Anti-phasic oscillatory development for speech and noise processing in cochlear implanted toddlers.

Human brain demonstrates amazing readiness for speech and language learning at birth, but the auditory development preceding such readiness remains unknown. Cochlear implanted (CI) children (n = 67; mean age 2.77 year ± 1.31 SD; 28 females) with prelingual deafness provide a unique opportunity to study this stage. Using functional near-infrared spectroscopy, it was revealed that the brain of CI children was irresponsive to sounds at CI hearing onset. With increasing CI experiences up to 32 months, the brain demonstrated function, region and hemisphere specific development. Most strikingly, the left anterior temporal lobe showed an oscillatory trajectory, changing in opposite phases for speech and noise. The study provides the first longitudinal brain imaging evidence for early auditory development preceding speech acquisition.

Electronic and elastic properties of metastable Zr3N4: a joint experimental and theoretical study.

The electronic structures and elastic properties of metastable Zr3N4 phases have been investigated using the first-principles calculations with the Heyd-Scuseria-Ernzerhof (HSE06) hybrid functional, in comparison with those of the stable ZrN phase. All three metastable Zr3N4 phases (including orthorhombic, spinel and Th3P4-type phases) are found to be semiconducting with bandgaps of 1.72-1.94 eV. In particular, the computationally indirect bandgap of 1.72 eV of orthorhombic Zr3N4 is consistent with the experimental value of 1.8 eV. The detailed analyses of the electronic structures reveal that the change of electrical conductivity from metallic ZrN to semiconducting Zr3N4 is mainly due to the electron transfer from Zr to N atoms, which weakens the Zr-Zr interactions and reduces the proportion of metallic bonding. In addition, the elastic properties of Zr3N4 and ZrN phases have been calculated. The theoretical hardness values of ZrN and orthorhombic Zr3N4 are 18.06 and 6.98 GPa, respectively, agreeing well with the experimental values of 19.26 and 7.90 GPa. This work may further promote the understanding of the promising Zr-N material system.

Reevaluating the splice-altering variant in TECTA as a cause of nonsyndromic hearing loss DFNA8/12 by functional analysis of RNA.

PURPOSE: The aim of this study was to determine the genetic cause of early onset autosomal dominant hearing loss segregating in five-generation kindred of Chinese descent and provide preimplantation genetic testing (PGT)for them. METHODS: Clinical examination, pedigree analysis and exome sequencing were carried out on the family. Minigene-based splicing analysis, in vivo RNA analysis and protein structure prediction by molecular modeling were conducted on the candidate variant. PGT for the causative variation and chromosome aneuploidis based on SNP analysis has been used for avoidance of hearing loss in this family. RESULTS: All the affected individuals presented with moderate down-sloping hearing loss and whole-exome sequencing identified a novel splice-site variant c.5383+6T>A in the tested subjects within the TECTA locus. Genotyping of all the 32 family members confirmed segregation of this variant and the hearing loss phenotype in the extended family. Functional analysis of RNA and molecular modeling indicates that c.5383+6T>A is a pathogenic splice-site variant and should be considered as genetic cause of the hearing loss. Furthermore, a successful singleton pregnancy with no variation in TECTA c.5383+6 was established and a healthy male child was born by PGT. CONCLUSION: We have identified a novel variant c.5383+6T>A in TECTA ZA-ZP inter-domain, which could be attributable to the early-onset autosomal dominant hearing loss. The implications of our study are valuable in elucidating the disrupted RNA splicing and uncovering the genetic cause of hearing loss with TECTA pathogenic variants, as well as providing reproductive approaches to healthy offspring.

Comparative analysis of vestibular endolymphatic hydrops grading methods and hearing loss in Ménière's disease: a retrospective MRI study using 3D-real inversion recovery sequence.

