Emily Young

St. Paul's Hospital

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Brian D. Westerberg

University of British Columbia

Jane Lea

University of British Columbia

Marc J. W. Lammers

University of Antwerp

Michael Yong

Stanford University

I.M. Loftus

St George’s University Hospitals NHS Foundation Trust

Kevin Gregory‐Evans

University of British Columbia

Anat Yanai

University of British Columbia

Peter Holt

St George's Hospital

Matt Thompson

Endologix (United States)

Frederick K. Kozak

British Columbia Children's Hospital

Cooperative Institutions

Genomics England

University College London

Biomedical Research Networking Center on Neurodegenerative Diseases

23andMe (United States)

National Hospital for Neurology and Neurosurgery

Instituto de Salud Carlos III

Inserm

Centro de Investigación Biomédica en Red

Universidad de Sevilla

National Institutes of Health

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Risk of Stroke and Myocardial Infarction After Sudden Sensorineural Hearing Loss: A Meta‐Analysis

The Laryngoscope (2020)

Marc J. W. Lammers Emily Young Brian D. Westerberg Jane Lea

The pathophysiology of idiopathic sudden sensorineural hearing loss (ISSNHL) is still unknown, but labyrinthine artery infarction has been proposed. The objective of this study was to perform a systematic review and conduct a meta-analysis assessing the risk of developing stroke and myocardial infarction after presentation with ISSNHL.A systematic literature review was conducted using Pubmed, Embase, Web of Science, and Cochrane Libraries. All studies investigating an association between ISSNHL and stroke and/or myocardial infarction (MI) were included. Adhering to the MOOSE guideline, two independent reviewers extracted data, assessed risk of bias, and evaluated the relevance and quality of evidence.Three observational studies evaluating the risk of stroke in ISSNHL were included (n = 6,521 patients). All individual study results indicated an increased relative risk of stroke after ISSNHL (unadjusted relative risk range 1.21-1.63). Pooled adjusted hazard ratios revealed a 1.42-fold increased risk of stroke after ISSNHL (hazard ratio [HR] 1.42; 95% confidence interval [CI] 1.15-1.75, I2 = 55%). Subgroup analysis of one study demonstrated that the increased risk is only present in adults aged above 50 years (HR 1.23; 95% CI 1.07-1.42). Five observational studies evaluating the risk of MI in patients with ISSNHL were included (n = 61,499 patients). Pooled analyses demonstrated that ISSNHL was not associated with MI (HR 1.08, 95% CI 0.87-1.34).ISSNHL may be an independent risk factor for the subsequent development of stroke especially in a subgroup of elderly patients. More studies are needed to confirm this association and to assess whether such patients would benefit from cardiovascular risk assessment and management to prevent future strokes. Laryngoscope, 131:1369-1377, 2021.

Stroke

Sudden Hearing Loss

10.1002/lary.29237

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Citations (21)

The prognostic value and pathophysiologic significance of three‐dimensional fluid‐attenuated inversion recovery (3D‐FLAIR) magnetic resonance imaging in idiopathic sudden sensorineural hearing loss: A systematic review and meta‐analysis

Clinical Otolaryngology (2019)

Marc J. W. Lammers Emily Young David Fenton Jane Lea Brian D. Westerberg

Abstract Background The underlying pathophysiology of idiopathic sudden sensorineural hearing loss (ISSNHL) is still unknown. However, an increasing number of observational studies report intralabyrinthine signal alterations in patients with ISSNHL using three‐dimensional fluid‐attenuated inversion recovery (3D‐FLAIR) magnetic resonance imaging (MRI). These findings warrant a meta‐analysis. Objective of review To conduct a meta‐analysis assessing the value of 3D‐FLAIR MRI in identifying possible underlying labyrinthine pathophysiologic mechanisms and prognostication in patients with ISSNHL. Search strategy Two reviewers independently searched the Pubmed, Embase and Cochrane Library from inception until October 10, 2018 and evaluated eligibility based on titles and abstracts of all retrieved studies. All studies reporting on 3D‐FLAIR imaging in ISSNHL were included. Subsequently, the full text of eligible studies were evaluated. Evaluation method Adhering to the MOOSE guideline, two independent reviewers extracted data, assessed risk of bias and evaluated the relevance and quality of evidence. Data on the number of patients and events were extracted and hearing levels were converted to standardised mean differences (SMD) for conducting meta‐analyses. Random effects models for meta‐analyses were applied. Results Eight observational studies met our inclusion criteria (n = 638 patients). In 29%, high signal intensity was found on 3D‐FLAIR imaging, suggesting labyrinthine pathology (labyrinthitis [79%], intralabyrinthine haemorrhage [21%]). High signal intensity on 3D‐FLAIR was associated with poorer hearing (SMD: 14 dB, 95% CI 5.67‐22.94) and vertigo (RR: 1.92, 95% CI 1.16‐3.17) at baseline. Multivariate analyses demonstrated that patients with high 3D‐FLAIR signal intensity had 21 dB lower final hearing pure‐tone averages (SMD: 21 dB, 95% CI 9.08‐33.24). Conclusions Three‐dimensional fluid‐attenuated inversion recovery MR imaging can identify an underlying labyrinthine condition in up to 29% of patients with sudden hearing loss in whom previously no cause could be identified. Their final pure‐tone averages are more than 20 dB worse than 3D‐FLAIR–negative patients, suggesting more severe labyrinthine damage. Findings such as these may contribute to our understanding of pathophysiologic mechanisms of ISSNHL.

