bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding our potential research publics: Exploring boundary disputes in recruitment to a sociological study
Authors: Hope Joanna
Published: May 2019

The international debate on public sociology has failed to increase our understanding of how we might engage with new publics, particularly potential research publics. Parallel literatures exploring over-research, research fatigue, non-response and public (mis)understanding of sociology can shed light on how underlying boundary disciplinary issues might influence willingness to participate in sociological research. This article explores the case study of parents of people with Rett syndrome, an over-researched group at the centre of competing research discourses following a breakthrough in genetic research. Data from a wider study was used to explore reasons for research participation, non-participation and dropout, including interviews ( n = 20) and a brief survey about reasons for non-response ( n = 58). An individualist perspective led to interpretations of social interventions as stigmatising and refusal to participate. Parent activists fundraising for and promoting genetic research challenged notions of voluntary groups as being receptive to organic public sociology. While individual benefits were experienced, there were signs of research fatigue from multiple approaches. Finally, the close link between social activism and research participation increased the risk of unwitting exploitation, an issue of concern for organic public sociology.
A Meta-Analysis on the Relationship Between Student Abstinence-Only Programs and Sexual Behavior and Attitudes
Authors: Jeynes William H.
Published: May 2019

This meta-analysis of 14 studies examines the relationship between abstinence-only programs and the sexual behavior and—attitudes of urban students from middle school to early in college. The results indicate a significant relationship between abstinence-only programs and the outcomes examined. Abstinence-only programs, as a whole, were associated with reduced premarital sexual behavior by nearly .4 of a standard deviation unit. For sexual behavior and attitudes combined, abstinence-only programs were associated with improvements of nearly .3 of a standard deviation unit. When sophisticated controls were utilized in each of these analyses, the effect sizes were smaller, but were all statistically significant. The importance of these results is discussed.
Pose detection of parallel robot based on improved RANSAC algorithm
Authors: Gao Guo-Qin , Zhang Qian , Zhang Shu
Published: May 2019

For the factors of complex image background, unobvious end-effector characteristics and uneven illumination in the pose detection of parallel robot based on binocular vision, the detection speed, and accuracy cannot meet the requirement of the closed-loop control. So a pose detection method based on improved RANSAC algorithm is presented. First, considering that the image of parallel robot is rigid and has multiple corner points, the Harris–Scale Invariant Feature Transform algorithm is adopted to realize image prematching. The feature points are extracted by Harris and matched by Scale Invariant Feature Transform to realize good accuracy and real-time performance. Second, for the mismatching from prematching, an improved RANSAC algorithm is proposed to refine the prematching results. This improved algorithm can overcome the disadvantages of mismatching and time-consuming of the conventional RANSAC algorithm by selecting feature points in separated grids of the images and predetecting to validate provisional model. The improved RANSAC algorithm was applied to a self-developed novel 3-degrees of freedom parallel robot to verify the validity. The experiment results show that, compared with the conventional algorithm, the average matching time decreases by 63.45%, the average matching accuracy increases by 15.66%, the average deviations of pose detection in Y direction, Z direction, and roll angle [Formula: see text] decrease by 0.871 mm, 0.82 mm, and 0.704°, respectively, using improved algorithm to refine the prematching results. The real-time performance and accuracy of pose detection of parallel robot can be improved.
The Revival of ‘Big Government’ Discourse in South Korea, 2017
Authors: Heo Inhye
Published: May 2019

After the democratisation of South Korea in 1987, political discourse on ‘big government’ nearly disappeared, largely because it recalled past authoritarianism. Authoritarian states are highly likely to employ ‘big government’ – exerting policy influence over the distribution of private resources – to sustain their political power, and Korea’s authoritarian state was no exception. Thus, newly inaugurated President Moon Jae-in’s official implication that he would pursue big government is notable, because he claimed to represent pro-democracy groups that opposed both historical authoritarianism and the former president’s undemocratic governance. In this context, this study examines external and internal political-economic factors behind the revival of big government discourse in Korea. Results show that critical factors included the lack of pressure in the global capitalist market and the dominance of governmentalists over marketists in the political-economic discourse influencing the administration’s maintenance and expansion of its political foundation.
Individual characteristics, secondary trauma and burnout in police sexual and violent offending teams
Authors: Gray Clarabella , Rydon-Grange Michelle
Published: May 2019

The traumatic nature of work conducted by specialist police staff places them at risk of developing work-related stress and psychological health difficulties. The study examined risk and resilience factors for secondary trauma, burnout and mental ill-health. A convenience sample of police staff ( N = 78) from several specialist sexual and violent offending teams completed an online survey. Results indicated that coping self-efficacy, dispositional mindfulness and psychological flexibility are resilience factors and insecure attachment style is a risk factor for secondary trauma, burnout and mental ill-health. Psychological approaches may be beneficial in promoting a resilient police workforce and maintaining operational effectiveness.
Heart Age, Cardiovascular Disease Risk, and Disparities by Sex and Race/Ethnicity Among New York City Adults
Authors: Tabaei Bahman P. , Chamany Shadi , Perlman Sharon , Thorpe Lorna , Bartley Katherine , Wu Winfred Y.
Published: May 2019

Objectives:

Cardiovascular disease (CVD) is the leading cause of mortality in the United States. The risk for developing CVD is usually calculated and communicated to patients as a percentage. The calculation of heart age—defined as the predicted age of a person’s vascular system based on the person’s CVD risk factor profile—is an alternative method for expressing CVD risk. We estimated heart age among adults aged 30-74 in New York City and examined disparities in excess heart age by race/ethnicity and sex.

