bluuebunny/crossref_metadata_2025_split huggingface dataset:
Therapeutic Effect of Middle Ear Tendon Resection on Middle Ear Myoclonic Tinnitus
Authors: Park Shi‐Nae , Kim Dong Kee , Park So Young , Lee Sung‐Hun , Park Kyoung‐Ho , Yeo Sang‐Won 
Published: September 2014

Objectives:Tinnitus secondary to middle ear myoclonus (MEM) is very rare but troublesome symptom. Recently, we published a paper about the clinical characteristics and the general therapeutic effects of this rare type of tinnitus in a large case series. Here in this study, we evaluated the therapeutic effects of middle ear tendon resection surgery on intractable tinnitus caused by MEM.Methods:This study included 20 patients with intractable tinnitus diagnosed with MEM and treated eventually with surgical resection of middle ear tendons through January 2007 to December 2013. Clinical characteristics and therapeutic response to surgical therapy were thoroughly evaluated.Results:Patients had a mean age of 32.3 years (range, 16‐60 years) and the male to female ratio was 10 to 10. The most frequent nature of their tinnitus was crackling sound. Impedance audiogram and otoendoscopic examination of the tympanic membrane were helpful in diagnosing MEM. Postoperatively, tinnitus decreased or even immediately disappeared in all cases of the study. Scores of tinnitus visual analog scale (VAS) and Tinnitus Handicap Inventory were significantly decreased. One of the patients showed delayed facial nerve palsy with complete recovery in 2 weeks. One patient showed the recurrence of symptom of MEM tinnitus within 1 year and was completely recovered by re‐operation.Conclusions:Sectioning of the middle ear tendons for middle ear myoclonic tinnitus seems to be safe and effective which can be considered as a promising treatment modality for intractable MEM tinnitus.
Tight Subperiosteal Pocket during Cochlear Implant Surgery: Results in a Large Cohort of Patients
Authors: Sweeney Alex D. , Carlson Matthew L. , Valenzuela Carla V. , Bennett Marc L. , Wanna George B. , Rivas Alejandro , Haynes David S. 
Published: September 2014

Objectives:(1) Investigate the results of cochlear implant receiver‐stimulator (RS) placement using the tight postauricular subperiosteal pocket technique. (2) Compare the efficiency of solely using a tight subperiosteal pocket compared to the conventional bone‐recess technique.Methods:Retrospective series from a tertiary academic referral center. All primary and revision cochlear implant patients in whom the RS was placed into a tight subperiosteal pocket without additional fixation were included. Primary outcome measures included RS migration, prevalence of flap complications requiring revision surgery, and time difference comparing the conventional bony well and trough technique to use of a tight subperiosteal pocket.Results:Two hundred consecutive cochlear implants (average age 46.9 years) were analyzed. At a mean follow‐up of 12.8 months, only 1 patient experienced device migration; however, none have required revision to date for complications related to RS placement. One patient experienced a hematoma that was managed with observation, and no other soft‐tissue flap complications occurred. The subperiosteal pocket technique resulted in a 20% reduction in total operative time compared to conventional RS placement methods (P <. 01).Conclusions:The tight subperiosteal pocket is a safe, durable, and time saving technique for RS placement during cochlear implantation. Notably, the prevalence of device migration was exceedingly low, and none have required revision surgery for device drift or flap complications to date.
Ubiquitous Aspirin: A Systematic Review of Its Impact on Sensorineural Hearing Loss
Authors: Kyle Meghann E. , Wang James C. , Shin Jennifer J. 
Published: September 2014

