bluuebunny/crossref_metadata_2025_split huggingface dataset:
Usefulness of 3D‐FLAIR MRI to Detect Inner Ear Abnormalities in Patients with Sudden SNHL
Authors: Tanigawa Tohru , Tanaka Hirokazu , Katahira Nobuyuki , Horibe Yuichiro , Ueda Hiromi 
Published: September 2014

Objectives:Three‐dimensional fluid‐attenuated inversion recovery magnetic resonance imaging (3D‐FLAIR MRI) has been used to detect alterations in the composition of the inner ear fluid. We aimed to investigate an association between the hearing level and the signal intensity of pre‐ and postcontrast 3D‐FLAIR MRI in patients with sudden‐onset sensorineural hearing loss (SNHL).Methods:3D‐FLAIR MRI was performed in 18 patients with sudden‐onset SNHL: 12 patients with mild‐to‐moderate SNHL (baseline hearing levels, ≤ 60 dB) and 6 patients with severe‐to‐profound SNHL (baseline hearing levels >60 dB).Results:High‐intensity signals in the inner ear were observed in 2 of 6 patients (33%) with severe‐to‐profound SNHL but not in those with mild‐to‐moderate SNHL (P <. 05). Signals were observed on MRI scans 6 or 18 days after SNHL onset.Conclusions:Our results indicate that 3D‐FLAIR MRI is not a useful tool for detecting inner ear abnormalities in patients with mild SNHL.
Trends in Pursuit of Otolaryngology Subspecialty Fellowship
Authors: Wilson Meghan N. , Kelley Kanwar S. , Carter John M. , Raol Nikhila P. 
Published: September 2014

Objectives:(1) Examine resident interest in otolaryngology subspecialty fellowship and factors affecting that interest over time and throughout residency. (2) Examine changes in fellowship availability and match rate over time.Methods:Data regarding fellowship interest, influencing factors, and demographics were extracted from the 2008‐2013 Section for Residents and Fellows‐in‐Training annual survey and examined in uni‐ and multivariate analyses. Historic fellowship match data available through match resources for pediatric otolaryngology, laryngology/broncho‐esophagology surgery, rhinology, and neurotology were collected.Results:Over 6 years, a total of 1958 residents and fellows responded to the survey. A statistically significant decrease in fellowship interest was seen between junior (PGY‐1 or PGY‐2/3) and senior residents (PGY‐4/5), with 79.9%, 73.3%, and 61.6% of PGY‐1, PGY‐2/3, and PGY‐4/5 residents, respectively, planning to pursue subspecialty training (P <. 001). Of the portion planning fellowship training, choice of the subspecialty did not change throughout residency. No difference was found in the percentage of residents interested in fellowship from 2008 to 2013. The most important factors in choosing a subspecialty were consistently type of surgical cases and nature of clinical problems. The number of fellowship positions in facial plastic surgery, pediatric otolaryngology, and rhinology have increased over the past decade.Conclusions:Interest in fellowship continues to be high, but desire to pursue fellowship training decreases with increased residency training. This decision is multivariate in nature. While most subspecialties have grown slowly over time, the match rate continues to be variable due to fluctuations in application numbers.
Visualization of Maculae and Membranous Semicircular Ducts in the Otic Capsule by Optical Coherence Tomography
Authors: Sakamoto Tatsunori , Tona Yosuke , Nakagawa Takayuki , Ito Juichi 
Published: September 2014

Objectives:(1) Show the possibility of using optical coherence tomography (OCT) to visualize the internal structure of the vestibule and semicircular canals with the bony capsule intact. (2) Study the effect of the decalcification. OCT is a nondestructive imaging modality that uses infrared light as it penetrates turbid biological tissue. Previously, OCT has been successfully used to visualize inside the cochlea in normal and abnormal inner ears.Methods:The OCT system, OCS‐1300SS (Thorlabs, Inc, NJ) with a central wavelength of 1300 nm and a theoretical axial resolution of 9 µm, was employed for image acquisition. Normal and Slc26a4 mutant mice were used as experimental animals. Inner ears were isolated and fixed with 4% paraformaldehyde. Samples were scanned before and after decalcification with 10% ethylenediaminetetraacetic acid for 7 days.Results:The saccular and utricular maculae and membranous semicircular ducts were delineated with OCT before and after decalcification. Image quality and imaging depth was better after the decalcification. Signals from the otolith were well observed before decalcification. Normal and pathologically dilated endolymphatic ducts in the bony canal in the knock‐out mice were also visualized.Conclusions:OCT have the potential to visualize maculae, membranous semicircular ducts, and the endolymphatic duct through the bony capsule. It may also provide new strategy to evaluate the pathology of otolith.
Vitamin C Deficiency Impairs Mineralization of Ossicle in Mice
Authors: Hu Jinwei , Guthrie O'Neil , Dong Wei , Xing Weirong , Xu Helen , Mohan Subburaman , Jung Timothy T. K. 
Published: September 2014