Fluid-attenuated inversion recovery

10.1111/coa.13432

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A Systematic Review of Percutaneous Mechanical Thrombectomy in the Treatment of Deep Venous Thrombosis

European Journal of Vascular and Endovascular Surgery (2011)

Alan Karthikesalingam Emily Young Robert J. Hinchliffe I.M. Loftus Matt Thompson

In selected cases of deep vein thrombosis (DVT), catheter-directed thrombolysis (CDT) may be superior to conventional treatment with anticoagulation alone, as it can prevent DVT recurrence and the development of post-thrombotic syndrome (PTS). Percutaneous mechanical thrombectomy (PMT) devices offer a minimally invasive adjunctive strategy and the data on these emerging technologies require review.To review the evidence for PMT devices in DVT in terms of case selection, technical feasibility and procedural outcomes.Medline, trial registries, conference proceedings and article reference lists were searched to identify case series reporting PMT device use. Data were extracted for review.16 retrospective case series have reported the use of rheolytic, rotational, or ultrasound-assisted PMT in a total of 481 patients. No randomised trials were available. Technical success of 82-100% was reported with Grade II or III lysis in 83-100% of patients. The different devices all appeared to be safe, with no reported procedure-related deaths or strokes and <1% incidence of symptomatic PE. Bleeding complications were reported in 6/16 studies, in which 4-14% of patients required transfusion (global incidence 11/146 patients, 7.5%).PMT appears feasible and safe, though the level of evidence available is poor. Major RCTs and registry data are required to determine the economic and clinical benefit of various devices used alone or in combination, for differing thrombus characteristics and clinical scenarios. Until these data are available there is little substantial evidence to support the routine use of PMT over CDT alone.

10.1016/j.ejvs.2011.01.010

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IGF-1 Mediated Neuroprotective Effects of Olfactory-Derived Mesenchymal Stem Cells on Auditory Hair Cells

Journal of Otolaryngology - Head and Neck Surgery (2024)

Marc J. W. Lammers Emily Young Anat Yanai Ishaq A. Viringipurampeer Trung Le

Importance Mesenchymal stem cells (MSCs) have the capability of providing ongoing paracrine support to degenerating tissues. Since MSCs can be extracted from a broad range of tissues, their specific surface marker profiles and growth factor secretions can be different. We hypothesized that MSCs derived from different sources might also have different neuroprotective potential. Objective In this study, we extracted MSCs from rodent olfactory mucosa and compared their neuroprotective effects on auditory hair cell survival with MSCs extracted from rodent adipose tissue. Methods Organ of Corti explants were dissected from 41 cochlea and incubated with olfactory mesenchymal stem cells (OMSCs) and adipose mesenchymal stem cells (AMSCs). After 72 hours, Corti explants were fixed, stained, and hair cells counted. Growth factor concentrations were determined in the supernatant and cell lysate using Enzyme-Linked Immunosorbent Assay (ELISA). Results Co-culturing of organ of Corti explants with OMSCs resulted in a significant increase in inner and outer hair cell stereocilia survival, compared to control. Comparisons between both stem cell lines, showed that co-culturing with OMSCs resulted in superior inner and outer hair cell stereocilia survival rates over co-culturing with AMSCs. Assessment of growth factor secretions revealed that the OMSCs secrete significant amounts of insulin-like growth factor 1 (IGF-1). Co-culturing OMSCs with organ of Corti explants resulted in a 10-fold increase in IGF-1 level compared to control, and their secretion was 2 to 3 times higher compared to the AMSCs. Conclusions This study has shown that OMSCs may mitigate auditory hair cell stereocilia degeneration. Their neuroprotective effects may, at least partially, be ascribed to their enhanced IGF-1 secretory abilities compared to AMSCs.

