bluuebunny/crossref_metadata_2025_split huggingface dataset:
TNM Staging Does Not Predict Survival in HPV‐Positive OPSCC
Authors: Ward Matthew J. , Mellows Toby , Riley Catherine L. , King Emma V. , Thomas Gareth J. 
Published: February 2015

Objective1) To establish the rates of HPV associated oropharyngeal SCC (OPSCC) in our local population. 2) To establish the effect of HPV on survival from OPSCC. 3) To establish relevance of TNM staging in OPSCC.MethodWe conducted a retrospective chart review of 256 consecutively treated OPSCCs in Southern England between 2000 and 2010. We recorded TNM stage and other potentially prognostic factors including differentiation, margin status, extracapsular spread, and tumor cohesion. HPV status was determined using both p16 immunohistochemistry and HPV in situ hybridization (ISH).ResultsA total of 57.4% of OPSCC were found to be HPV‐positive (p16‐positive, ISH‐positive) and had improved disease specific survival (DSS) (OR 0.290, P <. 001). TNM staging predicted for survival in HPV‐negative patients only (HPV‐ve OR 2.119, P =. 033; HPV+ve OR 2.022, P =. 49). Further analysis showed that although T stage was predictive in both cohorts (HPV‐ve OR 3.579, P =. 006; HPV+ve OR 11.654, P =. 001), N stage only predicted for DSS in HPV‐negative tumors (HPV‐ve OR 1.996, P =. 022; HPV+ve OR 1.437, P =. 623), despite the fact that a higher proportion of HPV‐positive tumors present with advanced nodal disease (N2/N3) (HPV+ve 75.3%, HPV‐ve 50.1%, P <. 001).ConclusionHPV‐positive OPSCC frequently presents with advanced nodal disease. However, in contrast to HPV‐negative disease, this does not have a negative effect on disease specific survival. These data show that classical prognostic indicators do not apply to HPV‐positive OPSCC and highlight the essential requirement for determining HPV status in OPSCC patients.
3D Reconstruction to Detect Fish Bones in Foreign Body Models
Authors: Yoo Young Sam , Lee Han Bee , Choi Jung Hwan , Cho Kyung Rai 
Published: February 2015

ObjectiveWhen fish bones are impacted in pharynx or in esophagus, it’s hard to find them with simple radiography. We designed foreign body models with fish bones and used their computed tomogram data to make 3D reconstructed images. Various modifications of 3D data were tested for foreign body detection.MethodBones from 3 species of fishes frequently consumed in Korea were used as foreign body models. Fish bones were sandwiched between plates of fish paste. Computed tomograms taken were converted into 3D images. Multi‐planar reconstruction, volume rendering, and virtual endoscopy were used to determine the characteristics of fish bones.ResultsShapes of the bones are easily reconstructed for the mandible. Gill cover and spine cannot be reconstructed perfectly. The shape could be figured out in every reconstructed image in volume rendered images after removal of soft tissue data. In measuring size, plane CT are useful in detecting margins. Volume rendered images also were suitable in measuring the size. The location of the foreign bodies could be easily measured if the reference point is given. The axial CT image or 3D images are both useful in calculating distance from the reference point. In view of orientation, 3D images are best of all.ConclusionSearching for fish bones and gathering information about them are difficult tasks in esophageal foreign body cases. Fish bone foreign body models and their reconstructed images are useful in getting information about size, shape, location, and orientation. This technique could be applied in finding real fish bone foreign bodies.
Balloon Cricopharyngeoplasty for Cricopharyngeal Achalasia
Authors: Rao‐Merugumala Srinivasa 
Published: February 2015

