bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medialization Thyroplasty Using the Pocket and Silicone Implant Technique
Authors: Taningco Maria Margarita F. , Ibay Emmanuel L. 
Published: April 2019

Objective: To describe a new method of medialization thyroplasty using a modified preformed nasal silicone implant.
Methods:
Design: Surgical Innovation
Setting: Tertiary Private Hospital
Participants: Four patients underwent medialization thyroplasty using a pocket and nasal implant technique performed by the senior co-author. The indication for medialization thyroplasty for these patients was hoarseness secondary to unilateral vocal fold paralysis of more than 6 months duration, and documented by flexible fiberoptic laryngoscopy. The outcomes were described with comparison of pre- and post-operative subjective voice assessment.
Results: Operative time was 15–30 minutes. Post-operative subjective improvement of voice quality was evident. Scars were minimal and aesthetically acceptable. The procedure could be done on an outpatient basis.
Conclusion: Medialization thyroplasty via a pocket and silicone implant technique is initially effective and may be a worthwhile alternative to the usual window technique.
Keywords: unilateral vocal cord paralysis; medialization thyroplasty; Isshiki thyroplasty; silicone implant
Bleeding Time using Moringa oleifera (Malunggay) Leaf Extract versus Saline Control in a Rabbit Epistaxis Model: A Randomized Controlled Trial
Authors: Caballero Paula Luz G. , Cachuela Joseph E. 
Published: April 2019

Objective: To determine bleeding time using Moringa oleifera leaf extract versus saline control in an experimental epistaxis model.
Methods:
Design: Randomized controlled trial
Setting: Tertiary Government Training Hospital
Subjects: Ten adult male New Zealand White rabbits were acclimatized for 1 week in a standard environment. One-centimeter long, full-thickness mucosal wounds in the junction of the nasal floor and anterior part of the septum were treated randomly with topical Moringa oleifera extract or colored isotonic saline control in either right or left nasal cavity, one site at a time. The duration of bleeding – time bleeding started to time bleeding stopped -- was recorded in seconds. Data was subjected to a t-test for paired samples.
Results: The mean bleeding time for wounds treated with Moringa extract was 53 seconds (range 38-70 secs), versus 159 seconds (range 100-218 secs) for controls. The bleeding time in the former was significantly shorter than in the latter (p = .000019, t-stat = 8.139), with a mean difference of 106 seconds between the two groups.
Conclusion: Moringa oleifera leaf extract was associated with significantly shorter bleeding time than saline control in this experimental epistaxis model, and may be worth investigating further as a hemostatic agent for epistaxis.
Keywords: epistaxis, malunggay, Moringa oleifera extract, topical hemostatic agent
Tuberculosis of the Thyroid
Authors: Fabito Elmer F. , Tipayno-Lubos Mary Jane , Ayahao Felixberto D. 
Published: April 2019

Objectives: To present a case of thyroid tuberculosis and to discuss its clinical presentation, differential diagnoses and management.
Methods:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
Results: A 55-year-old farmer presented with an 8-month progressively enlarging anterior neck mass, and fine needle aspiration biopsy yielded grossly turbid straw-colored aspirate admixed with blood with microscopy showing scattered inflammatory cells and macrophages set against a colloid background. After total thyroidectomy, hispathology revealed parenchymal infiltration by multiple aggregates of plump spindled to epitheloid cells forming granulomas with interspersed multinucleated giant cells, central caseation necrosis and surrounding fibrosis with chronic inflammatory infiltrates. The nodal masses also showed prominent germinal centers with interspersed epitheloid cells and foamy macrophages. Final diagnosis was chronic granulomatous inflammation consistent with tuberculosis.
Conclusion: Tuberculosis (TB) of the thyroid is a rare occurrence that can present as inflammation, infection or tumor formation of the thyroid gland. Diagnosis depends on identification of the tubercle from tissues and aspirates by acid fast staining and TB culture. Treatment consists of multiple drug therapy for tuberculosis but thyroidectomy may be an option if the thyroid gland is severely diseased.
Keywords: tuberculosis, endocrine; thyroid disease
Supernumerary Nostril in a 15-Year-Old Girl
Authors: Lluisma Ann Christie P. 
Published: April 2019