Objectives:The primary goal of this systematic review was to test the null hypotheses: (1) aspirin has no impact on the prevalence of sensorineural hearing loss; and (2) any such impact is not dose‐dependent.Methods:Computerized searches of MEDLINE, PubMed, Cochrane, and EMBASE databases through January 2014 were performed with manual searches and inquiries to topic experts. A systematic review was performed according to an a priori standardized protocol. Data extraction was performed by 2 independent parties (an audiologist and an otolaryngologist) and focused on relevant audiological measurements, study designs, and potential confounders.Results:The 37 criterion‐meeting studies included a combined total of 185,155 participants. Audiometric data consistently suggested aspirin had a deleterious, dose‐dependent effect. The strongest data analysis arose from a randomized placebo‐controlled trial, which demonstrated worse pure tone thresholds, speech discrimination scores, and hearing in background noise in the group receiving aspirin in 325 mg doses. Data from self‐report of hearing symptoms suggests the potential for effect modification by sex. Paradoxically, level 1 evidence also demonstrates that aspirin has a protective effect on hearing when co‐administered with gentamicin.Conclusions:With the large‐scale population use of aspirin for cardiovascular prophylaxis and other benefits, the potential risks to hearing health should be considered, particularly given that the effects may be reversible or improved with altered dosing. With the increasing prevalence of hearing loss in all age groups and segments of the population, attention to widespread exposures of risk may help preserve hearing‐related health.
Value of Endoscopy in Surgical Procedures to Stapedial Region
Authors: Alicandri‐Ciufelli Matteo , Marchioni Daniele , Villari Domenico , Presutti Livio 
Published: September 2014

Objectives:Evaluate the role of endoscopic approaches during exclusive or combined (microscopic and endoscopic) procedures to stapedial region, particularly in difficult cases or in anatomic abnormalities.Methods:From 2009 to 2014, 56 endoscopic exclusive or combined (microscopic and endoscopic) approaches to the stapedial region were performed at the otolaryngology department, University Hospital of Modena. Operations performed were stapedoplasties or explorative tympanotomies for conductive hearing loss. Video, patient charts, and operative reports from surgeries were reviewed in February 2014. Cases in which stapedial abnormalities were identified were included and analyzed in the present study.Results:In 8 cases a malformed stapes was identified. Of those, 6 were eventually treated, while in 2 cases, after a diagnosis was made, a conservative attitude was chosen. Under endoscopic view, precise procedures under direct view were made possible, even in very delicate and hidden regions.Conclusions:Whether chosen as a pure explorative tool, or as the main operatory visualization modality, endoscopy can guarantee very good visualization of the stapedial region, and may help in diagnosing and fixing altered stapedial conditions.
Comparison of Hybrid Laryngotracheal Reconstruction to Traditional Single and Double‐Stage Laryngotracheal Reconstruction
Authors: Raol Nikhila P. , Rogers Derek J. , Setlur Jennifer , Hartnick Christopher J. 
Published: September 2014

Objectives:(1) Describe outcomes from and modifications to the hybrid, also known as the one‐and‐a‐half stage, laryngotracheal reconstruction (LTR) technique. (2) Compare this technique to traditional single and double‐stage LTR (ssLTR/dsLTR).Methods:Retrospective review of patients under 18 years of age who underwent LTR by a single surgeon at a tertiary care otolaryngology specialty hospital from July 1, 2009, to December 31, 2013, was performed. Charts were assessed for age, sex, etiology of stenosis, type of reconstruction, comorbidities, length of stay, complications, and tracheostomy status.Results:Forty‐four patients were identified, with 13 one‐and‐a‐half stage LTRs, 27 ssLTRs, and 4 dsLTRs. Of the one‐and‐a‐half stage LTRs, an operation‐specific decannulation rate of 77% was noted, comparable with those for ssLTR and dsLTR. The one‐and‐a‐half stage LTR technique offered a significantly shorter period of narcotic use when compared with ssLTR (16 vs 23 days, P <. 01). Average length of stay for ssLTRs and hybrid LTRs was identical at 16 days; difference in length of stay between hybrid and dsLTRs was not statistically significant (16 vs 12.5 days, P =. 16).Conclusions:The hybrid LTR technique is well‐tolerated and useful in patients of all ages. Narcotics are able to be weaned more quickly because of the presence of a secure airway at all times via the existing tracheostomy. Use of a long stent prevents formation of granulation tissue that may be seen with a suprastomal stent. This technique should be considered in patients with high‐grade stenosis with a pre‐existing tracheostomy.
Ear Disease following Cleft Lip and Palate Surgery without Tympanostomy Tube Placement
Authors: Markey Jeff D. , Maine Rebecca G. , Daniels Kimberly , Corlew D. Scott , Gregory George , Palacio Herminia 
Published: September 2014

