bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Method to Create Vocal Fold Injuries in Mice
Authors: Yamashita Masaru , Bless Diane M. , Welham Nathan V. 
Published: October 2014

Objectives: The goal of this study was to develop a surgical method for the creation of vocal fold injuries in mice, as a precursor to the use of genetically engineered mouse models in the study of vocal fold wound healing and scar formation. Methods: Seven FVB strain mice were used in this study. A laryngoscope and 3 micro-instruments were designed and fabricated to facilitate endoscopic vocal fold visualization and the creation of vocal fold surgical injuries. The larynges were harvested 1 and 7 days after surgery, and the vocal fold injury sites were evaluated by routine hematoxylin and eosin staining. Additional immunohistochemical analysis of collagen type I and elastin distribution in the lamina propria was performed for an uninjured control larynx. Results: Endoscopic visualization and vocal fold stripping resulting in thyroarytenoid muscle exposure were successful in all animals. Histologic and immunohistochemical analyses revealed a simple lamina propria structure with relatively even collagen type I and elastin distribution in the control vocal fold, obliteration of vocal fold mucosa 1 day after surgery, and complete reepithelialization by 7 days. Conclusions: These results demonstrate the feasibility of creating reproducible vocal fold injuries via an endoscopic approach in mice. The observation that the mouse lamina propria may have a relatively simple histologic structure indicates that additional characterization should be performed and caution used in translating findings between this and other model systems.
Modulating Effects of Hypoxia and Hypercarbia on Glottic Closing Force
Authors: Sasaki Clarence T. , Hundal Jagdeep S. , Wadie Mikhail , Woo Jeong-Soo , Rosenblatt William 
Published: October 2014

Objectives: Aspiration has been identified as one of the independent risk factors for development of respiratory tract infections, the incidence of which varies from 10% to 65% in patients in intensive care units. The primary defense mechanism for protection of the lower airway is the glottic closure reflex (GCR), elicited by stimulation of the internal branch of the superior laryngeal nerve. This reflex, once considered highly stable, is now considered vulnerable to a growing number of clinical factors. This study was designed to explore the biomechanical effects of hypoxia and hypercarbia, common occurrences among critically ill patients, on the GCR. Methods: Five adult male Yorkshire pigs were used in the study. Both internal superior laryngeal nerves were simultaneously stimulated with bipolar platinum-iridium electrodes. The glottic closing force (GCF) was then measured by placing a pressure transducer between the adducting vocal folds under 3 different protocols: Protocol 1 (control), protocol 2 (hypoxia: Partial pressure of arterial oxygen [Pao2] levels of 90, 70, and 50 mm Hg), and protocol 3 (hypercarbia: Partial pressure of arterial carbon dioxide [Paco2] levels of 60 and 70 mm Hg). Six readings were recorded under each experimental paradigm, and Student's t-test was applied to calculate the statistical significance against the control. Results: Hypoxia reduced the GCF to 75%, 40%, and 29% of control for Pao2 levels of 90, 70, and 50 mm Hg, respectively, and hypercarbia reduced the GCF to 40% and 27% of control for Paco2 levels of 60 and 70 mm Hg, respectively. Conclusions: This is the first study that highlights the biomechanical impact of hypoxia and hypercarbia on the GCR, providing a unified explanation for the increased incidence of life-threatening aspiration in critically ill patients with such alterations.
Effect of Dehydration on Phonation Threshold Flow in Excised Canine Larynges
Authors: Witt Rachel E. , Regner Michael F. , Tao Chao , Rieves Adam L. , Zhuang Peiyun , Jiang Jack J. 
Published: October 2014

Objectives: The minimum airflow necessary to initiate stable vocal fold vibration — Phonation threshold flow (PTF) — May increase as exposure to dry air increases. A critical period of dehydration may exist after which phonation can no longer be initiated. Methods: We collected PTF data for 11 excised canine larynges mounted on a bench apparatus. Trials consisted of cycles of 10 seconds of phonation followed by 3 seconds of rest. During the experimental trials, subglottal flow of comparatively dry air was increased until phonation was initiated, and phonation was sustained for the remainder of the 10-second period. The subglottal flow was then decreased until phonation ceased. No saline solution was applied during the dehydration trials. During the control trials, subglottal airflow was humidified and saline solution was applied frequently to the vocal folds. Results: The PTF increased as exposure to dry air increased during the experimental trials (p = 0.010); this relationship was not statistically significant in control trials. A point existed after which phonation could not be initiated. Conclusions: Knowledge of the effect of exposure to dry air on PTF could be useful in the clinical assessment and prevention of dehydration. Further exploration of this relationship in vivo could be used to evaluate the effectiveness of current hydration therapies and provide theoretical support for the development of new ones.
Concurrent Intra-Arterial Chemotherapy and Radiotherapy for Advanced Laryngeal Cancer
Authors: Yoshizaki Tomokazu , Kondo Satoru , Wakisaka Naohiro , Murono Shigeyuki , Kitagawa Noriko , Tsuji Akira , Nakashima Masashi , Sanada Jun-Ichiro , Matsui Osamu 
Published: October 2014