Methods:

We applied data from the 2011, 2013, and 2015 New York State Behavioral Risk Factor Surveillance System to the non–laboratory-based Framingham risk score functions to calculate 10-year CVD risk and heart age by sex, race/ethnicity, and selected sociodemographic groups and risk factors.

Results:

Of 6117 men and women in the study sample, the average heart age was 5.7 years higher than the chronological age, and 2631 (43%) adults had a predicted heart age ≥5 years older than their chronological age. Mean excess heart age increased with age (from 0.7 year among adults aged 30-39 to 11.2 years among adults aged 60-74) and body mass index (from 1.1 year among adults with normal weight to 11.8 years among adults with obesity). Non-Latino white women had the lowest mean excess heart age (2.3 years), and non-Latino black men and women had the highest excess heart age (8.4 years).

Conclusions:

Racial/ethnic and sex disparities in CVD risk persist among adults in New York City. Use of heart age at the population level can support public awareness and inform targeted programs and interventions for population subgroups most at risk for CVD.
Facial Emotion Recognition: Virtual Reality Program for Facial Emotion Recognition—A Trial Program Targeted at Individuals With Schizophrenia
Authors: Souto Teresa , Silva Hugo , Leite Angela , Baptista Alexandre , Queirós Cristina , Marques António
Published: May 2019

People with severe mental illness (SMI), schizophrenia in particular, show considerable functional impairment in emotional recognition and social perception, which negatively affects interpersonal relationships and social functioning. Owing to its ecological validity, virtual reality (VR) has been observed to improve both assessment and training of emotional recognition skills of people with SMI. This article includes two studies: (a) a descriptive study on the Virtual Reality program for Facial Emotion Recognition (VR-FER) and (b) an empirical study that presents the results of the application of the VR-FER’s first module. For the second study, data were collected using two samples: a group of 12 people with schizophrenia and a reference group of 12 people who were mentally healthy. Data analysis comprised descriptive (mean, standard deviation) and inferential statistics (Mann–Whitney U test). Results showed that the first group presented a lower number of correct answers and a higher number of incorrect answers compared with the second group regarding facial emotion recognition (FER), thereby confirming the need to develop strategies to improve emotional recognition and social perception in people with schizophrenia. VR-FER is regarded a strategic training program for FER, using latest technology and following rehabilitation guidelines for SMI.
An investigation of migrants’ residential satisfaction in Beijing
Authors: Chen Yu , Dang Yunxiao , Dong Guanpeng
Published: May 2019

Chinese cities have witnessed enormous neighbourhood changes as a result of housing reforms, rapid urban expansion and massive rural-to-urban migration. Migrants, without local hukou status, are confronted with many constraints in accessing urban housing. While previous studies have focused on migrants’ poor housing conditions, relatively little is known about their self-selection into different neighbourhood types, as well as their subjective evaluation of the living environment in local areas. Drawing upon a large-scale questionnaire survey conducted in Beijing in 2013, we examine the factors influencing migrants’ residential choices, in particular urban villages versus other neighbourhood types, in a multinomial logit model, and the sources of residential satisfaction in a multilevel framework. The results show that migrants sort themselves into different neighbourhoods contingent on demographic and socio-economic factors, and express different levels of satisfaction after controlling for individual attributes and geographical context. Moreover, their self-selection significantly influences residential satisfaction.
A Cluster of Acoustic Neuromas in Fish Hatchery Workers
Authors: Page Elena H.
Published: May 2019

The National Institute for Occupational Safety and Health (NIOSH) received a request from the United States Fish and Wildlife Service (FWS) to determine if there is a relationship between acoustic neuroma and fish hatchery work. The request was triggered by a report from an FWS employee who suspected the possibility of such an association. Investigators used data provided by the personnel office of the FWS to calculate the incidence of acoustic neuroma among fish hatchery workers, and then to compare it with national rates.

Four confirmed cases of acoustic neuroma were found among former fish hatchery workers. The overall incidence was estimated to be 15.41 per 100,000 person-years. This rate is more than 15 times higher than the rate among the general population. Even so, the small number of cases, as well as other factors, preclude the NIOSH from concluding that there is a definite cause-and-effect relationship. Further study is warranted.
Osteoradionecrosis of the Temporal Bone in Nasopharyngeal Carcinoma after Radiotherapy: A Case Report
Authors: Tsang Willis S.S. , Ku Peter K.M. , Van Hasselt C. Andrew
Published: May 2019

Osteoradionecrosis of the temporal bone after external-beam radiotherapy for nasopharyngeal carcinoma is not uncommon following a long posttreatment interval. We describe the case of a man who had experienced this complication 13 years after he had undergone such radiotherapy. His condition resolved after removal of dead bone from the external auditory canal, followed by antibiotic therapy and periodic aural toileting.
A Method for Detecting Errors in Discounted Fee-For-Service Payments by Insurance Companies
Authors: Mujtaba Faiza , Sullivan Elizabeth , Lee K.J.
Published: May 2019

