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1.
Artigo em Chinês | MEDLINE | ID: mdl-32086905

RESUMO

Objective:To investigate the clinical characteristics and therapeutic effect of benign paroxysm positional vertigo(BPPV) secondary to middle ear surgery. Method:A total of 1 126 patients who underwent tympanoplasty or radical mastoidectomy due to chronic suppurative otitis media and middle ear cholesteatoma in our hospital from January 2014 to December 2018 were collected. Clinical data of BPPV within 1 month after surgery were collected, The incidence, incidence side, involved semicircular canal, onset time, age of onset, and duration of operation of secondary BPPV after middle ear surgery were analyzed. All patients with secondary BPPV were treated by manual reduction, and the efficacy was evaluated 1 day, 1 week, and 1 month after reduction. Result:2.13% (24 cases) of patients had secondary BPPV after operation, among which 2 cases were parietal incidence. 18 cases were involved in posterior semicircular canals and 6 cases were horizontal semicircular canals. The onset time was 1-12 days after the operation, with an average of (3.29±2.44) days. The mean age of onset was (51.62±10.15) years old, and there was no statistically significant difference between the age of patients without BPPV after middle ear surgery (P>0.05). The average operating time was (97.29±14.78) minutes, showing no statistically significant difference compared with patients in the group without BPPV (P>0.05). Fourteen cases (58.3%) were cured and 10 cases were improved after 1 day evaluation. Evaluated 1 week after treatment, 19 cases (79.17%) were cured and 5 cases were improved. Evaluated 1 month after treatment, all patients were cured without recurrence. Conclusion:BPPV secondary to middle ear surgery often appears 3 days after surgery, and the posterior semicircular canal of the operative ear is most commonly involved. Age and operation duration have no significant influence on the incidence of BPPV, and satisfactory therapeutic effect can be obtained through manipulative reduction.


Assuntos
Vertigem Posicional Paroxística Benigna/etiologia , Orelha Média/cirurgia , Procedimentos Cirúrgicos Otológicos/efeitos adversos , Adulto , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Canais Semicirculares/patologia
2.
Artigo em Chinês | MEDLINE | ID: mdl-32086911

RESUMO

Objective:A retrospective analysis of audiologic outcome and graft take rate on post-tympanoplasty with different middle ear mucosal conditions in wet ear. Method:According to the characteristics of middle ear mucosal condition and residual eardrum, 80 cases with wet ear of chronic suppurative otitis media were divided into the hydrocele group, the swelling group and the granulation group. The factors in different groups, including gender, age, disease course, sides, size and location of perforations, destruction of ossicular chain and reconstruction methods were analyzed. Moreover, postoperative hearing improvement and graft take rate were compared among the three groups. Result:There was no significant difference in gender, age, disease course, sides, size and location of perforations among the hydrocele group, the swelling group and the granulation group (P>0.05). Overall, the postoperative average Air-Bone Gaps(ABG) were reduced in all wet ear patients after surgery (P<0.01). The ABG was decreased from (25.5 ± 10.8) dB to(15.4 ± 9.4) dB in the hydrocele group, and decreased from (27.6 ± 8.7) dB to (15.2 ± 9.6) dB in the swelling group, and from (29.5 ± 7.7) dB to (17.2 ± 17.2) dB in the granulation group. The graft take rates were 90.0% in totally. There were no significant difference in graft take rates among the three groups, and 84.6% in the hydrocele group, 93.3% in the swelling group and 100.0% in the swelling group(P>0.05). Conclusion:Wet ear is not an absolute contraindication of tympanoplasty for chronic suppurative otitis media. Whether there was effusion, swelling or granulomatous hyperplasia in the tympanoplasty, the patients'hearing improved significantly after tympanoplasty, and the healing rate of the tympanoplasty did not decrease. Further basic and clinical studies are needed to standardize the timing of wet ear surgery, clarify the operative contraindication and elucidate the pathophysiological mechanism of eardrum healing.


