bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Modified Frontolateral Partial Laryngectomy with Laryngeal Framework Reconstruction
Authors: Sawatsubashi Motohiro , Umezaki Toshiro , Adachi Kazuo , Komune Shizuo 
Published: August 2013

Objectives:Endoscopic resection and radiotherapy are organ‐preservation strategies for glottic cancer because of the high local control and quality of voice after the therapy. However, frontolateral partial laryngectomy is still needed in some cases. This procedure has the complication of hoarseness. Therefore, we applied the theories of laryngeal framework surgery to partial laryngectomy with reconstruction using strap muscles and skin flap in order to improve postoperative voice qualities.Methods:We performed a modified frontolateral partial laryngectomy in three selected cases (rT1a, T3 cases). The retrospective analysis of voice qualities (PPQ, APQ, NHR, MPT) was performed in 10 frontolateral partial laryngectomy cases (7 conventional and 3 modified methods). Surgical procedure: Frontolateral vertical partial laryngectomy with tumor‐free margin was performed via laryngofissure approach. After tumor resection, approximation laryngoplasty was performed using sternothyroid muscle flap that was inserted into posterior dead space to gain better contact of the posterior vocal fold on the reconstructed vocal ridge. After these procedures, a reverted sternohyoid muscle was placed inside the preserved outer perichondrium to reduce dead space and externally medialize cervical skin flap, which shaped new vocal fold.Results:No recurrence was observed in any case. No aspiration and laryngeal stenosis were observed in any case. The postoperative voice qualities were improved over pretreatment qualities in modified cases. PPQ after modifying this method was better than conventional methods.Conclusions:It is better for voice quality to treat selected glottic cancers with this modified frontolateral partial laryngectomy.
Pharyngolaryngeal Reflux Simulating Vocal Fold Paralysis Hoarseness following Total Thyroidectomy
Authors: Ramalho Sara C. , Castro Eugénia , Ribeiro Leandro , Lima Nuno B. , Condé Artur 
Published: August 2013

Objectives:Systemic multifocal fibrosclerosis is a syndrome characterized by the presence of fibrosis in various locations, most often retroperitoneal, mediastinal, and thyroid (Riedel thyroiditis). The fibrosis in the thyroid tissue can extend to the laryngeal cartilages and muscles, leading to respiratory distress. A thyroidectomy is, in these cases, an intervention to consider. Recognize potential “rare” causes of hoarseness following thyroid surgery.Method:Hoarseness case study. A 69 year old man presented to the ear, nose, and throat (ENT) consultation with a history of hoarseness and aspiration following total thyroidectomy for Riedel's thyroiditis. Physical examination revealed exuberant pharyngolaryngeal reflux with consequent edema and redundancy of arytenoid mucosa with simetric mobility of the vocal folds.Results:Worsening dysphonia after total thyroidectomy, particularly in the context of Riedel thyroiditis, leads to suspicion of iatrogenic vocal fold paresis. The vocal fold preserved mobility, associated with signs of exuberant pharyngolaryngeal reflux with extensive mucosal damage, reveals an unsuspected cause of hoarseness. The authors postulate that post‐operatory changes in esophagic sphincter pressure may have triggered reflux.Conclusions:Rare causes of hoarseness following thyroid surgery should be considered in order to promptly establish a correct treatment plan.
Tacrolimus Prevents the Development of Laryngotracheal Stenosis in the Novel Rat Model
Authors: Araki Koji , Mizokami Daisuke , Tanaka Nobuaki , Tomifuji Masayuki , Yamashita Taku , Shiotani Akihiro 
Published: August 2013

