bluuebunny/crossref_metadata_2025_split huggingface dataset:
Harmonic Scalpel Assisted Superficial Parotidectomy
Authors: Muhanna Nidal , Peleg Uri , Schwartz Yehuda , Shaul Hanan , Perez Ronen , Sichel Jean-Yves 
Published: April 2014

Objective: The Harmonic Scalpel (HS) has been recently widely used to perform a variety of surgical procedures. We reviewed our experience with the use of HS in superficial parotidectomy to determine the safety and efficacy of this procedure, with regard to operative time, postoperative facial nerve function, and drainage output. Study Design: Nonrandomized retrospective review. Materials and Methods: The medical records of all patients who underwent superficial parotidectomy for benign pathology at Shaare Zedek Medical Center from January 2006 to July 2009 were retrospectively reviewed. Patients with prior facial nerve weakness or prior parotid surgery or who had undergone concurrent neck dissection or total parotidectomy were excluded. Results: Fifty-eight patients were reviewed; 26 patients underwent HS parotidectomy and 32 patients underwent conventional (cold knife) parotidectomy (control group). Harmonic Scalpel assisted parotidectomy was associated with significantly decreased length of surgery from 163.12 ± 21.8 minutes for controls to 137.3 ± 18.6 minutes in the HS assisted group ( P < .05). The incidence of temporary postoperative facial nerve paresis was significantly reduced from 43% in the controls to 23% in the HS group ( P < .05). No permanent facial nerve paralysis was reported. There were differences in the overall postoperative drain output between the HS and control groups, 68 ± 22.3 mL and 73.5 ± 38.2 mL, respectively, but these differences did not achieve significance. Conclusion: This study shows that HS assisted superficial parotidectomy for benign pathology is a safe technique and associated with reduced surgical time and incidence of temporary postoperative facial nerve paresis compared with conventional techniques.
Preventing Cuff Rupture During Tracheostomy
Authors: Sood Amit , Taheri M. Reza , Joshi Arjun S. 
Published: April 2014

Objective: The objective of our study is to describe the technique of distal endotracheal tube (ETT) positioning for avoiding cuff rupture and validate the technique in a virtual tracheostomy model. Methods: A prospective nonrandomized case series of 129 patients who had undergone tracheostomy using the senior author’s technique were evaluated. Primary outcome was ETT cuff rupture. One hundred normal patient computed tomography (CT) scans were used to generate a virtual tracheostomy model, and the probability of cuff rupture, among other values, was obtained. Results: One hundred twenty-three of 129 patients underwent tracheostomy without cuff rupture when the distal tip of the ETT was placed just proximal to the carina. After analysis of 100 3-dimensional CT scans, the average distance from the tracheotomy to the superior aspect of the cuff was 54.6 mm in men and 39.87 mm in women when a 6.5-size ETT was used, and 44.8 mm in men and 30.07 mm in women when a 7.5-size ETT was used. Virtual tracheotomy between the second and third tracheal rings resulted in no probability of inadvertent ETT cuff rupture. Conclusion: Distal ETT positioning during tracheostomy should be considered for avoiding inadvertent ETT cuff rupture.
Impedance Probe Testing Prior to Pediatric Airway Reconstruction
Authors: Hart Catherine K. , de Alarcon Alessandro , Tabangin Meredith E. , Hamilton Steven , Rutter Michael J. , Pentiuk Scott P. , Garza Jose M. 
Published: April 2014

Objective: This study aimed to determine if preoperative impedance testing changed management and if testing was associated with surgical outcome in patients undergoing airway reconstruction. Methods: Retrospective review of patients who had impedance testing prior to airway reconstruction at a tertiary pediatric hospital from January 2010 to September 2011. Charts were reviewed for demographics, medical/surgical history, impedance testing, and surgical outcomes. Results: Fifty-seven patients were included. Forty-seven (82%) were premature. Forty-seven (82%) had a primary diagnosis of subglottic stenosis. Twenty-six (45%) had prior airway surgery. Thirty-six (63%) had gastroesophageal reflux and 21 (36%) had undergone fundoplication. Patients without fundoplication had a median 46 total reflux, 7 proximal, and 14.5 acidic events compared to a median 5 total reflux, 0 proximal, and 0 acidic events in patients with fundoplication. Impedance testing changed management in 22% (8/36) of nonfundoplication patients and 9.5% (2/21) of fundoplication patients. In unadjusted analysis, fewer fundoplication patients had successful surgery compared to those without (33% vs 67%, P = .01). Prematurity, age at surgery, and previous airway surgery were also important predictors of surgical success. Conclusion: Fewer patients than anticipated had a change in management. Impedance testing was unlikely to change management in fundoplication patients. Patients with fundoplication were less likely to have a successful outcome, suggesting that factors other than reflux influence airway reconstruction outcomes.
Oxidative status and the severity of clinical symptoms in patients with post-traumatic stress disorder
Authors: Borovac Štefanović Leda , Kalinić Dubravka , Mimica Ninoslav , Beer Ljubić Blanka , Aladrović Jasna , Mandelsamen Perica Marina , Ćurić Maja , Grošić Petra Folnegović , Delaš Ivančica 
Published: April 2014

