Melatonin for Tinnitus and Steroids to Ease Tonsillectomy Pain

Newswise — Twenty-three new research studies are featured in the February edition of Otolaryngology—Head and Neck Surgery, the medical/scientific journal of the American Academy of Otolaryngology—Head and Neck Surgery. They are:

1. “Steroids for Post-Tonsillectomy Pain Reduction: Meta-Analysis of Randomized Controlled Trials.” A University of Cincinnati study finds that providing a patient a single, intraoperative dose of dexamethasone may reduce post-tonsillectomy pain on the first day after surgery.

2. “Patient Selection and Efficacy of Pillar Implant Technique for Treatment of Snoring and Obstructive Sleep Apnea/Hypopnea Syndrome.” Findings revealed that the Pillar implant offered overall subjective and objective “cure” rates of 88 percent and 34 percent for snoring and obstructive sleep apnea, respectively.

3. “Evaluation of Potential Predictors of Outcome of Laser-Assisted Uvulopalatoplasty for Snoring.” Laser-Assisted Uvulopalatoplasty (LAUP) is a common treatment for snoring, but up to 50 patients obtain little or no sustained benefit. Researchers examine predictive factors to identify snorers benefiting from LAUP.

4. “Evaluation of Type 3 Portable Monitoring in Unattended Home Setting for Suspected Sleep Apnea: Factors That May Affect Its Accuracy.” This prospective study examines whether a home sleep study is as effective as a standard polysomnography (PSG) among patients with obstructive sleep apnea.

5. “The Effects of Melatonin on Tinnitus and Sleep.” A new research effort concludes that melatonin use is associated with improvement of tinnitus and sleep. The impact of melatonin on sleep was greatest among patients with the worst sleep quality, but its impact on tinnitus was not associated with the severity of the tinnitus.

6. “Inhibition of Post-Meningitic Cochlear Injury with Cerebrospinal Fluid Irrigation.”
Labyrinthitis ossificans, the pathologic ossification of the otic capsule associated with profound deafness and loss of vestibular function, occurs frequently as a consequence of bacterial meningitis and subsequent inflammation of the inner ear. This study examines whether a dilution of concentration of inflammatory mediators through cerebrospinal fluid (CSF) irrigation will lead to a reduction in both inner ear pathology and permanent hearing loss.

7. “Hyaluronate Gel Stapedotomy.” This study evaluated hearing results and postoperative dizziness after stapedotomy (a surgical technique for the improvement of hearing in otosclerosis) with application of sodium hyaluronate gel (HG) to the oval window niche during fenestration of the footplate.

8. “Histologic Changes in the Anterior Mallear Ligament and the Head of the Malleus in Otosclerosis.” Research recorded hyalinization (development of a clear, eosinophilic, homogeneous substance occurring in cellular degeneration ) of the AML as follows: none, patchy, or diffuse in 95 temporal bones (TBs) with otosclerosis: 52 with stapedial fixation (SF); 43 without fixation (NSF); and 52 age-matched controls.

9. “Perioperative Complications with the Bone-Anchored Hearing Aid.” A retrospective review examined the complications and experiences of 58 patients who underwent implantation of bone-anchored hearing loss for unilateral conductive, mixed, or sensorineural hearing

10. “Comparison of Intradermal Dilutional Testing with the Multi-Test II Applicator in Testing for Mold Allergy.” Findings address modified quantitative testing and its efficacy for determining starting doses for immunotherapy with fungal allergens.

11. “Proinflammatory Effects of Staphylococcus Aureus Exotoxin B on Nasal Epithelial Cells.”
This study aimed to evaluate the effects of Staphylococcus aureus exotoxin B (SE-B) on proinflammatory cytokine/chemokine releases in primary nasal epithelial cell cultures (NECC) of subjects with and without chronic rhinosinusitis (CRS

12. “Correlation between Middle Turbinate and Ipsilateral Ethmoid Histopathology in Chronic Rhinosinusitis.” In this study, 22 patients with inflammatory paranasal sinus disease without polyps were enrolled. A partial middle turbinectomy and ethmoidectomy were performed and the histopathologic findings of the surgical specimens were studied. The general degree of inflammation, epithelial thickening, and inflammatory cell count were measured.

