bluuebunny/crossref_metadata_2025_split huggingface dataset:
Videostroboscopic Evaluation of Neoglottis in Alaryngeal Patients after Tracheoesophageal Voice Reconstruction without Prosthesis
Authors: Madrid Jeanne O. , Ureta Celso V. 
Published: April 2019

Objective: To investigate by means of videostoboscopy the characteristics of the neoglottis after total laryngectomy with primary or secondary voice reconstruction using a non-prosthetic tracheoesophageal fistula technique
Methods:
Design: Cross-Sectional Study
Setting: Tertiary Public Hospital
Subjects: Twenty alaryngeal patients
Results: Videostroboscopy enabled evaluation of the neoglottis in all but two patients with a pectoralis major myocutaneous flap reconstruction of the pharyngoesophageal segment. Pooling of saliva was present in the cranial neoglottic opening in all subjects, but obscured visualization in these two. A circular neoglottic shape was most commonly seen. Vibration of the neoglottis was noted in 90% of all alaryngeal patients and was associated with a regular mucosal wave. Pharyngoesophageal vibration was noted in two thirds of patients. It was associated with a strong mucosal wave, regular vibration and a longer open phase.
Conclusion: Videostroboscopy confirmed that neoglottic vibration accompanies sound production while pharyngoesophageal vibration may reinforce and enhance voice production in alaryngeal patients with non-prosthetic TE voice reconstruction.

Keywords: larynx, total laryngectomy, voice reconstruction, tracheoesophageal (te) fistula speech, alaryngeal voice, alaryngeal speech, videostrobe
Extranasopharyngeal Angiofibroma of the Larynx
Authors: Trinidad Connie Angel J. , David Michael Joseph C. , Chua Antonio H. 
Published: April 2019

Objective: To present a rare case of laryngeal extranasopharyngeal angiofibroma, discussing its diagnosis, treatment and differences from the more typical juvenile angiofibroma.

Methods:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One

Result: A 51-year-old male with a two-year history of hoarseness developed difficulty of breathing. Direct laryngoscopy showed a 2x2x1cm glistening, multinodular, pedunculated, firm, pink mass attached to the posterior half of the right true vocal fold obstructing the glottic opening and extending superiorly to the ventricle. Microlaryngeal excision was done. Histopathology showing numerous vascular channels surrounded by dense paucicellular fibrous tissue was consistent with angiofibroma.
Conclusion: Primary extranasopharyngeal angiofibroma is rare, with only 4 previously reported cases occurring in the larynx. We presented what may possibly be the first locally reported case. Although histopathologically similar to the more common juvenile nasopharyngeal angiofibroma, this was atypically seen in the larynx of an older adult patient. Direct laryngoscopy provided excellent exposure for identification as well as complete surgical resection. Unlike the nasopharyngeal type, no massive bleeding was encountered. Prognosis for this extranasopharyngeal angiofibroma is excellent as recurrence is noted to be rare, however, long term follow-up is recommended.
Keywords: extranasopharyngeal angiofibroma, laryngeal angiofibroma
Postoperative Wound Complications in Modified Meatoplasty vs Z- Meatoplasty in Canal Wall Down Mastoidectomy at a Tertiary Hospital: A Randomized Controlled Trial
Authors: Gumban Ma. Theresa L. , Almazan Natividad A. 
Published: April 2019

