Objective: To determine the incidence and volume of pneumolabyrinth using early temporal bone computed tomography (TBCT) findings and evaluate the correlation between pneumolabyrinth and various clinical variables. Study Design: Retrospective case review. Setting: Tertiary academic center. Patients: Fifty-three consecutive adult cochlear implantation (CI) recipients (53 ears) with normal inner ears who underwent high-resolution TBCT within 3 days after CI were included. Intervention: Axial TBCT images were used for detection and measurement of pneumolabyrinth. Main Outcome Measures: Incidence and volume of pneumolabyrinth were evaluated. In addition, the following clinical variables were analyzed to evaluate the correlation with pneumolabyrinth volume: demographics, implant type, surgical approach, postoperative dizziness, and preservation of functional residual hearing. Results: Pneumolabyrinth was present in all patients, and the average volume was 8.496 mm3. Pneumolabyrinth was confined to the cochlea (pneumocochlea) in all patients except for one who also had pneumovestibule. The pneumolabyrinth volume in patients with postoperative dizziness was significantly larger than that in patients without postoperative dizziness (10.435 mm3 vs. 8.016 mm3; p = 0.029). Multivariate analysis showed that a larger volume of pneumolabyrinth was significantly associated with postoperative dizziness (odds ratio, 1.420; 95% confidence interval, 1.114–1.808; p = 0.005). Conclusion: A certain volume of pneumolabyrinth was always present in the early stage after CI, and the volume of pneumolabyrinth measured using early TBCT findings was significantly associated with the occurrence of postoperative dizziness.
Background and Objective Although numerous studies have reported surgical results of uvulopalatopharyngoplasty, efficacies of extended uvulopalatal flap (EUPF) surgery have only been reported in a few studies. Thus, the aim of this study was to evaluate the success rate of EUPF and investigate the advantage and practicality of this surgery.Methods Medical records of patients who underwent EUPF surgery were retrospectively analyzed. Through medical record analysis, demographic information was confirmed. Postoperative polysomnography (PSG) results were divided into a surgical ‘success’ group and a ‘failure’ group. Patients’ PSG results, questionnaires, and cephalometry were comparatively analyzed.Results All sleep parameters of PSG except rapid eye movement latency and hypopnea index were significantly improved after surgery. Ten patients were in the success group (success rate, 33.3%) and 20 patients were in the failure group. Among preoperative PSG parameters, apnea-hypopnea index, apnea index, and number of awakenings showed significant differences between the two groups. However, there were no significant differences in results of cephalometry or Friedman stage between the two groups.Conclusions The EUPF surgery can change sleep factors and improve subjective symptoms in obstructive sleep apnea patients. It could be considered as one of the treatment options for patients with surgical indications, although its success rate was only 33.3%.
Background and Objectives Polylactic-co-glycolic acid (PLGA) plate has been recognized for its biocompatibility and biomechanical properties and used widely in various clinical fields. The aim of this study was to evaluate the usefulness and reliability of PLGA plate as a graft material in septorhinoplasty. Subjects and Method Medical records were retrospectively analyzed for patients who underwent septorhinoplasty including extracorporeal septoplasty from January 2017 to June 2020. We evaluated demographics, diagnosis, operation techniques, and complications of PLGA plate as a graft material used in these patients. Results A total of 33 patients were enrolled in this study. Twenty-eight were male and 5 were female. The median age was 32 years old. The follow-up period after surgery was 6-32 months, and the mean follow-up period was 18.03 months. The PLGA plate was used in unilateral spreader graft (n=17), bilateral spreader graft (n=10), batten graft (n=3), strengthening of septal extension graft (n=2) and columellar strut graft (n=3), and fixing L-strut during extracorporeal septoplasty (n=12). During the follow-up period, no patient experienced extrusion or exposure of the grafts. Mild complications, such as redness of the columella skin, granulation in the marginal incision site, and pain on the nasal dorsum were observed in three patients; these complications were temporary and patients improved with conservative treatments. Conclusion The PLGA plate may be a useful graft material in correcting deviated nose especially when the harvested septal cartilage is insufficient and if used carefully in limited locations such as L-strut and columella.
Background and Objectives A recent study revealed that calcitonin gene-related protein (CGRP) plays an important role in inflammatory airway diseases. However, the influence of CGRP on chronic rhinosinusitis (CRS) has not been studied. This study investigated the expression, activity, and potential pathogenic role of CGRP in patients with CRS with nasal polyposis (CRSwNP).Subjects and Method Patients with CRSwNP and control subjects were enrolled. The CRSwNP group was divided according to the presence of eosinophilic polyps and non-eosinophilic polyps. Nasal polyps (NPs) and uncinate tissues (UTs) from patients with CRSwNP and UTs from control subjects were obtained to investigate the expression of α-/β-CGRP and chromogranin A. In addition, the expression patterns of cytokines following exposure to exogenous CGRP were analyzed in dispersed nasal polyp cells (DNPCs) from patients with eosinophilic or non-eosinophilic CRSwNP. The effects of CGRP on lipopolysaccharide (LPS)-induced nuclear factor-kappa light chain enhancer of activated B cells (NF-κB) signaling change were evaluated in THP-1 cells.Results The expression of α-/β-CGRP and number of CGRP-producing cells were significantly higher in NPs from patients with CRSwNP than in UTs from controls. Exogenous CGRP decreased the expression of inflammatory cytokines and increased that of the anti-inflammatory cytokines in DNPCs from patients with eosinophilic nasal polyps (EPs) and also increased the expression of tissue remodeling-related and anti-inflammatory cytokines in DNPCs from patients with non-eosinophilic nasal polyps (N-EPs). CGRP inhibited the nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor (IκB) phosphorylation and NF-κB translocation in LPS-stimulated M1 macrophages.Conclusion CGRP expression in NPs may play a significant role in nasal polypogenesis through inflammatory modulation, and it could be a future target to modulate certain aspects of CRSwNP.
Objectives: The association between the chorda tympani nerve (CTN) and atresiaplasty has not been investigated. This study aimed to describe the course of the CTN observed during atresiaplasty for congenital aural atresia (CAA) and explore the feasibility of CTN preservation.Methods: In this retrospective study, six consecutive patients who underwent atresiaplasty in a tertiary academic center were included. The course of the tympanic segment of the CTN and its preservation feasibility were evaluated. Atresiaplasty was performed using an anterior approach. The average Jahrsdoerfer score was 8.7 points (range, 8-9 points). Results:The CTN was located in the atretic plate in all patients. It emerged from an average of 5.6 mm (range, 5.2-6.1) inferior to the incus buttress and crossed the middle ear in an anterior-superior direction. The distance between the neck of the malleus and the CTN varied in the absence of the malleus handle. However, when the malleus handle developed, the CTN passed between the incus and the malleus handle. The CTN was preserved in two of the six patients. They had a Jahrsdoerfer score of 9 and grade I microtia. Conclusion:The CTN was located in the atretic plate, emerging from an average distance of 5.6 mm inferior to the incus buttress. The incus buttress might serve as a good anatomical landmark to identify and preserve the CTN. CTN preservation is feasible in atresiaplasty candidates with a Jahrsdoerfer score of 9 and auricular deformity of grade I.
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