Lateral Canal Research Articles

Penetration of Three Endodontic Sealers in Simulated Lateral Canals during the Lateral Condensation Technique: An In Vitro Study.

This study aimed to compare the penetration depths of AH Plus, BioRoot RCS, and GuttaFlow 2 into simulated lateral canals when used with the cold gutta-percha lateral compaction technique. Twelve resin training blocks (4 canals perch each resin block) were used. Each primary artificial canal had two lateral canals (apical and coronal). The main canals were instrumented with WaveOne Gold and irrigated with distilled water. The resin blocks were divided into three groups (N = 4 each/16 artificial canals), according to the type of root canal sealer; Group I: AH Plus, Group II: BioRoot RCS, and Group III: GuttaFlow 2. All canals were obturated with the cold lateral condensation technique. The linear extension of each endodontic sealer into the apical and coronal lateral canals was measured using a digital stereomicroscope and measuring software. Data were statistically analyzed using a one-way analysis of variance. The percentages of filling of the lateral canals were calculated and statistically compared using the Mann-Whitney test. The experimental sealers exhibited variable penetration depths into the lateral canals. All sealers showed significantly better penetration ability into the apical lateral canals than the coronal lateral canals (P < 0.05). AH Plus (3.184 ± 0.012 mm/99.5%) and GuttaFlow 2 (3.176 ± 0.017 mm/99.25%) were significantly better than BioRoot RCS (3.096 ± 0.026 mm/96.75%) in filling the apical lateral canals (P < 0.05). BioRoot RCS was the best sealer to fill coronal lateral canals (3.322 ± 0.085 mm/83.05%). During the lateral condensation technique, the filling of the lateral canals is affected by the type of root canal sealer and the location of the lateral canals All the sealers tested have a good ability to fill the apical lateral, while BioRoot RCS was effective in filling both the coronal and apical lateral canals.

CeruminousSyringocystadenoma papilliferum: An Extremely Rare Neoplasm of the External Ear

Abstract Introduction/Objective Syringocystadenoma papilliferum (SCAP) is a rare benign adnexal tumor derived from the apocrine or the eccrine sweat glands on the face or the scalp. Ceruminous glands are modified apocrine glands in the external auditory canal and produce cerumen that helps the ear canal against physical damage and microbial invasion. Neoplastic transformation of these glands is even rarer among these benign tumors. Methods/Case Report Here we report a case of a 29-year-old female with a three-month history of progressively worsening right-sided ear pain, muffled hearing, aural fullness, and right-sided shooting aches. She reported that her ear felt sensitive to touch and was painful if she lay on it. Previous treatments included steroids and oral antibiotics without any improvement in symptoms. A physical exam revealed a right narrow ear canal with a cystic mass to the superior lateral canal wall. A CT Temporal Bone showed a 1 cm oval soft tissue lesion in the lateral osseous portion of the right external auditory canal with no underlying osseous erosions identified. This is nonspecific, and neoplasm cannot be excluded. The decision was made for excision. The mass ruptured during excision with dishwater appearing fluid. Microscopic examination showed papillae lined by bilayered glandular epithelium projecting into a cystic lumen. Well defined myoepithelial cell layer is appreciated. Decapitation secretions and plasma cells are noted to be present in the stroma. A final diagnosis of Syringocystadenoma papilliferum is made. Results (if a Case Study enter NA) NA. Conclusion Ceruminous Syringocystadenoma papilliferum is an extremely rare benign tumor of the ceruminous glands of the external ear. Complete excision is the treatment of choice

