bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Experimental Study on Maximum Sound Output Capabilities and Preferred Listening Levels Using Different Earphone Types
Authors: Destriza Waynn-Nielsen C. , De Castro Roderick B. , Enriquez Howard M. 
Published: April 2019

Objective: The study aims to compare the maximum sound output capabilities of different earphone types/music style combinations. The study also intends to assess the preferred listening levels (PLL) of test subjects using different earphone types with background noise accession. The study also seeks to determine the presence or absence of a threshold shift on headphone/music style combination PLL’s that exceed the recommended noise limit.
Methods
Study Design: Experimental Study
Setting: Tertiary Government Hospital
Subjects: Thirty (30) hearing healthy volunteers were sampled from hospital staff aged 18-40 years, with no known history of ear pathology and/or use of any known ototoxic drugs, with normal otoscopy and audiograms of less than 20dB from 125Hz to 8000Hz, and no exposure to loud noise from any source within the previous 3 days.
The sound pressure levels (SPL) delivered by three (3) types of earphones (earbud type, in-ear type, supra-aural type) were measured at maximum volume setting of a personal media player (iPod, Apple Inc.), while playing different music genres. The test subjects were asked to listen at their preferred listening levels (PLL) using the different types of earphones at increasing background noise accession.
Results: The earbud type averaged the greatest SPL among the earphone types, and pop music averaged the greatest SPL among the music styles. Comparison of the maximum output capabilities revealed that there was a significant difference among different brands of earphones of the same type. However, no significant difference were found among songs of similar music style and across different music styles in all earphones except the in-ear type. PLL average was at 90.4dB in a silent environment with increasing intensity as background noise accentuated. Supra-aural earphones registered the least increase in PLL in a loud environment, due to its higher background noise-attenuating capabilities.
Conclusion: Having a significant difference among earphone types with regard their maximum output capabilities, it is recommended to check the specifications of the earphone type one intends to use. In using personal media players (PMP), the volume should be set at the lowest comfortable level. While choice of music style remains the discretion of the listener, the choice of music style should be considered for long periods of listening. Because the PLL of test subjects were alarmingly high, the authors recommend intervention in their listening habits. Background noise attenuating capabilities of earphones play a factor in reducing excessive sound energy from reaching the ear, reducing the PLL, and decreasing the risk for noise-induced hearing loss.
Keywords: earphones, music styles, personal media players, preferred listening levels, recreational noise, noise-induced hearing loss
A Case Series of Tessier 3, 4, 7 and Combined 4,7 Craniofacial Clefts
Authors: Rances Karen Adiel D. , Cruz Emmanuel Tadeus S. , Pascual Arsenio L. , Tinaza Jomar S. 
Published: April 2019

Objective: To report a case series of Tessier 3, 4, 7 and combined 4,7 craniofacial clefts, their clinical presentations, surgical approaches and outcomes in light of the current literature.
Methods:
Study Design: Case series
Setting: Tertiary Government Hospital
Subjects: 5 patients
Results: Five patients aged 3 to 14-years-old with Tessier 3, 4 (2 cases), 7 and combined 4,7 were included in this study: Tessier 3 – medial orbitomaxillary cleft extending through the bony skeleton traversing obliquely across the lacrimal groove, Tessier 4 – median orbitomaxillary cleft traversing vertically thru the inferior eyelid, infraorbital rim and orbital floor extending to the lip between the philtral crest and the oral commissure (2 cases), Tessier 7 - macrostomia and cleft oral commissure, and combined Tessier 4 and 7, combining features described above. Four underwent 2- or 3-stage surgeries while 1 declined.
Conclusion: Five craniofacial clefts were presented. Because of the varying patterns of craniofacial deformities, a series of surgical procedures, tailor-made for each individual were performed on four. Otolaryngologists who perform maxillofacial and cosmetic surgery should have good background knowledge about craniofacial defects and be familiar with the surgical approaches at their disposal to yield favorable results that are appropriate to their local contexts.
Keywords: Tessier Clefts No. 3, 4 and 7, oculoplasty, commisuroplasty, alar transpositional flap, canthopexy
Epitheloid Hemangioendothelioma of the Submandibular Region
Authors: Ranjit Peter , Madhusudan Parekh Nayan , Suhaili Dayangku Norsuhazenah Pengiran , Bickle Ian Christopher 
Published: April 2019

