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Purpose: A vertical jump (VJ) is a common task performed in several sports, with the height achieved correlated to skilled performance. Loaded VJs are often used in the training of recreational and professional athletes. The bilateral deficit (BLD), which refers to the difference between the heights achieved by a bilateral jump and the sum of two unilateral jumps, has not been reported for loaded jumps and the findings for unloaded jumps are inconclusive. The purpose of this study was threefold: (a) to quantify and compare BLD in countermovement (CMJ) and squat jumps (SJ), (b) to explore the effects of an additional 10% of body weight (BW) load on the BLD in both CMJ and SJ, and (c) examine the relationship between magnitude of BLD and jump performance in both jumps and conditions. Methods: Forty participants (22 for CMJ and 18 for SJ) performed a bilateral jump and unilateral jumps on each leg with and without an added load equivalent to 10% of each participant's bodyweight. Results: BLD was evident in all conditions, with CMJ BLD values nearly double those for the SJ. The extra load did not affect the magnitude of BLD. BLD had a significant correlation with unilateral jump height, expect for the 110%BW SJ. Conclusions: BLD is present in SJs and CMJs at both loaded and unloaded conditions. The SJs have about half of the BLD observed in CMJs regardless of additional load. Participants who had higher single leg jumps seemed to also have higher BLDs, but there was no evidence of association between the bilateral jump height and BLD.

Objective: To report outcomes of a large cohort of patients who underwent endoscopic endonasal transsphenoidal surgery (EETS) for resection of a pituitary adenoma with subsequent Resorb-X plate (RXP) sellar reconstruction. Methods: A retrospective review of 620 EETS operations performed at a single academic center between 2005 and 2020 was conducted. Results: A total of 215 EETS operations of 208 patients were identified between 2012 and 2020 who underwent reconstruction with the RXP after EETS for pituitary tumor resection with a final pathologic diagnosis of pituitary adenoma. Analysis of pooled data revealed a mean preoperative tumor volume of 6.8 cm3 (range: 0.038-51.03 cm3). Postoperative cerebrospinal fluid leak occurred in 2 patients (0.93%). Postoperative meningitis occurred in 1 patient (0.47%). There were no cases of RXP extrusion. Conclusions: The rate of postoperative CSF leak and meningitis after use of the RXP for sellar reconstruction compares favorably to other methods, including use of autologous grafts and flaps. Use of RXP during EETS is a safe and efficacious method of sellar reconstruction and may obviate the need for autologous tissue reconstruction after pituitary adenoma resection. [ABSTRACT FROM AUTHOR]

Objective: Endoscopic repair of skull base defects is required following resection of intracranial pathology via the endoscopic endonasal approach (EEA). Many closure techniques have been described, but choosing between techniques remains controversial. We report outcomes of 560 EEA procedures of skull base reconstruction performed on 508 patients over a 15‐year‐period. Halfway through this period, we adopted the use of a rigid, bioabsorbable extrasellar plate for reconstruction, enabling a comparison between this technique and those used previously. Methods: All patients undergoing EEA from 2005 to 2019 at our institution were retrospectively reviewed. Demographic information, surgical pathology, tumor dimensions and radiographic features, reconstructive technique, and patient‐related outcomes were collected and analyzed with univariate and multivariate statistical modeling. Results: Five‐hundred sixty procedures were performed on 508 patients. The series complication rate was 8.2%. Overall, cerebrospinal fluid (CSF) leak rate was 5.0% but varied significantly across closure techniques (p < 0.001). Critically, the CSF leak rate in the 272 cases prior to our 2013 adoption of the Resorb‐X Plate (RXP) was 8.5%, whereas leak rate in the subsequent 288 cases was 1.7%. RXP was protective against CSF leak (p = 0.001), whereas gross total resection (GTR) correlated with increased leak rate (p = 0.001). Patient BMI was significantly associated with risk of leak (p = 0.047). Other variables did not impact leak risk. Conclusion: Reconstructive technique, extent of resection, and patient BMI significantly contributed to CSF leak rate. GTR was associated with increased leak risk while the RXP was protective. The bioabsorbable RXP is an effective option for rigid skull base repair with comparatively few complications. Level of Evidence: 3 Laryngoscope, 133:1092–1098, 2023 [ABSTRACT FROM AUTHOR]