Objective: To describe a rare case of a supernumerary nostril and its management, and to discuss the different theories pertaining to this type of deformity.
Methods:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
Results: A 15-year-old girl was born with one extra nasal opening. Nasal endoscopy after 15 years revealed a mucosa-lined cavity that ended blindly. Computed tomography scan showed a small opening lateral to the right nasal ala which did not communicate with the right nasal cavity. A crescent incision was made along the inner circumference of the supernumerary nostril and the blind ending nasal tract was excised. A portion of the ala was removed and a Z-plasty repair was performed.
Conclusion: Treatment has to be tailored as to the presentation of a supernumerary nostril and any other associated deformity. Though various surgical interventions exist, the goal of repair is to create a functioning and normal-appearing nose.
Keywords: Supernumerary Nostril, Accessory Nostril
Prevalence and Reasons for Non-Follow-Up of Newborns with “Refer” Results on Initial Hearing Screening
Authors: Ong Kimberly Mae C. , Cruz Teresa Luisa G. , Grullo Precious Eunice R. 
Published: April 2019

Objective: To determine the prevalence rate of follow-up among infants who had a “refer” result on initial newborn hearing screening and to identify reasons for default by parents or guardians.

Method:
Study Design: Cross-sectional study
Setting: Tertiary public university hospital
Participants: 79 parents or guardians whose newborns obtained a “refer” result on initial hearing screening were interviewed over the phone.

Results: Among those babies who had a “refer” result on initial hearing screening, 51% followed up for repeat testing. The most common reasons for non-follow up by parents or guardians include being busy, distance from the hospital and baby’s health condition.

Conclusions: The follow-up rate in this study is higher compared to previous figures (27%), but is still below target. The reasons for non-follow-up obtained suggest problems may exist on all levels of the healthcare system. Appropriate solutions to address these problems should be explored.

Keywords: neonatal screening, hearing loss, infant, newborn, hearing tests, otoacoustic emissions
Unilateral Horizontal Semicircular Canal Malformation Causing Recurrent Vertigo
Authors: Yang Nathaniel W. 
Published: April 2019

A 62-year-old man consulted for recurrent episodes of vertigo lasting from seconds to several minutes. The vertigo was variably described as spinning, lateral swaying, and a feeling of being “unsure of his position in space.” These episodes were noted to have begun when the patient was still in his 20’s. Standard pure tone audiometry revealed a mild-to-moderate downsloping mixed hearing loss in the left ear. Bithermal caloric testing indicated the presence of a significant left-sided peripheral vestibular loss. Due to the fact that the vertigo episodes presented relatively early in life, the possibility of a congenital inner ear malformation was considered as a cause for his symptoms. Computerized tomographic (CT) imaging of the temporal bone was performed. This clearly showed the left horizontal semicircular canal lacking a central bony island. (Figure 1 and 2) The cochlea, superior and posterior semicircular canals, vestibular and cochlear aqueducts, and ossicular chain were grossly normal.
A malformation of the horizontal or lateral semicircular canal is one of the most common inner ear malformations, as it is the last vestibular structure to be formed during inner ear embryogenesis. As such, it may occur in isolation or may be associated with other vestibular, cochlear, or middle ear malformations.1,2 Although vertigo and dizziness are symptoms to be expected in such a condition, existing data indicates that it may be totally asymptomatic, or it may also present as a sensorineural, conductive, or mixed type of hearing loss.1,3 Radiologic imaging is of prime importance in diagnosing such conditions, especially when auditory and/or vestibular symptoms manifest early in life. This case perfectly illustrates the need for such studies, as the patient went undiagnosed for more than forty years!
No definitive statements can be gleaned from existing medical literature with respect to treatment. However, in patients with debilitating vestibular symptoms, management with modalities that selectively target the vestibular system, but spare the auditory system, such as vestibular neurectomy and trans-tympanic aminoglycoside therapy appear to be reasonable options.