Objectives:(1) Describe the current benefits and risks associated with perioperative prophylactic myringotomy during cleft lip/palate surgery. (2) Recognize potential predictive factors associated with middle ear disease following cleft lip/palate surgery. (3) Incorporate ethnic differences into treatment algorithms regarding tympanostomy tubes.Methods:A total of 241 children (129 Ecuadorian, 112 Chinese) underwent cleft lip/palate repair (2000‐2009). Veau classification, age, history of ear infections, and cleft side were recorded. Average age was 2.4 years and 11.1 years for Ecuadorian and Chinese children, respectively. No patients underwent tympanostomy tube placement. Following surgical correction, serial otoacoustic emissions (OAE) testing, and tympanometry were performed, and a parental questionnaire was administered regarding behavioral hearing deficits and history of ear infections before and after surgery. Data were recorded and compared individually for the 2 populations and as a group to identify disease prevalence and correlative factors.Results:No association existed between Veau classification and deficits in tympanometry, OAE, or subjective hearing. Reported ear infections after surgery were fewer than before but were not significant (26% to 21%). Abnormal OAE testing was associated with abnormal tympanometry and subjective hearing deficits (P <. 0001 and P =. 004). Ecuadorian children had higher number of ear infections pre‐ and postoperatively (P =. 043 and P <. 001) and higher number of abnormal tympanograms (P =. 003). No significant difference existed regarding OAE testing.Conclusions:Severity of the cleft lip/palate is not a predictive factor of middle ear disease and hearing impairment when no tympanostomy tube is placed. Ideal pressure equalization tube protocols should incorporate ethnic differences.
The Efficacy of Mometasone Furoate Nasal Spray in the Treatment of Adenoidal Hypertrophy in Children
Authors: Hassanzadeh Nadia , Majidi Mohammad R. , Salehi Maryam , Hajipour Reyhaneh 
Published: September 2014

Objectives:Realize whether the adenoid size and severity of chronic nasal obstruction symptoms may decrease with intranasal mometasone furoate application in children affected with adenoidal hypertrophy.Methods:Forty children with severe adenoidal hypertrophy (aged between 4‐12 years) were recruited between August 2012 and April 2013 in a prospective randomized clinical trial. Primary nasal endoscopy showed more than 75% choanal obstruction in all patients. Subjects were randomly divided into 2 groups. The study group (n = 20) underwent mometasone nasal spray treatment (100 micrograms per nostril every 12 hours) for 4 weeks, and the control group (n = 20) received saline solution nasal spray as placebo in the same manner. Adenoid size and subjective symptoms were evaluated and compared between the 2 groups.Results:At the start of the experiment, there was no significant difference in the mean scores for any of the subjective symptoms (nasal obstruction, snoring, mouth breathing) between the 2 treatment groups. At the end of 4 weeks, statistically significant improvement was observed in total subjective symptom scores with mometasone treatment compared with placebo (P <. 05). A significantly greater number of patients in the study group showed a reduction in adenoid size compared with the control group (70% versus 20%, P =. 001).Conclusions:Treatment with mometasone furoate nasal spray causes a substantial improvement in nasal obstruction symptoms and reduction in size of adenoid in children with adenoidal hypertrophy and may obviate the need for surgery in these patients.
Hospital and Surgeon Adherence to Pediatric Tonsillectomy Guidelines Regarding Perioperative Dexamethasone and Antibiotic Administration
Authors: Padia Reema , Wilkes Jacob , Korgenski Kent , Srivastava Rajendra , Meier Jeremy D. 
Published: September 2014

