bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative prophylactic antibiotics for facial fractures: A systematic review and meta‐analysis
Authors: Habib Andy M. , Wong Alexander D. , Schreiner Geoffrey C. , Satti Komal F. , Riblet Natalie B. , Johnson Heather A. , Ossoff Jacob P. 
Published: May 2018

ObjectivePerioperative antibiotic prophylaxis in patients undergoing surgery for maxillofacial fractures is standard practice. However, the use of postoperative antibiotic prophylaxis remains controversial. This systematic review and meta‐analysis sought to evaluate the effect of postoperative antibiotic therapy on the incidence of surgical site infection (SSI) in patients with maxillofacial fractures.MethodsMEDLINE, Embase, and the Cochrane Library were searched from inception through October 2017. Randomized controlled trials (RCTs) and cohort studies evaluating the efficacy of pre‐, peri‐, and postoperative antibiotic prophylaxis in preventing SSI in maxillofacial fractures were included. Data were extracted from studies using a standardized data collection form, with two reviewers independently performing extraction and quality assessment for each study. Risk ratios (RRs) for SSI were pooled using a random‐effects model.ResultsAmong 2,150 potentially eligible citations, 13 studies met inclusion criteria and provided data to be included in a meta‐analysis. The addition of postoperative antibiotic prophylaxis to a standard preoperative and/or perioperative antibiotic regimen showed no significant difference in the risk of SSI (RR = 1.11 [95% CI: 0.86‐1.44], P > .1). There were also no differences in the risk of SSI when restricting the analysis to mandibular fractures (eight studies, RR = 1.22 [95% CI: 0.92‐1.62]) or open surgical techniques (eight studies, RR = 1.02 [95% CI: 0.62‐1.67]). A sensitivity analysis did not find any significant differences in risk when restricting to RCTs (seven trials, RR = 1.00 [95% CI: 0.61‐1.67]) or cohort studies (six studies, RR = 1.21 [95% CI: 0.89‐1.63]).ConclusionsOur findings, along with the available evidence, does not support the routine use of postoperative antibiotic prophylaxis in patients with maxillofacial fractures. Avoiding the unnecessary use of antibiotic therapy in the postoperative period could have important implications for healthcare costs and patient outcomes. Laryngoscope, 129:82–95, 2019
Evaluation and treatment of pulsatile tinnitus associated with sigmoid sinus wall anomalies
Authors: Eisenman David J. , Raghavan Prashant , Hertzano Ronna , Morales Robert 
Published: May 2018

ObjectiveDescribe clinical and radiographic features of sigmoid sinus wall anomalies (SSWA) associated with pulsatile tinnitus (PT) and determine factors predictive of response to surgery.MethodsPreoperative diagnostic imaging and treatment response were reviewed after surgical repair of 40 ears among 38 consecutive patients presenting with PT associated with SSWA who underwent transtemporal sinus wall reconstruction.ResultsTwenty‐three ears had isolated sigmoid sinus dehiscence, and 17 had diverticulum. The rates of transverse sinus stenosis (TSS) and empty sella, 66% and 32% respectively, were significantly higher than in historical controls (P = 0.02 and 0.001). Thirty‐six out of 40 subjects (90%) had complete resolution of their PT following surgery, including all those with a diverticulum. For subjects with dehiscence alone without diverticulum, a favorable response to surgery was strongly associated with the presence of TSS (P = 0.01) and empty sella (P = 0.02).ConclusionSigmoid sinus diverticulum and dehiscence are a clinically important cause of PT. Women of childbearing age with an elevated body mass index (BMI) are commonly affected, and there is a high rate of associated TSS and empty sella. Transtemporal sinus wall reconstruction has a high rate of success in appropriately selected patients. Patients with isolated sinus wall dehiscence without diverticulum, TSS, or empty sella are less likely to respond to transtemporal sinus wall reconstruction. These data imply a multifactorial cause of PT in at least some patients with SSWA.Level of Evidence: 4Laryngoscope, 128:S1–S13, 2018
Study design and early result of a phase I study of SABR for early‐stage glottic cancer
Authors: Yu Tosol , Wee Chan Woo , Choi Noorie , Wu Hong‐Gyun , Kang Hyun‐Cheol , Park Jong Min , Kim Jung‐In , Kim Jin Ho , Kwon Tack‐Kyun , Chung Eun‐Jae 
Published: May 2018

