Common Cavity Research Articles

Carcinoma buccal cavity: Late presentation and salvage, experience from a North Indian center

Carcinoma buccal cavity, the most common oral cavity cancer was seen in our set up in more than 50% cases. Forty patients of carcinoma buccal cavity were studied at JN Medical College, Aligarh Muslim University, and Aligarh over a period of last 5 years (2003-2008). Mean age at presentation 36.5 years (30-55) years. Male: Female, 27:13. Most common association was with smoking and chewing tobacco and pan over a mean long period of 15 years (8-22 years). Most common location was lateral wall of buccal cavity over cheek area related to their typical chewing habit of keeping the tobacco over that area over a prolonged period. Most of them, more than 90% (36 cases) presented late involving both mucosa and skin and in 25% cases also involving the alveolus and mandible. Wide excision and modified radical neck dissection with or without mandibulectomy (marginal, partial or hemimandibulectomy) done in all cases. Reconstruction was done by pedicled pectoralis major (PM) and deltopectoral (DP), the workhorse flaps for head and neck reconstruction for mucosal lining and skin cover respectively in 25 cases. Five cases needed only lining done by PM flap. Ten cases were salvaged by pedicled forehead flap for both lining and cover. All the cases healed properly with acceptable results and good functional recovery. Two cases reported recurrence treated with postoperative radiotherapy. Poor socioeconomic status, smoking and chewing habit, poor oral hygiene, malnutrition and moreover lack of awareness led to late presentation. However, an attempt was made for salvage at our center.

Radiographic diagnosis of trans-stapedial cerebrospinal fluid fistula

Objective To report the high-resolution computed tomography and magnetic resonance imaging (MRI) findings of a bulging oval window in children with recurrent meningitis and congenital cerebrospinal fluid fistula. Study Design Case series. Setting Academic medical center children's hospital. Subjects and Methods A series of eight ears in four children with profound, bilateral sensorineural hearing loss and perilymphatic hydrops were evaluated. Two patients presented with recurrent meningitis. All children were assessed with high-resolution computed tomography, and two children also underwent MRI. Results Seven of eight ears had a common cavity malformation. The vestibular compartment showed severe dysplasia (n = 5), moderate dysplasia (n = 1), or a single semicircular canal (n = 2). The lamina cribrosa was clearly absent in four of eight ears. Its presence was difficult to assess in ears with small internal auditory canals. A bulging oval window, present in six of eight ears, was defined as a fluid density on high-resolution computed tomography or a hyperintense mass demonstrated by T2-weighted MRI protruding from the vestibule into the middle ear cavity. When present, this herniation of a fluid-filled sac could be seen on both MRI and computed tomography. This imaging finding was surgically confirmed in two patients. Conclusion The bulging oval window, which represents a fluid-filled sac, can be identified by both high-resolution computed tomography and MRI. Communication between the middle ear and the subarachnoid space through the inner ear is an important etiology for recurrent meningitis in children with sensorineural hearing loss.

Transfer of Prokaryotic Algal Symbionts from a Tropical Ascidian (Lissoclinum punctatum) Colony to Its Larvae

Lissoclinum punctatum is a colonial ascidian that harbors the symbiotic prokaryotic alga Prochloron in its tunic and in the peribranchial and common cloacal cavities. Most symbiotic cells in the tunic are intracellular (tunic phycocytes), while those in the cavities are extracellular. We found that neither gametes nor embryos brooded in the tunic were associated with photosymbionts. We determined that algal cells attach to posterior parts of the trunk of hatching larvae swimming in the common cloacal cavity. No symbiont cells were found intracellularly in larval tissues. Thus, extracellular Prochloron cells in the cloacal cavities were transferred to the larvae, but intracellular photosymbionts in the tunic were not. The intracellular symbiosis must be reestablished in each generation after larval settlement.