PURPOSE: To compare the correlation between different grading methods of vestibular endolymphatic hydrops (EH) and the severity of hearing loss in Ménière's disease (MD), and evaluate the diagnostic value of these methods in diagnosing MD. METHODS: This retrospective study included 30 patients diagnosed with MD from June 2021 to August 2023. All patients underwent inner ear MR gadolinium-enhanced imaging using three-dimensional (3D)-real inversion recovery sequences and pure-tone audiometry. The EH levels were independently evaluated according to the classification methods outlined by Nakashima et al. (Acta Otolaryngol Suppl 5-8, 2009. https://doi.org/10.1080/00016480902729827 ) (M1), Fang et al. (J Laryngol Otol 126:454-459, 2012. https://doi.org/10.1017/S0022215112000060 ) (M2), Barath et al. (Am J Neuroradiol 35:1387-1392, 2014. https://doi.org/10.3174/ajnr.A3856 ), (M3), Liu et al. (Front Surg 9:874971, 2022. https://doi.org/10.3389/fsurg.2022.874971 ), (M4), and Bernaerts et al. (Neuroradiology 61:421-429, 2019. https://doi.org/10.1007/s00234-019-02155-7 ) (M5), with a subsequent comparison of interobserver agreement. After achieving a consensus, an analysis was performed to explore the correlations between vestibular EH grading using different methods, the average hearing thresholds at low-mid, high-, and full frequencies and clinical stages. The diagnostic capabilities of these methods for MD were then compared. RESULTS: The interobserver consistency of M2-M5 was superior to that of M1. The EH grading based on M4 showed a significant correlation with the average hearing thresholds at low-mid, high-, and full frequencies and clinical stages. M1, M2, M3, and M5 correlated with some parameters. A receiver operating characteristic curve analysis indicated that M5 significantly outperformed M1, M2, M3, and M4 in terms of diagnostic efficiency for MD. CONCLUSION: M4 showed the strongest correlation with the degree of hearing loss in patients with MD, whereas M5 showed the highest diagnostic performance.

Factors Affecting Visual-Only Speech Recognition in Individuals With Cochlear Implants.

Objectives: Several reports have underlined the benefits of speechreading (visual-only speech recognition) on speech recognition in individuals with hearing loss after cochlear implantation (CI). However, the factors that would affect the ability of speechreading are unclear. The aim of the present study is to assess the factors that affect speechreading abilities in CI users. Methods: A total of 104 participants were enrolled in this retrospective study. They viewed silent videos of sentences being spoken by a model and were tasked with repeating what they thought had been said. They were tested under audio-only and visual-only conditions. Factors (such as the age, the age of CI; <3 years old vs 3-8 years old; male vs female, etc) believed to affect speechreading abilities were analyzed. Results: The age range of the participants is 8 to 34 years. CI users showed significantly different speechreading abilities among themselves. The authors found that age and hearing loss at 3 to 8 years of age were positively related to superior speechreading recognition scores. Conclusions: CI users followed a more complex method of perceptual compensation. Those who have suffered hearing loss between 3 and 8 years of age are more sensitive to developing an advantage in speech recognition by using speechreading. Older age positively affects speechreading abilities; thus, the more experience CI has, the greater speechreading ability they may exhibit.

Association Between Vestibular Aqueduct Morphology and Meniere's Disease.

OBJECTIVE: To investigate the relationship between vestibular aqueduct (VA) morphology and Meniere's disease (MD) using ultrahigh-resolution computed tomography (U-HRCT). METHODS: Retrospective data were collected from 34 patients (40 ears) diagnosed with MD in our hospital who underwent temporal bone U-HRCT with isotropic 0.05-mm resolution, magnetic resonance with gadolinium-enhanced, and pure-tone audiometry; 34 age- and sex-matched controls (68 ears) who underwent U-HRCT were also included. VA patency was qualitatively classified as locally not shown (grade 1), locally faintly shown (grade 2), or clearly shown throughout (grade 3). The width of the outer orifice and VA length and angle were quantitatively measured. Differences in VA morphology between the MD and control groups were analyzed. The correlations between VA morphology and the degrees of hearing loss and endolymphatic hydrops (EH) were also analyzed. RESULTS: VA was classified as grades 1-3 in 11, 17, and 12 ears in the MD group and 5, 26, and 37 ears in the control group, respectively. The patency differed significantly between the groups (p < 0.01). The width of the outer orifice and length of VA were significantly smaller in the MD group than those in the control group (p < 0.05). Both VA patency and length were correlated with the degree of EH in the cochlea and the vestibule (p < 0.05). No difference was found between VA morphology and the degree of hearing loss (p > 0.05). CONCLUSION: The morphological characteristics of VA were found to be associated with the occurrence of MD and the degree of EH. LEVEL OF EVIDENCE: 4 Laryngoscope, 2024.