Assuntos
Otite Média com Derrame/cirurgia , Timpanoplastia , Doença Crônica , Orelha Média/patologia , Humanos , Estudos Retrospectivos , Resultado do Tratamento , Membrana Timpânica
3.
HNO ; 68(1): 55-58, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31531685

RESUMO

Adenomas are very rare tumors of the middle ear. They are benign neoplasms originating from the glandular components of the mucous membrane of the middle ear. The middle ear adenoma was first described by Hyams and Michaels in 1976, which was named an adenomatous tumor. This article reports the case of a 50-year-old female patient, who presented with recurrent right-sided dull otalgia and pulse synchronous tinnitis, which began 1 year prior to presentation, with the suspected diagnosis of a glomus tympanicum tumor. Following the otorhinolaryngological examination and imaging an unclear mesotympanal space-occupying lesion was detected. A transmeatal endoscopic complete removal of the tumor was carried out. The histopathological investigations enabled the diagnosis of an adenoma of the middle ear. Adenomas are a rare differential diagnosis of tumors of the middle ear. In cases with a suitable localization an adequate exposure and removal of this rare tumor can be achieved by a transmeatal endoscopic access.


Assuntos
Adenoma , Neoplasias da Orelha , Adenoma/diagnóstico , Adenoma/patologia , Adenoma/terapia , Neoplasias da Orelha/diagnóstico , Neoplasias da Orelha/patologia , Neoplasias da Orelha/terapia , Orelha Média , Endoscopia , Feminino , Humanos , Pessoa de Meia-Idade , Osso Temporal
4.
Ann Otol Rhinol Laryngol ; 129(3): 216-223, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31631685

RESUMO

OBJECTIVES: To compare preoperative temporal bone high-resolution computed tomography (HRCT) readings to intraoperative findings during exploratory tympanotomy for suspected cases of isolated congenital middle ear malformations (CMEMs) and summarize the malformations that can and cannot be diagnosed with HRCT. METHODS: A retrospective study was conducted. All cases were confirmed as isolated CMEMs during surgery. Detailed clinical records were reviewed, with a focus on imaging and surgical findings. RESULTS: One hundred and thirty-two patients and 145 ears were reviewed. Ninety cases (62.1%) could be identified as isolated CMEMs and at least one as middle ear anomaly using preoperative HRCT. Fifty-five cases (37.9%) were reported to be completely normal and the patients underwent exploratory tympanotomy to determine the final diagnosis. Stapes fixation, either alone or associated with other ossicular chain anomalies, contributed to 53.1% of the cases. Most cases of aplasia or dysplasia of the ossicular chain, for example, aplasia/dysplasia of the long process of the incus, aplasia of the stapes' superstructure, and atresia of the oval window were easily identified in preoperative HRCT. However, fixation of the ossicular chain can be elusive in HRCT, and exploratory tympanotomy is needed for a definitive diagnosis. CONCLUSIONS: HRCT provides helpful preoperative clinical information in CMEM and may obviate the need for middle ear exploration in some cases. The negative findings (anomalies that are difficult to identify through preoperative HRCT) and the positive findings (anomalies that are relatively easy to identify through preoperative HRCT) were summarized.


Assuntos
Orelha Média/anormalidades , Janela do Vestíbulo/anormalidades , Adolescente , Adulto , Criança , Pré-Escolar , Anormalidades Congênitas/diagnóstico , Orelha Média/diagnóstico por imagem , Orelha Média/patologia , Feminino , Perda Auditiva Condutiva/diagnóstico , Perda Auditiva Condutiva-Neurossensorial Mista/diagnóstico , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Janela do Vestíbulo/diagnóstico por imagem , Janela do Vestíbulo/patologia , Cuidados Pré-Operatórios , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
5.
Br J Radiol ; 93(1105): 20190677, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31593485

RESUMO

The retrotympanic anatomy is complex and variable but has received little attention in the radiological literature. With advances in CT technology and the application of cone beam CT to temporal bone imaging, there is now a detailed depiction of the retrotympanic bony structures.With the increasing use of endoscopes in middle ear surgery, it is important for the radiologist to appreciate the nomenclature of the retrotympanic compartments in order to aid communication with the surgeon. For instance, in the context of cholesteatoma, clear imaging descriptions of retrotympanic variability and pathological involvement are valuable in pre-operative planning.The endoscopic anatomy has recently been described and the variants classified. The retrotympanum is divided into medial and lateral compartments with multiple described potential sinuses separated by bony crests.This pictorial review will describe the complex anatomy and variants of the retrotympanum. We will describe optimum reformatting techniques to demonstrate the structures of the retrotympanum and illustrate the associated anatomical landmarks and variants with CT. The implications of anatomical variants with regards to otologic surgery will be discussed.