Objective: To compare the postoperative complications (narrowing of the enlarged canal and perichondritis) of a meatoplasty without conchal cartilage removal and more raw skin area (modified meatoplasty) versus a meatoplasty with conchal cartilage removal and less raw skin area (Z meatoplasty) including other sequelae (hyperemia, formation of granulation tissue and discharge from the cavity) which may lead to complications in canal wall down post-auricular mastoidectomy.
Methods:
Design: Concealed, randomized controlled clinical trial
Setting: Tertiary Public Hospital
Patients: Twenty-one ears of 19 patients with chronic suppurative otitis media (CSOM) undergoing postauricular open mastoidectomy (radical or modified radical mastoidectomy) between February to July 2009 were randomly assigned to undergo modified meatoplasty (Group A: n=11 ) and Z meatoplasty (Group B:n=10). Main outcome measures were postoperative rates of meatoplasty complications and mastoidectomy sequelae that may lead to complications, on weeks 1, 2 and 4.
Results: On the 1st postoperative week, the Z meatoplasty was associated with a higher incidence of hyperemia at the incision site [A: 36.4%, B: 90% (p <0.02)]. The specific complication of perichondritis or other sequelae (discharge from the cavity, granulation tissue) or were no different in both types of meatoplasty. On the second postoperative week, the modified meatoplasty was associated with a higher incidence of narrowing of the canal (73% vs 20%) P<0.02; [RR = 3.64 (CI:1.00,13.23)] The only factor associated with this complication was the modified meatoplasty procedure itself [RR = 3.64 (CI: 1.00, 13.23)]. Perichondritis, and the sequelae of mastoidectomy (discharge from the cavity, granulation tissue) were no different in both types of meatoplasty.
Conclusion: Among CSOM patients who underwent postauricular open mastoidectomy, the Z meatoplasty was associated with a greater risk of hyperemia at the incision site than the modified meatoplasty in the 1st operative week. Compared to the Z meatoplasty, the modified meatoplasty was associated with greater risk of narrowing of the canal on the 2nd postoperative week.
Keywords: meatoplasty; mastoidectomy; complications
Cervical Vagal Schwannoma
Authors: Yong Doh Jeing , Hailani Iskandar , Yunus Mohd Razif bin Mohamad 
Published: April 2019

Objective: To present a case of cervical vagal schwannoma and describe our experience with the clinical presentation, surgical management and outcome of an elderly patient with this pathology.
Methods:
Design: Case Report
Setting: Tertiary Public Hospital
Patients: One
Result: A 65-year-old lady presented with a recently enlarging, pulsatile right sided neck mass that had been asymptomatic for 15 years. Contrast CT revealed a circumscribed non-enhancing heterogenous 4 x 4 x 7 cm mass splaying the right internal jugular vein and common carotid artery. A neurogenic tumour was considered, and the mass was excised from the vagus nerve with preservation of adjacent structures. Final histopathologic reading was schwannoma. However, the patient succumbed to complications following a second surgery for expanding hematoma.
Conclusion: Schwannomas are benign, slow growing tumours that arise from Schwann cells of the nerve sheath. Cervical schwannomas originating from the vagus nerve are rare, but should be considered in patients presenting with solitary neck masses. Surgical extirpation is still the treatment of choice for nerve sheath tumours and recurrence is uncommon. Efforts should be made to preserve unaffected structures and patients should be counseled preoperatively on the possible high risk of morbidity especially in the elderly group where close follow up and aggressive rehabilitation should be instituted following surgery.

Keywords: Cervical schwannoma, vagus nerve, neurogenic tumour; parapharyngeal space
Accuracy of Siemens HearCheck™ Navigator as a Screening Tool for Hearing Loss
Authors: Abes Generoso T. , Reyes-Quintos Ma. Rina T. , Tantoco Ma. Leah S. 
Published: April 2019

Objective: To calculate the accuracy, sensitivity, specificity and positive predictive values of the Siemens HearCheck™ Navigator in detecting hearing loss and to compare values of these parameters when the examination is done in a soundproof booth and in a quiet room.

Methods:
Design: Analytical, cross-sectional study
Setting: Tertiary Public University Hospital
Patients: Patients seen at the Ear Unit of a tertiary public university hospital from June 2009 to August 2010 were tested using the Siemens HearCheck™ Navigator and pure tone audiometry, inside a soundproof audiometry booth and in a quiet room with an ambient noise of 50dB, with a different investigator for each examination. Each ear was treated as a separate subject. Results obtained from the HearCheck™ Navigator were designated as observed values and were classified as “no hearing loss” for green light, and “with hearing loss” for yellow or red lights. Results were compared with pure tone air conduction averages designated as gold standard values. Normal hearing acuity (0-25 dB) was classified as no hearing loss. Pure tone air conduction averages of 26dB and above were classified as “with hearing loss” and were further stratified as mild hearing loss (26-40dB) and moderate or worse hearing loss (>41 dB). Observed and gold standard values were compared and tabulated in a 2x2 table for all levels of hearing loss, mild hearing loss, and moderate or worse hearing loss. Accuracy, sensitivity, specificity, positive and negative predictive values of the Siemens HearCheck™ Navigator inside a soundproof audiometry booth and in a quiet room were determined using pure tone audiometry as the gold standard.

Results: 100 patients (200 ears) were tested, with a median age of 43 years old (range 15-75), and an almost equal number of male and female participants (52 males, 48 females). Accuracy rate of the Siemens HearCheck™ Navigator inside the soundproof audiometry booth and in a quiet room were 82.5% and 84% respectively for all levels of hearing loss. Sensitivity, specificity, positive and negative predictive values were similar whether the examination was done inside the soundproof audiometry booth or in a quiet room. These values were notably higher in patients with moderate or worse hearing loss compared to patients with mild hearing loss.

