bluuebunny/crossref_metadata_2025_split huggingface dataset:
Necrotizing Otitis Externa
Authors: Barbosa Maria H. , Cruz Fabiana C. , Felix Fellipe , Tomita Shiro , Marques Marise P. , Sousa Sergio , Quintanilha Jaqueline 
Published: February 2015

ObjectiveEvaluate the cases of necrotizing otitis externa (NOE) with regard to gender, mean age, comorbidities, clinical presentation, involvement of cranial nerve and its resolution, isolated germs at culture of swabs or biopsies of EAM, and findings at image evaluation.MethodThe patient presented severe otalgia, auricular plenitude and right peripherical facial palsy. He submitted to a swab test and also to a biopsy of the external auditory meatus. Other examinations were requested: a complete blood count, C‐reactive protein, a mastoid computer tomography, and mastoid scintigraphy.ResultsTen patients were evaluated, 4 of them were women and 6 men. All of them had type II diabetes. The most common initial finding was external meatus polyps (90% of the cases), followed by cranial nerve palsy (50% of the cases). There was complete remission of that palsy in 51% of the cases, incomplete remission in 16%, and no remission in 33% after treatment. In most of the cases, Pseudomonas aeruginosa was found (60%). Mastoid and external auditory meatus alterations were the most common disturbance in computed tomography.ConclusionThis case reports a patient with a cellular immunosuppression disease which appeared to have an NOE complicated by cranial nerve paralysis based on his clinical picture and complementary evaluation except for the scintigraphy study. The histopathological analysis revealed a neoplastic etiology for the ear involvement.
Postural Response to Unexpected Changes
Authors: de Abajo Jorge , Perez Nicolas 
Published: February 2015

Objective1) Determine the characteristics of postural responses to unexpected changes in the support‐surface in patients with unilateral peripheral vestibular deficit and analyze differences between patients achieving a clinical compensated status and those without. 2) Find out which is the best clinical data to predict the vestibular compensation status.MethodTwenty‐seven adults suffering unilateral peripheral vestibular deficits (vestibular neuritis, Ménière’s disease, neurinoma, trauma and benign recurrent vertigo) were included. Neurocom equipment was used to create pulses unexpectedly. Sway Star system was used to measure the angle and the angular velocity of the body during the stimulus.ResultsThe range of peak to peak excursion, the area of the displacement angle, the range of peak to peak velocity excursion in pitch and roll directions and the mean path velocity were studied. When using the caloric test results to classify the patients as compensated or not compensated significant differences (p minor to 0.001) of the body angle in the roll direction were found, although all the stimuli were made in the pitch direction. However, when using the caloric test, the cardiovascular risk or the patient’s clinical course to classify the groups, no differences were found.ConclusionThe rotatory test is the best diagnostic method to predict vestibular compensation status of patients with vestibular deficits. Patients suffering vestibular deficit with an uncompensated status, have more difficulties to give an appropriate postural response in the roll direction to unexpected support‐surface movements.
Recurrence in Cholesteatoma Surgery and the Use of Laser
Authors: Son Hwa Jung , Samy Ravi N. , Meinzen‐Derr Jareen 
Published: February 2015

ObjectiveCholesteatomas have a high‐rate of recurrence, regardless of the surgical approach used. Our hypothesis was that use of the handheld CO2 laser would reduce recurrence of cholesteatoma by removing microscopic disease, particularly in challenging or difficult to treat areas.MethodA total of 384 mastoidectomies performed by a single‐surgeon between 2006 and 2011 were reviewed (22 in the non‐laser and 23 in the laser group that met the inclusion criteria). Outcome measures included recurrence rate and complication rates. Independent variables included smoking status, bilaterality and the extent of disease as assessed by Marres staging (1984).ResultsAverage follow‐up was 25 months; average separation between the first and second stage was 8 months. There were 1 Marres stage 1, 29 stage 2, 1 stage 3, and 13 stage 4 patients and the distribution between the 2 groups was similar. There were no facial nerve paralysis cases, and 1 sensorineural (SNHL) hearing loss after the first procedure in the nonlaser group. There was no difference in the rate of recidivism noted at the second stage between the laser group (34.8%) and nonlaser group (30.4%). There was no apparent correlation between smoking status or bilaterality of disease and recurrence.ConclusionWhile the safety of cholesteatoma surgery with handheld laser is confirmed without any incidence of SNHL or facial nerve paresis, in this retrospective study, there does not appear to be any reduction in the rate of recidivism. A prospective study is clearly warranted to demonstrate efficacy.
Electroacoustic/Clinical Study of Inexpensive Hearing Aid
Authors: Babu Seilesh 
Published: February 2015

