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Pyykkö I, Vinay, Vetkas A, Zou J, Manchaiah V. Association of Head Injury, Neck Injury or Acoustic Trauma on Phenotype of Ménière's Disease. Audiol Res 2024; 14:204-216. [PMID: 38391776 PMCID: PMC10885978 DOI: 10.3390/audiolres14010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/24/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024] Open
Abstract
The aim of the present study was to investigate adverse effects of head injury, neck trauma, and chronic noise exposure on the complaint profile in people with Ménière's disease (MD). The study used a retrospective design. Register data of 912 patients with MD from the Finnish Ménière Federation database were studied. The data comprised case histories of traumatic brain injury (TBI), neck trauma and occupational noise exposure, MD specific complaints, impact related questions, and the E-Qol health-related quality of life instrument. TBI was classified based on mild, moderate, and severe categories of transient loss of consciousness (TLoC). The mean age of the participants was 60.2 years, the mean duration of the disease was 12.6 years, and 78.7% were females. Logistic regression analysis, linear correlation, and pairwise comparisons were used in evaluating the associations. 19.2% of the participants with MD had a history of TBI. The phenotype of participants with TBI was associated with frequent vestibular drop attacks (VDA), presyncope, headache-associated vertigo, and a reduction in the E-QoL. Logistic regression analysis explained the variability of mild TBI in 6.8%. A history of neck trauma was present in 10.8% of the participants. Neck trauma associated with vertigo (NTwV) was seen in 47 and not associated with vertigo in 52 participants. The phenotype of NTwV was associated with balance problems, VDA, physical strain-induced vertigo, and hyperacusia. Logistic regression analysis explained 8.7% of the variability of the complaint profile. Occupational noise exposure was recorded in 25.4% of the participants and correlated with the greater impact of tinnitus, hyperacusis, and hearing loss. Neither the frequency, duration, or severity of vertigo or nausea were significantly different between the baseline group and the TBI, NTwV, or noise-exposure groups. The results indicate that TBI and NTwV are common among MD patients and may cause a confounder effect.
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Affiliation(s)
- Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Otolaryngology, Tampere University, 33100 Tampere, Finland
| | - Vinay
- Department of Neuromedicine and Movement Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Artur Vetkas
- Faculty of Medicine, University of Tartu, 50090 Tartu, Estonia
| | - Jing Zou
- Hearing and Balance Research Unit, Field of Otolaryngology, Tampere University, 33100 Tampere, Finland
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of the Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai 201823, China
| | - Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO 80045, USA
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO 80045, USA
- Virtual Hearing Lab., Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, CO 80045, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0001, South Africa
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal 576104, Karnataka, India
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Pyykkö I, Pyykkö, N, Manchaiah V. Associations Among Medical Therapy, SelfAdministered Exercise, and Characteristics of Ménière's Disease. J Int Adv Otol 2023; 19:323-332. [PMID: 37528598 PMCID: PMC10544177 DOI: 10.5152/iao.2023.21559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 08/02/2022] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND The aim of the current study was to explore the associations among different therapeutic procedures, self-administered exercise, and characteristics of Ménière's disease. METHODS The study used a retrospective design and included 539 people with Ménière's disease who were focusing on self-administered exercise. The mean age and history of Ménière's disease among these participants were 61.9 years and 15.6 years, respectively. Of the participants, 79.5% were female. The data were collected by an electronic questionnaire that focused on symptoms of Ménière's disease, exercise and training habits, balance problems, impacts of the complaints, quality of life, medical treatment, physiotherapy, and psychotherapy. RESULTS Of the participants, 79.3% used medical treatment. Betahistine (56.8%) was the most popular followed by periodical anti-emetic use (41.0%) and diuretics (22.4%). Of the participants 70% were doing some self-administered training. The frequency of training depended on age, severity of balance problems, vestibular drop attacks, and gait problems. The type of training depended on age, quality of life, vestibular drop attacks, and gait problems. No association was found between vertigo and frequency/type of balance training. CONCLUSION The use or effect of therapeutic procedures for Ménière's disease patients was not related to symptoms experienced. Most participants with Ménière's disease used training programs that aimed to alleviate their condition, especially balance-, gait-, and vestibular drop attack-associated problems. Patient support organizations should be working to help characterize the types of balance disorders people are dealing with in order to individually tailor a rehabilitation program to the patient's needs.
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Affiliation(s)
- Ilmari Pyykkö
- Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Tampere, Finland
| | - Nora Pyykkö,
- University of Tartu, Faculty of Medicine, Tartu, Estonia
| | - Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, Colorado, USA
- Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, Colorado, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Department of Speech and Hearing, Manipal University, School of Allied Health Sciences, Manipal, Karnataka, India
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Zou J, Zhang G, Li H, Zhao Z, Zhang Q, Pyykkö I, Mäkitie A. Multiple genetic variants involved in both autoimmunity and autoinflammation detected in Chinese patients with sporadic Meniere's disease: a preliminary study. Front Neurol 2023; 14:1159658. [PMID: 37273692 PMCID: PMC10232973 DOI: 10.3389/fneur.2023.1159658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/20/2023] [Indexed: 06/06/2023] Open
Abstract
Background The mechanisms of Meniere's disease (MD) remain largely unknown. The purpose of this study was to identify possible genetic variants associated with immune regulation in MD. Methods The whole immune genome of 16 Chinese patients diagnosed with sporadic MD was sequenced using next-generation sequencing. Results Definite pathological variants of MEFV (c.1223G>A, c.1105C>T), COL7A1 (c.5287C>T), and ADA (c.445C>T) contributing to the clinical phenotype were found in three patients. Limited and likely pathological variants of TLR3 (c.2228G>A) and RAB27A (c.560G>A) were detected in one patient each. The following definite pathological variants impairing the structure and function of translated proteins were detected in 10 patients, and multigene variants occurred in five patients: PRF1 (c.710C>A), UNC13D (c.1228A>C), COLEC11 (c.169C>T), RAG2 (c.200G>C), BLM (c.1937G>T), RNF31 (c.2533G>A), FAT4 (c.11498A>G), PEPD (c.788A>G), TNFSF12 (c.470G>A), VPS13B (c.11972A>T), TNFRSF13B (c.226G>A), ERCC6L2 (c.4613A>G), TLR3 (c.2228G>A), ADA (c.445C>T), PEPD (c.151G>A), and MOGS (c.2470G>A). The following limited pathological variants impairing the structure and function of translated proteins were detected in five patients, with double gene variants identified in one patient: EXTL3 (c.1396G>A), MTHFD1 (c.2057G>A), FANCA (c.2039T>C), LPIN2 (c.1814C>T), NBAS (c.4049T>C), and FCN3 (c.734G>A). Conclusion Patients with sporadic MD carry multiple genetic variants involved in multiple steps of immune regulation, which might render patients susceptible to developing inflammation via both autoimmune and autoinflammation mechanisms upon internal stress.
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Affiliation(s)
- Jing Zou
- Department of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
- Research Program in Systems Oncology, Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Guoping Zhang
- Department of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Hongbin Li
- Department of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Zikai Zhao
- Department of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Qing Zhang
- Department of Otolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Antti Mäkitie
- Research Program in Systems Oncology, Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Gürkov R, Barath K, de Foer B, Fukushima M, Gluth M, Hornibrook J, Perez-Fernandez N, Pyykkö I, Sone M, Usami SI, Wang W, Zou J, Naganawa S. A plea for systematic literature analysis and conclusive study design, comment on: "Systematic review of magnetic resonance imaging for diagnosis of Meniere disease". J Vestib Res 2023; 33:151-157. [PMID: 31658075 DOI: 10.3233/ves-190662] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Robert Gürkov
- Department of Otorhinolaryngology Head and Neck Surgery, Klinikum Bielefeld, Bielefeld, Germany
| | - Krisztina Barath
- Radiologie und Neuroradiologie am Glattzentrum, Wallisellen, Switzerland
| | - Bert de Foer
- Department of Radiology, GZA Hospitals Antwerp, Belgium
| | - Munehisa Fukushima
- Department of Otolaryngology and Head and Neck Surgery, Kansai Rosai Hospital, Amagasaki, Japan
| | - Michael Gluth
- Section of Otolaryngology- Head & Neck Surgery, The University of Chicago Medicine & Biological Sciences, Chicago, USA
| | - Jermy Hornibrook
- Canterbury District Health Board, Department of Otolaryngology, Christchurch, New Zealand
| | | | | | | | - Shin-Ichi Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, China
| | - Wuqing Wang
- Eye Ear Nose and Throat Hospital of Fudan University, China
| | - Jing Zou
- Department of Otolaryngology, Changhai Hospital Second Military Medical University, Shanghai, China
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Beukes E, Manchaiah V, Pyykkö N, Pyykkö I. Adverse COVID-19 vaccination effects in Finnish patients with Ménière's disease: a cross-sectional study. F1000Res 2022; 11:893. [PMID: 36483315 PMCID: PMC9706144 DOI: 10.12688/f1000research.113143.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 01/13/2023] Open
Abstract
Background: The association between reporting adverse coronavirus disease 2019 (COVID-19) vaccination effects and those with a history of audiovestibular difficulties is unknown. The aim of this research is therefore to investigate adverse vaccination effects in adults with a history of Ménière's disease. Specifically, the incidence of adverse effects, the factors associated with those reporting adverse effects and the relationship between the reporting of audiovestibular and other adverse effects. Methods: A mixed-methods exploratory cross-sectional survey study design was used. Data were collected from 333 members of the Finnish Ménière Association. The survey was designed to obtain demographic information that may be associated with having adverse effects or not, vaccination-specific information and adverse vaccination effects. Both health and audiovestibular adverse events were identified. Data analysis included comparing those reporting and not reporting adverse vaccination effects. Results: The mean age was 63 years with 81% being female. Of the 327 respondents who had one of the COVID-19 vaccinations (Comirnatry/ Pfizer, Astra Zeneca, or Moderna), 203 (62%) reported no adverse effects. The type of or number of vaccinations were not related to the reporting of adverse effects. The most frequently reported adverse effects were injection site tenderness (38%), arm pain (21%), fever (15%) and headaches (15%). Post-vaccination tinnitus and vertigo (both 7%) were the most frequently reported audiovestibular-related symptoms, followed by aural fullness (6%) and hearing loss (4%). Those reporting previous pre-vaccination vertigo were more likely to have post-vaccination vertigo. The presence of post-vaccination tinnitus, hearing loss, and aural fullness, predicted the presence of post-vaccination vertigo. Conclusions: A small proportion of patients with a history of Ménière's disease may experience adverse post-vaccination effects. Further research is required to explore whether adverse post-vaccination audiovestibular effects are more prevalent in those with a history of otological disorders compared with the general population.
