bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acoustic Effects of Asymmetric Laryngeal Activation
Authors: Mendelsohn Abie , Chhetri Dinesh K. , Neubauer Juergen , Berry David A. , Berke Gerald S. 
Published: February 2015

ObjectiveSymmetric activation of laryngeal intrinsic musculature is considered essential for optimal voice production. However, phonatory consequences of asymmetric laryngeal activation are poorly understood. The objective of this study was to investigate the phonatory characteristics of an asymmetrically activated larynx.MethodsBilateral recurrent laryngeal nerves (RLNs) were stimulated in a graded fashion (from threshold to maximal activation) in a canine phonation model. 121 combinations of left‐right RLN activation states (spanning symmetric and asymmetric activation states) were analyzed for phonatory instabilities (number of bifurcations) in the 1.5s acoustic signal after neuromuscular activation.ResultsAsymmetric laryngeal activation produced frequent phonatory instabilities. Highest levels of instabilities were seen during phonation at extreme asymmetric conditions and asymmetries during near‐maximum RLN stimulation. Linear regression models demonstrated significant association (P <. 01) between percent of RLN stimulation and acoustic/aerodynamic measures. Phonation onset time (ms) (Left RLN: Coef = 1.44, CI = 1.01‐1.86; Right RLN: Coef = 2.71, CI = 2.29‐3.13) and subglottic pressure (kPa) (Left RLN: Coef = 0.01, CI = 0.011‐0.014; Right RLN: Coef = 0.01, CI = 0.009‐0.013) increased with increasing RLN stimulation. Subglottic airflow (l/min) (Left RLN: Coef = −0.29, CI = −0.36‐0.20; Right RLN: Coef = −0.29, CI = −0.37‐0.21) and fundamental frequency (Hz) (Left RLN: Coef = −0.59, CI = −0.76‐0.42; Right RLN: Coef = −0.24, CI = −0.41‐0.07) decreased with increasing RLN stimulation.ConclusionHigher levels of asymmetric laryngeal activation are associated with increasing phonatory instabilities. These results can be applied to further characterize asymmetric laryngeal states that lead to vocal irregulaties.
Association of Laryngopharyngeal Symptoms
Authors: Chirakkal Pramod 
Published: February 2015

ObjectiveTo determine the incidence of laryngopharyngeal symptoms and signs in gastroesophageal reflux disease and to assess the response of these symptoms and signs to antireflux therapy.MethodThirty patients were selected for this 2‐year prosepective randomized case control study based on the inclusion and exclusion criteria. A complete history, videolaryngoscopy, UGI endoscopy with biopsy, and 24‐hour pH monitoring were performed. Ten healthy volunteers without any laryngopharyngeal symptoms or symptoms of GERD were used as controls.ResultsIn this 2‐year prospective study the incidence of laryngopharyngeal symptoms and signs with GERD and their response to antireflux therapy was established. Eighty‐seven percent of patients with laryngopharyngeal complaints had gastroesophageal reflux studied. Statistical analysis: Pearson chi‐square test was used for statistical analyses of the comparative studies. A P value of <.05 was considered significant.ConclusionIn short gastroesophageal reflux disease is a common disease that impairs quality of life. Laryngopharyngeal symptoms are reliable predictors of GERD. With increased number of GERD symptoms one should be aware of the most common symptoms so as to institute early therapy.
Dysphagia Characteristics in Zenker’s Diverticulum
Authors: Bergeron Jennifer L. , Long Jennifer L. , Chhetri Dinesh K. 
Published: February 2015

ObjectiveTo evaluate the presenting signs and symptoms of dysphagia in patients with Zenker’s diverticulum (ZD).MethodAll patients surgically treated for ZD over a 6‐year period were identified. Charts were reviewed for dysphagia history and findings on fiberoptic endoscopic evaluation of swallowing (FEES). Dysphagia symptoms and swallowing abnormalities were compared across groups based upon diverticulum size (small <1 cm, medium 1‐3 cm, and large >3 cm).ResultsForty‐one patients were identified. ZD size was available in 39 cases (6 small, 18 medium, 15 large). Regurgitation symptoms were less frequent in patients with small (17%) compared to medium (70%) or large diverticula (73%) (P <. 01). Similarly, esophagopharyngeal reflux (EPR) on FEES was less frequent in patients with small (17%) compared to medium (88%) and large diverticula (92%) (P <. 01). EPR was present in all patients presenting for revision surgery (N = 9). In all cases, EPR resolved after successful treatment. Eighteen percent of all patients had evidence of pharyngeal weakness on FEES which did not change significantly on initial postoperative exam.ConclusionDysphagia with EPR is predictive of a ZD larger than 1 cm, and may be useful in preoperative planning. EPR is also helpful in identifying patients with recurrent or residual symptomatic ZD following surgical treatment. Pharyngeal weakness is present in a subset of ZD patients.
Injection Laryngoplasty: Impact on Swallowing and Aspiration
Authors: Willis Elena , Tan Melin , Palma Gina , Herschman Miriam 
Published: February 2015