ObjectiveTo evaluate a series of patients with dysphagia who required diagnostic rigid endoscopy including failed flexible endoscopies (had hypopharyngeal cancer). To present a rare case of cricopharyngeal achalasia and to document the diagnostic process followed. Determine the efficacy and the safety of endoscopic balloon cricopharyngeoplasty (EBCP) for cricopharyngeal achalasia.MethodTo evaluate 99 consecutive patients including 5 failed flexible endoscopies (referred from elsewhere) who underwent rigid hypopharyngoscopy ± laryngoscopy for dysphagia ± hoarse voice since 2005, and to present 1 unusual case of cricopharyngeal achalasia and its effective management with EBCP.ResultsAmong the 99 patients, the 5 patients had prior flexible endoscopy/gastroscopy showed hypopharyngeal cancer (2 circumferential, 2 pyriform fossae, and 1 with tumor with bilateral cervical and distant metastasis). The false reassurances of these flexible endoscopies lead to the advanced presentations of these tumors. One representative case includes an 80‐year‐old Asian female patient presented with 3‐year history of progressive severe dysphagia, cachexia, and choking on liquids. Cricopharyngeal achalasia was noted on rigid endoscopy and EBCP was performed, which was well tolerated with no postoperative complications with complete relief of dysphagia. The patient was discharged on the same day.ConclusionCricopharyngeal achalasia is a rare and potentially lethal cause of dysphagia, due to aspiration in the elderly. EBCP offers a safe an effective, safe alternative to conventional procedures. Symptomatic relief is immediate and complete with no long‐term recorded recurrence; hence, EBCP is proposed as a simple alternative to laser/open procedures.
Endoscopic Posterior Cricoid Expansion in Children
Authors: Gerber Mark E. , Modi Vikash K. , Ward Robert F. , Gower Verlia , Thomsen James R. 
Published: February 2015

ObjectiveTo review our experience with endoscopic posterior cricoid split and costal cartilage graft placement in the management of pediatric bilateral vocal fold immobility (BVFI), posterior glottic stenosis (PGS), and subglottic stenosis (SGS).MethodMulti‐institutional retrospective case series of all patients treated with endoscopic posterior cricoid split and costal cartilage graft placement (EPCSCG) by any of the authors. Outcomes measured include: indications, complications, outcome.ResultsTwenty‐six patients underwent EPCSCG. Age range at time of surgery was 1 month to 15 years. Overall, there was an excellent success rate with 25/26 either never requiring tracheostomy or achieving decannulation and 24/26 having adequate symptom control. The mean follow‐up was 23.15 months. Sixteen patients had resolution of their symptoms. Fourteen patients had SGS in isolation or in combination with cricoarytenoid fixation, glottic stenosis or vocal fold immobility. Thirteen achieved decannulation and/or had resolution of preoperative symptoms. Three patients had isolated PGS or cricoarytenoid fixation with 2 achieving decannulation without additional procedures and the third decannulated after revision endoscopic division of a congenital anterior glottic web. Nine patients had isolated BVFI. Two of the 9 had failed prior laryngeal surgeries and 4 did not have tracheostomies at the time of their EPCSCG. Of these 9 patients, 7 had resolution of their airway symptoms without additional procedures.ConclusionBased on this experience, EPCSCG is worth consideration for the management of select pediatric patients with BVFI, PGS, and SGS.
CT‐Measured Normative Costochondral Growth in Children
Authors: Andreoli Steven M. , Mills Jared C. , Kilpatrick Lauren A. , White David R. , Patel Krishna G. 
Published: February 2015

ObjectiveCareful operative timing is required for children undergoing microtia repair using autologous costochondral grafting. There remains a paucity of data regarding cartilaginous growth of the ribs and synchondrosis routinely harvested during microtia repair. This study employs CT imaging to generate normative costochondral growth curves in children.MethodA population study was performed at a tertiary pediatric hospital. Chest CTs were reviewed in children ages 3 to 20 years. Demographic information was recorded. CT measurements included: cartilaginous length of ribs 6, 7, and 8 and the height of the synchondrosis between ribs 6 and 7.ResultsA total of 360 studies were reviewed. At age 6: ribs 6, 7, and 8 measure 5.76 ± 0.65, 7.57 ± 0.87, and 6.68 ± 1.06 cm, respectively. In adulthood ribs 6, 7, and 8 measure 8.29 ± 1.00, 11.10 ± 1.19, and 8.95 ± 1.99 cm. The vertical height of the synchondrosis between ribs 6 and 7 at years 6 and 20 are 2.64 ± 0.37 and 3.59 ± 0.52 cm. Synchondrosis height is 85% and 100% of adult auricle width at ages 6 and 8, respectively. Beginning at 3 years, ribs 6, 7, and 8 grow near linearly at 1.71, 2.46, and 1.35 mm, respectively, per year. Mean synchondrosis growth is 1.81 mm annually. Gender‐ and race‐specific growth charts are presented.ConclusionCartilaginous growth of ribs 6 to 8 during childhood is nearly linear. Synchondrosis height approaches adult auricle width at 8 years. Rib size is consistently larger in males and on the left side. These data allow planning for the pediatric otolaryngologist and facial plastic surgeon performing microtia surgery.
Microdebrider in Management of Obstructive Laryngeal Tumors
Authors: Hassan Mohamed H. , Gaafar Alaa , Bahgat Ahmad Y. , Elhady Mona Abd 
Published: February 2015