References

Johnson J, Lalwani AK. Sensorineural and conductive hearing loss associated with lateral semicircular canal malformation. Laryngoscope 2000 Oct;110(10):1673–1679. DOI:10.1097/00005537-200010000-00019 PMID: 11037823

Casselman JW, Delanote J, Kuhweide R, van Dinther J, De Foer B, Offeciers EF. Congenital malformations of the temporal bone. In: Lemmerling M, De Foer B, editors. Temporal bone imaging. Berlin Heidelberg: Springer-Verlag; 2015, pp. 120-154.

Kim CH, Shin JE, Lee YJ, Park HJ. Clinical characteristics of 7 patients with lateral semicircular canal dysplasia. Res Vestib Sci 2012;11(2):64-68.
Posterior Nasal Neurectomy In Treatment of Intractable Rhinitis: A Preliminary Series
Authors: Vo Minh Cong , Pham Huu Kien , Nguyen Minh Hien 
Published: April 2019

Objective: To evaluate the efficacy and safety of posterior nasal neurectomy on the treatment of nasal congestion, rhinorrhea, sneezing, and post-nasal discharge in intractable rhinitis patients.
Methods
Design: Preliminary case series
Setting: Tertiary University Medical Center
Participants: Ten (10) patients with intractable rhinitis underwent endoscopic posterior nasal neurectomy in both sides. Symptoms were compared pre- and post-operatively one month and one year after surgery using Visual Analog Scale (VAS) scores. Endoscopic pre- and one-month post-operative Lund-Mackay scores were also compared.
Results: All four mean nasal symptom scores were reduced significantly at 1-month follow-up for nasal congestion (1.5 ± 1.08 vs 4.1 ± 0.5687, p = .00001), rhinorrhea (0.7 ± 0.823 vs 3.4 ± 0.966, p = .00001) post-nasal discharge (0.9 ± 0.994 vs 2.4 ± 1.5, p = .03), and sneezing (1.1 ± 0.738 vs 3 ± 0.943, p = .02). Mean endoscopic scores were also reduced significantly at one month, from 12.9 ± 2.55 to 4.2 ± 3, p = 0.0001.In the 6 patients that followed up at 1-year, post-operative mean nasal symptoms were still significantly better for congestion (0.6667 ± 0.8165 vs 4 ± 0.632, p = 0.00001), rhinorrhea (0.6667 ± 0.5164 vs 3.67 ± 1.033, p = .001), post-nasal discharge (0.1667 ± 0.40825 vs 2.17 ± 1.835, p = .033), sneezing (0.5 ± 0.54772 vs 3.17 ± 0.983, p = 0.0001). Mean post-operative VAS nasal scores and endoscopic scores were well associated (Correlation Coefficient -.648, p = .048).
Conclusion: Posterior nasal neurectomy could be considered as a safety and effective way to treat intractable rhinitis patients in Vietnam.
Keywords: Posterior nasal neurectomy, vasomotor rhinitis, allergic rhinitis, vidian neurectomy
Evaluation of the Newborn Hearing Screening Program in The Medical City based on Joint Commission on Infant Hearing (JCIH) 2007 Position Statement Quality Indicators
Authors: Que Mary Harmony B. , Reyes-Quintos Maria Rina T. 
Published: April 2019

Objective : The objective of this study is to evaluate the newborn hearing screening program in The Medical City based on the Joint Committee on Infant Hearing (JCIH) 2007 Position Statement Quality Indicators.
Methods:
Study Design: Cross - Sectional Survey
Setting: Tertiary Private Hospital
Participants : All newborns who underwent newborn hearing screening in The Medical City for the year 2015.
Results: Of 2,010 patients delivered in the hospital in year 2015, 1,986 (98.8%) were screened. Among the 59 babies with initial “refer” results, 15 (25.42%) “referred” a second time while 24 (40.68%) “passed” the rescreening. Twenty (33.89%) did not undergo rescreening (10 were classified as dropouts, while another 10 did not undergo rescreening for various reasons. Of those who “referred” during rescreening, only 9 (60%) had further evaluation done with ABR/ASSR. Among these, 4 (26.66%) had hearing loss and proceeded with the appropriate monitoring and management while 5 (33.33%) had normal hearing.
Conclusion : The current newborn hearing screening program in the Medical City was able to reach JCIH 2007 quality indicators for screening but not for confirmation of hearing Loss. All patients with hearing loss were managed with early rehabilitation.
Keywords: Newborn hearing screening, otoacoustic emission test, auditory brainstem response test, auditory steady state response test
Operative Time and Tympanic Membrane Integrity in Endoscopic Transcanal versus Microscopic Post-Auricular Tympanoplasty for Chronic Otitis Media
Authors: Escalderon Jenina Rachel D.J. , Lim William L. 
Published: April 2019