Objective1) Understand whether a new low‐cost (<$200) hearing aid has adequate technical specifications. 2) Learn if patients with mild to moderately severe hearing loss report satisfaction scores comparable to those reported in the literature while using this hearing aid.MethodAn analysis of the hearing aid was performed evaluating critical electroacoustic parameters. A prospective study was performed on 9 patients from August 2010 to July 2011 who wore the device for 30 days and completed 2 surveys: “International Outcome Inventory–Hearing Aids” and “Satisfaction with Amplification in Daily Living.”ResultsThe hearing aid met gain and output targets previously described in the literature. All 9 participants completed the study. The device met the range of norms for all 7 items in the IOI‐HA (P <. 05) and for 3 of the 5 categories of SADL.ConclusionThe low‐cost hearing aid was found to be electroacoustically adequate and a reasonable low‐cost solution to meet the needs of those value‐ and cost‐conscious patients with up to moderately severe hearing loss who were not using amplification via a custom hearing device due to cost considerations.
The Association of Anterior Inferior Cerebellar Artery in IAC with Tinnitus and Hearing Loss
Authors: Cho Yong Hee , Lee Seung‐Hwan , Park Chul‐won , Min Hyun Jung , Choi Eui Je , Oh Jae Ho , Lee Dong Won 
Published: February 2015

ObjectiveTinnitus is a common disorder, but the etiology of this disorder remains unknown. The objective of this study was to assess the correlation between anatomic type and the thickness of the anterior inferior cerebellar artery (AICA) loop with tinnitus, using 3D‐fast imaging employing steady state acquisition magnetic resonance image (MRI).MethodSeventy‐four patients with tinnitus and 82 asymptomatic controls were included in this study. Otologic symptoms, which were measured based on the results of a pure tone audiometry, were reviewed. We evaluated the position and thickness of the AICA vascular loop in 3D‐FIESTA MRI using 2 scoring systems. The first system was Chavda classification based on the anatomic location of the AICA loop. The second scoring system was used to measure the thickness of the AICA loop. The AICA loops were classified into 2 groups based on thickness, thinner than adjacent facial nerve and thicker than the facial nerve.ResultsEars with type I, II AICA loops showed significantly higher rates of tinnitus than those with type III. There was no association between the type of AICA loop and subtype of tinnitus (pulsatile, nonpulsatile). There was no association between the type of tinnitus and hearing loss. Ears with thinner AICA loop had a higher rate of tinnitus than those with thicker AICA loop.ConclusionThe type I, II and thinner AICA loop was significantly correlated with tinnitus. Compression of VIIIth cranial nerve by AICA loops at a cerebellopontine angle and impaired blood flow through thevessel may be the pathophysiology of tinnitus.
Vestibulopathy in Childhood and Adolescence
Authors: Duarte Juliana A. , Ganança Fernando F. , Chen Vitor G. , Almeida Roberta R. , Campos Roberto A. , Silva Maria Laura S. , Pires Anna Paula B. A. 
Published: February 2015

ObjectiveEvaluate diagnosis and treatment aspects at a clinic for children with otoneurology disorders.MethodRetrospective case series, held in otoneurology pediatric service. We evaluated the charts of all patients seen from 2006 to 2010.ResultsEighty‐eight patients were included. The average age was 9.87 years. There were 46 girls (52.27%). The most prevalent diagnosis was BPVC in 48 (54.54%) cases, followed by vestibular metabolic syndrome (VMS), 21 (23.86%), and vestibular migraine in 10 (11.36%) patients. The majority (77.27%) had poor eating habits. The majority, 48 (54.54%), complained of vertigo. The vectoelectronystagmography (VENG) showed no changes in 22 (41.51%). In 30 (43.47%) patients improvement was noted with vestibular rehabilitation and dietary counseling, and dietary counseling alone was administered in 27 (39.13%) patients.ConclusionThere was a predominance of the diagnosis of BPVC. Its close relationship with a history of migraine and its benign nature of evolution were noted. We noted the importance of monitoring, dietary counseling, and the role of vestibular rehabilitation on vestibular childhood and adolescence.
A Comparison of Revision Adenoidectomy Rates by Technique
Authors: Sapthavee Andrew , Billings Kathleen , Penn Edward 
Published: February 2015

