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There have been no useful imaging methods to diagnose benign paroxysmal positional vertigo (BPPV), a common cause of vertigo, depending on the characteristic symptom.To visualize horizontal canal (HC) BPPV using 3DCT and assess its clinical usefulness.Ten BPPV patients were diagnosed with distinct BPPV, canalolithiasis, and cupulolithiasis of the HC (hc-BPPV, hc-BPPV-cu), which were definitely diagnosed on the basis of criteria of BPPV by the Barany Society and 10 healthy subjects without a history of dizziness were investigated using 3DCT with several different CT window values (CTWVs).The HCs of BPPV patients were clearly visualized and the luminal aspects showed differences among ears with cupulolithiasis, canalolithiasis and no symptoms healthy subjects.3DCT images visualized the characteristic changes of the HC of patients with BPPV compared to healthy subjects. The HC images were coincident with the clinical condition of cupulolithiasis and canalolithiasis. This imaging technique is clinically useful for diagnosing, treating and assessing the prognosis of HC BPPV.

Surgical treatment of head and neck cancers requires ever increasing resources for in-patients in hospital ORL-HNS departments. It is now generally accepted that advanced surgery followed by radiot...

The technique of ultrastructural analysis of biological materials was applied early in studies on the inner ear. Pioneering work was done by Hans Engstrom (1912–2004) and Jan Wersall (1930–2017) at...

Occlusion of the entrance to paranasal sinuses is a serious problem in infectious or allergic diseases of the nose. Fortunately the rapid development of FESS technology has appreciably reduced the ...

The very first article published in Acta Oto-Laryngologica in English concerned tuberculosis affecting the bronchial glands. In Copenhagen, Denmark, Professor Schmiegelow (1856–1949) stated explici...

Background: In the inner ear, evidence has been gathered indicating that melatonin plays important roles in inner ear physiology and pathophysiology. However, no attempt has been made previously to...

Conclusion: Gastric type H+,K+-ATPase in the vestibular end organs may be of importance for K+ circulation and may also be related to pH regulation in vestibular end organs and endolymphatic sac.Objective: To analyze the expression of gastric-type H+,K+-ATPase in normal mouse vestibular end organs.Methods: 8 weeks old CBA/J mice were used in this study. The presence of gastric-type H+,K+-ATPase α and β in the vestibular end organs, viz. utricle, saccule, ampulla, vestibular ganglion, and endolymphatic sac, was investigated using immunohistochemistry.Results: In the vestibular end organs, H+,K+-ATPase α and β were almost identical. H+,K+-ATPase was expressed in sensory cells, the basolateral surface of dark cells, fibrocytes, in vestibular ganglion cells, and in the upper region of the endolymphatic sac epithelial cells.

In 2018 Acta Oto-Laryngologica will be celebrating its centenary. Over the past century the journal built up a firm foundation and is now recognized as one of the foremost publications in the field...

In this paper from 1936, Robert Barany (1876–1936; Nobel Prizewinner 1914) in Uppsala, Sweden, describes how submucosal or intravenous injection of 5 ml 1% Novocain-adrenalin can suppress tinnitus ...

The middle fossa approach to the internal auditory canal was developed in 1958 by House and his team in Los Angeles, California, USA. Since most acoustic tumours derive from the vestibular division...

Jan Wersall, former Professor and Head of the Department of Otorhinolaryngology and Head & Neck Surgery (ORL-HNS) at Karolinska Hospital, Stockholm, Sweden, has died at the age of 87.Jan Wersall st...

The expression of sirtuin in vestibular end organs and cochlea responds differently to age-related changes. Down-regulation of SIRT1, 3, and 5 in the cochlea may weaken the protective activity regarding degeneration of the organ of Corti as well as of spiral ganglion cells, resulting in the development of age-related hearing loss. An increase in SIRT 1, 4, or 5 in vestibular tissue could indicate an increased need of detoxification of reactive oxygen species and an increased anti-ageing potential.To analyse the expression of sirtuins (SIRT1-7) in the normal young and old mouse inner ears.Young (8 weeks) and old (22 months) CBA/J mice were used in this study. Localization of SIRT1-7 in the inner ear, i.e. cochlea, vestibular end organs, and vestibular ganglion, was investigated using real-time PCR and immunohistochemistry.In the vestibular end organs, the expression of SIRT1, 2, 4, 5 (both mRNA and protein), SIRT6, and 7 (only mRNA) was found to be increased, while a slightly decreased immunoreactivity was observed in SIRT3. In the cochlea, the expression of SIRT1, 3, and 5 (both mRNA and protein) was decreased in the old mice, whereas no noticeable difference was observed regarding SIRT2, 4, 6, or 7.