Background The aim of this study was to measure the parameters of oxidative stress in the blood of patients with post-traumatic stress disorder. Methods The study included 80 male war veterans who participated actively in the Homeland war in Croatia. Volunteers were divided into two groups: 50 veterans diagnosed with post-traumatic stress disorder and 30 without diagnosis. The self-assessment Hospital Anxiety and Depression Scale and the Beck Depression Inventory were used to detect the severity of depression and anxiety in the post-traumatic stress disorder patients. Catalytic concentrations of superoxide dismutase and glutathione peroxidase in erythrocytes and the concentration of malondialdehyde in serum were measured spectrophotometrically. Results Although the catalytic concentrations of erythrocyte superoxide dismutase and erythrocyte glutathione peroxidase were within the reference range for both groups, the values obtained for the post-traumatic stress disorder group were significantly lower ( P < 0.001). For serum malondialdehyde concentrations, no statistically significant differences between the groups were found. Conclusions Lower catalytic concentrations of erythrocyte superoxide dismutase and erythrocyte glutathione peroxidase in patients with post-traumatic stress disorder may indicate a weaker response to oxidative stress due to impaired enzyme activity and/or decreased synthesis. Conversely, no significant changes in serum malondialdehyde concentrations suggest a compensated balance and adaptive response to (oxidative) stress.
Macrophage Infiltrate Is Elevated in CRSwNP Sinonasal Tissue Regardless of Atopic Status
Authors: Banks Caroline A. , Schlosser Rodney J. , Wang Eric W. , Casey Sarah E. , Mulligan Ryan M. , Mulligan Jennifer K. 
Published: April 2014

ObjectiveMacrophages are major producers of inflammatory cytokines; however, their role in chronic rhinosinusitis (CRS) has not been clearly defined. The aim of this study was to quantify macrophages in sinus tissue of patients with various subtypes of CRS and determine the impact of atopic status on macrophage infiltrate.Study DesignProspective immunohistochemical study of human sinonasal tissue.SettingAcademic medical center.Subjects and MethodsHuman sinonasal tissue was taken from patients with CRS with nasal polyposis (CRSwNP, n = 8), CRS without nasal polyposis (CRSsNP, n = 8), and controls (n = 8) undergoing surgery for CSF leak repair or endoscopic excision of non‐secreting pituitary tumor. Samples were immunohistochemically stained for macrophage/monocyte markers Mac387 and CD68.ResultsCRSwNP patients had significantly increased numbers of Mac387 and CD68 cells compared to control patients (P <. 05) or CRSsNP patients (P <. 01). CRSsNP had significantly increased number of cells staining for CD68 compared to controls (P <. 05). The increased presence of macrophages measured by either marker in CRSwNP was independent of atopic status.ConclusionMacrophages are increased in CSRwNP patients regardless of atopic status and may contribute to the immunopathology of CRS.
Risk Factors for Preoperative and Postoperative Hearing Loss in Children Undergoing Pressure Equalization Tube Placement
Authors: Sidell Douglas , Hunter Lisa L. , Lin Li , Arjmand Ellis 
Published: April 2014