Objective1) To determine the efficacy of the powered endoscopic microdebrider as a tool in the management of obstructive laryngeal tumors. 2) To compare the histopathological diagnosis between a biopsy taken using the laryngeal forceps and the resected tissue from the microdebrider.MethodThis study is a prospective randomized study. Eighteen patients presented with obstructive laryngeal tumors to the outpatient clinic or emergency room of Alexandria Main University Hospital in 12 months duration starting from November 2010 till November 2011. Tumor debulking was done using laryngeal microdebrider.ResultsAll cases presented with moderate to severe stridor, the lesion obstructing more than 50% of the lumen of the larynx. In all cases tracheotomy could be avoided until a definitive therapy was initiated. No significant bleeding was encountered during these procedures. The operating time was directly dependent on the volume of the tumor. Both biopsies (one taken by forceps and the other from tissues resected by microdebrider) gave the same diagnosis except in 1 patient, as there were artifacts in microdebrider collected tissues.ConclusionEndoscopic debulking of laryngeal tumors using the microdebrider is a safe, accurate, and reliable method, thus preventing tracheotomy in most cases. The use of microdebrider does not preclude the submission of tissue for histological analysis. These preliminary results are encouraging and worthy of further evaluation and comparison with other techniques.
“Punch” Method for Bone‐Anchored Hearing Aid Placement
Authors: Goldman Richard A. , Shaia Wayne T. , Georgolios Alexandros 
Published: February 2015

ObjectiveVarious techniques have been described for bone anchored hearing system placement. Alterations to the initial technique have helped lower complication rates. Additional modifications can continue to improve postoperative results. A safe, streamlined approach for bone anchored hearing system placement to limit these known complication rates will be presented.MethodA retrospective chart review of 15 consecutive adult patients from an otology/neurotology practice was performed. Patients underwent the “Punch” method for placement using a 4‐mm implant with the longer 9‐mm abutment. The initial incision is performed using a 12‐mm punch biopsy with variations to the standard procedure.ResultsFifteen of 15 patients had successful placement of the bone anchored device. Ten were Oticon Ponto® systems, and 5 were the Cochlear BAHA® systems. There were no cases of tissue overgrowth, failure of osseointegration, or major postoperative infections. The only complications were minor skin infections that were treated with oral and topical antibiotic. All operative times were recorded and found to be less than 15 minutes. Postoperative follow‐up ranged from 10 to 24 months. All implants were found to be well integrated.ConclusionBone‐anchored hearing system placement with longer abutments may reduce postoperative tissue overgrowth. Using the “Punch” method decreases major postoperative infections, reduces incision length, improves cosmesis, and decreases operative time. Larger studies are needed to determine if the low complication rate demonstrated in this study will continue.
Assessing Quality of Life in Bilateral Cochlear Implants
Authors: Nahm Edmund A. , King Nancy , Liberatos Penny , Shi Qiuhu , Kim Ana H. 
Published: February 2015

Objective1) Validate a newly developed Comprehensive Cochlear Implant Questionnaire (CCIQ) as a tool for assessing changes in quality of life after receiving a second cochlear implant (CI) in the contralateral ear. 2) Correlate speech perception changes after the second CI with quality of life.MethodCCIQ is a 28‐item, 5‐point Likert‐scale questionnaire that assesses physical and psychosocial benefits of CI. This was administered to patients who received bilateral CI at our center. Test‐retest reliability and Cronbach’s alpha were used to validate the CCIQ. Speech perception was tested using CNC, HINT, and AZBio.ResultsWe identified 103 adult bilateral CI patients from 2004 to 2011. Of 58 respondents, 21 completed a retest CCIQ. Test‐retest reliability was satisfactory, with 60% of items greater than 0.6. Coefficients for 6 of the 9 subdomains exceeded 0.6. Data suggest that internal consistency was acceptable (>0.7) for domains speech perception in quiet and noise, localization, and music, and good (>0.80) for subdomain vestibular effects. Descriptive statistics for speech perception on CNC were 62.4 ± 22.5% and 70.5 ± 18.4% using one versus bilateral CI, respectively. HINT scores were 68.0 ± 36.8% and 83.7 ± 15.4%, and AZBio 63.5 ± 34.6% and 91.6 ± 8.6%.ConclusionEarly CCIQ data indicate this as a promising measure in assessing quality of life specific to bilateral CI patients. Overall, patients reported improved quality of life. Quantitative data on speech perception demonstrate increased trend in audiometric scores after the second CI. However, further testing is needed to strengthen these findings.
Benign Paroxysmal Positional Vertigo: 16‐Year Experience
Authors: Prokopakis Emmannuel , Kaprana Antigoni , Vlastos Ioannis , Tsagournisakis Minas , Christodoulou Panagiotis , Velegrakis George A. 
Published: February 2015