Assuntos
Orelha Média/anatomia & histologia , Orelha Média/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Membrana Timpânica/anatomia & histologia , Membrana Timpânica/diagnóstico por imagem , Pontos de Referência Anatômicos , Colesteatoma da Orelha Média/diagnóstico por imagem , Colesteatoma da Orelha Média/cirurgia , Tomografia Computadorizada de Feixe Cônico , Humanos , Otoscopia
6.
Nature ; 576(7785): 44-45, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31792418
7.
Vestn Otorinolaringol ; 84(5): 85-88, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31793534

RESUMO

The procedure of taking an impression of the external auditory canal for the manufacture of individual earplugs in the ear canals can be associated with complications in some cases. The article describes the clinical case of ingestion of the impression mass during taking the impression of the external auditory canal in the patient with chronic otitis media. The presence of pronounced hearing loss has become the basis for the selection of a hearing aid. As a result, during taking a cast of the external auditory canal, the material fell into the middle ear cavity. Despite contacting specialists, the patient experienced earache with periodic suppuration during the year. When contacting our clinic, perforation of the tympanic membrane was detected and a CT of the temporal bones revealed a foreign body in the tympanic cavity. The patient underwent surgical treatment. The clinical case we are observing and the literature data show how important it is collect to carefullythe anamnesis and conduct otorhinolaryngological examination before the procedure for taking an impression of the external auditory canal when selecting a hearing aid.


Assuntos
Corpos Estranhos , Auxiliares de Audição , Perfuração da Membrana Timpânica , Meato Acústico Externo , Orelha Média , Humanos , Membrana Timpânica
8.
Laryngorhinootologie ; 98(12): 885-897, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31810105

RESUMO

Cholesteatoma is a chronic inflammation of the middle ear, which leads to a progressive bony destruction of the petrous bone. Main symptoms are fetid otorrhea, hearing loss and dizziness. Left untreated, cholesteatoma may be fatal due to intracranial complications. The following overview is intended to illustrate the current and generally recognized knowledge of genesesi, clinical symptoms und preoperative diagnostical procedure. Surgical therapie will be focussed in a second part.


Assuntos
Colesteatoma , Surdez , Orelha Média , Perda Auditiva , Humanos , Osso Petroso
9.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 54(11): 870-874, 2019 Nov 07.
Artigo em Chinês | MEDLINE | ID: mdl-31795552

RESUMO

Keratin (K) is the main component of the epithelial cell mesenchymal cytoskeleton, which protects the integrity of epithelial cells and maintains the function of normal epithelial cells. The expression of keratin affects epidermal proliferation and differentiation, and so as to be used as a marker for proliferation, differentiation and migration of keratinocytes. Middle ear cholesteatoma is one of the common ear diseases. In the middle ear cholesteatoma, keratinocytes over-proliferate and keratin debris accumulates. In this paper, we reviewed the recent studies on middle ear cholesteatoma and explained the possible mechanisms of keratin in the pathogenesis of middle ear cholesteatoma from the aspects of "proliferation" and " bone resorption ". At the same time, the existing problems as well as the prospect of the future research were discussed.


