Open Ankle Injury without Associated Fracture or Dislocation Requiring Surgical Intervention: A Case Report.

Introduction: Bony and ligamentous ankle injuries are some of the most commonly treated injuries by orthopedic surgeons. Open ligamentous ankle injuries without an associated fracture or dislocation are rare and to our knowledge have only sparsely been described in the literature. We present a case and successful treatment of an open lateral ankle injury with capsular rupture and ligamentous damage without fracture or dislocation in a 22-year-old female.

Acute Ankle Diastasis Injuries Treated with Dynamic, Static Fixation or Anatomic Repair: A Meta-Analysis and Systematic Review of Comparison Studies.

Background: Acute ankle diastasis injuries are complex and debilitating. These injuries occur when the syndesmotic complex becomes compromised. Treatments of acute syndesmotic injuries include static fixation with screws, dynamic fixation with an elastic device, or anatomic repair of the damaged ligament.

An Absorbance Peak Template for Clinical Assessment of Sound Conduction in Newborn Ears.

Purpose: Power absorbance measures recorded over a wide range of frequencies allow for clinical inferences about the outer/middle ears' acoustic mechanics. A frequency-dependent feature in the newborn wideband absorbance response, the prominent mid-frequency absorbance peak, has been linked to middle-ear resonance. However, current normative methods were not designed to assess subtle changes in such features.

Erratum: The Rise and Fall of Aural Acoustic Immittance Assessment Tools.

[This corrects the article DOI: 10.1055/s-0043-1764139.].

Implementation of Wideband Acoustic Immittance in Clinical Practice: Relationships among Audiologic and Otologic Findings.

A number of studies have produced normative and developmental data and examples of wideband acoustic immittance (WAI) obtained in ears with pathologies and or dysfunction. However, incorporation of this tool into clinical audiology and otolaryngology practice has been slower than expected, potentially due to challenges with interpretation, integration into existing test batteries, and confidence in practical application. This article presents information aimed at helping clinicians increase their confidence in using this new tool by becoming more familiar and making connections with the ways that WAI outcomes both align with and add to standard immittance, audiometric and otologic diagnostic test outcomes.

The Rise and Fall of Aural Acoustic Immittance Assessment Tools.

Clinical assessment of middle ear function has undergone multiple transformations and developments since the first acoustic impedance measurements were made in human ears nearly a century ago. The decades following the development of the first acoustic impedance bridge by Metz in 1946 witnessed a series of technological advancements leading to the widespread use of single-frequency admittance tympanometry in the 1960s. In the 1970s, multi-frequency and multi-component tympanometry (MFT) emerged for clinical use, allowing for a better understanding of the middle ear acoustic-mechanical response at frequencies between 200 and 2,000 Hz.

Pressurized transient otoacoustic emissions measured using click and chirp stimuli.

Transient-evoked otoacoustic emission (TEOAE) responses were measured in normal-hearing adult ears over frequencies from 0.7 to 8 kHz, and analyzed with reflectance/admittance data to measure absorbed sound power and the tympanometric peak pressure (TPP). The mean TPP was close to ambient.

Systematic review of periprosthetic tibia fracture after total knee arthroplasties.

Aim: To investigate the known incidences, treatment options, and related outcomes of periprosthetic tibia fractures after total knee arthroplasty (TKA).

Methods: A literature search was done to identify studies that fit the inclusion criteria. The database search yielded 185 results, which were further reduced by the exclusion criteria to 13 papers, totaling 157 patients that met these criteria.

Effects of ear-canal static pressure on pure-tone thresholds and wideband acoustic immittance.

Background: Wideband acoustic immittance (WAI) measures provide information about middle-ear function across the traditional audiometric frequency range from 0.25 to 8.0 kHz.

Characteristics of wideband acoustic immittance in patients with middle-ear dysfunction.

Background: Wideband acoustic immittance (WAI) measurements are a relatively new class of aural acoustic tests that have shown promise as useful tools for evaluating middle-ear status. A growing body of work has described WAI for infants, children, and adults with normal middle-ear function, but a relatively limited number of studies have investigated the influence of specific middle-ear disorders on WAI. Although emerging WAI research data show promising results, additional measurements from ears of patients with a variety of middle-ear disorders are needed.

Consensus statement: Eriksholm workshop on wideband absorbance measures of the middle ear.

The participants in the Eriksholm Workshop on Wideband Absorbance Measures of the Middle Ear developed statements for this consensus article on the final morning of the Workshop. The presentations of the first 2 days of the Workshop motivated the discussion on that day. The article is divided into three general areas: terminology; research needs; and clinical application.

Wideband acoustic immittance: tympanometric measures.

Wideband tympanometry (WT) measurements provide a view of the acoustic response properties of the middle ear over a broad range of frequencies and ear-canal pressures. These measurements show sensitivity to trends in ear-canal/middle ear maturation and changes in middle ear status as a result of different types of dysfunction. While results from early WT work showed improvements over ambient wideband tests in terms of test performance for identifying middle ear dysfunction and conductive hearing loss (CHL), more recent studies have shown high, but similar test performance for both ambient and tympanometric wideband tests.

Acoustic reflex measurement.

Middle ear muscle reflex (MEMR) measurements have been a part of the standard clinical immittance test battery for decades as a cross-check with the behavioral audiogram and as a way to separate cochlear from retrocochlear pathologies. MEMR responses are measured in the ear canal by using a probe stimulus (e.g.

