bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Anatomical Study of the Cochlea among Filipinos using High-Resolution Computed Tomography Scans
Authors: Fernando Adrian F. , De Jesus Brian Joseph dG. , Opulencia Alejandro P. , Maglalang Gil M. , Chua Antoio H. 
Published: April 2019

Objective: To describe the cochlear anatomy among Filipinos through high resolution computed
tomography (HRCT) imaging.

Methods:
Design: Retrospective Study
Setting: Tertiary Private University Hospital
Patients: Cochlear images retrospectively obtained from computed tomography (CT) scans of subjects who underwent cranial, facial, paranasal sinus and temporal bone computed tomography from October 2009 to July 2010 were reconstructed and analyzed.

Results: 388 cochlear images were obtained from the scans of 194 subjects (101 males and 93 females, aged 1 to 90 years old, mean = 52 years) and reconstructed for analysis. The mean coiled cochlear height measured 4.36 mm on the right (A.D.) and 4.34 mm on the left (A.S.). Measurement from the oval window to the distal end of the basal turn (equivalent to the horizontal dimension of the cochlea or the mean length of the basal turn) was 7.55 mm A.D. and 7.60 mm A.S. The vertical and horizontal dimensions of right and left cochleas were identical in all subjects (S.D. = 0.35). The right and left cochlear turns were identical in each subject, exhibiting 2 ½ turns in 92.3% of subjects and 2 ¾ turns in 7.7% of subjects.The cochlear dimensions were similar in all subjects, regardless of age. No cochlear ossification or malformation was noted on any CT image.

Conclusion: The 7.55 mm mean length of the cochlear basal turn among Filipinos in this study was 1.24 mm shorter than the average length of the basal turn of 8.81 mm reported elsewhere. Further studies of the cochlear dimensions in specific age groups and its correlation to audiometric status are recommended to determine other significant physiologic correlations.

Keywords: cochlea, cochlear turn, high-resolution computed tomography (HRCT), magnetic resonance imaging (MRI)
Intraparotid Facial Nerve Schwannoma with Temporal Bone Extension
Authors: Laoag Alexander T. , Chua Antonio H. , De Guzman Thanh Vu T. , Castañeda Samantha S. , Malanyaon Jose A. 
Published: April 2019

Objective: To present a rare case of facial schwannoma manifesting as a parotid mass and discuss its diagnosis and treatment.Methods: Design: Case Report Setting: Tertiary Government Hospital Patient: OneResults: A 48-year-old female was seen for a 2-year progressive left hemifacial paralysis and a 5-month gradually enlarging left infraauricular mass with episodes of tinnitus but intact hearing and balance. Physical examination showed a left-sided House Brackmann grade VI facial paralysis and a 5 x 4 x 3 cm soft, ill-defined, slightly movable, nontender, left infraauricular mass. Gadolinium-enhanced magnetic resonance imaging revealed a 5 cm heterogeneouslyenhancing lobulated mass centered within the deep lobe of the left parotid gland extending to the left mastoid, with facial nerve involvement. A diagnosis of a facial nerve tumor, probably a schwannoma, was entertained. Pure tone audiometry revealed normal hearing thresholds for both ears with dips at 6-8 KHz on the left. The patient underwent total parotidectomy withfacial nerve tumor resection via transmastoid approach, with simultaneous facial – hypoglossal nerve anastomosis reconstruction. Histopathologic findings confirmed the diagnosis of a schwannoma. Postoperative facial function was Grade VI. Hearing and hypoglossal nerve function were preserved.Conclusion: A progressive hemifacial paralysis of chronic duration with or without the presence of an infra-auricular mass should raise the suspicion of a facial nerve tumor. Gadolinium-enhanced magnetic resonance imaging is valuable since intraparotid facial nerve schwannomas are mostly diagnosed intraoperatively when the neoplasm and the nerve are exposed and determined to be contiguous. The clinician should be aware that not all parotid masses are salivary gland in origin.Keywords: intraparotid facial nerve schwannoma, facial nerve paralysis, parotid mass
Auricular Perichondritis in a Tertiary Rural Hospital
Authors: Dhar Gautam , Basak Bijan , Gayen Ganesh Chandra , Ray Ritam 
Published: April 2019

