Early Experience with a Novel Treatment for Menière's Disease: A Long Acting Dexamethasone Formulation for Precise Delivery to the Round Window Membrane.

Objective: To investigate the safety and feasibility of precise delivery of a long-acting gel formulation containing 6% dexamethasone (SPT-2101) to the round window membrane for the treatment of Menière's disease.

Study Design: Prospective, unblinded, cohort study.

Setting: Tertiary care neurotology clinic.

Effect of killed autogenous polyvalent vaccines against Vibrio harveyi, V. alginolyticus and Streptococcus iniae on survival and immunogenicity of Asian seabass (Latescalcarifer).

Vibriosis and Streptococcosis are the most important bacterial diseases that infect Asian seabass (Lates calcarifer) in various stages of its life cycle. Vaccination is a cost-effective strategy to prevent the occurrence of infectious diseases and increase sustainability in the aquaculture industry. This study was aimed to develop and evaluate a killed polyvalent vaccine against Vibrio harveyi, V.

Neurotropic Cutaneous Malignancies: Case Report on Keratinocyte Derived Malignancies of the Head and Neck With Perineural Invasion.

Background: The recent addition of immunotherapy as a treatment modality to surgery and radiation has vastly improved disease control for patients with keratinocyte-derived carcinomas (KCs) that are incurable with local therapies alone. With the advent of immune checkpoint inhibitors (ICPis) in non-melanoma skin cancers comes diagnostic and therapeutic challenges when considering treatment strategies for patients presenting with clinical perineural invasion (cPNI) of locally advanced KC of the head and neck.

Objectives: We report four cases that convey the diagnostic and therapeutic complexity of managing patients with neuropathic symptoms from cutaneous neurotropic carcinomas of the head and neck.

Olfactory Neuroblastoma: Re-Evaluating the Paradigm of Intracranial Extension and Cyst Formation.

The purpose of the current study was to assess the prevalence of cyst formation at the brain-tumor interface in olfactory neuroblastoma. We used the UCLA patient-based Pathology and Radiology Head and Neck Database (UPP&R HAND) to identify the largest patient cohort reported to date with imaging and pathology data. Eighteen of thirty-one patients (58.

4D CT Parathyroid for the General Radiologist: A Pictorial Essay of Illustrative Cases.

Primary hyperparathyroidism is a morbid disease that affects multiple organ systems and causes a multitude of debilitating symptoms if not properly diagnosed and treated. Minimally invasive parathyroidectomy is now the standard of care for the treatment of primary hyperparathyroidism. In the hands of experienced high-volume surgeons, the success rate of this treatment is approximately 95%.

Ontogenic development of the digestive tract in larval and juvenile Vimba bream, Vimba vimba.

In this study we examined the ontogenic development of the digestive tract of Vimba bream (Vimba vimba, Family: Cyprinidae) during the first 60 days of life (hatching to 60 days after hatching [DAH]). Samples of developing Vimba bream were randomly selected at various stages of development: 1-8, 10, 15, 20, 25, 30, 40, 50, and 60 DAH. For the histological and histochemical studies on the development of the alimentary canal, tissue sections prepared from the sampled hatchlings were stained with hematoxylin-eosin and periodic acid-Schiff and observed under a light microscope.

High Resolution Three-Dimensional Delayed Contrast MRI Detects Endolymphatic Hydrops in Patients With Vertigo and Vestibular Schwannoma.

Objective: Advances in high resolution magnetic resonance imaging (MRI) have enabled the detection of endolymphatic hydrops (EH), a pathological ballooning of the endolymphatic fluid system, known to be associated with Menière's disease. When a patient has a known diagnosis of vestibular schwannoma and develops recurrent episodic vertigo spells, many surgeons recommend surgical intervention, attributing the vestibular symptoms to the vestibular schwannoma. The aim of this study is to evaluate the clinical outcome in patients with vestibular schwannoma and EH, treated medically, for recurrent spells of vertigo.