Objectives:Vitamin C‐deficient (VCD) mice develop spontaneous bone fractures and exhibit hearing loss. However, the effects on the micro‐architecture of the ossicles and the underlying mechanisms have not been fully understood. In this study, we test the hypothesis that vitamin deficiency impairs osteoblast differentiation and function of the ossicles.Methods:The morphologic characteristics of the ossicles in VCD and wild‐type mice were evaluated with a stereoscopic microscope. Micro‐structure of the ossicles was analyzed by micro computed tomography (µCT). Osteoblast differentiation was determined by immunostaining of the bone marker gene, osteocalcin. Sound transmission along the ossicular chain was evaluated with laser Doppler vibrometer.Results:The ossicles in VCD mice demonstrated thinner bone in the manubrium of malleus and stapes footplate. µCT analyses further verified that the bone volume/total volume fraction (BV/TV) was significantly reduced in the stapes footplate (51.5 ± 3.9% vs 61.2 ± 1.5%; P <. 05) and the manubrium of malleus (24.9 ± 5.3% vs 39.0 ± 5.0%; P <. 05) in VCD mice. The expression of osteocalcin was significantly decreased in the ossicles of VCD mice (17.8 ± 3.3 vs 32.4 ± 4.7; P <. 05). However, the preliminary data revealed a modest change in sound transmission along the ossicular chain.Conclusions:These findings suggest that VCD decreased expression of osteoblast differentiation marker, osteocalcin, and reduced bone volume and of the ossicles without significantly altering sound transmission. These results may indicate that the pathogenesis of VCD‐induced hearing loss might be due to a deficiency at the inner ear or auditory neuron level. Further studies are warranted.
Worse Preoperative Hearing Thresholds and Younger Patients in Tomographic Retrofenestral Otosclerosis
Authors: Palma Camilo , Caro Carlos Stott , Delano Paul H. , Ojeda Alejandro , Gonzalez Gonzalo Miranda 
Published: September 2014

Objectives:Usually, the diagnosis of otosclerosis is based on clinical and audiometric findings, and its confirmation requires surgical exploration of the middle ear. More recently, it has been suggested that high‐resolution computed tomography of the temporal bone (TTB) could diagnose and classify otosclerosis into fenestra otosclerosis (FO) and retrofenestral or cochlear otosclerosis (RFO). However, there are relatively few studies that relate these tomographic features with clinical and surgical findings. The aims of the study were to: (1) classify otosclerosis patients with preoperative TTB into fenestra or retrofenestral otosclerosis, and (2) compare these image findings with pre‐ and postoperative auditory thresholds and epidemiological findings.Methods:Retrospective study by reviewing medical records of otosclerosis patients (2006‐2011) undergoing estapedostomy in the Clinical Hospital of the University of Chile (tertiary institution), who were evaluated with preoperative TTB and had full audiometric data. Descriptive statistics and t test or analysis of variance with Tukey post hoc test were used as necessary, considering a P value <.05 as significant.Results:A total of 74 estapedostomies from 56 patients were evaluated. The TTB study had 87% sensitivity for the surgical diagnosis of fenestral otosclerosis. Age and hearing thresholds were significantly lower in patients with tomographic RFO compared to FO otosclerosis (t test, P <. 05).Conclusions:The TTB is a useful imaging method to classify otosclerosis patients into RFO and FO varieties. In addition, the RFO corresponds to a more aggressive variety of otosclerosis (younger patients and lower auditory thresholds), and thus this method may be used as a prognostic tool.
The Effect of Sinus Balloon Catheter Dilation on the Management of Child Chronic Rhinosinusitis
Authors: Tan Guolin 
Published: September 2014

Objectives:Observe the effect and safety of sinus balloon catheter dilation (SBCD) on the management of chronic rhinosinusitis in children.Methods:Twenty‐seven children (8‐14 years old) with chronic rhinosinusitis were randomized into 2 groups: 13 cases were carried out SBCD, and 14 cases treated with medication. The effect was assessed by disease‐specific questionnaire (20‐items sino‐nasal outcome test, SNOT‐20) and visual analog score (VAS).Results:At 3‐ and 6‐month follow‐up, the scores of SNOT‐20 and VAS were significantly decreased compared with baseline in both SBCD group and controls (P <. 05), and significantly lower in SBCD group than in the control group (P <. 05). The overall effect demonstrated that the rate of much‐improved and improved was 92.3% in SBCD group, and significantly higher than control group.Conclusions:SBCD is an effective and minimally invasive method for child chronic rhinosiunusitis
Evading Detection and Antibiotics: Internalization Rates of Different Strains of Group A Streptococcus
Authors: Jiang Zi Yang , Nair Vidhya , Wasserzug Oshri , Mitchell Ron B. , Shiloh Michael 
Published: September 2014