The Effect of Hearing Loss and Working Memory Capacity on Context Use and Reliance on Context in Older Adults.

OBJECTIVES: Older adults often complain of difficulty in communicating in noisy environments. Contextual information is considered an important cue for identifying everyday speech. To date, it has not been clear exactly how context use (CU) and reliance on context in older adults are affected by hearing status and cognitive function. The present study examined the effects of semantic context on the performance of speech recognition, recall, perceived listening effort (LE), and noise tolerance, and further explored the impacts of hearing loss and working memory capacity on CU and reliance on context among older adults. DESIGN: Fifty older adults with normal hearing and 56 older adults with mild-to-moderate hearing loss between the ages of 60 and 95 years participated in this study. A median split of the backward digit span further classified the participants into high working memory (HWM) and low working memory (LWM) capacity groups. Each participant performed high- and low-context Repeat and Recall tests, including a sentence repeat and delayed recall task, subjective assessments of LE, and tolerable time under seven signal to noise ratios (SNRs). CU was calculated as the difference between high- and low-context sentences for each outcome measure. The proportion of context use (PCU) in high-context performance was taken as the reliance on context to explain the degree to which participants relied on context when they repeated and recalled high-context sentences. RESULTS: Semantic context helps improve the performance of speech recognition and delayed recall, reduces perceived LE, and prolongs noise tolerance in older adults with and without hearing loss. In addition, the adverse effects of hearing loss on the performance of repeat tasks were more pronounced in low context than in high context, whereas the effects on recall tasks and noise tolerance time were more significant in high context than in low context. Compared with other tasks, the CU and PCU in repeat tasks were more affected by listening status and working memory capacity. In the repeat phase, hearing loss increased older adults' reliance on the context of a relatively challenging listening environment, as shown by the fact that when the SNR was 0 and -5 dB, the PCU (repeat) of the hearing loss group was significantly greater than that of the normal-hearing group, whereas there was no significant difference between the two hearing groups under the remaining SNRs. In addition, older adults with LWM had significantly greater CU and PCU in repeat tasks than those with HWM, especially at SNRs with moderate task demands. CONCLUSIONS: Taken together, semantic context not only improved speech perception intelligibility but also released cognitive resources for memory encoding in older adults. Mild-to-moderate hearing loss and LWM capacity in older adults significantly increased the use and reliance on semantic context, which was also modulated by the level of SNR.

Carbon nanoparticles beneficial for prophylactic central compartment lymph node dissection in cN0 papillary thyroid carcinoma.

Objective: This study explored prophylactic central compartment lymph node dissection (pCCLND) for patients with cN0 papillary thyroid carcinoma (PTC) and the effect of carbon nanoparticles (CNP) on surgical outcomes. Methods: This retrospective study reviewed PTC cases treated at our tertiary medical institution between January 2019 and December 2022. Only patients with indications for total thyroidectomy and cN0 disease were included. CNP has been associated with a higher number of harvested lymph nodes and a lower rate of accidental parathyroid gland (PTG) removal. Patients who used CNP in this study were classified as group 1, while those who denied its use were classified as group 2. Results: In total, 116 cases were included, with 80 patients in group 1 and 36 in group 2. Most patients were in stage T1, with 68 (85.0 %) patients in group 1 and 31 (86.1 %) in group 2. Postoperative hoarseness occurred in 3 (3.8 %) patients in group 1 and 1 (2.8 %) in group 2, which recovered within two months. In group 2, 250 nodes were harvested, 72 (28.8 %) of which were metastatic; in group 1, 889 nodes were harvested, 316 (35.5 %) of which were metastatic; the difference regarding the rates of metastatic lymph nodes between the 2 groups was statistically significant (P = 0.047). Differences in postoperative blood calcium and parathyroid hormone levels between the two groups were statistically significant (P = 0.035 and P = 0.034, respectively). There were symptoms of hypocalcemia in 6 (16.7 %) patients in group 2 but in only 2 (2.5 %) in group 1, all of which recovered within three months; the difference was statistically significant (p = 0.017). Conclusion: pCCLND is worth undertaking for cN0 PTC. CNP is beneficial for achieving more thorough dissection and reducing temporary hypoparathyroidism.