Assuntos
Colesteatoma da Orelha Média/metabolismo , Citoesqueleto/metabolismo , Orelha Média/metabolismo , Células Epiteliais/metabolismo , Queratinócitos/metabolismo , Queratinas/biossíntese , Reabsorção Óssea , Diferenciação Celular , Movimento Celular , Proliferação de Células , Colesteatoma da Orelha Média/etiologia , Humanos , Mesoderma/metabolismo , Mesoderma/patologia
10.
Undersea Hyperb Med ; 46(5): 619-623, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31683359

RESUMO

Objective: Scuba diving and freediving are popular activities around the world, and their growth has increased the frequency of related pathology. A good ability to equalize is of paramount importance for diving. This is especially true for freediving, during which dive time is limited to just one breath. Even though equalization disorders are quite common in divers, a scoring system does not exist to date. In this paper we propose a new scoring system for equalization problems of freedivers: the EP score, shorthand for "equalization problems." Methods: We administered the EP score assessment to 40 Italian freediving spearfishermen who were divided in two groups: Group A comprised 20 freedivers complaining of equalization problems and multiple barotraumas but totally asymptomatic in their everyday lives. These individuals had already received medical treatment and nasal surgery without improvement and then had undergone Eustachian tube balloon dilation. Group B comprised 20 healthy freedivers without any history of equalization disorders. We performed a statistical analysis to evaluate the reliability of this scoring system and to evaluate its usefulness in diagnosis and follow-up. Results: Our data show substantial statistical differences between healthy freedivers and freedivers complaining of equalization disorders (Z-Score = -5.396 at p ⟨ 0.05); data do not show any statistical difference between healthy freedivers and patients successfully treated by Eustachian tube balloon dilation (U-value = 152.5 and Z-Score= -1.271 at p ⟨ 0.05). Conclusion: The EP score assessment seems to be a reliable tool to quantify equalization disorders during freediving and to evaluate how the difficulty varies over time and after treatment. Since equalization disorders could be present in different populations, the EP score assessment could be applicable to a wider group.


Assuntos
Suspensão da Respiração , Mergulho/fisiologia , Otopatias/diagnóstico , Orelha Média/fisiologia , Tuba Auditiva , Adulto , Pressão Atmosférica , Barotrauma/etiologia , Barotrauma/prevenção & controle , Dilatação , Otopatias/etiologia , Otopatias/terapia , Tuba Auditiva/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estatísticas não Paramétricas , Inquéritos e Questionários , Adulto Jovem
11.
Eur. j. anat ; 23(6): 435-446, nov. 2019. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-185086

RESUMO

Thorough knowledge of the variation of intrahepatic course of the portal vein is essential for pre-operative assessment of various hepatic surgeries like hepatectomy and live donor liver transplant. This study aims to determine the variation in the branching pattern of the portal vein in South Indian population. The branching pattern of the portal vein was studied by 3D reconstruction of 100 contrast-enhanced computed tomography images and in 15 formalin fixed livers using modified luminal casting technique. Radiologically, the normal portal vein anatomy was seen in 89%. The most common variation was trifurcation of portal vein (5%). A rare anomaly was noted in one case where the left portal vein gave a branch to segment VII. Using the modified luminal casting technique all the 15 specimens displayed Type I portal vein anatomy. The most common variation in the intrahepatic branching pattern observed was the right posterior segmental division supplying segment VIII. A rare left portal vein variation, in which it gave branches to segments V and VIII was noted. In this study, variations in the segmental supply of the portal vein were observed, which have not been studied in detail previously in the Indian population. Variations on the left portal vein are infrequent. A prior knowledge of such variations will help the interventional radiologists to reduce misinterpretations and subsequent misdiagnosis and guide the hepatobiliary


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Nervo Facial/anatomia & histologia , Nervo Facial/diagnóstico por imagem , Orelha Média/anatomia & histologia , Dissecação/métodos , Cadáver , Osso Temporal/anatomia & histologia , Deiscência da Ferida Operatória/diagnóstico por imagem , Orelha Média/diagnóstico por imagem , Anatomia/educação , Reabsorção Óssea/patologia
12.
Orv Hetil ; 160(41): 1639-1643, 2019 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-31587577

RESUMO

The endoscopic middle ear surgery as a new technique has been introduced during the past few years in our country and it is available in only a few hospitals. Beyond the lack of external incision, endoscopic transcanal approach provides wide field of view to previously hidden middle ear spaces compared to the traditional microscopic technique. In this case report, we present an endoscopic surgery of middle ear capillary haemangioma that is a rare entity in tympanic cavity, therefore little has been published in the literature. Generally, these kind of vascular tumours occur in the internal auditory canal or in the perigeniculate ganglion area while this lesion originated from the inner surface of the inferior part of the bony tympanic ring. We discuss the difficulties in differential diagnosis and imaging tests then the treatment options. Orv Hetil. 2019; 160(41): 1639-1643.