In order to discover and correct inaccurate payments received from insurance companies, a practice requires a plan for the systematic, efficient, and prompt monitoring of receipts. When any such discrepancies are detected, the physician can query the insurance company and correct the problem. Once the system is in place, it behooves each physician to look at the results at least weekly. Monitoring receipts requires interest, know-how, and persistence in the face of ever-confusing payment methodologies. This paper explains one such plan for detecting and correcting inaccurate insurance company payments.
Acanthamoeba Sinusitis with Subsequent Dissemination in an AIDS Patient
Authors: Kim Sam Y. , Syms Mark J. , Holtel Michael R. , Nauschuetz Karen K.
Published: May 2019

Otolaryngologists can play an important role in the care of patients with acquired immunodeficiency syndrome (AIDS) and/or human immunodeficiency virus infection. We present the case of an AIDS patient who was hospitalized for dehydration and who was soon found to have sinusitis and subsequent disseminated infection caused by Acanthamoeba. To treat the Acanthamoeba infection, the patient was started on oral itraconazole and intravenous metronidazole; IV pentamidine was added 2 days later. Despite aggressive therapy, on the eleventh day of hospitalization, the patient was obtundent and provided minimal response to noxious stimuli. He died on the sixteenth day of hospitalization.

This case is one of only six reported cases of Acanthamoeba associated with sinusitis. Current therapeutic regimens have not been successful for most of these patients, and the prognosis is poor.
Spondyloepiphyseal Dysplasia Congenita Associated with Conductive Hearing Loss
Authors: Dahiya Ravinder , Cleveland Sandra , Megerian Cliff A.
Published: May 2019

Spondyloepiphyseal dysplasia is a disorder characterized by abnormalities of growth. Previous studies of this disorder have identified a significant incidence of associated hearing loss. Hearing loss has been reported to occur in 25 to 30% of affected patients. To date, all reports of associated hearing loss have indicated the presence of a sensorineural component.

In this article, we report the case of a child who was diagnosed with spondyloepiphyseal dysplasia congenita and who was found to have a significant conductive hearing loss with a Carhart's notch, indicating the likely presence of stapes footplate fixation. We also review the diagnosis of this condition and the literature associated with hearing loss as it occurs with this disorder.
Kimura's Disease: A Case Report
Authors: Karavattathayyil Sebastian J. , Krause John R.
Published: May 2019

Kimura's disease is a rare, idiopathic condition that usually affects young men of Asian descent. The disease is characterized by swelling and lesions in the head and neck region, with involvement of the subcutaneous soft tissue, major salivary glands, and lymph nodes. Patients almost always have eosinophilia and elevated serum immunoglobulin E levels. The diagnosis is established by biopsy. Kimura's disease is usually self-limiting. Its etiology is unknown but is thought to be a manifestation of an aberrant allergic response. In this paper, we describe the case of a 30-year-old patient who was diagnosed with Kimura's disease at our institution.
A Father and Son with a Nonsevere form of Crouzon's Syndrome
Authors: Mamikoglu Bülent , Mamikoglu Aysegül
Published: May 2019

Crouzon's syndrome is a hereditary autosomal-dominant disorder. In its classic form, patients experience a premature closure of the cranial sutures, which leads to brachycephaly, proptosis, a small maxilla, and anomalies of the external and middle ear. In this report, we describe the case of a father and son who both had a nonsevere form of this disorder. The two men did not have brachycephaly or proptosis, but they did have ptosis and a mixed-type hearing loss.
Initial Report of a Case of Carcinosarcoma of the Supraglottis
Authors: Ernster Joel A. , Franquemont Douglas W. , Sweeney James P.
Published: May 2019

Minor salivary gland carcinosarcoma is a rare malignancy with an ominous prognosis. This report recounts a single case of supraglottic minor salivary gland carcinosarcoma that was treated aggressively. We discuss the peculiarities of the histology, with special mention of the distinction that must be made between mucosal-origin and salivary-gland-origin carcinosarcoma. Carcinosarcomas are aggressive regardless of their origin, but differentiating their origin is important because the prognosis is worse for those that arise in salivary glands than for those that originate in the surface epithelium. This report adds to the literature a new case of minor salivary-gland-origin carcinosarcoma involving the upper airway. It is the first case we could identify in which the supraglottis was involved.
The Role of Rhinomanometry, Acoustic Rhinometry, and Mucociliary Transport Time in the Assessment of Nasal Patency
Authors: Passàli Desiderio , Mezzedimi Chiara , Passàli Giulio Cesare , Nuti Daniele , Bellussi Luisa
Published: May 2019

We conducted a study of 60 patients with different nasal pathologies who complained of nasal obstruction. Our goal was to evaluate the reliability of rhinomanometry, acoustic rhinometry, and the measurement of mucociliary transport time in helping make the diagnosis of nasal pathologies. We also sought to discover whether there is a correlation between the findings of these objective tests and the results of patients’ own subjective assessments of nasal obstruction. We found that acoustic rhinometry was more specific and more sensitive than rhinomanometry in diagnosing rhinopathies inpatients with structural anomalies. Symptom scores as rated by patients on the visual analog scale frequently did not correlate with objective measures, as patients often overestimated the severity of their obstruction. However, for a few patients, there was a correlation between symptom scores and mucociliary transport times.
Xanthoma of the Temporal Bone: A Unique Case of this Rare Condition
Authors: Friedman Oren , Hockstein Neil , Willcox Thomas O. , Keane William M.
Published: May 2019