In Situ Vaccination with An Injectable Nucleic Acid Hydrogel for Synergistic Cancer Immunotherapy.

Recently, therapeutic cancer vaccines have emerged as promising candidates for cancer immunotherapy. Nevertheless, their efficacies are frequently impeded by challenges including inadequate antigen encapsulation, insufficient immune activation, and immunosuppressive tumor microenvironment. Herein, we report a three-in-one hydrogel assembled by nucleic acids (NAs) that can serve as a vaccine to in situ trigger strong immune response against cancer. Through site-specifically grafting the chemodrug, 7-ethyl-10-hydroxycamptothecin (also known as SN38), onto three component phosphorothioate (PS) DNA strands, a Y-shaped motif (Y-motif) with sticky ends is self-assembled, at one terminus of which an unmethylated cytosine-phosphate-guanine (CpG) segment is introduced as an immune agonist. Thereafter, programmed cell death ligand-1 (PD-L1) siRNA that performs as immune checkpoint inhibitor is designed as a crosslinker to assemble with the CpG- and SN38-containing Y-motif, resulting in the formation of final NA hydrogel vaccine. With three functional agents inside, the hydrogel can remarkably induce the immunogenic cell death to enhance the antigen presentation, promoting the dendritic cell maturation and effector T lymphocyte infiltration, as well as relieving the immunosuppressive tumor environment. When inoculated twice at tumor sites, the vaccine demonstrates a substantial antitumor effect in melanoma mouse model, proving its potential as a general platform for synergistic cancer immunotherapy.

Comparison of ASSR and frequency specificity ABR induced by NB CE-Chirp for prediction of behavioral hearing thresholds in children with conductive hearing loss.

BACKGROUND: Electrophysiological tests are often used to evaluate hearing loss in infants and young children with conductive hearing loss, no matter to quantify or characterize. However, there are advantages and disadvantages associated with the various electrophysiological tests that are currently available. Therefore, there is no gold standard test. This study aimed to compare the value of narrow-band (NB) CE-Chirp-induced auditory steady-state response (ASSR) and auditory brainstem response (ABR) for assessing hearing thresholds in children with conductive hearing loss. We hope to identify an effective electrophysiological testing method to evaluate conductive hearing loss and provide a reference for clinical hearing assessment of infants with conductive hearing loss. SUBJECTS: and Methods: We selected 27 children (41 ears) aged 3-6 years with otitis media with effusion (OME). Within 1 day, they underwent behavioral audiometry and NB CE-Chirp-induced ASSR and ABR tests in sequence. Pearson's correlation analysis was performed to compare behavioral audiometry thresholds and ASSR and ABR response thresholds at 500, 1000, 2000, and 4000 Hz. RESULTS: The behavioral audiometry thresholds of all children were strongly correlated with the response thresholds of the two electrophysiological tests, with correlation coefficients of 0.659, 0.605, 0.723, and 0.857 for ASSR, and 0.587, 0.684, 0.753, and 0.802 for ABR. The proportion of children with a difference of ≤10 dB between ASSR and behavioral audiometry thresholds or between ABR and behavioral audiometry thresholds was not high, especially in the low frequencies. ABR results were superior to ASSR results in terms of predicting actual hearing levels. At 0.5, 1, 2, and 4 kHz, the average differences between the behavioral hearing thresholds and ASSR thresholds in the 41 ears were 5.6, 5.7, 2, and 5.6 dB, respectively. The average differences between behavioral hearing thresholds and ABR thresholds was -5.6, -1.4, -6.8, and 3.2 dB, respectively. The hearing loss configuration of the ASSR exhibited a peaked pattern, similar to behavioral audiometry, whereas the ABR exhibited an ascending pattern. The time to perform the single-ear ASSR test was 5.9 min, whereas the ABR test took 17.0 min. CONCLUSION: ASSR and ABR induced by the NB CE-Chirp correlated well with behavioral audiometry in children with conductive hearing loss. The NB CE-Chirp ASSR has advantages in terms of testing time and hearing configuration evaluation, whereas ABR has better reliability than ASSR. However, the stability of ASSR and ABR induced by the NB CE-Chirp is poor, and the thresholds obtained cannot replace behavioral audiometry in evaluating the true hearing of children with conductive hearing loss. However, ASSR and ABR can be used as auxiliary tests for cross-validation.