Conclusion: The Siemens HearCheck™ Navigator shows potential as an accurate, portable, easy-to-use tool to screen for hearing loss, especially for cases of moderate or worse hearing loss, without the need for soundproof audiometry booths or special training. It is recommended that further studies be done to differentiate degrees of hearing loss, and to evaluate its usefulness in other target populations, including school children and the elderly.

Keywords: hearing screening, hearing screening tool, accuracy, hearingloss, HearCheck™ Navigator
Audiological Manifestations in Kabuki (Niikawa-Kuroki) Syndrome
Authors: Tobias Celina Ann M. , Gloria-Cruz Teresa Luisa , Chiong Charlotte M. 
Published: April 2019

Objective: To describe the audiological profile, clinical features and briefly summarize the speech and language development of a child with Kabuki syndrome (KS). KS is a rare malformation syndrome that usually presents with mental retardation and multiple congenital anomalies including ear diseases and hearing loss.

Methods:
Design: Case report
Setting: Tertiary Public University Hospital
Subject: One patient

Results: A five-year-old female diagnosed with KS at age three presented with moderate to severe conductive hearing loss in the right ear with a drop at the high frequencies and moderate to severe conductive sloping hearing loss in the left ear. She also had fluctuating tympanometric findings. She was fit with binaural hearing aids.

Conclusion: Ear diseases and hearing loss should immediately be considered in patients diagnosed with KS. A comprehensive audiological and otolaryngological evaluation should also be performed when presented with a KS case.

Keywords: Kabuki syndrome, Niikawa-Kuroki syndrome, hearing loss, multiple anomalies
Complete Dislocation of the Lens of the Eye - Always Review the Complete Study
Authors: Bickle Ian C. 
Published: April 2019

This 37 year-old male patient underwent high resolution CT imaging of the face including paranasal sinuses following trauma. Computed tomography (CT) has a well-established role in the assessment of the facial bones in the context of trauma, in particular for fractures involving the paranasal sinuses and orbit. High resolution imaging permits isotropic reconstruction in multiple planes. Its use in imaging the contents of orbit itself is more select, with both direct clinical examination and even orbital ultrasound used to assess the globe and lens of the eye.1
Traumatic dislocation of the lens of the eye may entail the partial or complete translocation of the lens from its normal position within the anterior aspect of the eye.2 The high attenuation lens ‘floats’, within the vitreous of the globe (Figures 1, 2 and 3).
Following trauma to the face the injuries may be multiple and cross sub-speciality boundaries, but one should be alert to all injuries. In reviewing CT images one should be forensic in the review of all the anatomy covered, even it is not related to the original clinical query or not pertinent to one’s own clinical speciality.
As an old mentor once told me, ‘Before you take the film down, have one last paranoid look.’
Learning Point: Always review the entirety of the imaging performed
despite the focus of one’s clinical or speciality interest.
The Recurrent Laryngeal Nerve in Relation to the Inferior Thyroid Artery in Adult Filipino Cadavers
Authors: Matubis Jacob S. , Dumlao Karen June P. , Carrillo Ryner Jose C. 
Published: April 2019

Objective: To describe the anatomic relationship of the recurrent laryngeal nerve and the inferior thyroid artery in adult cadavers in the Philippines and to compare the proportions of these anatomic relationships with those reported in the foreign literature.
Methods:
Study design: Descriptive, cross-sectional
Setting: University of the Philippines College of Medicine Anatomy Laboratory
Subjects: Fifty-four (54) preserved cadavers (108 sides) dissected within a period from June 2008 to Aug 2010. The anatomy and position of both the right and the left recurrent laryngeal nerves (RLN) and inferior thyroid arteries (ITA) were noted. The RLN was further classified into 2 variations: non-branching or branching prior to insertion at the cricothyroid joint, under the inferior constrictor muscle. The ITA was also classified into non-branching and branching. The results were compared to two foreign studies using a Z-test for two proportions.
Results: Fifty four (54) cadavers (108) sides were dissected. Among the cadavers, both the recurrent laryngeal nerves and inferior thyroid arteries had a maximum of two branches although both the RLNs and ITAs for both the right and left sides were mostly non-branching. The right side of one cadaver was noted to have both a branching RLN and a branching ITA. There were no non-recurrent laryngeal nerves seen among the 54 cadavers.
For both left and right sides, the RLN was mostly dorsal to the ITA. Branching RLNs was mostly dorsal to a non-branching ITAs. Most of the non-branching RLNs were dorsal to the ITAs. Non-branching RLNs were usually dorsal to the ITA.

