Shrinkage of ipsilateral taste buds and hyperplasia of contralateral taste buds following chorda tympani nerve transection

The morphological changes that occur in the taste buds after denervation are not well under- stood in rats, especially in the contralateral tongue epithelium. In this study, we investigated the time course of morphological changes in the taste buds following unilateral nerve transection. The role of the trigeminal component of the lingual nerve in maintaining the structural integrity of the taste buds was also examined. Twenty-four Sprague-Dawley rats were randomly divided into three groups： control, unilateral chorda tympani nerve transection and unilateral chorda tympani nerve transection ＋ lingual nerve transection. Rats were allowed up to 42 days of re- covery before being euthanized. The taste buds were visualized using a cytokeratin 8 antibody. Taste bud counts, volumes and taste receptor cell numbers were quantified and compared among groups. No significant difference was detected between the chorda tympani nerve transection and chorda tympani nerve transection ＋ lingual nerve transection groups. Taste bud counts, volumes and taste receptor cell numbers on the ipsilateral side all decreased significantly compared with control. On the contralateral side, the number of taste buds remained unchanged over time, but they were larger, and taste receptor cells were more numerous postoperatively. There was no evidence for a role of the trigeminal branch of the lingual nerve in maintaining the structural integrity of the anterior taste buds.

Treatment of laryngopharyngeal reflux disease: A systematic review

BACKGROUNG For a long time,laryngopharyngeal reflux disease(LPRD)has been treated by proton pump inhibitors(PPIs)with an uncertain success rate.AIM To shed light the current therapeutic strategies used for LPRD in order to analysis the rationale in the LPRD treatment.METHODS Three authors conducted a PubMed search to identify papers published between January 1990 and February 2019 about the treatment of LPRD.Clinical prospective or retrospective studies had to explore the impact of medical treatment(s)on the clinical presentation of suspected or confirmed LPRD.The criteria for considering studies for the review were based on the population,intervention,comparison,and outcome framework.RESULTS The search identified 1355 relevant papers,of which 76 studies met the inclusion criteria,accounting for 6457 patients.A total of 64 studies consisted of empirical therapeutic trials and 12 were studies where authors formally identified LPRD with pH-monitoring or multichannel intraluminal impedance-pH monitoring(MII-pH).The main therapeutic scheme consisted of once or twice daily PPIs for a duration ranged from 4 to 24 wk.The most used PPIs were omeprazole,esomeprazole,rabeprazole,lansoprazole and pantoprazole with a success rate ranging from 18%to 87%.Other composite treatments have been prescribed including PPIs,alginate,prokinetics,and H2 Receptor antagonists.CONCLUSION Regarding the development of MII-pH and the identification of LPRD subtypes(acid,nonacid,mixed),future studies are needed to improve the LPRD treatment considering all subtypes of reflux.

Imaging and review of a large pre-auricular pilomatrixoma in a child

A 10-year-old girl presented with a mildly tender mass in the right preauricular region. The mass became larger, and the overlying skin turned purple. There was no clinical response to a course of either cephalexin or clarithromycin. The remainder of the head and neck examination was normal including normal facial nerve function. Lyme titers and a computed tomographic (CT) scan with contrast of the facial region were obtained. The CT scan demonstrated the lesion to be superficial to the parotid gland. The lyme titer was elevated and doxycycline was begun. The mass appeared to reduce in size after doxycycline treatment, but then grew and turned erythematous. The lesion was surgically excised and was vascular with calcification and cheesy inclusions. The mass was quite close to the skin and the clinical diagnosis at the time of surgery was a pilomatrixoma, which was corroborated on pathological evaluation.

Otolithic organ function in patients with profound sensorineural hearing loss

Profound sensorineural hearing loss (PSHL) is not uncommonly encountered in otology. In clinics, there is a high incidence of otolithic damage in patients with PSHL, but relevant reports are few. Sharing a continuous membranous structure and similar receptor cell ultrastructures, the cochlea and vestibule may be susceptible to the same harmful factors. Disorders of the inner ear may result in a variety of manifestations, including vertigo, spatial disorientation, blurred vision, impaired articulation, and hearing impairment. Considering the diversity of clinical symptoms associated with PSHL with otolithic dysfunction, it may be frequently misdiagnosed, and objective means of testing the function of otolithic organs should be recommended for hearing-impaired patients. Vestibular-evoked myogenic potentials (VEMPs) via air-conducted sound are of great importance for the diagnosis of otolithic function. Hearing devices such as cochlear implants are commonly accepted treatments for PSHL, and early identification and treatment of vestibular disorders may increase the success rate of cochlear implantation. Therefore, it is necessary to increase awareness of otolithic functional states in patients with PSHL.