Xanthoma of the temporal bone is extremely rare; we describe only the fourteenth reported case. Our case is further remarkable because it is the first report of such an occurrence in a patient with familial type III hyperlipoproteinemia. Moreover, while otalgia, infection, hearing loss, and tinnitus were the most common initial symptoms in the previous 13 cases, our patient reported only diplopia, vertigo, and unstable gait. The patient underwent a simple mastoidectomy and debulking, and his diplopia, vertigo, and unstable gait resolved.
Otoacoustic Emissions in Patients with Retrocochlear Dysfunction: A Report of Five Cases
Authors: Ried Ernesto U. , Ried Ernesto G. , Avilés Mónica
Published: May 2019

This article describes the results of otoacoustic emissions testing in five patients with sensorineural hearing loss. We conducted an audiologic evaluation and performed image and cerebral function studies on each patient. Our investigation revealed that all five had spontaneous otoacoustic emissions and/or distortion product otoacoustic emissions. Pharmacologic treatment with anxiolytics, antidepressants, and anticonvulsant drugs was successful in alleviating symptoms in three patients. An organic and a central functional cause of symptoms was found in the remaining two patients. Before pharmacologic therapy, the spontaneous otoacoustic emissions were of high intensity, and the distortion product emissions were minimal. Following drug therapy, the former disappeared and the latter appeared.
Transmaxillary Excision of a Rare Cavernous Hemangioma of the Infratemporal Fossa
Authors: Sarac Sarp , Koybasi Serap , Kaya Sefa
Published: May 2019

Cavernous hemangiomas that manifest as a primary tumor of the infratemporal fossa are exceedingly rare. We report such a case in a 40-year-old woman. Her lesion was excised via a transantral anterior approach. Although this approach is usually recommended only for biopsy, in selected cases it can be used to excise a lesion without causing any significant complications. We recommend the transantral anterior approach for relatively small, benign lesions that show no evidence of invasion into surrounding tissues because it does not expose the patient to surgical complications such as transient or permanent facial nerve injury or cosmetic deformity.
Nasal Septal Perforation: A Rare Extraintestinal Manifestation of Crohn's Disease
Authors: Kriskovich Mark D. , Kelly Steven M. , Jackson W. Daniel
Published: May 2019

Nasal manifestations of Crohn's disease are quite rare. They are typified by chronic mucosal inflammation, obstruction, bleeding, and occasionally septal perforation—signs and symptoms that are common to many disease states of the nose. Nasal findings, much like oral lesions, can precede the more typical gastroenterologic manifestations of Crohn's disease. Otolaryngologists should be aware of such an association and consider the diagnosis of Crohn's disease in atypical cases of nasal disease. We report the case of a 12-year-old boy who had severe Crohn's disease and a nasal septal perforation, and we discuss this complication in the context of its otolaryngologic manifestations.
Unplanned Admissions following Outpatient Otologic Surgery: The University of Arkansas Experience
Authors: Dorahoffer John , Manning Lance
Published: May 2019

We analyzed the outpatient otologic surgery experience at our institution to identify those factors that are associated with a high risk of postoperative complications that require an unplanned hospital admission. We found that among a group of 662 patients who underwent group II otologic procedures (i.e., tympanoplasty with or without mastoidectomy, stapedotomy, and middle ear exploration), the overall admission rate was 4.7%, of which 3.9% were unplanned. A significantly larger percentage of children were admitted than adults (5.7 vs. 2.3%), primarily for nausea and vomiting. Three factors were significantly associated with unplanned admissions: the type of surgery (tympanomastoidectomy with ossicular reconstruction), the duration of general anesthesia (>2 hr), and asthma as a coexisting condition. The choice of antiemetic administered (ondansetron or droperidol) and the specific agents used for general anesthesia did not appear to have any significant impact on unplanned admissions. We recommend that the three predisposing factors be taken into consideration when formulating the treatment plan. Scheduling an inpatient procedure for patients who have risk factors for complications requiring hospitalization would avoid the extra costs and stress associated with unplanned admissions.
Giant Benign Sinonasal Squamous Papilloma: Report of a Case
Authors: Mok Johnny S.W. , Tong Michael C.F. , Van Hasselt C. Andrew
Published: May 2019

We treated a patient with a giant squamous papilloma in the nasal cavity and maxillary sinus that extended through a bony defect into the oral cavity. The mass was excised with a combined endoscopic, Caldwell-Luc, and transoral approach. Lesions of this type are rare, but when they do occur, the rate of recurrence is high. Therefore, long-term followup, including endoscopic examination, is important.
Case Report: Acute Management of External Laryngeal Trauma
Authors: Ikram Mubasher , Naviwala Saleem
Published: May 2019