Introduction  Pituitary apoplexy commonly presents with visual and hormonal deficits. While traditionally regarded as an emergency, there have been increasing trends toward conservative management. Our institutional practice consists of early surgery; therefore, we reviewed our series evaluating vision outcomes, hormone function, and complications compared with the present literature. Methods  We retrospectively reviewed our institution's medical records to identify pituitary apoplexy patients who were treated via the endoscopic endonasal approach by a single neurosurgeon (senior author). We recorded basic demographics, radiographic and operative features, and preoperative and postoperative vision and hormone status. Univariate and multivariate statistical analyses were performed. Pooled data analysis of visual outcomes in the current literature using Bayesian inference was performed. Results  We identified 44 patients with histologically confirmed pituitary apoplexy treated by endoscopic transsphenoidal decompression; 77% were treated within 24 hours of presentation. Total 45% had cranial nerve (CN) palsy, 36% anopsia, and 20% had visual acuity deficits. Postoperatively, 100% of CN palsies improved, 81% of anopsias improved, and 66.7% of visual acuity deficits improved. Long-lasting panhypopituitarism (25%) and hypothyrodism (22%) were common. Cavernous sinus involvement predicted residual tumor (p  = 0.006). Pooled Bayesian inference showed 30% improvement in vision outcomes with surgical management compared with medical management with a number needed to treat of 3.3. Conclusion  Early surgery for pituitary apoplexy was associated with excellent visual outcomes and the need for long-term hormone replacement is common. Cavernous sinus involvement is an independent predictor of residual tumor. Pooled statistical analysis favors aggressive surgical management of apoplexy for improved visual outcomes. [ABSTRACT FROM AUTHOR]

Background: Chronic rhinosinusitis (CRS) is one of the most common chronic diseases in adults in both developing and developed countries. The etiology and pathogenesis of CRS remain poorly understood, and the disease is refractory to therapy in many patients. Mast cell activation has been demonstrated in the sinonasal mucosa of patients with CRS; however, the specific contribution of mast cells to the development and pathogenesis of this disease has not been established. Objective: The objective of this study was to investigate the role of mast cells in the development of CRS. Methods: C57BL/6 wild-type and C57BL/6-KitW-sh/W-sh mast cell–deficient mice were immunized by intraperitoneal allergen injection and subsequent chronic low dose intranasal allergen challenges. The sinonasal phenotypes of these groups were then evaluated and compared to saline-treated controls using radiologic, histologic, and immunologic methods. Results: Wild-type mice exposed to chronic intranasal allergen developed many features seen in human CRS, including mucosal thickening, cystic changes, polyp development, eosinophilia, goblet cell hyperplasia, and mast cell activation. In contrast, sinonasal pathology was significantly attenuated in mast cell–deficient mice subjected to the same chronic allergen protocol. Specifically, tissue eosinophilia and goblet cell hyperplasia were reduced by approximately 50% compared to wild-type levels. Surprisingly, none of the mast cell–deficient mice subjected to chronic allergen challenge developed cystic changes or polypoid changes in the nose or sinuses. Conclusions: These data identify a critical role for mast cells in the development of many features of a mouse model of eosinophilic CRS, suggesting that therapeutic strategies targeting mast cells be examined in humans afflicted with this disease. [ABSTRACT FROM AUTHOR]

The article offers information on a study conducted by the authors on the reconstruction of cranial base with the use of the resorbable polylactide acid plate. Topics discussed include manipulation of the plate according to size, use of the plate within multilayer closure without surgical flaps, reduction in the need of sealants in surgery, and reduced cost compared to the costs of tissue harvest.

Studies have reported that the age‐adjusted incidence of cognitive impairment and dementia have decreased over the past two decades. Aging is the predominant risk factor for Alzheimer's disease and related dementias and for neurocognitive decline. However, aging alone cannot explain changes in the overall age‐adjusted incidence of dementia. The objective of this position paper was to describe the potential for cohort and period effects in cognitive decline and incidence of dementia. Cohort effects have long been reported in demographic literature, but starting in the early 1980s researchers began reporting large historical cohort trends in cognitive function. At the same time, period effects have emerged in the form of economic factors and stressors in early and midlife that may result in reduced cognitive dysfunction. Recognizing that aging individuals today were once children and adolescents and that research has clearly noted that childhood cognitive performance are associated with old‐age cognitive performance, this review proposes the need to connect these cohort effects with differences in late‐life functioning. [ABSTRACT FROM AUTHOR]