Facial paralysis in cerebral infarction:A case of misdiagnosis and literature review

Facial paralysis can be classified as central or peripheral facial paralysis based on the location of the underlying lesion,both of which demonstrate facial motor dysfunction.In the currently report,a patient admitted to the department of otology,First People’s Hospital of Qinhuangdao,presented with facial asymmetry as the initial symptom of a cerebral infarction and was first misdiagnosed as peripheral facial paralysis.The case is reported as follows.

Advantages of Short-term Personalized Vestibular Rehabilitation at Home Guided by Professional Therapist for Treatment of Decompensated Vestibular Vertigo

Objective Patients suffered a lot from decompensated vestibular vertigo.Pharmacotherapy and vestibular rehabilitation training have been proven to be effective in prompting vestibular compensation.Routine rehabilitation training is faced with the challenges of patients’compliance,completion,the average recuperation time and so on.This study is aimed to investigate advantages of short-term personalized vestibular rehabihitation at home guided by professional therapist.Methods A short-term personalized vestibular rehabilitation program(ST-PVR)was designed for patients with decompensated vestibular vertigo in this study.Results Patients experiencing the ST-PVR program showed significant improvement of Self-Rating Anxiety Scale(SAS),Dizziness Handicap Inventory(DHI),Activities-Specific Balance Confidence Scale(ABC)scores by the second follow-up(at 2nd week after treatment,P<0.05).However-improvement in the medication group occurred slightly later,DHI for 1 month and SAS for 2 months after treatment(P<0.05).Also,the improvement in the onset time of unilateral weakness(UW)at 2nd week after treatment in the personalized vestibular rehabilitation(PVR)group was faster than that in the medication group.Conclusion In general,the short-term PVR program showed great advantages by prompting vestibular compensation quickly and putting forward future direction for clinical treatment on decompensated vestibular vertigo.

Mitochondrial Regulation of Macrophages in Innate Immunity and Diverse Roles of Macrophages During Cochlear Inflammation

Macrophages are essential components of the innate immune system and constitute a non-specific first line of host defense against pathogens and inflammation.Mitochondria regulate macrophage activation and innate immune responses in various inflammatory diseases,including cochlear inflammation.The distribution,number,and morphological characteristics of cochlear macrophages change significantly across different inner ear regions under various pathological conditions,including noise exposure,ototoxicity,and age-related degeneration.However,the exact mechanism underlying the role of mitochondria in macrophages in auditory function remains unclear.Here,we summarize the major factors and mitochondrial signaling pathways(e.g.,metabolism,mitochondrial reactive oxygen species,mitochondrial DNA,and the inflammasome)that influence macrophage activation in the innate immune response.In particular,we focus on the properties of cochlear macrophages,activated signaling pathways,and the secretion of inflammatory cytokines after acoustic injury.We hope this review will provide new perspectives and a basis for future research on cochlear inflammation.

阳离子聚合物纳米基因载体在内耳的应用进展

由于耳蜗特殊的解剖和生理结构,使全身给药和基因治疗很难在局部达到有效的浓度。因此关于内耳局部给药的研究目前已成为耳科研究的热点。选择合适的载体是内耳局部给药的关键问题。阳离子聚合物纳米载体是具有低毒、无免疫原性、可修饰、携带力强、易获得等优点,为内耳给药载体的选择提供了新的可能。本文总结了阳离子聚合物的特性,介绍了其在携带基因/药物方面的优越性,回顾其作为载体在内耳的应用情况,为内耳疾病局部药物/基因治疗的临床应用提供指导。

Cell proliferation during hair cell regeneration induced by Math1 in vestibular epithelia in vitro

