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Temporal and spectral contributions to musical instrument identification and discrimination among cochlear implant users

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2016年第3期2卷 -页

作者： Sandra M. Prentiss David R. Friedland Tanner Fullmer Alison Crane Timothy Stoddard Christina L. Runge Department of 0tolaryngology and Communication Sciences Medical College of Wisconsin Milwaukee WI USA

Objective: To investigate the contributions of envelope and fine-structure to the perception of timbre by cochlear implant (CI) users as compared to normal hearing (NH) listeners. Methods: This was a prospective cohort comparison study. Normal hearing and cochlear implant patients were tested. Three experiments were performed in sound field using musical notes altered to affect the characteristic pitch of an instrument and the acoustic envelope. Experiment 1 assessed the ability to identify the instrument playing each note, while experiments 2 and 3 assessed the ability to discriminate the different stimuli. Results: Normal hearing subjects performed better than CI subjects in all instrument identification tasks, reaching statistical significance for 4 of 5 stimulus conditions. Within the CI population, acoustic envelope modifications did not significantly affect instrument identification or discrimination. With envelope and pitch cues removed, fine structure discrimination performance was similar between normal hearing and CI users for the majority of conditions, but some specific instrument comparisons were significantly more challenging for CI users. Conclusions: Cochlear implant users perform significantly worse than normal hearing listeners on tasks of instrument identification. However, cochlear implant listeners can discriminate differences in envelope and some fine structure components of musical instrument sounds as well as normal hearing listeners. The results indicated that certain fine structure cues are important for cochlear implant users to make discrimination judgments, and therefore may affect interpretation toward associating with a specific instrument for identification.

关键词： Music Timbre Cochlear implant Envelope Fine-structure

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The impact of round window vs cochleostomy surgical approaches on interscalar excursions in the cochlea:Preliminary results from a flat-panel computed tomography study

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2016年第3期2卷 -页

作者： Nicole T. Jiam Charles J. Limb Department of 0tolaryngology e Head and Neck Surgery University of California San Francisco School of Medicine USA

Objective: To evaluate incidence of interscalar excursions between round window (RW) and cochleostomy approaches for cochlear implant (CI) insertion. Methods: This was a retrospective case-comparison. Flat-panel CT (FPCT) scans for 8 CI users with Med-El standard length electrode arrays were collected. Surgical technique was identified by a combination of operative notes and FPCT imaging. Four cochleae underwent round window insertion and 4 cochleae underwent cochleostomy approaches anterior and inferior to the round window. Results: In our pilot study, cochleostomy approaches were associated with a higher likelihood of interscalar excursion. Within the cochleostomy group, we found 29% of electrode contacts (14 of 48 electrodes) to be outside the scala tympani. On the other hand, 8.5% of the electrode contacts (4 of 47 electrodes) in the round window insertion group were extra-scalar to the scala tympani. These displacements occurred at a mean angle of occurrence of 364 ° ± 133 ° , near the apex of the cochlea. Round window electrode displacements tend to localize at angle of occurrences of 400 ° or greater. Cochleostomy electrodes occurred at an angle of occurrence of 19 ° -490 ° . Conclusions: Currently, the optimal surgical approach for standard CI electrode insertion is highly debated, to a certain extent due to a lack of post-operative assessment of intracochlear electrode contact. Based on our preliminary findings, cochleostomy approach is associated with an increased likelihood of interscalar excursions, and these findings should be further evaluated with future prospective studies.

关键词： Cochlear implantation Round window insertion Cochleostomy Interscalar excursion Electrode position Flat-panel computed tomography Surgical approach

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Improvement in word recognition following treatment failure for sudden sensorineural hearing loss

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2016年第3期2卷 -页

作者： Taha A. Jan Elliott D. Kozin Vivek V. Kanumuri Rosh K. Sethi David H. Jung Department of 0tolaryngology Massachusetts Eye and Ear Infirmary Harvard Medical School Boston MA 02114 USA

Objectives: Patients with sudden sensorineural hearing loss (SSNHL) may have word recognition scores (WRS) that correlate with pure tone average (PTA). We hypothesize that there is a subset of patients with SSNHL who have improved WRS despite stable PTA. Methods: Retrospective case review at a tertiary otolaryngology practice. Results: We identified 13 of 113 patients with SSNHL whose WRS increased despite overall stable pure tone averages. There was an observed average improvement in WRS by 23.8 points in this patient cohort at follow-up, with mean initial PTA in the affected ear at 48.7 dB. Conclusions: We identify a novel cohort of SSNHL patients that have failed treatment as measured by PTA, but who have increased WRS over time. These data have implications for patient counseling and lend insight into the pathophysiology of SSNHL.