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Affiliation(s)
- Eldre Beukes
- Vision and Hearing Sciences Research Group, Anglia Ruskin University, Cambridge, Cambridgeshire, CB1 1TP, UK
- Virtual Hearing Lab, Virtual Hearing Lab, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, Colorado, USA, Aurora, Colorado, USA
| | - Vinaya Manchaiah
- Virtual Hearing Lab, Virtual Hearing Lab, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, Colorado, USA, Aurora, Colorado, USA
- Department of Otolaryngology–Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- UC Health Hearing and Balance, University of Colorado Hospital, Aurora, Colorado, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, Gauteng, South Africa
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Nora Pyykkö
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Ilmari Pyykkö
- Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Tampere, Finland
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Liu Y, Pyykkö I, Naganawa S, Marques P, Gürkov R, Yang J, Duan M. Consensus on MR Imaging of Endolymphatic Hydrops in Patients With Suspected Hydropic Ear Disease (Meniere). Front Surg 2022; 9:874971. [PMID: 35574547 PMCID: PMC9096015 DOI: 10.3389/fsurg.2022.874971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Endolymphatic hydrops (EH) is considered the histological hallmark of Meniere's disease. Visualization of EH has been achieved by special sequences of inner ear magnetic resonance imaging (MRI) with a gadolinium-based contrast agent via intravenous or intratympanic administration. Although it has been applied for more than 10 years since 2007, a unified view on this technique has not yet been achieved. This paper presents an expert consensus on MRI of endolymphatic hydrops in the following aspects: indications and contra-indications for patient selection, methods of contrast-agent administration (intravenous or intratympanic), MRI sequence selection, the specific scanning parameter settings, and standard image evaluation methods and their advantages and disadvantages. For each part of this consensus, a comment is attached to elucidate the reasons for the recommendation.
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Affiliation(s)
- Yupeng Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Otolaryngology, Faculty of Medicine and Health Technology, School of Medicine, Tampere University, Tampere, Finland
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Pedro Marques
- Unit of Otorhinolaryngology, Department of Surgery and Physiology, University of Porto Medical School, Porto, Portugal
| | - Robert Gürkov
- ENT Centre at Red Cross Square, University of Munich, Munich, Germany
| | - Jun Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
- *Correspondence: Jun Yang
| | - Maoli Duan
- Ear Nose and Throat Patient Area, Trauma and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden
- Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Maoli Duan
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Zou J, Zhao Z, Li H, Zhang G, Zhang Q, Lu J, Pyykkö I. Dexamethasone does not affect endolymphatic hydrops (EH) in patients with Meniere’s disease within 24 h, and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 minutes. J Otol 2022; 17:164-174. [PMID: 35847578 PMCID: PMC9270566 DOI: 10.1016/j.joto.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/23/2022] [Accepted: 02/28/2022] [Indexed: 11/28/2022] Open
Abstract
Background Intratympanic administration of gadolinium chelate allows for a better visualization of endolymphatic hydrops (EH) using MRI than intravenous injection and was recently further improved to facilitate high-quality imaging of EH in 7 min. The aim of the present study was to simplify the intratympanic administration protocol by mixing gadolinium chelate with therapeutic dexamethasone and to evaluate the effects of this mixture on the visualization of EH in MRI. Materials and methods In an in vitro study, the potential impact of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) on the stability of dexamethasone was evaluated by analyzing dynamic changes in dexamethasone with high-performance liquid chromatography (HPLC) after mixing with Gd-DTPA. Ten patients with definite Meniere's disease (MD) were recruited to study the potential interference of dexamethasone on MRI visualization of EH, and 49 patients with MD were recruited to evaluate the effect of intratympanic injection of Gd-DTPA mixed with dexamethasone on MRI of EH using a 3T MR machine and a novel heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery reconstructed using a magnitude plus zero-filled interpolation (hT2FLAIR-MZFI) sequence. Results The retention times and peak area of dexamethasone in HPLC were not modified by the addition of Gd-DTPA. EH grading in the cochlea and vestibule was not influenced in any ear by intratympanic injection of dexamethasone. Excellent inner ear images were obtained from all patients, and EHs with various grades were displayed. There were significant correlations between diagnosis and cochlear EH (p < 0.01, Spearman's Rho), between diagnosis and vestibular EH (p < 0.01, Spearman's Rho), and between cochlear and vestibular EH (p < 0.01, Spearman's Rho). The distribution of Gd-DTPA plus dexamethasone negatively correlated with the grade of vestibular EH. Injury of the endolymph-perilymph barrier was detected in one cochlea and three vestibules of 59 inner ears with MD. Conclusions Intratympanic administration of Gd-DTPA plus dexamethasone yielded high-quality MRI images of EH in patients with MD using a novel 7-min protocol and simplified the clinical application. Intratympanic administration of Gd-DTPA plus dexamethasone might be used to test its therapeutic effect in future work. Level of evidence 3.
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Zou J, Zhao Z, Zhang G, Zhang Q, Pyykkö I. MEFV, IRF8, ADA, PEPD, and NBAS gene variants and elevated serum cytokines in a patient with unilateral sporadic Meniere’s disease and vascular congestion over the endolymphatic sac. J Otol 2022; 17:175-181. [PMID: 35847575 PMCID: PMC9270563 DOI: 10.1016/j.joto.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/05/2022] [Accepted: 03/09/2022] [Indexed: 10/25/2022] Open
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Pyykkö I, Pyykkö N, Zou J, Manchaiah V. Does the Self-training in Ménière’s Disease Fit the Disease Characteristics and Help Alleviate the Balance Problems? J Int Adv Otol 2022; 18:25-31. [PMID: 35193842 PMCID: PMC9449710 DOI: 10.5152/iao.2022.21205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: To examine whether the self-initiated exercise in Ménière’s disease fits the characteristics of the balance problems. Methods: This retrospective study included 539 people with Ménière’s disease belonging to the Finnish Ménière Federation. The mean age was 61.9 years with a mean history of Ménière’s disease of 15.6 years. The data were collected with an online questionnaire. Results: In total, 30% of the patients did not do any training, 23% did training once a week, 22% did 2-3 times a week, and 26% did the training daily. The most common training exercises were different self-training exercises (26%) followed by walking (16%), guided training (15%), viewing plus balance training (10%), and viewing training (4%). Non-defined balance problems (18%) were associated with recent vertigo attacks. Swaying type of balance problems were present in 23% and they used all types of training programs. Rocking type of balance disorder was present in 8% and they preferred guided training exercises. Tripping off type of balance disorder was present in 25% and they preferred viewing plus balance training. Conclusions: The type of self-training used was related to the type of balance problems reported. When choosing the vestibular rehabilitation in Ménière’s disease , the type of balance disorder should be characterized and the rehabilitation program should be individually tailored.
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Affiliation(s)
- Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Otolaryngology, Tampere University Faculty of Medicine and Health Technology, Tampere, Finland
| | - Nora Pyykkö
- University of Tartu Faculty of Medicine, Tartu, Estonia
| | - Jing Zou
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of the Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, Colorado, USA
- Corresponding author: Vinaya Manchaiah, e-mail:
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Pyykkö I, Pyykkö N, Zou J, Manchaiah V. Characterization of Balance Problems and Rehabilitation Needs of Patients with Ménière's Disease. Audiol Res 2022; 12:22-32. [PMID: 35076449 PMCID: PMC8788294 DOI: 10.3390/audiolres12010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/24/2021] [Accepted: 12/24/2021] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND To explore and characterize balance problems in subjects with Ménière's disease (MD). METHODS A total of 539 people with MD with a mean age of 61.9 years, mean disease history of 15.6 years, and 79.5% females were recruited. The online questionnaire, consisting of 39 questions, including both structured and open-ended questions, focused on symptoms of MD, balance problems, impacts of the complaints, and quality of life (QoL). RESULTS After hearing loss (58%) and tinnitus (50%), balance problems (44%) were among the most commonly reported MD complaints, even higher than the impact of vertigo (40%). However, only 22% reported that those balance problems made obvious impacts in their daily lives. The most common balance problem that significantly reduced QoL was tripping (34%). Swaying (25%) had a limited impact on QoL, whereas rocking (10%) was less common but caused a significant impact on QoL. Non-defined balance problems were reported at 18%; these were occasional and correlated with vertigo attacks. Older participants had more frequent tripping problems. Younger participants more frequently reported swaying and rocking. CONCLUSIONS Risk factors predicting poor postural control were mostly related to complaints reflecting otolith pathology. Different types of postural problems require different strategies to manage balance control and cope with the disease.