Assuntos
Neoplasias da Orelha/cirurgia , Orelha Média/diagnóstico por imagem , Hemangioma/cirurgia , Timpanoplastia/métodos , Neoplasias da Orelha/patologia , Endoscopia , Feminino , Hemangioma/patologia , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
13.
Vestn Otorinolaringol ; 84(4): 33-38, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31579055

RESUMO

The dynamics of indicators of free-radical oxidation in various purulent-inflammatory diseases of the middle ear in 280 patients was studied. Significant violations of the processes of free radical oxidation in the serum of blood were taken for the patients, the degree of which depends entirely on the severity and nature of the inflammation. A complex treatment with the use of antioxidant therapy in 280 patients was carried out. Positive results were obtained, confirmed by clinical and laboratory indicators. The pathogenetic significance and dependence of the course of purulent-inflammatory diseases of the middle ear on the processes of free radical oxidation was established, which was reflected in the determination of the duration of treatment of various forms of both acute and chronic otitis media.


Assuntos
Radicais Livres , Otite Média Supurativa , Doença Crônica , Orelha Média , Radicais Livres/metabolismo , Humanos , Otite Média Supurativa/metabolismo , Oxirredução
14.
Vestn Otorinolaringol ; 84(4): 51-54, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31579059

RESUMO

Formation of labyrinth fistulas and destruction of the facial nerve canal in children with middle ear cholesteatoma is rare. Data of children with cholesteatoma of the middle ear, operated in the ENT department of MONIKI, is analyzed. Several clinical observations of multiple-aged patients with the presence of cholesteatoma intra-temporal complications are presented. The preoperative computer tomography made it possible to diagnose the presence of the labyrinth fistula and the destruction of the facial nerve channel, which was confirmed intraoperatively.


Assuntos
Colesteatoma da Orelha Média , Otite Média , Criança , Colesteatoma da Orelha Média/complicações , Colesteatoma da Orelha Média/diagnóstico , Colesteatoma da Orelha Média/terapia , Doença Crônica , Orelha Média , Nervo Facial/patologia , Humanos , Otite Média/complicações , Otite Média/diagnóstico , Otite Média/terapia , Estudos Retrospectivos
15.
Vestn Otorinolaringol ; 84(4): 55-60, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31579060

RESUMO

The short literary review of frequency of occurrence, complaints, results of diagnostics and surgical treatment of patients about osteomine is presented to a drum cavity in article. Two own cases of clinical inspection and surgical treatment of patients about osteomine of a drum cavity are described.


Assuntos
Neoplasias Ósseas , Osteoma , Neoplasias Ósseas/diagnóstico , Orelha Média , Humanos , Osteoma/diagnóstico
16.
Infect Immun ; 87(12)2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31548315

RESUMO

Nontypeable Haemophilus influenzae (NTHi) is a major pathogen causing acute otitis media (AOM). The pathology of AOM increases during long-term infection in the middle ear (ME), but the host cellular immune response to bacterial infection in this inflamed environment is poorly understood. Using the Junbo mouse, a characterized NTHi infection model, we analyzed the cellular response to NTHi infection in the Junbo mouse middle ear fluid (MEF). NTHi infection increased the total cell number and significantly decreased the proportion of live cells in the MEF at day 1, and this further decreased gradually on each day up to day 7. Flow cytometry analysis showed that neutrophils were the dominant immune cell population in the MEF and that NTHi infection significantly increased their proportion whereas it decreased the monocyte, macrophage, and dendritic cell proportions. Neutrophil and macrophage numbers increased in blood and spleen after NTHi infection. The T-cell population was dominated by T-helper (Th) cells in noninoculated MEF, and the effector Th (CD44+) cell population increased at day 2 of NTHi infection with an increase in IL-12p40 levels. Sustained NTHi infection up to 3 days increased the transforming growth factor ß levels, decreasing the effector cell population and increasing the T-regulatory (T-reg) cell population. In the preinflamed ME environment of the Junbo mouse, neutrophils are the first responder to NTHi infection followed by T-reg immune suppressive cells. These data indicate that sustained NTHi infection in the ME induces the immune suppressive response by inducing the T-reg cell population and reducing immune cell infiltration, thus promoting longer-term infection.


