Commentary on Safety and Effectiveness of VYC-15L, a Hyaluronic Acid Filler for Lip and Perioral Enhancement.

No abstract available

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Performance Plateau in Prelingually and Postlingually Deafened Adult Cochlear Implant Recipients.

Objective: To characterize the performance plateau after unilateral cochlear implantation (CI) in prelingually and postlingually deafened adults and to compare their relative progress. Study Design: Retrospective chart review. Setting: Tertiary referral center. Patients: Prelingually and postlingually deaf adults who received a unilateral CI and completed a minimum of 2 years of follow-up at our center. Intervention: Unilateral CI. Main Outcome Measures: : Standard speech perception testing (consonant-nucleus-consonant [CNC] monosyllabic word test and hearing in noise test [HINT] or AzBio sentence test) were performed preoperatively and 3 and 12 months postoperatively, and annually thereafter. Results: In postlingually deaf patients (n = 102), there was a significant improvement in word scores for 3 years postimplantation (p

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Cochlear Implantation in Children With Congenital Single-Sided Deafness.

Objective: To determine audiological and clinical results of cochlear implantation in children with congenital single sided deafness (SSD), with an emphasis on children implanted before and after 6 years of age. Study Design: Retrospective study. Setting: Tertiary referral center. Subjects: Twenty one children with congenital SSD who were implanted aged 10 months to 11;3 years. Intervention: Unilateral cochlear implantation. Main Outcome Measures: Speech recognition in noise via the German Oldenburg Sentence Test for Children (OlKiSa), lateralization ability, and subjective evaluation of hearing results using self- and third-party assessment questionnaires. Results: Significant improvements of all three aspects of true binaural hearing were found. The most striking improvement was the combined head shadow effect by 2.11 dB (squelch effect: 0.95 dB, summation effect 0.98 dB). An improvement of lateralization ability was also demonstrated. Parents had a high overall level of satisfaction with their children's cochlear implantation. Subjective benefit was verified in all three subscales of the Speech, Spatial, and Qualities of Hearing Questionnaire. No significant difference was found between subjects implanted before the age of 6 with those implanted later. Three of the five subjects with a follow-up of greater than 3 years were limited users or nonusers. Conclusions: Cochlear implant (CI) provision provides children with congenital SSD with significant audiological and subjective benefits which can be seen even in children implanted after the age of 3;6. The problem of limited use and nonuser, however, should not be ignored and has to be considered for further studies. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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The Role of Rho/Rho-Kinase Pathway in the Pathogenesis of Cholesteatoma.

Objective: To assess the role of Rho/Rho-kinase pathway in the pathogenesis of cholesteatoma. Materials and Methods: Thirty-eight patients with cholesteatoma, who had gone mastoidectomies were enrolled in this prospective study. Cholesteatomas matrix (CM) and a piece of the external ear canal skin (EECS as control) were taken and transferred to the liquid nitrogen and kept at -86 [degrees]C for Rho A and Rho-kinase (ROCK) analysis with Western blotting and commercial ELISA kits (Cell Biolabs Inc., San Diego, CA). The tissues were homogenized by an appropriate ice-cold lysis buffer. Following centrifugation, the supernatant was taken and total protein amount was detected by the Bradford method. Thereafter, tissue homogenates were subjected to sodium dodecyl sulphate (SDS)-polyacrylamide gel electrophoresis electrophoresis then transferred to nitrocellulose membrane where it was treated with specific monoclonal primary antibody against to ROCK-2 and HRP-conjugated seconder antibody, respectively. The protein blots were visualized with commercial x-ray film and dansitometrically analyzed by the Scion Image Program (Cell Biolabs Inc., San Diego, CA). In another series of experiments, Rho-kinase activities were assessed by ROCK-2 ELISA kits. Results: There were no statistical differences in Rho A translocation between CM and EECS. However, ROCK activity was found to be lower in CM than EECS as detected by ELISA kits. Furthermore, ROCK protein expression was also significantly lower in CM than EECS as demonstrated by Western blotting. Conclusion: Given Rho-kinase could take essential roles in cell differentiation, the results of this study implicate that down-regulated Rho-kinase could be responsible for the keratinocyte undifferentiation seen in cholesteatoma pathogenesis. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Conductive Hearing Loss From a Jugular Bulb Anomaly.

No abstract available

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Benign Temporomandibular Joint Lesions Presenting as Masses in the External Auditory Canal.

Objective: Describe benign lesions arising from the temporomandibular joint (TMJ) that presented as masses in the external auditory canal (EAC). Study Design: Retrospective case series of two academic medical centers. Patients: Six patients with lesions emanating from the TMJ that presented as EAC masses. Lesions included pigmented villonodular synovitis (PVNS), nodular fasciitis, foramen of Huschke herniation with salivary fistula, fibroepithelial polyp, superficial angiomyxoma, and giant cell tumor (GCT). Intervention: Surgical resection. Main Outcome Measures: Tumor control, TMJ function, and hearing. Results: All patients presented with hearing loss, TMJ pain, and otalgia. Three patients with EAC occluding masses developed entrapment cholesteatoma between the mass and tympanic membrane. Following surgical resection, four patients were free of disease. The patient with PVNS has a stable remnant at 3 years follow up and the patient with giant cell tumor is under active surveillance. Hearing improved in three patients, remained stable in one patient, and worsened in two patients. All had resolution of their TMJ and ear pain. Conclusions: EAC masses of uncertain origin should be imaged preoperatively to exclude lesions best not biopsied (e.g., encephalocele, facial nerve schwannoma, paraganglioma). In the differential of EAC masses, lesions emanating from the TMJ need to be considered, especially for those based anteriorly. Understanding the extent of TMJ involvement is crucial for surgical planning which optimizes outcome. Goals for therapy are to control the underlying disease process, restore patency of the EAC, improve hearing, and preserve function of TMJ. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Intraoperative Bleeding and the Risk of Residual Cholesteatoma: A Multivariate Analysis.

Objective: Residual cholesteatoma most frequently occurs where visualization and surgical access are restricted by anatomic constraints. Other factors that compromise surgical field visualization might also increase rates of residual cholesteatoma. We evaluated whether impaired surgical field clarity from bleeding increases rates of residual cholesteatoma. Study Design: Prospective cohort study. Setting: Tertiary care hospital. Patients: Consecutive series of children having intact canal wall surgery for cholesteatoma. Interventions: Impact of bleeding on surgical field clarity was assessed intraoperatively on a six-point scale. Main Outcome measures: Presence of residual cholesteatoma was established at follow up clinical encounters, second stage procedures, and with magnetic resonance imaging. Multiple logistic regression was used to determine the influence of surgical field clarity and other factors on rates of residual cholesteatoma. Results: Surgery was completed on 232 ears and residual cholesteatoma found in 45 (19%) ears. Multivariate regression analysis of cases completed with atticotomy or tympanoplasty demonstrated that surgical field clarity was a significant predictor of residual cholesteatoma (OR [odds ratio] 4, 95%CI 1.05-15; p = 0.04). Cholesteatoma extent was the most significant predictor of residual cholesteatoma when including cases requiring combined approach tympanomastoidectomy (OR 2.2, 95%CI 1.4-3.3; p

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