ObjectiveAvoidance of organs at risk has become possible with advances in image‐guided volumetric‐modulated arc therapy (VMAT) techniques. This study was designed to evaluate the safety and feasibility of stereotactic ablative radiotherapy (SABR) for early stage glottic cancer. This report presents the preliminary result of the first and second dose level.MethodsFraction size was increased from 3.5 gray (Gy) (total dose 59.5 Gy) to 9 Gy (total dose 45 Gy). Dose‐limiting toxicities were defined as grade 3 or higher treatment‐related toxicities. Voice outcome was assessed with electroglottography, and quality of life (QoL) was measured with the Head and Neck Cancer Inventory (HNCI).ResultsSeven patients received 59.5 Gy at 3.5 Gy per fraction as the first dose level, and five patients received 55 Gy at 5 Gy per fraction as the second dose level. None of the patients developed grade 3+ toxicity throughout a median follow‐up of 17.5 months (range, 1.7–30.6 months). One patient in the second dose level recurred in the primary site at 4 months after radiotherapy (RT) and received total laryngectomy. The rest of participants were disease‐free at locoregional and distant sites. Jitter, shimmer, mean phonation time, and noise‐to‐harmony ratio did not change significantly at 6 months after RT. HNCI scores between pretreatment and posttreatment were not significantly different (P = 0.221).ConclusionThis study revealed acceptable toxicity, voice outcome, and QoL in patients treated with hypofractionated VMAT of 3.5 Gy and 5 Gy per fraction. This phase I study is currently ongoing with a dose of 55 Gy in 11 fractions and 45 Gy in five fractions.Level of Evidence2b. Laryngoscope, 2560–2565, 2018
Quantification of tissue‐engineered trachea performance with computational fluid dynamics
Authors: Eichaker Lauren , Li Chengyu , King Nakesha , Pepper Victoria , Best Cameron , Onwuka Ekene , Heuer Eric , Zhao Kai , Grischkan Jonathan , Breuer Christopher , Johnson Jed , Chiang Tendy 
Published: May 2018

Objectives/HypothesisCurrent techniques for airway characterization include endoscopic or radiographic measurements that produce static, two‐dimensional descriptions. As pathology can be multilevel, irregularly shaped, and dynamic, minimal luminal area (MLA) may not provide the most comprehensive description or diagnostic metric. Our aim was to examine the utilization of computational fluid dynamics (CFD) for the purpose of defining airway stenosis using an ovine model of tissue‐engineered tracheal graft (TETG) implantation.Study DesignAnimal research model.MethodsTETGs were implanted into sheep, and MLA was quantified with imaging and endoscopic measurements. Graft stenosis was managed with endoscopic dilation and stenting when indicated. Geometries of the TETG were reconstructed from three‐dimensional fluoroscopic images. CFD simulations were used to calculate peak flow velocity (PFV) and peak wall shear stress (PWSS). These metrics were compared to values derived from a quantitative respiratory symptom score.ResultsElevated PFV and PWSS derived from CFD modeling correlated with increased respiratory symptoms. Immediate pre‐ and postimplantation CFD metrics were similar, and implanted sheep were asymptomatic. Respiratory symptoms improved with stenting, which maintained graft architecture similar to dilation procedures. With stenting, baseline PFV (0.33 m/s) and PWSS (0.006 Pa) were sustained for the remainder of the study. MLA measurements collected via bronchoscopy were also correlated with respiratory symptoms. PFV and PWSS found via CFD were correlated (R2 = 0.92 and 0.99, respectively) with respiratory symptoms compared to MLA (R2 = 0.61).ConclusionsCFD is valid for informed interventions based on multilevel, complex airflow and airway characteristics. Furthermore, CFD may be used to evaluate TETG functionality.Level of EvidenceNA. Laryngoscope, E273–E280, 2018
Treatment outcomes of patients with primary squamous cell carcinoma of the retromolar trigone
Authors: Rizvi Zain H. , Alonso Jose E. , Kuan Edward C. , St. John Maie A. 
Published: May 2018