Assuntos
Orelha Média/patologia , Infecções por Haemophilus/patologia , Haemophilus influenzae/imunologia , Neutrófilos/imunologia , Otite Média com Derrame/patologia , Linfócitos T Reguladores/imunologia , Animais , Contagem de Linfócito CD4 , Linfócitos T CD8-Positivos/imunologia , Modelos Animais de Doenças , Orelha Média/microbiologia , Infecções por Haemophilus/microbiologia , Subunidade p40 da Interleucina-12/metabolismo , Macrófagos/imunologia , Camundongos , Otite Média com Derrame/microbiologia , Linfócitos T Auxiliares-Indutores/imunologia , Fator de Crescimento Transformador beta1/metabolismo
18.
mSphere ; 4(5)2019 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-31484741

RESUMO

Otitis media (OM) is a cluster of diseases of the middle ear that commonly result from bacterial infection. OM subtypes in which the tympanic membrane is intact (acute otitis media and otitis media with effusion) are presumed to result from pathogen translocation through the eustachian tube. Recent molecular-based studies have suggested that a diverse middle ear microbiome exists in the absence of disease. These have been largely unsupported by culture and feature species that commonly contaminate low-biomass sequencing data. Combining culture-based and molecular techniques, we undertook a detailed investigation of the evidence for bacterial colonization of the healthy middle ear. Middle ear (ME), nasopharynx (NP), and external ear canal (EC) swabs were collected from a total of 25 adult patients undergoing cochlear implant, stapedotomy, or translabyrinthine vestibular schwannoma resection. Diagnostic culture, microscopy, quantitative PCR, and 16S rRNA gene amplicon sequencing were used to assess sample bacterial content. EC and NP microbiota were consistent with previous reports. In contrast, bacterial levels in ME samples were not significantly above those in unused control swabs. Commonly detected taxa were among recognized sequencing contaminants (Methylobacterium, Pseudomonas, and Acinetobacter). Linear regression of dominant ME taxa confirmed a negative relationship between relative abundance and bacterial load, consistent with contamination. No bacteria were detected by microscopy or diagnostic culture in any middle ear sample. Our findings cast substantial doubt on previous reports identifying a healthy middle ear microbiome using 16S amplicon sequencing.IMPORTANCE Recent molecular-based studies have suggested that a diverse middle ear microbiome in adults and children can exist in the absence of disease. These studies have been largely unsupported by culture and feature species that commonly contaminate low-biomass sequencing data. While 16S rRNA gene amplicon sequencing has proven to be a highly informative technique in many clinical contexts, it is susceptible to spurious signal arising from sequencing reagent contaminants where sample biomass is low. Combining culture-based and molecular techniques, we undertook a detailed investigation of the evidence for bacterial colonization of the healthy middle ear. In finding no evidence of viable bacterial cells in middle ear samples, our study further underlines the importance of careful consideration of amplicon sequence data derived from very-low-biomass contexts and the value of analytical approaches that combine culture and molecular techniques.


Assuntos
Orelha Média/microbiologia , Microbiota , Adulto , Idoso , Idoso de 80 Anos ou mais , Bactérias/genética , Bactérias/isolamento & purificação , Orelha Externa/microbiologia , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Nasofaringe/microbiologia , RNA Ribossômico 16S/genética , Células-Tronco , Adulto Jovem
19.
Biomed Res Int ; 2019: 2070548, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31485439