Objectives: An intra-arterial chemoradiotherapy regimen (RADPLAT) provides remarkable local control for head and neck cancer. This study evaluates the efficacy of a reduced RADPLAT protocol in patients who are candidates for total laryngectomy. Methods: Forty-three patients with advanced laryngeal cancer were treated with 2 courses of intra-arterial cisplatin infusion (100 mg per body) during 40-Gy irradiation. The patients who showed a greatly diminished tumor received sequential irradiation. The patients with obvious residual disease received chemotherapy during the sequential irradiation. Poor responders, with less than 50% tumor reduction, underwent total laryngectomy. Results: Forty-two patients completed the protocol. All surviving patients were followed for at least 3 years. Thirty-four patients were alive (80% of the supraglottic cases and 87.5% of the glottic cases). Local control was achieved in 27 patients (67.5% of the 11 glottic cases and 64.0% of the supraglottic cases). The glottic cohort showed better progression-free survival rates than did the supraglottic cohort (68.8% and 45.0%, respectively; p = 0.019). There were 2 cases of grade 3 neutropenia and 3 cases of grade 3 mucositis. No patients required tube feeding. One patient required tracheostomy 3 months after the completion of the treatment protocol. Conclusions: Concurrent chemoradiotherapy with a reduced dose of intra-arterial cisplatin is feasible for patients with advanced glottic cancer.
Prothrombotic Gene Mutations in Patients with Sudden Sensorineural Hearing Loss and Cardiovascular Thrombotic Disease
Authors: Capaccio Pasquale , Cuccarini Valeria , Ottaviani Francesco , Fracchiolla Nicola Stefano , Bossi Anna , Pignataro Lorenzo 
Published: October 2014

Objectives: Impaired cochlear perfusion seems to be an important event in sudden sensorineural hearing loss. Prothrombotic gene mutations have been related to vascular disorders and sudden hearing loss. We assessed the prothrombotic risk in 10 patients with sudden sensorineural hearing loss who had previously experienced cardiovascular events to support its vascular pathogenesis. Methods: Ten patients underwent hematologic tests (MTHFR C677T/A1298C, prothrombin G20210A, platelet GlyIIIaA1/A2, and V Leiden G1691A genotyping; fibrinogenemia; cholesterolemia; homocysteinemia; folatemia). The results were compared with those of 100 previously investigated patients with sudden hearing loss alone and those of 200 healthy controls. DNA was isolated from peripheral blood leukocytes, and the gene mutations were investigated by polymerase chain reaction and a LightCycler DNA analyzer. Results: Two patients had 2 mutant alleles, 6 had 3, and 2 had 4. The mean homocysteine, cholesterol, and fibrinogen levels were above the upper limit of normal; the mean folate levels were slightly above the lower limit of normal. Multiple mutations were more frequent in the patient group than in the previously analyzed patients and healthy controls. Conclusions: The association between inherited and acquired prothrombotic factors in patients with sudden sensorineural hearing loss and thrombotic diseases in other sites suggests that a multifactorial mechanism may underlie microvascular cochlear impairment. Hematologic investigation, including MTHFR, prothrombin, platelet, and V Leiden genotyping, may help to detect patients at potential risk of recurrent hearing loss and multiple microvascular diseases, and could be usefully performed in otherwise idiopathic sudden sensorineural hearing loss.
Use of Neuromuscular Electrostimulation in the Treatment of Dysphagia in Patients with Multiple Sclerosis
Authors: Bogaardt Hans , van Dam Danielle , Wever Nienke M. , Bruggeman Caroline E. , Koops Johan , Fokkens Wytske J. 
Published: October 2014