ObjectivePressure equalization tube (PET) placement is the most common surgical procedure performed during childhood. Current guidelines recommend more prompt management of children with otitis media with effusion who are at greater risk for speech‐language and developmental problems. This study was designed to examine risk factors for continued post‐PET hearing loss in a large pediatric clinical sample.Study DesignRetrospective analysis using the electronic medical record.SettingTertiary care children's hospital.SubjectsPediatric patients undergoing PET placement between January 2009 and October 2012 who had audiometric tests.MethodsDemographics, patient diagnoses, and hearing loss information were extracted. Multivariate binary logistic regression models were used to identify associations between patient‐specific characteristics and the presence of hearing loss.ResultsIn total, 3949 children with 4598 audiology visits were included (2357 males and 1592 females; mean age, 3.3 years), and 1272 preoperative and 3329 postoperative audiograms were performed. Using multivariate modeling, the only variable significantly associated with preoperative hearing loss was low tympanometric static acoustic admittance. Postoperative hearing loss was positively associated with patient age, preoperative hearing loss, lower tympanometric equivalent canal volumes, and Down syndrome. Other factors, including cranial/facial anomalies, low birth weight or prematurity, allergies, and asthma, were not determined to be risk factors for hearing loss.ConclusionOur results support hearing testing to identify candidates for PET surgery and to determine treatment effectiveness after surgery, since hearing loss cannot be predicted on the basis of risk or demographic factors. These data have important preoperative counseling and postoperative management implications.
Surgical Techniques for Zenker's Diverticulum: A Comparative Analysis
Authors: Leibowitz Jason M. , Fundakowski Christopher E. , Abouyared Marianne , Rivera Andrew , Rudman Jason , Lo Ka‐Ming , Weed Donald , Civantos Francisco 
Published: April 2014

ObjectiveTo compare the different modalities for treatment of Zenker's diverticulum and the associated clinical outcomes.Study DesignCase series with chart review.SettingTertiary care hospital.Subjects and MethodsBetween 1995 and 2011, 164 patients underwent surgery for Zenker's diverticulum (stapler, n = 69; laser, n = 68; open, n = 27). Patient sociodemographics, medical comorbidities, pre‐ and postoperative subjective dysphagia and regurgitation score, complications, length of stay, time to oral intake, and recurrence were reviewed for each surgical modality.ResultsNo statistically significant difference in diverticulum prevalence was associated with age, gender, or treatment group. Mean length of hospital stay was not significantly different between the 3 groups (P =. 14). A significant difference in time to oral intake was observed in the laser group compared with the other 2 groups (P =. 012). No significant difference in recurrence (P =. 21) or complication (P =. 12) rates was identified between the 3 groups. Although all 3 groups demonstrated a significant decrease between preoperative and postoperative dysphagia and regurgitation scores, the degree of improvement was not significant when the 3 groups were compared.ConclusionThere is no single “best” approach to Zenker's diverticulum. The open, laser, and stapler methods are equally effective and have similar complication rates.
Resident Research Experience and Career Path Association: A National Survey of Recent Otolaryngology Graduates
Authors: Zahtz Gerald , Vambutas Andrea , Hussey Heather M. , Rosen Lisa 
Published: April 2014

ObjectiveTo determine whether the research rotation experience affects the career path of otolaryngology residents.Study Design/SettingTwo web‐based surveys were disseminated by the AAO‐HNS; one to current and former resident trainees and the other to current residency program directors.Subjects and MethodsA web‐based survey was disseminated to all AAO‐HNS members classified as otolaryngology residents or residency graduates within the last 6 years, regarding their research rotation and its potential influence on their career path. A second web‐based survey was delivered simultaneously to program directors to evaluate their perception of the need for research in a training program and their role in the rotation. Chi‐square tests for independence as well as multivariate analyses were conducted to determine whether aspects of the resident research rotation related to career path.ResultsThe resident survey was completed by 350 respondents (25% response rate), and 39 program directors completed the second survey (37% response rate). Multiple factors were examined, including federal funding of faculty, mentorship, publications prior to residency, success of research project measured by publication or grant submission, and type of research. Multivariate analyses revealed that factors most predictive of academic career path were intellectual satisfaction and presence of a T32 training grant within the program (P <. 05).ConclusionThe composition and quality of the residency research rotation vary across institutions. Factors that enhance stronger intellectual satisfaction and the presence of T32 grant, which demonstrates an institution's commitment to research training, may promote pursuit of a career in academia versus private practice.
Discrepancy between Objective and Subjective Outcomes after Adenotonsillectomy in Children with Obstructive Sleep Apnea Syndrome
Authors: Kang Kun‐Tai , Weng Wen‐Chin , Lee Chia‐Hsuan , Lee Pei‐Lin , Hsu Wei‐Chung 
Published: April 2014