Application of arterial spin labeling perfusion MRI to differentiate benign from malignant intracranial meningiomas.

Purpose: Differentiating WHO grade I-III of meningioma by non-invasive imaging is challenging. This study investigated the potential of MR arterial spin labeling (ASL) to establish tumor grade in meningioma patients.

Material And Methods: Pseudo-continuous ASL with 3D background suppressed gradient and spin echo (GRASE) was acquired on 54 patients with newly diagnosed or recurrent intracranial meningioma.

Growth Performance, Hemato-Immunological Responses, and Digestive Enzyme Activities in Silvery-Black Porgy (Sparidentex hasta) Fed Dietary Bovine Lactoferrin.

An 8-week study was conducted to evaluate three different diets supplemented with bovine lactoferrin (LF) at 0 (control), 800, and 1200 mg LF kg diet on somatic growth, hemato-immunological parameters, antioxidant status, and digestive enzyme activities in silvery-black porgy (Sparidentex hasta) juveniles. Fish fed the 800 mg LF kg diet had higher growth performance and feed utilization parameters than the other groups. Hematological and liver antioxidant parameters were not affected by dietary LF supplementation.

Factors Associated With Discordance Between Preoperative Parathyroid 4-Dimensional Computed Tomographic Scans and Intraoperative Findings During Parathyroidectomy.

Importance: Parathyroid 4-dimensional computed tomographic scans (4D-CTs) have emerged as an accurate and cost-effective initial localization study for patients with primary hyperparathyroidism. However, potential limitations and factors affecting the accuracy of preoperative 4D-CTs remain poorly defined.

Objectives: To characterize factors associated with missed parathyroid lesions on preoperative 4D-CTs and to investigate patterns of commonly observed errors.

Abdominal-pelvic scanning parameters revisited: a case for Z-axis reduction in patients with clinical suspicion for acute appendicitis.

Purpose: The purpose of this study was to determine if CT for appendicitis can be abbreviated to begin at the top of the L2 vertebral body level and still maintain the detection rate of appendicitis and other symptomatic pathology without omitting significant incidental findings.

Methods: Retrospective review of CT abdomen-pelvis exams for suspected appendicitis over a 5-month period was performed. The Z-axis scan length of the original full scans and theoretical limited scans from the top of L2 were recorded and calculated.

A Story in Black and White: Radiologic Evaluation in the Multidisciplinary Setting.

Strong engagement from expert radiologists is essential in ensuring the optimal function of a multidisciplinary group focused on the treatment of head and neck cancer. Active participation in multidisciplinary conference can be among the most rewarding roles for radiologists. Despite many benefits to radiologist involvement in multidisciplinary teams, there are obstacles and challenges that can prevent full participation.

Anatomic Variations in Pituitary Endocrinopathies: Implications for the Surgical Corridor.

 Functioning pituitary adenomas may produce endocrinopathies such as acromegaly and Cushing syndrome. Both conditions lead to characteristic anatomic variations as a result of hormonally induced abnormal soft tissue deposition. We evaluate the anatomic differences between acromegalics and Cushing disease patients and compare these dimensions to controls.

Bilateral Endolymphatic Hydrops in a Patient With Migraine Variant Without Vertigo: A Case Report.

Objective: To use modern high-resolution inner ear imaging modalities to evaluate for endolymphatic hydrops (EH) in a patient with migraine-associated fluctuating hearing loss without vertigo spells or dizziness.

Background: EH has been well described in patients with Meniere's disease on both human temporal bone studies and modern high-resolution imaging; however, there is no study to date, to our knowledge, that examines the presence of EH in a patient with migraine and bilateral hearing loss. We present the MRI findings using a sequence for detecting EH in a unique case of a patient experiencing migraine headaches accompanied by fluctuating hearing loss without vertigo.

Facial nerve stimulation following cochlear implantation for X-linked stapes gusher syndrome leading to identification of a novel POU3F4 mutation.