Scalable geometric quantum computing with Cooper-pair box qubits in circuit QED

We theoretically present a scheme to realize the scalable geometric quantum computing with Cooper-pair box (CPB) qubits in circuit QED. A one-dimensional transmission line resonator in circuit QED acting as quantum data bus generates a common cavity mode and interacts with each CPB. It is found that the interqubit couplings between any pair of qubits are switchable by individually adjusting the gate pulses applied to the selected CPBs. In this proposed scheme, we can both controllably and selectively address logic gates in geometric scenarios, which opens the possibility to implement the scalable fault-tolerant quantum computing with Josephson qubits.

Two species of Copepoda parasitic in the algal-bearing ascidian, Didemnum molle (Herdman), in Okinawa, Japan

Abstract Two species of parasitic copepods are described from the common cloacal cavity of the algal-bearing (photosymbiotic) compound ascidian, Didemnum molle (Herdman), occurring in Okinawa, Japan. They are a new form of Lichomolgidae (Poecilostomatoida), Lobomolgus okinawaensis new genus, new species, and a new species of Notodelphyidae (Cyclopoida), Doroixys capillosus. The new genus Lobomolgus is unique among the lichomolgid genera in having in the female a pair of long, dorsolateral processes on each of the last two somites of the metasome. It is also characteristic in having in the female a highly reduced endopod (a small lobe tipped with one seta) on leg 4 and bearing an armature of III, 5 (not II,I,5) on the last exopodal segment of leg 4. Doroixys capillosus, new species, can be distinguished from its congeners by the possession of: 1) a 6-segmented antennule, 2) a mandibular endopod with 5 setae, 3) a maxilliped tipped with 6 setae, 4) a 2-segmented endopod on leg 3, and 5) a cephalosome with r...

Effect of cochleostomy size on perilymph fistula control

Although the overall incidence of perilymphatic gushers is approximately 1%, patients with inner ear anomalies are at an increased risk for development of perilymphatic gushers. As cochlear implantation becomes more common in patients with inner ear anomalies (e.g., Mondini defect or common cavity defect), the ability to successfully seal such leaks becomes of paramount importance to reduce the risk of subsequent meningitis. A 1.0-mm and a 1.5-mm cochleostomy were placed superior to the round window in two respective temporal bones. Cochlear implant electrodes (Cochlear [Lane Cove NSW, Australia], Med-El [Insbruck, Austria] and Advanced Bionics [Valencia, CA]) were placed in the cochleostomy and sealed with porcine periosteum. A fixed amount of pressure was applied to the inner ear, and the presence or absence of a leak was recorded for 10 different packings of each cochleostomy diameter at 0, 10, 15, 20, and 30 cm H(2)O. For the Cochlear, Med-El, and Advanced Bionics electrode, no statistically significant difference was noted between the 1.0-mm and the 1.5-mm cochleostomy at 0, 10, 15, and 20 cm H(2)O. At 30 cm H(2)O, no leaks were noted with the 1.5-mm cochleostomy for any brand. For the 1.0-mm cochleostomy at 30 cm H(2)O, 6/10 of the Cochlear trials leaked (P = .004), 2/10 of the Med-El trials leaked (P = .24), and 5/10 of the Advanced Bionics trials leaked (P = .03). The 1.5-mm cochleostomies are associated with a decreased risk of perilymphatic fistula as compared to 1.0-mm cochleostomies at 30 cm H(2)O; this likely represents a phenomenon of packing adequacy.

A FGF3 mutation associated with differential inner ear malformation, microtia, and microdontia

Analysis of association between genotype and phenotype. Prospective genetic study in a family. Auditory investigations, computer tomography, and genetic sequencing of the fibroblast growth factor 3 (FGF3) gene were performed on a Somali family presenting with autosomal recessive, hearing impairment, microdontia, and outer ear morphologies ranging from normal auricle development to microtia assessed as type 1 Weerda dysplasia in affected individuals. Computed tomography imaging identified differential inter- and intraindividual malformations of the inner ear including labyrinth aplasia, development of a common cavity to the presence of a cochlear with 1.5 windings (Mondini malformation) in affected individuals, symptoms similar to those described as labyrinth aplasia, microtia, and microdontia (LAMM) syndrome, caused by mutations in FGF3. Genetic sequencing revealed the presence of a novel p.R95W missense mutation in FGF3 segregating with pathology. The p.R95W mutation substitutes a positively charged arginine for a polar tryptophan in the highly conserved RYLAM consensus of the beta 6 sheet of FGF3 that interacts with FGFR2. These findings describe, for the first time, variable inner ear malformations and outer ear dysplasia in the presence of constant microdontia, associated with homozygous inheritance of the p.R95W mutation in FGF3, mirroring phenotypes observed in mouse models ablating FGF3/FGFR2 signaling.