ObjectiveTo assess the short and long‐term efficacy of canalith repositioning procedure (CRP) in the treatment of patients with benign paroxysmal positional vertigo (BPPV).MethodNine hundred sixty‐five patients (481 men and 484 women, from 18 to 84 years old) were enrolled in this prospective study during 1995‐2010. Inclusion criteria were patient history compatible with BPPV and positive provocative maneuver (either Dix‐Hallpike or Roll test). Reported duration of symptoms at the time of their first examination varied from 1 day to 18 months. A variant of Epley and Barbeque maneuver was used. The Epley maneuver was used for posterior and anterior canal involvement, and “Barbeque roll” was used for horizontal canal involvement. Short‐term follow‐up was obtained 48 hours and 7 days after initial treatment, whereas long‐term follow‐up was obtained at repeated 6 month intervals.ResultsThe posterior semicircular canal was involved in 849 (88%) patients treated, whereas the horizontal and anterior semicircular canals were involved in 96 (10%) and 20 (2%) patients, respectively. Symptoms subsided immediately in 819 patients (85%) by the first CRP. Only 19 patients (2%) required CRP more than 3 times. Patients’ mean follow‐up was 72 months; symptom recurrence was noted in 135 patients. The great majority of them were elderly patients (n = 33) or had a history of either vestibular neuropathy (n = 27) or head trauma (n = 58).ConclusionOur data, based on long‐term follow‐up, suggest that CRP remains an efficient and long‐lasting noninvasive treatment for BPPV.
Central Auditory Function Evaluation in 811 Individuals
Authors: Sanchez Maura L. , Chaves Adriana , Alvarez Ana Maria , Tangerina Rodrigo D. P. 
Published: February 2015

ObjectiveTo describe central auditory function results in individuals who presented with language impairment, learning disability, and/or attention deficit.MethodCentral auditory behavioral tests from 811 patients were retrospectively analyzed: 497 (61%) were males, and median age was 20 years.ResultsOne hundred ninety‐one (24%) individuals had normal values; 197 (24%) presented signs of central auditory immaturity; 226 (28%) presented signs of central auditory immaturity in association with language, memory, and/or attention impairment; and 196 (24%) presented signs of isolated cognitive and language impairment. Auditory dysfunction was more frequently observed in patients aged between 6 and 8 years. Cognitive and language impairment signals were better detected in those aged more than 9 years.ConclusionThe tests chosen to evaluate central auditory behavior were able to identify the existence of specific dysfunctions and to point out the existence of auditory deficit underlying cognitive and language impairments.
Immediate Flap Repair of Pediatric Dog Bite Lip Avulsions
Authors: Wong Timothy S. , Adelson Robert T. 
Published: February 2015

Objective1) Recognize the operative technique for performing the split orbicularis oris myomucosal flap. 2) Identifiy candidates for repair using split orbicularis myomucosal flap. 3) Understand the utility of the split orbicularis oris myomucosal flap in the repair of complex dog bites of the flap.MethodCase series of full thickness pediatric lip avulsion injuries secondary to dog bites with immediate flap reconstruction. Cases were reviewed from the last 5 years at an academic institution. All procedures were performed by the same surgeon. Outcome measures included pre‐ and postoperative photographs as well as assessment of patient satisfaction.ResultsA total of 3 patients underwent immediate primary repair of complex dog bites of the lip using split orbicularis myomucoal flaps. All patients were admitted postoperatively for IV antibiotic therapy and were discharged within 1 to 2 days on a 7‐ to 10‐day course of augmentin. No patients developed a postoperative wound infection. None of the patients required a scar revision procedure, and only 1 patient developed postoperative milia, which was managed in the office. Oral competence was maintained in all patients without any evidence of microstomia.ConclusionThe split orbicularis oris myomucosal flap can be used to repair full thickness lip injuries secondary to dog bite injury. There is no evidence of increased postoperative infection when used for immediate reconstruction and oral competence is maintained. This flap provides good cosmetic outcomes without the need for scar revision.
Intratympanic Dexamethasone and HBO for Sudden Hearing Loss
Authors: Yang Chao‐Hui , Shao Chi‐Hsin , Wu Re‐Wen , Hwang Chung‐Feng 
Published: February 2015