Hair cell regeneration is the fundamental method of correcting hearing loss and balance disorders caused by hair cell damage or loss. How to promote hair cell regeneration is a hot focus in current research. In mammals, cochlear hair cells cannot be regenerated and few vestibular hair cells can be renewed through spontaneous regeneration. However, Math1 gene transfer allows a few inner ear cells to be transformed into hair cells in vitro or in vivo. Hair cells can be renewed through two possible means in birds： supporting cell differentiation and transdifferentiation with or without cell division. Hair cell regeneration is strongly associated with cell proliferation. Therefore, this study explored the relationship between Math1-induced vestibular hair cell regeneration and cell division in mammals. The mouse vestibule was isolated to harvest vestibular epithelial cells. Ad-Math1-enhanced green fluorescent protein （EGFP） was used to track cell division during hair cell transformation.5-Bromo-2′-deoxyuridine （BrdU） was added to track cell proliferation at various time points. Immunocytochemistry was utilized to determine cell differentiation and proliferation. Results demonstrated that when epithelial cells were in a higher proliferative stage, more of these cells differentiated into hair cells by Math1 gene transfer. However, in the low proliferation stage, no BrdU-positive cells were seen after Math1 gene transfer. Cell division always occurred before Math1 transfection but not during or after Math1 transfection, when cells were labeled with BrdU before and after Ad-Math1-EGFP transfection. These results confirm that vestibular epithelial cells with high proliferative potential can differentiate into new hair cells by Math1 gene transfer, but this process is independent of cell proliferation.

Prevention of laryngeal webs through endoscopic keel placement for bilateral vocal cord lesions

Transoral microresection for treatment of vocal cord lesions involving the anterior commissure may result in anterior glottic webs. In this study, we retrospectively reviewed 54 patients who underwent microsurgery for bilateral lesions involving the anterior commissure and categorized them into two groups. The keel placement and control groups received endoscopic keel placement and mitomycin C, respectively. During the follow-up of at least 1 year, the laryngeal web formation rate significantly decreased in the keel placement group compared with that in the control group （18.6% versus 54.5%, P 〈 0.05）. Furthermore, the voice handicap index-10 scores for patients without web formation decreased in both the keel placement and control groups （P 〈 0.0001 and P 〈 0.001, respectively）. A pseudomembrane covering the vocal cords was detected in 16.3% （7 of 43） cases after keel removal. A total of 100% （7 of 7） of these cases and 2.8% （1 of 36） of the other cases formed laryngeal webs （P 〈 0.0001）. Endoscopic keel placement could be an effective method for preventing anterior glottic webs after surgery for bilateral vocal cord diseases involving the anterior commissure. The pseudomembrane observed at the time of keel removal may imply a high risk of web formation.

An individualized immune signature of pretreatment biopsies predicts pathological complete response to neoadjuvant chemoradiotherapy and outcomes in patients with esophageal squamous cell carcinoma

No clinically available biomarkers can predict pathological complete response(pCR)for esophageal squamous cell carcinomas(ESCCs)with neoadjuvant chemoradiotherapy(nCRT).Considering that antitumor immunity status is an important determinant for nCRT,we performed an integrative analysis of immune-related gene profiles from pretreatment biopsies and constructed the first individualized immune signature for pCR and outcome prediction of ESCCs through a multicenter analysis.During the discovery phase,14 differentially expressed immune-related genes(DEIGs)with greater than a twofold change between pCRs and less than pCRs(<pCRs)were revealed from 28 pretreatment tumors in a Guangzhou cohort using microarray data.Ten DEIGs were verified by qPCR from 30 cases in a Beijing discovery cohort.Then,a four-gene-based immune signature(SERPINE1,MMP12,PLAUR,and EPS8)was built based on the verified DEIGs from 71 cases in a Beijing training cohort,and achieved a high accuracy with an area under the receiver operating characteristic curve(AUC)of 0.970.The signature was further validated in an internal validation cohort and an integrated external cohort(Zhengzhou and Anyang cohorts)with AUCs of 0.890 and 0.859,respectively.Importantly,a multivariate analysis showed that the signature was the only independent predictor for pCR.In addition,patients with high predictive scores showed significantly longer overall and relapse-free survival across multiple centers(P<0.05).This is the first,validated,and clinically applicable individualized immune signature of pCR and outcome prediction for ESCCs with nCRT.Further prospective validation may facilitate the combination of nCRT and immunotherapy.

