Nasopharyngeal radium irradiation: The lessons of history.

In the Netherlands, nasopharyngeal radium irradiation was started in 1945. The indications included refractory symptoms of otitis media with effusion and other adenoid-related disorders after adenoidectomy. It was considered a safe and effective therapy.

Microbial profiling does not differentiate between childhood recurrent acute otitis media and chronic otitis media with effusion.

Objectives: Otitis media (OM) is one of the most frequent diseases of childhood, with a minority of children suffering from recurrent acute otitis media (rAOM) or chronic otitis media with effusion (COME), both of which are associated with significant morbidity. We investigated whether the microbiological profiling could be used to differentiate between these two conditions.

Methods: Children up to five years of age, with rAOM (n = 45) or COME (n = 129) and scheduled for tympanostomy tube insertion were enrolled in a prospective study between 2008 and 2009.

Inflammation in the middle ear of children with recurrent or chronic otitis media is associated with bacterial load.

Background: Viral upper respiratory tract infections have been described as an important factor in the development of otitis media (OM), although it is unclear whether they facilitate bacterial OM or can directly cause OM. To clarify the role of viral infections in OM, we compared the relative contribution of viruses and bacteria with the induction of inflammatory cytokine responses in the middle ear of children suffering from OM.

Methods: Children up to 5 years of age, with recurrent or chronic episodes of OM and scheduled for ventilation tube insertion were enrolled in a prospective study.

A large vestibular schwannoma that did not grow for 18 years.

Introduction: Treatment strategies for vestibular schwannoma include microsurgery, stereotactic radiotherapy and conservative management (wait and scan). To avoid neurological complications or even death, surgery is the preferred treatment for large tumours with an extrameatal diameter > 3.0 cm.

Prediction of vestibular schwannoma growth: a novel rule based on clinical symptomatology.

Objectives: The aim of this study was to formulate a predictive rule for vestibular schwannoma growth during the initial observation period after diagnosis.

Methods: Logistic regression models were fitted, with tumor growth in the first year as the dependent variable and patient characteristics as the independent variables. Backward selection was used to eliminate superfluous predictors.

Gamma knife radiosurgery for vestibular schwannomas: identification of predictors for continued tumor growth and the influence of documented tumor growth preceding radiation treatment.

Objectives/hypothesis: Gamma knife radiosurgery (GKRS) has become an important treatment modality for vestibular schwannomas. The primary aim of this study was to investigate whether tumor growth at the moment of GKRS has any correlation with the outcome. The secondary aim was to identify clinical predictors of radioresistance in vestibular schwannoma patients treated with GKRS.

Follow-up after gamma knife radiosurgery for vestibular schwannomas: volumetric and axial control rates.

Objectives/hypothesis: A prospective long-term follow-up study was conducted to evaluate the results of gamma knife radiosurgery (GKRS) for vestibular schwannoma (VS) patients. Both axial and volumetric measurements are used to determine tumor size during follow-up.

Study Design: Individual prospective cohort study.

Correlation between subjective and objective evaluation of the nasal airway. A systematic review of the highest level of evidence.

Background: There is no consensus about the value of objective measurements of nasal patency.

Objective: To assess the correlation between the subjective sense of nasal patency and the outcomes found with rhinomanometry and acoustic rhinometry.

Type Of Review: Structured literature search.

Quality of life after gamma knife radiosurgery treatment in patients with a vestibular schwannoma: the patient's perspective.

This study evaluates the impact of gamma knife radiosurgery (GKRS) on the quality of life (QOL) of patients with a sporadic vestibular schwannoma (VS). This study pertains to 108 VS patients who had GKRS in the years 2003 through 2007. Two different QOL questionnaires were used: medical outcome study short form 36 (SF36) and Glasgow benefit inventory (GBI).

Development of a non-invasive murine infection model for acute otitis media.

Otitis media (OM) is one of the most frequent diseases in childhood, and Streptococcus pneumoniae is among the main causative bacterial agents. Since current experimental models used to study the bacterial pathogenesis of OM have several limitations, such as the invasiveness of the experimental procedures, we developed a non-invasive murine OM model. In our model, adapted from a previously developed rat OM model, a pressure cabin is used in which a 40 kPa pressure increase is applied to translocate pneumococci from the nasopharyngeal cavity into both mouse middle ears.

Gamma knife radiosurgery for vestibular schwannomas: results of hearing preservation in relation to the cochlear radiation dose.

Objectives/hypothesis: This study was designed to evaluate hearing preservation after gamma knife radiosurgery (GKRS) and to determine the relation between hearing preservation and cochlear radiation dose in patients with a sporadic vestibular schwannoma (VS).

Methods: Prospective study involving patients suffering from VS who received GKRS from June 2003 until November 2007. Pure tone and speech audiometry were conducted before and after GKRS.

Imaging of electrode position in relation to electrode functioning after cochlear implantation.