Objectives:(1) Determine the internalization rates of different strains of Group A Streptococcus (GAS). (2) Determine whether statistically different internalization rates occur in patients who receive a tonsillectomy for sleep‐disordered breathing/sleep apnea versus chronic/recurrent tonsillitis. (3) Facilitate the development of GAS vaccineMethods:In vitro microbiology/tissue culture study at an academic tertiary referral center. All tonsillectomy specimens (performed for sleep disordered breathing spectrum and recurrent/chronic tonsillitis spectrum) were collected at the authors’ institution from September 2013 to November 2013. Each specimen was swabbed and bacteria cultured and emm typed. Only specimens with GAS were included in the study. The strains were grown in brain heart infusion (BHI) media to an optic density at 600 nm of 0.5. HeLa and nasopharyngeal carcinoma Detroit 562 cells were grown in tissue culture and subsequently infected with individual strains of GAS at a multiplicity of infection (MOI) of 1:10 for 2 hours. Cells were then washed with Dulbecco's Modified Eagle Media (DMEM) and reincubated with DMEM plus gentamycin. The cells were then lysed, serial dilutions performed, and the lysate plated. Bacteria were counted and percent internalizations were calculated. This was repeated in triplicate for each strain.Results:Out of 396 eligible patients, 66 strains of GAS have been isolated. Both the Detroit and HeLa cells have been successfully grown in BHI. The bacterial strains have been subcultured. The authors plan on infecting the cells in March 2014 and will have have conclusive results by April 2014.Conclusions:None provided.
Experience and Outcomes of New Developments in Bone Conduction Hearing Technologies in Children
Authors: Felton Mark , Gaskin Julian , Eltham Penny , O'Driscoll Martin , Woolford Timothy J. , Nichani Jaya , Bruce Iain 
Published: September 2014

Objectives:(1) Recognize that percutaneous implant stability in children can be measured using radio frequency analysis (RFA) to generate Implant Stability Quotients (ISQs) and guide sound processor loading. (2) Discuss sound processor loading of the Cochlear BahaÒ (BIA300, BA400) transcutaneous implants at 4‐6 weeks in selected children and potential advantages of the transcutaneous ATTRACT implant.Methods:We collected data prospectively on all children undergoing implantable BC implants at surgery and follow up appointments. We aimed to assess implant stability over time in children undergoing 1‐stage surgery using RFA measurements and investigate the possible implications for earlier loading following surgery. Our experience and outcomes with the ATTRACT transcutaneous device as part of the controlled market release (3+ cases) will also be reviewed.Results:Nine children underwent 10 BI300 implants with a mean age of 9 years 4 months. 7 children received the BA400 percutaneous device without soft tissue reduction, with a mean age of 7 years 11 months. Using RFA the mean ISQ at surgery for BI300 implants was 60 and the corresponding unadjusted value for BA400 implants was 50. Changes in ISQs over time are discussed, showing the potential for processor loading at 4‐6 weeks.Conclusions:Greater implant stability has been demonstrated using the BI300 and BA400 implants, which would subsequently enable early Baha loading. The transcutaneous ATTRACT system potentially offers further improvement in cosmesis and skin inflammation and is likely to have greater acceptance in children with microtia and canal atresia and those who would have previously declined Baha.
Hemifacial Mircrosomia: A New Classification System?
Authors: Neumann Colin , Sidman James D. , Lander Timothy , Tibesar Robert J. 
Published: September 2014