Functional results of revision canal wall down mastoidectomy

In this retrospective study,we evaluated the preoperative and intraoperative findings and functional results of revision surgery after canal wall down mastoidectomy.We reviewed 34 patients(14 men,20 women;age,17–68 years)who underwent revision canal wall down mastoidectomy from March 2006 to March 2017 in the Department of Otology of the First Affiliated Hospital,Wenzhou Medical University,China.This study was approved by the Ethics Committee of the First Affiliated Hospital,Wenzhou Medical University,China(approval No.2008-05-02A11)on May 2,2008.The possible reasons for previous surgical failures were confirmed by the operative findings and included a narrow auditory meatus orifice(100%),recurrent or residual cholesteatoma(82%),high facial ridge(94%),residual air cells(47%),and labyrinthine fistula(12%).The mean time until achievement of dry ear after surgery was 5.8±2.4 weeks.After a mean 6-month follow-up,the mean postoperative air–bone gap decreased from 33.8±4.8 to 17.1±5.1dB in 30 patients who underwent mastoidectomy with simultaneous tympanoplasty.However,no significant postoperative hearing change had occurred in the other 4 patients with eustachian tube occlusion.All patients were followed up for>24 months with a disease-free dry ear and stable hearing results.The main reasons for lack of dry ears after mastoidectomy were a narrow auditory meatus orifice,recurrent or residual cholesteatoma,high facial ridge,and residual air cells.Early dry ear and hearing promotion are obtainable in most patients using revision canal wall down mastoidectomy.

Atoh1转录因子在耳蜗内的转译后调节（英文）

Atoh1属于bHLH转录因子家族成员,其对耳蜗毛细胞的胚胎发育及损伤后再生具有重要作用。许多讯号通道在转录水平上对Atoh1有调节作用,包括Notch和Wnt通道。在蛋白转译后水平,Atoh1是经由泛素-蛋白酶通道所调节。体外细胞实验及体内动物实验都显示:经由上述讯号通道的调节手段不仅影响耳蜗发育,也导致毛细胞的损伤后再生。本综述回顾了耳蜗内各个对Atoh1调节讯号通道研究的进展,并聚焦于泛素-蛋白酶通道对Atoh1进行转译后调节及其对毛细胞发育的影响。

Foreign Body Reaction After Cochlear Implantation： A Case Report

Foreign body reaction is a rare complication after cochlear implantation.When such complications do occur,they may be intractable and difficult to be cured with antibiotics or surgical revision that may lead to cochlear reimplantation finally.In this article,we presented a patient with foreign body reaction who recovered well after cochlear reimplantation and has been in good health throughout the 6 years of follow-up at regular intervals in Affiliated Eye Ear Nose and Throat Hospital of Fudan University.

Frontiers in auditory bioscience and technology: a special feature on recent advances in hearing research

IwasgreatlyhonoredtobeaskedbyHelen ZHANG,Former Managing Editor,to serve as a guest editorofthisspecialfeatureofJournalofZhejiang University-SCIENCEB(Biomedicine&Biotechnology)on'FrontiersinAuditoryBioscienceand Technology(FABT)'.

Methicillin-resistant Staphylococcus aureus in acute otitis externa

Objective:Otologic methicillin-resistant Staphylococcus aureus(MRSA)infection has historically been rare,but given the rise in community-acquired MRSA carriage and infection at other body sites,prevalence rates may be changing.The goal of this study was to determine the prevalence of MRSA in recent otologic cultures from patients with acute otitis externa(AOE).Study design:Retrospective review of an institutional microbiologic database.Methods:A retrospective analysis was performedon serial culture isolates taken fromthe ear at a quaternary care hospital from January 2014 to April 2016.The causative pathogen and antibiotic sensitivity was determined by culture isolation and end point mean inhibitory concentration(MIC)testing.Medical records were reviewed to document patient characteristics,chronicity of infection,symptomatology,and previous treatments.Results:Over the study period,173 patients were diagnosed with AOE and underwent otologic cultures of the ear.Fifty-three(30.6%)of cultures grew S.aureus(SA).Of SA infections,15(28.3%)were identified as MRSA.MRSA patients were typically older than patients with methicillin-sensitive SA(MSSA)(mean age 46.7
17.9 vs 29
19.4,PZ0.003)and had more medical comorbidities(4 vs 1.7,PZ0.001).Compared to patients with MSSA,patients with MRSAwere significantly more likely to have had prior ototopical antibiotic exposure(37%vs 73%,PZ0.019).Conclusion:Contemporary ear culture isolates at quaternary care center show higher rates of MRSA compared to historical reports in the literature.Clinicians should consider ear cultures to identify MRSA AOE.Level of Evidence:IV.