Objective: Auricular perichondritis refers to inflammation involving the perichondrium of the external ear. It is a very serious disease which may lead to permanent deformity of the pinna. We describe the predisposing factors, pathogenic organisms, interventions and residual deformities in a prospective consecutive sample of patients.
Methods:
Design: Prospective Cohort Study
Setting: Tertiary Rural Government Teaching Hospital
Participants: All patients presenting with auricular perichondritis for a period of one year, between March 2011 and February 2012 were consecutively enrolled, and a clinical history and demographic details were obtained. Routine hematologic, blood biochemical examinations and culture / sensitivity of discharge from the pinna were conducted, and empiric intravenous ciprofloxacin was administered and continued if confirmed by culture and sensitivity. Those sensitive to co-amoxiclav, ceftazidime or amikacin were shifted to those medications. Medications were shifted to oral forms when available and indicated by resolution of acute inflammation, wound healing and no growth on cultures. Parenteral medications were maintained until the same parameters were achieved. Surgical incision and drainage was also performed when indicated, followed by a standardized wound care regimen. Follow up was for six months ending with assessment of pinna deformity.
Results: Of the total study population of 50, 76% were male and 24% were female; 15-75 years of age (range 60 years) displaying male predominance and clustering in the fourth decade of life. The most common predisposing factors were trauma from motor vehicle accidents (30%) followed by high ear piercing (22%). Pseudomonas aeruginosa (48%) followed by Staphylococcus aureus (20%) were the most common organisms isolated. All were managed with intravenous antibiotics, but 76% also required surgical intervention. Sixty-eight percent developed residual deformities of the pinna, with 50% being total and 18% being partial.

Conclusion: Auricular perichondritis is a frightening disease which requires early management. As Pseudomonas aeruginosa is the commonest organism, antipseudomonal antibiotics should be started as early as possible. Despite medical and surgical intervention, residual deformities may ensue.

Keywords: auricular perichondritis, pinna, trauma, Pseudomonas aeruginosa
Gastrointestinal Stromal Tumor of the Tongue
Authors: Formanez Andrie Jeremy , Galvan-Bravo Grace Naomi B. 
Published: April 2019

Objective: To report a case of a gastrointestinal stromal tumor presenting as a recurrent tongue mass
Methods:
Study Design: Case Report
Setting: Tertiary Public Hospital
Participant: One patient
Results: A 40-year-old Filipino soldier from Camarines Sur presented with a recurrent tongue mass two years after excision of a progressively-enlarging, firm, fixed, non-tender mass at the left posterior third of the tongue diagnosed as a Schwannoma. Repeat surgery involved partial glossectomy via midline mandibular swing. Final histopathologic report after immunohistochemical studies for CD117, SMA, and S100 was extraintestinal gastrointestinal stromal tumor of the tongue. The patient was started on the c-kit tyrosine kinase inhibitor Imatinib with no recurrence 10 months post treatment.
Conclusion: Gastrointestinal stromal tumor may be considered when presented with a recurrent tongue mass despite complete surgical resection. Surgical removal is curative for most lesions. Post-operative chemotherapy with the use of Imatinib is valuable.
Keywords: recurrent tongue mass, gastrointestinal stromal tumor, immunohistochemistry, c-kit tyrosine kinase inhibitor
CT 3D Reformatting Technique to Aid Microtia Reconstruction Procedure Planning
Authors: Bickle Ian C. 
Published: April 2019

This 8 year-old girl presented to a tertiary surgical centre with a history from birth of an absent left and a malformed right pinna, and associated bilateral hearing impairment.
On clinical examination, the left pinna was absent and the right dysplastic. No penetrable external auditory meati were evident. Bilateral hearing impairment, more pronounced on the left, was confirmed with auditory testing.
Prior to surgery high resolution CT imaging of the temporal bones was performed. In addition a CT of the lower thoracic cavity was undertaken to assess the costal cartilage for surgical planning.