ObjectiveNo studies are available comparing revision adenoidectomy rates between patients who underwent suction coagulator or powered‐shaver (microdebrider) techniques at their initial surgery. Our objective is to compare revision adenoidectomy rates between these 2 instrument groups. This information may be able to guide technique selection and assist training resident otolaryngologists.MethodThis study is a retrospective chart review of patients who underwent revision adenoidectomy at Children’s Memorial Hospital in Chicago, Illinois, from June 2007 through December 2011. The patients were divided into 2 groups based on technique of adenoidectomy used at the time of initial surgery, and the regrowth rate analyzed.ResultsDuring the 4.5‐year study period, 7399 adenoidectomies or adenotonsillectomies were performed. A total of 94 revisions were performed (1.27%). Microdebrider was used in 4071 adenoidectomies, and the remaining 3328 cases were performed with mainly electrocautery, and less often curette or coblator. Total revisions done with the microdebrider at initial surgery during the time period was 33 (0.81%). Total revisions done with the suction bovie at initial surgery was 46 (at least 1.38%). The mean age at presentation for primary adenoidectomy was 2.85 years. The average interval until revision adenoidectomy was 29 months. These data will be further analyzed statistically.ConclusionSymptomatic regrowth of adenoid tissue is rare. There was a trend toward a lower rate of adenoid regrowth requiring revision surgery in those who underwent microdebrider versus suction bovie adenoidectomy initially. Revision adenoidectomy occurs at a rate of 1.3% overall, while the revision rate with the microdebrider technique is 0.8%.
Adenotonsillar Surgery and Guidelines in Italy
Authors: Motta Gaetano , Testa Domenico , Spadera Lucrezia , Landolfo Pasquale Gianluca , Massimilla Eva Aurora , Motta Sergio 
Published: February 2015

Objective1) Ascertain the impact that guidelines on (adeno)‐tonsillectomy have had on the clinical behavior of ENT specialists in Italy. 2) Evaluate the indications—inclusion criteria—for adeno‐tonsillar surgery in children, adopted by ENT specialists, particularly referring to comorbidities.MethodA multicentric study including 14770 children undergoing (adeno)‐tonsillectomy in 2002, 2004, 2006, and 2008 was conducted in 14 Italian otorhinolaryngological units. Data regarding indications and surgical procedures were gathered using a predesigned questionnaire and elaborated with analysis of variance, taking P value <.05 as the threshold for statistical significance.ResultsOver the 4‐year study period, the incidence of the analyzed interventions did not significantly change (P value >.05), with adenotonsillectomy comprising the most commonly performed (64.1%). No significant variations in the indications for these operations were observed, except for adenotonsillectomy in children having 5 or more feverish episodes in the preceding year without nasal obstruction (decreased: P =. 010). The coexistence of feverish episodes and nasal obstruction was the most frequent surgical indication (65.2%). We also found a high preoperative incidence of middle ear inflammations (43.3%), recovered or improved persistently in 88.5% of the cases after surgery.ConclusionItalian guidelines were not implemented by ENT units involved in the survey; in most cases the indications for adeno‐tonsillectomy are based on the overall clinical presentation rather than on a single symptom. The need to review the Italian guidelines is evident.
Characteristics of Patients Undergoing Supraglottoplasty
Authors: Garritano Frank G. , Carr Michele M. 
Published: February 2015