Objectives: We explored the possible effects of neuromuscular electrostimulation on the swallowing function of patients with multiple sclerosis and swallowing problems. Methods: Twenty-five patients (average age, 53.1 years; SD, 9.8 years) with multiple sclerosis and swallowing problems were treated for 3 weeks with 2 sessions per week of neuromuscular electrostimulation. The average time since the onset of multiple sclerosis was 16.5 years (SD, 10.2 years). Seventeen patients were examined with transnasal flexible endoscopy 1 week before treatment and 1 week after treatment. Results: After treatment, a significant decrease in pooling of saliva in the pyriform sinuses was seen in 6 patients (p = 0.03), and significantly less aspiration during swallowing of thin liquids (p < 0.01) was seen in 9 patients. Overall, the 25 patients reported that their swallowing had improved (p < 0.01), and in 20% of the patients, it had become less strenuous. No adverse effects of the treatment were reported. Conclusions: Our study showed that the treatment of swallowing problems with neuromuscular electrostimulation in patients with multiple sclerosis in this sample was successful in the reduction of pooling of saliva and in the reduction of aspiration.
Measurement of Cross-Sectional Dimensions of the Cricoid Cartilage: A Computed Tomographic Study
Authors: Shin Hyun-Woo , Ahn Youngjin , Sung Myung-Whun , Kim Kwang Hyun , Kwon Tack-Kyun 
Published: October 2014

Objectives: We measured the cross-sectional dimensions of the cricoid cartilage and degrees of ossification of the marrow space for designing a cricoid implant. Methods: We reviewed 100 age- and sex-matched neck computed tomography scans that were performed at Seoul National University Hospital from 2001 to 2005. Under a standardized computed tomography window setting, the height of the cricoid cartilage marrow and the thickness of the marrow space and the ossified inner and outer cortices were measured by one observer. Results: The mean height of the cricoid cartilage marrow was 13.6 mm (range, 5.5 to 20.5 mm) in women and 17.5 mm (range, 13.0 to 24.5 mm) in men. The mean thickness of the cricoid cartilage marrow was 3.17 mm (range, 1.22 to 4.75 mm) in women and 5.13 mm (range, 3.42 to 7.60 mm) in men. We also observed that women in general have a higher density of the cricoid marrow than men; 4 women and 1 man had a markedly denser marrow space. There were individual variations in size and density of the cricoid marrow. Conclusions: Human adult cricoid cartilages have sufficient marrow space for cricoid implantation. Preoperative evaluation of the size and density of the cricoid marrow is recommended for individual application of the cricoid implant.
Impact of Supraglottoplasty on Aspiration in Severe Laryngomalacia
Authors: Richter Gresham T. , Wootten Christopher T. , Rutter Michael J. , Thompson Dana M. 
Published: October 2014

Objectives: We examined the incidence and significance of aspiration in infants with severe laryngomalacia (LM) who undergo supraglottoplasty. Methods: We performed a 5-year retrospective review of a prospective database from 2 tertiary care pediatric institutions. The studied patients were 50 consecutive infants with severe LM who underwent supraglottoplasty (median age, 4.5 months) and functional endoscopic evaluation of swallowing (FEES) with or without laryngopharyngeal stimulation testing. The intervention was cold-knife microlaryngeal supraglottoplasty and reflux management. The main outcome measure was aspiration resolution. Results: Preoperative FEES identified laryngeal penetration in 44 infants (88%) with severe LM. Laryngeal penetration with aspiration beyond the vocal folds was noted in 36 infants (72%). Postoperative FEES (median follow-up, 3.8 months) indicated resolution of laryngeal penetration and aspiration in 36 (81.8%) and 31 (86.1%) of these patients, respectively. The 14 patients without preoperative aspiration showed no evidence of aspiration after supraglottoplasty. In patients with aspiration, the mean preoperative laryngopharyngeal stimulation test threshold was 8.45 mm Hg. This improved on average by 4.0 mm Hg after supraglottoplasty (paired t-test, p < 0.0001). Multiple medical comorbidities were present in the 5 patients who had persistent aspiration after supraglottoplasty, including congenital heart disease (all 5 patients), congenital syndromes (4 patients), neurologic disorders (2 patients), and a need for tracheostomy (2 patients). Conclusions: Laryngeal penetration and aspiration improve after cold-knife supraglottoplasty. Supraglottoplasty does not cause aspiration in patients who do not have preoperative aspiration. Supraglottoplasty may not improve aspiration in patients with multiple medical comorbidities.
Clinical Significance of the Summating Potential—Action Potential Ratio and the Action Potential Latency Difference for Condensation and Rarefaction Clicks in Meniere's Disease
Authors: Ohashi Toru , Nishino Hirohito , Arai Yoko , Hyodo Makoto , Takatsu Mitsuharu 
Published: October 2014