ROLE OF HIGH RESOLUTION COMPUTED TOMOGRAPHY IN THE EVALUATION OF TEMPORAL BONE LESIONS

Objectives: The study’s primary goal is to assess inflammatory, traumatic, and neoplastic disorders that impact the temporal bone using high resolution computed tomography (HRCT). The other aim is to comprehend how HRCT can diagnose and detect pathologies of the temporal bone. Methods: The study was conducted at Dr. Patnam Mahender Reddy Institute of Medical Sciences from Jan 2018 to Jan 2020 with a sample size of 60. Written consent for participation in the study was taken before the scan. The study was evaluated with multidetector HRCT-HITACHI 128 SLICE machine. CT images are usually acquired or displayed in axial and coronal planes. Results: Among 60 patients, 44 patients were diagnosed with infections, 11 were diagnosed with tumors, and five patients with anatomical variants. Among 60 patients, 32 (53.3%) were male patients, and 28 (46.6%) were female patients; hence, study shows a male preponderance. Out of 60 patients, the highest number was recorded in those aged 21–30 years 16 (36%). Among 60 patients, 44 suspected of having a middle ear infection were studied. Among these 44 patients, 27 (61.3%) were diagnosed with otomastoiditis, 16 (36%) patients were diagnosed with cholesteatoma, and 1 (2.2%) patient was diagnosed with malignant otitis externa. In our study population of 60 patients, 11 were diagnosed with neoplasms. Among the 11 patients, 7 (67%) were diagnosed with acoustic neuroma in the cerebellopontine angle. Conclusion: The existence of cholesteatoma, changes to the ossicular chain, and erosion of the lateral semicircular canal were all intraoperatively detected in the present study with excellent sensitivity to the clinical and radiographic findings. For correcting any congenital ear anomalies, the HRCT results were helpful for planning and management tools for the surgeon.

Labyrinthine Fistula in Chronic Otitis Media Surgery: Management and Outcomes.

The objective of this retrospective study was to present the experience on the management of labyrinthine fistula secondary to chronic otitis media in a tertiary center. 263 patients, who underwent tympanomastoidecomy, in Centro Hospitalar Universitário do Porto, between 2015 and 2020 were reviewed, to select only those with labyrinthine fistulas. 26 patients (9.89%) had cholesteatoma complicated by fistula of the lateral semicircular canal. Most frequent symptoms were unspecific, such as otorrhea, hearing loss and dizziness. Preoperative high-resolution computed tomography predicted fistula in 54%. Using the Dornhoffer and Milewski classification, 10 cases (38.46%) were identified as stage I, 15 (57.69%) at stage II, and 1 (3.85%) as stage III. The choice between open or closed surgical procedure was independent of the type of fistulae. The cholesteatoma matrix was completely removed from the fistula and immediately covered by autogenous material. In one patient matrix was left over the fistula. After surgery, hearing (bone conduction) was preserved or improved in 73% of the patients. There was no statistically significant relationship between the extent of the labyrinthine fistula, type of material used in fistula repair and the hearing outcome. Also, we didn't find a statistically significant relationship between extent of the labyrinthine fistula and the presence of facial nerve canal dehiscence, tegmen timpani erosion, sigmoid sinus exposure or ossicular bone erosions. In conclusion, a complete and nontraumatic removal of cholesteatoma matrix over the fistula in a single-staged procedure, is a safe and effective procedure, which achieves a hearing preservation or improvement in most cases.

Recurrent Vestibulopathy: Comparison of Vestibular Test Results with Ménière’s Disease and Vestibular Migraine

