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Objectives This study investigated the effectiveness of a specialized manual physical therapy (PT) program at improving voice among patients diagnosed with concomitant muscle tension dysphonia (MTD) and cervicalgia at a tertiary care voice center. Materials and Methods Cervicalgia was determined by palpation of the anterior neck. Both voice therapy (VT) and PT was recommended for all patients diagnosed with MTD and cervicalgia. PT included full-body manual physical therapy with myofascial release. Patients underwent: 1) VT alone, 2) concurrent PT and VT (PT with VT), 3) PT alone, 4) VT, but did not have PT ordered by treating clinician (VT without PT order) or 5) VT followed by PT (VT then PT). The pairwise difference in post–Voice Handicap Index-10 (VHI-10) controlling for baseline variables was calculated with a linear regression model. Results 178 patients met criteria. All groups showed improvement with treatment. The covariate-adjusted differences in mean post–VHI-10 improvement comparing the VT alone group as a reference were as follows: PT with VT 9.95 (95% confidence interval 7.70, 12.20); PT alone 8.31 (6.16, 10.45); VT without PT order 8.51 (5.55, 11.47); VT then PT 5.47 (2.51, 8.42). Conclusion Among patients diagnosed with MTD with cervicalgia, treatment with a specialized PT program was associated with improvement in VHI-10 scores regardless of whether they had VT. While VT is the standard of care for MTD, PT may also offer benefit for MTD patients with cervicalgia.

Objectives: Associations between the gut microbiome and various non-GI related diseases have been detailed in recent studies. This investigation aims to directly compare the gut and sinus microbes in patients with chronic sinus disease and in control patients to determine if any link exists between the sinus and gut microbiota. Methods: This was a prospective study conducted from February 2016 to August 2017. It was conducted at a tertiary care academic rhinology practice on 16 patients undergoing rhinologic surgery. The primary outcome measure was to determine if any overlap exists between the gut and sinus microbiome in a given subject. A secondary outcome was to assess the effect of prior antibiotic therapy on the diversity of the gut microbiome. Results: There were 7 patients with chronic rhinosinusitis (CRS) with polyps, 6 patients with CRS without polyps and 3 control patients. Only one patient demonstrated an overlap of sinus and gut microbiotia. In patients receiving a reduced number of antibiotic courses over the past 24 months (0 or 1 course), there was a mean of 7.7 (SD 2.2) gut bacteria isolated from stool samples. In patients receiving more antibiotic courses (2+ courses), there was a mean of 5.1 (SD 2.3) gut bacteria isolated. This difference reached statistical significance (p=0.043). Conclusion: Minimal overlap between the sinus and gut microbiome was demonstrated, but further studies are needed to elucidate this potential association. This study supports the theory that antibiotics tend to reduce microbial diversity in the gastrointestinal tract.

Objective To determine if mitoquinone (MitoQ) attenuates cisplatin-induced hearing loss in guinea pigs. Study Design Prospective and controlled animal study. Setting Academic, tertiary medical center. Subjects and Methods Guinea pigs were injected subcutaneously with either 5 mg/kg MitoQ (n = 9) or normal saline (control, n = 9) for 7 days and 1 hour before receiving a single dose of 10 mg/kg cisplatin. Auditory brainstem response thresholds were measured before MitoQ or saline administration and 3 to 4 days after cisplatin administration. Results Auditory brainstem response threshold shifts after cisplatin treatment were smaller by 28 to 47 dB in guinea pigs injected with MitoQ compared with those in the control group at all tested frequencies (4, 8, 16, and 24 kHz, P = .0002 to .04). Scanning electron microscopy of cochlear hair cells showed less outer hair cell loss and damage in the MitoQ group. Conclusion MitoQ reduced cisplatin-induced hearing loss in guinea pigs. MitoQ appears worthy of further investigation as a means of preventing cisplatin ototoxicity in humans.