Objectives:(1) Analyze associated findings in patients with hemifacial microsomia. (2) Determine if a new classification of hemifacial microsomia is possible.Methods:A retrospective chart of all patients diagnosed with hemifacial microsomia treated at Children's Hospital of Minnesota. Each chart was reviewed for the presence of facial paralysis, microtia/anotia, aural atresia, mandibular hypoplasia, midface hypoplasia, dermoids, vertebral abnormalities, ocular abnormalities, sensorineural hearing loss, laterality, renal abnormalities, developmental delay, and skin tags.Results:A total of 75 patients with hemifacial microsomia were included in this study. There were 43 males and 32 females with an average age of 8.51 ± 5.45 years at the time of chart review. Occurrences for each defect were: facial paresis/paralysis (26.7%), microtia/anotia (73.3%), mandibular hypoplasia (72%), midface hypoplasia (57.3%), vertebral deformities (21.3%), ocular abnormalities (24%), dermoids (21.3%), renal abnormalities (12%), SNHL (17.3%), skin tags (42.7%), bilateral and developmental delay (24%). Regression models were used that showed the odds of having a spinal defect are 3.13 (P =. 001) times higher for each additional craniofacial defect present; furthermore if a patient has 2 or more craniofacial defects, the odds of having spinal defect were 31.6 (P =. 001) times as high as in patients with 1 or fewer. The odds of developing a renal defect were 36.0 (P =. 001) times as high as in patients with 1 or fewer craniofacial defects.Conclusions:The number of craniofacial defects, not just type or severity, increase the risk of having extracranial abnormalities in patients with hemifacial microsomia.
High‐Speed Video or Video Stroboscopy in Children: Which Sheds More Light?
Authors: Shinghal Tulika , Campisi Paolo 
Published: September 2014

Objectives:(1) Compare the utility of high‐speed video (HSV) versus videostroboscopy (VS) in the assessment of children with normal voices and glottic pathologies. (2) Evaluate the ease of assessment of children with HSV.Methods:This study involved a retrospective assessment of 7 children who had previously undergone HSV and VS in the past 5 years. The 14 videos of these 7 patients were then randomized and presented to 4 groups of blinded evaluators: 2 trained laryngologists, 2 speech language pathologists (SLP) with voice training and experience in a voice clinic, 2 pediatric otolaryngologists, and 2 otolaryngology residents. Raters were asked to evaluate the videos using a standardized scoring tool and to complete a questionnaire assessing their opinion of HSV and VS.Results:Evaluators required more time to complete their assessment of VS (2.95 minutes ± 2.41 minutes) than HSV (2.31 minutes ± 1.92 minutes; P =. 004). There was no difference with respect to ease of evaluation (P =. 878), diagnostic accuracy across evaluator groups or in recording modality accuracy (P =. 5). The overall agreement between VS and HSV was moderate. (Kappa [SE]: 0.446 [0.029]). The debrief questionnaire revealed that 5 out of 8 (62.5%) preferred VS to HSV.Conclusions:This is the first comparative study between HSV and VS in patients under 18 years of age. HSV permitted faster evaluation than VS with similar diagnostic accuracy between the 2 modalities. However, the evaluators in this study preferred VS to HSV.
Improving Handoffs for Tracheotomy Patients: Introducing the Connecticut Airway Risk Evaluation to Otolaryngologists
Authors: Kavanagh Katherine R. , Kelly Raeanne , Hughes Amy L. , Valdez Tulio A. , Murray Nicole 
Published: September 2014

Objectives:(1) Describe the Connecticut Airway Risk Evaluation (CARE) system, an airway grading system describing the risk of a patient's airway above the tracheotomy tube. The CARE was designed to improve handoffs between caregivers for tracheotomized patients. (2) Analyze the reliability of teaching and ease of learning the CARE system for otolaryngologists.Methods:The CARE system is a simple, easy to use scale that divides patients into the following groups: 1, easily intubatable; 2, intubatable with specialized techniques or equipment; or 3, not intubatable. A brief tutorial was designed to introduce the system and was presented to a group of otolaryngologists. A 30‐point questionnaire was administered in which patients’ airways and airway management techniques were described, and the participant was asked to grade each example according to the CARE system.Results:Fifteen participants completed the study, including 9 attending physicians and 6 resident physicians. Overall interrater reliability was calculated for all participants with a 90.3% agreement (Kappa = 0.837). Attending physicians had a 86.1% agreement (Kappa = 0.766). Resident physicians showed 98.9% agreement (Kappa = 0.981).Conclusions:The CARE system is a reliable method of classifying airway risks in the event of an airway emergency in a tracheotomized patient. We have shown that the CARE system can be easily taught to otolaryngologists with high interrater reliability. The CARE system may help simplify handoffs between caregivers while emphasizing the important aspects of a patient's airway. Adequate implementation of the CARE system may improve the understanding of airway management options in complex tracheotomized patients.
Incidence of Congenital CMV
Authors: Jeyakumar Anita S. , Warrington Stephanie , Seybolt Lorna , Zabaleta Jovanny 
Published: September 2014