A new murine model of Ménière's disease has been developed, based on long-term administration of vasopressin. Induction of vestibular dysfunction in the present animal model can cause additional stress, by reducing inner ear blood flow. Latanoprost, a selective agonist for the FP prostanoid receptor, may become a new remedy for Ménière's disease.The purpose of this study was to develop a more suitable animal model, with a closer resemblance to the pathophysiological process in Ménière's disease.Adult CBA/J or ICR mice were treated by subcutaneous injection of vasopressin for 5 days up to 8 weeks. Morphological analyses were performed of the cochlea, vestibular end organs and endolymphatic sac. The effect of latanoprost on the development of endolymphatic hydrops was also examined.All experimental animals showed mild to moderate endolymphatic hydrops, increasing in severity as the vasopressin treatment was prolonged. Animals treated with vasopressin for 8 weeks showed severe endolymphatic hydrops with partial loss of outer hair cells and spiral ganglion cells. These animals also had a reversible vestibular dysfunction following intratympanic injection of epinephrine. Latanoprost inhibited the development of endolymphatic hydrops caused by vasopressin.

Increased expression of Dicer may be a prognostic biomarker for patients with laryngeal squamous cell carcinoma (LSCC).Recent studies have shown that many microRNAs (miRNAs) play an important role in the development and progression of human cancers. Dicer, one of the most important enzymes of the miRNA machinery, performs the final step of biogenesis of miRNAs. This study aimed to investigate the impact of Dicer expression on patient survival in human LSCC.We detected the expression of Dicer in larynx tissue specimens from 76 LSCC samples and 26 polyps by immunohistochemistry. The clinicopathological and prognostic significance of Dicer expression was investigated in LSCC.Our data showed that the expression of Dicer was significantly higher in the LSCC than in the polyp tissue specimens. Moreover, the expression level of Dicer was significantly associated with the pTNM stage and tumor lymph node metastasis. Kaplan-Meier survival analyses revealed a strong association between tumor Dicer expression and the survival of the patients with LSCC.

Conclusion: In the present study, classification of the patterns of 3D CT images of the ductus reuniens (reuniting duct) (RD), saccular duct (SD), and endolymphatic sinus (ES) gave more precise information for assessing the pathological condition of Meniere's disease (MD) than our previous study. Objective: This study attempted to provide more detailed information on MD by classifying the patterns of 3D CT images of the RD, SD, and ES in patients with MD. Methods: We examined the ears of 62 patients with definitely diagnosed unilateral MD based on the criteria of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) using 3D CT. The 3D CT images of bony grooves of RD, SD, and ES (BRD, BSD, and BES) were classified into patterns according to aspects of their patency. Results: BRD could be classified into six types by assessing their patency defined using the criteria in this study. In the ears on the affected side of patients with MD, the BRD, BSD, and BES lost continuity in 3D CT images along their bony routes and were significantly different from normal healthy ears (p < 0.01). There were no significant differences among each stage of MD in the distributions of BRD and BES except for BSD.

Conclusion: We found that aquaporins (AQPs) in the fluid transporting cells, such as vestibular dark cells and endolymphatic sac epithelial cells, seem to be of importance in fluid transport in the inner ear, while those in the sensory and ganglion cells may play a functional role in sensory cell transduction. Objective: Expression of AQPs (0–12) was analyzed in normal mouse vestibular end organs. Methods: CBA/J mice were used in this study. Localization of AQPs 0–12 in the vestibular end organs and endolymphatic sac was investigated by immunohistochemistry. Results: The AQPs were found abundantly distributed in many structures in the vestibular end organs, i.e. vestibular sensory and supporting cells, vestibular dark cells, vestibular ganglion cells, and the endolymphatic sac.

Gastric type HTo analyze the expression of gastric-type H8 weeks old CBA/J mice were used in this study. The presence of gastric-type HIn the vestibular end organs, H

Conclusion The present findings show that all four types of histamine receptors (H1R, H2R, H3R, and H4R) are present in the inner ear, thus supporting the hypothesis that histamine plays a physiological role in the inner ear. Objective To analyse the presence of histamine receptors in the normal mouse inner ear. Methods CBA/J mice were used in this study. The localization of H1R, H2R, H3R, and H4R in the inner ear, i.e. cochlea, vestibular end organs, vestibular ganglion, and endolymphatic sac, was studied by real-time PCR and immunohistochemistry. Results The mRNA for each receptor sub-type was detected in the inner ear. In the immunohistochemical study, the organ of Corti, spiral ganglion, vestibular ganglion, vestibular sensory epithelium, and endolymphatic sac cells showed an immunofluorescent reaction to all histamine receptors.

Conclusion: It is suggested that aquaporins (AQPs) 1, 2, and 3, and vasopressin type 2 receptors (V2Rs) in the fluid transporting cells, such as stria vascularis, vestibular dark and transitional cells, and endolymphatic sac epithelial cells, have an important role in fluid transport in the inner ear, while those in the sensory and ganglion cells may play a functional role in the sensory cell transduction system. Objective: To analyze expression of AQP1, AQP2, and AQP3 as well as V2Rs in the normal mouse inner ear. Methods: CBA/J mice were used in this study. Localization of AQP1, AQP2, AQP3, and V2Rs in the inner ear, i.e. cochlea, vestibular end organs, and endolymphatic sac, was investigated by immunohistochemistry. Results: The results show that AQP1, AQP2, AQP3, and V2Rs are abundantly distributed in many inner ear structures, i.e. stria vascularis, inner and outer hair cells, spiral ganglion cells, vestibular sensory and ganglion cells, vestibular dark and transitional cells, and the endoly...

