Faculty Bibliography

Children with profound congenital or prelingual deafness encounter significant difficulties in the development of skills in an oral language such as English. Their language development, however, can be accelerated if they receive a cochlear implant-a sensory aid that facilitates language acquisition by providing important auditory information. The present study used the Reynell Developmental Language Scales (RDLS) to assess language skills pre- and postimplant in 44 pediatric cochlear implant users. All users were profoundly to totally deaf, either at birth or before the age of 3 years. They all received cochlear implants before the age of 6 and were programmed with state-of-the-art stimulation strategies (CIS or SPEAK) since the day of initial stimulation. The main finding was that postimplantation language development proceeded at a pace that was not significantly different from normal. Thus, the language gap present at implantation did not increase after children started using the device, as it would if they had not received cochlear implants. Nevertheless, it is important to conduct further studies to determine whether these conclusions apply when other language skills, such as the use of grammar, are measured

OBJECTIVE: RADPLAT (concurrent selective supradose intraarterial cisplatin and external-beam irradiation) delivers extraordinarily high cisplatin concentration to head and neck structures. This study was designed to quantify and compare RADPLAT and systemic chemoradiation treatment effects on swallowing and speech. METHODS: Videofluorographic swallowing studies and articulation testing of 14 head and neck cancer patients treated with RADPLAT were compared with 16 treated with systemic chemoradiation 1 month after treatment. RESULTS: RADPLAT and systemic chemoradiation patients did not differ significantly on most swallow outcome measures, and there was significantly less aspiration on 1 and 3 mL liquid for RADPLAT individuals. Speech function was comparable except for RADPLAT's significantly worse /s, z/ productions. CONCLUSIONS: Increased concentration of cisplatin to the head and neck did not result in generally reduced swallowing or articulatory function

Sarcoidosis is a systemic chronic granulomatous disease of unknown etiology. Although it most commonly affects African-Americans, Scandinavians, and the Irish, individuals of all races and ethnicities are susceptible. The otolaryngologist will most frequently encounter sarcoidosis involving the sinonasal region; however, other sites in the head and neck may be involved. Head and neck affliction with sarcoidosis most frequently accompanies pulmonary involvement, although, in rare cases, it may present in the absence of any systemic manifestations. We present a patient of Eastern European origin treated for persistent epiphora and recurrent dacryocystitis without any other medical problems. Because medical therapy and canalicular intubation failed, an endoscopic dacryocystorhinostomy (DCR) was performed. Histologic examination of the lacrimal sac showed noncaseating granulomas. Further workup revealed an elevated angiotensin-converting enzyme (ACE) level and hilar adenopathy. At no time did the patient have any other signs or symptoms of sarcoidosis. This unique case highlights 4 important issues for the otolaryngologist: (1) sarcoidosis may occur almost anywhere in the head and neck and is not strictly limited to the upper respiratory tract; (2) sarcoidosis may occur in the head and neck even in the absence of any pulmonary or other systemic involvement; (3) sarcoidosis may affect persons of all races, both sexes, and all ages; and (4) routine histopathologic examination after excision of the nasolacrimal sac is recommended

Intraoperative irradiation (IORT) refers to the delivery of a single high dose of radiation therapy at the time of surgery when the tumor bed can be precisely defined and adjacent normal tissue maximally protected. It can be effectively delivered using either electrons (IOERT) or photons produced from a high-dose-rate gamma emitting radioisotope (HDR-IORT) and has been explored primarily for locally advanced or recurrent tumors at high risk for local failure despite extensive resection and full dose external beam radiation. With coordinated multidisciplinary interaction, IORT can be integrated in a combined-modality setting without undue additional toxicity. The purpose of this review will be to summarize the growing HDR-IORT experience in the treatment of various cancers, to compare its efficacy and toxicity vis a vis the IOERT data, and to discuss future trials as well as new areas of potential application.

Spike timing-dependent modulation of synaptic efficacy is concomitant with changes in dendritic structure (Engert and Bonhoeffer 1999), a process thought to require actin polymerization. Recent studies have indicated both that plasticity-inducing activity modulates spine actin dynamics (Star and Murthy 2002) and that actin assembly is necessary for the maintenance of long-term potentiation (Krucker et al. 2000). We report here that actin dynamics are necessary for spike timing-dependent plasticity (STDP) in visual cortex. Whole-cell recordings were made from L2/3 pyramids and EPSPs were evoked by extracellular stimulation at 0.2 Hz. When the postsynaptic cell spiked less than 25 s before presynaptic activation, LTD was induced (-38+-4%, n=22). When presynaptic stimulation was followed less than 12 ms by a postsynaptic AP, LTP was induced (59+-9%, n=21). However, when 20 muM cytochalasin D, an inhibitor of actin polymerization, was included in the whole-cell pipette, neither LTP (n=4, p>0.4) nor LTD (n=3, p>0.4) could be induced. Latrunculin A, which sequesters monomeric actin, and phalloidin, which stabilizes polymeric actin, were applied intracellularly (10 muM and 100 muM) and prevented induction of LTP (n=3, p>0.6; n=3, p>0.25). These results suggest that dynamic actin turnover is necessary for spike-timing dependent plasticity