Objectives: This study was aimed to elucidate the diagnostic significance of the summating potential (SP)–action potential (AP) ratio and the AP latency difference between condensation and rarefaction clicks (AP con-rar difference) in Meniere's disease. Methods: The AP and SP were recorded transtympanically in 67 patients with definite Meniere's disease. The SP/AP ratio and the AP con-rar difference were assessed in terms of 1) their interrelationship, 2) their relationship to hearing level, and 3) the rate of occurrence of abnormal values according to the stages of Meniere's disease. Results: No correlation was found between the SP/AP ratio and the AP con-rar difference. Neither the SP/AP ratio in general nor the AP con-rar difference was correlated with the hearing level. However, enhanced values of the SP/AP ratio (0.35 or higher) were moderately correlated with the hearing level (r = 0.51), and their occurrence rate was 55.2%. An increased AP con-rar difference (0.13 ms or longer) was not correlated with the hearing level, and its occurrence rate was 50.2%; it appeared most frequently at stage 3 (p < 0.05). Conclusions: An enhanced SP/AP ratio might not always indicate the presence of endolymphatic hydrops associated with an increase in endolymphatic pressure. An increased AP con-rar difference might reflect the presence of a biased basilar membrane resulting from an increased endolymphatic pressure, and hence it is diagnostically essential to simultaneously evaluate the SP/AP ratio and the AP con-rar difference.
Mild and Variable Audiometric and Vestibular Features in a Third DFNA15 Family with a Novel Mutation in POU4F3
Authors: de Heer Anne-Martine R. , Huygen Patrick L. M. , Collin Rob W. J. , Kremer Hannie , Cremers W. R. J. 
Published: October 2014

Objectives: Cochleovestibular characteristics were investigated in a Dutch DFNA15 family with a novel POU4F3 mutation, L223P Methods: A 4-generation pedigree was constructed of the Dutch family with the novel L223P POU4F3 mutation. Pure tone audiometric data were collected and analyzed cross-sectionally in mutation carriers. Age-related typical audiograms were derived. Vestibular examination was performed in most of the mutation carriers. The results were compared to those obtained from previously identified 884del8 and L289F POU4F3 mutation carriers. Results: A novel mutation (L223P) in POU4F3 segregated with hearing impairment in the present family. Audiometric analysis generally showed an early-adult to midlife onset of hearing impairment. High-frequency hearing impairment was observed most frequently. Age-related typical audiograms showed a down-sloping configuration at ages of more than 30 years, with the fastest rate of progression at the high frequencies. Vestibular function tests revealed hypofunction of the vestibular labyrinth in 2 mutation carriers (not statistically significant). Conclusions: The clinical features in the present family with a POU4F3 mutation were fairly similar to those in the 2 previously described DFNA15 families, but the level of hearing impairment was milder, and there was no substantial vestibular dysfunction.
Three-Year Postimplantation Auditory Outcomes in Children with Sequential Bilateral Cochlear Implantation
Authors: Scherf Fanny , Van Deun Lieselot , van Wieringen Astrid , Wouters Jan , Desloovere Christian , Dhooge Ingeborg , Offeciers Erwin , Deggouj Naïma , De Raeve Leo , Wuyts Floris L. , Van de Heyning Paul 
Published: October 2014

Objectives: We report on the auditory abilities and speech performance in quiet and noise of 35 children with sequential bilateral cochlear implantation after 3 years of bilateral implant use. Methods: Testing was done in bilateral and both unilateral listening conditions. The assessments took place before the second implantation and at several time intervals after fitting. As different auditory tests were used, the children were categorized by their age at the second implantation: Younger or older than 6 years. Results: The pure tone averages for the bilateral condition were significantly better than those for either unilateral condition after 12 months of bilateral implant use and remained so from that test interval onward. The speech recognition outcomes in quiet and noise also improved significantly for almost all children after 36 months, although a linear regression analysis showed a beneficial effect of younger age at first implantation on the speech-in-noise results. Conclusions: Bilateral cochlear implantation offered advantages to all children in comparison with the first implant — Even the children who received the second implant after the age of 6 years. Compared to the younger children, the older children needed a longer adjustment period to gain bilateral benefit. However, they obtained similar results after 2 years of bilateral implant use.
Self-Reported Listening Habits and Enjoyment of Music among Adult Cochlear Implant Recipients
Authors: Migirov Lela , Kronenberg Jona , Henkin Yael 
Published: October 2014