Brain-derived neurotrophic factor (BDNF) can prevent auditory brainstem response (ABR) threshold shift changes caused by Pseudomonas aeruginosa exotoxin A (PaExoA).Peptides of the neurotrophin family are known to prevent neuronal death during embryonic development by interacting with specific membrane receptors. The purpose of this study was to investigate whether a single dose of BDNF is an effective protectant against toxic effects of PaExoA-induced ABR threshold shifts.Eight groups of Sprague-Dawley rats were used. There were five control groups (n = 20) as follows. Group A (n = 4) received NaCl solution; group B (n = 3) received 4 µg BDNF; group C (n = 4) received 1 μg/20 μl PaExoA; group D (n = 4) received 2 μg/20 μl PaExoA; group E (n = 5) received 10 µg/20 µl PaExoA injected into the round window niche. Three treatment groups (n = 13) received a single dose of PaExoA and 4 µg of BDNF simultaneously. Group 1 (n = 3) received 1 μg/20 μl PaExoA + 4 µg of BDNF; group 2 (n = 5) received 2 μg/20 μl PaExoA + 4 µg BDNF; group 3 (n = 5) received 10 μg/20 μl PaExoA + 4 µg BDNF. ABR was used to measure efficacy by analyzing threshold shifts before and after injections.A single dose of BDNF prevented changes in ABR thresholds following exposure to increasing concentrations of PaExoA injected into the middle ear.

Objectives: We sought to identify the prevalence of otitis media with effusion (OME) in urban Chinese children in Xi'an, China. Methods: Five kindergartens and 3 primary schools were randomly selected in the urban area of Xi'an. Screening otoscopic and tympanometric examinations were performed on 2,902 children (1,491 boys and 1,411 girls) 2 to 8 years of age. Children with an abnormal tympanogram and simultaneous otomicroscopic signs of effusion were given a diagnosis of OME. Results: The overall prevalence of OME was 4.3%. By age group, the prevalence was 14.0% in 2-year-olds, 8.3% in 3-year-olds, 5.0% in 4-year-olds, 4.9% in 5-year-olds, 2.8% in 6-year-olds, 1.7% in 7-year-olds, and 3.2% in 8-year-olds. The prevalence rate for OME was 4.7% for boys versus 3.9% for girls, and 3.0% in the right ear versus 2.7% in the left, showing no statistically significant difference between genders or between ear sides (p > 0.05). Conclusions: The prevalence of OME in urban areas of Xi'an is not high in comparison with that of the same age group in surrounding areas.

Conclusions: Use of artificial biological material - acellular dermal matrix (Alloderm, ADM) - combined with pectoralis major myocutaneous flaps (PMMFs) or other cervical tissue is a feasible technique with which to reconstruct a large circumferential defect involving the oral cavity and hypopharynx. Objective: This paper presents a review of seven patients with advanced hypopharyngeal carcinoma treated at Tianjin Medical University Cancer Institute & Hospital, China, over a 4-year period. Methods: ADM was used in the form of tissue patches for reconstruction. Five of the seven patients underwent total laryngectomy and total hypopharyngectomy, and reconstruction with a combination of PMMF and ADM tissue patches to restore hypopharyngeal functions. Two other patients underwent tumour resection. The defect in the posterior pharyngeal wall was reconstructed with ADM. Treatment details of the seven patients are discussed. Results: All five PMMFs and seven ADM tissue patches survived. No pharyngeal fistula occurred. Satisfactory healing was observed between the wound margin and ADM 10 days after operation. The trauma area was completely covered by growing epithelium 18-37 days after operation. To some degree, stenosis of the pharyngeal cavity did occur, but patients could have a regular diet following dilatation of the stenosis. Five patients are free of disease after 18-42 months of follow-up.

Conclusion: In spite of no clinical signs of facial paresis, a pathological lip force (LF) will strongly influence swallowing capacity (SC). Stroke patients with impaired SC suffer a subclinical facial paresis. The results support earlier findings that LF training can be used to treat dysphagia. Objectives: Lip muscle training with an oral screen can improve both LF and SC in stroke patients, irrespective of the presence or absence of facial palsy. The aim was therefore to study the influence of LF on SC. Methods: This prospective study included 22 stroke patients, aged 38-90 years, with dysphagia, 12 with initial unilateral facial paresis and 45 healthy subjects, aged 25-87 years. All were investigated with a Lip Force Meter (LF100), and with an SC test. Results: A significant correlation was found between LF/SC (p = 0.012) in stroke patients but not in healthy subjects. LF/SC was not age-related in stroke patients. LF was not age-dependent in healthy subjects, but SC decreased with increasing age (p < 0.0001). However, SC did not reach a pathological value and a regression analysis showed that 73% of the variation in SC is attributable to LF and age.