RESUMO

Objectives: The purpose of this study was to explore the effectiveness of wideband acoustic immittance (WAI) in the diagnosis of otosclerosis by comparing the differences in the energy reflectance (ER) of WAI between patients with otosclerosis and age- and gender-matched normal hearing controls in the Chinese population. Methods: Twenty surgically confirmed otosclerotic ears were included in the otosclerotic group. The ER of WAI at ambient and peak pressures, resonance frequency, and 226-Hz tympanogram were collected prior to surgery using a Titan hearing test platform (Interacoustics A/S, Middelfart, Denmark). All diagnoses of otosclerosis in the tested ear were confirmed by surgery after the measurements. Thirteen normal adults (26 ears) who were age- and gender-matched with the otosclerotic patients were included as the control group. Results: At peak pressure, the ERs of otosclerotic patients were higher than those of the control group for frequencies less than 4,000Hz and were lower for frequencies greater than 4,000Hz. In addition, within the analyzed frequencies, the differences observed at 2,520Hz was statistically significant (p<0.05/16=0.003, Bonferroni corrected). At ambient pressure, the differences observed at 1,260 and 6,350Hz were statistically significant (p<0.05/16=0.003, Bonferroni corrected). Although the differences between the otosclerotic and control groups exhibited similar trends to those in studies implemented in Caucasian populations, the norms in the present study in the control group were different from those in the Caucasian populations, suggesting racial differences in WAI test results. Regarding the middle ear resonance frequency, no significant difference was observed between the two groups (P>0.05). Conclusion: WAI can provide valuable information for the diagnosis of otosclerosis in the Chinese population. Norms and diagnostic criteria corresponding to the patient's racial group are necessary to improve the efficiency of WAI in the diagnosis of otosclerosis.


Assuntos
Otosclerose/fisiopatologia , Testes de Impedância Acústica/métodos , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático , Audiometria/métodos , Orelha Média/fisiopatologia , Grupo com Ancestrais do Continente Europeu , Feminino , Audição/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Adulto Jovem
20.
PLoS Biol ; 17(9): e3000087, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31479440

RESUMO

Kabuki Syndrome patients have a spectrum of congenital disorders, including congenital heart defects, the primary determinant of mortality. Seventy percent of Kabuki Syndrome patients have mutations in the histone methyl-transferase KMT2D. However, the underlying mechanisms that drive these congenital disorders are unknown. Here, we generated and characterized zebrafish kmt2d null mutants that recapitulate the cardinal phenotypic features of Kabuki Syndrome, including microcephaly, palate defects, abnormal ear development, and cardiac defects. The cardiac phenotype consists of a previously unknown vasculogenesis defect that affects endocardium patterning and, consequently, heart ventricle lumen formation. Additionally, zebrafish kmt2d null mutants have angiogenesis defects depicted by abnormal aortic arch development, hyperactive ectopic blood vessel sprouting, and aberrant patterning of the brain vascular plexus. We demonstrate that zebrafish kmt2d null mutants have robust Notch signaling hyperactivation in endocardial and endothelial cells, including increased protein levels of the Notch transcription factor Rbpj. Our zebrafish Kabuki Syndrome model reveals a regulatory link between the Notch pathway and Kmt2d during endothelium and endocardium patterning and shows that pharmacological inhibition of Notch signaling rebalances Rbpj protein levels and rescues the cardiovascular phenotype by enhancing endothelial and endocardial cell proliferation and stabilizing endocardial patterning. Taken together, these findings demonstrate that Kmt2d regulates vasculogenesis and angiogenesis, provide evidence for interactions between Kmt2d and Notch signaling in Kabuki Syndrome, and suggest future directions for clinical research.


Assuntos
Anormalidades Múltiplas/etiologia , Face/anormalidades , Doenças Hematológicas/etiologia , Neovascularização Fisiológica/genética , Receptores Notch/metabolismo , Doenças Vestibulares/etiologia , Anormalidades Múltiplas/metabolismo , Animais , Modelos Animais de Doenças , Orelha Média/anormalidades , Células Endoteliais/metabolismo , Coração/embriologia , Cardiopatias Congênitas/genética , Doenças Hematológicas/metabolismo , Proteína de Ligação a Sequências Sinal de Recombinação J de Imunoglobina/metabolismo , Mutação , Palato/anormalidades , Fenótipo , Receptores Notch/antagonistas & inibidores , Doenças Vestibulares/metabolismo , Peixe-Zebra , Proteínas de Peixe-Zebra/metabolismo
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