Objectives: We sought to assess the associations between self-reported listening habits and enjoyment of music, and the following variables: Age at implantation, gender, prelingual versus postlingual deafness, duration of deafness, duration of cochlear implant (CI) use, type of CI, speech coding strategy, and speech perception abilities. Methods: A questionnaire on listening habits and enjoyment of music before the onset of deafness and after implantation was sent to 85 adult CI recipients who had been using the devices for at least 6 months. Results: Of the 53 responders, 39 (73.6%) listened to music after implantation. Listening to music was not significantly related to age at implantation, gender, duration of deafness, duration of CI use, type of CI device, speech coding strategy, or open-set speech perception abilities. The 14 nonlisteners were postlingually deafened. The ratings of enjoyment were the same for 22.6% of patients, improved for 26.4%, and worse for 50.9%. Only 2 of 13 patients who played a musical instrument and 14 of 24 patients who sang before the onset of deafness resumed their musical activities. Conclusions: Despite the decline in listening habits and in the enjoyment of music after cochlear implantation, most patients do listen to music. The changes in listening habits and enjoyment were not related to the selected background variables.
Human Papillomavirus—Associated Oropharyngeal Squamous Cell Carcinomas: Primary Tumor Burden and Survival in Surgical Patients
Authors: Ukpo Odey C. , Pritchett Cedric V. , Lewis Jean E. , Weaver Amy L. , Smith David I. , Moore Eric J. 
Published: October 2014

Objectives: We sought to determine whether the primary tumor burden in oropharyngeal squamous cell carcinoma is lower in tumors positive for human papillomavirus (HPV) or in tumors with a smoking- or alcohol-related cause. Methods: We retrospectively reviewed medical records of patients at our institution who had squamous cell carcinoma of the palatine tonsils, base of tongue, soft palate, or pharynx from 1995 through 2006. The patients underwent primary surgical therapy. The main outcome measures were the HPV status of tumors and nodes and the survival rates (categorized by HPV status). Results: Of 102 treated patients, 48 (47.1%) had HPV-positive carcinomas. Primary tumor size was not significantly different between HPV-positive and HPV-negative tumors (median, 2.5 versus 2.0 cm; p = 0.43). Patients with HPV had a higher prevalence of neck nodal metastases (35% versus 11%; p = 0.003) and high-grade lesions (83% versus 64%; p = 0.03). Conclusions: Primary tumor burden was not associated with HPV status. Patients with HPV-positive oropharyngeal squamous cell carcinomas had a higher prevalence of neck nodal metastases and high-grade lesions.
Clinicopathologic Features and Outcome of the Oncocytic Variant of Papillary Thyroid Carcinoma
Authors: Gross Menachem , Eliashar Ron , Ben-Yaakov Avraham , Weinberger Jeffrey M. , Maly Bella 
Published: October 2014

Objectives: The purpose of this study was to define the clinicopathologic features and outcome of the oncocytic variant of papillary thyroid carcinoma (OVPTC) with a review of the literature. Methods: Twenty-three patients with OVPTC over a 10-year period were studied. Demographic, clinical, and histopathologic features and outcome data were analyzed retrospectively. Results: Seventeen women and 6 men, ages ranging from 20 to 76 years (95% confidence interval, 43.0 to 54.48), were studied. Cervical lymph node involvement was found in 43.4% of the patients. Most of the recurrences were associated with thyroid masses greater than 2 cm in diameter. Evaluation of the overall survival data by the Kaplan-Meier method revealed that most recurrences took place earlier than 30 months, and the majority of patients (74%) were well, with no evidence of disease, up to 78 months after the last treatment. All of the OVPTC cases presented as nonencapsulated tumors, and 78.2% demonstrated extrathyroid stromal invasion. Conclusions: OVPTC is a unique variant of papillary thyroid carcinoma that has distinctive clinicopathologic features. Since OVPTC is often associated with local invasion and may involve cervical lymph nodes, it may require more extensive surgery than classic papillary thyroid carcinoma.