We here present a 32-month follow-up of a case of Lermoyez syndrome combined with Meniere's disease. The patient was a 49-year-old male, with a stabilized severe hearing loss in the left ear for about 15 years after Meniere's disease. He started to show typical symptoms of Lermoyez syndrome in the right ear about 32 months ago. Audiologic data were obtained and imaging examinations were performed 0, 9, 15, 28, and 32 months after the onset of the Lermoyez syndrome. Pure tone threshold data obtained 5 months before the onset are also reported. The results show that the hearing thresholds, mainly at low frequencies, elevated rapidly during the first months shortly after the onset of the disease and slowly in later months. The glycerol test resulted in a remarkable hearing improvement at the beginning of the disease, but showed no detectable improvements as the disease advanced. Electrocochleogram revealed a -SP/AP value with click stimulus 0.65 at the 9th month and > 1.0 at the 28th month after the onset. Clinical manifestations of this patient fit well with a pathological endolymphatic hydrops.

Conclusion: Congenital unilateral pulmonary malformation can easily be misdiagnosed as a bronchial foreign body. Although rigid bronchoscopy helps the proper diagnosis, high risks associated with anesthesia and operative complications may limit its application. However, high-resolution computed tomography (CT) and three-dimensional lung reconstruction provide a non-invasive tool to improve the diagnosis of congenital unilateral pulmonary malformation. Objectives: To compare clinical manifestations, physical signs, and radiological examinations of congenital unilateral pulmonary malformation and bronchial foreign body, and summarize the characteristics and methods for diagnosis of congenital unilateral pulmonary malformation. Methods: Fourteen patients (five males and nine females, aged from 3 months to 14 years) with congenital unilateral pulmonary malformation, who were misdiagnosed or suspected as having bronchial foreign body or bronchial foreign body with pulmonary atelectasis, were analyzed retrospectively. Three typical cases are presented in detail. Results: All patients were previously misdiagnosed and treated as having pneumonia. From onset to final diagnosis, the longest misdiagnosis time was 10 years, and the shortest was 2 days. Only three patients presented with a history of foreign body inhalation. Six cases were finally diagnosed as having unilateral pulmonary malformation by rigid bronchoscope, five cases by X-ray and high-resolution CT scan, two cases by CT and three-dimensional lung reconstruction, and one case by autopsy. The malformation of left and right lungs was present in five and nine cases, respectively. Among these patients, four patients also had congenital cardiovascular diseases and other malformations, two patients underwent tracheotomy, and one patient died during salvage surgery.

TRPML3 may play distinct roles in the inner ear, such as stereociliar organization, sensory cell transduction, and inner ear fluid homeostasis, and TRPP3 may be important for fluid homeostasis in the inner ear.To study the expression of TRPML1-3 and TRPP2, 3, and 5 in the mouse inner ear.Localization of TRPML1-3 and TRPP2, 3, and 5 in the inner ear of CBA/J mice was investigated by immunohistochemistry.TRPML1-3 immunoreactivity was evident in the stria vascularis, spiral prominence, and spiral ligament. TRPML immunoreactivity was also observed in outer and inner hair cells, supporting cells, and spiral ganglion cells. The vestibular end organs, vestibular sensory cells, dark cells, and ganglion cells all showed immunoreactivity to TRPML. TRPP2 immunoreactivity was evident in the outer lining of the lateral wall of the cochlea, spiral ganglion cells, vestibular sensory cells, and ganglion cells. TRPP3 immunoreactivity was present in stria vascularis, spiral ganglion cells, vestibular sensory cells, dark cells, and ganglion cells. Faint TRPP5 immunoreactivity was observed in the spiral ganglion cells and vestibular ganglion cells.

Estrogen receptor (ER) alpha and beta were expressed in the inner ear, and expression decreased with increasing age. ERalpha may alter cochlear and vestibular sensory transduction, and ERbeta may have a neuroprotective function in the inner ear.Expression of ERalpha and ERbeta in the mouse inner ear and its alterations with sex and aging were analyzed.Male and female CBA/J mice aged 8 weeks and 24 months were used. The localization and the intensity of ERalpha and ERbeta immunoreactivity in the inner ear of young and old mice of both sexes were investigated by immunohistochemistry.ERalpha and ERbeta were co-expressed in the inner ear, i.e. in the nuclei of stria vascularis, outer and inner hair cells, spiral ganglion cells and vestibular ganglion cells, vestibular dark cells and endolymphatic sac. Strial marginal cells, outer hair cells and type II ganglion cells showed less expression of ERalpha. No gender- or age-related difference was noted in the expression pattern of ERalpha or ERbeta, but fluorescence intensity of ERalpha was stronger in young female mice than in young male mice. In contrast, ERbeta revealed no significant difference. In the old mice, fluorescence intensities of both ERalpha and ERbeta were significantly decreased in both sexes.

