The chronic ear/ [edited by] John L. Dornhoffer, Michael B. Gluth.

Includes bibliographical references and index.The Chronic Ear -- Title Page -- Copyright -- Dedication -- Contents -- Preface -- Acknowledgments -- Contributors -- Master Glossary -- Part 1. The Fundamentals of Chronic Ear Disease -- 1. Chronic Ear Disease in the Modern Era: Evolution of Treatment, Epidemiology, and Classification -- 2. Eustachian Tube Dysfunction, Mucosal Gas Exchange, and Effusion -- 3. Tympanic Membrane Wound Healing and Epithelial Migration -- 4. Pathophysiology of Cholesteatoma -- 5. Microbiology of Chronic Ear Disease -- 6. Histopathology of Chronic Otitis Media -- 7. Surgical Anatomy Relevant to the Chronic Ear -- 8. Biomaterials in Tympanomastoid Surgery -- 9. Middle Ear Mechanics in Hearing Reconstruction -- Part 2. Clinical Evaluation and Office Management of Chronic Ear Disease -- 10. Pearls in Audiovestibular Assessment -- 11. Radiographic Evaluation of Chronic Ear Disease -- 12. Inflammatory Conditions and Systemic Diseases Affecting the Middle Ear -- 13. Myringitis -- 14. Office Evaluation and Management of a CanalWall-Down Mastoid Cavity -- 15. Tubo-Tympanic Diseases: Retraction, Atelectasis, and Middle Ear Effusion -- 16. Evaluation and Nonsurgical Management of Chronic Suppurative Otitis Media -- 17. Intratemporal and Intracranial Complications of Otitis Media -- Part 3. Introduction to Surgical Management of Chronic Ear Disease -- 18. General Principles of Surgery for Chronic Ear Disease -- 19. Tympanostomy Tubes -- 20. Canalplasty and Meatoplasty -- 21. Cholesteatoma Dissection: Problems and Solutions -- Part 4. Roundtable on Tympanic Membrane Reconstruction -- 22. Overview and Introduction -- 23. Underlay and Related Techniques -- 24. Overlay Tympanoplasty Technique -- 25. Cartilage Tympanoplasty -- Part 5. Roundtable on Ossiculoplasty -- 26. Overview and Introduction -- 27. Reconstruction of the Incudostapedial Articulation.28. Autograft Ossicular Reconstruction -- 29. Ossiculoplasty with Synthetic PORPS and TORPS -- 30. The Malleus in Ossicular Reconstruction -- 31. Surgical Management of the Fixed Stapes in Chronic Ear Disease -- Part 6. Roundtable on Tympanomastoidectomy -- 32. Overview and Introduction -- 33. Canal Wall-Up Techniques -- 34. Epitympanectomy -- 35. Canal Wall-Down Mastoidectomy -- Part 7. Roundtable on Hybrid Tympanomastoid Surgical Techniques -- 36. Overview and Introduction -- 37. Retrograde Technique for Management of Cholesteatoma -- 38. Canal Wall Removal and Replacement with Obliteration -- 39. Soft-Wall Canal Reconstruction -- 40. Canal Wall Reconstruction Using the Titanium Mesh Cage -- Part 8. Special Topics and New Horizons in Surgery for Chronic Ear Disease -- 41. Mastoid Cavity Obliteration -- 42. Skull Base Approaches in Chronic Ear Surgery -- 43. Implantable Hearing Devices and Chronic Otitis Media -- 44. Endoscopic Ear Surgery -- 45. Eustachian Tuboplasty -- 46. Tympanic Membrane Tissue Engineering -- 47. Chronic Otitis Media in the Setting of Congenital Ear Disease -- 48. Skin Grafting in the Management of Chronic Ear Disease -- Index.1 online resource (xxii, 349 pages)

Cerebral Cortex Regions Selectively Vulnerable to Radiation Dose-Dependent Atrophy.

