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Round window membrane vibration may increase the effect of intratympanic dexamethasone injection
Park, S. H.,Moon, I. S. LARYNGOSCOPE 2014 The Laryngoscope Vol.124 No.6
Objectives/Hypothesis: We investigated whether the round window membrane (RWM) vibration can facilitate dexamethasone perfusion via the RWM in patients with sudden hearing loss. Study Design: Prospective study. Methods: We first performed an in vitro study using a semipermeable membrane. In the subsequent in vivo study, 20 mice were randomized into two groups: an intratympanic dexamethasone injection (ITDI)-only group, and an ITDI with RWM vibration group. Concentration of dexamethasone was investigated using high performance liquid chromatography. Third, we performed a prospective clinical study. Fifty-five refractory sudden hearing loss patients were divided into two groups: those who received ITDI only (n=36) and those who received ITDI with RWM vibration (n=19). Final hearing assessments were conducted 2 months after salvage treatment. Results: In the in vitro study, the concentration of dexamethasone increased with vibration time with the peak concentration observed at 3 minutes of vibration. In the in vivo study, ITDI with RWM vibration resulted in a significantly higher perilymph concentration of dexamethasone (7.68 +/- 3.13 mu g/ml) than that in the ITDI-only group (2.66 +/- 1.73 mu g/ml). In a clinical setting, the overall improvement in hearing was similar between the two groups. However, when we compared the speech discrimination score between the two groups, we found that the relative discrimination gain in the ITDI with RWM vibration group (18.11 +/- 23.54%) was higher than that in the ITDI-only group (7.00 +/- 15.54%) (P=0.042). Conclusion: RWM vibration can enhance the effect of intratympanic dexamethasone injection and is a viable treatment option for sudden hearing loss.
Kim, Y. M.,Oh, S. H.,Choi, J. S.,Lee, S.,Ra, J. C.,Lee, J. H.,Lim, J. Y. LARYNGOSCOPE 2014 The Laryngoscope Vol.124 No.3
Objectives/Hypothesis The purpose of this study was to investigate the regenerative efficacy of an injectable hyaluronic acid/mildly cross-linked alginate hydrogel (HA/ALG hydrogel) containing human adipose-derived mesenchymal stem cells (hAdMSCs) for vocal fold (VF) wound healing.Study DesignAnimal research.MethodsHA/ALG hydrogel containing hAdMSCs was injected into the VFs of rabbits immediately after direct injury. Endoscopic evaluations were performed at 1 and 3 months after injury, and functional evaluations of mucosal vibration and viscoelastic properties were carried out posteuthanization at 3 months after injury. Histopathologic and immunohistochemical evaluations of extracellular matrix (ECM) components and of hepatocyte growth factor (HGF) activity were conducted in injured VFs. The engraftment of implanted hAdMSCs was investigated by detecting fluorescent-labeled cells.ResultsThe administration of hAdMSCs and hAdMSCs in HA/ALG hydrogel produced better macroscopic morphologies than the injection of phosphate-buffered saline (PBS). Histologic evaluations revealed that treatment with hAdMSCs in HA/ALG produced more favorable ECM changes than hAdMSC. In particular, the treatment of hAdMSCs in HA/ALG hydrogel ameliorated excessive deposition of collagen type I and increased HGF activity in regenerating VFs. hAdMSCs in HA/ALG-treated VFs also exhibited functional improvements in viscoelastic properties. hAdMSCs in HA/ALG remained viable in recipient VFs at 1 month after transplantation, and some were observed to be fostered to differentiate into fibroblasts.ConclusionsThe findings of the present study suggest that HA/ALG hydrogel is a promising biomaterial for prolonging the retention time of stem cells in VFs and for promotion of VF wound healing.
An animal model of obstructive sleep apnea in rabbit
Yu, M. S.,Jung, N. R.,Choi, K. H.,Choi, K.,Lee, B. J.,Chung, Y. S. LARYNGOSCOPE 2014 The Laryngoscope Vol.124 No.3
Objectives/HypothesisAn animal model of obstructive sleep apnea (OSA) may help to investigate the pathophysiology of this disorder and develop appropriate treatments. We investigated the feasibility of a rabbit model of OSA.Study DesignAnimal study.MethodsTwelve New Zealand white rabbits were injected at the base of their tongues under endoscopic guidance with liquid silicone (experimental group, n=6) or normal saline (control group, n=6). Polysomnography was performed before and after injection. The development of OSA and changes in sleep parameters were compared between the two groups.ResultsBefore injection, all rabbits showed normal breathing during sleep without hypopnea. In the silicone group, the rabbits had a mean of 29.96.9 hypopneas/hour and a mean of 10.43.1 apneas/hour 1 month after silicone injection and 28.4 +/- 6.9 hypopneas/hour and 10.0 +/- 3.3 apneas/hour 3 months after silicone injection (P<0.05). Mean total sleep time decreased from 260.3 +/- 70.2 minutes at baseline to 152.5 +/- 38.8 minutes 1 month and 206.8 +/- 60.3 minutes 3 months after injection, with a decrease in stage II sleep. In the saline group, however, there were no breathing events during sleep.ConclusionsThese results show that silicone injections into the tongue base of rabbits can result in OSA.Level of EvidenceN/A Laryngoscope, 124:789-796, 2014