The in vitro system was used to study early ultrastructural effects following gamma irradiation of human pituitary adenomas and neurinomas with 30 and 70 Gy single doses, respectively. The acoustic neurinoma cells showed a large number of intracellular myelin figures and vesiculation of cytoplasm. The pituitary tumour cells showed vacuolization of cytoplasm and cell organelles. Occasionally, electron-dense cytoplasmic inclusion bodies with a fibrillar substructure occurred. The differences between the two types of tumours in irradiation-induced morphological changes may indicate differences in their biochemical structure and metabolic activities. The morphological findings after irradiation of specimens from all four neurinomas were rather similar after the same length of time but the structural alterations of pituitary cells differed considerably between individual tumours. The 70 Gy dose caused more rapidly-occurring morphological alterations than the 30 Gy single dose.

Conclusions. Malignant carotid body tumour (MCBT) is a clinically rare disease that often invades the carotid artery and cranial nerves. Diagnosis of malignant tumour should be based on extensive invasion of neighbouring organs and distant metastasis. Extensive resection should be undertaken early. Radiotherapy is effective, whereas chemotherapy is uncertain. Objective. To summarize the clinical pathological and prognostic characteristics of MCBT and explore methods for diagnosis and treatment. Materials and methods. The study material comprised clinical, pathological, therapeutic and follow-up data concerning nine patients (four males, five females) with MCBT, treated at Tianjin Cancer Hospital between January 1956 and June 2006. The material was analysed retrospectively. Disease duration averaged 6.4 years. Shamblin classification was: one case, type ?; 8 cases, type ?. All nine patients underwent ultrasound examination, four underwent digital subtraction arteriography (DSA) and three had magnetic resonance angiography (MRA). Five patients underwent preoperative training of compression of the carotid (Matas test). Extensive resection was performed in all nine cases. Results. The carotid artery was blocked in three patients. In one of these the artery was reconstructed with a vascular prosthesis, while two underwent carotid ligation. Eight patients suffered from a cranial nerve dysfunction (defect) and two suffered postoperatively from a hoarse voice, four had a glossal deviation, five had Horner's syndrome and one had a deviation of the lip angle. One patient had a congestive cough. The histopathological diagnosis in all nine cases was MCBT. One patient had metastases to a cervical lymph node and lung and another had liver metastasis. The median follow-up period was 3 years (range 6 months to 14 years). Six patients survived surgery, of whom two underwent radiotherapy. Two patients died and one could not be traced.

Conclusion: The bony saccular orifice to the bony groove of the ductus reuniens (reuniting duct) could not be visualized in the Meniere's ear with significantly greater frequency compared with normal subjects, which suggests that the reuniting duct is affected by radio-opaque substances in CT findings. Objective: This study investigated a more specific, objective, and simpler strategy to diagnose Meniere's disease by assessing the reuniting duct. Subjects and methods: We examined the cars of 12 patients with definitely diagnosed unilateral Meniere's disease in stage 3 based on Meniere's disease criteria proposed by the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), and the ears of 12 normal control subjects using three-dimensional (3D) cone beam CT. Results: The bony groove of the reuniting duct between the saccule and cochlea was visualized in all control subjects. However, the bony saccular orifice to the bony groove could not be visualized in the lesional ear of Meniere's patients with significantly greater frequency compared with those of the contralateral non-lesional ears and control ears (p < 0.01). This orifice was not patent in 66.7% (8 of 12 cars) on the lesional side but all contralateral non-lesional cars of the patients and normal control cars were patent.

Conclusion. The results of this study suggest that treatment with radical scavengers has the potential to become an effective new therapy for age-related hearing loss. Objective. To assess the efficacy of treatment with radical scavengers for age-related hearing loss. Subjects and methods. Rebamipide (300 mg/day), α-lipoic acid (60 mg/day), and vitamin C (600 mg/day) were given orally for at least 8 weeks to 46 elderly patients with age-related hearing loss. Results. Hearing levels after treatment were significantly improved at all frequencies.

Klotho protein content decreases with increasing age, which weakens resistance to oxidative stress, resulting in induced cell death as well as modulating endolymph fluid homeostasis. Down-regulation of klotho also leads to down-regulation of TRPV5 and TRPV6, resulting in modified Ca(2+) homeostasis in the inner ear, dysfunction of sensory cell transduction and causing hearing loss and/or vestibular disorders.Expression of klotho, TRPV5 and TRPV6 in the mouse inner ear and age-related changes were analysed.CBA/J mice aged 8 weeks and 24 months were used in this study. The localization of klotho, TRPV5 and TRPV6 in the inner ear of young and old mice was investigated by immunohistochemistry.Immunostaining for klotho was observed in stria vascularis, outer and inner hair cells (OHCs and IHCs), and in vestibular sensory cells and dark cells, and less intensely in the spiral and vestibular ganglion cells. Expression of TRPV5 was found in stria vascularis, organ of Corti, vestibular sensory cells and dark cells, and less intensely in the spiral and vestibular ganglion cells. Expression of TRPV6 was found in supporting cells of the organ of Corti, with weak labelling in OHCs and IHCs. Weak fluorescence was also noted in stria vascularis, and faint fluorescence in the spiral ligament. Vestibular sensory and dark cells as well as vestibular ganglion cells showed weak fluorescence. In the old animals, the expression patterns of klotho, TRPV5 and TRPV6 were identical with those in young animals, although fluorescence intensity was significantly weaker.