Introduction: Recurrent and episodic vestibular symptoms not fulfilling criteria for known episodic vestibular syndromes are named as recurrent vestibulopathy (RV). We aimed to compare the vestibular test results of RV patients with vestibular migraine (VM) and Ménière’s disease (MD). Methods: Twenty patients with MD, 20 patients with VM, 18 patients with RV, and 20 healthy volunteers (HC) were evaluated. Pure-tone hearing thresholds (PTHTs), video head impulse test (vHIT), functional head impulse test (fHIT), and cervical vestibular evoked myogenic potentials (cVEMPs) were studied. Results: PTHT of the MD-affected ears were significantly high, and cVEMP-corrected amplitudes were low when compared with the VM, RV, and HC (p < 0.001 for all). Amplitude asymmetry ratio was significantly high in MD-affected ears when compared with the HC (p = 0.014), VM (p = 0.038), and RV (p = 0.045). VEMP latencies and lateral canal vHIT gain were not different between groups (p > 0.05). The percentage of correctly identified optotypes on fHIT of the MD (p > 0.001), VM (p = 0.004), and RV (p = 0.001) patients were low in comparison with the HC. Conclusion: Apart from hearing loss, low cVEMP amplitudes on the affected side were the main feature in MD differentiating it from VM and RV. Vestibular test results of patients with RV and VM were similar. Low fHIT results in all groups indicate a functional deficit in gaze stabilization. Disabling vertigo attacks disturbing attention may be the cause of this functional impairment. MD, VM, and RV may be parts of a broad-spectrum disorder, RV patients representing milder forms not associated with cochlear or migrainous features.

Correlation between video head impulse test parameters and DHI score in patients with vestibular neuritis

Objective:To explore the correlation between the parameters of video head impulse test （vHIT）and dizziness handicap inventory （DHI） score in patients with vestibular neuritis. Methods:Clinical data of 46 patients with vestibular neuritis were retrospectively analyzed. All the patients underwent DHI evaluation and vHIT examination. They were divided into mild handicap group, moderate handicap group and severe handicap group according to DHI score. The correlations between the parameters of vHIT and DHI score were compared among the three groups. The important parameters of vHIT were compared including vestibulo-ocular reflex （VOR） gain, gain asymmetry ratio （GA）, abnormal saccade dispersion （PR%）. Results:Of the 46 patients, 10 were in the mild handicap group, 21 in the moderate handicap group, and 15 in the severe handicap group. ①In the comparison of the mean value of lateral semicircular canal VOR gain, the vHIT gain of patients with mild, moderate and severe handicap were 0.64±0.06, 0.53±0.11 and 0.37±0.10, respectively, the mean value of VOR gain was negatively correlated with DHI score among the three groups（r=-0.545, P<0.001）, and the pairwise comparisons among the three groups was statistically significant（P<0.05）. In comparison of the mean values of lateral semicircular canal GA, the GA values of mild, moderate and severe handicap groups were 46.40±21.81, 47.59±15.17 and 56.57±17.39, respectively, there was no significant linear correlation between GA values and DHI scores among the three groups（r=0.246, P>0.05）, there was no significant difference between the three groups（P>0.05）. In comparison of the mean PR% of the lateral semicircular canal, the mean PR% of patients with mild, moderate and severe handicap group were 32.00±10.62, 53.82±17.09 and 76.00±10.01, respectively, PR% was positively correlated with DHI score（r=0.726, P<0.001）, and the comparison among the three groups was statistically significant（P<0.05）. ②The vertical semicircular canal vHIT gain of patients with mild, moderate and severe handicap was 0.63±0.06, 0.52±0.15 and 0.38±0.16, respectively, the mean of VOR gain was negatively correlated with DHI score among the three groups（r=-0.487, P<0.01）, the comparison of mild-severe and moderate-severe group was statistically significant（P<0.05）, while there was no significant difference between the mild and moderate group（P>0.05）. In the comparison of the mean values of vertical semicircular canal GA, the GA values of mild, moderate and severe handicap groups were 40.40±15.31, 46.10±19.59 and 47.87±18.05, respectively, there was no significant linear correlation between GA values and DHI scores among the three groups（r=0.047, P>0.05）, there was no significant difference in GA among the three groups（P>0.05）. The PR% of patients with mild, moderate and severe handicap were 42.40±15.39, 54.14±17.60 and 64.93±10.95, respectively, there was a positive significant correlation between PR% and DHI score（r=0.454, P<0.05）, there was statistically significant in the comparison of mild-severe group（P<0.05）, while there was no statistical significance between the other groups（P>0.05）. Conclusion:The VOR gain and PR% value of vHIT in patients with vestibular neuritis are closely related to the DHI score, which can evaluate the vestibular function and the degree of vertigo.