ObjectiveAdenotonsillectomy (T&A) is the first line therapy for pediatric obstructive sleep apnea (OSA); however, inconsistency between objective and subjective outcomes perplexes physicians. This study investigates changes of objective and subjective outcomes in children with OSA after T&A, in particular, to elucidate correlations and discrepancies between these 2 measures.Study DesignCase series with record review.SettingTertiary referral medical center.Subjects and MethodsSymptomatic children with polysomnographic diagnosis of OSA (apnea‐hypopnea index [AHI] > 1) were included. All children underwent T&A to treat OSA, along with completely objective (polysomnography) and subjective (Obstructive Sleep Apnea 18‐Item Quality‐of‐Life Questionnaire [OSA‐18]) measures before and 3 months after surgery.ResultsOne hundred nineteen children were included (mean age, 6.9 ± 3.3 years; 76% boys). Adenotonsillectomy significantly reduced AHI from 15.4 ± 21.2 per hour to 1.6 ± 2.5 per hour (P <. 001). The OSA‐18 scores were significantly improved after surgery (P <. 001). A weak but statistically significant positive correlation was found between AHI and OSA‐18 scores preoperatively (ρ = 0.22, P =. 016) but not postoperatively (ρ = 0.04, P =. 677). Among those cases with residual OSA after surgery, only 6% (3/54) had a residual effect on quality of life (OSA‐18 score > 60).ConclusionAdenotonsillectomy improves both objective and subjective outcomes. After surgery, quality of life significantly improved subjectively, despite an incomplete resolution of OSA objectively, leading to a better correlation between objective and subjective measures before as opposed to after surgery. Discrepancy between the 2 measures warrants an evaluation of a child both objectively and subjectively when treating OSA.
Long‐Term Outcomes in Sinus Surgery: A New Tool for Measuring Health‐Related Quality of Life
Authors: Remenschneider Aaron K. , D'Amico Laura , Litvack Jamie R. , Gray Stacey T. , Holbrook Eric H. , Gliklich Richard , Metson Ralph 
Published: April 2014

ObjectiveThe 6‐question EuroQol 5‐Dimension Health Assessment (EQ‐5D) is a widely used, simple instrument that monitors general health‐related quality of life (HRQoL) in chronic disease. It has not previously been applied to US patients undergoing endoscopic sinus surgery (ESS).Study DesignProspective cohort study.SettingAcademic Medical Center.Subjects and MethodsThe study population consisted of 267 patients with chronic rhinosinusitis (CRS) who completed 2 disease‐specific instruments—the Chronic Sinusitis Survey (CSS) and the Sinonasal Outcomes Test‐22 (SNOT‐22)—and 1 general health‐related quality‐of‐life instrument—the EQ‐5D—before and after ESS for CRS. Baseline scores were compared to those collected 3 and 12 months after surgery and to the general US population.ResultsSurveys were completed at all time points by 186 patients, for a response rate of 69.7%. Patients with CRS, when compared to the US population, reported more problems in the domains of pain/discomfort (73.1% vs 40.8%, P <. 01), anxiety/depression (50.5% vs 26.4%, P <. 01), and usual activities (30.6% vs 15.0%, P <. 01). One year following ESS, there was a significant decrease in patients who reported problems with pain/discomfort (54.3%, P <. 001), anxiety/depression (30.6%, P <. 001), and usual activities (21.5%, P <. 01). After surgery, CRS anxiety/depression scores were no different from those of the US general population. Chronic Sinusitis Survey and SNOT‐22 scores demonstrated similar postoperative improvements.ConclusionThe EQ‐5D assessment provides meaningful general health outcomes data with low patient burden. Application of this instrument demonstrated long‐term improvement in the quality of life of patients who undergo sinus surgery.
Balloon Dilation of the Cartilaginous Portion of the Eustachian Tube
Authors: Silvola Juha , Kivekäs Ilkka , Poe Dennis S. 
Published: April 2014