Objective: To present an uncommon cause for a submandibular mass and review of the literature.
Methods:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
Results: A 25-year-old lady presented with a painless chronic submandibular swelling. Ultrasound identified a solid mass, following which an uncomplicated core biopsy was performed obtaining an accurate pre-operative histopathological diagnosis. Pre-operative arterial embolization of this vascular mass led to a relatively bloodless wide local excision. Radiological imaging for distant metastases was negative.
Conclusion: Epitheloid Hemangioendothelioma is an uncommon cause for a submandibular mass. A malignant vascular soft tissue tumor with morphologic characteristics similar to carcinomas, melanomas and epitheloid sarcomas, it has a high rate of metastasis and morbidity when it affects the soft tissues and viscera. Immunohistochemistry provides clues to differentiation, and recommended treatment consists of a surgical wide local excision with regional lymph node resection. As there are no established standard therapeutic protocols for this disease due to its rarity, an individual case-by-case approach and follow-up needs to be undertaken.
Keywords: epitheloid hemangioendothelioma, malignant vascular tumor, submandibular mass
Unilateral Pedunculated Polyp of the Palatine Tonsil
Authors: Mendoza Daniel Jose C. , Chua Antonio H. , Castañeda Samantha S. 
Published: April 2019

Objective: To report a benign tonsillar lesion presenting as a pedunculated polyp and discuss its diagnosis and management.

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

Results: A 14-year-old lad presented with a seven-year history of an elongated right tonsillar mass without associated bleeding, pain, dysphagia or obstructive sleep apnea. Physical examination revealed a pedunculated mass about 2 x 1 x 0.5cm in size located in the superior pole. After unilateral tonsillectomy, histopathological examination revealed lymphangectatic lipomatous fibrotic polyp.

Conclusion: Lymphangiomatous polyp of the palatine tonsils is an unusual benign lesion of the head and neck. These commonly present as unilateral, polypoidal mass that cannot be clinically differentiated from other benign tonsillar lesions. Tonsillectomy is the recommended surgical approach for both diagnostic and therapeutic purposes. Histopathological study must be done to confirm diagnosis.

Keywords: Palatine Tonsil, Pedunculated polyp, Hamartoma, Lymphangioma, Tonsillectomy
Value of the 6-Hour Postoperative Ionized Calcium Slope in Predicting Post- Thyroidectomy Occurrence of Hypocalcemia
Authors: Cabance Ryan E. , Cruz Emmanuel Tadeus S. 
Published: April 2019

Objective: To determine the value of the 6-hour postoperative ionized Calcium (iCa) slope, versus 6-hour postoperative Calcium alone, in predicting the occurrence of hypocalcemia in patients who underwent thyroid surgery in a tertiary hospital in Metro Manila.
Methods:
Study Design: Retrospective Cross-Sectional Study
Setting: Tertiary Private Hospital
Subjects: Pre-operative and 6-hour postoperative ionized calcium determinations were analyzed in 59 patients of the ENT-HNS department in a tertiary hospital in Metro Manila who underwent thyroid surgery from January 2009 to December 2013.
Results: The 6-hr postoperative iCa slope (difference between the pre-operative and 6-hour postoperative iCa levels) of ≥0.18 mmol/L correctly predicted 57.1% of patients who eventually developed hypocalcemia, with a specificity of 81.6%, and a positive predictive value of 63.2%. In contrast, the 6-hour postoperative iCa measurement identified only 23.8% (5 out of 21) patients who developed hypocalcemia.
Conclusion: The 6-hr postoperative iCa slope increased the probability of identifying patients who developed hypocalcemia from 23.8% to 57.1%. However, as a single determination, this may not suffice to take the place of serial iCa measurements after thyroid surgery.
Keywords: ionized calcium (iCa), hypocalcemia, thyroidectomy
Extended Transpalatine Approach for Excision of Juvenile Angiofibroma
Authors: Hernandez Josefino G. , Cabungcal Arsenio A. , Carrillo Ryner Jose D. 
Published: April 2019

