ABSTRACT
BACKGROUND AND OBJECTIVES: Facial nerve dysfunction in Bell's palsy is evaluated using various parameters including physical examination and electrophysiological studies. Associated symptoms of facial numbness or paresthesia are reported by some patients with Bell's palsy. The aim of this study was to investigate trigeminal nerve involvement in Bell's palsy using blink reflex test. SUBJECTS AND METHODS: Facial nerve and trigeminal nerve functions were assessed using House-Brackmann (HB) grading system, electroneuronography (ENoG) and blink reflex tests in 28 patients diagnosed as Bell's palsy. RESULTS: HB grades correlated with degeneration ratio from ENoG (p=0.002, chi-square test). The ipsilateral R1 reponse of the blink reflex was absent or abnormal in 27/28 patients (96.4%), and ipsilateral R2 response was absent or abnormal in 26/28 patients (92.8%). Contralateral R2 was abnormal in 5/28 patients (17.8%), suggesting involvement of trigeminal nerve in a portion of patients. The results of blink reflex test showed no significant correlation to the outcome of facial nerve function (HB grade) in Bell's palsy patients. CONCLUSIONS: Blink reflex test provides information about trigeminal and facial nerve functions in addition to ENoG results. Our study suggests that subclinical involvement of trigeminal nerve may accompany facial nerve dysfunction in Bell's palsy.
Subject(s)
Humans , Bell Palsy , Blinking , Facial Nerve , Hypesthesia , Paresthesia , Physical Examination , Trigeminal NerveABSTRACT
BACKGROUND AND OBJECTIVES: Newborn Hearing Screening (NHS) program aims to identify babies at risk of hearing loss and provide appropriate rehabilitation within the crucial period for language development. The risk of hearing loss in increased in babies discharged from neonatal intensive care unit (NICU) compared to wellbaby nursery. Transient evoked otoacoustic emission (TEOAE) or automated auditory brainstem response tests are utilized. The purpose of this study is to assess the outcome of NHS using TEOAE as initial evaluation method in NICU graduates. SUBJECTS AND METHODS: TEOAE was performed as initial screening method for NHS in NICU neonates born between February 2010 and November 2011. Babies referred from TEOAE were reevaluated with repeated TEOAE or auditory brainstem response. Referral rates were estimated and quality indicators for screening (Joint Committee on Infant Hearing position statement, 2007) were evaluated. RESULTS: Among 149 neonates graduated from NICU, 50 (33.6%) babies failed initial TEOAE ('refer'). A second stage TEOAE testing was performed in 41 (82.0%) of these babies: 35 (85.4%) passed and 6 (14.6%) were referred for diagnostic testing. From 2-stage TEOAE screening program, 6 neonates were referred for diagnostic audiological evaluation: sensorineural hearing loss was identified in 2 babies and 3 babies were lost to follow up. Quality indicators for screening were as follows: 1) 94.0% of all newborn infants admitted to NICU completed screening by 1 month of age, and 2) 4.0% of all newborn infants who fail initial screening and fail any subsequent rescreening before comprehensive audiological evaluation. CONCLUSIONS: Timely and adequate screening of hearing loss is prerequisite for accurate diagnosis and appropriate rehabilitation in infants especially from NICU. Further refinement of the current NHS with additional reliable screening technology is required for more stable and successful screening program.
Subject(s)
Humans , Infant , Infant, Newborn , Diagnostic Tests, Routine , Evoked Potentials, Auditory, Brain Stem , Hearing , Hearing Loss , Hearing Loss, Sensorineural , Intensive Care, Neonatal , Language Development , Lost to Follow-Up , Mass Screening , Nurseries, Infant , Quality Indicators, Health Care , Referral and ConsultationABSTRACT
BACKGROUND AND OBJECTIVES: Newborn Hearing Screening (NHS) program aims to identify babies at risk of hearing loss and provide appropriate rehabilitation within the crucial period for language development. The risk of hearing loss in increased in babies discharged from neonatal intensive care unit (NICU) compared to wellbaby nursery. Transient evoked otoacoustic emission (TEOAE) or automated auditory brainstem response tests are utilized. The purpose of this study is to assess the outcome of NHS using TEOAE as initial evaluation method in NICU graduates. SUBJECTS AND METHODS: TEOAE was performed as initial screening method for NHS in NICU neonates born between February 2010 and November 2011. Babies referred from TEOAE were reevaluated with repeated TEOAE or auditory brainstem response. Referral rates were estimated and quality indicators for screening (Joint Committee on Infant Hearing position statement, 2007) were evaluated. RESULTS: Among 149 neonates graduated from NICU, 50 (33.6%) babies failed initial TEOAE ('refer'). A second stage TEOAE testing was performed in 41 (82.0%) of these babies: 35 (85.4%) passed and 6 (14.6%) were referred for diagnostic testing. From 2-stage TEOAE screening program, 6 neonates were referred for diagnostic audiological evaluation: sensorineural hearing loss was identified in 2 babies and 3 babies were lost to follow up. Quality indicators for screening were as follows: 1) 94.0% of all newborn infants admitted to NICU completed screening by 1 month of age, and 2) 4.0% of all newborn infants who fail initial screening and fail any subsequent rescreening before comprehensive audiological evaluation. CONCLUSIONS: Timely and adequate screening of hearing loss is prerequisite for accurate diagnosis and appropriate rehabilitation in infants especially from NICU. Further refinement of the current NHS with additional reliable screening technology is required for more stable and successful screening program.
Subject(s)
Humans , Infant , Infant, Newborn , Diagnostic Tests, Routine , Evoked Potentials, Auditory, Brain Stem , Hearing , Hearing Loss , Hearing Loss, Sensorineural , Intensive Care, Neonatal , Language Development , Lost to Follow-Up , Mass Screening , Nurseries, Infant , Quality Indicators, Health Care , Referral and ConsultationABSTRACT
PURPOSE: We investigated the viability, the changes of thickness, and morphological changes of corneas stored in the Korean corneal storage medium (CS005) by comparing with those of corneas stored in Optisol GS (Chiron Co., Irvine, CA, USA). METHODS: Cat corneas preserved in the CS005 and Optisol GS were stored for up to 14 days at 4degrees C. The endothelial viability, ultrastructure, and the change of thickness were assessed by microscopy. In addition, the corneas preserved for 3 and 5 days were transplanted to cats and, after 3 months, the endothelial changes of transplanted corneas were evaluated using the scanning electron microscopy. RESULTS: Corneas preserved in CS005 or Optisol-GS showed the similar endothelial viability and cell density as the time of preservation. Cornea stored in both medium showed no significant difference in the change of corneal thickness by 7 days although the corneas stored in CS005 were slightly thicker by 14 days than tissues stored in Optisol-GS (193.6% vs. 164.7%, respectively). Ultrastructural examination of the corneas preserved in both medium showed the cytoplasmic vacuoles, nuclear changes, and edema with increasing the storage time. Transplanted corneas showed the similar structural changes in endothelial cell stored in CS005 or Optisol-GS. CONCLUSIONS: The endothelial viability and changes of corneas preserved in Korean corneal storage medium were similar to that in Optisol-GS. Therefore, this study suggests that corneal tissue can be safely stored in the Korean corneal storage medium, considering that donor corneas were generally used within 7 days after preservation.