ObjectiveVocal fold paralysis (VCP) and glottic insufficiency result in difficulties with dysphonia, dysphagia, and cough strength. This pilot study compares quality of life (QOL) and aspiration in patients with VCP before and after injection laryngoplasty (IL).MethodsA prospective case series at an academic tertiary care hospital on 7 pilot patients (age 64‐85 years, mean 71 years) with VCP and symptoms of aspiration. All patients underwent modified barium swallow (MBS) or fiberoptic endoscopic evaluation of swallow (FEES). MBS and FEES studies were evaluated using Penetration‐Aspiration scale (PENASP). Additionally, patients completed 2 QOL questionnaires, the EAT‐10 and the Voice Handicap Index (VHI). All patients underwent IL with micronized dermis. Four underwent unilateral injection, 3 underwent bilateral injection. Repeat evaluation at 3 months with MBS or FEES was again scored with PENASP scale. Patients again completed the questionnaires.ResultsAll 7 reported improvement in QOL on VHI (P =. 03). There was no difference in pre and post procedure EAT‐10 scores. Two of 7 patients showed decreased aspiration on thin liquid PENASP scores and 5 of 7 patients showed no change (P =. 19). There was no difference in pre and post PENASP scores with semi‐solids.ConclusionThis study suggests that IL improves QOL for patients with VCP and that IL may improve aspiration with thin liquids. A prospective case series with a larger sample size is needed to further evaluate the effects of IL on aspiration and quality of life.
Murine Model of a Drug‐Eluding Stent on Subglottic Stenosis
Authors: Lee Jennifer Y. , Cohen Noam A. , Singhal Sunil , Leahy Kevin , Ghosh Ankona , Philiponis Genevieve , Mirza Natasha 
Published: February 2015

ObjectiveThe study investigates the effect of a localized, steroid‐eluding stent on laryngotracheal complex (LTC) granulation in the murine model. We hypothesize that steroid treated LTCs will have reduced granulation compared to non‐treated LTCs using 2 techniques.MethodThe established murine model of LTC stenosis was used to compare effects of local mometasone furoate on airway granulation tissue. Using H&E staining, the thickness of lamina propria between control and treatment LTCs were compared. Using real‐time PCR, the relative level of IL1 and TGF beta were compared.ResultsUsing microscopy and H&E staining, the LTCs were found to have decreased amounts of granulation after treatment with mometasone furoate compared to untreated LTCs. Using RT‐PCR, the inflammatory marker IL‐1 was significantly decreased in LTCs treated with the mometasone furoate stent compared to untreated mice.ConclusionLocalized drug eluding stent appears to decrease granulation and inflammatory markers within laryngotracheal complexes. Further investigation into the therapeutic benefit of local drug‐eluding stents in the airway is warranted.
New Approaches for Locally Advanced Nasopharyngeal Carcinoma
Authors: Pecorari Giancarlo , Raimondo Luca , Garzaro Massimiliano , Airoldi Mario , Riva Giuseppe , Cerutti Marta , Giordano Carlo 
Published: February 2015