Objective: To describe the extended transpalatine approach (ETPA) with transection of the ipsilateral greater palatine artery and extension of the ipsilateral retromolar incision and its corresponding surgical outcomes and present it as an option in the excision of juvenile angiofibroma (JA).
Methods:
Study Design: Descriptive Case Series
Setting: Tertiary Public University Hospital
Subjects: 13 JA cases undergoing ETPA
Results: Records of JA in a tertiary hospital from 2007 – 2013 were reviewed. Out of 35 JA patients, 13 underwent excision via extended transpalatine approach. Preoperative work-up included CT scan with contrast with or without preoperative embolization. In all patients, the wide field allowed easy tumor excision and facilitated inspection and hemostasis. There was only one recurrence in our series, compared to 1 each for 4 endoscopic and 18 transmaxillary approaches. Not one of the patients developed a fistula or hypernasal speech. All patients had minimal palatal scarring, symmetric alveolar growth and palatal function.
Conclusion: The ETPA is a robust technique. It provides good exposure of JA with minimal preoperative requirements and postoperative complications.
Keywords: juvenile angiofibroma, juvenile nasopharyngeal angiofibroma, transpalatine approach
Vocal Fold Paralysis with Intraoperative Recurrent Laryngeal Nerve Identification versus Non-identification of Recurrent Laryngeal Nerve in Total Thyroidectomy: A Retrospective Cohort Study
Authors: Formanez Andrie Jeremy 
Published: April 2019

Objective: To determine the risk of vocal fold paralysis in patients who underwent total thyroidectomy with and without intraoperative recurrent laryngeal nerve identification.
Methods:
Study design: Retrospective cohort study
Setting: Tertiary military hospital
Population: 237 adult patients who underwent total thyroidectomy for benign lesions based on post-operative histopathology operated on by senior third or fourth year residents. Excluded were those who underwent lobectomy with isthmusectomy or reoperation/completion thyroidectomy, had intrathoracic goiters, confirmed malignancies based on post-operative histopathology, or cases wherein the RLN had to be sacrificed due to gross involvement of the nerve caused by malignancy.
Results: Group A, wherein intraoperative identification of RLN was done, had a temporary and permanent RLN injury incidence of 2.75% and 0.92% respectively. Group B, wherein intraoperative identification of RLN was not done, had a temporary and permanent RLN injury incidence of 17.19% and 12.5% respectively. Through binary linear regression, the probability of having temporary paralysis increases almost two-fold if the nerve is not identified, and the probability of having permanent paralysis increases by almost nine-fold if the nerve is not identified.
Conclusion: We recommend routine intraoperative RLN identification, which has a lower risk for temporary and permanent vocal fold paralysis when compared to non-identification of the RLN.
Keywords: cranial nerve injuries/prevention and control, recurrent laryngeal nerve injuries, thyroid neoplasms/surgery, thyroidectomy/adverse effects, vocal cord paralysis/prevention control
Clinical Profile of Patients with Laryngotracheal Stenosis in a Tertiary Government Hospital
Authors: Arriola Anna Carlissa P. , Chua Antonio H. 
Published: April 2019

Objective: To describe the clinical profile of patients with laryngotracheal stenosis over a 7-year period and discuss strategies for its prevention.
Methods:
Study Design: Retrospective Case Series
Setting: Tertiary Government Hospital
Participants: Patients with laryngotracheal stenosis confirmed by laryngoscopy and/or bronchoscopy
Results: Twenty-one patients were evaluated for laryngotracheal stenosis from January 2008 to June 2015, but only 13 with complete data were included in this study. Of the 13 patients, nine (69.2%) belonged to the pediatric age group. Ten (77%) were males and three (23%) were females. Laryngotracheal stenosis following endotracheal tube (ET) intubation was seen in 11 (84.6%) while 2 had thyroid masses and no history of prior ET intubation. Presenting symptoms or reasons for referral were wheezing (n=4), stridor (n=4), failure to decannulate the tracheostomy tube (n=3), and dyspnea (n=2). Duration of ET intubation was four to 60 days. The highest frequency of ET re-intubation was 5 times. Among those intubated, stenosis was glottic in one, subglottic in five and tracheal in five patients. Three had Cotton-Myer grade I stenosis, two had grade II, three had grade III and three had grade IV stenosis. Those with thyroid masses had tracheal stenosis.
Conclusion: Strategies for prevention of laryngotracheal stenosis should include routine airway endoscopy for patients with longstanding neck masses and for those with prolonged ET intubation, for whom the option of early prophylactic tracheostomy is worth considering. Otherwise, immediate post-extubation endoscopy may facilitate documentation and appropriate intervention.
Keywords: acquired laryngeal stenosis; tracheal stenosis; endoscopy; intubation, intratracheal; tracheostomy
An Initial Survey of Septorhinoplasty in Crooked Nose Deformities
Authors: Villafuerte Cesar V. , Dy Alexander Edward S. , Lapeña Jose Florencio F. 
Published: April 2019

