Age-related deterioration of saccule-related neural function is associated with decreased estimated glomerular filtration rate and increased free thyroxine.

OBJECTIVE: This study attempted to identify systemic factors for age-related decline in neural function originating from the saccule using cervical vestibular-evoked myogenic potentials (cVEMP) parameters. METHODS: We recruited 129 symptomatic vertiginous patients who did not have known disorder affecting the cVEMP pathway (mean age = 52.4 ±â€¯13.9). The indicators of saccule-related neural function were the sum of normalized cVEMP amplitude (SNA) and the average of p13 latency on both sides (average latency, AL). Any associations between cVEMP and systemic factors were evaluated using a linear regression. RESULT: SNA decreased with ageing (p < 0.001) in univariable regression. The estimated glomerular filtration rate (eGFR) was positively associated with SNA (p = 0.002). Hematocrit, C-reactive protein, vitamin D, and free thyroxine (T4) showed a trend of association with SNA (p < 0.2). SNA was associated with ageing, increased free T4, and decreased eGFR in multivariable analysis. In the subgroup analysis, SNA was significantly associated with free T4 in younger patients (mean age = 41.5 ±â€¯9.91) but not in the older ones (mean age = 63.5 ±â€¯6.54). AL did not show any significant associations with systemic factors. CONCLUSION: Decreased eGFR and increased free T4 as well as aging may be risk factors for decline of saccule-related neural function. SIGNIFICANCE: Neural function originating from the saccule may be affected by systemic factors.

Metachronous adenoid cystic carcinoma in the peripheral lung and at base of the tongue.

Primary lung adenoid cystic carcinoma (ACC) is extremely rare and accounts for approximately 0.1%-0.2% of all lung cancers. ACC of the head and neck has generally been regarded as a slow-growing, low-grade malignancy which has a tendency for local recurrence and frequent distant metastasis. When ACC of the lung is identified, physicians must determine whether it represents distant metastasis or a primary lung cancer. Thyroid transcription factor-1 staining is one of the most useful methods to differentiate primary from metastatic lesions in lung cancer. Herein we report a case of metachronous, not synchronous, ACC at the peripheral lung followed by ACC presentation at the base of the tongue, and review of relevant literatures.