Prevalence of Headache in Cochlear Implant Patients: A Cross-sectional Study.

INTRODUCTION: In Internet forums and other social media many reports regarding chronic headaches after cochlear implantation can be found. Although quite rare, there are also some reports in the literature. However, little is known regarding the true prevalence of headaches in persons who have undergone cochlear implant surgery. OBJECTIVES: The primary aim of this study was to investigate the 1-year prevalence of headache in patients having received a cochlear implantation ("cochlear implant group") in comparison with patients having undergone middle ear surgery ("surgery group") and persons with no history of head and neck surgery ("non-ear-nose-throat [ENT] group"). METHODS: Cross-sectional, monocentric study using a validated headache questionnaire. RESULTS: Three hundred persons were asked to participate. Two hundred thirty four valid questionnaires were returned. The participants' median age was 62 years, of whom 45% were women. The prevalence of headache was 31% (95%-confidence interval [CI]: [21; 42]) in the cochlear implant group and 46% (95%-CI: [35; 57]) in the surgery group with no significant difference between these two subgroups (p = 0.071). In the non-ENT group the prevalence of headache was significantly higher than in the other two subgroups (64%, 95%-CI: [52; 74]). DISCUSSION: The prevalence of headache is not higher in cochlear implant patients in comparison to middle ear surgery patients, other, non-ENT patients and the general German or European population. CONCLUSION: Cochlear implantation does not seem to be associated with an increased risk for developing headache.

Cytokine patterns in nasal secretion of non-atopic patients distinguish between chronic rhinosinusitis with or without nasal polys.

BACKGROUND: Being one of the most common nasal diseases, chronic rhinosinusitis (CRS) is subdivided into CRS with nasal polyps (NP) and CRS without nasal polyps (CRSsNP). CRSsNP presents itself with a TH1 milieu and neutrophil infiltration, while NP is characterised by a mixed TH1/TH2 profile and an influx of predominantly eosinophils, plasma cells and mast cells. For the purpose of discovering disease-specific cytokine profiles, the present study compares levels of mediators and cytokines in nasal secretions between CRSsNP, NP, and healthy controls. METHODS: The study included 45 participants suffering from NP, 48 suffering from CRSsNP and 48 healthy controls. Allergic rhinitis constituted an exclusion criterion. Nasal secretions, sampled using the cotton wool method, were analysed for IL-4, IL-5, IL-10, IL-12, IL-13, IL-17, IL-8, GM-CSF, G-CSF, IFN-γ, MCP-1, MIP-1α, MIP-1ß, eotaxin, and RANTES, and for ECP and tryptase, using Bio-Plex Cytokine assay or ELISA, respectively. RESULTS: Elevated levels of IL-5, IL-17, G-CSF, MCP-1, MIP-1α, MIP-1ß, ECP, and tryptase, as well as decreased levels of IL-10, IL-12, IL-13, and IFN-γ were detected in NP. CRSsNP presented increased levels of RANTES and MIP-1ß while IL-13 was decreased. No differences between the three groups were found for IL-4, IL-8, GM-CSF, and eotaxin. CONCLUSIONS: The present work suggests a disequilibrium of TH1 and TH2, together with a down-regulation of regulatory T lymphocytes and up-regulated TH17 in NP. Moreover, elevated levels of diverse mediators represent the activation of various inflammatory cells in this disease entity. The inflammation in CRSsNP, however, is only weakly depicted in nasal secretions. Therefore, cytokines in nasal secretions may provide helpful information for differential diagnosis.

Milestones in the History of Ear Reconstruction.

The reconstruction of ear deformities has been challenging plastic surgeons since centuries. However, it is only in the 19th century that reports on partial and total ear reconstruction start increasing. In the quest for an aesthetically pleasing and natural-looking result, surgeons worked on the perfect framework and skin coverage. Different materials and flap techniques have evolved. Some were abandoned out of frustration, while others kept evolving over the years. In this article, we discuss the milestones in ear reconstruction-from ancient times to early attempts in Western civilization to the key chapters of ear reconstruction in the 20th century leading to the current techniques.