Monte-Carlo based vertical underwater optical communication performance analysis with chlorophyll depth profiles.

Although underwater wireless optical communication (UWOC) has the advantages of high speed, low latency, and high confidentiality, the transmission of light in water will be affected by the absorption and scattering of particles, which will lead to the aggravation of channel path loss as well as channel pulse spreading, finally causing false codes. Therefore, how to analyze the channel impulse response (CIR) effectively is a key task in channel modeling. In this paper, we consider a two-way underwater vertical line-of-sight (LOS) communication system model, based on the inherent optical property (IOP) model of chlorophyll, using the Kopelevich phase function containing water depth information, the CIR curves under different water types and transceiver configurations are plotted using the Monte-Carlo Simulation (MCS). The obtained simulation results are fitted with the double gamma function (DGF) model and the Gaussian model, respectively. The Gaussian model exhibits better properties than the DGF model in each water condition. Based on the closed-form expression of the CIR obtained from the Gaussian model, we solve for the bit error rate (BER) and 3-dB bandwidth of the system under different settings. The conclusions obtained can be used for the design and optimization of underwater vertical channels.

Comparative study of the sensitivity of ultra-high-resolution CT and high-resolution CT in the diagnosis of isolated fenestral otosclerosis.

PURPOSE: To compare the diagnostic sensitivity of ultra-high-resolution computed tomography (U-HRCT) and HRCT in isolated fenestral otosclerosis (IFO). METHODS: A retrospective analysis was conducted on 85 patients (85 ears) diagnosed with IFO between October 2020 and November 2022. U-HRCT (0.1 mm thickness) was performed for 20 ears, HRCT (0.67 mm thickness) for 45 ears, and both for 20 ears. The images were evaluated by general radiologists and neuroradiologists who were blinded to the diagnosis and surgical information. The diagnostic sensitivity of U-HRCT and HRCT for detecting IFO was compared between the two groups. RESULTS: Excellent inter-observer agreement existed between the two neuroradiologists (Cohen's κ coefficient 0.806, 95% CI 0.692-0.920), with good agreement between the general radiologists (Cohen's κ coefficient 0.680, 95% CI 0.417-0.943). U-HRCT had a sensitivity of 100% (40/40 ears) for neuroradiologists and 87.5% (35/40 ears) for general radiologists, significantly higher than HRCT (89.2% [58/65 ears] for neuroradiologists; 41.5% [27/65 ears] for general radiologists) (p = 0.042, p' < 0.000). General radiologists' sensitivity with HRCT was significantly lower compared to neuroradiologists (p < 0.000), but no significant difference was observed when general radiologists switched to U-HRCT (p = 0.152). Among the 20 ears that underwent both examinations, U-HRCT detected lesions smaller than 1 mm in 5 ears, whereas HRCT's sensitivity for neuroradiologists was 40% (2/5 ears), significantly lower than for lesions larger than 1 mm (93.3%, 14/15 ears, p = 0.032). CONCLUSION: U-HRCT exhibits higher sensitivity than HRCT in diagnosing IFO, suggesting its potential as a screening tool for suspected otosclerosis patients. CRITICAL RELEVANCE STATEMENT: Ultra-high-resolution computed tomography has the potential to become a screening tool in patients with suspected otosclerosis and to bridge the diagnostic accuracy gap between general radiologists and neuroradiologists. KEY POINTS: • U-HRCT exhibits higher sensitivity than HRCT in the diagnosis of IFO. • U-HRCT has a significant advantage in the detection of less than 1 mm IFO. • U-HRCT has the potential to be used for screening of patients with suspected otosclerosis.