Clues for facial canal dehiscence in chronic otitis media

Introduction and objectivesThe goal of this study was to determine the impact of external and middle ear findings in the incidence of facial canal dehiscence (FCD) during mastoidectomy for chronic otitis media. Material and methodsWe examined the operative details of 186 patients who underwent primary tympanomastoidectomy for chronic otitis media between January 2015 and January 2020 retrospectively.In this study we only evaluated the second portion of the facial nerve canal. ResultsThe global prevalence of FCD was 22.6% (42/186 patients) with a higher incidence, of 38.7% (36/93), in patients with chronic otitis media with cholesteatoma (C-COM).Associations were found between facial canal dehiscence, labyrinthine fistula (p˂ .001) and facial nerve paralysis (p˂ .001).Ossicular erosions were observed at a significant level in patients with facial canal dehiscence, the incidence of FCD was significantly higher (p=.005, Odds ratio 5.489) when malleus and incus were eroded, incus plus stapes were eroded (p=.014; OR 4.059) and malleus, incus, and stapes together were eroded (p=.002; OR 4.929). ConclusionsThis study revealed an incidence of facial canal dehiscence of 22.6%. It also revealed that the presence of lateral semicircular canal fistula is associated with a higher prevalence of facial canal dehiscence.The same was noted in the case of some ossicular erosions, especially the combinations of eroded malleus and incus, incus and stapes, and all 3 ossicles.These findings raise awareness about the usefulness of middle ear findings in predicting FCD, thus providing valuable information for the otological surgeon to avoid iatrogenic injuries.

Osteoclast activity sculpts craniofacial form to permit sensorineural patterning in the zebrafish skull.

Efforts to understand the morphogenesis of complex craniofacial structures have largely focused on the role of chondrocytes and osteoblasts. Along with these bone-creating cells, bone-resorbing osteoclasts are critical in homeostasis of adult skeletal structures, but there is currently limited information on their role in the complex morphogenetic events of craniofacial development. Fundamental aspects of skull formation and general skeletal development are conserved from zebrafish to mammals. Using a cathepsinK reporter, we documented osteoclast location in the developing zebrafish skull over several weeks, from 5.18mm to 9.6mm standard length (approximately 15 to 34 days post fertilization). While broad distribution of osteoclasts is consistent across individuals, they are sparse and the exact locations vary among fish and across developmental time points. Interestingly, we observed osteoclasts concentrating at areas associated with neuromasts and their associated nerves, in particular the hyomandibular foramina and around the supraorbital lateral line. These are areas of active remodeling. In contrast, other areas of rapid bone growth, such as the osteogenic fronts of the frontal and parietal bones, show no particular concentration of osteoclasts, suggesting that they play a special role in shaping bone near neuromasts and nerves. In csf1ra mutants lacking functional osteoclasts, the morphology of the cranial bone was disrupted in both areas. The hyomandibular foramen is present in the initial cartilage template, but after the initiation of ossification, the diameter of the canal is significantly smaller in the absence of osteoclasts. The diameter of the supraorbital lateral line canals was also reduced in the mutants, as was the number of pores associated with neuromasts, which allow for the passage of associated nerves through the bone. Our findings define important and previously unappreciated roles for osteoclast activity in shaping craniofacial skeletal structures with a particular role in bone modeling around peripheral cranial nerves, providing a scaffold for wiring the sensioneural system during craniofacial development. This has important implications for the formation of the evolutionarily diverse lateral line system, as well understanding the mechanism of neurologic sequelae of congenital osteoclast dysfunction in human craniofacial development.

Evaluating children with vestibular migraine through vestibular test battery: A cross-sectional investigation.