This study assessed the electrode position in cochlear implant patients and evaluated the extent to which the electrode position is determinative in the electrophysiological functioning of the cochlear implant system. Five consecutively implanted adult patients received a multichannel cochlear implant. In all patients, the electrical impedance and the electrically evoked compound action potentials were recorded immediately after implantation.

Giant Cholesteatoma: Recommendations for Follow-up.

This report presents the management of five patients who presented with giant recurrent or residual cholesteatoma after periods of 2 to 50 years. Their case histories are highly diverse, but all provide evidence of the need for long-term follow-up.

Predictors of future growth of sporadic vestibular schwannomas obtained by history and radiologic assessment of the tumor.

Management of a sporadic vestibular schwannoma (VS) is still a subject of controversy, mainly due to distinct and unpredictable growth patterns. To embark on an appropriate therapy it is necessary to dispose of a reliable prediction about tumor progression. This study aims to design a risk profile with predictors for VS growth.

Evidence-based recommendations regarding the differential diagnosis and assessment of nasal congestion: using the new GRADE system.

Nasal congestion is an important symptom in nasal pathology and can be defined as an objective restriction of nasal cavity airflow because of mucosal pathology and/or increased mucus secretion (excluding anatomical variants). Using the new Grading Recommendations Assessment, Development and Evaluation system, evidence-based recommendations are made that will encompass different clinical questions regarding diagnostic modalities of nasal congestion: (i) their usefulness in assessment of presence and severity of congestion; (ii) their usefulness in assessment of etiological pathology responsible for congestion; and (iii) their usefulness in follow up and treatment effectiveness evaluation of nasal congestion.

Laser-assisted bypass of the internal carotid artery prior to treatment of an extensive angiofibroma.

A 23-year-old man presented with an extensive nasopharyngeal angiofibroma. The inferolateral trunk, a branch of the internal carotid artery, was a major source of arterial supply to the tumor. Therefore, surgery had to be done in two stages.

Advances in understanding the pathogenesis of pneumococcal otitis media.

In this review, a state of the art on otitis media research is provided with emphasis on the role of Streptococcus pneumoniae in the pathogenesis of this disease. Articles have been selected by MEDLINE search supplemented with a manual crosscheck of bibliographies. Pathogenic mechanisms in middle ear and eustachian tube are described.

Epidemiology of voice problems in Dutch teachers.

In order to assess voice complaints and absence from work due to voice problems among teachers of primary and secondary education, as well as among a control group, 2,117 questionnaires were analysed. The total group consisted of 1,878 teachers and 239 controls. Female teachers more frequently reported voice complaints and absence from work due to voice problems than their male colleagues.

Risk factors for voice problems in teachers.

In order to identify factors that are associated with voice problems and voice-related absenteeism in teachers, 1,878 questionnaires were analysed. The questionnaires inquired about personal data, voice complaints, voice-related absenteeism from work and conditions that may lead to voice complaints and absenteeism. Different factors play a role in the development and consolidation of voice problems.

Psychosocial impact of the teacher's voice throughout the career.

It is generally accepted that vocal performance decreases with age. This decrease can be expected to be more pronounced in voice loading professions, which may lead to occupational dysphonia. The aim of this study was to investigate the course of voice complaints, experienced handicap, and absenteeism of work due to voice problems throughout the teaching years.

The relationship between pre-treatment clinical profile and treatment outcome in an integrated stuttering program.

Unlabelled: A procedure for subtyping individuals who stutter and its relationship to treatment outcome is explored. Twenty-five adult participants of the Comprehensive Stuttering Program (CSP) were classified according to: (1) stuttering severity and (2) severity of negative emotions and cognitions associated with their speech problem. Speech characteristics (percentage of stuttered syllables, distorted speech score, and the number of correctly produced syllables on a diadochokinesis task) and emotional/cognitive states (emotional reaction, speech satisfaction, and attitudes toward speaking) were assessed before and after treatment, and at a 1- and 2-year follow-up.

The effect of otitis media in childhood on the development of middle ear admittance on reaching adulthood.

Objectives: To determine the long-term change in static admittance values of subjects with a positive or negative history of otitis media (OM) and ventilation tube (VT) insertion; and to investigate the association between static admittance values and tympanic membrane abnormalities.

Design: Prospective follow-up study.

Subjects: A total of 358 subjects with or without a history of OM (OM+ or OM-) and VT insertion (VT+ or VT-) derived from a birth cohort that had been observed from preschool to adulthood.

Immune status and eustachian tube function in recurrence of otitis media with effusion.

Objective: To study the combined role of immune status and eustachian tube function in the development of recurrent bilateral otitis media with effusion (OME).

Design: Prospective cohort study.

Setting: Three academic and general hospitals.

Natural course of tympanic membrane pathology related to otitis media and ventilation tubes between ages 8 and 18 years.

Objective: To present the course of tympanic membrane pathology in childhood and young adulthood after otitis media (OM) in early life.

Study Design: Prospective follow-up study.

Setting: Community study of a birth cohort.