Conclusion. It is suggested that simultaneous treatment with the radical scavenger edaravone has an effective protective effect against tobramycin ototoxicity in rat. Even if the edaravone treatment is postponed for 7 days, it can still prevent hearing loss, but a 14 day delay cannot protect from ototoxicity. Objectives. With the aim of alleviating hearing loss caused by aminoglycoside ototoxicity, we performed a trial to assess the hearing protective efficacy of the radical scavenger edaravone. Materials and methods. In part one of the study, 21 male Sprague-Dawley albino rats were used; 2 rats served as controls for the safety of edaravone. Eight rats each received 10 subcutaneous injections (s.c.) of tobramycin (160 mg/kg b.w.) once daily and saline injection intraperitoneally for 2 weeks. Eleven rats were given 10 s.c. tobramycin injections simultaneously with an intraperitoneal injection of edaravone (3 mg/kg b.w.). In part two, tobramycin was injected in 13 rats (as above). Five of these received two edaravone injections 7 days later and four rats similarly 14 days later. Auditory brainstem response (ABR) was used to assess hearing. Results. All rats treated only with tobramycin showed a deterioration of hearing. None of the rats given simultaneous treatment with tobramycin and edaravone demonstrated hearing loss. A 7 day delay in edaravone injection still prevented hearing loss, but a 14 day delay had only a temporary prophylactic effect.

It is suggested that transient receptor potential vanilloid (TRPV)-1 and -2 may be of pathological significance for sensory cells and ganglions, while TRPV-3 and -4 may play an important part in neuroprotection of the inner ear.Changes in the expression of TRPV-1, -2, -3, and -4 in gentamicin (GM)-treated mouse inner ear were studied.CBA/J mice were used in this study. The localization of TRPV-1, -2, -3, and -4 in the inner ear of both untreated and GM-treated CBA/J animals (intratympanic injection of 5 mg GM) was investigated by immunohistochemistry.TRPV-1, -2, and -3 were co-expressed in the inner ear sensory and ganglion cells, while TRPV-4 was also expressed in the stria vascularis and vestibular dark cells. Following GM treatment, the intensity of immunofluorescent reaction to TRPV-1 and TRPV-2 increased, while that to TRPV-3 and TRPV-4 decreased.

It is suggested that TRPCs play a functional role in the sensory cell transduction system in the inner ear.To study expression of TRPC 1-7 in the mouse inner ear.The localization of TRPC 1-7 in the inner ear of CBA/J mice was investigated by immunohistochemistry.TRPC immunoreactivity was observed generally in the inner ear, e.g. in the lateral wall of the cochlea, organ of Corti, spiral ganglion, vestibular end organs and vestibular ganglion. The immunofluorescent reaction to TRPC 3, 4, 5, and 7 in the stria vascularis was more intense than in the spiral prominence or spiral ligament. In the organ of Corti, TRPC immunoreactivity was observed in the outer hair cells (OHCs), inner hair cells (IHCs) and some supporting cells. TRPC 1-7 were all present in the ganglion cell body, TRPC 1 and 3 showing intense fluorescence, TRPC 2 and 7 moderate fluorescence and TRPC 4, 5 and 6 weak staining in ganglion fibres. In the vestibular end organs, vestibular hair cells (VHCs) showed immunoreactivity to all TRPCs. Nerve fibres in the subepithelial tissue were stained by TRPC 1, 3, 5, 6 and 7. Immunofluorescence to TRPC 1, 3, 4, 5, 6 and 7 was observed in the dark cells. In the vestibular ganglion, TRPC 1-7 were all present in the ganglion cell body. TRPC 1-4 and 7 elicited immunofluorescence in ganglion fibres.

A prefabricated oral screen has shown promising results as a muscle self-training device to improve the lip function of stroke patients affected by oropharyngeal dysphagia. However, a technique for the measurement of lip muscle force, whether in healthy individuals or in stroke patients, is lacking. The present study was designed to (1) test the intra- and interreliability of lip force measurements by means of a newly devised Lip Force Meter, LF100, (2) determine a normal lower limit for lip force in newtons (N), and (3) ascertain the instrument's sensitivity and specificity. LF100 is a modified strain gauge for recording the ability of lips to withstand pressure from a predentally placed oral screen. Forty-two healthy controls and 22 stroke patients agreed to participate in the trial. The controls and patients were examined three times with the LF100, with 2-min rest intervals, twice by investigator MH and once by investigator MO. Intrainvestigator reliability with the LF100 proved excellent in both controls and patients: ICC was 0.83 and 0.90, respectively. Interinvestigator reliability was good or excellent in both groups: ICC was 0.71 and 0.91. There was a significant difference in lip force between controls and stroke patients (mean = 24.7 +/- 6.3 N and 9.5 +/- 5.5 N, p0.001). The sensitivity of LF100 was 91% and the specificity 95%. The cutoff level for normal lip force was 15 N. The LF100 showed itself to be a suitable and reliable instrument for measuring lip force.