The present study aimed to investigate the status of vestibular function in children with vestibular migraine of childhood (VMC) reflected by vestibular function test battery and explore the pathophysiological implication of these instrument-based findings. The clinical data of 22 children (mean age 10.7 ± 2.9 years) with VMC who met the diagnostic criteria of the Barany Society were collected from September 2021 to March 2022. A vestibular function test battery on these children included a caloric test, video head impulse test (vHIT), cervical vestibular-evoked myogenic potential (cVEMP), and ocular vestibular-evoked myogenic potential (oVEMP); these parameters were triggered by air-conducted sound (ACS) and galvanic vestibular stimulation (GVS). The subjects were further divided into two groups: <3 months and >3 months according to the disease duration from symptom onset. The functional abnormalities and their characteristics reflected by the vestibular test battery, as well as the outcomes in children with or without aura, were analyzed. (1) The abnormal rate of the caloric test was 15.8% and that of vHIT was 0%. The response rates of ACS-cVEMP and ACS-oVEMP were 100% and 90.5%, respectively. The response rates of GVS-cVEMP and GVS-oVEMP were 100% and 88.9%, respectively. (2) No statistical difference was observed in the abnormal rate of the caloric test (P = 0.55) and the response rate of ACS-oVEMP (P = 0.21) between the two groups, irrespective of the course duration. (3) No statistical difference was detected in the abnormal rate of the caloric test (P = 0.53) and the response rate of ACS-oVEMP (P = 1.00) in children with or without aura. Vestibular function status comprehensively reported by the vestibular test battery did not show an aggravation with the disease duration in children with VMC. Also, it was not affected by the existence of aura in children with VMC. The high abnormal rates of the caloric test and oVEMPs (ACS-oVEMP and GVS-oVEMP) suggested that the lateral semicircular canal (low-frequency function component), the utricle, and the superior vestibular conduction pathway might be involved in VMC.

Morphology and morphometry of the inner ear of the dromedary camel and their influence on the efficiency of hearing and equilibrium

BackgroundThe inner ear morphology and size are linked to hearing and balance ability. The goal of this study was to determine the morphology and morphometrics of the dromedary camel's inner ear and how it influences hearing accommodation and equilibrium in the desert environment.Materials and methodsGross morphology, computed tomography images, and the endocast were used to show the inner ear morphology. A caliper and ImageJ software were used to take measurements on a plastic endocast.ResultsThe presence of the subarcuate fossa, flat cochlea, radii curvature of the semicircular canals, particularly the lateral semicircular canal, orthogonality, and the union between the semicircular canals, along with slightly increased saccule and utricle size, maintains camel balance on sandy ground, even during heavy sandstorms. The cochlear basilar membrane length and cochlea radii ratio aided low-frequency hearing and perception over a wide octave range.ConclusionThe camel's cochlear characteristics revealed a lengthy basilar membrane, a high radii ratio, 3.0 cochlear canal turns, and a very broad cochlea. The orthogonality of the semicircular canals, the high curvature of the lateral semicircular canal, the presence of the subarcuate fossa, and the confluence between the lateral and posterior semicircular canal were particular specifications that allowed the inner ear of the camel to adapt to desert living.

Endocasts of the basal sauropsid Captorhinus reveal unexpected neurological diversity in early reptiles.