Objectives/HypothesisSquamous cell carcinoma of the retromolar trigone (RMT SCC) is a relatively uncommon primary site for oral cavity malignancy. However, given its proximity to the mandible and buccal mucosa, RMT SCC typically exhibits early invasion and generally presents at an advanced stage. Large‐sample studies are needed to assess the epidemiology and clinical outcomes of this tumor. Our aim was to describe the determinants of survival in patients with RMT SCC.Study DesignRetrospective cohort study.MethodsRetrospective, population‐based cohort study of patients in the Surveillance, Epidemiology, and End Results tumor registry who were diagnosed with RMT SCC from 1973 to 2012. Primary endpoints were overall survival (OS) and disease‐specific survival (DSS).ResultsA total of 4,022 cases of RMT SCC were identified. The mean age at diagnosis was 65 years. Thirty‐nine percent of cases presented with stage IV disease. The median OS by stages I to IV were 73.7, 52.4, 27.5, and 23.4 months, respectively (P < .05). Overall, 34.3% of patients underwent surgery, 23.5% received radiation therapy, and 34.1% had both surgical and radiation therapy. On multivariate analysis, advanced age, greater tumor size, and advanced stage were associated with worse OS and DSS (P < .05), surgery predicted improved OS and DSS (P < .05), and radiation therapy predicted improved OS only (P < .05).ConclusionsRMT SCC is an aggressive malignancy that portends a poor prognosis, though early‐stage tumors (stages I and II) have significantly improved survival. Any surgical intervention independently predicted higher survival outcomes. There may be a role of dual modality approaches, particularly for larger tumors.Level of Evidence4 Laryngoscope, 128:2740–2744, 2018
Long‐term outcomes and prognosis in submandibular gland malignant tumors: A multicenter study
Authors: Lombardi Davide , Accorona Remo , Lambert Arnaud , Mercante Giuseppe , Coropciuc Ruxandra , Paderno Alberto , Lancini Davide , Spriano Giuseppe , Nicolai Piero , Vander Poorten Vincent 
Published: May 2018

Objectives/HypothesisSubmandibular gland tumors (SMGTs) are rare and characterized by heterogeneity in histologic profiles. The aim of the present study was to retrieve data on submandibular gland (SMG) malignancies and identify factors influencing survival.Study DesignRetrospective study.MethodsA multicenter, retrospective study on patients who underwent primary surgery for SMGTs at three referral centers was performed.ResultsAmong 204 patients with SMGTs, 50 (24.5%) with SMG malignancies were analyzed in detail. Definitive pT status was: 21 (42%) pT1, 14 (28%) pT2, 10 (20%) pT3, and five (10%) pT4. Nodal metastases and perineural spread were diagnosed in 15 (30%) and 25 (50%) patients, respectively. High‐grade lesions were identified in 32 (64%) patients. Follow‐up status, available for 49 (98%) patients, was as follows: 23 (47%) patients were alive without disease, 11 (22.5%) died of disease, five (10.2%) alive with disease, and 10 (20.4%) died of other causes. Five‐ and 10‐year overall survival (OS), disease‐specific survival (DSS), and recurrence‐free survival (RFS) were 66.4% and 57.1%, 76.6% and 72.1%, 69.1% and 62.4%, respectively. At univariate analysis, OS, DSS, and RFS were influenced by pT status, pN status, and perineural spread. OS and RFS were also affected by the presence of facial palsy and pain. RFS was negatively influenced by positive margins. Multivariate analysis confirmed that OS, DSS, and RFS were independently affected by perineural spread, whereas nodal involvement influenced only RFS.ConclusionsThe malignancy rate of SMGTs is comparable to that reported for parotid tumors. Most patients presented with high‐grade lesions. pT status, pN status, and perineural spread significantly affected prognosis.Level of Evidence4 Laryngoscope, 128:2745–2750, 2018
A standardized, closed‐loop system for monitoring pediatric tracheostomy‐related adverse events
Authors: McKeon Mallory , Munhall Daphne , Walsh Brian K. , Nuss Roger , Rahbar Reza , Volk Mark , Watters Karen 
Published: May 2018

