Cholesteatoma in chronic otitis media secondary to pars tensa perforation.

BACKGROUND: Acquired cholesteatoma secondary to pars tensa perforation was rare in clinic. OBJECTIVES: In this study, we explored factors related to acquired cholesteatoma in chronic otitis media patients with pars tensa perforation. MATERIAL AND METHODS: 262 adults (296 ears) with pars tensa perforation were divided into four groups: anterior perforation group, posterior perforation group, central perforation group, and marginal perforation group. Analysis was carried out in terms of cholesteatoma formation, adhesion of perforation edges, mastoid pneumatization, and the function of eustachian tube. RESULTS: Cholesteatoma was found in 34% (18 in 53 ears) in posterior perforation group, 14.3% (14 in 98 ears) in marginal perforation group, and 2.5% (2 in 80 ears) in anterior perforation group. For subjects with adhesion in perforation edges, cholesteatoma was approved in 94% of posterior perforation, 42% of marginal perforation and 25% of anterior perforation groups. The adhesion in perforation edges and function of eustachian tube instead of mastoid pneumatization were statistically significant for cholesteatoma formation. CONCLUSIONS AND SIGNIFICANCE: Acquired cholesteatoma was mostly found in patients with posterior and marginal perforation, followed by anterior perforation. Adhesion of perforation edges was another risk factor for cholesteatoma formation. Eustachian tube also functioned by influencing the ventilation of middle ear.

PGE2 inhibits neutrophil phagocytosis through the EP2R-cAMP-PTEN pathway.

Prostaglandin E2 (PGE2) is a potent lipid mediator of inflammation that modulates immune cell function by binding to unique G protein-coupled receptors (EP receptors). PGE2 production increases during microbial infection and inflammation. In this study, we assessed the effect of PGE2 on the phagocytosis of bacteria by neutrophils, which are key players during infection and inflammation. We also looked for specific EP receptor signaling pathways that contributed to the neutrophil phagocytic activity. PGE2 (50-1000 ng/ml) inhibited the phagocytosis of Escherichia coli by HL-60 human neutrophils in a concentration-dependent manner. Inhibition of neutrophil phagocytosis by PGE2 correlated with increased intracellular cyclic adenosine monophosphate (cAMP) production, and forskolin, an adenosyl cyclase agonist, confirmed the inhibitory effect of cAMP stimulation on neutrophil phagocytosis. The expression of EP2 receptors by HL-60 cells was confirmed by western blot analysis, and selective agonism of EP2 receptors mimicked the inhibition of phagocytosis by PGE2. The EP2 receptor antagonist AH-6089 partially blocked the inhibition of neutrophil phagocytosis PGE2. Specific inhibition of phosphatase and tensin homolog (PTEN) enzyme attenuated the inhibition of neutrophil phagocytosis by PGE2, and both PGE2 and increased intracellular cAMP increased neutrophil PTEN activity, which was associated with decreased PTEN phosphorylation. The results support negative regulation of the antimicrobial activity of neutrophils (i.e., phagocytosis), which has important implications for the future management of bacterial infections.

Microscopic Over-under Versus Medial Tympanoplasty for Larger Tympanic Membrane Perforations.

OBJECTIVES: To identify the differences in hearing, anatomical success rate, functional success rate, and complications between over-under tympanoplasty and medial tympanoplasty procedures. METHODS: The clinical data of patients with tympanic membrane perforation repaired by medial tympanoplasty between January 2011 and December 2016 and by over-under tympanoplasty between January 2017 and December 2020 were retrospectively analyzed. We evaluated the differences between medial tympanoplasty and over-under tympanoplasty. RESULTS: The overall success rate of over-under tympanoplasty was higher than that of medial tympanoplasty (90.76% vs 81.31%). In large perforations, the success rate of over-under tympanoplasty was higher than that of medial tympanoplasty (89.80% vs 71.43%). There was no statistically significant difference in the success rate between the two treatment groups for moderate perforations. Furthermore, there was no statistically significant difference in the incidence of complications between the two groups (P = .2637). CONCLUSIONS: Over-under tympanoplasty is more suitable for large perforations of the tympanic membrane and has a higher success rate as compared to medial tympanoplasty.

[IGF-1 activates the PI3K pathway through S1P/S1PR1 signaling to promote the migration of mouse alveolar epithelial cells].

Objective To investigate the effect of insulin-like growth factor 1 (IGF-1) on the migration of alveolar epithelial cells (AECs) and its related mechanisms. Methods The MLE-12 cells (mouse AEC line) were stimulated by IGF-1 and sphingosine 1 phosphate (S1P) in the presence or absence of the PI3K inhibitor Wortmannin. Then, the cell migration was detected by the scratch test and the expression of p-Akt was detected by Western blot. With AECs stimulated by IGF-1, the secretion and expression of S1P were tested by ELISA and Western blot respectively. In the blocking experiment, the effect of IGF-1 on cell migration or p-Akt expression was detected by scratch test or Western blot after the interference of AEC S1P receptor 1 (S1PR1) or the action of S1PR1 blocking antibody. Results After 12 hours of IGF-1 stimulation, the expression of p-Akt in AECs increased and the migration of AECs accelerated. When blocking PI3K signal, the effect of IGF-1 on promoting AEC migration was partially eliminated. IGF-1 induced AECs to produce S1P, which accelerated AEC migration through S1PR1. The expression of p-Akt in AECs increased after S1P stimulation. When blocking the PI3K pathway, the ability of S1P to accelerate the migration of AECs was reduced. When S1PR1 in AECs was blocked or interfered, the effect of IGF-1 on accelerating AEC migration and promoting AEC p-Akt expression was partially reduced. Conclusion IGF-1 activates the PI3K pathway through S1P-S1PR1 signal to promote the migration of AECs.