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Affiliation(s)
- Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Otolaryngology, Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland; (I.P.); (J.Z.)
| | - Nora Pyykkö
- Faculty of Medicine, University of Tartu, 50090 Tartu, Estonia;
| | - Jing Zou
- Hearing and Balance Research Unit, Field of Otolaryngology, Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland; (I.P.); (J.Z.)
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of the Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO 80045, USA
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO 80045, USA
- Virtual Hearing La, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, CO 80045, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng 0002, South Africa
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal 576104, India
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Zou J, Chen L, Li H, Zhang G, Pyykkö I, Lu J. Correction to: High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT 2W-3D-FLAIR reconstructed with magnitude and zero-filled interpolation. Eur Arch Otorhinolaryngol 2021; 279:2291. [PMID: 34921613 PMCID: PMC8986725 DOI: 10.1007/s00405-021-07216-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jing Zou
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head and Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China. .,Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
| | - Luguang Chen
- Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
| | - Hongbin Li
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head and Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Guoping Zhang
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head and Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jianping Lu
- Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China
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Zou J, Chen L, Li H, Zhang G, Pyykkö I, Lu J. High-quality imaging of endolymphatic hydrops acquired in 7 minutes using sensitive hT 2W-3D-FLAIR reconstructed with magnitude and zero-filled interpolation. Eur Arch Otorhinolaryngol 2021; 279:2279-2290. [PMID: 34145490 PMCID: PMC8986670 DOI: 10.1007/s00405-021-06912-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/26/2021] [Indexed: 11/26/2022]
Abstract
Background It is still challenging to detect endolymphatic hydrops (EH) in patients with Meniere’s disease (MD) using MRI. The aim of the present study was to optimize a sensitive technique generating strong contrast enhancement from minimum gadolinium–diethylenetriamine pentaacetic acid (Gd–DTPA) while reliably detecting EH in the inner ear, including the apex. Materials and methods All imaging was performed using a 3.0 T MR system 24 h after intratympanic injection of low-dose Gd–DTPA. Heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery reconstructed with magnitude and zero-filled interpolation (hT2W–FLAIR–ZFI) was optimized and validated in phantom studies and compared with medium inversion time inversion recovery imaging with magnitude reconstruction (MIIRMR). The following parameters were used in hT2W–FLAIR–ZFI: repetition time 14,000 ms, echo time 663 ms, inversion time 2900 ms, flip angle 120°, echo train length 271, and field of view 166 × 196 mm2. Results MRI obtained using hT2W–FLAIR–MZFI yielded high-quality images with sharper and smoother borders between the endolymph and perilymph and a higher signal intensity ratio and more homogenous perilymph enhancement than those generated with MIIRMR (p < 0.01). There were predominantly grade II EHs in the cochleae and grade III EHs in the vestibule in definite MD. EH was detected in the apex of 11/16 ipsilateral ears, 3/16 contralateral ears in unilateral definite MD and 3/6 ears in bilateral MD. Conclusions The novel hT2W–FLAIR–MZFI technique is sensitive and demonstrates strong and homogenous enhancement by minimum Gd–DTPA in the inner ear, including the apex, and yields high-quality images with sharp borders between the endolymph and perilymph. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-021-06912-4.
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Affiliation(s)
- Jing Zou
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head and Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China.
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
| | - Luguang Chen
- Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
| | - Hongbin Li
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head and Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Guoping Zhang
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head and Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jianping Lu
- Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China
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13
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Kutlubaev MA, Xu Y, Manchaiah V, Zou J, Pyykkö I. Vestibular drop attacks in Ménière's disease: A systematic review and meta-analysis of frequency, correlates and consequences. J Vestib Res 2021; 32:171-182. [PMID: 33935127 DOI: 10.3233/ves-201514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Vestibular drop attacks (VDA), also called Tumarkin otolith crises as a complication of Ménière's disease (MD) were first described in 1936. Nevertheless, a clearer understanding of their prevalence and manifestations is needed. THE OBJECTIVE of this review is to determine the frequency, correlates and consequences of VDA in MD. METHOD Three databases were searched (i.e., MEDLINE, PubMed and Google Academia). A total of 1,791 references were identified, of which 18 studies were considered eligible. There was a large variation in the definition of VDA used in the studies. RESULTS The frequency of VDA in MD leading to a fall to the ground varied from 3 to 19% in 9 hospital-based studies. In studies where a less restrictive definition of VDA included attacks with postural perturbation, tripping and near-to-fall situations was used the prevalence ranged from 50 to 72%. The pooled frequency of VDA leading to fall to the ground was 8% (95% CI 4 to 12%) in hospital-based studies. In these studies, VDA often occurred in severe and advanced MD whereas in cohort studies such connection was not found. Co-morbidity with migraine increased the likelihood of VDA occurrence in MD. In 3 studies syncope was recorded in connection to VDA with falls. In terms of clinical manifestation, audiometry, MRI, vestibular evoked muscle response measures indicated endolymphatic hydrops with involvement of the otolith system. The hearing loss was more pronounced, and balance was worse in MD patients with VDA than in those without. Injury associated with VDA was reported in only one study. CONCLUSIONS VDA is a common phenomenon in MD, occurring even in mild MD and complicated with syncope. Some preliminary evidence suggests that VDA may lead to severe injuries.
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Affiliation(s)
- Mansur A Kutlubaev
- Department of Neurology, Bashkir State Medical University, Lenin str, 3, Ufa, Russia
| | - Ying Xu
- Neuroscience Research Australia (NeuRA), Barker Street, Randwick, NSW, Australia.,School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, Texas, USA.,Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India
| | - Jing Zou
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of the Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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14
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Ahmad A, Rilla K, Zou J, Zhang W, Pyykkö I, Kinnunen P, Ranjan S. Enhanced gene expression by a novel designed leucine zipper endosomolytic peptide. Int J Pharm 2021; 601:120556. [PMID: 33798688 DOI: 10.1016/j.ijpharm.2021.120556] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 03/12/2021] [Accepted: 03/29/2021] [Indexed: 11/18/2022]
Abstract
An endosomal trap is a major barrier in gene therapy. We have designed an endosomolytic peptide based on the leucine zipper sequence and characterized it both structurally and functionally. The results illustrated that leucine zipper endosomolytic peptide (LZEP) exhibited appreciable hemolysis of human red blood cells (hRBCs) at pH 5.0, but negligible hemolysis at pH 7.4. Calcein release experiment indicated that only at pH 5.0 but not at pH 7.4, LZEP was able to permeabilize hRBCs. LZEP revealed significant self-assembly as well as peptide induced α-helical structure at pH 5.0. Unlike at pH 5.0, LZEP failed to self-assemble and showed a random coil structure at pH 7.4. Transfection data depicted that lipoplexes modified with LZEP resulted in significantly higher gene expression as compared to lipoplexes without LZEP. Interestingly, the transfection efficacy of LZEP modified lipid nanoparticles reached the levels of Lipofectamine 2000 (LF 2000), without any cellular toxicity as observed by MTT assay. The results suggest a novel approach for designing endosomolytic peptides by employing the leucine zipper sequence and simultaneously the designed peptides could be utilized for enhancing gene delivery into mammalian cells.
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Affiliation(s)
- Aqeel Ahmad
- Helsinki Biophysics and Biomembrane Group, Department of Biomedical Engineering and Computational Sciences, Aalto University, Espoo, Finland; Department of Medical Biochemistry, College of Medicine, Shaqra University, Shaqra, 11961, Saudi Arabia
| | - Kirsi Rilla
- Institute of Biomedicine, University of Eastern Finland, 70211 Kuopio, Finland
| | - Jing Zou
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Otolaryngology, Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Weikai Zhang
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Paavo Kinnunen
- Helsinki Biophysics and Biomembrane Group, Department of Biomedical Engineering and Computational Sciences, Aalto University, Espoo, Finland
| | - Sanjeev Ranjan
- Helsinki Biophysics and Biomembrane Group, Department of Biomedical Engineering and Computational Sciences, Aalto University, Espoo, Finland; Institute of Biomedicine, University of Eastern Finland, 70211 Kuopio, Finland.
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Abstract
The aim of the present study was to evaluate the severity of vestibular drop attack (VDA) in Ménière's disease (MD) and to examine the association between VDA severity and other MD-related complaints. The study used a cross-sectional survey design using an electronic questionnaire. The mean age of participants was 56.7 years, and the mean duration of MD was 12.4 years. Four categories of VDA were identified based on level of severity. VDA occurred in 305 (50.7%) of the 602 patients. Of these, 133 patients (22%) experienced mild VDA (i.e., associated with tripping); 80 (13%) experienced moderate VDA (i.e., associated with fall threat unless they had been able to grab support); and 92 (15%) experienced severe VDA (i.e., patients fell to the ground, as in a classical Tumarkin attack). In 70%of participants, VDA occurred less than once a week. VDA lasted for only a few seconds in 90%of participants. 87%reported single attacks, whereas 13%experienced VDA in clusters. VDA was associated with visual auras, reduced quality of life, poor postural control, and fatigue. Approximately half of MD patients experience VDA with varying degrees of severity. If VDA causes falls or near-falls, the attacks should be appropriately treated.