Objectives:Acquired laryngotracheal stenosis (LTS) is a challenging problem for otolaryngologists. Modulating the wound healing of airway mucosa is the key component for treating LTS. Drug‐eluting stents (DESs) with immunosuppressants as Tacrolimus have been dominant for the treatment of coronary artery diseases in the interventional cardiology owing to their efficacy in significantly reducing restenosis. Several studies suggested Tacrolimus might potentially have inhibitory effects on airway stenosis as seen in coronary DESs. The objective of the present study is to determine whether immunosuppressants modulate the wound healing of airway mucosa and prevent obstructive airway disease in an acute injury animal model.Methods:The authors recently reported the novel reliable LTS model in rats, whose laryngotracheal mucosa was scraped with a nylon brush through the tracheostoma. Tacrolimus (0.2 or 1.0 mg/kg i.m.) was systemically administered for 5 days. The pathological changes at the airway mucosa and the tracheal lumen were assessed at 7 days after the scraping. The percentage of stenosis was calculated by image analysis software.Results:Both hyperplasia of airway epithelium and thickened submucosal layer with extensive fibrosis, angiogenesis, and collagen deposition provoked lumen stenosis. There was significant preventive effect on airway stenosis in the lower dose of Tacrolimus (0.2mg/kg) compared to brushing only group (P < 0.05). The high dose of Tacrolimus group (1.0mg/kg) also showed a trend to potential protection of airway stenosis.Conclusions:This study suggests that the systemic immunosuppressive agent, Tacrolimus, has a preventive effect on LTS from mucosal injury of the airway.
Treatment of Recurrent Vocal Fold Hemorrhage in Ehlers‐Danlos Syndrome
Authors: Du Eugenie , Geller Melin T. 
Published: August 2013

Objectives:Ehlers‐Danlos syndrome (EDS) is a heterogeneous group of inherited connective tissue disorders. Generalized tissue and vascular fragility underlie many physical findings and resultant complications from the syndrome. We present a patient with vascular subtype of EDS with recurrent vocal fold hemorrhage who underwent successful treatment by microflap excision and CO2 laser ablation of true vocal fold microaneurysm. This is the first case report of a successful therapeutic laryngeal intervention for an EDS patient.Methods:Case report of one patient at a single institution.Results:A patient with hemorrhagic polyp after intubation underwent standard microscopic direct laryngoscopy and excision of a hemorrhagic polyp on her right true vocal fold. Hemorrhage recurred, and the patient underwent repeat microflap excision with identification of and CO2 laser ablation of a vocal fold microaneurysm. The patient experienced resolution of hemorrhage with resolution of dysphonia.Conclusions:This case report, the first documented therapeutic intervention for a vocal fold abnormality in EDS, highlights not only the care that should be taken when intubating patients with EDS but also the importance of considering additional measures needed to prevent recurrence of hemorrhage in patients with this connective tissue disorder.
Value of the Portuguese VHI and SVHI Instruments to Discriminate Voice Pathologies in Voice Professionals
Authors: Capucho Maria‐Clara P. , Escada Pedro A. , Aguiar Pedro , Ruah Carlos‐Moises B. 
Published: August 2013

Objectives:1) Determine the sociodemographic characteristics of a group of elite vocal performers (singers and actors). 2) Investigate the discriminating power of the Portuguese validated versions of the instruments VHI and SVHI in addressing different voice pathologies.Methods:The study had the participation of 324 individuals (217 singers and 107 actors). All the participants were evaluated by telescopic or transnasal laryngoscopy and completed: 1) a questionnaire addressing sociodemographic characteristics and vocal use; and 2) the Portuguese version of the VHI. All the singers completed also the Portuguese version of the SVHI. Descriptive statistics used mean, median, standard deviation, minimum, maximum values for quantitative variables, and absolute (n) and relative (%) values for qualitative variables. Receiver operating characteristic (ROC) curves were used to investigate the discriminating power of the VHI and SVHI instruments to address different voice pathologies.Results:Of the 324 subjects, 51.2% were female and 48.8% were male with a mean age of 40.8 years (range: 15‐82 years). 52.3% were single, followed by married (32.1%) and divorced/widowed (15.6%). Approximately 34% of subjects smoked on average and worked with the voice for nearly 21 years. Receiver‐operating characteristic curve analysis showed a weak discriminating power between diagnoses and VHI or SVHI scores, except for vocal cord nodules that are associated with a higher (worse) VHI score.Conclusions:The Portuguese versions of the VHI and SVHI instruments are useful to measure the voice handicap among Portuguese actors and singers but have a limited value to discriminate between vocal pathologies.
Vocal Fold Cover Layer with a Tissue‐Engineered Structure Containing Epithelium and Fibroblast of Oral Mucosa
Authors: Chitose Shunichi , Fukahori Mioko , Sueyoshi Shintaro , Kurita Takashi , Sato Kiminori , Nakashima Tadashi 
Published: August 2013