关键词： Sensorineural hearing loss Sudden sensorineural hearing loss Word recognition score Pure tone average

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Overview of smartphone applications for sleep analysis

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2016年第1期2卷 -页

作者： Adrian A. Ong M. Boyd Gillespie Medical University of South Carolina Department of 0tolaryngology e Head and Neck Surgery Charleston SC USA

Objective: To review and assess the current selection of sleep analysis smartphone applications (apps) available for download. Methods: The iOS and Google Play mobile app store were searched for sleep analysis apps targeted for consumer use. Alarm clock, sleep-aid, snoring and sleep-talking recorder, fitness tracker apps, and apps geared towards health professionals were excluded. App information and features were obtained from in-store descriptions, and the app developer website. Results: A total of 51 unique sleep apps in both iOS and Google Play stores were included. The apps were rated 3.8/5 in both stores, and had an average price of $1.12 in the iOS store and$0.58 in the Google Play store. >65% of sleep apps report on sleep structure, including duration, time awake, and time in light/deep sleep, while reporting of REM was limited. The availability of extra features was variable, ranging from 4% to 73% of apps. Conclusions: There are a variety of sleep analysis apps with a range of functionality. The apps with the most reviews from the each store are featured. Many apps provide data on sleep structure; however the algorithms are not validated by scientific literature or studies. Since patients may inquire about their sleep habits from these apps, it is necessary for physicians to be aware of the most common apps and the features offered and their limitations in order to properly counsel patients.

关键词： Mobile applications Smartphone Apps Sleep monitor Actigraphy

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Normal values of nasal NO and exhaled NO in young Chinese people aged 9 e 22 years

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2016年第1期2卷 -页

作者： Shaohua You Jing Zhang Yin Bai Lingchao Ji Hongtian Wang Department of 0tolaryngology Head and Neck Surgery People’s Liberation Army General Hospital Beijing 100853 China

Objective: To assess the normal levels of nasal nitric oxide (NNO) and fractional exhaled nitric oxide (FENO) in healthy Chinese young people, and to determine whether the obtained values were associated with age, sex, height, weight, BMI (body mass index) or BSA (body surface area). Methods: One hundred and twenty healthy people were selected from a total of 436 Chinese young people based on their answers to a questionnaire. An electrochemical analyzer (NIOX MINO system) was used to measure NNO and FENO. The relationship between NNO, FENO and age, sex, height, weight, BMI, BSA was analyzed using SPSS software. Results: The values of NNO were normal distributed (mean 273.5 ppb; SD 112.3). The values of FENO were non-normally (Skewed) distributed (median: 14.00 ppb; interquartile range: 7.00 ppb). The obtained NNO values were independent of age, sex, height, weight, BMI and BSA, but were positively correlated to lnFENO (FENO log base e); lnFENO values were also independent of age, height, weight, BMI and BSA, but correlated with NNO and sex. Conclusions: NNO values positively correlate with lnFENO in healthy people and the levels of each may be predicted by the other. The results of this study are expected to serve as a reference for future studies in China.

关键词： Nitric oxide Nasal cavity Lower respiratory tract Normal value Healthy people

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Interleukin-6 role in head and neck squamous cell carcinoma progression

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2016年第2期2卷 -页

作者： Moaz M. Choudhary Thomas J. France Theodoros N. Teknos Pawan Kumar Department of 0tolaryngology-Head and Neck Surgery and Comprehensive Cancer Center The 0hio State University Columbus 0H 43210 USA

Interleukin-6 (IL-6) is a pleiotropic cytokine which plays an important role in a number of cellular processes including proliferation, survival, differentiation, migration and invasion. IL-6 mediates its downstream effects by activating a number of signaling cascades including JAK/STAT, PI3K/AKT and MAPK pathways. In addition to its effects on tumor cells, IL-6 also regulates tumor progression and tumor metastasis by modulating tumor angiogenesis and tumor lymphangiogenesis. A number of studies have shown that IL-6 levels are markedly upregulated in cancer patients. We and others have shown that high IL-6 expression independently predicts tumor recurrence, tumor metastasis and poor survival in head and neck cancer patients. Therefore targeting IL-6 signaling is a potential therapeutic strategy for the treatment of head and neck squamous cell carcinoma (HNSCC). In this review, we discuss the current understanding of the role of IL-6 in HNSCC progression and potential therapeutic strategies to target IL-6 signaling for the treatment of head and neck cancer patients.

关键词： Head and neck squamous cell carcinoma Interleukin-6 JAK STAT3 MAPK PI3K/Akt Nanog

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Intra-tumor heterogeneity in head and neck cancer and its clinical implications

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2016年第2期2卷 -页

作者： Edmund A. Mroz James W. Rocco Department of 0tolaryngology-Head and Neck Surgery The James Cancer Hospital and Solove Research Institute The 0hio State University Columbus 0H USA

The presence of heritable differences among cancer cells within a tumor, called intra-tumor genetic heterogeneity, has long been suspected of playing a role in poor responses to therapy. Research over the past decade has documented the existence of such heterogeneity within tumors of individual patients and documented its potential clinical significance. The research methods for identifying this heterogeneity were not, however, readily adaptable to widespread clinical application. After a brief review of this background, we describe the development of a measure of intra-tumor genetic heterogeneity, based on whole-exome sequencing of individual tumor samples, that could be applied to biopsy specimens in a clinical setting. This measure has now been used in head and neck squamous cell carcinoma (HNSCC) to document, for the first time, a relation of high intra-tumor genetic heterogeneity to shorter overall survival in a large, multi-institutional study. The implications of heterogeneity for research and clinical care thus now need to be addressed.

