Effect of Growth Factor Supplementation on the Hair Cell Specific Markers of Cells Harvested from Basilar Membrane.

OBJECTIVE: Loss of auditory hair cells is a major cause of deafness. The presence of auditory progenitor cells in the inner ear raises the hope for mammalian inner ear cell regeneration. In this study, we aimed to investigate the effect of growth factor supplementations, namely a combination of epidermal growth factor (EGF), insulin-like growth factor (IGF), and beta (ß)-fibroblast growth factor (ßFGF), on the expression of hair cell-specific markers by cells harvested from the cochlear membrane. This would provide an insight into the capability of these cells to differentiate into hair cells. MATERIALS AND METHODS: EGF, IGF, and ßFGF were supplemented into the culture medium. The cells were evaluated by morphology, growth kinetic, gene expression, and protein expression. RESULTS: The cultured cells of mouse basilar membrane were spindle shaped. Growth factors-enriched medium promotes a significantly higher proliferative activity than the basic culture medium but did not alter the cell morphology. Growth factors-enriched medium did not show any significant differences in the protein expression of the hair cell-specific markers myosin VIIa and calretinin and the stem-cell marker nestin. Gene expression analysis showed that the expression of the hair cell-specific genes myosin VIIa and calretinin as well as the stem cell genes nestin, Rex1, and Sox2 was reduced after the cells were passaged in the growth factor-supplemented medium. Cells in the basic medium expressed a significantly higher level of hair cell-specific genes at certain passages. CONCLUSION: Growth factor supplementation could not maintain the expression of hair cell-specific markers by cells obtained from the cochlear membrane.

Supraglottoplasty for laryngomalacia: who will benefit?

OBJECTIVE: Laryngomalacia is the most common cause of neonatal and infantile stridor. The aim of this study was to assess the outcome of surgical intervention in children with laryngomalacia. METHODS: Between January 1998 and December 2008, 15 children with laryngomalacia underwent surgical intervention at the Universiti Kebangsaan Malaysia Medical Centre, from which only eight case notes were available. These were retrospectively reviewed for demographic data, symptoms, comorbidities, operative technique, postoperative recovery, complications, length of hospital stay including intensive care unit (ICU) care, and resolution of symptoms. RESULTS: Patients consisted of seven males and one female. One patient underwent three procedures, resulting in a total of 10 procedures for this study. The mean age was 15.6 months (range: 2-39 months). The most common indication for surgery was severe stridor resulting in failure to thrive. Intra-operatively, all patients were found to have short aryepiglottic folds, and four also had redundant arytenoid mucosa. Supraglottoplasty was performed in 10 patients: three by cold instruments and seven by laser. Successful extubation was achieved in the operating theatre in eight patients while the other two were extubated in the ICU on the same day. Postoperative ICU nursing was required in six patients: three for up to 3 days, and three for longer periods because of medical problems. Resolution of stridor was complete in four patients, partial in one, and no difference in five. Two patients defaulted follow-up. There were no postoperative complications from the procedures. The average length of follow-up was 15 weeks (range: 12 days to 7 years). CONCLUSION: Supraglottoplasty remains an effective method to treat severe laryngomalacia. Patients who will benefit most are those with severe laryngomalacia that is uncomplicated by neurological conditions or multiple medical problems. In our institution, early extubation is the norm, and a significant number of patients can be nursed in the normal wards and be discharged within 48 hours of the procedure.

Assessing day-case septorhinoplasty: prospective audit study using patient-based indices.

The objective of this study was to evaluate the safety, efficacy and acceptability to patients of day-case septorhinoplasty. Twenty-nine patients undergoing elective septorhinoplasty in a dedicated teaching hospital day-case unit were asked to complete day surgery questionnaires (DSQ) at six weeks post-operatively. Details of surgery performed, demographic data, readmission rates and complications were collected prospectively. No major complications were recorded. One patient had to be admitted for overnight observation following post-operative bleeding. The DSQ showed that the great majority of patients were satisfied from the day-case setting (satisfaction score 81). This preliminary study showed that day surgery septorhinoplasty was acceptable to the patient and was associated with a very low re-admission rate. We believe that in carefully selected young healthy patients it is an acceptable alternative to an in-patient procedure.

The association between periodontal disease and peritonsillar infection: a prospective study.

OBJECTIVE: To study the relationship between periodontal status and peritonsillar disease/recurrent tonsillitis. STUDY DESIGN AND SETTING: A total of 158 patients presenting over a 3-year period with peritonsillar abscess (PTA) confirmed by needle aspiration and a control group of 112 patients booked for elective tonsillectomy for recurrent tonsillitis (RT) were examined in terms of their periodontal status using the WHO Community Periodontal Index of Treatment Needs (CPITN). RESULTS: The mean CPITN index was 2.81 (Standard Deviation [SD], 1.10) in patients with PTA and 1.41 (SD, 0.92) in patients with RT. One hundred seven of 158 patients with PTA had significant periodontal pathology (CPITN, 3 or 4) compared with 12 of 112 patients with RT. These differences were statistically significant. CONCLUSION: Patients with peritonsillar abscess had an increased prevalence of periodontal disease as compared with patients with recurrent tonsillitis. SIGNIFICANCE: There is a need to further explore this correlation and determine its nature, although it could be the result of common pathogenic factors, a causal relation cannot be excluded.