ObjectiveStudies of balloon Eustachian tuboplasty (BET) have shown encouraging results in small series with short follow‐ups. Our pilot study suggested that patients with protracted otitis media with effusion (OME) or atelectasis of the tympanic membrane (TM) could benefit from BET.Study DesignA prospective study where subjects act as their own controls. Patients from the pilot study and additional cases were enrolled in this cohort with long‐term follow‐up.SettingRegional Academic Center.Subjects and MethodsOut of 80 patients who underwent BET, 41 consecutive Eustachian tube (ET) operations were included. Subjects’ inclusion criteria were OME and/or TM atelectasis, type B or C tympanograms, and inability to inflate their middle ears by Valsalva maneuver. All patients had longstanding ET dysfunction relieved only by repeated tympanostomies. Outcomes included ability to perform a Valsalva maneuver, audiometry, tympanometry, videoendoscopy of the ET with mucosal inflammation rating scores, and otomicroscopy.ResultsAll cases were dilated successfully, without significant complications. Mean follow‐up was 2.5 years (range, 1.5‐4.2 years). Eighty percent (33/41) could do a Valsalva maneuver postoperatively; none of these ears required new tympanostomy tubes and subjective symptoms were relieved. Tympanometry results showed overall improvement. Nine patients had persistent perforations and 3 declined removal of the tube. Subjective symptoms were not relieved for 10% (4/41).ConclusionThe results show that BET can effectively improve ET function in ears with OME or atelectasis. The procedure is well tolerated and without significant complications. The follow‐up continues and we are investigating possible reasons for failures.
Choroidal changes after cardiopulmonary bypass
Authors: Pekel G , Alur İ , Alihanoglu YI , Yagci R , Emrecan B 
Published: April 2014

Aim: Choroid, which is the vascular tissue responsible for blood supply to the outer parts of the retina, might be affected by hemodynamic events. We aimed to reveal choroidal thickness and ocular pulse amplitude changes after cardiopulmonary bypass in which gross hemodynamic alterations occur. Methods: Forty-two eyes of 42 patients who underwent heart surgery with cardiopulmonary bypass were examined in this prospective, cross-sectional case series. The spectral domain optical coherence tomography (Spectralis, Heidelberg, Germany) was used to analyze sub-foveal choroidal thickness. The ocular pulse amplitude, the surrogate of gross choroidal blood flow, was measured with the Pascal dynamic contour tonometer (Pascal DCT, Swiss Microtechnology AG, Port, Switzerland).. The intraocular pressure was also measured with this tonometer. The examinations were performed pre-operatively and post-operatively at the first week and first month. Results: The mean age of the patients was 58.8 ± 12.4 years. The mean sub-foveal choroidal thickness and ocular pulse amplitude values did not change statistically significantly after the operations at the follow-up visits (p>0.05). Also, there were no important correlations between cardiopulmonary bypass time and mean sub-foveal choroidal thickness and ocular pulse amplitude changes at the post-operative first week (p>0.05). The intraocular pressure values were decreased markedly at the control visits (p<0.05). Conclusions: Sub-foveal choroidal thickness and ocular pulse amplitude are unchanged, while intraocular pressure decreases one week and one month after cardiopulmonary bypass.
Two novel SCN1A mutations identified in families with familial hemiplegic migraine
Authors: Weller Claudia M , Pelzer Nadine , de Vries Boukje , López Mercè Artigas , De Fàbregues Oriol , Pascual Julio , Arroyo María A Ramos , Koelewijn Stephany C , Stam Anine H , Haan Joost , Ferrari Michel D , Terwindt Gisela M , van den Maagdenberg Arn MJM 
Published: April 2014

Background Familial hemiplegic migraine (FHM) is a rare monogenic subtype of migraine with aura, characterized by motor auras. The majority of FHM families have mutations in the CACNA1A and ATP1A2 genes; less than 5% of FHM families are explained by mutations in the SCN1A gene. Here we screened two Spanish FHM families for mutations in the FHM genes. Methods We assessed the clinical features of both FHM families and performed direct sequencing of all coding exons (and adjacent sequences) of the CACNA1A, ATP1A2, PRRT2 and SCN1A genes. Results FHM patients in both families had pure hemiplegic migraine with highly variable severity and frequency of attacks. We identified a novel SCN1A missense mutation p.Ile1498Met in all three tested hemiplegic migraine patients of one family. In the other family, novel SCN1A missense mutation p.Phe1661Leu was identified in six out of eight tested hemiplegic migraine patients. Both mutations affect amino acid residues that either reside in an important functional domain (in the case of Ile1498) or are known to be important for kinetic properties of the NaV1.1 channel (in the case of Phe1661). Conclusions We identified two mutations in families with FHM. SCN1A mutations are an infrequent but important cause of FHM. Genetic testing is indicated in families when no mutations are found in other FHM genes.