Objectives: Crooked nose deformity is a commonly seen reason for septorhinoplasty in the otolaryngology clinic. The purpose of this study is to initially determine the different etiologies of patients with crooked nose deformities who underwent septorhinoplasty, and to describe the different types of crooked nose by their level of deviation and surgical management in our institution.

Methods:
Study design: Case Series
Setting: Tertiary Public University Hospital
Subjects: A chart review of all patients with a crooked nose deformity who were admitted at the otorhinolaryngology ward of the National University Hospital and underwent septorhinoplasty from January 2012 to January 2015 was conducted, and data consisting of age, sex, etiology of crooked nose deformity, level of deviation, cartilage source, and surgical intervention were obtained and analyzed.

Results: A total of 21 patients underwent septorhinoplasty for crooked nose deformity in the study period. The most common etiology for crooked nose was physical violence (13/21 or 62%), followed by sports injury (4/21 or 19%), vehicular accidents (2/21 or 9%), and accidental fall (1/21 or 5%). There were more upper and middle third deviations than lower third deviations. Sixteen out of 21 patients (76%) underwent open rhinoplasty, while the rest underwent an endonasal approach. Twelve (57%) underwent intervention on the nasal fracture after at least a year (old or neglected fracture) as compared to the 9 (43%) who had immediate intervention after less than two weeks. Thirteen used septal cartilage, while 4 used conchal cartilage, and 1 used tragal cartilage. The most common grafts used were spreader and camouflage, followed closely by dorsal onlay, and columellar strut grafts.

Conclusions: The majority of crooked nose deformities that were subjected to septorhinoplasty in our department were secondary to old nasal bone fractures caused by physical violence. Upper and middle third level deviations were more common, and most underwent open rhinoplasty with autologous cartilage grafts. Future studies may increase our understanding of, and improve our techniques in septorhinoplasty for crooked nose deformities in Filipino noses in particular, and Asian noses in general.

Keywords: rhinoplasty, deviated nose, crooked nose, septorhinoplasty, nasal trauma
Mandibular Ameloblastoma with Lung Metastasis 10 Years after Resection
Authors: Siy Rabo Justin Iohanne , Carpela Allan B. , Guevara Eutrapio S. , Romualdez Joel A. 
Published: April 2019

Objective: To present a case of mandibular ameloblastoma with pulmonary metastasis after ten years and discuss the possible pathophysiology, diagnostic and therapeutic options.
Methods:
Study Design: Case Report
Setting: Tertiary Private Hospital
Subject: One
Conclusion: Though benign, ameloblastoma has a high propensity for local invasion and may metastasize. It is difficult to predict metastasis, even with adequate treatment of the primary lesion. There is no standard protocol to prevent or detect metastatic ameloblastoma, but regular and close follow up may ensure early diagnosis.
Keywords: ameloblastoma, metastatic ameloblastoma, lung metastasis, follicular type ameloblastoma, odontogenic tumor
Glomangiopericytoma: The Sinonasal Mimic Of Soft Tissue Hemangiopericytoma
Authors: Villanueva Emilio Q. , Carnate Jose M. 
Published: April 2019