ObjectiveThe objective of this study is to compare the efficacies of intratympanic dexamethasone (ITD), hyperbaric oxygen (HBO), and their combination (ITD plus HBO) as salvage therapies for sudden sensorineural hearing loss (SSNHL) patients after failure of systemic therapy.MethodNinety‐seven refractory SSNHL patients are enrolled in this study. Among them, 34 received ITD alone, 19 received HBO alone, 13 received a combination of ITD plus HBO, and 31 did not receive salvage therapies. The hearing outcome is determined by hearing gains between the audiometry before and after salvage therapies.ResultsCombination of ITD and HBO provides significantly greater hearing gain in 250 Hz and 500 Hz than the other 3 groups (P <. 05). Besides, in patients with initial profound hearing loss (>90 dBHL), the addition of HBO to ITD has a significantly larger hearing gain in mean thresholds of 500, 1000, 2000, and 4000 Hz (28.64 ± 3.49 dB) than ITD injection alone (15.75 ± 4.16 dB, P =. 029) and without any salvage therapies (13.64 ± 6.05 dB, P =. 015).ConclusionFor patients with profound hearing loss, we recommend a combination of ITD injection and HBO as salvage therapies after failure of systemic steroid therapy. The benefit is greatest especially in lower frequencies.
Management of the Incus Body in Ossiculoplasty
Authors: Capra Gregory G. , Shah Anil N. , Ge Xianxi , Balough Ben J. , Pfannenstiel Travis J. 
Published: February 2015

Objective1) Evaluate the sound transfer impact of removal of the incus body in ossicular chain reconstruction (OCR) utilizing an incus strut prosthesis. 2) Provide basic science data to guide clinical decision making in ossiculoplasty.MethodOCR with an incus strut prosthesis was performed on 7 human temporal bones with and without the incus body. The difference in round window membrane (RWM) peak‐ to‐peak displacements (90‐dB SPL, 250 to 8000 Hz) using single‐point laser Doppler vibrometry (LDV) was compared to observed baseline, intact ossicular chain values.ResultsFor each of the 7 temporal bones, the average displacement decreased across most sound frequencies with OCR as compared with baseline. Median velocity differences (×10–3), with 95% confidence intervals in parentheses, from baseline for OCR with incus were 4.8 mm/s (2.1‐6.4), while median differences from baseline for OCR without incus were 3.0 mm/s (1.7‐4.2). A signed‐rank test yielded P =. 002, implying the median velocity is significantly lower when the incus body is removed. Secondarily, a variance ratio test showed no difference in variability between the 2 study arms (P =. 925).ConclusionRemoval of the incus body in OCR utilizing an incus strut prosthesis significantly reduces the sound transfer function of the middle ear relative to its preservation. The finding suggests that preserving the incus body may stabilize the malleus and the tympanic membrane.
Ischemia and Wound Healing in a Cutaneous Flap Murine Model
Authors: Ludlow David , Lian Timothy S. 
Published: February 2015

Objective1) To establish a murine model to investigate cutaneous flap wound healing following ischemia reperfusion injury. 2) To characterize wound healing in a murine model with respect to tensile strength, blood flow, and tissue survival following varying periods of ischemia in a cutaneous flap.MethodTwenty‐eight cutaneous flaps based on the inferior epigastric artery in C57BL/6J/CD11 mice were elevated. Ischemia up to 270 minutes was produced. Following ischemia, skin flaps were inserted then monitored for flap necrosis daily for 2 weeks using digital imaging. Wound tensile strength and blood flow were evaluated on day 14.ResultsPeak necrosis for flaps with ischemia times >210 minutes occurred on postoperative day 5 (necrosis M = 57%, CI: 52, 64%). Skin tensile strengths and blood flow for ischemic times >210 minutes were significantly less than tensile strengths for ischemic times <210 minutes.ConclusionThe described cutaneous flap murine model establishes basic wound healing characteristics following ischemic injury that may be useful in further study of novel interventions that enhance wound healing and cutaneous flap survival ultimately resulting in improved patient outcomes.