Purpose and objectivesNeurologic deficits after brain radiation therapy (RT) typically involve decline in higher-order cognitive functions such as attention and memory rather than sensory defects or paralysis. We sought to determine whether areas of the cortex critical to cognition are selectively vulnerable to radiation dose-dependent atrophy.Methods and materialsWe measured change in cortical thickness in 54 primary brain tumor patients who underwent fractionated, partial brain RT. The study patients underwent high-resolution, volumetric magnetic resonance imaging (T1-weighted; T2 fluid-attenuated inversion recovery, FLAIR) before RT and 1 year afterward. Semiautomated software was used to segment anatomic regions of the cerebral cortex for each patient. Cortical thickness was measured for each region before RT and 1 year afterward. Two higher-order cortical regions of interest (ROIs) were tested for association between radiation dose and cortical thinning: entorhinal (memory) and inferior parietal (attention/memory). For comparison, 2 primary cortex ROIs were also tested: pericalcarine (vision) and paracentral lobule (somatosensory/motor). Linear mixed-effects analyses were used to test all other cortical regions for significant radiation dose-dependent thickness change. Statistical significance was set at α = 0.05 using 2-tailed tests.ResultsCortical atrophy was significantly associated with radiation dose in the entorhinal (P=.01) and inferior parietal ROIs (P=.02). By contrast, no significant radiation dose-dependent effect was found in the primary cortex ROIs (pericalcarine and paracentral lobule). In the whole-cortex analysis, 9 regions showed significant radiation dose-dependent atrophy, including areas responsible for memory, attention, and executive function (P≤.002).ConclusionsAreas of cerebral cortex important for higher-order cognition may be most vulnerable to radiation-related atrophy. This is consistent with clinical observations that brain radiation patients experience deficits in domains of memory, executive function, and attention. Correlations of regional cortical atrophy with domain-specific cognitive functioning in prospective trials are warranted

Cerebral Cortex Regions Selectively Vulnerable to Radiation Dose-Dependent Atrophy.

Purpose and objectivesNeurologic deficits after brain radiation therapy (RT) typically involve decline in higher-order cognitive functions such as attention and memory rather than sensory defects or paralysis. We sought to determine whether areas of the cortex critical to cognition are selectively vulnerable to radiation dose-dependent atrophy.Methods and materialsWe measured change in cortical thickness in 54 primary brain tumor patients who underwent fractionated, partial brain RT. The study patients underwent high-resolution, volumetric magnetic resonance imaging (T1-weighted; T2 fluid-attenuated inversion recovery, FLAIR) before RT and 1 year afterward. Semiautomated software was used to segment anatomic regions of the cerebral cortex for each patient. Cortical thickness was measured for each region before RT and 1 year afterward. Two higher-order cortical regions of interest (ROIs) were tested for association between radiation dose and cortical thinning: entorhinal (memory) and inferior parietal (attention/memory). For comparison, 2 primary cortex ROIs were also tested: pericalcarine (vision) and paracentral lobule (somatosensory/motor). Linear mixed-effects analyses were used to test all other cortical regions for significant radiation dose-dependent thickness change. Statistical significance was set at α = 0.05 using 2-tailed tests.ResultsCortical atrophy was significantly associated with radiation dose in the entorhinal (P=.01) and inferior parietal ROIs (P=.02). By contrast, no significant radiation dose-dependent effect was found in the primary cortex ROIs (pericalcarine and paracentral lobule). In the whole-cortex analysis, 9 regions showed significant radiation dose-dependent atrophy, including areas responsible for memory, attention, and executive function (P≤.002).ConclusionsAreas of cerebral cortex important for higher-order cognition may be most vulnerable to radiation-related atrophy. This is consistent with clinical observations that brain radiation patients experience deficits in domains of memory, executive function, and attention. Correlations of regional cortical atrophy with domain-specific cognitive functioning in prospective trials are warranted

Efficient coding of subjective value

ISSN:1097-6256ISSN:1546-172