Sound detection with the cochlear implant in five ears of four children with congenital malformations of the cochlea.

To determine if the cochlear implant can enable sound detection in children with a congenitally deformed cochlea, we reviewed warble-tone thresholds in five ears of four children in the implant clinical trials program. Of the five ears, there were two common cavity deformities, two cochlear hypoplasias, and one incomplete partition. Four of the five ears had an auditory response to stimulation by the implant at the same level as ears deafened by other disorders. One ear that had an auditory response to stimulation also produced facial stimulation that precluded use of the implant. The one ear that did not stimulate was the incomplete partition. This ear had a very narrow internal auditory canal. Three patients are now using the implant in three ears to detect sound. Results show that a cochlear implant may enable sound detection in a patient with a malformed cochlea but that a very narrow internal auditory canal (less than 1.5 mm) detected preoperatively on radiographs may contraindicate an implant. Such anatomy suggests only a rudimentary audiovestibular nerve or no such nerve and only a facial nerve.

From labyrinthine aplasia to otocyst deformity

Inner ear malformations (IEMs) are rare and it is unusual to encounter the rarest of them, namely labyrinthine aplasia (LA) and otocyst deformity. They do, however, provide useful pointers as to the early embryonic development of the ear. LA is characterised as a complete absence of inner ear structures. While some common findings do emerge, a clear definition of the otocyst deformity does not exist. It is often confused with the common cavity first described by Edward Cock. Our purpose was to radiologically characterise LA and otocyst deformity. Retrospective analysis of CT and MRI data from four patients with LA or otocyst deformity. Middle and inner ear findings were categorised by two neuroradiologists. The bony carotid canal was found to be absent in all patients. Posterior located cystic structures were found in association with LA and otocyst deformity. In the most severe cases, only soft tissue was present at the medial border of the middle ear cavity. The individuals with otocyst deformity also had hypoplasia of the petrous apex bone. These cases demonstrate gradual changes in the two most severe IEMs. Clarification of terms was necessary and, based on these findings, we propose defining otocyst deformity as a cystic structure in place of the inner ear, with the cochlea, IAC and carotid canal absent. This condition needs to be differentiated from the common cavity described by Edward Cook. A clear definition of inner ear malformations is essential if outcomes following cochlear implantation are to be compared.

Bilateral Cochlear Implantation in Children With Anomalous Cochleovestibular Anatomy

To outline clinical experience with bilateral cochlear implantation in children with cochleovestibular anomalies. A prospective cohort study with a mean follow-up of 12 months. An academic, pediatric, tertiary referral center. All eligible children were prospectively recruited from January 1, 2007, through October 31, 2008. Ten children aged 9 to 33 months who had congenital inner ear malformations, including common cavity, incomplete partition, and cochleovestibular hypoplasia, participated. Bilateral cochlear implantation was performed sequentially with an interimplantation delay greater than 2 years in 7 children and less than 1 year in 1 child. Bilateral simultaneous implantation was performed in 2 children. Complications, hearing outcomes, and balance outcomes. All children underwent successful implantation. Five children had a perilymph "gusher" (on 1 side only), and there were no other complications. All children had 22 active electrodes bilaterally and achieved speech reception. All 8 children who underwent closed-set speech perception testing scored above 75%, and 5 of the 7 children who underwent open-set testing achieved scores above 75%. Despite variable vestibular function before bilateral implantation, no prolonged imbalance occurred, although 3 children (30%) had transient unsteadiness for up to 2 weeks after the second implantation. Bilateral cochlear implantation was performed safely and successfully in children with a spectrum of bilaterally anomalous cochleovestibular anatomy. Hearing outcomes suggest that these children should not be excluded from undergoing bilateral implantation. This study provides guidance on candidacy issues, surgical decision making, and surgical techniques in this group.