Captorhinids are a group of Paleozoic amniotes that represents one of the earliest-diverging clades of eureptiles. Although captorhinids are one of the best-known and most well-studied clades of early amniotes, their palaeoneuroanatomy has gone largely unexamined. We utilized neutron computed tomography to study the virtual cranial and otic endocasts of two captorhinid specimens. The neurosensory anatomy of captorhinids shows a mixture of traits considered plesiomorphic for sauropsids (no expansions of the cerebrum or olfactory bulbs, low degree of encephalization, low ossification of the otic capsule) and those considered more derived, including moderate cephalic and pontine flexures and a dorsoventrally tall bony labyrinth. The inner ear clearly preserves the elliptical, sub-orthogonal canals and the short, rounded vestibule, along with an unusually enlarged lateral canal and a unique curvature of the posterior canal. The reconstructed neurosensory anatomy indicates that captorhinids were sensitive to slightly higher frequencies than many of their contemporaries, likely reflecting differences in body size across taxa, while the morphology of the maxillary canal suggests a simple, tubular condition as the plesiomorphic state for Sauropsida and contributes to the ongoing discussions regarding the phylogenetic placement of varanopids. This study represents the first detailed tomographic study of the brain and inner ear of any basal eureptile. The new data described here reveal that the neuroanatomy of early sauropsids is far more complex and diverse than previously anticipated, and provide impetus for further exploration of the palaeoneuroanatomy of early amniotes.

Bibliometric analysis of top-cited articles in Journal of Dental Sciences

Background/purposeBibliometric analysis is a method for quantifying the article distribution, impact, and performance. The purpose of this study was to identify the most top-cited articles published in Journal of Dental Sciences (JDS) and further analyze their main characteristics. Materials and methodsWeb of Science, Journal Citation Reports database was searched to retrieve the most-cited articles in JDS published from 2007 to July 31, 2022. Among the included top-cited articles, the following parameters were recorded and analyzed: article title, article type, year, country, number of citations, and average citations pre year. Microsoft Excel was applied for the descriptive bibliometric analysis. Results41 top-cited articles were filtered from total 1165 JDS articles in Web of Science database. The results showed that 41 top-cited articles were cited between 20 and 186 times from Journal Citation Reports. Most of the article types are original article (28/41, 68.29%) following by review article (7/41, 17.07%). The majority of articles were originated from Taiwan (23/41, 56.10%). The top 4 most cited articles were relative to the research topic on COVID-19, lateral canal, guided-tissue regeneration barriers, and platelet-rich fibrin, respectively. However, articles analyzed by the average citations per year since publication were focused on COVID-19 followed by artificial intelligence. ConclusionThis bibliometric analysis illustrates the progress and trend of researches in JDS. The results may also offer a reference for recognizing the hot issues with the most citations in JDS.

Clinical case: second mandibular premolar with three root canals

The effectiveness and success of endodontic treatment depends on the doctor's professionalism and knowledge of the anatomy and morphology of root canals. The equipment that is at the disposal of the dentist is also of great importance. At the moment, it is difficult to imagine the diagnosis of complex endodontic pathology without the use of cone-beam computed tomography. Diagnostic radiographs in different projections are important for getting an idea of the number of existing root canals, but do not always give a complete picture of the anatomy and morphology of root canals. Magnifying devices (binoculars and dental microscope) are also very helpful for competent treatment in modern dentistry in general and endodontics in particular. Premolars of the mandible are among the most difficult teeth for endodontic treatment due to a sufficient number of variations in internal morphology, the presence of additional root canals, apical deltas and lateral canals.

Presentation, Management, and Hearing Outcomes of Labyrinthine Fistula Secondary to Cholesteatoma: A Systematic Review and Meta-analysis.