ObjectiveTo evaluate 2 different schemes of neoadjuvant chemotherapy (NACT) followed by 2 different concomitant chemoradiotherapy (CHRT) schedules in loco‐regionally advanced nasopharyngeal carcinoma (A‐NPC) observed in a nonendemic population.MethodSeventy homogeneous patients affected by A‐NPC were enrolled in this retrospective study. Forty patients (group A) underwent 3 cycles of NACT with cisplatin+epirubicin followed by cisplatin+70 Gy RT; and 30 patients (group B) received 3 cycles of NACT with carboplatin+taxol followed by weekly carboplatin+taxol for 7 weeks+concomitant 70Gy RT.ResultsAfter NACT, results in group A and B were: CRs 30% vs 33%, PRs 60% vs 60%, NC 10% vs 6.6%; after CHRT: CRs 75% vs 87%, PRs 25% vs 13%. After median follow‐up of 54 months (A) and 49 months (B), 3‐5 years progression‐free survival were 75% vs 80% and 65% vs 75%, respectively, and overall survival was 84% vs 85% and 77% vs 80%, respectively; 5 years locoregional control was 70% vs 90%, and 5 years distant metastases–free survival was 75% vs 85%. NACT toxicity was as follows: G3‐4 neutropenia 40% vs 83%, G3 thrombocytopenia 12% vs 13%, G3 anemia 0% vs 10% and G3 mucositis 2.5% vs 6.6%; CHRT toxicity was as follows: G3‐G4 neutropenia 20% vs 63%; G3 anemia 2.5% vs 17%, G3‐G4 mucositis 32.5% vs 69%; skin toxicity 25% vs 23% and G3 neurotoxicity 5% vs 10%.ConclusionNACT followed by CHRT represents a feasible, highly effective treatment for patients with A‐NPC, with excellent locoregional disease control and overall survival and with low incidence of distant metastases. Double drug CHRT in group B is characterized by higher incidence of acute toxicities without significant impact on major clinical outcomes.
Nonsurgical versus Surgical Management of Vocal Cord Nodules
Authors: Salari Behzad , Toutounchi Javad S. , Ghiasi Samad , Mobaraki Hajar Y. , Toutounchi Neghisa , Nezami Nariman 
Published: February 2015

ObjectiveVocal cord nodules are of the most common benign laryngeal pathologies that may cause dysphonia and hoarseness. This study aimed to assess the effectiveness of surgical versus nonsurgical interventions for vocal cord nodules.MethodIn a cohort study, 60 patients with vocal cord nodules were enrolled in 2 groups. The study was carried out from 2010‐2011 at Imam Reza Hospital of Tabriz. One group underwent surgical microscopic excision, and the other one was managed with medical and speech therapies. The results were evaluated 3 months later.ResultsThe mean age of patients was 37.35 ± 9.22 years with male to female ratio of 36/24. In each group, 27% of patients were smokers. Sixty percent of patients in the surgical group had job‐related use of voice, compared to 72% in the nonsurgical group. In the surgical group, 63% of patients had bilateral nodules versus 76% in the nonsurgical group. In evaluating improvement of voice quality there was no statistically significant difference between the 2 groups regarding patient satisfaction and the surgeon’s evaluations (P =. 16 and P =. 07, respectively).ConclusionThere was no definite difference between surgical and nonsurgical interventions of vocal cord nodules.
The Use of the Pulse Dye Laser: Treatment of Sulcus Vocalis
Authors: Choi Hong‐Shik , Chisang Hwang 
Published: February 2015

ObjectiveBased on the similarity between the histopathology of sulcus vocalis and scar tissue, and numerous reports on pulse dye laser (PDL) regarding laryngeal lesions, especially the scar tissue, the authors evaluated the efficacy of treating sulcus vocalis with PDL and named this surgical procedure “PDL glottoplasty.”MethodsThis study was conducted on 25 patients diagnosed with sulcus vocalis on video‐stroboscopy at Gangnam Severance Hospital from August 2006 to February 2012. The delivery energy was fixed at 0.74J per pulse, and all procedures were performed under general anesthesia, exposing the larynx with suspension laryngoscope and observing the lesion with microscope. Aerodynamic, stroboscopic, and acoustic voice analyses were performed pre‐ and postoperatively, and electroglottographic analysis was conducted for voice analysis on sentence domain.ResultsThe vocal folds generally showed alleviated vocal fold stiffness and mucosal wave, resulting in improved vocal fold vibration and dysphonia. And most PDL glottoplasty patients showed definite improvement in post‐treatment voice analysis indices. The differences between pre‐ and postoperative voice parameter were statistically significant.ConclusionPDL glottoplasty seems to be beneficial to the treatment of sulcus vocalis. Considering that the results of other various elaborate techniques have been disappointing and even induced secondary scar formation, resulting vocal fold stiffness, our study of PDL glottoplasty using the characteristic photoangiolysis of the sublesional microcirculation of the PDL offers favorable alternative to the treatment of sulcus vocalis.
Endoscopic Excision of Forehead Lipomas
Authors: Groom Kelly L. , Roofe Scott B. 
Published: February 2015