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Affiliation(s)
- Ilmari Pyykkö
- Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Finland
| | - Nora Pyykkö
- Faculty of Medicine, University of Tartu, Tartu, Estonia.,Finnish Ménière Federation, Helsinki, Finland
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, Texas, USA.,Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India
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16
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Pyykkö I, Pyykkö N, Manchaiah V. Vestibular drop attacks in Ménière’s disease and its association with migraine. Eur Arch Otorhinolaryngol 2020; 277:1907-1916. [DOI: 10.1007/s00405-020-05890-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 02/25/2020] [Indexed: 12/12/2022]
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17
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Pyykkö I, Manchaiah V, Zou J, Levo H, Kentala E. Driving Habits and Risk of Traffic Accidents among People with Ménière's Disease in Finland. J Int Adv Otol 2020; 15:289-295. [PMID: 31287436 DOI: 10.5152/iao.2019.5915] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The study evaluated the driving habits and risk of traffic accidents among people with Ménière's disease (MD) in Finland. MATERIALS AND METHODS The study used a cross-sectional survey design. Members of the Finnish Ménière Federation (FMF) were contacted and requested to participate in an online survey. In total, 558 FMF members (58.7% response rate) responded to the survey. RESULTS People with MD were responsible for significantly fewer traffic accidents (0.8%) annually than individuals in the general population (1.7%). In addition, the lifetime risk of car accidents was lower among subjects with MD (8.3%) than that among individuals in the general population (24 to 28%). Nearly half of the total participants had either reduced the frequency of driving or had given up driving because of their condition. Factors such as gender, balance problems, visual problems with visual aura, and syncope during vestibular drop attacks can help explain the reasons for giving up car driving. One third (35.9%) of the participants were able to anticipate the MD attack before they decided to drive a car. Participants with falls during a vestibular drop attack, attacks of rotary vertigo, syncope during vestibular drop attacks, and those who were of a younger age were at a higher risk of experiencing a vertigo attack while driving a car. The most common strategies to avoid car accidents were selective driving and not driving when symptoms appeared. CONCLUSION The results show that people with MD are at a lower risk of traffic accidents than individuals in the general population, which can be explained by selective driving.
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Affiliation(s)
- Ilmari Pyykkö
- Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Tampere, Finland
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, Texas, USA;Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India
| | - Jing Zou
- Department of Otolaryngology, Head and Neck Surgery, Center for Otolaryngology-Head - Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Hilla Levo
- Department of Otolaryngology, University of Helsinki School of Medicine, Helsinki, Finland
| | - Erna Kentala
- Department of Otolaryngology, University of Helsinki School of Medicine, Helsinki, Finland
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Pyykkö I, Manchaiah V, Färkkilä M, Kentala E, Zou J. Association between Ménière’s disease and vestibular migraine. Auris Nasus Larynx 2019; 46:724-733. [DOI: 10.1016/j.anl.2019.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 01/16/2019] [Accepted: 02/03/2019] [Indexed: 12/17/2022]
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19
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Pyykkö I, Manchaiah V, Zou J, Levo H, Kentala E. Association between Syncope and Tumarkin Attacks in Ménière's Disease. J Int Adv Otol 2019; 15:135-140. [PMID: 31058603 PMCID: PMC6483450 DOI: 10.5152/iao.2019.6094] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 01/15/2019] [Accepted: 03/19/2019] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES The aim of the current study was to further collect evidence that would confirm the hypothesis that vestibular drop attacks (VDAs) could cause syncope in patients with Ménière's disease (MD). MATERIALS AND METHODS A cross-sectional survey design was employed in the present study. An Internet-based survey was administered on 602 individuals with MD. The mean age of the participants was 56.7 (25-75) years, and the mean duration of the disease was 12.4 (0.5-35) years. RESULTS VDAs with varying severity were present among 307 (50.7%) patients and led to fall in 92 patients, and syncope occurred in 45 patients with VDA. The overall percentage of syncope due to MD was 4.7%. Factors, such as duration of disease, age, and gender of the patient, did not explain attacks of syncope. Migraine and headache were not associated with syncope. Syncope was witnessed in 23 and self-reported by 22 patients. Syncope was associated with frequent VDA, duration of VDA, and falls that occurred during VDA. Patients with syncope reported the experience as frightening, had reduced general health-related quality of life, had higher anxiousness scores, and suffered more from fatigue. They also experienced problems with work, employment, and social restrictions. CONCLUSION Approximately 5% of patients with MD suffer from syncope, and syncope occurs among patients with VDA. In vestibular syncope, the sympathetic tone is lost, and baroreflex feedback is inhibited leading to fall and syncope. The consequences of vestibular syncope are severe, and patients face injuries and a significantly reduced quality of life.
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Affiliation(s)
- Ilmari Pyykkö
- Department of Otolaryngology, University of Tampere, School of Medicine, Tampere, Finland
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, School of Medicine, Beaumont, USA
| | - Jing Zou
- Department of Otolaryngology, University of Tampere, School of Medicine, Tampere, Finland
| | - Hilla Levo
- Department of Otolaryngology, University of Helsinki, School of Medicine, Helsinki, Finland
| | - Erna Kentala
- Department of Otolaryngology, University of Helsinki, School of Medicine, Helsinki, Finland
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20
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Affiliation(s)
- Henry Joutsijoki
- Faculty of Natural Sciences, University of Tampere, Tampere, Finland
| | - Jyrki Rasku
- Faculty of Natural Sciences, University of Tampere, Tampere, Finland
| | - Ilmari Pyykkö
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Martti Juhola
- Faculty of Natural Sciences, University of Tampere, Tampere, Finland
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21
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Abstract
Multidetector computed tomography has been the benchmark for visualizing bony changes of the ear, but has recently been challenged by cone-beam computed tomography. In both methods, all inner ear bony structures can be visualized satisfactorily with 2D or 3D imaging. Both methods produce ionizing radiation and induce adverse health effects, especially among children. In 3T magnetic resonance imaging, the soft tissue can be imaged accurately. Use of gadolinium chelate (GdC) as a contrast agent allows the partition of fluid spaces to be visualized, such as the bulging of basilar and Reissner's membranes. Both intravenous and intratympanic administration of GdC has been used. The development of positive endolymph imaging method, which visualizes endolymph as a bright signal, and the use of image subtraction seems to allow more easily interpretable images. This long-awaited possibility of diagnosing endolymphatic hydrops in living human subjects has enabled the definition of Hydropic Ear Disease, encompassing typical Meniere's disease as well as its monosymptomatic variants and secondary conditions of endolymphatic hydrops. The next challenge in imaging of the temporal bone is to perform imaging at the cellular and molecular levels. This chapter provides an overview of current temporal bone imaging methods and a review of emerging concepts in temporal bone imaging technology.
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Pyykkö I, Manchaiah V, Zou J, Levo H, Kentala E. Impact of Tumarkin attacks on complaints and work ability in Ménière’s disease. J Vestib Res 2018; 28:319-330. [DOI: 10.3233/ves-180634] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ilmari Pyykkö
- Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Tampere, Finland
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA
- Audiology India, Mysore, Karnataka, India
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India
| | - Jing Zou
- Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Tampere, Finland
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head and Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Hilla Levo
- Department of Otolaryngology, University of Helsinki, Helsinki, Finland
| | - Erna Kentala
- Department of Otolaryngology, University of Helsinki, Helsinki, Finland
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Abstract
A common European Community driving licence was established in 1980. However, there are major differences among the countries as regards medical conditions that legally affect driving ability. This article discusses various assessment guidelines for dizzy patients. These range from a total absence of specified binding requirements in Finland or regulations open to clinical interpretation in Switzerland, to inappropriately strict regulations in Germany. We focus on requirements for patients with vestibular disorders in Germany which have been in force since 2014. These guidelines stipulate that for group 1 driving licence (private cars < 3.5 t, motorbikes): (1) patients with Menière's disease (attacks without prodromes) must have had no attacks for 2 years before it is possible to drive again. (2) Patients with vestibular migraine without prodromes must not have had any attacks for 3 years. For a group 1 and group 2 driving licence ("professional driver"): (3) patients with bilateral vestibulopathy as a rule are considered to have a driving disability. Similarly, strict restrictions have been formulated for ocular motor disorders such as downbeat and upbeat nystagmus and for patients with functional (psychosomatic) forms of dizziness such as phobic postural vertigo. The authors represent a working group of the European Dizzynet focusing on the topic "fitness to drive with vertigo and balance disorders". They agree that European guidelines must be revised and harmonized, for some are too strict and the required dizziness-free intervals are too long; others must be revised, for they are too lax. A common European standard is needed.