Outcomes of ossicular disruption in traumatic facial paralysis: a case series.

BACKGROUND: As tympanotomy using the transcanal approach was a routine surgical technique for traumatic ossicular disruption, the efficacy of the posterior tympanum approach was rarely explored. AIM: This study aimed to investigate whether the hearing outcomes improved after simultaneous ossiculoplasty and facial nerve decompression using the posterior tympanum approach compared with the transcanal approach. MATERIAL AND METHODS: The data of 11 patients who underwent ossiculoplasty and facial nerve decompression using the posterior tympanum approach and 21 patients who underwent ossiculoplasty via transcannal approach were analyzed. RESULTS: The average air-bone gap (ABG) of patients undergoing posterior tympanotomy showed a statistically significant improvement. Postoperative ABG within 20 dB was observed in 81.8% of patients in the posterior tympanum group and 76.2% of patients in the transcanal group. However, the ABG closure in the two groups was not statistically different. CONCLUSIONS AND SIGNIFICANCE: Simultaneous ossiculoplasty using the posterior tympanum approach was practical, and the hearing outcomes were promising for the patients with traumatic facial nerve paralysis and ossicular disruption.

Otitis media with effusion in adults with patulous Eustachian tube.

Highlight1. Patients with patulous Eustachian tube (PET) were older, had a shorter duration of disease, and were more likely to develop bilateral otitis media with effusion.2. Patients with PET were more likely to develop comorbidities of gastroesophageal reflux and allergies.

Perception of speech produced by native and nonnative talkers by listeners with normal hearing and listeners with cochlear implants.

PURPOSE The aim of this study was to evaluate the understanding of English sentences produced by native (English) and nonnative (Spanish) talkers by listeners with normal hearing (NH) and listeners with cochlear implants (CIs). METHOD Sentence recognition in noise was measured in adult subjects with CIs and subjects with NH, all of whom were native talkers of American English. Test sentences were from the Hearing in Noise Test (HINT) database and were produced in English by four native and eight nonnative talkers. Subjects also rated the intelligibility and accent for each talker. RESULTS The speech recognition thresholds in noise of subjects with CIs and subjects with NH were 4.23 dB and 1.32 dB poorer with nonnative talkers than with native talkers, respectively. Performance was significantly correlated with talker intelligibility and accent ratings for subjects with CIs but only correlated with talker intelligibility ratings for subjects with NH. For all subjects, performance with individual nonnative talkers was significantly correlated with talkers' number of years of residence in the United States. CONCLUSION CI users exhibited a larger deficit in speech understanding with nonnative talkers than did subjects with NH, relative to native talkers. Nonnative talkers' experience with native culture contributed strongly to speech understanding in noise, intelligibility ratings, and accent ratings of both listeners with NH and listeners with CIs.

Effect of speaking rate on recognition of synthetic and natural speech by normal-hearing and cochlear implant listeners.

OBJECTIVE: Most studies have evaluated cochlear implant (CI) performance using "clear" speech materials, which are highly intelligible and well articulated. CI users may encounter much greater variability in speech patterns in the "real world," including synthetic speech. In this study, the authors measured sentence recognition with multiple talkers and speaking rates, and with naturally produced and synthetic speech in listeners with normal hearing (NH) and CIs. DESIGN: NH and CI subjects were asked to recognize naturally produced or synthetic sentences, presented at a slow, normal, or fast speaking rate. Natural speech was produced by one male and one female talker; synthetic speech was generated to simulate a male and female talker. For natural speech, the speaking rate was time-scaled while preserving voice pitch and formant frequency information. For synthetic speech, the speaking rate was adjusted within the speech synthesis engine. NH subjects were tested while listening to unprocessed speech or to an eight-channel acoustic CI simulation. CI subjects were tested while listening with their clinical processors and the recommended microphone sensitivity and volume settings. RESULTS: The NH group performed significantly better than did the CI-simulation group, and the CI-simulation group performed significantly better than did the CI group. For all subject groups, sentence recognition was significantly better with natural speech than with synthetic speech. The performance deficit with synthetic speech was relatively small for NH subjects listening to unprocessed speech. However, the performance deficit with synthetic speech was much greater for CI subjects and for CI-simulation subjects. There was significant effect of talker gender, with slightly better performance with the female talker for CI subjects and slightly better performance with the male talker for the CI simulations. For all subject groups, sentence recognition was significantly poorer only at the fast rate. CI performance was very poor (approximately 10% correct) at the fast rate. CONCLUSIONS: CI listeners are susceptible to variability in speech patterns caused by speaking rate and production style (natural versus synthetic). CI performance with clear speech materials may overestimate performance in real-world listening conditions. The poorer CI performance may be because of other factors besides reduced spectro-temporal resolution, such the quality of electric stimulation, duration of deafness, or cortical processing. Optimizing the input or training may improve CI users' tolerance for variability in speech patterns.