ABSTRACT
The aim of the present study was to collect published studies and compare the diagnostic accuracy of different markers for nasopharyngeal carcinoma (NPC). We systematically searched PubMed/MEDLINE, EMBASE, Cochrane Library, CNKI, and Wanfang for relevant studies until April 29, 2020. The revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to evaluate the methodological quality of the studies. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) values of the diagnostic markers were combined by a bivariate mixed effect model to compare their diagnostic accuracy. We explored heterogeneity through meta-regression. In total, 244 records from 101 articles were included, with 49,432 total study subjects (13,109 cases and 36,323 controls). EA-IgG, Zta-IgG, and Epstein-Barr virus (EBV) DNA load in non-invasive nasopharyngeal brushings (EBV-DNA brushings) have both high sensitivity and specificity, EBNA1-IgG and VCA-IgG have only high sensitivity, and EBNA1-IgA, VCA-IgA, Rta-IgG, Zta-IgA, HSP70, and serum sialic acid (SA) have only high specificity. The bivariate mixed effect model of EA-IgA had a significant threshold effect. Meta-regression analysis showed that ethnicity affected EBNA1-IgA, EBNA1-IgG, VCA-IgA, and EBV DNA load in plasma, test methods affected EBNA1-IgG, publication year affected VCA-IgA, and sample size affected Rta-IgG. There was significant publication bias for VCA-IgA and Rta-IgG (P < 0.05). EA-IgG, Zta-IgG, and EBV-DNA brushings are good diagnostic markers for NPC. The diagnostic accuracy was influenced by publication year, sample size, test methods, and ethnicity.
ABSTRACT
Background: For patients with posterior semicircular canal (PSC) BPPV, Epley re-position maneuver and some improvement methods are the most efficient treatment methods. But there were still 9.43% patients who were not benefit from Epley re-position maneuver.Objective: To measure the angles of semicircular canals and evaluate its effect on Epley maneuver.Methods: Fifteen skull specimens, containing 30 temporal bone specimens were included. After Micro-CT scanning, 3D reconstruction was loaded with the CT image. The angles between each semicircular canal and each standard skull plane were measured. Furthermore, the angles' effect on Epley maneuver was evaluated according to the three-dimension (3D) model.Results: Angles of PSC plane: Frankfurt plane was 71.54 ± 6.51, sagittal plane was 53.77 ± 5.36°, and the coronal plane was 43.33 ± 3.56°. Angles between PSC and the sagittal plane of skulls had an adverse effect on Epley maneuver, when it was less than 45°.Conclusion: 1. Variation could be found in angles between the semicircular canals and the standard planes of skulls, which meant variation of semicircular canals' location existing in skulls. 2. The variation of angles between PSC and sagittal plane could have an adverse effect on the Epley maneuver when the angle was less than 45°, which may cause the Epley maneuver to be invalid.
Subject(s)
Benign Paroxysmal Positional Vertigo/rehabilitation , Semicircular Canals/diagnostic imaging , Humans , Imaging, Three-Dimensional , Moving and Lifting Patients , X-Ray MicrotomographyABSTRACT
Understanding the anatomical variations in the human cochlea is important for cochlear implants. This study examined these variations using a reconstructed fusion model of the skull and temporal bone. The three-dimensional (3D) digital model of the temporal bone was reconstructed from multiple axial micro-computed tomography (CT) scans of temporal bone and high resolution CT of the skull from 15 cadavers. A skull model was reconstructed and merged with the reconstructed temporal bone. The 3D relationship between the cochlea and the skull's mid-sagittal plane was analyzed. The α and ß angles of the cochlear autogenous rotation and bottom position, respectively, further subdivided the cochlear spatial orientation. The relationship between the base of the cochlea and the round window was evaluated with the Φ angle. Cochlear size was measured and the relationship was statistically analyzed. Cochlear implant electrode arrays were observed in five cases of right-temporal bone specimens. The α, ß, and Φ angles were 46.01 ± 9.65, 56.79 ± 3.58, and 44.41 ± 7.23, respectively. The α angle varied greatly and was negatively correlated to the Φ angle (correlation coefficient = -0.211, P < 0.05). Among the five specimens, the α and Φ angle of the 2R and 4R cochlear specimens was lower and higher than the mean value, respectively. These measurements revealed variations in the size and position of the cochlea. Some of these variations may require surgical adjustments for insertion of electrodes with cochlear implants and present a greater challenge for implantation of cochlear electrode implantation. These data also provide a better understanding of variations in human cochlear anatomy. Anat Rec, 301:1086-1095, 2018. © 2017 Wiley Periodicals, Inc.