Quench-Limited SRF Cavities: Failure at the Heat-Affected Zone

With the recent progress in surface cleaning, the performance of superconducting RF cavities is mostly limited by a quench. It is important to understand the nature of the quench origin. In a common SRF cavity design the RF magnetic field is concentrated near the equatorial weld of the cavity. This weld has long been the major suspect in forming a surface defect, either as an impurity or in an increased surface roughness, that eventually gives rise to a quench. We used surface mounted thermometers to obtain a temperature map of the cavity in the quench region. A high temperature, temporal, and spatial resolution of the thermometry system allows us to pinpoint the quench origin with an accuracy of a few millimeters. We found that the hot-spot precursor forms in the weld heat-affected area rather than in the melted zone. The high resolution optical inspection found surface defects in exactly the same locations as the temperature mapping system. We will describe the measurement techniques and discuss possible scenarios of formation of these defects.

Two New Species of Photosymbiotic Ascidians of the GenusDiplosomafrom the Ryukyu Archipelago, with Partial Sequences of the COI Gene

Two new species of Diplosoma are described from coral reefs in the Ryukyu Archipelago, Japan: D. watanabei sp. nov. and D. gumavirens sp. nov. Colonies of both species are green due to algal symbionts of Prochloron, which are distributed in the common cloacal cavity. Both species are characterized by the point of emergence of the retractor muscle and a unique combination of stigma numbers among the four rows of the branchial sac. There are three adhesive papillae in the embryos of D. watanabei, as in most ascidian embryos and larvae, whereas the pre-hatching embryos of D. gumavirens sp. nov. posses 12-16 adhesive papillae. Partial sequences of the cytochrome c oxidase subunit I (COI) gene discriminated the new species from each other and from congeners.

T1229 Objective Definition and Detection of Transient Lower Esophageal Relaxation Revisited: Is There Room for Improvement?

The advent of pharmacological agents that inhibit TLESRs has increased the need for accurate objective identification and scoring of these events. The only current objective criteria were published over 10 years ago (Am.J.Physiol,1995;268:G128-13) and have not been subject to rigorous evaluation. Aims: To assess the performance of the TLESR criteria with regard to intraand inter-assessor variability and to improve them where necessary. Methods: Two 3-hour post-prandial esophageal manometric and pH recordings were performed at least 1 week apart in 20 healthy volunteers. Each recording was duplicated and all recordings were given a unique identifier, creating two datasets of 40 recordings. The recordings were analysed by 5 experienced observers for the occurrence of TLESRs based on their expert opinion. Scored TLESRs were also analysed for the presence of the original 4 criteria as well as inhibition of the crural diaphragm (ID), a prominent after-contraction (AC), acid reflux and an esophageal common cavity. Results: For TLESRs based on the observer's expert opinion, the overall inter-observer agreement was 59% (range 56-67%) and the intra-observer agreement 75% (60-89%). When TLESRs were restricted to those fulfilling the original criteria, inter-observer agreement fell to 46% (40-53%) and the intra-observer agreement to 60% (44-67%). Cleaning the recordings by removal of technically flawed sections (up to 20% of any one recording) improved inter and intra-observer agreement by 5%. Inclusion of additional criteria (ID and AC) for the identification of TLESRs in the second dataset resulted in interand intra-observer agreements of 62% (52-70%) and 69% (53-79%) respectively, close to those based on the observers expert opinion (64% (56-71%), 71% (61-80%). A consensus analysis performed collectively by 3 observers and based on the new criteria (original ± ID and AC) resulted in agreement between the paired recordings of 84%. The remaining disagreement was largely the result of technical difficulties with the recordings.Conclusions: The original criteria for the definition of TLESRs allows for substantial interand intra-observer variability. Incorporation of additional objective criteria reduces the variability. However, the highest level of intra-observer agreement can be achieved by consensus analysis.