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Affiliation(s)
- Doreen Huppert
- German Center for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians University, Marchioninistr. 15, 81377, Munich, Germany.
| | - Dominik Straumann
- Department of Neurology, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland
| | - Mans Magnusson
- Department of Otorhinolaryngology, Lund University, Lund, Sweden.,Department of Clinical Science, Lund University, Lund, Sweden
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Department of Otolaryngology, University of Tampere, Lääkärinkatu 1, Room E222, 33520, Tampere, Finland
| | - Thomas Brandt
- German Center for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians University, Marchioninistr. 15, 81377, Munich, Germany
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24
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Affiliation(s)
- Ilmari Pyykkö
- Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Tampere, Finland,
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, Texas, United States,
- The Swedish Institute for Disability Research, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden,
- Audiology India, Mysore, Karnataka, India,
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India,
| | - Jing Zou
- Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Tampere, Finland,
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China, and
| | - Hilla Levo
- Department of Otolaryngology, University of Helsinki, Helsinki, Finland
| | - Erna Kentala
- Department of Otolaryngology, University of Helsinki, Helsinki, Finland
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Pyykkö I, Manchaiah V, Zou J, Levo H, Kentala E. Do patients with Ménière’s disease have attacks of syncope? J Neurol 2017; 264:48-54. [DOI: 10.1007/s00415-017-8452-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 03/06/2017] [Accepted: 03/10/2017] [Indexed: 01/08/2023]
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Zou J, Lähelmä J, Arnisalo A, Pyykkö I. Clinically relevant human temporal bone measurements using novel high-resolution cone-beam CT. J Otol 2017; 12:9-17. [PMID: 29937832 PMCID: PMC6011811 DOI: 10.1016/j.joto.2017.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/12/2017] [Accepted: 01/16/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To test the feasibility of measuring fine temporal bone structures using a newly established cone-beam computed tomography (CBCT) system. MATERIALS AND METHODS Six formalin-fixed human cadaver temporal bones were imaged using a high-resolution CBCT system that has 900 frames and copper + aluminum filtration. Fine temporal bone structures, including those of the facial nerve canal and vestibular structures, were identified and measured. RESULTS The fine structures of the middle ear, including the tympanic membrane, tendon of the tensor tympani, cochleariform process of the semicanal of the tensor tympani, pyramidal eminence, footplate of the stapes, full path of the facial nerve within the temporal bone, supralabyrinthine space, semicircular canals, pathway of the subarcuate canal, and full path of the vestibular aqueduct, were clearly demonstrated. The vestibular aqueduct has a midpoint width of 0.4 ± 0.0 mm and opercular width of 0.5 ± 0.1 mm (mean ± SD). The length of the internal acoustic meatus was 10.6 ± 1.2 mm (mean ± SD), and the diameter of the internal acoustic meatus was 3.7 ± 0.3 mm (mean ± SD). CONCLUSION This novel high-resolution CBCT system has potentially broad applications in the diagnosis of inner ear disease and in monitoring associated pathological changes, surgical planning, navigation for the ear surgery, and temporal bone training.
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Affiliation(s)
- Jing Zou
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland
| | | | - Antti Arnisalo
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland
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27
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Manchaiah V, Pyykkö I, Zou J, Levo H, Kentala E. Patient-reported benefits from patient organization magazines and Internet-based peer support in Ménière's disease. Patient Prefer Adherence 2017; 11:1851-1857. [PMID: 29138539 PMCID: PMC5667786 DOI: 10.2147/ppa.s142257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To facilitate self-help, the Finnish Ménière's Federation (FMF) provides various kinds of support to persons with Ménière's disease (MD), which includes patient magazines (PM) and Internet-based peer support (iPS). The current study aimed to evaluate the benefits reported by MD patients in terms of PM and iPS. METHOD The study used a cross-sectional survey design with a mixture of structured and open-ended questions administered online. A sample of 185 patients from the FMF membership database provided complete data. RESULTS Ninety-two percent of the respondents rated PM as useful, or very useful. The main benefits of PM included: information on the disease and complaints, information about elements of peer support program, patient's experience with useful positive case studies, relevant news on MD, and information of activity of the FMF. Of the 185 persons, 68 reported that they did not have a need for peer support as their disease was either in silent phase or did not cause any annoyance. The main reasons for nonuse were: mild disease, personal reasons, and problems in using. Regarding the benefits of iPS, 75% of recent and 64% of chronic MD patients said that they would benefit from such a program. The main benefits of iPS included: reliable information on the disease and its management, peer support useful for coping with the disease, information about managing MD symptoms, information about managing attitude, and information about therapy. Moreover, the study identified different groups of individuals, which included: nonusers of support from patient organizations, those who used the support but did not feel they benefited, and those who used and also benefited from such programs. CONCLUSION The current study results provide some information about the preferences of MD patients regarding different forms of support and could certainly prove helpful while developing wider support strategies.
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Affiliation(s)
- Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA
- Department of Behavioural Sciences and Learning, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden
- Audiology India, Mysore
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India
- Correspondence: Vinaya Manchaiah, Department of Speech and Hearing Sciences, Lamar University, PO Box 10076, Beaumont 77010, TX, USA, Tel +1 409 880 8927, Fax +1 409 880 2265, Email
| | - Ilmari Pyykkö
- Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Tampere, Finland
| | - Jing Zou
- Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Tampere, Finland
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Hilla Levo
- Department of Otolaryngology, University of Helsinki, Helsinki, Finland
| | - Erna Kentala
- Department of Otolaryngology, University of Helsinki, Helsinki, Finland
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Mannerström M, Zou J, Toimela T, Pyykkö I, Heinonen T. The applicability of conventional cytotoxicity assays to predict safety/toxicity of mesoporous silica nanoparticles, silver and gold nanoparticles and multi-walled carbon nanotubes. Toxicol In Vitro 2016; 37:113-120. [DOI: 10.1016/j.tiv.2016.09.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/11/2016] [Accepted: 09/09/2016] [Indexed: 11/30/2022]
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Zou J, Pyykkö I, Hyttinen J. Inner ear barriers to nanomedicine-augmented drug delivery and imaging. J Otol 2016; 11:165-177. [PMID: 29937826 PMCID: PMC6002620 DOI: 10.1016/j.joto.2016.11.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 11/15/2016] [Accepted: 11/18/2016] [Indexed: 02/08/2023] Open
Abstract
There are several challenges to inner ear drug delivery and imaging due to the existence of tight biological barriers to the target structure and the dense bone surrounding it. Advances in imaging and nanomedicine may provide knowledge for overcoming the existing limitations to both the diagnosis and treatment of inner ear diseases. Novel techniques have improved the efficacy of drug delivery and targeting to the inner ear, as well as the quality and accuracy of imaging this structure. In this review, we will describe the pathways and biological barriers of the inner ear regarding drug delivery, the beneficial applications and limitations of the imaging techniques available for inner ear research, the behavior of engineered nanomaterials in inner ear applications, and future perspectives for nanomedicine-based inner ear imaging.
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Affiliation(s)
- Jing Zou
- Department of Otolaryngology – Head and Neck Surgery, Center for Otolaryngology – Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, University of Tampere, Tampere, Finland
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, University of Tampere, Tampere, Finland
| | - Jari Hyttinen
- Department of Electronics and Communications Engineering, BioMediTech, Tampere University of Technology, Tampere, Finland
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Feng H, Pyykkö I, Zou J. Involvement of Ubiquitin-Editing Protein A20 in Modulating Inflammation in Rat Cochlea Associated with Silver Nanoparticle-Induced CD68 Upregulation and TLR4 Activation. Nanoscale Res Lett 2016; 11:240. [PMID: 27142878 PMCID: PMC4854861 DOI: 10.1186/s11671-016-1430-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/13/2016] [Indexed: 06/05/2023]
Abstract
Silver nanoparticles (AgNPs) were shown to temporarily impair the biological barriers in the skin of the external ear canal, mucosa of the middle ear, and inner ear, causing partially reversible hearing loss after delivery into the middle ear. The current study aimed to elucidate the molecular mechanism, emphasizing the TLR signaling pathways in association with the potential recruitment of macrophages in the cochlea and the modulation of inflammation by ubiquitin-editing protein A20. Molecules potentially involved in these signaling pathways were thoroughly analysed using immunohistochemistry in the rat cochlea exposed to AgNPs at various concentrations through intratympanic injection. The results showed that 0.4 % AgNPs but not 0.02 % AgNPs upregulated the expressions of CD68, TLR4, MCP1, A20, and RNF11 in the strial basal cells, spiral ligament fibrocytes, and non-sensory supporting cells of Corti's organ. 0.4 % AgNPs had no effect on CD44, TLR2, MCP2, Rac1, myosin light chain, VCAM1, Erk1/2, JNK, p38, IL-1β, TNF-α, TNFR1, TNFR2, IL-10, or TGF-β. This study suggested that AgNPs might confer macrophage-like functions on the strial basal cells and spiral ligament fibrocytes and enhance the immune activities of non-sensory supporting cells of Corti's organ through the upregulation of CD68, which might be involved in TLR4 activation. A20 and RNF11 played roles in maintaining cochlear homeostasis via negative regulation of the expressions of inflammatory cytokines.
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Affiliation(s)
- Hao Feng
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Medisiinarinkatu 3, 33520, Tampere, Finland
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Medisiinarinkatu 3, 33520, Tampere, Finland
| | - Jing Zou
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Medisiinarinkatu 3, 33520, Tampere, Finland.
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head and Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China.