Conclusions. That the endolymphatic sac (ES) reacts to changes in inner ear blood flow may be important for homeostasis of the inner ear fluid volume and pressure. Objectives. To elucidate the effect of changes in inner ear blood flow on the ES and to learn more about the volume and pressure regulatory function of the ES. Materials and methods. Epinephrine or sodium nitroprusside (SNP) was injected into the middle ear cavity of adult CBA/J mice. The ES were analyzed morphologically by light microscopy. Results. Epinephrine reduced the luminal size of the ES leading to an accumulation of intraluminal homogeneous substance. Injection of SNP increased the size of the ES lumen, accompanied by a collapse of the lateral intercellular space (LIS) and dense perisaccular tissue. These changes were almost reversed 4 h after injection.

Training with an oral screen can improve lip force (LF) and swallowing capacity (SC) in stroke patients with oropharyngeal dysphagia, irrespective of the duration of pretreatment of dysphagia, and irrespective of the presence or absence of central facial paresis. It is more plausible that treatment results are attributable to sensory motor stimulation and the plasticity of the central nervous system than to the training of the lip muscles per se.A close relationship has been demonstrated between LF and SC in stroke patients whether or not they are affected by facial paresis. It is not known how training of lip function can improve swallowing capacity. The present study was therefore designed to ascertain: (i) if training with an oral screen can improve the LF and SC of stroke patients with oropharyngeal dysphagia; to establish (ii) if improvement in LF and SC is connected with the presence or absence of central facial palsy, (iii) on the interval between stroke onset and initiation of treatment, (iv) on age, or (v) on sex.This was a retrospective study of 30 stroke patients, 49-88 years old, who were investigated with a Lip Force Meter, LF100 (LF100) and a swallowing capacity test (SCT) before and after a period of self-training lasting at least 5-8 weeks, using an oral screen. Initial central facial paresis was present in 24 patients.The median LF was 7 Newtons (N) (range 0-27) before treatment and 18.5 N (range 7-44) after treatment (p0.001). The median SC was 0 ml/s (range 0-9.1) before treatment and 12.1 ml/s (range 0-36.7) at follow-up (p0.001). There was no significant difference in swallowing improvement between patients with versus those without facial paresis. The interval between stroke attack and start of treatment, ranging from a few days up to 10 years, had no significant influence on the treatment results, nor did age or sex. The facial paresis was improved or at least ameliorated in all patients after the lip training period.

It is suggested that transient receptor potential vanilloids (TRPVs) may play a functional role in cell physiology and TRPV-4 and -2 may play an important part in fluid homeostasis in the inner ear.Expression of TRPV-1, -2, -3, and -4 in the normal mouse inner ear was studied.CBA/J mice were used in this study. The localization of TRPV-1, -2, -3, and -4 in the inner ear, i.e. cochlea, vestibular end organs, and endolymphatic sac, was investigated by immunohistochemistry.TRPV-1, -2, and -3 were co-expressed in hair cells and supporting cells of the organ of Corti, in spiral ganglion cells, sensory cells in vestibular end organs, vestibular ganglion cells, and sensory nerve fibers. TRPV-2 was also detected in the stria vascularis, dark cells, and endolymphatic sac. TRPV-4 was expressed in hair cells and supporting cells of the organ of Corti, in marginal cells of the stria vascularis, spiral ganglion cells, vestibular sensory cells, vestibular dark cells, vestibular ganglion cells, and epithelial cells of the endolymphatic sac.

In patients with head and neck squamous cell carcinoma (HNSCC) radioimmunodiagnosis could offer a more specific and sensitive tumor diagnostic method. Our aim was to evaluate the labeling and biodistribution of the novel radioimmunoconjugate (111)In-cMAb U36. In this study cMAb U36, targeting CD44v6, and huA33, as a negative control, were labeled with indium-111, using the chelator CHXA''-DTPA. Immunoreactivity assays and binding studies were performed in vitro. Biodistribution and tumor imaging were conducted after intravenous injection of the radioimmunoconjugate to nude mice bearing HNSCC xenografts expressing CD44v6. The immunoreactive fraction was very high and the binding was CD44v6-specific. In vivo results demonstrated a promising biodistribution, with tumors clearly accumulating radioactivity with time. At 168 h postinjection (p.i.) the tumor uptake was 54.7 +/- 16.6% injected dose/g. The cMAb U36 had significantly (p < 0.05) higher uptake in tumors 72 h p.i. compared to huA33. We produced a novel radioimmunoconjugate targeting CD44v6 for possible use in the detection of HNSCC. The conjugate demonstrates no adverse effects from labeling and a favorable biodistribution.

Conclusion. A new murine model for the study of Meniere's disease has been developed by treatment with both lipopolysaccharide (LPS) and aldosterone. Induction of vestibular dysfunction in the hydropic animal model may entail additional stress such as reduced inner ear blood flow, and sudden acute changes in endolymph volume and/or pressure. Objective. The purpose of this study was to develop a more suitable animal model, showing closer resemblance to the pathophysiological process in Meniere's disease. Materials and methods. Adult CBA/J mice were treated by intratympanic injection of LPS, intraperitoneal injection of aldosterone, or injection of both LPS and aldosterone. Morphological analyses were performed in the cochlea and endolymphatic sac. Results. All experimental animals showed mild to moderate endolymphatic hydrops. Those treated with both LPS and aldosterone showed reversible vestibular dysfunction after the intratympanic injection of epinephrine.