Objectives:American Academy of Otolaryngology—Head and Neck Surgery 2011 guidelines for pediatric tonsillectomies recommend routine administration of perioperative dexamethasone and against routine antibiotic administration. The purpose of this study is to review adherence to these 2 guidelines.Methods:An observational cohort was reviewed of all children ages 1 to 18 years undergoing same‐day‐surgery adenotonsillectomy (T&A) at a multi‐hospital network from 2007 to 2012. A standardized electronic data system was used to determine whether dexamethasone and/or antibiotics were given in the hospital. The rate of dexamethasone and antibiotic administration was compared in the years 2007 to 2011 (preguidelines) with the year 2012 (postguidelines).Results:The study cohort included 16,310 children undergoing T&A at 19 hospitals by 61 surgeons. A total of 91.3% of the patients from 2007 to 2011 (N = 13,557) received dexamethasone compared with 93.2% of the children in 2012 (N = 2,753). A total of 18.2% of the children from 2007 to 2011 received antibiotics compared with 14.7% in 2012 (P <. 05). Dexame‐thasone was given in the majority of cases before and after the guidelines were published. Seventeen of the 61 surgeons administered antibiotics in more than 50% of the cases in 2007 to 2011. Postguidelines in 2012, only 2 of these 17 surgeons adhered to the guidelines by not giving antibiotics in the majority of cases.Conclusions:The majority of hospitals and surgeons administered perioperative dexamethasone before and after the guidelines were published. While the rate of antibiotic administration statistically decreased in 2012 compared to 2007‐2011, only 2 surgeons appeared to have changed their practice. With the purpose of the guideline to limit the risks and side effects of perioperative antibiotics, interventions are needed to improve guideline adherence.
Outcome of Overlay versus Underlay in Pediatric Tympanoplasty
Authors: Duval Melanie , Park Albert H. 
Published: September 2014

Objectives:Determine whether overlay tympanoplasty has equivalent outcome to underlay tympanoplasty in children.Methods:A retrospective cohort study was performed. Data from primary tympanoplasties performed between 2005 and 2013 in children ages 2 to 13 years old by a single surgeon at a single pediatric tertiary care institution were reviewed. Outcome reviewed included anatomical success, hearing results and cholesteatoma.Results:A total of 104 cases were included; 21 overlay and 83 underlay tympanoplasties. Children having undergone an overlay tympanoplasty were more likely to have an anterior perforation (P =. 003); other characteristics were similar between the 2 groups including size of the perforation. The rate of anatomical success was 82% for underlay and 95% for overlay tympanoplasties (odds ratio = 4.41, P =. 006). Children having undergone an overlay tympanoplasty had significantly worse hearing results (P =. 02) and had an increased rate of post‐tympanoplasty cholesteatoma (P =. 03). After multivariate analysis controlling for the effect of perforation location and size the odds of anatomical success after overlay tympanoplasty was 2.45 times greater (P =. 44) compared to underlay tympanoplasty. Age and craniofacial anomalies were not found to influence the success rate of overlay compared to underlay tympanoplasty.Conclusions:In the current series, overlay pediatric tympanoplasty was associated with a higher rate of anatomical success, but worse hearing outcome and increased risk of cholesteatoma. Further, larger studies are needed to define which children benefit from the increased anatomical success rate of overlay tympanoplasty.
Pediatric Head and Neck Malignancies: Incidence and Trends 1973 to 2010
Authors: Hughes Charlotte , Schwartz Isaac E. , Brigger Matthew T. 
Published: September 2014

Objectives:Determine the current epidemiology of head and neck cancer in the US pediatric population.Methods:The SEER (Surveillance, Epidemiology, and End Results) database was accessed to gather epidemiologic data regarding pediatric head and neck cancer between 1973 and 2010. Specific trends related to demographic background, histologic diagnosis, tumor location and incidence, as well as general trends of all pediatric cancers were extracted.Results:The total burden and incidence rates of pediatric cancer as well as head and neck cancer specifically continue to rise. Cancer was diagnosed in children under15 years of age at a rate of 12.5 (95% confidence interval [CI] 11.9‐13.1) per 100,000 from 1973 to 1975 and 17.3 (95% CI 16.7‐17.9) per 100,000 in 2007 to 2009, representing an increase of 38%. Head and neck cancers in the same age group increased from 1.1 (95% CI 1.0‐1.3) per 100,000 in 1973 to 1975 to 2.0 (95% CI 1.8‐2.2) per 100,000 in 2007 to 2009, a total increase of 81%. Despite this increased incidence, the proportion of head and neck cancers to all cancers in the pediatric population has remained stable.Conclusions:Similar to pediatric cancer in general, the public health burden of pediatric head and neck cancer continues to rise. Although the proportion of head and neck malignancy to pediatric cancer in general is stable, the increasing incidence raises concern for potential underlying associations that may be amenable to intervention.
Prevalence and Risk Factors of Otitis Media with Effusion Among School Children in Saudi Arabia
Authors: Abou‐Halawa Ashraf S. , Alhumaid Humaid I. 
Published: September 2014