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Zou J, Isomäki A, Hirvonen T, Aarnisalo A, Jero J, Pyykkö I. Label-free visualization of cholesteatoma in the mastoid and tympanic membrane using CARS microscopy. J Otol 2016; 11:127-133. [PMID: 29937821 PMCID: PMC6002602 DOI: 10.1016/j.joto.2016.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 09/02/2016] [Accepted: 09/06/2016] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE The present study aimed to evaluate the possibility of using coherent anti-Stokes Raman spectroscopy (CARS) microscopy to determine the specific molecular morphology of cholesteatoma by detecting the natural vibrational contrast of the chemical bonds without any staining. MATERIALS AND METHODS Specimens from the mastoid and tympanic membrane with and without cholesteatoma were analyzed using CARS microscopy, two-photon excited fluorescence (TPEF) microscopy, and the second harmonic generation (SHG) microscopy. RESULTS In cholesteatoma tissues from the mastoid, a strong resonant signal at 2845 cm-1 was observed by CARS, which indicated the detection of the CH2 hydro-carbon lipid bonds that do not generate visible signals at 2940 cm-1 suggestive of CH3 bonds in amino acids. A strong resonant signal at 2940 cm-1 appeared in an area of the same specimen, which also generated abundant signals by TPEF and SHG microscopy at 817 nm, which was suggestive of collagen. In the tympanic membrane specimen with cholesteatoma, a strong resonant signal with corrugated morphology was detected, which indicated the presence of lipids. A strong signal was detected in the tympanic membrane with chronic otitis media using TPEF/SHG at 817 nm, which indicated collagen enrichment. The CARS and TPEF/SHG images were in accordance with the histology results. CONCLUSION These results suggest the need to develop a novel CARS microendoscope that can be used in combination with TPEF/SHG to distinguish cholesteatoma from inflammatory tissues.
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Affiliation(s)
- Jing Zou
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland
| | - Antti Isomäki
- Biomedicum Imaging Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Timo Hirvonen
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Antti Aarnisalo
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Jussi Jero
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland
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Zou J, Pyykkö I, Bretlau P, Klason T, Bjelke B. In Vivo Visualization of Endolymphatic Hydrops in Guinea Pigs: Magnetic Resonance Imaging Evaluation at 4.7 Tesla. Ann Otol Rhinol Laryngol 2016; 112:1059-65. [PMID: 14703111 DOI: 10.1177/000348940311201212] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In order to find out whether it is possible to visualize experimental endolymphatic hydrops in the cochlea with magnetic resonance imaging (MRI) at 4.7 T, we used 11 guinea pigs. Five normal guinea pigs were used as controls. Early manifestation of endolymphatic hydrops was evaluated in endolymphatic sac (ES)-intact animals (n = 6), and advanced manifestation in ES-damaged animals (n = 5) by means of MRI with gadolinium-diethylenetriaminepentaacetate-bismethylamide (Gd-DTPA-BMA) contrast agent. Hearing was tested with electrocochleography. The surface area of 3 partitions of the cochlea was used to quantify endolymphatic hydrops. The fine structure of the 3 partitions of the cochlea was visualized with MRI in all animals, as Gd-DTPA-BMA appeared mainly in the scala tympani and scala vestibuli. As early as 5 days after endolymphatic sac surgery, endolymphatic hydrops started to appear as visualized by MRI and also verified with histology. Severe damage to the inner ear barrier with Gd-DTPA-BMA leakage into the scala media was detected with MRI in 1 ES-damaged animal that had a 60-dB hearing loss. To conclude, endolymphatic hydrops can be visualized with high-resolution MRI by means of Gd-DTPA-BMA, and it is possible to quantify the extent of endolymphatic hydrops. Damage to the inner ear barrier or possible rupture of membranes can be shown with the assistance of Gd-DTPA-BMA.
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Affiliation(s)
- Jing Zou
- Department of Otolaryngology, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden
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Abstract
Factors related to postural stability and the course of recovery after vestibular schwannoma surgery were analyzed in a retrospective study of 177 patients and in a prospective study of 44 patients. Before surgery, 7 of the 44 patients in the prospective group complained of postural instability. The body sway velocity was measured. In the retrospective study, the sway velocity was abnormal under nonvisual control in 63% of the patients and under visual control in 34%. The sway velocity correlated with tumor size, smooth pursuit deficit, and postoperative work history. We compared patients with abnormal postural control to those with normal postural control, and found that the former relied to a greater extent on visual information and the latter on proprioceptive information. In the prospective study, the sway velocity increased after the operation, and 1 year after surgery it had not returned to preoperative values. In the logistic regression analysis, a translabyrinthine approach, rehabilitation, the patient's age, and preserved function of the facial nerve predicted a good outcome of postural stability. The retrosigmoid approach and depression were the most significant risk factors for postoperative gait difficulties. Vestibular rehabilitation increased the reliance on proprioception for maintenance of postural control and improved postural stability.
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Affiliation(s)
- Hilla Levo
- Department of Otolaryngology, Helsinki University Central Hospital, Helsinki, Finland
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Bondarenko OM, Heinlaan M, Sihtmäe M, Ivask A, Kurvet I, Joonas E, Jemec A, Mannerström M, Heinonen T, Rekulapelly R, Singh S, Zou J, Pyykkö I, Drobne D, Kahru A. Multilaboratory evaluation of 15 bioassays for (eco)toxicity screening and hazard ranking of engineered nanomaterials: FP7 project NANOVALID. Nanotoxicology 2016; 10:1229-42. [PMID: 27259032 PMCID: PMC5030619 DOI: 10.1080/17435390.2016.1196251] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Within EU FP7 project NANOVALID, the (eco)toxicity of 7 well-characterized engineered nanomaterials (NMs) was evaluated by 15 bioassays in 4 laboratories. The highest tested nominal concentration of NMs was 100 mg/l. The panel of the bioassays yielded the following toxicity order: Ag > ZnO > CuO > TiO2 > MWCNTs > SiO2 > Au. Ag, ZnO and CuO proved very toxic in the majority of assays, assumingly due to dissolution. The latter was supported by the parallel analysis of the toxicity of respective soluble metal salts. The most sensitive tests/species were Daphnia magna (towards Ag NMs, 24-h EC50 = 0.003 mg Ag/l), algae Raphidocelis subcapitata (ZnO and CuO, 72-h EC50 = 0.14 mg Zn/l and 0.7 mg Cu/l, respectively) and murine fibroblasts BALB/3T3 (CuO, 48-h EC50 = 0.7 mg Cu/l). MWCNTs showed toxicity only towards rat alveolar macrophages (EC50 = 15.3 mg/l) assumingly due to high aspect ratio and TiO2 towards R. subcapitata (EC50 = 6.8 mg Ti/l) due to agglomeration of TiO2 and entrapment of algal cells. Finally, we constructed a decision tree to select the bioassays for hazard ranking of NMs. For NM testing, we recommend a multitrophic suite of 4 in vitro (eco)toxicity assays: 48-h D. magna immobilization (OECD202), 72-h R. subcapitata growth inhibition (OECD201), 30-min Vibrio fischeri bioluminescence inhibition (ISO2010) and 48-h murine fibroblast BALB/3T3 neutral red uptake in vitro (OECD129) representing crustaceans, algae, bacteria and mammalian cells, respectively. Notably, our results showed that these assays, standardized for toxicity evaluation of “regular” chemicals, proved efficient also for shortlisting of hazardous NMs. Additional assays are recommended for immunotoxicity evaluation of high aspect ratio NMs (such as MWCNTs).
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Affiliation(s)
- Olesja M Bondarenko
- a Laboratory of Environmental Toxicology , National Institute of Chemical Physics and Biophysics , Tallinn , Estonia
| | - Margit Heinlaan
- a Laboratory of Environmental Toxicology , National Institute of Chemical Physics and Biophysics , Tallinn , Estonia
| | - Mariliis Sihtmäe
- a Laboratory of Environmental Toxicology , National Institute of Chemical Physics and Biophysics , Tallinn , Estonia
| | - Angela Ivask
- a Laboratory of Environmental Toxicology , National Institute of Chemical Physics and Biophysics , Tallinn , Estonia
| | - Imbi Kurvet
- a Laboratory of Environmental Toxicology , National Institute of Chemical Physics and Biophysics , Tallinn , Estonia
| | - Elise Joonas
- a Laboratory of Environmental Toxicology , National Institute of Chemical Physics and Biophysics , Tallinn , Estonia .,b Faculty of Science and Technology , Institute of Ecology and Earth Sciences, Tartu University , Tartu , Estonia
| | - Anita Jemec
- c Biotechnical Faculty , University of Ljubljana , Ljubljana , Slovenia
| | - Marika Mannerström
- d The Finnish Centre for Alternative Methods (FICAM) , School of Medicine, University of Tampere , Tampere , Finland
| | - Tuula Heinonen
- d The Finnish Centre for Alternative Methods (FICAM) , School of Medicine, University of Tampere , Tampere , Finland
| | - Rohit Rekulapelly
- e The Centre for Cellular & Molecular Biology, Habsiguda , Hyderabad, Telangana , India , and
| | - Shashi Singh
- e The Centre for Cellular & Molecular Biology, Habsiguda , Hyderabad, Telangana , India , and
| | - Jing Zou
- f Hearing and Balance Research Unit , Field of Oto-Laryngology, School of Medicine, University of Tampere , Tampere , Finland
| | - Ilmari Pyykkö
- f Hearing and Balance Research Unit , Field of Oto-Laryngology, School of Medicine, University of Tampere , Tampere , Finland
| | - Damjana Drobne
- c Biotechnical Faculty , University of Ljubljana , Ljubljana , Slovenia
| | - Anne Kahru
- a Laboratory of Environmental Toxicology , National Institute of Chemical Physics and Biophysics , Tallinn , Estonia
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Zou J, Ostrovsky S, Israel LL, Feng H, Kettunen MI, Lellouche JPM, Pyykkö I. Efficient penetration of ceric ammonium nitrate oxidant-stabilized gamma-maghemite nanoparticles through the oval and round windows into the rat inner ear as demonstrated by MRI. J Biomed Mater Res B Appl Biomater 2016; 105:1883-1891. [DOI: 10.1002/jbm.b.33719] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 04/04/2016] [Accepted: 05/09/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Jing Zou
- Department of Otolaryngology-Head and Neck Surgery; Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University; Shanghai China
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere; Tampere Finland
| | - Stella Ostrovsky
- Laboratory of Nanoscale Materials and Systems, Department of Chemistry, Bar-Ilan University; Ramat-Gan Israel
| | - Liron L. Israel
- Laboratory of Nanoscale Materials and Systems, Department of Chemistry, Bar-Ilan University; Ramat-Gan Israel
| | - Hao Feng
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere; Tampere Finland
| | - Mikko I. Kettunen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland; Kuopio Finland
| | - Jean-Paul Moshe Lellouche
- Laboratory of Nanoscale Materials and Systems, Department of Chemistry, Bar-Ilan University; Ramat-Gan Israel
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere; Tampere Finland
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Abstract
OBJECTIVE: To study the prevalence of Menière's disease (MD) in the general population of Southern Finland. STUDY DESIGN AND SETTING: Prospective study based on population register data. A questionnaire was sent to 5000 randomly selected persons aged 12 years or more living in the Helsinki University Hospital area. We enquired about whether recipients had experienced vertigo associated with a moving sensation, hearing loss, or tinnitus. For exclusion purposes, we also asked about general illnesses, ear infections, former head and ear traumas, noise exposure, medication, and use of tobacco and alcohol. To assess the validity of the population-based study, we randomly selected a sample of 100 people among those reporting vertigo. They were clinically examined at our vestibular unit. The clinical examination was supplemented by audiologic and otoneurologic tests. RESULTS: The response rate was 63%. In the final study sample of 3116 people, 216 reported the triad of vertigo, hearing loss, and tinnitus. By using the most recent criteria of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology–Head and Neck Surgery, we were able to identify 16 definite MD patients from the total sample, yielding a prevalence of 513 of 100,000 persons. Among the 16 MD subjects, 9 patients had already been diagnosed with MD and 1 patient was diagnosed during the clinical examination. A peak prevalence of 1709 of 100,000 was seen in the age group 61 to 70 years. CONCLUSIONS: Our population-based estimate of MD prevalence is much higher than in previous reports.