Objective1) To examine the characteristics of patients undergoing supraglottoplasty for the treatment of laryngomalacia. 2) To better understand the features of laryngomalacia that may predispose patients to the need for future supraglottoplasty.MethodRetrospective case series evaluating patients who underwent supraglottoplasty for laryngomalacia at our academic tertiary care children’s hospital between 2005 and 2012 and examining their demographic information, medical comorbidities, symptoms, indications for surgery, operative findings and procedure, site of laryngeal obstruction, operative techniques, and surgical success rates.ResultsFifteen patients with laryngomalacia underwent seventeen procedures. The most common indications for supraglottoplasty were persistent stridor (93.3%), difficulty feeding (53.3%), and failure to thrive (33.3%). The most common comorbidities were gastroesophageal reflux (86.7%) and cardiopulmonary disease (40%). Operative findings included shortened aryepiglottic folds in 14 patients (93.3%), retropositioned epiglottis in 14 (93.3%), and prolapsed arytenoids in 4 (26.7%). Thirteen patients (86.7%) underwent division of the aryepiglottic folds and 4 underwent ablation of arytenoid mucosa (26.7%). Of the 14 patients who had followed up at the study conclusion, 13 (92.9%) had symptom improvement and 9 (64.3%) had complete resolution of their symptoms.ConclusionSupraglottoplasty is an effective treatment for laryngomalacia. Outcomes in our patients are similar to those reported in prior literature. The findings of shortened aryepiglottic folds and a retropositioned epiglottis appear to be disproportionately represented in our cohort of patients undergoing supraglottoplasty.
IgE in Infants with Laryngomalacia: Risk for Asthma
Authors: Abdel‐Aziz Mahmoud F. 
Published: February 2015

ObjectiveTo evaluate a possible predictive value for developing asthma later on in infants with laryngomalacia by measuring specific immunoglobulin E (IgE) antibodies to food and/or inhalant allergens.MethodSixty‐four children having congenital laryngeal stridor “laryngomalacia” before 18 months of age were followed prospectively until early school age. Serum levels of food and inhalant allergen‐specific IgE antibodies were determined at presentation, using the CAP system IgE FEIA (Pharmacia, Uppsala, Sweden). At 6 to 8 years, the children were evaluated for asthma and allergic manifestations.ResultsAsthma was present in 24 (37.5%) children at school age. Food‐specific IgE antibodies of ≥ 0.35 kU/L were found in 27 (42%) infants, but only specific IgE to wheat and to egg white at the level of ≥ 0.35 kU/L were significantly associated with later asthma. In regard to specific IgE to the mixture of food allergens, the cutoff level of ≥ 0.70 proved to be significant. Inhalant allergen‐specific IgE of ≥ 0.35 kU/L was found in 16 cases (25%) and was significantly predictive of asthma.ConclusionPresence of specific IgE of ≥ 0.35 kU/L to wheat, egg white, or inhalant allergens are predictive of later childhood asthma. Consequently, detection of those specific IgE antibodies in those infants may facilitate the early diagnosis of asthma, especially in cases with no clinically evident atopic manifestations.
Immunity in Children with Chronic Tonsillitis
Authors: Danilov Lucian , Diacova Svetlana , Ababii Ion , Maniuc Mihail , Vinogradova Tatiana , Ababii Polina 
Published: February 2015

Objective1) To explore some aspects of systemic immunity reactions in chronic tonsillitis. 2) To compare systemic immunity reactions in chronic tonsillitis in children and adults.MethodProspective study design in 2011. Subjects: 24 children and 13 adults with chronic tonsillitis. Setting: Otolaryngology department, Moldova. Outcome measures: C reactive protein, antistreptolysin O, absolute and relative amount of B lymphocytes, immunoglobulins–A, M, G, circulatory immune complexes, interleukins IL‐4, IL‐8, IL‐1β in blood serum.ResultsInterleukin‐8 is 6.5 times higher in children than in adults (P =. 047), interleukin‐1β is 17.4 times higher (P =. 045). Level of serum IgA in adults is higher than in children (P =. 038), antistreptolysin–O titre is 1.4 times higher.ConclusionStudy of interleukin‐1β and interleukin‐8 is useful in understunding the etiopathogenetic mechanism of chronic tonsillitis in children. Nonspecific immune factors play an important role in immune response in chronic tonsillitis in children, while in adults the main role is held by specific immune response.
Reinnervation for Vocal Fold Paralysis: Results in Children
Authors: Setlur Jennifer , Bunting Glenn W. , Ballif Catherine , Hartnick Christopher J. 
Published: February 2015