T1230 TLESR Termination By Swallows: A Chance Event

The advent of pharmacological agents that inhibit TLESRs has increased the need for accurate objective identification and scoring of these events. The only current objective criteria were published over 10 years ago (Am.J.Physiol,1995;268:G128-13) and have not been subject to rigorous evaluation. Aims: To assess the performance of the TLESR criteria with regard to intraand inter-assessor variability and to improve them where necessary. Methods: Two 3-hour post-prandial esophageal manometric and pH recordings were performed at least 1 week apart in 20 healthy volunteers. Each recording was duplicated and all recordings were given a unique identifier, creating two datasets of 40 recordings. The recordings were analysed by 5 experienced observers for the occurrence of TLESRs based on their expert opinion. Scored TLESRs were also analysed for the presence of the original 4 criteria as well as inhibition of the crural diaphragm (ID), a prominent after-contraction (AC), acid reflux and an esophageal common cavity. Results: For TLESRs based on the observer's expert opinion, the overall inter-observer agreement was 59% (range 56-67%) and the intra-observer agreement 75% (60-89%). When TLESRs were restricted to those fulfilling the original criteria, inter-observer agreement fell to 46% (40-53%) and the intra-observer agreement to 60% (44-67%). Cleaning the recordings by removal of technically flawed sections (up to 20% of any one recording) improved inter and intra-observer agreement by 5%. Inclusion of additional criteria (ID and AC) for the identification of TLESRs in the second dataset resulted in interand intra-observer agreements of 62% (52-70%) and 69% (53-79%) respectively, close to those based on the observers expert opinion (64% (56-71%), 71% (61-80%). A consensus analysis performed collectively by 3 observers and based on the new criteria (original ± ID and AC) resulted in agreement between the paired recordings of 84%. The remaining disagreement was largely the result of technical difficulties with the recordings.Conclusions: The original criteria for the definition of TLESRs allows for substantial interand intra-observer variability. Incorporation of additional objective criteria reduces the variability. However, the highest level of intra-observer agreement can be achieved by consensus analysis.

Single Polarization-Mode-Beating Frequency Fiber Laser

We demonstrate a single-frequency fiber laser cavity that allows for measuring changes in the relative phase of two independent orthogonal polarization modes. Longitudinal-mode selection is carried out by a matched-pair of fiber Bragg gratings in a Fabry-Perot configuration and an intracavity polarizing beam splitter allows for adjustments on each polarization independently. The polarization-mode-beating signals generated with this laser are stable over long periods of time, owing to the noise cancellation effect achieved by the common cavity shared by both polarizations. This heterodyne detection scheme allows for measuring changes in frequency as small as 5 kHz, or equivalently, wavelength changes of 40 am (attometers) which are practically impossible to resolve in the wavelength domain. The proposed configuration has possible significance as an ultrasensitive and stable polarimetric optical fiber sensor.

Coupling of midaudio frequency thermoacoustic prime movers.

Multiple unit midaudio frequency thermoacoustic engine arrays have been studied in terms of synchronized self-sustaining oscillators. Thermoacoustic engines can be acoustically coupled through shared gas when attached to a common cavity. The coupling between devices was studied by varying the cavity volume, and by varying the separation distance between devices in an array. Frequency and phase measurements for two-engine arrays have suggested that the engines entrain at a common frequency with approximately zero phase difference implying the onset of synchronization. Amplitude measurements of synchronized arrays suggest that the acoustic amplitude is equal to the sum of the amplitudes of each uncoupled engine, and agree with predictions. Synchronization of four or more units in an array implies that the coupling between engines is global and depends on the volume of the cavity and the density of the gas within the cavity. The detuning between two engines was increased until synchronization no longer occurred. The threshold for this was found to be for a frequency difference of between 80 and 98 Hz for the given coupling strength when operating near 2.5 kHz. [Research supported by the U.S. Army Space and Missile Defense Command/U.S. Army Forces Strategic Command.]