We report a case of a nine-year-old male who presented with facial nerve stimulation four years after cochlear implantation. Computed tomography was performed revealing a dilated internal auditory meatus and the cochlear implant electrode was found to be protruding into the fallopian canal at the level of the geniculate ganglion. Subsequent genetic analysis demonstrated X-linked deafness type 2 (DFNX2) caused by a novel c.

Head and neck Epstein-Barr virus mucocutaneous ulcer: Case report and literature review.

Objectives/hypothesis: To report the clinical presentation, treatment, and management outcomes of patients with Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) of the head and neck, which is a newly characterized pathologic entity with aggressive morphology but follows an indolent, self-limiting clinical course.

Study Design: Case report and literature review.

Methods: A case of EBVMCU of the base of tongue is reported and a retrospective review of all cases of EBVMCU of the head and neck at a single academic institution was conducted between January 1, 1986 and April 1, 2015.

Prospective Validation of Two 4D-CT-Based Scoring Systems for Prediction of Multigland Disease in Primary Hyperparathyroidism.

Background And Purpose: Patients with multigland primary hyperparathyroidism are at higher risk for missed lesions on imaging and failed parathyroidectomy. The purpose of this study was to prospectively validate the ability of previously derived predictive score systems, the composite multigland disease score, and the multiphase multidetector contrast-enhanced CT (4D-CT) composite multigland disease score, to identify patients with a high likelihood of multigland disease.

Materials And Methods: This was a prospective study of 71 patients with primary hyperparathyroidism who underwent 4D-CT and successful parathyroidectomy.

Camellia sinensis supplemented diet enhances the innate non-specific responses, haematological parameters and growth performance in Mugil cephalus against Photobacterium damselae.

This study evaluated the effect of dietary supplementation of Camellia sinensis leaf-extract on non-specific immune responses and disease resistance of Mugil cephalus fingerling against P. damselae. Fish were fed with 0 (unsupplemented), 50, 100 and 200 mg/kg of green tea extract (GTE) supplemented diets.

High Resolution MRI Shows Presence of Endolymphatic Hydrops in Patients Still Symptomatic After Endolymphatic Shunt Surgery.

Objective: Endolymphatic hydrops has been well described in patients with Ménière's syndrome; however, causation has not been established. Decompression of the endolymphatic sac has been proposed as a means to relieve hydrops and improve vertigo symptoms, but the efficacy of the surgery is debated. Until recently, there have been few objective measures of efficacy other than patients' subjective symptoms.

Blood-Labyrinth Barrier Permeability in Menière Disease and Idiopathic Sudden Sensorineural Hearing Loss: Findings on Delayed Postcontrast 3D-FLAIR MRI.

Background And Purpose: Menière disease and idiopathic sudden sensorineural hearing loss can have overlapping clinical presentation and may have similar pathophysiology. Prior studies using postcontrast 3D-FLAIR MR imaging suggest abnormal blood-labyrinth barrier permeability in both conditions, but the 2 diseases have not been directly compared by using the same imaging techniques. We hypothesized that delayed postcontrast 3D-FLAIR MR imaging would show differences in blood-labyrinth barrier permeability between Menière disease and idiopathic sudden sensorineural hearing loss.

Hypopharyngeal venous malformation presenting with foreign body sensation and dysphagia.

Objective: Review the importance of imaging selection and clinicoanatomic correlation for a vascular malformations presenting with unique symptomatology.

Methods: Case study and literature review.

Results: A 64-year-old female presented with globus and dysphagia ongoing for 40 years.

Endolymphatic Hydrops Reversal following Acetazolamide Therapy: Demonstration with Delayed Intravenous Contrast-Enhanced 3D-FLAIR MRI.

Endolymphatic hydrops, the primary pathologic alteration in Menière disease, can be visualized by using delayed intravenous contrast-enhanced 3D-FLAIR MR imaging. It is not known whether MR imaging-demonstrable changes of hydrops fluctuate with disease activity or are fixed. We describe the results of baseline and posttreatment MR imaging studies in a group of subjects with Menière disease with hydrops who were treated with acetazolamide.