The local patterns of the course of the RLN in relation to the ITA approximates those of Chinese where there is predominance of the RLN dorsal to the ITA but differs from those of Brazilians where the RLN is usually between ITA branches.

Conclusion: There are multiple anatomical variations with regards to the relationship of the RLN and the ITA. The anatomic variation among Asians may be different from Brazilians. The surgeon’s knowledge of the possible various configurations of the RLN and ITA should be able to help in identification and preservation of the RLN and prevention of complications in thyroid surgery.
Keywords: recurrent laryngeal nerve, inferior thyroid artery, thyroid surgery, Filipino cadavers, anatomical variations
Hoarseness Due to Cardiovascular Disease: Two Cases of Cardiovocal Syndrome
Authors: Anuar Khairullah , Baki Marina Mat , Sani Abdullah , Sabir Husin Athar Primuharsa Putra 
Published: April 2019

Objective: To report two cases of Cardiovocal syndrome (or Ortner’s syndrome) due to cardiovascular disease.
Methods:
Study Design: Case Report
Setting: Tertiary University Hospital
Subjects: Two
Results: Two patients with cardiovocal syndrome, one due to an aortic saccular aneurysm and the other due to severe mitral stenosis underwent surgery to correct the underlying cardiovascular disease. Post-operatively, the hoarseness resolved completely in the patient with mitral stenosis but persisted in the patient with aortic saccular aneurysm.
Conclusion: Cardivascular disease should be considered as a differential diagnosis in a patient with hoarseness. A high index of suspicion is needed to make an early diagnosis, which can lead to surgical correction of the potentially life-threatening, underlying cardiovascular disease.
Keywords: Cardiovocal hoarseness, Ortner’s syndrome, cardiovascular disease, aortic aneurysm, mitral stenosis
Accuracy of Reflexive Behavioral (“Baah”) Test in the Screening for Hearing Impairment in Infants Six Months Old and Below
Authors: Garcia Marieflor Cristy M. , Chiong Charlotte M. , Abes Generoso T. , Carrillo Ryner Jose C. 
Published: April 2019

Objective: To determine the prevalence of hearing loss among infants six months old and below sent for newborn hearing screening in our institution, and to measure the accuracy, sensitivity, specificity and positive predictive values of reflexive behavioral (“Baah”) test in detecting hearing loss in infants.Methods: Design: Cross-sectional study Setting: Ear Unit of a tertiary government hospital Participants: Infants less than Six months old sent for newborn hearing screening at the Ear Unit of a tertiary government hospital from April to September, 2011 were recruited. All participants were tested with OAE for hearing screening. OAE was also used as the standard for evaluating hearing impairment. The reflexive behavioral (“Baah”) test was then done using the human voice as a loud sound stimulus, and the response recorded were auropalpebral, startle and blinking response to the sound. Thesensitivity, specificity, accuracy, positive and negative predictive value of the test was then measured.Results: From April to September 2011, a total of 101 patients were tested, with a male to female ratio of 1.1:1 (53 males, 48 females). The prevalence of hearing impairment in this study population was 6.9% (7 out of 101). The reflexive behavioral (“Baah”) test was found to have sensitivity of 71.4%, specificity of 95.7%, accuracy rate of 94%, positive predictive value of 55.6% and negative predictive value of 97.8%.Conclusion: The reflexive behavioral (“Baah”) test shows potential as an accurate, acceptable and cost-effective screening tool to identify infants that may be at higher risk for hearing impairment. This test may aid the health care providers, in areas without OAEs, in identifying infants who are in need further hearing diagnostic evaluation, with OAEs or other hearing tests. It is recommended that the “Baah” test be implemented in the community to test its reproducibility in a larger population and outside the hospital setting.Keywords: reflexive behavioral test, “Baah” test, otoacoustic emission, hearing screening
Respiratory Epithelial Adenomatoid Hamartoma of the Nasal Septum
Authors: Zulkepli Siti Zulaili , Husain Salina , Gendeh Balwant Singh 
Published: April 2019