PET plays an important role in staging, on suspicion of recurrence and for detection of occult primary tumours in the head and neck.Since 1998 we have used positron emission tomography (PET) with (18F)fluorodeoxyglucose (FDG) to assess selected patients. This procedure has often helped in making decisions on staging and treatment.The case records of the first 80 patients (104 PET examinations) were studied retrospectively.A total of 39 examinations were performed for staging. PET detected all primary tumours except two (stage T1), and staging was adjusted after 13%. In all, 33 PET examinations were performed on suspicion of recurrent tumour. In 52% of these PET determined further treatments; in 21% PET had a direct impact on the surgical planning. In 18 patients with metastases from an occult primary tumour, PET detected 39% of those tumours; in 22% it was the sole modality to do so. No recurrences or second primary tumours were detected when PET was used for follow-up of clinically cured patients. Results were similar when squamous cell carcinomas (SCCs) were considered alone as compared to the complete material. The mean standardized uptake value (SUV) was higher for cases deemed tumour-positive than in negative cases.

Background: In the growing field of tumor targeting, there is an urgent need to profile suitable molecular targets. In this study, CD44v6 and EGFR expression was quantified in samples of patients with head and neck squamous cell carcinoma (HNSCC) using a single-dose (SD) radioimmunoassay. Methods: The SD radioimmunoassay using 125I-chimeric monoclonal antibody (cMAb) U36 and 125I-cMAb cetuximab was first validated and then applied to quantify the expression of their target antigen molecules, CD44v6 and EGFR, in patient samples. Results were compared to immunohistochemical staining. Results: The SD assay provided sensitive quantitative values of the molecular targets studied, generally agreeing with the immunohistochemistry (IHC) results. The results indicated that expression of CD44v6 (0.2-20 nmol/μg membrane) was generally higher than that of EGFR (0.6-2.3 nmol/μg membrane) in the tumor samples analyzed, which corresponded to an average of 700,000 and 90,000 antigen molecules per cell, respectively. Conclusions: The SD radioimmunoassay is simple, reliable, and can be performed on a small amount (50 mg) of tissue. This assay could be a useful tool in the growing field of personalized cancer therapy, and can be used as a complement to IHC. In the tumors studied, CD44v6 was generally expressed at a higher level than EGFR, which might suggest that it could be more readily targeted by MAbs.

Introduction and aim: To develop a protocolized monitor schedule in microvascular free flap reconstruction, we investigated a possible correlation between the outcome and the interval between clamp release and start of revision. Materials and methods: All the charts of patients treated between 2000 and 2006 with a free flap were evaluated. The patients who underwent a flap revision were further analyzed. Results: A total of 608 free flaps were evaluated; 69 of these flaps were revised. Most vascular complications took place within the first 24 h; the latest complication was observed 8 days after surgery. After 6 days post surgery, the number of revisions decreased considerably. With regard to the salvaged flaps the mean time to start the revision was 46.5 h (SD 39). With regard to the failed revisions, the mean time to start the revision was 82.0 h (SD 47). This difference proved significant (P 5 0.006). Conclusion: Our data shows that the majority of anastomotic failures occur within the first 24 h. Thereafter, the frequency of failures decreases. We also found that the time between initial reconstruction and start of the salvage procedure influences the outcome of the revision negatively. V V C 2007 Wiley-Liss, Inc. Microsurgery 27:612‐616, 2007. Since its introduction in the late fifties, 1 the free flap has evolved to the method of choice as a means to fill large defects. In the last decade, success rates of 95% and higher have been reported. 2‐5 Despite these high success rates, complications do occur. They can be divided into general and ischemic related complications. General complications include infection, hematoma, and systemic complications such as pulmonary and cardiac problems. Ischemic related complications are caused by arterial and/or venous occlusion or insufficiency. When an ischemic complication occurs and is not acted on fast enough, it will cause necrosis of the flap, either partially or

Sudden Sensorineural Hearing Loss (SSHL) was commonly seen in middle aged people. Tinnitus was reported by 87.2% of the patients, and dizziness or vertigo were reported by 48.5%. The most common concomitant disorder of SSHL was hyperlipidemia.A retrospective register study with SSHL was performed in Xi'an, China, from 2000-2009.Of 617 inpatients, the right ear was affected in 267 cases, the left ears in 282 cases, and both ears in 68 cases. The most common age of patients was 41-50 years. There were 20.4% SSHL patients with hypertension, coronary artery disease, or diabetes, and 49.6% patients with hyperlipidemia. Auditory Brainstem Responses (ABR) were performed in 460 patients (504 ears) before treatment, and the ABR threshold of 56.4% ears was90 dB. The constituent ratio of patients with an ABR threshold over 90 dB was greater in the vertigo group than the other group. CT and/or MRI scans were available in 277 cases, of which 40 cases (14.4%) were abnormal.