Stereocilia (inner ear)

10.1177/19160216241258431

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The Olfactory Mucosa: a Potential Source of Stem Cells for Hearing Regeneration

Regenerative Medicine (2018)

Emily Young Brian D. Westerberg Anat Yanai Kevin Gregory‐Evans

The olfactory mucosa contains cells that enable it to generate new neurons and other supporting cells throughout life, allowing it to replace cells of the mucosa that have been damaged by exposure to various insults. In this article, we discuss the different types of stem cell found within the olfactory mucosa and their properties. In particular, the mesenchymal-like cells found within the lamina propria will be reviewed in detail. In addition, we discuss potential applications of olfactory-derived stem cells toward hearing regeneration secondary to either inner hair cell loss or primary or secondary auditory nerve degeneration.

Olfactory mucosa

Lamina propria

Olfactory ensheathing glia

10.2217/rme-2018-0009

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Citations (24)

A Systematic Review of the Role of Cardiopulmonary Exercise Testing in Vascular Surgery

European Journal of Vascular and Endovascular Surgery (2012)

Emily Young Alan Karthikesalingam Sam Huddart Rupert M. Pearse R.J. Hinchliffe

Blinding

Vascular surgery

10.1016/j.ejvs.2012.03.022

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Citations (52)

Identification of novel risk loci, causal insights, and heritable risk for Parkinson's disease: a meta-analysis of genome-wide association studies

The Lancet Neurology (2019)

Mike A. Nalls Cornelis Blauwendraat Costanza L. Vallerga Karl Heilbron Sara Bandrés‐Ciga

Genome-wide Association Study

LRRK2

Genetic Association

Mendelian Randomization

Mendelian inheritance

Missing heritability problem

10.1016/s1474-4422(19)30320-5

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Citations (1,884)

Subjective and objective vestibular changes that occur following paediatric cochlear implantation: systematic review and meta-analysis

Journal of Otolaryngology - Head and Neck Surgery (2019)

Michael Yong Emily Young Jane Lea Hannah Foggin Erica Helena Zaia

Objective Cochlear implantation can result in post-operative vestibular dysfunction of unknown clinical significance. The objective of this study was to characterize the presence, magnitude, and clinical significance of vestibular dysfunction that occurs after pediatric cochlear implantation. Data sources The databases Embase, Medline (OvidSP), and PubMed were used. Only articles published in English were included. Grey literature and unpublished sources were also reviewed. Study selection Articles published from 1980 until the present which documented pre-operative and post-operative vestibular testing on children under the age of 18 were used. Data extraction Parameters that were assessed included number of patients, pre- and post-operative vestibular-evoked myogenic potentials (VEMPs), head impulse testing (HIT), calorics, and posturography, timing of pre- and post-operative testing, symptomatology, and other demographic data such as etiology of the hearing loss. Data synthesis Ten articles were included. Relative risk values evaluating the effect of cochlear implantation on vestibular function were calculated for VEMPs and caloric testing due to the availability of published data. I 2 values were calculated and 95% confidence intervals were reported. Separate analyses were conducted for each individual study and a pooled analysis was conducted to yield an overall relative risk. Assessment on risk of bias in individual studies and overall was performed. Conclusion Pediatric cochlear implantation is associated with a statistically significant decrease in VEMP responses post-operatively (RR 1.8, p < 0.001, I 2 91.86, 95%CI 1.57–2.02). Similar results are not seen in caloric testing. Insufficient data is available for analysis of HIT and posturography. Further studies are necessary to determine the effect of cochlear implantation on objective vestibular measures post-operatively and whether any changes seen are clinically relevant in this population.

Cochlear Implantation

10.1186/s40463-019-0341-z

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Citations (30)

Commentary: Effect of cochlear implantation on vestibular function in children: A scoping review

Frontiers in Pediatrics (2022)

Michael Yong Emily Young Jane Lea Hannah Foggin Erica Helena Zaia

GENERAL COMMENTARY article Front. Pediatr., 21 December 2022Sec. Pediatric Otolaryngology Volume 10 - 2022 | https://doi.org/10.3389/fped.2022.1101540

Cochlear Implantation

10.3389/fped.2022.1101540

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