Eur Arch Otorhinolaryngol. 2025 Jan 17. doi: 10.1007/s00405-024-09182-y. Online ahead of print.

ABSTRACT

BACKGROUND: Subjective tinnitus is characterized by perception of sound in the absence of any external or internal acoustic stimuli. Many approaches have been developed over the years to treat tinnitus (medical and nonmedical). However, no consensus has been reached on the optimal therapeutic approach. Electrical nerve stimulation targeting peripheral auditory pathways presents a promising area of investigation for the treatment of tinnitus. Non-invasive transcutaneous vagal nerve stimulation of the auricular branch of the vagus nerve has been introduced and studied but its success rate varies and conflicting results have been reported. In this study we aim to assess the role of transcutaneous electrical nerve stimulation in alleviation of tinnitus in normal hearing subjects and to study the different factors that may affect the degree of alleviation of tinnitus.

METHODS: The study group consisted of 64 subjects (38 male and 26 female). The age ranged between 20 and 60 years. All of them suffering from subjective tinnitus. Assessment of tinnitus loudness analyzed by Visual Analogue Scale (VAS) which was applied before and directly after TENS stimulation.

RESULTS: There is a statistically significant difference in tinnitus loudness before and after TEN stimulation as assessed by VAS. 45 out of 64 (70.31%) patients had improvement after TENS, from them nine patients had a complete reduction of tinnitus. There is no statistically significant relation between the studied variables and the degree of tinnitus reduction.

CONCLUSION: ta-VNS is an effective treatment of subjective tinnitus but we could not assess for how long this residual inhibition persists due to lack of long term follow up. However, it is difficult to decide who might benefit from ta-VNS, patients with unilateral tinnitus on right ear and those with whistling sound have more reduction in tinnitus loudness than others.

PMID:39825198 | DOI:10.1007/s00405-024-09182-y

Psychophysiology. 2025 Jan;62(1):e14753. doi: 10.1111/psyp.14753.

ABSTRACT

The decline in noradrenergic (NE) locus coeruleus (LC) function in aging is thought to be implicated in episodic memory decline. Transcutaneous auricular vagus nerve stimulation (taVNS), which supports LC function, might serve to preserve or improve memory function in aging. However, taVNS effects are generally very heterogeneous, and it is currently unclear whether taVNS has an effect on memory. In this study, an emotional memory task with negative events involving the LC-NE system was combined with the short burst of event-related taVNS (3 s) in younger adults (N = 24). The aim was to investigate taVNS-induced changes in pupil dilation during encoding and possible taVNS-induced improvements in (emotional) memory performance for early and delayed (24 h) recognition. Negative events were associated with increased pupil dilation and better memory performance. Additionally, real as compared to sham or no stimulation selectively increased memory for negative events. Short bursts of stimulation, whether real or sham, led to an increase in pupil dilation and an improvement in memory performance over time, likely due to the attention-inducing sensory modulation of electrical stimulation.

PMID:39815765 | PMC:PMC11736245 | DOI:10.1111/psyp.14753

Neurocrit Care. 2025 Jan 15. doi: 10.1007/s12028-024-02195-9. Online ahead of print.

ABSTRACT

BACKGROUND: Intracranial hemorrhage (ICH) is a devastating stroke subtype with a high rate of mortality and disability. Therapeutic options available are primarily limited to supportive care and blood pressure control, whereas the surgical approach remains controversial. In this study, we explored the effects of noninvasive vagus nerve stimulation (nVNS) on hematoma volume and outcome in a rat model of collagenase-induced ICH.

METHODS: Adult male Wistar rats were randomized into two study groups: (1) ICH-treated (rats treated with five 2-min nVNS) and (2) ICH-control (ICH with sham nVNS). Each group received either a 0.1-U or a 0.2-U collagenase dose. After assessing neurological function, rats were euthanized at 24 h for spectrophotometric hemoglobin assay, hematoma volume measurements, and histological studies.

RESULTS: The ICH-treated group that received the 0.1-U collagenase dose demonstrated significantly smaller hematoma volume and improved motor function compared with the ICH-control with the same dose. Furthermore, the pooled data for the ICH-treated groups (both 0.1 U and 0.2 U of collagenase) revealed a reduction in neuronal loss in the perihematomal region in the histopathological studies. This effect was not significant for the group that received a 0.2-Ucollagenase dose.

CONCLUSIONS: nVNS therapy in acute settings may provide a neuroprotective effect and limit hematoma expansion in smaller volumes, improving neurological function post-ICH.

PMID:39815107 | DOI:10.1007/s12028-024-02195-9

Epilepsy Res. 2025 Jan 9;210:107510. doi: 10.1016/j.eplepsyres.2025.107510. Online ahead of print.

ABSTRACT

BACKGROUND: Epilepsy is a major neurological disorder, typically managed with Anti-Seizure Medication (ASM). Nevertheless, a substantial 30 % of patients did not respond satisfactorily to ASMs, classifying their condition as Drug-Resistant Epilepsy (DRE). Vagus Nerve Stimulation (VNS) was recommended as a potential solution.