Objectives:Congenital cytomegalovirus (CMV) is the most common cause of newborn infections in developed countries, affecting up to 1% of newborn babies. Symptomatic CMV can occur in up to 10% of viral positive babies, including manifestations ranging from sensorineural hearing loss, microcephaly, developmental delays, and others. The aim of the study was to evaluate the incidence of congenital CMV in a general population of newborn babies.Methods:Institutional review board approval was obtained. Newborn blood spots were obtained. The blood spots were evaluated using quantitative real time polymerase chain reaction (PCR) for CMV. The PCR primers and probes were purchased from Life Technologies and based on the sequences published by Schovoerer et al. A CMV standard curve was generated for each PCR run with a human cytomegalovirus (AD169) and a quantitated viral DNA PCR control (Advanced Biotechnologies, Inc). The DNA was serially diluted to obtain a quantitative curve.Results:Six hundred blood spots were analyzed: 50% were male; 50% were Caucasian; 50% were African American. One female African American baby was found to have CMV.Conclusions:Our local data suggest a smaller incidence of CMV than the general population. The study is a small study and the implications are unclear. Further study is needed.
Management of Sudden‐Onset Sensorineural Hearing Loss in Children
Authors: Dedhia Kavita K. , Chi David H. 
Published: September 2014

Objectives:(1) Report our experience in children with sudden‐onset sensorineural hearing loss (SSNHL). (2) Describe the etiology and management of children with SSNHL.Methods:Retrospective review of 20 children with SSNHL, from 2000‐2013 at a tertiary pediatric facility. Patients had the following inclusion criteria: history of normal hearing, hearing loss occurring in less than 3 days, and audiogram documentation.Results:The average age of patients presenting with SSNHL was 11 years 2 months (22 months‐18 years). Only 6 (30%) presented prior to 2 weeks. Tinnitus (55%) was the most common associated symptom, followed by otalgia (25%), and vertigo (20%). Eight patients had bilateral hearing loss, 6 only right and 6 only left. Hearing loss severity ranged from profound (45%) being most common to mild. Etiology was unknown (30%), viral (30%), due to an anatomic abnormality (20%), endolymphatic hydrops (10%), autoimmune (5%), perilymphatic fistula (5%), and suppurative labyrinthitis (5%). Eight patients had initial treatment with oral steroids of which 50% had improvement on audiograms. Two patients underwent intratympanic injections, and both showed improvement. Of the 12 patients with no treatment, only 1 had improved hearing.Conclusions:The true incidence of SSNHL is unknown. Younger children may be unable to express hearing loss. Unique aspects of pediatric SSNHL are delayed presentation and higher percent of anatomic findings. In our study, 70% presented more than 2 weeks after experiencing symptoms. Anatomic abnormalities are in 20% of patients. Hearing improvement occurred in 50% of children treated with oral steroids. Intratympanic steroid treatment is another option but may have practical limitation in the pediatric population.
Neonatal Macroglossia: Demographics, Cost of Care, and Associated Comorbidities
Authors: Patel Anju K. , Mildenhall Nicholas R. , Mader Nicholas S. , Scott Andrew R. 
Published: September 2014

Objectives:(1) Examine the birth prevalence of macroglossia, assessing for differences across sex, race, socioeconomic status, and geographic location. (2) Identify comorbidities associated with isolated and syndromic forms of macroglossia and determine how such factors may influence length of stay (LOS) and cost of admission.Methods:Retrospective cross‐sectional study using the 2006 and 2009 Kids’ Inpatient Databases (KID).Results:The national birth prevalence of macroglossia was 3.4 out of 10,000 births (n = 556) with a higher rate in females (3.9/10,000, P =. 001) and blacks (4.5/10,000, P =. 01). Patients were classified as isolated (n = 423, 76%) or syndromic (n = 133, 24%) based on associated diagnoses. Syndromic cases were more prevalent in the West (P =. 01). LOS and cost were increased in the syndromic group (26.2 days vs 4.8 days, P <. 01; $30.1k vs $3.9k, P <. 01), while LOS and cost for isolated macroglossia were similar to the general population. The rate of concurrent cardiac anomalies, cleft palate, and Down syndrome was increased in patients with macroglossia compared to unaffected newborns (P <. 01). Rates of respiratory distress, feeding problems, GERD, endotracheal intubation, and prolonged ventilator support were higher in the syndromic group (P <. 01). Newborns with isolated macroglossia suffered these conditions at the same rate as the general population.Conclusions:The birth prevalence of macroglossia varies by sex, race, and geographic location. Prolonged LOS and increased cost are associated with syndromic forms of macroglossia. Syndromic comorbidities rather than enlargement of the tongue in and of itself appear to be the chief contributors to increased LOS and cost in this population.