ObjectiveDescribe a method of endoscopic forehead lipomas that results in minimal visible scarring and good cosmetic results.MethodWe present a retrospective case series of 4 patients who presented with forehead lipomas from July 2009 to December 2011. Patients underwent endoscopic excision of the lipomas using pretrichial incisions and standard endoscopic brow instrumentation. Outcomes measured were cosmetic results, presence of a depressed scar, and postoperative complications.ResultsAll patients had good cosmetic results with no depressed scars and no postoperative complications.ConclusionEndoscopic excision is an effective, minimally invasive, and cosmetically satisfying approach to forehead lipomas in the population who desires to avoid a visible scar.
Ultrasound Study of the Normal Upper Esophageal Sphincter
Authors: Moriniere Sylvain , Hammoudi Karim , Boiron Michele , Patat Frederic 
Published: February 2015

ObjectiveThe purpose of this study was to develop a methodology and standard settings for ultrasound study of the upper esophageal sphincter (UES) during swallowing.MethodThis was a prospective study of 25 healthy volunteers. Neck ultrasonography was performed as each volunteer swallowed 10 mL of water. The parameters studied were: diameter, anterior and lateral displacement of UES duration of UES, opening and UES displacement. Student’s t tests were applied for the statistical analysis.ResultsThe mean diameter of the closed UES was 0.78 ± 0.13 cm, while the mean duration of opening was 415 ± 57.66 ms, and the mean duration of displacement was 937 ± 120.98 ms. Maximum anterior and lateral displacement of the UES was 0.42 ± 0.12 cm and 0.35 ± 0.18 cm, respectively. There was a significant difference between men and women for lateral displacement of the UES (P =. 04).ConclusionThis study established standards for ultrasound study of the UES during swallowing, using a non‐invasive readily accessible method that may be useful for assessing swallowing disorders involving the UES (Zenker’s diverticulum, fibrosis, stricture).
A Study of Cholesteatoma and Mastoid Pneumatization
Authors: Iqbal Isma Z. , Watson Carl 
Published: February 2015

Objective1) To evaluate the relationship between cholesteatoma and the degree of mastoid pneumatization. 2) To assess the relationship between the location of cholesteatoma and mastoid pneumatization.MethodA prospective analysis on all patients undergoing mastoid exploration for cholesteatoma during 1993‐2011 was performed. The degree of mastoid pneumatization and the site of cholesteatoma were recorded. All patients were operated on and graded by the same surgeon. Revision surgery and atticotomy, where pneumatization could not be assessed, were excluded.ResultsA total of 393 (222: male, 171: female) patients underwent surgery for cholesteatoma; 203 were left sided, and 190 were right sided. The mean age of the patients was 37 years (range 6‐79). Pneumatization of the mastoid was: sclerotic 23% (90), diploic 16.7% (66), and cellular 60.3% (237, P <. 001), respectively. Attico‐antral cholesteatoma was present in 88.9% sclerotic, 95.4% diploic, and 91.1% cellular mastoids. Middle ear (ie, sinus tympani, anterior tympanum, posterior tympanum, and Eustachian tube) cholesteatoma was present in 54.4% of sclerotic, 56% of diploic, and 51.9% of cellular mastoids.ConclusionIn this study, cholesteatoma was most frequently found in relatively well‐pneumatized mastoids; this casts doubt on the theory that relatively poor mastoid pneumatization and the subsequent development of cholesteatoma may have a common etiology.
Anterior Cartilage Island Tympanoplasty: Functional Outcome
Authors: Saleh Essam A. 
Published: February 2015

ObjectiveDescribe a technique of anterior cartilage island tympanoplasty and report outcome and hearing results using this technique in type I tympanoplasty.MethodRetrospective chart review at a tertiary referral center. One hundred thirty‐one patients who underwent type I tympanoplasty were evaluated. A semilunar conchal cartilage island was placed under the anterior annulus, and an underlay temporalis fascia graft was placed over the cartilage. Hearing results were assessed by comparing the preoperative and postoperative air‐bone gaps.ResultsThe fascia was either placed medial to the handle of the malleus (group I) or lateral to the handle after separating it from the drum (group II). Graft take was successful in 95.4% of cases with no statistical difference between both groups (95.8% in group I and 94.4% in group II). Air‐bone gap improved significantly in both groups compared to the preoperative one (P <. 001). The postop air‐bone gap was 5.2 dB and 7.1 dB for groups I and II, respectively. Ninety percent of cases had an air‐bone gap of 10 dB or less.ConclusionAnterior cartilage island tympanoplasty is an effective technique that yielded good anatomic and functional results.
Bax siRNA Protects against TNFα‐Induced Hair Cell Loss
Authors: Dinh Christine T. , Bas Esperanza , Gupta Chhavi , Dinh John N. , Vu Ly , Van De Water Thomas R. 
Published: February 2015