The current study systematically reviewed the literature to compare auditory outcomes of patients treated for labyrinthine fistula (LF) based on characteristics of disease and surgical management. PubMed, Scopus, Web of Science. Original series (at least five cases) published from 2000 reporting management and hearing results of LF secondary to cholesteatoma were included. Proportion and odds-ratio (OR) meta-analyses were conducted through inverse variance random-effects models based on logit transformation. The prevalence of LF is estimated to be 7% (95% confidence interval [CI], 5-9%). Fistulae involving the lateral semicircular canal (90%; 95% CI, 87-93%) and larger than 2 mm (53%; 95% CI, 43-64%) were common, whereas membranous involvement was less frequent (20%; 95% CI, 12-30%). Complete removal of the cholesteatoma matrix overlying the LF was mostly applied. Bone conduction (BC) preservation was frequently achieved (81%; 95% CI, 76-85%); new-onset postoperative anacusis was rarely reported (5%; 95% CI, 4-8%). A higher chance of BC preservation was associated with sparing the perilymphatic space (OR, 4.67; 95% CI, 1.26-17.37) or membranous labyrinth (OR, 4.56; 95% CI, 2.33-8.93), exclusive lateral semicircular canal involvement (OR, 3.52; 95% CI, 1.32-9.38), smaller size (<2 mm; OR, 3.03; 95% CI, 1.24-7.40), and intravenous steroid infusion (OR, 7.87; 95% CI, 2.34-26.42). LF occurs in a significant proportion of patients with cholesteatoma. In the past two decades, complete removal of the cholesteatoma matrix followed by immediate sealing has been favored, supported by the high proportion of BC preservation. Hearing preservation depends primarily on characteristics of the LF, and specific surgical strategies should be pursued. Intraoperative and postoperative intravenous steroid infusion is recommended.

Head shaking does not alter vestibulo ocular reflex gain in vestibular migraine.

Vestibular Migraine (VM) is the most common cause of non-positional episodic vestibular symptoms. Patients with VM commonly report increased motion sensitivity, suggesting that vestibular responses to head movement may identify changes specific to VM patients. Here we explore whether the vestibulo-ocular reflex (VOR) gain alters in response to a clinical “headshake” maneuver in patients with VM. Thirty patients with VM in the inter-ictal phase, 16 patients with Benign Positional Paroxysmal Vertigo (BPPV) and 15 healthy controls were recruited. Patients responded to the question “Do you feel sick reading in the passenger seat of a car?” and completed a validated motion sickness questionnaire as a measure of motion sensitivity. Lateral canal vHIT testing was performed before and after headshaking; the change in VOR gain was calculated as the primary outcome. Baseline VOR gain was within normal limits across all participants. There was no significant change in VOR gain after headshaking in any group (p = 0.264). Patients were 4.3 times more likely to be in the VM group than in the BPPV group if they reported nausea when reading in the passenger seat of a car. We postulate that a headshake stimulus may be insufficient to disrupt cortical interactions and induce a change in VOR gain. Alternatively, changes in VOR gain may only be apparent in the acute phase of VM. Reading in the passenger seat of a car was considered uncomfortable in all VM patients suggesting that this specific question may be useful for the diagnosis of VM.

Caloric and video head impulse test dissociated results in dizzy patients.

IntroductionWe are now able to detect abnormalities for any semicircular canal with the use of the video head impulse test (vHIT). Prior to the vHIT, the gold standard for unilateral canal paresis of the lateral canal was considered the caloric test. Clinical cases where the caloric test and vHIT are discordant are not uncommon.MethodsRetrospective study. All consecutive cases of dizziness seen from 11/2020 to 12/2021 for which the patient underwent both caloric and vHIT tests performed within 10 days, were reviewed. Patients with discordant results were included. We evaluated the caloric response, vHIT gains for all canals and saccades, with and without gain abnormalities.ResultsWe included 74 cases of dizziness with dissociated results. The most common finding was a normal caloric response with abnormal vHIT results (60.8%); the main abnormal finding on vHIT was the presence of saccades. In this group, 37.7% of patients had normal gains and refixation saccades. In addition, the most found low gain was for the posterior canal. The main diagnosis in this group was vestibular migraine. For the group with unilateral caloric paresis and normal vHIT gain in the lateral canal, the main diagnosis was Ménière's disease.DiscussionThe most common disorders with discordant results were Ménière's disease and vestibular migraine. The caloric test and vHIT are complementary and combining both tests provide greater clinical information. Further research is needed to understand refixation saccades with normal gains.