Objective: To compare surgical outcomes (operative time and tympanic membrane integrity) obtained by endoscopic transcanal tympanoplasty (ET) and microscopic post-auricular tympanoplasty (MT) in patient with inactive chronic otitis media.
Methods:
Design: Retrospective Cohort
Setting: Multicenter study in 3 Private Tertiary Hospitals
Participants: 18 patients who underwent microscopic or endoscopic tympanoplasty for chronic otitis media.
Results: Each group had 9 patients, with median age of 43 (31-65 years) for the MT and 47 (29-59 years) for the ET group. There was no significant difference in median age of the two groups (Mann-Whitney U=17, P=.22). Male: female ratio was (5:4) and (6:3) for the ET and MT group respectively, with no significant difference in gender distribution (c2= 0.90, P=.34). Mean operative time for the ET and MT group was 86.7 minutes and 140.6 minutes, respectively, with significantly lower mean operative time for the ET group (t= 3.57, P=.0025). There was complete tympanic membrane graft uptake in both groups.

Conclusion: Regardless of technique, tympanoplasty is an effective surgical treatment among patients with inactive chronic otitis media. Endoscopic tympanoplasty is an alternative to conventional microscopic tympanoplasty that may use less operative time, producing similarly complete graft uptake.

Keywords: chronic otitis media, tympanoplasty, endoscopic tympanoplasty, microscopic tympanoplasty, perforation, tympanic membrane
Recurrent Laryngeal Nerve Paralysis and Hypocalcemia in Superior to Inferior Compared to Inferior to Superior Dissection Approaches in Thyroidectomy
Authors: Yu Randel D. 
Published: April 2019

Objective: To compare the incidence of recurrent laryngeal nerve injury and hypocalcemia in patients who underwent thyroidectomy using a superior-inferior versus an inferior to superior approach in identifying the recurrent laryngeal nerve in a tertiary government hospital between January 2012 to December 2016.
Methods
Design: Retrospective Cohort Study
Setting: Tertiary Government Hospital
Patients: Records of two hundred forty-one (241) adult patients who underwent surgery for thyroid diseases in the department of Otorhinolaryngology – Head and Neck Surgery between January 2012 and December 2016 were evaluated. Records of patients with postoperative hoarseness after total thyroidectomy or lobectomy with isthmusectomy and hypocalcemia after total thyroidectomy were reviewed, and operative techniques analyzed for the approaches to recurrent laryngeal nerve identification.
Results: Records of 119 patients (aged 20-73; median 41-years-old) meeting inclusion and exclusion criteria were analyzed. Of 57 thyroidectomies using a superior-inferior approach, 42 were bilateral, totaling 99; of 62 using an inferior-superior approach, 40 were bilateral, totaling 102. There was a higher incidence of post-operative complications among those who underwent inferior-superior dissection than those who underwent superior-inferior dissection. Chi square test showed the former approach (versus the latter) had 4.86 times the relative risk (RR) of permanent RLN injury (1.9%, 0.0475 to 5.5914, p=.3058), 1.62 times the RR of transient RLN injury (5%, 0.3971 to 6.5889, p=.5021), 1.92 times the RR of permanent hypocalcemia (1.9%, 0.0.1806 to 21.2838, p=.5910), and 2.06 times the RR of transient hypocalcemia (17%, 0.9055 to 4.4333, P=.0738). However, there was no significant difference between the two approaches with regard to hoarseness (independent t test, t value 0.90; p = .367) or hypocalcemia (t=0.428; p= .796).
Conclusion: There is no significant difference in the incidence of recurrent laryngeal nerve injury and hypocalcemia in patients who underwent thyroidectomy using a superior-inferior versus an inferior to superior approach in identifying the recurrent laryngeal nerve. Intraoperatively, surgeons may shift from one approach to the other as needed, and we recommend that they be well versed in both approaches and fully knowledgeable of the various anatomical courses of the recurrent laryngeal nerve and locations of parathyroid gland.
Keywords: recurrent laryngeal nerve injuries, thyroid neoplasms, thyroidectomy, vocal cord paralysis, hypoparathyroidism, hypocalcemia
Pathologic Laryngoscopic Findings, Number of Years in Teaching, and Related Factors among Secondary Public-School Teachers in Bacolod City, Negros Occidental
Authors: Mundo Nathalie P. , Vinco Von V. 
Published: April 2019