Objectives/HypothesisAdvancement in neonatal and pediatric intensive care has increased the need for chronic‐care interventions, including tracheostomy. It is well established that children with a tracheostomy are at a high risk for adverse events, many of which are preventable. Despite this, there is no standardized method of monitoring tracheostomy‐related adverse events (TRAEs). Our objective was to describe and assess a standardized, closed‐loop system for monitoring TRAEs.Study DesignProspective Study.MethodsA specific tracheostomy‐related category was established within the adverse event reporting system in January 2015. Monthly TRAE reports were supplied to the multidisciplinary tracheostomy team (MDT) with descriptions of event type, severity, and preventability. The MDT reviewed events and discussed necessary follow‐up. The frequency of events was standardized by inpatient tracheostomy days (ITDs) using an automated monthly list. Adverse events were tracked using a control chart. Aggregated data were divided into biannual reports for analysis.ResultsEighty‐five TRAEs were reported between January 2015 and June 2017, averaging 5.75 per 1,000 ITDs. Most common events include unplanned decannulation (50%) and improper use of tracheostomy supplies (21%). The frequency of all preventable events has decreased by 76% since the second half of 2015. During this timeframe, minor events have decreased, moderate events have maintained a frequency of less than one per 1,000 ITDs, and only one severe event occurred.ConclusionsThis standardized, closed‐loop reporting method, modeled after other successful intensive care unit reporting systems, accurately tracks TRAEs. We have observed a decrease in preventable TRAEs without a negative impact on rates of severe events. Results suggest improved quality of care for patients with tracheostomy.Level of Evidence4. Laryngoscope, 128:2419–2424, 2018
In search of a longitudinal animal model of evoked swallow function
Authors: Langerman Jared , Doukas Sotirios G. , Hasegawa Hisashi , Goodrich James , Lerner Michael , Sasaki Clarence 
Published: May 2018

BackgroundA malfunction or impairment of swallow function can potentiate aspiration events and interfere with both quality of life and survival. Establishing an animal model for swallow research would provide a better understanding of its pathophysiology and would also allow for the development and validation of physiologically based clinical interventions to improve swallow function. Two requirements define the ideal model for longitudinal exploration: 1) identification of species similar to human in form and function; and 2) provision for reliable and reproducible evoked swallow under general anesthesia and one that would also support a longitudinal study design.ObjectiveWe hypothesize that an anesthetized porcine model under dexmedetomidine‐based or ketamine‐based anesthesia will support a reproducible and stable evoked swallow response.MethodsSeven neutered male Yorkshire pigs were anesthetized using combinations of dexmedetomidine‐based or ketamine‐based anesthesia for induction and maintenance of anesthesia during the experimental portion of our study. Single stimulation of iSLN or vagus nerve, bilateral simultaneous single stimulation of iSLN or vagus nerve, and stimulus trains applied to afferent nerves were performed.ResultsNone of the seven pigs demonstrated evoked swallow events, both during inhalational anesthesia (1.0 MAC) or during post‐washout intravenous anesthesia (dexmedetomidine, ketamine/fentanyl or ketamine alone).ConclusionOur results support a high degree of organizational neurophysiologic complexity characterizing the swallow reflex and highlight the challenges and limitations of intraoperative study in survival models.Level of EvidenceNA Laryngoscope, 2018
Guide design in virtual planning for scapular tip free flap reconstruction
Authors: Kass Jason I. , Prisman Eitan , Miles Brett A. 
Published: May 2018

BackgroundVirtual surgical planning (VSP), intraoperative cutting guides and stereolithographic models, provides the head and neck reconstructive surgeon with powerful tools for complex reconstruction planning. Despite its use in fibular osteocutaneous reconstruction, application to the scapular tip has not been as widely reported.MethodsFrom 2013 to 2014, four cases of either mandibular or maxillary reconstruction were completed with the scapular tip osseous free flap. All four cases underwent preoperative VSP with patient‐specific guide design.ResultsPatient‐specific guides were generated for scapular tip harvest. Guide placement was improved using a stabilizing flange and bracket design. With minimal disruption of the overlying periosteum a wedge osteotomy was successfully implemented in one case.ConclusionsUnlike the fibula and iliac crest donor sites, the scapular tip has overlying muscle attachments that make intraoperative osteotomies challenging. Attention to key aspects of scapular anatomy, including the fibrous tip and extensive overlying muscle, permits effective guide design.Level of evidence4
Simultaneous labyrinthectomy and cochlear implantation in unilateral meniere's disease
Authors: Perkins Elizabeth , Rooth Meredith , Dillon Margaret , Brown Kevin 
Published: May 2018