Real-Time Intraoperative Computed Tomography to Assist Cochlear Implant Placement in the Malformed Inner Ear

Cochlear implantation is increasingly being performed in children with inner ear malformations. In severe cochleovestibular anomalies, such as severe partitioning defects and common cavity dysplasia, positioning of the electrode array can be hazardous, with inadvertent placement into the internal auditory canal (IAC) or carotid canal being well known. We describe a case in which real-time intraoperative computed tomographic scanning was used to help achieve proper electrode positioning in a child with a severe malformation. Child with common cavity malformations undergoing cochlear implantation. Intraoperative computed tomography used during implantation procedure. Use of technique in determining electrode position. A 10-year-old patient with bilateral common cavity malformations presented with declining performance in a functioning implant placed 7 years earlier. The family elected implantation of the contralateral ear. Via a posterior labyrinthotomy approach, a straight array was placed into the common cavity. Intraoperative computed tomographic scanning was immediately performed on the operating room table, showing that the array was in the IAC. A second attempt with a different insertion angle also resulted in IAC placement. In a third attempt, the electrode was advanced as a loop, grasping the tip through an adjacent second labyrinthotomy. Computed tomography confirmed good position against the outer wall of the cavity. Real-time intraoperative computed tomography is a new technology with many potential applications in surgery. In our patient, it allowed rapid and accurate determination of electrode position and helped achieve ideal placement in a severely malformed inner ear.

Vestibular evoked myogenic potentials of children with inner ear malformations before and after cochlear implantation

Conclusions: Our results show that among the patients with inner ear malformations, there were two patients with sensory cells of sacculus and inferior vestibular neurons and at least five patients with inferior vestibular neurons only, but no patients without sensory cells and vestibular neurons, as determined on the basis of vestibular evoked myogenic potentials (VEMPs). Objective: The aim of this study was to investigate whether sensory cells of sacculus or inferior vestibular neurons or both are present in cochlear implant patients with inner ear malformations, particularly common cavity (CC) deformity, using VEMPs. Patients and methods: Seven children with inner ear malformation who underwent cochlear implantation (CI) participated in this study. The patients had CC deformity (n=2), incomplete partition type I (n=2), incomplete partition type II (n=1), or a narrow internal auditory canal (IAC) (n=2). It was possible to record VEMPs before and after CI in three patients and not before but after CI in four patients. After surgery, VEMPs were recorded with the cochlear implant device switched both off and on. Results: Before the CI, two patients showed VEMPs and one patient showed no VEMPs, whereas in four patients no VEMPs could be recorded. All the patients showed VEMPs with the cochlear implant on.

耳性髄液漏を伴った髄膜炎を発症した内耳奇形合併成人例

We report a 46-year-old man with bacterial meningitis and left cerebrospinal fluid (CSF) otorrhea associated with inner ear malformation (common cavity type). Left tympanotomy showed granulation over the stapes and water-like otorrhea, and the stapes was separated from the thickened incus long arm. A partial defect was present in the stapes foot plate, and removal of the stapes led to pronounced leakage of CSF. We therefore packed the vestibule with fascia and small pieces of auricular cartilage tightly and then positioned the cap of the vestibule with fascia and fibrin glue. He has remained well and free from meningitic symptoms for two years after the operation. Our case indicates that the occlusion of the vestibule with fascia and auricular cartilage should be considered even in cases without a history of meningitis.

Gross anatomy of the oropharyngeal cavity in the ostrich (Struthio camelus)

Summary There are significant structural differences between the mouth and pharyngeal cavity of birds and mammals.It is usual to refer to a common oropharyngeal cavity of birds because the soft palate, which forms such an obvious delineation between the mouth and pharyngeal cavity, is absent. Six male adult ostriches were used to study the oropharyngeal cavity and its components including the beak, hard palate, pharynx, tongue and the larynx macroscopically. This study revealed that these components in ostrich have different features trom other birds. In the ostrich, the beaks are spoon-shaped and the tongue is characterized by a short, broad and semicircular form. The hard palate is concave with a prominent median mucosal fold in its 2/3 rostral area and two oblique choanal slits in its caudal third area. The roof of pharynx presents infundibular slit in midline, a deep concave notch in caudal border and pharyngeal tonsils on its dorsal surface. The larynx protrudes trom the floor of pharynx and consists of the unpaired cricoid cartilage and the paired arytenoid cartilages.