External laryngeal trauma is rare, accounting for less than 1% of all trauma cases seen at major centers. We report the case of a man who experienced multiple injuries, including an external laryngeal trauma. The primary signs and symptoms of his laryngeal trauma were hoarseness, hemoptysis, the loss of his laryngeal prominence (Adam's apple), neck tenderness, traumatic emphysema in the neck, and a small penetrating wound to the right of the laryngeal prominence. The patient underwent immediate tracheostomy and surgical exploration. On long-term followup, his voice quality and airway patency improved. This case illustrates the importance of rapid identification and early management of laryngotracheal trauma in a patient with multiple injuries.
Intravascular Papillary Endothelial Hyperplasia (Masson's Tumor) Manifesting as a Lateral Neck Mass
Authors: Pantanowitz Liron , Muc Ronald , Spanger Manfred , Sonnendecker Hein , McIntosh William A.
Published: May 2019

Intravascular papillary endothelial hyperplasia is a benign lesion of vascular origin that is caused by an excessive proliferation of endothelial cells in normal blood vessels or vascular malformations. We report the case of a 26-year-old man who had such a lesion deep within the soft tissues of his neck. Imaging studies revealed a 6-cm-diameter mass, with its epicenter in the right retromandibular space. The mass extended into the right parapharyngeal space and compressed the pharynx. The mass was excised, and the patient recovered uneventfully. We discuss the management of this lesion, with emphasis on radiologic and histologic assessment and the differential diagnosis.
Subperiosteal Release of the Floor of the Mouth Musculature in two Cases of Pierre Robin Sequence
Authors: Siddique Shoab , Haupert Michael , Rozelle Arlene
Published: May 2019

Many management approaches have been considered to relieve upper respiratory obstruction in patients with Pierre Robin sequence, but the choice of treatment is determined by the severity of the obstruction. These options include prone positioning, the use of a nasal trumpet, and surgery. One surgical technique is the subperiosteal release of the floor of the mouth musculature. The theory behind this procedure is that this musculature is under tension, and therefore it pushes the tongue upward and backward, resulting in respiratory obstruction. In theory, the release of this musculature from the mandible should alleviate the tension and hence clear the obstruction. In an attempt to objectively evaluate this theory, we performed subperiosteal release surgery on two infants. Our first patient required an emergent tracheostomy on postoperative day 2 because of the onset of surgically induced airway edema. To avoid this complication in the second patient, we performed a tracheostomy at the same time as surgery. Pre- and postoperative magnetic resonance imaging in the second patient revealed only a minimal change in the anatomy of the floor of the mouth musculature. We believe the subperiosteal release of the floor of the mouth musculature requires further evaluation before it can be considered to be effective in the surgical treatment of respiratory obstruction in Pierre Robin sequence.
The Success of 6-Month Stenting in Endonasal Frontal Sinus Surgery
Authors: Weber Rainer , Mai Roland , Hosemann Werner , Draf Wolfgang , Toffel Paul
Published: May 2019

The ultimate success or failure of frontal sinus surgical procedures, whether they be endonasal or external, is determined essentially by the rate of restenosis of the frontal sinus outflow tract or neo-ostium postoperatively. Long-term stenting for a period of several months significantly reduces the rate of restenosis, particularly in difficult cases. We retrospectively reviewed the cases of 12 patients who received 21 frontal nasal stents, which were left in place for 6 months. Based on outcomes measures that included endoscopy or radiologic findings and patients’ self-evaluations, we conclude that frontal nasal stents that are left in place for 6 months are more effective than stents that are removed earlier. We recommend that this type of management be considered in difficult revision cases and before performing an external operation.
Extraintestinal Crohn's Disease: Case Report and Review of the Literature
Authors: Ulnick Keith M. , Perkins Jonathan
Published: May 2019

Crohn's disease is a granulomatous inflammatory bowel disease. Its pathologic findings include noncontiguous chronic inflammation and noncaseating granulomas. Any segment of the gastrointestinal tract can be involved, but it is uncommon to find that Crohn's disease has spread beyond the intestine. We describe the case of a man with extraintestinal Crohn's disease that was marked by quiescent involvement of the lower gastrointestinal tract and florid involvement of the nasal cavity, supraglottic structures, glottis, and skin.
Second Malignant Neoplasms of the Head and Neck in Survivors of Retinoblastoma
Authors: Wenzel Christopher T. , Halperin Edward C. , Fisher Samuel R.
Published: May 2019

Retinoblastoma is a malignant tumor of the embryonic retina. Although it is rare, it is the most common primary eye tumor of childhood. Life expectancy following treatment is now excellent, but survivors who have heritable retinoblastoma face an increased risk of a second malignant head or neck neoplasm. A second neoplasm, which often occurs in the irradiated field of the original tumor, has become the most significant threat to the survival of these patients. We report the case of a young girl who was cured of her retinoblastoma only to later develop a second nonocular tumor that metastasized to the superficial parotid gland. She underwent a superficial parotidectomy and neck dissection, but the malignancy eventually recurred and required further surgery and radiation therapy. In this article, we discuss the etiology, incidence, sites of occurrence, and management options for a second malignant neoplasm in retinoblastoma survivors. The head and neck surgeon must be vigilant in the diagnosis and management of second neoplasms in this patient population because they often occur in irradiated fields; surgical management is important to patient survival.
Lateralized Carotid Artery: An Unusual Cause of Pulsatile Tinnitus
Authors: Pak Martin Wai , Kew J. , van Hasselt C. Andrew
Published: May 2019