13. “Nasal Airflow Recovery after Decongestion Test Is Associated With Bronchial Hyperreactivity in Patients with Allergic Rhinitis.” This study sought to assess the relationship between pulmonary function and nasal airflow recovery after a topical vasoconstrictor had been administered in patients with allergic rhinitis (perennial, seasonal, or mixed allergic rhinitis).

14. “Combined Endoscopic Medial and External Lateral Orbital Decompression for Progressive Thyroid Eye Disease.” This retrospective study reviewed patients with thyroid eye disease with severe proptosis, exposure keratitis, or compressive optic neuropathy. This was conducted by comparing the efficacy of endoscopic medial and lateral orbital wall surgery to 3-wall decompression.

15. “Diffuse Mucosal Inflammation in Nasal Polyps and Adjacent Middle Turbinate.” The nasal polyp is the most common mass lesion in the nose with unclear cause or origin. In this study, researchers investigated the association of allergy and type of cellular inflammation in Asian patients with nasal polyps.

16. “Packing in Endoscopic Sinus Surgery: Is It Really Required?” According to Israeli researchers, most endoscopic sinus surgery procedures can be managed without packing or any other measures to stem blood flow. Local anesthesia, use of local vasoconstrictors, and careful operative technique minimize the need for nose packing, thus reducing patient’s discomfort, postoperative complications, and cost of surgery.

17. “Distribution of Class I and II Human Leukocyte Antigens in the Larynx.” The detailed distribution of major transplantation antigens in the human larynx is made clear. Class II antigens implicated as initiators of organ transplant rejection were primarily found in six areas: mucosal surface epithelium, submucosal glands, ducts, vascular endothelium, perichondrium, and Schwann cells of nerves.

18. “Endoscopic Stapling Diverticulotomy: An Audit of Difficulties, Outcome, and Patient Satisfaction.” A pharyngeal pouch occurs when the pharyngeal lining herniates. Endoscopic stapling diverticulotomy offers rapid recovery in most patients, with early oral intake and short hospital stay. There is a high degree of symptom relief, and the patient’s satisfaction rate is high. The assessment of the pharyngeal pouch size is an important factor when deciding the best management for a patient with a pharyngeal pouch.

19. “Partial Laser Arytenoidectomy in the Management of Bilateral Vocal Fold Immobility: A Modification Based on Functional Anatomical Study of the Cricoarytenoid Joint.” The objectives of this study were to establish the anatomical relationships between the arytenoid and cricoid cartilages and apply these findings to design an arytenoidectomy based on a sound anatomical basis.

20. “Histopathologic and Cytopathologic Diagnostic Discrepancies in Head and Neck Region: Pitfalls, Causes, and Preventive Strategies.” What provides a better diagnosis of a head and neck mass? Clinicians commonly utilize fine needle aspiration biopsy (FNAB) for the primary investigation of head and neck masses. Correlation of these results with the surgical resection diagnosis is an essential part of quality control and assurance programs in all cytology laboratories.

21. “Radial Forearm Free Flap Donor Site Outcomes Comparison by Closure Methods.” In examining head and neck cancer patients, researchers compared the functional and aesthetic outcomes of radial forearm free flap (RFFF) donor sites reconstructed with full-thickness skin graft (FTSG), split thickness skin graft (STSG) alone, and STSG overlying an acellular dermal matrix.

22. “In Vivo Characterization of Parathyroid Lesions by Use of Gamma Probe: Comparison with Ex Vivo Count Method and Frozen Section Results.” A study from Turkey examines the hypothesis that if timing of gamma probe-guided parathyroidectomy were individualized according to an optimal-time-to-surgery technique, in vivo characterization of parathyroid lesions would be possible. Research findings were compared with an ex vivo counting method and frozen section results.

23. “Epithelial Lacrimal Gland Tumors: A Clinicopathological Study of 18 Cases.” The
lacrimal gland is responsible for the secretion of tears. The aim of this study was to report the clinicopathological features of 18 epithelial tumors of the lacrimal gland treated in a single institution.

The abstracts for these research studies can be viewed online at http://www.mosby.com/oto.