mitad de los niños con parálisis cerebral presentan además otra secuela severa. Los factores asociados significativamente con evolución neurosensorial anormal fueron peso de nacimiento menor de 1 000 g, hemorragia intraventricular grados 3 y 4, convulsiones, apneas y ductus. En análisis de regresión logística, la apnea fue significativa e independientemente asociada a evolución neurosensorial anormal Objective: to report the neurosensory disabilities at an corrected age (CA) of 24 months of very low birth weight (VLBW) babies born between 1994 and 1996 in the Neonatal Unit of the Sótero del Río Hospital, Chile. Patients and methods: 254 infants of 268 survivors (95%) from a total of 424 VLBW babies were prospectively followed-up with clinical, neurological, sensory and psychomotor evaluations. 181 children (71%) have completed the 2 year study. Results: 32% (59/181) had an abnormal neurological examination at 24 months, 13% (24/181) had severe disabilities, 6.6% (12/181) cerebral palsy, 6% had a Bayley Mental Developmental Index of less than 70, 3% had severe neurosensory impairment and 1 was blind. About half of the children with cerebral palsy had another disability. Risk factors for severe deficits included a birth weight of less than 1 000gm, intraventricular haemorrhage grade 3-4, seizures, apnoea and a patent ductus. Using a multiple logistic regression analysis to adjust for neurological outcome, apnoea was a high risk factor