Leupeptin reduces impulse noise induced hearing loss

<p>Abstract</p> <p>Background</p> <p>Exposure to continuous and impulse noise can induce a hearing loss. Leupeptin is an inhibitor of the calpains, a family of calcium-activated proteases which promote cell death. The objective of this study is to assess whether Leupeptin could reduce the hearing loss resulting from rifle impulse noise.</p> <p>Methods</p> <p>A polyethelene tube was implanted into middle ear cavities of eight fat sand rats (16 ears). Following determination of auditory nerve brainstem evoked response (ABR) threshold in each ear, the animals were exposed to the noise of 10 M16 rifle shots. Immediately after the exposure, saline was then applied to one (control) ear and non-toxic concentrations of leupeptin determined in the first phase of the study were applied to the other ear, for four consecutive days.</p> <p>Results</p> <p>Eight days after the exposure, the threshold shift (ABR) in the control ears was significantly greater (44 dB) than in the leupeptin ears (27 dB).</p> <p>Conclusion</p> <p>Leupeptin applied to the middle ear cavity can reduce the hearing loss resulting from exposure to impulse noise.</p

Endoscopic Contralateral Superiorly Based Mucoperiosteal Nasal Septal Flap for Closure of Cerebrospinal Fluid Leak

Objective A novel local contralateral superiorly based mucoperiosteal nasal septal flap (CSBMNSF) for closure of a cerebrospinal fluid (CSF) leak from the middle anterior base of the skull is described. Materials and Methods A retrospective review of patients having endoscopic sinus surgery (ESS) with a CSF leak between 2000 and 2009 was performed. The surgical technique is described. Two vertical parallel incisions are performed anteriorly and posteriorly in the contralateral septal mucosa, joined inferiorly by a horizontal incision. Elevation of the flap is completed, leaving it pedicled superiorly. A window is created at the highest aspect of the nasal septum to allow transfer of the flap to the affected side. Results Four patients with a CSF leak post-ESS for excision of a congenital meningocele, tumor removal, and chronic sinusitis are described. All were treated successfully using a CSBMNSF. Conclusion A novel, easy-to-handle local flap for closure of defects in the anterior middle skull base is described. The use of this flap offers less morbidity and less bulkiness compared with other local or regional flaps

Inferior Flap Tympanoplasty: A Novel Technique for Anterior Perforation Closure

Objective. To report a novel tympanoplasty modification for anterior tympanic membrane perforation closure. Materials and Methods. A prospective study on 13 patients who underwent inferior tympanoplasty between December 2008 and May 2011 was carried out. In our technique, an inferior rather than a posterior flap is raised and the graft is laid from the inferior direction to obtain better access to the anterior part of the tympanic membrane perforation and provide better support. Results. A total of 13 patients underwent the novel inferior tympanoplasty technique with a mean age of 33 years. Six patients had undergone tympanoplasties and/or mastoidectomies in the past, 3 in the contralateral ear. A marginal perforation was observed in 3 cases, total perforation in 2 and subtotal in 1 case. The mean preoperative pure-tone average was 40.4 dB (10 to 90 dB), compared to 26.5 dB (10 to 55 dB) postoperatively. All perforations were found to be closed but one (92.3% success rate). Conclusions. The inferior tympanoplasty technique provides a favorable outcome in terms of tympanic membrane closure and hearing improvement for anterior perforations, even in difficult and complex cases. It is based on a well-known technique and is easy to implement

Fibrin Sealant Reduces Pain after Tonsillectomy: Prospective Randomized Study

Objectives: Postsurgical pain in adults following tonsillectomy with fibrin sealant or electrocoagulation was assessed by surface electromyography (sEMG), a dysphagia severity rating scale (DSRS), and a visual analog scale (VAS) pain score. Methods: For group 1 (n = 40), hemostasis was achieved by fibrin sealant spraying to the tonsillar fossae. For group 2 (n = 40), hemostasis was achieved by bipolar or needle point electrocautery. The timing of single swallowing and continuous drinking and the mean electrical activity of the masseter, infrahyoid, and submental-submandibular muscles were compared with a normative database during 30 days and with DSRS and VAS scores. Results: Electrical activity of the masseter and infrahyoid muscles was significantly higher in both groups in comparison with the normative database (p &gt; .05 to p &gt; .005), whereas timing was less affected. The combined sEMG, DSRS, and VAS assessment showed that tonsillectomy ended with sealant causes less pain than electrocoagulation (p &gt; .05). The DSRS score data were in strong positive correlation with the sEMG records, whereas the VAS pain score was less informative. Conclusions: The combined sEMG and pain score data indicate that the electrocautery hemostatic technique is more painful and traumatic than the sealant technique. Surface electromyography of swallowing is a simple, reliable evaluation method for postsurgical odynophagia complaints and might be used as an objective tool for pain assessment. </jats:sec

Extended High Frequency Audiometry for Revealing Sudden Sensory Neural Hearing Loss in Acute Tinnitus Patients

Introduction The measurement of extended high-frequency (EHF) audiometry has become more popular recently, mainly in connection with ototoxicity and noiseinduced hearing loss. New-onset tinnitus evaluation includes a standard hearing test that shows no pathology. Objective The aim of the present study was to evaluate the possibility that acute tinnitus is essentially connected to sudden sensory neural hearing loss (SSNHL), by utilizing EHF audiometry in cases in which standard audiometry for frequencies between 250 Hz to 8 kHz is within normal limits. Methods A retrospective study was conducted between January 2009 and May 2014 that included all patients presenting with acute tinnitus and normal standard audiometry. All patients underwent EHF audiometry and were treated accordingly. Results Thirty-two patients with acute tinnitus and asymmetric sensorineural hearing loss on EHF audiometry were identified. The average deltas between the ears were between 9.2 and 33dB (worse in the affected ear). Conclusion Extended high-frequency audiometry up to 20,000 Hz should be performed in all patients with acute tinnitus and standard audiometry within normal limits