ObjectiveIn a single‐institution, FDA‐approved IDE study, subjects with unilateral Meniere's disease and intractable vertigo underwent concurrent labyrinthectomy and cochlear implantation to determine speech perception, localization, and quality of life outcomes.MethodsThree subjects with unilateral Meniere's disease with normal or near‐normal hearing in the contralateral ear underwent simultaneous labyrinthectomy and cochlear implantation. Sound localization, speech perception in noise and quiet, tinnitus handicap index, and quality of life measures were evaluated at 1, 3, and 6 months after implant activation.ResultsSound localization testing demonstrated immediate benefit postimplantation with the cochlear implant (CI). RMS error with CI on was 22 degrees (±2) and with CI off was 63 (±15) at 6 months. Mean CI alone scores were 22% (±20) at 1 month and improved to 43% (±20) and 49% (±11) at the 3‐ and 6‐month intervals, respectively. AzBio sentences in babble (0 dB SNR) scores presented in the most challenging listening condition (S0NContra) were 28% (±20) at 1 month, 38% (±18) at 3 months, and 45% (±24) at 6 months. Tinnitus Handicap Inventory (THI) significantly improved from an average preoperative score of 42 (±26) to 0 at 6 months. Quality of life measures improved overall over the postimplantation follow‐up intervals.ConclusionsSubjects with unilateral Meniere's Disease who underwent simultaneous labyrinthectomy and cochlear implantation experienced improvements in sound localization, speech understanding, tinnitus severity, and quality of life with device use. There was a trend for better performance over the postoperative intervals.Level of Evidence2b.
Lightweight, Highly Permeable, Biocompatible, and Antiadhesive Composite Meshes for Intraperitoneal Repairs
Authors: Hu Minhui , Lin Xidong , Huang Rongkang , Yang Keli , Liang Yeru , Zhang Xingcai , Wang Hui , Wu Dingcai 
Published: May 2018

AbstractVentral hernia is a public health issue and millions of meshes are used to repair abdominal wall defects every year. Polypropylene‐based composite meshes represent an important class of materials for intraperitoneal repair, but the meshes generally give rise to infection, seroma, migration, and adhesion, leading to severe consequence or even reoperation. Here, a facile and versatile one‐way fabrication of lightweight, highly permeable, and biocompatible composite meshes with superior antiadhesion properties is proposed by modifying polypropylene meshes with well‐defined polydopamine nanocoating. The resulting composite meshes are found to significantly enhance the biocompatibility and antiadhesion effect in rat model. The scalable production and excellent biomedical properties of composite meshes make them a promising candidate for future‐generation ventral hernia repair materials.
Treatment of restless legs syndrome: Evidence‐based review and implications for clinical practice (Revised 2017)§
Authors: Winkelmann Juliane , Allen Richard P. , Högl Birgit , Inoue Yuichi , Oertel Wolfgang , Salminen Aaro V. , Winkelman John W. , Trenkwalder Claudia , Sampaio Cristina 
Published: May 2018

AbstractThe objective of the current review was to update the previous evidence‐based medicine review of treatments for restless legs syndrome published in 2008. All randomized, controlled trials (level I) with a high quality score published between January 2007 and January 2017 were reviewed. Forty new studies qualified for efficacy review. Pregabalin, gabapentin enacarbil, and oxycodone/naloxone, which did not appear in the previous review, have accrued data to be considered efficacious. Likewise, new data enable the modification of the level of efficacy for rotigotine from likely efficacious to efficacious. Intravenous ferric carboxymaltose and pneumatic compression devices are considered likely efficacious in idiopathic restless legs syndrome. Bupropion and clonidine were reviewed, but the lack of data determined a rating of insufficient evidence for efficacy. The following interventions continue to be considered efficacious as in 2008: levodopa, ropinirole, pramipexole, cabergoline, pergolide, and gabapentin. Bromocriptine, oxycodone, carbamazepine, and valproic acid are considered likely efficacious. Oral iron is nonefficacious in iron‐sufficient subjects, but its benefit for patients with low peripheral iron status has not been adequately evaluated. Restless legs syndrome augmentation has been identified as a significant long‐term treatment complication for pramipexole more than pregabalin and possibly for all dopaminergic agents more than α2δ ligands. Therefore, special monitoring for augmentation is required for all dopaminergic medications as well as tramadol. Other drugs also require special safety monitoring: cabergoline, pergolide, oxycodone, methadone, tramadol, carbamazepine, and valproic acid. Finally, we also highlighted gaps and needs for future clinical research and studies of restless legs syndrome. © 2018 International Parkinson and Movement Disorder Society