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Affiliation(s)
- Mari Havia
- Department of Otorhinolaryngology, Helsinki University Hospital, Finland.
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Pyykkö I, Zou J, Schrott-Fischer A, Glueckert R, Kinnunen P. An Overview of Nanoparticle Based Delivery for Treatment of Inner Ear Disorders. Methods Mol Biol 2016; 1427:363-415. [PMID: 27259938 DOI: 10.1007/978-1-4939-3615-1_21] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Nanoparticles offer new possibilities for inner ear treatment as they can carry a variety of drugs, protein, and nucleic acids to inner ear. Nanoparticles are equipped with several functions such as targetability, immuno-transparency, biochemical stability, and ability to be visualized in vivo and in vitro. A group of novel peptides can be attached to the surface of nanoparticles that will enhance the cell entry, endosomal escape, and nuclear targeting. Eight different types of nanoparticles with different payload carrying strategies are available now. The transtympanic delivery of nanoparticles indicates that, depending on the type of nanoparticle, different migration pathways into the inner ear can be employed, and that optimal carriers can be designed according to the intended cargo. The use of nanoparticles as drug/gene carriers is especially attractive in conjunction with cochlear implantation or even as an inclusion in the implant as a drug/gene reservoir.
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Affiliation(s)
- Ilmari Pyykkö
- Department of Otolaryngology, University of Tampere and University Hospital of Tampere, Tampere, 33014, Finland. .,Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, University of Tampere, Medisiinarinkatu 3, Tampere, 33520, Finland.
| | - Jing Zou
- BECS, Department of Biomedical Engineering and Computational Science, Aalto University, Aalto, 02150, Espoo, Finland
| | - Annelies Schrott-Fischer
- Department of Otolaryngology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria
| | - Rudolf Glueckert
- Department of Otolaryngology, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria
| | - Paavo Kinnunen
- BECS, Department of Biomedical Engineering and Computational Science, Aalto University, Aalto, Finland
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Rasku J, Pyykkö I, Levo H, Kentala E, Manchaiah V. Disease Profiling for Computerized Peer Support of Ménière's Disease. JMIR Rehabil Assist Technol 2015; 2:e9. [PMID: 28582248 PMCID: PMC5454554 DOI: 10.2196/rehab.4109] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 06/16/2015] [Accepted: 07/12/2015] [Indexed: 01/09/2023] Open
Abstract
Background Peer support is an emerging form of person-driven active health care. Chronic conditions such as Ménière’s disease (a disorder of the inner ear) need continuing rehabilitation and support that is beyond the scope of routine clinical medical practice. Hence, peer-support programs can be helpful in supplementing some of the rehabilitation aspects. Objective The aim of this study was to design a computerized data collection system for the peer support of Menière’s disease that is capable in profiling the subject for diagnosis and in assisting with problem solving. Methods The expert program comprises several data entries focusing on symptoms, activity limitations, participation restrictions, quality of life, attitude and personality trait, and an evaluation of disease-specific impact. Data was collected from 740 members of the Finnish Ménière’s Federation and utilized in the construction and evaluation of the program. Results The program verifies the diagnosis of a person by using an expert system, and the inference engine selects 50 cases with matched symptom severity by using a nearest neighbor algorithm. These cases are then used as a reference group to compare with the person’s attitude, sense of coherence, and anxiety. The program provides feedback for the person and uses this information to guide the person through the problem-solving process. Conclusions This computer-based peer-support program is the first example of an advanced computer-oriented approach using artificial intelligence, both in the profiling of the disease and in profiling the person’s complaints for hearing loss, tinnitus, and vertigo.
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Affiliation(s)
- Jyrki Rasku
- School of Information Sciences, Tampere University, Tampere, Finland.,Hearing and Balance Research Unit, Department of Otorhinolaryngology, Tampere University, Tampere, Finland
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Department of Otorhinolaryngology, Tampere University, Tampere, Finland
| | - Hilla Levo
- Department of Otolaryngology, University of Helsinki, Helsinki, Finland
| | - Erna Kentala
- Department of Otolaryngology, University of Helsinki, Helsinki, Finland
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, United States.,The Swedish Institute for Disability Research, Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.,Audiology India, Mysore, India
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Zou J, Hannula M, Lehto K, Feng H, Lähelmä J, Aula AS, Hyttinen J, Pyykkö I. X-ray microtomographic confirmation of the reliability of CBCT in identifying the scalar location of cochlear implant electrode after round window insertion. Hear Res 2015; 326:59-65. [DOI: 10.1016/j.heares.2015.04.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 04/01/2015] [Accepted: 04/07/2015] [Indexed: 01/12/2023]
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Zou J, Pyykkö I. Calcium Metabolism Profile in Rat Inner Ear Indicated by MRI After Tympanic Medial Wall Administration of Manganese Chloride. Ann Otol Rhinol Laryngol 2015; 125:53-62. [DOI: 10.1177/0003489415597916] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: To evaluate the efficacy of the novel method for the targeted delivery of Mn++ to the inner ear and monitor calcium metabolism activity in the inner ear. Materials and Methods: Dynamic signal changes of Mn++ in the rat inner ear were followed using T1-weighted magnetic resonance imaging (MRI) after administration of 2.5 µl MnCl2 (500 mM) to the medial wall of the middle ear cavity. Results: Mn++ passed through both the oval and round windows and distributed in the perilymphatic compartments, where it formed bright sharp lines along the fluid-cellular borders 12 minutes post administration and entered the endolymph sufficiently after 45 minutes. After 6 hours, the distribution of Mn++ shifted from a fluid-dominant pattern to a cell-dominant pattern. Mn++ concentrated in the area of the basilar membrane, periphery process, and soma of the spiral ganglion on day 2; became more distinguishable on day 4; declined on day 8; and remained detectable for 16 days post administration. Conclusions: The novel targeted delivery method efficiently introduced Mn++ into the inner ear. The dynamic distribution pattern of Mn++ in the inner ear shown by MRI indicates that this method can be used to monitor calcium metabolism activity in the inner ear.
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Affiliation(s)
- Jing Zou
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland
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Zou J, Lähelmä J, Koivisto J, Dhanasingh A, Jolly C, Aarnisalo A, Wolff J, Pyykkö I. Imaging cochlear implantation with round window insertion in human temporal bones and cochlear morphological variation using high-resolution cone beam CT. Acta Otolaryngol 2015; 135:466-72. [PMID: 25675836 PMCID: PMC4487572 DOI: 10.3109/00016489.2014.993090] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Conclusions: The present experimental set-up of high spatial resolution cone-beam computed tomography (CBCT) showed advantages of demonstrating the critical landmarks of the cochlea in identifying the position of intracochlear electrode contacts and has the potential for clinical application in cochlear implant (CI) surgery. Objective: To evaluate a newly developed CBCT system in defining CI electrode array in human temporal bone and cochlear morphological variation. Methods: Standard electrode, flexible tip electrode (Flex28), and an experimental electrode array with 36 contacts from MED-EL were implanted into the cochleae of six human temporal bones through an atraumatic round window membrane insertion. The cochleae were imaged with 900 frames using an experimental set-up based on a CBCT scanner installed with Superior SXR 130-15-0.5 X-ray tube in combination with filtration of copper and aluminum. Results: In all temporal bones, the landmarks of the cochlea, modiolus, osseous spiral lamina, round window niche, and stapes were demonstrated at an average level of 3.4–4.5. The contacts of electrode arrays were clearly shown to locate in the scala tympani. There was a linear correlation between the ‘A’ value and cochlea height, and between the A value and actual electrode insertion length for the first 360° insertion depth.