Contribution of inter-trial phase coherence at theta, alpha, and beta frequencies in auditory change detection.

Introduction: Auditory change detection is a pre-attentive cortical auditory processing ability. Many neurological and psychological disorders can lead to defects in this process. Some studies have shown that phase synchronization may be related to auditory discrimination. However, the specific contributions of phase synchronization at different frequencies remain unclear. Methods: We analyzed the electroencephalogram (EEG) data of 29 healthy adults using an oddball paradigm consisting of a standard stimulus and five deviant stimuli with varying frequency modulation patterns, including midpoint frequency transitions and linear frequency modulation. We then compared the peak amplitude and latency of inter-trial phase coherence (ITC) at the theta(θ), alpha(α), and beta(ß) frequencies, as well as the N1 component, and their relationships with stimulus changes. At the same time, the characteristics of inter-trial phase coherence in response to the pure tone stimulation and chirp sound with a fine time-frequency structure were also assessed. Result: When the stimulus frequency did not change relative to the standard stimulus, the peak latency of phase coherence at ß and α frequencies was consistent with that of the N1 component. The inter-trial phase coherence at ß frequency (ß-ITC)served as a faster indicator for detecting frequency transition when the stimulus frequency was changed relative to the standard stimulus. ß-ITC demonstrates temporal stability when detecting pure sinusoidal tones and their frequency changes, and is less susceptible to interference from other neural activities. The phase coherence at θ frequency could integrate the frequency and temporal characteristics of deviant into a single representation, which can be compared with the memory trace formed by the standard stimulus, thus effectively identifying auditory changes. Pure sinusoidal tone stimulation could induce higher inter-trial phase coherence in a smaller time window, but chirp sounds with a fine time-frequency structure required longer latencies to achieve phase coherence. Conclusion: Phase coherence at theta, alpha, and beta frequencies are all involved in auditory change detection, but play different roles in this automatic process. Complex time-frequency modulated stimuli require longer processing time for effective change detection.

Energy effective utilization of circulating fluidized bed fly ash to prepare silicon-aluminum composite aerogel and gypsum.

To reduce the cost of Si-Al aerogels preparation, circulating fluidized bed fly ash (CFA) was developed to be as the alternative to synthetic precursors. High energy consumption of alkali-melting and secondary wastes production were the major challenges. Here, a technique characterized by effective energy consumption and non-secondary waste was developed to convert CFA into Si-Al aerogel. The process consists two stages, preparation of Si-Al sol by sintering of CFA and Na2CO3 followed by sulfuric acid leaching, and synthesis of Si-Al aerogel by so-gel with trimethyl chlorosilane modification and ambient pressure drying. The optimization results of proportion and sintering temperature showed that the optimal temperature of sintering of Na2CO3 and CFA with the mass ratio of 0.7 was 750 °C, 100 °C lower than that of most other waste aluminosilicate materials. CaSO4·0.5H2O which meet building gypsum requirement was obtained by specifying the drying temperature of acid-leached residue at 126 °C for 2 h. The modification procedure was explored to obtain Si-Al aerogel with a large specific surface area of 857 m2/g and hydrophobic angle of 139.3°. Thermal and mechanical properties tests indicated that the Si-Al aerogels and gypsum produced from CFA exhibited promising thermal insulation and the potential application in construction.

Evaluation of the relationship between endolymphatic hydrops and hearing loss in Meniere's disease based on three-dimensional real inversion recovery sequence

Abstract Objectives: The degree of endolymphatic hydrops in Meniere's disease may be related to hearing loss. However, the results of prior studies have been inconsistent. We aimed to investigate the relationship between endolymphatic hydrops and hearing loss characteristics in Meniere's disease. Methods: This study included 54 patients (62 ears) with Meniere's disease. Patients underwent three-dimensional real inversion recovery sequences for magnetic resonance imaging and puretone audiometry. Endolymphatic hydrops were assessed according to Gurkov's criteria (2011). Correlations between different degrees of endolymphatic hydrops and pure-tone audiometry, as well as staging, were analysed. Results: Pure tone audiometry and staging were higher for vestibular endolymphatic hydrops complicated by cochlear ones than isolated cochlear or vestibular hydrops (both p<0.05). There was no significant correlation between vestibular endolymphatic hydrops and pure-tonal audiometry or staging (all p > 0.05). The degree of hydrops in the middle turn was correlated with the mid-frequency hearing threshold (p<0.05). The degree of cochlear hydrops was correlated with the audiometry, low-frequency hearing thresholds, mid-frequency hearing thresholds and staging (p<0.01). Conclusion: The types and sites of endolymphatic hydrops based on a 3D-real inversion recovery sequence can be used to indicate the degree of hearing loss in patients with Meniere's disease. Level of evidence: Level III.

