Safe Removal Of Gliomas To Preserve Language Requires Less Extensive Brain Exposure Than Previously Thought

from Medical News Today.com

A more limited approach to craniotomy—the procedure through which a patient’s skull is opened up to expose the brain—than has traditionally been used by neurosurgeons can maximize resection and minimize lasting side effects when tumours within or near language pathways are removed, according to the results of a prospective study published in the New England Journal of Medicine.

Role of computed tomography and bronchoscopy in speech prosthesis aspiration

from Annals of Otology, Rhinology, and Laryngology

Tracheoesophageal puncture prostheses (TEPPs) are an integral aspect of speech rehabilitation for many patients who have undergone total laryngectomy. Because one flange of the prosthesis sits in the trachea and the other in the esophagus, these devices can be aspirated or swallowed if dislodged. Five cases of prosthesis aspiration that occurred in 4 veterans within a 16-month period are described. The 5 aspirated TEPPs resulted in highly variable clinical presentations ranging from complaints of “lost” TEPPs in asymptomatic patients to near-asphyxiation. Furthermore, the aspirated TEPPs were not reliably demonstrated on chest radiographs, often leading to delayed diagnosis. Aspiration of TEPPs may be more common than formerly recognized, and chest computed tomography or bronchoscopy is indicated in cases of missing TEPPs not demonstrated on plain films.

The N3 potential compared to sound and galvanic vestibular evoked myogenic potential in healthy subjects and in multiple sclerosis patients

from the Journal of Vestibular Research

Both sound (s-) and galvanic (g-) vestibular-evoked myogenic potential (VEMP) enable us to study the saccular pathways. However, the VEMP can be abnormal for non-vestibular factors, such as insufficient activation of the sterno-cleido-mastoid (SCM) muscle or a lesion that involves the accessory nucleus and/or nerve or the SCM muscle. These drawbacks do not affect another technique that evaluates the saccular function: the N3 potential.

We recorded both the s- and the g-VEMP and the N3 potential in a group of 31 healthy subjects to establish a reference range. The N3 potential and the s-VEMP were recordable bilaterally from all the subjects, whereas the g-VEMP was undetectable uni- or bilaterally in 7 subjects. The latency and amplitude values of the s-VEMP did not differ from those of the g-VEMP. For all three techniques, the latency and amplitude values from the right and from the left recording and/or stimulation side were the same. We suggest using normative latency and amplitude values based on the mean and ratio of the right- and left-side values.

The s-VEMP, the N3 potential and the auditory evoked response (ABR) were compared in 15 subjects suffering from multiple sclerosis. The three techniques detected a similar number of abnormalities, but these abnormalities were not correlated. This suggests that these different techniques should be regarded as complementary in evaluating saccular function.