Objective: To determine the presence or absence of gross laryngeal or vocal cord pathology during endoscopic examination and determine if there is a relationship between these findings, the number of years in teaching, and the presence of other risk factors among teachers in a public secondary school in Bacolod City.

Methods
Study Design: Cross-sectional study
Setting: Secondary public school in Bacolod City, Philippines
Participants: A total of 50 school teachers participated in the study, conducted from July 2016 to May 2017. They completed a questionnaire on demographic data, professional profile, and lifestyle profile and underwent laryngoscopic examination.

Results: The most common pathologic laryngoscopic findings were vocal fold nodule (12%), swollen arytenoids (10%), paretic vocal cords (6%) and epiglottic mass (6%). There was no significant relationship between laryngoscopic findings and number of years teaching (X2 = 0.103, df = 1, p = .748. However, there was a significant relationship between laryngoscopic findings, smoking (X2 = 6.419, df = 1, p = .011) and daily water intake (X2 = 10.208, df = 2, p =.006).

Conclusions: Results of this study suggest that in terms of voice care, public school teachers may benefit from avoidance of smoking and increased water intake.

Keywords: teachers, vocal cord, hoarseness, voice, laryngoscopy, videostroboscopy
Lethal Midline Granuloma in a 15-Year-Old Girl: A Diagnostic Dilemma
Authors: Gonzales Ian Christian A. 
Published: April 2019

Objective: To report a case of lethal midline granuloma and discuss the diagnostic and treatment dilemma, and management.
Methods
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
Results: A 15-year-old girl under treatment for pulmonary tuberculosis presented to the Emergency Room for epistaxis and a nasopalatine lesion. She was managed as a case of nasopalatine osteomyelitis for one month and discharged on antibiotics. She returned due to bleeding after being lost to follow up for 3 more months. Hemostasis, debridement and biopsy yielded atypical cells, possibly lymphoma. Immunohistochemistry confirmed the diagnosis of NK-cell lymphoma. Unfortunately, she expired prior to initiation of chemotherapy.
Conclusion: Clinicians must have a high index of suspicion for lethal midline granuloma in chronic, non-healing midline lesions. Multiple biopsies confirm the diagnosis, and earlier initiation of treatment may improve prognosis.

Keywords: Granuloma, lethal midline; Lymphoma, extranodal NK-T-cell
Can Modified Laryngosternopexy (Laryngoclaviculopexy) Project the Larynx Anteriorly?
Authors: Carrillo Ryner Jose D. , Lapeña Jose Florencio F. 
Published: April 2019

Laryngosternopexy is a suturing method between the thyroid lamina and sternal ligament in order to relieve tension from the anastomosis when performing segmental resection of the airway. A thick absorbable monofilament suture is passed through thyroid lamina and the interclavicular ligament of the sternum in a figure of eight fashion as described by Castellanos.1,2 In laryngosternopexy, the suture support is ventral to the anastomotic site in the midline. However, this places the “pexy” sutures in the way, making a tracheotomy and second stage decannulation difficult. We describe a modified laryngosternopexy (laryngoclaviculopexy) that can be performed with the “pexy” sutures out of the way to allow access to the trachea, and our initial experience with three patients.