Diagnosis and Open Surgical Management of Laimer's Diverticulum: Case Series and Review of the Literature.

Objectives: Laimer's diverticulum (LD) is a very rare clinical entity originating between the cricopharyngeus muscle (CPM) and circular muscular fibers of the esophagus. Its diagnosis and management remain to be elucidated. This article summarizes our experience in its diagnosis and open surgical management.Methods: A retrospective review of LD cases treated at our tertiary medical institution was conducted between July 2018 and May 2023. The clinical and demographic data were retrieved from case notes.Results: Three cases were included in this review. There were 2 male patients and 1 female patient. The average and median ages were 47.3 and 54 years, respectively. Presenting symptoms included hoarseness, pharyngeal foreign body sensation, and neck mass. All 3 diverticula were on the left side, with the first 2 cases discovered accidentally on gastric endoscopic or cervical MRI examinations. After evaluating esophageal swallowing with barium sulfate or urografin contrast media, all the patients consented to undergo an open surgical procedure. During surgical exploration, the diverticula were found to be on the posterior part of the cervical esophagus, below CPM, and away from the recurrent laryngeal nerve, and only then, could the diagnosis of LD be established. Then, diverticulectomy and manual suturing of the esophagus was performed. Recovery of all 3 patients was uneventful. Nasogastric tube feeding lasted 7 to 12 days until esophageal examinations demonstrated no leak, and then, oral liquid feeding resumed. The median duration of follow-up was 50 months. No recurrence of symptoms or diverticulum was observed, and the swallowing function of all 3 patients was excellent.Conclusions: An open surgical approach is not only important for the diagnosis of LD, but can also be utilized as a safe and effective treatment.

Intracapsular Enucleation of Brachial Plexus Schwannoma With Intraoperative Neuromonitoring: A Case Series Study and a Review of Literature.

OBJECTIVE: Brachial plexus schwannoma (BPS) is a rare clinical entity that poses a significant challenge for head and neck surgeons due to its neuroanatomical complexity and potential severe complications, such as major motor or sensory neurological deficits or pain of the corresponding upper extremity. This article summarizes our experience in its diagnosis and intracapsular enucleation with intraoperative neuromonitoring (INM). METHODS: A retrospective review of BPS cases treated at our tertiary medical institution was conducted between April 2020 and May 2023. The clinical and demographic data were retrieved from case notes. RESULTS: Totally, 3 cases were included. All 3 patients were male, aged 43 to 54 years (median age = 52). The presenting symptom was a palpable supraclavicular mass in all these cases (2 on the left side and 1 on the right side). Neuromonitoring was performed with a 4-channel nerve integrity monitor, with the electrodes placed in the upper arm and forearm muscles, as demonstrated in the literature. After exposing the mass and identifying its origin from the brachial plexus, a unipolar stimulating probe was used to stimulate the tumor surface or the nerves with a 1.0-mA current, and a longitudinal incision into the tumor capsule was made along a carefully mapped line with no INM response. Then the mass was carefully exposed and meticulously dissected from its capsule to achieve an intact enucleation. Immediate postoperative neurological deficit was documented in Case 1 as a mild grasping weakness. The recovery of the other 2 patients was uneventful. The follow-up duration was 7 to 38 months (median = 8 months). The minor motor deficit of Case 1 recovered completely 1 month after surgery. No recurrence of BPS was observed. CONCLUSIONS: Intracapsular enucleation with INM could result in complete removal of BPS and minimal postoperative neurological deficit, whose recovery was quick and satisfactory.