Discussion
Microtia is a congenital deformity of the pinna, with a wide spectrum of abnormalities ranging from complete absence (anotia) to a relatively, well formed, but dysplastic pinna (Figure 2). It occurs in 1 in every 6,000 births, with a higher preponderance in select racial groups, such as the Japanese.1
For decades surgical procedures have been performed and evolved for the treatment of microtia. In contemporary practice theses may either be autogenous, using costal cartilage or alloplastic, using the likes of porous high density polyethylene (Medpor).2 The key autogenous surgical techniques in common practice are those described by the Brent and Nagata.3,4
Autogenous costal cartilage is utilised in one of the key stages in reconstructing the pinna to fabricate the auricular framework. The age at which the procedure is performed is typically in childhood (8 – 10 years of age), when costal cartilage is believed to be well formed and fusion may have occurred at the mid-lower ribs levels (7th – 9th). Traditionally no pre-operative imaging has been undertaken given the difficulties with visualising cartilage at this age. On standard CT chest with traditional viewing methods the costal cartilage is poorly if at all seen in children. However, utilising some of the more advanced 3D software algorithms on contemporary CT scanners, accurate assessment to aid the surgeon prior to scheduling a procedure can be performed (Figure 1). The configuration of costal cartilage may be reviewed and if adequate fusion has occurred. A potential framework can then be outlined (Figure3a). In addition selective dimensions can be recorded to the nearest millimeter (Figure 3b). This post-processing work is undertaken with the reporting radiologist and surgical lead for the procedures.
*Images in our institutions were acquired on Siemens Somatom 64 slice scanner with radiographic parameters of kV 120, Mas 46, slice thickness 0.6mm and DLP of 68 without the use of intravenous contrast. Coronal 3D reconstructions were performed using the InSpace software, using an arterial algorithm (Figures 1 and 3a). Alternatives employed include the use of soft tissue algorithm (Figure 3b).
Epithelial-Myoepithelial Carcinoma of the Salivary Gland
Authors: Carnate Jose M. , Lapeña José Florencio F. 
Published: April 2019

The World Health Organization (2005) defines an epithelial-myoepithelial carcinoma (EMC) as a malignancy composed of two cell types that typically form duct-like structures.1 We present herein an archival case from the parotid gland.

EMC occurs primarily in the major salivary glands particularly in the parotid where it presents as a painless, slow-growing mass.1 Microscopic examination shows bi-layered tubular duct-like structures with pale to clear areas (Figure 1). The inner luminal layer is composed of cuboidal cells that are of epithelial derivation while the outer layer is composed of polygonal cells that are of myoepithelial derivation (Figures 2 and 3). The latter typically have abundant clear cytoplasm.1,2
The epithelial-myoepithelial dualism is confirmed using immunohistochemical stains; the epithelial cells being immunoreactive for low molecular weight keratin and the myoepithelial cells for S-100 protein, muscle specific actin, vimentin and p63.1, 3

EMC is primarily a tumor of adulthood with peak incidence in the sixth and seventh decades. First described by Donath et al. in 1972,3 they are rare salivary gland neoplasms with an incidence of less than 1% arising mainly in the parotid gland4 although they have been documented in the lungs.5 Perineural and vascular invasion are frequent and recurrence occurs in around 40% of cases and metastasis in 14%.1 Although thought to be of low-grade malignancy, fatal courses have been described4 and “analysis of the various series have demonstrated that tumors with a solid growing pattern, nuclear atypia, DNA aneuploidy and high proliferative activity, generally have a more aggressive behavior and a higher frequency of local recurrences and metastases.”3
Intraoperative Distance Between the Main Trunk of the Facial Nerve and Surgical Landmarks Used in Parotidectomy: A Prospective Study
Authors: Mendoza Daniel Jose C. , Castañeda Samantha S. , Chua Antonio H. 
Published: April 2019

Objective: to determine the mean distance of the main trunk of the facial nerve from two commonly employed surgical landmarks (tragal pointer and tympanomastoid suture line) among a sample of Filipino adults undergoing parotidectomy.

Methods
Study Design: Prospective Descriptive Study
Setting: Tertiary Government Training Hospital
Subjects: 22 patients without facial paralysis undergoing surgery for parotid neoplasms were evaluated intraoperatively.

Results: The main trunk of the facial nerve was found to be 9.0mm (standard deviation of 2.8mm) from the tragal pointer and 6.1mm (standard deviation of 2.0mm) from the tympanomastoid suture line.

Conclusion: The mean distance from the main trunk of the facial nerve to two of the most commonly utilized landmarks in identification of the nerve during parotidectomy was 9.0mm (standard deviation of 2.8mm) from the tragal pointer and 6.1mm (standard deviation of 2.0mm) from the tympanomastoid suture line. These may serve as reference values for surgeons in safer identification and preservation of the facial nerve during parotidectomy.