A 42-year old Filipino male with a 10-month history of progressive left nasal obstruction and rhinorrhea and a clinical impression of nasal polyposis underwent endoscopic sinus surgery with partial ethmoidectomy and polypectomy.
We received several dark-brown, irregular, rubbery tissue fragments with an aggregate diameter of 3 cm. Histopathologic examination shows sheets of spindly tumor cells beneath the respiratory epithelial lining. These spindle cells are closely packed and arranged in short fascicles and storiform clusters surrounding hyalinized large vessels or thin-walled submucosal blood vessels. (Figures 1 and 2) There is no atypia or necrosis. Immunohistochemical studies show strong immunoreactivity to muscle specific actin, and focal reactivity to S-100. (Figure 3) Stains for CD34, caldesmon, cytokeratin, and desmin, are negative. (Figure 4) Based on these features, we diagnosed the case as glomangiopericytoma.
Glomangiopericytoma is a rare tumor arising from the pericytes surrounding capillaries, and accounts for less than 0.5% of all sinonasal tumors.1 It has a very slight female preponderance, with a peak incidence during the seventh decade of life. The most common symptom is nasal obstruction, or epistaxis, with accompanying difficulty breathing, sinusitis and headache. A mass, or polyp is the most common clinical finding.2
Hematoxylin–eosin staining shows a well-delineated but unencapsulated cellular tumor underneath the normal respiratory epithelium that effaces or surrounds adjacent normal structures.2 The tumor is composed of closely packed, uniform, oval to spindle-shaped cells, in short fascicles and in storiform, whorled or palisaded patterns. The cells surround numerous branching thin-walled, blood vessels, thus the morphologic resemblance to soft tissue hemangiopericytoma/solitary fibrous tumor. However, in contrast to hemangiopericytoma, glomangiopericytoma shows diffuse reactivity to muscle actins, and non-reactivity to CD34, while hemangiopericytoma shows the reverse reactions. Desmin and caldesmon are likewise non-reactive, distinguishing the tumor from leiomyomas or leiomyosarcomas of the upper aerodigestive tract. Cytokeratin non-reactivity distinguishes it from spindle cell carcinoma. S100, although typically negative, can be focally and weakly positive in a small percentage of tumor.3
Glomangiopericytoma is categorized as a borderline low malignancy tumor with an overall survival of >90% in 5 years but which tends to recur in up to 30% of cases. Strict follow-up is thus required, especially if complete resection is not achieved.1
Granulation Tissue mimicking a Glomus Tumor in a Patient with Chronic Middle Ear Infection
Authors: Ong Kimberly Mae C. , Labra Patrick John P. , Ricalde Rosario R. , Manasan Criston Van C. , Carnate Jose M. 
Published: April 2019

Objective: To present an unusual cause of pulsatile tinnitus, presenting in a young adult suffering from chronic recurrent foul-smelling discharge from the same ear.
Methods:
Study Design: Case report
Setting: Tertiary National University Hospital
Patient: One

Results: A 24-year old woman presented with pulsatile tinnitus on a background of chronic recurrent foul-smelling discharge. Clinico-radiologic findings seemed consistent with a glomus tympanicum coexisting with chronic suppurative otitis media with cholesteatoma. She underwent tympanomastoidectomy with excision of the mass. Histopathologic evaluation revealed the mass to be granulation tissue.
Conclusion: Pulsatile tinnitus is rarely associated with chronic middle ear infection. Granulation tissue arising at the promontory may mimic glomus tumors when accompanied with this symptom. Despite this revelation, it would still be prudent to prepare for a possible glomus tumor intraoperatively, so that profuse bleeding and complications may be avoided.
Keywords: tinnitus, pulsatile; otitis media, suppurative; glomus tympanicum
A 15-Year Occult Foreign Body in the Subglottic Area of A 50-Year-Old Woman
Authors: Segocio Donnie Jan D. , Dayanghirang Christine D. , Cachuela Joseph E. 
Published: April 2019

Objective:
To present a case of subglottic foreign body (FB) impaction in a 50-year-old woman diagnosed with bronchial asthma for 15 years.
Methods:
Design: Case Report
Setting: Tertiary Public Hospital
Patient: One
Results: A 50-year-old woman with recurrent cough and dyspnea for 15 years that had been managed as bronchial asthma, developed stridor and halitosis in the last 5 years. Flexible laryngoscopy revealed a subglottic mass and CT scan confirmed a suspicious foreign body in the lumen of the subglottis. Signs and symptoms resolved after peroral endoscopic removal of the foreign body from the larynx. Histopathology of the extracted material from the airway confirmed it to be “bone tissue.”
Conclusion: Foreign body aspiration can occur in adults without predisposing factors. Its diagnosis can be challenging as it can mimic respiratory disorders such as bronchial asthma. Endoscopy and computed tomography are valuable for correct diagnosis and management. An incorrect initial diagnosis should be considered in the light of unresolved symptoms and prompt referral to an appropriate specialist may prevent undue suffering and dangerous complications.
Keywords: foreign body aspiration, occult airway foreign body