We describe the case of a patient who had a pulsatile tinnitus that was caused by a laterally displaced internal carotid artery. Her condition was treated with the use of a hearing aid, which suppressed the tinnitus. We also review the literature on laterally displaced internal carotid arteries, and discuss their differentiation from a congenitally aberrant artery.
Lymphoma: An Update on Evolving Trends in Staging and Management
Authors: Dailey Seth H. , Sataloff Robert T.
Published: May 2019

Because lymphoma frequently manifests as a neck mass, otolaryngologists are often the first to evaluate and diagnose it. Excisional biopsy of lymph nodes generally provides the definitive diagnosis. After diagnosis, however, the otolaryngologist's involvement generally wanes as subsequent treatment of the patient is provided by an oncology team. Nevertheless, it is important for the otolaryngologist to be familiar with current concepts in the comprehensive evaluation and treatment of lymphoma patients. This knowledge allows us to participate in and facilitate timely testing, which helps avoid undue delays between the documentation of physical findings and the initiation of treatment. Otolaryngologists also need to be up to date on recent developments in the treatment of lymphomas in order to be able to answer questions regarding staging and prognosis, to make the proper referrals, and to help our patients understand current controversies and treatment practices.
Reinforcement of an end-to-end Tracheal Resection Anastomosis with Fibrin Glue: A Case Report
Authors: Kacker Ashutosh , Huo Jerry
Published: May 2019

Tracheal resection and primary anastomosis is the treatment of choice for a short-segment stenosis. However, the procedure does carry the risk of two potentially fatal complications: anastomosis breakdown and leak. We describe the case of a 67-year-old man who was treated for a 3-cm tracheal stenosis secondary to a prolonged intubation and multiple tracheostomies. The patient underwent a tracheal resection and primary anastomosis. The anastomosis was reinforced with fibrin sealant, which created an airtight seal. The patient was extubated postoperatively, and he healed without complication. Fibrin sealant is a convenient, safe, and effective material for reinforcing anastomotic suture lines.
Malignant Tumors of the Nose and Paranasal Sinuses: A Retrospective Review of 291 Cases
Authors: Goldenberg David , Golz Avishai , Fradis Milo , Martu Dan , Netzer Aviram , Joachims H.Z.
Published: May 2019

Malignant neoplasms of the nose and paranasal sinuses are not common among the general population. We present a retrospective study of 291 cases of malignant tumors of the nose and paranasal sinuses that were diagnosed in a northern Romanian population over a period of 35 years. We review the etiology, diagnosis, prognosis, and treatment of these tumors.
Diagnosis and Treatment of Lipomas of the Internal Auditory Canal
Authors: Wang Chen-Chi , Tien Hui-Chi , Hsu Chen-Yi
Published: May 2019

A Chinese woman came to the otolaryngology department with a complaint of a longstanding progressive left hearing loss and intractable tinnitus. A finding of asymmetry on sensorineural hearing loss and auditory brainstem response testing provided evidence of a retrocochlear lesion on the left side. Computed tomography and magnetic resonance imaging detected a tumor in the left internal auditory canal (IAC). In addition to these radiologic features, our suspicion of the possibility of an IAC lipoma was raised by the observation of multiple lipomas over the patient's trunk and limbs. The patient underwent a complete tumor resection via the translabyrinthine approach. Pathology confirmed the diagnosis of an IAC lipoma. Although we were not able to preserve the hearing in her left ear, the patient was satisfied that we had relieved her constant tinnitus. In this article, we review the particulars of this case and discuss the clinical, radiologic, and pathologic features of IAC lipomas.
Bilateral Peritonsillar Abscess: Case Report and Presentation of its Clinical Appearance
Authors: Mobley Steven Ross
Published: May 2019

Although there is no consensus on its incidence, bilateral peritonsillar abscess is an unusual variant of an otherwise relatively common otolaryngologic disease. A bilateral peritonsillar abscess can be differentiated from other oropharyngeal pathology with a detailed physical examination and complementary imaging. Its diagnosis should always be considered in patients who have signs and symptoms that are suggestive of peritonsillar abscess but whose intraoral examination yields atypical findings, as well as in patients with marked distress or trismus. This article describes the case of a young man who came to the emergency room with bilateral peritonsillar abscess. The author believes that this report contains the only published photograph of the intraoral appearance of this condition.
Nasal T-cell Lymphoma: Case Report and Review of Diagnostic Features
Authors: Gourin Christine G. , Johnson Jonas T. , Selvaggi Kathy
Published: May 2019

A 73-year-old man was referred to us for evaluation of extensive nasal crusting and progressive erosion of the nasal midline structures. Clinical examination suggested that the patient had a T-cell lymphoma, a suspicion that was confirmed on immunohistochemical analysis. The patient was treated with combination chemo- and radiotherapy and exhibited a marked response. At the 14-month followup, he remained disease-free.
Repair of a Large Septal Perforation with a Radial Forearm Free Flap: Brief Report of a Case
Authors: Mobley Steven Ross , Boyd J. Bryan , Astor Frank C.
Published: May 2019