OBJECTIVE: To evaluate clinical efficacy of VNS on patients with DRE in reduction of seizures through a systematic review and meta-analysis using a random effects model.

METHODS: A systematic search was done from PubMed, ScienceDirect, Cochrane Library and Google Scholar databases on observational studies and randomized controlled trials (RCTs) for the clinical effectiveness of VNS among DRE patients. A meta-analysis was performed to obtain the pooled estimate of the clinical effectiveness of VNS in terms of seizure reduction and the odds ratio (OR) for patients achieving > 50 % seizure reduction. Heterogeneity was assessed using visual inspection of forest plots and I² statistic.

RESULTS: A total of 1023 articles were retrieved from the electronic search. After removing duplicates, non-relevance and non-availability of efficacy data, 28 articles were included in the final analysis. Of these, 9 are RCTs and 19 are observational studies. The pooled estimate of > 50 % seizure reduction was 0.46 (95 % CI: 0.40-0.51) and the pooled estimate of the OR comparing > 50 % vs ≤ 50 % seizure reduction was 0.76 (95 % CI: 0.44-1.29).

CONCLUSION: Our meta-analysis showed that 46 % of DRE patients have experienced ≥ 50 % seizure reduction with VNS treatment. It should be considered in patients in whom ASM has failed or who continue to experience seizures after medication.

PMID:39809131 | DOI:10.1016/j.eplepsyres.2025.107510

Updates Surg. 2025 Jan 14. doi: 10.1007/s13304-025-02095-3. Online ahead of print.

ABSTRACT

The unprecedented technical and technological evolution in thyroid surgery has labelled it as an extremely safe and efficient procedure, and indeed “typifies perhaps better than any other operation the supreme triumph of the surgeon’s art.”-William Halsted, 1852-1922. Surgeon’s experience reflected by annual case load is the most important denominator in thyroid surgery. Nevertheless, even high-volume thyroid surgeons in high-volume centres are not immune to its complications. Despite the advances in surgical technology and techniques, recurrent laryngeal nerve (RLN) injury is still a wellknown complication of thyroid surgery. The considerable postoperative morbidity associated with it and its impact on the patient’s overall quality of life make it a dreadful complication of thyroid surgery and a common cause of malpractice accusations. Intraoperative RLN reconstruction is not widely used in clinical practice, but the evidence so far makes it a viable and safe alternative to traditional techniques with better long-term results, as it prevents the occurrence of atrophy of the vocal cord and should be considered in the operating room if possible. Furthermore, immediate reconstruction of an intraoperatively detected RLN injury has been strongly recommended by the 2020 American Association of Endocrine Surgeons guidelines. After neurorrhaphy, RLN regeneration occurs but in a random, misdirected fashion resulting in simultaneous contraction of abductors and adductors. Therefore, normal vocal fold function/mobility is typically not restored. The objective of this technical note is to describe a novel immediate RLN repair technique that has a strong propensity to regenerate and reinnervate laryngeal muscles and potentially restore laryngeal mobility.

PMID:39808246 | DOI:10.1007/s13304-025-02095-3

Clin Auton Res. 2025 Jan 15. doi: 10.1007/s10286-024-01100-w. Online ahead of print.

NO ABSTRACT

PMID:39810033 | DOI:10.1007/s10286-024-01100-w

Epilepsy Behav Rep. 2024 Dec 13;29:100734. doi: 10.1016/j.ebr.2024.100734. eCollection 2025 Mar.

ABSTRACT

For patients with drug-resistant epilepsy who are not candidates for epilepsy surgery, Vagus nerve stimulation (VNS) is the most widely available neuromodulation option and has been available in several countries for 30 years. Given its broad availability and extended history on the market, many healthcare providers (HCPs) have developed individualized practice habits regarding the titration and dosing of VNS. This study provides novel evidence to describe the extent to which VNS management differs among providers and discusses recent literature that indicates how unique programming approaches may impact patient outcomes. In this work, practice habits regarding the titration and dosing of VNS were explored through a survey of HCPs and an examination of ongoing study data collected as part of the CORE-VNS Study. The global survey revealed significant variability in dosing and titration habits. Providers reported a wide range of initial/maximum target doses and time-to-dose, even if the population averages approximated guidance from professional societies and the manufacturer’s labeling. Variable dosing and titration were reflected in varied perception of how long it takes to realize the clinical benefits of VNS. In the CORE-VNS Study, this reported experience was represented in how different generator models were used, with users of SenTiva (and the Scheduled Programming feature) depicting faster time-to-dose than those using earlier models of VNS. Our results suggest VNS providers would benefit from continued training on the use of VNS and the use of the scheduled programming feature to enhance consistency of VNS management among providers.

PMID:39803413 | PMC:PMC11721848 | DOI:10.1016/j.ebr.2024.100734

ACG Case Rep J. 2025 Jan 10;12(1):e01588. doi: 10.14309/crj.0000000000001588. eCollection 2025 Jan.