Low-grade papilárny adenóm zo saccus endolymphaticus – kazuistika

The authors present a case report of a 38-year-old female patient admitted at the Department of Otorhinolaryngology and Head and Neck Surgery in Ružomberok with an 18-month history of vertigo, right-sided tinnitus, sensorineural hearing loss and facial nerve paresis. The patient was dia gnosed with an 8 mm temporal bone tumor, located in the area of the lateral posterior semicircular canal and vestibule, which was intraoperatively identified as an extremely rare aggressive low-grade adenocarcinoma of the endolymphatic sac. In the case report, the authors discuss the anatomy, dia gnosis, CT and MRI images, the chosen surgical procedure and the subsequent dispensarization of the patient as well as an overview of the relevant literature. Keywords papillary adenocarcinoma – Heff ner’s tumor – saccus endolymphaticus

A new species of deep-water Lethrinops (Cichlidae) from Lake Malawi.

A new species of cichlid fish, Lethrinops atrilabris is described from specimens collected by trawling at a depth of around 90 m off Monkey Bay, southern Lake Malawi. It is assigned to the genus Lethrinops on the basis of its vertical flank barring, lack of enlarged cephalic lateral line canal pores and the form of the lower jaw dental arcade. It can be distinguished from congeneric species by its male breeding dress of contrasting flank barring and dark ventral surface, most strikingly on the lips, throat and chest, its relatively small known maximum size [<75 mm standard length (SL)], large eyes (38%-41% head length), laterally compressed body (depth 2.5-2.7 times max head width) and lower gill raker count (13-14).

Assessment of Saccular and Semicircular Canal’s Function in Behcet’s Disease

Background and Aim: Behcet’s disease (BD) is a multisystemic, chronic and progressive disorder with a relatively high prevalence in Iran. Therefore, this study aimed to compare the vestibular function between Iranian BD patients and normal subjects using cervical vestibular- evoked myogenic potentials (cVEMPs) and video head impulse test (vHIT). Methods: In this cross-sectional study, 44 patients with definitive BD in the inactive stage of disease and 30 age and sex matched normal subjects were evaluated via cVEMP and vHIT tests and dizziness handicap inventory (DHI). Then the parameters of the tests were compared between the two groups by statistical methods. Moreover, the effects of DHI scores and other contextual variables on the test results were examined. Results: In terms of the cVEMP test, the response rate and mean latency of p13 in the left ear were significantly lower, the amplitude of the cVEMP wave in the left ear and the amplitude asymmetry ratio were significantly higher in BD patients compared to normal subjects (p&lt;0.05). Fifteen BD patients had abnormal amplitude and nine patients had abnormal latency of cVEMP responses. In terms of the vHIT test, the mean vestibule-ocular reflex gain of the left posterior semicircular canal and the mean gain asymmetry ratio of lateral canals were significantly higher in BD patients than in the controls (p&lt;0.05). Conclusion: the vestibular system of some patients with BD is disturbed and the results of this study indicate the presence of unilateral vestibular weakness in BD. So vestibular assessment can be helpful for these patients. Keywords: Cervical vestibular evoked myogenic potentials; video head impulse test; saccule; semicircular canals; behcet’s disease

Lasers in endodontics review

Lasers have been a significant advancement in the field of endodontics. Be it effective cleaning, root canal treatment, surgery etc. The lateral accessory canals and anatomical complexities have been a restraint in root canal procedure, for such cases lasers have been introduced to simplify the process &amp; have good clinical results. As there has been a boon in the improvement of laser techniques, many latest lasers having a broad array of characteristics is accessible and can also be helpful in several areas related to dentistry. When compared with conventional techniques, laser treatments have been proven to be more advantageous. The purpose of this article is to summarize laser applications in endodontics, including their use in pulp diagnosis, dentinal hypersensitivity, pulp capping and pulpotomy, sterilization of root canals, root canal shaping &amp; obturation &amp; apicectomy. This article reviews the role of lasers in endodontics since the early 1970s &amp; summarizes what future may hold for endodontics. With the potential availability of many new laser wavelengths and modes, much interest is developing in this promising field.