We treated a 38-year-old man who had a large septal perforation that had been caused by chronic nasal inhalation of cocaine. We were able to repair the perforation with a left radial forearm free flap. Long-term followup indicates a successful closure of the defect and a natural thinning of the flap. The patient remains symptom-free more than 2 years following surgery.
A Metal Ring that had Been Lodged in a Child's Nasopharynx for 4 Years
Authors: Ogut Fatih , Bereketoglu Muslum , Bilgen Cem , Totan Secil
Published: May 2019

A considerable number of articles on foreign-body ingestion and inhalation have been reported in the literature. Of these, nasopharyngeal foreign bodies are rare. Unless they cause total obstruction, symptoms typically appear late. Foreign bodies, especially metal ones, can lodge in soft tissue, and their removal can be rather complicated. In this article, we describe the case of a 4-year-old girl who had had a gold ring lodged in her nasopharynx. The history led us to determine that the ring had been there since the child was 3 months old. A flexible fiberoptic nasopharyngeal examination revealed that the ring was embedded in the nasal surface of the soft palate and was enclosed by a thin layer of mucosal membrane. With the patient under general anesthesia, we were able to remove the foreign body with a 0° endoscope.
Treatment of Chronic Suppurative Otitis Media with Broncasma Berna
Authors: Nakatani Masaki
Published: May 2019

Broncasma Berna, an inactivated bacterial vaccine, has been safely used throughout the world for 30 years for the prevention or treatment of various infectious processes. Until now, there has been no published report regarding its use as a treatment for chronic suppurative otitis media. In this small study, five such patients (median age: 57 years) underwent a series of seven 0.05-ml injections of Broncasma Berna. In all cases, their otorrhea diminished markedly and their tympanic membranes were almost completely dry. The cost of treatment was extremely low.
Evaluation of Post-tonsillectomy Bleeding in the Adult Population
Authors: Bhattacharyya Neil
Published: May 2019

A retrospective review of a consecutive series of 685 adult patients undergoing tonsillectomy was conducted. Determinations were made of the post-tonsillectomy bleeding rate, the need for intervention to control bleeding, and the blood transfusion rate. Statistical analysis was used to determine whether bleeding rates differed according to three criteria: gender, indication for tonsillectomy, and age. Post-tonsillectomy bleeding occurred in 35 patients (5.1%); five of these patients experienced bleeding during the first 24 hours postoperatively, and the remaining 30 experienced delayed bleeding. When it occurred, the mean time lapse between tonsillectomy and bleeding was 6.9 days (±4.1). Twenty of the 35 patients (57.1%) required a procedure to control their bleeding, but no patient required a transfusion. There was no statistically significant difference in bleeding rates based on gender, the indication for surgery (chronic tonsillitis, obstructive sleep apnea syndrome, or to rule out neoplasia), and age. These results indicate that (1) post-tonsillectomy bleeding occurs in approximately 1 of 20 adults independent of individual patient characteristics, (2) more than half of patients who bleed are likely to require a procedure to control their hemorrhage, and (3) the need for transfusion is distinctly unlikely.
Cowden's Disease with Vocal Fold Involvement
Authors: To Edward W.H. , Tsang Wai-Ming , Pak Martin W. , Cheng Jack H.H. , Tse Gary M.K. , Van Hasselt Charles A.
Published: May 2019

Cowden's disease is a hereditary disorder characterized by oropharyngeal fibrosis and multiple hamartomas with potential malignant changes. We treated a 47-year-old man who had fibrotic lesions on the left vocal fold and an extensive amount of papillomatous lesions on the mucosa of the lips, tongue, and pharyngeal wall and on the skin of the axillae and buttocks. The pattern of distribution and the histopathologic features of these mucocutaneous lesions were diagnostic of Cowden's disease. To the best of our knowledge, this is the first reported case of Cowden's disease involving a vocal fold.
Sigmoid Sinus Thrombosis with Contralateral Abducens Palsy: First Report of a Case
Authors: Marzo Sam J.
Published: May 2019

Intracranial complications of acute and chronic otitis media can be difficult to recognize because the signs and symptoms are often subtle. This article describes a case of one such complication—sigmoid sinus thrombosis—that was manifested by a contralateral abducens palsy. The author believes that this is the first reported case of such an occurrence. This article also reviews the differential diagnosis of increased intracranial pressure and discusses the recognition and management of lateral sinus thrombosis.
Myxoid Angiomyoma of the Hard Palate: A Case Report
Authors: Holder Ray , Dellinger Tracy M. , Krolls Sigurds O. , Hill Willie J. , Livingston H. Mark , Alemar Gilberto O.
Published: May 2019

Angiomyomas are found with some frequency in the female genital tract. They can also appear in both sexes in the gastrointestinal tract and in the skin. The oral cavity is an unusual site for an angiomyoma. In this article, we describe the case of a 74-year-old woman who came to us with a nodule at the palatal midline. Following surgical excision of the growth and stent placement over the wound site, a biopsy analysis was performed. Histology of the removed tissue revealed an unusual variant of an angiomyoma: a myxoid angiomyoma.
Geniculate Neuralgia: Long-term Results of Surgical Treatment
Authors: Pulec Jack L.
Published: May 2019