Objective: Hamartomas are relatively uncommon, non-neoplastic malformations indigenous to the involved anatomic site. Respiratory epithelial adenomatoid hamartoma (REAH) is a subsetof hamartoma characterized by prominent glandular proliferation lined by ciliated epithelium originating from the surface epithelium. Their location in the nasal cavity is rare and when present, mostly associated with the posterior nasal septum. We present such a case arising from the anterior nasal septum.Methods: Design: Case report Setting: Tertiary University Referral Center Patient: OneResults: A 32-year-old lady who presented with a long-standing nasal block was found to have a broad-based nasal mass arising from the left anterior nasal septum. The lesion was histologicallydiagnosed as respiratory epithelial adenomatoid hamartoma following surgical excision.Conclusion: Respiratory epithelial adenomatoid hamartoma although rare must be taken intoconsideration in the differential diagnosis of nasal lesions.Keywords: respiratory epithelial adenomatoid hamartoma; anterior nasal septum; nasal block
Primary Thyroid Lymphoma
Authors: Musngi-Paras Claudine Ann , Salpin Ansarie P. , Veloso Januario D. 
Published: April 2019

Eight cases of primary thyroid lymphoma were reported in a tertiary government hospital from January 2005 to August 2011. All patients presented with a diffuse enlargement of both thyroid lobes with associated obstructive symptoms. Five of these cases were extranodal marginal zone lymphoma and three were diffuse large B-cell lymphoma. Clinical features that would favor a thyroid lymphoma include tumor size of greater that 7cm, obstructive symptoms, clinical hypothyroidism or history of Hashimoto thyroiditis. Thus, these features must be considered in evaluating thyroid nodules during fine-needle aspiration biopsy. Histologically, extranodal marginal zone B-cell lymphoma shows vaguely nodular to diffuse infiltrates of small to intermediate size atypical lymphoid cells infiltrating the thyroid follicles, while diffuse large B-cell lymphoma shows sheets of large atypical lymphoid cells infiltrating the thyroid follicular epithelium.
Keywords: Primary Thyroid Lymphoma, Extranodal Marginal Zone B-cell Lymphoma, Diffuse Large B-cell Lymphoma.
Giant Cell Tumor of the Maxilla
Authors: Saha Somnath , Sen Sharmila , Saha V. Padmini , Pal Sudipta 
Published: April 2019

Objective: To present a rare case of maxillary swelling; its investigation and management.

Methods:
Design: Case Report

Setting: Tertiary Rural Private Teaching Hospital

Patient: One

Results: A 45-year-old female presented with a right maxillary swelling of six months duration. Radiological investigation revealed a radiolucent lesion arising from the inferior aspect of the right maxilla with no areas of calcification. Incisional biopsy report was consistent with giant cell tumor. The mass was excised via a Weber Ferguson incision under general anesthesia.
Conclusion: Though rare, giant cell tumor should be considered as one of the differential diagnosis in cases of maxillary swelling. Adequate surgical excision with long-term follow-up should be the treatment of choice for managing a giant cell lesion of the maxilla.

Keywords: maxillary swelling, giant cell tumor
An Improvised Tracheotomy Speaking Valve
Authors: Delovino Kirt Areis E. , Lim William S. 
Published: April 2019

Objective: To design and test an improvised tracheotomy speaking valve fabricated from recycled parts of an anesthesia airway breathing circuit.
Methods:
Design: Surgical Instrumentation
Setting: Tertiary Private Hospital
Subjects: Speaking valves fabricated from discarded anesthesia breathing circuit parts were pilot-tested on 3 patients: one with vocal fold paralysis, another with a supraglottic mass and one post hemi-laryngectomy.
Results: The improvised tracheotomy speaking valve was inexpensive and relatively easy to assemble. All three patients tolerated speech well through the speaking valve and were pleased to reestablish their means of verbal communication. Maximum Phonation Time (MPT) averaged 8 seconds for all three subjects.
Conclusion: In our local setting, improving the quality of life of tracheotomized patients should be accessible to all, hence the value of an improvised speaking valve. It provides a more affordable means of restoring speech and because it is made from recycled materials, it is eco-friendly. Our improvised speaking valve is also a cheaper but viable alternative to more expensive commercially available ones. Clinical trials with standardized feedback questionnaires, multi-observer perceptual evaluation with a system such as the GRBAS and/or vocal acoustic measures in a speech laboratory should be made to assess long term use, efficiency and safety measures.
Keywords: tracheotomy, tracheostomy, speaking valve, speaking device