关键词： Head and neck squamous cell carcinoma Intra-tumor genetic heterogeneity Next-generation sequencing Targeted therapy

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Static and dynamic visual vertical perception in subjects with migraine and vestibular migraine

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2016年第3期2卷 -页

作者： Mark A. Miller Benjamin T. Crane School of Medicine and Dentistry University of Rochester Rochester NY 14642 USA Department of 0tolaryngology University of Rochester Rochester NY 14642 USA

Objective: To measure the static visual vertical and the effect of visual rotation on the perception of visual vertical in migraine and vestibular migraine subjects. By so doing, we may better understand the vestibular contribution to the pathophysiology of migraine, as well as the capacity for visual compensation. Methods: The perception of visual vertical in the presence of static and dynamic visual cues was prospectively studied in 10 subjects with migraine, 6 subjects with vestibular migraines, and 10 controls. Subjects used a dial to rotate a fluorescent green line to the vertical position. Static visual vertical (SVV) was measured with a black background, as well as with a static random-dot visual pattern. This pattern was then rotated at various velocities to measure dynamic visual vertical (DVV). Results: Migraine subjects had greater deviation from true vertical than controls in SVV ( P 0.05). The DVV in migraine subjects was greater than controls when rotated in the counterclockwise at-5 ° /s ( P 0.01), -20 ° /s ( P 0.01), and-80 ° /s ( P 0.01), but not when the line was rotated clockwise. Vestibular migraine subjects did not deviate significantly from controls in SVV ( P 0.37, P 0.22), but did show greater deviation in the DVV tasks at-80 and-20 ° /s ( P 0.05, P 0.03). Migraine and vestibular migraine subjects demonstrated a wider range of vertical deviance when compared to controls ( P 0.02). Conclusions: This study demonstrates a significant deviation of the perceived static as well as dynamic visual vertical in migraine subjects. Moving stimuli may have a greater influence on migraine and vestibular migraine subjects, which suggests an underlying sensory integration disorder.

关键词： Vestibular Visual Vertical Migraine

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Objective and subjective scar aesthetics with topical Manuka honey post-thyroidectomy:A randomized control study

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2016年第4期2卷 -页

作者： Andrew Thamboo Graeme Mulholland Kathleen Matthews Noel Ayoub Donald Anderson Department of 0tolaryngology e Head and Neck Surgery Stanford University School of Medicine 801 Welch Road Stanford CA 94305 USA

Objective: Leptospermum Honey (Manuka honey) has proven to be effective in improving acute and chronic wound healing presumably due to its antibacterial and anti-inflammatory properties. The aim is to determine if Manuka honey decreases scar formation and results in a cosmetically appealing scar. Methods: A prospective single-blinded randomized control trial was performed. All patients received an 8 cm incision. Patients randomized to honey treatment were instructed to apply Manuka honey paste topically to the incision site once per day post surgery for 4 weeks. The patients’ scar was then analyzed objectively by a blinded observer and subjectively at 4 and 8 weeks postoperatively. The primary outcome measure used was the Patient and Observer Scar Assessment Scale (POSAS). Results: A total of 21 patients completed the entire scar analysis (honey treatment = 9, standard treatment = 12). There was no statistically significant difference between patient scar assessment scale and observer scar assessment scale at 4 and 8 weeks postoperatively. Conclusion: Despite Leptospermum Honey’s reported anti-inflammatory and antibacterial properties, this study did not show a difference in scar appearance when applied.

关键词： Thyroid Thyroidectomy Scar Aesthetics Honey Topical Wound healing Naturopathic

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Transoral robotic surgery frontiers

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2016年第2期2卷 -页

作者： James R. Bekeny Enver Ozer Department of 0tolaryngology-Head and Neck Surgery The 0hio State University Medical Center The James Cancer Hospital and Solove Research Institute Columbus 0H 43210 USA

Transoral robotic surgery is a exciting field that continues to develop and push the boundaries of current procedural ability and challenges historical treatment paradigms. With the first use of a surgical robot in 1985, to the first clinical use of the robot transorally in 2005, there was some lag in adoption of robotic techniques in the head and neck region. However, since 2005 transoral robotic surgery has rapidly gained momentum amongst head and neck surgeons. With FDA approval of the da Vinci robot in 2009, transoral robotic surgery is currently offered as a treatment modality for malignant and nonmalignant disease of the head and neck region. This new technology is being used to reconsider historical treatment paradigms for malignancies of the upper aerodigestive tract due to the fact that minimally invasive surgical access to the oropharynx and larynx has been improved. Along with this enhanced access have come innovative procedures and uses of the technology for multiple facets of head and neck disease. Technology continues to improve and innovation in surgical robotics is expected to continue as more companies attempt to capture this market. This article aims to provide a view at the landscape of transoral robotic surgery and explore the future frontiers.

关键词： Robotic surgery

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