Faculty Bibliography

The consistent ability to gain and maintain nasal tip projection in the under projected nose is the trump card of the successful facial plastic surgeon. The underprojected nose is the nemesis that causes most of the disappointment in rhinoplasty for the patient and the surgeon. It is imperative that the surgeon recognize the many variations that constitute the underprojected nose, and this recognition must be made long before it is encountered in the operating room. The diagnosis of under projecting nasal tip is made by observation and by palpation. Several broad categories of nasal tips can be thought of as the underprojecting nasal tip family

Despite being the foundation of, or supplement to, many skull base exposures, the retrolabyrinthine approach has not been adequately illustrated in the skull base literature. As an aid to skull base surgeons in training, this article provides a step-by-step description of the microsurgical anatomy and operative nuances of this important technique

Childhood-onset dystonia is an autosomal dominant movement disorder associated with a three base pair (GAG) deletion mutation in the DYT1 gene. This gene encodes a novel ATP-binding protein called torsinA, which in the central nervous system is expressed exclusively in neurons. Neither the function of torsinA nor its role in the pathophysiology of DYT1 dystonia is known. In order to better understand the cellular functions of torsinA, we established PC12 cell lines overexpressing wild-type or mutant torsinA and subjected them to various conditions deleterious to cell survival. Treatment of control PC12 cells with an inhibitor of proteasomal activity, an oxidizing agent, or trophic withdrawal, resulted in cell death, whereas PC12 cells that overexpressed torsinA were significantly protected against each of these treatments. Overexpression of mutant torsinA failed to protect cells against trophic withdrawal. These results suggest that torsinA may play a protective role in neurons against a variety of cellular insults.

OBJECTIVES: Standard procedures for hearing aid fitting performed in accordance with established guidelines are well tolerated, safe, and effective. In this article, we present unusual complications after hearing aid fitting that required surgical management. METHODS: Four otologists at a major university center with a combined 65 years of experience performed a retrospective analysis of their surgical practice. Six patients were identified that had encountered severe complications from improper earmold fitting that required surgical intervention. RESULTS: One patient had a perforation of the tympanic membrane with earmold material found to have migrated into the middle ear cleft. The tympanic membrane healed spontaneously, resulting in persistent otalgia and a maximum air-bone gap. The earmold cast was successfully removed by means of a tympanomastoidectomy. Two patients with presbycusis and normal ear canals developed eardrum perforations and conductive hearing deficits. In both patients, earmold material was found partially occupying the middle ear cleft and removed by way of a transcanal approach. Three patients with prior canal wall down mastoidectomy defects and narrow external ear canals required microtoscopy under general anesthesia or canaloplasty for removal of impacted material. CONCLUSION: Proper fitting of hearing aids performed by well-trained medical professionals results in a very low incidence of significant complications. Perforation of the tympanic membrane with impaction of earmold material in the middle ear or mastoid bowl may occur and can be successfully managed by standard otologic surgical techniques

The inhibitory neurons of the thalamic reticular nucleus (TRN) contribute to the generation of widespread oscillations in the thalamocortical system. Some TRN neurons are interconnected by electrical synapses, and here we tested the possibility that electrical synapses mediate rhythmic synchrony in juvenile rats. Both the incidence and strength of electrical coupling between pairs of TRN neurons were a steep function of intersomatic distance, and coupling was absent at distances >40 microm. Presynaptic spike bursts evoked much larger electrical postsynaptic potentials than did single presynaptic spikes. Activation of metabotropic glutamate receptors (mGluRs) with a bath-applied agonist or an endogenous ligand released during tetanic stimulation induced robust rhythms of the subthreshold membrane potential, with a mean frequency of approximately 10 Hz. In the absence of fast chemical synaptic transmission, subthreshold rhythms and the action potentials that they evoked were well synchronized between closely spaced, electrically coupled pairs; rhythms in noncoupled cells were not synchronized. The results suggest that electrical synapses can coordinate spindle-frequency rhythms among small clusters of mGluR-activated TRN cells.

This study examined the effects of perceptual learning on nonword repetition performance of normal-hearing listeners who were exposed to severely degraded auditory conditions that were designed to simulate the auditory input of a cochlear implant. Twenty normal-hearing adult listeners completed a nonword repetition task using an eight-band, frequency-shifted cochlear implant simulation strategy both before and after training on open- and closed-set word recognition tasks. Feedback was provided during training. The nonword responses obtained from each participant were digitally recorded and played back to normal-hearing listeners. These listeners rated the nonword repetition accuracy in comparison to the original unprocessed target stimuli using a seven-point scale. The mean nonword accuracy ratings were significantly higher for the non words repeated after training than for non words repeated prior to training. These results suggest that the word recognition training tasks encouraged auditory perceptual learning that generalized to novel, nonword auditory stimuli. The present findings also suggest that adaptation and learning from the degraded auditory stimuli produced by a cochlear implant simulation can be achieved even in a difficult perceptual-motor task such as nonword repetition which involves both speech perception and production of an auditory stimulus that lacks any lexical or semantic representation

This study seeks to determine the ability of enzyme-linked immunosorbent assays of vocal fold secretions to detect and describe the inflammatory response in the vocal folds. Vocal fold and palatal secretions were collected during operation from patients with a range of vocal fold disorders and from control patients. The secretions were subjected to assays for interleukin-1beta, prostaglandin E2, and transforming growth factor beta. The results indicate a differential expression of mediators associated with the wound healing cascade in the vocal folds. The prostaglandin E2 levels clearly differentiated vocal fold secretions associated with laryngeal disease versus control sites. Furthermore, the interleukin-1beta concentrations were significantly elevated in subjects with epithelial lesions of the vocal folds as opposed to lesions of the lamina propria. Although still in its infancy, such analysis may ultimately hold scientific and clinical utility in the study and management of patients with vocal fold disease