Autosomal dominant non-syndromic hearing loss caused by a novel mutation in MYO7A: A case report and review of the literature.

BACKGROUND: Variants in the MYO7A gene commonly result in Usher syndrome, and in rare cases lead to autosomal dominant non-syndromic deafness (DFNA11). Currently, only nine variants have been reported to be responsible for DFNA11 and their clinical phenotypes are not identical. Here we present a novel variant causing DFNA11 identified in a three-generation Chinese family. CASE SUMMARY: The proband was a 53-year-old Han male who presented with post-lingual bilateral symmetrical moderate sensorineural hearing loss. We learned from the patient's medical history collection that multiple family members also had similar hearing loss, generally occurring around the age of 40. Subsequent investigation by high-throughput sequencing identified a novel MYO7A variant. To provide evidence supporting that this variant is responsible for the hearing loss in the studied family, we performed Sanger sequencing on 11 family members and found that the variant co-segregated with the deafness phenotype. In addition, the clinical manifestation of the 11 affected family members was found to be late-onset bilateral slowly progressive hearing loss, inherited in this family in an autosomal dominant manner. None of the affected family members had visual impairment or vestibular symptoms; therefore, we believe that this novel MYO7A variant is responsible for the rare DFNA11 in this family. CONCLUSION: We report a novel variant leading to DFNA11 which further enriches the collection of MYO7A variants, and our review of the nine previous variants that have been identified to cause DFNA11 provides a reference for clinical genetic counseling.

Evaluation of the relationship between endolymphatic hydrops and hearing loss in Meniere's disease based on three-dimensional real inversion recovery sequence.

OBJECTIVES: The degree of endolymphatic hydrops in Meniere's disease may be related to hearing loss. However, the results of prior studies have been inconsistent. We aimed to investigate the relationship between endolymphatic hydrops and hearing loss characteristics in Meniere's disease. METHODS: This study included 54 patients (62 ears) with Meniere's disease. Patients underwent three-dimensional real inversion recovery sequences for magnetic resonance imaging and pure-tone audiometry. Endolymphatic hydrops were assessed according to Gurkov's criteria (2011). Correlations between different degrees of endolymphatic hydrops and pure-tone audiometry, as well as staging, were analysed. RESULTS: Pure tone audiometry and staging were higher for vestibular endolymphatic hydrops complicated by cochlear ones than isolated cochlear or vestibular hydrops (both p < 0.05). There was no significant correlation between vestibular endolymphatic hydrops and pure-tonal audiometry or staging (all p > 0.05). The degree of hydrops in the middle turn was correlated with the mid-frequency hearing threshold (p < 0.05). The degree of cochlear hydrops was correlated with the audiometry, low-frequency hearing thresholds, mid-frequency hearing thresholds and staging (p < 0.01). CONCLUSION: The types and sites of endolymphatic hydrops based on a 3D-real inversion recovery sequence can be used to indicate the degree of hearing loss in patients with Meniere's disease. LEVEL OF EVIDENCE: Level III.

[Construction of malnutrition visualization system].

OBJECTIVE: To establish a set of visualization systems suitable for displaying the transition of malnutrition status in different population across time and space in China. METHODS: Based on the data characteristics of the four monitoring systems, including the China Nutrition and Health Surveillance, the China Health and Nutrition Survey, the Project of Children Nutrition Improvement in Poor Rural Regions, and the Nutrition Improvement Program for Rural Compulsory Education Students, to be merged and the requirements of this project, the client/server architecture(C/S architecture) application mode was adopted, the Visual Studio 2019 development tool set, Python 3.7-10 and C # 8.0 language programming were used for data integration, and a complete set of data preprocessing, data conversion and data integration calculation processes were established. RESULTS: The malnutrition visualization system provided a visualization display system for the nutritional status of different populations under the multi database fusion index system based on the integrated malnutrition database. The system was able to not only modify, delete and update data, but query, display and analyze malnutrition conditions including growth retardation, low weight, emaciation, micronutrient deficiency, overweight, and obesity. CONCLUSION: Malnutrition visualization system dynamically presented the time series and spatial distribution of malnutrition among Chinese residents, and explored the regional characteristics and major challenges of nutrition problems in different periods.