Objectives:A potential treatment option for severe vocal fold scarring is to replace the vocal fold cover layer with a tissue‐engineered structure containing autologous cells. The aim of this study is to develop a three‐dimensional cell‐populated matrix resembling the vocal fold layers of epithelium and lamina propria from autologous oral mucosa.Methods:A 3‐by‐3‐mm specimen of canine buccal mucosa was harvested and divided into epithelium and submucosa. Epithelial cells from the epithelium and fibroblasts from the submucosa were isolated and separately cultured. After the culturing for 2 weeks, the epithelial cells were seeded on mesh type oriented collagen gels containing the fibroblasts throughout a 2‐week‐culture period. The morphological characteristics of the cultured tissue were observed with immunohistochemical staining and transmission electron microscopy. Normal canine vocal fold and buccal mucosa were used as positive controls.Results:We successfully fabricated a vocal fold cover layer with a tissue‐engineered structure closely resembling the normal vocal fold layers of epithelium and lamina propria. The epithelium had three to five cell layers and did not resemble the original oral mucosa. The epithelial cells were immunostained with anti‐keratin 3 antibodies, anti‐b1 integrin antibodies, and anti‐p63 antibodies. The fibroblasts in the collagen gels were immunostained with anti‐vimentin antibodies. Electron microscopy revealed developed microvilli on the apical surface of the epithelial cells.Conclusions:The tissue‐engineered vocal fold cover layer from autologous oral mucosa has the possibility to reconstruct the vocal fold surface and to restore voice in patients with severe vocal fold scarring.
Vocal Fold Vibration of Patients with Reinke's Edema Observed Using High‐Speed Digital Imaging
Authors: Watanabe Takeshi , Kaneko Kennichi , Sakaguchi Koichi , Takahashi Haruo 
Published: August 2013

Objectives:1) Assess vocal fold vibration of patients with Reinke's edema using high‐speed digital imaging (HSDI) and videostoroboscopy. 2) Confirm that HSDI is useful for examining vocal folds with severe Reinke's edema.Methods:Study design is observational and cross‐sectional. The subjects were 7 patients with Reinke's edema (6 severe, 1 moderate; 6 female, 1 male; 55–74 years of age, mean 64.7 years). Their vocal folds were examined with HSDI system (1200 fps) and videostoroboscopy before microphonosurgery from October 2009 through February 2012. The following characteristics of vocal fold vibration were analyzed; glottic closure, mucosal wave propagation, symmetry, phase shift, frequency difference, periodicity, and contact with false vocal fold. Postoperative examinations were also performed in 5 subjects.Results:HSDI revealed periodic or quasi‐periodic vibration, anterior‐posterior phase shift, and contact of true and false vocal folds in all patients before surgery. Distinct left‐right asymmetry of vibration was observed in 6 patients. The vocal fold vibrations could not be tracked in 4 with severe edema. After surgery the vibrations became periodic and synchronized with strobolights in all patients. Little left‐right asymmetry of vibration remained in all patients.Conclusions:Though the vocal fold vibrations with Reinke's edema were periodic or quasi‐periodic, they were often difficult to observe with videostroboscopy in severe cases. HSDI can be a very useful tool for examining the vocal folds of patients with severe Reinke's edema, especially before surgery to find scarring and tumor.
Binaural Interlevel Differences and Alternate Binaural Loudness Balance in Cochlear Implant Recipients
Authors: Praetorius Mark , Khabas Rösli , Hoth Sebastian 
Published: August 2013

Objectives:We analyzed the effect of a single sided cochlear implant in recipients with single sided deafness.Methods:Twenty adult recipients of a cochlear implant with an acoustically hearing ear on the other side were included in this 2012 study. We analyzed the binaural interlevel differences (BILD), the alternate binalural loudness balance (ABLB) and the pitch matching abilities of these subjects.Results:In the BILD, the speech reception threshold (SRT) improved by 6 dB (P = 0.0022) compared with single sided hearing without cochlear implants. At the ABLB, the mean of similar sensed loudness between acoustic and cochlear implant hearing was between 49 and 54 dB. The pitch matching was in the range of three pure tones in these patients.Conclusions:Patients with asymmetric hearing or single sided deafness have a clear benefit in the BILD test.
Body Balance Rehabilitation in Older Persons with Peripheral Chronic Vestibular Disease
Authors: Dorigueto Ricardo S. , Doná Flavia , Kasse Cristiane A. , Scharlach Renata C. , Branco‐Barreiro Fatima C. , Gazzola Juliana M. , Maia Denise 
Published: August 2013