Objective1) Exhibit long‐term follow‐up results of patients with unilateral vocal fold immobility who underwent ANSA reinnervation of the recurrent laryngeal nerve. 2) Demonstrate the appropriate studies that should be performed at the time of follow‐up.MethodRetrospective review in a tertiary care otolaryngology practice. Four patients with symptomatic unilateral vocal fold paralysis who underwent recurrent laryngeal nerve reinnervation by a single surgeon were reviewed between September 2005 and December 2011. Postoperative measurements were obtained, both subjective (voice questionnaire) and objective (acoustic measurements and aerodynamics).ResultsThe study group included 3 girls and 1 boy ages 2 to 12 years. Mean follow‐up time was 4.25 years. Causes for vocal fold paralysis were cardiac surgery (3) and skull base neoplasm (1). Voice questionnaire results (0 = severely abnormal, 100 = normal) were 100 in 2 patients, 98 in 1 patient, and 96 in 1 patient indicating a high level of satisfaction postoperatively in all patients. Mean maximum phonation time was 7.7 seconds, mean s/z ratio was 2.15, and mean subglottal pressure was 8.8 cm H2O.ConclusionChildren who undergo ANSA reinnervation of the recurrent laryngeal nerve have normal or near normal subjective voice scores. Objective scores may not reflect the same change. In this population, it may be beneficial for the practitioner to rely upon subjective measures rather than objective measures to determine treatment success.
Rib Reconstruction of Absent Mandibular Condyles in Children
Authors: Goerke Derek , Sampson Daniel E. , Tibesar Robert , Sidman James D. 
Published: February 2015

Objective1) Describe pediatric costochondral graft reconstruction of the absent mandibular condyle. 2) Report the short‐term and long‐term outcomes and complications associated with performing this procedure in young children.MethodAll children treated for an absent mandibular condyle with a costochondral graft from 2002 to 2011 at Children’s Hospitals and Clinics of Minnesota were identified and a retrospective chart review was performed. Outpatient charts, hospital records, and operative reports were reviewed.ResultsTen patients aged 3 to 11 years old were identified. The most common diagnosis in 7 out of 10 patients was oculo‐auriculo‐vertebral syndrome. Three of the patients had a tracheostomy, of which one was decannulated following condylar reconstruction. Functional improvement, defined as improved symmetry, chewing, or better oral opening, was observed in 8 out of 10 patients. Five patients have required no further surgeries to date, with a mean follow‐up time of 3.9 years. Severe overgrowth of the graft was noted in 1 case and partial or complete resorption of the graft was also noted in 3 cases. Overgrowth occurred after 5.7 years whereas resorption occurred after an average of 2.5 years.ConclusionCostochondral grafts are an excellent surgical treatment option for children with severe mandibular malformations. Short‐term results show particular improvement in function and mandibular alignment. The mean follow‐up time with no revision surgery was substantial and indicates that rib grafting is a good addition to the armamentarium of treatment for this patient population.
Hange‐Shashin‐To Gargle against Radiation‐Induced Mucositis
Authors: Yamashita Taku , Matsunobu Takeshi , Tanaka Yuya , Araki Koji , Tomifuji Masayuki , Shiotani Akihiro 
Published: February 2015

ObjectiveChemoradiation has been recognized as one of the standard therapies for head and neck cancer. However, recent intensified chemoradiation can cause serious adverse events and influence treatment completion. We investigated the effect of Hange‐Shashin‐To, an herbal medicine, against chemoradiation‐induced mucositis in the context of the completion of chemoradiation.MethodSubjects were 10 head and neck cancer patients who underwent whole neck irradiation between May and November 2011. The patients gargled with 2.5 g Hange‐Shashinto‐To mixed with tap water 3 times a day during and after chemoradiation period, prohibiting eating and drinking for 30 minutes after the gargling.ResultsTwo patients started gargling with Hange‐Shashin‐To after grade III mucositis appeared, and the other 8 began it on the commencing date of chemoradiation. In 1 of the former 2 patients, the mucositis improved until grade I despite continued chemoradiation. Although the other remained grade III until the end of radiation, the gargling was useful for treatment completion without interruption. Of the latter 8 patients, 6 had grade I and 2 had grade II as the worst mucositis level in the chemoradiation period. Grade III or IV mucositis was not observed in this case series.ConclusionOur results suggest that Hange‐Shashin‐To can alleviate mucositis from chemoradiotherapy and contribute to treatment completion without interruption. Although further studies in a large number of patients are needed to confirm our findings, Hange‐Shashin‐To may be a useful adjunctive therapy in chemoradiation for head and neck cancer.