A rare cause of otalgia is geniculate neuralgia. In its most typical form, it is characterized by severe paroxysmal neuralgic pain centered directly in the ear. The pain can be of a gradual onset and of a dull, persistent nature, but occasionally it is sharp and stabbing. When the pain becomes intractable, an operation to surgically excise the nervus intermedius and geniculate ganglion via the middle cranial fossa approach is indicated. The purpose of this article is to review the long-term outcomes in 64 patients who were treated in this manner. Findings indicate that excision of the nervus intermedius and geniculate ganglion can be routinely performed without causing facial paralysis and that it is an effective definitive treatment for intractable geniculate neuralgia.
Endotracheal Tube Fire during Tracheostomy: A Case Report
Authors: Awan Mohammad Sohail , Ahmed Imtinan
Published: May 2019

Electrosurgery in the presence of volatile anesthetic gases has been associated with operating-room fires. We report a case in which an operating-room fire occurred while an intubated patient underwent electrosurgical tracheostomy. The fire in this case was caused by a combination of an oxygen-rich environment, a polyvinyl chloride tube, and heat generated by an electrosurgical unit. We also discuss factors that increase the risk of this type of fire and the management steps that should be undertaken in the event that such afire occurs, and we briefly review the literature on this subject.
Local Injection of OK-432 in the Treatment of Ranula: A Case Report
Authors: Watanabe Ken-ichi , Nakajima Hiroshi , Tomiyama Shunichi , Yagi Toshiaki , Jinnouchi Ken
Published: May 2019

We treated a 57-year-old woman for ranula. After aspirating the cyst's contents, we administered 0.1 KE/ml of OK-432 via local injection. One month later, the cyst had still persisted, so we repeated the procedure. After 2 weeks, the ranula began to shrink markedly, and at 4 weeks it had almost disappeared. No recurrence of the ranula was observed during the subsequent 1 year of follow-up. Following each injection, the patient developed transient fever and local swelling but no serious complications. Our experience suggests that OK-432 injection is an effective treatment for ranula. However, because this treatment causes the cyst to collapse rather than disappear completely, patients should be regularly monitored over the long term.
Management Pitfalls in the use of Embolization for the Treatment of Severe Epistaxis
Authors: Ortiz Justin M. , Bhattacharyya Neil
Published: May 2019

Angiographic embolization for the treatment of severe recurrent epistaxis was added to the traditional treatment options—nasal packing, cauterization, and surgical vessel ligation—in 1974. Since then, clinical experience has shown that this procedure is safe and effective. When epistaxis cannot he controlled with cautery, nasal packing is the most common next step. As such, it is often performed by emergency physicians and other clinicians who are not otolaryngologists. We report two cases in which intranasal neoplasms were obscured as a result of a significant distortion of the normal anatomy. This distortion was secondary to emergency-room treatment of severe epistaxis by repeated nasal packing followed by angiographic embolization. Pre-embolization angiographic studies and subsequent postembolization endoscopic evaluations did not reveal the presence of the occult neoplasms because of the presence of inflammation and edema after treatment. Clinicians should be aware that nasal packing and embolization can obscure the underlying source of epistaxis, and follow-up radiologic studies and endoscopic evaluations are essential to avoid delays in diagnosis.
Airway Management of the Severely Retrognathic Child: Use of the Laryngeal Mask Airway
Authors: Stocks Rose Mary S. , Egerman Robert , Thompson Jerome W. , Peery Michael
Published: May 2019

Successful airway management of an infant or child with moderate to severe retrognathia first requires recognition of a potential problem. If the child cannot be intubated in a standard fashion, the use of a laryngeal mask airway (LMA) should be considered. We describe two cases wherein a toddler and an infant with severe retrognathia failed multiple attempts at traditional intubation. Both had an anterior larynx and hypoplasia of the mandible. In both cases, a subsequent LMA was successfully placed. The severely retrognathic newborn or child presents to the physician a unique challenge in airway management. Techniques to manage this difficult pediatric airway are different from those used in the adult. Otolaryngologists should be aware of this intubation technique and include it in their armamentarium of airway-management strategies. The LMA is not recommended as the technique of choice for securing a difficult airway, but it is an effective alternative when indicated, and it might be life-saving.
A Rapid and Safe Middle Fossa Approach to the Geniculate Ganglion and Labyrinthine Segment of the Facial Nerve
Authors: Bento Ricardo Ferreira , Vuono de Brito Rubens , Sanchez Tanit Ganz
Published: May 2019

The middle fossa approach provides neurotologic surgical access to lesions of the geniculate ganglion and the labyrinthine portion of the facial nerve as well as to the internal acoustic canal, and therefore helps preserve cochlear function. Although this approach is widely used, surgeons are still not certain which anatomic landmarks are best to locate the facial nerve and internal acoustic canal without causing labyrinthine damage. The purpose of this article is to describe a fast and safe technique to expose the geniculate ganglion and the labyrinthine portion of the facial nerve in two structures of the middle ear: the cochleariform process and the tympanic portion of the facial nerve. We prospectively evaluated 32 patients who underwent surgical facial nerve exploration via the middle fossa approach. Our goal was to determine the incidence of intraoperative difficulties and complications; we found none, and hearing levels could not be maintained in only one of the 32 patients. Our technique allowed us to decompress the first genu and the labyrinthine segment of the nerve. It also allowed us to reach and manipulate its tympanic segment in a very short amount of surgical time.