Keywords: facial nerve, parotidectomy, tragal pointer, tympanomastoid suture line, anatomic landmarks
An Incidental Nasopharyngeal Carcinoma Coexistent with Primary Nasopharyngeal Tuberculosis
Authors: Chong Hon Syn , Mohammed Yunus Mohd Razif , Ali Norafidaah 
Published: April 2019

Objective: To describe a case of nasopharyngeal carcinoma coexistent with primary nasopharyngeal tuberculosis and review the literature.
Methods:
Design: Case Report
Setting: Tertiary Public University Hospital
Patient: One
Results: A 28-year-old man presented with recurrent sore throat and neck pain with clinically enlarged tonsils. He underwent a routine adenotonsilectomy. Histopathologic examination revealed non-keratinizing squamous cell carcinoma with caseating granulomatous inflammation typical for tuberculosis in the same adenoid specimen. Nasopharyngeal carcinoma was staged T2bN2M0. He was treated with concurrent chemoradiotherapy and a 9-month course of anti tuberculosis treatment. He recovered and remained symptom free 1 year after treatment.
Conclusion: Nasopharyngeal carcinoma (NPC) and tuberculosis (TB) are both very common diseases in Sabah, East Malaysia. However, it is very rare that both diseases present at the same time and same anatomical area in a patient. Diagnosis can be very challenging and confusing. Multidisciplinary consultations are warranted for appropriate treatment. Combined anti-tuberculosis treatment and concurrent chemoradiotherapy may be appropriate and effective.

Keywords: Nasopharyngeal carcinoma, Primary Nasopharyngeal Tuberculosis, adenotonsillectomy
Reconstruction of a Large Through and Through Defect of the Oral Cavity Using Double Anterolateral Thigh Free Flap
Authors: Alamani Jefferson A. , Castañeda Samantha S. , Fernando Adrian F. 
Published: April 2019

Objective: To present our application of a double anterolateral thigh (ALT) free flap in reconstruction of a large full thickness defect of the oral cavity, cheek and cervical area.
Methods:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
Results: A 77-year-old male with a 20 x 25 cm full thickness soft tissue defect on the facial and cervical area contiguous with a 6 x 6 cm buccal defect resulting from wide tumor ablation of a Stage IVA (T4aN2bM0) squamous cell carcinoma of the buccal mucosa underwent reconstruction using two ALT free flaps. An ALT flap was designed to cover the intraoral and cheek defect, while another ALT flap was used for external coverage of the cervical defect. The first ALT flap measured approximately 8 x 22 cm while the second ALT flap measured 6 x 22 cm harvested from the left and right thigh respectively. Temporary venous congestion was observed on the inferiorly placed ALT flap due to neck edema that spontaneously resolved on the 2nd post-operative day. Minimal donor site complications observed were linear scars, and a 1 x 4 cm dehiscence on the right thigh that healed spontaneously by secondary intention.

Conclusion: The utilization of a double anterolateral thigh free flap allowed single-stage reconstruction of the large soft tissue head and neck defect with little donor site morbidity, shorter operating time and shorter hospital stay.

Keywords: anterolateral thigh free flap (ALT flap), double ALT flap, full-thickness buccal defect
Assessment of the Ototoxic Effects of Amikacin and Meropenem among Neonates in a Tertiary Government Hospital
Authors: Agullo Edgar Jake A. , Victoria Francisco A. 
Published: April 2019

Objective: Using pre and post-treatment otoacoustic emission (OAE) tests, this study aimed to assess the ototoxic effect of meropenem, amikacin and meropenem plus amikacin among neonates treated for sepsis neonatorum in a neonatal intensive care unit versus untreated outpatient controls.
Methods:
Study design: Prospective Quasi-Experimental Controlled Clinical Trial
Setting: Tertiary Government Hospital
Subjects: Neonates treated for sepsis neonatorum in the Neonatal Intensive Care Unit between August to October 2012 who met inclusion criteria were included in this study. Controls were neonates born in the same institution who were not admitted and did not receive any antibiotic treatment. Excluded were those with APGAR < 5 at first minute, birth weight < 1000 grams, clinically evident congenital anomalies, and initial “refer” results on OAE.
Neonates were subjected to OAE testing before and after 7 days treatment with amikacin, meropenem, or a combination of both drugs. Results were analysed using chi-square test. Maternal drug intake, family history of hearing impairment and clinical outcomes (whether expired or discharged improved) were not included in this study. Assessment of ototoxic effects were limited to OAE alone and not confirmed by ABR.