Objectives:Evaluate the efficacy of a balance rehabilitation program in older persons with chronic vestibular disease.Methods:Prospective clinical trial conducted from September 2011 to December 2012. Setting: University center for balance disorders. Eligible patients (over 60 years old) with chronic vestibular disease underwent 12 to 16 sessions of individual body balance rehabilitation program (BRP). Each session lasted 60 minutes, twice per week, and was associated with diet orientation and daily exercises for labyrinth stimulation. Before and after therapy, the following data were collected: patient complaints, the Functional Gait Assessment, the Brazilian OARS Multidimensional Functional Assessment Questionnaire, the Dizziness Handicap Inventory (DHI) and static posturography parameters (limit of stability and balance functional reserve in ten visual, vestibular, and somatosensory conflicts).Results:Of 20 patients, 90.9% were female, with mean age of 71.70 years old. After BRP, there was reduction of most of symptoms (dizziness, imbalance and nausea), improvement in functional capacity (P < 0.05), gait stability (P = 0.003) and reduction in DHI scores (P = 0.001). The limit of stability measure increased (P = 0.001) and also the body balance functional reserve, mainly in conditions 2, 3 and 4 (P = 0.001) and 5 (P = 0.020).Conclusions:A body balance rehabilitation program was effective in reduction of symptoms, fall risk, and dizziness impact on quality of life in elderly patients with vestibular disorders, improving functional capacity, gait stability, and increasing the limit of stability and the balance functional reserve.
Cartilage Palisades in Type 3 Tympanoplasty: Functional and Hearing Results
Authors: Vashishth Ashish , Mathur Neeraj N. , Verma Deepak 
Published: August 2013

Objectives:Evaluate functional and hearing outcomes with use of full thickness broad cartilage palisades for tympanic membrane reconstruction in type 3 tympanoplasty using titanium prosthesis.Methods:The retrospective study done at a tertiary referral institute included 30 patients with posterior mesotympanic retraction pockets or tympanic membrane perforations requiring tympanic membrane and a type 3 ossicular reconstruction. Patients with disease extending beyond aditus requiring canal wall down mastoidectomy were excluded. Disease removal from posterior mesotympanic and epitympanic recesses was confirmed using angled endoscopy and ossicular reconstruction performed using titanium partial or total ossicular replacement prosthesis. The tympanic membrane reconstruction was done, with or without attic reconstruction, using full thickness broad cartilage palisades harvested from the tragus with attached perichondrium laterally. Patients were assessed at 12 and 24 weeks for graft status and any evidence of implant extrusion. Hearing evaluation was done using subjective assessment and pure tone audiometry.Results:Twenty‐seven out of 30 patients had intact and completely healed grafts postoperatively at 24 weeks (success rate of 90%) displaying full union and epithelization of palisades, with 3 patients displaying small defects. The mean pure tone air bone gap pre and postoperatively was 32.4 dB and 8.8 dB respectively, with most patients reporting satisfactory postoperative hearing. No evidence of implant extrusion was found in the 24 week period.Conclusions:Tympanic membrane reconstruction using full thickness palisades of tragal cartilage provides good functional and hearing outcomes in type 3 tympanoplasty using titanium prosthesis.
Clinical Characteristics of Posttraumatic Benign Paroxysmal Positional Vertigo
Authors: Yamamoto Hidefumi , Sunami Kishiko , Yamane Hideo 
Published: August 2013

Objectives:Although head trauma is considered a common cause of benign paroxysmal positional vertigo (BPPV), only a few studies have investigated posttraumatic BPPV (PT‐BPPV). The aim of this study was to assess the clinical characteristics of PT‐BPPV.Methods:We reviewed the clinical records of 19 patients with PT‐BPPV during the years 2001 to 2012. Patients with an onset of positional vertigo within 3 days of well‐documented head trauma were included in the PT‐BPPV group. Their outcome was compared with that of 54 patients with idiopathic BPPV (i‐BPPV) who were treated during the first half of 2011. We investigated the clinical characteristics of PT‐BPPV and the clinical differences between the PT‐BPPV and i‐BPPV groups.Results:Members of the PT‐BPPV group required more treatment sessions than did the members of the i‐BPPV group (P < 0.05). The mean number of treatment sessions in the PT‐BPPV and i‐BPPV groups was 3.74 ± 3.07 and 2.22 ± 1.24, respectively. The recurrence rate in the PT‐BPPV group (42.1%) was significantly higher than that in the i‐BPPV group (18.5%; P < 0.05).Conclusions:Our findings suggest that, compared to i‐BPPV, PT‐BPPV requires more treatment sessions to achieve remission and has a greater tendency to recur. We suggest the use of frequent treatment sessions and canalith repositioning maneuver for patients with PT‐BPPV.
Cochlear Implantation in a Residency Training Program: The Kaiser Permanente Oakland Experience
Authors: Do Jennifer B. , Handler Ethan B. , Rasgon Barry M. 
Published: August 2013