Objectives:Determine prevalence of otitis media with effusion (OME) in school children and analyze relevant risk factors.Methods:Through a cross‐sectional study, 1488 children in the age range, 6 to 12 years were randomly selected from 25 primary schools. A questionnaire was used to determine risk factors for OME. Otoscopy and tympanometry were used to diagnose and confirm OME. Pure tone average for children with confirmed OME was measured. Teachers of the children were asked to complete a questionnaire evaluating child's level of school performance. Those with or without OME were compared.Results:Prevalence of OME was 7.5% (112/1488). In univariate analysis, it was strongly associated with recurrent acute otitis media (AOM; P <. 0001) a large family size (P <. 0001), young age (P <. 0001), low maternal education (P <. 0001), and hearing loss symptom (P <. 0001). OME was significantly higher in schools located in rural districts (P <. 001). It is less strongly associated with history of preschool acute otitis media (P =. 002), nasal discharge (P =. 003), and snoring (P =. 03). Of these factors, 5 were found to be significant in the multivariate logistic regression model: age (odds ratio [OR] = 0.191, 95% confidence interval [CI]: 0. 124‐0.295), family size (OR = 4.192, 95% CI: 2.033‐8.643), school district (OR = 3.037, 95% CI: 1.933‐4.772), maternal education (OR = 0.399, 95% CI: 0.256‐0.621), and recurrent AOM (OR = 4.914, 95% CI: 2.677‐9.02).Conclusions:Prevalence of OME in Qassim region reaches 7.5% in school children. Young age, large family size, low maternal education, preschool AOM, hearing loss symptom, recurrent AOM, nasal discharge, and snoring are significant factors associated with the disease.
Standardizing OSA‐18 Instrument for Use as Metric in Pediatric Otolaryngology
Authors: Leslie Jessica , Bannos Cassandra , Kirby Alexann , Roberson David W. 
Published: September 2014

Objectives:(1) Determine whether the change in obstructive sleep apnea (OSA)‐18 pre‐ and posttonsillectomy could serve as a measure of surgical success. (2) Determine the practicality of administering pre‐ and posttonsillectomy OSA to a valid patient sample. Obstructive Sleep Apnea 18 (OSA‐18), a validated instrument, assesses quality of life (QOL) relative to severity of sleep‐related problems. Higher OSA‐18 scores are associated with poorer QOL.Methods:Prospective, case series methodology at a tertiary pediatric hospital. Patients undergoing tonsillectomy ± adenoidectomy for sleep‐disordered breathing (SBD). Two distribution‐collection methods were trialed attempting to systemize the process. In phase one (14 months) we collected pre‐intervention scores during the ambulatory clinic visit. In phase 2 (8 months) a single provider distributed pre‐intervention instruments to parents on the day of surgery. Both methods sent post‐tonsillectomy instruments using a web‐based tool.Results:In phase 1, 348 pre‐intervention instruments were collected. Fifty‐eight (16%) met inclusion criteria, and of these, 22 (38%) completed the postintervention instrument. In phase 2, 11 pretonsillectomy scores were collected, and 6 (55%) of these completed the posttonsillectomy instrument. In both groups, the average change in OSA‐18 was 33 points (1: 65 pre, 31 post; 2: 61 pre, 29 post, respectively).Conclusions:The OSA‐18 instrument demonstrates tonsillectomy +/‐ adenoidectomy is very successful at improving pediatric OSA‐related QOL. These data could document the value of the procedure. However, collecting pre‐ and post‐intervention scores from busy parents is operationally burdensome and only modestly successful. Use of change in OSA‐18 as an outcome metric will require a yet‐to‐be‐determined strategy to reliably collect pre‐and post‐surgery scores.