Results: OAE “refer” rates were as follows: no amikacin and no meropenem, 0% (0/42); amikacin only, 33.3% (3/9); meropenem only, 25% (2/8) and amikacin and meropenem, 50% (10/20). Statistical analysis showed that hearing loss was dependent on treatment (c2 =23.741, p = < 0.001). Overall, statistical analysis showed that there is an increased risk of hearing loss when treated with amikacin and/or meropenem as compared to no treatment.

Conclusion: There is an increased risk of ototoxicity when amikacin, meropenem, or a combination of both drugs is administered to neonates. While the ototoxic effects of amikacin have been elucidated, further studies involving meropenem and its potential ototoxic effect are recommended.

Keywords: ototoxicity, amikacin, meropenem, otoacoustic emission testing, neonatal hearing loss
A Vocal Cord Polyp in a Pediatric Patient
Authors: Nalangan Ma. Joan N. 
Published: April 2019

Objective: To present a case of vocal cord polyp in a pediatric patient and discuss its differential diagnosis, assessment and management.

Methods:
Study Design: Case Report
Setting: Tertiary Public Hospital
Participant: One

Results: A seven-year-old girl presented with hoarseness and a benign, unilateral mass seen at the junction of anterior and middle third of the vocal cord. The hoarseness resolved after excision, and histopathology confirmed an inflammatory vocal cord pseudo polyp.

Conclusion: Vocal cord polyps occur infrequently in children and adolescents. These cases are seldomly seen and reported and may arise from chronic abuse of the larynx, vocal cord trauma or phonotrauma. Hoarseness is the most common presenting symptom. Differential diagnoses include recurrent respiratory papillomatosis, laryngeal cyst and laryngeal nodule. The management of vocal cord polyps involves surgical removal followed by speech therapy.
Keywords: hoarseness, phonotrauma, vocal cord polyp, recurrent respiratory papillomatosis, vocal cord nodule, vocal cord cyst, flexible laryngoscopy, speech therapy
Gap Arthroplasty of Bilateral Temporomandibular Joint Ankylosis
Authors: Guintu Ferdinand Z. , Laoag Alexander T. , David Joselito F. 
Published: April 2019

Objective: To present a case of bilateral temporomandibular joint ankylosis that was managed successfully through gap arthroplasty.
Methods:
Design: Case report
Setting: Tertiary Government Hospital
Patient: One
Results:
A 25-year-old man presented with inability to open his mouth for 18 years after direct trauma to his chin. CT scan showed bilateral bony fusion of condyles to glenoid fossae, hypertrophic sclerosis and fusion of the condylar heads to the temporal bones. He underwent bilateral gap arthroplasty via preauricular approach with creation of a 15 mm space on the mandibular fossa. As of latest follow up, the patient maintained an inter-alveolar distance of 30 mm for 5 months postoperatively, through continuous aggressive mouth opening exercises.
Conclusion:
Gap arthroplasty may be an efficient procedure for temporomandibular joint ankylosis in achieving satisfactory post-operative inter-alveolar opening and articular function. Early and meticulous rehabilitation is required to prevent relapse. Long-term follow up is recommended to document possible recurrence.

Keywords: temporomandibular joint ankylosis, gap arthroplasty, TMJ ankylosis, ankylosis
Animated Demonstration of Selected ORLHNS Concepts and Surgeries: A Potential Adjunct to Learning
Authors: Agullo Edgar Jake A. , Samson Emmanuel S. , Victoria Francisco A. 
Published: April 2019

Objective: To create visual animated demonstrations of certain otorhinolaryngologic concepts and surgeries that can aid learning of students and ORL residents.
Methods: Several otorhinolaryngologic surgical procedures and pathophysiologic concepts were represented through 2-dimensional images. For every concept or procedure, a series of images was drawn and manipulated using the software Adobe Photoshop CS4. The series of images were then put into animation using the software Morpheus Photo Animation Suite v3.15.
Result: The end results were demonstrations of otorhinolaryngologic concepts and surgical procedures in movie (.AVI) format.
Conclusion: Concepts and surgeries in the field of otorhinolaryngology are usually explained or documented using texts or simple images. The generated animated demonstration of these ideas can aid in the learning of the ORL specialist.
Keywords: animation, surgical procedure demonstration, pathophysiology animated presentation