Objective1) Understand the role of Bain tumor necrosis factor alpha (TNFα)‐induced auditory hair cell (HC) death in rat organ of Corti (OC) explants in vitro 2. Determine the effectiveness of short interfering RNA that targets Bax mRNA (Bax siRNA) against TNFα‐induced HC loss.MethodOC explants dissected from 3‐day‐old rats were cultured in control media, TNFα, TNFα+BasiRNA, or Bax siRNA for 0, 48, and 96 hours in vitro. Real‐time PCR, ELISA, HC viability studies, immunofluorescence, and confocal microscopy were performed. ANOVA with post hoc testing was used with P value set <.05.ResultsExplants exposed to TNFα‐only demonstrated significant declines in the number of viable HCs while displaying increased Bax mRNA and protein expression, when compared to control explants. In contrast, the levels of viable HCs, Bax mRNA, and protein expression in explants treated with TNFα+Bax siRNA or Bax siRNA alone approached levels similar to OC explants cultured in control media. Immunolocalization studies demonstrated increased expression of Bax protein in the auditory HCs of the basal turn in TNFα‐only treated explants, while OC explants cultured in control media, TNFα+Bax siRNA, or Bax siRNA alone did not display noticeable Bax expression.ConclusionTNFα initiates the programmed cell death of auditory HCs in vitro through up regulation of pro‐apoptotic Bax gene and protein expression. Bax siRNA blocks TNFα‐induced apoptosis of HCs as demonstrated by decreased Bax mRNA and protein expression, which results in increased numbers of viable HCs in the treated OC explants.
Facelift Approach for Parotidectomy
Authors: Grover Nancy , D’Souza Alwyn 
Published: February 2015

Objective1) To critically evaluate the literature on the use of facelift approach (MFI) for parotidectomy, where available, in direct comparison to the traditional cervicofacial approach (CFI). 2) To provide objective evidence for its use.MethodRetrospective review of literature up to 2011,The terms parotidectomy, parotid, face lift, and aesthetic were used to search Medline, Embase, PubMed, Cochrane, and CINHAL. Reference lists were cross‐checked to include relevant studies. Only English language literature with human subjects was searched.ResultsWe identified 19 relevant studies. A total of 416 patients undergoing parotidectomy via MFI have been described. Most were performed for benign lesions, and superficial/partial parotidectomy were the most commonly performed procedures. Exposure of facial nerve was adequate. Complication rates are not increased with MFI. Outcomes in terms of postoperative scarring are good as reported by patients. Major limitations were: anterior exposure, though a recent study has reported 49 cases of anterosuperior tumors successfully resected with MFI; use in obese patients; ptotic and voluminous parotid masses; and restraint by fresh trainees.ConclusionObjective evidence certainly justifies using the facelift approach for well‐selected cases, which has been increasingly reported in literature in the last decade with expanding indications. In our opinion the limitations described are surmountable. PROMs have shown high satisfaction rates with this approach.
Bilateral Bone‐Anchored Hearing Aids: A Systematic Review
Authors: Janssen Renee M. , Hong Paul , Chadha Neil K. 
Published: February 2015

ObjectiveTo systematically review the outcomes of bilateral versus unilateral bone‐anchored hearing aids (BAHA) for individuals with bilateral permanent conductive hearing loss (CHL) with the goal of 1) deriving clinically oriented insights into the advantages and disadvantages of bilateral fitting; and 2) identifying gaps in knowledge to stimulate future research.MethodMedline, EMBASE, and Cochrane databases were searched for studies of all languages published between 1977 and July 2011. Studies were included if subjects of any age had permanent bilateral CHL and bilateral implanted BAHAs. Outcome measures of interest included audiologic evaluation, quality of life indicators, and reports of adverse events.ResultsA total of 628 abstracts were generated from the literature searches; 11 studies met the criteria for data extraction and analysis. All 11 studies were observational. In most studies, comparisons between unilateral and bilateral BAHA were intra‐subject. Bilateral BAHA provided additional audiologic benefit compared to unilateral BAHA (improved thresholds for tones [2 studies], speech in quiet [5 studies] and in noise [3 studies], and improved localization [3 studies]), and patients perceived additional subjective benefit from bilateral BAHA [3 studies]. Disadvantages of bilateral BAHA included listening in noise in some conditions [3 studies], additional cost, and presumed increase in adverse event risk.ConclusionBilateral BAHA provided additional objective and subjective benefit compared to unilateral BAHA; however, there was a limited number of studies available with good quality evidence. Aspects of bilateral BAHA that would benefit from further investigation are described, and recommendations for bilateral BAHA candidacy criteria are provided.