Pediatric applications of wideband acoustic immittance measures.

Wideband acoustic immittance (WAI) measures have potential capability to improve newborn hearing screening outcomes and middle ear diagnosis for infants and children. To fully capitalize on these immittance measures for pediatric hearing care, developmental and pathologic effects need to be fully understood. Published literature on wideband immittance (reflectance, absorbance, tympanometry, and acoustic reflexes) is reviewed in this article to determine pathologic effects in newborns, infants, and children relative to standard audiologic tests such as otoacoustic emissions (OAEs), standard tympanometry, air and bone conduction auditory brainstem response, and otoscopy.

Wideband acoustic immittance measures: developmental characteristics (0 to 12 months).

Rapid developmental changes of the peripheral auditory system in normal infants occur in the first year of life. Specifically, the postnatal development of the external and middle ear affects all measures of external and middle ear function including wideband acoustic immittance(WAI). This article provides an overview of WAI studies in newborns and infants from a developmental perspective.

A transcriptomic analysis of Echinococcus granulosus larval stages: implications for parasite biology and host adaptation.

Background: The cestode Echinococcus granulosus--the agent of cystic echinococcosis, a zoonosis affecting humans and domestic animals worldwide--is an excellent model for the study of host-parasite cross-talk that interfaces with two mammalian hosts. To develop the molecular analysis of these interactions, we carried out an EST survey of E. granulosus larval stages.

Wideband aural acoustic absorbance predicts conductive hearing loss in children.

Objective: This study tested the hypothesis that wideband aural absorbance predicts conductive hearing loss (CHL) in children medically classified as having otitis media with effusion.

Design: Absorbance was measured in the ear canal over frequencies from 0.25 to 8 kHz at ambient pressure or as a swept tympanogram.

Determining the presence or absence of middle ear disorders: an evidence-based systematic review on the diagnostic accuracy of selected assessment instruments.

Purpose: To conduct an evidence-based systematic review on the state of the evidence and the diagnostic accuracy of multifrequency tympanometry (MFT), 1000 Hz tympanometry, and wideband acoustic transfer functions in determining the presence or absence of middle ear disorders.

Method: A systematic search of the literature published between 1975 and 2011 was conducted. Articles meeting the selection criteria were appraised by 2 reviewers and vetted by a 3rd for methodological quality.

Wideband acoustic transfer functions predict middle-ear effusion.

Objectives/hypothesis: Compare the accuracy of wideband acoustic transfer functions (WATFs) measured in the ear canal at ambient pressure to methods currently recommended by clinical guidelines for predicting middle-ear effusion (MEE).

Study Design: Cross-sectional validating diagnostic study among young children with and without MEE to investigate the ability of WATFs to predict MEE.

Methods: WATF measures were obtained in an MEE group of 44 children (53 ears; median age, 1.

Characterization of the Arabidopsis thaliana exocyst complex gene families by phylogenetic, expression profiling, and subcellular localization studies.

*The exocyst is a complex of eight proteins (Sec3p, Sec5p, Sec6p, Sec8p, Sec10p, Sec15p, Exo70p and Exo84p) involved in tethering vesicles to the plasma membrane during regulated or polarized secretion. Here, the plant exocyst complex was explored in phylogenetic, expression, and subcellular localization studies. *Evolutionary relationships of predicted exocyst subunits were examined in the complete genomes of Arabidopsis thaliana, Oryza sativa, Populus trichocarpa and Physcomitrella patens.

Wideband acoustic-reflex test in a test battery to predict middle-ear dysfunction.

A wideband (WB) aural acoustical test battery of middle-ear status, including acoustic-reflex thresholds (ARTs) and acoustic-transfer functions (ATFs, i.e., absorbance and admittance) was hypothesized to be more accurate than 1-kHz tympanometry in classifying ears that pass or refer on a newborn hearing screening (NHS) protocol based on otoacoustic emissions.

Sound-conduction effects on distortion-product otoacoustic emission screening outcomes in newborn infants: test performance of wideband acoustic transfer functions and 1-kHz tympanometry.

Objective: Universal newborn hearing screening (UNHS) test outcomes can be influenced by conditions affecting the sound conduction pathway, including ear canal and/or middle ear function. The purpose of this study was to evaluate the test performance of wideband (WB) acoustic transfer functions and 1-kHz tympanometry in terms of their ability to predict the status of the sound conduction pathway for ears that passed or were referred in a UNHS program.

Design: A distortion-product otoacoustic emission (DPOAE) test was used to determine the UNHS status of 455 infant ears (375 passed and 80 referred).

The conservation and evolutionary modularity of metabolism.

Background: Cellular metabolism is a fundamental biological system consisting of myriads of enzymatic reactions that together fulfill the basic requirements of life. The recent availability of vast amounts of sequence data from diverse sets of organisms provides an opportunity to systematically examine metabolism from a comparative perspective. Here we supplement existing genome and protein resources with partial genome datasets derived from 193 eukaryotes to present a comprehensive survey of the conservation of metabolism across 26 taxa representing the three domains of life.

Wideband absorbance tympanometry using pressure sweeps: system development and results on adults with normal hearing.

A system with potential for middle-ear screening and diagnostic testing was developed for the measurement of wideband energy absorbance (EA) in the ear canal as a function of air pressure, and tested on adults with normal hearing. Using a click stimulus, the EA was measured at 60 frequencies between 0.226 and 8 kHz.