ABSTRACT

Syncope is characterized by a transient loss of consciousness. Swallow syncope, a rare cause of syncope, is caused by vagus nerve activation resulting in vasodilation and bradycardia, thus causing transient hypotension and cerebral hypoperfusion. It is diagnosed through clinical history, cardiac, and esophageal evaluation. We present a case of swallow syncope in a patient with significant cardiac history. Initial cardiac and esophageal testing was normal. Long-term telemetry revealed bradycardia with swallowing, and the patient underwent pacemaker placement. Swallow syncope is associated with a variety of esophageal and cardiac conditions. Management involves addressing the underlying cause; pacemaker placement is sometimes necessary. KEYWORDS: syncope; swallow syncope; reflex syncope; pacemaker.

PMID:39802929 | PMC:PMC11723683 | DOI:10.14309/crj.0000000000001588

Respir Res. 2025 Jan 13;26(1):15. doi: 10.1186/s12931-025-03108-w.

ABSTRACT

BACKGROUND: Neuroimmune interaction is an underestimated mechanism for lung diseases, and cryoablation is a competitive advantageous technique than other non-pharmacologic interventions for peripheral nerve innervating the lung. However, a lack of cryodenervation model in laboratory rodents leads to the obscure mechanisms for techniques used in clinic.

METHOD: Herein, we developed a novel practical method for mouse peripheral nerve cryoablation, named visualized and simple cryodenervation (VSCD). We first estimated the feasibility, safety and effectiveness of the technique via haematoxylin-eosin staining, histochemistry or immunofluorescence staining and immunoblotting assay. We then constructed the acute lung injury (ALI) model triggered by lipopolysaccharide (LPS) to verify the effect of VSCD in the resolution of pulmonary inflammation. Besides, the IL-10 knockout mice were also applied to explain the underlying mechanism of the protective activity of VSCD in ALI mice.

RESULT: We demonstrated that VSCD was able to induce a reliable and stable blockade of innervation, but reversible structural damage of mouse vagus nerve without detectable toxicity to lung tissues. Cholinergic parasympathetic nerve in the mouse lung coming from vagus nerve was activated at the initial stage (1 week) after VSCD, and blocked 3 weeks later. By use of the ALI mouse model, we found that VSCD effectively decreased pulmonary inflammation and tissue damage in the ALI mice. Moreover, the activated cholinergic anti-inflammatory pathway (CAP) and elevated IL-10 expression might explain the protective action of VSCD following LPS challenge.

CONCLUSION: This study fills the gap in the cryoablation for mouse vagus nerve, thereby guiding the application of cryodenervation in clinical management of pulmonary diseases. It also offers evidence of anti-inflammatory potential of VSCD in ALI mouse model and opens therapeutic avenues for the intervention of acute lung inflammation.

PMID:39806332 | PMC:PMC11730848 | DOI:10.1186/s12931-025-03108-w

Euroasian J Hepatogastroenterol. 2024 Jul-Dec;14(2):210-213. doi: 10.5005/jp-journals-10018-1456. Epub 2024 Dec 27.

ABSTRACT

BACKGROUND: Enhanced recovery after surgery (ERAS) protocols advocate for early enteral feeding to prevent postoperative ileus. Chewing gum acts as a type of sham feeding that triggers the cephalic phase of digestion by stimulating the cephalic vagus nerve. This can enhance gastrointestinal motility and may lead to quicker recovery of gas and bowel movements.

OBJECTIVES: To assess how chewing gum during the early postoperative phase affects the duration of postoperative ileus in terms of time to appreciation of first flatus, time to passage of first stools, and duration of hospital stay.

MATERIALS AND METHODS: The study was conducted in our division of colorectal surgery. This is a case-control study carried out over three years (2020-2023). A total of 100 patients were included, the first 50 were allocated to the control group, and another 50 were allocated to the chewing gum group. All patients above the age of 14 years who underwent resection for colorectal cancers were included.

RESULTS: The average age in the control group was 51.44 years and that in the chewing gum group was 50.04 years. The average duration of surgery for the control group was 156.3 minutes (2.6 hours) and 163.8 minutes (2.7 hours) in the chewing gum group. The average time of passage of the first flatus in the chewing gum group was 51.28 hours compared to 66.26 hours in the control group (p = 0.0002). The average time to first bowel movement in the chewing gum group was 71.42 hours. In comparison, the time to first bowel movement in the control group was 85.78 hours (p = 0.000011). The average hospital stay in the chewing gum group was 6.3 days and that in the control group was 6.4 days (p = 0.274254).

CONCLUSION: Chewing gum as a means of sham feeding is a cost-friendly method that significantly decreases the postoperative ileus but has no effect on postoperative hospital stay.

HOW TO CITE THIS ARTICLE: Zargar T, Wagay BA, Banday I, et al. The Effect of Chewing Gum on the Return of Bowel Activity after Colorectal Cancer Surgery. Euroasian J Hepato-Gastroenterol 2024;14(2):210-213.

PMID:39802852 | PMC:PMC11714110 | DOI:10.5005/jp-journals-10018-1456