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Affiliation(s)
- Jing Zou
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland
- Correspondence: Jing Zou MD PhD, Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Medisiinarinkatu 3, 33520 Tampere, Finland. +358 401901307. +358 3 364 1482.
| | | | - Juha Koivisto
- Department of Physics, University of Helsinki, Helsinki, Finland
| | | | | | - Antti Aarnisalo
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Jan Wolff
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland
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Affiliation(s)
- M Juhola
- Department of Computer Science, University of Turku, Finland
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Schalen L, Pyykkö I, Korttila K, Magnusson M, Enbom H. Effects of intravenously given barbiturate and diazepam on eye motor performance in man. Adv Otorhinolaryngol 2015; 42:260-4. [PMID: 3213738 DOI: 10.1159/000416119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- L Schalen
- Department of Otolaryngology, University Hospital of Lund, Finland
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Affiliation(s)
- H Aalto
- Institute of Occupational Health, Vantaa, Finland
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Pyykkö I, Manchaiah VKC, Kentala E, Levo H. Significant others of patients with hearing and balance disorders report positive experiences. Int J Audiol 2015; 53:285-6. [PMID: 24617594 DOI: 10.3109/14992027.2013.869840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ilmari Pyykkö
- * Department of Otorhinolaryngology, University of Tampere , Tampere , Finland
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Ahmad A, Ranjan S, Zhang W, Zou J, Pyykkö I, Kinnunen PK. Novel endosomolytic peptides for enhancing gene delivery in nanoparticles. Biochimica et Biophysica Acta (BBA) - Biomembranes 2015; 1848:544-53. [DOI: 10.1016/j.bbamem.2014.11.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 10/28/2014] [Accepted: 11/06/2014] [Indexed: 12/26/2022]
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Zou J, Hannula M, Misra S, Feng H, Labrador RH, Aula AS, Hyttinen J, Pyykkö I. Micro CT visualization of silver nanoparticles in the middle and inner ear of rat and transportation pathway after transtympanic injection. J Nanobiotechnology 2015; 13:5. [PMID: 25622551 PMCID: PMC4312601 DOI: 10.1186/s12951-015-0065-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 01/07/2015] [Indexed: 12/20/2022] Open
Abstract
Background Silver nanoparticles (Ag NPs) displayed strong activities in anti-bacterial, anti-viral, and anti-fungal studies and were reportedly efficient in treating otitis media. Information on distribution of AgNPs in different compartments of the ear is lacking. Objective To detect distribution of Ag NPs in the middle and inner ear and transportation pathways after transtympanic injection. Methods Contrast effect of Ag NPs in the micro CT imaging was assessed in a phantom. AgNPs at various concentrations (1.85 mM, 37.1 mM, and 370.7 mM) were administered to rat middle ear using transtympanic injection and cadaver heads were imaged using micro CT at several time points. Results The lowest concentration of Ag NPs that could be visualized using micro CT was 37.1 mM. No difference was observed between the solvents, deionized H2O and saline. Ag NPs at 37.1 mM were visible in the middle ear on 7 d post-administration. Ag NPs at 370.7 mM generated signals in the middle ear, ossicular chain, round window membrane, oval window, scala tympani, and Eustachian tube for both 4 h and 24 h time points. A gradient distribution of Ag NPs from the middle ear to the inner ear was detected. The pathways for Ag NPs to be transported from the middle ear into the inner ear are round and oval windows. Conclusion This study provided the imaging evidence that Ag NPs are able to access the inner ear in a dose-dependent manner after intratympanic administration, which is relevant to design the delivery concentration in the future clinic application in order to avoid adverse inner ear effect.
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Affiliation(s)
- Jing Zou
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Medisiinarinkatu 3, 33520, Tampere, Finland. .,Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China.
| | - Markus Hannula
- BioMediTech and Department of Electronics and Communications Engineering, Tampere University of Technology, Tampere, Finland.
| | - Superb Misra
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK. .,Materials Science and Engineering, Indian Institute of Technology-Gandhinagar, Ahmedabad, India.
| | - Hao Feng
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Medisiinarinkatu 3, 33520, Tampere, Finland.
| | | | - Antti S Aula
- BioMediTech and Department of Electronics and Communications Engineering, Tampere University of Technology, Tampere, Finland. .,Department of Medical Physics, Imaging Centre, Tampere University Hospital, Tampere, Finland.
| | - Jari Hyttinen
- BioMediTech and Department of Electronics and Communications Engineering, Tampere University of Technology, Tampere, Finland.
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Medisiinarinkatu 3, 33520, Tampere, Finland.
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Toppila E, Pyykkö I, Pääkkönen R. Evaluation of the Increased Accident Risk From Workplace Noise. International Journal of Occupational Safety and Ergonomics 2015; 15:155-62. [DOI: 10.1080/10803548.2009.11076796] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Zou J, Koivisto J, Lähelmä J, Aarnisalo A, Wolff J, Pyykkö I. Imaging Optimization of Temporal Bones With Cochlear Implant Using a High-resolution Cone Beam CT and the Corresponding Effective Dose. Ann Otol Rhinol Laryngol 2014; 124:466-73. [DOI: 10.1177/0003489414565004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To evaluate the impact of tube voltage, tube current, pulse number, and magnification factor on the image quality of a novel experimental set-up and the corresponding radiation. Materials and Methods: Six human temporal bones with cochlear implant were imaged using various tube voltages, tube currents, pulse numbers, and magnification. The effect of radiation was evaluated using a metaloxide semiconductor field-effect transistor (MOSFET) dosimeter device on an anthropomorphic RANDO RAN102 male head phantom. A copper and aluminum combination filter was used for hardware filtration. Results: Overall, 900 frames, 11 mA, and 88 kV provided the best image quality. In temporal bones imaged with the optimized parameters, the cochlea, osseous spiral lamina, modiolus, stapes, round window niche, and oval window landmarks were demonstrated with anatomic structures still fully assessable in all parts and acceptable image quality. The most dominant contributor to the effective dose was bone marrow (36%-37 %) followed by brain (34%-36%), remainder tissues (12%), extra-thoracic airways (7%), and oral mucosa (5%). Conclusions: By increasing the number of frames, the image quality of the inner ear details obtained using the novel cone-beam computed tomography improved.
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Affiliation(s)
- Jing Zou
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, University of Tampere, Tampere, Finland
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Juha Koivisto
- Department of Physics, University of Helsinki, Helsinki, Finland
| | | | - Antti Aarnisalo
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Jan Wolff
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, University of Tampere, Tampere, Finland
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, University of Tampere, Tampere, Finland
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Zou J, Feng H, Mannerström M, Heinonen T, Pyykkö I. Toxicity of silver nanoparticle in rat ear and BALB/c 3T3 cell line. J Nanobiotechnology 2014; 12:52. [PMID: 25467963 PMCID: PMC4272548 DOI: 10.1186/s12951-014-0052-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 11/12/2014] [Indexed: 11/18/2022] Open
Abstract
Background Silver nanoparticles (AgNPs) displayed strong activities in anti-bacterial, anti-viral, and anti-fungal studies and was reportedly efficient in treating otitis media .The potential impact of AgNPs on the inner ear was missing. Objective Attempted to evaluate the potential toxicity of AgNPs in the inner ear, middle ear, and external ear canal after transtympanic injection in rats. Results In in vitro studies, the IC50 for AgNPs in neutral red uptake assay was lower than that in NAD(P)H-dependent cellular oxidoreductase enzyme assay (WST-1) and higher than that in total cellular ATP and nuclear membrane integrity (propidium iodide) assessments. In in vivo experiments, magnetic resonance imaging (MRI) showed that significant changes in the permeability of biological barriers occurred in the middle ear mucosa, the skin of the external ear canal, and the inner ear at 5 h post-transtympanic injection of AgNPs at concentrations ranging from 20 μg/ml to 4000 μg/ml. The alterations in permeability showed a dosage-response relationship, and were reversible. The auditory brainstem response showed that 4000 μg/ml AgNPs induced hearing loss with partial recovery at 7 d, whereas 20 μg/ml caused reversible hearing loss. The functional change in auditory system was in line with the histology results. In general, the BALB/c 3T3 cell line is more than 1000 times more sensitive than the in vivo studies. Impairment of the mitochondrial function was indicated to be the mechanism of toxicity of AgNPs. Conclusion These results suggest that AgNPs caused significant, dose-dependent changes in the permeability of biological barriers in the middle ear mucosa, the skin of the external ear canal, and the inner ear. In general, the BALB/c 3T3 cell line is more than 1000 times more sensitive than the in vivo studies. The rat ear model might be expended to other engineered nanomaterials in nanotoxicology study. Electronic supplementary material The online version of this article (doi:10.1186/s12951-014-0052-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jing Zou
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland. .,Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China.
| | - Hao Feng
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland.
| | - Marika Mannerström
- The Finnish Centre for Alternative Methods, School of Medicine, University of Tampere, Tampere, Finland.
| | - Tuula Heinonen
- The Finnish Centre for Alternative Methods, School of Medicine, University of Tampere, Tampere, Finland.
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland.
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