Objectives:Assess the complications of cochlear implantation and determine whether resident physicians can perform this procedure safely.Methods:Retrospective chart review of consecutive cochlear implant recipients who underwent primary cochlear implantation performed with extensive resident surgeon involvement between January 1, 2005 and April 30, 2012. Setting: Tertiary care teaching hospital. One hundred and fifty‐nine adults and children collectively underwent a total of 194 primary cochlear implant operations (n = 194). Complications after cochlear implantation were classified into major and minor categories. Minor complications included those that either settled spontaneously or with conservative management. Major complications were defined as those requiring further surgery or hospitalization. Spontaneous failures of internal devices were reported separately.Results:The overall complication rate was 11.3% (22 of 194 cochlear implant cases). Minor complications occurred in 14 cases (7.2%). These included wound infection or dehiscence, hematoma formation, delayed facial paresis, and non‐auditory stimulation. Major complications were present in 8 cases (4.1%). These involved implant malposition or migration, incorrect device implantation, flap‐related problems, chronic infection with cholesteatoma, and severe vertigo requiring hospitalization. One of the 8 patients experiencing a major complication required device explantation. There were no post‐operative deaths, cases of meningitis, or persistent facial nerve palsies in this series. Device failures occurred in 4 cases (2.1%).Conclusions:The rate of complications is comparable to those published by other institutions. Residents can safely and successfully perform cochlear implant surgery. With close supervision, satisfactory results can be achieved.
Cochlear Implantation in the Very Elderly
Authors: Wong Daniel J. , Moran Michelle , O'Leary Stephen 
Published: August 2013

Objectives:Evaluate the outcomes following cochlear implantation in the very elderly population (age ≥ 85), with a particular emphasis on peri‐operative surgical course, mobility, dizziness, and speech perception outcomes.Methods:A retrospective cohort study was conducted from June 2001 to May 2012 comparing groups aged 85+ to 80‐84, and 75‐79 at the time of first cochlear implantation. Retrospective collection of parameters was done by reviewing medical records and outpatient notes at the RVEEH in Melbourne. Parameters of interest included: speech recognition testing pre‐ and post‐implantation, symptomatic dizziness and effects upon independent living post‐operatively, pre‐operative vestibular tests, and post‐operative tests if symptomatic, presence of dementia in medical records, and incidence of perioperative medical and surgical complications.Results:Two hundred twenty‐six patients over age 70 at the time of surgery were identified to have a CI512 or CI24RE implanted. The oldest patient was 93 at the time of surgery. Speech recognition testing gradually improved after implantation in this population with a low incidence of postoperative complications.Conclusions:Geriatric patients can still benefit from cochlear implantation, and age should not be a limitation for cochlear implantation (CI) surgery. The population ≥ 85 years tend to have greater difficulty with mobility and are at greater risk of dementia and cognitive impairment, but they still benefit, with improved speech perception following cochlear implantation. Although the presence of co‐morbidities increases the risk of perioperative complications with age, cochlear implantation can be done safely and provides significant patient benefits.
Delayed Surgical Treatment for Long Onset Facial Paralysis
Authors: Rivas Jose A. , Garcia Laura , Forero Victor H. , Rivas Alejandro 
Published: August 2013

Objectives:Present qualitative evidence that supports surgical intervention to those patients with long onset facial paralysis.Methods:Retrospective study of clinical and surgical records of patients operated from July 2006 to September 2012. Twenty‐two patients with long onset facial paralysis were operated at a specialized center. Patients underwent surgical facial nerve decompression. Preoperatory and outcomes were recorded with the House‐Brackmann facial function score (HBs). Intraoperative stimulation response was obtained as indicator prognostic outcome for facial nerve function.Results:Patients who undergo surgical decompression obtain reduction in the HBs when intraoperative stimulation is obtained.Conclusions:Surgical decompression of the facial nerve is an option for subjects with long onset facial nerve paralysis with improvement of facial function through time.